In scenes familiar from the television series The Sopranos, the so-called "men of honour" are no longer content to keep their problems within their families, researchers have found.
A study by Palermo University on the island of Sicily found clinical anxiety in 20 per cent of Mafia relatives and personality disorders in 17 per cent.
Girolamo Lo Verso, a psychologist who led the research, said: "Psychiatric problems are steadily rising among the families, a sign that the monolithic culture of Mafia society is crumbling."
Dr Lo Verso's research, The Psychology of Organised Crime in the Mezzogiorno, studied the cases of 81 patients linked to Italy's three main Mafia organisations - Sicily's Cosa Nostra, the Camorra in Campania and Calabria's 'Ndrangheta.
Dr Lo Verso said: "These people are victims of terrible identity crises because they aren't used to seeing their world view challenged.
"They're like fundamentalists, but as soon as something happens that brings the security wall down, they have crises.
"That's why they go and see a psychiatrist and many say that they feel a lot better for speaking to someone about their problems."
Dr Lo Verso said that food disorders, anxiety and depression, sexual problems and a sense of inadequacy and shame at failing to live up to macho stereotypes were the most common problems encountered.
"In one real-life case, a homosexual son of a top ... boss rebels against his father's code and dares to come out of the closet, causing personal pain and wider clan uproar."
In the hit television series about New Jersey mobsters, Tony Soprano confided his depression and panic attacks over his "business" to a psychiatrist, while in the Hollywood blockbuster Analyze This, Robert De Niro's Godfather also talks over his anxities on a psychiatrist's couch.
Thanks to Nick Pisa
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