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Bovero A, Pesce S, Botto R, Tesio V, Ghiggia A. Self-Transcendence: Association with Spirituality in an Italian Sample of Terminal Cancer Patients. Behav Sci (Basel) 2023; 13:559. [PMID: 37504006 PMCID: PMC10376349 DOI: 10.3390/bs13070559] [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] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 07/29/2023] Open
Abstract
Terminally ill cancer patients often experience demoralization and loss of dignity, which undermines their spiritual wellbeing, which could, however, be supported by the presence of other factors such as self-transcendence and religious coping strategies. To assess self-transcendence and religious coping strategies and how they influence spirituality, we studied 141 end-stage cancer patients (64.3% male; mean age 68.6 ± 14.6) with a Karnofsky Performance Status ≤ 50 and a life expectancy ≤ 4 months using the Self-Transcendence Scale, the Demoralization Scale, the Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing (FACIT-Sp-12), the Brief Religious COPE, and the Patient Dignity Inventory. To understand the effects of these variables on spirituality, hierarchical multiple regression was performed on FACIT-Sp-12. The final model predicted 67% of the variance in spiritual wellbeing. Demoralization was the strongest influencing factor (β = -0.727, p < 0.001), followed by self-transcendence (β = 0.256, p < 0.001), and positive religious coping (β = 0.148, p < 0.05). This study suggests that self-transcendence and positive religious coping may be protective factors for spirituality in terminal cancer patients. These factors should be considered in treatment to promote spiritual wellbeing and improve patients' quality of life at the end of life.
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Affiliation(s)
- Andrea Bovero
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy
| | - Sara Pesce
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy
| | - Rossana Botto
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy
- Department of Neuroscience, University of Turin, AOU Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy
| | - Valentina Tesio
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy
| | - Ada Ghiggia
- Department of Life Sciences, University of Trieste, Via Edoardo Weiss 21, 34128 Trieste, Italy
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Bovero A, Opezzo M, Tesio V. Relationship between demoralization and quality of life in end-of-life cancer patients. Psychooncology 2023; 32:429-437. [PMID: 36604571 DOI: 10.1002/pon.6095] [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] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 12/14/2022] [Accepted: 01/01/2023] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the relationship between demoralization and health-related quality of life (HRQoL) in a sample of end-of-life cancer patients with a life expectancy of 4 months or less undergoing palliative care, controlling for sociodemographic, clinical, and psychological variables. METHODS Sociodemographic, clinical, and psychological data from 170 end-of-life cancer patients were collected using the following scales: Edmonton Symptom Assessment System for palliative care patients' symptoms; Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms; Functional Assessment of Cancer Therapy Scale - General Measure (FACT-G) for HRQoL; Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being for spirituality (FACIT-Sp); Demoralization Scale - Italian Version (DS-IT) for demoralization. RESULTS The DS-IT showed that 51.8% of cancer patients were severely demoralized. In addition, 36.5% of the sample had clinically significant depressive symptoms and QoL was severely impaired (FACT-G). The result of regression analysis showed that demoralization (especially "Disheartenment" and "Sense of failure") was the strongest contributor for HRQoL, followed by ESAS_Lack of Well-Being and depression (PHQ-9), with the final model explaining 66% of the variance of the FACT-G. CONCLUSIONS The results highlight a very high prevalence of severe demoralization in end-of life cancer patients. Moreover, demoralization was not only associated with patients' HRQoL, but it was also the most important contributing factor. This finding underscores the need to identify preventive or therapeutic psychological interventions that focus on preventing existential distress, and thus improve the QoL of dying patients in their last days of life.
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Affiliation(s)
- Andrea Bovero
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, Turin, Italy
| | - Marta Opezzo
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, Turin, Italy
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Romeo A, Tesio V, Ghiggia A, Di Tella M, Geminiani GC, Farina B, Castelli L. Traumatic experiences and somatoform dissociation in women with fibromyalgia. Psychol Trauma 2022; 14:116-123. [PMID: 33646804 DOI: 10.1037/tra0000907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: Psychological factors like traumatic life events seem to affect the etiopathogenesis and the exacerbation of fibromyalgia (FM), a chronic widespread musculoskeletal pain syndrome. This Study investigated the prevalence of traumatic events, with a particular attention to the whole life span, and both psychoform and somatoform dissociation in patients with FM, compared with healthy controls (HC). In addition, the possible effects of traumatic events and dissociative experiences on FM symptoms have been analyzed. Method: Traumatic experiences, dissociative symptoms, and psychological distress were assessed in 99 consecutive patients with FM and 107 healthy women. Student t-tests for two independent samples were used to determine differences between the FM and HC groups. A hierarchical multiple regression analysis was used to explore the possible contribution of trauma and dissociation to FM symptoms. Results: Results revealed that the levels of both somatoform and psychoform dissociation were higher among patients with FM than HC (p < .001). Moreover, patients with FM experienced significantly more negative life events than HC (p < .001). Finally, the data suggested that the severity of FM disabilities was significantly predicted by the presence of depressive symptoms, somatoform dissociation, cumulative trauma, and educational level. The final Model explained 40% of the variance. Conclusions: Results suggest that the construct of somatoform dissociation could serve as a useful framework to improve our understanding of FM symptoms, and stressed the importance of evaluating the effects of multiple traumas in cumulative form because this has substantial implications for the evaluation and treatment of patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | - Ada Ghiggia
- Department of Psychology, University of Turin
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Ghiggia A, Pierotti V, Tesio V, Bovero A. Personality matters: relationship between personality characteristics, spirituality, demoralization, and perceived quality of life in a sample of end-of-life cancer patients. Support Care Cancer 2021; 29:7775-7783. [PMID: 34169327 PMCID: PMC8550274 DOI: 10.1007/s00520-021-06363-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/09/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Personality could be an interesting dimension to explore in end-of-life cancer patients, in order to investigate how personality affects quality of life. Thus, this study aimed to investigate the relationship among personality through the Big Five Inventory (BFI), spirituality, and demoralization and to explore their impact on their quality of life. METHODS A sample of 210 end-of-life Italian cancer patients were assessed with the BFI, the Demoralization Scale (DS), the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-SP-12), the Functional Assessment of Cancer Therapy Scale-General Measure (FACT-G), and the Karnofsky performance status. RESULTS Correlational analysis highlighted a significantly negative relationship between extraversion and agreeableness traits and all the demoralization dimensions. On the other side, neuroticism trait was significantly and positively correlated with the Demoralization Scale (p < 0.01). To understand the impact of these variables on quality of life (FACT-G), we performed a hierarchical multiple regression: in the final model, demoralization remained the strongest contributing factor (β = - 0.509, p < 0.001), followed by neuroticism (β = - 0.175, p < 0.001), spirituality (β = 0.163, p = 0.015), and Karnofsky index (β = 0.115, p = 0.012). CONCLUSION Our data underlined how both the neuroticism trait and demoralization are correlated with a worst health status in terminal cancer patients, whereas spirituality is a protective factor. The study of personality may allow to better understand the inner patient's experience and improve communication between patient and healthcare staff in order to build and apply better-tailored psychological treatment.
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Affiliation(s)
- Ada Ghiggia
- Clinical Psychology Unit, AOU Città dela Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy. .,Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy.
| | - Vanni Pierotti
- Clinical Psychology Unit, AOU Città dela Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy
| | - Valentina Tesio
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Andrea Bovero
- Clinical Psychology Unit, AOU Città dela Salute e della Scienza, Corso Bramante 88, 10126, Turin, Italy
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Franco P, Di Tella M, Tesio V, Gasnier A, Petit S, Spalek M, Bibault JE, Dubois L, Mullaney L, Redalen KR, Chargari C, Perryck S, Bittner MI, Bertholet J, Castelli L. Alexithymia and professional quality of life in radiation oncology: The moderator effect of the professional profile. Radiother Oncol 2021; 158:48-54. [PMID: 33577864 DOI: 10.1016/j.radonc.2021.01.033] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 01/19/2021] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE Cancer care can be taxing. Alexithymia, a personality construct characterized by difficulties in identifying and describing feeling and emotions, an externally-oriented thinking style and scarcity of imagination and fantasy, is significantly correlated with higher levels of both secondary traumatic stress (STS) and burnout and lower levels of compassion satisfaction in medical professionals in radiation oncology. In this study, we aimed to assess the difference in professional quality of life (QoL) and the association with alexithymia in this multidisciplinary field depending on the specific profession (radiation/clinical oncologist, RO; medical physicist, MP; radiation therapist, RTT). MATERIAL AND METHODS The study was conducted via an online questionnaire, receiving 1500 submissions between May and October 2018. Alexithymia was assessed via the Toronto Alexithymia Scale (TAS-20) and professional QoL was evaluated using the Professional Quality of Life Scale (ProQoL) version 5. Comparisons between the RO, RTT, and MP groups were performed by ANOVA or MANOVA, followed by Bonferroni corrected ANOVAs for continuous variables, and Pearson's chi-square test for categorical variables. The effect size was determined by calculating partial eta-squared (η2). RESULTS Profession had a moderator role on the correlation between alexithymia and STS, with RO being at a higher risk than MP and RTT. Further, the results of this study demonstrate the relevant point prevalence of decreased well-being at work even for professional categories such as MP despite the more technical profile and reduced interaction with patients. CONCLUSIONS This study demonstrates the importance of alexithymia as a factor contributing to decreased professional QoL amongst radiation oncology professionals. Alexithymic ROs are impacted to a higher extent compared to MPs and RTTs by the indirect exposure to patients suffering. It is worth addressing these observations in professional education, aiming to improve QoL for healthcare personnel.
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Affiliation(s)
- Pierfrancesco Franco
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Oncology, Radiation Oncology, University of Turin, Italy.
| | - Marialaura Di Tella
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
| | - Valentina Tesio
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
| | - Anne Gasnier
- Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Steven Petit
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Radiation Oncology - Erasmus Cancer Institute, Rotterdam, The Netherlands
| | - Mateusz Spalek
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology Center, Warsaw, Poland
| | - Jean-Emmanuel Bibault
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Ludwig Dubois
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Laura Mullaney
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Applied Radiation Therapy Trinity Research Group, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland
| | - Kathrine Røe Redalen
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Cyrus Chargari
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sophie Perryck
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Switzerland
| | - Martin-Immanuel Bittner
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Arctoris, Oxford, United Kingdom
| | - Jenny Bertholet
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Lorys Castelli
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
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Franco P, Tesio V, Bertholet J, Gasnier A, del Portillo EG, Spalek M, Bibault J, Borst G, Van Elmpt W, Thorwarth D, Mullaney L, Redalen KR, Dubois L, Bittner M, Chargari C, Perryck S, Heukelom J, Petit S, Lybeer M, Castelli L. OC-0593: Alexithymia, empathy and burn-out amongst RTTs: results from the PRO BONO survey. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00615-0] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ghiggia A, Bianco A, Castelli L, Baratta F, Birocco N, Scaldaferri M, Milla P, Tesio V, Rosso S, Torta R, Brusa P, Cattel F. Adherence to oral chemotherapy: Evidence from a randomised clinical trial. Eur J Cancer Care (Engl) 2020; 30:e13336. [PMID: 33006220 DOI: 10.1111/ecc.13336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/29/2020] [Revised: 06/23/2020] [Accepted: 08/19/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate the efficacy of a reinforcement message (RM) administered by a hospital pharmacist on adherence, through a randomised study involving patients undergoing oral chemotherapy from which an objective outcome measure and patients' subjective opinions were collected. A secondary aim was to detect which psychological or clinical factors influence adherence. METHODS Forty patients were enrolled and randomised to an experimental group (EG) or a control group (CG). The EG received a 10-minute RM provided by a hospital pharmacist with a doctor and a nurse. The CG received the standard of care. To measure adherence, plasma drug concentration and subjective evaluation were taken during the visits, in addition to a psychological assessment (coping strategies, psychological distress and personality traits). RESULTS The EG reported higher drug levels and a statistically significant higher mean score on the subjective evaluation. A linear regression model highlighted statistically significant differences in the plasma drug concentration, after considering toxicity and dose reduction and controlling for the Reward Dependence Scale of the Temperament and Character Inventory between the EG and the CG. CONCLUSION Adequate information and education on the therapy, using an RM strategy provided by a hospital pharmacist, seems to positively influence adherence to the treatment.
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Affiliation(s)
- Ada Ghiggia
- Clinical Psychology Unit, Città della Salute e della Scienza, Turin, Italy.,Department of Psychology, University of Turin, Turin, Italy
| | | | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
| | - Francesca Baratta
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Nadia Birocco
- Department of Oncology, Città della Salute e della Scienza, Turin, Italy
| | | | - Paola Milla
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | | | - Stefano Rosso
- Piedmont Cancer Registry, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology Unit, Città della Salute e della Scienza, Turin, Italy
| | - Paola Brusa
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Francesco Cattel
- Hospital Pharmacy, Città della Salute e della Scienza, Turin, Italy
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Franco P, Tesio V, Bertholet J, Gasnier A, Gonzalez del Portillo E, Spalek M, Bibault JE, Borst G, Van Elmpt W, Thorwarth D, Mullaney L, Røe Redalen K, Dubois L, Chargari C, Perryck S, Heukelom J, Petit S, Lybeer M, Castelli L. The role of alexithymia and empathy on radiation therapists' professional quality of life. Tech Innov Patient Support Radiat Oncol 2020; 15:29-36. [PMID: 32904144 PMCID: PMC7451808 DOI: 10.1016/j.tipsro.2020.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 05/28/2020] [Revised: 07/15/2020] [Accepted: 07/19/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND PURPOSE Physical and mental well-being are crucial for oncology professionals as they affect performance at work. Personality traits, as alexithymia and empathy, may influence professional quality of life. Alexithymia involves diminished skills in emotion processing and awareness. Empathy is pertinent to the ability to understand another's 'state of mind/emotion'. The PROject on Burn-Out in RadiatioN Oncology (PRO BONO) investigates professional quality of life amongst radiation oncology professionals, exploring the role of alexithymia and empathy. The present study reports on data pertinent to radiation therapists (RTTs). MATERIAL AND METHODS An online survey targeted ESTRO members. Participants were asked to fill out 3 questionnaires for alexithymia, empathy and professional quality of life: (a) Toronto Alexithymia Scale (TAS-20); (b) Interpersonal Reactivity Index (IRI); (c) Professional Quality of Life Scale (ProQoL). The present analysis focuses on RTTS to evaluate compassion satisfaction (CS), secondary traumatic stress (STS) and Burnout and their correlation with alexithymia and empathy, using generalized linear modeling. Covariates found significant at univariate linear regression analysis were included in the multivariate linear regression model. RESULTS A total of 399 RTTs completed all questionnaires. The final model for the burnout scale of ProQoL found, as significal predictors, the TAS-20 total score (β = 0.46, p < 0 0.001), and the individual's perception of being valued by supervisor (β = -0.29, p < 0.001). With respect to CS, the final model included TAS-20 total score (β = -0.33, p < 0.001), the Empatic Concern domain (β = 0.23, p < 0.001) of the IRI questionnaire and the individual's perception of being valued by colleagues (β = 0.22, p < 0.001). CONCLUSIONS Alexithymia increased the likelyhood to experience burnout and negatively affected the professional quality of life amongst RTTs working in oncology. Empathy resulted in higher professional fulfillment together with collegaues' appreciation. These results may be used to benchmark preventing strategies and implement organization-direct and/or individual-directed interventions.
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Affiliation(s)
- Pierfrancesco Franco
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy
| | - Valentina Tesio
- Department of Psychology, “ReMind the Body” Research Group, University of Turin, Italy
| | - Jenny Bertholet
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Anne Gasnier
- Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Mateusz Spalek
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - Jean-Emmanuel Bibault
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Jean-Emmanuel Bibault, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305-5847, USA
| | - Gerben Borst
- Department of Oncology, Radiation Oncology Department, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Wouter Van Elmpt
- The M-Lab, Department of Precision Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Daniela Thorwarth
- Section for Biomedical Physics, University Hospital for Radiation Oncology Tubingen, Tuebingen, Germany
| | - Laura Mullaney
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Applied Radiation Therapy Trinity Research Group, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Kathrine Røe Redalen
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ludwig Dubois
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- The M-Lab, Department of Precision Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Cyrus Chargari
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sophie Perryck
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Jolien Heukelom
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Department of Oncology, Radiation Oncology Department, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Steven Petit
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium
- Department of Radiation Oncology – Erasmus Cancer Institute, Rotterdam the Netherlands
| | | | - Lorys Castelli
- Department of Psychology, “ReMind the Body” Research Group, University of Turin, Italy
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Tesio V, Castelli L, Franco P. In response to Chaturvedi: Professional quality of life, burnout and alexithymia. Radiother Oncol 2020; 155:e6-e7. [PMID: 32871167 DOI: 10.1016/j.radonc.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Valentina Tesio
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
| | - Lorys Castelli
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
| | - Pierfrancesco Franco
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Oncology, Radiation Oncology, University of Turin, Italy.
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Affiliation(s)
- Pierfrancesco Franco
- European Society for Radiotherapy & Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy.
| | - Valentina Tesio
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
| | - Lorys Castelli
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
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Franco P, Tesio V, Bertholet J, Gasnier A, Gonzalez Del Portillo E, Spalek M, Bibault JE, Borst G, Van Elmpt W, Thorwarth D, Mullaney L, Røe Redalen K, Dubois L, Chargari C, Perryck S, Heukelom J, Petit S, Lybeer M, Castelli L. Professional quality of life and burnout amongst radiation oncologists: The impact of alexithymia and empathy. Radiother Oncol 2020; 147:162-168. [PMID: 32417347 DOI: 10.1016/j.radonc.2020.05.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 01/09/2020] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND PURPOSE Different factors may influence the professional quality of life of oncology professionals. Among them, personality traits, as alexithymia and empathy, are underinvestigated. Alexithymia is about deficits in emotion processing and awareness. Empathy is the ability to understand another's 'state of mind'/emotion. The PROject on BurnOut in RadiatioN Oncology (PRO BONO) assesses professional quality of life, including burnout, in the field of radiation oncology and investigates alexithymia and empathy as contributing factors. MATERIAL AND METHODS An online survey was conducted amongst ESTRO members. Participants completed 3 validated questionnaires for alexithymia, empathy and professional quality of life: (a) Toronto Alexithymia Scale; (b) Interpersonal Reactivity Index; (c) Professional Quality of Life Scale. The present analysis, focusing on radiation/clinical oncologists, evaluates Compassion Satisfaction (CS), Secondary Traumatic Stress (STS) and Burnout and correlates them with alexithymia and empathy (empathic concern, perspective taking and personal distress) with generalized linear modeling. Significant covariates on univariate linear regression analysis were included in the multivariate linear regression model. RESULTS A total of 825 radiation oncologists completed all questionnaires. A higher level of alexithymia was associated to decreased CS (β: -0.101; SE: 0.018; p < 0.001), increased STS (β: 0.228; SE: 0.018; p < 0.001) and burnout (β: 0.177; SE: 0.016; p < 0.001). A higher empathic concern was significantly associated to increased CS (β: 0.1.287; SE: 0.305; p = 0.001), STS (β: 0.114; SE: 0.296; p < 0.001), with no effect on burnout. Personal distress was associated to decreased CS (β: -1.423; SE: 0.275; p < 0.001), increased STS (β: 1.871; SE: 0.283; p < 0.001) and burnout (β: 1.504; SE: 0.245; p < 0.001). CONCLUSIONS Alexithymic personality trait increased burnout risk, with less professional satisfaction. Empathic concern was associated to increased stress, without leading to burnout, resulting in higher professional fulfillment. These results may be used to benchmark preventing strategies, such as work-hour restrictions, peer support, debriefing sessions, and leadership initiatives for professionals at risk.
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Affiliation(s)
- Pierfrancesco Franco
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Oncology, Radiation Oncology, University of Turin, Italy.
| | - Valentina Tesio
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
| | - Jenny Bertholet
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Joint Department of Physics, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Anne Gasnier
- Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Mateusz Spalek
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - Jean-Emmanuel Bibault
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Radiation Oncology Department, Hopital Europeen Georges Pompidou, Universite Paris Descartes, Paris, France
| | - Gerben Borst
- Department of Oncology, Radiation Oncology Department, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Wouter Van Elmpt
- The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Daniela Thorwarth
- Section for Biomedical Physics, University Hospital for Radiation Oncology Tubingen, Germany
| | - Laura Mullaney
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Applied Radiation Therapy Trinity Research Group, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland
| | - Kathrine Røe Redalen
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ludwig Dubois
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; The M-Lab, Department of Precision Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Cyrus Chargari
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sophie Perryck
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Switzerland
| | - Jolien Heukelom
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Oncology, Radiation Oncology Department, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Steven Petit
- European Society for Radiotherapy&Oncology (ESTRO) Young Committee, Brussels, Belgium; Department of Radiation Oncology - Erasmus Cancer Institute, Rotterdam, The Netherlands
| | | | - Lorys Castelli
- Department of Psychology, "ReMind the Body" Research Group, University of Turin, Italy
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12
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Larice S, Ghiggia A, Di Tella M, Romeo A, Gasparetto E, Fusaro E, Castelli L, Tesio V. Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis. Scand J Psychol 2019; 61:271-280. [PMID: 31674683 DOI: 10.1111/sjop.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 01/20/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022]
Abstract
Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients' quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.
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Affiliation(s)
- Sara Larice
- Department of Psychology, University of Turin, Turin, Italy
| | - Ada Ghiggia
- Clinical Psychology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | | | - Annunziata Romeo
- Clinical Psychology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Eleonora Gasparetto
- Clinical Psychology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Enrico Fusaro
- Rheumatology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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13
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Romeo A, Di Tella M, Ghiggia A, Tesio V, Torta R, Castelli L. Posttraumatic growth in breast cancer survivors: Are depressive symptoms really negative predictors? Psychol Trauma 2019; 12:244-250. [PMID: 31478712 DOI: 10.1037/tra0000508] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Breast cancer (BC) diagnosis is a potentially traumatic event, the related challenges of which can trigger positive or negative reactions. Posttraumatic growth (PTG) is defined as a positive psychological change experienced as a result of the struggle. The present study aimed to shed light on the relationship between the evolution of depressive symptoms over time and PTG in a group of BC survivors. METHOD Depressive symptoms at the time of diagnosis (T0) and 2 years later (T1) were evaluated to investigate their potential impact on the level of PTG at T1. A total of 147 BC patients were recruited and divided into 4 groups according to the changes in depressive symptoms they experienced over time (patients who were never depressed, no longer depressed, still depressed, and depressed now). A One-way analysis of variance was run to compare the levels of PTG for the four groups. RESULTS The One-way analysis of variance showed that PTG score was significantly different among groups with different levels of depressive symptoms (p = .008). Post hoc comparisons indicated that the PTG score was statistically significantly higher in the no longer depressed group compared with the still depressed and depressed now groups. CONCLUSIONS The current results suggest that high levels of depressive symptoms, displayed at the time of cancer diagnosis, can be considered catalysts for PTG at follow-up, on condition that women experience elevated depressive symptoms only in the first period of the disease. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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14
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Tesio V, Ghiggia A, Di Tella M, Castelli L. Utility of the Diagnostic Criteria for Psychosomatic Research in assessing psychological disorders in fibromyalgia patients. J Affect Disord 2019; 256:219-220. [PMID: 31200161 DOI: 10.1016/j.jad.2019.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/03/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Valentina Tesio
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy; Clinical and Oncological Psychology, "Città della Salute e della Scienza" Hospital of Turin, Corso Bramante 88/90, 10126 Turin, Italy.
| | - Marialaura Di Tella
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
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15
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Tesio V, Goerlich KS, Hosoi M, Castelli L. Editorial: Alexithymia: State of the Art and Controversies. Clinical and Neuroscientific Evidence. Front Psychol 2019; 10:1209. [PMID: 31178809 PMCID: PMC6543916 DOI: 10.3389/fpsyg.2019.01209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/07/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Katharina S Goerlich
- Department of Biomedical Sciences, Behavioural and Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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16
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Airoldi M, Bovero A, Botto R, Adriano B, Opezzo M, Tesio V, Torta R. Demoralization and associated features in an Italian sample of end-of-life cancer patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e23004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e23004 Background: Demoralization is an expression of cancer-related existential distress that emerges from feelings of loss and changes linked to a life-threatening clinical condition. It is characterized by subjective incompetence, sense of failure, hopelessness, loss of purpose/meaning and low self-esteem. The study aimed to explore prevalence, latent dimensions and associated features of demoralization in a sample of end-of-life cancer patients. Methods: Participants were recruited for a cross-sectional assessment. For each patient, demoralization, anxiety, depression, physical symptoms, pain, spiritual well-being, and dignity were evaluated through validated rating scales and personal and medical data were gathered by a clinician. Final sample consisted of 235 end-of-life cancer patients with a Karnofsky Performance Status (KPS) lower than 50 and a life expectancy of few weeks. Results: High levels of demoralization occurred in 22.6% (n = 53) of patients. Sixty-four participants (27.2%) had low demoralization and 50.2% (n = 118) had moderate demoralization. Emotional Distress and Inability to Cope, Loss of Purpose and Meaning, Worthlessness, Sense of Failure and Dysphoria were the five latent dimensions of demoralization emerged from the factor analysis. Demoralization was significantly associated with depression, anxiety, dignity, spiritual well-being and the physical symptoms except for nausea and breathing problems. Conclusions: Demoralization levels seem to be higher in this distinctive population than in advanced cancer patients. This could be due to the fact that end-of-life cancer patients are in a severe clinical condition and nearing death. The emerged demoralization dimensions could be five forms of expression of the existential distress typical of this illness phase. The considerable number of patients suffering from demoralization strengthen the need for psychological interventions in order to reduce the existential distress at the end of life, focusing on finding meaning and detecting spiritual concerns.
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Affiliation(s)
- Mario Airoldi
- 2nd Medical Oncology Division, A. O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Andrea Bovero
- Psycho-oncology Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - Rossana Botto
- Department of Neuroscience, University of Turin, Torino, Italy
| | - Beatrice Adriano
- Psycho-oncology Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - Marta Opezzo
- Psycho-oncology Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - Valentina Tesio
- Department of Psychology, University of Turin, Turin, Turin, Italy
| | - Riccardo Torta
- Psycho-oncology Unit, Department of Neuroscience, University of Turin, Turin, Italy
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17
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Romeo A, Di Tella M, Ghiggia A, Tesio V, Gasparetto E, Stanizzo MR, Torta R, Castelli L. The Traumatic Experience of Breast Cancer: Which Factors Can Relate to the Post-traumatic Outcomes? Front Psychol 2019; 10:891. [PMID: 31105621 PMCID: PMC6491882 DOI: 10.3389/fpsyg.2019.00891] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 12/13/2018] [Accepted: 04/03/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Post-traumatic growth (PTG) is considered a positive outcome of struggling with a traumatic event, distinct, and opposite from negative outcomes, i.e., psychological distress. The present study aimed to shed light on the relationship between potentially relating factors (i.e., coping strategies, perceived social support, and attachment style) and both positive and negative psychological outcomes. Methods: A total of 123 breast cancer survivors were recruited, who completed a battery of self-report questionnaires, assessing PTG, psychological distress, coping strategies, perceived social support, and attachment style. Three regression analyses were run to evaluate whether relating factors were significant predictors of the positive and negative psychological outcomes. Results: The regression analyses showed that the "Fatalism" coping strategy and perceived social support were two significant predictors of PTG. Instead, the "Helpless-Hopeless" and "Anxious Preoccupation" coping strategies, as well as an insecure attachment style, were significant predictors of depression, while the "Anxious Preoccupation" coping strategy and an insecure attachment style were significant predictors of anxiety. Conclusions: The present findings showed that the factors underlying a positive or negative outcome are different and specific. While perceived social support and a fatalistic attitude seem to play a key role in the positive outcome, dysfunctional coping strategies, together with an insecure attachment style, appear to be related with negative psychological outcome. Considering these factors in clinical practice would help patients to give meaning to their traumatic experience, enhancing psychological growth.
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Affiliation(s)
| | | | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Eleonora Gasparetto
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Maria Rosa Stanizzo
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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18
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Franco P, Tesio V, Bertholet J, Gasnier A, del Portillo EG, Spalek M, Bibault J, Borst G, Van Elmpt W, Thorwhart D, Mullaney L, Redalen KR, Dubois L, Bittner M, Chargari C, Lybeer M, Castelli L. OC-0327 The PRO BONO survey (PROject on Burn-Out in RadiatioN Oncology). Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30747-9] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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19
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Castelnuovo G, Giusti EM, Manzoni GM, Saviola D, Gabrielli S, Lacerenza M, Pietrabissa G, Cattivelli R, Spatola CAM, Rossi A, Varallo G, Novelli M, Villa V, Luzzati F, Cottini A, Lai C, Volpato E, Cavalera C, Pagnini F, Tesio V, Castelli L, Tavola M, Torta R, Arreghini M, Zanini L, Brunani A, Seitanidis I, Ventura G, Capodaglio P, D'Aniello GE, Scarpina F, Brioschi A, Bigoni M, Priano L, Mauro A, Riva G, Di Lernia D, Repetto C, Regalia C, Molinari E, Notaro P, Paolucci S, Sandrini G, Simpson S, Wiederhold BK, Gaudio S, Jackson JB, Tamburin S, Benedetti F. What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation. Front Neurol 2018; 9:310. [PMID: 29867723 PMCID: PMC5968866 DOI: 10.3389/fneur.2018.00310] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/19/2018] [Indexed: 12/12/2022] Open
Abstract
Background It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy.
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Affiliation(s)
- Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emanuele Maria Giusti
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Donatella Saviola
- Cardinal Ferrari Rehabilitation Center, Santo Stefano Rehabilitation Istitute, Fontanellato, Italy
| | | | - Marco Lacerenza
- Pain Medicine Center, San Pio X Clinic, Humanitas, Milan, Italy
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Chiara Anna Maria Spatola
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Alessandro Rossi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | - Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | - Margherita Novelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | - Valentina Villa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | | | | | - Carlo Lai
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Eleonora Volpato
- Department of Psychology, Catholic University of Milan, Milan, Italy.,HD Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Cesare Cavalera
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Department of Psychology, Harvard University, Cambridge, MA, United States
| | | | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
| | - Mario Tavola
- Anesthesia and Intensive Care, ASST Lecco, Lecco, Italy
| | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Marco Arreghini
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Loredana Zanini
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Amelia Brunani
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Ionathan Seitanidis
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Giuseppe Ventura
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Paolo Capodaglio
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit, San Giuseppe Hospital, Verbania, Italy
| | - Guido Edoardo D'Aniello
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Federica Scarpina
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy
| | - Andrea Brioschi
- Istituto Auxologico Italiano IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Verbania, Italy
| | - Matteo Bigoni
- Istituto Auxologico Italiano IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Verbania, Italy
| | - Lorenzo Priano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Istituto Auxologico Italiano IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Verbania, Italy
| | - Alessandro Mauro
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Istituto Auxologico Italiano IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Verbania, Italy
| | - Giuseppe Riva
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Daniele Di Lernia
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Camillo Regalia
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Paolo Notaro
- Pain Medicine, Anesthesiology Department, A.O. Ospedale Niguarda ca Granda, Milan, Italy
| | | | - Giorgio Sandrini
- C. Mondino National Neurological Institute, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Susan Simpson
- University of South Australia, Adelaide, SA, Australia.,Regional Eating Disorders Unit, NHS Lothian, Livingston, United Kingdom
| | | | - Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | | | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Fabrizio Benedetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
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Tesio V, Di Tella M, Ghiggia A, Romeo A, Colonna F, Fusaro E, Geminiani GC, Castelli L. Alexithymia and Depression Affect Quality of Life in Patients With Chronic Pain: A Study on 205 Patients With Fibromyalgia. Front Psychol 2018; 9:442. [PMID: 29670558 PMCID: PMC5893813 DOI: 10.3389/fpsyg.2018.00442] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 03/16/2018] [Indexed: 12/29/2022] Open
Abstract
Pain in fibromyalgia (FM) is accompanied by a heterogeneous series of other symptoms, which strongly affect patients’ quality of life and interfere with social and work performance. The present study aimed to evaluate the effects of alexithymia on both the physical and the psychosocial components of the health-related quality of life (HRQoL) of FM patients, controlling for the concomitant effects of depression, anxiety, and pain. In particular, given the strong interconnection between depression and alexithymia, the relationship between alexithymia and HRQoL as mediated by depressive symptoms was further investigated. Data were collected on a consecutive sample of 205 female patients with a main diagnosis of FM. The results showed that about 26% of the patients showed the presence of alexithymia, as assessed by the Toronto Alexithymia Scale (TAS-20). Clinically relevant levels of depressive and anxiety symptoms were present in 61 and 60% of the patients, respectively. The results of the hierarchical multiple regression analyses showed that pain intensity (PI) and depressive symptoms explained the 45% of the variance of the physical component of HRQoL (p < 0.001). Regarding the mental component of HRQoL, depressive and anxiety symptoms, alexithymia, and PI significantly explained 61% of the variance (p < 0.001). The mediation analyses confirmed that alexithymia had a direct effect on the mental component of HRQoL and showed a statistically significant indirect effect on both the physical and the mental components, through the mediation of depressive symptoms. In conclusion, the results of the present study suggested the presence of both a direct and an indirect effect of alexithymia, in particular of the difficulty identifying feeling, on the HRQoL of patients with FM. Indeed, even though the concomitant presence of depressive symptoms is responsible of an indirect effect, alexithymia per se seems to directly contribute to worsen the impact that this chronic pain pathology has on the patients’ quality of life, especially regarding the psychosocial functioning.
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Affiliation(s)
| | | | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
| | - Annunziata Romeo
- Department of Psychology, University of Turin, Turin, Italy.,Clinical Psychology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Fabrizio Colonna
- Clinical Psychology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Enrico Fusaro
- Rheumatology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | | | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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Tella MD, Enrici I, Castelli L, Colonna F, Fusaro E, Ghiggia A, Romeo A, Tesio V, Adenzato M. Alexithymia, not fibromyalgia, predicts the attribution of pain to anger-related facial expressions. J Affect Disord 2018; 227:272-279. [PMID: 29127814 DOI: 10.1016/j.jad.2017.10.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 07/14/2017] [Revised: 09/12/2017] [Accepted: 10/30/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Fibromyalgia (FM) is a syndrome characterized by chronic, widespread musculoskeletal pain, occurring predominantly in women. Previous studies have shown that patients with FM display a pattern of selective processing or cognitive bias which fosters the encoding of pain-related information. The present study tested the hypothesis of an increased attribution of pain to facial expressions of emotions (FEE), in patients with FM. As previous studies have shown that alexithymia influences the processing of facial expressions, independent of specific clinical conditions, we also investigated whether alexithymia, rather than FM per se, influenced attribution of pain to FEE. METHODS One hundred and twenty-three women (41 with FM, 82 healthy controls, HC) were enrolled in this cross-sectional case-control study. We adopted two pain-attribution tasks, the Emotional Pain Estimation and the Emotional Pain Ascription, both using a modified version of the Ekman 60 Faces Test. Psychological distress was assessed using the Hospital Anxiety and Depression Scale, and alexithymia was assessed using the Toronto Alexithymia Scale. RESULTS Patients with FM did not report increased attribution of pain to FEE. Alexithymic individuals demonstrated no specific problem in the recognition of basic emotions, but attributed significantly more pain to angry facial expression. LIMITATIONS Our study involved a relatively small sample size. The use of self-reported instruments might have led to underestimation of the presence of frank alexithymia in individuals having borderline cut-off scores. CONCLUSIONS Alexithymia, rather than FM per se, plays a key role in explaining the observed differences in pain attribution to anger-related facial expressions.
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Affiliation(s)
| | - Ivan Enrici
- Department of Philosophy and Educational Sciences, University of Turin, Turin, Italy; Neuroscience Institute of Turin, Turin, Italy.
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
| | - Fabrizio Colonna
- A.O.U. "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Enrico Fusaro
- A.O.U. "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
| | | | | | - Mauro Adenzato
- Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin, Turin, Italy
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Carletto S, Tesio V, Borghi M, Francone D, Scavelli F, Bertino G, Malucchi S, Bertolotto A, Oliva F, Torta R, Ostacoli L. The Effectiveness of a Body-Affective Mindfulness Intervention for Multiple Sclerosis Patients with Depressive Symptoms: A Randomized Controlled Clinical Trial. Front Psychol 2017; 8:2083. [PMID: 29250012 PMCID: PMC5714860 DOI: 10.3389/fpsyg.2017.02083] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/15/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose: Mindfulness interventions have been shown to treat depressive symptoms and improve quality of life in patients with several chronic diseases, including multiple sclerosis, but to date most evaluation of the effectiveness of mindfulness interventions in multiple sclerosis have used patients receiving standard care as the control group. Hence we decided to evaluate the effectiveness of a group-based body-affective mindfulness intervention by comparing it with a psycho-educational intervention, by means of a randomized controlled clinical trial. The outcome variables (i.e., depression, anxiety, perceived stress, illness perception, fatigue and quality of life) were evaluated at the end of the interventions (T1) and after a further 6 months (T2). Methods: Of 90 multiple sclerosis patients with depressive symptoms (Beck Depression Inventory-II score greater than 13) who were randomized, 71 completed the intervention (mindfulness group n = 36; psycho-educational group n = 35). The data were analyzed with GLM repeated-measures ANOVA followed by pairwise comparisons. Results: Per-protocol analysis revealed a time by group interaction on Beck Depression Inventory-II score, with the mindfulness intervention producing a greater reduction in score than the psycho-educational intervention, both at T1 and at T2. Furthermore, the mindfulness intervention improved patients’ quality of life and illness perception at T1 relative to the baseline and these improvements were maintained at the follow-up assessment (T2). Lastly, both interventions were similarly effective in reducing anxiety and perceived stress; these reductions were maintained at T2. A whole-sample intention-to-treat (ITT) analysis broadly confirmed the effectiveness of the mindfulness intervention. Conclusion: In conclusion, these results provide methodologically robust evidence that in multiple sclerosis patients with depressive symptoms mindfulness interventions improve symptoms of depression and anxiety and perceived stress, modulate illness representation and enhance quality of life and that the benefits are maintained for at least 6 months. Trial registration: the study was registered in the ClinicalTrials.gov registry (NCT02611401).
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Affiliation(s)
- Sara Carletto
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Martina Borghi
- Neurologia 2 - Centro di Riferimento Regionale Sclerosi Multipla, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Italy.,Clinical Psychology and Psychosomatics Service, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, University of Turin, Orbassano, Italy
| | - Diana Francone
- Clinical Psychology and Psychosomatics Service, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, University of Turin, Orbassano, Italy
| | - Francesco Scavelli
- Neurologia 2 - Centro di Riferimento Regionale Sclerosi Multipla, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Italy.,Clinical Psychology and Psychosomatics Service, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, University of Turin, Orbassano, Italy
| | - Gabriella Bertino
- Clinical Psychology and Psychosomatics Service, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, University of Turin, Orbassano, Italy
| | - Simona Malucchi
- Neurologia 2 - Centro di Riferimento Regionale Sclerosi Multipla, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Italy
| | - Antonio Bertolotto
- Neurologia 2 - Centro di Riferimento Regionale Sclerosi Multipla, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Italy
| | - Francesco Oliva
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Riccardo Torta
- Clinical and Oncological Psychology, Città della Salute e della Scienza Hospital of Turin, Turin, Italy.,Department of Neuroscience, University of Turin, Turin, Italy
| | - Luca Ostacoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Clinical and Oncological Psychology, Città della Salute e della Scienza Hospital of Turin, Turin, Italy
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23
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Di Tella M, Tesio V, Ghiggia A, Romeo A, Colonna F, Fusaro E, Geminiani GC, Bruzzone M, Torta R, Castelli L. Coping strategies and perceived social support in fibromyalgia syndrome: Relationship with alexithymia. Scand J Psychol 2017; 59:167-176. [PMID: 29110306 DOI: 10.1111/sjop.12405] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 05/18/2017] [Accepted: 10/04/2017] [Indexed: 02/03/2023]
Abstract
Fibromyalgia (FM) is a chronic pain syndrome characterized by high levels of psychological distress and alexithymia, a personality disposition affecting emotional self-awareness. The main aim of the present study was to investigate for the first time the relationship between alexithymia and coping strategies on the one hand, and alexithymia and perceived social support on the other, in a sample of FM patients. To reach this aim, 153 FM patients completed a battery of tests assessing coping strategies, perceived social support, alexithymia, psychological distress and pain intensity. Four regression analyses were performed to assess whether alexithymia was still a significant predictor of coping strategies and perceived social support, after controlling for psychological distress. High levels of both psychological distress and alexithymia were found in our sample of FM patients. Regarding coping strategies, FM patients reported higher scores on problem-focused coping, with respect to the other two coping strategies. The regression analyses showed that the externally-oriented thinking factor of alexithymia significantly explained both problem- and emotion-focused coping, while the difficulty-describing feelings factor of alexithymia proved to be a significant predictor of perceived social support. Only the variance of dysfunctional coping ceased to be uniquely explained by alexithymia (difficulty identifying feelings factor), after controlling for psychological distress, particularly anxiety. These results highlight a negative relationship between alexithymia and both the use of effective coping strategies and the levels of perceived social support in FM patients. An adequate assessment of both alexithymia and psychological distress should therefore be included in clinical practice with these patients.
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Affiliation(s)
| | | | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Fabrizio Colonna
- A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy
| | - Enrico Fusaro
- A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy
| | - Giuliano Carlo Geminiani
- Department of Psychology, University of Turin, Turin, Italy.,A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy
| | - Maria Bruzzone
- A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy
| | - Riccardo Torta
- A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy.,Department of Neuroscience, University of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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Ghiggia A, Romeo A, Tesio V, Tella MD, Colonna F, Geminiani GC, Fusaro E, Castelli L. Alexithymia and depression in patients with fibromyalgia: When the whole is greater than the sum of its parts. Psychiatry Res 2017; 255:195-197. [PMID: 28577473 DOI: 10.1016/j.psychres.2017.05.045] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [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] [Received: 10/05/2016] [Revised: 05/26/2017] [Accepted: 05/29/2017] [Indexed: 12/12/2022]
Abstract
This study investigated the link between alexithymia and depressive symptoms in Fibromyalgia (FM). 181 FM women and 181 healthy controls (HC) were compared using the Hospital Anxiety and Depression Scale and the Toronto Alexithymia Scale. A moderation analysis was performed to examine the moderation effect of the group (FM vs. HC) on the relationship between alexithymia and depression. Group was a significant moderator, highlighting a stronger relationship between alexithymia and depressive symptoms in the FM compared to HC. The study highlighted that the association between alexithymia and depression is different when we consider FM patients rather than the healthy population.
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Affiliation(s)
- Ada Ghiggia
- Department of Psychology, University of Turin, Italy
| | | | | | | | - Fabrizio Colonna
- Clinical and Oncological Psychology, Department of Neuroscience, "Città della Salute e della Scienza" Hospital of Turin, Italy
| | | | - Enrico Fusaro
- Rheumatology Unit, "Città della Salute e della Scienza" Hospital of Turin, Italy
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Tesio V, Marra S, Molinaro S, Torta R, Gaita F, Castelli L. Screening of depression in cardiology: A study on 617 cardiovascular patients. Int J Cardiol 2017; 245:49-51. [PMID: 28747268 DOI: 10.1016/j.ijcard.2017.07.065] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 03/07/2017] [Revised: 06/27/2017] [Accepted: 07/18/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression screening in the cardiovascular disease (CVD) care setting is under-performed, also because the issue of the optimal screening tools cut-off is still open. We analysed which HADS (Hospital Anxiety and Depression Scale) total score cut-off value shows the best properties in two groups of 357 Acute Coronary Syndrome (ACS) and 260 Chronic Coronary Artery Disease (CAD) hospitalized patients. METHODS A Receiver Operating Characteristics (ROC) curve was plotted for both groups using the Montgomery-Asberg Depression Rating Scale (MADRS) as the criterion. Accuracy, positive (PPV) and negative (NPV) predictive values were computed for different cut-off scores. RESULTS The ROC curves confirmed the excellent/very good accuracy of the HADS in both groups, with an area under the curve of 0.911 for the ACS and 0.893 for the CAD patients. The cut-off of 14 showed the best compromise between high sensitivity and good specificity in both groups, with high negative predicted values (95.5% and 92.4%, respectively). CONCLUSION Using a cut-off value of 14, the HADS could be considered a good screening tool to identify hospitalized CAD and ACS patients requiring a more accurate depression assessment, in order to promptly plan the most appropriate treatment strategies and prevent the negative effects of depression in CVD patients.
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Affiliation(s)
- Valentina Tesio
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy.
| | - Sebastiano Marra
- Division of Cardiology, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126 Turin, Italy
| | - Stefania Molinaro
- Clinical Psychology and Psycho-Oncology Unit, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126 Turin, Italy
| | - Riccardo Torta
- Clinical Psychology and Psycho-Oncology Unit, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126 Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, University of Turin, "Città della Salute e della Scienza" Hospital, Corso Bramante 88, 10126 Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy
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26
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Ghiggia A, Torta R, Tesio V, Di Tella M, Romeo A, Colonna F, Geminiani GC, Fusaro E, Batticciotto A, Castelli L. Psychosomatic syndromes in fibromyalgia. Clin Exp Rheumatol 2017; 35 Suppl 105:106-111. [PMID: 28681716] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this study was to compare the prevalence of psychosomatic symptoms in patients with fibromyalgia (FM) or rheumatoid arthritis (RA). METHODS Seventy-six consecutive women with FM and 80 with RA without concomitant FM were assessed using the Diagnostic Criteria for Psychosomatic Research (DCPR) interview to evaluate the presence of psychosomatic syndromes. Beck Depression Inventory - II (BDI-II) and Form Y of the State-Trait Anxiety Inventory (STAI-Y) were administered in order to assess the symptoms of anxiety and depression. RESULTS Significantly higher levels of anxiety and depression were found in the FM patients (p<0.001), and each FM patient (as against 79% of the RA patients) presented at least one DCPR syndrome. Comparisons of psychological distress between the FM patients with and without each of the psychosomatic syndromes revealed high levels of anxiety and depression in the patients with the psychosomatic condition. CONCLUSIONS The findings of this study highlight the greater presence of psychological distress and psychosomatic syndromes in patients with FM than in RA patients. The FM patients with psychosomatic symptoms also showed high levels of psychological distress. A better understanding of the psychosomatic manifestations of FM syndrome could allow clinicians to structure tailored interventions that take more account of the emotional distress associated with the physical complaints.
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Affiliation(s)
- Ada Ghiggia
- Department of Psychology, University of Turin, Italy
| | - Riccardo Torta
- Clinical and Oncological Psychology, Department of Neuroscience, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | | | | | - Fabrizio Colonna
- Clinical and Oncological Psychology, Department of Neuroscience, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Enrico Fusaro
- Rheumatology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Alberto Batticciotto
- Rheumatology Unit, ASST-Fatebenefratelli- L. Sacco University Hospital, Milan, Italy
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27
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Romeo A, Tesio V, Castelnuovo G, Castelli L. Attachment Style and Chronic Pain: Toward an Interpersonal Model of Pain. Front Psychol 2017; 8:284. [PMID: 28286493 PMCID: PMC5323382 DOI: 10.3389/fpsyg.2017.00284] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/10/2016] [Accepted: 02/14/2017] [Indexed: 12/21/2022] Open
Abstract
Chronic pain (CP) is a burdensome symptom. Different psychological models have been proposed to explain the role of psychological and social factors in developing and maintaining CP. Attachment, for example, is a psychological construct of possible relevance in CP. The first studies on the role of attachment in CP did not investigate the partner’s psychological factors, thus neglecting the influence of the latter. The main aim of this mini-review was to examine the more recent literature investigating the relationship between CP and attachment style. In particular, whether or not more recent studies assessed the psychological variables of a patient’s partner. The articles were selected from the Medline/PubMed database using the search terms “attachment” AND “pain”; “CP” AND “attachment style,” which led to nine papers being identified. The results showed that, even though the key point was still the hypothesis that an insecure attachment style is associated with CP, in recent years researchers have focused on the possible psychological aspects mediating between attachment style and CP. In particular, worrying, coping strategies, catastrophizing and perceived spouse responses to pain behavior were taken into account. Only one study considered the role of the reciprocal influence of attachment style of both patient and partner, underlining the role of real significant others’ responses to pain behaviors. In conclusion, the results of the present mini-review highlight how in recent years researchers have moved toward investigating those psychological aspects that could mediate the relationship between attachment and CP, while only partially evaluating the interpersonal perspective.
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Affiliation(s)
| | | | - Gianluca Castelnuovo
- Psychology Research Laboratory, IRCCS Istituto Auxologico ItalianoVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
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Romeo A, Ghiggia A, Tesio V, Di Tella M, Torta R, Castelli L. Post-traumatic growth, distress and attachment style among women with breast cancer. J Psychosoc Oncol 2017; 35:309-322. [PMID: 28145810 DOI: 10.1080/07347332.2017.1289291] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Annunziata Romeo
- Department of Psychology, University of Turin, Turin, Italy
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
| | | | | | - Riccardo Torta
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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29
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Di Tella M, Ghiggia A, Tesio V, Romeo A, Colonna F, Fusaro E, Torta R, Castelli L. Pain experience in Fibromyalgia Syndrome: The role of alexithymia and psychological distress. J Affect Disord 2017; 208:87-93. [PMID: 27750065 DOI: 10.1016/j.jad.2016.08.080] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [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] [Received: 05/19/2016] [Revised: 07/21/2016] [Accepted: 08/27/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic pain syndrome with a high prevalence of alexithymia, a personality disposition that affects emotional self-awareness. The present study aimed to investigate the relationship between alexithymia and pain, differentiating between the sensory and affective components of pain experience, in a sample of FM patients. METHODS One hundred and fifty-nine FM patients completed a battery of tests assessing pain experience, pain intensity, alexithymia and psychological distress. In order to characterize the clinical profile of alexithymic FM patients, alexithymic and non-alexithymic groups were compared on the different measures. Two regression analyses were performed on the total sample, in order to investigate the relationship between alexithymia and pain, controlling for psychological distress. RESULTS Alexithymic FM patients presented higher scores on all the clinical measures compared to non-alexithymic ones. Positive correlations were found between alexithymia and the affective, but not the sensory, dimension of pain experience variables. Regression analyses showed that alexithymia (difficulty identifying feelings factor) ceased to uniquely predict affective pain, after controlling for psychological distress, particularly anxiety. In addition, none of the alexithymia variables significantly explained pain intensity variance. Finally, a significant effect of anxiety in mediating the relationship between alexithymia and affective pain was found. LIMITATIONS No longitudinal data were included. CONCLUSIONS These findings show the presence of higher levels of pain and psychological distress in alexithymic vs. non-alexithymic FM patients, and a relevant association between alexithymia and the affective dimension of pain experience. Specifically, this relationship appears to be significantly mediated by anxiety.
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Affiliation(s)
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy.
| | | | | | - Fabrizio Colonna
- A.O.U. Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Enrico Fusaro
- A.O.U. Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Riccardo Torta
- Department of Neuroscience, University of Turin, Turin, Italy; A.O.U. Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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30
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Ghiggia A, Castelli L, Riva G, Tesio V, Provenzano E, Ravera M, Garzaro M, Pecorari G, Franco P, Potenza I, Rampino M, Torta R. Psychological distress and coping in nasopharyngeal cancer: an explorative study in Western Europe. PSYCHOL HEALTH MED 2016; 22:449-461. [PMID: 27687515 DOI: 10.1080/13548506.2016.1220600] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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] [Indexed: 10/21/2022]
Abstract
Nasopharyngeal carcinoma (NPC) is the head and neck cancer with the greatest impact on patients' quality of life. The aim of this explorative study is to investigate the psychological distress, coping strategies and quality of life of NPC patients in the post-treatment observation period. Twenty-one patients disease-free for at least two years were assessed with a medical and a psycho-oncological evaluation. Clinically relevant depressive symptoms (CRD) were present in 23.8% of patients and 33.3% reported clinically relevant anxiety symptoms (CRA). Patients with CRD and CRA showed a significantly higher score in the use of hopelessness/helplessness and anxious preoccupation coping strategies and a worse quality of life. Even in the post-treatment period, about a quarter of patients showed CRD and CRA. Results showed that patients with high anxiety or depressive symptoms seem to use dysfunctional coping strategies, such as hopelessness and anxious preoccupation, more than patients with lower levels of anxiety and depression. The use of these styles of coping thus seems to be associated to a higher presence of CRA or CRD symptomatology and to a worse quality of life.
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Affiliation(s)
- Ada Ghiggia
- a Department of Psychology , University of Turin , Turin , Italy
| | - Lorys Castelli
- a Department of Psychology , University of Turin , Turin , Italy
| | - Giuseppe Riva
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Valentina Tesio
- a Department of Psychology , University of Turin , Turin , Italy
| | - Erica Provenzano
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Mattia Ravera
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Massimiliano Garzaro
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Giancarlo Pecorari
- b First Ear Nose and Throat Division, Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Pierfrancesco Franco
- c Radiation Oncology Unit, Department of Oncology , University of Turin , Turin , Italy
| | - Ilenia Potenza
- c Radiation Oncology Unit, Department of Oncology , University of Turin , Turin , Italy
| | - Monica Rampino
- c Radiation Oncology Unit, Department of Oncology , University of Turin , Turin , Italy
| | - Riccardo Torta
- d Clinical and Oncological Psychology, Department of Neuroscience , 'Città della Salute e della Scienza', Hospital of Turin , Turin , Italy
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Castelli L, Tesio V. Commentary: Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients. Front Psychol 2016; 7:740. [PMID: 27242640 PMCID: PMC4871879 DOI: 10.3389/fpsyg.2016.00740] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/04/2016] [Indexed: 12/02/2022] Open
Affiliation(s)
- Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
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32
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Torta RGV, Tesio V, Ieraci V, Castelli L, Zizzi FB. Fibro-fog. Clin Exp Rheumatol 2016; 34:S6-S8. [PMID: 27049627] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 03/07/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Riccardo G V Torta
- Clinical and Oncological Psychology, A.O.U Città della Salute e della Scienza; and Department of Neuroscience, University of Turin, Italy
| | - Valentina Tesio
- Clinical and Oncological Psychology, A.O.U Città della Salute e della Scienza; and Department of Psychology, University of Turin, Italy.
| | - Valentina Ieraci
- Clinical and Oncological Psychology, A.O.U Città della Salute e della Scienza; and Department of Neuroscience, University of Turin, Italy
| | | | - Francesca B Zizzi
- Clinical and Oncological Psychology, A.O.U Città della Salute e della Scienza; and Department of Neuroscience, University of Turin, Italy
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Civilotti C, Castelli L, Binaschi L, Cussino M, Tesio V, Di Fini G, Veglia F, Torta R. Dissociative symptomatology in cancer patients. Front Psychol 2015; 6:118. [PMID: 25759675 PMCID: PMC4338656 DOI: 10.3389/fpsyg.2015.00118] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/22/2015] [Indexed: 11/13/2022] Open
Abstract
Introduction: The utilization of the post-traumatic stress disorder (PTSD) diagnostic spectrum is currently being debated to categorize psychological adjustment in cancer patients. The aims of this study were to: (1) evaluate the presence of cancer-related traumatic dissociative symptomatology in a sample of cancer patients; (2) examine the correlation of cancer-related dissociation and sociodemographic and medical variables, anxiety, depression, and post-traumatic stress symptomatology; (3) investigate the predictors of cancer-related dissociation. Methods: Ninety-two mixed cancer patients (mean age: 58.94, ds = 10.13) recruited from two hospitals in northern Italy were administered a questionnaire on sociodemographic and medical characteristics, the Karnofsky Scale to measure the level of patient activity and medical care requirements, the Hospital Anxiety and Depression Scale (HADS) to evaluate the presence of anxiety and depression, the Impact of Event Scale Revised (IES-R) to assess the severity of intrusion, avoidance, and hypervigilance, and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) to quantify the traumatic dissociative symptomatology. Results: 31.5% of participants report a PDEQ score above the cutoff. The results indicated that dissociative symptomatology was positively correlated with HADS scores (HADS-Anxiety: r = 0.476, p < 0.001; HADS-Depression: r = 0.364, p < 0.001) and with IES-R scores (IES-R-Intrusion: r = 0.698, p < 0.001; IES-R-Avoidance: r = 0.619, p < 0.001; IES-R- Hypervigilance: r = 0.681, p < 0.001). A stepwise regression analysis was performed in order to find the predictors of cancer-related traumatic dissociative symptomatology. The results converged on a three predictor model revealing that IES-R-Intrusion, IES-R-Avoidance, and IES-R-Hyperarousal accounted for 53.9% of the explained variance. Conclusion: These findings allow us to hypothesize a specific psychological reaction which may be ascribed to the traumatic spectrum within the context of cancer, emphasizing the close relationship between the origin of dissociative constituents which, according to the scientific literature, compose the traumatic experience. Our results have implications for understanding dissociative symptomatology in a cancer population and can help develop clinical programs of prevention and support for patients.
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Affiliation(s)
- Cristina Civilotti
- Department of Psychology, University of Turin Turin, Italy ; Fondazione Edo ed Elvo Tempia per la Lotta contro i Tumori Biella, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
| | - Luca Binaschi
- Fondazione Edo ed Elvo Tempia per la Lotta contro i Tumori Biella, Italy ; Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin Turin Italy
| | | | - Valentina Tesio
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin Turin Italy
| | - Giulia Di Fini
- Department of Psychology, University of Turin Turin, Italy
| | - Fabio Veglia
- Department of Psychology, University of Turin Turin, Italy
| | - Riccardo Torta
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin Turin Italy
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Tesio V, Torta DME, Colonna F, Leombruni P, Ghiggia A, Fusaro E, Geminiani GC, Torta R, Castelli L. Are Fibromyalgia Patients Cognitively Impaired? Objective and Subjective Neuropsychological Evidence. Arthritis Care Res (Hoboken) 2014; 67:143-50. [PMID: 25047247 DOI: 10.1002/acr.22403] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 07/08/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Valentina Tesio
- Città della Salute e della Scienza Hospital and University of Turin; Turin Italy
| | | | | | - Paolo Leombruni
- Città della Salute e della Scienza Hospital and University of Turin; Turin Italy
| | | | - Enrico Fusaro
- Città della Salute e della Scienza Hospital; Turin Italy
| | | | - Riccardo Torta
- Città della Salute e della Scienza Hospital and University of Turin; Turin Italy
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Di Tella M, Tesio V, Leombruni P, Colonna F, Bruzzone M, Scarati M, Fusaro E, Torta R, Castelli L. THU0589-HPR An Investigation of Emotional Processing Abilities in Fibromyalgia Syndrome. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4372] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Tesio V, Molinaro S, Castelli L, Andriani M, Fanelli AL, Marra S, Torta R. Screening of depression in cardiac patients: is the HADS an effective tool? Int J Cardiol 2014; 172:e344-5. [PMID: 24461980 DOI: 10.1016/j.ijcard.2013.12.308] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [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: 12/26/2013] [Accepted: 12/30/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Valentina Tesio
- Clinical Psychology and Psycho-Oncology Unit, "Città della Salute e della Scienza" Hospital of Turin, Italy; Department of Neuroscience, University of Turin, Italy.
| | - Stefania Molinaro
- Clinical Psychology and Psycho-Oncology Unit, "Città della Salute e della Scienza" Hospital of Turin, Italy; Department of Neuroscience, University of Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
| | - Monica Andriani
- Cardiology Unit, Cardiovascular and Thoracic Department, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Anna Laura Fanelli
- Cardiology Unit, Cardiovascular and Thoracic Department, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Sebastiano Marra
- Cardiology Unit, Cardiovascular and Thoracic Department, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology and Psycho-Oncology Unit, "Città della Salute e della Scienza" Hospital of Turin, Italy; Department of Neuroscience, University of Turin, Italy
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Molinaro S, Tesio V, Castelli L, Sbarra P, Usmiani T, Fanelli A, Marra S, Torta R. Fast screening of depression in cardiac patients: a study on 350 patients. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5118] [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: 11/12/2022] Open
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Castelli L, De Santis F, De Giorgi I, Deregibus A, Tesio V, Leombruni P, Granieri A, Debernardi C, Torta R. Alexithymia, anger and psychological distress in patients with myofascial pain: a case-control study. Front Psychol 2013; 4:490. [PMID: 23914181 PMCID: PMC3728491 DOI: 10.3389/fpsyg.2013.00490] [Citation(s) in RCA: 23] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 07/12/2013] [Indexed: 12/22/2022] Open
Abstract
Aims: The aim of this study was to investigate psychological distress, anger and alexithymia in a group of patients affected by myofascial pain (MP) in the facial region. Methods: 45 MP patients [mean (SD) age: 38.9 (11.6)] and 45 female healthy controls [mean (SD) age: 37.8 (13.7)] were assessed medically and psychologically. The medically evaluation consisted of muscle palpation of the pericranial and cervical muscles. The psychological evaluation included the assessment of depression (Beck Depression Inventory—short form), anxiety [State-Trait Anxiety Inventory Form Y (STAI-Y)], emotional distress [Distress Thermometer (DT)], anger [State-Trait Anger Expression Inventory—2 (STAXI-2)], and alexithymia [Toronto Alexithymia Scale (TAS)]. Results: the MP patients showed significantly higher scores in the depression, anxiety and emotional distress inventories. With regard to anger, only the Anger Expression-In scale showed a significant difference between the groups, with higher scores for the MP patients. In addition, the MP patients showed significantly higher alexithymic scores, in particular in the Difficulty in identifying feelings (F1) subscale of the TAS-20. Alexithymia was positively correlated with the Anger Expression-In scale. Both anger and alexithymia showed significant positive correlations with anxiety scores, but only anger was positively correlated with depression. Conclusion: A higher prevalence of depressive and anxiety symptoms associated with a higher prevalence of alexithymia and expression-in modality to cope with anger was found in the MP patients. Because the presence of such psychological aspects could contribute to generate or exacerbate the suffering of these patients, our results highlight the need to include accurate investigation of psychological aspects in MP patients in normal clinical practice in order to allow clinicians to carry out more efficacious management and treatment strategies.
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Affiliation(s)
- Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
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Castelli L, Tesio V, Colonna F, Molinaro S, Leombruni P, Bruzzone M, Fusaro E, Sarzi-Puttini P, Torta R. Alexithymia and psychological distress in fibromyalgia: prevalence and relation with quality of life. Clin Exp Rheumatol 2012; 30:70-77. [PMID: 23110722] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 10/01/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with other symptoms like fatigue, stiffness, non-restorative sleep and psychological distress that strongly affects the quality of life in FM patients. While the psychological distress has been widely explored in FM, only a few studies investigated alexithymia, an emotional dysregulation trait. AIMS Evaluate the prevalence of alexithymia and psychological distress and their impact on patients quality of life. METHODS A battery of tests assessing alexithymia, depression, anxiety, emotional distress symptoms and the health related quality of life (HRQoL) was filled out by 55 female FM patients. After having analysed their prevalence, two regression analyses were performed in order to evaluate the role that alexithymia, depression, anxiety, emotional distress and pain characteristics have on quality of life of FM patients. RESULTS Results showed that a clinically relevant level of psychological distress was present in more than half of our sample, whereas alexithymic traits were present in 20% of the patients. Regression analyses showed that pain intensity, depression and current pain were the variables that best contribute to explain the physical component of the HRQoL while anxiety, depression and pain intensity were the variables that mainly contributed to explain the mental component of quality of life. CONCLUSIONS These results underline the high prevalence of alexithymia in FM patients and the great impact of psychological symptoms on FM patients HRQoL. Wholistic care of FM patients which addresses both physical and psychological symptoms is needed.
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Affiliation(s)
- Lorys Castelli
- Department of Psychology, University of Turin, Via Po 14, 10123, Turin, Italy.
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