During the COVID-19 pandemic, there have been multiple reports about an unforeseen surge in adolescents and young adults exhibiting sudden onset functional tic-like behaviors. This phenomenon has been mainly associated with the female gender and occasionally after exposure to social media content featuring similar patterns of functional tic-like behaviors. A significant portion of these individuals have been directed to specialist clinics for movement disorders with initial misdiagnoses of late-onset refractory Tourette syndrome. Distinguishing between rapid onset functional tic-like behaviors and neurodevelopmental tics as part of Tourette syndrome can be challenging; however, the differential diagnosis is facilitated by focusing on specific clinical and demographic factors, which we have explored in a systematic literature review. Compared to neurodevelopmental tics, functional tic-like behaviors typically present with a more abrupt and intense manifestation of symptoms, onset at a later age, higher prevalence among females, inability to suppress tics, coexisting anxiety and depression, and sometimes a history of exposure to social media content portraying tic-like behaviors of a similar nature. This novel manifestation of a functional neurological disorder may thus be viewed as an emerging neuropsychiatric condition potentially triggered/exacerbated by the psychosocial repercussions of the COVID-19 crisis.

Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric comorbidities, including eating disorders (EDs). We aimed to investigate the potential association between key disease characteristics, including psychological features, and the development of EDs in a clinical sample of adolescents with IBDs. We enrolled 52 adolescents with IBDs, 83% of whom were in clinical remission, and systematically collected additional information on disease duration, the total number of relapses, the use of steroids, and the number of hospital admissions. All participants completed a validated psychometric battery assessing psychological symptoms (Symptom Checklist-90–Revised, SCL-90-R), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and ED symptomatology (Eating Disorders Inventory-3rd edition, EDI-3). About one in ten patients (9.6%) reported Eating Disorder Risk scores higher than the cut-off on the EDI-3 subscale, specifically addressing the risk of developing EDs. According to the EDI-3 scores, the risk of developing EDs directly correlated with the number of total relapses of IBDs (p < 0.05). The TAS-total scores also correlated with the number of total relapses (p < 0.01), as well as with the number of steroid cycles (p < 0.05), the number of hospital admissions (p < 0.05), and overall disease duration (p < 0.05). Our findings suggest that disease relapses increase the risk of developing both EDs and alexithymia in adolescents with IBDs. The recurrence of disease relapses should be identified and screened early on to prevent the onset of psychiatric disorders, including EDs. Research should be conducted on larger samples with different IBD phenotypes to further investigate the characteristics of patients with IBDs at risk of developing EDs.

Background: Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric co-morbidities, including restrictive eating disorders (REDs), with which they share common pathogenic mechanisms, including gut–brain axis dysregulation. We conducted a case–control study systematically exploring the psychopathological profiles and alexithymia in adolescents with IBDs compared with a clinical group of adolescents diagnosed with REDs in order to test the hypothesis of common psychological characteristics between the two patient populations. Methods: We recruited 76 patients with IBDs and 76 age-matched controls with REDs (64 adolescents with anorexia nervosa and 12 adolescents with avoidant/restrictive food intake disorder). All participants completed a validated psychometric battery assessing psychological symptoms (SCL-90-R), ED features (EDI-3), and alexithymia (TAS-20). Comprehensive socio-demographic and clinical data were extracted from the medical records. Results: A total of 12 patients with IBDs (15.8%) scored higher than the cut-off (>70th percentile) on the EDI-3 scale for Eating Disorder Risk (EDI-EDRC), with a psychological profile comparable to RED patients. Female gender (OR = 0.133, p = 0.020) and longer disease duration (OR = 1.055, p = 0.036) were identified as significant risk factors for the development of EDs. Conclusions: Our findings suggest common psychological traits between patients with REDs and patients with IBDs at risk of developing EDs during adolescence, highlighting the need for early screening for EDs in patients with IBDs who present with specific socio-demographic and disease characteristics.

Background: Female individuals with inflammatory bowel diseases (IBDs) are more likely to develop restrictive eating disorders (REDs), with both conditions appearing to share common pathophysiological pathways. We conducted a case–control study exploring eating symptomatology and interoceptive profiles in female adolescents with IBDs compared with adolescents diagnosed with REDs, in order to test the hypothesis that the two clinical populations exhibit similar interoceptive characteristics. Methods: We recruited 33 female adolescents with IBDs and 54 controls with REDs matched for age and gender. All participants completed a validated psychometric battery assessing eating disorder features (EDI-3) and interoceptive awareness (MAIA-2). Results: Twenty-seven percent of patients with IBD scored above the cut-off (>70th percentile) on the EDI-3 Eating Disorder Risk Composite (EDRC), showing an eating and interoceptive profile comparable to that of patients with REDs. The two sub-cohorts within the IBD sample differed in the ‘Not-Worrying’ and ‘Trusting’ MAIA-2 subscales, with the IBD cohort at risk of developing an ED reporting lower scores. Conclusions: Our findings indicate comparable interoceptive profiles between adolescents with IBDs who are at risk of developing EDs and patients with a confirmed diagnosis of REDs. This similarity underscores the need to further investigate the shared pathogenic mechanisms underlying these conditions, particularly the role of the gut–brain axis (GBA).

Postural orthostatic tachycardia syndrome (POTS) is an autonomic condition characterized by sustained excessive postural tachycardia, often accompanied by a range of other symptoms of orthostatic intolerance, including heart palpitations, light-headedness, weakness, tremulousness, blurred vision, nausea, headache, dizziness and syncope. POTS predominantly affects young females. Little is known about the exact pathophysiology of this condition; however, preliminary reports about comorbidity profile of POTS suggest a possible link with functional disorders. The striking increase in functional tic-like behaviors (a specific phenotype of functional movement disorder) during the COVID-19 pandemic offered a privileged opportunity to further explore the possible association between POTS and functional neurological disorder. In the present study, we retrospectively assessed the prevalence of POTS in two large patient populations from a specialist clinic for tic disorders: (1) patients with neurodevelopmental tics who received a diagnosis of Gilles de la Tourette syndrome (GTS), and (2) patients who developed tic-like behaviors and received a diagnosis of functional tics since the onset of the COVID-19 pandemic (April 2020 – December 2024). The prevalence of POTS was 0/638 in the GTS group and 4/177 (2.3%) in the functional tics group. The four patients with POTS were females, with age at assessment ranging from 17 to 24 years. In addition to describing their clinical characteristics, we discuss the significance of the selective association between POTS and functional tic-like behaviors, in the absence of comorbidity between POTS and neurodevelopmental tics.

Background/Objectives: Inflammatory bowel diseases (IBDs) are relapsing–remitting gastrointestinal disorders often emerging in adolescence and frequently associated with psychiatric co-morbidities, including eating disorders (EDs). Deficiency in interoception—awareness of internal bodily sensations—is a transdiagnostic feature in EDs, with emerging evidence suggesting its relevance also in IBDs. This study aimed to assess interoceptive abilities in adolescents with IBDs compared to healthy adolescents. Methods: A total of 76 patients with IBDs and 90 healthy controls were enrolled in the study. All participants completed a comprehensive psychometric assessment, including measures of interoceptive sensibility (MAIA-2) and eating-related symptomatology (EDI-3). Results: Up to one in six (15.8%) patients with IBDs were found to be at high risk of developing EDs (EDI-3 Eating Disorder Risk Composite scale >70th percentile). Mean MAIA-2 scores were largely comparable, with the exception of the MAIA-2 Trusting subscale, which assesses whether the experience of one’s body is rated as safe and trustworthy. Specifically, patients with IBDs at high risk of developing EDs reported lower scores than both healthy controls and patients with IBDs at low risk of developing EDs, with a statistically significant difference emerging in the comparison with the latter group (p = 0.044). Conclusions: Adolescents with IBDs who report an elevated risk of developing eating disorders have a psychological profile characterised by increased disordered eating symptomatology, accompanied by selective impairment in interoceptive trust, as evidenced by reduced trust in internal bodily signal. These findings highlight the clinical relevance of thorough clinical assessment and early psychological intervention in this vulnerable population.