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Published on: June 20, 2020
Psychopathological Severity Across the Cognitive Continuum: A Comparative Study of Adolescents with Average
Roberto Averna1, Gianluca Sesso1, Massimo Apicella1,2
1Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, Rome, Italy.
Journal of Child and Adolescent Psychopharmacology
|July 23, 2026
Summary
Adolescents with borderline intellectual functioning (BIF) experience significant adaptive challenges and require more psychiatric treatment. This highlights the need to consider cognitive abilities in child and adolescent mental healthcare planning.
Area of Science:
- Child and Adolescent Psychiatry
- Neuropsychiatry
- Cognitive Functioning
Background:
- Borderline intellectual functioning (BIF) is linked to increased psychiatric vulnerability but is poorly understood regarding clinical severity and treatment needs.
- Adolescents with BIF present unique challenges in inpatient settings.
Purpose of the Study:
- To compare psychopathological burden, adaptive functioning, suicidality, and psychopharmacological treatment in hospitalized adolescents with BIF versus average intellectual functioning and intellectual disability.
- To characterize the clinical profile and treatment complexity of BIF in adolescent psychiatry.
Main Methods:
- Retrospective chart review of 194 adolescents (aged 12-18) admitted to a tertiary child and adolescent neuropsychiatry unit.
- Classification into three groups based on full-scale IQ: BIF, average intellectual functioning, and intellectual disability.
- Analysis of cognitive functioning, psychiatric diagnoses, symptom severity, adaptive behavior, global functioning, suicidality, emergency service utilization, and psychotropic medication at discharge using nonparametric statistics.
Main Results:
- Adolescents with BIF exhibited poorer adaptive functioning (conceptual and practical domains) than those with average IQ, despite similar global functioning.
- The BIF group showed persistent behavioral dysregulation with internalizing and externalizing symptoms, more emergency psychiatric admissions, and higher antipsychotic prescription rates at discharge.
- Suicidality patterns differed, with cognitive impairment groups showing lower overall rates and specific modalities (precipitation, defenestration).
Conclusions:
- BIF in adolescence is associated with distinct functional impairments and clinical complexity, including adaptive difficulties.
- There is an increased reliance on psychopharmacological treatment for adolescents with BIF.
- Cognitive functioning assessment is crucial for effective treatment planning in inpatient child and adolescent psychiatry.
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