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BACKGROUND: Bigorexia or muscle dysmorphia (MD) is a subtype of body dysmorphic disorder, and it is characterized by an excessive dissatisfaction with body size and muscularity. Orthorexia nervosa (ON) is an obsessive focus on healthy eating and emotional distress related to food choices that are perceived as unhealthy. MD and ON are considered two emerging psychiatric disorders. METHODS: The aim of this study was to evaluate the prevalence of traits of ON and MD between amateurs and professional athletes who practice bodybuilding. The secondary endpoint of the study is to identify the anabolic steroid abuse among the athletes. To this end we have administered a dichotomic questionnaire to 60 young men: 30 amateur bodybuilders (ABBs) and 30 professional bodybuilders (PBBs). RESULTS: Scores compatible with a full-blown MD disorder have been found in 100% of subjects of PBB group and in 83% of ABB group. Afull-blown ON has been detected in 87% of BBPs and 40% of BBAs and a risk for ON in 10% of BBPs and in 37% of BBAs. CONCLUSIONS: This study shows a high co-occurrence of MD and ON among the bodybuilders suggesting a link between eating disorders and body dysmorphic disorders.

Objective: Despite of the large prevalence of obstructive sleep apnea syndrome (OSAS) in pediatric age, numerous aspects of its impact on day life and on parental quality are still poor studied and considered in the clinical management. The study evaluated the stress levels and copying styles in a large sample of mother of children with OSAS. Method: 374 mothers of children affected by OSAS (mOSAS) were compared with a group of mothers of 421 neurotypical healthy children (mTDC) for stress perceived stress levels and for coping strategies. Subjects were recruited from Italian Regions in Sicily, Campania, Calabria and Umbria. Results: Among both groups mOSAS and mTDC no differences were reported for children age (p=0.340), children gender (p=0.956), similarly for age of mothers (p=0.188). Discussion: The perceived stress assessment in mOSAS showed higher rate of all parental stress scores of PSI-SF: Parental Distress domain (p

Background: Autism spectrum disorders (ASD) are neurobehavioral and developmental conditions that include impairments in a triad of behavioral domains: social development, communication and repetitive behavior/obsessive interests. This case-control study aims to assess executive functioning in ASD preschoolers. Methods: A sample of 50 children participated in the study (24 males and 26 females; age ranged between 2.7 and 3.5 years). The study sample was subdivided into two groups: 25 ASD children and 25 typically developing children as a control group. All participants were administered the BRIEF-P test to assess executive functioning. Results: The two groups were counterbalanced for age and gender. Comparison analysis between the two groups revealed significantly higher scores in ASD children in two subscales of BRIEF-P: inhibition and shifting. Conclusion: These data evidenced significant impairments in several dimensions of executive functions in ASD children. Detecting these deficits at a very early stage of development could therefore have a great impact on clinical practice.

Introduction: Autism spectrum disorders (ASD) are a complex set of neurological dysfunction and development characterized by deficits in social and non-verbal interaction. Few studies have explored the executive functioning in ASD preschoolers. The aim of this pilot study is the assessment of executive functioning in preschool children with ASD. Material and methods: 8 ASD children (7 males, 1 female) mean age 3.09 (SD ± 0.83 years) were enrolled in the study and compared with a control group of 15 typically developing children (12 males, 3 females) (mean age 24.3 ± 0.61). All subjects underwent assessment of executive functioning with the BRIEF-P test. Results: The two groups were matched for age (p = 0.625) and gender (p = 0.900). Table 1 shows the comparison between the two groups at the BRIEF-P, with significantly higher scores on all subscales of ASD children compared with controls. Conclusions: Despite the small sample examined the results of this study agree with what is already known in the literature confirm the presence of a significant deficit in executive functions of subjects with ASD emphasizing for the first time the emergence of such problems at an early stage of development, but demanding further studies to confirm this.

Introduction: The sinactive developmental model provides suggests a different way for the brain study by observing the children behavior. In all neurodevelopmental disorders, we can observe autonomic alteration comprising sleep disorders, meal behaviour alteration and self-regulatory impairment. These alterations/impairment are very frequent in autism spectrum disorders (ASD) (1-12). Aim of the present preliminary study is the assessment of metabolic rate in children affected by ASD. Material s and methods. 5 males affected by ASD aged 7-10 years (mean age 6.73±3:39), were recruited. The average score at the ADOS scale was 12.24 (SD± 3.29). The control group consisted of 5 males typically developing children (TDC) aged 7 to 11 years (mean age 7.92 ± 3.23). Autonomic/Metabolic evaluation: Free-living daily physical activity was measured using either the SenseWear Armband in order to calculate the total energy expenditure (TEE), baseline (REE) and the metabolic physical activity for prolonged periods of time. In general, the SenseWear Armband allows objective monitoring of the lifestyle including duration and sleep efficiency. Results: ASD subjects show values of total energy expenditure (p = 0.0047) and active energy expenditure (p = 0.044) significantly higher compared to control subjects (Table 1). In addition, ASD children have a metabolic intermediate significantly higher than healthy subjects (p=0.015). (Table 1). Finally, the ASD children show a significant reduction of sleep time (p = 0.027) (Table 1). Conclusion: ASD can represents a very significant risk factor for developing sleep disorders and to high energy expenditure, although further studies are needed in this respect.

Introduction: Autism spectrum disorder (ASD) is a behavioral syndrome caused by a developmental disorder, biologically determined, with onset in the first three years of life. The areas concerned are mainly those related to social communication, social interaction and mutual functional and symbolic play. In the last decades, different conceptions of autism have taken, also emphasizing different sensory-perceptual abnormalities as the basis of the central features of disorder. This pilot study intends to address the issue of sensory perception in preschool children affected by ASD. Material and methods: 11 ASD children were enrolled (7 males, 4 female) aged between 2.3 years and 4.6 years, (mean age 3.29 ± 0.72). The control group consisted of 24 typical developing children (15 males, 9 females) (mean age 3.08 ± 0.87). All subjects underwent assessment of sensory perceptual abilities according to the Bogdashina's Sensory Profile Checklist Revised (SPCR) evaluation (43). Results: The two groups are comparable for age (p = 0.491) and sex distribution (p = 0.755). Table 1 shows the comparison between the two groups results in the SPCR, specifically, individuals with ASD, showed significantly higher scores on near all perception areas evaluated than healthy controls, suggesting a clear perceptual impairment in ASD subjects. Only for olfactory perception two groups were comparable. Conclusions: no significant differences in behavioral reaction to smell stimulation between ASD and typical developing children, and this result could be explained according to the early age of our sample that could cause high reactivity to smell stimulation also in typical developing examined children.

Introduction: Anxiety is the psychological process by which the individual reacts to dangerous external stimuli, triggering responses (mediated by norepinephrine, GABA and serotonin) involving physiological reactions and cognitive strategies. Anxiety can be differentiated in state anxiety and trait anxiety. Fragile X Syndrome (FXS) is a disorder most commonly caused by a triplet repeat expansion of > 200 cytosine-guanine-guanine (CGG) repeats in the 50 untranslated region of the Fragile X mental retardation 1 (FMR1) gene. Aim of the present study is investigating the state or trait anxiety in a sample of mothers of children affected by X-fragile. Materials and methods: 84 mothers (mean age 48.36 ± 7.11) of children affected by FXS were recruited and compared with mother of 171 typical developing children (mean age 46.18 ± 9.53). The Scale State-Trait Anxiety Inventory for Adults (STAI) was used in order to assess the anxiety levels. Results: All mothers of children affected by FXS showed high score of anxiety levels at the STAI evaluation (Table 1), with no differences were found between mothers of males and females children affected. Conclusions: Mothers of children with FXS appear to be in a state of anxiety effects and suddenly even higher than those found later in mothers of children with other chronic diseases.

Introduction: Obstructive sleep apnea syndrome (OSAS) affects up to 4% of pediatric population, with many co-morbidities in the medium-long term. Functional alterations in prefrontal cortex (PFC) may explain why OSAS impacts aspects such as: executive functions, memory, motor control, attention, visual-spatial skills, learning and mood regulation. Emotional intelligence (EI) is a complex neuropsychological function that could be impaired in many clinical conditions. Aim of the study is to evaluate the difference in emotional intelligence skills among children with OSAS and healthy subjects Materials and methods: 29 children (16 males) mean age 9.5 ± 1.54 years, affected by OSAS were compared with 60 typical developing children similar for gender (p = 0,871), age (p = 0,934) and socio-economic status (p = 0.714). Bar-On emotional quotient inventory, youth version (EQ-i: YV) was used in order to assess the Emotional Quotient. Results: Apnea/hypopnea index (AHI) results to be 8.76 ±3.45 with medium desaturation index (ODI) amounting to 2:52 ± 21.5, average saturation 92.7±4.8 %, average desaturation 4.9 %. OSAS children have significant differences in Interpersonal scales (84.95 ± 07.03 vs. 99.61 ± 8.96; p

Orexin system regulates sleep/wake states and its deficiency result in narcolepsy thus indicating the crucial role of orexins in maintaining wakefulness. There are two types of orexin peptides: the orexin-A (OXA or hypocretin 1) and orexin-B (OXB or hypocre- tin 2). The Majority of the central nervous system orexin peptides are synthesized in neurons located in the lateral and back hypotha- lamus and send projections throughout the brain regions Orexin neurons are “multi-tasking” hence regulating also energy homeosta- sis, reward systems and feeding behaviour through connection with hypothalamic nuclei and through responsiveness to leptine and glucose. It has recently been found a connection with lymbic system suggesting a further possible role of orexins in regulating emo- tions. All the studies conducted confirm that orexin system regulates vigilance states, energy homeostasis, reward system, and emo- tions. These crucial role might be the target to develope treatments of narcolepsy, obesity, emotional stress, and drug addiction.

The consciousness is the expression of an enormous and complex variety of neurobiological events, phenomenological and psychological that, from the early stages of development, prepare the emergence soil of the Self. It is a complex of tangible and intan- gible characters distinct from one another - neural infrastructure, awareness, temporality, qualitative subjectivity, intentionality - to such an extent as to seem welded faces of the same prism. Consciousness is not a simple function of the mind, but its organization. In this paper we intend to show how its order is not strictly hierarchical, but sustained by multiple horizontal levels, each of which in a structural and functional continuum with several emerging phenomena. The same distinction between quantitative aspects (surveil- lance) and qualitative (content of consciousness) of consciousness is founded on the premise that the supervision is regulated by widespread in projection systems of the brain stem, hypothalamus and thalamus; while the content of consciousness depends on the cortical activity, and particularly from the associative areas of the cortex connected between them. The so-called disturbances of consciousness (vegetative state, the minimally conscious state, a coma, the Locked in syndrome) suggests the existence of an altera- tion of a common underlying system. Although the current heterogeneity of the data makes it impossible to attribute with certainty whether positive or negative about the alleged absence of consciousness in the individual patient, the search is deriving significant benefits from the accumulation of neuroimaging evidence in paintings like coma, general anesthesia , sleep, epilepsy and somnambu- lism. In this sense, it seems increasingly urgent a deeper understanding of the neural correlates during sleep or general anesthesia, as well as the relationships between neural processes and altered states of consciousness generated by pharmacological manipulations.

Background: Cerebral palsy (CP) is the most common pediatric disability causing long-term functional limitations. CP remarkably influences the life of those affected and their families. For this reason it is important and necessary to direct attention not only type of the CP, but also the impact the disorder has on the child, parents, siblings and the entire family as a whole. The aim of this study was to assess the impact of CP on the child’s quality of life, considering parents’ perceptions about their child's illness, in order to underline the impact the illness has not only on the child but also his/her family. Methods: The study included both parents of the 36 subjects enrolled (19 males and 17 females), with established CP diagnosis. The effect of CP on the families was assessed using the Impact of Childhood Illness Scale. This questionnaire assesses the quality of life in children with epilepsy and other chronic pathologies and in their families. All questions refer to effect to the illness family. The scale comprises 30 questions divided into four sections: impact of illness and its treatment ; impact on development and child s adjustment; impact on parents and impact on the family. Descriptive analyses were used for data analysis and it is also calculated the rank correlation coefficient Spearman’s rho. Results and conclusion: The mothers’ group presents little higher average scores than the group of fathers in two four subscales or in the basement “Impact on the child” and “Family impact on the organization”. This could be due to the fact that mothers are concerned most of the child's caregiver, living most of all the difficulties that entails; mothers show greater concerns than fathers. In subscale “Impact on parents” the average score of the answers of the group of mothers coincide with that of the fathers; the experience and the experience of his son's illness is analogous for both parents. No significant differences were found from the correlational analysis between the individual items of the subscales and the different forms of CP. In families of children with CP, strategies for optimizing caregiver physical and psychological health include supports for behavioral management and daily functional activities as well as stress management and self-efficacy techniques.

Introduction: Borderline intellectual functioning (BIF) children comprises a group of subjects whit intelligence quotient (IQ) ranging 71-85, with a prevalence about 13.6%. Several studies pinpointed the role of parenting on BIF management. Aim of present study was evaluating with objective and validated tool the parental stress rate in mothers of an Italian sample of BIF children. Materials and methods: 26 BIF children (20 males and 6 females) aged 6-10 years (mean age 10.36± 2.03), according to DSM-5 criteria, and 53 (42 males and 11 females) typical developing children (mean age 10.58 ± 1.97) were recruited for present study. Mothers of all enrolled children underwent an evaluation with Parental Stress Index (PSI) test. Results: The two studied groups were comparable for age (p = 0.646) and gender (p = 0.956). Table 1 shows comparison between BIF and Control groups among PSI-SF scale results (Table 1), specifically mothers of BIF children have a significantly higher levels of global parental stress (p

During some JET vertical displacement events (VDEs) plasma current and position are found to be toroidally asymmetric. When asymmetries lock, the vessel has been observed to move horizontally, consequently strong horizontal forces are expected following plasma asymmetries, whether locked or rotating. The cause of horizontal forces is, as already identified in previous works, the asymmetric circulation of current in the structures. The physics mechanism responsible for these asymmetric currents is instead an open issue and it is the object of the present analysis. In particular it will be shown that the asymmetry is not due to a direct exchange of current between plasma and structure (as in the case of halo currents) but to asymmetric conductive paths which arise, in the structures, when the plasma column asymmetrically wets the wall. Simulations of this phenomenon using finite element (FE) models have been conducted to reproduce the JET observation during locked and rotating asymmetric VDEs. Estimated sideways force, asymmetry ( I p asym ) and normalized asymmetry ( A p asym ) of plasma current, vertical position at different toroidal locations during the disruption and halo current asymmetry have been compared with measurements done at JET during upward AVDEs. The substantial match between experiments and simulations confirms the soundness of the assumptions. Furthermore, the same physical model applied to downward VDEs shows that divertor support and coils, together with the geometry of the limiting surfaces, considerably lessen asymmetric loads as experienced at JET after installing those components.

Objectives: Deficits in facial emotion recognition and Theory of Mind are frequent in patients with epilepsy. Although this evidence, studies on pediatric age are few and the relation between these abilities and other cognitive domain remains to be better elucidated. The purpose of our study is to evaluate facial emotion recognition and Theory of Mind in children and adolescents with focal epilepsy, and correlate them with intelligence and executive functions. Materials and methods: Our work is a cross-sectional observational study. Sixty-two children and adolescents aged between 7-16 years diagnosed by focal epilepsy and 32 sex/age-matched controls were recruited. All participants were administered a standardized battery tests to assess social cognition (NEPSY-II), executive functions (EpiTrack Junior) and cognitive non-verbal level (Raven Progressive Matrices). Results: Emotion recognition mean score was significantly lower in the epilepsy group than in the controls to Student's t-test (p

Background and Objectives: Siblings of disabled children are more at risk of developing mental illnesses. More than 50 international studies show that about 8% of children and adolescents suffer from a mental disorder, which is almost always a source of difficulties both at the interpersonal level (in the family and with peers) and at school. Healthy siblings of children with disabilities are one of the groups most at risk for consequences in psychological health and well-being. As some authors suggest, siblings build their idea of &ldquo, being people&rdquo, in terms of character and personality, by continuously and daily confronting themselves with the theme of disability and a family context subjected to continuous stress. The following contribution aims to compare emotional&ndash, behavioral disorders in healthy siblings of children with autism spectrum disorder, in healthy siblings of children with Down&rsquo, s syndrome and in healthy siblings of children with typical development. Materials and Methods: The results involve 153 children from the region of Campania and their caregivers through the administration of the Strength and Difficulties Questionnaire. Results: From the data, it emerged that siblings of children with autism spectrum disorder and siblings of children with Down&rsquo, s syndrome have a greater emotional fragility, especially among male subjects. Conclusions: Our results require us to reflect on the clinical and policy measures needed to ensure the well-being of siblings of disabled children, mainly through appropriate sibling coping training.

Functional non-retentive fecal incontinence (FNRFI) is a common problem in pediatric age. FNRFI is defined as unintended loss of stool in a 4-year-old or older child after organic causes have been excluded. FNRFI tends to affects up to 3% of children older than 4 years, with males being affected more frequently than females. Clinically, children affected by FNRFI have normal intestinal movements and stool consistency. Literature data show that children with fecal incontinence have increased levels of separation anxiety, specific phobias, general anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder. In terms of possible relationship between incontinence and sleep, disorders of sleep organization have been observed in the pathogenesis of enuresis so generating the hypothesis that the orexinergic system may have a crucial role not only for the sleep organization per se but also for the sphincterial control in general. This study aimed to focus on specific neurophysiological aspects to investigate on the possible relationship between sleep organizational abnormalities and FNRFI. Specifically, we aimed to measure orexin serum levels in children with FNRFI and assess their polysomnographic sleep macrostructure patterns. Two study groups were considered: FNFRI (n = 45) and typically developed (TD) (n = 45) group. In both groups, sleep patterns and respiratory events were assessed by polysomnographic recordings (PSG) during a period of two nights at least, and plasma levels of Orexin-A were measured in each participant. The findings of this initial investigation seem to support a major role of Orexin-A in sleep organization alterations in children with FNFRI. Also, our data suggest that sleep habits evaluation should be considered as screening and complementary tool for the diagnosis of fecal incontinence in children.

Autism spectrum disorder (ASD) refers to complex neurobehavioral and neurodevelopmental conditions characterized by impaired social interaction and communication, restricted and repetitive patterns of behavior or interests, and altered sensory processing. Environmental, immunological, genetic, and epigenetic factors are implicated in the pathophysiology of autism and provoke the occurrence of neuroanatomical and neurochemical events relatively early in the development of the central nervous system. Many neurochemical pathways are involved in determining ASD; however, how these complex networks interact and cause the onset of the core symptoms of autism remains unclear. Further studies on neurochemical alterations in autism are necessary to clarify the early neurodevelopmental variations behind the enormous heterogeneity of autism spectrum disorder, and therefore lead to new approaches for the treatment and prevention of autism. In this review, we aim to delineate the state-of-the-art main research findings about the neurochemical alterations in autism etiology, and focuses on gamma aminobutyric acid (GABA) and glutamate, serotonin, dopamine, N-acetyl aspartate, oxytocin and arginine-vasopressin, melatonin, vitamin D, orexin, endogenous opioids, and acetylcholine. We also aim to suggest a possible related therapeutic approach that could improve the quality of ASD interventions. Over one hundred references were collected through electronic database searching in Medline and EMBASE (Ovid), Scopus (Elsevier), ERIC (Proquest), PubMed, and the Web of Science (ISI).

Objectives Cognitive abilities and executive functions in children and adolescents are important indicators of quality of life as well as academic and social achievements. Cognitive and executive functioning are often impaired in patients with epilepsy and can be exacerbated by seizures and antiseizure drugs. The aim of our observational retrospective study was to assess executive functioning in patients with pediatric epilepsy, currently taking a single antiseizure medication. Materials and methods Records of 172 children and adolescents aged between 6 and 18 years (mean age = 12 ± 3.4 years) with newly diagnosed epilepsy who had not yet commenced an antiepileptic treatment were included in the study. Longitudinal changes in executive functioning were assessed using the EpiTrack Junior test at baseline, before the introduction of antiepileptic monotherapy, and at 3-month, 6-month, and 9-month follow-up visits. All patients commenced a single antiepileptic treatment (levetiracetam n = 54; valproic acid n = 52; ethosuximide n = 20; oxcarbazepine n = 22; carbamazepine n = 24). Age, sex, seizure types, and seizure baseline frequency were also recorded. Results Relative to baseline, Epitrack Junior mean scores deteriorated at the 9-month follow-up visit for patients taking valproic acid, ethosuximide, and carbamazepine, but this was only statistically significant for patients taking carbamazepine. In contrast, mean scores improved for subjects taking levetiracetam and oxcarbazepine at the 9-month follow-up visit relative to baseline, but this was only statistically significant for patients taking levetiracetam. Conclusions Levetiracetam was the only antiseizure medication that led to slight improvements in executive functioning; whereas carbamazepine led to deteriorations in cognitive functioning. Further research using double-blinded, placebo-controlled trials are needed to confirm these results.

The objective of our study was to evaluate the impact of the COVID-19 pandemic on the emotional and behavioral symptoms in minors with neuropsychiatric disorders and on parental stress through a standardized neuropsychological assessment, comparing the data collected before the pandemic with those collected during the lock-down. Another goal of our study was to analyze the relationship between parental stress and behavioral/emotional symptoms in children. Our study was conducted on 383 families of patients who had already been referred at the Child Neuropsychiatry Unit of the University Hospital of Salerno for different neuropsychiatric conditions. All the parents completed two neuropsychological standardized questionnaires for the assessment of parental stress (PSI—Parenting Stress Index-Short Form) and the emotional/behavioral problems of their children (Child Behaviour CheckList). The data collected during the pandemic were compared with those collected from questionnaires administered during the six months preceding the pandemic, as is our usual clinical practice. The comparison between the mean scores of PSI and CBCL before and after the pandemic showed a statistically significant increase in all subscales analyzed in the total sample. The correlation analysis showed significant positive relationship between the subscale Total Stress of PSI and the subscales Total Problems and Internalizing Problems of CBCL. Our study suggested that the COVID-19 pandemic and the corresponding measures adopted led to an increase in internalizing and externalizing symptoms in children and adolescents with neuropsychiatric disorder. Similarly, parental stress increased during COVID-19 and ahigher level of stress in parents can be related to the internalizing symptoms of their children.

Purpose: The importance of dental care and oral hygiene is often underestimated in people with autism spectrum disorder (ASD). Comorbidity with dental anxiety is greater in ASD subjects who also show unusual reactions to sensory stimuli. The aim of our study was to assess the efficacy for a sensory-adapted environment and targeted methods in reducing anxiety and positively influencing cooperation in children with ASD during a dental examination or specific treatments. Material and methods: The sample consisted of 50 Italian children with a diagnosis of ASD (36 males and 14 females; aged 9–10 years) presenting with mild intellectual disability (ID) and verbal language skills. The subjects enrolled in the study had at least two decayed teeth and all were treated in two different dental environments: regular dental environment (RDE) and sensory-adapted dental environment (SADE). Results: 20% of the sample was successfully treated in RDE, while 68% of subjects were successfully treated in SADE. Conclusions: Results suggest that a sensory-adapted environment positively affects the therapeutic dental treatment in patients with ASD and reaffirm that sensory dysregulation in children with ASD is a crucial factor influencing the successful outcome of oral care.

Although a few years have passed since the beginning of the COVID-19 pandemic, a large body of scientific literature is already present on the impact that the worldwide spread of the virus has had on people’s quality of life [...]

During the outbreak of COVID-19 in Italy, people often failed to adopt behaviors that could have stopped, or at least slowed down, the spread of this deadly disease. We offer cognitive explanations for these decisions, based on some of the most common heuristics and biases that are known to influence human judgment and decision-making, especially under conditions of high uncertainty. Our analysis concludes with the following recommendations: policymakers can and should take advantage of this established science, in order to communicate more effectively and increase the likelihood that people choose responsible actions in a public health crisis.

Neurodevelopmental disorders are a group of neuropsychiatric diseases that affect the developing brain due to a complex interaction between genetic and environmental factors [...]

The International Classification of Headache Disorders, 3rd edition (ICHD3) defines Short-lasting Unilateral Neuralgiform Headache Attacks (SUNHA) as attacks of moderate or severe, strictly unilateral head pain lasting from seconds to minutes, occurring at least once a day and usually associated with prominent lacrimation and redness of the ipsilateral eye. Two subtypes of SUNHA are identified: Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing (SUNCT) and Short-lasting Unilateral Neuralgiform headache attacks with cranial Autonomic symptoms (SUNA). These pathologies are infrequent in children and difficult to diagnose. The authors reviewed the existing literature on SUNCT and SUNA, especially in the developmental age, which describes the pathophysiology in detail and focuses on the therapeutic options available to date. SUNHA-type headaches must be considered on the one hand, for the possibility of the onset of forms secondary to underlying pathologies even of a neoplastic nature, and on the other hand, for the negative impact they can have on an individual’s quality of life, particularly in young patients. Until now, published cases suggest that no chronic variants occur in childhood and adolescents. In light of this evidence, the authors offer a review that may serve as a source to be drawn upon in the implementation of suitable treatments in children and adolescents suffering from these headaches, focusing on therapies that are non-invasive and as risk-free as possible for pediatric patients.

The present study investigates the role of attentional style as a moderator variable between temporal perspective and social network addiction, since little is known about users’ cognitive variables involved in this kind of addictive behavior. To achieve this goal, a sample of 186 volunteers and anonymous social networking sites users (M = 34%; F = 66%; Mage = 22.54 years; SD = 3.94; range: 18 ÷ 45 years) participated in a cross-sectional study. All participants filled out self-report instruments measuring temporal perspective, internal vs. external attentional style, and social network addiction. The results align with the previous literature and show that present fatalistic and past negative time orientations are associated with social network addiction, whereas the future is a negative precursor. Moreover, a four-step hierarchical regression analysis showed that internal attentional style is a significant moderator of the relationship between high levels of temporal perspective and a high level of social network addiction. This result suggests that social network-addicted users are oriented toward internal stimuli such as their intrusive thoughts or feelings and that social network addiction is similar to obsessive compulsive disorders, depression, or anxiety. Despite its limitations, the present study could contribute to the efforts of clinicians, psychiatrists, psychologists, teachers, and all those who seek to combat social network addiction in developing treatment programs to reduce its harmful effects.

Several studies evidenced increased elevated symptomatology levels in anxiety, general stress, depression, and post-traumatic stress related to COVID-19. Real difficulties in the effective control of time that could be responsible for mental health issues and loss of vitality were also reported. Prior literature highlighted how perceived control over time significantly modulates anxiety disorders and promotes psychological well-being. To verify the hypothesis that perceived control over time predicts fear of COVID-19 and mental health and vitality mediate this relationship, we performed an online survey on a sample of 301 subjects (female = 68%; Mage = 22.12, SD = 6.29; age range = 18–57 years), testing a parallel mediation model using PROCESS macro (model 4). All participants responded to self-report measures of perceived control over time, COVID-19 fear, mental health, and vitality subscales of the Short-Form-36 Health Survey. Results corroborate the hypotheses of direct relationships between all the study variables and partially validate the mediation’s indirect effect. Indeed, mental health (a1b1 = −0.06; CI: LL = −0.11; UL = −0.01; p < 0.001) rather than vitality (a2b2 = −0.06; CI: LL = −0.09; UL = 0.03; n.s.) emerges as a significant mediator between perceived control over time and fear of COVID-19. Practical implications of the study about treatment programs based on perceived control over time and emotional coping to prevent fear and anxiety toward the COVID-19 pandemic are discussed.

Introduction: The purpose of our study was to perform a comparative analysis of social cognition in children and adolescents with epilepsy, autism spectrum disorder (ASD), specific learning disorder (SLD) and in typical development (TD) controls. The secondary aim was to relate social cognition to some clinical and demographic characteristics.Methods: Our work is a transversal observational study. The recruits were 179 children and adolescents aged between 6 and 18 years diagnosed with epilepsy, ASD, or SLD and 32 subjects with TD. All the participants underwent neuropsychological assessment of Emotion Recognition (ER) and Theory of Mind (ToM) skills.Results: All three clinical groups performed significantly worse than controls in ER and ToM. The ASD group achieved significantly lower performance than the other groups; however, the scores of SLD and epilepsy groups were comparable. The ER performances are related to non-verbal intelligence only in the group with epilepsy.Conclusion: Children and adolescents with focal epilepsy, SLD, or ASD may present a deficit of varying extent in emotion recognition and ToM, compared with TD peers. These difficulties are more pronounced in individuals with ASD, but impairment worthy of clinical attention also emerges in individuals with SLD and epilepsy.

Introduction: Perampanel (PER) is a non-competitive AMPA glutamate receptor antagonist approved for focal and generalized seizures as add-on therapy. PER does not seem to negatively affect the cognitive profile in children and adolescents, but its influence on visuospatial abilities is still to be assessed. The aim of our study was to assess visuospatial skills through a standardized neuropsychological evaluation in adolescents taking PER for 12 months.Methods: Our sample included 46 adolescents aged 12–18 years with focal and generalized drug-resistant epilepsy already in therapy with one or two antiseizure medications. Changes in visuospatial perception and memory were assessed by the Rey–Osterrieth Complex Figure Test at baseline (before taking PER) and after 12 months of pharmacological treatment. Executive functions and non-verbal intelligence were also assessed at baseline.Results: After 12 months of PER therapy, the mean scores on the Rey–Osterrieth Complex Figure Test remained almost unchanged for both visuospatial perception and visuospatial memory skills. At baseline, visuospatial memory was related to executive function, and visuospatial perception was related to executive function and non-verbal intelligence.Conclusions: Adjunctive treatment with PER did not negatively affect visuospatial skills. No adverse event effects have been reported after 12 months of follow-up, and this suggests a good tolerability in the middle-to-long term.

Some studies show that the diagnosis of Autism Spectrum Disorder could be considered reliable and stable in children aged 18 to 24 months. Nevertheless, the diagnostic stability of early ASD diagnosis has not yet been fully demonstrated. This observational study examines the one-year diagnostic stability of autism spectrum disorder diagnosis in a clinical sample of 147 children diagnosed between 18 and 48 months of age. The ADOS-2 scores were used in order to stratify children in three levels of symptom severity: Autism (AD; comparison score 5–7), Autism Spectrum Disorder (ASD; comparison score 3–4), and Sub-Threshold Symptoms; (STS; comparison score 1–2). Results: Overall, the largest part of children and toddlers diagnosed with autism spectrum disorder between 18 and 48 months continued to show autistic symptoms at one-year follow-up evaluation. Nevertheless, a significant percentage of children with higher ADOS severity scores exhibited a reduction of symptom severity and, therefore, moved towards a milder severity class one year later. Conversely, the number of subjects of the STS group meaningfully increased. Therefore, at one-year follow-up a statistically significant (χ2(2) = 181.46, p < 0.0001) percentage of subjects (25.2% of the total) who had received a categorical diagnosis of Autistic Disorder or Autism Spectrum Disorder in baseline no longer met the criteria for a categorical diagnosis. Furthermore, children who no longer met the criteria for autism spectrum disorder continue to show delays in one or more neurodevelopmental areas, possibly related to the emergence of other neurodevelopmental/neuropsychiatric disorders. Overall, the comprehensive results of the study account for a high sensibility but a moderate stability of ASD early diagnosis.

Clotiapine is an atypical antipsychotic indicated for the management of a series of acute psychotic disorders. The current literature lacks evidence concerning the tolerability and clinical use of this drug in the management of individuals with anorexia nervosa (AN). In this study, we report two cases of adolescents with AN, treated with clotiapine. The reason for the administration of clotiapine was, for both patients, the manifestation of bizarre delusions concerning food and calories. Patient 1 presented a presyncope after the first dose of clotiapine, and treatment was rapidly discontinued. Patient 2 was treated with clotiapine for 9 months; doses were titrated from 20 mg/day to 70 mg/day, with an improvement in the reported delusions, which also enhanced compliance with psychological and nutritional interventions. EKG, QTc, white blood count, and red blood count were not relevantly influenced by the introduction of clotiapine in either patient. No extrapyramidal effect was documented. These reports stress the need for further studies assessing the tolerability and potential effect of clotiapine in treating adolescents with AN and delusional symptomatology.

In recent years, there has been a renewed attention to lifestyle-based interventions in people with autism spectrum disorder. The positive effects of physical exercise programs have been well documented both in healthy people and in people with disabilities in the fields of psychological well-being, cognitive outcome and medical health. There is much less evidence about the opportunity to attempt a team-group sport for people with autism. Although researchers seem to suggest an overall positive effect, playing team sports for people with autism spectrum disorder (ASD) means dealing with difficulties in social interactions and limitations in motor functions. This narrative review aims to report studies about the effects, improvements and difficulties that people with autism have to face when they play the world’s most popular team sport: soccer.

Background. Craniofacial anomalies and minor neurological dysfunction (MNDs) have been identified, in literature, as risk factors for neurodevelopmental disorders. They represent physical indicators of embryonic development suggesting a possible contributory role of complications during early, even pre-conceptional, phases of ontogeny in autism spectrum disorders (ASD). Limited research has been conducted about the co-occurrence of the two biomarkers in children with ASD. This study investigates the associative patterns of cranio-facial anomalies and MNDs in ASD children, and whether these neurodevelopmental markers correlate with intensity of ASD symptoms and overall functioning. Methods. Caucasian children with ASD (n = 33) were examined. Measures were based on five anthropometric cranio-facial indexes and a standardized and detailed neurological examination according to Touwen. Relationships between anthropometric z-scores, MNDs and participant characteristics (i.e., age, cognitive abilities, severity of autistic symptoms measured using the Childhood Autism Rating Scale (CARS) checklist) were assessed. Results. With respect to specific MNDs, significant positive correlations were found between Cephalic Index and Sensory deficits (p-value &lt, 0.001), which did not correlate with CARS score. Importantly, CARS score was positively linked with Intercanthal Index (p-value &lt, 0.001), and negatively associated with posture and muscle tone (p-value = 0.027) and Facial Index (p-value = 0.004). Conclusion. Our data show a link between a specific facial phenotype and anomalies in motor responses, suggesting early brain dysmaturation involving subcortical structures in cerebro-craniofacial development of autistic children. This research supports the concept of a &ldquo, social brain functional morphology&rdquo, in autism spectrum disorders.

Several studies have documented learning disabilities (LDs) in subjects with epilepsy, who have been shown to be at greater risk of mild neuropsychological damage, with the consequent risk of academic failure. This retrospective study aimed to investigate the peculiarities of reading and writing disorders in subjects with idiopathic epilepsy. The reading and writing performance of 35 children affected by reading and writing disorders and idiopathic epilepsy (R/WD + E group) has been compared with the performance of 37 children with only reading and writing disorders (R/WD group). A comparison group of 22 typical developing healthy children (TDC group) was also included in the study. As expected, the TDC group reached better performances in the reading and writing tests administered. Between R/WD + E and R/WD groups, there was a substantial analogy in reading and writing disabilities. The differences between the two clinical groups concern writing ability in sentences dictation and verbal and visuospatial short-term memory in digit span and memory-for-location (MFL) tests.

The DHRS9 gene is involved in several pathways including the synthesis of allopregnanolone from progesterone. Allopregnanolone is a positive modulator of gamma aminobutyric acid (GABA) action and plays a role in the control of neuronal excitability and seizures. Whole-exome sequencing performed on a girl with an early onset epilepsy revealed that she was a compound heterozygote for two novel missense mutations of the DHRS9 gene likely to disrupt protein function. No previous studies have reported the implication of this gene in epilepsy. We discuss a new potential pathogenic mechanism underlying epilepsy in a child, due to a defective progesterone pathway.

Reliability, accuracy, and timeliness of diagnostic testing for SARS-CoV-2 infection have allowed adequate public health management of the disease, thus notably helping the timely mapping of viral spread within the community. Furthermore, the most vulnerable populations, such as people with intellectual disability and dementia, represent a high-risk group across multiple dimensions, including a higher prevalence of pre-existing conditions, lower health maintenance, and a propensity for rapid community spread. This led to an urgent need for reliable in-house rapid testing to be performed prior to hospital admission. In the present study, we describe a pooling procedure in which oropharyngeal and nasopharyngeal swabs for SARS-CoV-2 detection (performed prior to hospital admission using rapid RT-PCR assay) are pooled together at the time of sample collection. Sample pooling (groups of 2–4 samples per tube) allowed us to significantly reduce response times, consumables, and personnel costs while maintaining the same test sensitivity.

Background. Obstructive sleep apnea syndrome (OSAS) affects up to 4% of a pediatric population, with many comorbidities in the medium-long term. Functional alterations in the prefrontal cortex (PFC) may explain why OSAS impacts aspects such as executive functions, memory, motor control, attention, visual-spatial skills, learning, and mood regulation. Emotional intelligence (EI) is a complex neuropsychological function that could be impaired in many clinical conditions. Purpose. The aim of the study is to evaluate the difference in emotional intelligence skills among children with OSAS and healthy subjects (nOSAS). Methods. 129 children (72 males; mean age 7.64±1.98 years) affected by OSAS were compared to 264 non-OSAS (nOSAS) children (138 males; mean age 7.98±2.13) similar for gender, age, and socioeconomic status. In order to assess the emotional quotient, the Bar-On Emotional Quotient Inventory: Youth Version (EQ-i:YV) was used. Results. The comparison for means and standard deviation between OSAS children and nOSAS children for EQ-i:YV scores showed significant differences for Interpersonal, Adaptability, and Stress Management scales and EQ Total score. Conclusions. Our findings highlighted the role of intermittent hypoxia in the genesis of the effects of sleep-related respiratory disorders, which involves also aspects different from physical impairments.

We report the second case, to the best of our knowledge, of a mother with Prader–Willi syndrome (PWS) who gave birth to a daughter with Angelman syndrome (AS). The menarche occurred when she was 16, and the following menstrual cycles were irregular, but she never took sexual hormone replacement therapy. At the age of 26, our patient with PWS became pregnant. The diagnosis was confirmed by molecular genetic testing that revealed a ~5.7 Mb deletion in the 15q11.1–15q13 region on the paternal allele in the mother with PWS and the maternal one in the daughter with AS, respectively. Both the mother with PWS and the daughter with AS showed peculiar clinical and genetic features of the two syndromes. Our case report reaffirms the possible fertility in PWS; therefore, it is very important to develop appropriate socio-sexual education programs and fertility assessments in order to guarantee the expression of a healthy sexuality.

Object Migraine headache prevalence ranges from 1.2 to 3.2% at 7 years of age, increasing with age up to 4-19% in adolescents.1 The aim of the present study is investigating the personality style associated with children and adolescent affected by Migraine without aura (MwA), through administration of the projective Rorschach test and statistical comparison with a group of age- and sex matched healthy controls. Methods 137 patients (74 males and 63 females), aged 7.3–17.4 years (mean age 11.4, SD 3.02 years), affected by MwA according to the IHs-3 criteria. The projective Rorschach test has been administrered to all the cases and controls. Statistical comparisons of groups were performed through comparison of mean values using Student’s t-test for the Rorschach variables treated as numerical variables (R, W%, W+%, D%, F%, F+%, R% l.t., F+% l.t. A%, H%, Anat%, Ban% and Orig%). P-values ,0.05 were considered statistically significant. For statistical analysis, the software STATISTICA (data analysis software system, version 8.1; StatSoft, Inc., 2001) was used. Results No statistical differences were found between the MwA and healthy control group for age (p=0.55), and sex distribution (p=0.804). From the comparison between the two samples MwA group shows lower W responses (p

Objectives: Primary monosymptomatic nocturnal enuresis (PMNE) is a common problem in childhood and studies about the sleep habits of affected children are not conclusive. Work-family conflict (WFC) results from the incompatibility between family demands and business/workplace needs. WFC can impact parental quality with many consequences on children health. Aim of study is assessing the prevalence of sleep disturbances in enuretic children, sons of work-shifters. Materials and methods: 80 children (67 males) aged 5-13 years (mean 10,43; SD ± 1,99), were consecutively referred for PMNE. Sleep habits were investigated with Sleep Disturbances Scale for Children (SDSC) and the results were compared with a control group of 255 (190 males) typical developing children (TDC) sons of no shift-workers, matched for age (mean 10.57 SD ± 1,89; p = 0.569) and sex distribution (Chi-square= 2.416; p = 0.120). Results: To evaluate statically differences among mean values of two samples, the Chi-square test was performed. Logistic regression was assessed to verify the role of paternal shift-working as risk factor for sleep disorders. p=0.05. All sleep disturbances categories were more prevalent in PMNE children sons of shift-workers than control group (Chi-square= 43.926; p

Introduction: The core of autism spectrum disorders (ASD) consists of alterations of neurological functions that affect the typical developmental trajectory leading to deficits in social interaction and non-verbal behaviors. In general, ASD is diagnosed at age three and many other frequent neurological signs may be present, such as sleep disorders. The aim of study is evaluating sleep habits in a sample of ASD children. Material and methods: The study population consists of 65 ASD children (43 males and 22 females), aged between 2 and 11 years (mean 5.73 ± 2.39 years). The control group consists of 114 children with typical development (68 males and 46 females), aged between 3 and 10 years (mean 5.91 ± 2.23 years). The diagnosis of ASD was confirmed by the evaluation ADOS -2, while the evaluation of sleep habits with the SDSC tests. Results: The two groups were matched for age (p = 0.633) and sex distribution (p = 0.483). The ASD subjects show a significantly higher rate of sleep disorders in all categories explored by SDSC tests (Table 1). Discussion: The sleep of people with ASD is compromised at any age and regardless of the severity of social impairment and communication, but not the level of development. Still, ASD is a very important risk factor for the development of sleep disorders, although the report could also be interpreted in the opposite manner.

Resume But de l’etude Jusqu’a ces dernieres annees, l’utilisation de SAA etait reservee exclusivement aux athletes professionnels. Dans les pays anglo-saxons, l’usage des SAA a une large diffusion parmi les adolescents et les lyceens. En Australie, aux Etats-Unis et en Angleterre, l’utilisation des SAA pourrait devenir un probleme de societe a moins qu’il ne le soit deja, du fait des troubles du comportement chez les consommateurs. La litterature met en evidence, chez les utilisateurs de SAA, la consommation concomitante de nombreuses autres substances, susceptibles de favoriser des comportements agressifs et dangereux envers autrui et envers soi-meme. L’objet de cette etude concerne les habitudes, la style de vie et le profil psychologique d’un groupe d’adolescents frequentant les centres sportifs de la ville de Palerme (Italie), et utilisant des SAA. Patients et methode Ont ete interroges, dans les gymnases et les centres sportifs, 120 sujets (86 hommes et 34 femmes de 16 et 19 ans). Pour cette recherche, une version italienne, adaptee du questionnaire americain « Massachusetts Youth Risk Behaviour Survey », a ete utilisee. Le questionnaire comprend une evaluation precise de l’utilisation de SAA et des questions a propos de l’existence de comportements a risque : usage de drogues, tentatives de suicide, comportements sexuels a risque. L’« Adjective Check List » (ACL) a egalement ete utilisee. A partir des donnees obtenues, une analyse de correlation (correlation de rang Rho de Spearman) a ete realisee. Resultats L’analyse des donnees a montre que 24 % des sujets font usage de steroides anabolisants a differentes frequences (20 % des sujets de sexe feminin utilisent des SAA) ce qui est un pourcentage d’utilisation plus eleve que ceux indiques dans la litterature. Ceux qui utilisent des SAA, declarent, plus frequemment que les non-utilisateurs, avoir serieusement pense au suicide (7,2 %) et ne pas utiliser le preservatif pour un rapport sexuel occasionnel (53 % versus 48 %), deniant le risque de contracter le SIDA. Dans notre etude, l’analyse de correlation entre les echelles de l’ACL et l’utilisation (variable de steroides) fournit des elements interessants : les sujets qui utilisent des SAA paraissent avoir moins d’initiative et des interets plus etroits, etre plus reserves, plus conventionnels. Ces individus sont plus enclins a l’autodepreciation, accables par les problemes quotidiens, ils decrivent des relations ambigues avec les autres, avec des conduites d’opposition inhabituelles et peu conformes. Ils sont peu enclins a faire face aux exigences de la vie quotidienne. Ils sont enclins a la superstition, ont une faible capacite a faire face au stress. Ils sont plus soupconneux et mefiants quant aux intentions des autres et sont sur la defensive quant a eux-memes. Les rapports aux autres sont difficiles car ils sont anxieux, craignant d’etre impliques emotionnellement, detaches et sceptiques sur les intentions d’autrui. Ils n’aiment pas la routine. Ils semblent insatisfaits de leur situation actuelle. Ils reagissent mal a la pression sociale. Ils sont percus comme imprevisibles, se controlant mal et influences par des preoccupations irrationnelles ou depourvues de logique. Discussion Cette etude s’inscrit dans l’ensemble de la litterature psychiatrique et confirme les donnees les plus recentes provenant d’etudes anterieures, fournissant un profil psychologique pertinent des jeunes qui utilisent des SAA. L’adolescent usant ces SAA semble timide dans les relations interpersonnelles, il a tendance a l’autodepreciation, il est querelleur, et ceci en proportion de la frequence d’utilisation de ces substances. De nombreuses etudes indiquent que les SAA sont des substances psychostimulantes et qu’ils sont utilises pour cette raison. De nombreux utilisateurs de SAA combinent leur utilisation a d’autres substances. On peut donc supposer que les consommateurs de SAA (en particulier ceux qui prennent d’autres produits) sont pousses a cette consommation pour ses effets psychostimulants. Ce sont souvent les effets sur les muscles qui maintiennent la dependance.

BackgroundStudies about the impact of developmental dyslexia (DD) on parenting are scarce. Our investigation aimed to assess maternal stress levels and mothers’ copying styles in a population of dyslexic children.MethodsA total of 874 children (500 boys, 374 girls; mean age 8.32 ± 2.33 years) affected by DD was included in the study. A total of 1,421 typically developing children (789 boys, 632 girls; mean age 8.25 ± 3.19 years) were recruited from local schools of participating Italian Regions (Abruzzo, Calabria, Campania, Puglia, Umbria, Sicily) and used as control-children group. All mothers (of both DD and typically developing children) filled out an evaluation for parental stress (Parenting Stress Index—Short Form) and coping strategies [Coping Inventory for Stressful Situations (CISS)].ResultsNo statistical differences for mean age (p = 0.456) and gender (p = 0.577) were found between DD and control children. Mothers of children affected by DD showed an higher rate of all parental stress indexes (Parental Distress domain p