Year-old Adolescents Research Articles

Episodic syndromes associated with migraine (clinical and epidemiological study in pediatric practice)

Migraine in children can manifest itself in non-pain clinical phenotypes, among which several episodic syndromes associated with migraine (ESAM) are identified. A significant association with the later development of migraine was found for infantile colic syndrome, benign torticollis, abdominal migraine (AM), cyclic vomiting syndrome (CVS) and benign paroxysmal vertigo (BPV).Objective: to identify the clinical and epidemiological characteristics of childhood ESAM and its association with migraine.Material and methods. The study was conducted in Tambov Children's Clinical Hospital. A total of 250 children were included in the study: 120 (48%) girls and 130 (52%) boys aged 5 to 18 years (mean age 13±2.9 years, median age 13 [11; 15] years) with headache complaints. The diagnosis of ESAM was made according to the ICHD-3 criteria.Results. ESAM was observed in 95 (38%) patients aged 5–18 years. An analysis of the prevalence of ESAM in the different age groups showed that in children aged 5–10 years CVS (n=12; 4.8%) was more common than AM (n=6; 2.4%) and BPV (n=5; 2%). In the group of 11–14 year-old children, the frequency of AM clearly predominated (n=11; 4.4%), while in the group of 15–18 year-old adolescents, BPV (n=15; 6%) was observed more frequently compared to CVS (n=9; 3.5%) and AM (n=5; 2%).Conclusion. The results of the study indicate a high incidence of ESAM in child and adolescent patients of somatic and neurological hospitals. The data obtained show the importance of timely diagnosis and correct treatment of ESAM.

Knowledge, attitudes, and behaviours about gender equality: a cross-sectional survey of adolescents from rural India.

Background: Gender equality is a fundamental human right and vital to accelerate global progress towards several Sustainable Development Goals (SDGs). Adolescents' involvement is essential to achieve such equality and SDGs to develop peaceful sustainable societies. However, there are limited data especially from developing countries such as India to plan gender equality related programmes targeted at adolescents. Methods: We conducted a cross-sectional survey to assess gender equality related knowledge, attitudes, and behaviours among 16 to 19 year-old adolescents from sixty villages of the Maharashtra state of India. Results: Data from 1306 respondents (667 females and 639 males) showed a mean score of 30 out of 44, suggesting an overall moderate gender equality score in rural adolescents. The majority of girls (68.3%) were in the high scoring group, whereas the majority of boys were in the moderate group (60.3%). Regression analysis showed that responses from boys were associated with lower scores compared to responses from girls by five points (adjusted β-coefficient: -4.99, 95%CI: -5.85 to -4.12, p<0.001). Conclusions: Our findings suggest that there is a need to involve adolescents with a major focus on boys to improve gender equality in rural areas of Maharashtra. This will help introduce concepts of equality from an early age to educate boys, empower girls, and address gender-based discrimination and violence against girls and women.

Suicidal ideation in adolescence: an explanation from three of its associated variables in Bogotá, 2009

Objective: To determine the relationship between hopelessness, loneliness and the level of family health in school-age adolescents with and without suicidal ideation to deepen in the knowledge of this phenomenon from a nursing point of view and to pose promotion and prevention options in Bogotá, Colombia. Method: This was a cross-sectional, comparative, correlational, descriptive and quantitative study. The sample was selected in the period between February and April 2009, through mixed sampling and 482 school-attending 14-17 year-old adolescents were included. Widely recognized and highly qualified psychometric tools were used to measure the variables concerned. Univariate, bivariate and multivariate statistic analysis were used to describe the behavior of each variable, to explore the relationships and contrasts between these variables and to estimate the effect of the independent variables on the presence of suicidal thoughts. This study has followed the ethical considerations necessary for research involving human beings.Results: 20% of the sample used reported the presence of suicidal thoughts or desires. All variables studied influence the presence of suicidal thoughts except age, socioeconomic strata, borough and type of school. However, with the use of logistic regression methods, the variables that best express the presence of suicidal thoughts are: previous suicide attempt, low self-esteem, depression and belonging to an unhealthy family.Conclusions: Data on suicidal ideation and attempts made in this study support the idea of implementing greater preventive efforts within families and schools. Identifying adolescents at risk of suicide or mental health disorders, and build effective prevention and treatment programs is a priority.

Epidemiological profile of allergic respiratory disease in Mexican children

Objective: Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México. Methods: Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. Results: A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%). Conclusions: Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients. Keywords: Asthma; Rhinitis; Eczema; Wheezing; Allergy And Immunology; Child.

Epidemiological profile of allergic respiratory disease in Mexican children

Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México. Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%). Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients.

Derivational Morphology Training in French-Speaking, 9- to 14- Year-Old Children and Adolescents With Developmental Dyslexia: Does it Improve Morphological Awaraness, Reading and Spelling Outcome Measures?

Children with developmental dyslexia (DD) display partially preserved morphology skills which they rely upon for reading and spelling. Therefore, we conducted explicit and intensive training of derivational morphology in individuals with DD, ages 9 to 14 years, in order to assess its effect on: morphological awareness, reading (speed and accuracy), and spelling. Our pre-posttest design included a group trained in derivational morphology and a group of children who continued their business-as-usual rehabilitation program with their speech-language therapist. Results showed effects on morphological awareness and on the spelling of complex words, with a large between-group effect size for trained items and a large to moderate effect size for untrained items. All these gains tended to be maintained over time on the delayed posttest, 2 months later. For reading, the results were more contrasted, with large between-group effect sizes for accuracy and speed for trained items, reducing to a small effect for accuracy on the delayed posttest. For untrained items, small effects were observed on accuracy (at both posttests) but not on speed. These results are very promising and argue in favor of using derivational morphology as a medium to improve literacy skills in French-speaking children and adolescents with DD.

Depression among currently married ever pregnant adolescents in Uttar Pradesh and Bihar: Evidence from understanding the lives of adolescents and young adults (UDAYA) survey, India.

Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers.

All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study

BackgroundAll-cause and suicide mortalities of gender-referred adolescents compared with matched controls have not been studied, and particularly the role of psychiatric morbidity in mortality is unknown.ObjectiveTo examine all-cause and suicide...

1150. Invasive meningococcal disease vaccination – a targeted literature review of adolescents and parents/caregivers’ preferences

Abstract Background Invasive meningococcal disease (IMD) serogroups A, B, C, W, Y are commonly prevented by MenACWY and MenB vaccines. MenABCWY candidate vaccines could potentially provide benefits as less injections, simplified schedules, and increased uptake. However, there is limited insight on factors influencing preferences for IMD vaccines/vaccination (Vax). This targeted literature review synthesized evidence of factors influencing IMD Vax preferences in 16–23-year-old adolescents/young adults (Ado/YA) and parents/caregivers (P/CG) of 16-18 year-old adolescents. Methods PubMed and Google Scholar were searched globally to identify publications on IMD Vax attitudes and preferences (Table 1). Studies were restricted to English and published between 2005-2022. Data were extracted and synthesized from full text reviews to list IMD Vax preference attributes. Results From the 77 abstracts screened, 19 publications were extracted (Table 2) and 17 relevant for Ado/YA and P/CG. Knowledge of disease severity (20% of Ado/YA articles) and vaccine (29% of P/CG articles) were the most reported factors influencing Vax preference. Severity of disease increased Vax preference for both groups (14%), while low disease awareness limited P/CGs’ willingness to vaccinate children (14% of P/CG articles). Some Ado/YA preferred fewer injections in the immunization series due to reduced injection site discomforts (13%). P/CG preferred less injections due to less time and less physician visits, as it may reduce vaccine preparation/injection/administration and indirect costs associated with parental work loss (7%). However, their concerns over injection-related pain were a Vax barrier (14%). IMD vaccine effectiveness was recognized by Ado/YA (13%). Longer duration of protection was important for P/CG (14%), whilst herd immunity and direct protection was preferred in Ado/YA (13%). Conclusion Findings highlight IMD Vax characteristics as key considerations among Ado/YA and P/CG when making Vax decisions. To improve vaccination coverage and protection, the evidence supports preferences for vaccinations offering benefits such as fewer injections. Trade-offs between factors relevant for a IMD combination vaccine need further research. Disclosures Shahina Begum, GSK: Employee Eliazar Sabater Cabrera, PhD, GSK: Employee|GSK: Stocks/Bonds Oscar Herrera-Restrepo, PhD, GSK: Stocks/Bonds Twinkle Khera, Mtech, IQVIA: Advisor/Consultant Willings Botha, PhD, IQVIA: Advisor/Consultant Laurie Batchelder, PhD, IQVIA: Advisor/Consultant Zeki Kocaata, PhD, GSK: Stocks/Bonds

Adaptation of the sexual and reproductive empowerment scale for adolescents and young adults in Kenya.

Measuring empowerment is critical to understanding the level of control adolescents and young adults (AYA) have over their sexual and reproductive health (SRH) behaviors, and could provide a key window into addressing their unique SRH needs. We adapted the Sexual and Reproductive Empowerment (SRE) scale for AYA for use in an East African context. This multi-method qualitative study sampled 15-23 year-old female adolescents and young adults in Kisumu, Kenya. We conducted in-depth interviews (n = 30) and analyzed transcripts with an inductive, constant comparison approach. Empowerment domains were integrated with Kabeer's (1999) framework in a conceptual model, which we referenced to revise the original and develop new scale items. Items underwent expert review, and were condensed and translated through team-based consensus-building. We evaluated content validity in cognitive interviews (n = 25), during which item phrasing and word choice were revised to generate an adapted SRE scale. Participants (n = 55) had a median age of 18 (range 16-23), and 75% were under 19 years. We categorize three types of adaptations to the SRE scale: new item generation, item revision, and translation/linguistic considerations. We developed nine new items reflecting AYA's experiences and new domains of empowerment that emerged from the data; new domains relate to self-efficacy in accessing sexual and reproductive health care, and how material needs are met. All items were revised and translated to echo concepts and language relevant to participants, navigating the multilingualism common in many African countries. Centering the voices of female Kenyan AYA, this study provides insight into measuring the latent construct of adolescent sexual and reproductive empowerment in an East African setting, and supports the adapted SRE scale's content validity for Kenya. We detail our multi-method, theory-driven approach, contributing to limited methods guidance for measure adaptation across contexts and among diverse adolescent populations.

Associations between physical fitness and cerebellar gray matter volume in adolescents.

Despite the importance of the developing cerebellum on cognition, the associations between physical fitness and cerebellar volume in adolescents remain unclear. We explored the associations of physical fitness with gray matter (GM) volume of VI, VIIb and Crus I & II, which are cerebellar lobules related to cognition, in 40 (22 females; 17.9 ± 0.8 year-old) adolescents, and whether the associations were sex-specific. Peak oxygen uptake (V̇O2peak ) and power were assessed by maximal ramp test on a cycle ergometer, muscular strength with standing long jump (SLJ), speed-agility with the shuttle-run test (SRT), coordination with the Box and Block Test (BBT) and neuromuscular performance index (NPI) as the sum of SLJ, BBT and SRT z-scores. Body composition was measured using a dual-energy X-ray absorptiometry. Cerebellar volumes were assessed by magnetic resonance imaging. V̇O2peak relative to lean mass was inversely associated with the GM volume of the cerebellum (standardized regression coefficient (β) = -0.038, 95% confidence interval (CI) -0.075 to 0.001, p = 0.044). Cumulative NPI was positively associated with the GM volume of Crus I (β = 0.362, 95% CI 0.045 to 0.679, p = 0.027). In females, better performance in SRT was associated with a larger GM volume of Crus I (β = -0.373, 95% CI -0.760 to -0.028, p = 0.036). In males, cumulative NPI was inversely associated with the GM volume of Crus II (β = -0.793, 95% CI -1.579 to -0.008 p = 0.048). Other associations were nonsignificant. In conclusion, cardiorespiratory fitness, neuromuscular performance and speed-agility were associated with cerebellar GM volume, and the strength and direction of associations were sex-specific.

Prenatal exposure to perfluoroalkyl substances and liver injury in 21 year-old adolescents: The Taiwan Maternal and Infant cohort study

Prenatal exposure to perfluoroalkyl substances and liver injury in 21 year-old adolescents: The Taiwan Maternal and Infant cohort study

Impact of dental caries and nutritional status on oral health related quality of life in young Indian adolescents.

A combination of poor oral health status and malnourishment ultimately affect the quality of life of the person. Hence, these tools may help in identifying individuals at risk of poor quality of life and malnutrition caused by oral problems especially in adolescents. To test the association between dental caries, nutritional status and Oral Health Related Quality of Life (OHRQoL) in 12-15 year-old school going adolescents. A cross sectional study was conducted on 12-15-year-old school going adolescents. A total of 1214 adolescents participated in the study. Data on quality of life was collected using OHIP-14 and clinical examination was done to assess the DMFT status and Body Mass Index (BMI) as measure of nutritional status of the subjects. DMFT was found to be positively correlated with total OHIP score, however BMI was negatively correlated with OHIP. Controlling for BMI, partial correlation analysis revealed that there is a weak association between OHIP and DMFT scores which was found to be statistically significant. Both caries experience and nutrition status had significant impact on Quality of Life. All the three parameters were found to be correlated to each other.

Frequency of vigorous physical activity and depressive symptoms across adolescence: Disentangling the reciprocal associations between different groups and subtypes of symptoms

Physical activity has a demonstrated positive effect on youth depressive symptoms. However, very few studies have explored the bi-directionality of the links between physical activity and depression. The present study aims at filling this gap and tests whether any associations are moderated by sex. Moreover, the role of subtype of depressive symptoms, vegetative (i.e., lack of energy, poor sleep) or non-vegetative (i.e., mood-related), is explored. Participants were 910 12–13 year-old Swedish adolescents (56% girls) who answered a three-wave survey at ages 12–13 (T1), 15–16 (T2), and 18–19 (T3). Using a cross-lagged structural model, depression predicted decreased frequency of vigorous physical activity (VPA) from T1 to T2 (β = −0.09, p < .05) and from T2 to T3 (β = −0.10, p < .01), while frequency of VPA at T2 decreased depression at T3 (β = −0.12, p < .05). Associations did not differ between boys and girls. Non-vegetative symptoms predicted decreased frequency of VPA from T1 to T2 (β = −0.10, p < .05), while frequency of VPA at T2 predicted decreased non-vegetative symptoms at T3 (β = −0.15, p < .05). Vegetative symptoms predicted decreased frequency of VPA from T1 to T2 (β = −0.09, p < .05), while have a reciprocal influence with VPA from T2 to T3. Overall, our results highlight an association across adolescence between VPA and depression. The association becomes stronger and reciprocal in middle adolescence, which suggests this period as an effective developmental time to plan physical-activity-based interventions to decrease youth depressive symptoms.

The Development of Disordered Eating in Male Adolescents: A Systematic Review of Prospective Longitudinal Studies

AbstractA lack of research exists about the development of disordered eating in adolescent males. A systematic review was undertaken with the primary aim of identifying psychosocial risk factors that are prospectively associated with the development of disordered eating attitudes and behavior in adolescent males. The review’s secondary aim was to appraise the appropriateness of the psychometric assessment measures used to identify those risk factors. Electronic databases Scopus (Elsevier), PsycINFO (EBSCO), PsycARTICLES, Medline (Ovid), Web of Science Core Collection and Pubmed (Thomson Reuters) were searched for prospective longitudinal research involving 11–19 year-old adolescents that was published between 2010 and 2022. Twenty-one publications met inclusion criteria and thirty-five factors including fourteen psychological factors, ten body appearance factors, four sociocultural factors, three familial and four peer factors were identified as prospectively associated with the development of disordered eating attitudes and behavior in male adolescents. The psychometric assessment measures used to identify those factors, together with the proportion of female respondents upon whose data the measures were based, were critically appraised. Accurate assessment is imperative in generating reliable and valid research and informing clinical practice. Existing female-centric psychometric assessments normed predominantly on female participants may not be appropriate for use with adolescent males.

Impact of music therapy and hand massage in the pediatric intensive care unit on pain, fear and stress: Randomized controlled trial

PurposeThis study was performed with the aim of assessing the effect of music therapy and hand massage on pain, fear and stress among 12–18 year-old adolescents treated in the pediatric intensive care unit (PICU). DesignThis study was a randomized controlled trial, with single-blind design. MethodsThe adolescents were divided into groups with 33 receiving hand massage, 33 receiving music therapy and 33 in the control group. Collection of data used the Wong-Baker FACES (WB-FACES) Pain Rating Scale, Children's Fear Scale (CFS) and blood cortisol levels. FindingsIn the study, adolescents in the music therapy group had lower mean points for WB-FACES before, during and after the procedure by a significant level compared to the control group (p < 0.05). Additionally, the CFS mean points before and during the procedure were lowest in the music therapy group, while the music therapy and massage groups were determined to have lower points by a significant level after the procedure compared to the control group (p < 0.05). However, when the mean cortisol levels of adolescents before the procedure and on the 1st and 2nd day after the procedure were compared, there was no significant difference between the groups (p > 0.05). ConclusionsIt was determined that hand massage and music therapy were more effective than standard care at reducing pain and fear levels during blood drawing among 12–18-year-old adolescents in the PICU. Practice implicationsNurses may use music therapy and hand massage to manage fear and pain related to blood drawing in the PICU.

Safety and immunogenicity of SCB-2019, an adjuvanted, recombinant SARS-CoV-2 trimeric S-protein subunit COVID-19 vaccine in healthy 12–17 year-old adolescents

ABSTRACT We previously demonstrated the efficacy of the COVID-19 vaccine candidate, SCB-2019, in adults in the SPECTRA phase 2/3 efficacy study. We extended the study to include 1278 healthy 12–17-year-old adolescents in Belgium, Colombia, and the Philippines who received either two doses of SCB-2019 or placebo 21 days apart, to assess immunogenicity as neutralizing antibodies against prototype SARS-CoV-2 and variants of concern, and safety and reactogenicity as solicited and unsolicited adverse events with a comparator group of young adults (18–25 years). In participants with no evidence of prior SARS-CoV-2 infection SCB-2019 immunogenicity in adolescents was non-inferior to that in young adults; respective geometric mean neutralizing titers (GMT) against prototype SARS-CoV-2 14 days after the second vaccination were 271 IU/mL (95% CI: 211–348) and 144 IU/mL (116–178). Most adolescents (1077, 84.3%) had serologic evidence of prior SAR-CoV-2 exposure at baseline; in these seropositive adolescents neutralizing GMTs increased from 173 IU/mL (135–122) to 982 IU/mL (881–1094) after the second dose. Neutralizing titers against Delta and Omicron BA SARS-CoV-2 variants were also increased, most notably in those with prior exposure. SCB-2019 vaccine was well tolerated with generally mild or moderate, transient solicited and unsolicited adverse events that were comparable in adolescent vaccine and placebo groups except for injection site pain – reported after 20% of SCB-2019 and 7.3% of placebo injections. SCB-2019 vaccine was highly immunogenic against SARS-CoV-2 prototype and variants in adolescents, especially in those with evidence of prior exposure, with comparable immunogenicity to young adults. Clinical trial registration: EudraCT 2020–004272–17; ClinicalTrials.gov NCT04672395.

Risk behaviors among migrant adolescents in Italy

Abstract Background Over the last decade, the student population migrated to Italy has quadrupled, but studies on their potentially harmful behaviors such as substance use are still scarce. The aim of this research is to monitor risk behaviors among migrant adolescents in Italy and provide appropriate indications for the definition of targeted policies and interventions. Methods A representative sample of 15 year-old adolescents was drawn from the 2018 Italian Health Behavior in School-aged Children (HBSC) survey data. Smoking habits, alcohol consumption and drunkenness were investigated and differences with Italian peers were assessed. Findings Results were based on more than 18,500 students, of which 16% were migrants: 32.7% from Western countries (We), 32.5% from Eastern European countries (Ee), and 34.8% from non-Western/non-European countries (nW). Compared with natives, students from nW countries showed a lower risk of smoking habits (OR: 0.72, 95%CI: 0.58-0.89) and weekly alcohol consumption (OR:0.57, 95%CI:0.43-0.75), whereas drunkenness was more prevalent among Ee migrants (OR: 1.42, 95%CI: 1.10-1.83). Overall, both migrant and Italian girls showed a lower risk of unhealthy behaviors than boys. Conclusions Compared to the native counterparts, migrant adolescents showed differences in substance use according to their ethnic background. We observed two different immigration patterns: the Western immigrants, who came from countries with higher affluence and share similar risk behaviors with native peers, and non-Western immigrants, who came from less affluent countries and seemed to maintain the risk behaviors of their culture of origin. Key messages

La somnolence chez les adolescents: étiologie et conséquences multiples

Over the past century a dramatic decline in sleep duration among adolescents, such as more than one hour of sleep loss per night, has been reported. A debt in sleep duration could lead to sleep deprivation, a major risk factor associated with daytime sleepiness. Sleepiness refers to the inability to maintain an adequate level of alertness during the day which may result in more or less being able to control falling asleep at inappropriate times. This literature review updates on sleepiness regarding its characteristics, etiology and consequences on adolescents. Studies revealed that from 25 % to 78 % of adolescents had reported sleepiness. Its manifestations may include heavy lids, yawns, difficulties to concentrate and emotional irritability. In addition, while it is recommended that adolescents under 18 years-old should sleep from eight to ten hours a night, only 63 % of them actually do so. The etiology of sleep deprivation and sleepiness in this population can be explained by various biological and societal factors. First, the sleep-wake cycle of adolescents shows a biological shift from the beginning of pubertal maturation, described as a perfect storm. It refers to a social jetlag by going to sleep and waking up later and accumulating a sleep debt during weekdays which they try to reimburse during weekends. This phenomenon can be explained by physiological changes such as a slower accumulation of sleep pressure. In addition to this perfect storm, environmental and societal factors contribute to the social jetlag and reduce sleep duration in adolescents. Screen exposure before bedtime can delay sleep and wake onset, which is a risk factor for sleeping debt. Substance use such as caffeine, cigarettes or electronic vaporizer, ADHD or freely available medication, alcohol, cannabis use or drug consumption could further disrupt sleep-wake cycle by stimulating, depressing or otherwise disrupting the central nervous system. Early, before 8:30 am, class start times have been associated with chronic sleep deprivation, higher level of sleepiness and delayed melatonin peak secretion. Adolescents working or doing extracurricular occupations for more than 20hours a week are more at risk for reduced sleep duration and sleepiness. Parental supervision about sleep during the weekdays were associated with more appropriate bedtime. Adolescents from low socio-demographic characteristics and from minority ethnic groups have reported displaying a shorter sleep duration. Finally, sleep disorders of a physiological origin such as narcolepsy, sleep apnea or restless legs syndrome, may explain the sleep deprivation and sleepiness. Sleep deprivation and sleepiness in adolescents have consequences on their health. Cognitive functioning, such as problem solving, attention or memory, as well as school performance, can be compromised by sleep deprivation and sleepiness. At the psychological level, adolescents reporting sleepiness are more prone to display mental health problems: associations were found between sleepiness and subjective perception of depression, anxiety, somatic complaints as well as with antisocial behaviors. Finally, 68 % of 16 year-old adolescents reported they drove a car, and the reported sleepiness could lead to road accidents due to reduced attentional functioning, reaction time and decision-making abilities. In the United-States, from 7 % to 16.5 % of deadly accidents were related to driving while drowsy. Highlighting etiology and problems associated with sleep deprivation and sleepiness in adolescents could guide researchers and clinicians towards the development of possible interventions. Public health measures and knowledge transfer programs regarding modifiable psychosocial and societal factors associated with sleep-wake bioregulation could increase awareness in parents as well as in political and societal decision makers.

Aripiprazole lai two-injection start in a 16 year-old with Schizophrenia

IntroductionAripiprazole LAI is approved for the treatment of schizophrenia in adults. Recently, Europe and Canada approved the use of the two-injection start (TIS) regimen: two separate injections of 400 mg long-acting aripiprazole along with a single 20 mg dose of oral aripiprazole. Aripiprazole showed efficacy in the treatment of adolescents with acute schizophrenia in several controlled trials, leading to its approval for 13-17 year-old adolescents with schizophrenia by the EMA. However, the LAI formulation still remains off-label in adolescents.ObjectivesTo demonstrate the efficacy and safety of the TIS regimen of aripiprazole LAI formulation in a 16 year-old adolescent with schizophrenia.MethodsWe evaluated the symptoms of schizophrenia and general severity by means of the PANSS and CGI scales. The scales were administered at hospital admission, after 3 weeks, 5 weeks, and at 4-weeks follow-up.ResultsAt the admission the patient PANSS total score was 136, the CGI score of 7. Aripiprazole was started and up-titrated to 30 mg/day. After 3 weeks, the positive symptoms were significantly reduced; due to the persistence of negative symptoms, clozapine 100 mg/day was added. At week 5 the PANSS total score decreased to 81. Due to poor insight we proposed aripiprazole LAI with the two-injection start. One month later, global functioning and illness insight improved; PANSS score was 43, CGI score 2. There was no evidence of akathisia or other side effects.ConclusionsAripiprazole LAI showed good efficacy and tolerability in an adolescent with schizophrenia. The two-injection start regimen was a safe and viable option.DisclosureNo significant relationships.