Publications by authors named "Maria Rosaria Juli"

14 Publications

  • Page 1 of 1

The Socio-Sexual Experiences in Southern Italians during the COVID-19 Pandemic: A Clustering Analysis.

Psychiatr Danub 2021 Sep;33(Suppl 9):169-171

Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy.

The COVID-19 outbreak has dramatically impacted on socioeconomic structure, individual freedom, general wellbeing, psychological health and sexuality. Indeed, social distancing, home confinement and the fear of contagion have reduced the possibility of romantic encounters thus influencing sexual activity, desire and behavior and, consequently, modifying socio-sexual experiences. The aim of this study is to examine sociosexuality and sociosexual experiences in southern Italians during the COVID-19 pandemic.
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September 2021

An Epidepic in the Pandemic: The Most Difficult Challenge for Young Adolescents.

Psychiatr Danub 2021 Sep;33(Suppl 9):142-147

Departmentt of Psychology, University Magna Graecia, Viale Europa, 88100 Catanzaro, Italy,

The pandemic due to COVID-19 has had a huge psychological impact on individuals all over the world, in particular the international literature is noting an increase in pathologies among children and adolescents adolescenti (Pappa et al. 2020, Keles et al. 2020, Pigaiani et al. 2020, Solmi et al. 2021). Adolescence is a time when individuals observe physical changes in their bodies, experience new interests and desires, and find themselves with greater freedom, independence and responsibility; although variably defined, adolescence is generally believed to begin with the onset of puberty and end with assuming social roles as adults (Dahl 2004, Spear 2000). Among the changes that the adolescent has to face are: accepting one's body, acquiring a social role, female or male, establishing new relationships with peers of both sexes, achieving emotional independence from parents and other adults, acquiring social behavior responsible, learn a system of values and an ethical conscience as a guide to one's behavior, develop intellectual skills and prepare for a profession, achieve independence (Juli 2020). All this is not always easy and, many times young people find themselves facing a tortuous path that can give rise to the onset of some mental pathologies; if we then take into account the pandemic period we are experiencing, all this can get complicated. The data released by the Ministry of Health (2021) in the first months of the year, highlight that in Italy today there are about three million young people suffering from Eating Disorders (ED) with early onset before the age of 13 and the number tends to constantly increase. In 1990 Gordon spoke of Eating Disorders as a real social epidemic both in prevalence and incidence and if the preliminary studies conducted during the last year in which we lived the pandemic experience, confirm the increase of about 30% , in the years to come we will find an entire population of young adolescents with dietary difficulties (Santini et al. 2020).
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September 2021

New Therapeutic Strategies for Eating Disorders and Obesity Treatment.

Psychiatr Danub 2021 Sep;33(Suppl 9):84-85

Mental Health Department, Azienda Sanitaria Provinciale di Catanzaro, Catanzaro, Italy,

Eating disorders are disabling, deadly, and costly mental disorders that considerably impair physical health and disrupt psychosocial functioning. Disturbed attitudes towards weight, body shape, and eating play a key role in the origin and maintenance of eating disorders. Eating disorders have been increasing over the past 50 years and changes in the food environment have been implicated. All health-care providers should routinely enquire about eating habits as a component of overall health assessment. Six main feeding and eating disorders are now recognised in diagnostic systems: anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant-restrictive food intake disorder, pica, and rumination disorder (Treasure 2020).
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September 2021

Body Identity Search: The Suspended Body.

Psychiatr Danub 2020 Sep;32(Suppl 1):83-87

Department of Psychology, Magna Graecia University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy,

The morphological transformations that occur during adolescence with rapid rhythm have an unprecedented psychological resonance and it is of fundamental importance to understand the way in which they are lived, perceived and elaborated.These fast body changes and the related social pressures make young people paying more attention to their physical appearance. Among the changes that the adolescent must face are: accepting their own body, acquiring a social role, establishing new relationships with peers,achieving emotional independence from parents. All of this is not always easy and many times they face a so difficult path that can produce the onset of some mental pathologies. Typical disorders that adolescents can face are the ones related to food. In these pathologies there is an isolation of the soul which corresponds to an alienation from the body: what remains in this loneliness is the gap between the idealized body and the objectified body. In this process of identity determination the idealized body is not able to relate to the real body (Cuzzolaro 2017). The dimension of their own body and the ability to meet the other bodies in the world are compromised; the only possible knowledge is represented by the impoverishment of their own subjectivity and by the attempt to recover it at an abstract level. Adolescents live in a condition of temporal suspension: the future is compromised and the past is demonized; what remains is a present moment made eternal by an indefinitely suspended instant (Juli 2018). Too fat for the anorexic, repulsive for binge eating; Merleau-Ponty already in 1945 expressed the concept of corporeality by using the following simple and very effective statement: "I am my body". This statement highlights the centrality of the body, of the person and his/her identity; this aspects are highly conflicting and, at the same time, pathologically united, in eating disorders.
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September 2020

A New Rating Scale (SAVE-9) to Demonstrate the Stress and Anxiety in the Healthcare Workers During the COVID-19 Viral Epidemic.

Psychiatr Danub 2020 Sep;32(Suppl 1):5-9

Psychiatric Studies Center (Cen.Stu.Psi.), Piazza Portici, 11 - 25050 Provaglio d'Iseo (BS), Italy,

The COVID-19 epidemic has been a major global public health problem during past months in Italy and in several other Countries and on the date of publication of this article, is still a serious public health problem. The health staff, engaged in the care of the sick and in the prevention of the spread of the infection have been subjected to a further increase in psychological difficulties and work-related stress, related to the workload for the continuous influx of sick and intense and close working shifts for the viral emergency. The SAVE-9 (Stress and Anxiety to Viral Epidemics - 9 items) scale has been developed as a tool for assessing work anxiety and stress in response to the viral epidemic of health professionals working to prevent the spread of the virus and to treat infected people.
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September 2020

The "Imperfect Beauty" in Eating Disorders.

Psychiatr Danub 2019 Sep;31(Suppl 3):447-451

Family Counseling Service of Foggia, via C. Baffi, 1, Foggia, Italy,

Not only philosophers, but also artists and scientists have always struggled to find a universal definition of beauty. Not even Darwin could find an answer to the question: are there any parameters of beauty that we can apply to every species. Nobody can give a valid definition for the perception of beauty in others. Can a definition in subjective terms be achieved? If I say something is beautiful, it only means that it is beautiful for me, but it does not mean that is necessarily beautiful for everyone else. Beauty is a subjective experience, but it is not only a perceptive experience! According to the Treccani Dictionary of Italian Language, beauty can be defined as: something capable of pleasing the soul through the senses and become an object worthy of contemplation. Developmental biologists say that when people talk about how beautiful a person is, they tend to highlight those qualities that make them more or less attractive. These qualities can be, for example, if and how much I look like their father or mother. Does this mean there can be universal parameters of beauty for the human species? According to Professor Semir Zeki, there are universal parameters of beauty and the easiest way to define them is in a negative way. This means that whoever has his eyes in a different position, compared to where the eyes are placed in a nation or race, cannot be called beautiful. According to this, could there be a model of beauty in our society? Today's society gives a considerable importance to appearance, it is even thought that being "beautiful" can achieve happiness, love and success. Mass media show icons of perfection and ideals of beauty almost unattainable and makes us to believe that achieving them would make us feel fulfilled; therefore underestimating other values such as happiness, family, friendship and beauty. There is less and less space for self-acceptance and developing other qualities, whereas we invest more into treatments of various kinds to change our body, considering it as an object we can manipulate, or as a tool to achieve goals. Particularly young people, today, are conditioned by the myth of beauty and by the canons imposed by newspapers, TV and the media, which demands virtual beauty without originality. According to this canon, women must always be slim but firm and sinuous, with flowing bleached hair, perfect make-up, smooth skin, full lips and long nails. On the other hand, men are forced to resemble the football players: muscular, but not too much, without a belly and marked abdominals muscles, tall, well-shaved, fragrant, or even shaving their whole body. According to Charmet: "We live in a continuous casting, with boys feeling inadequate and ugly". Adolescence is then considered a period full enthusiasm but also of torment, such as long struggles in front of the mirror with the different ways of "decorating" a suddenly new body. This is a particularly fertile ground for the onset of pathologies such as depression, dysmorphophobias, eating disorders and other pathologies. They become 'mutants', because they change and adapt to the current fashion; nowadays these changes affect not only women, but also men. Pathologies are also in the rise among increasingly younger people, aged 10 to 20 years old. In addition, there are new pathologies, such as orthorexia (the obsession for healthy eating) or drunkorexia (a combination of fasting/binge eating with alcohol abuse). Often, these are associated with other psychiatric disorders or serious physical complications. However, only a small percentage of people suffering from these conditions ask for help.
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September 2019

The Suffering Body: Manipulation and Discomfort in Eating Disorders.

Psychiatr Danub 2018 Nov;30(Suppl 7):521-526

Family Counseling Service of Foggia, via C. Baffi, 1, Foggia, Italy,

What is the meaning of piercing and tattoo in sixteen years old? What are the deep reasons, affective and relational, that explain the explosion of this "fashion" among teenagers? The recent spread of these practices among young people and very young people offered the opportunity to reflect on the value attributed to the body manipulation in teenager growth context. Inked bodies, pierced, and other similar manipulations, express a communicative intention, whose strength is proved by the violence of these practices. The sense of the message, however, risks remaining obscure to adults, who lack the tools to decode it. Self-injury begins as a general expression of a lack of integration between oneself and the alienation of one's own body, resulting in conflicting and split feelings. Many manifest a behavior of disrespect, disapproval, devaluation of the bodily ego, whose self-injurious gesture would represent a particularly dramatic expression. The variability that characterizes the manifestations of self-injury prevents one from applying to a universal definition, valid under any circumstances. Instead it reveals the conceptual flexibility of self-injury that appears itself as a peculiar product in the current historical time. In a society that increasingly accepts various forms of transformative intervention on the physicality of each, where piercing and tattoos, once considered barbaric practices, now these become ordinary practices, a distinction between ornaments and self-injuries becomes necessarily confused (Levenkron 1998). The ego leak is unnecessarily buffered, occluded, braked trough any means (food, alcohol, substances, self-injury, shopping, kleptomania) because the bets are not really the shape of the body but the possibility to escape the dissolution of the Self. Self-injury and eating disorder have many common factors: impulsive, ritualistic, hidden behavior characterized by shame and guilt. These are experiences that use the body to resolve psychological conflicts and feelings of tension, anger, loneliness and emptiness. The two syndromes report a distorted image and a deep disdain of their body, lived as an enemy to fight, punish and anesthetize. The body that gets sick is very often of a teenager. The food and the obsession with the shape of the body have a primary value because they validate the identity structure, precarious, shaky, of personality in progress. The adhesion to the symptom is understandable only from this point of view, this self-destructive research, carried out to the bitter end, would not otherwise be explained if underneath there was not the fear of the disagreement of the ego. The body becomes the refuge, the theater where you can experience the emotions that you cannot tolerate in life. The problem that revolves around the emotional life is just that: we feel that we cannot control our emotions, and unable to support them from within, we try an external control. All teenagers experience pubertal transformations in a problematic way, as accepting them requires the cognitive integration of one's body into a positive image.
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November 2018

Perception of body image in early adolescence. An investigation in secondary schools.

Psychiatr Danub 2017 Sep;29(Suppl 3):409-415

Family Counseling of Foggia, via C. Baffi, 1, Foggia, Italy,

Introduction: The clinical evidence shows that the onset of eating disorders is increasing in the prepubescent phase or even in childhood. Already starting from the prepubescence the certainties related to the body start to unwind and the individual is encouraged to build new ones, based both on the anatomic transformation of his/her own body and on the social expectation according to the identity. The onset of a Eating Disorders is normally between 13 and 25 years, but in the last years we recorded a lowering in the onset threshold to an age between 11 and 13 years, with some earlier cases at 7 years (Franzoni et al. 2012). Many theories consider body dissatisfaction as the immediate antecedent to the development of this eating disorder. Different studies have confirmed that a strong concern for physical appearance could sometimes precede an eating disorder (Cuzzolaro 2004). The alteration of the body image is the major predictive factor for the relapse, the patients themselves refer that it is one of the major obstacles for the realization of a lasting recovering. In the following study one hundred kids between 10 and 15 years old, without any Eating Disorders diagnosis, have been tested to evaluate whether if already from this age there is a concern about body image starting at this age, the fear of gaining weight and the desire to be slimmer. It is known, indeed, that these factors, if significantly present in a subject, can turn into predictive factors of a psychopathology. We need to build our body image over time; changing our percertion of reality can change also what we see, in particular the body image we strive for changes (Bianchini 2008).

Method: 100 teenagers split in 53 females and 47 males aged between 10 and 14 years, randomly picked in the secondary school.

Results: The results of the study show that in the age between 10 and 15 years the concern for the body shape is already present, without difference between the genders. Although 45% of the sample is underweight, the Figure Raiting Scale test both males and females want to be of lesser weight. 91 subjects reached a BSQ test score of over 34, so most of the sample has a strong concern for their physical appearance. The results obtained by administering the BUT test also highlighted concern about the body with moderate gravity.

Discussion: Body dissatisfaction, as so many studies have confirmed, can be considered a precursor of psychopathology. Concerns concern both female gender and male gender. It is also necessary to pay close attention to the pressure exerted by family members, friends and the media towards a difficult to reach thinness ideal. That is why we need to focus on strengthening protective factors in adolescents with prevention and awareness campaigns which are properly targeted.

Conclusion: The work resulted a useful reflection on the building of the body image as an early risk factor for the onset of pathologies linked to this concept. We need to commit to an educative practice of support for adolescent, recognition and sharing, which does not avoid the presence of the adults, but in fact it is enriched. It would be appreciated if we could introduce in the school, in the program of different subjects, the discussion regarding different aspects of a healthy nutrition and the formation of a solid self-esteem in order, for the students, to have a critical interpretation of the media message on food, body and beauty. It is desirable to promote the emancipation of the adolescents from a condition of dependence to discover their own place in the world. The educative action can help developing the research of the meaning of the own personality.
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September 2017

Clinical Utilisation and Usefullness of the Rating Scale of Mixed States, ("Gt-Msrs"): a Multicenter Study.

Psychiatr Danub 2017 Sep;29(Suppl 3):365-367

Piazza Portici, 11, 25050 Provaglio d'Iseo (BS), Italy,

The rating scale "G.T. MSRS" has been designed to improve the clinical effectiveness of the clinician psychiatrists, by enabling them to make an early "general" diagnosis of mixed states. The knowledge of the clinical features of the mixed states and of the symptoms of the "mixity" of mood disorders is crucial: to mis-diagnose or mis-treat patients with these symptoms may increase the suicide risk and make worse the evolution of mood disorders going to the dysphoric state. This study is the second validation study of the "G.T. MSRS" rating scale, in order to demonstrate its usefullness.
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September 2017

Childhood obesity: global issues.

Psychiatr Danub 2016 Sep;28(Suppl-1):87-91

"Consultorio familiare Il Faro", via C. Baffi, 1, Foggia, Italy,

The eating disorders are a group of situations which are very complex that include abnormal feeding patterns, too much worry about the physical aspect, no real perception of the body image and a strong link between all these factors and the levels of self-esteem (Fairburn & Harrison 2003, Sigel 2008, American Academy of Pediatrics 2010, Dalle Grave 2011). From the '50s of the previous century we had a continuous increase of the Eating Disorders (Dalle Grave 2011). Indeed, in the National Program of the Prevention is stated that: "The spread of the eating disorders is very fast and relevant; there is no other disease with the same propagation and that looks like a real social epidemic" (The Ministry of Health 2010). At the same time, there was a reduction of the time of onset (Favaro et al. 2009) with cases of girls 8/9 years old, before having their first period (Dalla Ragione 2012). This means that the pediatricians should pay more attention to the eating disorders because there is a big delay in the diagnosis that can have a negative impact on the therapy to apply and on the prognosis (American Academy of Pediatrics 2010). Overweight and eating disorders are the main problems of public health among adolescents and many works show a direct link between eating disorders and child obesity (Babio et al. 2009). In the case of children, the diagnosis is very complex, especially during the early adolescence (-12 years) due to the large heterogeneity of the somatic expressions that make difficult a precise nosographic study. Therefore, it is necessary that the pediatrician has a good knowledge about the eating disorders in order to identify them quickly and to start a multidisciplinary path and to promote an improvement in the long term.
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September 2016

Can Violence cause Eating Disorders?

Psychiatr Danub 2015 Sep;27 Suppl 1:S336-8

Family Counseling Service of Foggia, Via Stazione, 60/A, Catanzaro, Italy,

The origin and course of eating disorders and nutrition have a multifactorial etiology and should therefore take into consideration: psychological factors, evolutionary, biological and socio-cultural (Juli 2012). Among the psychological factors we will focus on violence (in any form) and in particular on the consequences that they have on women, which vary in severity. Recent studies show that women get sick more than men, both from depression and eating disorders, with a ratio of 2:1; this difference begins in adolescence and continues throughout the course of life (Niolu 2010). The cause of this difference remains unclear. Many studies agree that during adolescence girls have negative feelings more frequently and for a longer duration caused by stressful life events and difficult circumstances, such as abuse or violence. This results in an increased likelihood of developing a symptom that will be connected to eating disorders and/or depression. As far as the role of food is concerned in eating disorders, it has a symbolic significance and offers emotional comfort. Eating means to incorporate and assimilate, and even in an ideal sense, the characteristics of the foods become part of the individual. Feelings that lead to binges with food are normally a result of feelings related to abuse or violence and lead to abnormal behavior which leads to binging and the final result being that the person is left feeling guilty and ashamed. Research confirms that 30% of patients who have been diagnosed with eating disorders, especially bulimia, have a history of sexual abuse during childhood. Ignoring the significance of this factor can result in the unleashing of this disease as the patient uses the disorder as his expressive theater (Mencarelli 2008). Factors that contribute to the possibility of developing an eating disorder are both the age of the patient at the time of the abuse and the duration of the abuse. The psychological effects that follow may include dissociative symptoms and symptoms of an Eating Disorder.
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September 2015

The presence of depression in women who are victims of violence. The experiences of Anti Violence centers in the region of Calabria.

Psychiatr Danub 2014 Nov;26 Suppl 1:97-102

Clinical Psychologist, Psychotherapist, Specialist in Alimentary Behaviour Disorders, Consultant at the Family Counseling Service of Foggia, Foggia, Italy,

Introduction: As is clear from research accredited by the ONU, the violence suffered by the partner, husband or other family members is the leading cause of death and disability for women aged 15 to 44 years. The WHO has also shown that at least one in five women suffers a beating or any form of violence in herl lifetime. Gender-based violence is undoubtedly a widespread phenomenon on a worldwide scale regardless of ethnicity, religion, social class,or level of education. It is a traumatic experience that produces different effects depending on the type of violence and the person who is the victim. There is a close relationship of cause and effect between violence and health status of women. They are in fact relevant primary effects related to the consequences of direct physical violence on the body and the side effects associated with mental and physical damage to repetitive exposure and situations of traumatic impact. The health consequences can be of different nature,rainging from Physical, Psychological and Behavioral, Sexual and Reproductive, to Death. The first important Psychological consequences are Depressive Disorder and Anxiety. The objective of this study was to analyze, through the administration of diagnostic tests, the methods of the links of the subjects on the one hand, attachment and relationships on the other; grouped in practice to detect if there is a close relationship between a Depressive Disorder and Violence suffered.

Method: 20 women aged between 23 and 50 years who have experienced various forms of violence, were randomly selected and followed by the three anti-violence centers of Calabria.

Results: The Separation Anxiety Depressive trait that explains the current Depression is not the result of the violence, but it is due to lack of self-confidence, difficulty im being identified and ability to plan for their lives. These difficulties are established in the woman through an enmeshed relationship with her partner, in fact, what has emerged is the establishment of an Insecure Attachment.

Discussion: Women who have been raped are traumatized individuals, who have not recovered from trauma, and therefore are vulnerable to pain. In relationships that have established themselves they feel responsible for what they have now (guilt, lack self-confidence, difficulty in separating); denying Separation Anxiety and remaining trapped in a violent relationship. The term Separation Anxiety denotes an aspect of behaviour, considered as a pathological form as well as clarified by the DSM V (even in adults); In fact, this is the separation anxiety which is manifested by extreme anxiety and those who suffer from it are tied more to the partner and/or parents that are the very cause of the symptom. This discomfort is related to childhood, therefore, the evidence suggests that there is a close relationship between what one has lived in that era and adult life.

Conclusion: Women victims of violence, must overcome the separation anxiety that has been established as a result of trauma, the latter if not processed coincides with the shame and the guilt. This will be possible if they are given valid support, which is psychological / psychotherapeutic and pharmacological , to accompany and support them towards a new lease of life.
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November 2014

Analysis of multi-instrumental assessment of eating disorders: comparison between Anorexia and Bulimia.

Psychiatr Danub 2012 Sep;24 Suppl 1:S119-24

Centro per la cura dei Disturbi Del Comportamento Alimentare, Perugia, Italy.

Introduction: The origin and course of eating disorders constitute a multifactorial etiopathology. This is why it is important to consider the psychological, developmental, biological and socio - cultural evaluation of each patient. The Diagnostic and Statistical Manual DSM IV - TR (APA, 1994) distinguishes two main eating disorders: Anorexia Nervosa and Bulimia Nervosa. Together with them are described a broad and heterogeneous category (EDNOS) of "atypical eating disorders," that is a clinically significant eating disorder, but that does not meet all the diagnostic criteria for Anorexia Nervosa or Bulimia Nervosa. The aim of this pilot study was to analyze the differences detectable in anorexic and bulimic patients in relation to several factors of mental functioning, particularly with respect to the presence of distinctive characteristics and symptoms and the associated substrate personality.

Method: 20 patients with eating disorders who have a residential rehabilitation program, all women, 10 diagnosed with AN aged between 18 years and 31 years, including (5 Restrictive and 5 with Purging) and 10 diagnosed with BN aged between 19 years and 31 years (including 5 with Purging).

Results: The pictures of AN and BN can be placed within a continuum of symptoms that distinguishes them exclusively for the presence or absence of bulimic episodes; also the symptom of bulaemia can be considered a most important aspect in the distinction between anorexia and bulimia as all other aspects of mental functioning appear to be similar in almost direct measurement, and finally some food pathological events are associated with personality characteristics, Axis I symptoms and quality of life, linked to specific types of global functioning.

Discussion: Some symptoms may have different functions depending on the patient's personality style: a patient may develop a symptom of anorexia because it is competitive and a perfectionist, another as a form of self-punishment or as a strategy to regulate the feeling of being out of control, another again as a phenotypic expression of an underlying mood disorder, in the same way the purging may represent a reaction for a patient who is emotionally dysregulated or a measure of weight control which is more deliberate for a patient who is highly controlled perfectionist.

Conclusion: There is a need to look at eating disorders within a global view of mental functioning, these conditions may be considered "diagnostic trans', ie disturbances traveling along a continuum, and are therefore characterized by a "diagnostic migration."
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September 2012

Involvement of genetic factors in bipolar disorders: current status.

Psychiatr Danub 2012 Sep;24 Suppl 1:S112-6

Centro Studi Psichiatrici, Provaglio D'Iseo, Italy.

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. The involvement of genetic factors has been evaluated through twin, family, linkage and association studies but specific genes that contribute to the illness remain unclear. This study gives an overview of available literature.
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September 2012
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