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25 ottobre 2011




per comprendere e aiutare tutti coloro che soffrono di questa patologia così importante e ancora così sconosciuta.....



"Noi ci saremo...e invitiamo tutti a esserci con noi!"
Il reparto DCA di Villa
dei Fiori.



17 ottobre 2011





permalink | inviato da villadeifiori il 17/10/2011 alle 8:27 | Leggi i commenti e commenta questo postcommenti (2) | Versione per la stampa

8 agosto 2011




Cinema sotto le stelle


Domani Martedì 9 Agosto
ore 19,30
- PROIEZIONE SU MAXISCHERMO -






permalink | inviato da villadeifiori il 8/8/2011 alle 13:27 | Leggi i commenti e commenta questo postcommenti (0) | Versione per la stampa

16 luglio 2011





Villa dei Fiori
presenta







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8 luglio 2011





Villa dei Fiori

presenta

 


5 luglio 2011


 


EstateInsieme 2011


Pubblichiamo volentieri le immagini relative ai primi due appuntamenti di "EstateInsieme 2011" di Villa dei Fiori.



21/06/2011 CONCERTO – Musica d'autore Marcello Giuffrida








28/06/2011 Emiliano Fiacchi - Tributo a Michael Jackson  






28 giugno 2011





permalink | inviato da villadeifiori il 28/6/2011 alle 9:32 | Leggi i commenti e commenta questo postcommenti (0) | Versione per la stampa

1 giugno 2011


Congresso Internazionale
EFRR
Perspectives and controversial issues for research
in rehabilitation
May 26-28, 2011
Riva del Garda Italy



 
La ricerca di Villa dei Fiori
Casa di Cura Neuropsichiatrica Privata Accreditata SSN, via delle Benedettine 18 Roma, Italy


The Psychiatric Rehabilitation Therapy role in the GAF rating scale score variation within combined therapy in voluntary in-patient treatment.

Lo Cascio Gerland, Cavallaro Antonino, De Marco Angela Maria, D’Arconte Valentina


INTRODUCTION

The Rehabilitation Therapy use within an institution dedicated to treat psychiatric disorders in the acute and subacute during a brief hospitalization it’s a therapeutic possibility that must be evaluated and possibly included in a therapeutic protocol which could utilize its full potential. Our work aims to make a contribution as a pilot study to that goal. The purpose of this work was to assess whether and how the association of the Psychiatric Rehabilitation Therapy within combined therapy during the time of in-patient treatment go to have a positive impact on the GAF score of a sample group of patients with psychiatric pathology in acute and subacute phase and if this impact changes s and how to change depending on variables such as diagnosis, hospitalization’s duration, psychological and pharmacologic therapy combination.

MATERIAL AND METHOD
Pharmacological therapy
: Pharmacological therapy consists of daily administration of psychoactive drugs (neuroleptics, antidepressants, mood stabilizers, anxiolytics, hypnotics) personalized and dedicated to the individual patient after a medical and psychiatric examination and checked daily.

Rehabilitation therapy: Rehabilitation therapy consists of four therapeutic activities-groups: theater, music, film club and book reading. Each activity is conducted by a professional who observes and guides the groups-members. These activities, in various ways, are aimed at the stimulation and at the recovery of individual, interpersonal and social patient's skills, in order to promote a more appropriate return in the social context after the hospitalization. Patients examined in our study and included in the subgroups C and D (see below) attended at least two of such activities.

Psychological therapy: Psychological therapy consists of individual psychological sessions three or more times per week, led by a psychologist with psychodynamic training. The aim of these sessions is to support the patients during hospitalization and help them to verbalise emotions related to pathology, in order to facilitate its acceptance, reduce stigma and discover and use their skills and resources.

GAF scale: GAF scale (global assessment of functioning) is a scale rating the overall psycho-social – working functioning. Simple and fast, but, at the same time reliable and direct, GAF is the international rating scale most representative to explore the aspects that we proposed to assess in this study.

RESULTS
We evaluated a sample group of 250 patients admitted in our hospital for at least 10 days between April 2010 and September 2010 and within 4 diagnostic groups (DSM IV-TR):
1) Patients  with PSYCHOSIS / SCHIZOPHRENIA
2) Patients  with BIPOLAR DISORDER
3) Patients with  MAJOR DEPRESSION
4) Patients with PERSONALITY DISORDERS
GAF rating scale was administered to each patient at the hospital admission time and at the hospital discharge time. At the admission time, after  a psychiatric and psychological-rehabilitation evaluation to assess the insight of each patient and their specific needs and requirements , each group was divided into 4 subgroups:
a) patients treated with PHARMACOLOGICAL THERAPY
b) patients treated with PHARMACOLOGICAL THERAPY and PSYCHOLOGICAL THERAPY
c) patients treated with PHARMACOLOGICAL THERAPY and REHABILITATION THERAPY
d) patients treated with PHARMACOLOGICAL THERAPY, PSYCHOLOGICAL THERAPY and REHABILITATION THERAPY
So, we observed 16 groups of patients (1a, 1b,1c,1d; 2a, 2b,2c,2d; 3a,3b,3c,3d; 4a,4b,4c,4d) during their hospital stay.
We observed a sample group of 285 patients, 155 males (54%) and 130 female (46%). Sample group medium age was 52.3 years, hospitalization medium duration was 34.9 days.
The patients sample group was composed in this way within the diagnostic groups:
Group 1) 109 patients, 38%
Group 2) 42 patients, 15%
Group 3) 34 patients,12%
Group 4) 100 patients, 35%

Total sample group medium GAF score was 47.5 at admission time (GAF in), 63.1 at discharge time (GAF out). GAF in and out medium variance was 15.6. The amount of patients who made exclusively pharmacotherapy was 163; the amount of patients who made pharmacological therapy and psychological therapy was 77; the amount of patients who made pharmacological therapy and rehabilitation therapy was 21; the amount of patients who made pharmacological therapy, psychological therapy and rehabilitation therapy was 24.
In detail, these are the results that we observed for each diagnostic group:

Group 1 (tot 109)

Subgroups

Patients number

Medium GAF in

Medium GAF out

Medium variance GAF in-out

Hospitalization

medium

duration (days)

a

81

42.1

55.7

13.6

34.8

b

13

49

64.9

15.92

38.8

c

11

47.7

59.2

11.5

34.7

d

4

40.3

61.3

21.5

53.3

Group 2 ( tot 42)

Subgroups

Patients number

Medium GAF in

Medium GAF out

Medium variance GAF in-out

Hospitalization

medium

duration (days)

a

30

44.5

65.7

21.2

34.0

b

11

50.1

71.7

21.5

36.1

c

1

60

80

20

18

d

0

0

0

0

0

Group 3 (tot 34)

Subgroups

Patients number

Medium GAF in

Medium GAF out

Medium variance GAF in-out

Hospitalization medium

duration (days)

a

14

49.1

72.0

22.9

29.2

b

16

50.2

69.4

19.2

35

c

0

0

0

0

0

d

4

58.8

74.5

15.8

47.8

Group  4 (tot 100)

Subgroups

Patients number

Medium GAF in

Medium GAF out

Medium variance GAF in-out

Hospitalization medium duration (days)

a

38

61.8

49.2

12.6

30.6

b

37

52.2

68.6

16.1

32.0

c

9

53.9

63.7

9.8

42.6

d

16

67.1

51.1

15.9

47.3


CONCLUSION:

The first and evident data coming out from our study is GAF variance in-out significant increase in all patients treated with only pharmacological therapy in comparison with others (14.6 vs. 17.3). We also observed that the medium hospitalization duration of patients treated with only pharmacological therapy  is less in comparison with others (33.7 days vs. 47.1 days). In detail, the biggest increase in the GAF score  among patients treated with only pharmacological therapy in comparison with others happens in the Group 1 (12.5 vs 5.2) and in the Group 4 (12.0 vs 4). This evidence changes within the groups 2 and 3: in the group 2 GAF variance in-out increase among patients treated with only pharmacological therapy in comparison with others is very small (21.1 vs. 21.5), and in Group 3 GAF variance in-out is lower among patients treated with only pharmacological therapy in comparison with others( 18.5 vs 22.7). This evidence shows that the impact of pharmacological therapy  is significant and fast in mood disorders (groups 2 and 3), wheras in psychotic disorders and personality disorders (groups 1 and 4)  that impact is not decisive.
In particular this impact is not decisive in the group 1 maybe because, in patients with Psychosis or Schizophrenia, part of the disease symptoms are chronic ,so, hardly changeable. Within groups 2 and 3,hospitalization medium duration among patients treated with combined therapy is longer than patients treated with only pharmacological therapy (36.1 days vs 33.4 days in the group 2 and 37.5 days vs 29.2 days in the group 3). This let us think that combined therapy is the first choice for patients with more severe diseases. If we analyze the patients treated with pharmacological therapy  and rehabilitation therapy, but not with psychological therapy,  GAF in-out variance is heavily lower. This  can indicate that patients not treated with psychological therapy cope with rehabilitation therapy superficially, understanding  less the value of that activity, and, that the rehabilitation therapy shows significant effects after long time, so, combined therapy with psychological therapy can make the patients more conscious about the importance of the rehabilitation therapy's positive impact on their disease. All that can improve patient compliance and can abbreviate hospitalization duration. Finally we must consider that patients treated with only pharmacological  therapy  and rehabilitation therapy are patients with more severe disease and  low insight. Usually they are treated in this way in order to improve their compliance to hospitalization and medical treatment, and, in these cases, we are not expecting in any case a significant increase GAF in-out variance because of the disease acuteness of this  class of patients.

 




permalink | inviato da villadeifiori il 1/6/2011 alle 10:29 | Leggi i commenti e commenta questo postcommenti (0) | Versione per la stampa

10 marzo 2011



3 marzo 2011


 


Le poesie degli ospiti di Villa dei Fiori



In una prima pubblicazione abbiamo dedicato la nostra attenzione al disegno, ed ora la volgiamo ad un'altra modalità espressiva: il pensiero poetico.
Abbiamo invitato quindi i nostri ospiti ad esprimere delle emozioni in forma scritta, senza un tema prefissato, che poi abbiamo raccolto in un libro.
I nostri pazienti parlano spesso dell'amore ideale, dell'amore per i familiari, di abbandono e di deprivazione, temi che agitano il cuore e offuscano la mente, presenti in modo più o meno intenso nella psicopatologia della vita quotidiana. Alcuni di loro riescono ad affrontare argomenti così importanti con una semplicità ed una spontaneità uniche, in modo libero e svincolato dalle ideologie e dai modelli culturali imposti. La poesia diventa dunque luogo di evasione e libertà, dimensione nella quale collocare gioie e delusioni quotidiane, espressione di tutto quello che nella realtà non riusciamo ad esprimere per paura di non essere compresi. La poesia diventa così un dialogo con se stessi in cui le emozioni prendono corpo nelle parole.

                                                                            Dott.ssa Francesca Doddi
                                                                                         Psicologa

Il libro non è in vendita, viene distribuito agli ospiti della struttura e ai loro parenti. Villa dei Fiori però vuole farne omaggio ai primi dieci affezionati lettori che ne faranno richiesta scrivendo una mail al seguente indirizzo:

villa.fiori@libero.it



 

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