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In the past few years psychological characteristics in patients with organic bowel disorder have been poorly considered. However recent studies underline that psychological features increase gastrointestinal symptoms. The aim of this study is to investigate metacognition and emotions in patients with organic bowel disorder and functional bowel disorder. 33 outpatients with organic diagnosis and 28 outpatients with functional diagnosis were assessed with MCQ-30, ANPS and Brief-Cope; moreover stress was evaluated in all outpatients. Results revealed that two groups show the same psychological disturbances and there are no differences between organic patients and functional patients. Statistical analysis indicated significant relations between dysfunctional metacognitive beliefs and negative emotions. Specifically, Beliefs of Uncontrollability and Danger (UD) are significantly related to Fear, Anger and Sadness. Moreover Fear and Anger are significantly related to stress; dysfunctional metacognitive beliefs are related to coping strategies. Beliefs of UD are related to Using Emotional Support; Positive Beliefs (PB) are related to Planning, while Cognitive Confidence (CC) is related to Self-Blame. Unexpectedly results are higher in patients with organic diagnosis. Our results suggest to reconsider psychological influences in patients with organic diagnosis of gastrointestinal disease. Keywords:Metacognition; Inflammatory bowel diseases; Functional gastrointestinal disorders; Emotions; Coping, Mediterranean Journal of Clinical Psychology, Vol 2, No 1 (2013)

Background Navigated transcranial magnetic stimulation (nTMS) enables preoperative mapping of the motor cortex (M1). The combination of nTMS with diffusion tensor imaging fiber tracking (DTI-FT) of the corticospinal tract (CST) has been described; however, its impact on surgery of motor-eloquent lesions has not been addressed. Objective To analyze the impact of nTMS-based mapping on surgery of motor-eloquent lesions. Methods In this retrospective case-control study, we reviewed the data of patients operated for suspected motor-eloquent lesions between 2012 and 2015. The patients underwent nTMS mapping of M1 and, from 2014, nTMS-based DTI-FT of the CST. The impact on the preoperative risk/benefit analysis, surgical strategy, craniotomy size, extent of resection (EOR), and outcome were compared with a control group. Results We included 35 patients who underwent nTMS mapping of M1 (group A), 35 patients who also underwent nTMS-based DTI-FT of the CST (group B), and a control group composed of 35 patients treated without nTMS (group C). The patients in groups A and B received smaller craniotomies (P = .01; P = .001), had less postoperative seizures (P = .02), and a better postoperative motor performance (P = .04) and Karnofsky Performance Status (P = .009) than the controls. Group B exhibited an improved risk/benefit analysis (P = .006), an increased EOR of nTMS-negative lesions in absence of preoperative motor deficits (P = .01), and less motor and Karnofsky Performance Status worsening in case of preoperative motor deficits (P = .02, P = .03) than group A. Conclusion nTMS-based mapping enables a tailored surgical approach for motor-eloquent lesions. It may improve the risk/benefit analysis, EOR and outcome, particularly when nTMS-based DTI-FT is performed.