Anna Riva

1. Couvade syndrome, often described as the male analog of pseudocyesis, is a poorly understood condition in which expectant fathers develop somatic and psychological symptoms mirroring those of th...

Background/Objectives: Inflammatory bowel diseases (IBDs) are relapsing–remitting gastrointestinal disorders often emerging in adolescence and frequently associated with psychiatric co-morbidities, including eating disorders (EDs). Deficiency in interoception—awareness of internal bodily sensations—is a transdiagnostic feature in EDs, with emerging evidence suggesting its relevance also in IBDs. This study aimed to assess interoceptive abilities in adolescents with IBDs compared to healthy adolescents. Methods: A total of 76 patients with IBDs and 90 healthy controls were enrolled in the study. All participants completed a comprehensive psychometric assessment, including measures of interoceptive sensibility (MAIA-2) and eating-related symptomatology (EDI-3). Results: Up to one in six (15.8%) patients with IBDs were found to be at high risk of developing EDs (EDI-3 Eating Disorder Risk Composite scale >70th percentile). Mean MAIA-2 scores were largely comparable, with the exception of the MAIA-2 Trusting subscale, which assesses whether the experience of one’s body is rated as safe and trustworthy. Specifically, patients with IBDs at high risk of developing EDs reported lower scores than both healthy controls and patients with IBDs at low risk of developing EDs, with a statistically significant difference emerging in the comparison with the latter group (p = 0.044). Conclusions: Adolescents with IBDs who report an elevated risk of developing eating disorders have a psychological profile characterised by increased disordered eating symptomatology, accompanied by selective impairment in interoceptive trust, as evidenced by reduced trust in internal bodily signal. These findings highlight the clinical relevance of thorough clinical assessment and early psychological intervention in this vulnerable population.

Background: Female individuals with inflammatory bowel diseases (IBDs) are more likely to develop restrictive eating disorders (REDs), with both conditions appearing to share common pathophysiological pathways. We conducted a case–control study exploring eating symptomatology and interoceptive profiles in female adolescents with IBDs compared with adolescents diagnosed with REDs, in order to test the hypothesis that the two clinical populations exhibit similar interoceptive characteristics. Methods: We recruited 33 female adolescents with IBDs and 54 controls with REDs matched for age and gender. All participants completed a validated psychometric battery assessing eating disorder features (EDI-3) and interoceptive awareness (MAIA-2). Results: Twenty-seven percent of patients with IBD scored above the cut-off (>70th percentile) on the EDI-3 Eating Disorder Risk Composite (EDRC), showing an eating and interoceptive profile comparable to that of patients with REDs. The two sub-cohorts within the IBD sample differed in the ‘Not-Worrying’ and ‘Trusting’ MAIA-2 subscales, with the IBD cohort at risk of developing an ED reporting lower scores. Conclusions: Our findings indicate comparable interoceptive profiles between adolescents with IBDs who are at risk of developing EDs and patients with a confirmed diagnosis of REDs. This similarity underscores the need to further investigate the shared pathogenic mechanisms underlying these conditions, particularly the role of the gut–brain axis (GBA).

Background: Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric co-morbidities, including restrictive eating disorders (REDs), with which they share common pathogenic mechanisms, including gut–brain axis dysregulation. We conducted a case–control study systematically exploring the psychopathological profiles and alexithymia in adolescents with IBDs compared with a clinical group of adolescents diagnosed with REDs in order to test the hypothesis of common psychological characteristics between the two patient populations. Methods: We recruited 76 patients with IBDs and 76 age-matched controls with REDs (64 adolescents with anorexia nervosa and 12 adolescents with avoidant/restrictive food intake disorder). All participants completed a validated psychometric battery assessing psychological symptoms (SCL-90-R), ED features (EDI-3), and alexithymia (TAS-20). Comprehensive socio-demographic and clinical data were extracted from the medical records. Results: A total of 12 patients with IBDs (15.8%) scored higher than the cut-off (>70th percentile) on the EDI-3 scale for Eating Disorder Risk (EDI-EDRC), with a psychological profile comparable to RED patients. Female gender (OR = 0.133, p = 0.020) and longer disease duration (OR = 1.055, p = 0.036) were identified as significant risk factors for the development of EDs. Conclusions: Our findings suggest common psychological traits between patients with REDs and patients with IBDs at risk of developing EDs during adolescence, highlighting the need for early screening for EDs in patients with IBDs who present with specific socio-demographic and disease characteristics.

Introduction: Little is known about thepsychological correlates of inflammatory bowel diseases (IBDs) in the pediatric population. We, therefore, conducted a case-control study systematically exploring psychopathological profiles and alexithymia in adolescents with IBDs. Methods: We recruited 52 patients with IBDs (of whom 43 in clinical remission) and 52 age- and gender-matched healthy controls. All participants completed a validated psychometric battery assessing psychological symptoms Symptom Checklist-90-Revised and alexithymia Toronto Alexithymia Scale-20. Results: Adolescents with IBDs reported significantly higher scores across all psychopathological domains compared to controls, with more pronounced differences in depression and obsessive-compulsive symptoms (both P < 0.001). However, there were no significant differences in alexithymia scores between the two groups. Conclusion: These findings underscore the psychological distress experienced by adolescents with IBDs, emphasizing the importance of early identification and intervention to prevent the development of fully fledged psychiatric disorders. Further research is needed to better characterize the psychopathological profiles of different clinical phenotypes of IBDs and to explore possible correlations with the clinical course of these chronic conditions.

Background/Objectives: The co-morbidity between neurodevelopmental tics and functional tic-like behaviors (FTBs) in patients with Tourette syndrome (TS) is relatively under-investigated. The demographic and clinical characteristics of a large sample of patients with TS who presented with co-morbid FTBs (functional overlay) were assessed to raise awareness of this complex clinical presentation and to shed light on the differential diagnosis between the two conditions. Methods: We analyzed the clinical data of 63 patients (44 females, mean age 24 years, range 13–40) with pre-existing TS who (sub)acutely developed co-morbid FTBs (TS + FTBs) after the onset of the COVID-19 pandemic and compared them with 63 age- and gender-matched controls with TS (neurodevelopmental tics only). The diagnosis of co-morbid FTBs was validated by the European Society for the Study of Tourette Syndrome (ESSTS) criteria. Results: Complex vocal tics (p < 0.001), including coprolalia (p = 0.002), and self-injurious behaviors (p < 0.001), often as part of tic attacks (p < 0.001), were confirmed to be more commonly reported by the group of patients with TS + FTBs, who were also more likely to present with anxiety (p < 0.001) and other functional neurological symptoms (p < 0.001) compared to patients with TS. Conclusions: Patients with TS and co-morbid FTBs can pose significant diagnostic and treatment challenges. By systematically applying ESSTS criteria, we confirmed specific red flags for the diagnosis of functional overlay in patients with TS. The correct identification of this composite clinical phenotype plays a key role in preventing the misdiagnosis of treatment-resistant TS and implementing tailored treatment interventions.

Objective: Anorexia nervosa and borderline personality disorder are often associated and share some core elements, including emotional dysregulation and affective instability. Nevertheless, the association of these two conditions in adolescence is still little studied.Method: The present study aims at investigating, through a multidimensional assessment, the psychopathological characteristics of adolescents affected by anorexia nervosa in comorbidity with borderline personality disorder on a sample of 127 female adolescents, through the comparison with adolescents with borderline personality disorders and adolescents with anorexia nervosa. All participants completed a validated psychometric battery assessing alexithymia (Toronto Alexithymia Scale‐20), depression (Children's Depression Inventory), psychological symptoms (Symptom Checklist‐90–Revised) and psychological symptoms relevant in eating disorders (Eating Disorders Inventory‐3).Results: Adolescents with anorexia nervosa in comorbidity with borderline personality disorder show intermediate features between the two disorders individually in the general psychopathological profile, but a peculiar psychological profile regarding the eating symptomatology, with worse features compared to adolescents with the sole anorexia nervosa.Conclusions: Results suggest a peculiar clinical and psychopatological endophenotype in adolescents with anorexia nervosa in comorbidity with borderline personality disorders, indicating the need to define specific and tailored treatment for this population.

Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric comorbidities, including eating disorders (EDs). We aimed to investigate the potential association between key disease characteristics, including psychological features, and the development of EDs in a clinical sample of adolescents with IBDs. We enrolled 52 adolescents with IBDs, 83% of whom were in clinical remission, and systematically collected additional information on disease duration, the total number of relapses, the use of steroids, and the number of hospital admissions. All participants completed a validated psychometric battery assessing psychological symptoms (Symptom Checklist-90–Revised, SCL-90-R), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and ED symptomatology (Eating Disorders Inventory-3rd edition, EDI-3). About one in ten patients (9.6%) reported Eating Disorder Risk scores higher than the cut-off on the EDI-3 subscale, specifically addressing the risk of developing EDs. According to the EDI-3 scores, the risk of developing EDs directly correlated with the number of total relapses of IBDs (p < 0.05). The TAS-total scores also correlated with the number of total relapses (p < 0.01), as well as with the number of steroid cycles (p < 0.05), the number of hospital admissions (p < 0.05), and overall disease duration (p < 0.05). Our findings suggest that disease relapses increase the risk of developing both EDs and alexithymia in adolescents with IBDs. The recurrence of disease relapses should be identified and screened early on to prevent the onset of psychiatric disorders, including EDs. Research should be conducted on larger samples with different IBD phenotypes to further investigate the characteristics of patients with IBDs at risk of developing EDs.

Peroneal neuropathy and polyneuropathy are displayed with a variable percentage in subjects affected by eating disorders and in particular by anorexia nervosa. Actually, little is known on features of these complications during the paediatric age. We describe the case of a female adolescent with right peroneal palsy and subclinical polyneuropathy associated with anorexia nervosa (AN). We review previous research about peroneal mononeuropathy and polyneuropathy associated with AN, and we develop a diagnostic and therapeutic protocol to help clinicians recognize and treat these disorders.

Purpose: Eating disorders (EDs) are psychiatric disorders with a typical prevalence in adolescence. EDs have long been wrongly considered female gender-bound disorders, resulting in a systematic underrepresentation of males in EDs research. The main goal of the present study is exploring the clinical and psychological characteristics of adolescent males with EDs in comparison with females. Methods: In this observational and retrospective study, 14 males and 28 females hospitalized for eating disorders during the adolescent age (from 12 to 17.11 years) were recruited. Main clinical data (age, BMI, duration of illness), behavioural characteristic of the disorder (over-exercising, self-harm, purging-behaviours) and psychological symptoms (Eating Disorders Inventory-3rd edition—EDI-3, Symptom Checklist-90-Revised—SCL-90, Children’s Global Assessment Scale—C-GAS) were collected and examined for significant correlations with severity of body mass index (BMI). Results: Adolescent males show a peculiar and more severe psychopathological profiles partially influenced by BMI and characterized by purging-behaviours, over-exercising, obsessive–compulsive behaviour, anxiety, and psychoticism. Conclusion: This study suggests a gender-specific profile of adolescent males with EDs, which may be considered in diagnosis and treatment. Level III: Evidence obtained from retrospective well-designed case–control study.