Search Results (5)

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition with a complex and multifactorial etiology, diagnosed on the basis of clinical criteria. Medical comorbidities are common and often lead to instrumental examinations; however, the clinical utility of routinely performing such tests remains uncertain. This study aimed to assess the practical value of instrumental assessments in ASD by examining both prescribing behaviors and the prevalence of abnormal findings in a sample of autistic children. Methods: A combined-method approach was adopted: (1) an online survey of child neuropsychiatrists across the Piedmont region (Italy) explored current attitudes and practices regarding instrumental testing in children with ASD; (2) a retrospective cross-sectional analysis examined the frequency and clinical relevance of abnormal findings in ASD patients who underwent comprehensive testing at a tertiary hospital in Turin. Results: The survey showed that 85.7% of centers follow specific protocols for instrumental examinations, though practices vary considerably. Genetic testing and blood analyses are routinely performed, while EEG, MRI, audiometry, and metabolic screenings are generally based on clinical indication. In the retrospective study, instrumental tests revealed a low rate of clinically significant findings. Clinically relevant genetic abnormalities were detected in 7.9% of CGH-array tests. EEG abnormalities were seen in 9% of cases, though 57% had nonspecific or unclear results. Among biochemical parameters, notable findings included altered lipid profiles (45%), ferritin deficiency (24%), and anemia (12.5%) and no metabolic disorders were identified. Discussion: These findings highlight substantial variability in clinical practice and suggest that while some instrumental tests may provide valuable insights, routine screening is often of limited benefit. The high prevalence of nonspecific findings reinforces the need for careful clinical correlation, emphasizing the importance of balancing comprehensive assessment against the risks of over-testing and challenges in interpreting results. Future research should focus on developing evidence-based guidelines for instrumental assessments in this population. Full article

Objectives: To evaluate the influence of job demands and resources on burnout risk among Italian pediatric neuropsychiatrists. Methods: This cross-sectional study was conducted between December 2023 and February 2024 and involved Italian pediatric neuropsychiatrists. The study applied the Job Demands-Resources (JD-R) model to assess the impact of job demands (such as work–family conflict, time pressure, and job uncertainty) and job resources (like organizational support and perceived job meaning) on burnout. Burnout was measured through emotional exhaustion, depersonalization, and personal accomplishment subscales. Demographic data, including gender and career stage, were analyzed for their association with burnout. Results: High job demands were significantly associated with increased emotional exhaustion and depersonalization, while greater job resources correlated with lower burnout levels and higher personal accomplishment. Gender differences emerged, with female neuropsychiatrists reporting significantly higher emotional exhaustion and lower personal accomplishment than male neuropsychiatrists. Seniority was not a strong predictor, but early-career professionals, particularly residents, exhibited higher susceptibility to emotional exhaustion. Perceived job meaning and organizational support were protective factors across all burnout subscales, buffering the effects of job demands. Conclusions: Burnout risk in Italian pediatric neuropsychiatrists is shaped by both job demands and resources. Addressing work–family conflict, job uncertainty, and time pressure alongside enhancing organizational support and fostering job meaning is crucial to mitigate burnout. Special attention should be given to early-career professionals and female neuropsychiatrists to reduce their emotional exhaustion and improve their well-being. These findings provide valuable insights for developing targeted strategies to improve well-being in this field, ultimately enhancing patient care. Full article

Treatment of IgE-mediated food allergy involves avoiding the food causing the allergic reaction. In association, an action plan for allergic reactions is indicated, sometimes including self-injectable adrenaline. In addition to these dietary and medical implications, there are two equally important ones: nutritional and psychosocial. From a nutritional point of view, it is known that children suffering from food allergy have a growth delay in height and weight compared to their non-allergic peers. Specifically, this condition is directly related to the specific food excluded from the diet, the number of foods excluded and the duration of the elimination diet. From a psychosocial point of view, the child often cannot eat the foods other guests eat. Children with food allergy may perceive an aura of parental anxiety around their mealtime and may be afraid that what they eat could have harmful consequences for their health. Furthermore, children’s and their parents’ quality of life appears to be affected. The need to manage the allergy and the nutritional and psychosocial problems positions the pediatric nutritionist and the child neuropsychiatrist as support figures for the pediatric allergist in managing the child with food allergy. Full article

The SARS-CoV-2 pandemic had a negative impact on the mental health of children and adolescents. Eight focus groups and six individual hearings were conducted to gain insights from the perspectives of 97 Italian professionals from a variety of disciplines, including child and adolescent neuropsychiatrists, pediatricians, general practitioners, social workers, psychologists, teachers, school deans, non-governmental organizations, and a researcher. Urban and rural settings were represented. The present research has been promoted by the Italian Independent Authority for Children and Adolescents (Autorità Garante per l’Infanzia e l’Adolescenza, AGIA) in collaboration with the National Institute of Health (Istituto Superiore di Sanità, ISS) and the Ministry of Education and its scientific value has been supervised by a Scientific Committee. The results of the focus groups’ discussions revealed increased vulnerability, with the onset of new mental health disorders in healthy individuals and those in a condition of disadvantage, migratory contexts, and with disabilities. The already critical pre-pandemic structural and operational issues of existing services have been exacerbated. In healthcare, the activation of telemedicine has been a great asset but at the same time has generated challenges and critical issues that are still unresolved. Professionals emphasized the need to pay special attention to planning integrated responses aimed at overcoming inequalities and fragmentation. The result of this initiative translates into a set of operational recommendations useful for guiding investments and policies directed toward the protection of the mental health of minors in the health, educational, and social spheres from the outset. Full article

Children with Autism Spectrum Disorder (ASD) were particularly vulnerable to disruptions caused by the COVID-19 pandemic. In this study we conducted an anonymous caregiver survey to assess the impact of the COVID-19 pandemic on the psychosocial and behavioral health of children with ASD. Data from 700 responses identified several significant factors predicting greater difficulties for the child including pre-existing behavioral challenges (OR = 5.179; 95% CI: 2.696, 9.951), disrupted sleep (OR = 2.618; 95% CI 1.341, 5.112), and a diagnosis of depression (OR = 3.425; 95% CI: 1.1621, 4.116). Greater difficulties for caregivers in managing their child’s behaviors were associated with sleep disturbances (OR = 1.926; 95% CI: 1.170, 3.170), self-injurious behavior (OR = 3.587; 95% CI: 1.767, 7.281), and managing the child’s school activities (OR = 3.107; 95% CI: 1.732, 5.257) and free time (OR = 3.758; 95% CI: 2.217, 6.369). However, being under the care of a neuropsychiatrist was associated with less difficulty in managing the child’s behaviors (OR = 2.516; 95% CI: −1.046, −5.382). Finally, the presence of comorbidities (OR = 2.599; 95% CI: 1.053, 4.067) and a greater difficulty in managing the child’s school activities (OR = 2.531; 95% CI: 1.655, 3.868) and free time (OR = 1.651; 95% CI: 1.101, 2.478) were associated with an increased likelihood of caregiver desire for their child to return to in-person school in the fall. The COVID-19 pandemic had a wide-ranging impact on the behaviors of children with ASD and challenges for their caregivers. Full article