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Background: Lithium is the gold-standard treatment for Bipolar Disorder (BD) in both adults and adolescents, effectively managing mood episodes and reducing suicide risk. While its efficacy in neurotypical youth is well established, its use in adolescents with Autism Spectrum Disorder (ASD) and comorbid BD remains under-researched. Here, we present the protocol for a study aiming to evaluate the efficacy and tolerability of Extended-Release Lithium Salts in treating adolescents with BD and comorbid ASD compared to neurotypical BD patients. Methods: This longitudinal prospective naturalistic comparative study will enroll lithium-naïve adolescents aged 12–18 with BD, with or without comorbid ASD, from the Department of Child and Adolescent Psychiatry and Psychopharmacology. Participants will be followed for six months while receiving Extended-Release Lithium Salts treatment. Primary outcomes will include mood instability, suicidality, emotional dysregulation, and aggression, assessed through a range of clinical rating scales and diagnostic tools at baseline, three months, and six months. Secondary outcomes will focus on the safety and tolerability of Extended-Release Lithium Salts, with measures including side effect ratings, physical exams, and laboratory tests. Results: We hypothesize that Extended-Release Lithium Salts will demonstrate non-inferiority in treating BD symptoms in adolescents with comorbid ASD compared to those without ASD. Conclusions: This study is poised to fill a significant gap in the literature by providing critical data on the use of lithium for adolescents with BD and ASD. Findings will inform clinical practice and future research, potentially guiding more personalized treatment approaches for this complex and vulnerable population. [ABSTRACT FROM AUTHOR]

Objective: Emotional Dysregulation (ED) is characterized by the inability to manage emotions effectively, leading to maladaptive behaviors, and often co-occurs with psychiatric conditions carrying significant long-term consequences. Early diagnosis of ED is thus essential for targeted interventions. To address this need, we developed and validated the "Reactivity of Emotions in Adolescents: Caregivers' Tool" (REACT), a novel parent-rated questionnaire designed to assess ED in adolescents. Method: The present study involved two samples, one drawn from the general population (n = 89 healthy controls from local schools) and the other composed of clinical patients (n = 76 adolescents with different psychiatric and/or neurodevelopmental conditions). Patients' diagnoses were confirmed through the clinical interview K-SADS-PL to explore the presence of any psychopathological conditions. Participants from both groups completed the RIPoSt-Y questionnaire, providing a measure of ED, while their parents filled out the ARI, measuring affective reactivity in youth. Confirmatory and exploratory factor analyses were performed to refine the questionnaire's internal structure. Results: The final REACT questionnaire consists of 55 items distributed across three subscales, namely Negative Emotionality, Irritability, and Excitability. Psychometric evaluation showed that these subscales demonstrated excellent internal consistency and strong construct validity, with clinical patients scoring higher on all subscales compared to healthy controls. The REACT questionnaire showed also high convergent validity by exhibiting significant positive correlations with established measures of ED. Conclusions: This novel tool represents a valuable improvement in the assessment of ED in adolescence as it may facilitate tailored interventions to provide emotional well-being and long-term outcomes. [ABSTRACT FROM AUTHOR]

The correlation between maternal exposure to stressful and traumatic events during pregnancy and autism spectrum disorder (ASD) in offspring has been studied in the literature. Fewer studies, however, have considered the mother's exposure to traumatic events during childhood. This work focuses on maternal exposure to these events in childhood and/or adulthood, relating it to autism spectrum disorder in offspring. A questionnaire was used to assess whether and to what type of event the mothers have been exposed, and to assess eventual peri-traumatic dissociation related to the traumatic event. The mothers involved in this study were recruited at the Child Neuropsychiatry Outpatient Clinic of the University Hospital of Palermo. 22 mothers (natural mothers) gave their time to participate in this pilot study, and all who were considered have the characteristics required to be enrolled in this study. The control group consists of 50 mothers of children with diagnosis of language disorder (LD). The difference between maternal exposure to stressful and traumatic events in the group of cases compared to the control group is statistically significant (p = 0.03); the median value is 7 in the cases vs 4.5 in controls. The finding of a greater number of stressful and traumatic events in mothers of children with autism spectrum disorder compared to mothers of children with language disorder could suggest the existence of a correlation between maternal exposure to stress and trauma and the risk of developing autism in offspring. [ABSTRACT FROM AUTHOR]