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Background: The aim of our study was to evaluate how sociodemographic factors, psychosocial adaptation to pregnancy and well-being levels are associated with the onset of preterm uterine contractions allowing symptomatic preterm labor. Methods: In a prospective case-control design, 51 consecutive women admitted for threatened preterm labor were enrolled. The patients received standard care. The day before discharge, once contractions had been stopped, the patients were administered 2 questionnaires: the Prenatal Self-Evaluation Questionnaire of Lederman and the Psychological Well-Being Scales. Controls were enrolled among asymptomatic, healthy women attending routine prenatal care. They were matched for parity and gestational age. Results: Gestational age at inclusion ranged from 25 to 34 weeks. Fourteen cases and 4 controls delivered preterm. Cases were less educated than controls, showed a lower acceptance of pregnancy and worse relationship with others, namely with the husband, compared to controls. They also displayed a reduced environmental mastery. Conclusion: Having a low education, poor relationship with others, including the husband, and impaired coping skills appeared to be independent risk factors for the development of symptomatic preterm labor in urbanized women.

Background. There is increasing awareness that the goal of treatment in Generalized Anxiety Disorder (GAD) should not simply be a response, but restoration of normal function. The aim of this study was to apply a novel psychotherapeutic approach for increasing the level of remission in GAD. Methods. Twenty patients with DSM-IV GAD devoid of comorbid conditions were randomly assigned to 8 sessions of Cognitive Behavioral Therapy (CBT) or the sequential administration of 4 sessions of CBT followed by other 4 sessions of Well-Being Therapy (WBT). Assessment methods included the Anxiety and Depression Scales of Paykel's Clinical Interview for Depression (CID), Ryff's Psychological Well-Being Scales (PWB) and Kellner's Symptom Questionnaire (SQ). A one-year follow-up was undertaken. Results. Significant advantages of the CBT-WBT sequential combination over CBT only were observed with both observer and self-rated methods after treatment. Such gains were maintained at follow-up. Conclusions. These preliminary results suggest the feasibility and clinical advantages of adding WBT to the treatment of GAD. They lend support to a sequential use of treatment components for achieving a more sustained recovery.

In the last decade there has been increasing interest in the potential of early preventive interventions capable of promoting psychological well being in order to reduce the risk of childhood psychological distress. This study analyzes the differential effects of strategies for promotion of psychological well-being (Well-Being Therapy, WBT) and removal of distress (Anxiety Management, AM) in a non clinical school setting.Our sample consisted of eight classes (N=162 students) attending middle schools in Northern Italy which were randomly assigned to a protocol derived from WBT (4 classes) and to an anxiety-management protocol (AM) (4 classes). Immediately before and after both school interventions students were assessed using the Psychological Well-Being Scales (PWB), Kellner's Symptom Questionnaire (SQ) and the Revised Children's Manifest Anxiety Scale (R-CMAS). A six month follow-up was performed in the following school year, and students were re-assessed with the same psychometric instruments.Our results lend support to the possibility to change attitudes to psychological well-being and distress with brief interventions in school (both well-being improving and distress removing).Further investigations should determine whether the combined and sequential integration of well-being and symptom oriented strategies may yield more complete and lasting effects that each strategy alone.

Background: There is increasing interest in the psychobiological mechanisms of resilience and psychological well-being. It is conceivable that activation of such mechanisms in the school setting may entail long-term benefits, both in terms of the developmental process and of prevention of distress. This study wants to apply and test the efficacy of a school-based intervention protocol derived from well-being therapy (WBT) compared to cognitive-behavioral strategies. Methods: School interventions were performed in a population of 111 students randomly assigned to: (a) a protocol using theories and techniques derived from cognitive-behavioral therapy; (b) a protocol derived from WBT. Assessment before and after interventions was performed using two self-rating scales: Kellner’s Symptom Questionnaire and Ryff’s Psychological Well-Being Scales. Results: Both school-based interventions resulted in a comparable improvement in symptoms and psychological well-being. Conclusions: This new well-being-enhancing strategy could play an important role in the prevention of psychological distress in school settings and in promoting optimal human functioning among children.

Background: Selective serotonin reuptake inhibitors (SSRI) are widely used in medical practice. They have been associated with a broad range of symptoms, whose clinical meaning has not been fully appreciated. Methods: The PRISMA guidelines were followed to conduct a systematic review of the literature. Titles, abstracts, and topics were searched using the following terms: ‘withdrawal symptoms' OR ‘withdrawal syndrome' OR ‘discontinuation syndrome' OR ‘discontinuation symptoms', AND ‘SSRI' OR ‘serotonin' OR ‘antidepressant' OR ‘paroxetine' OR ‘fluoxetine' OR ‘sertraline' OR ‘fluvoxamine' OR ‘citalopram' OR ‘escitalopram'. The electronic research literature databases included CINAHL, the Cochrane Library, PubMed and Web-of-Science from inception of each database to July 2014. Results: There were 15 randomized controlled studies, 4 open trials, 4 retrospective investigations, and 38 case reports. The prevalence of the syndrome was variable, and its estimation was hindered by a lack of case identification in many studies. Symptoms typically occur within a few days from drug discontinuation and last a few weeks, also with gradual tapering. However, many variations are possible, including late onset and/or longer persistence of disturbances. Symptoms may be easily misidentified as signs of impending relapse. Conclusions: Clinicians need to add SSRI to the list of drugs potentially inducing withdrawal symptoms upon discontinuation, together with benzodiazepines, barbiturates, and other psychotropic drugs. The term ‘discontinuation syndrome' that is currently used minimizes the potential vulnerabilities induced by SSRI and should be replaced by ‘withdrawal syndrome'.

This book brings together the latest research on positive psychology from an international cast of researchers and particularly from the growing body of European researchers. The chapters describe research and practice from diverse fields of positive psychology, covering topics such as happiness and well-being, motivation and goals, personality, academic performance and coping, measurement and interventions. The book emphasizes a cultural approach to the human pursuit of well-being. It is unique in that it presents research from a range of cultures, such as Russia, Croatia, and Egypt, in addition to ten different Western cultures. This approach helps broaden our understanding of those aspects of human experience that make life worth living in diverse cultural conditions. The book includes well-known and new authors from the field and contains selected papers that were presented at the 4th European Conference of Positive Psychology held in 2008 in Croatia.

I fattori che hanno influito precocemente nello sviluppo della persona sono spesso stati oggetto di indagine nella ricerca psicosomatica. Data la difficoltà di reperire informazioni retrospettive, particolare importanza hanno assunto gli studi che impiegano modelli animali. Eventi come la separazione precoce dalla madre risultano correlati ad una certa alterazione dei meccanismi di regolazione, comportando un aumento dell’attivazione dell’asse ipotalamo-ipofisi-surrene e della secrezione di prolattina. Ciò può rendere l’individuo più vulnerabile agli effetti dello stress nel corso della vita. Inoltre, si è messa in luce la relazione tra abuso fisico e sessuale nell’infanzia e disturbi medici, quali la sindrome dell’intestino irritabile e il dolore cronico. Infine, storie di maltrattamenti nell’infanzia risultano significativamente associati, nell’età adulta, a vari problemi di salute, come disturbi funzionali e comportamenti a rischio.

There is controversy surrounding the term psychosomatic. If it is used as an equivalent of consultation liaison psychiatry, there is little justification for retaining it. Psychosomatic medicine, however, may be defined as a comprehensive interdisciplinary framework for the assessment of psychosocial factors affecting individual vulnerability, course, and outcome of any type of disease; holistic consideration of patient care in clinical practice; and integration of psychological therapies in the prevention, treatment, and rehabilitation of medical disease. Psychosomatic medicine has developed several clinimetric tools for assessing psychosocial variables in the setting of medical disease and has raised the need for specific evaluations in medical assessment. The term psychosomatic medicine today seems to be more timely than ever and provides a home for innovative and integrative thinking at the interface of behavioral and medical sciences.

La riabilitazione può essere intesa come un processo di apprendimento e ri-apprendimento capace di stimolare e sostenere le risorse adattive in rapporto al processo di sviluppo. Al di là degli ambiti d’intervento legati alla disabilità, oggi si va sempre più delineando un’area di intervento riabilitativo riguardante il cosiddetto rischio psicosociale. La riabilitazione psicosociale si rivolge quindi a quelle condizioni familiari e sociali che, al di là dell’esistenza di una patologia psichica più o meno invalidante, configurano un rischio in grado di porre a repentaglio i potenziali evolutivi del bambino o dell’adolescente, compromettendo la sua salute mentale. In essa confluiscono i contributi della psicologia clinica e dello sviluppo, della neuropsichiatria infantile, della psicologia della famiglia, della psicologia sociale e giuridica, della psichiatria forense, designando un’area che risulta particolarmente feconda per le potenziali applicazioni operative. Le situazioni di rischio psicosociale sono innumerevoli: - bambini e adolescenti vittime di maltrattamento, abuso, violenza intrafamiliare, o in condizione di trascuratezza; - bambini e adolescenti cresciuti in famiglie con genitori affetti da disturbi mentali o da gravi sociopatie; - problemi connessi all’adozione o all’affidamento extrafamiliare; - bambini e adolescenti vittime di eventi traumatici di origine ambientale; - bambini e adolescenti portatori di disturbi mentali cronici e di condizioni di disabilità; - giovani e adolescenti devianti, autori di comportamenti aggressivi e violenti, individuali o di gruppo. Il volume si rivolge agli operatori che agiscono in questo settore (neuropsichiatri infantili, psicologi, assistenti sociali, educatori), offrendo, all’insegna di un approccio integrato e multidisciplinare, principi ed esperienze cliniche utili per valutare le situazioni a rischio e per programmare e monitorare gli interventi più efficaci.

Lo scopo del capitolo è fornire una panoramica sulle ricerche applicate al trattamento del disturbo post-traumatico da stress. Vengono illustrati gli studi più significativi, con riferimento anche alle meta-analisi, fornendo le basi per l'applicazione clinica delle tecniche che si sono dimostrate efficaci per questo disturbo psichico.

The aim of the present study was to examine the differential effects of strategies for promotion of psychological well-being (Well-Being Therapy, WBT) and removal of distress (Anxiety Management, AM) in a non-clinical school setting.162 students attending middle schools in Northern Italy were randomly assigned to: (a) a protocol derived from WBT; (b) an anxiety-management protocol (AM). The students were assessed immediately before and after the interventions, and after 6 months using: Psychological Well-Being Scales (PWB), Symptom Questionnaire (SQ) and the Revised Children's Manifest Anxiety Scale (RCMAS). In school children, well-being and symptom focused interventions produced slightly different effects on psychological dimensions. WBT, by facilitating progression toward positive and optimal functioning, may integrate symptom-centered strategies.

The objective of this study was to test the efficacy of a new school program for the promotion of psychological well-being (PWB) and optimal human functioning in adolescence. A specific strategy for enhancing PWB, well-being therapy (WBT), has been developed, and controlled investigations have documented its efficacy in adult clinical populations. In this study, a school-based intervention derived from WBT and adapted for an adolescent population has been compared to an attention-placebo intervention in a high school setting. Nine classes (227 students) of one high school volunteered to participate and were randomly assigned to WBT intervention group (five classes, 129 students) and attention-placebo group (four classes, 98 students). Both school-based interventions consisted of six, 2-h sessions. Assessment was performed at preintervention and postintervention, and after 6 months using symptom questionnaire (SQ), PWB scales, and revised children’s manifest anxiety scale (RCMAS). A significant effect of WBT in improving the personal growth scores and the total PWB score at retest were observed. WBT school-based intervention resulted also in a significant improvement in: SQ physical well-being and in RCMAS physiological anxiety at retest, SQ anxiety at follow-up and SQ somatization both at retest and at follow-up. All these symptom dimensions display an opposite pattern in the attention-placebo group, i.e., they tend to get worse at follow-up. A school intervention based on promoting positive emotions and well-being was effective not only in increasing PWB among adolescents, but also in decreasing distress, in particular somatization. Future research with larger samples and longer follow-up are necessary to confirm the efficacy of school WBT.

INTRODUZIONE: La letteratura scientifica ha mostrato che nell’infanzia e nell’adolescenza il disagio psicologico si manifesta prevalentemente sotto forma di sintomatologia ansiosa e particolarmente marcati risultano essere i fenomeni di somatizzazione. Negli ultimi anni nelle scuole è aumentato l’interesse nei confronti di interventi preventivi volti ad incrementare il livelli di benessere psicologico e a ridurre quelli di disagio psichico. L’ obiettivo di questo studio è applicare e comparare gli effetti di due interventi scolastici, uno specificatamente indirizzato a promuovere il benessere psicologico (Well-Being Therapy-WBT) e l’altro finalizzato a ridurre i livelli di ansia. METODO: 165 studenti (70F, 95M; età media = 11.41±0.56), frequentanti 8 diverse scuole medie localizzate nel nord Italia, hanno aderito volontariamente al progetto. Le classi sono state randomizzate alle seguenti condizioni sperimentali: a) un protocollo di promozione del benessere psicologico (WBT); b) un protocollo di gestione dell' ansia (AM). Entrambi gli interventi consistevano di sei incontri di due ore a cadenza settimanale. Gli studenti sono stati valutati durante la prima e l’ultima sessione degli interventi e sei mesi dopo la loro conclusione usando: 1) le Psychological Well-Being Scales (PWB), il Symptom Questionnaire (SQ) e la Revised Children’s Manifest Anxiety Scale (R-CMAS). Per valutare i cambiamenti nelle varie sottoscale dei questionari usati all’interno dei due gruppi sperimentali è stata utilizzata un’analisi della varianza per misure ripetute within group. Per comparare gli effetti dei due interventi è stata condotta un’analisi della varianza, usando i punteggi iniziali come covariate. RISULTATI: L’analisi della varianza per misure ripetute all’interno del gruppo WBT ha messo in evidenza un significativo aumento dell’Autonomia (PWB) e una riduzione dell’ansia fisiologica tra il retest e il follow-up. L’analisi della varianza per misure ripetute all’interno del gruppo AM ha invece evidenziato una riduzione dell’Ansia (SQ) tra il test e il retest. Inoltre il punteggio nella scala della Preoccupazione (R-CMAS) è diminuito al retest e ulteriormente al follow-up. L’analisi della covarianza ha messo in evidenza che il protocollo di gestione dell’ansia è più efficace nel ridurre l’Ansia (SQ), mentre il protocollo di WBT ha un effetto significativamente maggiore nell’aumentare la Buona Disposizione verso gli altri (SQ). CONCLUSIONI: L’intervento diretto alla gestione dell' ansia e delle emozioni negative si è rivelato efficace per ridurre i livelli di malessere psicologico negli adolescenti, soprattutto per quanto riguarda i sintomi di somatizzazione e ansia fisiologica. L’intervento finalizzato alla promozione del funzionamento ottimale si è rivelato efficace nell‘aumentare i livelli di benessere, apportando un miglioramento nei rapporti interpersonali dei ragazzi. Ulteriori studi sono necessari per valutare l’efficacia di un’integrazione dei due protocolli.

Background: There is increasing literature on the unsatisfactory degree of remission that current therapeutic strategies yield in unipolar depression. The aims of this review were to survey the available literature on residual symptoms of depression, to introduce new targets for therapy and to outline a more stringent definition of recovery. Method: Studies were identified by using MEDLINE (English language articles published from 1967 to June 2006; keywords: recovery, remission, residual symptoms, sequential treatment, drugs and psychotherapy, related to depressive disorder and depression) and a manual search of the literature and Index Medicus for the years 1960-2006. Results: Most patients report residual symptoms despite apparently successful treatment. Residual symptoms upon remission have a strong prognostic value. There appears to be a relationship between residual and prodromal symptomatology. The concept of recovery should involve psychological well-being. Conclusions: Appraisal of subclinical symptomatology in depression has important implications for pathophysiological models of disease and relapse prevention. New therapeutic strategies for improving the level of remission, such as treatment on residual symptoms that progress to become prodromes of relapse, may yield more lasting benefits.

Introduction. Psychological debriefing uses brief unsystematic exposure and is ineffective for Post-Traumatic Stress Disorder (PTSD) and its related symptoms. Systematic exposure alone and cognitive restructuring alone are each effective. Other approaches too may be useful. Methods. The treatment of three PTSD patients is detailed in which there was no exposure to the main traumatic event. There was exposure to related cues in case 1, exposure to related and other cues followed by Well-Being Therapy (WBT) in case 2, and WBT in case 3. Discussion and Results. The three patients improved enduringly, confirming earlier findings that exposure to the main trauma is not essential for PTSD to improve. Conclusions. Study is needed of therapeutic mechanisms in PTSD, and of the value of WBT in a randomized controlled trial.