Psychoanalytical Association

Abstract: Both people with dementia and their caregivers show a decrease in quality of life and well-being. The Alzheimer Café (AC) is a psychosocial intervention supporting both people with dementia and their caregivers. This pilot study aims to (1) create a network of Alzheimer’s associations operating in different Italian regions; (2) assess the project’s feasibility; and (3) evaluate the impact of AC participation on (a) the quality of life of people with mild cognitive impairment (MCI) or dementia and (b) the caregivers’ depressive symptoms and burden. We conducted a multicenter pilot study involving a network of Alzheimer’s associations. People with MCI or dementia (referred to as “participants”) and their caregivers participated in weekly AC meetings that included psychosocial, cognitive, physical, and educational activities. We enrolled a total of 168 participants and 161 caregivers through a network of 16 AC across eight Italian regions. We measured the outcomes at baseline and at 6 and 12 months. The primary outcome was the change in the participants’ quality of life. Secondary outcomes included changes in caregiver burden, depressive symptoms, and psychological stress. We used generalized linear models to analyze the changes in test scores over time. At follow-up, the participants’ neuropsychiatric symptoms had significantly improved, and their overall quality of life remained stable. Among the caregivers, distress related to the participants’ neuropsychiatric symptoms significantly declined, and burden remained moderate. The AC appears to reduce participants’ neuropsychiatric symptoms and has a beneficial impact on caregivers’ distress, suggesting its potential as a valuable psychosocial support model.

In most countries, a criminal conviction requires evidence that the individual committed the act and that they had the mental capacity to understand what they were doing and that it was wrong. Youth, as an indicator of brain development, is one factor affecting criminal capacity. Worldwide, this has commonly been managed in part by setting in law an age below which criminal incapacity is presumed, so no prosecution is possible. Considerable variation in the MACR was confirmed across 195 countries. Some countries have no MACR. Otherwise, the MACR ranges from 7years (some African and South Asian countries) to 18 (some South American countries); many North Asian, European and a few African countries set theirs at 14 which is the most frequently found level, and also the minimum age recommended by the United Nations Convention on the Rights of the Child. Therefore, how do countries set or change their MACR? To explore change, efforts to change and impact of change in MACR internationally. Between February 1st 2022 and December 31st 2023, members of an international research group (GIRAF-Group of International Researchers in Adolescent Forensics) were asked to complete an emailed questionnaire about changes in the MACR, or efforts to change it, in their country since 2000. Reports were then collated, circulated and discussed within the group. Among the 14 countries responding in detail about the MACR, efforts to raise the MACR had been successful in three, but in nine such efforts had been unsuccessful; in at least two countries pressures were to lower their MACR, but in only one, Denmark, did that happen (from 15 to 14) in the data collection period (though this change was subsequently reversed). Factors most influencing retention of a lower age were exceptional individual cases, which triggered press and political interest in retaining a higher age, and well-evidenced and developed arguments from legal, social and medical or other clinical bodies. The wide differences in the MACR between countries suggest under-use of evidence in deciding it. We need more governmental willingness to bring the MACR at least to the UN-recommended level-but accompanied by research into the impact of this. Efforts targeted exclusively on child and adolescent welfare may have less effect if they also force children through the criminal justice system, with consequent impact on self-identity and sense of citizenship. A low MACR is also likely to be more directly and indirectly costly than a higher one.

Excess weight is often incorrectly linked to pathological eating behaviors without considering the complexity of underlying causes. The aim of this study is to explore the intersections between obesity and Eating Disorders, with particular reference to the Binge Eating Disorder (BED). This study analyzed (1) the presence of BED in a population of 293 individuals affected by obesity using the Binge Eating Questionnaire and (2) the correlations between body weight (BMI) and eating behavior (Eating Disorder Questionnaire). Data analysis revealed that only 12% of the sample met the criteria for an Eating Disorder and that the body mass index was not correlated with pathological eating behavior but with body dissatisfaction (p<.001). The study suggests that only a modest percentage of individuals with obesity have comorbid Eating Disorders, and that weight is correlated with a state of distress (internalized stigma?) that may constitute a maintenance factor hindering health behaviors. This study highlights the need for differentiated and personalized clinical and therapeutic interventions.

Si può essere esuli per i più disparati motivi; fra i tanti, il bisogno di trovare lavoro o sfuggire ad un regime totalitario dove la libertà di pensiero è equiparata a reato. Dalla testimonianza di Siegfried Gerhardt, lui stesso costretto ad espatriare per quest’ultima ragione, emerge quanto profonda sia l’amarezza degli esuli nel trovare luoghi e persone a loro ostili, la cui assenza di partecipazione verso i nuovi arrivati li fa sentire – più che mai – degli intrusi, rendendo impervia la via dell’integrazione e della riappropriazione dell’identità. Sensazione ancor più dolorosa, nel caso di Siegfried Gerhardt che si considera “Esule nella propria Patria”. Ciò richiama una frase del famoso poeta e scrittore Adelbert von Chamisso, che ha trascorso tutta la vita in un sofferente peregrinare da esule: sono sempre fuori posto, non mi sento mai al posto giusto. Occorre, dunque, “esiliarsi dall’esilio”, trarre forza e consolazione nella bellezza (e nella bontà) dell’arte, eterno concetto dostoevskijano, che salva dalle ostilità della vita. Così ha fatto Siegfried Gerhardt.

Mazin schreibt über antagonistische Anforderungen an die Psychoanalyse bezüglich Garantien. Garantien gehören in den Bereich der Prognostik. In der Psychoanalyse haben wir es jedoch mit einer anderen Zeitlichkeit zu tun, die nicht so sehr in die Zukunft geht, als vielmehr aus der Zukunft zurückkommt.

International audience

Cet article opère un essai de rapprochement de deux textes, « Absence psychique de négation, rage destructrice et déséquilibres somatiques », de G. Szwec, et « Non deux fois non » de J.-B. Pontalis. Les deux auteurs, tout en partant de points de vue théoriques divergents, se penchent sur le même phénomène, la défaillance, chez certaines personnes, de la négation au sens freudien. Le premier centre son intérêt sur les somatisations qui peuvent découler de cet échec, le second sur la « réaction thérapeutique négative », qu’il considère comme une manière de dire « non » à l’analyse à travers un acte. Un cas clinique vient illustrer comment le travail analytique peut contribuer à la construction de la négation et dans le même mouvement au processus de subjectivation.