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Cognitive therapy, originally conceived for the treatment of emotional illnesses, has been successively used also in treating patients with more severe mental disorders. In this article, the results obtained by Shearin & Linehan (this volume) in a few controlled trials of dialectical behavior therapy in patients with borderline personality disorders are discussed. Differences between the treatment approach followed by Shearin & Linehan, which focuses on the modification of specific behaviors, and that favored by the author, which is aimed at restructuring dysfunctional working models of self and environment, are highlighted. In the conclusion it is emphasized that the use of a structured, didactic and cognitive-behaviorally oriented approach focused on personal growth might represent an important and much wanted breakthrough in the treatment of the most disturbed patients with a borderline personality disorder.

Cognitive therapy has emerged as a feasible and valuable complement to the treatment of patients suffering from a schizophrenic disorder. It can be carried out at various levels and with different goals in mind and its use is not in conflict with concomitant and strictly individualized medication. In the article some of the approaches most commonly used are pointed out and some of the results of various approaches are highlighted.

The results of several investigations suggest a possible relationship between a subject's experience of the rearing attitudes of his parents and the later development of various kinds of psychopathological disorders. Most studies, however, are based on small populations and on dubious assumptions about linear causal relationships between parental rearing practices and poorly defined mental disorders. This article gives a theoretical background to a comprehensive multinational study of rearing practices and psychopathology, now in progress. It is suggested that dysfunctional parental rearing practices may contribute to the development of dysfunctional self-schemata by the offspring and that these dysfunctional self-schemata represent an important pathogenetic link between rearing practices and psychopathological disorders.

One of the most patent inconsistencies in the application of the 1978 Psychiatric Reform Act in many areas of Southern Italy has resulted from the irrational choice, by regional governments, of the general hospitals in which Psychiatric Special Units had to be implemented, and from the inappropriate determination of territorial boundaries defining the competence of such Units. Thus, in the city of Naples, it was decided, in June 1978, to set up Psychiatric Special Units only in the two University Psychiatric Departments and in the Psychiatric Emergency Ward at S. Gennaro Hospital. These Units, equipped with an overall number of 39 beds, were put in charge with the whole province of Naples (about three millions inhabitants). Quite arbitrarily, it was established that University Departments had to admit patients coming from the city of Naples and S. Gennaro Hospital those residing in the rest of the province. By an equally arbitrary choice, female patients from the city of Naples were entrusted to the University Department I and male patients to the Psychiatric Department II. In the following years, from 1979 to 1983, some additional Units were set up in general hospitals of the Naples province. Nonetheless, available beds have not exceeded the overall number of 69, and the catchment areas of the three pre-existing Special Units have not been modified. The chaotic situation engendered by this incongruous application of the Reform Act is outlined, by means of an analysis of the requests for compulsory admission addressed to the Special Unit at the Psychiatric Department I of Naples University during the periods June 16, 1978-December 31, 1979 and June 16, 1982-December 31, 1983.

In a series of fifty depressed patients and 258 controls possible differences in the early family situation as concerns parental rearing practices have been investigated by means of the Swedish EMBU inventory. The results show that the depressive experienced their parents as more "rejecting", more "overprotecting" and less "emotionally warm" as compared to their normal counterparts.

In the course of a multicenter controlled trial of the effects of neuroleptic drugs on patients with schizophrenic or paranoid syndromes a comparison was made between the Swedish symptom rating scale--Mårtens' S-scale especially designed for patients with schizophrenic syndromes--and a new rating scale--the Comprehensive Psychopathological Rating Scale--CPRS. The Spearman rank correlation coefficient between the two scales was found to be 0,48 and as the inter-rater reliability for both scales was found to be quite satisfactory the validity of the scales is discussed. The CPRS scale was found to be easy to handle even for untrained doctors and in a separate study of inter-rater reliability where 5 doctors saw 16 patients a quite satisfactory reliability rk = 0,70--0.97, was found for 33 out of 39 items. In some items, espically those concerning different aspects of affective disturbances a lower inter-rater reliability was found but these items have been revised in later versions of the scale.

Eighty-five Italian and forty-nine Swedish patients consecutively admitted for compulsory treatment to either an Italian or a Swedish psychiatric unit in selected areas of the two countries have participated in an exploratory study aimed at assessing the main characteristics of compulsory admitted patients, and in particular, the immediate reason for admission. The two series proved to be quite similar as concerns most sociodemographic variables, and as concerns clinical diagnosis and severity of the morbid condition at admission as measured by means of a rating scale. More Swedish than Italian patients lived alone when admitted to hospital, and for more of them the request for admission was made by other people than relatives, and a larger proportion of them was accompanied to the hospital by medical or social welfare personnel. In both series the largest proportion had a low educational level and belonged to the lower social groups. The same proportion in the two series had previous admissions. The most common reason for admission was "odd or improper behaviour" for the Swedish patients, and "feared or manifest dangerousness" for the Italian patients. The Italian patients remained at hospital on average half the time than the Swedish patients.

Twenty-six, respectively twenty-three untrained Italian doctors participated in the rating of two patients with a preliminary Italian version of the CPRS. Despite an unfavourable setting, and some linguistic inaccuracies in the translation, a quite satisfactory degree of agreement was reached among the doctors. The Italian version of the CPRS has now been rewritten using a terminology more familiar to Italian psychiatrists.