LIBRI DI LUIGI JANIRI

The relationship between traumatic experiences and major depressive disorder provides relevant insight into the etiopathogenesis of major depression. The purpose of the current paper is to provide a narrative review on the role of both early-life trauma and recent stressful life events in the onset and maintenance of major depression. We searched for studies using PubMed, PsycLIT, PsycINFO and EBSCOhost electronic databases. The review of the studies suggests that most episodes of major depression are preceded by some stressful life events, mostly involving interpersonal loss. The central role of childhood adversity (parental death, divorce and marital discord, parental mental illness and substance abuse, exposure to family violence, neglect, and sexual and physical abuse) has also been extensively investigated. Evidence in current literature supports the notion that the impact of childhood traumatic experiences is more enduring and profound and leads to cumulative effects of stressful or traumatic events later in life. Furthermore, recent research has explored possible mediators of the trauma-depression relationship focusing on the identification of factors associated with resilient responses to traumatic stressors. Genetic influences, neurobiological pathways and psychosocial determinants have been found to be primarily involved in mediating resilient phenotypes.

In materia di tossicodipendenza si scontrano opposti schieramenti ideologici, e si banalizzano i medesimi dati epidemiologici, clinici e terapeutici. Una diversità di posizioni che si manifesta nella diagnosi stessa, e fa parlare di “doppia diagnosi”, contemporanea presenza di una malattia internistica e di una malattia psichiatrica, oppure co-presenza di due differenti malattie della mente, la tossicodipendenza come patologia psichiatrica “pura” accanto ad altre co-presenti malattie della mente.