19 results on '"Milone, Annarita"'
Search Results
2. Emotional Dysregulation and Sleep Problems: A Transdiagnostic Approach in Youth.
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Sesso, Gianluca, Guccione, Fulvio, Pisano, Simone, Valente, Elena, Narzisi, Antonio, Berloffa, Stefano, Fantozzi, Pamela, Viglione, Valentina, Milone, Annarita, and Masi, Gabriele
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SLEEP quality ,PATHOLOGICAL psychology ,INTERNALIZING behavior ,EMOTION regulation ,COGNITIVE ability ,SLEEP ,SLEEP interruptions - Abstract
Background: Sleep is a complex phenomenon that affects several aspects of life, including cognitive functioning, emotional regulation, and overall well-being. Sleep disturbances, especially during adolescence, can negatively impact emotional regulation, making it a critical factor in targeting psychopathology. Methods: This study explores the interplay between emotional dysregulation (ED) and sleep patterns in a sample of 90 adolescent patients by means of self- and parent-rated clinical measures. Results: Our findings reveal a bidirectional relationship between ED and sleep problems. Adolescents with higher affective instability experience poorer sleep quality, while those with worse sleep quality exhibit higher internalizing problems. Additionally, emotional reactivity is associated with disrupted circadian rhythms. Conclusions: These results emphasize the significance of addressing sleep problems in the context of psychopathology treatment, potentially leading to improved outcomes. Further research is needed to determine the most effective treatment strategies, including nonpharmacological and pharmacological interventions. Understanding the intricate relationship between sleep problems and emotion regulation offers insights for more targeted and effective treatment approaches for youths struggling with ED. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Adolescent selfie: an Italian Society of Paediatrics survey of the lifestyle of teenagers
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Smorti, Martina, Milone, Annarita, Gonzalez Gonzalez, José, and Vitali Rosati, Giovanni
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- 2019
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4. Persistent Non-Suicidal Self-Injury and Suicidality in Referred Adolescents: A Longitudinal Study Exploring the Role of Cyclothymic Temperament.
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Masi, Gabriele, Pisano, Simone, Sesso, Gianluca, Mazzullo, Cristina, Berloffa, Stefano, Fantozzi, Pamela, Narzisi, Antonio, Placini, Francesca, Valente, Elena, Viglione, Valentina, and Milone, Annarita
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SELF-injurious behavior ,SUICIDAL ideation ,SUICIDAL behavior ,ATTEMPTED suicide ,TEMPERAMENT - Abstract
Non-suicidal self-injury (NSSI) is deliberate harm to the body surface without suicidal intent, though it may be a predictor of suicide attempts. Our aim was to test the hypothesis that persisting and recovering NSSI may have a different longitudinal risk for suicidal ideation and behavior and that the intensity of Cyclothymic Hypersensitive Temperament (CHT) may increase this risk. Fifty-five patients (mean age 14.64 ± 1.77 years) referred for mood disorders according to the DSM-5 were consecutively recruited and followed-up for a mean of 19.79 ± 11.67 months and grouped according to the presence/absence of NSSI at baseline and follow-up into three groups: without NSSI (non-NSSI; n = 22), with NSSI recovered at follow-up (past-NSSI; n = 19), and with persistent NSSI at follow-up (pers-NSSI; n = 14). At follow-up, both NSSI groups were more severely impaired and failed to improve internalizing problems and dysregulation symptoms. Both NSSI groups reported higher scores in suicidal ideation compared to non-NSSI, but only pers-NSSI presented higher scores in suicidal behavior. CHT was higher in pers-NSSI, followed by past-NSSI and then by non-NSSI. Our data support a continuity between NSSI and suicidality, and they suggest the prognostic validity of persistent NSSI, associated with highest CHT scores. [ABSTRACT FROM AUTHOR]
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- 2023
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5. A novel multidimensional questionnaire for the assessment of emotional dysregulation in adolescents: Reactivity, Intensity, Polarity and Stability questionnaire-youth version (RIPoSt-Y).
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Sesso, Gianluca, Milone, Annarita, Drago, Flavia, Viglione, Valentina, Berloffa, Stefano, Boldrini, Silvia, Loriaux, Nina, Valente, Elena, Molesti, Agnese, Placini, Francesca, Montesanto, Anna Rita, Pisano, Simone, and Masi, Gabriele
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TEENAGERS , *QUESTIONNAIRES , *ADOLESCENT psychiatry , *TEST validity , *GENDER - Abstract
Background: The failure to regulate emotions, namely emotional dysregulation (ED), is a relevant construct in adolescent psychiatry, in terms of prognostic and developmental implications. We developed and validated a novel self-report questionnaire for the assessment of ED, the RIPoSt-Y, both in clinical and non-clinical samples.Methods: Items selection and subscales construction were conducted on healthy controls (n=374), while test-retest reliability was evaluated in a subsample (n=72); internal consistency was examined both in the control group and in two clinical samples, respectively including patients with Bipolar Spectrum Disorders (BSD; n=44) and ADHD (n=34). Construct, concurrent and convergent validity were also assessed.Results: Thirty-one items were finally retained, and three subscales were identified (Affective Instability, Emotional Reactivity, Interpersonal Sensitivity). Test-retest was significant for each subscale with moderate-to-good correlations, and internal consistency showed good-to-excellent coefficients. Construct validity was supported by significant differences between patients and controls and gender-related differences. Concurrent validity was confirmed through significant associations with two subscales of the CHT-Q, while convergent validity proved to be significant with the CBCL/YSR dysregulation-profile. Cut-offs were also computed to discriminate clinically significant scores of ED.Limitations: The use of a school-based survey to recruit controls could have biased our results; gender distributions between clinical and non-clinical samples were significantly different.Conclusions: Our novel questionnaire proved to be a valid and reliable tool able to assess the presence of ED in youths and to characterize this fundamental construct in its multidimensional facets. [ABSTRACT FROM AUTHOR]- Published
- 2021
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6. An Exploratory Study of Emotional Dysregulation Dimensions in Youth With Attention Deficit Hyperactivity Disorder and/or Bipolar Spectrum Disorders.
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Masi, Gabriele, Sesso, Gianluca, Pfanner, Chiara, Valente, Elena, Molesti, Agnese, Placini, Francesca, Boldrini, Silvia, Loriaux, Nina, Drago, Flavia, Montesanto, Anna Rita, Pisano, Simone, and Milone, Annarita
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ATTENTION-deficit hyperactivity disorder ,BIPOLAR disorder ,CHILD Behavior Checklist ,MENTAL illness - Abstract
Emotional dysregulation (ED) is currently the most frequently used term to describe children with an impaired regulation of emotional states. Recent research studies speculate whether ED may be a neurodevelopmental disorder itself, a shared risk factor, or a common key feature of several psychiatric disorders, including, among others, attention deficit hyperactivity disorder (ADHD), and bipolar spectrum disorders (BSD). The association between ADHD and ED is one of the main reasons of misconceptions in the definition of boundaries between ADHD and BSD, leading to the frequent misdiagnosis of ADHD as BSD. Since ED is a multidimensional concept, a novel instrument—the Reactivity, Intensity, Polarity and Stability (RIPoSt) scale—was recently developed to assess the different dimensions of ED, which could help in detecting specific ED profiles in clinical youths. Our study included 154 patients, aged 13.8 ± 2.3 years, diagnosed with either ADHD, BSD, or comorbid condition, and a school-based sample of 40 healthy control (HC) adolescents, aged 12.5 ± 1.2 years. The RIPoSt scale and the Child Behavior Checklist were administered to both groups. Our results indicate that affective instability and negative emotionality subscales, as well as negative emotional dysregulation, are higher in BSD, both pure and comorbid with ADHD, while emotional impulsivity is higher in the comorbid condition and similar in the ADHD and BSD alone group; all clinical groups scored higher than HC. Conversely, positive emotionality is similar among clinical groups and within them and HC. Our findings also support the validity of the RIPoSt questionnaire, since the instrument proved to have good-to-excellent internal consistency, and strongly significant positive correlations were found with the CBCL-Dysregulation Profile, which is a commonly used, indirect measure of ED. Hence, the five subscales of the RIPoSt can be reliably used as an effective tool to study the emotional dysregulation in different clinical conditions, to help disentangle the complex relationship between ADHD and juvenile BSD and to provide clinicians with crucial evidence for better diagnostic characterization and therapeutic indications. [ABSTRACT FROM AUTHOR]
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- 2021
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7. Lithium treatment in bipolar adolescents: a follow-up naturalistic study.
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Masi, Gabriele, Milone, Annarita, Scrinzi, Giulia, Mucci, Maria, Viglione, Valentina, Bruni, Gabriella, Berloffa, Stefano, and Pisano, Simone
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BIPOLAR disorder in adolescence , *THERAPEUTIC use of lithium , *CREATININE , *THYROTROPIN , *ELECTROCARDIOGRAPHY - Abstract
Background: Although lithium is currently approved for the treatment of bipolar disorders in youth, long term data, are still scant. The aim of this study was to describe the safety and efficacy of lithium in referred bipolar adolescents, who were followed up at the 4th (T1) and 8th (T2) month of treatment.Methods: The design was naturalistic and retrospective, based on a clinical database, including 30 patients (18 males, mean age 14.2±2.1 years).Results: Mean blood level of lithium was 0.69±0.20 mEq/L at T1 and 0.70±0.18 mEq/L at T2. Both Clinical Global Impression-Severity (CGI-S) and Children Global Assessment Scale (C-GAS) scores improved from baseline (CGI-S 5.7±0.5, C-GAS 35.1±3.7) to T1 (CGI-S 4.2±0.70, C-GAS 46.4±6.5; P<0.001), without significant differences from T1 to T2. Thyroid-stimulating hormone significantly increased from 2.16±1.8 mU/mL at baseline to 3.9±2.7 mU/mL at T2, remaining within the normal range, without changes in T3/T4 levels; two patients needed a thyroid hormone supplementation. Creatinine blood level did not change. No cardiac symptoms and electrocardiogram QTc changes occurred. White blood cell count significantly increased from 6.93±1.68 103/mmc at baseline to 7.94±1.94 103/mmc at T2, and serum calcium significantly increased from 9.68±0.3 mg/dL at baseline to 9.97±0.29 mg/dL at T2, both remaining within the normal range; all the other electrolyte levels were stable and normal during the follow-up. The treatment with lithium was well tolerated, probably due to the relatively low lithium blood levels. Gastrointestinal symptoms (16.7%), sedation (9.7%) and tremor (6.4%) were the most frequently reported side effects.Conclusion: Lithium was effective and safe in adolescent bipolar patients followed-up for eight months. [ABSTRACT FROM AUTHOR]
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- 2018
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8. Non suicidal self-injury in referred adolescents with mood disorders and its association with cyclothymic-hypersensitive temperament.
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Masi, Gabriele, Milone, Annarita, Montesanto, Anna Rita, Valente, Elena, and Pisano, Simone
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SELF-mutilation , *SUICIDE risk factors , *PATHOLOGICAL psychology , *AFFECTIVE disorders , *DISEASES in teenagers , *SUICIDAL behavior , *MENTAL depression , *BIPOLAR disorder , *SELF-injurious behavior , *SEX distribution , *TEENAGERS' conduct of life , *TEMPERAMENT , *SUICIDAL ideation , *CROSS-sectional method , *PSYCHOLOGICAL factors , *PSYCHOLOGY - Abstract
Background: Non suicidal self-injuries (NSSIs) are deliberate self-harm behaviors without suicidal intent, usually starting in adolescence, with increasing rates of occurrence both in epidemiological and clinical samples. Several studies associated cyclothymic-hypersensitive temperament (CHT) with self-harm behaviors and suicidal risk. Aim of this study is to explore the association between NSSIs and CHT in a clinical sample of adolescents. We hypothesized that CHT may differentiate NSSI from non-NSSI adolescents with mood disorders, when other psychopathological features are controlled for.Methods: A consecutive sample of 89 adolescents with mood disorders were assessed for presence and phenomenology of NSSIs, CHT, demographics, comorbid categorical psychiatric diagnoses, dimensional psychopathology, impairment and previous suicide attempts.Results: NSSIs were reported in 52% of the sample, with higher rates in females and in bipolar disorder. Regression analyses showed that CHT, but not age, gender, bipolar vs depression diagnosis, functional impairment, was associated with NSSIs.Discussion: CHT may be in close association with NSSIs in adolescents with mood disorders. An assessment of CHT in adolescents referred for mood disorder may help to detect specific psychological features of NSSIs, which may improve diagnostic and treatment strategies.Limitations: Given the cross-sectional design, a developmental relation between CHT and NSSIs cannot be determined. The small sample size and the selection bias of severely impaired patients limit the generalization of the results. More sophisticated measures of CHT may consent to explore other dimensions of the cyclothymic construct (i.e., emotional intensity, emotional reactivity, emotional stability, positive vs. negative emotions, interpersonal sensitivity, impulsivity). [ABSTRACT FROM AUTHOR]- Published
- 2018
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9. Conduct disorders and psychopathy in children and adolescents: aetiology, clinical presentation and treatment strategies of callous-unemotional traits.
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Pisano, Simone, Muratori, Pietro, Gorga, Chiara, Levantini, Valentina, Iuliano, Raffaella, Catone, Gennaro, Coppola, Giangennaro, Milone, Annarita, and Masi, Gabriele
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BEHAVIOR disorders in children ,ANTISOCIAL personality disorders ,PARENT-child relationships ,PATHOLOGICAL psychology ,EARLY intervention (Education) ,EARLY diagnosis ,ADOLESCENCE ,CHILDREN ,DIAGNOSIS ,THERAPEUTICS - Abstract
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. [ABSTRACT FROM AUTHOR]
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- 2017
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10. Update on the safety of second generation antipsychotics in youths: a call for collaboration among paediatricians and child psychiatrists.
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Pisano, Simone, Catone, Gennaro, Veltri, Stefania, Lanzara, Valentina, Pozzi, Marco, Clementi, Emilio, Iuliano, Raffaella, Riccio, Maria Pia, Radice, Sonia, Molteni, Massimo, Capuano, Annalisa, Gritti, Antonella, Coppola, Giangennaro, Milone, Annarita, Bravaccio, Carmela, and Masi, Gabriele
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PREVENTION of drug side effects ,ANTIPSYCHOTIC agents ,INTERPROFESSIONAL relations ,TYPE 2 diabetes ,PATIENT monitoring ,PATIENT safety ,PEDIATRICIANS ,PSYCHIATRISTS - Abstract
During the past decade, a substantial increase in the use of second generation antipsychotics (SGAs) has occurred for a number of juvenile psychiatric disorders, often as off-label prescriptions. Although they were thought to be safer than older, first generation antipsychotics, mainly due to a lower risk of neurological adverse reactions, recent studies have raised significant concerns regarding their safety regarding metabolic, endocrinological and cardiovascular side effects. Aim of this paper is to update with a narrative review, the latest findings on safety of SGAs in youths. Results suggest that different SGAs may present different safety profiles. Metabolic adverse events are the most frequent and troublesome, with increasing evidences of heightened risk for type II diabetes mellitus. Results are discussed with specific emphasis on possible strategies of an active monitoring, which could enable both paediatricians and child psychiatrists to a possible prevention, early detection, and a timely management of such effects. [ABSTRACT FROM AUTHOR]
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- 2016
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11. Efficacy of a multimodal treatment for disruptive behavior disorders in children and adolescents: Focus on internalizing problems.
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Masi, Gabriele, Milone, Annarita, Paciello, Marinella, Lenzi, Francesca, Muratori, Pietro, Manfredi, Azzurra, Polidori, Lisa, Ruglioni, Laura, Lochman, John E., and Muratori, Filippo
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TREATMENT of behavior disorders in children , *COMBINED modality therapy , *TREATMENT effectiveness , *ANXIETY , *COMMUNITY mental health services - Abstract
Disruptive Behavior Disorders (DBDs) are among the most common reasons for youth referrals to mental health clinics. Aim of this study is to compare short and medium term efficacy of a multimodal treatment program (MTP), compared to community care (treatment-as-usual, TAU). The sample included 135 youths with DBDs (113 males, age range 9-15 years, mean age 12±2.5 years) were assigned either to a MTP (n=64), or addressed to community care for a TAU (n=71). Outcome measures were the Child Behaviour Checklist (CBCL) and the Children's Global Assessment Scale (C-GAS). All subjects were assessed at the baseline (T0), after 1-year treatment (T1) and after a 2-year follow-up (T2). Compared with patients receiving TAU, youths in the MTP showed, both at T1 and T2, significantly lower scores on CBCL Externalizing Scale, Internalizing Scale, Anxious/Depressed, Social Problems, and Aggressive Behavior, and higher scores at the C-GAS. Improvement in Internalizing Scales was particularly evident, with a shift from the clinical to the non-clinical range. Rate of use of mental health services and scholastic failure were reduced in the MTP. It is suggested that the improvement of the Internalizing symptoms is a crucial component of the therapeutic process in this MTP. [ABSTRACT FROM AUTHOR]
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- 2014
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12. Olanzapine treatment in adolescents with severe conduct disorder
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Masi, Gabriele, Milone, Annarita, Canepa, Giovanna, Millepiedi, Stefania, Mucci, Maria, and Muratori, Filippo
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BEHAVIOR disorders , *DELINQUENT behavior , *ANTIPSYCHOTIC agents , *DRUG efficacy , *MEDICAL records - Abstract
Abstract: The most severe forms of conduct disorder (CD) are highly stable and disabling disorders, more likely to persist in time and to evolve into disruptive or antisocial behaviors. One crucial issue in the prognosis of these forms of CD is the high resistence to both non-pharmacological and pharmacological treatments, with antipsychotic drugs being frequently used in refractory cases. Aim of this study was: (1) to explore efficacy and tolerability of olanzapine treatment in adolescents with severe CD; (2) to identify predictors of olanzapine treatment outcome. This was a retrospective study, based on clinical records of the first 23 adolescents diagnosed as having a CD, diagnosed with a clinical interview (K-SADS), either pure or with comorbid diagnoses, and treated with olanzapine. All these patients did not respond satisfactorily to non-pharmacological intervention and to adequate dosages of mood stabilizers (lithium and/or valproate). The sample consisted of 16 males and seven females, 16 inpatients and seven outpatients (mean age 13.6 ± 1.9 years, range 11–17.2 years), followed-up for a period ranging from 6 to 12 months (mean 8.8 ± 2.7 months). Outcome measures included the Modified Overt Aggression Scale (MOAS), Clinical Global Impression-Improvement (CGI-I) and Children Global Assessment Scale (CGAS). During the follow-up, all patients were involved in non-pharmacological treatments (psychotherapy, family therapy, or day-hospital group treatments). Based on both an improvement of at least 50% at MOAS and a score 1 or 2 at CGI-I, 14 out of 23 patients (60.9%) were classified as responders at the end of the follow-up. Significant improvement at the last observation was found in MOAS (P < 0.001) and CGAS (P < 0.001) scores. Olanzapine dosage was 8 ± 3.2 mg/day (range 5–20 mg/day). Mean weight gain at the end of the follow-up was 4.6 ± 3 kg. The predictors of a positive treatment response was an impulsive-affective versus controlled-predatory type of aggression. Age at onset of CD and comorbid disorders did not affect treatment response. These preliminary findings suggest that olanzapine may improve behavior in adolescents with severe and treatment-refractory CD and impulsive aggression. [Copyright &y& Elsevier]
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- 2006
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13. Clozapine Treatment for Aggressive Behaviors in Youths with Neurodevelopmental Disorders.
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Berloffa, Stefano, Masi, Gabriele, Falcone, Francesca, Simonelli, Valerio, Narzisi, Antonio, Valente, Elena, Viglione, Valentina, Milone, Annarita, and Sesso, Gianluca
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Objectives: The aim of this study was to assess effectiveness and tolerability of Clozapine in the treatment of aggression in youth with Neurodevelopmental Disorders. Methods: Patients were consecutively admitted at our third-level university hospital with nationwide catchment from June 2018 to October 2022, and followed up to July 2023. Eligibility criteria were as follows: (1) Autism Spectrum Disorder (ASD) and/or Intellectual Disability/Borderline Cognitive Functioning, (2) behavioral dyscontrol with physical aggression; (3) age range between 8 and 18 years; (4) clinical indication for Clozapine treatment after at least two failed trials with other Second-Generation Antipsychotics (SGAs); (5) availability of an at least 6-month-long follow-up. To evaluate the response to Clozapine, we used the Clinical Global Impressions (CGI) rating scales (Clinical Global Impressions-Severity [CGI-S] and Clinical Global Impressions-Improvement [CGI-I]), the Children's Global Assessment Scale (CGAS), and the Aberrant Behavior Checklist (ABC). Results: Twenty-six children and adolescents (21 boys, age 13.47 ± 2.05 years, follow-up duration 9.77 ± 3.50 months) were included in the analysis. Clinical severity (CGI-S) and functional impairment (Clinical Global Assessment Scale) significantly improved, as well as the ABC Total Score and the scores in several subscales. Sixteen patients (61.54%) were responders (CGI-I ≤2), and 13 (50.00%) displayed remission of aberrant behaviors (ΔABC-Total >35), while response/remission condition was not affected by add-on medications and psychotherapy. Most frequent side effects were increased appetite (50.00%), sialorrhea (38.46%), and increased repetitive behaviors (26.92%). Two patients presented epileptic seizures, while no patients presented leucopoenia. Conclusions: Our results suggest that Clozapine may be helpful in ameliorating treatment-resistant aggression in youth with neurodevelopmental conditions. Possible pharmacological strategies for the management of most frequent side effects are also suggested. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Development of bipolar disorder in patients with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis of prospective studies.
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Brancati, Giulio Emilio, Perugi, Giulio, Milone, Annarita, Masi, Gabriele, and Sesso, Gianluca
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ATTENTION-deficit hyperactivity disorder , *BIPOLAR disorder , *LONGITUDINAL method , *TEENAGERS - Abstract
Background: Increasing attention has been recently paid to precursors of bipolar disorder (BD). Symptoms of attention-deficit/hyperactivity disorder (ADHD) have been reported among the most common prodromes of BD. The aim of this study was to estimate the risk of BD in youths affected by ADHD based on prospective studies.Methods: A systematic review was conducted according to the PRISMA guidelines. A meta-analysis of single proportions was performed to compute the overall occurrence of BD in ADHD individuals. Binary outcome data were used to calculate risk estimates of BD occurrence in ADHD subjects versus Healthy Controls (HC).Results: An overall proportion of BD occurrence of 10.01% (95%-confidence interval [CI]: 6.47%-15.19%; I2 = 82.0%) was found among 1248 patients with ADHD over 10 prospective studies. A slightly higher proportion was found when excluding one study based on jack-knife sensitivity analysis (11.96%, 95%-CI: 9.15%-15.49%; I2 = 54.1%) and in three offspring studies (12.87%, 95%-CI: 8.91%-18.23%). BD occurrence was not significantly associated with mean follow-up duration (p-value = 0.2118). A greater risk of BD occurrence in ADHD versus HC from six studies was found (risk ratio: 8.97, 95%-CI: 4.26-18.87, p-value < 0.0001).Limitations: Few prospective studies have been retrieved in our search and most were not specifically aimed at assessing BD in followed-up ADHD patients.Conclusions: Greater clinical attention should be paid to ADHD as an early precursor of BD since a substantial proportion of ADHD patients is expected to be diagnosed with BD during the developmental age. [ABSTRACT FROM AUTHOR]- Published
- 2021
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15. Is emotional dysregulation a risk indicator for auto-aggression behaviors in adolescents with oppositional defiant disorder?
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Muratori, Pietro, Pisano, Simone, Milone, Annarita, and Masi, Gabriele
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ADJUSTMENT disorders in children , *AGGRESSION (Psychology) in children , *OPPOSITIONAL defiant disorder in adolescence , *CHILD Behavior Checklist , *SELF-mutilation in adolescence - Abstract
Background: The Child Behavior Checklist Dysregulation Profile (CBCL-DP), (high scores in Anxious/Depressed, Attention Problems, and Aggressive Behavior subscales), has been related to poor emotional and behavioral self-regulation in children and adolescents. Our aim is to evaluate if it may be associated with auto-aggression in youth with oppositional defiant disorder (ODD). Method In 72 consecutively referred youths with ODD, emotional dysregulation was assessed with the CBCL-DP, auto-aggression and physical aggression against other persons with the Modified Overt Aggression Scale.Results: Regression analysis showed that greater higher CBCL-DP scores were associated to higher levels of auto-aggression, even when controlling for the levels of physical aggression against others and CBCL Total score.Limitations: The small sample size, the cross-sectional design, and the lack of a control group limit the generalization of our findings.Conclusions: Referred ODD youths with higher scores of CBCL-DP are more likely to present auto-aggression, besides aggression against others. The CBCL could improve the screening and detection of these high-risk patients. [ABSTRACT FROM AUTHOR]- Published
- 2017
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16. A NATURALISTIC EXPLORATORY STUDY OF OBSESSIVE-COMPULSIVE BIPOLAR COMORBIDITY IN YOUTH.
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Masi, Gabriele, Berloffa, Stefano, Mucci, Maria, Pfanner, Chiara, D’Acunto, Giulia, Lenzi, Francesca, Liboni, Francesca, Manfredi, Azzurra, Milone, Annarita, and D'Acunto, Giulia
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OBSESSIVE-compulsive disorder , *MENTAL health services , *DIAGNOSIS of obsessive-compulsive disorder , *COMORBIDITY , *DISEASES in youths , *MEDICAL practice , *SYMPTOMS - Abstract
Background: Growing evidence supports the comorbidity between bipolar disorder (BD) and obsessive-compulsive disorder (OCD) in children and adolescents. Our aim is to further explore clinical and treatment implications of this comorbidity, as it appears in clinical practice.Method: The sample included 429 consecutive patients with BD and/or OCD as primary diagnoses, followed for a mean period of 6 months (range 4-9 months), 172 with BD (102 males, mean age 13.7±2.9 years), 169 with OCD (118 males, mean age of 13.2±2.7 years) and 88 with comorbid BD+OCD (56 males, mean age 14.2±2.6 years, 52 with BD as the primary diagnosis), followed for a mean period of 6 months (range 4-9 months). The comorbid group was compared to pure BD and OCD groups, to explore differential clinical and treatment features.Results: The BD-OCD comorbidity was found in 33.8% of the BD patients and in 34.2% of the OCD patients. Age at onset of BD and OCD were not different in pure and "comorbid" groups. The comorbid group presented a higher occurrence of BD type II and hoarding symptoms, and more frequently received a psychotherapy and second generation antipsychotics, but it presented the poorest outcome in terms of response to treatments. Severity at baseline (clinical severity and functional impairment), hoarding obsessions and compulsions, and conduct disorder comorbidity were associated with a treatment non-response.Limitations: A selection bias may have increased the rate of comorbidity, as most of the patients were referred to our tertiary hospital for severe BD and/or OCD and pharmacological treatment. We have used CGI-I as an outcome measure, not a specific measure of BD or OCD symptoms' severity and improvement. The short duration of the follow-up may limit our conclusions.Conclusions: The timely identification of BD-OCD comorbidity may have relevant clinical implications in terms of symptomatology, course, treatment and outcome. [ABSTRACT FROM AUTHOR]- Published
- 2018
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17. Lithium treatment in bipolar adolescents: a follow-up naturalistic study
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Stefano Berloffa, Simone Pisano, Annarita Milone, Valentina Viglione, Gabriele Masi, Gabriella Bruni, Maria Mucci, Giulia Scrinzi, Masi, Gabriele, Milone, Annarita, Scrinzi, Giulia, Mucci, Maria, Viglione, Valentina, Bruni, Gabriella, Berloffa, Stefano, and Pisano, Simone
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safety ,medicine.medical_specialty ,Neuropsychiatric Disease and Treatment ,Lithium (medication) ,Sedation ,QT interval ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,White blood cell ,Internal medicine ,medicine ,0501 psychology and cognitive sciences ,adolescents ,Bipolar disorder ,Original Research ,bipolar disorder ,business.industry ,05 social sciences ,Thyroid ,medicine.disease ,3. Good health ,030227 psychiatry ,medicine.anatomical_structure ,lithium ,adolescent ,Long term data ,medicine.symptom ,business ,050104 developmental & child psychology ,Hormone ,medicine.drug - Abstract
Gabriele Masi,1 Annarita Milone,1 Giulia Scrinzi,2 Maria Mucci,1 Valentina Viglione,1 Gabriella Bruni,1 Stefano Berloffa,1 Simone Pisano3 1IRCCS Stella Maris Foundation, Developmental Psychiatry and Psychopharmacology Unit, Pisa, Italy; 2Child Neuropsychiatry Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy; 3Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, University of Salerno, Salerno, Italy Background: Although lithium is currently approved for the treatment of bipolar disorders in youth, long term data, are still scant. The aim of this study was to describe the safety and efficacy of lithium in referred bipolar adolescents, who were followed up at the 4th (T1) and 8th (T2) month of treatment.Methods: The design was naturalistic and retrospective, based on a clinical database, including 30 patients (18 males, mean age 14.2±2.1 years).Results: Mean blood level of lithium was 0.69±0.20 mEq/L at T1 and 0.70±0.18 mEq/L at T2. Both Clinical Global Impression-Severity (CGI-S) and Children Global Assessment Scale (C-GAS) scores improved from baseline (CGI-S 5.7±0.5, C-GAS 35.1±3.7) to T1 (CGI-S 4.2±0.70, C-GAS 46.4±6.5; P
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- 2018
18. Putative Mechanisms of Action and Clinical Use of Lithium in Children and Adolescents: A Critical Review
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Gennaro Catone, Giulia Scrinzi, Giangennaro Coppola, Gabriele Masi, Paramala Santosh, Emilio Clementi, Simone Pisano, Annarita Milone, Marco Pozzi, Carmela Bravaccio, Pisano, Simone, Pozzi, Marco, Catone, Gennaro, Scrinzi, Giulia, Clementi, Emilio, Coppola, Giangennaro, Milone, Annarita, Bravaccio, Carmela, Santosh, Paramala, and Masi, Gabriele
- Subjects
adolescents ,children ,efficacy ,lithium ,mechanism of action ,pharmacokinetics ,safety ,Pediatrics ,Bipolar Disorder ,Lithium (medication) ,Poison control ,Efficacy ,0302 clinical medicine ,Antimanic Agents ,Medicine ,Pharmacology (medical) ,pharmacokinetic ,Child ,Children ,Randomized Controlled Trials as Topic ,Clinical Trials as Topic ,Age Factors ,General Medicine ,Adolescents ,Lithium ,Mechanism of action ,Pharmacokinetics ,Safety ,Adolescent ,Antidepressive Agents ,Depressive Disorder, Major ,Humans ,Lithium Compounds ,Psychiatry and Mental health ,Neurology ,Conduct disorder ,Schizophrenia ,medicine.drug ,medicine.medical_specialty ,Young Mania Rating Scale ,Article ,03 medical and health sciences ,Bipolar disorder ,Pharmacology ,Depressive Disorder ,business.industry ,Major ,medicine.disease ,030227 psychiatry ,Clinical trial ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
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.
- Published
- 2017
19. Update on the safety of second generation antipsychotics in youths: a call for collaboration among paediatricians and child psychiatrists
- Author
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Maria Pia Riccio, Annarita Milone, Massimo Molteni, Giangennaro Coppola, Stefania Veltri, Gennaro Catone, Valentina Lanzara, Gabriele Masi, Carmela Bravaccio, Emilio Clementi, Raffaella Iuliano, Sonia Radice, Antonella Gritti, Annalisa Capuano, Marco Pozzi, Simone Pisano, Pisano, Simone, Catone, Gennaro, Veltri, Stefania, Lanzara, Valentina, Pozzi, Marco, Clementi, Emilio, Iuliano, Raffaella, Riccio, Maria Pia, Radice, Sonia, Molteni, Massimo, Capuano, Annalisa, Gritti, Antonella, Coppola, Giangennaro, Milone, Annarita, Bravaccio, Carmela, and Masi, Gabriele
- Subjects
Adverse event ,medicine.medical_specialty ,Adolescent ,Early detection ,Review ,Adolescents ,Weight Gain ,Lower risk ,Off-label use ,Antipsychotic ,03 medical and health sciences ,0302 clinical medicine ,Basal Ganglia Diseases ,Risk Factors ,SAFER ,medicine ,Antipsychotics ,Humans ,Medical prescription ,Child ,Psychiatry ,Adverse effect ,Children ,Dyslipidemias ,Child psychiatrists ,business.industry ,Active monitoring ,Off-Label Use ,030227 psychiatry ,Long QT Syndrome ,Diabetes Mellitus, Type 2 ,Adverse events ,Pediatrics, Perinatology and Child Health ,Practice Guidelines as Topic ,Drug Monitoring ,business ,030217 neurology & neurosurgery ,Antipsychotic Agents - Abstract
During the past decade, a substantial increase in the use of second generation antipsychotics (SGAs) has occurred for a number of juvenile psychiatric disorders, often as off-label prescriptions. Although they were thought to be safer than older, first generation antipsychotics, mainly due to a lower risk of neurological adverse reactions, recent studies have raised significant concerns regarding their safety regarding metabolic, endocrinological and cardiovascular side effects. Aim of this paper is to update with a narrative review, the latest findings on safety of SGAs in youths. Results suggest that different SGAs may present different safety profiles. Metabolic adverse events are the most frequent and troublesome, with increasing evidences of heightened risk for type II diabetes mellitus. Results are discussed with specific emphasis on possible strategies of an active monitoring, which could enable both paediatricians and child psychiatrists to a possible prevention, early detection, and a timely management of such effects.
- Published
- 2016
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