The association between social isolation, loneliness and psychological problems in young adults: A study during the acute phase of COVID-19 in Italy.

During the COVID-19 pandemic, governments had to impose social isolation measures to safeguard the citizens' health. However, this could have affected psychological problems. The aim of the present study was to investigate the psychological effects associated with social and emotional isolation during the acute phase of the COVID-19 in Italy. To this purpose, the degree of social isolation and loneliness and the presence of psychological problems (externalising and internalising) were investigated online in a sample of 395 young adults (18-30 years; 57% women). Results confirmed the relevant association between social isolation, loneliness and psychological problems, in both internalising and externalising dimensions. Particularly, loneliness showed the strongest association. Moreover, consistently with surveys conducted during the COVID-19-era, data highlighted that men were more vulnerable to social isolation and loneliness than women. These results underline the need for adequate interpersonal support during moments of isolation to prevent negative effects on psychological problems.

The assessment of cyclothymic-hypersensitive temperament in youth with mood disorders and attention deficit hyperactivity disorder.

BACKGROUND: Cyclothymic-hypersensitive temperament (CHT) has been related to both depression and bipolarity, as well as to suicidality. Recently, a psychometrically sound way of assessment has been validated in youth (Cyclothymic-Hypersensitive Temperament Questionnaire, CHTQ), but data on clinical populations are still scant. Aim of our study is to further explore the structure and other psychometric properties of the revised version of CHTQ and its clinical implications in clinical samples. METHODS: The study is based on a dataset of patients with unipolar depression, bipolar disorder and attention deficit and hyperactivity disorder (ADHD) (243 patients, 135 males, mean age 14.22 ± 2.16 years, age range 9-18 years), compared to a community sample of adolescents (398 subjects, 95 boys, mean age 15.47 ± 1.96 years, age range 10-18 years) RESULTS: The two-correlated factor structure of CHT has been confirmed, with a moodiness/hypersensitiveness factor, correlated with internalizing symptoms, and an impulsiveness/emotional dysregulation factor, correlated with externalizing symptoms. All CHTQ scores correlate with global functioning. CHTQ total scores discriminate patients from healthy controls. Only CHTQ impulsiveness/emotional dysregulation subscale score is higher in bipolar patients, compared to unipolar depression and ADHD, whereas neither CHTQ moodiness/hypersensitiveness subscale score nor CHTQ total score discriminate between clinical groups. LIMITATION: Data on current mood states are unavailable. Patients were recruited in a third level clinic. The unipolar depression group is relatively small. CONCLUSION: CHT may be a rapid and reliable screening and diagnostic tool in the clinical practice with youth, exploring the cyclothymic dimension in different psychiatric disorders.

At-risk early adolescents profiles in the community: A cluster analysis using the strengths and difficulties questionnaire.

Early adolescence, with its several changes and demands, represents a delicate period of life. Several studies highlighted that during early adolescence, emotional and behavioral problems tend to increase. Using a person-centered approach, the present study explored the emotional and behavioral functioning profiles in a sample of Italian preadolescent students. Participants were 2959 youths (1533 males and 1426 females; age 10-14 years); they completed the Strengths and Difficulties Questionnaire (SDQ) and the Inventory of Callous Unemotional traits (ICU). Findings revealed four different profiles: "no psychopathology" (41.5%), "low psychopathology with sub-threshold hyperactivity" (33%), "predominantly internalizing" (19%), and "predominantly externalizing" (6.5%). The two latter clusters are characterized by high levels of SDQ Total Score. The "predominantly internalizing" is distinguished by a higher prevalence of females, and the "predominantly externalizing" by a higher prevalence of males and higher CU traits. A person-oriented approach allowed for identifying subgroups of early adolescents who may significantly vary in their configuration of internalizing and externalizing problems. Such subgroups may reflect youths for whom the creation of prevention and intervention programs could be more tailored.

The Relation of Callous-Unemotional Traits and Bullying in Early Adolescence Is Independent from Sex and Age and Moderated by Conduct Problems.

In youths, callous-unemotional (CU) traits and conduct problems (CP) are independently associated with bullying perpetration and these effects are also observed when controlling for sex. Moreover, research indicates that the co-existence of high levels of both CU and CP further increase the risk. Although several studies have examined the relationship between CU traits and traditional bullying, few have also included a measure of cyberbullying and very few of them have focused the early adolescence. The aim of this study was to replicate and extend these findings in a large sample of Italian early adolescents considering both traditional and cyberbullying behaviors. Data were extracted from the Bullying and Youth Mental Health Naples study (BYMHNS) which included 2959 students of 10-15 years of age. CP, CU traits, traditional bullying behaviors, and cyberbullying behaviors were assessed by multi-item self-report scales. As expected, we replicated the significant and specific association between CU traits and traditional bullying, extending the findings to cyberbullying. In addition, in the latter case the effect was moderated by CP. The theoretical and clinical implications of these results were discussed.

Self-harm, suicidal ideation, and the positive symptoms of psychosis: Cross-sectional and prospective data from a national household survey.

BACKGROUND: Schizophrenia is associated with premature mortality, partly through increased suicide rates. AIMS: To examine (1) if persecutory ideas, auditory hallucinations, and probable cases of psychosis are associated with suicidal thoughts or attempts cross-sectionally and prospectively, and (2) if such links are mediated by specific affective factors (depression, impulsivity, mood instability). METHOD: We analysed the 2000, 2007, and 2014 British Adult Psychiatric Morbidity Surveys (APMS) separately. Measures of psychosis provided independent variables for multi-stage logistic regressions, with suicidal thoughts and attempts as dependent variables. We also conducted analyses to assess mediation by affective variables, and longitudinal analyses on a subset of the 2000 dataset. RESULTS: In every dataset, persecutory ideas, auditory hallucinations and probable psychosis were associated cross-sectionally with lifetime suicidal attempts and thoughts, even after controlling for confounders, with a single exception (persecutory ideation and suicide attempts were unconnected in APMS 2014). Cross-sectional associations between auditory hallucinations and suicidal phenomena were moderated by persecutory ideation. In the 2000 follow-up, initial persecutory ideas were associated with later suicidal thoughts (O.R. 1.77, p < 0.05); there were no other longitudinal associations. In the 2007 and 2014 datasets, mood instability mediated the effects of psychotic phenomena on suicidality more strongly than impulsivity; depression was also an important mediator. There were appreciable direct effects of positive symptoms on suicidal thoughts and behaviour. CONCLUSIONS: Improving psychotic symptoms and ameliorating co-morbid distress may in itself be effective in reducing suicidal risk in schizophrenia. Given their potential mediating role, mood instability and depression may also be targets for intervention.

Phantom Phone Signal: why it should be of interest for psychiatry.

Phantom Phone Signal (PPS) refers to the false perception of a mobile phone ringing, vibrating and blinking, when in fact it did not. A recent literature about PPS is growing, parallel to an increasing interest about its possible psychopathological implications. The present review aims to synthesize the current knowledge about the phenomenon, and to present a conceptual framework that integrates PPS as a putative index of psychopathology. Furthermore, we propose possible directions for further research. The phenomenon seems highly prevalent, irrespective of age and gender, although estimates are still inconsistent. We have analysed possible factors associated to PPS, disentangling them in person-related (i.e. characteristics of individuals who experience PPS) and phone use-related factors (i.e., time spent using the phone, time of the mobile in vibrating mode, the carrying location of the device, average number of call/message in a day, etc). Literature regarding the association between PPS and mental illness is limited, as most of the samples are not clinical and too sectorial. Preliminary data suggest that anxiety/depression and stress-related problems seem to be the psychopathological background favouring the experience of PPS. Despite PPS is a common phenomenon, it usually do not seem to significantly impact the people's quality of life. However, they deserve attention, given the huge diffusion of phone mobiles, particularly in children and adolescents, as it may be an index for emotional or stress-related difficulties. Future studies are needed to better clarify its frequency and its possible impact on everyday life. Studies in clinical samples may further clarify its psychopathological implications.

Association between anorexia nervosa and other specified eating or feeding disorders and paranoia in adolescents: what factors are involved?

INTRODUCTION: In eating disorders, the association with other psychiatric symptoms is of particular interest. The association between anorexia nervosa and psychotic symptoms is less studied than that with affective disorders (anxiety/depression). The aim of this study is to describe a psychotic symptom (paranoia) in adolescents with anorexia nervosa looking at several potential explicative associated factors: eating disorder symptoms, body image concerns, depression and social anxiety. Our hypothesis is that paranoia in anorexia nervosa patients is better explained by the concomitant depression and social anxiety symptoms than the core symptoms of the disease (eating disorder symptoms or body image concerns). METHODS: This is a retrospective study. Consecutive, help-seeking adolescents, admitted to the Eating Disorder Service of the Integrated Pediatric Care Department, Luigi Vanvitelli University Hospital, constituted the sample. Data was obtained through retrospective collection of clinical interviews and self-report questionnaires, used for the routine assessment of these patients, administered by trained and expert child and adolescent psychiatrists, they were the Eating Attitude Test-26 (EAT-26), the Body Uneasiness Test-A (BUT-A), the Children Depression Inventory (CDI), the Liebowitz Social Anxiety Scale-Children and Adolescents (LSAS-CA) and the paranoia subscale of the Specific Psychotic Experiences Questionnaire (SPEQ). RESULTS: We obtained data from 92 adolescents with anorexia nervosa and other specified feeding or eating disorder (OSFED). Our regression model explained that paranoia (SPEQ-paranoia subscale) in this population was better explained by depression (CDI) (coefficient= 0.415 SD: 0.210, p=0.052) and social anxiety symptoms (LSAS-CA) (coefficient= 0.253 SD: 0.060; p<0.001) than eating disorder symptoms (EAT-26) (coefficient= 0.092 SD: 0.107; p=0.398) and body image concerns (BUT-A) (coefficient= 1.916 SD: 2.079; p=0.359). CONCLUSIONS: This study has some theoretical, clinical and treatment implications. It is important to carrying out screening for the presence of psychotic symptoms in patients with eating or feeding disorders. These symptoms and associated factors (depression and social anxiety) may complicate the clinical picture of the disease with the need, in certain cases, of psychopharmacological drugs and, among these, anti-psychotics. Finally in the psychotherapy context, paranoid ideas may be subject of treatment for patient with anorexia nervosa.

Emotional symptoms and their related factors in adolescents during the acute phase of Covid-19 outbreak in South Italy.

BACKGROUND: Several studies have shown that during COVID-19 pandemic outbreak, emotional symptoms increased in the general population. Less is known about youths. METHODS: We surveyed a sample of Italian adolescents during the strictest quarantine period and assessed the effects of socio-demographic and psychological factors on current emotional symptoms. A convenient sample of 326 adolescents (age range 14-19 years) participated in a web-based survey. We collected data on several socio-demographic and psychological variables (summarized into three indexes: environmental context, changes in lifestyle, and worries about infection) and psychopathological symptoms (previous psychopathological status, current anxiety and depressive symptoms). RESULTS: Descriptive analysis showed that adolescents have experienced quarantine under very different conditions; they reported 47.5 and 14.1% of anxiety and depressive symptoms, respectively. Regression analyses indicated that previous psychopathological status and worries about infection are linked to anxiety and that female gender, previous psychopathological status (moderated by change in lifestyle), worse environmental context are linked to depression. CONCLUSION: This study indicates that, facing the COVID-19 pandemic and its related safety measures, adolescents show relevant emotional symptoms and therefore should be monitored, assessed and supported.

Vitamin D deficiency is not related to eating habits in children with Autistic Spectrum Disorder.

BACKGROUND AND AIMS: Autism Spectrum Disorder (ASD) is characterized by the impairment of communication and social interaction and by repetitive, restricted and stereotyped interests. ASD is often accompanied by comorbidities; eating disorders are frequent and imply important nutritional deficits (i.e. deficiencies of vitamins, minerals and fatty acids). Vitamin D has a critical role in neurodevelopment and serum levels in ASD are reported inadequate. A useful reference for setting up a correct diet in childhood is the food pyramid, which is inspired by the Mediterranean Diet (MD). The MD guarantees an intake of nutrients, considered optimal to maintain an adequate nutritional status. The aim of this study is to explore serum levels of Vitamin D and food habits (through MD adherence) in a sample of children with ASD and evaluate a possible correlation between these factors. METHODS: study participants include 91 children 47 presenting ASD and 44 healthy typically-developing (TD) subjects, as control group. We evaluated serum level of Vitamin D in both group; anthropometric parameters (weight, height, body mass index-BMI-and growth percentile) and MD adherence have been explored, in order to investigate the correlation among those data and level of Vitamin D in children with ASD. Lastly, the association between Vitamin D levels and severity of ASD symptoms has been analysed. RESULTS AND CONCLUSION: 74% of ASD group presented blood levels of Vitamin D under 30 ng/ml (normal range 30-100 ng/ml). The analysis performed showed that the two groups were significant different regards Vitamin D levels (t = 2.24, p < 0.05), according to literature. 31.9% of children with ASD presented a condition of overweight and 12.6% a condition of obesity. Adherence to the MD was low in 25.5% of cases. No significant statistical correlation has been found between Vitamin D serum levels, anthropometric parameters and the adherence to MD in the ASD group.

Details of the Contents of Paranoid Thoughts in Help-Seeking Adolescents with Psychotic-Like Experiences and Continuity with Bullying and Victimization: A Pilot Study.

Background: Psychosis recognizes an interaction between biological and social environmental factors. Adversities are now recognized to be consistently associated with psychotic-like experiences (PLEs). The purpose of this study was to describe the contents of paranoid symptoms and to focus on their relationship with bullying and victimization in help-seeking adolescents. Methods: Help-seeking adolescents who screened positive for PLEs participated in the study. They performed a battery self-report questionnaire for data collection (paranoia: the Specific Psychotic Experiences Questionnaire (SPEQ); the content of paranoid thoughts: the Details of Threat (DoT); bullying victimization: the Multidimensional Peer Victimization Scale (MPVS); depression: the Children's Depression Inventory (CDI); and anxiety: the Multidimensional Anxiety Scale (MASC)). Results: The participants were 50 adolescents (52% female; mean age: 170 months). The contents of their paranoid symptoms were related to victimization and, in particular, the certainty of threats was correlated with physical (0.394, p < 0.01) and verbal bullying (0.394, p < 0.01), respectively. The powerfulness of the threats correlated with verbal victimization (0.295, p < 0.05). The imminence of the threats was linked to verbal (0.399, p < 0.01) victimization. Hours under threat correlated with verbal (0.415, p < 0.01) victimization. The sureness of the threat had a moderate correlation with physical (0.359, p < 0.05) and verbal (0.443, p < 0.01) victimization, respectively. The awfulness of the threat was linked to social manipulation (0.325, p < 0.05). Conclusions: We described the content of the persecutory symptoms. The powerfulness, imminence, sureness, and awfulness of threats correlated with the level of physical, verbal and social manipulation victimization. Teachers and family must actively monitor early signs of bullying victimization, and school psychologists should promote preventive and therapeutic intervention. From a social psychiatry perspective, the prevention of bullying victimization is necessary.

Cyclothymic-hypersensitive temperament in youths: Refining the structure, the way of assessment and the clinical significance in the youth population.

BACKGROUND: Although a better understanding of the prodromes of affective disorders in youth has important clinical and research implications, empirical data are still unconclusive. Cyclothymic-hypersensitive temperament (CHT) has been linked to both depression and bipolarity, as well as to suicidality. Its conceptualization is still debated, as well as a comprehensive, psychometrically sound way of assessment. METHODS: factor structure, reliability, measurement invariance, convergent and divergent validity of the previously published CHT questionnaire (a youth version derived from Temperament Evaluation in Memphis Pisa and San Diego (TEMPS) was assessed in a school-based sample of 2959 students aged from 10 to 14 years (mean age = 11.8 ± 0.97 years). Furthermore, accuracy, sensitivity and specificity were calculated for a new cut-off score related to the presence of general psychopathology symptoms. RESULTS: CHT is better conceptualized in a two-correlated factors model, a moodiness/hypersensitiveness factor, more associated with internalizing symptoms, and an impulsiveness/emotional dysregulation factor, more associated with externalizing symptoms. The revised 22-items version of the CHT questionnaire with a cut-off score of 15 for females and 17 for males results accurate, sensitive and specific enough for the recognition of cyclothymic adolescents with clinical symptoms. LIMITATION: the cross sectional design and the self-report nature of the measures limit the findings. DISCUSSION: Cyclothymic-hypersensitive temperament is a relevant concept in the realm of affective disorder and can be reliably assessed in youths. It may describe youths with the coexistence of both internalizing and externalizing symptoms that can be difficult to diagnose with a DSM perspective.

Coping Power Universal for middle school students: The first efficacy study.

INTRODUCTION: The present study examined the efficacy of the universal prevention version of the Coping Power Program in reducing behavioral and emotional problems and in promoting prosocial behaviors in middle-school classrooms. METHODS: The study used a randomized control study design; and the sample included 839 middle-school Italian youths (411 males), attending 40 middle-school classrooms. The students were in seventh or eighth grade, and they had an average age of 13.24 years (SD = .65; range 12-14 years). Ninety students were Africans, the rest were Caucasian. Teachers and parents completed the Strengths and Difficulties Questionnaire, before and after intervention. We used the 24-session universal prevention adaptation of Coping Power, which aims to improve children's emotional regulation and social problem-solving skills. RESULTS: Linear mixed models and effect sizes indicated that behaviors improved as a result of the Coping Power intervention. Specifically, the program was effective in reducing internalizing problems and increasing prosocial behaviors. CONCLUSIONS: The Coping Power Universal effectively adapts an existing evidence-based program, and is believed to be a useful strategy also to improve social emotional skills in middle-school students.

A glance into psychiatric comorbidity in adolescents with anorexia nervosa.

BACKGROUND: Eating disorders display several psychiatric comorbidities. The aim of this study was to describe these comorbidities in a group of adolescent patients with anorexia nervosa or OSFED (Other Specified Feedind or Eating Disorder). We have evaluated the comorbidity both with a clinical interview (categorical comorbidities) and with a self-report interview (dimensional comorbidities) in order to compare the two profiles. METHODS: The study was carried out at the Division of Child and Adolescent Psychiatry (eating disorder service for developmental age) of the Luigi Vanvitelli University of Campania (ex Second University of Naples). Data were collected retrospectively from chart review, routinely gathered during the clinical assessment. RESULTS: Seventy-two subjects constituted the sample, 62 (86.1%) were female and 10 (13.9%) male. The most frequent categorical comorbidities were social anxiety disorder (SS: 38; 52.8%), Depression disorder (SS: 30; 41.7%) and generalized anxiety disorder (SS: 14; 19.4%). The mean scores at dimensional questionnaires were 15.5 (SD: 10.7) for the depression (Children Depression Inventory) and 34.8 (SD: 28.3) for social anxiety (Liebowitz Social Anxiety Scale). CONCLUSIONS: Data analysis showed that social anxiety and depression were the most common categorical comorbidities in young patients with eating disorders. However, comparing the data from the clinical interview with those of the self-interviews revealed that patients well recognize social anxiety symptoms, but tend to deny depressive ones.

Attempting to disentangle the relationship between impulsivity and longitudinal self-harm: Epidemiological analysis of UK household survey data.

BACKGROUND: Impulsivity may be an important risk factor in terms of future self-harm. However, the extent of this, whether it may relate to self-harm that is new in onset and/or repetition of self-harm, and the detail of any interaction with mood instability (MI) and childhood sexual abuse (CSA) requires detailed examination. AIMS: We used the 2000 Adult Psychiatry Morbidity Survey and an 18-month follow-up data to test hypotheses relating to the role of impulsivity, CSA and MI in the inception and persistence of self-harm. METHODS: We assessed associations of impulsivity with (1) suicidal self-harm (SSH) and (2) non-SSH (NSSH) at baseline and follow-up, controlling for confounders including MI. Finally, we tested whether impulsivity mediated the relationship between CSA and self-harm. RESULTS: A total of 8,580 respondents were assessed at baseline and 2,406 at follow-up as planned. Impulsivity significantly predicted emergence of new NSSH at 18-month follow-up even after adjustment for MI and other confounders. Impulsivity did not significantly predict repetition of NSSH, or repetition or new inception of SSH, even before inclusion of MI in the model. However, the absolute numbers involved were small. Cross-sectionally, impulsivity was a stronger mediator of the link between CSA and SSH (13.1%) than that between CSA and NSSH (4.8%). CONCLUSION: Impulsivity may increase the risk of future development of NSSH independently of MI, which is clinically important for risk assessment. The involvement of impulsivity in the repetition of self-harm generally appears less certain. However, impulsivity may have a role in SSH in the context of previous CSA.

Epidemiological pattern of bullying using a multi-assessment approach: Results from the Bullying and Youth Mental Health Naples Study (BYMHNS).

BACKGROUND: Bullying is a widespread phenomenon that has captured attention from mental health researchers. Several studies have assessed bullying prevalence with some methodological concerns. OBJECTIVES: Preliminary, we analyzed the psychometric properties of two bullying scales for victimization (the multidimensional peer victimization scale - MPVS) and for perpetration (the bully subscale of the Illinois bully scale - IBS-B); then, we estimated bullying prevalence; finally, we evaluated the effect of gender and classroom on the phenomenon. PARTICIPANTS AND SETTING: 2959 students from the metropolitan city of Naples constituted the sample. METHODS: Data collection was obtained using a multi-assessment approach that included both single-item questions and intensity scales in order to compare the two methods. RESULTS: The two scales resulted valid and showed good reliability. The MPVS displayed a 1-factor second order model. The IBS-B had a mono-factorial structure. Both showed full invariance for gender and classroom. Prevalence of victimization was 37% whereas that for perpetration was 21%. As expected we obtained several bullying prevalence results depending on the specificity of questions and in particular repetitiveness of episodes. There was a good correspondence between results of single-item questions and multi-item scales. Finally results demonstrated several differences for gender and classroom attended. CONCLUSION: In this epidemiological study the multi-assessment approach identified different but complementary features of bullying phenomena. The use of the two measurement approaches allowed us to obtain more precise and exhaustive information on bullying prevalence and compare it with previous findings.

Phantom Phone Signals in youths: Prevalence, correlates and relation to psychopathology.

The term Phantom Phone Signals (PPS) refers to the perception of a mobile phone ringing, vibrating and blinking when in fact it did not. Data in youth are lacking, and controversies exist on whether PPS is related to psychopathology. In the present study, we showed data on the prevalence of PPS in a population (N = 2959) of students aged 10 to 14 years. We also explored the possible association between PPS and emotional or behavioural problems. Our results showed that PPS is a relatively common phenomenon with a prevalence rate of 58.9%, being more frequent in females. In univariate and multivariate analyses, we also found an association between the presence of PPS and emotional problems and temper tantrums, after accounting for relevant covariates. PPS is a relevant phenomenon to be considered in youth. It is common and may be a signal for emotional problems.

Putative Mechanisms of Action and Clinical Use of Lithium in Children and Adolescents: A Critical Review.

BACKGROUND: Lithium is a first-line treatment for bipolar disorder in adults, but its mechanism of action is still far from clear. Furthermore, evidences of its use in pediatric populations are sparse, not only for bipolar disorders, but also for other possible indications. OBJECTIVES: To provide a synthesis of published data on the possible mechanisms of action of lithium, as well as on its use in pediatric samples, including pharmacokinetics, efficacy, and safety data. METHODS: Clinical trials in pediatric samples with at least one standardized measure of efficacy/ effectiveness were included in this review. We considered: i) randomized and open label trials, ii) combination studies iii) augmentation studies iv) case series including at least 5 patients. RESULTS: Different and non-alternative mechanisms of action can explain the clinical efficacy of lithium. Clinical studies in pediatric samples suggest that lithium is effective in managing manic symptoms/episodes of bipolar disorder, both in the acute phase and as maintenance strategy. Efficacy on depressive symptoms/phases of bipolar disorder is much less clear, while studies do not support its use in unipolar depression and severe mood dysregulation. Conversely, it may be effective on aggression in the context of conduct disorder. Other possible indications, with limited published evidence, are the acute attacks in Kleine-Levin syndrome, behavioral symptoms of X-fragile syndrome, and the management of clozapine- or chemotherapy- induced neutropenia. Generally, lithium resulted relatively safe. CONCLUSIONS: Lithium seems an effective and well-tolerated medication in pediatric bipolar disorder and aggression, while further evidences are needed for other clinical indications.

Differences in Metabolic Factors Between Antipsychotic-Induced Weight Gain and Non-pharmacological Obesity in Youths.

BACKGROUND: Youth exposed to antipsychotics may experience several metabolic consequences that often limit the effectiveness of this class of drugs. OBJECTIVES: The aim of this study was to compare several metabolic markers between subjects who experienced antipsychotic-induced weight gain and untreated obese patients. METHODS: Nineteen non-diabetic youth (mean age 159 months, mean body mass index z-score 1.81) experiencing antipsychotic-induced weight gain and an age-, sex-, and body mass index-matched group of non-diabetic obese patients with no record of treatment (n = 19, mean age 147 months, mean body mass index z-score 2) were compared for a wide range of metabolic factors using a Bioplex Multiplex system. RESULTS: C-peptide, glucose-dependent insulinotropic polypeptide, and adipsin were significantly higher in the antipsychotic-induced weight gain group, whereas visfatin was significantly higher in the untreated obese patients. When age, sex, pubertal status, and body mass index were controlled, C-peptide, glucose-dependent insulinotropic polypeptide, and visfatin remained significant, whereas adipsin fell slightly below the threshold of statistical significance. No other statistically significant difference emerged. CONCLUSIONS: Antipsychotic-induced weight gain and untreated obesity showed some similarities, confirming that levels of some hormones, such as leptin and ghrelin, are related to body mass index rather than to antipsychotic exposure. Some differences were also noted; for example, the antipsychotic-induced weight gain group displayed higher C-peptide, glucose-dependent insulinotropic polypeptide, and adipsin, which may reflect ß-cell stress and may suggest susceptibility to insulin resistance and lower visfatin, possibly indicating a lower inflammatory status.

Psychotic-like experiences in help-seeking adolescents: Dimensional exploration and association with different forms of bullying victimization - A developmental social psychiatry perspective.

BACKGROUND: Psychotic-like experiences (PLEs) are common in the general population and increase the risk of psychotic disorders. Adolescents are a high-risk group of this condition. Stressful events, such as bullying, have a role in the onset of PLEs. This study has several aims: (1) to assess PLEs in adolescents seeking help from a Child and Adolescent Mental Health Service, (2) to assess the association of PLEs with specific bullying victimization and (3) to assess difference in PLEs and victimizations by sex and age. METHODS: Participants were help-seeking (HS) adolescents initially screened for PLEs. They completed an assessment including characteristics of PLEs and bullying victimization. We paid particular attention to different kinds of PLEs and victimization. RESULTS: In total, 50 PLE-positive adolescents screened from 324 HS adolescents (15.4%) constituted the sample. Paranoia and verbal bullying were the PLEs and form of victimization most represented, respectively. Verbal bullying was strongly associated with paranoia (odds ratio (OR): 4.40, confidence interval (CI): 2.8-5.9, p < .001). Results remained significant after controlling for confounder (socio-demographic, anxiety, depression and for the latter analysis also other forms of victimization). Furthermore, social manipulation showed a strong association of paranoia and physical bullying with grandiosity. Verbal bullying was also associated with psychotic negative symptoms, but controlling for emotional symptoms and other victimization led to a reduction in the effect. Men were more involved in physical victimization and experienced grandiosity; on the contrary, late adolescents were most involved in social victimization and negative psychotic symptoms Conclusion: PLEs are relevant in HS adolescents. Bullying victimization interacts with the onset of these phenomena. In particular, verbal bullying predicted paranoia onset significantly.

Conduct disorders and psychopathy in children and adolescents: aetiology, clinical presentation and treatment strategies of callous-unemotional traits.

Conduct Disorder (CD) is a psychiatric diagnosis characterized by a repetitive and persistent pattern of behaviour in which the basic rights of others and major age-appropriate social norms or rules are violated. Callous Unemotional (CU) traits are a meaningful specifier in subtyping CD for more severe antisocial and aggressive behaviours in adult psychopathology; they represent the affective dimension of adult psychopathy, but they can be also detected in childhood and adolescence. The CU traits include lack of empathy, sense of guilt and shallow emotion, and their characterization in youth can improve our diagnostic, prognostic and therapeutic abilities. A strong genetic liability, in interaction with parenting and relevant environmental factors, can lead to elevated levels of CU traits in children. We pointed out that CU traits can be detected in early childhood, may remain stable along the adolescence, but a decrease following intensive and specialized treatment is possible. We here provide a narrative review of the available evidences on CU traits in three main domains: aetiology (encompassing genetic liability and environmental risk factors), presentation (early signs and longitudinal trajectories) and treatments.