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Background Among early-onset conduct problems (CP), associated with more disruptive behaviors of greater intensity and stability, several domains have been proposed from a variable-centered perspective to capture their heterogeneity: oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional traits (CU). Using a person-centered approach, the present study aims to identify distinct profiles of child CP, examining different predictors and developmental outcomes. Methods Data included parent- and teacher-reported questionnaires from an ongoing longitudinal study (ELISA). Latent profiles were identified first in a community sample ( n  = 2,103; age 4–8 years; 50.9% boys) and replicated in a high-CP subsample ( n  = 168; 70.24% boys). Results Four profiles emerged in the community sample (Normative Development, Daring/Impulsive, Low prosociality + Fear; Low prosociality + Psychopathic Traits [PP]), and three in the high-CP sample (same except the normative). The identified CP profiles aligned with the ADHD and CU domains, but not the ODD domain. Differences in activity, punitive and inconsistent parenting emerge as the most significant predictors. Regarding the outcomes, the Low prosociality + PP profile stands out as the group with the most severe emotional, social and behavioral maladjustment. Conclusions These findings highlight the heterogeneity within CP, and the importance of designing specific and tailored interventions for each identified profile.

Children and adolescents with psychopathic traits show deficits in emotion recognition, but there is no consensus as to the extent of their generalizability or about the variables that may be moderating the process. The present Systematic Review brings together the existing scientific corpus on the subject and attempts to answer these questions through an exhaustive review of the existing literature according to PRISMA 2020 statement. Results confirmed the existence of pervasive deficits in emotion recognition and, more specifically, on distress emotions (e.g., fear), a deficit that transcends all modalities of emotion presentation and all emotional stimuli used. Moreover, they supported the key role of attention to relevant areas that provide emotional cues (e.g., eye-region) and point out differences according to the presence of disruptive behavior and based on the psychopathy dimension examined. This evidence could advance the current knowledge on developmental models of psychopathic traits. Yet, homogenization of the conditions of research in this area should be prioritized to be able to draw more robust and generalizable conclusions.

Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research has linked the child’s fearlessness and callous–unemotional (CU) traits, as well as experiences of parental warmth and punitive parenting, to CP. However, few studies have tested the interplay of these factors in contributing to future CP development. The present study aimed to test the InterFear model, which suggests that fearlessness in early childhood leads to CP through an indirect pathway involving low positive parenting, high negative/punitive parenting, and callous–unemotional (CU) traits. The sample included 2467 Spanish children (48.1% girls; Mage = 4.25; SD = 0.91), followed up across a five-year period. Besides a direct association between fearlessness in early childhood and future CP, the results found an indirect pathway whereby fearlessness reduces positive parenting and increases punitive parenting, which contributes to the development of CU traits and sets the stage for CP in later childhood. The specific indirect effect from fearlessness to CP via CU traits accounted for most of the variance, suggesting the existence of a temperamental pathway independent of parental variables. Further, two additional indirect pathways, exclusive of fearlessness, were identified, which started with low parental warmth and positive parenting, leading to CP via CU traits. These findings support the InterFear model, demonstrating multiple pathways to CP with the involvement of fearlessness, parenting practices, and CU traits. This model might play a pivotal role in the development of targeted prevention and intervention strategies for CP.

Background Multimorbidity is associated with higher mortality rates, reduced functional capacity, and lower health‐related quality of life (HRQoL). Multidisciplinary transitional care interventions (TCIs) provided after hospital discharge have the potential to improve HRQoL and patient satisfaction. Methods A systematic review was conducted, inception to October 2023, focusing on randomized clinical trials retrieved from MEDLINE, Embase, CENTRAL, CINAHL, and PsycINFO. The primary outcome measures were HRQoL and patient satisfaction. Secondary outcomes included mortality, adverse events, activities of daily living, adherence, hospitalizations, length of stay, emergency department visits, specialist and primary care visits, social support, mood, and caregiver burden. Risk of bias was assessed using the Cochrane RoB‐2 tool, and the overall quality of evidence was evaluated with GRADE. When possible, a meta‐analysis was conducted using Stata 17. Results A total of 21 studies (N = 5790) were included. The data suggest that TCIs may lead to small improvements in short‐term HRQoL (1 month: MD = 0.22; 95% CI: 0.19–0.42), although this effect diminishes by 3 months. No evidence was found for patient satisfaction. TCIs likely do not reduce mortality or hospitalization rates but may result in a slight reduction in depression (SMD = −0.27; 95% CI: −0.47 to −0.06). Evidence on other outcomes is limited, with no significant differences observed in adverse events or adherence. Conclusion Overall, TCIs have a limited impact on mortality or hospitalization rates and may offer short‐term improvements in HRQoL and depression, while evidence for patient satisfaction and other outcomes remains limited and their long‐term effects remain uncertain.

Multimorbidity is increasingly present in our environment. Besides, this is accompanied by a deterioration of social and environmental conditions and affects the self-care ability and access to health resources, worsening health outcomes and determining a greater complexity of care. Different multidisciplinary and multicomponent programs have been proposed for the care of complex patients around hospital discharge, and patient-centered coordination models may lead to better results than the traditional ones for this type of patient. However, programs with these characteristics have not been systematically implemented in our country, despite the positive results obtained. Hospital Universitario de Canarias cares for patients from the northern area of Tenerife and La Palma, Spain. In this hospital, a multicomponent and high-intensity care program is carried out by a multidisciplinary team (made up of family doctors and nurses together with social workers) with complex patients in the transition of care (SPICA program). The aim of this program is to guarantee social and family reintegration and improve the continuity of primary healthcare for discharged patients, following the patient-centered clinical method. Implementing multidisciplinary and high-intensity programs would improve clinical outcomes and would be cost-effective. This kind of program is directly related to the current clinical governance directions. In addition, as the SPICA program is integrated into a Family and Community Care Teaching Unit for the training of both specialist doctors and specialist nurses, it becomes a place where the specific methodology of those specialties can be carried out in transitional care. During these 22 years of implementation, its continuous quality management system has allowed it to generate an important learning curve and incorporate constant improvements in its work processes and procedures. Currently, research projects are planned to reevaluate the effectiveness of individualized care plans and the cost-effectiveness of the program.

Complex multimorbid patients often experience uncoordinated care transitions, increasing the risk of poor adherence, fragmented care, and adverse outcomes. Multicomponent, patient-centered interventions may improve transitional care, but evidence remains limited and heterogeneous. This pre-post intervention study evaluated the impact of SPICA, a multicomponent, high-intensity, patient-centered transitional care program implemented in Tenerife, Spain. Eligible adult patients with multimorbidity and complexity were consecutively enrolled between September 2023 and June 2024. Primary outcome was adherence to pharmacological treatment (Morisky Medication Adherence Scale-4). Secondary outcomes included patient satisfaction (Baker's Questionnaire), health-related quality of life (HRQoL, EQ-5D-5L), disease (Disease Burden Morbidity Assessment), and treatment burden (Treatment Burden Questionnaire). Outcomes were assessed at baseline and one-month post-discharge. Multivariate linear regression was used for the satisfaction outcome, and bivariate models were conducted to explore predictors of the remaining intervention outcomes. McNemar's Chi-squared test was used to evaluate changes in adherence rates, and ANCOVA models for other outcomes measured at both pre- and post-intervention. Among the 112 patients, adherence improved from 53.4 to 84.9% (  < 0.001). Satisfaction with care was high (median 71; IQR 67-81). Significant improvements were observed in HRQoL (mobility [  - 0.56], pain/discomfort [  - 0.55], anxiety/depression [  - 0.37], EQ-5D Index [ 0.14], EQ-VAS [ 7.08]), and treatment burden (  - 12.24). Baseline scores were the most consistent predictors of improvement; age, sex, and comorbidity were not significant factors. A multicomponent, high-intensity, patient-centered intervention such as SPICA appears to be associated with improvements in adherence and health outcomes in complex multimorbid patients transitioning from hospital to primary care, and may also be linked to high levels of patient satisfaction. Effects were more pronounced in those with worse baseline scores, suggesting a positive impact among those most in need. Nevertheless, further studies with more robust methodological designs are required to confirm these associations.

[This corrects the article DOI: 10.3389/fmed.2025.1650973.].