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Misophonia is a neurophysiological disorder with behavioral implications, is complex and multifactorial in origin, and is characterized by an atypical and disproportionate emotional response to specific sounds or associated visual stimuli. Triggers include human-generated sounds, mainly sounds related to feeding and breathing processes, and repetitive mechanical sounds. In response to the triggering stimulus, the patient experiences immediate, high-intensity, disproportionate physical and emotional reactions that affect their quality of life and social functioning. The symptoms of misophonia can occur at any age, but onset in childhood or adolescence is most common. Affected children live in a constant state of anxiety, suffer continuous physical and emotional discomfort, and are thus exposed to significant chronic stress. Chronic stress, especially during childhood, has consequences on the main biological systems through the dysregulation of the hypothalamic–pituitary–adrenal axis, including the gastrointestinal tract. Here, we provide arguments for a positive correlation between misophonic pathology and gastrointestinal symptoms, and this hypothesis may be the starting point for further longitudinal studies that could investigate the correlations between these childhood vulnerabilities caused by misophonia and their effect on the gastrointestinal system. Further research to study this hypothesis is essential to ensure correct and timely diagnosis and optimal psychological and pharmacological support.

(1) Background: Family factors play an important role in the management of diabetes, establishing a relationship between conflicts and non-adherence to therapy. High values of HbA1c are involved in specific complications of the disease (retinopathy, nephropathy, neuropathy, ketoacidosis). This study aimed to determine the role of systemic family psychotherapeutic interventions in increasing the quality of parent–child/adolescent relationships and in optimizing the child’s glycemic control. (2) Methods: In this prospective observational study, 64 parents of children and adolescents with type 1 diabetes were evaluated regarding their relationship with their children, using the Child–Parent Relationship Scale-Short Form (CPRS-short form). The children were divided into three groups: one participated for 6 months in systemic family psychotherapy with children and their parents (FT), the second group participated in individual psychotherapy (IT), and the control group (CG) received no intervention. HbA1c values were recorded before and after the interventions. (3) Results: HbA1c means decreased significantly after the family psychotherapy program. The scores on closeness in the family therapy group increased significantly, and the scores on conflict decreased significantly after the intervention, compared with IT and CG. (4) Conclusions: Systemic family psychotherapy produces better results in disease management and in strengthening parent–child relationships.

The objective of this review was to present the main ethical issues in minor patient healthcare activity including: minor patient consent, parental consent, confidentiality and medical examination. The particular ethical issues that arise in the medical care of children and adolescents overlap with those of other patients, who lack decision-making capacity or have diminished decision-making capacity. Children should always be respected as persons. A consent from the child and parental permission be sought whenever possible, by using appropriate tools. Even minor patient demonstrated the ability to understand essential elements of healthcare activity and the details of the medical examination, there is variability in children’s level of understanding, mainly due to their age and maturity. The legal framework in every country represents a guide for the medical doctors and a reference for their patients.

Inflammatory bowel disease (IBD), which includes Crohn’s disease, ulcerative colitis, and unspecified inflammatory bowel disease, is a chronic, unpredictable and immune-mediated condition of the gastrointestinal tract. In pediatric populations, the diagnosis of a chronic and debilitating pathology significantly reduces quality of life. Children diagnosed with IBD may cope with physical symptoms such as abdominal pain or fatigue, but mental and emotional well-being are also important for preventing and reducing the risk of developing psychiatric conditions. Short stature, growth delay and delayed puberty can contribute to poor body image and low self-esteem. Furthermore, treatment per se can alter psycho-social functioning due to the side effects of medication and surgical procedures such as colostomy. It is essential to acknowledge and treat early signs and symptoms of psychiatric distress in order to prevent the development of serious psychiatric disorders in adult life. The literature underlines the importance of incorporating psychological and mental health services as part of the management of inflammatory bowel disease. Diagnosing mental health problems in pediatric patients with IBD can improve their adherence to treatment and pathology course and, consequently, reduce long-term morbidity and mortality.

Assessing mental health in children and adolescents with insulin-dependent diabetes (IDD) is an issue that is underperformed in clinical practice and outpatient clinics. The evaluation of their thoughts, emotions and behaviors has an important role in understanding the interaction between the individual and the disease, the factors that can influence this interaction, as well as the effective methods of intervention. The aim of this study is to identify psychopathology in adolescents with diabetes and the impact on treatment management. A total of 54 adolescents with IDD and 52 adolescents without diabetes, aged 12–18 years, completed APS–SF (Adolescent Psychopathology Scale–Short Form) for the evaluation of psychopathology and adjustment problems. There were no significant differences between adolescents with diabetes and control group regarding psychopathology. Between adolescents with good treatment adherence (HbA1c < 7.6) and those with low treatment adherence (HbA1c > 7.6), significant differences were found. In addition, results showed higher scores in girls compared with boys with IDD with regard to anxiety (GAD), Major Depression (DEP), Post-Traumatic Stress Disorder (PTSD), Eating Disturbance (EAT), Suicide (SUI) and Interpersonal Problems (IPP). No significant differences were found regarding the duration of the disease. Strategies such as maladaptive coping, passivity, distorted conception of the self and the surrounding world and using the negative problem-solving strategies of non-involvement and abandonment had positive correlation with poor glycemic control (bad management of the disease). The study highlighted the importance of promoting mental health in insulin-dependent diabetes management.

The aim of this review study is to analyze and describe the main moral and ethical aspects regarding the minor patients’s healthcare related procedures. The Pediatric Ethics differentiate from that of the competent adults, such particularities including surrogate decisions, confidentiality issues, genetic testing and research related matters, end-of-life situations and legal framework. An important aspect is that the child is not entirely lacking capacity, in fact, the literature underlines the importance of listening, analyzing and taking into consideration the minor patient’s opinions, statements or judgements according to their age and cognitive development. The approach of the minor patient should always take into account the triad “doctor-parent-child” without neglecting any of the participants and their role. The main responsibility of the healthcare professionals is to act guided by the best interests of the minor patient.