Gigliotti Federica, Cammisa Luca, Riezzo Sara, Terrinoni Arianna
Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy.
Behavioural Neuroscience, Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.
J Clin Med. 2025 Jul 7;14(13):4807. doi: 10.3390/jcm14134807.
: Emotional dysregulation (ED) is a transdiagnostic feature of multiple adolescent psychiatric disorders and a predictor of functional impairment and self-harming behaviors. Despite its clinical relevance, pharmacological treatments targeting ED in youth remain underexplored. This retrospective study investigated the clinical effectiveness and tolerability of adjunctive lithium therapy in adolescents with severe ED, independent of specific diagnostic categories. : A total of 35 inpatients (13-17 years) with significant ED were divided into two groups based on pharmacological treatment: lithium add-on therapy (Li group, = 17) and standard therapy without lithium (Control group, = 18). Clinical severity (CGI-S) and global functioning (C-GAS) were assessed at baseline (T0), 6 months (T1), and 12 months (T2). A mixed-design ANOVA was performed to assess group × time interactions. Adverse events and treatment adherence were also examined. : At T1, the Li group showed a significantly greater reduction in symptom severity (CGI-S) compared to the Control group ( = 0.029). Global functioning (C-GAS) improved over time in both groups ( < 0.001), with no significant interaction effects. Adverse effects, primarily metabolic and endocrine, were more frequent in the Li group but did not reduce adherence. : Adjunctive lithium therapy may reduce symptom severity in adolescents with severe ED without negatively affecting treatment tolerability or adherence. These findings support the potential utility of lithium in complex adolescent cases and warrant further prospective research.
情绪调节障碍（ED）是多种青少年精神疾病的一种跨诊断特征，也是功能损害和自伤行为的一个预测指标。尽管其具有临床相关性，但针对青少年ED的药物治疗仍未得到充分探索。这项回顾性研究调查了辅助性锂盐治疗对患有严重ED的青少年的临床有效性和耐受性，而不考虑具体的诊断类别。
共有35名患有显著ED的住院青少年患者（年龄在13 - 17岁之间）根据药物治疗被分为两组：锂盐附加治疗组（锂盐组，n = 17）和不使用锂盐的标准治疗组（对照组，n = 18）。在基线期（T0）、6个月（T1）和12个月（T2）评估临床严重程度（CGI - S）和整体功能（C - GAS）。进行混合设计方差分析以评估组×时间的交互作用。还检查了不良事件和治疗依从性。
在T1时，与对照组相比，锂盐组的症状严重程度（CGI - S）有显著更大程度的降低（P = 0.029）。两组的整体功能（C - GAS）均随时间改善（P < 0.001），且无显著交互作用。锂盐组的不良反应（主要是代谢和内分泌方面）更频繁，但未降低治疗依从性。
辅助性锂盐治疗可能降低患有严重ED的青少年的症状严重程度，而不会对治疗耐受性或依从性产生负面影响。这些发现支持了锂盐在复杂青少年病例中的潜在效用，值得进一步开展前瞻性研究。
