A comprehensive investigation of psychological features in chronic patients is very important for tailoring effective treatments. In this study we tested anxiety, depression, health related quality of life (HR-QoL), alexithymia, coping styles, and defense mechanisms, in eighty-four patients with Crohn disease (CD) and ulcerative colitis (UC). Participants reported low to moderate HRQoL and anxiety, apart from alexithymia. Women experienced lower QoL and higher levels of anxiety and depressive symptoms. Coping and defense strategies were related to distress symptoms and QoL. Positive attitude and principalization, showed negative associations with depression, anxiety and alexithymia and were also found to be associated with mental health. CD patients used significantly more turning against objects (p=0.02) and projections (p=0.01) and UC patients used more reversal (p=0.04). Elderly women showed higher anxiety symptoms and lower perceived QoL. Multiple regression analysis revealed anxiety and depression were independently associated with QoL. Significant differences emerged in defense styles among CD and UC. CD participants used more maladaptive coping and defense styles which were related to mental distress, depression and anxiety, together with higher level of alexithymia. Findings suggest that psychological aspects play a key role in mental health in patients suffering from inflammatory bowel diseases. A multi-integrated clinical strategy including psychotherapeutic interventions should be considered in treating CD and UC.

The doctor–patient relationship is a central factor in healthcare delivery. Artificial Intelligence (AI) represents an emerging technological frontier whose implications remain to be fully clarified. Evidence-based studies provide reliable analyses of effects and offer a deeper understanding of both limits and benefits. This narrative review aimed to explore the role of AI in modern clinical practice, with particular reference to its effects on the doctor–patient relationship. Scopus and Web of Science databases were searched between 1 and 10 December 2025 to identify suitable studies. Inclusion criteria comprised English-language articles published in the last 10 years, with a direct focus on the doctor–patient relationship and exclusively employing empirical research designs. A total of 21 studies published between 2021 and 2025 were identified as eligible. The most common AI applications were conceptual systems discussed at a perceptual level (thirteen studies), followed by simulated AI decision-making scenarios (two studies). Implemented AI applications were less frequent and mainly included AI-based clinical decision support systems, administrative and documentation-focused tools, and a small number of conversational or relational AI applications (six studies in total). These studies focused on patients, healthcare professionals, and medical students preparing for future clinical roles. Results highlighted generally positive patient attitudes toward AI, often mediated by educational level, technological familiarity, and risk awareness. Among healthcare professionals, positive attitudes also emerged, although concerns regarding epistemic and professional values were noted. Greater involvement of clinicians in its development was consistently recommended. Findings from academic samples aligned with those of patients and clinicians, showing that integrating AI with traditional clinical practices was consistently preferred. Empathy, compassion, effective communication, accuracy, ethics, and trust were highlighted as fundamental values essential for mitigating risks. These elements are fundamental to the effective implementation of technologies aimed at improving clinical practice, while an integrative perspective is needed to safeguard the doctor–patient relationship. Overall, the use of AI in medical practice emerged as promising. Further studies should strengthen the empirical basis of the field to support an evidence-based approach to AI integration in healthcare.

Growing evidence highlights the crucial role of defense mechanisms in the context of chronic diseases. However, few studies have evaluated the impact of these implicit emotion regulation strategies on the adaptation processes related to inflammatory bowel diseases (IBD). This narrative review aimed to explore the role of defense mechanisms in patients with IBD and clarify their association with related psychological and physical symptoms. A literature search was conducted using PubMed and PsycINFO databases to select studies considering defense mechanisms in patients with IBD. Inclusion criteria were English language articles, diagnosis of Crohn’s disease or ulcerative colitis, and use of validated assessment instruments specifically related to defense mechanisms. Six studies, including a total of 664 patients, were deemed eligible. Immature defense mechanisms were commonly detected in IBD patients, with significant effects on psychological and physical health. Significant associations were found between defense mechanisms, perceived health-related quality of life (HR-QoL), and psychological distress. Findings suggested that immature defense mechanisms may negatively impact the management of disease, leading to lower perceived HR-QoL, decreased treatment adherence, and increased risk of psychopathological symptoms. Considering these findings, we suggest that an integrated clinical evaluation, including an in-depth investigation of defense mechanisms, may promote more effective psychological treatments and improve psychological well-being in patients suffering from IBD.

Background: Alexithymia has been recognised as a predictor of negative outcomes in various chronic conditions, including type 2 diabetes mellitus (T2DM). However, evidence concerning its role in type 1 diabetes mellitus (T1DM) remains limited. This systematic review aims to explore the relationship between alexithymia and T1DM. Methods: In June 2025, following PRISMA guidelines, a systematic review was conducted using Scopus, PubMed, and Web of Science databases. Studies specifically addressing the relationship between alexithymia and type 1 diabetes mellitus were analysed. The search strategy included the keywords “Alexithymia” AND (“Type 1 Diabetes Mellitus” OR “T1DM”). The NIH Study Quality Assessment Tool was employed to evaluate the methodological quality of the selected studies. Results: Fifteen studies met the inclusion criteria. The systematic analysis of the literature highlighted three dominant themes: alexithymia was found to be associated with patients’ health status concerning weight and obesity, glycaemic control, and psychopathological symptoms. Moreover, alexithymia emerged as a potential predictor of adverse outcomes in T1DM self-management. Conclusions: Available evidence suggests that alexithymia has a clinically relevant impact on the management of T1DM. However, further research involving larger samples and longitudinal designs is needed to bridge the gap with other chronic conditions. Promoting evidence-based research in this area is aligned with the need for targeted psychological assessment, specific interventions, and improved care strategies.

Defense mechanisms are automatic psychological processes that regulate emotional conflicts and modulate adaptation to internal and external stressors. As implicit components of emotion regulation, they play a transdiagnostic role across psychological and physical domains of health. Among the available instruments, the Defense Mechanisms Rating Scales-Self-Report-30 (DMRS-SR-30) directly operationalizes the hierarchical model of defenses, widely considered the gold standard framework for their empirical assessment. This systematic review aimed to synthesize findings from all studies that had employed the DMRS-SR-30 to date, summarizing its psychometric properties, domains of application, and clinical implications. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies were full-text peer-reviewed articles written in English employing the DMRS-SR-30. Risk of bias was assessed according to study design using an established quality appraisal tool. Twenty-six studies met the inclusion criteria. The main domains of application were medical conditions, mental health and psychopathology, personality, and stress-related adjustment. Across these research areas, mature defenses were consistently associated with adaptive functioning and resilience, whereas immature and neurotic defenses predicted higher psychological distress, maladjustment, and psychopathology. The findings from the validation studies demonstrated that the scale exhibited robust reliability, construct validity, and clinical sensitivity. The DMRS-SR-30 provides a valid, efficient, and clinically meaningful method to assess the full hierarchy of defense mechanisms through a self-report tool. Its overall defensive functioning (ODF) index may offer an integrative measure of adaptive capacity that can complement standard psychodiagnostic and medical evaluations. Incorporating the assessment of defensive functioning can enhance the holistic understanding of patients, improve compliance with treatment, and promote person-centered care within mind-body health contexts.

Background: Cyberchondria, defined as excessive or compulsive online searching for health-related information, has emerged as a paradigmatic condition at the intersection of health anxiety, digital behavior, and cognitive vulnerability. Increasingly observed in clinical settings, it reflects a maladaptive strategy to manage uncertainty and bodily symptoms, exacerbated by algorithm-driven content, emotional salience, and informational overload in digital environments. Cyberchondria may have important implications for medical outcomes, including inappropriate healthcare utilization, reduced adherence to medical advice, disruption of the doctor-patient relationship, and impaired quality of life, especially in individuals managing chronic or recurrent health conditions. Aim: This article proposes an integrative framework for understanding cyberchondria that combines clinical psychology, cognitive science, and complexity theory. We argue that cyberchondria should not be viewed solely as an individual pathology, but as an emergent property of a dynamic system destabilized by recursive feedback loops, epistemic instability, and algorithmic bias. Methods: A narrative synthesis of empirical and theoretical literature was conducted, drawing from studies on health anxiety, online behavior, metacognition, and systemic models of mental disorders. Sources were selected from PubMed, Scopus, and interdisciplinary publications in psychiatry, cognitive science, and digital ethics. Results: Cyberchondria is consistently associated with intolerance of uncertainty, reassurance-seeking, and dysfunctional metacognitive beliefs. Its persistence is sustained by cognitive distortions and by the structure of digital health information, which prioritizes emotionally salient or sensational content over clinical reliability. The phenomenon can be theoretically modelled using concepts such as psychological entropy, nonlinear amplification, and cognitive decoherence under informational stress. Conclusion: Effective responses to cyberchondria must operate across multiple levels: psychological (CBT and metacognitive strategies), educational (digital health literacy), relational (doctor–patient alliance), and systemic (ethical design of digital platforms). Integrating complexity-based perspectives may offer new pathways for understanding and mitigating the destabilizing effects of cyberchondria in the digital age.