BackgroundGroup therapies are routinely provided for patients with severe mental illness. The factors important to the group experience of patients are still poorly understood and are rarely measured. To support further research and practice, we aimed to develop a questionnaire that captures how patients experience groups within a community mental health context.MethodsAn initial pool of 39 items was conceptually generated to assess different aspects of group experiences. Items were completed by 166 patients with severe mental illness attending group therapies in community mental health services in Italy. Patients with different psychiatric diagnoses who attended at least 5 group sessions were included. An exploratory factor analysis was used to identify different dimensions of group experiences and to reduce the number of items for each dimension.ResultsThe resulting questionnaire has five subscales: 1) sharing of emotions and experiences, 2) cognitive improvement, 3) group learning, 4) difficulties in open expression and 5) relationships. Each subscale has 4 items. The scale and sub-scales have good internal consistency.ConclusionsThe Ferrara Group Experiences Scale is conceptually derived and assesses dimensions of group experience that are theoretically and practically relevant. It is brief, easy to use and has good psychometric properties. After further validation, the scale may be used for research into patient experiences across different group therapy modalities and for evaluation in routine care.
Consultation–liaison psychiatry (CLP) manages psychiatric care for patients admitted to a general hospital (GH) for somatic reasons. We evaluated patterns in psychiatric morbidity, reasons for referral and diagnostic concordance between referring doctors and CL psychiatrists. Referrals over the course of 20 years (2000–2019) made by the CLP Service at Modena GH (Italy) were retrospectively analyzed. Cohen’s kappa statistics were used to estimate the agreement between the diagnoses made by CL psychiatrist and the diagnoses considered by the referring doctors. The analyses covered 18,888 referrals. The most common referral reason was suspicion of depression (n = 4937; 32.3%), followed by agitation (n = 1534; 10.0%). Psychiatric diagnoses were established for 13,883 (73.8%) referrals. Fair agreement was found for depressive disorders (kappa = 0.281) and for delirium (kappa = 0.342), which increased for anxiety comorbid depression (kappa = 0.305) and hyperkinetic delirium (kappa = 0.504). Moderate agreement was found for alcohol or substance abuse (kappa = 0.574). Referring doctors correctly recognized psychiatric conditions due to their exogenous etiology or clear clinical signs; in addition, the presence of positive symptoms (such as panic or agitation) increased diagnostic concordance. Close daily collaboration between CL psychiatrists and GH doctors lead to improvements in the ability to properly detect comorbid psychiatric conditions.
Questo articolo descrive la rilevanza del costrutto della resilienza in salute mentale e le sue implicazioni in Psicoterapia Focale Breve. L'intervento focale breve che descriviamo garantisce una risposta terapeutica a bisogni emergenti di salute modifi cando i fattori che ostacolano il normale processo evolutivo. Il modello pone specifi ca attenzione al processo di valutazione, che considera i fattori psicosociali ed č orientato a defi nire il problema focale, che puň ostacolare in qualsiasi fase del ciclo di vita il fi siologico processo evolutivo. Il target dell'intervento focale č rappresentato da individui con disagio emotivo in relazione ad eventi correnti di vita e che, in assenza di puntuale valutazione e trattamento, rischierebbero una disabilitŕ psicosociale. La Psicoterapia Focale Breve, rafforzando alcune dimensioni della resilienza, facilita la elaborazione dell'ostacolo evolutivo e sviluppa capacitŕ di auto-terapia; il ruolo attivo dell'individuo come agente del proprio cambiamento riduce il tempo di intervento e soprattutto garantisce che il processo evolutivo prosegua al di lŕ del setting e dopo il termine della terapia.
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