A broad spectrum of concomitant disorders may complicate heart failure adding further morbidity and mortality risk. Comorbidities may be subdivided into cardiovascular and noncardiovascular. The first group includes hypertension, coronary artery disease, peripheral artery disease, cerebrovascular disease, arrhythmias and valvular heart disease. Noncardiovascular comorbidities include respiratory, endocrine, metabolic, nutritional, renal, hematopoietic, neurological as well as musculoskeletal conditions. In recent years, advances in the treatment of heart failure have not been attended by important changes in management of its comorbidities. They now seem to be major causes of the poor prognosis of heart failure patients. In this review we provide an updated summary of the epidemiological, pathophysiological and clinical characteristics of comorbidities as well as their potential impact for heart failure treatment.

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Aim of this work was empirical assessment of the different components of couple relationship in a general population sample, through the construction and validation of an inventory composed of items based on psychoanalytic theories, the analysis of its factor structure and of the relationship of factor scores with other relevant variables. A group of 15 psychoanalysts developed 48 4-point items pertaining to the following areas, drawn from the most relevant psychoanalytic theories: Eroticism/Passion; Tenderness/Attachment/Care; Security/Fidelity; Dependence; Illusion/Idealization; Pregenital Aspects; Destructiveness; Play Capacity; Similarity/Difference of Partner from Parental Figures; and Alterity/Fusionality. After pilot administration to 100 subjects and refinement, the inventory was administered to 610 general population subjects (324 females) aged between 25 and 60, living together with a heterosexual partner for at least 12 months. Subjects were also administered a Marital Satisfaction Scale, the Experiences in Close Relationships Scale Revised (ECR-R) and measures of relevant sociodemographic variables. Factor Analysis yielded five factors, explaining 34.89% of variance, labeled: Idealization/Persecution, Attunement, Mistrust, Erotic Fantasies, and Dependence. Attunement explained the highest proportion of variance, thus emerging as the most relevant dimension. Another prominent finding was the coalescence of items originally conceived to measure the presence of oedipal, pregenital, and destructive components in a single factor, Erotic Fantasies. Internal reliability was satisfactory for all factorial scales. Marital Satisfaction correlated positively with Attunement and Dependence, and negatively with Idealization/Persecution, Mistrust and Erotic Fantasies. Secure subjects appeared high on Attunement, Fantasies and Dependence; Avoidant subjects appeared high on Mistrust, low in Attunement, Fantasies and Dependence; Anxious subjects appeared high in Fantasies and Dependence, low in Attunement.

Though better knowledge concerning alexithymia in childhood could improve understanding of its development during the lifespan, it has been scarcely investigated in children. A necessary step in research on alexithymia is to create instruments for assessing the construct. The object of the present study was to develop an Italian Alexithymia Questionnaire for Children based on the instrument proposed by Rieffe et al. (2006) and to examine its factor structure and reliability. The English version of the questionnaire was translated into Italian and it was administered to 576 children recruited from primary and secondary schools (age mean = 10.78, s.d. = 1.67; males 357 and 219 females). Exploratory Factor Analysis (EFA) revealed preliminary evidence of a four-factor structure, which explained 37.90% of the variance: Factor 1 "Difficulty Describing Feelings", Factor 2 "Difficulty Identifying Feelings", Factor 3 "Confusion on Physical Sensations" and Factor 4 "Externally-Oriented Thinking". As to reliability, the Cronbach alpha indicated adequate internal consistency. Pearson correlations among the total score and the four factors were statistically significant. Moreover, the sample was divided into two groups (children and pre-adolescents) and a ttest was conducted: children showed significantly higher scores than adolescents on the total score of the questionnaire. No significant gender differences in mean total scores were found.Key words: alexithymia, childhood, questionnaire, Italian versionParole chiave: alessitimia, etŕ evolutiva, questionario, versione italiana

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