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MARCO RIGATELLI
COLLABORATORE DI RICERCA
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze sede Policlinico
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Pubblicazioni
2021
- First-episode Psychosis and Migration in Italy: Results from a Study in the Italian Mental Health Services (Pep-Ita Study)
[Articolo su rivista]
Tarricone, I.; D'Andrea, G.; Storbini, V.; Braca, M.; Ferrari, S.; Reggianini, C.; Rigatelli, M.; Gramaglia, C.; Zeppegno, P.; Gambaro, E.; Luciano, M.; Ceregato, A.; Altamura, M.; Barrasso, G.; Primavera, D.; Carpiniello, B.; Todarello, O.; Berlincioni, V.; Podavini, F.; Morgan, C.; Murray, R. M.; Di Forti, M.; Muratori, R.; Berardi, D.
abstract
Background: Migrants present high rates of psychosis. A better understanding of this phenomenon is needed. Methods: We conducted a multicentre First-Episode Psychosis (FEP) prospective study over two years (January 2012–December 2013) to evaluate first-generation migrants presenting with FEP at the participating Community Mental Health Centers (CMHCs). Results: 109 FEP migrants were identified. Almost half of them were highly educated, employed and in a stable affective relationship. The average age was 32.8 (± 9.8) years, and the average length of stay in Italy was 8.6 (± 8.8) years. About 2/3 of patients were referred to CMHCs following Emergency Department access or psychiatric admission. Conclusions: Our finding of a “high functioning portrait” of FEP migrants allow us to hypothesize that a high burden of negative psychosocial factors is likely to be needed for the FEP onset. Furtherly, mental health services should implement more appropriate resources and organizational methods to respond to migrants’ health needs.
2020
- Clinical and Socio-demographic Variables Associated with the Outcome of Vocational Rehabilitation Programs: A Community-Based Italian Study
[Articolo su rivista]
Mattei, G; Venturi, G; Alfieri, S; Colombini, N; Ferrari, S; Rigatelli, M; Starace, F; Galeazzi, G M
abstract
This study aims to identify clinical and socio-demographic variables associated with the outcome of vocational rehabilitation programs (VRPs). All users of an Italian Community Mental Health Centre (CMHC) included in VRPs delivered according to the model of Supported Employment in years 2011-2016 were retrospectively enrolled. Fifty users who ended the program with employment were compared with fifty users who dropped out, with respect to clinical and socio-demographic variables. VRPs lasting less than 6 months and oriented toward the competitive labor market had a higher probability of employment. Among users who successfully ended the VRP, the median of health interventions significantly decreased after employment. In the same group of users, less non-health interventions strictly linked to the VRP were required, when compared with users who dropped out. We conclude that employment is associated with improvement of users' clinical conditions and reduced workload for the CMHC.
2018
- Metabolic Syndrome, Anxiety and Depression in a Sample of Italian Primary Care Patients
[Articolo su rivista]
Mattei, Giorgio; Padula, Maria Stella; Rioli, Giulia; Arginelli, Lodovico; Bursi, Roberto; Bursi, Serena; Epifani, Antonio Matteo; Pingani, Luca; Rigatelli, Marco; Rosato, Francesca Maria; Sacchetti, Andrea; Galeazzi, Gian Maria; Ferrari, Silvia
abstract
This cross-sectional study aimed at measuring the correlation and association of anxiety, depression and comorbid anxiety-depression symptoms with metabolic syndrome (MetS) in a sample of Italian primary care patients who attended their General Practitioner clinics over a 1-month period in 2013. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depressive symptoms. The sample was made up of 129 patients (57% women; mean age, 61 ± 12 years). The prevalence of MetS varied from 40% (Adult Treatment Panel III-Revised criteria) to 48% (International Diabetes Federation criteria). The prevalence of symptoms of anxiety, depression and comorbid anxiety and depression was, respectively, 26%, 2%, and 15%. MetS (defined according to Adult Treatment Panel III-Revised criteria) was associated with comorbid anxiety-depressive symptoms (odds ratio [OR] = 3.84, 95% confidence interval [CI] = 1.26–11.71), but not with anxiety or depressive symptoms only. Out of the individual components of MetS, enlarged waist circumference was associated with anxiety symptoms (OR = 4.22, 95% CI = 1.56–11.44).
2018
- Stakeholders' views on vocational rehabilitation programs: a call for collaboration with Occupational Health Physicians
[Articolo su rivista]
Mattei, Giorgio; Sacchi, Valentina; Alfieri, Salvatore; Bisi, Antonella; Colombini, Niccolò; Ferrari, Silvia; Giubbarelli, Giuseppe; Gobba, Fabriziomaria; Modenese, Alberto; Pingani, Luca; Rigatelli, Marco; Rossetti, Marisa; Venturi, Giulia; Starace, Fabrizio; Galeazzi, Gian Maria
abstract
The triple-dip recession taking place in Italy in 2008-2014 impacted negatively on health, mainly by increasing the rate of unemployment. This increased the prevalence of mental health disorders, while reducing the number of available places on vocational rehabilitation programs (VRPs) delivered by the psychiatric services.
2017
- Effectiveness and acceptability of psycho-education group intervention for people hospitalized in psychiatric wards and nurses
[Articolo su rivista]
Mattei, G.; Raisi, F.; Burattini, M.; Galeazzi, G. M.; Mazzi, F.; Pingani, L.; Reggianini, C.; Rigatelli, M.; Righi, A.; Starace, F.; Vallone, P.; Ferrari, S.
abstract
Objective: To assess effectiveness and acceptability of a Psycho-education Group Intervention (PGI) on a sample of patients admitted to a Psychiatric Inpatient Unit (PIU) and on ward nurses. Methods: Case-control study. PGI was delivered according to the model of Vendittelli and colleagues (2008). Male and female patients aged 18-70 were eligible. Cases attended the PGI, while controls did not. A 5-item ad hoc Likert-scale was used to record ward atmosphere. The Italian version of the Simple Feedback Question Form for people attending Cognitive Behaviour Therapy Group (SFQF-CBTG) was administered to each patient before discharge. The primary outcome was readmission rate after 6 months from discharge, secondary outcomes were ratings of ward atmosphere by nurses and feed-back from people hospitalized. All Statistics were performed with STATA 13.1. Results: Fifty-two patients were enrolled, 17 cases and 35 controls. No significant differences emerged in the primary outcome, though compulsory readmissions were noticeable only among controls. Ratings of ward atmosphere in relation to group activities did not differ. Seventeen SFQF-CBTG were filled in. Most cases reported at discharge to have found the group "helpful", stating that "they would attend it in the future again", and "group topics were not difficult". Conclusions: No evidence emerged in favour or against effectiveness of the PGI for patients and ward nurses, though the intervention was rated as acceptable and feasible.
2017
- Impact of the economic crisis on health-related behaviors in Italy
[Articolo su rivista]
Mattei, Giorgio; DE VOGLI, Roberto; Ferrari, Silvia; Pingani, Luca; Rigatelli, Marco; Galeazzi, Gian Maria
abstract
Evidence exists supporting the impact of the Great Recession on health-related behaviors internationally, though few studies are available concerning the Italian population.
2017
- Indicators of Complex Care During the Consultation-Liaison Psychiatry Activity at the Transplant Center of the Policlinico Hospital, Modena
[Articolo su rivista]
Mattei, Giorgio; Laghi, Alessandro; Balduzzi, Sara; Moscara, Maria; Piemonte, Chiara; Reggianini, Corinna; Rigatelli, Marco; Ferrari, Silvia; Pingani, Luca; Galeazzi, Gian Maria
abstract
OBJECTIVE:
The objective of this study was to identify possible biopsychosocial predictors of organizational complexity in patients referred to the consultant psychiatrist for assessment before liver transplantation.
METHODS:
This was a case-control study. All psychiatric consultations performed before and after liver transplantation from January 1, 2008 to December 31, 2013 were included. Complexity was operationalized as "undergoing two or more psychiatric consultations". Controls were defined as patients who were assessed only once by the consultant. Cases were represented by patients who underwent two or more consultations. Statistical analysis was performed with STATA 13.1, using logistic regressions.
RESULTS:
In this study, 515 consultations were requested for 309 patients potentially eligible for liver transplantation. Controls were 209 (67.6%); cases were 100 (32.4%). Positive psychiatric history (odds ratio [OR] = 2.44; 95% confidence interval [CI], 1.43-4.16), viral or toxic (alcohol- or drug-related) liver disease (OR = 1.93; 95% CI, 1.09-3.42), use of psychotropic medications at the baseline (OR = 2.15; 95% CI, 1.14-4.07), and female gender (OR = 1.77; 95% CI, 1.01-3.11) were significantly associated with an increased probability of being cases.
CONCLUSIONS:
Positive psychiatric history, viral or toxic liver disease, use of psychotropic medications at the index referral, and female gender are possible biopsychosocial predictors of complexity in patients eligible for liver transplantation.
2017
- Never too late to be anxious: validation of the Geriatric Anxiety Inventory, Italian version
[Articolo su rivista]
Ferrari, Silvia; Signorelli, M. S; Cerrato, F; Pingani, Luca; Massimino, M; Valente, S; Forlani, M; Bonasegla, P; Arcidiacono, E; De Ronchi, D; Rigatelli, Marco; Aguglia, E; Atti, A. R.
abstract
Aim – The aim of this work was to validate the Italian version of GAI (GAI-It) and its short form (GAI-It SF) in an over 65-population.
Methods – In 3 recruitment areas across Italy, two raters reciprocally blind to results assessed eligible subjects; a semi-structured diagnostic clinical interview was performed by a psychiatrist.
Results – Among the 76 enrolled subjects (mean age 72.7±6.8 years), anxiety symptoms were very common: 69.7% (moderate/severe HADS-Anxiety), 76.3% (moderate/severe STAI-state), 71.0% (moderate/severe STAI-trait), 61.8% (GAI), 55.3% (GAI-SF). Sensitivity, specificity and positive predictive value of GAI confirmed a good reliability of the Italian version, with Cronbach’s Alpha equal to 0.93 for GAI-It and to 0.77 for GAI-It SF, indicating a very good and good construct validity, respectively, of the scales. The Pearson correlation index demonstrated a moderately positive correlation among GAI, GAI-SF and STAI.
Conclusions – Our data confirm the validity of GAI-It as a valuable instrument to assess anxiety in an elderly population, for clinical and research purposes.
2016
- Psychometric validation of the Italian version of the Reported and Intended Behaviour Scale (RIBS)
[Articolo su rivista]
Pingani, Luca; Evans Lacko, S; Luciano, M; Del Vecchio, V; Ferrari, Silvia; Sampogna, G; Croci, I; Del Fatto, T; Rigatelli, Marco; Fiorillo, A.
abstract
Many instruments have been developed and validated to assess the stigma associated with mental disorders and its various domains across different populations. To our knowledge, the Reported and Intended Behaviour Scale (RIBS) is the only validated questionnaire to analyse the presence of reported and intended stigmatising/discriminatory behaviours towards people with mental health problems in the general population. The aims of the study presented herein are to translate and validate the RIBS in Italian language and to adapt it to the Italian socio-cultural background (RIBS-I).
2016
- Stigma in the context of schools: Analysis of the phenomenon of stigma in a population of university students
[Articolo su rivista]
Pingani, L; Catellani, S; Del Vecchio, V; Sampogna, G; Ellefson, S. E; Rigatelli, Marco; Fiorillo, A; Evans Lacko, S; Corrigan, P. W.
abstract
Background: Students have stereotyped views about people with mental illness. In particular, they believe that
these persons are incurable, dangerous, unpredictable and responsible for their condition. This study aims to
investigate the levels of public stigma in an Italian university population.
Methods: The Attribution Questionnaire 27 - Italian Version (AQ-27-I) was administered to a sample of students
from the Faculty of Medicine and Surgery of the University of Modena and Reggio Emilia. After examining the
psychometric characteristics of the AQ-27-I (Cronbach’s Alpha and Confirmatory Factor Analysis), multiple linear
regression analyses were carried out to identify the predictors of stigmatizing attitudes in this population.
Results: Three hundred and eleven students completed the questionnaire, with a response rate of 32.81 % (out of
the 948 contacted by email). The AQ-27-I showed good psychometric properties with an α = .68, and the fit indices
of the models that partially supported the factor structure and paths. The two variables identified as possible
predictors of stigmatizing attitudes (total score of AQ-27-I) were age and time spent reading newspapers.
Conclusions: Antistigma campaigns are needed in university contexts, targeted in particular to students in health
professions.
2015
- Apple or pear? A cross sectional study on the association between body shape and symptoms of anxiety and depression in primary care female patients
[Abstract in Rivista]
Rioli, G; Mattei, Giorgio; Ferrari, Silvia; Bursi, S; Rigatelli, Marco; Pingani, Luca; Galeazzi, Gian Maria
abstract
INTRODUCTION - "Apple" body shape (Waist-to-Hip Ratio, WHR>1) is a documented risk factor for
cardiovascular diseases, the first cause of morbility and mortality in Western societies. Mental disorders,
especially anxiety and depression, are also related to cardiovascular diseases with accumulating evidence
that these conditions have in common a dysregulation of inflammatory pathways. Nevertheless, joint
assessment of WHR and symptoms of anxiety and depression has not been reported commonly so far.
AIM - To explore the association between WHR and symptoms of anxiety and depression in a female
primary care sample.
METHODS - Cross-sectional design. Evaluation of all consecutive women undergoing a GP consultation in
a Northern Italy Practice. Exclusion criteria: age <40 or >80; use of antidepressants or antipsychotics;
previous stroke or heart attack; obesity due to hereditary. Psychometric assessment was done by HADS
(Hospital Anxiety and Depression Scale). Statistical analysis was performed using STATA.
RESULTS - 125 women were assessed. WHR was inversely associated to HADS-Anxiety subscale score
(β=-5.28, p=.02) e HADS-Depression subscale score(β=-4.02, p=.04) in the 40-60 years’ subgroup. In
particular, WC was positively related to HADS-A (β=13.39, p=.02) e HADS-D (β=10.38, p=.03) while HC
was inversely associated to HADS-A (β=-11.3, p=.01) and HADS-D (β=-8.6, p=.03). No associations were
found in older groups.
CONCLUSION - 'Pear” body shape (WHR<1), with a peripheral distribution of fat, is inversely associated to
symptoms of anxiety and depression in women aged 40 to 60. The post-menopausal transition to the 'apple”
model, with a central fat distribution, could explain the lack of correlations in women >60 years.
2015
- Association between anxiety and depressive symptoms with metabolic syndrome in primary care: Results of an Italian cross-sectional study involving outpatients
[Abstract in Rivista]
Mattei, G; Rioli, G; Ferrari, Silvia; Galeazzi, Gian Maria; Bursi, S; Padula, Sm; Pingani, Luca; Rigatelli, Marco
abstract
Background: Metabolic syndrome (MetS) is a heterogeneous entity
represented by the coexistence of multiple alterations: abdominal adiposity, impaired glucose tolerance, hypertriglyceridemia, HDL
hypocolesterolemia and hypertension. Symptoms of anxiety and
depression are frequently comorbid with MetS. Aim of the present
study was to measure the association between symptoms of anxiety
and depression with the five criteria of MetS in outpatients attending
GPs' practices.
Method: This is a cross-sectional study, involving male and female
patients aged 40–80 attending five GPs' practices within one month
in Modena, Northern Italy approved by the local Ethical Committee.
All patients were screened for the presence of MetS and depressive/
anxiety symptoms, using the Hospital Anxiety and Depression Scale.
Exclusion criteria: age b40 or N80; use of antidepressants or
antipsychotics; previous stroke, heart attack or cardiovascular
disease; diagnosed psychotic or mood disorder (according to the
DSM-IV-TR); diabetes; pregnancy; hereditary disease linked to
obesity. All data were adjusted for socio-demographic confounders.
Multiple logistic analysis performed with STATA 13.0.
Results: 128 subjects were enrolled in the study (55 men and 73
women), 48 presented with MetS (ATP-III-Revised criteria). MetS
was associated with depression only in the female group (OR =6.33,
p= 0.01), also when adjusting for age (OR =5.13, p= 0.02). MetS
was not associated with anxiety in both males and females, and with
depression in men. Among the individual components of MetS,
only waist circumference was associated with anxiety in the female
group (OR=4.40, p=0.04) also when adjusting for age (OR=4.34,
p=0.04).
Conclusion: Women aged between 40 and 60, presenting with MetS
and attending the primary care services should been regularly
screened for the presence of depression. Chronic systemic inflammation
could represent the biological link between MetS and
psychological symptoms. Further researches are needed to better
clarify this possible relation.
2015
- Association between symptoms of anxiety and depression and BMI in Primary Care patients: a cross sectional study
[Abstract in Rivista]
Mattei, Giorgio; Rioli, G; Ferrari, Silvia; Bursi, S; Pingani, Luca; Rigatelli, Marco; Galeazzi, Gian Maria
abstract
Background: Metabolic syndrome (MetS) is a heterogeneous entity
represented by the coexistence of multiple alterations: abdominaladiposity, impaired glucose tolerance, hypertriglyceridemia, HDL
hypocolesterolemia and hypertension. Symptoms of anxiety and
depression are frequently comorbid with MetS. Aim of the present
study was to measure the association between symptoms of anxiety
and depression with the five criteria of MetS in outpatients attending
GPs' practices.
Method: This is a cross-sectional study, involving male and female
patients aged 40–80 attending five GPs' practices within one month
in Modena, Northern Italy approved by the local Ethical Committee.
All patients were screened for the presence of MetS and depressive/
anxiety symptoms, using the Hospital Anxiety and Depression Scale.
Exclusion criteria: age b40 or N80; use of antidepressants or
antipsychotics; previous stroke, heart attack or cardiovascular
disease; diagnosed psychotic or mood disorder (according to the
DSM-IV-TR); diabetes; pregnancy; hereditary disease linked to
obesity. All data were adjusted for socio-demographic confounders.
Multiple logistic analysis performed with STATA 13.0.
Results: 128 subjects were enrolled in the study (55 men and 73
women), 48 presented with MetS (ATP-III-Revised criteria). MetS
was associated with depression only in the female group (OR =6.33,
p= 0.01), also when adjusting for age (OR =5.13, p= 0.02). MetS
was not associated with anxiety in both males and females, and with
depression in men. Among the individual components of MetS,
only waist circumference was associated with anxiety in the female
group (OR=4.40, p=0.04) also when adjusting for age (OR=4.34,
p=0.04).
Conclusion: Women aged between 40 and 60, presenting with MetS
and attending the primary care services should been regularly
screened for the presence of depression. Chronic systemic inflammation
could represent the biological link between MetS and
psychological symptoms. Further researches are needed to better
clarify this possible relation.
2015
- Is hyperglycemia associated with anxious-depressive symptoms? An Italian study in primary care setting
[Abstract in Rivista]
Rioli, G; Mattei, Giorgio; Galeazzi, Gian Maria; Ferrari, Silvia; Bursi, S; Pingani, Luca; Rigatelli, Marco
abstract
Background: Recent researches exploring the relationship between
impaired glucidic tolerance, hyperglycemia or frank type II diabetes
mellitus and symptoms of anxiety and depression, mostly conducted
on in-patients or highly selected samples and on foreign populations,
have reported conflicting results. Nevertheless, these medical and
mental conditions are often comorbid in clinical practice. Chronic
and systemic inflammation could represent the trait d\'union
between these conditions. Primary care represents an interesting
setting for exploring this comorbidity, given the high prevalence of
psychiatric symptoms displayed by patients. The aims of this
research was to measure the association between hyperglycemia
and symptoms of anxiety and/or depression in out-patients, and to
fill the lack of studies on comorbidity between depression and
anxiety disorders and medical conditions in Primary Care services.
Method: The present was a cross-sectional study. We evaluated all
consecutive patients undergoing a GP consultation in a Northern
Italy practice. Exclusion criteria: age b40 or N80; use of antidepressants
or antipsychotics medication; psychosis (schizophrenia, schizoaffective,
bipolar, organic, or tall as psychotic disorder by DSM IV-TR) or major
depression; pregnancy; previous stroke or heart attack; type I diabetes
mellitus. The psychometric assessment was done by HADS (Hospital
Anxiety and Depression Scale). Blood Glucose measurements (BM) in
the last 6 months were considered in our analysis. Hyperglycemia cutoff:
blood glucose N100 mg/dl. The statistical analysis was performed
using STATA with multiple linear regressions.
Results: 209 subjects were recruited in our study (84 men and
125 women). Of those, 48 (22.9%) were affected by hyperglycemia:
22 were men and 26 women. Hyperglycemia was related to HADS-D
score in the men sample (β = .44, p = .01). No association was
found between hyperglycemia and HADS-A, either in men or in
women.
Conclusion: The presence of hyperglycemia, well-known cardiovascular
risk factor, may have a clinical value in predicting the presence
of depressive symptoms, especially in men. Further studies should
examine whether our results are generalizable to other populations
and whether they are applicable to clinical depression. Molecular
researches could focus on clarifying the pathophysiological reasons
for such association, also exploring reasons for sex differences.
2015
- Is low blood pressure always healthy? Evidence of an inverse association between depressive symptoms and arterial blood pressure in a primary care sample
[Abstract in Rivista]
Rioli, G; Mattei, Giorgio; Galeazzi, Gian Maria; Ferrari, Silvia; Bursi, S; Pingani, Luca; Rigatelli, Marco
abstract
Background: Common mental health problems, such as anxiety and depression, have been related to the imbalance of the autonomous
nervous system, also involved in blood pressure regulation. Low blood pressure readings have mainly been regarded as positive,
but recent studies suggest low blood pressure is correlated with depression. The aim of the present research was to investigate the
relationship between symptoms of anxiety and depression and blood pressure measures in a primary care sample.
Method: We conducted a cross-sectional study that received the approval of the local Ethical Committee. All consecutive patients
undergoing a GP consultation in a Northern Italy practice were evaluated, with the following exclusion criteria: age b40 or N80; use
of antidepressants or antipsychotics medication; psychosis or major depression; previous stroke or heart attack; type I diabetes mellitus;
obesity related to hereditary conditions; pregnancy. The psychometric assessment was done by HADS (Hospital Anxiety and
Depression Scale). Arterial blood pressure was measured twice using a stethoscope and a sphygmomanometer at the right upper
arm after 5 min of seated rest; the mean measure was considered. High Blood Pressure (BP) cut-offs: systolic BP ≥130 mm Hg and/or
diastolic BP ≥ 85 mm Hg, according to IDF 2005 guidelines. The statistical multiple linear regression analysis was performed using
STATA. Results: 209 subjects were enrolled in the study (125 women and 89 men). 122 subjects (58.1% of the whole sample) suffered from high
blood pressure, and 98 of them (46.7%) followed an antihypertensive pharmacological therapy. A statistically significant inverse correlation
between high diastolic BP and symptoms of depression at the HADS-D scale (β= −.28, p= .01) was found in the whole sample.
The association was maintained in the male subsample, also after stratification by age, especially in the 40–60 years' group of patients
(β=−.53, p =.04). On the contrary, no significant association was found between anxiety and BP measures. Conclusion: This study confirms an inverse association between high diastolic BP and depression at epidemiological level in an outpatients sample; longitudinal studies are needed in order to examine temporal occurrence and to explore the pathophysiology and the molecular mechanism at the basis of this association. Further researches should also investigate whether our results are generalizable to other populations.
2015
- Neuroenhancer use amongst Italian medical students: a survey
[Abstract in Rivista]
Pighi, Marcella; Ferrari, Silvia; Pingani, Luca; Pontoni, G; Rigatelli, Marco; Galeazzi, Gian Maria
abstract
Introduction.
Increasing use of substances by university students to improve cognitive performance ('neuroenhacement')
has been reported. This refers not only to over-the-counter supplements, energy drinks, coffee and tobacco,
but also to psychostimulants and modafinil. Little is known about this phenomenon in Italy.
Aims.
To explore prevalence of use of substances as cognitive enhancers by Italian medical students and their
attitudes towards prescription-only medication (methylphenidate, amphetamine, atomoxetine, modafinil)
used for this purpose.
Methods
An ad hoc questionnaire was distributed to 433 medical students of the University of Modena and Reggio
Emilia. Valid response rate was 83.8% (N=363).
Results
271 students (74.7%) reported use of substances to improve cognition in the last 30 days. Coffee (73%,
N=265) and tea (33.3%, N=121) were the most used, followed by caffeinated sodas (15.7%, N=57), tobacco
(10.2%, N=37) and vitamin B supplements (8.8%, N=32). Prescription-only medicines were used by 2
students (0.6%) and, overall, only 4 students reported lifetime use (1.2%). 295 (83.3% ) students mentioned
concerns about safety and side effects as main reasons not to use. Use of cognitive enhancers as a group
in the last 30 days slightly correlated with alcohol (r = 0.124; p = 0.023) and cannabis use (r = 0.114; p =
0.036).
Conclusions
Italian medical students use many substances as cognitive enhancers, but this seems not to apply to
psychostimulants and modafinil. Cultural and regulatory differences may underlie this difference with other
Countries, which warrants further research.
2015
- Occupational health physicians and the impact of the Great Recession on the health of workers: a qualitative study
[Articolo su rivista]
Mattei, Giorgio; Ferrari, Silvia; Giubbarelli, C; Pingani, Luca; Uracci, Gm; Rigatelli, Marco; Galeazzi, Gian Maria
abstract
Background: Italy is one of the Eurozone members where the 2008 “Great Recession” struck worst, with a 9% drop in national GDP between 2008 and 2013. The negative effects of the recession on the health of the Italian population were documented on a nation-wide level. However, few local or regional studies are currently available in the scientific literature. Objectives: To assess the impact on workers’ health of the economic recession in the industrial area of Sassuolo (Modena, Northern Italy), and to provide recommendations for targeted interventions. Methods: Two focus groups were conducted, involving 8 occupational health physicians (OHPs) active in the area. Rough descriptions were analyzed using MAXQDA 11, according to the principles of grounded theory. Results: 261 segments were coded, divided into four areas. The first, “changes in contemporary world”, pointed out that the recession may have just made pre-existing problems worse, accelerating reductions in staff and workers’ benefits. The second, “social area”, highlighted a decrease in vertical social capital and the beginning of new trends in emigration. The third, “work area”, covered workers’ fear of losing their jobs if they were ill and a reduction in horizontal social capital, namely difficult relations between co-workers. The fourth, “medical area”, indicated a general worsening of workers’ health in the Sassuolo ceramic district compared to previous years. The OHPs reported an increase in muscular- skeletal complaints, gastritis, tension-type headache, irritable bowel syndrome symptoms, back pain, panic attacks, insomnia, tachycardia, and other medically unexplained symptoms. Anxiety problems seemed to prevail over depressive manifestations. An increase was reported for antidepressants and benzodiazepines consumption. Conclusions: The local impact of the economic crisis on health was mainly negative, consistent with available national
data. Mental health professionals could work together with OHPs, e.g., through Balint Group-like meetings, to develop targeted psychosocial and clinical interventions addressing the medical, psychological and social needs of workers, also involving advocacy and fostering workers’ empowerment.
2015
- Psychiatric consultations in pre-orthoptic liver transplantation patients with substance use disorders: focus on timing of cessation and referral and retention by community service
[Abstract in Rivista]
Reggianini, Corinna; Moscara, Maria; Ferrari, Silvia; Laghi, A; Mattei, Giorgio; Piemonte, Chiara; Rigatelli, Marco; Galeazzi, Gian Maria
abstract
Introduction: In Italy, 6 months of abstinence from alcohol/substances are required before OLT, evidence
for this recommendation remaining controversial. No standard approach linking abstinence duration at the
index psychiatric pre-OLT evaluation to referral to Community Services is followed.
Aims: To report data of the Modena Consultation-Liaison Psychiatric Service (MCLPS) for pre-OLT patients
with Substance Use Disorders (SUDs), and to evaluate patients’ concordance with referrals.
Methods: Case-control study. Data source: database of MCLPS. Psychiatric evaluations pre-OLT from
01/01/2008 to 31/12/2013 were extracted. Patients were controls if they had a SUD and abstinent for more
than 6 months; cases if they had a SUD with less than 6 months of abstinence. Chi-squared analysis was
performed with STATA 13.0.
Results: 515 consultations were requested for 309 pre-OLT patients, 36.3% (N=112) of patients had a
current or past SUD. Controls were 80 (71.3%), while cases - who had stopped use less than 6 months
before the consultation, or were still using- were 20 (17.9%). 52.5% of controls (N=42) and 85.0% of cases
(N=17) were referred to community services (Chi 5.71; p=0.02). 70.0% of cases (N=14) and 33.6% of
controls (N=27) were seen at least twice (Chi 7.22; p=0.01). 16.7% (N=2) of cases and 23.5 % (N=4) of
controls referred to community services reported concordance with Consultant’s recommendation at reassessment,
a non-significant difference with cases (Chi 0.00; p=1.00).
Conclusions: Consistently with previously research in this field, no difference of concordance with
recommendations emerged between patients with SUD with different duration of abstinence.
2015
- Tako-Tsubo cardiomyopathy and psychiatric disorders: Review of comorbidity
[Abstract in Rivista]
Rioli, Giulia; Galeazzi, Gian Maria; Ferrari, Silvia; Rigatelli, Marco
abstract
Background: In recent times, the connections between mental health and cardiac outcomes have been under increasing investigation.
Tako-Tsubo Cardiomyopathy (TTC) is also called “broken heart syndrome”, since it has been described to occur after emotionally
stressful events; it presents as an acute reversible coronary syndrome due to a transient failure of the left ventricle, in the absence of
obstructive coronary heart disease. It has a 10-timehigher prevalence in
postmenopausal women and may have a strong correlation with biopsycho-
social stress.
Aim: To review existing studies on TTC in comorbidity with psychiatric
disorders.
Method: Four PubMed literature searches performed during January
2015 (search terms: tako-tsubo AND psy*; tako-tsubo AND anxiety;
tako-tsubo AND depression; tako-tsubo AND mania) provided 9
references: 4 case reports, 2 reviews, 2 prospective studies and 1
case–control study.
Results: Not only chronic psychological stress (present in 2/3 of these
patients, on average), but also a high co-occurrence of anxiety
and depression (from 50 to 70% of patients with this cardiopathy),
panic attacks (diagnosed in almost 20% of women with tako-tsubo),
subthreshold and full-blown PTSD (co-morbid in almost 40% of patients
according to a 2-year prospective study) were associated with TTC. It
has been suggested that changes in circulating levels of catecholamines
combined to heart's abnormal response to these hormones could be at
the pathophysiological basis for such associations.
Conclusion: The present literature review confirms a high cooccurrence
of comorbid conditions with increased sympathetic
activity (in particular anxiety, depression and panic disorder), which
could be risk factors for TTC. More studies, especially longitudinal
ones, are needed to better clarify the causative pathways of this
usually reversible, but potentially lethal, syndrome, especially among
post-menopausal women.
2015
- The HD project" - biomarkers of depression in HIV newly diagnosed patients
[Abstract in Rivista]
Ferrari, Silvia; Menozzi, Marianna; Alboni, Silvia; Miselli, Manuela; Rigatelli, Marco; Ghidoni, Andrea
abstract
Background: Inflammatory mediators may be relevant to explain the frequent comorbidity between depression, neurocognitive disorders and HIV. HIV induces activation of inflammatory mediators, mainly cytokines, that have been involved in the onset of depression and response to antidepressant treatment.
Aim: To identify recurring profiles of inflammatory biomarkers subtending depression, effectiveness of antidepressants and neurocognitive disorders among HIV-infected individuals.
Method: All adult newly HIV-diagnosed out-patients attending HIV clinics in three towns of Northern Italy will be screened, assessed for depression and studied immunologically and for neurocognitive disorders. The study-specific set of immune biomarkers will consist of: IL-1β and α, IL-6, IL-23, IL-18, IFN-γ, TNFα, MCP1, IL-8, BDNF, FGF-8, CNTF; IL1Ra, IL18Rα type II, IL18Rβ short, IL18BP.
Results: 17 patients have been enrolled so far: of these, 6 (35%) were positive to PHQ-9 screening. Three of the 6 PHQ-9-positive patients were positive to the diagnostic assessment for depression. No neurocognitive disorders were found among the 17 patients. As the project will develop, it is expected that frequency of depression, neurocognitive disorders and effective antidepressant treatment will be found to correlate to the profile of immune biomarkers. These findings might help to understand the etiology of depression in HIV, and specifically the role of inflammation and immunological changes.
2015
- The impact on mental health of the economic recession in the district of Sassuolo (Modena): opinions of local occupational physicians.
[Abstract in Rivista]
Mattei, Giorgio; Urraci, Gm; Ferrari, Silvia; Galeazzi, Gian Maria; Rigatelli, Marco
abstract
INTRODUCTION The recent economic recession and the subsequent strategy of austerity have deceased
the amount of resources devoted to health care. They may also have contributed to the deterioration of the
population health.
AIM To assess the impact on mental health of the economic recession in the district of Sassuolo (Modena),
by collecting and analyzing opinions of local Occupational Physicians.
METHODS Qualitative survey, by focus groups, conducted in Sassuolo (Modena), industrial center of
ceramics, involving 8 Occupational Physicians active in the area. Rough descriptions analyzed
independently by GU and GM using MAXQDA, with the independent supervision of a third researcher (SF),
according to the principles of the General Grounded Theory. The second focus group was intendened as
respondent validation of the first, yet it gathered further data, up to theortical saturation.
RESULTS Two focus groups, about one hour long, attended by 8 Occupational Physicians, 7 during the first
focus group, 4 during the second (of these, 3 attending both focus groups). The coding process yielded 261
segments, divided into four main areas: "changes in contemporary world" (16 coded segments), "social
area" (82 coded segments), "medical area" (94 coded segments), "working area" (69 coded segments).
CONCLUSIONS The impact of the economic crisis on health produced mainly negative consequences,
locally, consistently with national data. Psychiatrists should work together with Occupational Physicians to
develop targeted interventions, addressing social, political and medical needs. A more structured liaison
between Psychiatry and Occupational Medicine is an interesting and useful tool for future action and
advocacy.
2015
- University students' identification of stigmatizing schizophrenia in Italian newspapers
[Articolo su rivista]
Pingani, L; Evans Lacko, S; Del Vecchio, V; Luciano, M; Catellani, S; Hamati, A; Rigatelli, Marco; Fiorillo, A.
abstract
Stigma associated with mental disorders represents one main obstacle to receive appropriate care for people with mental disorders. Compared to adults, university students have higher levels of stigmatizing attitudes toward patients with schizophrenia. The primary aim of this case-control study was to assess university students’ ability to identify stigma toward schizophrenia in Italian newspapers. Secondary aims were: a) to explore differences in stigmatizing attitudes among two different groups of university students (health professionals [HP] and nonhealth professionals [n-HP]) and b) to compare the attitudes of these two groups with those of a sample of expert psychiatrists. The electronic archives of two Italian newspapers were searched using the term “schizo” (as a word or part of it). One hundred seventy articles published between January and December 2011 were identified. Students from the HP group and expert psychiatrists had a higher ability to detect stigmatizing attitudes in newspapers. Students from the n-HP group had a higher concordance with the experts on the topics “characteristics of the article” and “services and rights.” Our findings highlight the importance of targeting university students with correct and updated information about schizophrenia and its psychosocial consequences.
2015
- Young and burnt? Italian contribution to the international BurnOut Syndrome Study (BOSS) among residents in psychiatry
[Articolo su rivista]
Ferrari, Silvia; Cuoghi, Giulia; Mattei, Giorgio; Carra, Elena; Volpe, U; Jovanovic, N; Beezhold, J; Rigatelli, Marco; Galeazzi, Gian Maria; Pingani, Luca
abstract
The Burnout Syndrome (BS) is a common condition among health care professionals, yet data concerning its prevalence and associated factors among psychiatric residents are lacking. Objectives: To report the results of the Italian contribution to "BOSS", an international multicentre research project aiming at estimating the burden of BS among residents in psychiatry, and at identifying factors contributing to its development and prevention. Methods: Cross-sectional study. The BOSS online questionnaire, which collected socio-demographic data and five psychometric tools (MBI-GS, AWLS, PHQ-9, SIBQ, BFI), was administered electronically to 180 Italian residents in psychiatry. Simple and multiple linear regressions were performed to analyse data. Results: 108 questionnaires provided data for the study (response rate: 60%). Mean age: 30.5 +/- 3.7 years. Eighty percent of the sample were female. A moderate level of BS emerged, related to work conditions, absence of major depression, satisfaction with pay or less academic activity. Only 0.9% (N=1) of the sample showed PHQ-9 scores suggestive of major depression, while lifetime suicidal ideation was admitted by 16% of residents. For the three dimensions of the MBIGS, Italian sample scores were consistent with previously published results concerning pooled data in a FrenchCroatian sample, reporting moderate levels of BS. Higher workload, symptoms of depression and lower satisfaction predicted higher levels of Emotional Exhaustion and Cynicism. Conclusions: Italian residents in psychiatry showed overall moderate levels of BS, related to workload and work organization. Other alerts of psychic distress were found among participants, namely symptoms of depression, suicidal ideation and use of psychotropic medications.
2014
- Consultation-liaison psychiatry and the “Women Wellness Project”: analysis of the association between cardiovascular risk factors and psychiatric comorbidity
[Abstract in Rivista]
Mattei, Giorgio; Simoni, Elena; Borghi, Ambra; Bursi, S; Capitani, C; Coppi, Francesca; Ferrari, Silvia; Gorlato, Giulia; Pingani, Luca; Rigatelli, Marco; Rossi, Rosario
abstract
INTRODUCTION The Consultation-Liaison Psychiatry Service of the Modena General Hospital collaborates regularly with the Cardiology Clinic,
within the Woman Wellness Project (WWP). Aim of this collaboration is detection and prevention of post-menopausal correlated diseases,
including psychiatric syndromes.
AIM To investigate the association between cardiovascular risk factors (BMI, blood pressure, hyperglycemia, hypertrygliceridemia) and
psychiatric symptoms in peri-post menopausal.
METHODS Ecological study. Data between January 2008 and December 2012 were collected. Correlations, logistic regessions and categorial
regressions were performed with STATA.
RESULTS 675 outpatients attended the WWP. 90 (13.3%) were referred to the psychiatrist; 9 refused the examination. Of the remaining 57.7%
had a positive psychiatric history and 22.03% already receaved a psychiatric therapy. 40.6% had at least two medical diseases, mainly:
overweight (54.2%), hypertension (40.7%) and dyslipidemia (49.1%). After psychiatric consultation emerged that: 11.9% had anxiety symptoms,
27.1% had depressive symptoms and 47.5% presented both anxiety and depressive symptoms. Only 7 patients (11.9%) had a negative
psychiatric examination. The regression analysis pointed out no significant association between the cardiometabolic risk-factors and the
psychiatric symptomatology. Differently, the outcome at the end of the psychiatric consultation was associated with BMI (r = -.26; p = .05) and
heart rate (r = .33; p = .01).
CONCLUSIONS Heart rate and BMI emerge as factors associated with the psychiatric symptomatology presented by the patient. This finding is
consistent with previous researches. The absence of significant associations at the regression analysis could be explained by the small sample
considered in the present study.
2014
- Correlation of articular involvement, skin disfigurement, and unemployment with depressive symptoms in patients with systemic sclerosis: a hospital sample
[Articolo su rivista]
Tedeschini, Enrico; Pingani, Luca; Simoni, Elena; Ferrari, D; Giubbarelli, C; Giuggioli, D; Lumetti, F; Rigatelli, Marco; Ferri, Clodoveo; Ferrari, Silvia
abstract
Background: Systemic sclerosis (SSc) is a connective tissue disease associated with increased functional impairment,
body image distress due to skin lesions, and psychosocial comorbidity, particularly depression. Prevalence
of depressive symptoms in SSc patients ranges from 36% to 65% and it contributes to the worsening of any
aspect of the disease. The aim of this study was to investigate the prevalence and clinical and non-clinical correlates
of depressive symptoms in a sample of outpatients with SSc.
Methods: Seventy-eight consecutive SSc outpatients were recruited from February 2005 to July 2007. Sociodemographic
and SSc-related clinical data were collected, including a modified Rodnan Skin Score, the Valentini
Disease Activity Index and psycho-metric assessment of disability and pain. Depressive symptoms were assessed
using the Beck Depression Inventory (BDI). Two questions on perception of support from relatives and impact
of disfigurements were also directly addressed to subjects.
Results: The BDI mean score was 10.5 ( 8.3), with 36 subjects (46.2%) scoring above clinical significance.
Unemployment, increased disability, pain, disease activity and articular involvement were significantly associated
with more depressive symptoms. Older age, unemployment and more depressive symptoms were also
related with complaints of disfigurements due to skin involvement.
Conclusions: Depression is an influential prognostic factor in SSc. The present study contributes to the knowledge
of the relationship between depression and clinical features routinely collected in rheumatology settings in
order to develop a standardized assessment of psychosocial distress in routine rheumatologic procedures.
2014
- Disturbi psichiatrici in corso di patologie mediche
[Capitolo/Saggio]
Giubbarelli, Cinzia; Baraldi, Sara; Rigatelli, Marco; Ferrari, Silvia
abstract
Il capitolo descrive le diverse modalità rilevanti per la clinica con cui la patologia psichiatria può complicare o essere complicata da altre patologie mediche, con particolare riferimento alle forme depressive, al delirium ed alle difficoltà di gestione farmacologica
2014
- First-episode psychosis and migration in Italy (PEP-Ita migration): a study in the Italian mental health services
[Articolo su rivista]
Tarricone, Ilaria; Braca, Mauro; Allegri, Fabio; Barrasso, Giuseppe; Bellomo, Antonello; Berlincioni, Vanna; Carpiniello, Bernardo; Ceregato, Alessio; Conforti Donati, Marco; Defilippi, Samuele; Del Vecchio, Valeria; De Rosa, Corrado; Ferrannini, Luigi; Ferrari, Silvia; Furio, Maria Antonietta; Gramaglia, Carla; La Cascia, Caterina; Luciano, Mario; Mulè, Alice; Nardini, Marcello; Podavini, Francesca; Primavera, Diego; Reggianini, Corinna; Rigatelli, Marco; Todarello, Orlando; Turella, Elena; Ventriglio, Antonio; Zeppegno, Patrizia; Fiorillo, Andrea; Berardi, Domenico
abstract
Background: It has been frequently reported a higher incidence of psychotic disorders in immigrants than in
native populations. There is, however, a lack of knowledge about risk factors which may explain this phenomenon.
A better understanding of the causes of psychosis among first-generation migrants is highly needed, particularly in
Italy, a country with a recent massive migration.
Methods/Design: The “Italian study on first-episode psychosis and migration (PEP-Ita)” is a prospective observational
study over a two-year period (1 January 2012–31 December 2013) which will be carried out in 11 Italian mental health
centres. All participating centres will collect data about all new cases of migrants with first-episode psychosis. The general
purpose (“core”) of the PEP-Ita study is to explore the socio-demographic and clinical characteristics, and the pathways to
care of a population of first-episode psychosis migrants in Italy. Secondary aims of the study will be: 1) to understand risk
and protective factors for the development of psychotic disorders in migrants; 2) to evaluate the correlations between
psychopathology of psychotic disorders in migrants and socio-demographic characteristics, migration history, life
experiences; 3) to evaluate the clinical and social outcomes of first-episode psychoses in migrants.
Discussion: The results of the PEP-Ita study will allow a better understanding of risk factors for psychosis in
first-generation migrants in Italy. Moreover, our results will contribute to the development of prevention
programmes for psychosis and to the improvement of early intervention treatments for the migrant population
in Italy.
2014
- I disturbi da sintomi somatici
[Capitolo/Saggio]
Ottolini, Fedra; Giubbarelli, Cinzia; Piemonte, Chiara; Rigatelli, Marco; Ferrari, Silvia
abstract
Il capitolo descrive la nuova versione DSM del capitolo relativo ai pregressi disturbi somatoformi, specificandone le difficoltà diagnostiche
2014
- Modalità di presentazione del disagio psichico nei migranti: accessi in pronto soccorso e comportamenti suicidairi.
[Abstract in Atti di Convegno]
Pizzirani, Margherita; Reggianini, Corinna; Bettelli, Margherita; Santunione, Anna Laura; Ferrari, Silvia; Rigatelli, Marco; Silingardi, Enrico; Galliani, Ivan
abstract
Dall'analisi degli accessi al PS dei due ospedali di Modena di italiani e stranieri e il numero di suicidi, gli AA fanno alcune considerazioni sulla difficoltà di individuare un percorso di presa in carico psichiatrica per i pazienti migranti che nel 59% dei casi presentano disturbi apsecifici, suggestivi di somatizzazione.
2014
- Moderators of remission with interpersonal counselling or drug treatment in primary care patients with depression: Randomised controlled trial
[Articolo su rivista]
Menchetti, M; Rucci, P; Bortolotti, B; Bombi, A; Scocco, P; Kraemer, H. C; Berardi, D; Luciano, C; Lia, L; Manganaro, D; Magnani, M; Nespeca, C; Succu, M; Bellino, S; Bogetto, F; Zizza, M; Colombini, N; Rigatelli, Marco; Simoni, E; Tedeschin, E; Baranzini, F; Bortolaso, P; Callegari, C; Diurni, G. C. M; Vender, S; Martinelli, V; Politi, P; Sciarini, P; Piselli, M; Quartesan, R; Bellomo, A; De Salvia, M; Ferretti, M; Iuso, S; Petito, A; Affatati, V; Todarello, O; Carpiniello, B; Contu, C; Pinna, F.
abstract
Background
Despite depressive disorders being very common there has
been little research to guide primary care physicians on the
choice of treatment for patients with mild to moderate
depression.
Aims
To evaluate the efficacy of interpersonal counselling
compared with selective serotonin reuptake inhibitors (SSRIs),
in primary care attenders with major depression and to
identify moderators of treatment outcome.
Method
A randomised controlled trial in nine centres (DEPICS,
Australian New Zealand Clinical Trials Registry number:
ACTRN12608000479303). The primary outcome was remission
of the depressive episode (defined as a Hamilton Rating
Scale for Depression score
4
7 at 2 months). Daily
functioning was assessed using the Work and Social
Adjustment Scale. Logistic regression models were used to
identify moderators of treatment outcome.
Results
The percentage of patients who achieved remission at
2 months was significantly higher in the interpersonal
counselling group compared with the SSRI group (58.7%
v.
45.1%,
P
= 0.021). Five moderators of treatment outcome
were found: depression severity, functional impairment,
anxiety comorbidity, previous depressive episodes and
smoking habit.
Conclusions
We identified some patient characteristics predicting a
differential outcome with pharmacological and psychological
interventions. Should our results be confirmed in future
studies, these characteristics will help clinicians to define
criteria for first-line treatment of depression targeted to
patients’ characteristics.
2014
- Psichiatria di liaison
[Capitolo/Saggio]
Simoni, Elena; Ferrari, Silvia; Rigatelli, Marco
abstract
Il capitolo descrive la storia, le funzioni, le modalità operative attuali della psichiatria di consultazione e collegamento, branca della psichiatria dedicata in particolare alla gestione della comorbilità medico-psichiatrica ed alla patologia psicosomatica
2014
- Short-term effects of the 2008 Great Recession on the health of the Italian population: an ecological study
[Articolo su rivista]
Mattei, Giorgio; Ferrari, Silvia; Pingani, Luca; Rigatelli, Marco
abstract
Purpose To report on the effects on health that the 2008 Great Recession is producing in Italy, by comparing the consistency of Italian data with general observations reported in the scientific literature, and by pointing out consequences on the rates of all-cause mortality, cardiovascular mortality, male suicidal behaviours, daytime alcohol drinking and traffic fatalities.
Methods This is an ecological study in which MEDLINE, PsycINFO and PubMed were searched for the literature with combinations of the following keywords: economic recession, financial crisis, unemployment, health, suicide and mental health. Data from two Italian government agencies (Italian Institute of Statistics, ISTAT, and Italian Agency of Drugs, AIFA) in the years from 2000 to 2010 were obtained and analysed, by producing models of multiple linear regressions.
Results After the recession onset, all-cause mortality remained stable, and was not associated with the economic fluctuations. Differently, cardiovascular mortality was associated with the rate of unemployment, and showed a significant increase in 2010. Alcohol consumption increased in 2009, the year with the worst real GDP decrease (-5.1 %). Though the total rate of suicide was not associated with the economic situation, male completed and attempted suicides due to financial crisis were significantly associated with the rate of unemployment and the real GDP. The increasing diffusion of antidepressants was not associated with a lowering of the rate of suicide.
Conclusions The data on the Italian situation here discussed are sufficiently reliable to conclude that a link exists between the ongoing economic recession and health and mental health of Italians. Further research is needed to understand more in detail and with stronger reliability such link, to support primary and secondary preventive interventions and orient the development of effective sociopolitical interventions.
2014
- Vertigo "In the Pink": The Impact of Female Gender on Psychiatric-Psychosomatic Comorbidity in Benign Paroxysmal Positional Vertigo Patients
[Articolo su rivista]
Ferrari, Silvia; Monzani, Daniele; Baraldi, S; Simoni, E; Prati, G; Forghieri, M; Rigatelli, Marco; Genovese, Elisabetta; Pingani, Luca
abstract
BACKGROUND:
Comorbidity between vestibular and psychiatric disorders in predisposed individuals is underestimated, untreated, and may result in chronicization and poor quality of life. There are few studies concerning the type and the prevalence of psychiatric-psychosomatic distress in patients with benign paroxysmal positional vertigo (BPPV).
OBJECTIVE:
The aim of this study was to evaluate psychiatric-psychosomatic comorbidities, in particular anxiety, depression, somatization symptoms, and alexithymia, in a group of BPPV patients compared with healthy subjects, and according to gender.
METHODS:
Case-control study comparing 92 BPPV patients recruited at the ENT Unit of Modena General Hospital between November 2007 and December 2010, and 141 healthy controls. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Diagnostic Criteria for Psychosomatic Research (DCPR), Brief Symptom Inventory (BSI), and Toronto Alexithymia Scale (TAS-20) were used to perform psychometric assessment.
RESULTS:
BPPV patients scored higher than controls, with statistical significance, at BDI, BSI somatization, anxiety, and phobic anxiety subscales, and STAI state anxiety; a larger proportion of BPPV patients suffered from clinically significant BDI depressive symptomatology; DCPR disease phobia, functional somatic symptoms secondary to a psychiatric disorder, and demoralization were more common among BPPV subjects. High levels of symptomatology were still found among BPPV female patients, but not among males, even after controlling for symptom severity.
CONCLUSIONS:
Affective symptomatology, such as depression, demoralization, phobia and anxiety, and somatization, were significantly prevalent in BPPV patients, and female gender may be a predisposing factor.
2013
- A LITERARY WORKSHOP FOR INCREASING ASSERTIVENESS IN PATIENTS WITH EATING DISORDERS: A RANDOMIZED CONTROLLED TRIAL
[Articolo su rivista]
Pingani, Luca; Fulvio, Arnone; Maria Laura, Chierici; Elena De, Bernardis; Sara, Donelli; DEL GIOVANE, Cinzia; Vera, Vinci; Giuliano, Turrini; Rigatelli, Marco; Ferrari, Silvia
abstract
Objectives: To assess the effectiveness of a literary workshop activity for increasing linguistic skills and assertiveness in patients with eating disorders (ED).Methods: Twenty-four patients consequently admitted to the ED In-patient Unit at the Private Clinic “Villa Maria Luigia” (Parma, Northern Italy) were enrolled in the study. Of these, 8 were randomly assigned to treatment and 16 to care as usual (being the difference between treatment and care as usual only represented by the literary workshop activity). The literary workshop consisted in 15 weekly 60-minute group sessions. Linguistic and expressive skills were provided and tested during the sessions. The Rathus Assertiveness Schedule and the Verbal Fluency Test (phonemic and semantic) were administered to all patients at the beginning and at the end of hospitalization. Results: A significant improvement of semantic skills, phonetic skills and assertiveness (p<.01) was registered in the treatment group. A positive correlation was also found between variations of linguistic skills and assertiveness in the treatment group, but not in the control group. Conclusions: Effectiveness of a literary workshop activity within a rehabilitation program for patients suffering from ED was suggested: improved communication and language skills might have a positive and significant impact on patients' levels of assertiveness
2013
- A step backward: the “Rough” facial nerve grading system
[Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Piccinini, Alessia; Grammatica, Alberto; Salafia, Francesca; Ciancimino, Cristel; Cunsolo, Eliomaria; Pingani, Luca; Rigatelli, Marco; Genovese, Elisabetta; Monzani, Daniele; Gioacchini, FEDERICO MARIA; Marchioni, Daniele; Presutti, Livio
abstract
Several modalities currently exist to rate the degree of facial function clinically but even though it has significant limitations, the most widely used scale is the House-Brackmann grading system (HBGS). A simplified scale is introduced here, the 'Rough' Grading System (RGS - Grade I: normal movement; Grade II: slight paralysis; Grade III: frank paralysis with eye closure; Grade IV: frank paralysis without eye closure; Grade V: almost complete paralysis with only slight movements; Grade VI: total paralysis). The aim of the present study was to verify the interrater reliability and the interscale validity of this simplified grading system.
STUDY DESIGN:
Scale validation study based on a prospective cohort.
METHODS:
Fifty patients with facial palsy, consecutively referred to our department were filmed while performing some codified facial movements. Then two independent groups (one rating using the HBGS, the other rating using the RGS) assigned a grade after reviewing the videos. The time required for the rating was also noted.
RESULTS:
The HBGS showed a mean value of interrater agreement of 0.46 while the RGS showed a mean value of 0.59. The concurrent validity between HBGS and RGS ranged from 0.86 to 0.90 (p < 0.001 for every comparison). There was no statistically significant difference between HBGS and RGS in the mean time taken for rating (p = 0.15).
CONCLUSIONS:
The RGS reached an adequate level of interrater reliability, higher than the HBGS. The correlation between the two scales is high and the times required for rating are similar. The present results may justify the use of the RGS in routine clinical practice.
LEVEL OF EVIDENCE:
N/A
2013
- Alexithymia in the medically ill. Analysis of 1190 patients in gastroenterology, cardiology, oncology and dermatology
[Articolo su rivista]
Porcelli, P; Guidi, J; Sirri, L; Grandi, S; Grassi, L; Ottolini, Fedra; Pasquini, P; Picardi, A; Rafanelli, C; Rigatelli, Marco; Sonino, N; Fava, Ga
abstract
Objective: To use the Diagnostic Criteria for Psychosomatic Research (DCPR) for characterizing alexithymia in a large and heterogeneous medical population, in conjunction with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and other DCPR criteria.
Method: Of 1305 patients recruited from 4 medical centers in the Italian Health System, 1190 agreed to participate. They all underwent an assessment with DSM-IV and DCPR structured interviews. A total of 188 patients (15.8%) were defined as alexithymic by using the DCPR criteria. Data were submitted to cluster analysis.
Results: Five clusters of patients with alexithymia were identified: (1) alexithymia with no psychiatric comorbidity (29.3% of cases); (2) depressed somatization with alexithymic features (23.4%); (3) alexithymic illness behavior (17.6%); (4) alexithymic somatization (17%) and (5) alexithymic anxiety (12.8%).
Conclusions: The results indicate that DCPR alexithymia is associated with a comorbid mood or anxiety disorder in about one third of cases; it is related to various forms of somatization and abnormal illness behavior in another third and may occur without psychiatric comorbidity in another subgroup. Identification of alexithymic features may entail major prognostic and therapeutic differences among medical patients who otherwise seemto be deceptively similar since they share the same psychiatric and/or medical diagnosis. (C) 2013 Elsevier Inc. All rights reserved.
2013
- Assessing Alexithymia with the Diagnostic Criteria for Psychosomatic Research. A cluster analysis in 1190 medical patients
[Abstract in Rivista]
Porcelli, P; Guidi, J; Sirri, L; Grandi, S; Grassi, L; Ottolini, Fedra; Pasquini, P; Picardi, A; Rafanelli, C; Rigatelli, Marco; Sonino, N; Fava, Ga
abstract
Meeting Abstract
2013
- Cibo ed emozioni: falsi miti o strumento clinico?
[Abstract in Rivista]
Cameli, Michela; Ferrari, Silvia; N., Colombini; Rigatelli, Marco
abstract
Stefania ha 29 anni. Orfana di padre, che soffriva di anoressia nervosa ed è deceduto prematuramente per infarto del miocardio, vive con la madre, che è invece affetta da una grave patologia renale in terapia dialitica 3 volte alla settimana. Si definisce una “bimba grassottella e serena” fino alla prima adolescenza: inizia allora ad acquisire uno stile alimentare restrittivo, con importante dimagramento che rende necessari svariati ricoveri in ambiente psichiatrico. Viene posta diagnosi di anoressia nervosa. In Day Hospital, dove è giunta per un intervento riabilitativo di reinserimento socio-lavorativo, presenta sin dall’inizio uno stile alimentare irregolare e disordinato, estremamente restrittivo da un punto di vista quantitativo ma non qualitativo: tende a saltare i pasti, salvo poi prediligere il consumo di cibi grassi durante le occasioni sociali. Sono evidenti rituali ossessivi di organizzazione dei pasti, su cui è imperniata tutta la sua vita. Estremamente seduttiva nelle relazioni con medici e pazienti, non abbandona neanche dopo mesi le sue abitudini alimentari, non riesce a raggiungere il peso auspicato e non elabora progetti lavorativi di nessun tipo.
Anna ha invece 30 anni. Alta, magrissima, bella ragazza alla moda, lavora come commessa ma sogna di diventare una cantante famosa. La sua storia clinica è caratterizzata dal presentarsi e ripresentarsi di sintomi somatici vari, per i quali si sottopone a svariati accertamenti e terapie, tra cui: eritema nodoso; dermatite simil-psoriasica al cuoio capelluto ed acne; disturbi della fonazione; irregolarità mestruali con addominalgie; ed in particolare disturbi intestinali con alvo prevalentemente e marcatamente diarroico. In relazione a quest’ultima sintomatologia, molto invalidante, ed anche con riferimento alla presunta origine allergica dei sintomi cutanei, si sottopone a svariati regimi dietetici, che segue in modo rigido per un certo periodo e che poi abbandona, tornando ad uno stile alimentare irregolare e caotico, che la fa sentire in colpa proprio perché irregolare. Situazione familiare di grande invischiamento, madre ipercontrollante e svalutante, padre assente e inaffidabile. Figlia unica.
Il cibo ha un’enorme importanza fisica e simbolica per l’essere umano. Indispensabile per la sopravvivenza, diventa un elemento anche metaforico di benessere ed equilibrio bio-psico-sociale. I due casi clinici presentati forniranno l’opportunità di riflettere sulle potenziali funzioni di prevenzione e terapia che interventi basati sull’alimentazione (psicoeducazione, riabilitazione tramite attività culinaria…) possono avere rispetto al disagio psichico.
2013
- Disturbi del comportamento alimentare in pazienti uomini trattati presso un servizio di Day Hospital in Psichiatria
[Abstract in Rivista]
M., Moscara; Bolondi, Marisa; Cuoghi, Giulia; Cameli, Michela; Miselli, Manuela; Visentini, Chiara; Ferrari, Silvia; Rigatelli, Marco
abstract
DCA in soggetti maschi
2013
- Eating disorders in male patients: medical and psychiatric co-morbidity
[Abstract in Rivista]
Moscara, Maria; Bolondi, Marisa; Cuoghi, Giulia; Cameli, Michela; Miselli, Manuela; Visentini, Chiara; Ferrari, Silvia; Rigatelli, Marco; Mattei, Giorgio
abstract
ntroduction
Men make up approximately 10% of the diagnoses of specified Eating Disorders (ED), with Bulimia Nervosa more common in men than Anorexia. However, Eating Disorder Not Otherwise Specified (EDNOS) are more prevalent in men than Anorexia and Bulimia combined. Rates of concurrent depression and personality disorders are also high in men with EDNOS, as well as rates of medical co-morbidity.
Objectives
To describe a sample of male patients attending a Psychiatric Day Hospital.
Aims
To understand possible links between the diagnosis of ED and medical and psychiatric co-morbidity among male subjects.
Methods
Clinical data about male patients attending the Psychiatric Day Hospital of Modena from 05/01/2009 to 13/06/2012 were collected and analyzed. Psychiatric diagnoses were defined according to DSM IV criteria, medical comorbidities according to ICD10 criteria.
Results
Male patients with ED were on the whole 11 (7.9% of total patients). Nine of them (81.8%) were diagnosed with EDNOS; 7 had medical co-morbidity, namely gastrointestinal (36.4%), respiratory (9.1%), renal (9.1%), rheumatologic (18.2%), cardiac (9.1%) and hypertension (16.6%); 9 had psychiatric co-morbidity, namely personality disorders (46.2%), major depression (30.8%), substance abuse (15.4%) and anxiety disorders (7.7%). Only 1 male patient (9.1%) was suffering from the ED, with no medical or psychiatric co-morbidity.
Conclusions
Male patients suffering from ED are increasing and knowledge on their clinical features are less clear than for female subjects, resulting in a more difficult and less effective clinical management. Despite the small sample size, this study attempts to increase the understanding of this clinical population.
2013
- Exploration of experiences in therapeutic groups for patients with severe mental illness: development of the Ferrara group experiences scale (FE- GES)
[Articolo su rivista]
Rosangela, Caruso; Luigi, Grassi; Bruno, Biancosino; Luciana, Marmai; Luciano, Bonatti; Maria, Moscara; Rigatelli, Marco; Catherine, Carr; Stefan, Priebe
abstract
Abstract
Background: Group therapies are routinely provided for patients with severe mental illness. The factors important to the group experience of patients are still poorly understood and are rarely measured. To support further research and practice, we aimed to develop a questionnaire that captures how patients experience groups within a community mental health context.
Methods: An initial pool of 39 items was conceptually generated to assess different aspects of group experiences. Items were completed by 166 patients with severe mental illness attending group therapies in community mental health services in Italy. Patients with different psychiatric diagnoses who attended at least 5 group sessions were included. An exploratory factor analysis was used to identify different dimensions of group experiences and to reduce the number of items for each dimension.
Results: The resulting questionnaire has five subscales: 1) sharing of emotions and experiences, 2) cognitive improvement, 3) group learning, 4) difficulties in open expression and 5) relationships. Each subscale has 4 items. The scale and sub-scales have good internal consistency.
Conclusions: The Ferrara Group Experiences Scale is conceptually derived and assesses dimensions of group experience that are theoretically and practically relevant. It is brief, easy to use and has good psychometric properties. After further validation, the scale may be used for research into patient experiences across different group therapy modalities and for evaluation in routine care.
Keywords: Group therapy, Patient experiences, Severe mental illness, Community mental health care
2013
- International Study of Student Career Choice in Psychiatry (ISoSCCiP): results from Modena, Italy
[Articolo su rivista]
Ferrari, Silvia; Reggianini, Corinna; Mattei, Giorgio; Rigatelli, Marco; Pingani, Luca; Bhugra, D.
abstract
Italy was one of the 16 countries to take part in the International Study of Student Career Choice in Psychiatry (ISoSCCiP).
This paper reports and comments on the IsoSCCiP data on Italian medical students. Italian fi nal year medical students
from the University of Modena and Reggio Emilia were asked to fi ll in an on-line questionnaire during the fi rst semester
of two consecutive academic years (2009 – 2010, 2010 – 2011). Step-wise logistic regressions were performed. Of the 231
students invited, 106 returned completed questionnaires (response rate 46.7%). Women constituted 66%, and mean age
was 25.14 (SD 1.15). Psychiatry was the second most common choice of possible career by students (5.7%, n 6).
Choosing psychiatry was predicted by having volunteered for further clinical/research activities in psychiatry (p 0.01),
believing that ‘ the problems presented by psychiatric patients are often particularly interesting and challenging ’ (p 0.01),
and by accounts of personal/family experience with physical illness (p 0.01). Both personal factors and factors related to
training may be involved in the choice of psychiatry among Italian medical students. Cultural and organizational specifi cities
of Italian mental healthcare may be involved, particularly the strong tradition of social psychiatry.
2013
- Internet as a tool to estimate psychiatrists’ opinions on consultation activity in the Emergency Room: a mix-method survey
[Articolo su rivista]
Mattei, Giorgio; Tedeschini, Enrico; Pingani, Luca; Rigatelli, Marco; Ferrari, Silvia
abstract
OBJECTIVES This study aims at exploring the attitudes of psychiatrists towards their work as consultants in the Emergency Room (ER). Considerations and suggestions concerning the use of Internet-based surveys for research purposes are also offered.
METHODS A quali-quantitative Internet survey was sent to 288 psychiatrists. The 11-item questionnaire was made up of 8 half-structured questions, 2 multiple-choice questions and 1 open question. Surveymonkey was used to collect responses. Data collection went on for two weeks, from June 1st until June 15th 2011. Psychiatric consultation activity in the ER deals with assessing and managing patients with mental health problems in the specific context of urgency/emergency.
RESULTS Out of the 288 invitations sent by e-mail, 132 questionnaires were returned (response rate: 45.8%); of these, 58 provided useful data for the research since they were answered by psychiatrists who usually practice as consultants in the ER. Fifty-three percent of the responders were women. Mean age was 43.6 years ± 7.4. Forty percent of the consultants said they are called in the ER “more than once a week”, mainly due to “acute clinical failures” (31%), “behavioural emergencies” (22%), “acute clinical onsets” (17%) and “self-harm behaviours” (13.8%). Social emergencies were indicated as a rare cause of consultation (1.7%), yet they were considered particularly challenging by the 36.2% of psychiatrists. A large amount of psychiatric assessments in the ER (69%) led “to prescribe a therapy and send the patient to the mental health community centre”. Some critical aspects were pointed out, such as: “lack of suitable setting” (50.9%) for meeting the patient, a “trend to delegate to the psychiatrist” (45.5%) by the ER personnel, “poor autonomy of the personnel working in the ER” (38.2%), and “poor perceived safety” (30.9%) by the consultant. Yet, it is noticeable that the vast majority of psychiatrists (75.9%) reported that they enjoy their activity as consultants in the ER.
CONCLUSIONS The study points out that the majority (75.9%) of psychiatrists like their job as consultants in the ER, even if referrals are not always appropriate and settings sometimes fail to be suitable. Some relevant critical aspects were also addressed that should provide suggestions for improvement of effectiveness, organization and integration within the general hospital, to reduce waste of resources. Internet is useful and feasible as a research tool, due to low costs and easy logistics, particularly when studying younger subjects, though limited external validity might be a problem only partially addressed by adopting mixed-method strategies of research.
2013
- Miglioramento delle abilità linguistiche e dell'assertività nei disturbi del comportamento alimentare: studio randomizzato controllato di un'attività di laboratorio letterario [Improving linguistic skills and assertiveness in eating disorders: A randomized controlled trial on a literary workshop activity]
[Articolo su rivista]
Pingani, Luca; Arnone, F; Chierici, Ml; De Bernardis, E; Donelli, S; Del Giovane, C; Vinci, V; Turrini, G; Rigatelli, Marco; Ferrari, Silvia
abstract
Objectives: To assess the effectiveness of a literary workshop activity for increasing linguistic skills and assertiveness in patients with eating disorders (ED). Methods: Twenty-four patients consequently admitted to the ED in-patient unit at the private clinic "Villa Maria Luigia" (Parma, Northern Italy) were enrolled in the study. Of these, 8 were randomly assigned to treatment and 16 to care as usual (the only difference between treatment and care as usual was the literary workshop activity). The literary workshop consisted in 15 weekly 60-minute group sessions. Linguistic and expressive skills were provided and tested during the sessions. The Rathus Assertiveness Schedule and the Verbal Fluency Test (phonemic and semantic) were administered to all patients at the beginning and end of hospitalization. Results: A significant improvement of semantic skills, phonetic skills and assertiveness (p < 0.01) was registered in the treatment group. A positive correlation was also found between variations of linguistic skills and assertiveness in the treatment group, but not in the control group. Conclusions: The results of this study suggest that a literary workshop activity within a rehabilitation program for patients suffering from ED can aid in improving communication and language skills that might have a positive and significant impact on levels of assertiveness.
2013
- Who cares for it? How to provide psychosocial interventions in the community
[Articolo su rivista]
Pingani, Luca; Fiorillo, A; Luciano, M; Catellani, S; Vinci, V; Ferrari, Silvia; Rigatelli, Marco
abstract
Background: Since the Mental Health Reform Law 1978/180, in Italy mental hospitals have been progressively closed and
a community-centred psychiatric care oriented to rehabilitation began. After almost 35 years, the de-institutionalization
process is now complete. However, psychosocial interventions in the community are provided only rarely, although a
specific mental health professional, the psychiatric rehabilitation technician, has been established in Italy.
Material: Training courses and the education of psychosocial rehabilitation technicians have been analysed and the
university degree has been described. Moreover, the practical and theoretical skills needed at the end of the training
course have been discussed.
Discussion: Psychiatric rehabilitation technicians are trained to perform multidisciplinary rehabilitative and educational
interventions for people with severe mental disorders and their carers. They represent an innovative professional
workforce in mental health care, not yet established outside Italy, whose role and activities are essential in a communitybased
mental health system model.
Conclusion: The skills needed for properly performing psychosocial interventions are not available in other mental
health professionals and it is not possible that these interventions, which require in-depth training, are performed by
professionals with a different background. It is advisable that psychiatric rehabilitation technicians become an integral and
permanent component of an efficient community psychiatric staff.
2012
- A cluster analysis-derived classification of psychological distress and illness behavior in themedically ill
[Articolo su rivista]
G. A., Fava; J., Guidi; P., Porcelli; C., Rafanelli; A., Bellomo; S., Grandi; L., Grassi; L., Mangelli; P., Pasquini; A., Picardi; R., Quartesan; Rigatelli, Marco; N., Sonino
abstract
Background. The classification of psychological distress and illness behavior in the setting of medical disease is stillcontroversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of thisinvestigation was to assess whether the joint use of DSM-IV categories and the Diagnostic Criteria for PsychosomaticResearch (DCPR), that provide identification of syndromes related to somatization, abnormal illness behavior,irritable mood, type A behavior, demoralization and alexithymia, could yield subtyping of psychosocial variables inthe medically ill.Method. A cross-sectional assessment using both DSM-IV and the DCPR was conducted in eight medical centers inthe Italian Health System. Data were submitted to cluster analysis. Participants were consecutive medical out-patientsand in-patients for whom a psychiatric consultation was requested. A total of 1700 subjects met eligibility criteria and1560 agreed to participate.Results. Three clusters were identified : non-specific psychological distress, irritability and affective disturbanceswith somatization.Conclusions. Two-step cluster analysis revealed clusters that were found to occur across clinical settings. Thefindings indicate the need of expanding clinical assessment in the medically ill to include the various manifestationsof somatization, illness behavior and subclinical distress encompassed by the DCPR.
2012
- Anniversary Reactions in Medical Patients
[Articolo su rivista]
Piero, Porcelli; Giovanni Andrea, Fava; Chiara, Rafanelli; Antonello, Bellomo; Grandi, ; Luigi, Grassi; Paolo, Pasquini; Angelo, Picardi; Roberto, Quartesan; Rigatelli, Marco
abstract
Abstract: The aim of this study was to explore the prevalence and characteristicsof anniversary reactions (somatic symptoms occurring at the anniversaryof specific events) in a large sample of 1498 medical patients fromdifferent medical settings who underwent the Structured Clinical Interview forDSM-IV (SCID) and the Structured Interview for Diagnostic Criteria forPsychosomatic Research (DCPR), which provide definition of anniversaryreactions. In 54 (3.6%) of the 1498 patients for whom anniversary reactionwas identified, 61.1% had a concurrent DSM-IV diagnosis. Other syndromesrelated to somatization, abnormal illness behavior, irritable mood, demoralization,and alexithymia were present in 9 of 10 cases. Symptoms of theconversion syndrome were found in 6 (0.4%) patients with the SCID andin 67 (4.5%) patients with the DCPR, 20% of whom also had anniversaryreaction. The results should alert physicians to enquire about the timing ofsymptoms in relation to meaningful personal events
2012
- CL-psychiatry in primary care - the Modena model
[Abstract in Rivista]
Ferrari, Silvia; N., Colombini; M., Andreoli; Rigatelli, Marco
abstract
Abstracts of the 20th European Congress of Psychiatry
2012
- Consulenze, certificazioni e problematiche di genere
[Relazione in Atti di Convegno]
Ferrari, Silvia; Moretti, Valentina; Pighi, Marcella; A. R., Atti; Martire, Lisa; Tedeschini, Enrico; Rigatelli, Marco
abstract
psichiatria di consultazione, certificazioni, sesso femminile
2012
- How does economic recession in Italy affect the health of Italian people?
[Abstract in Rivista]
Mattei, Giorgio; Ferrari, Silvia; Rigatelli, Marco
abstract
Abstracts of the 20th European Congress of Psychiatry
2012
- MUPS in the general hospital: outcomes of psychiatric consultations over 10 years of activity
[Abstract in Rivista]
Ferrari, Silvia; Martire, L; Rigatelli, Marco
abstract
Not available
2012
- Mental illness and mass media: review of the literature since 1950 up to date
[Abstract in Rivista]
Pingani, Luca; Vinci, V; Colavito, Mg; Rigatelli, Marco; Ferrari, Silvia
abstract
Introduction and aims: Mass media have become the main source of information on mental illness.
In recent years, numerous studies documented a relationship between a stigmatizing presentation of
psychiatric disorders and negative perception of mental illness by general population. This paper
aims at analyzing how mental illness is described in scientific articles published by journals and
magazines and delineating the average portrait of a psychiatric patient offered by media to the
general population.
Methods: Scientific articles published from 1957 until August 2010 were reviewed, collecting
positive and negative expressions commonly associated to mental illness; a qualitative assessment
method of these was then applied.
Results: Negative descriptions of mental illness resulted by far more common than positive ones;
generally, the tone and the negative attitude that describes mental illness are in the titles and in
short articles, often sensational and dramatic, put on the front page, referring to stories of crime and
danger. The titles are often inconsistent with the contents of the article. Moreover, there is a
discriminatory and derogative language or a language of derision or pity. If there are positive
descriptions, they are associated with the involvement of mental health experts, the active role of
the psychiatric patient in the mass media or the effect produced by anti-stigma campaigns towards
journalists.
Conclusions: Although negative and stigmatizing depictions predominate, there are still
opportunities for improving media reporting of mental illness, which should be taken up in future
media strategies.
2012
- Migrants presenting with suicidal behaviours at the A&E department in Modena
[Abstract in Rivista]
Ferrari, Silvia; Martire, L; Pizzirani, M; Reggianini, C; Rigatelli, Marco; Santunione, Anna Laura
abstract
Not available
2012
- Opinions of general hospital ward staff on a consultation-liaison psychiatry service
[Abstract in Rivista]
Ferrari, Silvia; Catellani, S; Pingani, Luca; Rigatelli, Marco; Simoni, E.
abstract
Objective: Consultation-Liaison Psychiatry is the application area of
psychiatry dealing with psychosocially distressed patients in nonpsychiatric
health care settings and providing integration of the psychosomatic
and bio-psycho-social theories with clinical practice. The
overcoming of sectorialization in contemporary medical care through
the establishment of effective collaboration is its main theoretical
framework. This study collects evaluations of doctors and charge nurses
working in non-psychiatric wards of the Modena General Hospital,
about the Psychiatric and Psychosomatic Consultation Service
(PPCS).
Method: 330 health professionals (medical doctors and charge
nurses) were contacted by e-mail or in person, and required to compile
an anonymous questionnaire over a two-week period, in June
2009.
Results: 109/330 (33.03%) responded to the questionnaire, of these
the vast majority (n=95, 87.20%) were medical doctors. The majority
of respondents (84.39%) estimated a range of frequency of psychiatric
referrals between 1 and 24% of their patients. The most
frequent reasons for referrals were suspected depression (60.55%)
or anxiety (53.21%). The PPCS intervention was rated as “very useful"
particularly for psychopharmacotherapeutic advice (84.40%), to improve
communication with patients and relatives (73.39 and 39.45%
res-pectively) and to facilitate after-discharge care (33.94%). Half of
the sample also recognized an improvement of their own knowledge
and skills in the management of mentally ill patients.
Conclusion: TheModena PPCS is perceived as effective and useful by
its users. It is relevant to assess opinions of consultees and ward staff
on Consultation and Liaison activities, to better focus clinical and
training interventions as well as to improve organisational procedures.
2012
- PSYCHIATRIC DISORDERS IN RHEUMATOLOGY: EVALUATION OF A SCREENING PROTOCOL IN 100 HOSPITALIZED PATIENTS
[Abstract in Rivista]
Lumetti, Federica; Giuggioli, Dilia; Manfredi, Andreina Teresa; Ferrari, D; Tedeschini, E; Simoni, E; Rigatelli, Marco; Ferri, Clodoveo
abstract
not available
2012
- Physical restraints in an italian psychiatric ward: clinical reasons and staff organization problems.
[Articolo su rivista]
R. D., Lorenzo; S., Baraldi; M., Ferrara; S., Mimmi; Rigatelli, Marco
abstract
To analyze physical restraint use in an Italian acute psychiatric ward, where mechanical restraint by belt is highly discouraged but allowed.|Data were retrospectively collected from medical and nursing charts, from January 1, 2005, to December 31, 2008. Physical restraint rate and relationships between restraints and selected variables were statistically analyzed.|Restraints were statistically significantly more frequent in compulsory or voluntary admissions of patients with an altered state of consciousness, at night, to control aggressive behavior, and in patients with "Schizophrenia and other Psychotic Disorders" during the first 72 hr of hospitalization.|Analysis of clinical and organizational factors conditioning restraints may limit its use.
2012
- Predictors of dropout from in-patient treatment of eating disorders: an italian experience
[Articolo su rivista]
Pingani, Luca; Catellani, S; Arnone, F; De Bernardis, E; Ziosi, G; Turrini, G; Rigatelli, Marco; Ferrari, Silvia
abstract
Introduction. The aim of the study was to examine possible risk factors for dropout from in-patient treatment for eating disorders (ED).
Materials and methods. The present study consisted in a retrospective analysis of clinical and non-clinical available information about 186 patients suffering from ED consecutively admitted into the Villa Maria Luigia Private Hospital (Parma, Italy) in the a three-year period between (01/01/2006- and 31/12/2009). Socio-demographics, clinical history and current features, and results to the following psychometric instruments were analysed: Eating Disorder Questionnaire (EDQDA), Predisposing, On-set and Maintaining risk factors list for Eating Disorders, Eating Disorders Inventory-II, Body Uneasiness Test and SCL-90.
Results. Of the 186 patients, 46 (24.7%) voluntarily left the treatment program prematurely. Predictive factors included poor educational and professional achievements, parents’ divorcing, parents’ history of substance abuse and difficulties in interpersonal relationships.
Discussion. Dropout is a multifactorial phenomenon with deep clinical consequences: the recognition of possible risk factors may support the choice of specific therapeutic strategies to improve the treatment of ED and its outcomes.
2012
- Prevenzione dei disturbi mentali attraverso il collegamento con l’ospedale generale
[Abstract in Rivista]
Ferrari, Silvia; Martire, Lisa; Ghidoni, Andrea; Rigatelli, Marco
abstract
Descrizione di come l'attività di liaison nell'ospedale generale possa prevenire la comorbilità medico-psichiatrica
2012
- Psychiatry between politics and ethics: opinions of final-year medical students
[Abstract in Rivista]
Mattei, Giorgio; Ferrari, Silvia; Rigatelli, Marco
abstract
Abstracts of the 20th European Congress of Psychiatry
2012
- Scoop or stigma? La psicopatologia sui quotidiani dal 1950 a oggi
[Abstract in Rivista]
Pingani, Luca; Ferrari, Silvia; Vinci, Vera; S., Catellani; G., Ziosi; Rigatelli, Marco
abstract
Psicopatologia descritta da quotidiani negli ultimi anni in Italia
2012
- Stigma and discrimination toward mental illness: translation and validation of the Italian version of the Attribution Questionnaire-27 (AQ-27-I).
[Articolo su rivista]
Pingani, L.; Forghieri, M.; Ferrari, Silvia; Ben Zeev, D.; Artoni, P.; Mazzi, F.; Palmieri, G.; Rigatelli, Marco; Corrigan, P. W.
abstract
The aim of this study was to translate the Attribution Questionnaire-27 (AQ-27) to the Italian language (AQ-27-I), and to examine the reliability and validity of this new Italian version.|The questionnaire was translated using the standard translation/back-translation method. Cronbach's alpha and intraclass coefficients were used to estimate instrument reliability. Confirmatory factor analysis was conducted to corroborate the original English version factor structure in the new measure, and to establish validity. Path analyses were meant to validate relationships found in the English version among Italian-speaking participants.|The AQ-27-I demonstrated acceptable internal consistency, with a Cronbach's alpha of 0.82 for the total scale and ranging between 0.52 and 0.91 for the subscales. The test-retest reliability was also satisfactory, with intraclass correlation coefficients of 0.72 for the total scale and ranging between 0.51 and 0.89 for the subscales. Fit indices of the model supported the factor structure and paths.|The AQ-27-I is a reliable measure to assess stigmatizing attitudes in Italian.
2012
- Suicidal migrants in Modena
[Abstract in Rivista]
Reggianini, Corinna; Martire, Lisa; Ferrari, Silvia; Pizzirani, Margherita; Santunione, Anna Laura; Rigatelli, Marco
abstract
Self-harm behaviours, including attempted and complete suicide, have been reported to be common among migrants. Data from our analysis confirm general epidemiologic features of suicide, with complete suicide by hanging more typical among adult males and self-harm behaviours by drug ingestion more typical among youg adult females.
2012
- The Psychiatric-Psychosomatic Consultation Service (PPCS) of Modena: eleven years of experience between clinical, training and research activities
[Abstract in Rivista]
Ferrari, Silvia; Martire, L; Rigatelli, Marco
abstract
Not available
2012
- Type A behaviour: a reappraisal of its characteristics incardiovascular disease
[Articolo su rivista]
L., Sirri; G. A., Fava; J., Guidi; P., Porcelli; C., Rafanelli; A., Bellomo; S., Grandi; L., Grassi; P., Pasquini; A., Picardi; R., Quartesan; Rigatelli, Marco; N., Sonino
abstract
Aims: The role of type A behaviour in cardiovascular disease is controversial andmost of the research is based on self-rating scales. The aim of this study was toassess the prevalence of type A behaviour in cardiology and in other medical set-tings using reliable interview methods that reflect its original description.Methods: A sample of 1398 consecutive medical patients (198 with heart trans-plantation, 153 with a myocardial infarction, 190 with functional gastrointestinaldisorders, 104 with cancer, 545 with skin disorders and 208 referred for psychiat-ric consultation) was administered the Structured Clinical Interview for the DSM-IVand the Structured Interview for the Diagnostic Criteria for Psychosomatic Research(DCPR) which identifies 12 clusters, including type A behaviour. Results: A cardiaccondition was present in 366 patients. There was a significant difference in theprevalence of type A behaviour in cardiovascular disease (36.1%) compared withother medical disorders (10.8%). Type A behaviour frequently occurred togetherwith psychiatric and psychosomatic disturbances, particularly irritable mood, eventhough in the majority of cases it was not associated with DSM diagnoses. Amongcardiac patients, those with type A behaviour were less depressed, demoralisedand worried about their illness. Conclusions: Type A behaviour was found tooccur in about a third of cases of patients with cardiovascular disease. Only in alimited number of cases was it associated with depression. It has a lifestyle conno-tation that may have important clinical consequences as to stress vulnerability andillness behaviour.
2011
- Adolescent violence: the parallel psychiatric histories of two teenagers
[Relazione in Atti di Convegno]
R., Di Lorenzo; V., Moretti; C., Muratore; M., Pighi; Ferri, Paola; Rigatelli, Marco
abstract
IntroductionViolent behaviour in children and adolescents can include a wide range of behaviour: explosive temper tantrums, physical aggression, fighting, threats or attempts to hurt others, use of weapons, cruelty toward animals, fire setting, intentional destruction of property and vandalism. Most studies have pointed out that the exposure to violence in the home and/or community, the presence of stressful socio-economic factors in family environment, the being the victim of physical abuse and/or sexual abuse contribute to an increased risk of violent behaviour in children and adolescents (Wolfe et al., 2001). These conditions can affect dimensions of development such as peer and intimate relationships, self-regulation of emotions, and behavioural adjustment (Kaplan et al., 1999; Thompsona &Tabone, 2010). Violence often represents one of symptoms of psychiatric diseases and constitutes ones of major challenges of our time because it is difficult to treat. In fact, it evokes feelings of fear, provokes hostility and calls for punitive responses which can produce an escalation of violence (Greenwood, 2005).MethodWe analyzed the parallel history of two adolescent girls, who presented stressful family socioeconomic factors (poverty, severe deprivation, single parenting, etc.) in childhood, Attention-Deficit/Hyperactivity Disorder (ADHD) in scholar age, wide range of aggressive and self-dangerous behaviour with an extreme mood instability and impulsivity in adolescence, which required long and frequent psychiatric hospitalizations with the diagnosis of Borderline Personality Disorder (BPD).ResultsThe two young girls, despite of their disruptive and dangerous life-style, are alive but at the price of strong dependence from institutions. After long psychiatric inpatient care, they live in two different therapeutic communities, require pharmacologic therapy and frequent but brief hospitalizations, follow rehabilitative programs with many professionals aimed to acquire capacity of autonomy.Discussion and conclusionsThe clinical history of these two emblematic cases confirms the literature observations that child deprivation, emotional neglect or abuse may lead to perpetration of perverse life style characterized by violence and self-destructiveness and may affect mental health development. Many psychiatric disorders are associated to child maltreatment and abuse such as ADHD and BPD (Matthies et al., 2011; Miller et al., 2008), which can reflect an early developmental failures of containment. The complexity of these cases, characterized by the persistence of a childhood disease, developed into a stables unstable mood chronic pathology till the late adolescence, suggests us pathogenic relationship among BPD, Bipolar Disorder and ADHD, as observed by other authors (Benazzi, 2008; Rydén et al., 2009; Zapolski et al., 2010; Zepf , 2009). Finally, these clinical cases suggest that an emphatic therapeutic approach and a long-term rehabilitative program based on creative and constructive responses may be more effective in reducing violence than a coercive or punitive approach (Greenwood, 2005).
2011
- Aggression and violence in Psychiatric, Emergency and General Hospital settings: an Italian experience
[Relazione in Atti di Convegno]
Ferri, Paola; R., Di Lorenzo; F., Reggiani; Rigatelli, Marco
abstract
IntroductionHealth care professionals, especially nurses, are at the highest risk of violence in the workplace. Nurses present 16 times more frequent risk of victimization than other workers and psychiatric nurses report the highest rate of violent assault in comparison to other nurses. The National Institute of Occupational Safety and Health (NIOSH) (2002) defines violence in the workplace as “all situations of physical assault, threatening behavior or verbal abuse that occur in the workplace”. This phenomenon, which is steadily increasing, may affect the professional resilience of operators and may account for the high rate of burn out syndrome in health care professionals.AimIt is a preliminary cross-sectional investigation among nurses in order to evaluate the rate and the features of violence incidents that occurred during the previous 3 years in the following health care settings: Emergency, Psychiatric and General Hospital.Materials and MethodsA self-assessment questionnaire, “Violent Incident Form” (VIF) (Arnetz, 1998), was subministered in order to identify the following features of aggressiveness occurred during the previous 3 years in the health care workplaces above mentioned.ResultsIn Psychiatric Wards, violence appeared more frequent inside the ward, without a specific pattern in comparison to nurse shifts; physical attack was prevalent; aggressors were more frequently young and male patients; most consequences were physical damages reported by professionals, but their reaction was never represented by a police report.In Emergency Departments, verbal aggression was prevalent and took place most frequently in waiting rooms during night shifts; aggressors were more frequently male relatives of patients, with an age ranged between 40-49 years; the most frequent reaction of professionals was a police report even without physical damages reported.In General Hospital Wards, violence was less frequent than in the other settings; verbal attacks were prevalent and most frequently occurred inside the ward during day shifts; aggressors were represented similarly by both patients and relatives, with an age ranged between 50-59 years; the most frequent reactions of professionals were both police and incident reports.Discussion and ConclusionOur results, in accordance with the literature, highlight that aggressiveness in health care settings is a frequent and notable phenomenon which can be strongly conditioned by illnesses of patients and by the way they are assisted them in each setting.
2011
- Antidepressants for major depressive disorder in patients with a co-morbid axis-III disorder: a meta-analysis of patient characteristics and placebo response rates in randomized controlled trials.
[Articolo su rivista]
N., Iovieno; E., Tedeschini; V. E., Ameral; Rigatelli, Marco; G. I., Papakostas
abstract
The objective of this study is to assess whether the antidepressants are effective in treating major depressive disorder (MDD) in patients with a co-morbid axis-III disorder, and to compare the relative efficacy (vs. placebo) of antidepressants between these patients and those enrolled in general MDD trials. Medline/Pubmed publication databases were searched. We selected for randomized, double-blind, placebo-controlled trials of antidepressants for MDD, whether conducted in a general population, or in populations with an axis-III disorder. Antidepressants were more effective than placebo in patients with axis-III disorders overall [risk ratio for response (RR)=1.42, P<0.0001], as well as specifically for post-stroke (RR=1.43, P=0.04), human-immunodeficiency virus positive or acquired immunodeficiency syndrome (RR=1.66, P=0.005), but not cancer patients (RR=1.26, P=0.19). There was a trend for higher placebo response rates in studies, which did (41.2%) versus those which did not (37.7%) select for axis-III disorders (P=0.06), and significantly higher antidepressant response rates in studies which did (57.4%) versus those which did not (53.5%) select for axis-III disorders (P=0.01). Antidepressants are effective for MDD in patients who present with co-morbid axis-III disorders and as effective (vs. placebo) in this population as they are in the general MDD population. Higher general response rates observed in the co-morbid MDD population are intriguing, and require replication.
2011
- Assessment of quality of life in over-80 patients undergoing cardio-surgery: Is it feasible?
[Abstract in Rivista]
G., Pontoni; Ferrari, Silvia; D., Gabbieri; I., Pedulli; D., Gambetti; I., Ghidoni; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- Attendance at a Primary Care Clinic: pattern of use over time and related psychiatric morbidity
[Abstract in Rivista]
Ferrari, Silvia; Ascari, A; Andreoli, M; Peggi, M; Rigatelli, Marco
abstract
Not available
2011
- Common mental disorders in migrants in primary care services: an emerging issue for CLP
[Abstract in Rivista]
Tarricone, I; Ferrari, Silvia; Marseglia, M; De Gregorio, M; Braca, M; Morri, M; Carchia, G; Menchetti, M; Rigatelli, Marco; Berardi, D.
abstract
Not available
2011
- Depression in primary care: interpersonal counseling vs selective serotonin reuptake inhibitors. The DEPICS Study. A multicenter randomized controlled trial. Rationale and design.
[Articolo su rivista]
Menchetti, M; Bortolotti, B; Rucci, P; Scocco, P; Bombi, A; Berardi, D; Affatati, V; Alberini, G; Baranzini, F; Bellino, S; Bellomo, A; Blasi, T; Bogetto, F; Bortolaso, P; Callegari, C; Carpiniello, B; Colombini, N; Contu, C; Croci, G; De Salvia, M; Diurni, M; Elisei, S; Ferretti, M; Fiore, P; Fusar Poli, P; Iuso, S; Lacalamita, A; La Ferla, T; Lia, L; Luciano, Cc; Magnani, M; Manganaro, D; Martinelli, V; Martino, I; Montaguti, Mb; Nespeca, C; Petito, A; Pinna, F; Piselli, M; Politi, P; Quartesan, R; Rella, A; Restaino, F; Rigatelli, Marco; Sciarini, P; Simoni, E; Succu, M; Tedeschini, E; Todarello, O; Vender, S; Zaccagni, L; Zizza, M.
abstract
BACKGROUND: Depression is a frequently observed and disabling condition in primary care, mainly treated by Primary Care Physicians with antidepressant drugs. Psychological interventions are recommended as first-line treatment by the most authoritative international guidelines but few evidences are available on their efficacy and effectiveness for mild depression.METHODS/DESIGN: This multi-center randomized controlled trial was conducted in 9 Italian centres with the aim to compare the efficacy of Inter-Personal Counseling, a brief structured psychological intervention, to that of Selective Serotonin Reuptake Inhibitors. Patients with depressive symptoms referred by Primary Care Physicians to psychiatric consultation-liaison services were eligible for the study if they met the DSM-IV criteria for major depression, had a score ≥ 13 on the 21-item Hamilton Depression Rating Scale, and were at their first or second depressive episode. The primary outcome was remission of depressive symptoms at 2-months, defined as a HDRS score ≤ 7. Secondary outcome measures were improvement in global functioning and recurrence of depressive symptoms at 12-months. Patients who did not respond to Inter-Personal Counseling or Selective Serotonin Reuptake Inhibitors at 2-months received augmentation with the other treatment.DISCUSSION: This trial addresses some of the shortcomings of existing trials targeting major depression in primary care by evaluating the comparative efficacy of a brief psychological intervention that could be easily disseminated, by including a sample of patients with mild/moderate depression and by using different outcome measures.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12608000479303.
2011
- Economic recession in Italy: a review of short-term effects on health
[Abstract in Rivista]
Mattei, G; Ferrari, Silvia; Rigatelli, Marco
abstract
Not available
2011
- Feasibility of assessing quality of life in over-80 patients undergoing cardio-surgery
[Abstract in Rivista]
Ferrari, Silvia; Pontoni, G; Gabbieri, D; Gambetti, D; Ghidoni, I; Rigatelli, Marco
abstract
Not available
2011
- Frequent attenders at a primary care clinic: Occasional or regular abusers?
[Abstract in Rivista]
A., Ascari; Ferrari, Silvia; M., Andreoli; M., Peggi; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- Home visit in mental health care: the “italian way”
[Abstract in Rivista]
Ferrari, Silvia; L., Malavolta; M. R., Laghezzi Ortolani; S., Mimmi; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- Intermed self-assessment: developing an instrument to evaluate biopsychosocial complexity
[Abstract in Rivista]
C., Piemonte; A., Disavoia; Ferrari, Silvia; E., Simoni; F., Huyse; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- Migrant pathways to community mental health centres in Italy.
[Articolo su rivista]
I., Tarricone; E., Stivanello; Ferrari, Silvia; N., Colombini; E., Bolla; M., Braca; C., Giubbarelli; C., Costantini; S., Cazzamalli; S., Mimmi; D., Tedesco; M., Menchetti; Rigatelli, Marco; E., Maso; M., Balestrieri; S., Vender; D., Berardi
abstract
BACKGROUND: Many studies indicate that migrants in western countries have limited access to and low utilization of community mental health centres (CMHCs) despite the high prevalence of mental disorders. AIMS: We aimed to compare migrant pathways to care across four CMHCs located in different Italian provinces and to identify pathway to care predictors. METHODS: Migrants attending the four CMHCs between 1 July 1999 and 31 December 2007 were included in the study. Data were gathered retrospectively from clinical data sets and chart review. RESULTS: Five hundred and eleven (511) migrants attended the four CMHCs, 61% were referred by GPs or other health services and 39% followed non-medical pathways to care (self-referral or through social and voluntary organizations), with important site variations. Younger age and being married were predictors of medical pathways to care; lacking a residence permit and having a diagnosis of substance abuse were related to non-medical pathways. CONCLUSIONS: Pathways to CMHCs are complex and influenced by many factors. Non-medical pathways to care seem to be frequent among migrants in Italy. More attention should be paid to developing psychiatric consultation liaison models that also encompass the social services and voluntary organizations.
2011
- Predictors of dropout from inpatient treatment for eating disorders
[Abstract in Rivista]
S., Catellani; F., Arnone; E., De Bernardis; Ferrari, Silvia; L., Pingani; G., Ziosi; G., Turrini; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- Project “social point”: Partnership of sociality activities of mental health service recipients
[Abstract in Rivista]
V., Poggi; R., Ambrosino; M., Ciambellini; Ferrari, Silvia; E., Melati; L., Pingani; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- Quality of life assessment after cardiac surgery in octogenarians: is it really feasible?
[Abstract in Rivista]
G., Pontoni; Ferrari, Silvia; D., Gabbieri; M., Pedulli; D., Gambetti; I., Ghidoni; Rigatelli, Marco
abstract
quality of life,heart surgery,elderly
2011
- Severe mental illness is an HIV indicator disease
[Abstract in Rivista]
M., Ferrara; G., Solignani; Ferrari, Silvia; Rigatelli, Marco; Guaraldi, Giovanni
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- Subtyping depression in the medically ill by cluster analysis.
[Articolo su rivista]
Guidi, J; Fava, Ga; Picardi, A; Porcelli, P; Bellomo, A; Grandi, S; Grassi, L; Pasquini, P; Quartesan, R; Rafanelli, C; Rigatelli, Marco; Sonino, N.
abstract
BACKGROUND: There is increasing awareness of the need of subtyping major depressive disorder, particularly in the setting of medical disease. The aim of this investigation was to use both DSM-IV comorbidity and the Diagnostic Criteria for Psychosomatic Research (DCPR) for characterizing depression in the medically ill.METHODS: 1700 patients were recruited from 8 medical centers in the Italian Health System and 1560 agreed to participate. They all underwent a cross-sectional assessment with DSM-IV and DCPR structured interviews. 198 patients (12.7%) received a diagnosis of major depressive disorder. Data were submitted to cluster analysis.RESULTS: Two clusters were identified: depressed somatizers and irritable/anxious depression. The somatizer cluster included 58.6% of the cases and was characterized by DCPR somatization syndromes (persistent somatization, functional somatic symptoms secondary to a psychiatric disorder, conversion symptoms, and anniversary reactions) and DCPR alexithymia. The anxious/irritable cluster had 41.4% of the total sample and included DCPR irritable mood and type A behavior and DSM-IV anxiety disorders.LIMITATIONS: The study has limitations due to its cross-sectional nature. Further, these findings require additional validation in another sample.CONCLUSIONS: The findings indicate the need of expanding clinical assessment in the medically ill to include the various manifestations of somatization, irritable mood, type A behavior and alexithymia, as encompassed by the DCPR. Subtyping major depressive disorder may yield improved targets for psychosomatic research and treatment trials.
2011
- Validation of a web-radio station (“Radio Tab”) run by users of the Reggio Emilia mental health service: A pilot study
[Abstract in Rivista]
E., Mazzoni; Ferrari, Silvia; L., Pingani; G., Zanni; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- Vulnerability and diagnosis of psychosis among migrant patients in Modena
[Abstract in Rivista]
C., Giubbarelli; Ferrari, Silvia; C., Reggianini; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2011
- “SVAROSKI”: A computerised method of assessment of rehabilitation outcomes
[Abstract in Rivista]
A., Gandolfi; F., Arnone; M. L., Chierici; E., De Bernardis; M., De Bernardis; Ferrari, Silvia; A., Mori; L., Pingani; G., Turrini; Rigatelli, Marco
abstract
Abstracts of the 19th European Congress of Psychiatry
2010
- ARE PSYCHOPATHOLOGICAL SYMPTOMS IN PATIENTS WITH DEMENTIA RELATED TO STRESS PERCEPTION IN THE CAREGIVER?
[Abstract in Rivista]
Pingani, L; Cataldo, I; De Bernardis, M; Ughetti, Ml; Fulvio, A; De Bernardis, E; Ferrari, Silvia; Turrini, G; Rigatelli, Marco
abstract
Not available
2010
- Burn-out syndrome among Italian psychiatry residents: Results for Italy from the BOSS international study
[Abstract in Rivista]
Ferrari, Silvia; Pingani, Luca; Cuoghi, Giulia; Jovanovic, N; Beezhold, J; Rigatelli, Marco
abstract
Background and aims: Acknowledged risk factorsfor burnout syndrome include being a mental healthworker, younger age (in the sense of less professionalexperience) and status as a residents. The aim of theBOSS International Study was to put all these and otherrisk factors together and study their associations, aspredictors of this undesirable condition. 20 countriesworldwide were involved. Results from the Italianparticipants are displayed and discussed here.Methods: An invitation to join in the study was sentto 193 residents in psychiatry from the whole nationalterritory of Italy, including a link to the BOSS onlinequestionnaire (Italian version); this collects data ondemographics, education, working circumstances, andfrom five psychometric instruments (Maslach BurnoutInventory – MBI-GS, Areas of Worklife Survey, PHQ-9,Big Five Inventory - 10, Suicide Ideation and BehaviourQuestionnaire).Results: A total of 113 residents completed the survey(58.5% response rate, 22/78% M/F, mean age 30.3-3.7). Mean scores at the three MBI components were2.9 (exhaustion), 1.9 (cynicism) and 4.8 (professionalefficacy), accounting for low levels of burnout amongthe respondents. 14% of respondents confessed theywere on daily medication, mainly antidepressants (42%)and self-prescribed (50%). Out of all respondents, 34.8%met criteria for PHQ-9 minor depression, and 8.9%. formajor depression. Only PHQ9-depression was found tobe a statistically significant predictor of burnout.Conclusions: Despite the low level of burnout amongItalian residents in psychiatry, other findings in theBOSS survey suggested the need for improved supportand tutoring of young psychiatrists-to-be. This presents asignificant challenge for training organisations.
2010
- Evaluation of HIV positive recipients of orthotopic liver transplant (OLT): an observational study in the modena consultation liaison psychiatric service
[Abstract in Rivista]
Borsari, Lucia; M., Ferrara; V., Barbanti Silva; Pingani, Luca; S., Cocchi; Guaraldi, Giovanni; Gerunda, Giorgio Enrico; Rigatelli, Marco; Ferrari, Silvia
abstract
18th European Congress of Psychiatry
2010
- Evaluation of psychological impact of facial lipoatrophy in HIV: the “assessment of face & body change and distress” questionnaire
[Abstract in Rivista]
M., Ferrara; R., Murri; E., Bertaccini; G., Orlando; M., Vandelli; M., De Paola; R., Bucciardini; Rigatelli, Marco; R., Esposito; Guaraldi, Giovanni; Ferrari, Silvia
abstract
18th European Congress of Psychiatry
2010
- INTERMED from training to clinical implementation. The complex patient in different care settings
[Abstract in Rivista]
Ferrari, Silvia; A., Disavoia; Zannoni, Enrica; Ferri, Paola; F. C., Stiefel; C., Zdrojewski; F. J., Huyse; Rigatelli, Marco
abstract
complexity assessement
2010
- Intermed from training to clinical implementation: the complex patient in different care settings
[Abstract in Rivista]
Disavoia, Alessandra; Zannoni, Enrica; Ferrari, Silvia; Ferri, Paola; F. J., Huyse; Rigatelli, Marco
abstract
The aim of this work was to assess preliminary the effectiveness of a training program on the clinical use of INTERMED.Methods: after a group training on the use of INTERMED carried out between April and September 2009, the method was applied to 30 female patients aged between 20 and 65, subsequently referring to three clinical settings: a GP clinic; a psychiatry day-care clinic; a CLP out-patient clinic. Demographic and clinical data were collected, together with administration of HADS and WHOQol-bref.Results: the mean INTERMED score was 20.8, borderline as to definition of complex cases. Patients from the GP clinic and in the CLP setting scored lower than patients from the psychiatric day-clinic (27.8), suggesting that the presence of severe psychiatric disturbances might contribute to increasing the level of case-complexity. Concordance with results at HADS and WHOQoL was high.Conclusions: these preliminary positive results will hopefully open the way to a wider diffusion of this tool in clinical practice in the area of Modena.
2010
- Italian validation of AMDP-system: prelyminary results
[Abstract in Rivista]
F., Mazzi; S., Grandi; Ferrari, Silvia; L., Pingani; Rigatelli, Marco
abstract
18th European Congress of Psychiatry
2010
- Mental health services utilisation of migrants in Modena
[Abstract in Rivista]
C., Giubbarelli; Ferrari, Silvia; S., Mimmi; Rigatelli, Marco
abstract
18th European Congress of Psychiatry
2010
- Migrant and mental health services in Modena
[Abstract in Rivista]
C., Giubbarelli; Ferrari, Silvia; Reggianini, Corinna; Rigatelli, Marco
abstract
mental health, migrants
2010
- Psychiatry and culture: Quantifying the contamination
[Abstract in Rivista]
Ferrari, Silvia; Menozzi, Marianna; Piemonte, Chiara; Pontoni, G.; Masoni, L.; Rigatelli, Marco
abstract
Background and aims: Psychiatry has strong andcircular connections with culture and society, which arereflected in a continuous and progressive phenomenonof “contamination” of common language and colloquialexpressions. The analysis of this phenomenon mightprovide with significant elements for training and clinicalactivities. The aim of this work was to collect and analyzeexpressions in colloquial language originally derivedfrom psychiatric technical terminology.Methods: A hundred and ten fifth-year medical students(M/F% = 42/58; mean age = 23.5 ± 3.1) attending theirsemester in psychiatry were asked to list and discuss624 EACLPP Abstracts / Journal of Psychosomatic Research 68 (2010) 605–679as many words, phrases and expressions as possiblereferring to psychiatry and mental health. A semiqualitativeanalysis of the expressions collected wascarried out.Results: A list of 150 expressions was drawn andthen classified in the following 5 categories: technicalpsychiatric terms; medical-neurological terms; referencesto psychoanalysis; terms referring to abnormalityand need for care; not pertinent terms. Psychiatricexpressions, though usually exploited with pertinence,are used alternatively to define individual or others’states or conditions, with different intentions in the twocases, either as means for emphasis or ridiculisation.Conclusion: Due to fears and prejudices evoked bypsychiatric themes, an attempt on exorcising andtaking distance leads to the use of psychiatric terms aspotentially offensive and despising. This work suggeststhe need to work – especially in training settings – onfilling the gap between common and medical languagesand to analyze critically the contaminations as suggestiveof very relevant cultural issues
2010
- Psychopathological distress, body image perception and social phobia in patients with hearing aids and cochlear implants
[Abstract in Rivista]
F., Eleuteri; M., Forghieri; Ferrari, Silvia; A., Marrara; Monzani, Daniele; Rigatelli, Marco
abstract
18th European Congress of Psychiatry
2010
- Social disfunction and body disperception in patients with cochlear implants
[Abstract in Rivista]
Forghieri, Matilde; F., Eleuteri; Ferrari, Silvia; A., Marrara; Monzani, Daniele; Rigatelli, Marco
abstract
Social disfunction and body disperception in patients with cochlear implants
2010
- Suicide: 5-year follow up among the psychiatric population of an Italian mental health service
[Abstract in Rivista]
R., Di Lorenzo; F., Fiorini; S., Mimmi; E., Simoni; Rigatelli, Marco
abstract
18th European Congress of Psychiatry
2010
- THE EFFECTS OF A LITERARY WORKSHOP FOR INCREASE ASSERTIVITY IN PATIENTS WITH EATING DISORDERS: A RANDOMIZED CONTROLLED TRIAL
[Abstract in Rivista]
Pingani, L; Arnone, F; Chierici, Ml; De Bernardis, E; Donelli, S; Ferrari, Silvia; Zucchi, G; Turrini, G; Rigatelli, Marco
abstract
Not available
2010
- Teamwork in psychiatry
[Abstract in Rivista]
M., Miselli; M., Pighi; Ferrari, Silvia; V., Barbanti Silva; S., Mimmi; Rigatelli, Marco
abstract
18th European Congress of Psychiatry
2010
- The different psychological profiles of subjects attending melanoma screening campaigns and those delaying diagnosis: an aid for designing preventive campaigns?
[Articolo su rivista]
Forghieri, Matilde; Longo, Caterina; Galeazzi, Gian Maria; Rigatelli, Marco; Seidenari, Stefania; Pellacani, Giovanni
abstract
Patient delay in seeking medical attention for melanoma (MM) constitutes one of the main challenges in designing prevention campaigns. No conclusive studies exploring psychological aspects of those patients, using standardized psychometric instruments, are currently available. We hypothesized that the attitude toward illness of subjects attending the melanoma screening day (EMD) would differ from patients diagnosed with MM following the usual clinical pathways. Five psychometric tests, assessing attitude toward illness, were administered both to EMD and MM groups, this latter further divided into two subgroups (good and bad detectors, GD and BD) considering the histo-clinical characteristics of the lesion. The Mann-Whitney U Test and Pearson Chi Square test were used to compare EMD patients with the other groups and to compare psychometric scores between GD and BD. BD and GD groups showed significant differences. Interestingly, the BD group was characterized by higher scores in Temperament and Character Inventory Fearful subscale, Multidimensional Health Locus of Control Powerful Others scale and Illness Behaviour Questionnaire General Hypochondriasis, Affective Disturbance and Irritability subscales. BD patients tend to react in a phobic manner to medical recommendations and they appear to favour external and more assertive help, which would suggest choosing a more direct approach in proposing a prevention campaign. Although this is a pilot study and further studies are needed, it gives new insight to build up more effective prevention campaigns for those patients.
2010
- The psychiatric team: a space to work and live in
[Abstract in Rivista]
Ferrari, Silvia; BARBANTI SILVA, Veronica; Pighi, Marcella; S., Mimmi; Rigatelli, Marco
abstract
The psychiatric team: a space to work and live in
2010
- Training on how to use the INTERMED: the experience at Modena Medical School
[Abstract in Rivista]
Zannoni, Enrica; A., Bombi; A., Bonatti; T., Delli Carri; Disavoia, Alessandra; Ferrari, Silvia; V., Mazzali; Simoni, Elena; Ferri, Paola; F. J., Huyse; Rigatelli, Marco
abstract
Background: INTERMED is an instrument to assess bio-psycho-social case complexity in general health care by focusing on past, present and future health needs and risks of patients. It consists in a structured interview leading to definition of 20 variables and related anchor points. The total score ranges from 0 to 60, reflecting the level of complexity and the related care needs/risks. Aim: To describe the training process on the use of INTERMED and to assess its effectiveness.Methods: A training group of 9 subjects (4 student nurses, 3 residents in psychiatry, 1 consultant psychiatrist and 1 psychiatric nurse) had two-hour meetings twice a month between April and September 2009. After introductory sessions on theoretical aspects and inter-trainee simulations on interviewing and scoring techniques, students were assigned the task of producing video-recorded clinical material, which was used to comment on interviewing skills and practice on scoring. Individual and consensus scores were collected at the beginning and at the end of the training and compared statistically by means of Cohen’s kappa. Results: Motivation and involvement of students in the training was high (participation was on a voluntary basis during extra-work hours), as well as satisfaction, particularly among the student nurses. Agreement between individual and consensus scores was high already at the beginning of the training (Cohen’s kappa mean value of 0.80) and slightly improved during the course. Conclusions: The training process gave positive results both on the quantitative and the qualitative sides of evaluation. A six-month 25-hour training period is a reasonable time for learning how to master the instrument, although it needs to be followed by the clinical practice. These preliminary positive results will hopefully open the way to a wider diffusion of this tool in clinical practice in the area of Modena.
2010
- Training on how to use the INTERMED: the experience at Modena Medical School
[Abstract in Rivista]
Ferrari, Silvia; Zannoni, Enrica; A. R., Bombi; A., Bonati; T., Delli Carri; A., Disavoia; V., Mazzali; E., Simoni; Ferri, Paola; F. C., Stiefel; C., Zdrojewski; F. J., Huyse; Rigatelli, Marco
abstract
complexity assessment
2010
- Two extreme and parallel cases of borderline personality disorder
[Abstract in Rivista]
R., Di Lorenzo; V., Moretti; C., Muratore; M., Pighi; Rigatelli, Marco
abstract
18th European Congress of Psychiatry
2010
- Update in psycho-geriatric activity at a CL psychiatry service in the general hospital
[Abstract in Rivista]
Ferrari, Silvia; Forghieri, M; Pingani, L; Rigatelli, Marco
abstract
Not available
2010
- “Am I just paranoid?!”: a study about psychiatric contaminations on colloquial language
[Abstract in Rivista]
Ferrari, Silvia; M., Menozzi; C., Piemonte; G., Pontoni; L., Masoni; Rigatelli, Marco
abstract
18th European Congress of Psychiatry
2010
- “No country for old men”: consultation-liaison psychiatry activities in a geriatric population
[Abstract in Rivista]
Ferrari, Silvia; M., Forghieri; L., Pingani; Rigatelli, Marco
abstract
18th European Congress of Psychiatry
2009
- A proposal of screening for psychiatric disorders in a rheumatologic ward.
[Abstract in Rivista]
C., Giubbarelli; D., Ferrari; E., Tedeschini; F., Lumetti; E., Simoni; Ferrari, Silvia; Ferri, Clodoveo; Rigatelli, Marco
abstract
XII ANNUAL MEETING OF THE EUROPEAN ASSOCIATION FORCONSULTATION-LIAISON PSYCHIATRY AND PSYCHOSOMATICS (EACLPP)
2009
- Anger, social dysfunction and psychopathological distress in hearing- impaired patients
[Abstract in Rivista]
M., Forghieri; Monzani, Daniele; Galeazzi, Gian Maria; C., Gherpelli; Rigatelli, Marco
abstract
17th EPA Congress
2009
- Antidepressants for the treatment of fibromyalgia.
[Abstract in Rivista]
Ferrari, D; Giubbarelli, C; Giunti, M; Tedeschini, E; Ferrari, Silvia; Rigatelli, Marco; Ferri, Clodoveo
abstract
Not available
2009
- Assessing somatization with various diagnostic criteria.
[Articolo su rivista]
Lara, Mangelli; Alessandra, Bravi; Giovanni A., Fava; Ottolini, Fedra; Piero, Porcelli; Chiara, Rafanelli; Rigatelli, Marco; Nicoletta, Sonino
abstract
BACKGROUND: Somatization is a widespread clinical phenomenon that cuts across diagnostic categories, both psychiatric and medical. OBJECTIVE: This study investigates whether somatization can be assessed with a comprehensive diagnostic system, the Diagnostic Criteria for Psychosomatic Research (DCPR) in gastroenterology and cardiology (myocardial infarction) patients. METHOD: Authors assessed a group of 343 outpatients, 190 gastroenterology and 153 cardiology outpatients, with functional gastrointestinal disorders and recent first myocardial infarction. RESULTS: A total of 146 patients were diagnosed by the DCPR Somatization cluster and 106 by the DCPR Abnormal Illness Behavior cluster; 27 patients who met DSM-IV criteria for somatoform disorders were not classified with any DCPR somatization syndromes, whereas 120 with DCPR Somatization cluster did not satisfy the criteria for DSM-IV somatoform disorders. CONCLUSION: Findings suggest that the DCPR is able to identify clinical and subthreshold psychosomatic syndromes and that it can used jointly with the DSM-IV.
2009
- Cannabis abuse at first episode psychosis (FEP): Data from mental health centres in modena and Bologna, Italy
[Abstract in Rivista]
I., Tarricone; E., Rossi; D., Pecile; A., Castellani; A., Paparelli; V., Bandieri; Ferrari, Silvia; L., Pingani; R., Di Lorenzo; Rigatelli, Marco; D., Berardi
abstract
17th EPA Congress
2009
- Consultation liaison psychiatry in otoneurology
[Abstract in Rivista]
Forghieri, Matilde; Ferrari, Silvia; Monzani, Daniele; Rigatelli, Marco
abstract
Background and aims: Balance disorder is oneof the most common health problems (Perez etal., 2003). A huge amount of scientific literaturedescribes the coexistence of a significant linkbetween vestibular and psychiatric disorders(Monzani et al, 2006) and its neurobiologicbackground (Balanban et al., 2001). We aim todescribe the relationship between otoneurologyand psychiatry.Methods: We considered two conditions: 1-where anxiety has a predominant role inoriginating vestibular symptoms such as phobicpostural vertigo (Brandt, 1996), space andmotion discomfort, dizziness andlightheadedness in panic attacks (Furman andJacob, 2001); 2-when pre-existing vestibulardysfunction is worsened by anxiety symptoms,increasing vestibulo-oculo-motor reflex gain(Yardley et al, 1995) and reducing adaptationmechanisms in visuo-vestibular conflicts(Viaud-Delmon et al., 2000).Results: A critical review of scientific dataexploring how vestibular and psychiatricdisorders clinically interact will be presented,together with preliminary results concerning ourstudies on: psychopathological profile andalexithimia in patients suffering from positionalparossistic vertigo, anger in hearing impairedpatients, posturography and eating disorder,coping strategies in hyperacusic patients , bodyimage perception in patients using acousticprothesis.Conclusions: Scientific literature was examinedand potential applications explored concerningthe connection between otoneurology andpsychiatry.
2009
- Consultation-liaison psychiatry in primary care: an experience in Modena, Italy
[Abstract in Rivista]
Tedeschini, Enrico; N., Colombini; Simoni, Elena; Ferrari, Silvia; Rigatelli, Marco
abstract
Consultation-liaison psychiatry in primary care: an experience in Modena, Italy
2009
- Cross-cultural psychiatry, liaison psychiatry and other major challenges for modern psychiatrists
[Abstract in Rivista]
Ferrari, Silvia; V., Barbanti Silva; M., Forghieri; Rigatelli, Marco
abstract
17th EPA Congress
2009
- Depression in rehumatic patients
[Abstract in Rivista]
Tedeschini, Enrico; D., Ferrari; M., Giunti; Ferrari, Silvia; Ferri, Clodoveo; Rigatelli, Marco
abstract
Depression in rehumatic patients
2009
- Ideal and reality of team-working in psychiatry.
[Abstract in Rivista]
Ferrari, Silvia; Pighi, M; Silva, Vb; Mimmi, S; Rigatelli, Marco
abstract
Not available
2009
- Medical-psychiatric comorbidity
[Abstract in Rivista]
Rigatelli, Marco; Ferrari, Silvia; Pingani, Luca
abstract
Medical-psychiatric comorbidity
2009
- Metabolic syndrome and psychiatric comorbidity the modena protocol
[Abstract in Rivista]
Po, S; Cameli, M; Ferrari, Silvia; Pingani, L; Chiurlia, E; Iaccarino, D; Modena, Maria Grazia; Rigatelli, Marco
abstract
Not available
2009
- Physical restraint in italian psychiatric ward: a follow-up of 3 years
[Abstract in Atti di Convegno]
R., Di Lorenzo; Ferri, Paola; Rigatelli, Marco
abstract
Physical restraint is an ultimate instrument which can be adopted when relational and pharmacological containment is ineffective or not suitable. Its intents are to reduce aggressive and/or dangerous behaviour, with the aim of solving the condition which caused it, and, meantime, to ensure the safety of both patient and medical personnel. The purpose of this work is to examine the behaviour of inpatients and assess whether the response of staff is appropriate. Finally, it has the aim of inviting operators to reflect on the need to adopt the more appropriate containment and on whether physical restraint is actually useful.
2009
- Psychiatric comorbidity in end-stage liver disease patients with and without HIV infection
[Abstract in Rivista]
BARBANTI SILVA, Veronica; Ferrari, Silvia; Pingani, Luca; Rigatelli, Marco
abstract
Psychiatric comorbidity in end-stage liver disease patients with and without HIV infection
2009
- Psychiatric consultation activities to migrant patients in the general hospital
[Abstract in Rivista]
Ferrari, Silvia; Giubbarelli, C; Rigatelli, Marco
abstract
Not available
2009
- Validation of the Italian version of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM)
[Articolo su rivista]
Palmieri, Gaspare; C., Evans; V., Hansen; G., Brancaleoni; Ferrari, Silvia; P., Porcelli; F., Reitano; Rigatelli, Marco
abstract
The CORE-OM (Clinical Outcomes in Routine Evaluation- Outcome Measure) was translated into Italian and tested in non-clinical (n=263) and clinical (n=647) samples. The translation showed good acceptability, internal consistency and convergent validity in both samples. There were large and statistically significant differences between clinical and non-clinical datasets on all scores. The reliable change criteria were similar to those for the UK referential data. Some of the clinically significant change criteria, particularly for the men, were moderately different from the UK cutting points. The Italian version of the CORE-OM showed respectable psychometric parameters. However, it seemed plausible that non-clinical and clinical distributions of self-report scores on psychopathology and functioning measures may differ by language and culture.
2008
- Cl service in modena: The Italian experience
[Abstract in Rivista]
Rigatelli, Marco; Ferrari, Silvia; L., Pingani
abstract
Not available
2008
- Comorbid depression in rheumatic patients
[Abstract in Rivista]
Ferrari, D.; Tedeschini, E; Giunti, M; Ferrari, Silvia; Rigatelli, Marco; Ferri, Clodoveo
abstract
Not available
2008
- Differences in posturographic measures betweeneating disordered females and healthy subjects:preliminary results
[Abstract in Rivista]
Forghieri, Matilde; Monzani, Daniele; Galeazzi, Gm; Gherpelli, Chiara; Rigatelli, Marco
abstract
Background and aims: Posturography is a non invasivetechnique to objectively assess postural control. Weinvestigated the relationship between stabilization indexesafter mirror exposure and body image psychologicalappraisal measures in a diagnosed eating disorderpopulation, comparing it with a healthy subject one.Methods: Clinical population (N=17) and control healthypopulation (N=17) were matched for age and sex. BMI wasrecorded and every subject was administered the Italianversions of psychometric instruments assessing body imageself-perception. Static posturography (S.Ve.P. Amplifon)was performed measuring body sway with eyes open (EO)or closed (EC) during exposure to a full size mirror (M) ofa fashion model (FM) a neutral object (NO) or a verticalbar (VB). We reported descriptive statistics for sociodemographicdata and t test to compare psychometric andposturographic scores.Results: Cases and controls significantly differed inpsychometric scoring scales measuring body imageconcerns and phobic reaction (p<.001). Posturographicmeasures were significantly only in the EO and VBcondition (p<.05) and in the M and FM ones (p<.01).Conclusions: Results confirm the hypothesis thatposturography measures of female eating disorderedpatients differ from those of a control group.
2008
- EACLPP conference in Bologna
[Articolo su rivista]
Berardi, D; Bortolotti, B; Tarricone, I; Rigatelli, Marco; Ferrari, Silvia; Pingani, Luca
abstract
A description of main features and peculiarities of the 2007 annual meeting of the european association for consultation liaison psychiatry and psychosomatic which was held in Bologna, Italy.
2008
- Five years of Consultation Liaison Psychiatry in a Dermatological ward: An Italian experience
[Abstract in Rivista]
Pingani, L; Forghieri, M; Po, S; Mazzi, F; Longo, Caterina; Pellacani, Giovanni; Rigatelli, Marco
abstract
Not available
2008
- Frequent attenders in primary care: impact of medical, psychiatric and psychosomatic diagnoses
[Articolo su rivista]
Ferrari, Silvia; Galeazzi, Gian Maria; Mackinnon, Andrew; Rigatelli, Marco
abstract
Background: Anxiety, mild depression and somatization are common in Primary Care (PC). Several studies have suggested that they may play a role in causing an excessive use of health care services, especially when combined to medical morbidity. The present case-control study explored how psychiatric and psychosomatic diagnoses and perceived quality of life are associated to the phenomenon of frequent attendance.Methods: The 50 most frequent attenders (FAs) in a one-year period at a PC clinic in Italy were compared to 50 randomly selected average frequency attenders at the same clinic. Socio-demographic and medical data were collected from PC files. The SCID-brief version for research and the Structured Interview for Diagnostic Criteria for use in Psychosomatic Research (DCPR) were administered to both patient groups. Quality of life was also assessed.Results: FA status was associated with being female, older, less well educated, and living with their spouse and/or children. Medical-psychiatric comorbidity was more frequent in the FA group than in the control group. The median number of psychosomatic-DCPR syndromes per patient was 4 among FAs compared to only 1 in controls. Functional somatic symptoms secondary to a psychiatric disorder, type A behaviour, irritable mood, and demoralization were significantly associated with being an FA. Perceived quality of life was significantly lower among FAs, although this was no longer significant after adjusting for socio-demographic variables. Conclusions: The present study confirms the association between medical-psychiatric comorbidity and frequent utilization of PC resources. It suggests a role for DCPR criteria in revealing sub-threshold psychiatric comorbidity predicting a pattern of frequent attendance.
2008
- Geropsychiatric consultation burden in a general hospital in Italy
[Abstract in Rivista]
Forghieri, M; Pingani, L; Giubbarelli, C; Po, S; Mazzi, F; Rigatelli, Marco
abstract
Not available
2008
- Mental health services and primary care in Castelfranco Emilia (Italy): comparing two different methods of integration
[Abstract in Rivista]
Colombini, N; Tedeschini, E; Simoni, E; Ferrari, Silvia; Zurlini, A; Montaguti, A; Rigatelli, Marco
abstract
Not available
2008
- Psychosomatic psychiatry: a comment from Italy
[Articolo su rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
Reasons in favour and against the proposal of the suggestions for a new name for consultation liaison psychiatry are offered and discussed.
2008
- Suicide intervention skills in health professionals: A multidisciplinary comparison
[Articolo su rivista]
Palmieri, G.; Forghieri, M.; Ferrari, S.; Pingani, L.; Colombini, N.; Rigatelli, M.
abstract
Aim of the study: Training in the recognition and management of suicidal risk is of crucial importance for prevention. The aim of our study was to compare competence in assessing and managing suicidal patients in different groups of Italian health professionals. Materials and methods: Two hundred and thirty two professionals completed the Suicide Intervention Response Inventory (SIRI-2) and a questionnaire on perceptions of risk and protective factors in suicidal patients. Results and conclusions: Exposure to suicidal patients was found to be widespread in all groups, but specific training in suicide assessment and intervention was conspicuously rare. Psychiatrists outscored all other groups. Taken together, our findings suggest the necessity of further training in suicide intervention for Italian health professionals, and especially for emergency service personnel and general practitioners.
2008
- Suicide intervention skills in health professionals: a multidisciplinary comparison
[Articolo su rivista]
Palmieri, Gaspare; Forghieri, Matilde; Ferrari, Silvia; Pingani, Luca; Coppola, P.; Colombini, N.; Rigatelli, Marco; Neimeyer, R. A.
abstract
Training in the recognition and management of suicidal risk is of crucial importance for prevention. The aim of our study was to compare competence in assessing and managing suicidal patients in different groups of Italian professionals. Two hundredand thirty two professionals (38 psychiatrists, 50 general practitioners, 34 psychiatric nurses, 60 doctors and nurses working in accident and emergency services, and50 medical students) completed the Suicide Intervention Response Inventory (SIRI-2) (Neimeyer & Bonelle, 1997) and a questionnaire on perceptions of risk and protective factors in suicidal patients. Exposure to suicidal patients was found to be widespread in all groups, but specific training in suicide assessment and intervention was conspicuously rare. Psychiatrists outscored all other groups andpsychiatric nurses scored significantly higher than general practitioners in identifying appropriate responses to suicidal patients. Taken together, our findings suggest thenecessity of further training in suicide intervention for Italian health professionals, and especially for emergency service personnel and general practitioners.
2008
- Understanding somatisation through Cross-Cultural Liaison psychiatry
[Abstract in Rivista]
Ferrari, Silvia; Malmusi, D; Giubbarelli, C; Pingani, L; Rigatelli, Marco
abstract
Not available
2008
- Validity of the Italian adaptation of the Tinnitus Handicap Inventory; focus on quality of life and psychological distress in tinnitus-sufferers
[Articolo su rivista]
Monzani, Daniele; Genovese, Elisabetta; Marrara, A.; Gherpelli, Chiara; Pingani, Luca; Forghieri, M.; Rigatelli, Marco; Guadagnin, T.; Arslan, E.
abstract
The aim of this study was to determine the validity of the Italian translation of the Tinnitus Handicap Inventory (THI) by Newman et al. in order to make this self-report measure of perceived tinnitus handicap available both for clinical and research purposes in our country and to contribute to its cross-cultural validation as a self-report measure of perceived severity of tinnitus. The Italian translation of the Tinnitus Handicap Inventory (THI) was administered to 100 outpatients suffering from chronic tinnitus, aged between 20 and 82 years, who attended the audiological tertiary centres of the University Hospital of Modena and the Regional Hospital of Treviso. No segregation of cases was made on audiometric results; patients suffering from vertigo and neurological diseases were excluded. Pyschoacoustic characteristics of tinnitus (loudness and pitch) were determined and all patients also completed the MOS 36-Item Short Form Health Survey to assess self-perceived quality of life and the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. The THI-I showed a robust internal consistency reliability (Cronbach's alpha = 0.91) that was only slightly lower than the original version (Tinnitus Handicap Inventory-US; Cronbach's alpha = 0.93) and its Danish (Cronbach's alpha = 0.93) and Portuguese (Cronbach's alpha = 0.94) translations. Also its two subscales (Functional and Emotional) showed a good internal consistency reliability (Cronbach's alpha = 0.85 and 0.86, respectively). On the other hand, the Catastrophic subscale showed an unacceptable internal consistency reliability as it is too short in length (5 items). A confirmatory factor analysis failed to demonstrate that the 3 subscales of the THI-I correspond to 3 different factors. Close correlations were found between the total score of the Italian translation of the Tinnitus Handicap Inventory and all the subscales of the MOS 36-Item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale scores indicating a good construct validity. Moreover, these statistically significant correlations (p < 0.005) confirmed that the self-report tinnitus handicap is largely related to psychological distress and a deterioration in the quality of life. On the other hand, it was confirmed that the tinnitus perceived handicap is totally independent (p > 0.05) from its audiometrically-derived measures of loudness and pitch thus supporting previous studies that focused on the importance of non-auditory factors, namely somatic attention, psychological distress and coping strategies, in the generation of tinnitus annoyance. Finally the results of the present study suggest that the THI-I maintains its original validity and should be incorporated, together with other adequate psychometric questionnaires, in the audiological examination of patients suffering from tinnitus and that psychiatric counselling should be recommended for the suspected co-morbidity between tinnitus annoyance and psychological distress.
2008
- What is the biopsychosocial role of human immunodeficiency virus positivity in patients with end-stage liver disease who undergo orthotopic liver transplantation?
[Articolo su rivista]
Barbanti Silva, Veronica; Ferrara, Maria; Mazzi, Fausto; Pingani, Luca; Cocchi, Stefania; Romano, Antonio; Masetti, Michele; Gerunda, Giorgio Enrico; Guaraldi, Giovanni; Rigatelli, Marco
abstract
INTRODUCTION: Since 2003 the National Research Program for Solid Organ Transplantation in patients with human immunodeficiency virus (HIV) is active at our liver transplantation center. Patients with HIV who enter this protocol are assessed by the Consultation Liaison Psychiatry Service. The aim of the present study was to evaluate their psychiatric comorbidity.
METHODS: An observational prospective study was conducted comparing end-stage liver disease (ESLD) patients with and without HIV. After the assessment, the psychiatrist compiled the Transplant Evaluation Rating Scale (TERS) and the Montgomery Asberg Depression Rating Scale (MADRS). Baseline evaluation was made before inclusion on the OLT waiting list and the follow-up evaluation was made 12 months later.
RESULTS: From January 2003 to December 2006 we assessed 553 patients: 39 (6%) with HIV and 361 (94%) without HIV. The 2 groups were homogeneous for gender (75% of male patients; P=not significant [NS]) but not for age (46+/-5 vs 56+/-9; P=NS). Psychiatric history was negative in 176 (49%) patients without HIV and in 6 (15%) patients with HIV (P< .001). At baseline psychiatric comorbidity was present in 33 HIV patients (85%) and in 148 non-HIV patients (41%; P< .001). At follow-up MADRS highlighted an improvement in all of the items for HIV patients. In the non-HIV group, the variation was as follows: baseline, 7.10; follow-up, 8.15. In the HIV group, the variation was as follows: baseline, 10.20; follow-up, 4.09 (P< .001). The average score at TERS was higher among patients with HIV (43+/-9 vs 35+/-9; P=NS).
CONCLUSIONS: At baseline HIV patients with ESLD showed a higher rate of psychopathology, but they improved at follow-up; the contrary happened in the non-HIV group.
2008
- What is the role of HIV positivity in patients with ESLD who undergo Oltxiter?
[Abstract in Rivista]
Barbanti, Sv; Ferrara, M; Mazzi, F; Pingani, L; Cocchi, S; Guaraldi, Giovanni; Gerunda, Giorgio Enrico; Rigatelli, Marco
abstract
Not available
2008
- What is the role of HIV positivity in patients with ESLD who undergo to OLTx Iter?
[Abstract in Rivista]
V., Barbanti Silva; M., Ferrara; L., Pingani; F., Mazzi; S., Cocchi; Guaraldi, Giovanni; A., Romano; M., Masetti; Gerunda, Giorgio Enrico; Rigatelli, Marco
abstract
Not available
2007
- A preliminary study of a measure of role-play competence in psychodynamic interpersonal therapy.
[Articolo su rivista]
Palmieri, Gaspare; F., Margison; E., Guthrie; J., Moorey; G., Hardy; C., Evans; M., Barkham; Rigatelli, Marco
abstract
We report a 15-item role-play competence measure. Ratings by three judges of 34 role plays from psychodynamic interpersonal therapy training showed good inter-rater (.73-.79) and internal reliability (.84-.96). Validity was supported as scores were statistically significantly associated with psychotherapy experience. Most participants achieved satisfactory ratings supporting the training.
2007
- Accuracy of structured vs. unstructured psychiatric diagnosis in a consultation-liaison psychiatric service.
[Abstract in Rivista]
Mazzi, F; Panicali, F; Po, S; Amoretti, A; Rigatelli, Marco
abstract
Not available
2007
- Aripiprazole: effectiveness and safety under naturalistic conditions.
[Articolo su rivista]
Genedani, Susanna; Rigatelli, Marco; Rosaria Di, Lorenzo; Amoretti, Alessandra; Forghieri, Matilde; Fiorini, Fiorenza
abstract
A retrospective study was conducted to examine aripiprazole's effectiveness and safety in a naturalistic treatment setting in both inpatients and outpatients affected by schizophrenia and other psychotic disorders. All patients with schizophrenia, schizoaffective and delusional disorders, and schizoid and schizotypal personality disorders treated with aripiprazole from March 1, 2005, to March 1, 2006, in the authors' community mental health service were divided into outpatient (n=26) and inpatient (n=17) groups; the average treatment periods were 204 days and 25 days, respectively. Effectiveness was evaluated by improvement of symptoms (a 25% reduction of Brief Psychiatric Rating Scale [BPRS] score from baseline) and functioning level (a 50% increase of Global Assessment of Functioning [GAF] scale score from baseline), as well as dropout rate. Adverse effects and their impact on treatment course were also evaluated. The final scores of the 2 scales showed a statistically significant difference from baseline (BPRS: p<.001 in the 2 groups; GAF: p<.005 in inpatients, p<.001 in outpatients). The average improvements in BPRS and GAF were 54% and 35%, respectively, in outpatients and 71% and 71% in inpatients. Side effects included anxiety, psychomotor agitation, insomnia, and psychotic symptom worsening. The dropout rate was 24% in inpatients and 23% in outpatients, largely because of the aforementioned side effects. The data, though limited by the small sample and naturalistic methodology, suggest that aripiprazole may be effective for both long- and short-term treatment, with a greater improvement among inpatients and a similar dropout rate between groups.
2007
- Delirium and other emergencies
[Capitolo/Saggio]
Gill, P; Rigatelli, Marco; Ferrari, Silvia
abstract
Not available
2007
- Disturbi psichiatrici in corso di patologie mediche
[Capitolo/Saggio]
Rigatelli, Marco; Ferrari, Silvia; S., Po
abstract
Malattie mediche e psichiatriche non solo in alcuni pazienti coesistono, ma molto spesso contribuiscono a determinarsi o ad aggravarsi vicendevolmente o si manifestano le une con i sintomi delle altre.Le patologie psichiatriche associate a disturbi medici spesso non vengono riconosciute o vengono interpretate come una reazione normale dell’individuo: tendenza che si associa ad effetti negativi sia nei confronti delle condizioni dei pazienti che in termini di costi sanitari.
2007
- European guidelines for training in consultation–liaison psychiatry and psychosomatics: Report of the EACLPP Workgroup on Training in Consultation–Liaison Psychiatry and Psychosomatics
[Articolo su rivista]
Wolfgang, Söllner; Francis, Creedb; Rigatelli, Marco; European Association of Consultation–Liaison, Psychiatry; Psychosomatics Workgroup on Training in, Consultation–liaison
abstract
ObjectiveThe European Association of Consultation–Liaison Psychiatry and Psychosomatics (EACLPP) has organized a workgroup to establish consensus on the contents and organization of training in consultation–liaison (C–L) for psychiatric and psychosomatic residents.MethodsInitially, a survey among experts has been conducted to assess the status quo of training in C–L in different European countries. In several consensus meetings, the workgroup discussed aims, core contents, and organizational issues of standards of training in C–L. Twenty C–L specialists in 14 European countries participated in a Delphi procedure answering a detailed consensus checklist, which included different topics under discussion.ResultsConsensus on the following issues has been obtained: (1) all residents in psychiatry or psychosomatics should be exposed to C–L work as part of their clinical experience; (2) a minimum of 6 months of full-time (or equivalent part-time) rotation to a C–L department should take place on the second part of residency; (3) advanced training should last for at least 12 months; (4) supervision of trainees should be clearly defined and organized; and (5) trainees should acquire knowledge and skills on the following: (a) assessment and management of psychiatric and psychosomatic disorders or situations (e.g., suicide/self-harm, somatization, chronic pain and psychiatric disorders, and abnormal illness behavior in somatically ill patients); (b) crisis intervention and psychotherapy methods appropriate for medically ill patients; (c) psychopharmacology in physically ill patients; (d) communication with severely ill patients and dying patients, as well as with medical staff; (e) promotion of coordination of care for complex patients across several disciplines; and (f) organization of C–L service in relation to general hospital and/or primary care.In addition, the workgroup elaborated recommendations on the form of training and on assessment of competency.ConclusionThis document is a first step towards establishing recognized training in C–L psychiatry and psychosomatics across the European Union.
2007
- I disturbi somatoformi
[Capitolo/Saggio]
Rigatelli, Marco; Ferrari, Silvia; C., Giubbarelli
abstract
La categoria dei disturbi somatoformi rappresenta un tentativo, messo in atto dal DSM III e non condiviso da tutti gli autori, di fornire una sistematizzazione descrittiva ed a-teoretica del complesso fenomeno della somatizzazione.I disturbi somatoformi comprendono forme cliniche accomunate dalla presentazione di sintomi fisici in assenza di reperti organici o meccanismi fisiopatologici noti.I disturbi somatoformi sono il risultato di processi eterogenei e complessi che vedono l’azione di diversi fattori biologici, psicologici e socio-culturali.I disturbi somatoformi, frequenti nella popolazione generale, si associano ad alto utilizzo dei servizi sanitari e hanno significative ricadute sul piano socio-economico.
2007
- Integration between mental health and primary care service: Does it really improve quality of psychiatric care?
[Abstract in Rivista]
Colombini, N; Tedeschini, E; Ferrari, Silvia; Rigatelli, Marco
abstract
Not available
2007
- Is the psychosocial condition of patients who undergo OLTx ITER affected by the etiology of liver disease?
[Abstract in Rivista]
Barbanti, Sv; Ferrara, M; Pingani, L; Ferrari, Silvia; Rigatelli, Marco
abstract
Not available
2007
- Psichiatria di liaison
[Capitolo/Saggio]
Rigatelli, Marco; Ferrari, Silvia
abstract
La psichiatria di liaison è l’area di applicazione della psichiatria che si occupa dei pazienti con disagio psichico presso i contesti di cura non specialistici psichiatrici (ospedale generale, medicina generale…)La psichiatria di liaison si propone come interfaccia tra la psichiatria e le altre discipline mediche, con un intento trasversale di realizzazione clinica del paradigma bio-psico-socialeI tre target clinici della psichiatria di liaison sono la comorbidità medico-psichiatrica, la patologia psicosomatica e le attività di liaison rivolte alle altre équipes medico-chirurgicheLa psichiatria di liaison presenta aspetti comuni rispetto alla medicina psicosomatica, ma anche specificità cliniche, formative e di ricerca, da salvaguardare e potenziare
2007
- Psychiatric disorders and cardiovascular diseases: State of the art.
[Abstract in Rivista]
Po, S; Pingani, L; Ferrari, Silvia; Rigatelli, Marco
abstract
Not available
2007
- Psychological factors affecting cardiologic conditions.
[Capitolo/Saggio]
Chiara, Rafanelli; Renzo, Roncuzzi; Ottolini, Fedra; Rigatelli, Marco
abstract
There are substantial data supporting a strong relationship between cardiovascular diseases and psychological conditions. However, the criteria for scientific validation of the entities currently subsumed under the DSM-IV category of 'Psychological factors affecting a medical condition' have never been clearly enumerated and the terms 'psychological symptoms' and 'personality traits' that do not satisfy traditional psychiatric criteria are not well defined; moreover, it is difficult to measure these subtypes of distress and there is always the need for a clinical judgment. In recent years psychosomatic research has focused increasing attention on these clinical and methodological issues. Psychosocial variables that were derived from psychosomatic research were then translated into operational tools, such as Diagnostic Criteria for Psychosomatic Research; among these, demoralization, irritable mood, type A behavior are frequently detected in cardiac patients. The joint use of DSM-IV criteria and Diagnostic Criteria for Psychosomatic Research allow then to identify psychological factors that seem to affect cardiologic condition. There remains the need to further investigate if treating both clinical and subsyndromal psychological conditions can improve quality of life and reduce the risk of morbidity and mortality in these patients.
2007
- Psychosocial factors associated with preterm uterine contractions
[Articolo su rivista]
Ottolini, F; Facchinetti, Fabio; Rigatelli, Marco; Tomba, E; Belaise, C; Ruini, C; Fava, Ga
abstract
Not available
2007
- Psychosomatic characterization of adjustment disorders in the medical setting: some suggestions for DSM-V.
[Articolo su rivista]
Grassi, Luigi; Lara, Mangelli; Giovanni A., Fava; Silvana, Grandi; Ottolini, Fedra; Piero, Porcelli; Chiara, Rafanelli; Rigatelli, Marco; Nicoletta, Sonino
abstract
BACKGROUND: Adjustment disorders have been found to be the most frequent psychiatric diagnosis in the medically ill. Problems have been raised, however, as to their clinical value. The aim of the study was to characterize the psychosomatic features of adjustment disorders. METHODS: One hundred patients with medical illness and a diagnosis of adjustment disorder according to DSM-IV criteria were interviewed according to the Diagnostic Criteria for Psychosomatic Research (DCPR) system, consisting of 12 clusters. RESULTS: A considerable overlap was shown between adjustment disorders and DCPR clusters related to abnormal illness behavior (health anxiety, tanatophobia, nosophobia and illness denial) (54\%), somatization (functional somatic symptoms secondary to a psychiatric disorder, persistent somatization, conversion symptoms and anniversary reaction) (37\%) and demoralization (33\%). Only 13 of the patients with adjustment disorders did not present any DCPR syndromes. LIMITATIONS: The study is cross-sectional and does not allow to determine the prognostic features of DCPR categorization. CONCLUSION: The clinical information which derives from the concomitant application of the DCPR might improve and make more specific the treatment of patients with adjustment disorders.
2007
- Somatic symptoms of distress in the general population: A comparison of natives and immigrants with a focus on social factors.
[Abstract in Rivista]
Malmusi, D; Ferrari, Silvia; Giubbarelli, C; Tarricone, I; Rigatelli, Marco
abstract
Not available
2007
- Testing ters and madrs on 567 pre-OLTx patients
[Abstract in Rivista]
V., Barbanti Silva; M., Ferrara; Ferrari, Silvia; Rigatelli, Marco
abstract
15th AEP Congress
2007
- What do they think of us? Opinions of general hospital ward staff ona CLP service
[Abstract in Rivista]
V., Barbanti Silva; Ferrari, Silvia; Rigatelli, Marco
abstract
15th AEP Congress
2006
- Applicazione di TERS E MADRS ad oltre 400 pazienti in screening pre-OLTx.
[Articolo su rivista]
BARBANTI SILVA, Veronica; Forghieri, Matilde; Ferrari, Silvia; Mazzi, F; Rigatelli, Marco
abstract
Applicazione di TERS E MADRS ad oltre 400 pazienti in screening pre-OLTx
2006
- Chronic hepatitis C and psychosocial distress
[Abstract in Rivista]
Barbanti, Sv; Tesini, Em; Ferrari, Silvia; Pigozzi, F; Pingani, L; Vandelli, Carmen; Rigatelli, Marco
abstract
Not available
2006
- Delirium in the neoplastic patient: Data on eight years of psychiatric consultation activity
[Abstract in Rivista]
Disavoia, A; Ferrari, Silvia; Forghieri, M; Rigatelli, Marco
abstract
Delirium in the neoplastic patient: data on eight years of psychiatric consultation activity
2006
- Depressione e cardiopatia: il punto di vista del medico di medicina generale
[Articolo su rivista]
Colombini, N; Ferrari, Silvia; Gabrielli, F; Rigatelli, Marco
abstract
Not available
2006
- Early intervention in the pre-psychotic phase: a survey among expert and non-expert psychiatrists and general practitioners
[Articolo su rivista]
Galeazzi, Gian Maria; Elkins, K.; Pingani, Luca; Rigatelli, Marco
abstract
Objectives: This study aimed at exploring views and comparing level of consensus across different groups of mental health professionals regarding the appropriateness of preventive interventions targeted at subjects with risk factors for the development of psychosis. Method: A survey was completed by 135 members of the International Early Psychosis Association ( IEPA), by 110 psychiatrists working in the Italian Region Emilia Romagna, and by 114 general practitioners working in the Province of Modena. The survey used three hypothetical case scenarios where a client, having tested positive for future psychosis to an imaginary infallible screening instrument, presents with either ( a) no symptoms and no interest in intervention; (b) no symptoms but requesting intervention; ( c) with some degree of anxiety and depression and requests assistance. Results: Mixed views prevailed on appropriateness of specific interventions across all groups regarding the hypothetical case scenario presented. Judgments varied according to clients' preferences and level of distress. IEPA members showed more inclination than other professionals to consider appropriate psychological and pharmacological intervention in an asymptomatic pre-psychotic state. The propensity for suggesting drug treatment was related to the belief that untreated psychosis causes neurotoxicity. Conclusions: Experts seem to have a more liberal view on the appropriateness of preventive interventions than community mental health psychiatrists and general practitioners. Further research addressing factors that influence experts' views seems warranted.
2006
- General hospital psychiatry in Italy: an update
[Articolo su rivista]
Ferrari, Silvia; Rigatelli, Marco
abstract
The turning point in the history of consultation–liaison psychiatry (CLP) in Italy was undoubtedly the passing of the famous Reform Law 180 in 1978, with its dramatic consequences on both the clinical and health organizational levels of psychiatry. This has brought psychiatry back to medicine and to the general hospital CL Cazzullo, M Comazzi, GP Guaraldi, M Rigatelli and A Verdecchia, General hospital psychiatry in Italy: on the hospitalization of psychiatric patients and consultation–liaison psychiatry after Law 180/1978, Gen Hosp Psychiatry 6 (1984), pp. 261–265. Abstract | View Record in Scopus | Cited By in Scopus (8)[1] and [2].The development of CLP in Italy since then has been slow and variable across the country. During the 1980s, a few specific and integrated CLP services were established in university-based hospitals (e.g., Milan, Modena, and Padua), which led the way for the implementation of other centers in the country (e.g., Naples and Ferrara). These were some of the centers that were involved as research sites in ECLW studies . During the 1990s, Italian CLP then gradually started to move out of the general hospital toward community primary care, with the establishment of specific CLP services for GPs (e.g., Verona, Bologna, and Reggio Emilia) and the development of relevant research projects .As such services increased, a shift occurred from on-demand urgent psychiatric referrals to planned, excellent integrated activities. This has been a major achievement; some of these services include Ferrara for psycho-oncology, Modena and Udine for transplant units, Bari for gastroenterology, and Milan and Genova for psychogeriatrics. Integrated and formalized clinical experiences such as these have stimulated research activities in the same fields—locally, nationally, and internationally .
2006
- Health-related quality of life in recent and long standing chronic HCV infection.
[Abstract in Atti di Convegno]
Tesini, E. M. C.; BARBANTI SILVA, V.; Pigozzi, F.; Ferrari, Silvia; DEL GIOVANE, C.; Marino, M.; Rigatelli, Marco; PONZ DE LEON, Maurizio; Vandelli, Carmen
abstract
Not available
2006
- Il rilassamento psico-tonico in psicosomatica
[Capitolo/Saggio]
Casolari, L; Ferrari, Silvia; Bonatti, R; Rigatelli, Marco
abstract
Not available
2006
- Irritable mood in Italian patients with medical disease
[Articolo su rivista]
L., Mangelli; Ga, Fava; L., Grassi; Ottolini, Fedra; S., Paolini; P., Porcelli; C., Rafanelli; Rigatelli, Marco; N., Sonino
abstract
Irritability may be a mood state independent of other moods and anxiety disorders, even though it may be symptomatic of several psychiatric disorders, such as major depression. The aims of this exploratory study were to verify the presence of irritable mood in a group of medical outpatients with a variety of clinical conditions (functional gastrointestinal disorders, cardiovascular disorders, endocrine diseases and cancer) and to examine its relationship with major depression. A total of 609 consecutive outpatients recruited from different medical settings were assessed according to DSM-IV and Diagnostic Criteria for Psychosomatic Research using semi-structured research interviews. Irritable mood was identified in 163 (27%) patients, while major depression was present in 113 (19%) patients. Even though there was a considerable overlap between the two diagnoses, 76 (67%) patients with major depression were not classified as irritable, and 126 (77%) patients with irritable mood did not satisfy the criteria for major depression. The findings suggest a high prevalence of irritability in the medically ill, which in most cases is independent of mood disorder. Further research may determine whether irritability, alone or in association with major depression, entails prognostic and clinical implications.
2006
- Is frequent attendance at a GP clinic a persistent feature?
[Abstract in Rivista]
Ferrari, Silvia; Rigatelli, Marco
abstract
Frequent attenders (FAs) account for a large proportion of contacts with general practitioners (GPs); their levels of physical and psychosocial morbidity are high. A debate exists on whether frequent attendance is a persistent feature or a temporary trait in the consultation pattern of patients. The aim of the study was to follow up the consultation pattern of a group of FAs and to compare features of persistent and occasional FAs.
2006
- La valutazione routinaria degli esiti della psicoterapia: traduzione e validazione preliminare del sistema CORE
[Articolo su rivista]
Palmieri, G; Evans, C; Freni, S; Baroni, A; Chicherio, M; Ferrari, Silvia; Palmieri, L; Rigatelli, Marco; Reitano, F.
abstract
In questo articolo viene presentato il sistema CORE (Clinical Outcomes for Routine Evaluation), costituito da una serie di strumenti per la valutazione degli esiti in psicoterapia e in particolare il CORE-OM (Outcome Measure) un questionario composto da 34 item che indaga diverse aree (benessere soggettivo, problemi e sintomi, funzionalità, rischio), largamente utilizzato nel Regno Unito per valutare l’esito delle psicoterapie nel Servizio Pubblico. Presentiamo qui la traduzione italiana del CORE-OM. È in corso un progetto nazionale multicentrico di validazione dello strumento su un vasto campione clinico in collaborazione con la SIPSOT (Società Italiana di Psicologia Ospedaliera e Territoriale), i cui risultati saranno resi noti il prossimo anno.
2006
- Life events and benign paroxysmal positional vertigo: A case-controlled study
[Articolo su rivista]
Monzani, Daniele; Genovese, Elisabetta; Virginia, Rovatti; Maria Ludovica, Malagoli; Rigatelli, Marco; Giorgio, Guidetti
abstract
CONCLUSIONS: Within the poorly understood mechanisms implicated in the aetiology of benign paroxysmal positional vertigo (BPPV), the results of this trial provide clinical evidence of a potential role of emotional stress connected to adverse life events as a trigger of otoconial dysfunction. High levels of anxiety, depression and somatization were recorded and considered psychogenic precursors of BPPV, thus emphasizing the role of psychological distress in precipitating peripheral vestibular disorders. Therefore, appraisal of life stress and psychological attitudes may have potential implications in the clinical assessment of this labyrinthine vertigo and its frequent relapses. OBJECTIVES: BPPV is one of the most common peripheral vestibular disorders, and although it has been the subject of several studies and debates, its aetiology still remains unknown in most cases. Because it has been shown that emotional stress is related to the onset or worsening of other inner ear dysfunctions such as Ménière's disease and sudden hearing loss, this study investigated the hypothesis that life events, mood and psychological attitudes may have a causal relationship with BPPV. PATIENTS AND METHODS: Fifty patients (40 females and 10 men; mean age 43.5+/-10.1 years, range 30-65 years) were recruited and compared with 50 healthy volunteers matched for sex, age and socio-demographic variables. Patients were selected among dizzy patients who were referred to the ENT Clinic of the University of Modena and Reggio Emilia from the emergency unit with a primary diagnosis of 'positional vertigo' and enrolled in the study only if they had a paroxysmal positional nystagmus as diagnosed by Dix-Hallpike and Semont's manoeuvres. Patients with a history of recurrent vertigo and additional otoneurological diseases were excluded. The Paykel Life Events Scale, Spielberger State-Trait Anxiety Inventory, Symptom Check List-90 Revisited and Hamilton Depression Scale were the psychometric questionnaires used to complete the audiological and vestibular examinations. RESULTS: Patients with BPPV reported significantly more life events than control subjects in the year preceding the onset of vertigo (p<0.005). Negative life events, objective negative impact and a poor degree of control were also significantly more frequent in patients compared with controls (p<0.005). There were no significant differences between groups concerning positive life events (p>0.05). Psychometric questionnaires recorded significantly higher levels of anxiety, depression and somatization in the pathological sample (p<0.005), as well as an increased obsessive-compulsive attitude (p<0.05).
2006
- Psychiatric consultation activities at the emergency department
[Abstract in Rivista]
Po, S; Giubbarelli, C; Disavoia, A; Ferrari, Silvia; Rigatelli, Marco
abstract
2006 EACLPP Meeting
2006
- TC6E SHOULD WE SUGGEST INTERVENTIONS WHEN RISK OF PSYCHOSIS IS VERY HIGH BUT SYMPTOMS AND DISTRESS LOW OR ABSENT?
[Abstract in Rivista]
Galeazzi, Gian Maria; K., Elkins; L., Pingani; Rigatelli, Marco
abstract
Not available
2006
- Tentativo di suicidio e rischio suicidiario. Analisi del fenomeno presso il Policlinico di Modena nel quadriennio 2000-2003
[Articolo su rivista]
Palmieri, Gaspare; Po, S; Ferrari, Silvia; Rigatelli, Marco
abstract
suicidio dal punto di vista del servizio di psichiatria di consultazione di modena
2006
- Testing TERS and MADRS on 400 pre-OLTx patients
[Abstract in Rivista]
BARBANTI SILVA, Veronica; Ferrari, Silvia; Forghieri, Matilde; Rigatelli, Marco
abstract
Testing TERS and MADRS on 400 pre-OLTx patients
2006
- The evaluation of competence in the assessment of the suicidal patient among different health professionals
[Abstract in Rivista]
Ferrari, Silvia; G., Palmieri; M., Forghieri; N., Colombini; Rigatelli, Marco
abstract
Not available
2006
- Views on psychosis and judgment of appropriateness of early interventions in pre-psychotic phase: A survey of members of the International Early Psychosis Association
[Articolo su rivista]
Galeazzi, Gian Maria; Elkins, K.; Pingani, Luca; Rigatelli, Marco
abstract
Background: The evidence base for preventive interventions in psychosis during the pre-psychotic
phase is still scarce. Professional views on this topic may be influenced by individual and professional
background factors.
Aims: To study factors that possibly influence judgmentsmade bymental health professionals dedicated
to early psychosis on the appropriateness of early interventions during the pre-psychotic phase.
Method: Members of the International Early Psychosis Association (IEPA) were asked general questions
about concepts of psychosis and about three case scenarios describing a client in the pre-psychotic phase.
Results: Views of 325 respondents were collected. About half the respondents thought that psychotic
experiences exist on a continuum with normal experiences. Psychologists were more likely than other
professional groups to endorse this view. A total of 52.6% of respondents (n¼171) believed that
untreated psychotic episodes cause irreversible brain changes. Psychologists were less likely to endorse
this view, which was associated with a willingness to offer pharmacologic interventions in pre-psychotic
phases. More than 80% agreed, in most severe cases, on proposing lifestyle changes and psychological
interventions.
Conclusions: When challenged with case scenarios, mental health professionals with clinical and
research experience with patients with early psychosis expressed varied opinions on the appropriateness
of pre-psychotic interventions, especially concerning pharmacologic treatment. Professional views
on this topic were related not only to the level of symptoms and degree of active request for help from
the client, but also to the professional’s role and different conceptions of psychosis endorsed. These
aspects warrant further study.
Declaration of interest: G. M. Galeazzi and K. Elkins are members of the IEPA. Funding is detailed in
Acknowledgments.
2006
- What do they think of us? Opinions of general hospital ward staff on a CLP service
[Abstract in Rivista]
Barbanti, Sv; Ferrari, Silvia; Rigatelli, Marco
abstract
Not available
2005
- Assessing demoralization and depression in the setting of medical disease.
[Articolo su rivista]
Lara, Mangelli; Giovanni A., Fava; Silvana, Grandi; Grassi, Luigi; Ottolini, Fedra; Piero, Porcelli; Chiara, Rafanelli; Rigatelli, Marco; Nicoletta, Sonino
abstract
OBJECTIVE: The aim of this study was to assess the presence of demoralization and major depression in the setting of medical disease. METHOD: 807 consecutive outpatients recruited from different medical settings (gastroenterology, cardiology, endocrinology, and oncology) were assessed according to DSM-IV criteria and Diagnostic Criteria for Psychosomatic Research, using semistructured research interviews. RESULTS: Demoralization was identified in 245 patients (30.4\%), while major depression was present in 135 patients (16.7\%). Even though there was a considerable overlap between the 2 diagnoses, 59 patients (43.7\%) with major depression were not classified as demoralized, and 169 patients (69.0\%) with demoralization did not satisfy the criteria for major depression. CONCLUSIONS: The findings suggest a high prevalence of demoralization in the medically ill and the feasibility of a differentiation between demoralization and depression. Further research may determine whether demoralization, alone or in association with major depression, entails prognostic and clinical implications.
2005
- Delirium in the cancer patient: eight years of psychiatric consultations
[Abstract in Rivista]
Ferrari, Silvia; Disavoia, A.; Rigatelli, Marco
abstract
EACLPP Meeting
2005
- Elderly inpatients from the perspective of modena consultation-liaison psychiatry service
[Abstract in Rivista]
Ferrari, Silvia; Gazzani, C; Vivoli, R; Rigatelli, Marco
abstract
Not available
2005
- Il Servizio di Consulenza psichiatrica-psicosomatica di Modena
[Articolo su rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
Non disponibile
2005
- Il problema diagnostico dei disturbi somatoformi
[Relazione in Atti di Convegno]
Rigatelli, Marco; Ferrari, Silvia; Galeazzi, Gian Maria
abstract
la diagnosi di somatizzazione è complessa e resa ancor più tale dall'attuale nosografia psichiatrica
2005
- Il trattamento della comorbilità psichiatrica nella patologia neurologica cronica.
[Relazione in Atti di Convegno]
Ferrari, Silvia; G., Janiri; Rigatelli, Marco
abstract
il ruolo dello psichiatra di consultazione nelle principali patologie neurologiche
2005
- Is old age a risk factor for psychiatric referral in the general hospital
[Abstract in Rivista]
Gazzani, C; Ferrari, Silvia; Rigatelli, Marco
abstract
Not available
2005
- La nuova medicina psicosomatica
[Articolo su rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
Not available
2005
- Prodromal symptoms in myocardial infarction
[Articolo su rivista]
Ottolini, Fedra; Modena, Maria Grazia; Rigatelli, Marco
abstract
BACKGROUND: Little is known about the prodromal phase of myocardial infarction (MI). The aim of this study was to explore this phase with methodologies which have been standardized in affective disorders. The psychological evaluation of patients with MI diagnosis is currently based on DSM-IV criteria. An alternative diagnostic and conceptual framework has been proposed by an international group of psychosomatic investigators. In this study, we are going to compare these new criteria, i.e. the Diagnostic Criteria for Psychosomatic Research (DCPR), with DSM-IV in a population where a high prevalence of psychological problems is expected. METHODS: A semistructured research interview based on Paykel's Clinical Interview for Depression for eliciting prodromal symptoms was administered to a consecutive series of 92 patients with a first episode MI diagnosis. Two interviews for the evaluation of psychological problems were administered according to DSM-IV and DCPR criteria. RESULTS: Most of the patients reported prodromal symptoms. Irritability, depressed mood and somatic anxiety were the most common prodromal symptoms. The results also show that the number of DCPR diagnoses was higher than the number of DSM-IV diagnoses. At least one DCPR diagnosis was found in all patients, whereas at least one DSM-IV diagnosis was present in 42 (46\%) patients. CONCLUSIONS: The prodromal phase of MI was found to be characterized by prodromal symptoms of affective type. The joint use of DSM-IV and DCPR criteria was found to improve the identification of psychological factors which could affect this phase. The results should alert the physician to the fact that patients presenting with irritability, depressed mood (including demoralization), anxiety and insomnia may be at risk of developing coronary artery disease.
2005
- Psychiatric disorders and depression in multiple sclerosis outpatients: Impact of disability and interferon beta therapy
[Articolo su rivista]
Galeazzi, Gian Maria; Ferrari, Silvia; Giaroli, Giovanni; Mackinnon, Andrew; Merelli, Elisa; Motti, L; Rigatelli, Marco
abstract
Associations between psychopathology and gender, duration of MS, disability and therapy with beta-interferons were studied in multiple sclerosis (MS) outpatients. A controlled descriptive epidemiological study was carried out in two Italian outpatient MS centres on 50 outpatients with clinically definite relapsing-remitting MS presenting for regular follow-up and 50 healthy controls matched for sex, age and educational level. Subjects were assessed with the Structured Clinical Interview for DSM-IV (SCID I), the Beck Depression Inventory (BDI) and the State Trait Anxiety Inventory (STAI). MS patients reported a higher prevalence of psychiatric disorders (odds ratio 3.17), with 46\% (n=23) suffering from major depressive disorder. The risk of suffering from any non-mood psychiatric disorder was also higher in MS patients than in controls (odds ratio 2.67). Risk factors for depression were female sex and severity of disability, but not therapy with interferon beta or longer duration of illness. Disability level, but not therapy with beta-interferons, is a risk factor for depression in MS outpatients. Regular screening for depression in this population is appropriate.
2005
- Somatization in a transcultural perspective: a survey in primary care
[Abstract in Rivista]
Rigatelli, Marco; Ferrari, Silvia; Malmusi, D; Giubbarelli, C.
abstract
Not available
2005
- Studi controllati randomizzati in psicoterapia: il caso della terapia interpersonale psicodinamica
[Articolo su rivista]
Palmieri, G; Guthrie, E; Po, S; Rigatelli, Marco
abstract
Not available
2005
- Syncope, pre-syncope, pseudo-syncope: the psychiatric causes
[Abstract in Rivista]
Ferrari, Silvia; Po, S; Rigatelli, Marco
abstract
Not available
2004
- A brief diagnostic screening instrument for mental disturbances in general medical wards
[Articolo su rivista]
Per, Fink; Eva, Ørnbøl; Frits J., Huyse; Peter De, Jonge; Antonio, Lobo; Thomas, Herzog; Joris, Slaets; Volker, Arolt; Graca, Cardoso; Rigatelli, Marco; Morten Steen, Hansen
abstract
OBJECTIVE: Mental illness is prevalent among general hospital ward patients but often goes unrecognised. The aim of this study was to validate the SCL-8d as a brief questionnaire for mental disturbances for use in general hospitals. METHODS: The study included 2040 patients, 18 years or older, consecutively admitted to 11 general internal medicine wards in seven European countries. All patients were screened on admission by means of the SCL-8d questionnaire. The psychometric performance (i.e., the internal validity) of the SCL-8d scale was tested using modern item response theory (IRT) in the form of the Rasch model. RESULTS: Differences between sample characteristics were considerable. Even so, the SCL-8d scale showed a remarkable, statistically significant fit in terms of internal homogeneity (P>.01) in all individual settings, except in Spain and Germany where the item "Everything is an effort" had to be excluded to obtain a fit. When pooling data from all centres, an excellent statistical significance of fit (P>.05) was obtained by exclusion of the "Effort" item. The scale was homogeneous as to gender (P>.05), but not age as it performed better among young patients than among patients older than 60 years (P<.01). In these two patient groups both internal and external homogeneity (gender, median age) was achieved. The SCL-8d sum score showed a marked correlation with current and previous treatment for mental illness. CONCLUSION: Apart from the "Effort" item ranking differently on the latent severity dimension as to age, the SCL-8d seems very robust from a psychometric point of view. Besides being short, the SCL-8d scale contains only emotional symptoms. It would therefore seem to be an excellent diagnostic tool for use in medical settings.
2004
- Anxiety affects vestibulospinal function of labyrinthine-defective patients during horizontal optokinetic stimulation
[Articolo su rivista]
Monzani, Daniele; Marchioni, D.; Bonetti, S.; Pellacani, P.; Casolari, L.; Rigatelli, Marco; Presutti, Livio
abstract
Comorbidity of vestibular and anxiety disorders wassuggested by epidemiological studies and, recently, newinsights into potential neural circuits which subserve bothbalance control and emotions, appear to support thishypothesis. In particular, disorienting visual surroundings,such as those generated by full-field moving scenes, equallydisrupt postural control of patients with vestibular or panicdisorders. In the present study, behaviour of body sway wasassessed in response to an optokinetic stimulation by meansof static posturography in 20 patients with vestibularneuritis (10 patients with normal affect and 10 with generalizedanxiety disorders, as diagnosed according to theAmerican Psychiatric Association criteria), and 20 normalsubjects who served as controls. Optokinetic responses andvestibulo-spinal function during a full-field, bi-directionalhorizontal optokinetic stimulation, were recorded simultaneously.Labyrinthine-defective patients with low and highlevel of anxiety showed a common pattern of asymmetricoptokinetic reflexes. On the contrary, body sway was foundto be increased more by eye closure and optokinetic stimulationtowards the defective labyrinth in patients affectedby high level of anxiety as compared to those with normalaffect and controls. These data confirm the combined effectof anxiety and labyrinthine dysfunction on vestibulo-spinalfunction which is disclosed by both visual suppression anddisorienting visual contexts.
2004
- Diagnostic problems about somatoform disorders
[Abstract in Rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
Diagnostic problems about somatoform disorders
2004
- Frequent attenders of primary care: getting to know them
[Abstract in Rivista]
Ferrari, Silvia; Galeazzi, Gian Maria; Rigatelli, Marco
abstract
Frequent attenders of primary care: getting to know them
2004
- Gradimento da parte dei medici non psichiatri del servizio di consulenza psichiatrica-psicosomatica del Policlinico di Modena
[Abstract in Rivista]
Barbanti Silva, V; Ferrari, Silvia; Rigatelli, Marco
abstract
Not available
2004
- Il problema diagnostico dei disturbi somatoformi
[Abstract in Rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
Stress, persona e malattia
2004
- Il trattamento della comorbilità psichiatrica nella patologia neurologica cronica
[Abstract in Rivista]
Ferrari, Silvia; Rigatelli, Marco
abstract
Not available
2004
- Interrater reliability, prevalence, and relation to ICD-10 diagnoses of the Diagnostic Criteria for Psychosomatic Research in consultation-liaison psychiatry patients.
[Articolo su rivista]
Galeazzi, Gian Maria; Ferrari, Silvia; Andrew, Mackinnon; Rigatelli, Marco
abstract
The Diagnostic Criteria for Psychosomatic Research (DCPR) have been proposed by an international group of psychosomatic investigators as an operationalized tool for the assessment of psychological distress in medical patients. The aims of the present study were to evaluate interrater reliability, the distribution of DCPR syndromes, and their relationship with ICD-10 diagnostic categories. One hundred consecutive patients who were referred for psychiatric consultation in a university general hospital consented to assessment for DCPR syndromes as elicited in a joint interview conducted by two researchers. The results showed excellent interrater agreement, with kappa values for the 11 DCPR syndromes ranging from 0.69 to 0.97. More patients met criteria for one or more of the DCPR (87\%) than for an ICD-10 diagnosis (75\%). Four DCPR syndromes were particularly prevalent: demoralization, alexithymia, illness denial, and type A behavior. DCPR criteria appear to be a useful, reliable, and promising approach in the assessment and description of psychological distress in medical patients. They may serve as a focus of intervention studies in this population.
2004
- Managing deliberate self-harm in the general hospital
[Abstract in Rivista]
Rigatelli, Marco; Palmieri, Gaspare; Ferrari, Silvia
abstract
Managing deliberate self-harm in the general hospital
2004
- Problems of early intervention in psychosis
[Abstract in Atti di Convegno]
Galeazzi, Gian Maria; Elkins, Kathryn; Rigatelli, Marco
abstract
Important questions reamin open about indications, potentials and limitations of intervention programs for individuals considered at very high risk of later psychotic development. The authors review problems in this research area.
2004
- The Modena Consultation-Liaison Psychiatry service, Italy
[Articolo su rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
The article provides a description of the Modena Service for consultation-liaison psychiatry (C-L P), with hints on its history, activity and research interests. The Modena C-L P service was founded in 1989 and, since then, has delivered up to about 1200 first psychiatric assessments each year. The main research interests were related to medical-psychiatric comorbidity and psychosomatics, and organisational standards of care in the general hospital and in primary care.
2004
- The patient admitted to a medical ward with comorbid depression and self-harm behaviour risk
[Abstract in Rivista]
Rigatelli, Marco; Palmieri, Gaspare; Ferrari, Silvia
abstract
The patient admitted to a medical ward with comorbid depression and self-harm behaviour risk
2004
- The patient with Personality Disorder in the General Hospital: the intervention of the Psychiatric Consultation Service
[Relazione in Atti di Convegno]
Rigatelli, Marco; Barbanti Silva, V; Ferrari, Silvia
abstract
Not available
2004
- The relationship between psychosomatic medicine and consultation-liaison psychiatry: an ongoing problem
[Abstract in Rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
The relationship between psychosomatic medicine and consultation-liaison psychiatry: an ongoing problem
2003
- General hospital psychiatry: the Italian experience.
[Articolo su rivista]
Rigatelli, Marco
abstract
No abstract available
2003
- L'uso degli psicofarmaci nel paziente con patologie mediche
[Capitolo/Saggio]
Rigatelli, Marco; Barduzzi, M; Vasta, A.
abstract
Not available
2003
- La pratica della psicosomatica in ospedale
[Capitolo/Saggio]
Palmieri, G; Rigatelli, Marco
abstract
Non disponibile
2003
- Medico, psichiatra e paziente terminale: cosa cambia?
[Relazione in Atti di Convegno]
Rigatelli, Marco; Ferrari, Silvia
abstract
atteggiamento e specificità dello psichiatra di consulenza rispetto alle tematiche di fine vita
2003
- Psichiatria e medicina
[Monografia/Trattato scientifico]
Gala, C; Bressi, C; Rigatelli, Marco
abstract
Not available
2003
- Tre tipi particolari di urgenze in psichiatria di consultazione
[Relazione in Atti di Convegno]
Rigatelli, Marco; Ferrari, Silvia; Bertoncelli, B; Massari, I.
abstract
attività di PdC in ospedale generale nell'urgenza
2002
- Antidepressivi ed ansiolitici nel paziente con patologie mediche
[Articolo su rivista]
Rigatelli, Marco; Balestrieri, M; Barduzzi, M.
abstract
Not available
2002
- C-L psychiatry and psychosomatic medicine are separated disciplines?
[Articolo su rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
Several issues enhance the differences that have gradually developed between Consultation-Liaison Psychiatry (CLP) and Psychosomatic Medicine (PM). PM has a strong and solid tradition inthe research field, as is well demonstrated by numbers of highly significant works in internationalliterature; it also does well in the area of education and teaching, either under- or postgraduate. But itis in the field of clinical activities and organisation of services that a blank is left: neither the‘‘psychosomatist’’ nor the specialisation do exist in most countries. CLP instead has only recentlywalked its first steps in the field of research, with some specific projects such as those brought aboutby the European Consultation-Liaison Workgroup (ECLW), though a further statement of identity isneeded; it is also gaining growing importance with teaching and training activities, addressed notonly to students but also to a variety of professional figures, with varying strategies: the liaison is initself a very powerful and direct, everyday educational tool, even in its less structured form. It is thenin the field of clinical activities and organisation that CLP has historically developed most, and‘‘psychosomatic problems’’ represent only a small proportion of the CL psychiatrist’s competencies.Some brief considerations are collected in this paper over the complex relationship between CLP andPM, which is far from being clear and definitive.
2002
- Consultation-liaison psychiatry in obstetrics and gynecology
[Articolo su rivista]
Rigatelli, Marco; Galeazzi, Gian Maria; G., Palmieri
abstract
Data documenting the activity of Modena and Reggio Emilia University Hospital Consultation-Liaison Psychiatry Psychosomatic Service (C-LPPS) to the 59 bed gynecological-obstetric unit are compared to the corresponding European Consultation Liaison Workgroup (ECLW) study results and discussed in the light of recent epidemiological studies suggesting a low rate of detection and psychiatric referral in obstetric and gynecological patients. All psychiatric consultations of gynecological-obstetric inpatients during a 3-year (1996-1998) period were included in this study and data were derived from valid and reliable consultation forms tested for reliability. Within the 3-year period 55 patients were referred to C-LPPS by the gynecological-obstetric unit for psychiatric consultation. Referral rate was 0.5% of the admitted patients in the unit. The gynecological-obstetric group represented 2.5% (vs. 4.5% ECLW study) of all psychiatric consultations requested in the study period. The most frequent reasons for referral were: current psychiatric symptoms (47.3% Modena study vs. 39% ECLW), psychiatric history (20% vs. 7.3%), unexplained physical symptoms (12.7% vs. 16.2%) and coping-compliance problems (3.6% vs. 16.6%). The most common ICD-10 psychiatric diagnoses were: neurotic, anxiety and adjustment disorders (41.8% vs. 31.2%), mood disorders (29% vs. 18.4%), personality disorders (7.3% vs. 6.1%), schizophrenic and other psychotic disorders (5.5% vs. 7%).
2002
- Il processo di consultazione psichiatrica e la valutazione
[Capitolo/Saggio]
Rigatelli, Marco; Salemi, O; Grassi, L.
abstract
Not available
2002
- International Perspectives on Consultation-Liaison psychiatry
[Capitolo/Saggio]
Huyse, F; Herzog, T; Malt, U; Cesarco, R; Creed, F; de Jonge, P; Friedman, T; Hosaka, T; Iwasaki, Y; Lobo, A; Rigatelli, Marco; Smith, G; Sollner, W; Stein, B; Stiefel, F; Strain, J; Zimmermann, P.
abstract
Not available
2002
- LA PSICHIATRIA DI LIAISON IN GINECOLOGIA E OSTETRICIA
[Capitolo/Saggio]
Palmieri, G; Casolari, L; Rigatelli, Marco
abstract
Not available
2002
- La psichiatria di consultazione e collegamento nell’ospedale generale.
[Capitolo/Saggio]
Rigatelli, Marco; Ferrari, Silvia; Gala, C; Grassi, L.
abstract
Not available
2002
- La valutazione della qualità
[Capitolo/Saggio]
Rigatelli, Marco; Bertoncelli, B; Galeazzi, Gian Maria
abstract
Not available
2002
- Manuale di psichiatria di consultazione.
[Monografia/Trattato scientifico]
Invernizzi, G.; Rigatelli, Marco; Gala, C.; Bressi, C.
abstract
Not available
2002
- Psicopatologia di genere: differenze ed uguaglianze
[Capitolo/Saggio]
Campalastri, R.; Rigatelli, Marco
abstract
Not available
2002
- Psicosomatica e psichiatria di consultazione e collegamento
[Capitolo/Saggio]
Rigatelli, Marco; Casolari, L; Ferrari, Silvia
abstract
Non disponibile
2002
- Scheda di rilevazione dati clinici
[Capitolo/Saggio]
Gala, C; Rigatelli, Marco; Sessini, M; Tavola, T; Raimondi, A.
abstract
Not available
2002
- The use of diagnostic criteria (DCPR) for assessing psychological distress in the setting of acute myocardial infarction
[Abstract in Rivista]
Rigatelli, Marco; Ottolini, F; Modena, Maria Grazia
abstract
Not available
2001
- A follow-up study of psychiatric consultations in the general hospital: what happens to patients after discharge
[Articolo su rivista]
Rigatelli, Marco; L., Casolari; I., Massari; Ferrari, Silvia
abstract
Background An appropriate follow-up is considered essential in the consultation-liaison psychiatry setting, but it is often neglected. This study evaluated the effectiveness of the psychiatric consultation process in the general hospital, by investigating what occurred to patients 3 to 5 months after discharge.
Methods We used a three-part questionnaire: (1) the results of the consultation process; (2) a telephone interview with patients; and (3) a telephone interview with the patients’ primary care physicians, to whom the patients were referred after discharge from hospital. We contacted all consecutive, unselected patients referred to psychiatric consultation from January to July 1999. Complete data were available for 119 patients from an initial group of 318.
Results The consultation process was well accepted by patients and useful to general hospital physicians to complete the final diagnosis of the patient when discharged from hospital. In most cases (78.9%), the psychiatric letter was attached to the discharge letter. The second part of the questionnaire indicated that most patients were satisfied with the consultation process. They thought it helped focus their problems and 60% asserted that they felt better after following their psychiatrists’ instructions or therapy. The primary care physicians agreed with the diagnostic results of the psychiatric consultation, mainly followed the psychiatrists’ advice, and generally expressed positive comments about the consultation-liaison service.
Conclusions Compliance of hospital physicians, patients, and primary care physicians was good. Follow-up studies on outcome of psychiatric consultations are few and further analysis is strongly recommended.
2001
- COMPRI--an instrument to detect patients with complex care needs: results from a European study.
[Articolo su rivista]
F. J., Huyse; P. d., Jonge; J. P., Slaets; T., Herzog; A., Lobo; J. S., Lyons; B. C., Opmeer; B., Stein; V., Arolt; N., Balogh; G., Cardoso; P., Fink; Rigatelli, Marco
abstract
The authors developed a screening instrument to detect patients in need of complex care coordination at admission to a general hospital. On the basis of a series of risk factors for care complexity, the authors constructed a short, care complexity prediction instrument (COMPRI) and assessed its qualities. The COMPRI is an easily administered screening instrument that detects patients at risk for complex care needs for whom care coordination is indicated. COMPRI's predictive power exceeds all currently available case-mix instruments.
2001
- Care complexity in the general hospital: results from a European study.
[Articolo su rivista]
P. d., Jonge; F. J., Huyse; J. P., Slaets; T., Herzog; A., Lobo; J. S., Lyons; B. C., Opmeer; B., Stein; V., Arolt; N., Balogh; G., Cardoso; P., Fink; Rigatelli, Marco; R. v., Dijck; G. J., Mellenbergh
abstract
There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between complexity indicators, highlighting differences between length of stay (LOS), objective complexity (such as medications or consultations), complexity ratings by the nurse, and complexity ratings by the doctor. Their findings illustrate limitations in the use of LOS as a sole indicator for care complexity. The authors show how objective and subjective complexity indicators can be used for early and valid detection of patients needing interdisciplinary care.
2001
- Consultation-Liaison psychiatric service delivery: Results from a European study
[Articolo su rivista]
F. J., Huyse; T., Herzog; A., Lobo; U. F., Malt; B. C., Opmeer; B., Stein; P. d., Jonge; R. v., Dijck; F., Creed; M. D., Crespo; G., Cardoso; R., Guimaraes Lopes; R., Mayou; M. v., Moffaert; Rigatelli, Marco; P., Sakkas; P., Tienari
abstract
The reported findings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from 11 European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized, reliability tested method of patient data collection, and data were collected describing pertinent characteristics of the hospital, the C-L service, and the participating consultants. The consultation rate of 1% (median; 1.4% mean) underscores the discrepancy between epidemiology and the services delivered. The core function of C-L services in general hospitals is a quick, comprehensive emergency psychiatric function. Reasons to see patients were the following. deliberate self-harm (17%), substance abuse (7.2%), current psychiatric symptoms (38.6%), and unexplained physical complaints (18.6%) (all means). A significant number of patients are old and seriously ill. Mood disorders and organic mental disorders are most predominant (17.7%). Somatoform and dissociative disorders together constitute 7.5%. C-L services in European countries are mainly emergency psychiatric services and perform an important bridge function between primary, general health, and mental health care.
2001
- La Psichiatria di Consultazione nell'Ospedale Generale
[Articolo su rivista]
Rigatelli, Marco; Ferrari, Silvia; Galeazzi, Gian Maria
abstract
Not available
2001
- L’organizzazione di un servizio di psichiatria di consultazione e collegamento
[Relazione in Atti di Convegno]
Rigatelli, Marco; Ferrari, Silvia
abstract
L’organizzazione di un servizio di psichiatria di consultazione e collegamento.
2001
- Mental disturbances and perceived complexity of nursing care in medical inpatients: results from a European study.
[Articolo su rivista]
P., Jonge; M., Zomerdijk; F., Huyse; P., Fink; T., Herzog; A., Lobo; J., Slaets; V., Arolt; N., Balogh; G., Cardoso; Rigatelli, Marco
abstract
AIMS AND OBJECTIVES: The relationship between mental disturbances - anxiety and depression, somatization and alcohol abuse - on admission to internal medicine units and perceived complexity of care as indicated by the nurse at discharge was studied. The goal was to study the utility of short screeners for mental disturbances to select patients for case-management on admission. DESIGN: The study had a cohort design: patients were included on admission and followed through their hospital stay until discharge. The study was conducted within the framework of the European Biomed 1 Risk Factor study. RESEARCH METHODS AND INSTRUMENTS: In the first 3 days of admission the patients were interviewed by a trained health care professional, who scored the SCL-8D, a somatization questionnaire based on the Whiteley-7 and the CAGE. At discharge, nurses rated the complexity of the patient's care. RESULTS: Patients with high scores on anxiety and depression (SCL-8D) and on somatization received higher ratings on perceived nursing complexity than those with low scores, with and without control for age, severity of illness and chronicity. The actual nursing intensity and medical care utilization, as measured daily by means of a checklist, could not explain these relations. No differences were found between patients with high or low scores on alcohol abuse. CONCLUSIONS: The study shows a potential use of screeners for mental disturbances to detect patients for whom nurses might need additional help. However, mental disturbance is not the sole criterion: functional status and other variables that predict medical and nursing care utilization should be included in a screening strategy for case-management programmes.
2001
- Psychological distress and disability in patients with vertigo.
[Articolo su rivista]
Monzani, Daniele; L., Casolari; G., Guidetti; Rigatelli, Marco
abstract
Vertigo is an extremely debilitating experience for the patient, especially during attacks; it is neither easy to identify nor control. The importance of psychosomatic factors has already been widely studied and discussed. In particular, it has been shown that stress factors are relevant in setting off episodes of dizziness, but there is no agreement if the presence of distress might influence the vestibular disability.|This study is concerned with evaluating the quality of life (QOL) in a group of 206 patients suffering from vertigo and 86 control patients, using the UCLA-Dizziness Questionnaire (UCLA-DQ) scale. The results were correlated with those achieved using the Hospital Anxiety and Depression Scale (HADS) psychometric test.|What is clear is that, in patients suffering from vertigo as regards those who are not, there is a significant amount of anxiety and depression distress, especially in female subjects. There appears to be no relationship between psychological change and the various forms of clinical vertigo. In terms of the QOL parameter, what emerges is that, from a statistical point of view, fear of becoming dizzy is most closely correlated with the perception of disability.|There is a also a need for psycho-education here in collaboration with the E.N.T. specialist so that the patient can learn to recognise his/her medical condition and be aware of the factors that primarily contribute to the deterioration of their QOL.
2001
- Risk factors for complex care needs in general medical inpatients: results from a European study.
[Articolo su rivista]
P. d., Jonge; F. J., Huyse; T., Herzog; A., Lobo; J. P., Slaets; J. S., Lyons; B. C., Opmeer; B., Stein; V., Arolt; N., Balogh; G., Cardoso; P., Fink; Rigatelli, Marco
abstract
The authors linked admission risk factors to a series of indicators for complex care delivery to enable detection of patients in need of care coordination at the moment of admission to the general hospital. The authors found 13 risk factors to be predictive of more than one indicator of care complexity. An admission risk screening procedure to detect patients in need of care coordination should focus on these risk factors and should include predictions made by doctors and nurses at admission and information collected from the patient and the medical chart.
2000
- A new C-L P complexity: Abortion after 1st trimester of pregnancy
[Abstract in Rivista]
Rigatelli, Marco; Ferrari, Silvia; Palmieri, G.
abstract
Not available
2000
- Audiovisual sexual stimulation by virtual glasses is effective in inducing complete cavernosal smooth muscle relaxation: a pharmacocavernosometric study.
[Articolo su rivista]
E. S., Pescatori; V., Silingardi; Galeazzi, Gian Maria; Rigatelli, Marco; A., Ranzi; W., Artibani
abstract
Audiovisual sexual stimulation (AVSS) is frequently employed to promote cavernosal smooth muscle relaxation (SMR) in hemodynamic diagnostic settings for erectile dysfunction. Our aim has been to adapt conventional AVSS to the particular test conditions of pharmacocavernosometry and pharmacocavernosography (DICC), by the use of virtual glasses. Thirty-seven consecutive patients undergoing DICC were randomized in two groups: no-AVSS and AVSS through commercially available virtual glasses (VG-AVSS) with tri-dimensional capabilities and stereophonic headphones. Such device partially excludes the patient from the surrounding environment. In both groups a standard dose of vasoactive agents was intracavernosally administered, and possibly repeated (re-dosing), until complete SMR was obtained (3 doses/patient maximum). Psychometric tests (State Trait Anxiety Inventory and ad hoc visual analogue scales for embarrassment, stress and pain) were administered before and after DICC. The no-AVSS group consisted of 18 patients, the AVSS group of 19. Number of needed vasoactive agent doses: in the no-AVSS group 6 patients needed 1 dose, 3 patients 2, 9 patients 3 (mean dose number: 2.17); in the AVSS group 15 patients needed 1 dose, 1 patient 2, 3 patients 3 (mean dose number: 1.37). The difference in the number of doses used in the two groups was statistically significant (Student's t-test P = 0.007). Complete SMR, regardless of the number of used doses: in the no-AVSS group 9 patients (50%) achieved complete SMR, in the AVSS group 16 patients (84.2%). The difference in the two groups was statistically significant (chi-square P = 0.026). From evaluated psychometric measures no statistically significant difference between the two groups was detected. VG-AVSS significantly promotes complete SMR without increasing test related stress or anxiety. Its induced arousal suggests the possibility of performing dynamic evaluations of the erectile function with the oral agent sildenafil in place of intracavernosally administered vasoactive agents. VG-AVSS furthermore constitutes a promising tool for the investigation of normal physiology and pathophysiology of female sexual function.
2000
- COMPRI: An instrument to detect patients with complex care needs
[Abstract in Rivista]
Huyse, Fj; de Jonge, P; Slaets, Jpj; Herzog, T; Lobo, A; Lyons, J; Opmeer, B; Stein, B; Arolt, V; Balogh, N; Rigatelli, Marco
abstract
Not available
2000
- Care complexity in the general hospital
[Abstract in Rivista]
de Jonge, P; Huyse, Fj; Lobo, A; Herzog, T; Slaets, Jpj; Lyons, Js; Opmeer, Bc; Stein, B; Arolt, V; Balogh, N; Rigatelli, Marco
abstract
Not available
2000
- Diagnostic problems in psychosomatics
[Abstract in Rivista]
Rigatelli, Marco; Galeazzi, Gian Maria; Ottloini, F.
abstract
Not available
2000
- European Consultation-Liaison Psychiatric Services: the ECLW Collaborative Study.
[Articolo su rivista]
F. J., Huyse; T., Herzog; A., Lobo; U. F., Malt; B. C., Opmeer; B., Stein; F., Creed; M. D., Crespo; G., Gardoso; R., Guimaraes Lopes; R., Mayou; M. v., Moffaert; Rigatelli, Marco; P., Sakkas; P., Tienari
abstract
To describe the patterns of organization of consultation-liaison (C-L) services in 11 European countries in relation to hospital characteristics and national approaches to C-L psychiatry.|Cross-sectional survey.|Services can best be described in terms of their size and seniority of their staff and whether or not they are multidisciplinary. Single-discipline services are based upon the standard medical consultant model, whereas those with multidisciplinary teams work in a way that is comparable with community mental health teams. German psychosomatic C-L services belonged to either model. National differences were found.|This first international study provides empirical evidence for the wide variation in the organization of C-L services. In view of the increasing numbers of patients with psychiatric disorder who are being treated in general hospitals and the changing patterns of medical care there are important implications for clarification and improvement of the role of C-L services.
2000
- European consultation-liaison services and their user populations: the European Consultation-Liaison Workgroup Collaborative Study.
[Articolo su rivista]
Huyse, Fj; Herzog, T; Lobo, A; Malt, Uf; Ompeer, Bc; Stein, B; Creed, F; Crespo, Md; Cardoso, G; GUIMARES LOPES, R; Mayou, R; VAN MOFFAERT, M; Rigatelli, Marco; Sakkas, P; Tienari, P.
abstract
The authors identified variations in the characteristics of patients referred to 56 consultation-liaison (C-L) services in 11 European countries. The authors found differences in the types of patients referred to the services, and there were significant differences between countries. The first difference lays in whether services saw patients for deliberate self-harm and for substance abuse. German psychosomatic C-L services saw virtually no such patients, although in other C-L services these patients constituted one-quarter to one-third of the patients referred. The second difference lays in the remaining group of referred patients. This group is best characterized by two dimensions. One describes the severity of psychopathology -- ranging from organic mental conditions to somatization. The other describes the clarity of the physical diagnosis -- ranging from patients referred by surgical wards to those referred by general medicine and neurology wards.
2000
- Indagine psicopatologica e di personalità in un campione di pazienti affetti da sclerosi multipla
[Articolo su rivista]
Rigatelli, Marco; Bordonaro, P; Palmieri, G; Merelli, E.
abstract
Not available
2000
- Possibilità e responsabilità di un servizio di psichiatria e di consultazione nei confronti del burn-out degli operatori sanitari
[Capitolo/Saggio]
Rigatelli, Marco; Massari, I; Ferrari, Silvia
abstract
Not available
2000
- Psychopathological and personality aspects in multiple sclerosis outpatients
[Abstract in Rivista]
Rigatelli, Marco; Bordonaro, P; Palmieri, G; Merelli, E.
abstract
Not available
2000
- Psychosocial problems secondary to canceran Italian multicentre survey of consultation-liaison psychiatry in oncology
[Articolo su rivista]
L., Grassi; P., Gritti; Rigatelli, Marco; C., Gala
abstract
Data relative to consultation-liaison psychiatry (C-L) in oncology are lacking. In order to examine this area, a multicentre investigation was conducted in 17 general hospitals in Italy. All psychiatric consultation requests for cancer patients referred to C-L during a 1-year period were evaluated. Only 5% (n=217 referred patients: 114 men and 103 women) of all C-L activity were for cancer patients. Most were 'routine' consultations (72%) for current psychiatric symptoms (69%) or coping/compliance problems (12%). Previous psychological or psychiatric disorders were shown in 32% of cases. Approximately 40% of patients were not informed of their referral to C-L. The most frequent ICD-10 psychiatric diagnoses were adjustment disorders (27%) and major affective disorders (23%). Transfer to psychiatric units was low (1%). These findings indicate the need for improvement of referral criteria to C-L and closer attention to continuity of psychosocial care of cancer patients during hospitalisation and post-discharge.
2000
- Quality management, accreditation and certification processes in C-L Psychiatry.
[Abstract in Rivista]
Rigatelli, Marco; Bertoncelli, B.
abstract
Not available
2000
- Questioni etiche nell'intervento dello psichiatra nell'ospedale generale
[Capitolo/Saggio]
de Bertolini, C; Rigatelli, Marco
abstract
Not available
2000
- Rise factors for complex care needs in general medical inpatients
[Abstract in Rivista]
de Jonge, P; Huyse, Fj; Herzog, T; Lobo, A; Slaets, Jpj; Lyon, Js; Opmeer, Bc; Stein, B; Arolt, V; Balogh, N; Rigatelli, Marco
abstract
Not available
2000
- Teaching and training in the psychiatric-psychosomatic consultation- liaison setting
[Articolo su rivista]
Rigatelli, Marco; Ferrari, Silvia; Uguzzoni, Ugo; Natali, Alba
abstract
Background: The consultation-liaison (C-L) psychiatrist isin an opportune position to undertake the tasks of education,training and assessment of performance as regardsfuture physicians, psychiatrists, specialists in otherbranches and nurses. This paper describes the educationand training programme in the Psychiatric-PsychosomaticC-L Service of Modena University Hospital. Descriptionof the Programme: This programme consists ofthe following main activities: (1) daily group-case supervision,performed by the full-time psychiatrist togetherwith the psychiatry residents of the C-L staff; (2) abimonthly quality management meeting, which is part ofa European project of measurement and improvement ofquality of service; (3) weekly lectures on selected topics;(4) monthly tutorials in research techniques; (5) bimonthlypresentations of literature reviews; (6) weekly clinicalcase conferences, which are the nucleus of the curriculumand which focus on the following main topics: ‘the patients’, ‘the intervention’ and ‘the group’, and (7) liaisonmeetings requested by non-psychiatric departments.Conclusions: A common denominator seenthroughout the teaching and training activities of such aprogramme is the attitude of openness and effort towardintegration which should be the C-L psychiatrist’s distinguishingmark, in the context of the general hospital.
2000
- The outcome of the biomed1 European quality management project: implications for the future of European C-L psychiatry and psychosomatics.
[Abstract in Rivista]
Herzog, T.; Stein, B.; Huyse, F. J.; Malt, U. F.; Cardoso, G.; Creed, F.; Lobo, A.; Rigatelli, Marco; Sollner, W.; Stiefel, F.
abstract
23rd European congress of psychosomatic research
2000
- Training medicine and psychiatry residents in the academic C-L setting
[Abstract in Rivista]
Rigatelli, Marco; Ferrari, Silvia
abstract
Not available
1999
- A multicenter investigation of consultation-liaison psychiatry in Italy. Italian C-L Group.
[Articolo su rivista]
C., Gala; Rigatelli, Marco; C. D., Bertolini; G., Rupolo; F., Gabrielli; L., Grassi
abstract
In order to evaluate the extent and quality of consultation-liaison (C-L) activity in Italy, a multicenter investigation was conducted in 17 general hospitals. All of the hospitalized patients referred to C-L psychiatry during a 1-year period were assessed by means of a specific instrument (Patient Registration Form, PRF-SF). Of 518,212 patients, 4182 were referred to C-L services (referral rate = 0.72%). Typical consultations were for female patients (60.1%), admitted to medical wards (71.5%), aged 55-75 years. Most interventions were carried out within 2 days; a minority (22%) were urgent requests. Gastrointestinal and cardiovascular disorders, and unexplained medical symptoms were the most frequent ICD-9 somatic diagnoses at admission. One-third of the patients were not informed of having been referred to C-L and half of them had a lifetime history of psychiatric disturbances. Most frequent ICD-10 psychiatric diagnoses were neurotic, stress-related, and somatoform syndromes (33.1%), affective syndromes (19.4%), and organic mental syndromes (10.7%). Two-thirds of the patients were given only one consultation whereas the reminder received two to four follow-up visits. The rate of transfer to psychiatric wards was low (2.1%). Psychopharmacological treatment was suggested in 65% of cases, and 75.5% of the patients were referred to community psychiatric care at discharge. The implications of the findings are discussed.
1999
- Le consulenze psichiatriche ripetute al Policlinico di Modena ed al SSM di Reggio Emilia: due esperienze a confronto.
[Relazione in Atti di Convegno]
Rigatelli, Marco; Ferrari, Silvia; M., Moscara; F., Asioli
abstract
aspetti comuni e specifici di due attività di psichiatria di consultazione, intra- ed extra-ospedaliera
1999
- New strategies for the general hospital psychiatrist: the complexity of care prediction. An european study.
[Articolo su rivista]
Rigatelli, Marco; Barbieri, C.; Poletti, R.; De Jonge, P.; Huyse, F.; Herzog, T.; Lobo, A.; Slaets, J.; Stein, B.; Galeazzi, Gian Maria
abstract
NOT AVAILABLE
1999
- Psichiatria di consultazione e coolegamento
[Capitolo/Saggio]
DE BERTOLINI, C; Rigatelli, Marco; Rizzardo, R; Pavan, L.
abstract
Not available
1999
- Psichiatria di consultazione e dipartimenti di salute mentale
[Relazione in Atti di Convegno]
Rigatelli, Marco; Ferrari, Silvia
abstract
aspetti comuni ed opportunità nell'ottica del lavoro territoriale
1999
- Relazione tra depressione maggiore e cardiopatia ischemica/ipertensiva nella donna in post-menopausa
[Articolo su rivista]
Rigatelli, Marco; Cappella, F; Bertoni, D; Muia, N; Molinari, R; Pala, F; Modena, Maria Grazia
abstract
Not available
1999
- Studio Europeo sulla Consulenza Psichiatrica-Psicosomaticain Ospedale Generale: l’esperienza italiana.
[Articolo su rivista]
Rigatelli, Marco
abstract
Not available
1999
- The COMPRI: An instrument for the prediction of length of stay at admission to the general hospital
[Abstract in Rivista]
Huyse, Fj; Slaets, Jpj; Herzog, T; Lobo, A; de Jonge, P; Fink, P; Cardoso, G; Rigatelli, Marco; Balogh, N; Lyons, Js
abstract
Not available
1998
- Complessità delle cure nei reparti medici nell'ospedale generale: uno studio europeo
[Abstract in Atti di Convegno]
Galeazzi, Gian Maria; Rigatelli, Marco; Grassi, L.
abstract
Gli autori presentano un modello originale di valutazione e di intervento per lo psichiatra in un Ospedale Generale, incentrato sulla predizione della complessità assistenziale del paziente al momento del ricovero.
1998
- LA DEPRESSIONE NELLA PATOLOGIA GASTROENTEROLOGICA
[Articolo su rivista]
Rigatelli, Marco; Galeazzi, Gian Maria; Barbieri, C; Neviani, V.
abstract
Not available
1998
- La psicosomatica nell'istituzione ospedaliera.
[Relazione in Atti di Convegno]
Rigatelli, Marco; Poletti, R.; Barbieri, C.; Cappella, F; Galeazzi, Gian Maria; Ranuccini, R.
abstract
Non disponibile
1998
- Lo psichiatra e i pazienti "non suoi": proposta di un referto per la consulenza psichiatrica-psicosomatica in Ospedale Generale.
[Relazione in Atti di Convegno]
Casolari, L.; Barbieri, C.; Galeazzi, Gian Maria; Poletti, R.; Rigatelli, Marco
abstract
Non disponibile
1998
- Scegliere lo Psichiatra per quel paziente (l'invio da un Servizio di Consulenza Psichiatrica Psicosomatica).
[Relazione in Atti di Convegno]
Barbieri, C.; Galeazzi, Gian Maria; Rigatelli, Marco
abstract
Non disponibile
1998
- Studio europeo sulla qualità in psichiatria di consultazione: l’”esperienza modenese”.
[Articolo su rivista]
Rigatelli, Marco; Galeazzi, Gian Maria; Barbieri, C.; Bertoncelli, B.; Casolari, L.; Cavicchioli, C.; Poletti, R.; Pastorelli, A.; Baraghini, G. F.; Herzog, T.; STEIN B., Eclw
abstract
Non disponibile
1997
- Complessità dell'assistenza come organizzatore dell'attività di consulenza psichiatrica-psicosomatica: dalla ricerca alla clinica.
[Relazione in Atti di Convegno]
Galeazzi, Gian Maria; Barbieri, C.; Cavicchioli, Chiara; Poletti, R.; Rigatelli, Marco
abstract
Non disponibile
1997
- Garantia de Qualidade em Psiquiatria de Ligacao.
[Articolo su rivista]
Cardoso, G; Correia, Tm; Luis, A; Herzog, T; Stein, B; Huyse, Fj; Malt, Uf; Creed, F; Lobo, A; Rigatelli, Marco
abstract
As far as we know, there is no experience of quality management in mental health care in Portugal. This study fills a gap in the area of consultation-liaison psychiatry. Due to its multidisciplinarity and to the complexity of the problems it deals with, consultation-liaison psychiatry seems a privileged field for the development of this kind of programme. The authors describe the different steps necessary for the implementation of a quality management study in one of the national centres and report some preliminary results that show the success it has attained.
1997
- La consulenza psichiatrica nel reparto di malattie infettive
[Capitolo/Saggio]
Rigatelli, Marco; Galeazzi, Gian Maria; Cavicchioli, Chiara; Natali, Alfredo; Pietri, Giulia; Poletti, R.
abstract
non disponibile
1997
- La gestione riabilitativa di alcuni pazienti con comorbilità medico-psichiatrica.
[Capitolo/Saggio]
Rigatelli, Marco; Galeazzi, Gian Maria
abstract
Non disponibile
1997
- La psichiatria di Liaison italiana e i suoi collegamenti con il resto d'Europa.
[Articolo su rivista]
Rigatelli, Marco; Barbieri, C.; Cavicchioli, Chiara; Galeazzi, Gian Maria; Pietri, Giulia; Poletti, R.
abstract
Non disponibile
1997
- Premieres Experiences dun programme de gestion de qualité dans un service de consultation liaison.
[Articolo su rivista]
Stiefel, F.; Cochand, P.; Guex, P.; Herzog, T.; Huyse, F. J.; Malt, U. F.; Creed, F.; Lobo, A.; Rigatelli, Marco; Cardoso, G.
abstract
NOT AVAILABLE
1997
- Time is now: per la psichiatria di consultazione.
[Articolo su rivista]
Rigatelli, Marco; Galeazzi, Gian Maria
abstract
Non disponibile
1996
- Emotional-affective state, beta-endorphin level and immune assessment in patients undergoing diagnostic laryngoscopy.
[Articolo su rivista]
Casolari, L.; Polia, L.; Rigatelli, Marco
abstract
NOT AVAILABLE
1996
- Il ruolo dei fattori psichici nei pazienti con disturbo vertiginoso
[Capitolo/Saggio]
Rigatelli, Marco; Barbieri, C; Galeazzi, Gian Maria
abstract
La Funzione dell'equilibrio. Anatomia e fisiologia del sistema dell'equilibrio. I disturbi dell'equilibrio.La terapia dei disaturbi dell'equilibrio. Il ruolo dei fattori psichici nei pazienti con disturbo vertiginoso. Vestibologia forense.
1996
- L’approccio psichiatrico ai pazienti con disturbi somatoformi in 52 ospedali di 11 paesi europei.
[Articolo su rivista]
Rigatelli, Marco; Casolari, L.; Cavicchioli, C.; Morellini, C.; Natali, A.; Pietri, G.; Poletti, R.; Sartini, F.; Zanni, L.
abstract
Non disponibile
1996
- The ECLW Collaborative Study .2. Patient Registration Form (PRF) instrument, training and reliability
[Articolo su rivista]
Lobo, A.; Huyse, F.; Herzog, T.; Malt, U. F.; Opmeer, B.; Rigatelli, Marco
abstract
This paper describes the development and testing of the Patient Registration Form (PRF), a standardized instrument for the description of patients seen by consultation-liaison (C-L) psychiatrists and psychosomatists in general hospitals, the referral patterns, the C-L interventions and their outcomes. The PRF study is part of a large multi-centre, European investigation on the effectiveness of mental health service delivery, conducted by the European C-L Workgroup for General Hospital Psychiatry and Psychosomatics (ECLW) and performed in the framework of the of the E.C. 4th Medical and Health Research Program. The final version of the PRF consists of 68 items. It was developed by the Program Management Group (PMG) and National Coordinators (NC) after long preparatory studies to assure both face and content validity and pilot testing. Two hundred and twenty consultants, who required 40 hours of training and came from 14 different European countries and 90 different sites, participated in the final reliability study. The PRF was tested in 13 written case histories. A 'gold standard' For the correct answers in each item was decided by 'consensus ratings' of the PMG and a subsequent 80% agreement by the NCs. A high standard (average kappa (kappa) greater than or equal to 0.70; at least 2/3 of the PRF items, kappa greater than or equal to 0.70) was required for the rater to be considered as 'reliable' (RR). The consultants considered the PRF both 'feasible' and 'acceptable' and 93.2% of them fulfilled the RR criteria. The calculated rater-'gold standard' reliability was satisfactory: only four PRF items were identified with low agreement coefficients and no biases were observed cross-nationally in the ratings. Given the implications of misclassification for evaluating C-L effectiveness and services, these results are important and the achievement unprecedented.
1996
- The ECLW collaborative study I. General outline.
[Articolo su rivista]
H. u. y. s. e. F., J.; Herzog, T.; Malt, U. F.; Rigatelli, Marco
abstract
Not available
1996
- The ECLW collaborative study III: training and reliability if ICD-10 diagnoses in the general hospital setting – an investigation of 220 consultants from 14 european countries.
[Articolo su rivista]
Malt, U. F.; Huyse, F. J.; Herzog, T.; Lobo, A.; Rigatelli, Marco; Rijssenbeek, A. J. M.; The, Eclw:
abstract
NOT AVAILABLE
1996
- The liaison psychiatrist turns up neuropsychiatry in the General Hospital.
[Abstract in Atti di Convegno]
Rigatelli, Marco; Cavicchioli, C.; Galeazzi, Gian Maria; Natali, A.; Pietri, G.; Poletti, R.
abstract
Non disponibile
1995
- A screening instrument for the detection of psychosocial risk factors in patients admitted to general hospital wards. Closure report.
[Capitolo/Saggio]
Huyse, F. J.; Cardoso, G. P.; Creed, F.; Herzog, T.; Lobo, A.; Malt, U. F.; Opmeer, B. C.; Rigatelli, Marco
abstract
Not available
1995
- Expressive relaxation training and anxiety disorders: a pilot study.
[Articolo su rivista]
Andreoli, A.; Casolari, L.; Rigatelli, Marco
abstract
Not available
1995
- L'urgenza psichiatrica nei reparti non psichiatrici dell'Ospedale Generale: riflessione sui risultati di uno studio multicentrico europeo.
[Abstract in Atti di Convegno]
Rigatelli, Marco; Casolari, L; Galeazzi, Gian Maria; Natali, A; Pietri, G; Poletti, R
abstract
Discussione su uno studio multicentrico riguardante le richieste di consulenza psichiatrica urgente.
1995
- Quality Assurance (QA) in Consultation Liaison Psychiatry and psychosomatics. Development and implementation of an European QA System.
[Capitolo/Saggio]
Herzog, T.; Huyse, F. J.; Cardoso, G.; Creed, F.; Malt, U. F.; Rigatelli, Marco; Lobo, A.
abstract
Not available
1995
- Rapporti superficiali o significativi nel lavoro del consulente psichiatra in ospedale generale?.
[Articolo su rivista]
Rigatelli, Marco; Bianchini, M.; Casolari, L.; Natali, A.
abstract
Non disponibile
1993
- Analogie e differenze fra Catatonia Letale Acuta e Sindrome Maligna da Neurolettici.
[Articolo su rivista]
Moscara, M.; Rigatelli, Marco
abstract
Non disponibile
1993
- Cortisol, prolactin and their immunity correlations in major depressed patients
[Articolo su rivista]
Rigatelli, Marco; Casolari, L.; Keller, S. T.; Andreoli, A.
abstract
Investigated the contribution of age, sex, panic disorder comorbidity, and levels of cortisol and prolactin in mediating the immune alterations found in major depressive episodes (MDEs) among 30 women and 25 men (mean age 43 yrs). Almost half of the Ss also had panic disorder. 55 age- and sex-matched Ss served as controls. Levels of cortisol and prolactin were elevated in female and younger Ss with MDE and in Ss with MDE and panic disorder. Prolactin levels, but not cortisol levels, were elevated in Ss with MDE alone. A significant positive correlation was found in Ss with MDE between cortisol plasma levels and total lymphocyte mitogen response, absolute T suppressors, and cells activated by dihydrotestosterone receptors. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
1993
- I complessi problemi clinici posti dal paziente con Sindrome di Munchausen.
[Articolo su rivista]
Morritti, A. R.; Bianchini, M.; Rigatelli, Marco
abstract
Non disponibile
1993
- La consulenza psichiatrica-psicosomatica nei 4 Ospedali dell’USL 16 di Modena: due anni a confronto.
[Articolo su rivista]
Rigatelli, Marco; Pietri, G.; Bianchini, M.; Natali, A.; Sartini, F.
abstract
Non disponibile
1993
- Psicoterapie integrate: una scelta possibile, talvolta necessaria.
[Articolo su rivista]
Italiano, R.; Cardinali, F.; Rigatelli, Marco
abstract
Non disponibile
1992
- The Psychiatric-psychosomatic consultations in Modena University Hospital Department of Dermatology. The Present state and the perspectives.
[Articolo su rivista]
Rigatelli, Marco; Bianchini, M.; Pietri, G.
abstract
Collected 3 yrs of data from 49 consultations in the dermatology department of a psychiatric-psychosomatic service. Dermatologists completed a referral checklist that included psychiatric and somatic diagnosis, interventions, and psychosocial and behavioral treatment. Most cases involved psychiatric or psychosomatic diagnoses: A psychosomatic genesis was noted for psoriasis and alopecia areata, and pruritus and chronic urticaria were considered of mixed origin, involving anxiety, repressed anger, or stress. Reasons for referral included psychopathological, psychosomatic, somatopsychic, and relational causes. Psychopathological reasons were most prevalent and involved anxiety and depression. Ongoing collaboration between psychiatrists and dermatologists is recommended with emphasis on precipitating effects of stressful life events and on the psychological repercussions of dermatoses. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
1991
- Consultation-Liaison Psychiatry in Western Europe
[Articolo su rivista]
Mayou, R.; Huyse, F. J.; Rigatelli, Marco; THE EUROPEAN CONSULTATION LIAISON, Workgroup
abstract
Not available
1991
- Consultation-Liaison Psychiatry. Does it help to get organized?
[Articolo su rivista]
Huyse, F. J.; Rigatelli, Marco; THE EUROPEAN CONSULTATION LIAISON, Workgroup
abstract
Not available
1991
- Study of the work of a community medical emergency service with psychosomatic and psychiatric patients.
[Articolo su rivista]
Rigatelli, Marco; M., Marcon; A. R., Morritti
abstract
The study aims to: (a) assess the incidence of functional/psychosomatic (FP) and psychiatric (P) calls to the Community Emergency Medical Service (during the night, week-ends, public holidays, when the primary care physicians are not on duty) and to determine the type of response provided; (b) highlight the diagnostic, relational, therapy and assistance problems involved in an approach to these patients at an emergency call level by a young, nonspecialist physician. The study data show that the quantitative importance of FP and P patients, as noted in the literature, is equally valid for emergency. But the study also highlights the numerous difficulties these patients cause to nonspecialist physicians. Liaison psychiatrist activity should find excellent growth potential in this new direction.
1989
- A clinical consultation-liaison experience in a rehabilitation service.
[Articolo su rivista]
Rigatelli, Marco; M., Marcon; A., Morritti
abstract
Consultation-liaison psychiatry, which seeks to make a clinical and cultural contribution to medical problems, is the subject of considerable debate at a theoretical level. Moreover, at least in Italy, it is far removed from total actualization in practical terms. On the basis of a clinical experience, the authors underscore how a fully articulated and complete consultation and liaison program can facilitate a third form of collaboration provided by the psychiatrist, i.e. on-going training. The authors define this as the process of focusing in on the casework and psychotherapeutic competencies of the medical staff.
1989
- Didattica, ricerca e clinica psicosomatica oggi.
[Articolo su rivista]
Rigatelli, Marco
abstract
Non disponibile
1989
- Orientamenti attuali in psicosomatica.
[Abstract in Rivista]
LO RUSSO, L.; Rigatelli, Marco
abstract
Non disponibile
1988
- [Psychosomatic follow-up of 70 women giving birth for the first time].
[Articolo su rivista]
Rigatelli, Marco; M., Gozzi; M., Bergamaschi; P., Dondi; A., Segre
abstract
Non presente
1987
- Proposta di una scheda per la consulenza psichiatrica/psicosomatica nell’Ospedale Generale.
[Articolo su rivista]
Rigatelli, Marco; Mari, M.; Corradi, L.
abstract
Non disponibile
1985
- THE COLOSTOMIZED PATIENT - A PSYCHOLOGICAL AND PSYCHOPATHOLOGICAL INVESTIGATION
[Articolo su rivista]
Rigatelli, Marco; Gualdi, G.
abstract
Not available
1984
- Aesthetico-functional rhinoseptoplasty. Clinicostatistic, psychologic and socio-economic considerations
[Articolo su rivista]
Mattioli, Rubens Giorgio; Dallari, S; Rigatelli, Marco; Curci, Paolo
abstract
Not available
1984
- General hospital psychiatry in Italy: on the hospitalization of psychiatric patients and consultation-liaison psychiatry after Law 180, 1978.
[Articolo su rivista]
C. L., Cazzullo; A. M., Comazzi; Guaraldi, Gian Paolo; Rigatelli, Marco; A., Verdecchia
abstract
The type of psychiatric assistance carried out in Italy before Basaglia's views gained ground--that is, before 1968, when his book L'Istituzione Negata was published--is first described. The "Democratic Psychiatry" movement he launched was the mainspring of Law 180 (1978), known to have led to the closing of asylums. This law has brought about moves to create new mental health community services covering wide areas, the setting up of special diagnosis and care sections in general hospitals responsible for compulsory admissions--and overcrowding in private clinics and University clinics within general hospitals. The role of the psychiatric ward (opposed by the supporters of "Democratic Psychiatry") and of consultation-liaison psychiatry within the ambit of the general hospital is then discussed in the light of our experience.
1984
- Psychosomatic study of 60 patients with vertigo.
[Articolo su rivista]
Rigatelli, Marco; L., Casolari; G., Bergamini; G., Guidetti
abstract
The authors examined 60 consecutive patients hospitalized in Modena University Otorhinolaryngological Clinic for vertigo by means of an interview and of three self-rating scales (Zung's SDS, SAS and the Middlesex Hospital Questionnaire). The control group was composed of an equal number of patients hospitalized in the same ward and period for different nonsurgical otiatric diseases; the two groups were matched for age, sex, residential area, sociocultural conditions, duration of hospitalization and disease. According to the clinical diagnosis carried out when discharged from hospital, the patients where divided into five groups (M�ni�re's disease, neuronitis, vertebrobasilar insufficiency, neurosensorial deafness, nucleoreticular syndrome of Ararslan). The data regarding depression (MHQ and SDS), anxiety (MHQ and SAS), neuroticism, somatization (MHQ) and the prevailing of hysterical personality traits in women (MHQ) resulted particularly relevant from a statistical viewpoint (p less than 0.01).
1981
- A global psychosomatic study of 16 consecutive patients with ulcerative colitis.
[Articolo su rivista]
Rigatelli, Marco
abstract
The author reports the results of a global psychosomatic study conducted upon a consecutive series of 16 patients with ulcerative colitis (UC), by means of an anamnestic biographic interview plus a projective test (TAT) in association with the usual clinical research applied. The most significant data deal with: the relationship with parental figures during infancy; the 'changes' in life during the period which preceded the clinical onset of UC; the presence of a latent or manifest depressive condition; the alexithymic characteristics; the lack of 'intermediate sphere'; the correlation between the reactivation of UC and certain environmental situations; the defence mechanisms; the type of object relationship.
1981
- Consulenza psichiatrica e ricerca psicosomatica.
[Articolo su rivista]
Rigatelli, Marco
abstract
Non disponibile
1981
- I significati della consulenza psichiatrica nell’Ospedale Generale.
[Abstract in Rivista]
Curci, P.; DE BERNARDINIS, M.; Montevecchi, M. T.; Rigatelli, Marco; Tedeschi, M.; Visintin, F.
abstract
Non disponibile
1981
- Interpretazione psicosomatica ed antropologica di un caso di alopecia decalcante.
[Articolo su rivista]
Montevecchi, M. T.; Tedeschi, M.; Rigatelli, Marco
abstract
Non disponibile
1981
- La consulenza psichiatrica in Ospedale Generale .Un convegno il giorno dopo. Suppl. fasc. 1 VOL.105, 1981,p.251
[Abstract in Rivista]
Curci, P.; Rigatelli, Marco
abstract
Non disponibile
1981
- La consulenza psichiatrica nell’Ospedale Generale. Atti del Convegno di Reggio Emilia
[Abstract in Rivista]
Curci, P.; Rigatelli, Marco
abstract
Non disponibile
1980
- Some experiences of consultation-liaison psychiatry in a university hospital.
[Articolo su rivista]
Rigatelli, Marco; Curci, Paolo; M. D., Berardinis
abstract
The authors present some of their experiences concerning psychiatric consultation in a 1,800-bed university hospital. Particular evidence is given to the development which the physician-psychiatrist relationship has had in the long run. The experiences refer to the consultation work carried out in the Department of Medicine, in the Division of Cardiology and in the Hemodialysis Unit.
1979
- Teorie dell’apprendimento e terapie del comportamento nell’attività di gruppo in un reparto psichiatrico per brevidegenti.
[Articolo su rivista]
Curci, P.; Rigatelli, Marco; Stefanutti, M.
abstract
Non disponibile
1978
- Studio psicodiagnostico (SCL-90). Versione italiana di un gruppo di portatori di pace-maker cardiaco.
[Articolo su rivista]
Tedeschi, M.; Rigatelli, Marco
abstract
Non disponibile
1977
- Osservazioni sul “Pensiero operazionale” in psicosomatica.
[Articolo su rivista]
Rigatelli, Marco
abstract
Non disponibile
1975
- Psychosomatic study (global) of some cases of ulcerative rectocolitis
[Articolo su rivista]
Rigatelli, Marco
abstract
No abstract available