Perrotta Giulio

This preprint has been withdrawn at the authors' request due to identified errors in the data and results. The authors plan to revise and verify the study before resubmission.

Obsessive‐compulsive disorder (OCD) is a common and disabling, as well as underdiagnosed, neuropsychiatric condition characterized by involuntary and unwanted obsessions and/or compulsions, often accompanied by states of severe anxiety, distress and shame, as well as other comorbid disorders. Despite the extensive literature available to date, only some of the neurobiological mechanisms underlying the symptomatic manifestations of the disorder have been clarified, underlining the need for further research. The brain structures involved are hippocampus, amygdala, striatum, thalamus, dorsolateral prefrontal cortex, anterior cingulate cortex, and orbitofrontal cortex; furthermore, most studies have mainly focused on the expressive modalities and on the individual structural and functional alterations of the brain, generating sometimes conflicting data. The aim of this article is therefore to summarize and bring together the main evidence collected so far on what would appear to be the neuroanatomical correlates and mechanisms underlying the disorder and its manifestations, to provide a sufficiently clear and complete overview.

Depressive spectrum disorders are considered among the most common in the general population. Major depressive disorder and persistent depressive disorder (or dysthymia) are the most recognized, but other depressive disorders exist with varying or no specificity. The main difference between major depressive disorder and dysthymia lies in the duration and intensity of symptoms. Improving our understanding of its etiology and pathogenesis must be a priority for health and safety. Given the complexity of the evidence in the literature, it was deemed useful to provide a comprehensive summary of the neuroanatomical dysfunctions currently identified, with particular attention to the anterior and medial cingulate cortex, dorsolateral and ventromedial prefrontal cortex, posterior parietal cortex, insula, amygdala, and hippocampus. Significant neural network alterations include hyperconnectivity of the default mode network (DMN), impairment of the executive control network (ECN), and dysfunction of the salience network (Salience Network). Neurophysiological markers reveal frontal alpha asymmetries and front-striatal metabolic alterations. Studying neural correlates is essential to deepen our understanding of the depressive spectrum and the development of personalized therapeutic interventions, including noninvasive neurostimulation techniques and target-specific pharmacological therapies, opening new avenues for translational research in neuropsychiatric settings.

In psychopathology, one of the most complex challenges is offered by the diagnostic comparison between patients with borderline personality disorder and those with bipolar spectrum disorder, as some of the symptoms characterizing the two disorders overlap. This detail can mislead therapists who are often called upon to diagnose these syndromes, and in some cases, there is a tendency to diagnose both as one is a personality disorder and the other is a mood disorder. This article provides the reader with a complete overview of these two disorders, highlighting some aspects that could redefine their clinical framework. This need could favor a reduction in cases of diagnostic error, also through the proposal of an innovative psychometric tool, Perrotta Border‐Bipolar Profile Diagnostic Questionnaire, currently being validated.

The incidence of mood disorders in the general population is quite high. Among the most common is bipolar disorder (BD), often associated with severe mood disorders, psychotic changes (e.g., delusions, hallucinations), impulsivity, and self-harm. However, its correct diagnosis is challenging, primarily due to the heterogeneity of clinical and symptomatic features, as well as individual differences among patients, such as comorbidity with other disorders (e.g., borderline personality disorder). Therefore, to improve understanding of its etiology and pathogenesis, refining the diagnosis must be a priority. Given the breadth and complexity of the evidence in the literature, we believe it is useful to provide a clear and comprehensive summary of the neuroanatomical and dysfunctional alterations observed, with particular attention to the prefrontal cortex, anterior cingulate cortex, cerebral ventricles, amygdala, hippocampus, cerebellum, and white matter. Through functional neuroimaging investigations it is possible to distinguish two main forms of bipolarism: the first (BD-I) is the most severe form, both in terms of manifested symptoms and in the structural and functional alterations detected; the second (BD-II) is the less severe form, which presents attenuated symptoms and mild or medium-severe alterations compared to the normotype criteria. Literature highlights the need to identify a precise study model, whether neuro-evolutionary or neuro-progressive or mixed, capable of offering clinical therapists greater scientific basis on which to anchor their diagnostic interpretations, and certainly the use of functional neuroimaging technology can be a good option even if it still presents costs that are not easily and freely sustainable by patients.

The issue of effective treatments for individuals with a history of sexual offending has legal, social, economic, political, and clinical impacts. Studies conducted on the topic of evaluating treatment outcomes for sex offenders have examined both biological and psychological interventions. The etiology of the phenomenon appears to be multifactorial, as the sexual harasser learns from the social and family context the norms that will constitute our framework of rules, in addition to the characteristics of temperament, character, and personality. Therefore, there is a need for a definite social–health policy at the government level to be able to address the legal-judicial, socio-political, and health problem of Italian sex offenders to reeducate and reintegrate them into society by drastically reducing or nullifying the risk of recidivism. This study proposes the “Trident State Program” (TSP), which could reduce or solve the problem of recidivism of Italian sexual offenders and promote a better process of re-education and reintegration of these individuals. The operational protocol of the program is being drafted.

Background: Sexuality is a central aspect of being human, even if people experience it in different ways in various stages of life. Sexuality in older people may be expressed, as well as affection, companionship, touch, and physical contact. However, older peoples’ sexual needs are not properly considered by themselves, caregivers, or healthcare professionals. Reviews on barriers related to identification and satisfaction of sexual needs of people living in nursing home are scarce. In this scenario we intended to summarize the state of evidence regarding sexual need identification and satisfaction among older people living in nursing homes and possible barriers that could limit sexual need identification and satisfaction. Methods: We carried out a narrative review. The included studies responded to the research question, using the following key words: nursing homes, sexuality or sexual need, or sexual behavior, older people. Searched databases included PubMed, Embase, CINAHL, PsycInfo, and Scopus. Results: After searching and screening we included 22 studies, finding three main topics: 1. identification of sexual needs by residents and healthcare personnel attitude and practice; 2. barriers and reasons hindering the identification of sexual needs; and 3. manifestation and satisfaction of sexual needs. Conclusions: The findings showed that nursing homes’ residents have different sexual needs, but there are many organizational, educational, and cultural barriers and negative attitudes of healthcare personnel. Supporting nursing home residents to express their sexual needs is a challenge for the healthcare professionals and managers of nursing homes.

Introduction: In the literature, depression is a medical condition that is well known and has been studied for decades, yet in clinical practice it often happens that depressive symptoms are confused with structured disorders or complexes. This incorrect interpretation can lead the psychiatrist to choose to make a psychopharmacological prescription, relegating psychotherapy to mere support or in any case reducing its importance, risking making the patient’s symptoms chronic and overloading the healthcare system. Materials and Methods: The literature up to December 2024 was reviewed and 40 articles were included in the review. A pilot study was conducted to verify the effectiveness and validation of the proposed theoretical model. Results: We propose the use of the “Perrotta Depressive Symptoms Assessment” (PDSYA) for the differential diagnosis in disorders with the manifestation of depressive symptoms, to facilitate the correct diagnosis and to reduce interpretative errors, both at a nosographic and therapeutic level. Conclusions: In the pilot study, in the content validity analysis, all items obtained a CVR score greater than the cut-off value, with a minimum score of 0.811. Therefore, all items of the scale were considered essential; also, regarding the relevance of the items in exploring the constructs investigated, optimal values of I-CVI (>0.93) and scale (S-CVI > 0.98) were obtained. Therefore, all items were rated as relevant. The validation study of the model is underway with a representative sample.

Introduction: Unresolved childhood traumas, throughout the human developmental stage, are capable of negatively affecting an individual’s psychophysical growth, promoting the onset of psychopathological conditions. In the literature, the intrapsychic processes capable of explaining this phenomenon are not yet known, and the specific consequences are not known with certainty. Method: The sample is composed of 44 Italian participants (16 males; 28 females), aged between 8 and 17 years (M: 12.9; SD: 3.1). By means of clinical interview and administration of the “Test of Separation Anxiety” (SAT), the “Perrotta Integrative Clinical Interviews”, version C-3 (PICI-C-3) and the “Perrotta Human Emotions Questionnaire” (PHE-Q), pediatric patients included in the population sample were investigated. Results: The data obtained from the research statistically showed significant differences (p < 0.001) between the clinical group and the control group, correlating pathological attachment style with a specific dysfunctional personality profile (p < 0.001), in the pediatric population studied. Conclusions: Unresolved childhood trauma is a predisposing factor for the onset of a psychopathological disorder, capable of impacting both functioning and personality structure; however, other factors have also been identified that, if present facilitate or exacerbate the morbid condition, such as the duration of exposure to the trauma, the repetitiveness of the negative effects of the trauma, the depth of the suffering experienced, possible behavioral reinforcers, other traumatizing causes, such as psychophysical violence (with or without sexual intent), genetic and familial predisposition to certain psychopathologies, extreme economic poverty, adverse socio-environmental and cultural context, and difficulty of integration. Early psychotherapeutic intervention can promote functional recovery.

Introduction: In the literature, the high risk of diagnostic error in diagnoses of borderline disorder and bipolar disorder, due to overlapping part of symptoms, is well known. There is a need to validate a psychometric instrument capable of reducing this risk. Materials and methods: A theory, model, scale and questionnaire related to the unified diagnosis of Border-Bipolar psychopathological condition (Perrotta Border-Bipolar Profile Diagnostic Questionnaire, PBBD-Q) was generated to be administered to a selected population; however, since there is no psychometric instrument capable of performing this analysis, the data were compared with the outcomes of the PICI-3-TA columns related to the disorders under investigation, to validate the proposed psychometric instrument. Results: In this study, a population of 232 individuals (96 males and 136 females), aged between 18 and 68 years (M: 39.4; SD: 3.1), was selected. KMO and EFA all show values above 0.500, which is still considered adequate. Statistical comparison between PBBD-Q and PICI-3-TA showed good significance (p = 0.017 and W = 0.878), with a fair correlation matrix (r = 0.866). Statistical analysis showed that the psychometric test has a well-defined and stable construct, with the variables well represented and positively correlated with another construct already validated. Conclusion: PBBD-Q is a valid, efficient, and effective psychometric tool to identify the exact unitary diagnosis of the Border-Bipolar psychopathological condition.