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Pruccoli J, Biagi C, Andreozzi L, Fetta A, Sacrato L, Tartarini C, Cordelli DM, Lanari M. Clinical and psychopathological profiles of children with somatic symptom disorders in a pediatric emergency unit: an observational study before and during the SARS-CoV-2 pandemic. Eur J Pediatr 2023; 182:1731-1739. [PMID: 36757495 PMCID: PMC9909631 DOI: 10.1007/s00431-023-04850-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/10/2023]
Abstract
Somatic symptom disorders (SSDs) are a group of clinical conditions characterized by heterogeneous physical symptoms, not directly supported by a demonstrable organic process. Despite representing a growing problem in the pediatric age, the literature lacks studies assessing the psychopathological and clinical features of subjects with SSD, particularly during the SARS-CoV-2 pandemic. This is a retrospective, observational study, involving two historical cohorts of children admitted to a tertiary referral Italian hospital over the 2 years preceding and following the start of the SARS-CoV-2 pandemic. Demographic, clinical, socio-economical, and psychological variables were investigated. Standardized tests for the developmental age were administered to assess psychopathological variables. Overall rates and trends of accesses for SSD, as compared to the total accesses for any cause at the Pediatric Emergency Room during the same periods, were reported as well. Fifty-one (pre-pandemic, 29; pandemic, 22) children with SSD were enrolled (age, 11.4 ± 2.4 years, F = 66.7%). Subjects in the pandemic historical cohort reported more frequently fever (p < 0.001), headache (p = 0.032), and asthenia (p < 0.001), as well as more chronic conditions in personal and family history, and fewer previous hospital accesses, as compared to the pre-pandemic cohort. Depressed mood and anxious traits were documented in both samples. None of them had an ongoing or a previously reported SARS-CoV-2 infection. During the pandemic, a clinical psychologist was more frequently consulted before the hospital discharge to mental health services, to support the diagnosis. Conclusion: This study showed the significant burden of SSD in children, highlighting the need to implement pediatricians' education to optimize the management of these patients. Children with SSD who accessed during the SARS-CoV-2 pandemic presented specific clinical features. Future studies, conducted on longitudinal and controlled samples, are indicated to further investigate children with these conditions. What is Known: • Somatic symptoms disorders (SSDs) are frequent in the pediatric age, especially in early adolescence. • Evidence remains scarce on the impact of the SARS-CoV-2 pandemic on SSDs in children. What is New: • Children with SSD who accessed during the SARS-CoV-2 pandemic presented specific clinical features. • The implementation of pediatricians' education and a multidisciplinary approach are needed to optimize the management of SSDs.
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Affiliation(s)
- Jacopo Pruccoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy ,Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Carlotta Biagi
- Pediatric Emergency Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, 40138, Italy.
| | - Laura Andreozzi
- Pediatric Emergency Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, 40138 Italy
| | - Anna Fetta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy ,Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Leonardo Sacrato
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy
| | | | - Duccio Maria Cordelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy ,Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, 40138 Italy
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Pruccoli J, La Tempa A, Francia V, Gualandi P, Malaspina E, Moscano F, Rossi F, Sacrato L, Rucci P, Parmeggiani A. Anorexia nervosa among first- and second-generation immigrant children and adolescents in Italy: treatment and clinical outcomes. Riv Psichiatr 2022; 57:80-87. [PMID: 35426426 DOI: 10.1708/3790.37739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Cultural and environmental factors have frequently been implicated in the pathogenesis of Eating Disorders (ED). Although ED have been considered as "Western culture-bound syndromes", increasing rates of ED among non-Western groups are being documented. The present study aims to investigate treatment and clinical outcomes among first-generation immigrant children and adolescents (FGI) (patients born abroad) and second-generation immigrant youth (SGI, patients born in Italy) with Anorexia Nervosa (AN). METHODS The study retrospectively compares treatment, hospitalizations, traumatic past events, clinical features, and treatment outcome (improvement in percentual body-mass index - %BMI) between FGI and SGI young patients with AN (10-18 years). Correlations were adjusted for age and severity (%BMI) at presentation. Treatments and outcomes were investigated at the baseline (T0), 2 weeks (T1), one month (T2), 3 months (T3), 6 months (T4), and 12 months (T5). RESULTS Thirty-six patients (50% FGI) were enrolled. At T1 (F(1.26)=6.335, p=0.018), and at T2 (F(1.30)=18.752, p<0.001) FGI presented a significantly higher %BMI improvement than SGI. FGI required significantly less (OR=0.379, p=0.017), and shorter (F(1.32)=5.827, p=0.022) hospitalizations, when compared with SGI. CONCLUSIONS When compared to SGI, FGI with AN required fewer and shorter hospitalizations and had a better early-treatment weight outcome. Larger nationwide studies should investigate the need for and access to treatment of immigrant populations with AN.
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Affiliation(s)
- Jacopo Pruccoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy - Dipartimento di Scienze Mediche e Chirurgiche, University of Bologna, Italy
| | - Angela La Tempa
- Dipartimento di Scienze Mediche e Chirurgiche, University of Bologna, Italy
| | - Valentina Francia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
| | - Paola Gualandi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
| | - Elisabetta Malaspina
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
| | - Filomena Moscano
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
| | - Francesca Rossi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
| | - Leonardo Sacrato
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy
| | - Paola Rucci
- Dipartimento di Scienze Biomediche e Neuromotorie, University of Bologna, Italy
| | - Antonia Parmeggiani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO Neuropsichiatria dell'Età Pediatrica, Bologna, Italy - Dipartimento di Scienze Mediche e Chirurgiche, University of Bologna, Italy
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Lanzarini E, Pruccoli J, Grimandi I, Spadoni C, Angotti M, Pignataro V, Sacrato L, Franzoni E, Parmeggiani A. Phonic and Motor Stereotypies in Autism Spectrum Disorder: Video Analysis and Neurological Characterization. Brain Sci 2021; 11:brainsci11040431. [PMID: 33800677 PMCID: PMC8066337 DOI: 10.3390/brainsci11040431] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
Stereotypies are among the core symptoms of Autism spectrum disorder (ASD) and can cause significant clinical impairment. At present, phonic stereotypies in ASD have been scarcely explored. This study investigates the frequency, variability, and typologies of phonic and motor stereotypies in children with ASD and their association with clinical neurological variables. We examined 35 patients by recording standardized video sessions and administering the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Phonic stereotypies were present in 83.0% of the patients. The most prevalent subtypes were noncommunicative vocalizations (60.0%), single syllables (37.1%), and echolalic stereotypies (22.9%). Noncommunicative vocalizations were more frequent in nonverbal patients (OR = 4.629, p = 0.008), while echolalic stereotypies were more represented in verbal patients (OR = 0.279, p = 0.028). Patients with intellectual disability (ID) showed a higher number (F(1,26) = 9.406, p = 0.005) and variability (F(1,25) = 7.174, p = 0.013) of motor stereotypies, with a higher number (F(1,26) = 13.268, p = 0.005) and variability (F(1,26) = 9.490, p = 0.005) of stereotypies involving the head/trunk/shoulders category. Patients with guttural stereotypies showed a higher variability of total motor stereotypies (OR = 1.487, p = 0.032) and self-directed motor stereotypies (OR = 4.389, p = 0.042). These results, combined with a standardized video-analysis, document the frequency and variability of phonic stereotypies among children with ASD. Correlations between specific phonic stereotypies and verbal abilities should be investigated further.
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Affiliation(s)
- Evamaria Lanzarini
- Child Neurology and Psychiatry Unit, Infermi Hospital, AUSL Romagna, 47923 Rimini, Italy;
| | - Jacopo Pruccoli
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Irene Grimandi
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Chiara Spadoni
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Marida Angotti
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Veronica Pignataro
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Leonardo Sacrato
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
| | - Emilio Franzoni
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Antonia Parmeggiani
- Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, 40138 Bologna, Italy; (J.P.); (I.G.); (C.S.); (M.A.); (V.P.); (L.S.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
- Correspondence: ; Tel.: +39-051-214-4013
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Pruccoli J, Solari A, Terenzi L, Malaspina E, Angotti M, Pignataro V, Gualandi P, Sacrato L, Cordelli DM, Franzoni E, Parmeggiani A. Autism spectrum disorder and anorexia nervosa: an Italian prospective study. Ital J Pediatr 2021; 47:59. [PMID: 33750445 PMCID: PMC7945370 DOI: 10.1186/s13052-021-01006-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Potential overlaps exist between psychopathological features of Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD). The impact of malnutrition on autistic traits in patients with AN should be considered. This study investigates possible associations among the psychopathology of Eating Disorders (EDs), ASD traits and BMI in a group of young patients with AN, using the EDI-3 (Eating Disorder Inventory-3) test and gold-standard measures for ASD. METHODS Prospective study involving 23 inpatients admitted to an Italian Centre for paediatric ED. ASD traits and ED psychopathology were assessed administering the ADOS-2 (Autism Diagnostic Observation Schedule-2), AQ (Autism Quotient) and EDI-3 tests. Both present and past autistic traits were investigated using different versions of AQ. Correlations were adjusted for BMI, Obsessive Compulsive Disorder (OCD) comorbidity and concurrent antipsychotic treatments. RESULTS An ASD diagnosis was possible in 22% of patients. Significant correlations were documented between ASD traits and ED psychopathology: AQ total-Interpersonal problems (IPC) (p = 0.041); AQ total-Global psychological maladjustment (GMPC) (p = 0.027); AQ social skills-Ineffectiveness (IC) (p = 0.018); AQ social skills-IPC (p = 0.019); AQ social skills-Affective problems (APC) (p = 0.025); AQ social skills-GMPC (p = 0.007); AQ attention switching-IPC (p = 0.020); ADOS-2 imagination-IC (p = 0.035). These correlations were independent of BMI, OCD and antipsychotic treatments. CONCLUSIONS ASD traits presented high prevalence in a group of young inpatients with AN. These traits were significantly correlated to 4 specific EDI-3 subscales and independent of BMI. This is the first study to investigate the relationship between ASD traits as measured with gold-standard measures, EDI-3 scores, and BMI.
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Affiliation(s)
- Jacopo Pruccoli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Altea Solari
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Letizia Terenzi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Elisabetta Malaspina
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Marida Angotti
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Veronica Pignataro
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Paola Gualandi
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Leonardo Sacrato
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Duccio Maria Cordelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Emilio Franzoni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Antonia Parmeggiani
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. .,Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
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Parmeggiani A, Boiani F, Capponi S, Duca M, Angotti M, Pignataro V, Sacrato L, Spinardi L, Vara G, Maltoni L, Cecconi I, Pastore Trossello M, Franzoni E. Neuropsychological profile in Italian children with neurofibromatosis type 1 (NF1) and their relationships with neuroradiological data: Preliminary results. Eur J Paediatr Neurol 2018; 22:822-830. [PMID: 29802023 DOI: 10.1016/j.ejpn.2018.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 04/04/2018] [Accepted: 04/29/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neurofibromatosis type 1 is a genetic disorder associated with cognitive deficits, learning disabilities and behavioral problems. These domains appear to have a still controversial debated association with local areas of T2-hyperintensities on MRI images, called unidentified bright objects (UBOs). METHODS A cohort of 36 children (aged 7-11 years) included consecutively, underwent neuropsychological and behavioral assessment to determine their cognitive and neuropsychological profile, and the frequency of specific learning disabilities. MRI examination was used to determine the impact of UBOs' presence, number, and location on the cognitive, neuropsychological and behavioral profile, and also the presence of optic glioma. RESULTS The mean full intelligence quotient was 104.6; only one child had mild intellectual disability. Forty one percent of children had a diagnosis of specific learning disabilities and reading was mainly involved. Twenty per cent had attention problems. All children had normal scores in visuo-motor and visuo-perceptual tests. UBOs were present in 94.0% of the MRI examinations. Two children had optic glioma. Children with UBOs in a specific location and children with UBOs elsewhere were statistically compared, no one of the location seemed to have an impact on general cognition measured with full intelligence quotient. The thalamus was associated with problems in calculation and striatum with behavioral problems. An inverse relationship between the number of UBOs and the full intelligence quotient was present, but without a statistical significance. CONCLUSIONS In this study, the specific location of UBOs did not seem to influence the general cognitive profile and also the relationship between their number and the full intelligence quotient was not significant; these results are still controversial in literature. Finally, the presence of UBOs in the thalamus and striatum may represent a neuroradiological pattern that influences performances in calculation and behavior respectively in children with Neurofibromatosis type 1.
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Affiliation(s)
- A Parmeggiani
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy.
| | - F Boiani
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - S Capponi
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - M Duca
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - M Angotti
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - V Pignataro
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - L Sacrato
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - L Spinardi
- Neuroradiology Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - G Vara
- Neuroradiology Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - L Maltoni
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - I Cecconi
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - M Pastore Trossello
- Neuroradiology Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - E Franzoni
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
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Pellicciari A, Di Pietro E, Sacrato L, Iero L, Franzoni E. Reconsidering food avoidance emotional disorder through discussion of four cases. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72432-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
ObjectivesThe Authors investigate the conceptualization of a group of patients with the same clinical and psychological patterns, affected by eating disturbances arisen during the age of latency.MethodsFour cases are presented and discussed. Each subject was diagnosed as Food Avoidance Emotional Disorder (FAED).ResultsThe described subjects present some of the typical features of eating disorders of adolescence. Moreover, regressive aspects, obligingness, dichotomyc behaviors and thoughts were noticed. The Authors observed that parental expectations and needs were transmitted to their sons.ConclusionsThrough the refusal of food the dochotomyc and fearful thoughts are crystallized. The child cannot comprehend the existence of a false Self built on the Other's expectations. The Authors believe that FAED can be a precursor of Anorexia nervosa in the affected children, who show a less organized cognitive structure due to their young age.
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Pellicciari A, Gualandi S, Iero L, Monti M, Di Pietro E, Sacrato L, Gualandi P, Franzoni E. Psychometric Evaluation of SAFA P Test for Eating Disorders in Adolescents: Comparative Validation with EDI-2. Eur Eat Disorders Rev 2011; 20:e108-13. [DOI: 10.1002/erv.1099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Luisa Iero
- Child Neuropsychiatry Unit; University of Bologna; Italy
| | - Morena Monti
- Child Neuropsychiatry Unit; University of Bologna; Italy
| | | | | | - Paola Gualandi
- Child Neuropsychiatry Unit; University of Bologna; Italy
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Abstract
We have reviewed the literature related to the current advances in comprehension of Eating Disorders (ED) in childhood and preadolescence. The state of art regarding the psychodynamic models concerning the onset of ED are explained. DSM-IV and ICD-10 criteria are discussed, pointing out their little value in the characterization of early eating difficulties. Historic and new diagnostic classifications are displayed in detail. We provided a clearer description of subclinical patterns. Finally we focus on the key role of the paediatrician in detecting and managing parental concerns regarding feeding.
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Affiliation(s)
- Leonardo Sacrato
- Child Neuropsychiatry Unit, Sant'Orsola Malpighi Hospital, University of Bologna, Italy
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Franzoni E, Fracasso A, Pellicciari A, Iero L, Gualandi P, Cimino A, Verrotti A, Sacrato L. The refusal of food in childhood: From our clinical experience to an evaluation of recent diagnostic classifications. Eat Weight Disord 2010; 15:e81-5. [PMID: 20571325 DOI: 10.1007/bf03325283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study, which was carried out because of the importance of eating disorders (EDs) acquired by the young and the need to organise resources and interventions for patients and their families, was to quantify the increased incidence of EDs arising early in life in order to identify the nosographic classification that best reflects the complexity of the symptoms. Between 2003 and 2008, we assessed 128 subjects aged less than 14 years and observed a constant increase in ED-related problems. Our analysis shows the importance of representative classification criteria suitable for young patients in order to improve diagnosis and therapeutic planning. The need for a specific classification for early childhood is underlined by the fact that comorbidities and overlapping patterns often complicate adequate assessment.
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Affiliation(s)
- E Franzoni
- Child Neurology and Psychiatry Unit, Policlinico Sant'Orsola Malpighi, University of Bologna, Via Massarenti 11, 40138 Bologna, Italy.
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