PubMed Health⌕ Search

Biomedical subjects

Giovanni Stanghellini

Publications and source records attributed to Giovanni Stanghellini.

10 recordsLinked to original sources
PubMed2007

Exploring the margins of the bipolar spectrum: temperamental features of the typus melancholicus.

BACKGROUND: Both the melancholic type of personality (TM) and the concept of temperament offer promising insights for the phenotypic characterization of mood-spectrum vulnerability. This research challenges the theoretical hiatus between the two psychopathological paradigms--the phenomenological and the neo-Kraepelinian--by means of an empirically-based approach. METHOD: Temperamental features were assessed through the Semi-structured Affective Temperament Interview (TEMPS-I) in an outpatient population of 116 clinically stable, euthymic subjects who suffered from a DSM IV major depressive disorder, previously enrolled for a study on the characteristics of major/unipolar depressive episode. The sample was subsequently evaluated and dichotomized according to the Criteria for Typus Melancholicus (CTM). RESULTS: The TM subjects exhibited statistically significant differences in the temperamental profile as compared to non-TMs (NTM). A specific association between TM and hyperthymic temperament (HT) was confirmed by binary logistic regression analysis, suggesting that the phenomenological distinction TM vs. NTM is supported by different predisposing Kraepelinian "fundamental states". LIMITATION AND CONCLUSIONS: Although it is uncertain whether the findings would generalize outside the Italian culture, they nonetheless delineate a strong aggregation between TM and hyperthymic temperament, indicating that (1) an integrative neo-Kraepelinian/phenomenological cooperative model is warranted to tap the complexity of the phenotypic diathesis for mood-disorders, and (2) the hyperthymic-melancholic type of personality rests on the margins of the bipolar spectrum. The main limitation of this study is that it enrolled a selected outpatient volunteer sample. A large scale study in general population is needed to confirm the hypothesis of a strong link between TM and HT and to shed light on the causes and meanings of this association.

Bipolar Disorder↗
PubMed2006

Values in persons with schizophrenia.

This is an explorative study on the values of persons with schizophrenia based on transcripts of individual therapy sessions conducted for 40 persons with chart diagnoses of schizophrenia or schizotypal disorder. Values are action-guiding attitudes that subject human activities to be worthy of praise or blame. The schizophrenic value system conveys an overall crisis of common sense. The outcome of this has been designated as antagonomia and idionomia. Antagonomia reflects the choice to take an eccentric stand in the face of commonly shared assumptions and the here and now "other." Idionomia reflects the feeling of the radical uniqueness and exceptionality of one's being with respect to common sense and the other human beings. This sentiment of radical exceptionality is felt as a "gift," often in view of an eschatological mission or a vocation to a superior, novel, metaphysical understanding of the world. The aim of this study is neither establishing new diagnostic criteria nor suggesting that values play an etio-pathogenetical role in the development of schizophrenia but improving our understanding of the "meaning" of schizophrenic experiences and beliefs, and by doing so reducing stigmatization, and enhancing the specificity and validity of "psychotic symptoms" (especially bizarre delusions) and of "social and occupational dysfunction" through a detailed description of the anthropological and existential matrix they arise from.

Delusions↗
PubMed2006

Typus melancholicus: personality structure and the characteristics of major unipolar depressive episode.

BACKGROUND: The melancholic type of personality (TM) has long been considered in continental and Japanese psychopathology as a relevant vulnerability trait constellation for the development of depression. METHOD: The symptom presentation in an outpatient population of 116 subjects suffering from a DSM-IV major depressive episode was rated according to the standardized documentation system of the Association for Methodology and Documentation in Psychiatry (AMDP). Personality features were explored by means of the Criteria for Typus Melancholicus (CTM). RESULTS: Statistically significant differences in depression-related psychopathological scores (i.e. higher level of guilt feelings, feeling of the loss of feelings, loss of vital drive and lower degrees of irritability and dysphoria) were found between TM and non-TM subjects, supporting the phenomenic specificity of TM depression at both symptom and subsyndromal level. LIMITATION AND CONCLUSIONS: Although our results were obtained in a selected sample of outpatients at an University Mental Health Center, they are indicative of psychopathological differences between TM and NTM in the core symptoms of depression. These differences highlight the importance of including TM criteria for phenotypic characterization of depressive disorder, suggesting that it may improve diagnostic and therapeutic practice and might be a reasonable psychopathologic endophenotype in investigating affective-spectrum vulnerability in at-risk populations.

Adult↗
PubMed2006

Assessing the social behavior of unipolar depressives: the criteria for Typus melancholicus.

AIM: (a) To define the nuclear characteristics of the melancholic type of personality (TM), that in European and Japanese psychopathological tradition is considered the model which most accurately describes the social behavior of unipolar depressives, through clear, valid, and synthetic criteria (criteria for TM = CTM); (b) to evaluate the diagnostic power, reliability, internal consistency, and other psychometric properties of these criteria. METHODS: Personality features of 115 unipolar depressives consecutively admitted to 2 psychiatric facilities were assessed with the CTM and with the Kasahara Scale (KS). Four further unipolar depressives were assessed with the CTM by 13 different raters (11 CTM-naive and 2 experienced). RESULTS: The CTM have shown high reliability and internal consistency. They were also highly concordant with the KS scores. CONCLUSIONS: The CTM can discriminate between TMs and non-TMs and suggests that the TM kind of personality is not a dimensional concept but a coherent structure in which one feature entails the presence of all the others.

Depressive Disorder↗
PubMed2005

Schizophrenic consciousness, spiritual experience, and the borders between things, images and words.

A prototypical feature of schizophrenic consciousness is that it undergoes a solidification of the imaginary space in which mental events take place. The bipartition between images and 'real' things is jeopardized and imagination is transformed into 'physical' forms. Parallel to this solidification of imaginary space in schizophrenic consciousness, more generally the rigid tripartite separation of things, images and words upon which the spatial order of consciousness is founded starts to erode. I explore different spiritual and philosophical traditions which shed light on and make more understandable the schizophrenic consciousness that call into question this separatedness. I argue that these traditions indicate that our current commonsensical approach to the separatedness between things, images and words is historically and culturally determined.

Consciousness↗
PubMed2005

Looking with both eyes open: fact and value in psychiatric diagnosis?

IN THIS ARTICLE WE ARGUE THE CASE FOR A PROPOSAL: that psychiatry should recognise, embrace and take seriously the role of values, alongside facts, in diagnosis. We present a three-step argument in support of our proposal; we raise a number of key questions from the perspectives of different stakeholders in mental health; and we conclude with a note on the significance of our proposal for building a more equal relationship between patients and professionals.

Journal Article↗
PubMed2004

What can philosophy do for psychiatry?

This article illustrates the practical impact of recent developments in the philosophy of psychiatry in five key areas: patient-centred practice, new models of service delivery, neuroscience research, psychiatric education, and the organisation of psychiatry as an international science-led discipline focused on patient care. We conclude with a note on the role of philosophy in countering the stigmatisation of mental disorder.

Journal Article↗
PubMedDate not supplied

Auditory verbal hallucinations--breaking the silence of inner dialogue.

Auditory verbal hallucinations (AVHs) are usually defined as perceptions of speech that occur in the absence of any appropriate external stimulus. This definition, we argue, is false. We maintain that AVHs are disorders of self-consciousness that are best understood as the becoming conscious of inner dialogue. Normally, subconscious interior conversations are experienced as a sense of partnership between distinct parts: we feel these parts as distinct, but also integrated and collaborating with each other in decision-making and in self-representation. AVHs attest to a breakdown in this process of interior conversation: the feeling of unity in duality falls apart, and the dialectic partnership on which self-representation is grounded shatters into a mere dichotomy. There is a fracture in self-consciousness. If ipseity (i.e. the prereflective modality of self-awareness, the self-feeling of one's own self in which the one who feels and what is felt is but one thing) is lacking, the sense of unity weakens, and the sense of duality increases. This crisis of ipseity is accompanied by an increase of reflexivity (i.e. the process through which I take a part of myself as a focal object of awareness). Hyperreflexivity contributes to the objectification of the sense of duality and to the loss of the sense of 'myness' of inner speech. In schizophrenics, inner dialogue becomes anomalously manifest. Whereas in normal conditions, inner dialogue is the medium for self-representation, AVHs arise through its morbid objectification: inner speech comes to the foreground in the concrete fashion of alien 'voices'.

Awareness↗