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ABSTRACT Objective Method Results Conclusions Anorexia nervosa and borderline personality disorder are often associated and share some core elements, including emotional dysregulation and affective instability. Nevertheless, the association of these two conditions in adolescence is still little studied.The present study aims at investigating, through a multidimensional assessment, the psychopathological characteristics of adolescents affected by anorexia nervosa in comorbidity with borderline personality disorder on a sample of 127 female adolescents, through the comparison with adolescents with borderline personality disorders and adolescents with anorexia nervosa. All participants completed a validated psychometric battery assessing alexithymia (Toronto Alexithymia Scale‐20), depression (Children's Depression Inventory), psychological symptoms (Symptom Checklist‐90–Revised) and psychological symptoms relevant in eating disorders (Eating Disorders Inventory‐3).Adolescents with anorexia nervosa in comorbidity with borderline personality disorder show intermediate features between the two disorders individually in the general psychopathological profile, but a peculiar psychological profile regarding the eating symptomatology, with worse features compared to adolescents with the sole anorexia nervosa.Results suggest a peculiar clinical and psychopatological endophenotype in adolescents with anorexia nervosa in comorbidity with borderline personality disorders, indicating the need to define specific and tailored treatment for this population. [ABSTRACT FROM AUTHOR]

Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric comorbidities, including eating disorders (EDs). We aimed to investigate the potential association between key disease characteristics, including psychological features, and the development of EDs in a clinical sample of adolescents with IBDs. We enrolled 52 adolescents with IBDs, 83% of whom were in clinical remission, and systematically collected additional information on disease duration, the total number of relapses, the use of steroids, and the number of hospital admissions. All participants completed a validated psychometric battery assessing psychological symptoms (Symptom Checklist-90–Revised, SCL-90-R), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and ED symptomatology (Eating Disorders Inventory-3rd edition, EDI-3). About one in ten patients (9.6%) reported Eating Disorder Risk scores higher than the cut-off on the EDI-3 subscale, specifically addressing the risk of developing EDs. According to the EDI-3 scores, the risk of developing EDs directly correlated with the number of total relapses of IBDs (p < 0.05). The TAS-total scores also correlated with the number of total relapses (p < 0.01), as well as with the number of steroid cycles (p < 0.05), the number of hospital admissions (p < 0.05), and overall disease duration (p < 0.05). Our findings suggest that disease relapses increase the risk of developing both EDs and alexithymia in adolescents with IBDs. The recurrence of disease relapses should be identified and screened early on to prevent the onset of psychiatric disorders, including EDs. Research should be conducted on larger samples with different IBD phenotypes to further investigate the characteristics of patients with IBDs at risk of developing EDs. [ABSTRACT FROM AUTHOR]

Our study aims to evaluate clinical predictors of menstrual cycle disorders in female athletes who compete in running disciplines. This is a prospective observational study. Women were recruited between January and May 2022. Fifty-three patients were enrolled and completed a questionnaire about menstrual cycle, physical activity, and food habit characteristics. Of the women in our population, 39.6% had menstrual irregularities and reported a significantly higher number of kilometers run per week (67 vs. 35, p:0.02). The number of kilometers run per week was associated with menstrual irregularities (for 10 km, OR 1.35; IC95% 1.05–1.73; p: 0.02) after adjusting for BMI, age, level of sport and caloric intake. The variable of "km run per week" appeared as a diagnostic indicator of irregular menstrual cycle with statistical significance (AUC ROC curve 0.71, IC95% 0.54–0.86, p-value=0.01) and the cut-off of 65 km run per week is a good indicator of the presence of irregular menstrual cycle (sensitivity (SE) and specificity (SP) of 55% and 81.48%). Menstrual cycle disorders are very frequent in female athletes, and the variable of km run per week may play a role in screening endurance athletes at high risk for these disorders. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, there have been multiple reports about an unforeseen surge in adolescents and young adults exhibiting sudden onset functional tic-like behaviors. This phenomenon has been mainly associated with the female gender and occasionally after exposure to social media content featuring similar patterns of functional tic-like behaviors. A significant portion of these individuals have been directed to specialist clinics for movement disorders with initial misdiagnoses of late-onset refractory Tourette syndrome. Distinguishing between rapid onset functional tic-like behaviors and neurodevelopmental tics as part of Tourette syndrome can be challenging; however, the differential diagnosis is facilitated by focusing on specific clinical and demographic factors, which we have explored in a systematic literature review. Compared to neurodevelopmental tics, functional tic-like behaviors typically present with a more abrupt and intense manifestation of symptoms, onset at a later age, higher prevalence among females, inability to suppress tics, coexisting anxiety and depression, and sometimes a history of exposure to social media content portraying tic-like behaviors of a similar nature. This novel manifestation of a functional neurological disorder may thus be viewed as an emerging neuropsychiatric condition potentially triggered/exacerbated by the psychosocial repercussions of the COVID-19 crisis. [ABSTRACT FROM AUTHOR]

Family influence is a crucial factor in the onset and maintenance of eating disorders. Nonsuicidal self‐injury (NSSI) and restrictive eating disorders (REDs) co‐occur in a significant percentage of subjects but family functioning of these families remains underexplored. This study examines the family functioning perceptions of 80 families with adolescents experiencing RED, comparing those with and without NSSI, alongside a control group, utilising the FACES‐IV assessment. The study also aims to compare the triadic (adolescent–mother–father) perception of family functioning in the three groups. The results reveal distinct family dynamics in adolescents with both RED and NSSI, marked by problematic functioning perceptions from all family members and low parental agreement. A further understanding of the family functioning of adolescents with RED with NSSI can help clinicians in defining the treatment setting. [ABSTRACT FROM AUTHOR]

Background: While substantial research focuses on the psychological characteristics of adolescents with Anorexia Nervosa (AN), little is known about the psychopathological profiles of their parents, especially of the fathers. Therefore, this study aims to investigate the psychopathological profiles of AN adolescents and their parents compared with a control group. Methods: This observational case-control study involved 94 families of adolescents aged 12 to 17: 47 families diagnosed with AN were matched with 47 control families. The sample mean is 15.9 with a standard deviation of 2.9 for BMI across the AN group. Inclusion criteria included adolescents aged 12 to 17 with a diagnosis of AN, and both parents available for the study. Exclusion criteria included AN secondary to medical conditions, severe psychotic disorders, intellectual disabilities, or insufficient understanding of the Italian language. The Symptom Checklist 90–Revised (SCL-90-R) assessing psychopathological symptoms in adolescents and their parents was administered. Statistical analyses compared SCL-90-R scores between AN and control groups and assessed inter-variability within the AN family. Results: Adolescents with AN and their parents displayed significantly higher SCL-90-R scores than controls across multiple dimensions. Specifically, mothers of AN adolescents exhibited higher scores on depression and psychoticism scales, while fathers exhibited higher psychoticism, total positive symptoms, and positive symptom distress. Notably, AN family showed reduced inter-individual variability in psychopathological profiles compared to controls, both within dyads (adolescent-mother, adolescent-father) and the entire family. Conclusion: This study highlights distinct psychopathological profiles in AN family and suggests potential factors of illness maintenance related to parental psychopathology. The findings emphasize the importance of involving the entire family, including fathers, in the therapeutic process for adolescents with AN. Further research with larger samples and structured interviews is needed to validate these results and expand our understanding of family involvement in AN psychopathology. [ABSTRACT FROM AUTHOR]

Background and purpose: Until the outbreak reported during the COVID‐19 pandemic, functional tics were considered to be a relatively rare clinical phenotype, as opposed to other functional movement disorders such as functional tremor and dystonia. To better characterize this phenotype, we compared the demographic and clinical characteristics of patients who developed functional tics during the pandemic and those of patients with other functional movement disorders. Methods: Data from 110 patients were collected at the same neuropsychiatry centre: 66 consecutive patients who developed functional tics without other functional motor symptoms or neurodevelopmental tics and 44 patients with a mix of functional dystonia, tremor, gait, and myoclonus. Results: Both groups were characterized by female sex preponderance (70%–80%) and (sub)acute onset of functional symptoms (~80%). However, patients with functional tics had a significantly earlier age at onset of functional symptoms (21 vs. 39 years). Exposure to relevant social media content was reported by almost half of the patients with functional tics, but by none of the patients with other functional movement disorders. Comorbidity profiles were similar, with relatively high rates of anxiety/affective symptoms and other functional neurological symptoms (nonepileptic attacks). Conclusions: Patients who developed functional tics during the pandemic represent a phenotypic variant of the wider group of patients with functional movement disorders, associated with younger age at onset and influenced by pandemic‐related factors, including increased exposure to specific social media content. Diagnostic protocols and treatment interventions should be tailored to address the specific features of this newly defined phenotype. [ABSTRACT FROM AUTHOR]

Background and purpose: The COVID‐19 pandemic has been associated amongst other things with a sharp increase in adolescents and young adults presenting acutely with functional tics. Initial reports have suggested clinically relevant differences between functional tics and neurodevelopmental tics seen in primary tic disorders such as Tourette syndrome. We aimed to provide confirmatory findings from the largest single‐centre cohort to date. Methods: In the present study we present data from 105 consecutive patients who developed functional tics during a 3‐year period overlapping with the COVID‐19 pandemic (April 2020–March 2023). All patients underwent a comprehensive neuropsychiatric assessment at a single specialist centre for tic disorders. Results: Female adolescents and young adults accounted for 69% of our sample. Functional tics had an acute/subacute onset in most cases (75% with a peak of severity within 1 month). We found a disproportionately high frequency of complex movements (81%) and vocalizations (75%). A subset of patients (23%) had a pre‐existing primary tic disorder (Tourette syndrome with functional overlay). The most common psychiatric co‐morbidities were anxiety (70%) and affective disorders (40%). Moreover, 41% of patients had at least one functional neurological disorder in addition to functional tics. Exposure to tic‐related social media content was reported by half of the patients. Conclusions: Our findings confirm substantial clinical differences between functional tics developed during the pandemic and neurodevelopmental tics. Both patient‐ and tic‐related red flags support the differential diagnostic process and inform ongoing monitoring in the post‐pandemic era. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to test the psychometric proprieties of the Reflective Functioning Questionnaire (RFQ) applied to younger (13–16 years) and older (17–20 years) Italian adolescents examining (1) the factorial structure of RFQ; (2) its invariance across age and sex; (3) correlations between RFQ subscale scores, as well as the associations of the RFQ with (4) psychological problems and alexithymia dimensions. Methods: A cross‐sectional study was conducted with 593 adolescents between the ages of 13 and 20 years old recruited from the community within Italy. These participants completed the RFQ, Symptom Checklist‑90, and Toronto Alexithymia Scale. Results: The two‐factor structure of the RFQ was confirmed. However, higher internal consistency of RFQ was obtained by removing two items that seemed problematic within this sample. Using a six‐item version of RFQ, the two‐factor structure was invariant across adolescent age and sex. Significant correlations among RFQ subscale scores, and between RFQ subscales with both psychological problems and alexithymia dimensions were found. Conclusions: Preliminary results reveal a short version of RFQ (six‐item) is a suitable measure to assess mentalizing in adolescents in the Italian context. [ABSTRACT FROM AUTHOR]

Primary headache (PH) is a common somatic disorder in childhood with a strong impact in terms of quality of life. There are several risk factors related to the development of this disorder including environmental factors as attachment bonds. However, studies in this direction are relatively few and have often used self‐report or semi‐projective measures looking at the only maternal attachment. Moreover, several studies have shown a link between somatoform pains and mentalizing abilities, but the relation between mentalizing and PH in childhood is unexplored. Therefore, this study aims at exploring attachment bonds, focusing on both maternal and paternal representations and mentalizing abilities in early adolescents with and without PH within a cross‐sectional case‐controlled design. A sample of 94 early adolescents aged 10–14 years (47 with PH and 47 without PH as a comparison group) completed the Child Attachment Interview to assess attachment representations to caregivers. Mentalizing abilities were assessed applying to the interviews in the Child and Adolescent Reflective Functioning Scale. PH adolescents showed a greater percentage of insecure‐preoccupied attachment to both parents, with higher level of preoccupied anger especially to father than the comparison group (p values from 0.000 to 0.014, effect size values from.31 to.45), while no differences emerged about mentalizing (p values from.264 to 0.312). The over‐representation of insecure–preoccupied attachment to both parents suggests a key role of parent–child interaction in early adolescents with PH, while the role of mentalizing abilities remains controversial and further studies are needed to address this issue. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Background. The presence of subthreshold psychotic symptoms in adolescents with eating disorders is poorly described. This study provides a detailed characterization of adolescents affected by eating disorders in the absence or presence of subthreshold psychotic symptoms, taking into account a wide set of sociodemographic, psychological, and clinical variables. Methods. Ninety-four adolescents diagnosed with eating disorders were interviewed, focusing on clinical anamnesis and sociodemographic data collection. The Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to assess the presence (HR+) or absence (HR-) of subthreshold psychosis. The clinicians completed a questionnaire on eating disorders severity, whereas patients provided self-report measures of global social functioning and psychological symptoms associated with eating disorders. Results. Attenuated psychotic symptoms were highly frequent (84% of subjects). HR+ patients experienced more frequently purging behaviors and dysmorphophobia and received a greater amount of antipsychotic drugs. Compared to HR-counterparts, HR+ patients reported higher eating disorders severity and psychological symptoms (i.e., ineffectiveness, interpersonal and affective problems) associated with eating disorders. Finally, a significant correlation between global social functioning and eating disorders severity emerged only for HR-subjects. Conclusions. These descriptive data are warranted to identify a potential psychotic core in eating disorders, mainly concerning body image and weight as well as specific psychological features. The availability of reliable and valid markers of risk can further increase our capacity to detect the early emergence of psychosis in adolescents with eating disorders, whose outcome might be worsened by the presence of psychotic symptoms. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to compare the Wechsler Intelligence Scale for Children® - fourth edition IV (WISC IV) intellectual profile of two groups of children with specific learning disorder, a group of bilingual children and a group of monolingual Italian children, in order to identify possible significant differences between them. Patients and methods: A group of 48 bilingual children and a group of 48 Italian monolingual children were included in this study. A preliminary comparison showed the homogeneity of the two groups regarding learning disorder typology and sociodemographic characteristics (age at WISC IV assessment, sex and years of education in Italy) with the exception of socioeconomic status. Socioeconomic status was then used as a covariate in the analysis. Results: Even if the two groups were comparable in specific learning disorder severity and, in particular, in the text comprehension performance, our findings showed that the WISC IV performances of the bilingual group were significantly worse than the Italian group in Full Scale Intelligence Quotient (P=0.03), in General Ability Index (P=0.03), in Working Memory Index (P=0.009) and in some subtests and clusters requiring advanced linguistic abilities. Conclusion: These results support the hypothesis of a weakness in metalinguistic abilities in bilingual children with specific learning disorders than monolinguals. If confirmed, this result must be considered in the rehabilitation treatment. [ABSTRACT FROM AUTHOR]

The recent literature on anorexia nervosa (AN) suggests that functional and structural abnormalities of cortico-limbic areas might play a role in the evolution of the disease. We explored global and regional brain volumes in a cross-sectional and follow-up study on adolescents affected by AN. Eleven adolescents with AN underwent a voxel-based morphometry study at time of diagnosis and immediately after weight recovery. Data were compared to volumes carried out in eight healthy, age and sex matched controls. Subjects with AN showed increased cerebrospinal fluid volumes and decreased white and gray matter volumes, when compared to controls. Moreover, significant regional gray matter decrease in insular cortex and cerebellum was found at time of diagnosis. No regional white matter decrease was found between samples and controls. Correlations between psychological evaluation and insular volumes were explored. After weight recovery gray matter volumes normalized while reduced global white matter volumes persisted. [ABSTRACT FROM AUTHOR]

Objective: To analyze the clinical and socio-demographic features in a sample of 10–17 years-old immigrant inpatients with a psychiatric disorder.Method: One hundred and thirty-eight immigrant adolescents,138 Italian controls age, gender, and diagnosis-matched were enrolled. Socio-demographic and clinical features were carried out from medical records. Immigrants were divided into three groups according to the migratory processes: first-generation participants immigrated alone (IAs) to reunite with their parents (58%); first-generation participants immigrated with their parents (IPs) (13.8%); second-generation participants (SGIs), born in Italy from immigrant parents (25.3%).Results: The onset of psychiatric symptoms in IAs occurred mainly after the first-year of stay in Italy (80.2%,p = 0.036, OR 5.25), while IPs were more likely to begin showing their symptoms 5 years after immigration. Moreover, IAs were more likely to be admitted to the emergency room for the first occurrence of an acute psychiatric disorder rather than for a chronic, previously-treated disease, when compared with SGIs and Italians.Conclusion: Among the immigrants, first-generation adolescents were the most likely to present a psychiatric acute disorder. When compared with Italians, immigrants were more likely to use the emergency room to access mental health services and tended to be hospitalized for an acute, previously unknown, disease. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to better understand the characteristics of the language-related skills of bilingual children with specific learning disorders (SLD). The aim is achieved by analyzing language-related skills in a sample of bilingual (Italian plus another language) and Italian monolingual children, with and without SLD. Patients and methods: A total of 72 minors aged between 9 and 11 were recruited and divided into four groups: 18 Italian monolingual children with SLD, 18 bilingual children with SLD, 18 Italian monolingual children without SLD, and 18 bilingual children without SLD. Each child underwent tests to evaluate different aspects of language skills: lexical and grammar, metalanguage and executive functions. Results: With regard to lexical and grammatical skills, the conditions of SLD and bilingualism both impact naming in terms of total number of errors for words with low frequency of use, while the condition of SLD has an effect on semantic errors for words with low frequency of use. The condition of bilingualism impacts on the total errors for words with high frequency of use and on circumlocution-type errors for words with low frequency of use. There were significant effects of bilingualism and SLD on the metalinguistic test for understanding implicit meaning, and an impact of SLD on phonological awareness was also found. Conclusion: The results suggest that both SLD and bilingualism have an effect on some lexical skills, in particular for words with low frequency of use. Both conditions, bilingualism and SLD, seem to impact on metalinguistic abilities that depend on lexical knowledge. These findings reinforce the importance of improving understanding of the neuropsychological profile of bilingual children with SLD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Riva, Musetti, Bomba, Milani, Montrasi and Nacinovich.)

Purpose: The aim of this study is to compare the Wechsler Intelligence Scale for Children ® - fourth edition IV (WISC IV) intellectual profile of two groups of children with specific learning disorder, a group of bilingual children and a group of monolingual Italian children, in order to identify possible significant differences between them., Patients and Methods: A group of 48 bilingual children and a group of 48 Italian monolingual children were included in this study. A preliminary comparison showed the homogeneity of the two groups regarding learning disorder typology and sociodemographic characteristics (age at WISC IV assessment, sex and years of education in Italy) with the exception of socioeconomic status. Socioeconomic status was then used as a covariate in the analysis., Results: Even if the two groups were comparable in specific learning disorder severity and, in particular, in the text comprehension performance, our findings showed that the WISC IV performances of the bilingual group were significantly worse than the Italian group in Full Scale Intelligence Quotient ( P =0.03), in General Ability Index ( P =0.03), in Working Memory Index ( P =0.009) and in some subtests and clusters requiring advanced linguistic abilities., Conclusion: These results support the hypothesis of a weakness in metalinguistic abilities in bilingual children with specific learning disorders than monolinguals. If confirmed, this result must be considered in the rehabilitation treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors report no conflicts of interest in this work.

Background: Anorexia nervosa commonly arises during adolescence and is associated with more than one medical morbidity. Abnormalities in brain structure (defined as "pseudoatrophy") are common in adolescents with anorexia nervosa; however, their correlations with endocrinological profiles and clinical parameters are still unclear. In particular, no study has described the impact of BMI (body mass index) variations (speed and magnitude of weight loss) on cerebral trophism changes., Methods: Eleven adolescents with anorexia nervosa and 8 healthy controls underwent cerebral MRI (magnetic resonance imaging) examination to obtain global and partial volumes (gray matter, white matter and cerebrospinal fluid) and clinical evaluation. The Mann-Whitney U test was used to compare partial volumes and clinical variables between cases and controls. The Spearman non-parametric test was performed in order to explore correlations between the variables studied., Results: The patients diagnosed with AN showed significantly increased cerebrospinal fluid (CSF) volumes and decreased total gray (GM) and white matter (WM) volumes. The degree of weight loss (deltaBMI) correlated inversely with the GM volume; the increase of CSF compartment correlated directly with the rapidity of weight loss (DeltaBMI/disease duration)., Conclusions: This study suggests a correlation between cerebral alterations in AN and the speed and magnitude of weight loss, and outlines its importance for the therapeutic treatment.