Papers by Ester Di Giacomo
Journal of Nervous & Mental Disease
The aim of the “Diogene Project” is to recruit, evaluate, and treat homeless people affected by p... more The aim of the “Diogene Project” is to recruit, evaluate, and treat homeless people affected by psychiatric disorders. Three multidisciplinary street units patrolled the streets in Milan, Italy, two/three evenings per week to recruit participants. A sociodemographic questionnaire, the HoNOS, and the GAF were administered at recruitment (T0), 1 year (T1), and 2 years (T2) after the first evaluation. Personalized treatment (none, social support, psychiatric treatment + social support) was tailored to each patient's needs. One hundred twelve homeless people participated. Forty-six users dropped out after the first assessment. The highest percentage of dropouts was registered among those who did not receive any kind of treatment (67.4%). Time spent on the street was not significantly correlated to adherence and outcome. Interestingly, the greatest improvement in psychopathological symptoms was recorded among patients under both treatments. This study confirms the validity of our mod...
Frontiers in Psychology
BackgroundAddictive behavior of gambling, gaming and internet activity is partly a new research d... more BackgroundAddictive behavior of gambling, gaming and internet activity is partly a new research domain and has not been well investigated with regard to sexual minority populations. Although health disparities between sexual minorities and the general population are well documented, there is a lack of inclusion of sexual minorities in both research and clinic. Among lesbian, gay and bisexual populations certain features could be present that play a role for the development of addictive behaviors, such as social isolation and increased risk of other psychiatric problems. The aim of this study was to investigate problem gambling, problem gaming and problematic internet behavior in a European context and if it is affected by sexual orientation status.MethodsAn online web-survey was distributed among web-panels in England, Poland, Switzerland, Italy, Spain, Denmark, and Sweden in 2017–2018.Result10 983 complete answers were collected. 7.1% of the participants had a sexual minority statu...
Borderline Personality Disorder and Emotion Dysregulation, 2022
The 11th revision of the World Health Organization (WHO) International Classification of Diseases... more The 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11) includes a fundamentally new approach to Personality Disorders (PD). ICD-11 is expected to be implemented first in European countries before other WHO member states. The present paper provides an overview of this new ICD-11 model including PD severity classification, trait domain specifiers, and the additional borderline pattern specifier. We discuss the perceived challenges and opportunities of using the ICD-11 approach with particular focus on its continuity and discontinuity with familiar PD categories such as avoidant PD and narcissistic PD. The advent of the ICD-11 PD classification involves major changes for health care workers, researchers, administrators, and service providers as well as patients and families involved. The anticipated challenges and opportunities are put forward in terms of specific unanswered questions. It is our hope that these questions will stimulat...
PloS one, 2015
Violence in acute psychiatric wards affects the safety of other patients and the effectiveness of... more Violence in acute psychiatric wards affects the safety of other patients and the effectiveness of treatment. However, there is a wide variation in reported rates of violence in acute psychiatric wards. To use meta-analysis to estimate the pooled rate of violence in published studies, and examine the characteristics of the participants, and aspects of the studies themselves that might explain the variation in the reported rates of violence (moderators). Systematic meta-analysis of studies published between January 1995 and December 2014, which reported rates of violence in acute psychiatric wards of general or psychiatric hospitals in high-income countries. Of the 23,972 inpatients described in 35 studies, the pooled proportion of patients who committed at least one act of violence was 17% (95% confidence interval (CI) 14-20%). Studies with higher proportions of male patients, involuntary patients, patients with schizophrenia and patients with alcohol use disorder reported higher rat...
The Journal of Clinical Psychiatry, Oct 19, 2021
disorder in pregnancy and postpartum: the possible etiologic role and implications of obsessive-c... more disorder in pregnancy and postpartum: the possible etiologic role and implications of obsessive-compulsive personality disorder.
Springer eBooks, 2013
Il concetto di “doppia diagnosi” (comorbidita tra uso di una o piu sostanze e almeno una patologi... more Il concetto di “doppia diagnosi” (comorbidita tra uso di una o piu sostanze e almeno una patologia psichiatrica) e ormai entrato nella realta clinica di area psichiatrica, dal momento che molti pazienti affetti da psicopatologia impiegano sostanze psicoattive, derivandone effetti comportamentali e/o clinici evidenti. I dati sulla presenza di patologia psichiatrica in popolazioni di tossicodipendenti stimano tassi di comorbidita variabili da piu del 50% al 93% (Regier et al., 1990; Offord et al., 1996; Brooner et al., 1997; Gregg et al., 2007), mentre, tra i soggetti affetti da una psicopatologia di grado severo, approssimativamente il 50% sviluppa una qualche forma di abuso o di dipendenza (Drake et al., 1993).
European Psychiatry, Apr 1, 2017
European Psychiatry, 2014
Nel presente capitolo e in quelli successivi si cerchera di analizzare in modo specifico la probl... more Nel presente capitolo e in quelli successivi si cerchera di analizzare in modo specifico la problematica del tentato suicidio nella popolazione adolescenziale. L’introduzione, l’epidemiologia e il tentativo di comprensione dei meccanismi eziopatogenetici e dinamici implicati serviranno come punto di partenza comune per esplorare piu in profondita le problematiche relative alla “doppia diagnosi”, al disturbo borderline di personalita, alla problematica del bullismo e ai disturbi del comportamento alimentare che affliggono in particolare la popolazione giovanile, implicando una stretta correlazione con la tematica del tentativo di suicidio.
European Psychiatry, 2013
Background The work purpose was to examine the role physical and sexual abuse during childhood pl... more Background The work purpose was to examine the role physical and sexual abuse during childhood plays as risk factors for committing acts of sexual violence or child abuse once becoming adults. Methods We selected - from EBM literature published in the last ten years - the most significant studies, no neglecting previous studies also useful for a better comprehension about physical and sexual abuses suffered during childhood and their commission once adults. Results To have been victims of physical and sexual violence during childhood predisposes to perpetrate similar behaviors. The family background seems to be the greatest risk factor for the development of such behaviors. This is demonstrated by studies of twins in which only one suffers sexual violence but both experience unfavorable outcomes like the examined. In particular, pedophiles are more exposed to sexual violence during childhood (73%) while rapist to physical and emotional abuse (68%, 70%), especially by parents (78%), but both share models of pathological attachment (anxious for pedophiles and avoiding for rapists). Conclusions Even if with different results, we can highlight how to be a victim of violence during childhood, especially in a family context characterized by physical or sexual violence, is one of the greatest risk factors in becoming an abuser. This evidence should be a major impetus to further researches, but mainly to act measures to safeguard the victims from the consequences of the trauma they suffered and from the development of future similar behavior.
European Psychiatry, 2013
The aim of the study is to evaluate risk factors for attempted suicide in psychiatric patients. W... more The aim of the study is to evaluate risk factors for attempted suicide in psychiatric patients. We compared three groups: psychiatric patients who attempted suicide, patients with the same diagnosis and no history of attempted suicide and healthy controls, through the administration of the following tests: TCI, SCL-90,WHOQOL, SASS, SF 36 and IIP. The subjects were matched for sociodemographic characteristics (sex, age, level of education, field of employment and role, marital status) with a 1:1:1 ratio. Results: We obtained statistically significant differences between patients who attempted suicide and patient who didn't in subscales: harm avoidance (TCI, p = 0.021) and environment area (WHOQOL, p = 0.021). We also underline we were able to discriminate healthy subjects from patients, but we didn't obtain statistically significant differences between controls and patients who attempted suicide in the subscales egocentricity (IIP, p=0.051), aggressiveness (IIP, p=0.057) and self-transcendence (TCI, p=0.255). Conclusion: These results underline the importance of caring, with preventing purpose, about personal history data such as socioeconomic status, living environment perceived safety, different tendency to inhibit own behaviors (correlated to previous suicide attempts), closure to external relations and aggressiveness.
Springer eBooks, 2013
Dati e informazioni sono disponibili, oltre che nel sito globale dell’OMS, anche nei siti regiona... more Dati e informazioni sono disponibili, oltre che nel sito globale dell’OMS, anche nei siti regionali della stessa. Nel sito europeo, in particolare, sono disponibili pubblicazioni specifiche (Sethi et al., 2011) e database che comprendono le cause di malattia e di disabilita e i tassi standardizzati di mortalita per causa (Health for all — Europe). In Europa, il suicidio e la maggiore causa di morte per traumatismo, con 162000 casi nel 2002: e il 21% di tutti i traumatismi e il 16% di DALY persi per trauma. In tutte le classi di eta e piu frequente nei maschi che nelle femmine (Sethi et al., 2011; WHO European Centre for Environment and Health, 2004; WHO European Health for All Database, 2012) (Figura 14.1).
Il suicidio rappresenta un importante problema di salute collettiva, oltre ad attrarre l’attenzio... more Il suicidio rappresenta un importante problema di salute collettiva, oltre ad attrarre l’attenzione e, spesso, la curiosita dell’opinione pubblica per la particolare drammaticita del gesto. Nonostante gli studi specifici sull’argomento siano generalmente ricondotti all’ambito sociologico, dalla seconda meta del ventesimo secolo l’interesse e aumentato grazie alla disponibilita di ricerche specifiche, sia a livello nazionale sia internazionale, finalizzate all’individuazione dei numerosi fattori di rischio coinvolti e alla conoscenza della loro complessa interazione.
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Papers by Ester Di Giacomo