Adolescent Admissions to Emergency Departments for Self-Injurious Thoughts and Behaviors.

The objective of the present study was to describe the incidence and the characteristics of Self-Injurious Thoughts and Behaviors (SITBs), among adolescents aged 11-18 admitted, over a two year period, to all the Emergency Departments of a Region of North-eastern Italy through a comprehensive analysis of medical records. A two-step search was performed in the regional ED electronic database. First, we identified the cases that had been clearly diagnosed as SITBs by an Emergency Department physician. Secondly, suspect cases were detected through a keyword search of the database, and the medical records of these cases were hand screened to identify SITBs. The mean annual incidence rate of SITBs was 90 per 100,000 adolescents aged 11-18 years. Events were more frequent in females. Drug poisoning was the most frequently adopted method (54%). In 42% of cases a diagnosis of SITB was not explicitly reported by the physician. In 65% of cases adolescents were discharged within hours of admission. Only 9% of patients started a psychiatric assessment and treatment program during hospital stay. This research confirms the high incidence of SITBs among adolescents and highlights the difficulty in their proper diagnosis and management. Such difficulty is confirmed by the fact that only a few patients, even among those with a clear diagnosis, were sent for psychiatric assessment. Correct identification and management of SITB patients needs to be improved, since SITBs are an important public health problem in adolescence and one of the main risk factors for suicide.

Psychopathological and personality traits underlie decision making in recent onset medication naïve anorexia nervosa: a pilot study.

The Iowa Gambling Task (IGT) analyzes the ability of participants to sacrifice immediate rewards in view of a long term gain. Anorexia Nervosa (AN) in addition to weight loss and body image disturbances is also characterized by the tendency to make decisions that may result in long-term negative outcomes. Studies that analyzed IGT performance in patients with AN were not consistent with each other. Fifteen adolescents with AN and 15 matched controls carried out IGT after being clinically and neuropsychologically evaluated. An interesting generalized estimating equation approach showed that four independent clinical variables, and not the group, explained IGT performances, such as blocks repetition, anxiety, psychogenic eating disorders and self transcendence. The impairment of decision making is not related to the diagnosis of AN, but it is driven by high levels of anxiety and self transcendence. Instead, some psychogenic eating disorders traits, related to illness severity, positively affected IGT performance in the whole sample. IGT impairment in AN found by prior studies could be related to these clinical features which are not always taken into account.

Impaired configural body processing in anorexia nervosa: evidence from the body inversion effect.

Patients with anorexia nervosa (AN) suffer from severe disturbances of body perception. It is unclear, however, whether such disturbances are linked to specific alterations in the processing of body configurations with respect to the local processing of body part details. Here, we compared a consecutive sample of 12 AN patients with a group of 12 age-, gender- and education-matched controls using an inversion effect paradigm requiring the visual discrimination of upright and inverted pictures of whole bodies, faces and objects. The AN patients presented selective deficits in the discrimination of upright body stimuli, which requires configural processing. Conversely, patients and controls showed comparable abilities in the discrimination of inverted bodies, which involves only detail-based processing, and in the discrimination of both upright and inverted faces and objects. Importantly, the body inversion effect negatively correlated with the persistence scores at the Temperament and Character Inventory, which evaluates increased tendency to convert a signal of punishment into a signal of reinforcement. These results suggest that the deficits of configural processing in AN patients may be associated with their obsessive worries about body appearance and to the excessive attention to details that characterizes their general perceptual style.

Visual body perception in anorexia nervosa.

OBJECTIVE: Disturbance of body perception is a central aspect of anorexia nervosa (AN) and several neuroimaging studies have documented structural and functional alterations of occipito-temporal cortices involved in visual body processing. However, it is unclear whether these perceptual deficits involve more basic aspects of others' body perception. METHOD: A consecutive sample of 15 adolescent patients with AN were compared with a group of 15 age- and gender-matched controls in delayed matching to sample tasks requiring the visual discrimination of the form or of the action of others' body. RESULTS: Patients showed better visual discrimination performance than controls in detail-based processing of body forms but not of body actions, which positively correlated with their increased tendency to convert a signal of punishment into a signal of reinforcement (higher persistence scores). DISCUSSION: The paradoxical advantage of patients with AN in detail-based body processing may be associated to their tendency to routinely explore body parts as a consequence of their obsessive worries about body appearance.

Autism and motor acts: experimental analysison mylohyoid muscle emg recordingsduring grasping-to-eat action - biomed 2010.

Most neuroscience studies do not pay enough attention to bio-mechanical related problems, such as the kinematic aspects of movements, that pose important boundary conditions, but are in general not sufficiently taken into consideration. In this work, using an experimental protocol based on measurements of mylohyoid (MH) muscle activity during grasping-to-eat actions, we debate the existence of impairments of action chains in children with autism spectrum disorders (ASD). We re-examine the results of an electromyographic (EMG) experiment on MH muscle presented in a previous study; and we compare them to the results of a new, similar experiment in order to study the electromyographic activity of MH in typically developing (TD) children and in children with ASD executing grasping-to-eat actions. Our results are remarkably different from the original work and seem to indicate that there is no clear experimental evidence of different action organization in children with ASD.