Vanna Berlincioni

First-episode psychosis and migration in Italy (PEP-Ita migration): a study in the Italian mental health services

BackgroundIt has been frequently reported a higher incidence of psychotic disorders in immigrants than in native populations. There is, however, a lack of knowledge about risk factors which may explain this phenomenon. A better understanding of the causes of psychosis among first-generation migrants is highly needed, particularly in Italy, a country with a recent massive migration.Methods/DesignThe “Italian study on first-episode psychosis and migration (PEP-Ita)” is a prospective observational study over a two-year period (1 January 2012–31 December 2013) which will be carried out in 11 Italian mental health centres. All participating centres will collect data about all new cases of migrants with first-episode psychosis. The general purpose (“core”) of the PEP-Ita study is to explore the socio-demographic and clinical characteristics, and the pathways to care of a population of first-episode psychosis migrants in Italy. Secondary aims of the study will be: 1) to understand risk and protective factors for the development of psychotic disorders in migrants; 2) to evaluate the correlations between psychopathology of psychotic disorders in migrants and socio-demographic characteristics, migration history, life experiences; 3) to evaluate the clinical and social outcomes of first-episode psychoses in migrants.DiscussionThe results of the PEP-Ita study will allow a better understanding of risk factors for psychosis in first-generation migrants in Italy. Moreover, our results will contribute to the development of prevention programmes for psychosis and to the improvement of early intervention treatments for the migrant population in Italy.

Giocare al teatro Nota clinica su un’esperienza di laboratorio teatrale con pazienti affette da DCA

Giocare al teatro Nota clinica su un’esperienza di laboratorio teatrale con pazienti affette da DCA - This essay aims to account for a biennal experience in a theatre workshop with female patients suffering from eating disorders, treated at the same time with group psycotherapy with an psycoanalytic orientation. Some clinical examples will be presented, in order to illustrate the group processes and the adopted methodology. Keywords: psycotherapy, theatre workshop, eating disorders.

Ghosts from the past: a clinical case study of intercultural therapy in contemporary Italy

In this work the authors aim to present a case study of intercultural therapy undertaken during a hospitalisation. Starting from a view of comprehension and de-centralisation of ones own cultural points of reference, typical of the complementarist method theorised by Georges Devereux, it highlights the relevance of the patients own theories concerning their suffering during the course of psychiatric treatment. The effort of the therapists in this context is to return to each migrant their own history and to reinstate their own specific life context, avoiding the attempt to fix the patients definition within nosographic categories or rigid models based on a priori assumptions. In this sense, the methodology employed by the ethno-therapist is not only suitable for patients belonging to cultures distant from ours, but it also becomes applicable for those who are local whenever, during the course of a therapy, specific cultural elements might emerge.

Bilingualism, Language Disorders and Intercultural Families in Contemporary Italy: Family Relations, Transmission of Language and Representations of Otherness.

This study aims to show how language disorders in children affect language transmission and the mixedness experience in intercultural families. To this end, it adopts a qualitative method of study based on the administration of ad hoc interviews to intercultural couples who consulted our Child Neuropsychiatry Service because of language disorders in their children. One of the main consequences, when the child of an intercultural couple presents a language disorder and a diagnostic process has to be initiated, may be interruption of the transmission of the second language, especially if it is the mother’s language. The decision to do this, which may be taken on the advice of teachers and health professionals, but also because the parents themselves often attribute their child’s language disorder to his bilingual condition, affects not only the relationship between the mother and her child, but also processes in the construction of parenthood and in the structuring of the child’s personality and the plurality of his affiliations. A clear understanding of how the dialectic between the categories of “alien” and “familiar” is managed in these contemporary families, which have to reckon with the condition of otherness, is crucial for psychiatrists and psychotherapists working in settings in which cultural difference is an issue to consider.

Le donne sul percorso migratorio: nuovi ruoli, nuove difficoltà

Le donne migranti rappresentano una parte fondamentale della popolazione immigrata nel nostro paese, una realta variegata e ormai consolidata, numericamente rilevante, ma ancora poco conosciuta ed esplorata. Le donne che migrano finiscono sempre per incidere sugli avvenimenti e sulla storia svolgendo importanti e determinanti funzioni sociali di mediazione culturale e dell’accoglienza, di legittimazione e di facilitazione delle imprese altrui. Tuttavia buona parte di esse vive ai margini della societa affrontando difficolta piu gravi di quelle degli uomini immigrati. Il presente lavoro nasce dalla scelta di volere offrire degli spunti di riflessione su quello che significa essere donna, madre, moglie, lavoratrice nel contesto di un’ esperienza migratoria e sulle difficolta che cio comporta. Una riflessione di natura etnopsichiatrica riguardante le difficolta, rischi e pericoli per la salute mentale delle donne che intraprendono il percorso della migrazione.

Nuove esigenze delle società multiculturali nel trattamento dei disagi e disturbi della psiche

Il confronto con l’alterita e diventato una necessita e l’approfondita conoscenza dell’Altro, lo strumento indispensabile per un’ efficace integrazione sociale. Ogni cultura crea, e continua a creare, un sapere e un saper-fare relativamente alla distinzione tra normale e anormale. Mentre la psichiatria cerca di estrapolare dal singolo caso indicazioni di ordine universale, l’etnopsichiatria, in costante dialogo con altre discipline quali antropologia, sociologia e etnologia, mette in rilievo piuttosto la peculiarita del paziente in rapporto al gruppo e all’ ambiente ai quali appartiene. L’etnopsichiatria puo certo contribuire a mettere a punto le modalita della prevenzione, comprensione, presa in carico dei disturbi psichici nei migranti. L’analisi dell’accesso ai servizi ha lo scopo di monitorare l’adeguatezza della risposta alla richiesta di cura e di orientare cambiamenti organizzativi e protocolli operativi.

Disturbi del Comportamento Alimentare e Dissociazione: uno studio caso-controllo

Eating disorders are a class of axis I mental disorders, characterized by abnormal eating behaviour. Many researches highlight the presence of dissociative experiences in several mental disorders and their role in patients’ outcome. In particular, scientific literature detect higher dissociative levels in patients with eating disorders than in general population. The aim of this study is evaluating dissociation in a sample of out-patients, comparing it to the one of healthy controls. The results are unexpected, because there are not any statistic differences between the two groups.

L’istituzione familiare tra mito e realtà

The family institution between myth and reality - This work takes into exam family as an institution starting with a vision of comprehension and decentralization, according to the complementaristic method by Gerges Devereux. Furthermore, examples taken from works in the ethnographic and trans-cultural psychotherapy field will be given, in order to better illustrate the discussed topics. It seems thus possible to conclude that family and parental forms are different (one from the other), and that an unambiguous and comprehensive definition is difficult. Efforts to understand and to find specific politics of reception are then required by clinician, educators and professionals who operate in the social field. Only this way differences won’t hurt anymore, and new generations will find their position in a broadened society. Key words: Trans-cultural psychiatry, anthropology, family, kinship.