Lately on these pages, a discussion is going on over the opportunity of the use of the definition ‘outsider’. Especially in the USA, it is judged as demeaning, discriminating and inappropriate, whilst in Europe, it is used in a much more unconcerned way. Mr Gioni curator of numerous international exhibitions including Manifesta 5 (2004), the 4th Berlin Biennale (2006), the 8th Gwangju Biennale (2010) and the 55th Venice Biennale (2013) shares his perspective on contemporary culture and self-taught art.

Objective - Epidemiology is in focus of attention these years. Psychiatry pioneered the development of epidemiological methods and their application in research and planning. Psychiatric epidemiology has been preoccupied with the secondary health service, i.e. the hospital-based service. The aim of the present paper is to discuss which monitoring systems and which types of data will be needed in the future. Method - The discussion is based on experience and results from existing psychiatric registers, mainly the Danish Psychiatric Case Register at the Department of Psychiatric Demography in Aarhus. Results - Some countries have developed monitoring systems to routinely record data on activities in the hospital sector, which is highly beneficial to quality assurance, research, and planning. However, after the introduction of decentralized psychiatry it is necessary to acknowledge the urgent need to move the focus for the employment of epidemiology to benefit also the activities in community psychiatry and in the primary mental health care sector. Though it involves great difficulties, monitoring systems to collect valid and reliable information from these systems of care must be developed. It is also necessary to develop epidemiological methods to be employed in research and quality assurance within this field. Such research methods should be used, not only in the exploration of the aetiology, course and clinical outcome of psychiatric disorders, but also when observing, for example, the social functioning and disability of psychiatric patients, the need for care, the meeting of needs, the health economy and patient flow between the different levels of the system of treatment. This results in large demands on data security, legislation and ethics for the collection and employment of data in the epidemio-logical models. Conclusion - It is recommended to give priority to extended utilization of existing register data; establishment of secondary mental health care registers in countries without such facilities; establishment of primary mental health care registers; establishment of disability monitoring systems; establishment of systems to monitor patients' resources; extended collaboration in this work between psychiatric epidemiologists, administrators, economists, and technicians.

Reported one-year prevalence of service use due to mental disorders in children and adolescents from the general population varies according to country, organization of services, and services considered. Among factors associated with use of services, the literature lists parental and school personnel's perception of problems, having a psychiatric diagnosis (especially externalizing), symptom severity, comorbid disorders, functional impairment, family burden, family environment or being a boy (Cabiya et al., 2006; Farmer et al., 2003; Sayal, 2004). A better understanding of these factors may help to optimize access to services of children needing help.

Aim — The aim of this paper is to present the results of a citation analysis concerned with the impact on the international literature of Italian researchers in psychiaty and psychology and of sub-fields, within these two disciplines, in 1995-1999 compared to 1985-1989. Method — We used a database prepared by the Institute for Scientific Information (ISI) that included all papers, with at least one Italian author, working in Italy, which appeared in two periods (1995-1999 and 1985-1989) in psychiatric or psychological journals listed in Current Contents. A citation analysis concerning the following years, up to 1999, was performed. Results — In 1995-1999 the most cited researchers were those involved in clinical psychology, psychiatry and psychopharmacology research. Neuropsychology, which dominated the period 1985-1989, underwent a clearcut decline. Conclusions — Citation analysis, concerning relatively short periods of time (five years), appears to be a very helpful tool for monitoring the development of scientific research in specific disciplines and the trend of the scientific production of researchers.

Objective - To collect data on the interface between general practice and psychiatry in Southern Italy and to shed light on attitudes, opinions and behaviours of general practitioners regarding psychological/psychiatric problems. Design - Postal questionnaire survey on the management of patients with psychological/psychiatric problems and on its correlation with demographic and other professional characteristics of the partecipant physicians. Setting - General practices in Bari (a Southern Italy's town). Main outcome measures - Comparison between responders and total population using chi-square test and percentages of answers to the different questions. Results - 20% of practition- ers returned the questionnaire, with a significantly higher number of those who specialized than in the total population. Training activities in psychiatry, demanded by 94% of the sample practitioners, are quite regularly pursued by no more than 13% of them actually. 56% report a 10-30% psychiatric morbility in their practices. Only 19% do agree to regard law 180 as «a real advancement in psychiatric care». 53% use to refer to the pychiatrist less than 10% of their psychiatric patients (60% of these showing anxious-depressive symptoms). 25% of psychosomatic disorders are prescribed an antispasmodic drug while «cerebroactive» and «tonic» (non-specific) compounds are respectively used in 75 and 23% of cases of psychic fatigue and poor cognitive performance. Conclusions - The data obtained may be not easily applied to the general source population due to the low percentage of responders. According to the sample, the perception of the difficulties in the management of psychic disturbances (which are still very common in the everyday practice), the demand for larger opportunities of specific training and of co-operation with psychiatrists (differently from the presently poor interaction) and the need of a greater rationalization of pharmacological treatments seem worth being underlined.

This work is directed to further investigate the significant relevance of psychotherapy to better management of acute psychiatric disorders. Over the last years, there was impressive increase of the amount of psychiatric patients referred to emergency and in-patient treatment and such increase allmost resulted from subjects with acute emotional discontrol associated with affective, personality and stress related disorders. According to such change of the clinical scene of contemporary psychiatry, more attention and funding are needed in the field of acute treatment services and combined treatment innovation and research is become a major challenge for community psychiatry. A real progress in the field is not, however a simple matter of psychoterapy technology transference. While several recent studies suggest that well designed combined treatment is cost-effective in these patients, new nosographic, management and dynamic models are required for succesful development of new crisis intervention programs within general psychiatry services.

Objective - To describe the cooperation in mental health that, since ten years, the Institute for Pharmacological Research ≪Mario Negri≫, Milan, is carrying out in Latin America. The project has developed along three main lines: the training of the mental health services personnel, the promotion of an epidemiological approach to the mental health care, and the assistance to the local health authorities in the field of mental health policy. Results - The most relevant goals of the project have been the Caracas Conference on the Latin American psychiatric hospitals and the constitution of an European Consortium for the technical cooperation with Latin America in mental health. Most of the activities have been done in cooperation with WHO regional office (Organización Panamericana de la Salud). Furthemore the paper outlines the main results of two epidemiologic studies carried out in Central America. Conclusions - The psychiatric hospitals phasing out, the setting up of mental health community-based services and the close cooperation between psychiatric services and primary health care services are the main objectives of a project of cooperation in mental health; training and epidemiological research must be the methodological tools of this type of cooperation.