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Antisocial Personality Disorder (ASPD) is a complex and often debilitating condition that can emerge from early behavioral disturbances in childhood and adolescence. This narrative review provides a comprehensive overview of the current understanding of ASPD in pediatric and adolescent populations, examining key diagnostic challenges, developmental trajectories, and emerging treatment approaches. Recent research underscores the critical role of the early identification of conduct disorder (CD) and oppositional defiant disorder (ODD) as precursors to ASPD. Specific attention is given to biological, environmental, and psychosocial risk factors, including genetic predispositions, family dynamics, and socio-economic adversity. Additionally, neuro-psychological research highlights deficits in executive function, emotion regulation, and social cognition, which may underline the persistent antisocial patterns. Neuroimaging studies suggest atypical neural activity in regions associated with empathy, reward processing, and impulse control. Effective intervention remains a challenge, as treatment options are limited and often complicated by co-occurring conditions, such as attention deficit hyperactivity disorder (ADHD) and mood disorders. Promising evidence supports the efficacy of integrative, multimodal approaches combining behavioral therapy, family interventions, and pharmacotherapy to reduce symptom severity and improve long-term outcomes. The review concludes by advocating for a public health approach that emphasizes prevention and early intervention, aiming to mitigate the progression to full ASPD in adulthood.

Aberrant salience, defined as the inappropriate attribution of significance to neutral stimuli, is increasingly recognized as a critical mechanism in the onset of psychotic disorders. In young individuals at ultra-high risk (UHR) for psychosis, abnormal salience processing may serve as a precursor to full-blown psychotic symptoms, contributing to distorted perceptions and the onset of psychotic ideation. This review examines current literature on aberrant salience among UHR youth, exploring its neurobiological, psychological, and behavioral dimensions. Through a comprehensive analysis of studies involving neuroimaging, cognitive assessments, and symptomatology, we assess the consistency of findings across diverse methodologies. Additionally, we evaluate factors contributing to aberrant salience, including neurochemical imbalances, dysregulation in dopamine pathways, and environmental stressors, which may jointly increase psychosis vulnerability. Identifying aberrant salience as a measurable trait in UHR populations could facilitate earlier identification and targeted interventions. Implications for clinical practice are discussed, highlighting the need for specialized therapeutic approaches that address cognitive and emotional dysregulation in salience attribution. Recent research underscores the importance of aberrant salience in early psychosis research and advocates for further studies on intervention strategies to mitigate progression to psychosis among UHR individuals.

Background: The gut microbiota plays a crucial role in brain development and function, especially in early life. Disruptions in the pediatric microbiota–gut–brain axis have been linked to neurodevelopmental and psychiatric disorders. We hypothesize that early-life dysbiosis can perturb neurodevelopment via the pediatric microbiota–gut–brain axis, increasing risk and/or severity of neuropsychiatric outcomes, and that microbiota-targeted strategies may mitigate this risk. Methods: We conducted a narrative review by searching PubMed, Scopus, and Web of Science up to January 2025 for studies addressing pediatric microbiota, neuropsychiatric development, and interventions. Human and animal studies were included if they provided mechanistic or clinical insights. Results: Key determinants of microbiota development in childhood include mode of delivery, feeding practices, antibiotic exposure, diet, and environment. Altered microbial composition has been associated with autism spectrum disorder, attention-deficit/hyperactivity disorder, mood disorders, anxiety, and anorexia nervosa. Mechanistic pathways involve immune modulation, neural signaling (including the vagus nerve and enteric nervous system), and microbial metabolites such as short-chain fatty acids. Interventions targeting the microbiota—ranging from dietary strategies and probiotics to psychobiotics and fecal microbiota transplantation—show promise but require further pediatric-focused trials. Conclusions: The pediatric microbiota–gut–brain axis represents a critical window for neuropsychiatric vulnerability and intervention. Early-life strategies to support a healthy microbiota may help reduce the risk or severity of psychiatric disorders. Future research should prioritize longitudinal pediatric cohorts and clinical trials to translate mechanistic insights into precision interventions.

Objective A high proportion of patients presenting to Emergency Departments (EDs) consists of vulnerable elderly people. Mental illnesses are frequently related to advancing age, with difficult to detect symptoms. The aim of this study was to investigate psychiatric drug use by geriatric patients in an ED for whom a psychiatric consultation was needed, according to their psychopathology and severity of outcome. Methods During 2014 to 2023, 342 aged patients (35.96% men and 64.04% women; median age = 73 years, range 68–79 years) sought help at the ED of our hospital and required psychiatric consultation. Results Male sex, nonsuicidal self‐harm, and access through emergency medical services were predictors of >48‐h ED stay/hospital admission (the main severity outcome). Patients with bipolar disorder (BD) and psychotic disorders were more socially disadvantaged and with significantly longer length of stay at the ED than the other groups. Additionally, BD patients had more psychiatric drug prescriptions at discharge than patients in the other diagnostic groups. Current nonsuicidal self‐harm emerged as a predictor of >48‐h ED stay/hospital admission. Conclusions Future studies should focus on investigating suicide risk in ED contexts, on correct diagnosing and on prescription appropriateness of medications in older adults with psychiatric disorders referring to the ED so to tailor‐cut treatment on individual patients' needs. Relevant to Clinical Practice This study highlights the significant impact of psychiatric conditions on healthcare utilization among elderly patients presenting to the ED. The findings emphasize the need for improved diagnosis and management of psychiatric disorders, medication optimization, and tailored treatment approaches. Highlights What is the primary question addressed by this study? Investigation on psychotropic drugs prescriptions and treatment outcomes of geriatric patients in an Emergency Department (ED) for whom a psychiatric consultation was needed. What is the main finding of this study? Male sex and bipolar/psychotic diagnoses were associated with worse outcome. Nonsuicidal self‐harm predicted longer ED stay and hospitalization and bipolar disorder was associated with higher psychopharmacological prescription rates. What is the meaning of the finding? Older patients with psychiatric disorders who refer to the ED need a careful management and a tailored care specifically adapted to clinical and psychopathological characteristics.

The Gram-positive bacterium Staphylococcus pseudintermedius is a leading cause of canine bacterial pyoderma, resulting in worldwide morbidity in dogs. S. pseudintermedius also causes life-threatening human infections. Furthermore, methicillin-resistant S. pseudintermedius is emerging, resembling the human health threat of methicillin-resistant Staphylococcus aureus. Therefore it is increasingly important to characterize targets for intervention strategies to counteract S. pseudintermedius infections. Here we used biophysical methods, mutagenesis, and X-ray crystallography, to define the ligand-binding properties and structure of SitA, an S. pseudintermedius surface lipoprotein. SitA was strongly and specifically stabilized by Mn2+ and Zn2+ ions. Crystal structures of SitA complexed with Mn2+ and Zn2+ revealed a canonical class III solute-binding protein with the metal cation bound in a cavity between N- and C-terminal lobes. Unexpectedly, one crystal contained both apo- and holo-forms of SitA, revealing a large side-chain reorientation of His64, and associated structural differences accompanying ligand binding. Such conformational changes may regulate fruitful engagement of the cognate ABC (ATP-binding cassette) transporter system (SitBC) required for metal uptake. These results provide the first detailed characterization and mechanistic insights for a potential therapeutic target of the major canine pathogen S. pseudintermedius, and also shed light on homologous structures in related staphylococcal pathogens afflicting humans.

Gram-positive bacteria assemble pili through class C sortase enzymes specialized in polymerizing pilin subunits into covalently linked, high-molecular-weight, elongated structures. Here we report the crystal structures of two class C sortases (SrtC1 and SrtC2) from Group B Streptococcus (GBS) Pilus Island 1. The structures show that both sortases are comprised of two domains: an 8-stranded β-barrel catalytic core conserved among all sortase family members and a flexible N-terminal region made of two α-helices followed by a loop, known as the lid, which acts as a pseudo-substrate. In vitro experiments performed with recombinant SrtC enzymes lacking the N-terminal portion demonstrate that this region of the enzyme is dispensable for catalysis but may have key roles in substrate specificity and regulation. Moreover, in vitro FRET-based assays show that the LPXTG motif common to many sortase substrates is not the sole determinant of sortase C specificity during pilin protein recognition.

Bipolar disorder (BD) is a severe psychiatric illness characterized by recurrent mood episodes and significant psychosocial impairment. Emerging evidence supports a bidirectional link between diet and mental health, with growing interest in nutritional psychiatry. This narrative review examines the psychological and psychiatric impact of diet in BD, focusing on biological mechanisms (gut–brain axis, neuroinflammation, oxidative stress, neurotransmitter synthesis, and HPA axis dysregulation) and the role of specific dietary patterns, including Western, Mediterranean, ketogenic, and anti-inflammatory diets. Key micronutrients such as omega-3 fatty acids, B-vitamins, magnesium, and vitamin D are explored in relation to mood regulation. This review also addresses psychological factors, including emotional eating, disordered eating behaviors, and the symbolic meaning of food in BD. Furthermore, it highlights the integration of nutritional psychoeducation into psychotherapy, the impact of comorbidities (e.g., obesity, metabolic syndrome), and the role of lifestyle factors such as sleep and physical activity. Despite promising findings, current research is limited by methodological heterogeneity. Future perspectives should include interdisciplinary, personalized interventions that incorporate nutritional strategies into standard care for BD.

IntroductionAngelman syndrome (AS) is a neurodevelopmental disorder characterized by cognitive disability, speech impairment, hyperactivity and seizures. Movement disorders have been reported in almost all AS subjects and they are described as “tremulous movements of limbs, unsteadiness, clumsiness or quick, jerky motions”. The presence of dystonia has barely been mentioned in subjects with AS and has never been studied in detail. The purpose of this study is to evaluate the prevalence, clinical features and severity of dystonia in a series of adolescents and adults with AS.MethodsWhole body video recordings of patients with genetically confirmed AS were evaluated. Dystonia was evaluated by mean of the movement subscale of Burke–Fahn–Marsden Dystonia Rating Scale (BFM).ResultsForty-four subjects with AS were evaluated. Fourteen recordings were excluded due to poor cooperation. We finally analyzed data of 30 subjects (15 F) with a median age of 28 years (range 15–51). Dystonia was present in 28/30 (93.3%) subjects. Among these, dystonia involved the upper limbs in 28/28 (100%), lower limbs in 8/28 (28.5%), mouth in 7/28 (25%), neck in 3/28 (10.7%), trunk in 1/28 (3.6%). Severity of dystonia ranged from slight to moderate. There was a linear correlation between severity of dystonia and increasing age. There was no difference in terms of severity of dystonia among genetic subgroups.ConclusionsDystonia is a common and previously underrecognized clinical feature of adults and adolescents with AS.

BackgroundEpilepsy and hypertension are common chronic conditions, both showing high prevalence in older age groups. This review outlines current experimental and clinical evidence on both direct and indirect role of hypertension in epileptogenesis and discusses the principles of drug treatment in patients with hypertension and epilepsy.MethodsWe selected English-written articles on epilepsy, hypertension, stroke, and cerebrovascular disease until December, 2018.ResultsRenin-angiotensin system might play a central role in the direct interaction between hypertension and epilepsy, but other mechanisms may be contemplated. Large-artery stroke, small vessel disease and posterior reversible leukoencephalopathy syndrome are hypertension-related brain lesions able to determine epilepsy by indirect mechanisms. The role of hypertension as an independent risk factor for post-stroke epilepsy has not been demonstrated. The role of hypertension-related small vessel disease in adult-onset epilepsy has been demonstrated. Posterior reversible encephalopathy syndrome is an acute condition, often caused by a hypertensive crisis, associated with the occurrence of acute symptomatic seizures. Chronic antiepileptic treatment should consider the risk of drug-drug interactions with antihypertensives.ConclusionsCurrent evidence from preclinical and clinical studies supports the vision that hypertension may be a cause of seizures and epilepsy through direct or indirect mechanisms. In both post-stroke epilepsy and small vessel disease-associated epilepsy, chronic antiepileptic treatment is recommended. In posterior reversible encephalopathy syndrome blood pressure must be rapidly lowered and prompt antiepileptic treatment should be initiated.

Background/Objectives: Although depression and anxiety are found to be affected by temperaments, little research has studied these relationships in pregnancy. The present study explored the associations among perinatal depression (PD), anxiety dimensions (state, trait, and generalized anxiety disorder (GAD)), and temperaments between women in the three trimesters of pregnancy through a network analysis approach. Moreover, differences in the severity of PD and anxiety between women in the three trimesters were evaluated. Methods: Women in first (N = 31), second (N = 184), and third (N = 54) trimesters of pregnancy were recruited in the present cross-sectional study. The network analysis included PD, anxiety dimensions, and temperaments. Three network models were estimated, and ANOVAs evaluated the differences in the severity of PD and anxiety, including trimesters as a between-subject factor. Results: PD and GAD were the nodes most strongly connected across the three groups. Cyclothymic, depressive, and anxious temperaments were most frequently associated with PD and GAD. Hyperthymic temperament was in the periphery of the three networks. Lastly, women in the first trimester had the highest severity of PD and GAD. Conclusions: PD and GAD showed the strongest associations. Anxiety dimensions had positive associations with PD and GAD, suggesting their role as possible risk factors. Temperaments were differently associated within the network between the three groups. Clinical interventions during pregnancy should target the central variables, considering their direct and indirect relationships.