[Tic disorders in children and adolescents. Clinical and genetic features, comorbidity]. / Disturbo da tic in età evolutiva. Aspetti clinici e genetici, comorbidità.

UNLABELLED: Tic disorders in children and adolescents. Clinical and genetic features, comorbidity. BACKGROUND: Aim of the study is to evaluate the clinical and genetic characteristics of tic disorders, in view of individuating similarities or differences relevant to the prognosis among different nosological groups. METHODS: A retrospective study of 79 children and adolescents (average age 9.3 yrs) was performed. The cases were diagnosed according to DSM-IV as: transitory tics (TT) 13 cases; chronic tics (CT) 50 cases; Tourette disease (TD) 16 cases. They were compared to a control group of 18 school age children without any neurological or psychiatric disturbance. The study included: semi-structured interviews focused on natural history of the disturbances, familiarity, presence of perinatal pathology, comorbidity; neurological examination, EEG, psychodiagnostic tests and investigation. RESULTS: Mean age of onset and type of first symptoms are the same in the three groups. Compared to the control group there is a significant increase in: familiarity for tics disturbances in TD; presence of perinatal pathological factors in the three groups of patients; comorbidity for obsessive-compulsive disorder (OCD) in CT and TD, comorbidity with ADHD in CT group. Three clinical cases are reported to exemplify the mixed features in the families and the different responsivity to the pharmacological treatment.

[Adolescents with scoliosis: psychological and psychopathological aspects]. / Adolescenti con scoliosi: aspetti psicologici e psicopatologici.

BACKGROUND: The present study focuses on psychological and psychopathological aspects in children and adolescents with scoliosis. METHODS: The case series included 28 subjects with scoliosis (7 males, 21 females; range 9-25 years; mean age 15.8 years) admitted to the Dept. of Orthopaedics of Gaslini Institute and referred to our observation. Psychological approach included semi-structured interviews focused on the evolution of scoliosis and based on questions about consciousness of illness, family and patient emotional reactions during treatment; familial, social and school adaptation; body image; onset of psychopathological disorders. Family relational and educational attitudes were also considered. The following psychological tests were also performed: Raven Progressive Matrices; "Draw-a-Person" test; Sacks' battery of incomplete sentences to evaluate cognitive aspects, body image, familial and social relationships, interactive aspects. RESULTS: During adolescence consciousness of illness appeared concomitantly with the beginning of treatment. Most subjects presented intellectual-relational compensation strategies, but in a reasonable number of cases they showed insecurity and inferiority feelings. On a conscious level, body image appeared normal in most cases, but unconsciously (in 45% of cases) there were anguish aspects related to feelings of body deterioration. During long-term treatments anxious reactions, sometimes temporary, (in 36% of cases) and depressive aspects (in 9% of cases) were observed. CONCLUSIONS: The results obtained stress the importance of the family and the medical staff in providing a reassuring and firm support, in order to face difficulties related to the patient's illness.

Long-term outcome of children and adolescents with anorexia nervosa: study of comorbidity.

Eighty-seven children and adolescents with anorexia nervosa, admitted to the Gaslini Department of Child Neurology and Psychiatry between 1976 and 1990, were followed up after a mean of 9.6 years. Outcome measures included the Morgan Russell Outcome Schedule as modified by Jeammet. Outcome was good in 43 (53%) cases, intermediate in 27 (34%) cases, and negative in 11 (14%) cases. No deaths occurred. Based on the Jeammet assessment schedule, the most significant items predicting outcome were insight; sexual, familial, and social relationships; and mental state. Gender of patients and early disease onset did not seem to be predictive measures. Poor outcome was associated with a severe initial clinical picture and length of in-patient treatment. In regard to comorbidity, mood and personality disorders seemed to be negative prognostic indicators, whereas anxiety disorders did not show prognostic value.

[New aspects concerning the corpus luteum]. / Nuovi aspetti riguardanti il corpo luteo.

We have summed up current knowledge about the formation and lysis of corpus luteum with the co-ordinate intervention of luteotrophic and luteolytic factors. Then we re-examined the function of the corpus luteum in the physiologic menstrual cycle and in the first period of pregnancy, with special attention to luteal insufficiency as a cause of endocrine miscarriage.