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Di Gennaro F, Papagni R, Segala FV, Pellegrino C, Panico GG, Frallonardo L, Diella L, Belati A, Santoro CR, Brindicci G, Balena F, Bavaro DF, Montalbò D, Guido G, Calluso L, Di Tullio M, Sgambati M, Fiordelisi D, De Gennaro N, Saracino A. Stigma and mental health among people living with HIV across the COVID-19 pandemic: a cross-sectional study. BMC Infect Dis 2024; 24:423. [PMID: 38649892 PMCID: PMC11034033 DOI: 10.1186/s12879-024-09315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact - although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) - PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy. METHODS From January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model. RESULTS 578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06-4.35]), family stigma (2.42 [1.65-3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder. CONCLUSIONS In this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.
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Affiliation(s)
- Francesco Di Gennaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Roberta Papagni
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Vladimiro Segala
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy.
| | - Carmen Pellegrino
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Gianfranco Giorgio Panico
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Luisa Frallonardo
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Lucia Diella
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Alessandra Belati
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Carmen Rita Santoro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Gaetano Brindicci
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Flavia Balena
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Davide Fiore Bavaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Domenico Montalbò
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari, Italy
| | - Giacomo Guido
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | | | | | - Margherita Sgambati
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari, Italy
| | - Deborah Fiordelisi
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Nicolò De Gennaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Annalisa Saracino
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
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Carabellese F, Carabellese F, Mandarelli G, Montalbò D, Parente L, La Tegola D, Petroni G, Bruno G, Catanesi R, Felthous AR. Between psychopathy and deviant socialization: A close look at the mafia men. Int J Law Psychiatry 2023; 89:101907. [PMID: 37441856 DOI: 10.1016/j.ijlp.2023.101907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023]
Abstract
The Italian mafia organizations represent a subculture with values, beliefs and goals that are antithetical to and undermining of the predominant society. The conduct of individual members includes such extreme violence for material gain, it may at least superficially suggest a severe personality disorder. Since the first edition of the DSM and into the 21st century, various terms have been used, sometimes interchangeably, but over time inconsistently, to designate the mentality and practices of mafia members. Only recently has the psychology of mafia members become a focus of serious scientific study. Following broader national multicenter research, the present study aimed at investigating the possible differences in psychopathy between those mafia associates who had been convicted only of mafia association (Group A, bosses), and those who were also convicted of violent crimes (Group B, soldiers). The Psychopathy Checklist-Revised (PCL-R) was administered to n = 48 male inmates convicted of mafia association (Mage 45.0 years, SD 10.9, range 20-80 years); Group A consisted of n = 26 (54%) subjects, Group B n = 22 (46%). Most of the sample (73%) did not manifest psychopathy (PCL-R ≥ 25) nor Mann-Whitney U test disclosed significant differences in the total PCL-R scores between the study groups. We found significantly higher scores of PCR-R factor 1 (interpersonal / affective) in the members of the mafia association also convicted of violent crimes (PCL-R F1, group A: 5.8 ± 3.7; group B: 7.9 ± 3.5; p < 0.05), this difference appeared explainable on the basis of a higher component of affective psychopathy. These initial results add to the limited literature on mafia and psychopathy and seem to suggest the existence of a specific component of psychopathy in the subgroup of mafiosi with overtly violent conduct.
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Affiliation(s)
- Felice Carabellese
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", p.za G. Cesare, 70124 Bari, Italy
| | - Fulvio Carabellese
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", p.za G. Cesare, 70124 Bari, Italy.
| | - Gabriele Mandarelli
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", p.za G. Cesare, 70124 Bari, Italy
| | - Domenico Montalbò
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", p.za G. Cesare, 70124 Bari, Italy
| | - Lia Parente
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", p.za G. Cesare, 70124 Bari, Italy
| | - Donatella La Tegola
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", p.za G. Cesare, 70124 Bari, Italy
| | - Giulia Petroni
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy
| | - Giulia Bruno
- St.Vincent's University Hospital, Dublin, Ireland
| | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", p.za G. Cesare, 70124 Bari, Italy
| | - Alan R Felthous
- Saint Louis University School of Medicine, Department of Psychiatry and Behavioral Neuroscience, Forensic Psychiatry Division, 1438 South Grand Blvd, Saint Louis, MO 63104, USA
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Mele F, Buongiorno L, Montalbò D, Ferorelli D, Solarino B, Zotti F, Carabellese FF, Catanesi R, Bertolino A, Dell'Erba A, Mandarelli G. Reporting Incidents in the Psychiatric Intensive Care Unit: A Retrospective Study in an Italian University Hospital. J Nerv Ment Dis 2022; 210:622-628. [PMID: 35394976 PMCID: PMC10860884 DOI: 10.1097/nmd.0000000000001504] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT To evaluate the characteristics of the reported workplace violence in a psychiatric intensive care unit (PICU) by analyzing an electronic hospital incident reporting system (IRS). One hundred thirty reports were retrieved from January 2017 to June 2020, referring to assaults committed by patients (71% males) with an average age of 29.8 years (SD, 14.9). The most frequent psychiatric diagnosis was a neurodevelopmental disorder (33%). Physical aggression (84%) was more frequent than the other types of aggression. Nurses and unlicensed assistive personnel were the most frequent victims (65%). Aggressions were more frequent on Friday (18%) and between 4 p.m. and 8 p.m. (35%). A total of 64.9% of the incidents happened in the first 5 days of hospitalization. A significant association between physical aggression and diagnosis of neurodevelopmental disorder emerged. IRS could be helpful to identify high-risk patient groups and develop clinical strategies to reduce adverse events in clinical practice.
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Affiliation(s)
- Federica Mele
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | - Luigi Buongiorno
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | | | - Davide Ferorelli
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | - Biagio Solarino
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | - Fiorenza Zotti
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | - Felice Francesco Carabellese
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Policlinico di Bari Hospital, Bari, Italy
| | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Policlinico di Bari Hospital, Bari, Italy
| | | | | | - Gabriele Mandarelli
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Policlinico di Bari Hospital, Bari, Italy
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Carabellese F, Felthous AR, Kennedy HG, Montalbò D, La Tegola D, Coluccia A, Ferretti F, Carabellese F, Catanesi R. Women and men of mafia between traditional cultural contexts and new social roles. Behav Sci Law 2021; 39:567-582. [PMID: 34414597 DOI: 10.1002/bsl.2533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/12/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
The Italian mafia organizations represent a subculture with values, beliefs, and goals that are antithetical to and undermining of the predominant society. The conduct of individual members includes such extreme violence for material gain, it may at least superficially suggest a severe personality disorder. Since the first edition of the DSM and into the 21st century, various terms have been used, sometimes interchangeably, but over time inconsistently, to designate the mentality and practices of mafia members. Only recently has the psychology of mafia members become a focus of serious scientific study. For the first time, investigators for the present study applied instruments, including the PCL-R, to examine for character psychopathology and specifically degrees of psychopathy in male and female mafia members, 20 female and 21 male members. Results showed some gender difference with the women having a higher score on Factor 1, in contrast to men who showed a lower score. Psychopathy and personality disorder were not found to be associated with membership in the mafia for either gender. Some psychopathic traits and gender differences warrant further research. Meanwhile these findings are consistent with a mentality characterized by beliefs and practices determined by a deviant culture rather than psychopathology.
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Affiliation(s)
- Felice Carabellese
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, p.za G. Cesare, Policlinico Universitario, Italy
| | - Alan R Felthous
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Harry G Kennedy
- Trinity College University, National Forensic Mental Health Service, Central Mental Hospital, Dundrum Dublin, Leinster, Ireland
| | - Domenico Montalbò
- Trinity College University, National Forensic Mental Health Service, Central Mental Hospital, Dundrum Dublin, Leinster, Ireland
| | - Donatell La Tegola
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, p.za G. Cesare, Policlinico Universitario, Italy
| | - Anna Coluccia
- School of Medicine, University of Siena, Siena, Italy
| | | | | | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, p.za G. Cesare, Policlinico Universitario, Italy
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Latorre V, Spaccavento S, Papazacharias A, Grassi F, Cantacessi M, De Dominicis F, Montalbò D, Semisa D. Risk evaluation of relapse into violent crime in offenders with mental disorders in two different rehabilitation programs: a case-control study. Clin Ter 2021; 172:438-441. [PMID: 34625776 DOI: 10.7417/ct.2021.2355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Over the last years, many research groups have been working on evaluating the most appropriate rehabilitation approaches in offenders with mental disorders, taking into account the need to prevent crime reiteration. The HKT-R (Historisch Klinisch Toekomst- Revised), recently validated in Italy, is a comprehensive tool that offers useful indications to healthcare operators on relapse hazard and major risk areas on which intensify rehabilitation treatments. The present study aims to assess the risk of violent crime recidivism in psychiatric patients during different rehabilitative pats. Materials&Methods the risk of violent crime recidivism was assessed by using the HKT-R in 34 patients with mental disorders treated in ordinary psychiatric therapeutic rehabilitative units (CRAP - Comunità Terapeutiche Riabilitative Assistenziali Psichiatriche) and in CRAP-D (Comunità Terapeutiche Riabilitative Assistenziali Psichiatriche Dedicate) specialized in crime offenders. Results and Conclusions Results have demonstrated a higher risk of violent behavior in CRAP-D, and a negative correlation between the risk of violent recidivism, global functioning of patients, and length of care program. These data suggest that residential rehabilita-tion programs, by improving personal and social functioning, could negatively impact the risk of violent crime recidivism, especially in patients with severe mental illness.
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Affiliation(s)
- V Latorre
- Departmental Unit of Penitentiary Psychiatry - Department of Mental Health ASL Bari, Italy
| | - S Spaccavento
- Direction of Department of Mental Health ASL Bari, Italy
| | | | - F Grassi
- Departmental Unit of Penitentiary Psychiatry - Department of Mental Health ASL Bari, Italy
| | - M Cantacessi
- Departmental Unit of Penitentiary Psychiatry - Department of Mental Health ASL Bari, Italy
| | - F De Dominicis
- Departmental Unit of Penitentiary Psychiatry - Department of Mental Health ASL Bari, Italy
| | - D Montalbò
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - D Semisa
- Departmental Unit of Penitentiary Psychiatry - Department of Mental Health ASL Bari, Italy.,Direction of Department of Mental Health ASL Bari, Italy
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Carabellese F, Felthous AR, Montalbò D, La Tegola D, Carabellese F, Catanesi R. The psychopathic dimension in women of mafia. Int J Law Psychiatry 2021; 74:101600. [PMID: 33486393 DOI: 10.1016/j.ijlp.2020.101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/21/2020] [Accepted: 06/11/2020] [Indexed: 06/12/2023]
Abstract
The authors focus their interest on the socially deviant mafia world, especially on the question of a psychopathic dimension of individuals in mafia. From the scientific point of view this continues to be an unknow world. In all these cases, individuals in mafia, their "feats", their profiles seem to correspond to popular conceptions of the psychopath. Even less known is the women's role in criminal organizations. Their historical role in recent decades has gradually shifted and become more important than it was in the past. The investigators' interest was focused on identifying the prevalence of the psychopathic dimension in mafia women. So the authors examined a sample of 20 convicted mafia women coming from Campania and Calabria, the regions of Camorra and 'Ndrangheta respectively, historical Italian criminal organizations. These women inherited their roles from previous bosses and successfully carried on the criminal business. The authors compared this sample of mafia women with a sample of female offenders with full criminal responsibility who were in common female prisons. Like men of mafia, the women of mafia have a low prevalence of the psychopathic dimension. Further research is necessary to identify the psychopathic dimension in larger samples of women, and then compare them with similar male samples.
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Affiliation(s)
- Felice Carabellese
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, p.za G. Cesare, 70124 Bari, Italy.
| | - Alan R Felthous
- Forensic Psychiatry Division, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Blvd., Saint Louis, MO 63104, USA.
| | - Domenico Montalbò
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, p.za G. Cesare, 70124 Bari, Italy.
| | - Donatella La Tegola
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, p.za G. Cesare, 70124 Bari, Italy.
| | - Fulvio Carabellese
- Department of Medical Sciences and Neurosciences, University of Siena, Italy.
| | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, p.za G. Cesare, 70124 Bari, Italy.
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Carabellese F, Felthous AR, Mandarelli G, Montalbò D, La Tegola D, Parmigiani G, Rossetto I, Franconi F, Ferretti F, Carabellese F, Catanesi R. Women and Men who Committed Murder: Male/Female Psychopathic Homicides. J Forensic Sci 2020; 65:1619-1626. [PMID: 32453452 DOI: 10.1111/1556-4029.14450] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/09/2020] [Accepted: 04/15/2020] [Indexed: 01/08/2023]
Abstract
The present study was designed to compare gender differences in psychiatric diagnosis with the dimension of psychopathy in women and men who had attempted or committed homicide. The study samples consisted of 39 homicidal females and 48 homicidal males who were confined in one of Italy's REMS or prison facilities in two southern provinces of Italy (Puglia and Basilicata). Assessment instruments included the SCID-5, the PID-5 IRF, and the PCL-R. Each gender group was stratified according to the level of criminal responsibility for the homicidal offense (full, partial, absent), and after assessments, according to the degree of the psychopathic dimension. There were clear gender differences in homicidal individuals. Female offenders were less likely to have had a record of criminal charges/convictions or imprisonment, and their homicides were more often intrafamilial, victimizing especially of their children, whereas males targeted intimate partners and extrafamilial victims. In the entire group, there was an inverse relationship between the level of psychopathy and the personality disorder on one side, and the psychotic disturbance on the other. Factor 2 (lifestyle/antisocial dimension) of the PCL-R was higher among the homicidal males, whereas females tended to score higher on Factor 1 (the interpersonal/affective dimension). Finally, if the psychopathic dimension is a qualifier for antisocial personality disorder, as indicated in DSM-5, this appears to be less true for females who tend to have other personality disorders.
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Affiliation(s)
- Felice Carabellese
- Section of Criminology and Forensic Psychiatry, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Alan R Felthous
- Forensic Psychiatry Division, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, Saint Louis, MO
| | - Gabriele Mandarelli
- Section of Criminology and Forensic Psychiatry, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Domenico Montalbò
- Section of Criminology and Forensic Psychiatry, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Donatella La Tegola
- Section of Criminology and Forensic Psychiatry, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | | | | | | | - Fabio Ferretti
- Department of Medical Science, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Fulvio Carabellese
- Department of Medical Science, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
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Carabellese F, Felthous AR, Mandarelli G, Montalbò D, Tegola DL, Rossetto I, Franconi F, Catanesi R. Psychopathy in Italian female murderers. Behav Sci Law 2019; 37:602-613. [PMID: 31762094 DOI: 10.1002/bsl.2430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/30/2019] [Accepted: 08/14/2019] [Indexed: 06/10/2023]
Abstract
Over the years, the number of homicides in Italy has progressively decreased, ultimately becoming one of the lowest rates in Europe (357 = 0.7 per 100,000 inhabitants in 2017, according to ISTAT). The number of homicides committed by women was about 9% of the total number of homicides during our study period. The percentage has increased in recent years because the total number of homicides has decreased without a proportionate decrease in the number of female homicides. Indeed, murder is an unusual type of crime for a woman and is often associated with a mental disorder, so when a woman committed a homicide, a psychiatric assessment was often performed. A forensic psychiatry expert was assigned to investigate the offender's psychopathology and mental state at the time of the offense. The root causes of the crime remained unexplained, however, due to the lack of a psychiatric precedent to justify this kind of assessment. The role of psychopathy in homicide has seldom been studied in female offenders, even though psychopathy has an important role in violent crimes. The investigators examined, clinically and historically, a sample of women who committed murder with different levels of criminal responsibility (female homicide offenders found not guilty by reason of insanity, having partial criminal responsibility, and convicted as criminally responsible and sentenced to prison) to identify the prevalence of the psychopathic dimension and its possible role in this sample. Prevalence and degree of psychopathic traits were examined in these female offenders using the Psychopathy Checklist-Revised. This study showed that females who had committed homicide were likely to suffer from mental illness; most of the homicidal acts were committed impulsively; and most female homicides occurred within the family, especially among women who were psychotic, but less so if they were psychopathic. Psychopathy tended to co-occur more with personality disorders than with psychotic psychopathology. Psychopathy was more evident among female homicide offenders who had been abused or traumatized. Psychopathic women who killed had high factor F1 scores and low antisocial component of factor F2.
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Affiliation(s)
- Felice Carabellese
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, Bari, Italy
| | - Alan R Felthous
- Forensic Psychiatry Division, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Gabriele Mandarelli
- Adjunct Professor of Forensic Psychiatry, Master of Clinical Criminology, Juridical Psychology, and Forensic Psychiatry Program, Department of Human Neurosciences, University of Roma "Sapienza", Italy
| | - Domenico Montalbò
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, Bari, Italy
| | - Donatella La Tegola
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, Bari, Italy
| | - Ilaria Rossetto
- Sistema Polimodulare REMS Castiglione delle Stiviere ASL, MN, Mantova, Orcid, ID, Italy
| | - Filippo Franconi
- Sistema Polimodulare REMS Castiglione delle Stiviere ASL, MN, Mantova, Orcid, ID, Italy
| | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, Bari, Italy
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Mandarelli G, Carabellese F, Felthous AR, Parmigiani G, Del Casale A, Catanesi R, Montalbò D, Ferracuti S. The factors associated with forensic psychiatrists' decisions in criminal responsibility and social dangerousness evaluations. Int J Law Psychiatry 2019; 66:101503. [PMID: 31706410 DOI: 10.1016/j.ijlp.2019.101503] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/27/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
Despite the central role in criminal trials, there is little research on the decision-making processes of experts in forensic psychiatry. We aimed to investigate the role of sociodemographic, psychopathological, and criminological characteristics in forensic psychiatric decisions on criminal responsibility and social dangerousness in criminal trials. We analyzed 302 forensic psychiatric reports provided by 16 forensic psychiatrists from the North, Central and Southern Italy. Defendants' psychiatric symptom severity was evaluated through the 24-item Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impression (CGI) scale and the Global Assessment of Functioning (GAF). Defendants judged not criminally responsible (Not-CRDs) presented with more severe psychiatric symptoms (positive symptoms, negative symptoms, manic excitement / disorganization), were more likely to be female, to be affected by a schizophrenia spectrum disorder, or bipolar spectrum disorder and to have had a higher number of previous psychiatric treatments and previous involuntary hospitalizations compared to their criminally responsible counterparts. Not-CRDs affected by a schizophrenia spectrum disorder, personality disorder, with severe psychiatric symptoms and with histories of criminal convictions and more victims were more likely to have received a judgment of social dangerousness. The forensic psychiatric evaluations were carried out on average of 770 days after the time of the crime, which in light of the other results, suggests an effect of the perceptions of the expert on the judgment of responsibility, raising the possibility of time bias on forensic judgments concerning defendants' mental responsibility.
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Affiliation(s)
- Gabriele Mandarelli
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.
| | - Felice Carabellese
- Section of Criminology and Forensic Psychiatry, University of Bari, Department of Interdisciplinary Medicine, Bari, Italy.
| | - Alan R Felthous
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, United States..
| | - Giovanna Parmigiani
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.
| | - Antonio Del Casale
- Department of Neuroscience, Mental Health, and Sensory Organs, "Sapienza" University of Rome, Rome, Italy.
| | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, University of Bari, Department of Interdisciplinary Medicine, Bari, Italy.
| | - Domenico Montalbò
- Section of Criminology and Forensic Psychiatry, University of Bari, Department of Interdisciplinary Medicine, Bari, Italy
| | - Stefano Ferracuti
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.
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Somma A, Fossati A, Ferracuti S, Caretti V, Montalbò D, La Tegola D, Carabellese F. Tracking Psychopathy in Female Italian Inmates: The Role of the DSM-5 Alternative Model of Personality Disorders Dysfunctional Personality Domains. Clin Neuropsychiatry 2019; 16:140-148. [PMID: 34908949 PMCID: PMC8650178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The present study aimed at testing the relationships between measures of psychopathy and measures of the DSM-5 Alternative Model of Personality Disorders (AMPD) domains in a sample of female offenders who were serving their sentences in Italian prisons. METHOD Thirty-eight Italian adult female inmates were underwent the Italian versions of the Psychopathy Checklist-Revised (PCL-R) and of the Personality Inventory for DSM-5-Informant Report Form (PID-5-IRF). RESULTS According to MM robust regression analysis results, high scores on the PID-5-IRF Disinhibition domain scale and low scores on the PID-5-IRF Anxiousness trait scale were significant and substantial predictors of the PCL-R total score. CONCLUSIONS As a whole, our findings support the hypothesis that assessing the DSM-5 AMPD domains (and traits) may be important for tracking psychopathy in female inmates.
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Affiliation(s)
- Antonella Somma
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Fossati
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | | | - Domenico Montalbò
- Sezione di Criminologia e Psichiatria Forense, Dipartimento Interdisciplinare di Medicina, Università degli Studi Aldo Moro di Bari, Italy
| | - Donatella La Tegola
- Sezione di Criminologia e Psichiatria Forense, Dipartimento Interdisciplinare di Medicina, Università degli Studi Aldo Moro di Bari, Italy
| | - Felice Carabellese
- Sezione di Criminologia e Psichiatria Forense, Dipartimento Interdisciplinare di Medicina, Università degli Studi Aldo Moro di Bari, Italy
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Carabellese F, Felthous AR, La Tegola D, Rossetto I, Montalbò D, Franconi F, Catanesi R. Psychopathy and Female Gender: Phenotypic Expression and Comorbidity; A Study Comparing a Sample of Women Hospitalized in Italy's Maximum Security Facility with Women Who were Criminally Sentenced and Imprisoned. J Forensic Sci 2019; 64:1438-1443. [PMID: 30859579 DOI: 10.1111/1556-4029.14039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 11/26/2022]
Abstract
Various studies have shown that women with psychopathy tend to commit crimes that are less violent than those of psychopathic men. The present study was designed to address the influence of psychopathy on the crimes committed by female offenders. A national sample of female offenders found NGRI or of diminished responsibility and at risk for criminal recidivism (OPG patients) was compared with a sample of female offenders who were convicted and imprisoned. Results of this comparison between the two groups of female offenders indicate that psychopathy is a transversal psychopathological dimension which may or may not be associated with other mental disorders. In both samples, the most commonly reported offenses among women with high PCL-R scores were minor offenses, not particularly violent, but they appear to be related to typical psychopathic features such as superficial charm, pathological lying, and manipulation.
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Affiliation(s)
- Felice Carabellese
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, p.za G., Cesare, 70124, Bari
| | - Alan R Felthous
- Forensic Psychiatry Division, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Blvd., Saint Louis, MO, 63104
| | - Donatella La Tegola
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, p.za G., Cesare, 70124, Bari
| | - Ilaria Rossetto
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, p.za G., Cesare, 70124, Bari
| | - Domenico Montalbò
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, p.za G., Cesare, 70124, Bari
| | - Filippo Franconi
- Sistema Polimodulare REMS Castiglione delle Stiviere ASL MN, Mantova, Italy
| | - Roberto Catanesi
- Sistema Polimodulare REMS Castiglione delle Stiviere ASL MN, Mantova, Italy
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Lozupone M, Veneziani F, Galizia I, Lofano L, Montalbò D, Arcuti S, Tortelli R, Barulli M, Capozzo R, Bonfiglio C, Panza F, Seripa D, Todarello O, Logroscino G. Validity of the Geriatric Depression Scale-30 against the gold standard diagnosis of depression in older age: The GreatAGE Study. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionDepression is a common disorder in late-life. Structured clinical interviews may be less efficient compared to self-administered questionnaires, but provide more accurate findings in terms of diagnosis. No population-based studies with both these depression assessment instruments have been ever performed.ObjectivesTo estimate the GDS-30 accuracy for depression assessment against the gold standard [Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID)] in subjects 65+ years in a random sampling of the general population.MethodsThe sample was collected in a population-based study (GreatAGE) conducted among elderly residents in Castellana, Southeast Italy. It includes 597 participants (57.62% males, mean age 73 years). Depression was assessed through the GDS-30 and the SCID, both double-blinded administered respectively by a trained neuropsychologist and psychiatrist. The GDS-30 screening performances were analyzed using ROC curves.ResultsAccording to the gold standard SCID, the rate of depressive disorder was 10.22% (15.81% of women; 6.1% of men) while with GDS-30 instrument 12.06% of the residents met the depression cutoff. Only 36.1% of GDS cases were true positive. At the optimal cutoff score (> 5), GDS had 62% sensitivity and 81% specificity. Using a more conservative cutoff (> 9), the GDS-30 specificity reached 91% while sensitivity dropped to 43%.ConclusionsThese preliminary results from the first population-based study that compares GDS-30 and SCID showed that the GDS-30 identified adequate levels of screening accuracy (AUC 0.76) compatible with scores established in community settings.FundingPRIN2009E4RM4Z.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Lozupone M, Veneziani F, Lofano L, Montalbò D, Galizia I, Barulli M, Tortelli R, Bonfiglio C, Todarello O, Logroscino G. Prevalence of Anxiety Disorders and Comorbid Affective Disorders in the Elderly of Castellana Grotte (italy). Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30350-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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