BACKGROUND:The COVID-19 pandemic had a substantial impact on the mental health of children and adolescents. The literature lacks large-scale research evaluating its consequences on teenagers with feeding and eating disorders (FED). This study aims to assess the impact of the COVID-19 pandemic on a population of patients of developmental age. METHODS:This single-center observational study compares two historical cohorts of children and adolescents diagnosed with FED, with a first consultation before (1st March 2018 to 31st October 2019) and during (1st March 2020 to 31st October 2021) pandemic. Demographic, clinical, nutritional, and treatment variables were assessed. RESULTS:We enrolled 479 patients (F=398, 83.1%), including 205 (F=161, 78.5% mean age 14.5±2.5, range 7.9-17.9 years) belonging to the first historical cohort and 274 (F=237, 86.5%; 14.4±2.1, range 6.5-17.9) to the second one (+33.7%). Increased mean new accesses/month (P=0.042) and a greater percentage of females (P=0.042) during the pandemic compared to the pre-pandemic period emerged. Physical hyperactivity (P=0.022) and suicidal behaviors (P=0.030) increased, while fewer patients required hospitalization (P=0.013). CONCLUSIONS:An increase in first visits for FED after the COVID-19 pandemic emerged, with females being the most affected. Physical hyperactivity and self-harming behaviors were intensified, while patients in need of hospitalization were reduced. Longitudinal studies are required.

PURPOSE Current guidelines, due to potential toxicity and lack of clinical evidence, do not recommend the use of lithium in the treatment of Anorexia Nervosa (AN). Scarce evidence is available on the use, side effects, and tolerability of this drug in children and adolescents with AN, a population characterized by specific clinical, metabolic, and hydro-electrolytic balance features. Here we report a case series of children and adolescents hospitalized for AN and treated with lithium. METHODS Case series reporting the use of lithium in 7 female young patients with AN. Reasons for introduction, dosages, formulation, plas-ma levels, adverse drug reactions (ADR) and modifi-cations of electrocardiogram (EKG) and plasma levels of glucose, cholesterol, creatinine, urea, sodium, and thyroid-stimulating hormone (TSH) were assessed. Re-sults. Reasons for the introduction of lithium included unstable mood, insufficient compliance with nutri-tional programs, and psychomotor agitation. In all of the patients an improvement on target symptoms was observed. Lithium was started at 171.4 (+/-56.7) mg/day, up to 600.0 (+/-173.2) mg/day. The most frequent scheme was three times daily. The mean plasmatic concentration was 0.6 (+/-0.3) mmol/L at one month. One pa-tient experienced polyuria, polydipsia and dry mouth, and another showed increased creatinine kinase. No major modifications of EKG, glucose, cholesterol, cre-atinine, urea, sodium emerged. CONCLUSIONS In this sample of children and adolescents hospitalized for AN, lithium was administered to improve psychiatric symptoms impairing compliance. All the patients experienced an improvement on these symptoms after being admin-istered lithium. ADR were reported in 2 cases. These data should be investigated in wider populations and controlled studies.

The present study investigates the impact of Autism Spectrum Disorder (ASD) traits on the treatment intensity and outcomes (psychopathology and weight) of 22 adolescent inpatients with Anorexia Nervosa (AN), who were selected on the basis of suspected ASD traits. ASD traits were measured at admission (T0) using the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and the Autism-Spectrum Quotient (AQ). Psychopathology was measured with Eating Disorder Inventory-3 (EDI-3) and Self-Administered Psychiatric Scales for Children and Adolescents (SAFA) at admission and discharge (T0, T1). Percentage BMI was assessed at admission, discharge, first follow-up (T2, 7–22 days) and second follow-up (T3, 22–45 days). Results were controlled for age and EDI-3 global psychological maladjustment. When compared with other patients with AN, AN individuals with ADOS-2 and AQ diagnostic scores for ASD showed overlapping types of treatments, as well as psychopathological and weight outcomes. ASD total scores were not correlated with treatment intensity or treatment outcomes. Preliminary results show that ASD traits do not impact treatment intensity and outcomes in adolescents with AN and suspected ASD traits.