Aim Individual placement and support (IPS) has a considerable body of evidence for its effectiveness in helping people with mental disorder to achieve and maintain competitive jobs. However, little data in young adult populations are currently available, especially in Europe. Aim of this study was to assess the effect of IPS in Italian young adults with moderate‐to‐severe mental illness, examining the main competitive employment outcomes and drop out rates during a 3‐year follow‐up period. Methods Participants (n = 54) were recruited from patients receiving psychiatric treatment in one of the seven adult Community Mental Health Centers of the Reggio Emilia Department of Mental Health. Together with drop out rates, we investigated job duration (total number of days worked), job acquisition (employment in the labour market for at least 1 day during the follow‐up), total hours per week worked, and job tenure (weeks worked on the longest‐held competitive job). Results A crude competitive employment rate of 40.7% and a crude drop out rate of 22.2% over the 3‐year follow‐up period were found. However, 66% of 42 clients who remained in the program over 3 years gained competitive employment at some time during the 3‐year period. Conclusions This research shows the feasibility of an IPS intervention model in the public mental health care system in Italy, especially for a young adult target population.
Confabulation, the production of statements and actions that are unintentionally incongruous to the subject's history, background, present and future situation, is a rather infrequent disorder, observed in several conditions affecting the nervous system. Little is known about the quantitative and qualitative evolution of confabulation in time. In this study we evaluated longitudinally the evolution of this disorder in a group of severe confabulators, using the Confabulation Battery (CB), a sensitive tool to detect confabulations in various memory domains. It was found that confabulations were stable over time and not temporally limited. It was also found that "Habits Confabulations" (HCs), i.e., habits and repeated personal events mistaken as specific, unique past and future personal episodes, or well-known public events when semantic knowledge is concerned, was the more frequently observed type of confabulation. Confabulations were also more prominent in the domain of Temporal Consciousness (TC), i.e., a specific form of consciousness that allows individuals to remember their personal past, to be oriented in their present world and to predict their personal future, than in Knowing Consciousness (KC), i.e., a specific form of consciousness allowing individuals to be aware of past, present and future impersonal knowledge and information. Confabulations showed also persistence, i.e., confabulations at the same questions over time, and consistency, i.e., same type of confabulation at the same question over time. These findings are discussed within the framework of the Memory, Consciousness and Temporality Theory.
Confabulation is an unusual sign in neurological and in neuropsychological pathologies. In this article we present an objective neuropsychological instrument, the Confabulation Battery (CB), which allows the quantifying and qualifying of different types of confabulations. The CB was administered to French and Italian normal participants. Data from the present study will allow clinicians and researchers, using the CB, to know how much and in which memory domains their confabulating patients confabulate compared to normal participants. We present international data, instructions and guidelines for the CB, a tool used in different ways worldwide. Not quantifying confabulations, namely not reporting how much and in which domain patients confabulate, can hardly lead to conclusions on the neurocognitive bases of this phenomenon. Following the instructions in this article, versions of the CB can be adapted in different languages and cultures. Quantification and qualification of confabulation is necessary and demanded in order to compare sensibly data from different research and clinical groups.
Confabulating patients produce statements and actions that are unintentionally incongruous to their history, background, present and future situation. Here we present the very unusual case of a patient with right hemisphere damage and signs of left visual neglect, who, when presented with visual stimuli, confabulated both for consciously undetected and for consciously detected left-sided details. Advanced anatomical investigation suggested a disconnection between the parietal and the temporal lobes in the right hemisphere. A disconnection between the ventral cortical visual stream and the dorsal fronto-parietal networks in the right hemisphere may contribute to confabulatory behaviour by restricting processing of left-sided stimuli to pre-conscious stages in the ventral visual stream.
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