Roberta Risola

Background: The communication of bad news in healthcare is a critical factor in patient care and workplace safety. Ineffective communication can contribute to emotional distress and aggression toward healthcare professionals. Despite its importance, many professionals lack the necessary training to manage these conversations effectively, increasing the risk of conflict. This study investigates the relationship between communication breakdowns and workplace violence in healthcare settings. Methods: This retrospective observational study analyzed incident reporting data from two major Local Healthcare Authorities in Southern Italy (2019–2023). Reports of aggression toward healthcare professionals were categorized by type (verbal or physical), triggering event, location, severity, and aggressor identity. Chi-square tests and linear regression models were used to identify trends and associations. Results: A total of 248 reported incidents were analyzed, with 85.1% classified as verbal aggression and 14.9% as physical aggression. The primary trigger was disagreement over clinical management (57.4%), followed by perceived delays in care (25.5%) and denial of assistance by family members (11.7%). Most incidents occurred in community-based healthcare services (42.6%) and emergency departments (25.5%). Family members were the primary perpetrators of physical assaults (64.3%), while patients were responsible for most verbal aggression (55.3%). Conclusions: Poor communication strategies contribute to workplace violence. Improving healthcare professionals’ communication skills through structured training, implementing conflict management strategies, and strengthening security measures in high-risk areas are crucial for reducing aggression. Future research should explore additional risk factors and assess the effectiveness of targeted interventions.

This contribution aims to analyse an Italian femicide case that progressed through three levels of trial up to the Supreme Court of Cassation and required an expert opinion. This analysis will address specific forensic psychiatry issues inherent to this field, i.e., the interaction between addiction, jealousy, and mental disorder in a femicide case, which necessitates a comprehensive understanding of both criminology and legal medicine. On one hand, the nosographic setup of the so-called dual diagnosis (in the case examined, there was alcohol addiction and a borderline personality disorder), together with conditions inherent to a personality disorder (in this specific case, at least a borderline state or actually marginal manifest disease) that integrated an infirmity with legal relevance. Both conditions were inserted in a relational context of dysfunctional and collusive characters in which the victim’s personality caused her, at a victimological level, to become an active partner co-responsible for the criminal act. Key points Forensic psychiatric analysis in a case of femicide.Nosographic difficulty in making dual diagnosis.Assessment of the perpetrator’s mental capacity and of diminished responsibility.Personal predisposition of the victim as an active partner in the crime.

Background: A psychological autopsy is a post-mortem investigative tool used to carry out a retrospective reconstruction of a missing subject’s life. The method includes gathering information from all the potentially involved parties, which may indicate the relevant elements directly or indirectly to trace the victim’s experience and identify personality traits, lifestyle, and interpersonal relationships. Discussion: Psychological autopsies are mainly performed during criminal investigations to identify the cause of death and the specific circumstances (natural, accidental, suicidal, or homicidal death). In addition, from an epidemiological point of view, this method aims to collect the relevant information about an individual’s behavior, circumstances, and reasons for their death to identify common risk factors to prevent new suicides. Although less frequently, this tool can also serve other purposes, such as the legal validity estimation of pre-death actions. Moreover, it may be used to assess whether mistakes have been made in treating people undergoing medical or psychological treatment. Conclusions: Currently, this methodology still has a limited diffusion on the Italian and European scenes due to the lack of standardized guidelines and substantial relevant scientific literature. It is the main factor affecting the tool’s reliability, validity, and systematic application in forensic investigations.