Somatic Symptomatology Research Articles

Autistic Traits and Somatic Symptom Disorders: What Is the Link?

Alterations in sensory processing, a key component of autism spectrum disorder (ASD), have recently attracted increasing attention as they result in peculiar responses to sensory stimuli, possibly representing a risk factor for the development of somatic symptom disorder (SSD). Contextually, other features also associated with ASD, such as alexithymia, camouflaging and altered verbal, and non-verbal communication, have been suggested to represent risk factors for the occurrence and worsening of somatic symptomatology. The aim of this work was to review the available literature about the association between SSD and the autism spectrum. The results highlighted not only a higher prevalence of autistic features in patients suffering from SSD and a higher prevalence of reported somatic symptomatology in subjects with ASD but also how ASD subjects with co-occurrent somatic symptoms exhibit more severe autism-linked symptomatology. From the paper reviewed also emerged many shared features between the two conditions, such as alexithymia, altered sensitivity to sensory stimuli, cognitive inflexibility, intolerance of uncertainty, and an increased risk of experiencing stressful life events, which may provide an explanation for the correlation reported. Even though studies on the topic are still scant, the evidence reported suggests the importance of further assessing the correlation between the two disorders.

Predictors of overload in parents of children with neuromuscular diseases.

Parents of children with neuromuscular diseases experience multiple difficulties in their daily lives that affect their physical and psychological health. The risk factors for these health issues have not been sufficiently investigated. Therefore, the aim of this study was to analyze the potential predictors of overload in these parents, including QoL, somatic symptomatology, life satisfaction, psychological adjustment and certain sociodemographic variables. A cross-sectional research study was conducted among parents who are caregivers for children with NMD in Spain. A convenience sample of 110 parents who were contacted by associations and hospitals was used. Variables were evaluated using the sociodemographic questionnaire, CarerQol-7D, PHQ-15, Barthel Index, Psychological Adaptation Scale, Zarit Overload Scale and Satisfaction with Life Scale. One of the most relevant findings of the present study is the identification of 3 overload groups (mild to moderate, moderate to severe, and severe overload) based on life satisfaction and somatic symptom scores within the predictive model of the discriminate analysis. Wilk's lambda of the discriminant function was 0.568, χ2 (2, n = 55) = 8.815, p < 0.001. This study presents a model that reveals the influence of unemployment, having a child with a severe level of dependency, the presence of somatic symptomatology and life satisfaction on caregiver overload. Likewise, the caregiver's self-esteem could be a protective factor against overload.

Post-divorce adjustment, coparenting and somatisation: Mediating role of anxiety and depression in high-conflict divorces

BackgroundDue to the overlap of somatisation with other psychiatric symptomatology and the difficulty of making a clear diagnosis, few studies have focused on somatic symptoms after divorce. Moreover, their results are controversial and do not provide a conclusive differentiation according to gender. Objective: The present study is based on the hypothesis that psychological difficulties of adjustment to divorce and coparenting are linked to somatic symptomatology, in a sample of high-conflict divorcees, considering anxious and depressive symptoms as mediating factors. The role of some control variables was considered: marital status, level of education, time elapsed since separation, type of custody, frequency of contact with the children, and type of relationship with the ex-partner. In addition, the differential role of gender was studied. MethodA path analysis was carried out with the IBM SPSS AMOS 28 programme. ResultsIts results supported the relationship between psychological difficulties of adjustment to divorce and somatisation, as well as the mediating role of anxiety. A direct relationship between coparenting and somatisation was also found. These results were invariant in men and women, although specific differences were identified in the impact of anxiety. LimitationsAs a preliminary study, it is not without limitations. Firstly, it can be noted that it is a homogeneous sample with similar socio-demographic characteristics. Furthermore, the instruments used are general screening tests, and it could be interesting to incorporate more specific assessment tools. ConclusionsThis study supported the link between the conflictive divorce and the somatic symptomatology, leading to further research.

The Effect of Physical Exercise during COVID-19 Lockdown.

The COVID-19 pandemic has exerted an effect on the general population that went over every expectation. To explore the effect of physical exercise (PE) during the national lockdown in Italy, a survey was drawn up and administered to a sample composed of 208 subjects. The questionnaire comprised 81 multiple-choice items, including sociodemographic data, health-related questions, and assessment of physical exercise, satisfaction with life, depression, and personality. The purpose of this study is to explore the role of physical exercise during the outbreak following the present hypothesis: first, if a link exists between the time spent on physical exercise during the lockdown and the perceived health condition, depressive and somatic symptomatology, and life satisfaction; second, to find associations among the SF-12 component summaries and the other psychological outcomes; and finally, to explore how physical and psychological variables are predictive of PCS-12 and MCS-12. The results showed that both vigorous and moderate physical exercise was strongly correlated with psychological variables, with statistically significant negative correlations found between age and physical exercise. Additionally, significant positive correlations were observed between physical exercise and mental health indices, such as MCS-12 and SWLS, whereas negative correlations were found with BDI, PCS-12, and SOM-H. The correlation analysis also revealed that physical and individual mental health summaries were associated with psychological outcomes, with statistically significant negative correlations found between PCS-12 and MCS, PCS-12 and SOM-H, and MCS-12 and BDI scores. Regression analysis showed that physical activities and psychological status both had a direct influence on perceived mental and physical well-being during the lockdown, accounting for 56.7% and 35.5% of the variance, respectively. The p-values for the significant correlations ranged from <0.05 to <0.01. Overall, these findings highlight the importance of physical exercise and psychological well-being in maintaining good health during the pandemic.

Art-thérapies et Mineurs Non Accompagnés : indications, dispositifs et efficacités

IntroductionThe global context has resulted in an increase in migration of certain populations who seek protection and/or a hope for a better future. Whether for economic, social or political reasons, inhabitants sometimes hastily leave their country in order to find refuge elsewhere. Some minors take the path of exile alone and cross borders and seas to reach France: they then respond to the French designation of Unaccompanied Minors (MNA). Their migratory journey is long and perilous, a source of trauma. Their physical and mental health is impaired. Upon their arrival in France, they present significant post-traumatic symptomatology: post-traumatic stress disorder (PTSD), depression, anxiety, sleep disorders, disorders with somatic symptomatology. Psychologists and psychotherapists working with them find themselves in a complicated position with many pitfalls: the need for an interpreter, the representations of the psychologist, or even the absence of a request for support. Psychological care becomes even more complex. MethodA review of the literature indicates the effectiveness of art therapy in treating migrant children and adolescents accompanied by their families. Art therapy is particularly useful to help migrant minors to experience physical and psychological relief, to express their feelings, their emotions, to reduce their sense of isolation, to develop their creativity and to begin a process of acculturation. In this article we have chosen to present three studies that demonstrate the effects of art therapy on these accompanied migrant children. As these studies show, art therapy has many benefits for these subjects: reduction of symptoms linked to PTSD such as anxiety, depression and development, among other things, of self-esteem, self-confidence and resilience and many others. AnalysisThis study allows us to highlight the relevance of designing effective and protocolized art therapy treatment programs for unaccompanied minors. ResultsIn the case of Unaccompanied Migrant Minors, a very limited number of studies are beginning to consider art therapy as an essential part of the psychotherapeutic process for these subjects. We also present three such studies whose results complete and confirm those from studies concerning accompanied migrant children. ConclusionTo conclude, it seems that art therapy is a practice that must find its place among the essential tools of field practitioners working with Unaccompanied Minors. Working with adolescents who are in physical, administrative and psychological limbo, art therapy would make it possible to overcome certain pitfalls and open up a number of possibilities, to reinforce their resilience and to re-actualize their creative potential.

THE IMPACT OF LIFE TRAUMA ON THE MENTAL HEALTH AND SUICIDAL BEHAVIOR: A STUDY FROM PORTUGUESE LANGUAGE COUNTRIES

Introduction: The word “trauma” is commonly used to refer to a stressful event, however, each person’s individual adaptability and coping capacity is what defines whether an event is traumatic for them. The psychological trauma resulting from a traumatic event compromise both the mental and physical health of the traumatized individual. Several studies report the incidence of traumatic experiences in community and clinical samples and in specific populations. Suicide is still a major global public health concern and globally more than 700,000 people die from suicide every year. There is substantial research regarding the impact that exposure to a traumatic event has on mental health and suicidal behavior in various study populations, but this area remains unexplored in the Community of Portuguese Language Countries (CPLC). Objective: This study aims to 1) describe the traumatic experiences, mental health levels and suicidal behavior, comparing differences between country of residence; 2) assess correlations between traumatic experiences and mental health and suicidal behavior; and 3) assess the impact of exposure to a traumatic event on mental health and suicidal behavior. Methods: The participants of this study are 1006 individuals from Portugal, Brazil, and African Countries with Portuguese as an Official Language (ACPOP). The measurement instruments included a sociodemographic questionnaire, Brief Symptoms Inventory-18 (BSI-18), Brief Trauma Questionnaire (BTQ), and the Portuguese version of Suicidal Behaviors Questionnaire-Revised (SBQ-R). Results: The results indicate that the rates of anxious, depressive, and somatic symptomatology are within the average range for a community population in Portugal. The ACPOP participants reported greater impact of war, while Portuguese participants reported greater impact of disasters and Brazilian participants reported greater impact of psychological and sexual abuse, assault, and death of a family member. Brazilian participants showed the worst levels of mental health and greater suicidal thoughts, but Portuguese participants showed greater probability of committing suicide. Although strong correlations were found between traumatic experiences and mental health levels and suicidal behavior, only physical and sexual abuse were positively correlated with all BSI-18 and SBQ-R subscales. A linear regression analysis revealed that traumatic experiences explain 23.4% of the variance in mental health levels and 11.6% of the variance in suicide probability. Conclusion: Mental health is of paramount importance for quality of life. Therefore, it is important to understand the risk factors for poor mental health outcomes including suicide risk, in this case exposure to traumatic events, for a direct and effective intervention and prevention. Our results elucidate and reinforce the impact of traumatic experiences on mental health and its role as a predictor of suicide attempts, contributing to a better understanding about these themes to assist future preventive or remedial intervention. Governments of Portuguese Language Countries should include strategies aimed at minimizing the impact of traumatic experiences when implementing mental health policies and prevention campaigns.

The impact of COVID-19 pandemic on the psychological well-being among health care workers: A 6-month cohort longitudinal survey study.

IntroductionHealth care workers (HCW) have been identified as a risk group to suffer psychological burden derived from Coronavirus Disease 19 (COVID-19) pandemic. In addition, possible gender differences in the emotional reactions derived from COVID-19 pandemic have been suggested in this population. The aims of the study were to explore the impact of COVID-19 as well as possible gender differences on mental health status and suicidality in a cohort of HCW.Materials and methodsOne thousand four hundred and thirty-two HCW responded to an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Mental health status was measured by General Health Questionnaire 28 (GHQ-28) in both time periods.ResultsHCW informed of a worsening in somatic symptomatology over the follow up period. Gender differences were found in all GHQ-28 dimensions as well in the total score of the questionnaire. Post hoc analyses displayed significant interaction between the time and gender in somatic and anxiety dimensions as well as in GHQ-28 total score. Stress produced by COVID-19 spreading and the feeling of being overwhelmed at work resulted the main predictors of psychological distress although each domain is characterized by a specific set of predictors.ConclusionsSomatic reactions represent the most sensitive dimension over the follow-up period. Moreover, women are characterized by a greater psychological distress at the beginning, although these differences tend to disappear over time. Finally, a complex network of factors predicted different dimensions of psychological distress, showing the complexity of prevention in high-risk populations facing major disasters.

Clinical progress note: Management of somatic symptomand related disorders in pediatric inpatients.

Clinical progress note: Management of somatic symptomand related disorders in pediatric inpatients.

La mémoire traumatique

The traumatic memory, a consequence of the psychotrauma induced by incestuous violence, has inhabited Delphine throughout her childhood and a large part of her adult life. At the age of 40, following the revelations of her sister, she began psychotherapy and identified the traumatic events. She is finally able to understand and link a plural somatic symptomatology to a post-traumatic syndrome... Delphine shares here the story of this traumatic memory.

P–577 Impaired double strand DNA repair in isolated Primary Ovarian Insufficiency with homozygous nonsense mutation of SPIDR

Abstract Study question To identify the etiology of isolated Primary Ovarian Insufficiency (POI) in a patient from an Indian consanguineous family. Summary answer A homozygous nonsense mutation of SPIDR in the patient yielded chromosomal instability: first evidence of a role of this gene in DNA repair. What is known already POI, affecting 1% of women under 40, is a public health problem. To date ∼ 70% of cases remain idiopathic. The leap due to exome sequencing, led to the identification of ∼ 80 genes, often in single or few cases. SPIDR was recently identified as a scaffolding protein connecting RAD51, a central player in homologous recombination, to BLM, a helicase implicated in the integrity of the genome. But its precise role is still unknown. A SPIDR mutation was previously associated with POI. However, contradictory conclusions were reported on the mechanism of SPIDR action and on its pathogenic role in POI. Study design, size, duration Prospective genetic study of a cohort of 150 pateints with POI worldwide using a custom-made targeted next generation sequencing (NGS) panel comprising 60 known POI-causing genes. A single patient was found mutated in SPIDR. Cytogenetic studies were performed to analyse the consequences of the mutation on DNA repair and sister chromatide exchanges (SCE). Participants/materials, setting, methods The patient with SPIDR mutation had POI with primary amenorrhea, delayed puberty and streaks ovaries. She was born to consanguineous Indian parents. No other mutation was detected in our cohort of 150 patients with POI. Targeted NGS was performed in the proposita. Familial segregation was performed by Sanger sequencing. Mitomycin C (MMC)-induced chromosomal breakages were studied and a sister chromatid exchange (SCE) assay was performed in patient’s peripheral lymphocytes. Main results and the role of chance We identified a novel homozygous nonsense mutation in the exon 7 of SPIDR (KIAA0146) c.814C&amp;gt;T, R272*, predicted to yield either a truncated protein, or a non-sense-mediated mRNA decay. The patient’s cells display increased chromosomal fragility with high MMC-induced chromosomal breaks when compared to a control. Remarkably, there was no increased SCE. In the previous report of a SPIDR mutation in POI, no cytogenetic studies were performed, and contradictory results were obtained on a homologous recombination test between the two sisters, either enhanced or reduced. In conclusion, we show here that inactivation of SPIDR results in a defect of double strand DNA damage repair, similar to alteration of the RAD51 pathway. There was no increased SCE, the hallmark of the BLM pathway. This observation has major consequences for this patient’s care : indeed mutations of DNA-repair genes may also yield to tumors/cancers. A long follow-up of the patient is needed in a multidisciplinary team to detect possible comorbidities. Indeed, even in the absence of somatic symptomatology, the patient has enhanced chromosomal instability highlighted by cytogenetic studies, that may yield tumor-predisposition. Limitations, reasons for caution No other mutation of SPIDR in the replication cohort of 150 POI patients. SPIDR mutation are thus very rare world-wide. Wider implications of the findings: This is the first evidence of chromosomal instability associated with SPIDR defect, providing strong evidence for a role of SPIDR in double strand DNA damage repair in humans and for its causal role in POI. Our study improves the knowledge on SPIDR function and confirms its involvement in POI worldwide. Trial registration number Not applicable

The Italian COVID-19 Psychological Research Consortium (IT C19PRC): General Overview and Replication of the UK Study.

The COVID-19 pandemic represents a major stressor for the psychological health of people worldwide. In the UK, the COVID19-Psychological Research Consortium Study (C19PRC) launched to evaluate the psychological impact of COVID-19 in the general population and its implications. The project was then extended to Italy and several other countries. This article provides an overview of the Italian C19PRC study and its replication of two specific findings from the UK C19PRC. In the first part, the relationship between anxiety and somatic symptomatology is examined. In the second part, we analyze the association between several factors and psychological health outcomes: depression/anxiety, traumatic stress, COVID-19 anxiety. In line with the study conducted in the UK, an online survey was administered to the adult Italian general population. The sample included 1038 respondents (age, mean = 49.94, SD = 16.14, 51.15% females) taken from four regions: Lombardia, Veneto, Lazio, and Campania. The relationship between predictors and outcomes was evaluated by means of logistic regression models. Somatic indices showed a positive association with anxiety, worse somatic symptoms were associated with mourning a loss of a beloved one due to COVID-19 and with precarious health conditions. Females showed a higher incidence of psychological issues. No differences in anxiety, depression, and traumatic stress were found across regions but the Campania region showed the most severe somatic symptomatology. In the second analysis, the factors associated with more severe psychological outcomes (i.e., anxiety and/or depression, traumatic stress, and COVID-19 related anxiety) were younger age, the presence of minors in the household, traumatic stressors, and precarious health conditions. No differences across regions emerged. The Italian results correspond to the UK findings for anxiety, depression, and traumatic stress. Both in the UK and Italy, the factors associated with worse psychological health were gender (female), younger age, having children, pre-existing health issues (both for oneself or someone close), and the moderate/high perceived risk of contracting COVID-19 within one month. In Italy, unlike the UK, lower household income and having (had) COVID-19 were not associated with poorer mental health. The psychological impact of COVID-19 can last for months; future research should explore all aspects of the psychological burden of COVID-19 in order to implement psychological interventions and promote psychological health.

Anxiety in Older Adolescents at the Time of COVID-19.

Corona Virus Disease-19 (COVID-19) is a catastrophic health risk, with psychological, emotional, social, and relational implications. From the early stages of the virus spread, the elderly population was identified as the most vulnerable, and health authorities have rightly focused on this frailer population. Conversely, less attention was given to the emotional and psychological dimensions of children and adolescents. Moreover, even though they were the subjects whose lives and health were at low risk, they, nevertheless, had to face a reality full of anxiety, fears, and uncertainties. The current study investigated the state of anxiety and emotional awareness in a sample of healthy older adolescents, 84 females and 64 males, aged 17 to 19, during the pandemic lockdown, using the Self-Rating Anxiety Scale and the Italian Emotion Awareness Questionnaire. An unexpected anxious phenomenology was found, affecting anxiety and the ideo-affective domain, while somatic symptomatology appeared to be less severe. The highest anxiety symptoms were breathing difficulties. These findings supported the hypothesis that the COVID-19 pandemic may be a risk condition for an increased state of anxiety in older adolescents and suggested the need to provide (1) an effective, empathic communication system with direct participation of older adolescents, (2) a psychological counseling service for the stress management of adolescents.

Self-efficacy and well-being in adolescents: A comparative study using variable and person-centered analyses

Abstract Introduction While there is already evidence positively linking higher levels of self-efficacy with well-being in adolescence, analyses have been of a bivariate or correlational nature. Previous studies have used both general self-efficacy, and a domain-specific approach. The present study operationalises three domains of self-efficacy (academic, social, and emotional), in a domain specific way, and additionally, examines how clusters, derived from scores on these domains relate to well-being. Methods Data were gathered on academic, social, and emotional self-efficacy, mental well-being, psychological and somatic symptomatology, frequency of physical exercise, and parental security. Participants were 3,485 adolescents (Mage = 17.0 [SD = 1.1] in their final year of High school in Northern Ireland. Results Results of bivariate analyses pointed to emotional self-efficacy as a key variable in adolescent well-being. In the cluster analyses, five clusters were identified, and in a series of regression analyses, membership of the High self-efficacy cluster (characterized by high scores on all three self-efficacy domains), was found to be optimal. Conclusions The application of cluster analysis revealed qualitative differences across a set of five categorical profiles. For that reason, interrelations among Self-Efficacy Questionnaire for Children scores at the group level should no longer be used to make inferences about how these variables function within individuals.

Early Pain and Other Somatic Symptoms Predict Posttraumatic Stress Reactions in Survivors of Terrorist Attacks: The Longitudinal Utøya Cohort Study.

Survivors of traumatic events commonly suffer from long-term pain and related somatic symptomatology. To test the predominant hypothesis that survivors' pain comprises sequela of persistent posttraumatic stress symptoms (PTSS), we assessed the sequential order of symptom development among young survivors of a terrorist attack. All 490 survivors of the 2011 Utøya (Norway) attacks were invited to the longitudinal Utøya cohort study; 355 (72.4%) participated. The mean survivor age was 19.3 years (SD = 4.6) and 169 were female (47.6%). Somatic symptoms, including headache, other pain and fatigue, and PTSS, were measured 4-5 months (T1), 14-16 months (T2), and 32-33 months (T3) after the attack. Longitudinal associations between somatic symptoms and PTSS were assessed in cross-lagged structural equation model (SEM) analyses, which were adjusted for known confounders. Higher pain levels and other somatic symptoms at T1 consistently predicted PTSS at T2 in SEM analyses, r = .473, p < .001. Beyond this early-to-intermediate posttraumatic phase, somatic symptoms did not significantly predict PTSS: T2-T3, r = .024, p = .831; T1-T3, r = -.074, p = .586. PTSS did not significantly predict later somatic symptomatology at T1-T2, r = .093, p = .455; T2-T3, r = .272, p = .234; or T1-T3, r = -.279, p = .077. The findings indicate that survivors' early pain and related somatic symptoms strongly and consistently predict later psychopathology. After severe psychological trauma, early interventions may need to address individuals' pain to hinder chronification.

Prevalence and Clinical Picture of Sleep Paralysis in a Polish Student Sample.

Sleep paralysis (SP) is a psychobiological phenomenon caused by temporary desynchrony in the architecture of rapid eye movement (REM) sleep. It affects approximately 7.6% of the general population during their lifetime. The aim of this study was to assess (1) the prevalence of SP among Polish students in Lublin (n = 439) using self-reported online surveys, (2) the frequency of SP-related somatic and psychopathologic symptoms, and (3) the factors potentially affecting the occurrence of symptoms among people experiencing SP. We found that the incidence of SP in the Polish student population was slightly higher (32%) than the average prevalence found in other student populations (28.3%). The SP clinical picture was dominated by somatic symptomatology: 94% of respondents reported somatic symptoms (most commonly tachycardia, 76%), 93% reported fear (most commonly fear of death, 46%), and 66% reported hallucinations (most commonly visual hallucinations, 37%). The number of SP episodes was related to sleep duration and supine position during sleep. The severity of somatic symptoms correlated with lifestyle variables and anxiety symptomatology. Our study shows that a significant proportion of students experience recurrent SP and that this phenomenon is associated with fear and physical discomfort. The scale of the phenomenon requires a deeper analysis.

Predictors of Somatic Symptomatology in War-Affected Youth in Northern Uganda: Findings from the WAYS Study

War experiences have been shown to have adverse long-term psychological sequelae. Nevertheless, the roles of different types of war events in predicting which mental health outcomes remain unclear. This study investigated the effects of different types of war events and socio-demographic characteristics on somatic symptoms in war-affected youth in Northern Uganda. A sample of 539 youth (mean age = 22.39; ± 2.03) participated in the study. Using maximum likelihood estimation in structural equation modelling, regression analyses were fitted to relate binary indicators of different types of war events to one latent factor capturing somatic symptoms. The results indicated that sex, marital status, and war types of “direct personal harm”, “deaths”, and “sexual abuse” independently and uniquely predicted somatic symptoms. Types of war events should be considered when planning interventions. Somatic symptoms may be a window into physical health and psychological sequelae. Implications for mental health service delivery are discussed.

Alexithymic Traits and Somatic Symptoms in Children and Adolescents: a Screening Approach to Explore the Mediation Role of Depression

The association among alexithymia, somatic symptoms and clinical correlates has been scantly investigated in children. The present study examined alexithymic features and somatic symptomatology in schoolchildren with high and low levels of depression, testing the role of depressive symptoms in mediating the associations between alexithymia and somatic symptoms. Seven-hundred schoolchildren were involved in this study and divided into two subgroups (8-10years and 11-14years) in order to test differences according to the age. Participants completed the Children's Somatization Inventory-24 for the assessment of somatic symptoms, the Alexithymia Questionnaire for Children to evaluate alexithymic features and the Children's Depression Inventory-2 to investigate depressive symptoms. Results showed that children with high levels of depression reported both higher alexithymia and somatic symptoms levels. Despite a direct effect of alexithymia on somatic symptoms, the mediation analyses also highlighted an indirect effect of alexythimia on somatic symptoms through depressive symptoms. Findings suggested that a depressive symptomatology may clarify why schoolchildren with high alexithymia scores tend to report higher levels of health problems. Results also support the possibility that depressive symptoms may contribute to the development of somatic symptomatology among schoolchildren in the presence of high levels of alexithymia.

Psychoeducation Can Ameliorate Somatic and Manic Symptomatology in Youth at High-Risk for Bipolar Disorder: A Randomized-Controlled Study

Background: Bipolar Disorder (BD) is a chronic, recurrent and potentially severe psychiatric disorder with relatively high prevalence rates and debilitating consequences. Delays in diagnosis and treatment of BD have been associated with longer depressive episodes, higher suicidality, shorter euthymic periods and poorer functioning in adulthood. For these reasons, early recognition of BD is clinically important. Given the high hereditary rates for BD, offspring of BD patients (high-risk [HR] group) are perfect candidates for research on early detection and prevention strategies. Psychoeducation is a structured and systematic intervention, in which the knowledge of the illness and its treatment is transferred to the patient and/or family in a didactic approach. Psychoeducation is a core component of psychotherapeutical interventions such as cognitive-behavioral therapy (CBT), family focused therapy (FFT) and interpersonal and social rhythm therapy (IPSRT). Several studies which explored the effectiveness of CBT, FFT and IPSRT in HR youth reported positive out-comes; but previously explored prevention interventions were mainly focused on symptomatic HR and none of them were done among asymptomatic HR. Therefore with this study, we aimed to evaluate the effect of psychoeducational intervention on asymptomatic HR youth. Methods: In this prospective randomized controlled study, total of 60 cases were enrolled and randomized into two group as cases who received psychoeducational intervention (PE+) (n=30) and who did not receive psychoeducational intervention (PE-) (n=30) on the first visit (T0). Groups were evaluated regarding their psychiatric symptomatology and quality of life (QoL) using DSM-5 Level 1 Cross-cutting Symptom Scale Child Form (CCSS-5) and Pediatric Quality of Life Questionnaire throughout four interviews with 3-month intervals (T0 – T3). Results: Even though psychoeducation did not have effect on QoL of the high-risk population; overall reduction in somatic and manic symptom severity in CCSS-5 was more distinct for PE+ group compared to PE- group. Conclusion: Results from this study are, to an extent, in line with previous psychotherapeutic interventions done in symptomatic HR which include psychoeducation as a core component. In fact improvement in affective symptomatology with CBT and longer remission periods with FFT can be explored in the same scope with the overall reduction in manic symptom severity we showed in PE+ group; but improvement in somatic symptomatology should be approached from a different angle. Overall reduction in somatic symptom severity of PE+ group that we found might be due to the positive effect of psychoeducation on family communication and problem-solving skill. However, there is no previous research indicating the presence of somatic symptoms/somatization disorders among HR youth; so whether somatic symptoms are the consequences of family conflict or a core component of prodromal phase of BD is still unclear. Studies state that psychological interventions are most effective if they are performed in the early stages of BD; therefore asymptomatic HR youth are critical for prevention strategies and more studies are needed in this population.

Sleep disturbances partially mediate the association between problematic internet use and somatic symptomatology in adolescence

The Internet is widely used among adolescents for different purposes, including social connections, entertainment and schoolwork. Nevertheless, research has demonstrated the negative impact of problematic internet use (PIU) on psychophysical well-being in adolescence. This study aims to investigate internet use and its association with somatic symptoms, exploring the specific role of sleep disturbances that affect overall sleep quality. A mediation model was used to demonstrate the link between PIU, somatic symptoms and sleep disturbances in a sample of 412 adolescents (52% of males) aged 10–17 (M = 14.12, SD = 1.46). We also investigated whether somatic symptoms were differently experienced and reported by participants at risk of developing internet addiction (n = 58) from those not-at risk (n = 354). Sleep disturbances partially mediated the relationship between PIU and somatic symptoms. Furthermore, PIU seems to lead to poorer sleep quality which may in turn result in physical problems with an increase in somatic symptoms. Findings of this study showed that adolescents at risk of developing internet addiction suffered from a specific somatic symptomatology respect to those not-at risk. Finally, PIU has a positive direct effect on somatic symptoms. These results highlight the role of sleep disturbances with implications for overall sleep quality in the association between PIU and somatic symptoms. When designing intervention programs, the associations between PIU, sleep quality and somatic symptoms in adolescence and the negative repercussions of PIU on psychophysical health should be kept in mind. Results are discussed within the context of recent scientific research.

Time attitudes and mental well-being, psychological, and somatic symptomatology in final year high school students

Research has shown that time perspective changes across the lifespan and recent studies have reported significant and meaningful associations between time perspective scores and scores on a range of mental, and physical health outcomes. In the present study, we examined the relationship between Time Attitudes (the affective dimension of time perspective) and mental well-being, as well as psychological and somatic symptoms in late adolescents, in a range of adjusted and unadjusted analyses. Participants were final year High school students (N = 3479 [40.9% Male]) in Northern Ireland. In line with a developing literature, time attitudes were operationalized through person-centred analyses: Cluster analysis yielded profiles, or time attitude categories, based on a six-factor index of attitudes toward the past, the present, and the future. Results supported those previously reported for younger adolescents, showing that higher mental-wellbeing, and both lower psychological and somatic symptomatology, were associated with membership of a Positive time attitudes profile. Further, these well-being constructs were positively associated with being male and reporting higher emotional self-efficacy. These results reported herein are in keeping with explanatory role of time attitudes in health and well-being outcomes among younger, and now older adolescents. We suggest that the next step in the investigation of time attitudes is to examine the extent (if at all) to which intervening with adolescents can nudge them towards a more positive appraisal of past, present, and future.