18 results on '"Milone, Annarita"'
Search Results
2. Callous–Unemotional Traits and Intelligence in Children with Externalizing Behavioral Problems.
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Fantozzi, Pamela, Muratori, Pietro, Levantini, Valentina, Mammarella, Irene, Masi, Gabriele, Milone, Annarita, Petrucci, Alessia, Ricci, Federica, Tacchi, Annalisa, Cristofani, Chiara, and Valente, Elena
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PERSONALITY ,CONFIDENCE intervals ,REGRESSION analysis ,ATTENTION-deficit hyperactivity disorder ,INTELLECT ,DESCRIPTIVE statistics ,QUESTIONNAIRES ,RESEARCH funding ,CHILDREN - Abstract
Research on the association between callous–unemotional (CU) traits and intelligence yielded contradictory results. Moreover, several previous studies focused on global intelligence scores or verbal vs. nonverbal/performance abilities usually evaluated with short/abbreviated instruments. The current study builds on these previous works and explores the link between CU traits and intelligence using the full version of the Wechsler Intelligence Scale for Children—4th Edition (WISC-IV), which provides four different verbal and nonverbal abilities scores. This guarantees a more detailed evaluation of children's intelligence and its relation to CU traits. The sample included children (N = 149; age 6–14 years old) with severe behavioral problems. Clinicians administered the WISC-IV, and parents completed questionnaires evaluating the child's externalizing problems and CU traits. Findings showed that CU traits were associated with lower verbal comprehension scores after also controlling for gender, age, externalizing problems, and the other WISC-IV indexes. In addition, CU traits and externalizing problems did not interact in predicting the WISC-IV indexes, and there were no significant differences in the WISC-IV indexes between children with CU traits and high vs. low externalizing problems. The current study suggests the relevance of assessing and addressing verbal abilities in children with behavioral problems and CU traits. [ABSTRACT FROM AUTHOR]
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- 2022
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3. Sensory Profiles in School-Aged Children with Autism Spectrum Disorder: A Descriptive Study Using the Sensory Processing Measure-2 (SPM-2).
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Narzisi, Antonio, Fabbri-Destro, Maddalena, Crifaci, Giulia, Scatigna, Stefano, Maugeri, Federica, Berloffa, Stefano, Fantozzi, Pamela, Prato, Adriana, Muccio, Rosy, Valente, Elena, Viglione, Valentina, Pecchini, Edoardo, Pelagatti, Susanna, Rizzo, Renata, Milone, Annarita, Barone, Rita, and Masi, Gabriele
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CHILDREN with autism spectrum disorders ,SCHOOL children ,SENSORIMOTOR integration ,AUTISM spectrum disorders ,PSYCHOEDUCATION ,AUTONOMY (Psychology) - Abstract
Background: Sensory reactivity is considered one of the diagnostic criteria for Autism Spectrum Disorders (ASD) and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. The characterization of the sensory processing in ASD has thus become crucial to identify the sensory and motor features influencing the development of personal autonomy. Objectives: The present study has two aims: (1) to compare the sensory processing between school-aged children with ASD and typically developing peers (TD); (2) to evaluate whether, within the ASD sample, the cognitive level and reported sensory symptoms explain the scores exhibited at the Sensory Processing Measure (SPM-2). Methods: The SPM-2 test was administered to the parents of 105 children with ASD and 70 TD. The ASD group was further subdivided into two groups, namely high and low functioning based on their cognitive level (High Functioning (HF), IQ > 80; Low Functioning (LF), IQ < 80). Results: ASD children exhibited higher scores throughout the SPM-2 total score and its multiple subscales. Within ASD, while HF and LF children did not differ in terms of the SPM-2 total score, a significant difference was found for the hearing, social participation, and balance and motion subscales. Conclusions: Aside from classical knowledge that the ASD population suffers from sensory processing disorders, we revealed that different sensory patterns are associated with high or low cognitive functioning. Beyond its neurobiological interest, such knowledge may be of fundamental importance for individualizing psychoeducational interventions in preschool- and school-aged children and later developmental stages. [ABSTRACT FROM AUTHOR]
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- 2022
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4. Internet Gaming Disorder in Children and Adolescents with Attention Deficit Hyperactivity Disorder.
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Berloffa, Stefano, Salvati, Andrea, D'Acunto, Giulia, Fantozzi, Pamela, Inguaggiato, Emanuela, Lenzi, Francesca, Milone, Annarita, Muratori, Pietro, Pfanner, Chiara, Ricci, Federica, Ruglioni, Laura, Tacchi, Annalisa, Tessa, Chiara, Villafranca, Arianna, and Masi, Gabriele
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STATISTICS ,ANALYSIS of variance ,GAMES ,ATTENTION-deficit hyperactivity disorder ,DESCRIPTIVE statistics ,CHI-squared test ,DISEASE prevalence ,INTERNET addiction ,LOGISTIC regression analysis ,DATA analysis ,CHILDREN ,ADOLESCENCE - Abstract
Although Attention Deficit Hyperactivity Disorder (ADHD) has been related to an increased risk for behavioral addictions, the relationship between ADHD and Internet Gaming Disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of IGD in a consecutive sample of ADHD youth, compared to a normal control group, and by assessing selected psychopathological and cognitive features in ADHD patients with and without IGD. One hundred and eight patients with ADHD (mean age 11.7 ± 2.6 years, 96 males) and 147 normal controls (NC) (mean age 13.9 ± 3.0 years, 114 males) were included in the study and received structured measures for IGD. In the ADHD group, 44% of the sample were above the IGD cut-off, compared to 9.5% in the NC group. ADHD patients with IGD presented with greater severity and impairment, more severe ADHD symptomatology, more internalizing symptoms, particularly withdrawal/depression and socialization problems, and more prominence of addiction and evasion dimensions. A binary logistic regression showed that the degree of inattention presented a greater weight in determining IGD. These findings may be helpful for identifying, among ADHD patients, those at higher risk for developing a superimposed IGD. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Narcissistic traits and self-esteem in children: Results from a community and a clinical sample of patients with oppositional defiant disorder
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Muratori, Pietro, Milone, Annarita, Brovedani, Paola, Levantini, Valentina, Melli, Gabriele, Pisano, Simone, Valente, Elena, Thomaes, Sander, Masi, Gabriele, Leerstoel Thomaes, Social and personality development: A transactional approach, Developmental Psychology, Leerstoel Thomaes, Social and personality development: A transactional approach, and Developmental Psychology
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Male ,Psychometrics ,Adolescent ,Cross-sectional study ,media_common.quotation_subject ,Emotions ,Self-concept ,Sample (statistics) ,Sensitivity and Specificity ,050105 experimental psychology ,Oppositional defiant disorder ,Self-esteem ,Narcissism ,medicine ,Humans ,0501 psychology and cognitive sciences ,Conduct problems ,Child ,Children ,media_common ,Problem Behavior ,Psychiatric Status Rating Scales ,05 social sciences ,Reproducibility of Results ,Causality ,Self Concept ,Clinical Psychology ,Psychiatry and Mental health ,Cross-Sectional Studies ,Attention Deficit and Disruptive Behavior Disorders ,Scale (social sciences) ,Female ,Self Report ,medicine.symptom ,Psychology ,050104 developmental & child psychology ,Clinical psychology - Abstract
Background Several studies have investigated relationships between narcissism, self-esteem and behavioral problems in children. Most of these studies have been conducted in community samples, rather than in clinical referred samples. This field of research is clinically important, because data on community samples suggest that narcissism is a significant risk factor for children's behavioral problems. Methods The study aimed to test the psychometric properties of the Child Narcissism Scale (CNS) in a community sample of Italian children and to explore the clinical utility of CNS in a sample of referred children with Oppositional Defiant Disorder (ODD). Results In the community sample, the Italian version of the CNS was shown to be a normally distributed, single-factor measure of childhood narcissism with very good internal consistency. Furthermore, high levels of narcissism were associated with less self-esteem in family relationships, more parent-reported conduct problems, and less teacher-reported pro-social behaviors. In the ODD sample, high levels of narcissism were associated with more conduct problems and emotional symptoms. Low levels of self-esteem were associated with more conduct problems. Limitations The cross sectional design does not allow for estimates of CNS test-retest reliability and sensitivity to change, nor does it allow for interpretations that suggest temporal precedence or causality. Conclusions We found support for the cross-cultural utility of the CNS as a short and comprehensive self-report measure of narcissistic traits, which can be used in community and clinical samples of children, and suggested how narcissism may be involved in children's behavioral problems.
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- 2018
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. 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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8. 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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9. Use of Quetiapine in Children and Adolescents.
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Masi, Gabriele, Milone, Annarita, Veltri, Stefania, Iuliano, Raffaella, Pfanner, Chiara, and Pisano, Simone
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ANTIPSYCHOTIC agents , *QUETIAPINE , *DRUG efficacy , *PSYCHOSES , *PSYCHIATRIC treatment , *CLINICAL trials , *CHILDREN , *TEENAGERS - Abstract
The atypical antipsychotic quetiapine has been used in different psychotic and non-psychotic disorders in children and adolescents in randomized clinical trials, open-label studies and chart reviews. Most of these studies suggest that quetiapine may be a promising agent with a potential for use in young patients. The aim of this paper is to critically review available literature on quetiapine in the treatment of children and adolescents with a variety of psychiatric disorders, including psychotic disorders, bipolar disorders (manic and depressive episodes), conduct disorder, autism spectrum disorder, Tourette's syndrome and personality disorders. Furthermore, we report on possible neurochemical pathways involved during treatment with quetiapine, and discuss some issues that are clinically relevant in daily practice, such as titration strategies, safety and tolerability, and monitoring possible side effects. Controlled studies support the short-term efficacy for treating psychosis, mania, and aggression within certain diagnostic categories. However, although quetiapine seems well tolerated in various pediatric populations during acute and intermediate treatments, and hyper-prolactinemia and extra-pyramidal side effects are consistently low among studies, weight gain and alterations in lipid profile need to be closely monitored. Furthermore, the distal benefit/risk ratio during long-term treatment remains to be determined. [ABSTRACT FROM AUTHOR]
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- 2015
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10. 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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11. Could You Give Me the Blue Brick? LEGO ® -Based Therapy as a Social Development Program for Children with Autism Spectrum Disorder: A Systematic Review.
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Narzisi, Antonio, Sesso, Gianluca, Berloffa, Stefano, Fantozzi, Pamela, Muccio, Rosy, Valente, Elena, Viglione, Valentina, Villafranca, Arianna, Milone, Annarita, and Masi, Gabriele
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CHILDREN with autism spectrum disorders ,SOCIAL development ,SOCIAL services ,CHILD development ,SOCIAL skills - Abstract
LEGO
® -based therapy is a social skills development program aimed at children with autism spectrum disorder (ASD). A systematic review of the literature was conducted using PRISMA guidelines. PubMed, Scopus and Web of Science bibliographic databases were searched from their date of inception to August 2020. The review included 19 studies. Studies were classified according to experimental designs (e.g., Randomized Control Trial, Non-Randomized Studies of Interventions and case report and series) and a narrative synthesis of each was provided, along with a critical discussion of the strengths and weaknesses of the available literature on the topic. Although LEGO® -based therapy appears a promising treatment for social interaction in ASD, the findings of LEGO® -based therapy studies should be interpreted and generalized with caution, due to the low quality of the studies and the small sample sizes. [ABSTRACT FROM AUTHOR]- Published
- 2021
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12. Autism Spectrum Disorder and Disruptive Behavior Disorders Comorbidities Delineate Clinical Phenotypes in Attention-Deficit Hyperactivity Disorder: Novel Insights from the Assessment of Psychopathological and Neuropsychological Profiles.
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Sesso, Gianluca, Cristofani, Chiara, Berloffa, Stefano, Cristofani, Paola, Fantozzi, Pamela, Inguaggiato, Emanuela, Narzisi, Antonio, Pfanner, Chiara, Ricci, Federica, Tacchi, Annalisa, Valente, Elena, Viglione, Valentina, Milone, Annarita, and Masi, Gabriele
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BEHAVIOR disorders ,ATTENTION-deficit hyperactivity disorder ,AUTISM spectrum disorders ,NEUROPSYCHOLOGICAL tests ,METACOGNITIVE therapy ,CHILD Behavior Checklist - Abstract
Although childhood-onset psychiatric disorders are often considered as distinct and separate from each other, they frequently co-occur, with partial overlapping symptomatology. Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) commonly co-occur with each other and with other mental disorders, particularly disruptive behavior disorders, oppositional defiant disorder/conduct disorder (ODD/CD). Whether these associated comorbidities represent a spectrum of distinct clinical phenotypes is matter of research. The aim of our study was to describe the clinical phenotypes of youths with ADHD with and without ASD and/or ODD/CD, based on neuropsychological and psychopathological variables. One-hundred fifty-one participants with ADHD were prospectively recruited and assigned to four clinical groups, and assessed by means of parent-reported questionnaires, the child behavior checklist and the behavior rating inventory of executive functions. The ADHD alone group presented a greater impairment in metacognitive executive functions, ADHD+ASD patients presented higher internalizing problems and deficits in Shifting tasks, and ADHD+ODD/CD subjects presented emotional-behavioral dysregulation. Moreover, ADHD+ASD+ODD/CD individuals exhibited greater internalizing and externalizing problems, and specific neuropsychological impairments in the domains of emotional regulation. Our study supports the need to implement the evaluation of the psychopathological and neuropsychological functioning profiles, and to characterize specific endophenotypes for a finely customized establishment of treatment strategies. [ABSTRACT FROM AUTHOR]
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- 2020
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13. A Naturalistic Study of Youth Referred to a Tertiary Care Facility for Acute Hypomanic or Manic Episode.
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Masi, Gabriele, Berloffa, Stefano, Muratori, Pietro, Mucci, Maria, Viglione, Valentina, Villafranca, Arianna, Inguaggiato, Emanuela, Levantini, Valentina, Placini, Francesca, Pfanner, Chiara, D'Acunto, Giulia, Lenzi, Francesca, Liboni, Francesca, and Milone, Annarita
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SUBSTANCE-induced disorders ,ATTENTION-deficit hyperactivity disorder ,TERTIARY care ,MENTAL illness ,BIPOLAR disorder - Abstract
Background: Bipolar Disorders (BD) in youth are a heterogeneous condition with different phenomenology, patterns of comorbidity and outcomes. Our aim was to explore the effects of gender; age at onset (prepubertal- vs. adolescent-onset) of BD; and elements associated with attention deficit hyperactivity disorder (ADHD) and Substance Use Disorder (SUD) comorbidities, severe suicidal ideation or attempts, and poorer response to pharmacological treatments. Method: 117 youth (69 males and 57 females, age range 7 to 18 years, mean age 14.5 ± 2.6 years) consecutively referred for (hypo)manic episodes according to the Diagnostic and Statistical Manual of Mental Disorders, 54th ed (DSM 5) were included. Results: Gender differences were not evident for any of the selected features. Prepubertal-onset BD was associated with higher rates of ADHD and externalizing disorders. SUD was higher in adolescent-onset BD and was associated with externalizing comorbidities and lower response to treatments. None of the selected measures differentiated patients with or without suicidality. At a 6-month follow up, 51.3% of the patients were responders to treatments, without difference between those receiving and not receiving a psychotherapy. Clinical severity at baseline and comorbidity with Conduct Disorder (CD) and SUD were associated with poorer response. Logistic regression indicated that baseline severity and number of externalizing disorders were associated with a poorer outcome. Conclusions: Disentangling broader clinical conditions in more specific phenotypes can help timely and focused preventative and therapeutic interventions. [ABSTRACT FROM AUTHOR]
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- 2020
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14. 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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15. 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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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. 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
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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
18. 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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