Social Cognition in Neuropsychiatric Disorders in Pediatric Age

Objective: The purpose of our study was to assess social cognition in ad-olescents and children with epilepsy or Specific Learning Disorder (SLD) compared to typical individuals. It was verified whether the age of onset, duration and drug therapy of epileptics can influence this ability and if there is a correlation between Social Cognition, intelligence and executive functions.Methods: This is an observational cross-sectional study that included a total of 125 subjects between 7 and 16 years (62 with focal epilepsy and 63 with SLD). The control group included 32 healthy subjects. Study sub-jects were evaluated with neuropsychological tools to evaluate executive functions (EpiTrack Junior), Social Cognition (NEPSY-II), and intelli-gence; a nonverbal cognitive test (Raven's Matrices) was used in subjects with Epilepsy, while WISC-IV was administered to SLDs.Results: the groups of subjects scored significantly lower than the con-trols in Social Cognition. The results showed a positive correlation be-tween affect recognition scores and executive function in both groups. In patients with epilepsy the deficit in Affect Recognition appeared to be linked with early age of onset of epilepsy, long term of disease and lack of non-verbal intelligence; a high frequency of seizures, on the other hand, was related to poor performance in the Theory of Mind (ToM). In the SLD group there was no correlation between social cognition and in-tellectual level.Conclusions: The results of our study suggest that individuals with focal epilepsy or SLD have deficits in the recognition of facial emotions and ToM compared to their peers.In epilepsy group, the Social Cognition deficit seems to be linked to char-acteristics of epilepsy, particularly the deficits in the recognition of facial emotions seems linked to problems in nonverbal intelligence and in exec-utive function.In the SLD group, however, the ability to recognize emotions was corre-lated only with executive functions.</p

Neuropsychological Profile, Emotional/Behavioral Problems, and Parental Stress in Children with Neurodevelopmental Disorders

Background: The aim of our study was to trace a specific neuropsychological profile, to investigate emotional-behavioral problems and parental stress in children with Autism Spectrum Disorder Level 1/High functioning (ASD-HF), Specific Learning Disorders (SLD) and Attention Deficit/Hyperactivity Disorder (ADHD) disorders and to highlight similarities and differences among the three groups. Methods: We retrospectively collected the data from a total of 62 subjects with ASD-HF (n = 19) ADHD (n = 21), SLD (n = 22) and 20 typical development. All the participants underwent neuropsychological standardized test for the evaluation of cognitive profile (Wechsler Intelligence Scale for Children Fourth Edition—WISC-IV), behavioral and emotional problems (Child Behavior CheckList CBCL), and parental stress (Parental Stress Index Short Form—PSI-SF). The scores of the ASD-HF, ADHD, and SLD groups were compared using non-parametric statistic methods (Kruskall–Wallis H test and U Mann–Whitney for post-hoc analysis). Results: The ASD-HF group were significantly higher in all areas of the WISC-IV than the other two clinical groups. The SLD group performed significantly lower than ASD-HF in Working Memory Index. The SLD group showed lower scores on the somatic problems subscale than the other two groups. In the Difficult Child subscale of the PSI-SF, parents of ADHD children scored lower than the mothers of SLD subjects and higher than the fathers of SLD subjects. In all three groups there are specific deficiencies compared to the control group in the cognitive profile, behavioral and emotional problems, and parental stress. Conclusions: Our comparative analysis highlighted similarities and differences in three groups of children with different neurodevelopmental disorders, helping to better define cognitive, behavioral, and emotional characteristics of these children and parental stress of their parents

Psychogenic Seizures in Adolescents: An "Evergreen" Diagnostic Challenge

Paroxysmal events are classified as non-epileptic or epileptic symptoms. The first ones are distinguished in psychogenic and organic/physiological paroxysmal events (Lüders et al., 2019). In organic and physiological disorders there are several symptoms: inattention, daydreaming, staring, sleep myoclonus, stereotyped movements, hypnotic spasms, tonic postures, parasomnia, movement disorders. Psychogenic non-epileptic seizures (PNES) are not associated with abnormal brain EEG activity and cannot be explained by other neurological disorders. PNES are also defined as functional neurological disorders and are included among the Conversion Disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013). This disorder is characterized by symptoms of impaired voluntary or sensorimotor function without the presence of other neurological or clinical conditions

Social Cognition in Neuropsychiatric Disorders in Pediatric Age

Objective: The purpose of our study was to assess social cognition in adolescents and children with epilepsy or Specific Learning Disorder (SLD) compared to typical individuals. It was verified whether the age of onset, duration and drug therapy of epileptics can influence this ability and if there is a correlation between Social Cognition, intelligence and executive functions. Methods: This is an observational cross-sectional study that included a total of 125 subjects between 7 and 16 years (62 with focal epilepsy and 63 with SLD). The control group included 32 healthy subjects. Study subjects were evaluated with neuropsychological tools to evaluate executive functions (EpiTrack Junior), Social Cognition (NEPSY-II), and intelligence; a nonverbal cognitive test (Raven's Matrices) was used in subjects with Epilepsy, while WISC-IV was administered to SLDs. Results: the groups of subjects scored significantly lower than the controls in Social Cognition. The results showed a positive correlation between affect recognition scores and executive function in both groups. In patients with epilepsy the deficit in Affect Recognition appeared to be linked with early age of onset of epilepsy, long term of disease and lack of non-verbal intelligence; a high frequency of seizures, on the other hand, was related to poor performance in the Theory of Mind (ToM). In the SLD group there was no correlation between social cognition and intellectual level. Conclusions: The results of our study suggest that individuals with focal epilepsy or SLD have deficits in the recognition of facial emotions and ToM compared to their peers. In epilepsy group, the Social Cognition deficit seems to be linked to characteristics of epilepsy, particularly the deficits in the recognition of facial emotions seems linked to problems in nonverbal intelligence and in executive function. In the SLD group, however, the ability to recognize emotions was correlated only with executive functions

Psychogenic Seizures in Adolescents: An “Evergreen” Diagnostic Challenge

Psychogenic non-epileptic seizures (PNES) are not associated with abnormal brain EEG activity and cannot be explained by other neurological disorders. PNES are also defined as functional neurological disorders and are included among the Conversion Disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). There is no doubt about the importance of an early and correct diagnosis of PNES. Diagnostic process is first based on an accurate clinical history. Video-EEG is considered the gold standard for the diagnosis, though it is often time consuming and it does not always allow to record an ictal event. When PNES is diagnosed, because it is not a seizure and no emergency treatment is required, the first goal is to ensure acceptance of the diagnosis. Initially, putative precipitating stressors need to be identified and addressed so that PNES can be contained and managed. Possible interventions for patients with PNES include psychotherapy, family counseling interventions, changes in the school environment and drug treatment. The latter may include anxyolytics and/or antidepressants; in case of a comorbid ADHD disorder, methylphenidate may be also considered.</em

Impact of COVID-19 Pandemic on Children and Adolescents with Neuropsychiatric Disorders: Emotional/Behavioral Symptoms and Parental Stress

The objective of our study was to evaluate the impact of the COVID-19 pandemic on the emotional and behavioral symptoms in minors with neuropsychiatric disorders and on parental stress through a standardized neuropsychological assessment, comparing the data collected before the pandemic with those collected during the lock-down. Another goal of our study was to analyze the relationship between parental stress and behavioral/emotional symptoms in children. Our study was conducted on 383 families of patients who had already been referred at the Child Neuropsychiatry Unit of the University Hospital of Salerno for different neuropsychiatric conditions. All the parents completed two neuropsychological standardized questionnaires for the assessment of parental stress (PSI—Parenting Stress Index-Short Form) and the emotional/behavioral problems of their children (Child Behaviour CheckList). The data collected during the pandemic were compared with those collected from questionnaires administered during the six months preceding the pandemic, as is our usual clinical practice. The comparison between the mean scores of PSI and CBCL before and after the pandemic showed a statistically significant increase in all subscales analyzed in the total sample. The correlation analysis showed significant positive relationship between the subscale Total Stress of PSI and the subscales Total Problems and Internalizing Problems of CBCL. Our study suggested that the COVID-19 pandemic and the corresponding measures adopted led to an increase in internalizing and externalizing symptoms in children and adolescents with neuropsychiatric disorder. Similarly, parental stress increased during COVID-19 and ahigher level of stress in parents can be related to the internalizing symptoms of their children

Competenze linguistiche e pragmatica in differenti condizioni del neurosviluppo: confronto tra i profili emersi al questionario ccc2

La definizione delle abilit\ue0 pragmatiche in bambini con difficolt\ue0 di linguaggio e nella comunicazione rappresenta una necessit\ue0 sempre maggiore in ambito clinico. Lo scopo dello studio riguarda quindi la descrizione di tali competenze in bambini di 8-10 anni con differenti condizioni del neurosviluppo. Il campione \ue8 formato da 3 gruppi clinici e da un gruppo di controllo: Spettro dell'autismo con buon funzionamento intellettivo e linguistico (ASD, n = 19), Disturbo del linguaggio con associato Disturbo specifico dell'apprendimento (DSL+DSA, n = 23), Disturbo specifico dell'apprendimento in assenza di riferite problematiche linguistiche (DSA, n = 21) e bambini con sviluppo tipico (CONT, n = 26). Tutti i genitori dei bambini hanno compilato il questionario CCC-2. Le scale globali di comunicazione e linguaggio differenziano nettamente il gruppo di controllo dai restanti gruppi clinici, con punteggi significativamente inferiori per questi ultimi. Le scale a valenza pragmatica mostrano punteggi deficitari per il solo gruppo ASD con risultati interessanti per i DSA+DSL. L'analisi delle sottoscale evidenzia che solo i gruppi DSA, DSA+DSL cadono all'indagine fonologica e sintattica. Le scale di coerenza e semantica del linguaggio fragili e omogenee in DSA e DSA+DSL, hanno un profilo differente nei bambini con ASD. Infine, le sottoscale pragmatiche e sociali appaiono fortemente compromesse in ASD rispetto a tutti i restanti gruppi. Dallo studio emerge una buona sensibilit\ue0 del questionario CCC2 nel differenziare bambini a sviluppo tipico da gruppi clinici, i quali presentano un quadro di fragilit\ue0 linguistiche anche in condizioni di un apparente buon adattamento verbale

Language and Pragmatics Across Neurodevelopmental Disorders: An Investigation Using the Italian Version of CCC-2

Impairments in structural language and pragmatics are well recognized in different neurodevelopmental disorders, yet in clinical work the discrimination of children with various language difficulties into different diagnostic profile is still a major challenge. Using the CCC-2 questionnaire this study assesses and compares language competences in a sample of Italian children (aged 8–10) with typical development (n = 26) and in children with different neurodevelopmental conditions: high-functioning Autism Spectrum Disorder (n = 19), Language Disorder with associated Developmental Dyslexia (n = 23), Developmental Dyslexia without linguistic impairments (n = 21). The results supported the validity of CCC2 as screening measure that is able to distinguish children with communication impairments from non-impaired peers

Competenze pragmatiche e linguistiche nei Disturbi Specifici dell'Apprendimento (DSA): uno studio attraverso il questionario CCC2

Scopo. Il lavoro ha come obiettivo la descrizione del profilo linguistico e pragmatico dei DSA tramite il questionario CCC2 compilato dai genitori. Metodo. Il campione è formato da 2 gruppi clinici e da un gruppo di controllo: DSA con disturbo di linguaggio (n = 23), DSA senza difficoltà di linguaggio (n = 21) e bambini con sviluppo tipico (n = 26). Risultati. I gruppi clinici ottengono punteggi significativamente inferiori nelle scale globali di comunicazione e linguaggio rispetto al gruppo di controllo. Risultato analogo si ha nell’indagine fonologica e sintattica. Infine, le scale di coerenza e semantica del linguaggio mostrano una fragilità in entrambi i gruppi di DSA. Conclusioni. Lo studio mostra la presenza di difficoltà linguistiche nei DSA, indipendentemente da una diagnosi associata di disturbi del linguaggio. Si evidenzia una buona sensibilità del questionario CCC-2 nell’individuare fragilità linguistiche anche in condizioni cliniche con apparente buon adattamento verbale