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The first law on mental health dates back to 1904, and attempted to encourage a uniform national discipline of the mental institutions and established as confinement criteria ‘social danger’ and ‘public scandal’. Very little exists in the scientific literature regarding this topic. A study conducted on the admissions to the Psychiatric Hospital of Collegno and Grugliasco (one of the largest in Italy) has highlighted few predictable aspects of mental health institutions. In particular, it suggests that the stereotype of “psychiatric imprisonment” not only does not correspond to the truth but has become misleading as well. In the past, patients were very often discharged from hospital due to overcrowding and high costs. In 1978 the Italian Parliament enacted the law Number 180. The importance of this law made admissions compulsory but also authorized the modalities and the timing of the Compulsory Psychiatric Treatment (CPT). By confronting the data relative to CPT in Turin from 2007 to 2009 (1,159 CPT per 868 subjects) and those dating back between 1985 and 1998 (4,819 CPT per 3,092 subjects) remarkable results emerge as regards psychiatric emergency in Italy. Recently there has been a higher incidence of CPT due to personality disorders, if compared with schizophrenia. It is clear not only the increasingly higher number of patients affected by these disorders, but also their characterization as emergency cases. In the CPT consent form, terms such as “psychomotor agitation”, “impulsivity” and/or “aggressiveness” are often adopted when making diagnoses both for the clinical evaluation and admission to hospital. These data support the hypothesis that some cases of compulsory admissions are necessary to contain disturbing behaviors, thus confirming CPT as a of social control tool. The institutional function of the Psychiatric Service of Diagnosis and Treatment in general hospital in Italy (PSDT) is responsible for emergency care. A study conducted for 7 years at our PSDT showed that many patients affected by schizophrenia had a positive history of substance abuse and these cases revealed a more severe psychopathology and a major resistance to treatment. Very often the Psychiatric Unit ended up to offering health care assistance to patients presenting with social emergency situations. Our data demonstrate a significant statistical correlation between admitted patients and the length of hospital stays. To fully understand the Italian Psychiatric Reform it is imperative to analyze the university network services and how the 40 Italian universities with psychiatric clinics deal with the education and training of the Mental Health Therapists. The reform established a department model offering diversified and specialized structures within one facility, the Department of Mental Health. The integration and coordination among psychiatry and the other health care services such as addiction treatment facilities, developmental neuropsychiatry, disability, geriatrics and social services had to be regulated. Providing clinical governance, maintaining and improving the quality of patients’ care within the healthcare system, integrating healthcare strategies and diagnostic and therapeutic approaches will be essential to this project. [Copyright &y& Elsevier]

Introduction: Alcohol abuse and dependence are frequently associated with psychiatric disorders and Personality Disorders, with differences among genders. However, only few studies investigated gender differences in personality disorders among alcoholics. Aims: The aim of our study is to investigate personality disorders in a sample of inpatient alcoholics applying Millon Clinical Multiaxial Inventory - III, and to describe gender differences in prevalence and comorbidity of personality disorders. Methods: The study population consist of 206 alcohol dependent patients entering detoxification treatment in a specialized clinic in Italy. At enrollment, patients filled in the Millon Clinical Multiaxial Inventory - III for the assessment of personality disorders and the AUDIT Test for the evaluation of alcohol consumption. Results: The sample consisted of 150 men and 56 women. According to Millon assessment, 25% percent of men vs 12% of women had one PDs, 16% vs 23% had two PDs, and 46% vs 48% had more than three PDs. A statistically significant higher proportion of women got high scores on Avoidant (21.4% vs 9.3%, p=0.020), Self-Defeating (50.0% vs 24.0%, p<0.001), and Borderline scale (42.9% vs 25.3%, p=0.015). Associations among PD are sporadic among men whilst are very frequent among women. Depressive, Self-Defeating and Borderline PDs are frequently associated both to other PDs and among each other, suggesting a possible female pattern. Conclusions: Borderline PD is confirmed to be more frequent among alcoholic women than among men. More studies are needed to clarify prevalence and associations of PDs, prognosis, and gender differences in alcoholics patients. [ABSTRACT FROM AUTHOR]

Objectives: Compassion is acknowledged as a key component of high-quality palliative care, producing positive outcomes for both patients and healthcare providers. The development of the Sinclair Compassion Questionnaire (SCQ) fulfilled the need for a valid and reliable tool to measure patients' experience of compassion. To validate the Italian version of the SCQ and to evaluate its psychometric properties in a sample of cancer patients with a life expectancy of less than 4 months., Methods: Cronbach's alpha estimates were computed to evaluate the internal reliability. Exploratory Factor Analysis, Confirmatory Factor Analysis, and Item Response Theory analyses were performed to assess the validity of the construct. Divergent validity was assessed using the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction, the revised Edmonton Symptom Assessment Scale, and the Trust in Oncologist Scale-Short Form. Data were collected from 131 patients recruited in either a hospital or a hospice setting., Results: The analyses confirmed the single factor structure of SCQit, with Confirmatory Factor Analysis factor loadings ranging between 0.81 and 0.92 and satisfactory internal reliability. Hospital setting and high diagnosis/prognosis awareness were associated with significantly lower SCQit scores, whereas practicing a religious faith was associated with greater experiences of compassion., Significance of Results: The Italian version of the SCQ (SCit) is a valid and reliable measure of patient-reported compassion. The SCQit can be used in clinical practice and research to measure the compassion experiences of terminally ill cancer patients and to evaluate the effectiveness of training to promote compassionate care in healthcare professionals.

Background: This systematic review and individual participant data meta-analysis (IPDMA) examined the overall effectiveness of eye movement desensitization and reprocessing (EMDR) in reducing posttraumatic stress disorder (PTSD) symptoms, achieving response and remission, and reducing treatment dropout among adults with PTSD compared to other psychological treatments. Additionally, we examined available participant-level moderators of the efficacy of EMDR., Methods: This study included randomized controlled trials. Eligible studies were identified by a systematic search in PubMed, Embase, PsyclNFO, PTSDpubs, and CENTRAL. The target population was adults with above-threshold baseline PTSD symptoms. Trials were eligible if at least 70% of study participants had been diagnosed with PTSD using a structured clinical interview. Primary outcomes included PTSD symptom severity, treatment response, and PTSD remission. Treatment dropout was a secondary outcome. The systematic search retrieved 15 eligible randomized controlled trials (RCTs); 8 of these 15 were able to be included in this IPDMA (346 patients). Comparator treatments included relaxation therapy, emotional freedom technique, trauma-focused cognitive behavioral psychotherapies, and REM-desensitization., Results: One-stage IPDMA found no significant difference between EMDR and other psychological treatments in reducing PTSD symptom severity ( β = -0.24), achieving response ( β = 0.86), attaining remission ( β = 1.05), or reducing treatment dropout rates ( β = -0.25). Moderator analyses found unemployed participants receiving EMDR had higher PTSD symptom severity at the post-test, and males were more likely to drop out of EMDR treatment than females., Conclusion: The current study found no significant difference between EMDR and other psychological treatments. We found some indication of the moderating effects of gender and employment status.

Objective: This study aimed to clarify the differential contributions of situational and individual factors to burnout symptoms experienced by two independent groups of specialist oncology nurses working in oncology hospital units or in hospices., Method: The study involved a group of specialist oncology nurses working in hospital oncology units (n = 59) and a group of specialist oncology nurses working in hospices (n = 33). Participants were invited to provide demographic data, and indicate the clinical setting in which they worked and their work experience; the Italian versions of the Maslach Burnout Inventory (MBI) (a measure of burnout symptoms), the Hospital Anxiety and Depression Scale (HADS) (a measure of anxiety and depression), and the Attachment Style Questionnaire (ASQ) (a measure of relational style) were then administered., Results: The two groups of nurses were well matched for age, work experience, and levels of anxiety and depression. Regarding their relational style, the two groups only differed significantly on two subscales of the ASQ (i.e. "Confidence" and "Relationships as Secondary"). The two groups significantly differed in the levels of all burnout symptoms investigated (emotional exhaustion, depersonalization, and personal achievement), with nurses working in hospital units showing higher levels of burnout symptoms. Interestingly, multivariate regression analyses showed that the institutional factor (clinical setting in which nurses worked) clearly emerged as the only factor that influenced the level of all burnout symptoms, whereas the contribution of individual factors was less significant., Significance of Results: These findings help to clarify the differential contributions of institutional and individual factors to burnout symptoms in specialist oncology nurses, and corroborate the need for interventions to contain nurses' burnout symptoms.