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This comment on Bottaccioli & Bottaccioli’s (2024a) article critically analyzes Franz Alexander’s role in developing contemporary psychosomatics in both its innovative aspects and limitations. On the one hand, Alexander contributed to emancipating the explanation of physical symptoms from the classical approach of the early 20th century stiffened on the model of hysterical conversion and promoted the organization of the international psychosomatic movement, including the Italian one. On the other hand, his limitations mainly concern the theoretical approach typical of 20th century psychoanalysis: adopting a one-dimensional model centered on intrapsychic conflict and the indeterminacy – necessary for the time – of a biological “X” factor as mediator. Instead, in the second half of the 20th century, a deficit-centered model of explanation (e.g., alexithymia) and complexity (e.g., biopsychosocial model) emerged, in which various moderating biomedical, psychological, and socio-cultural factors assume different relative weights in the explanation of physical illnesses and the clinical management of patients. [ABSTRACT FROM AUTHOR]

This article explores the evolution in the definition and management of pain according to the 2020 guidelines from the International Association for the Study of Pain (IASP), highlighting the importance of a holistic approach that encompasses sensory, emotional, and psychosocial aspects. It distinguishes between acute pain, as a temporary response to tissue damage, and chronic pain, which persists beyond the normal healing process, significantly impacting the patient’s quality of life. The article emphasizes the crucial role of patient education and prehabilitation in preventing pain chronicity and improving functional recovery, particularly in the preoperative context. It examines the effectiveness of pain education, which uses the biopsychosocial model to enhance understanding and management of chronic pain, and tele-rehabilitation as tools to optimize access to care and increase patient satisfaction. The article concludes by highlighting the need for further research to define the best educational and rehabilitative practices, with a special focus on integrating telemedicine into care pathways. [ABSTRACT FROM AUTHOR]

The face, through facial expressions, facilitates interpersonal communication and the expression of emotions. A facial deficit resulting from a lesion of the 7th cranial nerve (facial nerve) can result in an impairment of the patient’s quality of life, from both functional and subjective wellbeing perspectives. The purpose of this study is to investigate, through Narrative Medicine the illness experience of the patient with facial palsy and compare it to the score obtained on the Facial Disability Index (FDI), a validated scale that quantifies the impact of facial deficit on quality of life. [ABSTRACT FROM AUTHOR]

The Diagnostic Criteria of TemporoMandibular Disorders (DC/TMD) are a simple, repeatable tool with validated language for interpreting a patient’s medical history, evaluation and whether imaging is needed. They also provide tools for interpreting the psychosocial and behavioral aspects of the patient to understand whether the complained pain requires a multidisciplinary approach. DC/TMD involves two axes of evaluation: AXIS I (physical) and AXIS II (psychosocial). Twelve major temporomandibular disorder conditions were identified within AXIS I, which include myalgia, arthralgia and headache attributable to TMD, four different disc displacement conditions, degenerative joint disease, subluxation and dislocation of the temporomandibular joint. Psychosocial factors are at least as important in achieving treatment outcomes as are physical factors. Identifying these factors at the time of patient intake allows to set up functional treatment strategies. In addition, AXIS II management appears to have better prognostic value than AXIS I. [ABSTRACT FROM AUTHOR]

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Vulvodynia is a complex, multifactorial and difficult to diagnose syndrome that affects approximately 16% of the female population (Harlow et al., 2014). Affected women highlight the presence of vulvar discomfort often described as burning / pain that occurs in the absence of relevant observable causes. Over time, different of definitions have been attributed to this syndrome due to the difficulties encountered by the scientific community in understanding the true nature of the pathology. At present, the definition given by the Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia, in April 2015, seems to be the most valid. It defines vulvodynia as "vulvar pain lasting at least three months with no clear identifiable cause but which may have potential associated factors." Among them are mentioned various neurological, inflammatory, genetic, muscular and psychological factors that can coexist and overlap in the same patient, playing a fundamental role in the pain experience (Bornstein et al., 2016). Although numerous advances have been made in the study of this syndrome, there are still problems related to its etiology, which can further hinder the diagnostic and therapeutic process. In fact, the role played by psychological factors in the development and maintenance of vulvodynia is not yet fully understood. One wonders if the psychic factors present in these women are triggers or if they play an important role only in maintaining the syndrome. What is known for sure is that vulvodynia produces a significant negative impact on the quality of life of these women both on a sexual, that psychic and relational level. In fact, there are many women who present catastrophic thoughts in reference to their painful condition, fear of pain with consequent dysfunctional behaviors aimed at avoiding any sexual activity and hypervigilance understood as a continuous monitoring of genital sensations (Alappattu et al., 2017; Boerner, Rosen, 2015). Furthermore, these are often women who may question their sense of femininity (Mallie, Bergeron e Lambert, 2014) and develop a negative attribution style due to repeated sexual experiences that do not meet expected expectations. It follows that the negative meaning in reference to one's sexual life, generated by the painful experience, could cause a strong distress in the couple and favor the onset of anxious and depressive states present in each member of the relationship (Paquet et al., 2018). What has been said makes reflect on the importance in considering vulvodynia through a bio-psycho-social perspective that takes into account the interaction between the various biological, psychological and social factors capable of simultaneously increasing the development and maintenance of this syndrome. Therefore, are the evaluation of personal and relational experiences linked to the sexual symptom that these women exhibit is also of fundamental importance (Tripodi et al., 2016). The target of this study is to explore the sexual, emotional and psychopathological functioning of women with vulvodynia, comparing them with women without genito-pelvic diseases. The study was conducted on 69 women who completed a socio-demographic questionnaire, the Female Sexual Function Index (FSFI), the Symptom Checklist -90- Revised (SCL- 90-R), the Positive and Negative Affect Schedule (PANAS) and the Short Form McGill Questionnaire (SF-MGQ). The results suggest the presence of a reduced sexual functioning (greater pain and reduced lubrication) in women affected by vulvodynia; a higher level of mental distress (especially in severity: obsessivenesscompulsiveness, psychoticism and depression) and a more negative affectivity than in the control group. Future investigations could contribute to a better understanding of the impact this syndrome produces on the sexual wellness and quality of life of women who are affected by it, directing specialists towards forms of multidisciplinary intervention, which according to the bio-psycho-social model, might be more appropriate and effective. [ABSTRACT FROM AUTHOR]

The aim of this article is to point out the infl uence of Giovanni Liotti's ideas in the fi eld of systemic approach, on a theoretical level, and that of family therapy, in terms of therapeutic practice. [ABSTRACT FROM AUTHOR]

This short review aims to illustrate some topics of an international symposium recently held in Paris, dedicated to the comparison of rational and “parallel” medicines in the ancient world, but also with references to the modern and contemporary history. In this context the treatment of pain deserves attention, since in the history of medicine it has always been associated with the disease, and considerable efforts have made to suppress it. Two contributions have dealt with the placebo/nocebo effects, recostructing their history, highlighting both neurobiological and psychological mechanisms triggering them, and showing the bioethical implications deriving from induction of nocebo. Although the neural processes underlying these effects were not known to the science of the past, certain pratices were, however, used not only by doctors, but also by the Church to influence the ignorant people.