Adolescent selfie: an Italian Society of Paediatrics survey of the lifestyle of teenagers

Adolescent Mental Health: A Focus on Psychiatric Counseling from the Emergency Room of an Italian University Hospital in the Five Years from 2019 to 2023

Recent studies have revealed increasingly worse and more complex mental health conditions in young people, which is reflected in a growing trend in emergency room (ER) visits for acute psychopathological symptoms (APSs). This phenomenon has become exacerbated in recent decades, with a peak in the post-pandemic period. To better characterize the phenomenon, we investigated the change in the rate and type of ER counseling requests provided at the Child Neuropsychiatry Unit of the University Hospital of Bari, Italy over the period between 2019 and 2023 for subjects younger than 18 years old. For this purpose, we retrospectively analyzed a total number of 1073 urgent consultation reports retrieved through the reporting computerized operating system of our hospital. The distribution of the counseling requests provided for APSs and, among these, the distribution of the numbers of APSs and of the male: female ratio were significantly different over the years, with an increasing linear trend identified for APSs (p = 3.095 × 10-7), the average number of APSs (p = 3.598 × 10-7), and female gender prevalence (p = 0.03908), as well as for the patients with a history of psychotropic drug assumption (p = 0.0006319). A significant change in the number of urgent counseling requests received for eating disorders (p = 0.0007408), depression (p = 7.92 × 10-8), somatization (p = 4.03 × 10-6), self-harm (SA) (p = 1.358 × 10-6), and non-suicidal self-injury (NSSI) (p = 8.965 × 10-6) was found, with a significant increasing trend for anxiety (p = 0.0444), depression (p = 8.06 × 10-6), somatization (p = 0.004616), SA (p = 3.998 × 10-8), and NSSI (p = 5.074 × 10-7). The findings of our study support the hypothesis of an alarming progressive worsening of the mental health of children and adolescents, with an overlapping effect of the pandemic exacerbating the process.

Sex Education in Italy: An Overview of 15 Years of Projects in Primary and Secondary Schools

School-based sex education is essential to improve the knowledge and behavior of young people. Unlike most European countries, sex education in Italy is not compulsory in the school curriculum. Therefore, to assess potential gaps, the main aim of this study was to explore Italian regional initiatives about sex education. A review of gray literature from 2006 to 2021 was conducted in December 2021 on national databases and institutional websites of each Italian region, during which official documents on regional sex education programs were selected. Moreover, a rapid systematic review was carried out in scientific databases to find more information. For both reviews, the sex education topics recommended by UNESCO were used for extracting and analyzing data. A total of 12 Italian regions out of 20 had at least one sex education program, for a total of 39 projects. Overall, all the topics identified by UNESCO have been covered, with considerable differences between northern, central, and southern Italy. Contraception, love, marriage, partnerships, and family were the main topics discussed (hosted in 92% of the regions). Only 25% of the regions discussed pregnancy and birth. Disability was the least debated topic (17%). The rapid systematic review showed that relevant improvements were achieved after sex education interventions. In conclusion, this study underlined important limitations to the implementation of school-based sex education in Italy. Hence, it is necessary to increase sex education interventions to reach adequate standards and flatten the differences not only between Italian regions but also between Italy and other European countries.

Ten-Year Trend in Emergency Department Visits for Sexually Transmitted Infections among Adolescents: A Retrospective Cross-Sectional Study in Italy

Sexually transmitted infections (STIs) are frequently underdiagnosed, representing a serious public health concern, especially during adolescence and in more vulnerable communities.

AIM

to describe the last ten years of emergency department (ED) visits for STIs among adolescents.

METHODS

a retrospective cross-sectional observation was carried out in the Piedmont region in Italy. Data were retrieved through the Italian National Information System database. ED visits related to specific ICD-9-CM codes carried out on 11 to 19-year-old youths between 2011 and 2020 were investigated. Age-specific, crude, and standardized rates and admission ratios, with 95% confidence intervals (CIs), were calculated to estimate the STI trend.

RESULTS

from a total of 1,219,075 ED visits, 339 were related to STIs, representing an increasing ratio of 28 per 100,000 visits, primarily in females. Most infections occurred in girls (83.5%) and among 17 to 19-year-olds (71.5%). A drop in both ED visits and STI cases was observed in 2020. Genital Herpes and Genital Warts were more frequent in girls while Gonorrhea was more frequent in boys.

CONCLUSIONS

the increasing trend of ED visits for STIs, particularly in girls, represents an emerging relevant public health issue that needs to be urgently tackled.

Trends in admissions to a child and adolescent neuropsychiatric inpatient unit in the 2007-2017 decade: how contemporary neuropsychiatry is changing in Northwestern Italy

PURPOSE

Rising levels of psychopathology in the adolescent population have been evidenced in the last few years throughout the Western world. We aim to examine how contemporary neuropsychiatry is changing in Northwestern Italy and how this impacts inpatient services.

METHODS

The present research considered the 1177 admissions to a public neuropsychiatric inpatient service in the 2007-2017 decade. The annual percentual change (APC) was analysed for the total admissions, the number of the neurological vs psychiatric admissions, the length of inpatient stay, and the mean age at admission, also accounting for sex differences. The annual trend was also calculated for each diagnosis.

RESULTS

The overall number of inpatient admissions decreased significantly (APC = - 5.91), in particular for children under 12 years of age (APC = - 7.23). The rate of neurologic diagnoses significantly decreased (APC = - 26.44), while the length of the inpatient stay (APC = 6.98) and the mean age at admission (APC = 6.69) increased. Among the psychiatric diagnoses, depression significantly rose (APC = 41.89), in particular among female adolescents (APC = 40.30).

CONCLUSIONS

These data document a substantial change in the utilization of inpatient neuropsychiatric services for children and adolescents, with a major increase in psychiatric hospitalizations and a parallel decrease in neurological ones. These trends call for greater attention to early preventive intervention in mental healthcare system.

Psychometric Properties of the Strengths and Difficulties Questionnaire-Dysregulation Profile in Italian Early Adolescents

Emotional dysregulation is of great cause for concern because it is associated with severe outcomes. Currently, the identification of youths with signs of emotional and behavioral dysregulation is obtained through the assessment of a Dysregulation Profile (DP), including the Strengths and Difficulties Questionnaire-DP (SDQ-DP). Despite its increasingly frequent use in research, studies exploring the SDQ-DP properties are still limited, and no study with Italian samples is currently available. The current study aimed to explore the psychometric properties of the SDQ-DP parent-report and its association with difficulties in the school context in a sample of 332 Italian early adolescents. Results showed that the SDQ-DP parent-report is a single-factor measure with good internal consistency. Also, in both males and females, the SDQ-DP parent-report was associated with higher teacher-reported Internalizing (e.g., anxious symptoms) and Externalizing Problems (e.g., hyperactivity, conduct problems) and lower Prosocial Behavior. This study added further evidence about the utility of the SDQ-DP in the assessment, prevention, and treatment of emotional dysregulation.

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 Role of Technology and Social Media Use in Sleep-Onset Difficulties Among Italian Adolescents: Cross-sectional Study

Background

The use of technology and social media among adolescents is an increasingly prevalent phenomenon. However, there is a paucity of evidence on the relationship between frequency of use of electronic devices and social media and sleep-onset difficulties among the Italian population.

Objective

The aim of this study is to investigate the association between the use of technology and social media, including Facebook and YouTube, and sleep-onset difficulties among adolescents from Lombardy, the most populous region in Italy.

Methods

The relationship between use of technology and social media and sleep-onset difficulties was investigated. Data came from the 2013-2014 wave of the Health Behavior in School-aged Children survey, a school-based cross-sectional study conducted on 3172 adolescents aged 11 to 15 years in Northern Italy. Information was collected on difficulties in falling asleep over the last 6 months. We estimated the odds ratios (ORs) for sleep-onset difficulties and corresponding 95% CIs using logistic regression models after adjustment for major potential confounders.

Results

The percentage of adolescents with sleep-onset difficulties was 34.3% (1081/3151) overall, 29.7% (483/1625) in boys and 39.2% (598/1526) in girls. It was 30.3% (356/1176) in 11-year-olds, 36.2% (389/1074) in 13-year-olds, and 37.3% (336/901) in 15-year-olds. Sleep-onset difficulties were more frequent among adolescents with higher use of electronic devices, for general use (OR 1.50 for highest vs lowest tertile of use; 95% CI 1.21-1.85), use for playing games (OR 1.35; 95% CI 1.11-1.64), use of online social networks (OR 1.40 for always vs never or rarely; 95% CI 1.09-1.81), and YouTube (OR 2.00; 95% CI 1.50-2.66).

Conclusions

This study adds novel information about the relationship between sleep-onset difficulties and technology and social media in a representative sample of school-aged children from a geographical location that has not been included in studies of this type previously. Exposure to screen-based devices and online social media is significantly associated with adolescent sleep-onset difficulties. Interventions to create a well-coordinated parent- and school-centered strategy, thereby increasing awareness on the unfavorable effect of evolving technologies on sleep among adolescents, are needed.