Marinos Kyriakopoulos

Cortical brain morphology in early-onset psychosis (EOP; age of onset d = −0.36/−0.31), surface area (left/right: d = −0.42/−0.41), cortical volume (left/right: d = −0.58/−0.56), and Local Gyrification Index (LGI; left/right: d = −0.39/−0.52) in EOP relative to CTR. Diagnostic subgroup analyses showed broader and more pronounced case-control differences in early-onset schizophrenia for area, volume, and LGI. We found no associations with antipsychotic medication use, illness duration, age of onset, or positive symptoms. Negative symptoms were related to smaller left lingual volume (partial r = −0.21; p _FDR = 0.014) and antidepressant users had smaller area ( d = −0.43; p _FDR = 0.034) and volume ( d = −0.50; p _FDR = 0.003) of the right rostral anterior cingulate compared to non-users. Cortical thickness alterations in EOP showed a similar pattern to those observed in prior studies on adults with schizophrenia (SCZ; r = 0.62) and bipolar disorders (BD; r = 0.61). However, surface area alterations were overall 1.5 times greater for EOP than adult SCZ and 4.6 times greater than adult BD. In the largest study of its kind, we observed a widespread pattern of cortical alterations in adolescents with psychotic disorders, highlighting the potential impact of aberrant neurodevelopment on cortical morphology in this clinical group.

Summary: When thoroughly assessed, the prevalence of attention-deficit hyperactivity disorder (ADHD) in children/adolescents is estimated at 5%. There is no evidence that ADHD is over-diagnosed in the UK. Indeed, available data point to under-diagnosis, even though rigorous updated post-COVID-19 pandemic data are not available. Some cases may be misdiagnosed due to low-quality assessment, poor adherence to national guidance or inappropriate differential diagnosis. Beyond the controversy around over- or under-diagnosis and over-medicalisation of ordinary behaviours or emotions, the main issue is that UK clinical services cannot adequately support individuals with ADHD who need help. There is a risk that the narrative claiming ‘ADHD is over-diagnosed’ could be used to deny people with properly-diagnosed ADHD the care they deserve.

Background: Autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) may coexist in children and adolescents and present with several overlapping features. Aims: We aimed to assess the prevalence of ASD traits and diagnosis in children and adolescents with OCD, explore the correlation between OCD severity and ASD traits/diagnosis, and examine the impact of ASD traits/diagnosis on global functioning in this population. Method: Electronic searches were carried out on Pubmed, Embase and PsycINFO, using selected keywords and specified inclusion and exclusion criteria. Meta-analysis was performed with R Version 4.3.1. Results: Of 1410 studies initially identified, 29 reported on the prevalence of ASD traits or diagnosis. Pooled mean prevalence rate was 8.0% (95% CI 5.0–13%). ASD questionnaire scores were higher in OCD versus control groups (standardised mean difference: 1.23; 95% CI 0.76–1.69). There was limited significant correlation between ASD questionnaire scores and OCD questionnaire scores, and no significant differences in these scores were demonstrated between OCD samples and samples diagnosed with comorbid OCD and ASD (mean difference −0.41; 95% CI −1.23 to 0.40). Functional impairment appeared elevated with ASD traits/diagnosis in OCD, but meta-analysis feasibility was limited. Conclusions: This review indicates higher ASD traits and diagnosis in children and adolescents with OCD compared with the general population. Limited data and methodological constraints in trials limit generalisability, warranting further research.

Background: Mental health stigma remains a significant barrier to treatment and recovery, particularly among adolescents. This study explores perceived stigma in previously hospitalized adolescents, their perceptions of inpatient psychiatric care, and parental self-stigma. Methods: We employed a cross-sectional, mixed-methods design with 82 adolescents (n = 67 females), aged 12-17 years (M = 15.5, SD = 1.2) and their parents. Quantitative measures included the Adolescent’s Stigma Scale, Parents’ Self-Stigma Scale, and Strengths and Difficulties Questionnaire. Qualitative data were collected via open-ended questions and analyzed using content analysis. Results: Findings indicated notable perceived stigma, especially among older adolescents (15–17 years) and those two hospitalizations, with secrecy, self-stigma, and rejection associated with emotional and behavioural difficulties. Parental self-stigma correlated with child’s age and length of hospitalization, and inversely with adolescent secrecy. Qualitative findings revealed that hospitalization offered emotional support and opportunities for personal growth, yet also posed challenges to autonomy, social and educational stability, and psychological well-being. Conclusions: Findings highlight the need for flexible hospital policies, improved discharge communication, mental health literacy initiatives, and peer-support programs. Future research should examine cultural influences, stigma trajectories, and effective family-based interventions for adolescents.