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The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) has recently recognized a particular risk for posttraumatic stress disorder (PTSD) among first responders (criterion A4), acknowledging emergency units as stressful places of employment. Little data is yet available on DSM-5 among emergency health operators. The aim of this study was to assess DSM-5 symptomatological PTSD and posttraumatic stress spectrum, as well as their impact on work and social functioning, in the emergency staff of a major university hospital in Italy. One hundred and ten subjects (doctors, nurses, and health-care assistants) were recruited at the Emergency Unit of the Azienda Ospedaliero-Universitaria Pisana (Italy) and assessed by the Trauma and Loss Spectrum-Self Report (TALS-SR) and Work and Social Adjustment Scale (WSAS). A 15.7% DSM-5 symptomatological PTSD prevalence rate was found. Nongraduated persons reported significantly higher TALS-SR Domain IV (reaction to loss or traumatic events) scores and a significantly higher proportion of individuals presenting at least one maladaptive behavior (TALS-SR Domain VII), with respect to graduate ones. Women reported significantly higher WSAS scores. Significant correlations emerged between PTSD symptoms and WSAS total scores among health-care assistants, nongraduates and women. Our results showed emergency workers to be at risk for posttraumatic stress spectrum and related work and social impairment, particularly among women and nongraduated subjects.

Medically unexplained physical symptoms are frequently endorsed by children and adolescents in both clinical and community samples. The aim of this exploratory study is to examine the prevalence of somatic symptoms in a sample of 162 Italian children and adolescents consecutively referred to a Division of Child Neurology and Psychiatry from emotional and/or behavioral disorders. The role of age, gender, and psychiatric status was considered as a variable. Each patient received a DSM-IV assessment, including a diagnostic structured interview (DICA-R). The sample was divided according to gender (96 males, 66 females), age (70 children younger and 92 adolescents older than 12 years), and psychiatric diagnosis (Anxiety, Depression, Depression/Anxiety, Other). The presence of medically unexplained somatic symptoms was based on the responses to the DICA-R. Somatic complaints were reported in 69.2% of the patients. Headache was the most frequent somatic symptom (50.6%). Younger children showed higher rates of abdominal complaints than adolescents. No gender differences in frequency of somatic complaints were reported. Subjects with anxiety and/or depression reported significantly higher rates of somatic complaints, namely headache, than subjects with other mental disorders. No differences in frequency of somatic symptoms were evident between patients with anxiety, depression, and comorbid anxiety-depression. Our data suggest that an unexplained somatic symptom can be often considered as indicative of a neglected anxiety and/or depressive disorder. A collaboration between primary care physicians, pediatricians, and child psychiatrists may promote early diagnoses and timely treatments and prevent negative social and scholastic consequences.

This report examines the concurrent validity of different informant and self-report assessment instruments of psychopathology, both general and specific for anxiety and/or depression, in referred mentally retarded adolescents with a depressive and anxiety disorders, according to DSM IV criteria. A consecutive, unselected sample of 50 mildly and moderate mentally retarded adolescents (29 males and 21 females, aged 11.8 to 18 years, mean age 15.1) were assessed using standardized assessment techniques: Psychopathology Instrument for Mentally Retarded Adults (PIMRA) (informant version) (total score, affective and anxiety subscales), Child Behavior Checklist (CBCL) (informant version) (total score, internalizing and externalizing scores, anxiety-depression scale), Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scale. Patterns of correlation among measures were calculated. PIMRA and CBCL total scores were closely intercorrelated. Internalizing and externalizing scores of CBCL were not intercorrelated, but they both correlated with CBCL and PIMRA total scores. Anxiety measures were positively correlated; they correlated with PIMRA and CBCL total scores, as well as with the internalizing score of CBCL. Depression measures were not correlated; their correlation with more general measures of psychopathology was weak. Clinical implications of these findings are discussed.

Aim of this study was to investigate whether specific temperamental features were associated with anxiety and depressive disorders in adolescents, in their siblings and in their parents. Thirty adolescents with Anxiety disorders and 25 with both Anxiety and Depressive disorders were compared to 25 adolescents with learning disorders and to 28 normal subjects. Temperament in subjects and relatives was assessed by their parents with the EAS questionnaire. Subjects with Anxiety and Anxiety-Depression and their siblings showed higher scores on Emotionality and Shyness than Learning Disability and Normal subjects. Mothers and fathers of subjects from the Anxiety-Depression group had the highest Emotionality score. These findings suggest that both Emotionality and Shyness are prominent temperamental features in adolescents with anxiety with or without depression, and in their parents and siblings.

Prevalence, phenomenology, comorbidity, functional impairment and familial correlates of juvenile panic disorder (PD) are described in this study. A clinical interview (Diagnostic Interview for Children and Adolescents-Revised) was administered to 220 children and adolescents consecutively referred to a Division of Child Neurology and Psychiatry. 23 subjects (10.4%), aged 7 to 18 years, fulfilled DSM-IV criteria for PD. Reported panic symptoms are described, according to gender and chronological age. High comorbidity with generalized anxiety disorder (74%) and depression (52%) was noted. Agoraphobia (56%) and other phobias (56%) were significantly more frequent than in two control groups of subjects with generalized anxiety disorder and with depression. Antecedent and/or associated separation anxiety disorder was reported in 73% of the patients. Functional impairment, assessed with a specific diagnostic instrument (Children's Global Assessment Scale) was significantly greater in PD patients than in depressed or anxious patients. 90% of patients had at least one parent with an anxiety disorder, 52% had one parent with depressive disorder, 33% had one parent with drug treated PD.

Aim of this study is to examine the effect of depressive comorbidity in 108 children and adolescents with Generalized Anxiety Disorder (GAD). Fifty-five patients with GAD and depression were compared with 53 patients with GAD without depression. Age, gender and socioeconomic status did not differentiate the groups. Patients with comorbid depression had significantly more anxiety symptoms than patients without depression. Clinical presentation of GAD and pattern of comorbidity was similar in the two groups. Subjects with comorbid depression showed a more severe functional impairment, assessed with C-GAS. Data are discussed in the light of conceptualizations about the relationship between anxiety and depression.

This report examines clinical features of ‘pure’ dysthymic disorder (DD, without superimposed major depressive disorder, MDD) in a sample of children and adolescents. Profiles of symptomatology and comorbidity as a function of age and gender are described. The sample consisted of 48 subjects (22 males, 26 females, age range 7–18 years, mean age 12.1 years) screened from consecutively referred children and adolescents. All subjects were comprehensively diagnosed with structured diagnostic interviews (Schedule for Affective Disorders and Schizophrenia for School Age, Diagnostic Interview for Children and Adolescents-Revised), according to DSM-IV criteria. Depressed mood, irritability, loss of energy and fatigue, guilt and low self-esteem were present in more than 70% of the subjects. Differences in symptomatic profile between males and females were not significant. Children showed less symptoms than adolescents, but the symptomatic profile was comparable (only anhedonia was significantly more frequent in adolescents). Anxiety disorders were more commonly comorbid with DD, especially separation anxiety disorder in children (33%) and generalised anxiety disorder in adolescents (67%). Externalising disorders were less frequently represented in our sample (14%). An early diagnosis of ‘pure’ DD before the first episode of MDD is crucial for a timely intervention.

Anxiety disorders are common in patients with depressive disorders. This preliminary study investigated some clinical correlates of comorbidity between dysthymic disorder (DD) and generalized anxiety disorder (GAD) in a clinically referred sample of children and adolescents. After psychiatric evaluation, including a diagnostic clinical interview (DICA-R), 51 patients (25 males and 26 females, mean age 13.1 years) with an index diagnosis of DD associated with GAD were compared with 22 patients (13 males and 9 females, mean age 12.9 years) diagnosed as having pure DD. The comparison between subjects (DD with or without GAD) regarding the number of depressive symptoms did not show a significant main effect of group. Suicidal ideation was significantly more frequent in the group with comorbid GAD. Internalizing disorders were more frequent in the group of DD with GAD, while externalizing disorders were more frequent in the group without GAD. Functional impairment, assessed with the Children’s Global Assessment Scale, did not show significant differences between the two groups. Data are discussed in the light of conceptualizations about the relationship between chronic anxiety and depressive disorders.

We report on the separation of Cherenkov and scintillation light in BGO and BSO crystals read out with silicon photomultipliers (SiPMs). The two light components are disentangled on an event-by-event basis by combining optical filtering with waveform template fitting, exploiting their distinct spectral and temporal characteristics. Measurements were carried out using high-energy muon and positron beams at the CERN SPS North Area, demonstrating Cherenkov yields of up to \\(\\)150 ph.e./GeV in electromagnetic showers. This work provides the first demonstration of Cherenkov-scintillation separation in BGO and BSO crystals with SiPM readout, supporting the use of this technology as a building block for a dual-readout electromagnetic calorimeter, as foreseen in the IDEA detector concept for a future \\(e^+e^-\\) Higgs factory.

The Kleine-Levin syndrome (KLS) is characterized by periodic, sudden-onset episodes of hypersomnia, compulsive hyperphagia, and behavioral-emotional disorders (typically indiscriminate hypersexuality, irritability, impulsive behaviors), lasting from a few days to a few weeks, with almost complete remission in the intercritical periods. Depression, confusion, and thought disorders are frequently associated with the critical symptomatology, and they may suggest other psychiatric diagnoses (schizophrenia, mood disorder, conversion disorder) or a substance abuse. A diencephalic-hypothalamic dysfunction is suspected, even if this composite symptomatology cannot easily be linked to a simple mechanism. The aim of this article is to illustrate problems in differential diagnosis, using a case approach. History, course, and therapeutic intervention in a 21-year-old patient with KLS, associated with a clear psychiatric symptomatology and a critical affective pattern, is reported. Psychiatric correlates of KLS are discussed, including the relationship with affective disorders and the possible emotional impact of the attacks. Implications regarding a combined psychological and pharmacological treatment are also discussed.