The relationships between attachment quality, metacognition, and somatization in adolescents: The mediator role of metacognition.

PROBLEM: To investigate the associations between attachment quality, metacognition problems, and somatization. METHODS: One thousand and seven adolescents between the ages of 14-17 were included in the study. They completed the DSM-V Level 2 Somatic Symptoms Scale, the Inventory of Parent and Peer Attachment (short version), the Metacognitions Questionnaire for Children (MCQ-C), and the Strengths and Difficulties Questionnaire. The Spearmen's rank-order correlation test and structural equation modeling were used to analyze the associations between the scales. FINDINGS: Correlation coefficients and structural equation modeling indicated that attachment quality is significantly associated with somatic symptom severity, and MCQ-C scores play a partial mediator role in the relationship between attachment quality and somatization. CONCLUSION: Improving metacognitive skills in adolescents with low attachment quality may increase therapeutic success when addressing somatization.

A case imitating Panayiotopoulos syndrome.

Panayiotopoulos syndrome is one of the most common childhood-specific epileptic disorders. It is characterized by autonomic symptoms; the most common being emesis. However, the presence of emetic symptoms may cause misdiagnosis, for example with some organic disorders which have similar autonomic features. On the other hand, since this syndrome has been recently well documented, the tendency for early recognition may lead to overdiagnosis. Here, we present a case which could be mistaken for Panayiotopoulos syndrome based on anamnesis, however, with the aid of ictal video-EEG monitoring, the patient was shown to present with a non-epileptic psychogenic seizure. This report is an example of careful evaluation in order to avoid over- or underdiagnosis of this benign disorder. [Published with video sequences].