IntroductionThe use of movies in medical (particularly psychiatric) education has been often limited to portraits of mental illness and psychiatrists. The Psychiatric Institute of the Università del Piemonte Orientale has a longstanding tradition of working with/on movies according to a method developed by Eugenio Torre, using dynamic images as educational incitements. Our aim is to describe the preliminary results on the impact of this intervention in medical students.MethodsThe cinemeducation project lasted 6 months, and included 12 meetings. Forty randomly selected participants were assessed with: Attitudes Towards Psychiatry Scale (ATP-30), Social Distance Scale (SDS), Interpersonal Reactivity Index (IRI), and Toronto Alexithymia Scale (TAS), both at baseline and after 6 months, when the workshop was concluded.ResultsA significant increase was found in the ATP-30 score, and a reduction of the SDS and IRI-Personal Distress scale scores.ConclusionsInformal feedback from participants was strongly positive. Preliminary results from the assessment of participants are encouraging. Students’ attitudes towards psychiatry and ability to tolerate anxiety when experiencing others’ distress improved, while stigma decreased. The evocative power of movie dynamic images, developed in the group and integrated with the help of the group leader, can enrich students’ knowledge, both from a cognitive and emotional standpoint.
Objectives : We assessed gender differences in a sample of first-admission psychiatric inpatients with and without comorbid Substance Use Disorder (SUD) to identify possible risk factors and targets for gender-tailored treatment interventions. Methods:A retrospective study of first admissions to the University Psychiatry Ward, "Maggiore della Carità" Hospital, Novara, Italy, between 2003 and2012. The clinical charts of patients with (N=362) and without comorbid SUD (N=1111) were reviewed.Results: Differences in employment, educational, and marital statuses were found between male and female psychiatric patients with and without comorbid SUD. Having a degree was a protective factor for males, while it was a risk factor for females. Being divorced and having family problems were both risk factors for comorbidity in females. Regarding the diagnosis, results overlapped in males and females, and both affective and other disorders were risk factors for a comorbid SUD. Conclusions:A significant difference between male and female psychiatric patients with a comorbid SUD was the males' overall poorer psychosocial functioning. Marital status and family problems were risk factors for comorbid SUD in females. Both males and females showed various pathways of access to and choices of substances and, eventually, experienced different impacts on their lives. Hospitalization might help to set up a targeted intervention for patients with comorbidity, while accounting for gender differences. With respect to males, a treatment approach focused on the substance alone might help improve their functioning; females might have a greater benefit from a treatment approach focused on distress, family problems, and relational issues. 3The co-occurrence of severe mental health conditions with a drug abuse or dependence disorder (substance use disorder, SUD) is referred to as Dual Diagnosis (DD). Psychiatric patients with a comorbid SUD represent up to half of the patients in most mental health treatment systems, and comorbidity is associated with several significant implications with respect to symptoms, course, morbidity, treatment effectiveness and adherence, social issues (e.g. legal problems), use of psychiatric and emergency room services, and regrettably, with common negative outcomes (Owen et al., 1996; Kovasznay et al., 1997; Margolese et al., 2004; Ziedonis, 2004; Tosato et al., 2013).The co-morbidity rate of SUD and major mental problems in Europe is generally not as high as in US according to various studies, and it ranges from 20% to 65% (Kessler et al., 1996;Teesson et al., 2000; Mueser et al., 2003). Additionally, comorbidity rates between psychiatric illness and SUD appear to be particularly high in inpatient, crisis team (38-50%), and forensic settings (Drake et al., 2004).Comparisons between psychiatric patients with a comorbid SUD and those without show differences in socio-demographic, clinical, substance-related characteristics, and other background variables. For instance, Katz et al. (2008) found that com...
IntroductionCJD is a neurodegenerative disease with a rapid onset characterized by progressive dementia, myoclonus and also cerebellar, pyramidal and extrapyramidal signs. It is caused by an increased loss of neurons due to the abnormal conformation of a membrane protein.Case reportA 69 year-old woman was admitted to Psychiatry with a clinical picture characterized by psychomotor agitation, disorientation, confusion, confabulation, false ricognition, circumstantiality, perseveration, logorrhea and dysphoria. She presented no alterations of sense-perception. Her psychiatric history was silent. The neurological examination showed no focal neurological deficits and the first EEG was nonspecific. She became progressively more confused, with subsequent drowsiness with psychomotor agitation, aimless buste, disorganization and visual hallucinations. She started treatment with quetiapine (200 mg/die) and lorazepam (4 mg/die) without benefit. The second EEG was characterized by triphasic waves with diffuse projection. MRI angiography revealed the presence of diffuse cortical ribbon hyperintensity of gray matter. CSF examination showed positivity of 14/3/3 protein and a TAU protein value greater than 16000 pq/ml allowing diagnosis of CJD.ConclusionsWe emphasize the importance of a correct differential diagnosis in patients with psychiatric symptoms and rapidly progressive dementia unresponsive to therapy.
Objectives: To evaluate the subjective well-being of a group of patients who were hospitalized at the Institute of Psychiatry (Novara), compared to the severity of illness. Methods: Patients are evaluated at admission and discharge through self-administration of the SWN (Subjective Well-being under Neuroleptics) scale, which contains five subscales (emotional regulation; self-control; mental functioning; social integration and physical functioning) assessing patients' psychophysical and emotional well-being, calculating a value for each subscale and a total score. The clinician fills in the CGI (Clinical Global Impression) for each patient, which provides a global judgement in three areas: severity of illness, global improvement and therapeutic effectiveness. Results: From June 2009, 51 patients were evaluated at admission and discharge: 26 diagnosed with psychosis and 25 diagnosed with personality disorders. Preliminary data suggest a meaningful improvement of the physical functioning in the psychotic group, a tendency to improvement of the social integration area in the personality disorders group. Among the psychotic group, the schizophrenic patients (n°=14) have shown an improvement in the self-control subscale. Conclusions: Literature suggests that a high SWN score is associated with a better compliance and an early improvement of subjective well-being is a major predictor of the chance of remission. This study will allow to compare the subjective well-being evaluated by SWN with the clinical judgment of the CGI and above all if this can represent a predictor index for the compliance and the chance of remission.
Introduction:According to Torre's approach, dynamic images from movies may help to reflect on empathy-related issues, to develop a compassionate approach to patients and their sufferance, and to enhance awareness about stigmatizing attitudes. Since its development this method has been used by the Psychiatric Institute of the Università del Piemonte Orientale Amedeo Avogadro, Novara, for the education and training of medical students and, broadly speaking, of people involved in helping professions.Aims:To describe the preliminary results about the impact of this intervention in a sample of medical students.Methods:cinemeducation seminars lasted 6 months, and included 12 meetings. Movies were discussed from a psychological perspective in a group setting and experiences were integrated with the help of the group-leader. Data were collected anonymously via self-report questionnaires from 40 randomly selected participants. Assessment scales (Attitudes Towards Psychiatry, ATP-30; Social Distance Scale, SDS; Interpersonal Reactivity Index, IRI; Rosenberg Self-Esteem Scale, RSES; Toronto Alexithymia Scale, TAS) were administered both before and after the workshops.Results:a significant increase was found in the ATP-30 score (p = .034), and a reduction of the SDS (p = .022) and IRI-PD (p = .010) scores.Conclusions:although these results are preliminary, an improvement in students’ attitudes towards psychiatry was found, together with an increased ability of students to tolerate their own anxiety when experiencing others’ distress. This approach to movies allows developing both cognitive and emotional knowledge, which should be considered particularly important in medical education.
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