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Casavola V, Giampieri E, Paggi E, Scialò C, Possenti C, Stefano B, Lorusso O, di Giacomo E, Clerici M. Treating Homeless People With Psychiatric Disorders: Evidence From the Italian "Diogene" Project. J Nerv Ment Dis 2023; 211:870-875. [PMID: 37890026 DOI: 10.1097/nmd.0000000000001709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
ABSTRACT The aim of the "Diogene Project" is to recruit, evaluate, and treat homeless people affected by psychiatric disorders. Three multidisciplinary street units patrolled the streets in Milan, Italy, two/three evenings per week to recruit participants. A sociodemographic questionnaire, the HoNOS, and the GAF were administered at recruitment (T0), 1 year (T1), and 2 years (T2) after the first evaluation. Personalized treatment (none, social support, psychiatric treatment + social support) was tailored to each patient's needs. One hundred twelve homeless people participated. Forty-six users dropped out after the first assessment. The highest percentage of dropouts was registered among those who did not receive any kind of treatment (67.4%). Time spent on the street was not significantly correlated to adherence and outcome. Interestingly, the greatest improvement in psychopathological symptoms was recorded among patients under both treatments. This study confirms the validity of our model in approaching such vulnerable patients through specific interventions.
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Affiliation(s)
- Vita Casavola
- Casa della Carità Foundation, A. Abriani ONLUS, Milan, Italy
| | - Emanuela Giampieri
- Mental Health and Addiction Department, IRCCS S. Gerardo dei Tintori, Monza, Italy
| | - Elisabetta Paggi
- School of Medicine and Surgery, University of Milano, Bicocca, Milan, Italy
| | - Chiara Scialò
- Casa della Carità Foundation, A. Abriani ONLUS, Milan, Italy
| | | | - Bianchi Stefano
- Casa della Carità Foundation, A. Abriani ONLUS, Milan, Italy
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di Giacomo E, Moretti F, Colmegna F, Clerici M. Obsessive-compulsive disorder as the onset of bipolar disorder in adolescence. Bipolar Disord 2023; 25:519. [PMID: 37558613 DOI: 10.1111/bdi.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery-University of Milano Bicocca, Monza, Italy
- Psychiatric Department-IRCCS San Gerardo Dei Tintori-Italy, Monza, Italy
| | - Federica Moretti
- School of Medicine and Surgery-University of Milano Bicocca, Monza, Italy
- Psychiatric Department-IRCCS San Gerardo Dei Tintori-Italy, Monza, Italy
| | - Fabrizia Colmegna
- Psychiatric Department-IRCCS San Gerardo Dei Tintori-Italy, Monza, Italy
| | - Massimo Clerici
- School of Medicine and Surgery-University of Milano Bicocca, Monza, Italy
- Psychiatric Department-IRCCS San Gerardo Dei Tintori-Italy, Monza, Italy
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di Giacomo E, Andreini E, Lorusso O, Clerici M. The dark side of empathy in narcissistic personality disorder. Front Psychiatry 2023; 14:1074558. [PMID: 37065887 PMCID: PMC10097942 DOI: 10.3389/fpsyt.2023.1074558] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/28/2023] [Indexed: 04/18/2023] Open
Abstract
Narcissistic personality disorder is characterized by self-absorption, grandiosity, exploitation of others and lack of empathy. People with that disorder may switch from an overt form, mainly with grandiosity, to a covert presentation, with fears, hypersensitivity and dependence from others. Empathy represents a key point in detecting people affected by narcissistic personality disorder because, even if it is described as reduced, it plays a fundamental role in exploitation and manipulation. A systematic search of Literature without any language or time restriction, was performed combining thesaurus and free-search indexing terms related to Narcissistic personality disorder and empathy and produced 531 results. Fifty-two papers that analyzed possible issues in the empathic attitude of people with narcissistic personality disorder were included in this narrative review. Empathy is the capability of understating and feeling others emotions. It is not a unitary construct and can be distinguished in cognitive and affective. It might be channeled into prosocial and antisocial behaviors. A crucial trait identified in narcissistic empathy is affective dissonance that is closely related to rivalry as part of the dark tetrad (narcissism, machiavellianism, psychopathy, and sadism). Subjects affected by narcissistic personality disorder show greater impairment in affective aspects while their cognitive part of empathy appears preserved. Saving at least the cognitive aspects of empathy may contribute to therapeutic improvement of affective aspects.
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Affiliation(s)
- Ester di Giacomo
- Department of Mental Health and Addiction, Health Care Trust–IRCCS San Gerardo Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Elena Andreini
- Department of Mental Health and Addiction, Health Care Trust–IRCCS San Gerardo Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ottavia Lorusso
- Department of Mental Health and Addiction, Health Care Trust–IRCCS San Gerardo Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Health Care Trust–IRCCS San Gerardo Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
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di Giacomo E, Leone BE, Clerici M, Grassia F. Evidence of a third branch in the uncinate fasciculus and possible implications. J Neurol Neurosurg Psychiatry 2023; 94:497-498. [PMID: 36948578 DOI: 10.1136/jnnp-2023-331289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/24/2023]
Affiliation(s)
| | | | - Massimo Clerici
- University of Milan-Bicocca Faculty of Medicine and Surgery, Monza, Italy
| | - Fabio Grassia
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA
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di Giacomo E, Pessina R, Placenti V, Pescatore F, Colmegna F, Clerici M. Therapeutic termination of pregnancy and major psychiatric outcomes in parents. Psychiatry Res 2022; 317:114779. [PMID: 36030698 DOI: 10.1016/j.psychres.2022.114779] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Therapeutic termination of pregnancy (TToP) may have psychiatric outcomes like depression, anxiety and post-traumatic-stress disorder (PTSD). MATERIAL AND METHODS 45 couples had psychiatric evaluation before TToP and after one-year period. RESULTS TToP is linked to acute development of depressive symptoms that recover with time and professional support. Twelve percent of women developed PTSD (but 29.5% refused one-year evaluation due to mental distress at recalling TToP). Fathers showed no psychiatric outcomes. CONCLUSIONS Acute depressive symptoms after TToP improve with professional support but PTSD rate is concerning and stress importance of mental health implications and need for adequate related treatments.
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Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery, University of Milano-Bicocca, Lombardy, Italy; Psychiatric Department, ASST Monza, Lombardy, Italy.
| | - Rodolfo Pessina
- Psychiatric Residency Training Program, University of Milano-Bicocca, Lombardy, Italy
| | - Valeria Placenti
- Psychiatric Residency Training Program, University of Genoa, Liguria, Italy
| | - Francesca Pescatore
- Psychiatric Residency Training Program, University of Milano-Bicocca, Lombardy, Italy
| | | | - Massimo Clerici
- School of Medicine and Surgery, University of Milano-Bicocca, Lombardy, Italy; Psychiatric Department, ASST Monza, Lombardy, Italy
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Broman N, Prever F, di Giacomo E, Jiménez-Murcia S, Szczegielniak A, Hansson H, Håkansson A. Gambling, Gaming, and Internet Behavior in a Sexual Minority Perspective. A Cross-Sectional Study in Seven European Countries. Front Psychol 2022; 12:707645. [PMID: 35498152 PMCID: PMC9045133 DOI: 10.3389/fpsyg.2021.707645] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022] Open
Abstract
Background Addictive behavior of gambling, gaming and internet activity is partly a new research domain and has not been well investigated with regard to sexual minority populations. Although health disparities between sexual minorities and the general population are well documented, there is a lack of inclusion of sexual minorities in both research and clinic. Among lesbian, gay and bisexual populations certain features could be present that play a role for the development of addictive behaviors, such as social isolation and increased risk of other psychiatric problems. The aim of this study was to investigate problem gambling, problem gaming and problematic internet behavior in a European context and if it is affected by sexual orientation status. Methods An online web-survey was distributed among web-panels in England, Poland, Switzerland, Italy, Spain, Denmark, and Sweden in 2017-2018. Result 10 983 complete answers were collected. 7.1% of the participants had a sexual minority status (n = 774). Regression models found that there was no difference in gambling, gaming and internet behavior among heterosexual and sexual minority men. Sexual minority women were associated with problematic gambling and gaming behavior, when also controlling for age and nationality. When also controlling for psychological distress, women defining as having another sexual minority status than lesbian and bisexual remained significant for having a problematic gaming behavior (AOR = 2.3). Conclusion An awareness of female sexual minority perspectives is relevant in facilities treating behavioral addiction as well as in future research in behavioral addiction. More research is needed in problematic gambling and gaming behavior in different sexual minority populations with regard to psychiatric comorbidity and living conditions. An inclusion of sexual minority groups defining as other than gay and bisexual is needed in future research. No significant differences were found between heterosexual and sexual minority men in adjusted analysis in this study.
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Affiliation(s)
- Niroshani Broman
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
- Gambling Disorder Unit, Malmö Addiction Center, Region Skåne, Malmö, Sweden
| | - Fulvia Prever
- National Health System (NHS), Addiction Department, Milan, Italy
- SUN(N)COOP Scientific Director “Women and Gambling Project,” Milan, Italy
| | - Ester di Giacomo
- Section of Forensic Psychiatry, King’s College London, Institute of Psychiatry, London, United Kingdom
- School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
- Psychiatric Department -Azienda Socio-Sanitaria Territoriale (ASST), Monza, Italy
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Anna Szczegielniak
- Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Helena Hansson
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
| | - Anders Håkansson
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
- Gambling Disorder Unit, Malmö Addiction Center, Region Skåne, Malmö, Sweden
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Bach B, Kramer U, Doering S, di Giacomo E, Hutsebaut J, Kaera A, De Panfilis C, Schmahl C, Swales M, Taubner S, Renneberg B. The ICD-11 classification of personality disorders: a European perspective on challenges and opportunities. Borderline Personal Disord Emot Dysregul 2022; 9:12. [PMID: 35361271 PMCID: PMC8973542 DOI: 10.1186/s40479-022-00182-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/11/2022] [Indexed: 12/05/2022] Open
Abstract
The 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11) includes a fundamentally new approach to Personality Disorders (PD). ICD-11 is expected to be implemented first in European countries before other WHO member states. The present paper provides an overview of this new ICD-11 model including PD severity classification, trait domain specifiers, and the additional borderline pattern specifier. We discuss the perceived challenges and opportunities of using the ICD-11 approach with particular focus on its continuity and discontinuity with familiar PD categories such as avoidant PD and narcissistic PD. The advent of the ICD-11 PD classification involves major changes for health care workers, researchers, administrators, and service providers as well as patients and families involved. The anticipated challenges and opportunities are put forward in terms of specific unanswered questions. It is our hope that these questions will stimulate further research and discussion among researchers and clinicians in the coming years.
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Affiliation(s)
- Bo Bach
- Center for Personality Disorder Research, Slagelse Psychiatric Hospital, Region Zealand, Slagelse, Denmark
| | - Ueli Kramer
- Institute of Psychotherapy/General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Ester di Giacomo
- School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Joost Hutsebaut
- Viersprong Institute for Studies on Personality Disorders, Halsteren, Netherlands
| | - Andres Kaera
- Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Chiara De Panfilis
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | | | - Svenja Taubner
- Institute for Psychosocial Prevention, University Heidelberg, Heidelberg, Germany
| | - Babette Renneberg
- Clinical Psychology and Psychotherapy, Freie Universität, Habelschwerdter Allee 45, 14195, Berlin, Germany.
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di Giacomo E, Pessina R, Santorelli M, Rucco D, Placenti V, Aliberti F, Colmegna F, Clerici M. Therapeutic termination of pregnancy and women’s mental health: Determinants and consequences. World J Psychiatry 2021; 11:937-953. [PMID: 34888166 PMCID: PMC8613757 DOI: 10.5498/wjp.v11.i11.937] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/27/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
The therapeutic termination of pregnancy (TToP) is an induced abortion following a diagnosis of medical necessity. TToP is applied to avoid the risk of substantial harm to the mother or in cases of fetal unviability. This type of induced abortion is provided after the second semester of gestation if fetal illness or the pregnancy cause physical danger or pathological mental distress to the mother. Socio-cultural and economic determinants could influence the desire for children and family planning in couples, as well as the use of effective contraception and the choice to perform an induced abortion. Also, pre-existing mental health problems could affect the decision between carrying on a problematic pregnancy or having TToP. Furthermore, the TToP is a reproductive event with an important traumatic burden, but also with an intrinsic therapeutic effect and it can produce different psychological and psychopathological effects on women and couples. The aim of this review is to evaluate what demographic, reproductive and psychopathological determinants are involved in the choice of undergoing a TToP in women. Also, we will examine both positive and negative consequences of this procedure on women’s mental health, underlying which factors are related to a worse outcome in order to provide the best clinical support to vulnerable groups.
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Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery, University Milan Bicocca, Monza 20900, Lombardy, Italy
- Department of Psychiatric, ASST Monza, Monza 20900, Lombardy, Italy
| | - Rodolfo Pessina
- Psychiatric Residency Training Program, University Milan Bicocca, Monza 20900, Lombardy, Italy
| | - Mario Santorelli
- Psychiatric Residency Training Program, University Milan Bicocca, Monza 20900, Lombardy, Italy
| | - Daniele Rucco
- PhD Program in Psychology, Linguistics and Cognitive Neuroscience, University Milan Bicocca, Milano 20126, Lombardy, Italy
| | - Valeria Placenti
- Psychiatric Residency Training Program, University of Genova, Genova 16126, Liguria, Italy
| | - Francesca Aliberti
- Psychiatric Residency Training Program, University Milan Bicocca, Monza 20900, Lombardy, Italy
| | | | - Massimo Clerici
- School of Medicine and Surgery, University Milan Bicocca, Monza 20900, Lombardy, Italy
- Department of Psychiatric, ASST Monza, Monza 20900, Lombardy, Italy
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Giacomo ED, Placenti V, Colmegna F, Clerici M. Obsessive-Compulsive Disorder in Pregnancy and Postpartum: The Possible Etiologic Role and Implications of Obsessive-Compulsive Personality Disorder. J Clin Psychiatry 2021; 82. [PMID: 34670028 DOI: 10.4088/jcp.21lr14069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Psychiatric Department, ASST Monza, Monza, Italy.,Corresponding author: Ester di Giacomo, MD, PhD, School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48-20900 Monza, Italy
| | - Valeria Placenti
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Massimo Clerici
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Psychiatric Department, ASST Monza, Monza, Italy
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Marcatili M, Stefana A, Colmegna F, di Giacomo E, D'Amico E, Capuzzi E, Dakanalis A, Clerici M. Consultation psychiatry in COVID-19 patients: Lopinavir/ritonavir interactions with main psychiatric drugs. Psychiatry Clin Neurosci 2021; 75:145-146. [PMID: 33511703 PMCID: PMC8014835 DOI: 10.1111/pcn.13205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/06/2020] [Accepted: 01/12/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Matteo Marcatili
- Psychiatric Department, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Alberto Stefana
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fabrizia Colmegna
- Psychiatric Department, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Ester di Giacomo
- Psychiatric Department, San Gerardo Hospital, ASST Monza, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Emiliano D'Amico
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Enrico Capuzzi
- Psychiatric Department, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimo Clerici
- Psychiatric Department, San Gerardo Hospital, ASST Monza, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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di Giacomo E, Colmegna F, Biagi E, Zappa L, Caslini M, Dakanalis A, Clerici M. Anxiety and Depression: A Key to Understanding the Complete Expression of Personality Disorders. J Nerv Ment Dis 2021; 209:188-195. [PMID: 33273394 DOI: 10.1097/nmd.0000000000001279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Anxiety and depressive disorders affect one fourth of the population. Personality disorders often present comorbid with anxiety and depressive disorders during the lifetime course of the illness. To fully explore the interplay between personality disorders and anxiety or depression, 179 patients, consecutively admitted to the Anxiety and Depression Outpatient Department, were clinically evaluated and tested with the Mini-International Neuropsychiatric Interview and the Iowa Personality Disorder Screening. Twenty-six percent of the total sample was affected only by personality disorders (PDs), and 21% had a comorbidity between a personality, anxiety, and/or depressive disorder (Comorbidity). Compared with PDs, Comorbidity used more antipsychotics and benzodiazepines (4.3% vs. 9.6%, χ2 = 0.267; 43.4 vs. 72.6, p = 0.004), showing a worse clinical picture, and expressed more personality traits even without statistical significance (6.863 ± 2.328 vs. 7.609 ± 1.674, p = 0.105). The different impact of personality disorders compared with anxiety and/or depression has to be further analyzed in terms of economic load and resource allocation.
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12
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di Giacomo E, Pessina R, Colmegna F, Placenti V, Pescatore F, Aspesi F, Clerici M. Cannabis and Pregnancy: A Psychiatric, Medical, or General Population Issue? Eur Addict Res 2021; 27:156-160. [PMID: 33321487 DOI: 10.1159/000512155] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/08/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cannabis use during pregnancy may adversely affect the health of pregnant women and their fetus. Several recent surveys led in the US general population in the last decade showed an increase in cannabis use during pregnancy from 1.95 to 7%, with a 0.5% for medical-only purposes. OBJECTIVES Our aim was to investigate if an increased incidence might be due to a greater public acceptability after introduction of cannabis medical use or due to psychiatric implications and unmet needs. METHOD 500 pregnant women (302 psychiatric patients and 198 healthy controls) were tested with the Edimburgh Post-Natal Depression Scale, Beck Anxiety and Depression Inventory, and Structured Clinical Interview for the DSM-IV Axis II while substance use disorder was documented with the fulfillment of the DSM-5 criteria. RESULTS Five percent of the whole sample had a documented addiction to cannabis during pregnancy (all among psychiatric patients and none in the general population). All psychiatric patients with cannabis use disorder were affected by borderline personality disorder, except for 1 patient with cannabis and cocaine use disorders who suffered from adjustment disorder with anxiety. CONCLUSIONS Addiction to cannabis during pregnancy has an increased rate confirming surveys on the general US population but seem entirely linked to psychiatric issues, especially borderline personality disorder. Personality disorders may have been underestimated in surveys in the general population until now because these are usually not assessed.
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Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery-University of Milano, Bicocca, Italy, .,Psychiatric Department-ASST, Monza, Italy,
| | - Rodolfo Pessina
- School of Medicine and Surgery-University of Milano, Bicocca, Italy
| | | | - Valeria Placenti
- School of Medicine and Surgery-University of Milano, Bicocca, Italy
| | | | | | - Massimo Clerici
- School of Medicine and Surgery-University of Milano, Bicocca, Italy.,Psychiatric Department-ASST, Monza, Italy
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Affiliation(s)
- Ester di Giacomo
- Ester di Giacomo and Massimo Clerici are with the School of Medicine and Surgery, University of Milano, Bicocca, Italy, and also with the Psychiatric Department, Health Care Trust, Azienda Socio-Sanitaria Territoriale (ASST) Monza, Monza, Italy. Giovanni de Girolamo is with the Unitá Operativa di psichiatria Epidemiologica e Valutativa, Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. Gianluca Peschi is with the Health Care Trust, ASST Monza, Monza, Italy. Seena Fazel is with the Department of Psychiatry, University of Oxford, Oxford, UK
| | - Giovanni de Girolamo
- Ester di Giacomo and Massimo Clerici are with the School of Medicine and Surgery, University of Milano, Bicocca, Italy, and also with the Psychiatric Department, Health Care Trust, Azienda Socio-Sanitaria Territoriale (ASST) Monza, Monza, Italy. Giovanni de Girolamo is with the Unitá Operativa di psichiatria Epidemiologica e Valutativa, Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. Gianluca Peschi is with the Health Care Trust, ASST Monza, Monza, Italy. Seena Fazel is with the Department of Psychiatry, University of Oxford, Oxford, UK
| | - Gianluca Peschi
- Ester di Giacomo and Massimo Clerici are with the School of Medicine and Surgery, University of Milano, Bicocca, Italy, and also with the Psychiatric Department, Health Care Trust, Azienda Socio-Sanitaria Territoriale (ASST) Monza, Monza, Italy. Giovanni de Girolamo is with the Unitá Operativa di psichiatria Epidemiologica e Valutativa, Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. Gianluca Peschi is with the Health Care Trust, ASST Monza, Monza, Italy. Seena Fazel is with the Department of Psychiatry, University of Oxford, Oxford, UK
| | - Seena Fazel
- Ester di Giacomo and Massimo Clerici are with the School of Medicine and Surgery, University of Milano, Bicocca, Italy, and also with the Psychiatric Department, Health Care Trust, Azienda Socio-Sanitaria Territoriale (ASST) Monza, Monza, Italy. Giovanni de Girolamo is with the Unitá Operativa di psichiatria Epidemiologica e Valutativa, Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. Gianluca Peschi is with the Health Care Trust, ASST Monza, Monza, Italy. Seena Fazel is with the Department of Psychiatry, University of Oxford, Oxford, UK
| | - Massimo Clerici
- Ester di Giacomo and Massimo Clerici are with the School of Medicine and Surgery, University of Milano, Bicocca, Italy, and also with the Psychiatric Department, Health Care Trust, Azienda Socio-Sanitaria Territoriale (ASST) Monza, Monza, Italy. Giovanni de Girolamo is with the Unitá Operativa di psichiatria Epidemiologica e Valutativa, Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. Gianluca Peschi is with the Health Care Trust, ASST Monza, Monza, Italy. Seena Fazel is with the Department of Psychiatry, University of Oxford, Oxford, UK
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di Giacomo E, Bellelli G, Peschi G, Scarpetta S, Colmegna F, de Girolamo G, Clerici M. Management of older people during the COVID-19 outbreak: Recommendations from an Italian experience. Int J Geriatr Psychiatry 2020; 35:803-805. [PMID: 32363628 DOI: 10.1002/gps.5318] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/25/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Ester di Giacomo
- Department of Mental Health and Addiction, Health Care Trust, ASST Monza, Monza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Bellelli
- Department of Geriatric and Internal Medicine, University of Milano-Bicocca, Milan, Italy
| | - Gianluca Peschi
- Department of Social and Health Care, Health Care Trust, ASST Monza, Monza, Italy
| | | | - Fabrizia Colmegna
- Department of Mental Health and Addiction, Health Care Trust, ASST Monza, Monza, Italy
| | | | - Massimo Clerici
- Department of Mental Health and Addiction, Health Care Trust, ASST Monza, Monza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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15
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di Giacomo E, Colmegna F, Dakanalis A, Pessina R, Placenti V, Pescatore F, Clerici M. Screening for postpartum depression and borderline personality disorder: Food for thought. Aust N Z J Psychiatry 2020; 54:319-320. [PMID: 31813237 DOI: 10.1177/0004867419893425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Psychiatric Department, ASST Monza, Monza, Italy
| | | | - Antonios Dakanalis
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | | | | | - Massimo Clerici
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Psychiatric Department, ASST Monza, Monza, Italy
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16
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Mehlum L, Schmahl C, Berens A, Doering S, Hutsebaut J, Kaera A, Kramer U, Moran PA, Renneberg B, Ribaudi JS, Simonsen S, Swales M, Taubner S, di Giacomo E. Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges. Borderline Personal Disord Emot Dysregul 2020; 7:15. [PMID: 32742662 PMCID: PMC7391495 DOI: 10.1186/s40479-020-00131-9] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/24/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Over the last two decades an increasing number of countries have legalized euthanasia and physician-assisted suicide (EAS) leading to considerable debate over the inherent ethical dilemmas. Increasing numbers of people with personality disorders, faced with unbearable suffering, have requested and received assistance in terminating their lives. EAS in people with personality disorders has, however, received very sparse attention from clinicians and researchers. In this paper, we examine the literature on the practice and prevalence of EAS in people with personality disorders to date and discuss the associated challenges for research and practice. METHODS Narrative review of the literature combined with the authors' collective experience and knowledge of personality disorders. RESULTS In six of the eight countries where EAS is currently legal, mental disorders are accepted as disorders for which EAS may be granted. In four of these countries, EAS in minors with mental disorders is also accepted. Our literature search resulted in 9 papers on the subject of EAS in people with personality disorders. These studies suggest that most clinicians who grant EAS have indeed perceived their patients' suffering as chronic, unbearable and untreatable without prospect of improvement. The majority of patients with personality disorders had tried some form of psychotherapy, but very few had received any of the relevant evidence-based treatments. The decision to grant EAS based on a perception of the patient's illness as being untreatable with no prospect of improvement, could, thus, in many cases fail to meet the due care criteria listed in EAS laws. People with personality disorders more often wish for death for extended periods of time than people without these disorders. However, there is ample empirical data to show that suicidal tendencies and behaviour can be treated and that they fluctuate rapidly over time. CONCLUSIONS In light of our findings, we believe that the current legislation and practice of EAS for people with personality disorders is based on an inadequate understanding of underlying psychopathology and a lack of awareness about the contemporary treatment literature. Moreover, we assert that this practice neglects the individual's potential for having a life worth living.
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Affiliation(s)
- Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Ann Berens
- University Psychiatric Centre Duffel, CAPRI, faculty Medicine and Health Sciences, University Antwerp, Antwerp, Belgium
| | - Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Joost Hutsebaut
- De Viersprong Institute for Studies on Personality Disorders, Bergen op Zoom, The Netherlands
| | - Andres Kaera
- Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Ueli Kramer
- Department of Psychiatry, University of Lausanne, Lausanne, Switzerland
| | - Paul Anthony Moran
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Joaquim Soler Ribaudi
- Department of Psychiatry and Legal Medicine, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, UAB, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | | | | | - Svenja Taubner
- Institute for Psychosocial Prevention, University-Hospital Heidelberg, Heidelberg, Germany
| | - Ester di Giacomo
- School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.,Psychiatric Department-ASST Monza, Monza, Italy
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17
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di Giacomo E, Colmegna F, Aspesi F, Dakanalis A, Clerici M. Distinguishing Between Borderline Personality Disorder and Bipolar Disorder. J Clin Psychiatry 2019; 79. [PMID: 29718595 DOI: 10.4088/jcp.17lr11919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ester di Giacomo
- .,PhD Program in Neuroscience, Doctoral School, University of Milano-Bicocca, Monza, Italy.,School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Department of Psychiatry, ASST Monza, Monza, Italy
| | | | - Flora Aspesi
- Department of Psychiatry, ASST Monza, Monza, Italy
| | - Antonios Dakanalis
- School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimo Clerici
- School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Department of Psychiatry, ASST Monza, Monza, Italy
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18
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di Giacomo E, Krausz M, Colmegna F, Aspesi F, Clerici M. Estimating the Risk of Attempted Suicide Among Sexual Minority Youths: A Systematic Review and Meta-analysis. JAMA Pediatr 2018; 172:1145-1152. [PMID: 30304350 PMCID: PMC6583682 DOI: 10.1001/jamapediatrics.2018.2731] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE Suicide is the second-leading cause of death among adolescents. Sexual minority individuals are at a higher risk of suicide and attempted suicide, but a precise and systematic evaluation of this risk among sexual minority youths has not been documented to our knowledge. OBJECTIVE To examine the risk of attempted suicide among sexual minority adolescents, differentiating for each sexual minority group. DATA SOURCES Electronic databases (PubMed, Embase, and PsycINFO) were searched for articles published through April 30, 2017, with the following search terms: heterosexual, homosexual, bisexual, transgender, adolescents, teens, and attempted suicide. STUDY SELECTION Studies that reported attempted suicide in sexual minority adolescents compared with heterosexual peers were included. Thirty-five studies satisfied criteria for inclusion of 764 records identified. DATA EXTRACTION AND SYNTHESIS Pooled analyses were based on odds ratios (ORs), with relevant 95% CIs, weighting each study with inverse variance models with random effects. Risk of publication bias and analysis of heterogeneity through univariable and multivariable meta-regressions were also rated. MAIN OUTCOMES AND MEASURES The evaluation of increased odds of attempted suicide among sexual minority youths compared with heterosexual peers. RESULTS Thirty-five studies reported in 22 articles that involved a total of 2 378 987 heterosexual and 113 468 sexual minority adolescents (age range, 12-20 years) were included in the analysis. Sexual minority youths were generally at higher risk of attempted suicide (OR, 3.50; 95% CI, 2.98-4.12; c2 = 3074.01; P < .001; I2 = 99%). If estimated in each sexual minority group, the OR was 3.71 in the homosexual group (95% CI, 3.15-4.37; c2 = 825.20; P < .001; I2 = 97%) and 4.87 in the bisexual group (95% CI, 4.76-4.98; c2 = 980.02; P < .001; I2 = 98%); transgender youths were described as an individual group in only 1 study, which reported an OR of 5.87 (95% CI, 3.51-9.82). Meta-regressions weighted for the study weight highlighted that the presence of young participants (12 years old) was associated with heterogeneity in the bisexual group, whereas the year of sampling was associated with heterogeneity in the whole group when combined with other covariates. CONCLUSIONS AND RELEVANCE Our findings suggest that youths with nonheterosexual identity have a significantly higher risk of life-threatening behavior compared with their heterosexual peers. Public awareness is important, and a careful evaluation of supportive strategies (eg, support programs, counseling, and destigmatizing efforts) should be part of education and public health planning.
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Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy,Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy,Department of Neuroscience, Doctorate School of the University of Milano-Bicocca, Monza, Italy
| | - Micheal Krausz
- Institute of Mental Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Flora Aspesi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Massimo Clerici
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy,Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
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19
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di Giacomo E, Colmegna F, Pescatore F, Aspesi F, Fotiadou M, Clerici M. The burden of personality disorders on the DSM 5 addiction to tobacco during pregnancy. Compr Psychiatry 2018; 84:101-105. [PMID: 29729554 DOI: 10.1016/j.comppsych.2018.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/18/2018] [Accepted: 04/23/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Tobacco smoking is a major health concern. Many women smoke during their reproductive years, some of them during their pregnancy. Adverse outcomes for the newborns physical health are well recognized, while the influence on their mental health is still under investigation. We aim at demonstrating the contribution of maternal personality disorders in maintaining addiction to tobacco during pregnancy, to underline their role and the need of their detection as a preventive effort. METHOD 150 women, consecutively admitted to the Perinatal Psychiatric Outpatient Department were tested with the SCID II, CTQ, WHOQOL-BREF, EPDS, BDI and BAI. Tobacco use disorder was attested with the fulfillment of DSM 5 criteria. RESULTS 46% (n = 69) of the sample was affected by at least one personality disorder ("PD+"). "PD+" showed a significant higher rate of pregnant women addicted to tobacco (p = 0.021). The average number of cigarettes per day was notably distinct, since patients affected by "NPD" smokes twice the amount compared to "PD-" and "other PDs", while those affected by Borderline PD has a halfway consumption (7.20 ± 5.54 vs 3.37 ± 4.62 vs 3 ± 3.39 vs 5.50 ± 4.10). ANOVA and POST HOC showed a significance between "NPD" and "other PDs" (p = 0.035), and "other PDs" has significantly the highest rate of active smokers. CONCLUSION Personality disorders demonstrate to be a clear contributor in supporting addiction to tobacco during pregnancy. Short and long term health and mental consequences attested in the newborn, encourage awareness in detecting tobacco dependency during this sensitive period. The inclusion of personality evaluation and management in tobacco dependency treatment programs is strictly encouraged to boost their efficiency and increase tobacco abstinence.
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Affiliation(s)
- Ester di Giacomo
- PhD program in Neuroscience, Doctorate School of the University of Milano-Bicocca, Italy; School of Medicine and Surgery-University of Milano Bicocca, Italy; Psychiatric Department-ASST Monza, Italy.
| | | | | | | | - Maria Fotiadou
- Female Medium Secure Forensic Service, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Massimo Clerici
- School of Medicine and Surgery-University of Milano Bicocca, Italy; Psychiatric Department-ASST Monza, Italy
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20
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di Giacomo E, Arntz A, Fotiadou M, Aguglia E, Barone L, Bellino S, Carpiniello B, Colmegna F, Lazzari M, Lorettu L, Pinna F, Sicaro A, Signorelli MS, Clerici M. The Italian Version of the Borderline Personality Disorder Severity Index IV: Psychometric Properties, Clinical Usefulness, and Possible Diagnostic Implications. J Pers Disord 2018; 32:207-219. [PMID: 28604275 DOI: 10.1521/pedi_2017_31_294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Borderline personality disorder (BPD) has a core embodied in affective and behavioral dysregulations, impulsivity, and relational disturbance. Clinical presentation might be heterogeneous due to a combination of different symptoms listed in the DSM-5. Clinical diagnosis and assessment of the severity of manifestations might be improved through the administration of structured interviews such as the Borderline Personality Disorder Severity Index, 4th edition (BPDSI-IV). The psychometric properties of the Italian version of the BPDSI-IV were examined for the first time in 248 patients affected by BPD and 113 patients affected by bipolar disorder, proving to be a valid and accurate instrument with good internal consistency and high accuracy. The Italian version also demonstrates significant validity in the discrimination between these clinical groups (p < 5001).
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Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery, University of Milan, Bicocca, Italy.,Psychiatric, Department, S. Gerardo Health Care Trust, Monza, Italy.,PhD Program, in Neuroscience, Doctorate School, University of Milan, Bicocca
| | - Arnoud Arntz
- Department of Clinical, Psychology, University of Amsterdam, the Netherlands
| | - Maria Fotiadou
- Female Medium Secure Forensic Service, South London, and the Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, University of Catania, Italy
| | - Lavinia Barone
- Psychology, Section, Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
| | - Silvio Bellino
- Center for, Personality Disorders, Psychiatric Clinic, Department of Neuroscience, University of Turin, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Clinical and Molecular Medicine, Psychiatric Unit, University of Cagliari, Italy
| | | | - Marina Lazzari
- Psychiatric, Department, S. Gerardo Health Care Trust, Monza, Italy
| | - Liliana Lorettu
- Psychiatric Clinic, Department of Biomedical Science, University of Sassari, Italy
| | - Federica Pinna
- Department of Public Health, Clinical and Molecular Medicine, Psychiatric Unit, University of Cagliari, Italy
| | - Aldo Sicaro
- Psychiatric, Department, S. Gerardo Health Care Trust, Monza, Italy
| | | | | | - Massimo Clerici
- School of Medicine and Surgery, University of Milan, Bicocca, Italy.,Psychiatric, Department, S. Gerardo Health Care Trust, Monza, Italy
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21
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di Giacomo E, Aspesi F, Fotiadou M, Arntz A, Aguglia E, Barone L, Bellino S, Carpiniello B, Colmegna F, Lazzari M, Lorettu L, Pinna F, Sicaro A, Signorelli MS, Clerici M, Clerici M, Aspesi F, Aguglia E, Barone L, Bellino S, Bozzatello P, Brignolo E, Carpiniello B, Colmegna F, Ghiani A, Lazzari M, Lorettu L, Sicaro A, Battiato MC, Bon R, Contiero L, Denti A, Fotiadou M, Franco L, Ginanneschi AM, Lai A, Laneri G, Marchini M, Miragliotta E, Ostaldo L, Paggi E, Ravasi S, Roletto F, Ruta S, Signorelli MS, Zaccheroni D. Unblending Borderline Personality and Bipolar Disorders. J Psychiatr Res 2017; 91:90-97. [PMID: 28327444 DOI: 10.1016/j.jpsychires.2017.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 02/26/2017] [Accepted: 03/03/2017] [Indexed: 11/16/2022]
Abstract
Borderline Personality (BPD) and Bipolar (BP) disorders stimulate an academic debate between their distinction and the inclusion of Borderline in the Bipolar spectrum. Opponents to this inclusion attribute the important differences and possible diagnostic incomprehension to overlapping symptoms. We tested 248 Borderline and 113 Bipolar patients, consecutively admitted to the Psychiatric Unit, through DSM-IV Axis I and II Disorders (SCID-I/II), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Young Mania Rating Scale (YMRS) and Borderline Personality Disorder Severity Index-IV (BPDSI-IV). All the tests statistically discriminated the disorders (p < 0.0001). Overlapping symptoms resulted significantly different (impulsivity = 5.32 in BPD vs 1.55 in BP, p < 0.0001; emotional instability = 7.11 in BPD vs 0.55 in BP, p < 0.0001) and the range of their scores gives the opportunity for an even more precise discrimination. Distinctive traits (e.g. irritability or sexual arousal) are also discussed in order to try to qualify the core of these disorders to a higher degree. Comorbidity proves to be extremely small (3.6%). However, Borderline patients with manic features offer a privileged point of view for a deeper analysis. This allows for the possibility of a more precise examination of the nature and load of each symptom. Borderline Personality and Bipolar Disorders can be distinguished with high precision using common and time-sparing tests. The importance of discriminating these clinical features may benefit from this evidence.
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Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery, University of Milano Bicocca, Italy; Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy; Doctorate School of the University of Milano-Bicocca, Italy.
| | - Flora Aspesi
- Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy
| | - Maria Fotiadou
- Female Medium Secure Forensic Service, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, The Netherlands
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, University of Catania, Italy
| | - Lavinia Barone
- University of Pavia, Department of Brain and Behavioral Science, Psychology Section, Pavia, Italy
| | - Silvio Bellino
- Center for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, University of Turin, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Clinical and Molecular Medicine - Psychiatric Unit, University of Cagliari, Italy
| | | | - Marina Lazzari
- Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy
| | - Liliana Lorettu
- Department of Biomedical Science, Psychiatric Clinic, University of Sassari, Italy
| | - Federica Pinna
- Department of Public Health, Clinical and Molecular Medicine - Psychiatric Unit, University of Cagliari, Italy
| | - Aldo Sicaro
- Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy
| | | | | | - Massimo Clerici
- School of Medicine and Surgery, University of Milano Bicocca, Italy; Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy
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22
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di Giacomo E, Calabria M, Colmegna F, Fotiadou M, Pucci B, Vergani P, Clerici M. Pregnancy denial or concealement: A case report highlighting risks and forensic aspects. Aust N Z J Psychiatry 2016; 50:924-5. [PMID: 26956808 DOI: 10.1177/0004867416636242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ester di Giacomo
- Doctorate School, University of Milano-Bicocca, Milano, Italy School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy Psychiatric Department, S.Gerardo Health Care Trust, Monza, Italy
| | - Manuela Calabria
- Doctorate School, University of Milano-Bicocca, Milano, Italy Pediatric Department, S.Gerardo Health Care Trust, Monza, Italy
| | | | - Maria Fotiadou
- Female Medium Secure Forensic Service, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Barbara Pucci
- Fondazione Monza e Brianza per il Bambino e la Sua Mamma, Monza, Italy
| | - Patrizia Vergani
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy Obstetric and Gynecology Department, S.Gerardo Health Care Trust, Monza, Italy
| | - Massimo Clerici
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy Psychiatric Department, S.Gerardo Health Care Trust, Monza, Italy
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