To evaluate relationships between alexithymia, somatic complaints and depressive symptoms in a non-clinical sample of school-aged Italian adolescents.

A mixed male-female sample of 168 school-aged adolescents with a mean age of 15.8 years was investigated with self-reported rating scales. Scales were: Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory (BDI), Symptom Checklist 90 - Somatization Subscale (SCL-90-SOM), State-Trait Anxiety Inventory (STAI), Rosemberg Self Esteem Scale (RSES). Subjects were evaluated at three times: at the beginning (T0), at the middle (T1) and at the end (T2) of the scholastic year.

30 subjects (17.9%) were categorized as alexithymics and, overall, showed greater psychological distress than non-alexithymics. Alexithymia levels remained stable during the time as well as the number of alexithymics. Alexithymics were more suitable to develop more severe depressive symptoms. Results of a linear regression supported the notion that depressive symptoms at endpoint were significantly associated with female sex, DIF subscale of TAS-20 and higher SCL-90-SOM scores.

Alexithymia, depressive symptoms and somatic complaints appeared to be highly correlated in adolescence.

To assess subjective and objective sleep disturbances in an egyptan sample of children who have ADHD.

25 medication-free children with a clinical diagnosis of ADHD (21 boys and 4 girls; age range 5-12 years) recruited from outpatient psychiatry clinics- Tanta University Hospital, Egypt, were compared with 20 healthy matched controls.

All 25 children with ADHD and controls underwent a semi-structured psychiatric interview (Kiddie-SADS) and a behavior assessment by Conners Teacher Rating Scale (CTRS), Conners Parents Rating Scale (CPRS), and Swanson, Nolan and Pelham Rating Scale (SNAP-IV). The demographic, clinical and psychiatric information of all children was collected from the histories reported by the parents. All patients and control were administered a sleep questionnaire before undergoing nocturnal video-polysmography.

Parents reported a wide range of frequently occurring sleep disturbances in their children. Objective sleep measures revealed increase of rapid eye movement (REM) sleep latency and a decrease of REM sleep percentage, and decreased duration of sleep in children diagnosed with ADHD (p < 0.01). No significant correlations between objective sleep measures and clinical symptoms were found.

ADHD is associated with specific sleep alterations. The results stress the need for clinicians to routinely screen for the presence of sleep disorders, and found to future evidence-based guidelines on the management of sleep disturbances in children with ADHD.

The main purposes of this work are: recognition of presence of anxiety disorders in children and adolescents referred to our unit; comparison with other disorders; their type and spread; age of symptoms beginning; age of referrals, eventual differences in gender; source of referral and the scale of drop-out.

Data are collected from 1110 our referred cases; evaluated and treated in our service 2001-2009 year. We use the retrospective method to review our work. Data processing is done with Excel program.

From our 1110 referred cases assessed and treated in our unit we found 224 cases with one anxiety disorder. Anxiety disorders occupied the first place with 20, 18% of all cases; 51, 33% are males and 48, 61% females. In 85 from 224 cases accounted starting time of symptoms and find age 12, 25 year.In the sample of 224 cases with anxiety disorders the most prevalent is ASD with 33%, GAD 18%, Panic disorder 11%, etc. In 39% of cases the source of referral are family doctors/GP. The percentage of drop-out is 63%, where approximately 42, 25% terminated assessment or treatment after the first session. In 31, 69% of cases we use one medicament.

Anxiety disorders are among the most presented disorders in our unit. More diagnosed cases are males than females. Age group 0-6 year remains after age groups 7-12 and 13-18 years. Acute stress disorders dominated Generalized Anxiety Disorder and Panic Disorder.

Several clinical and neuroimaging studies suggest developmental lag in children with ADHD, which normalizes in late adolescence. However, studies using dimensional behavioral and neuropsychological assessment point to the persistent nature of deficits.

Two hundred five children with diagnosis of ADHD (187 boys, 18 girls; age 10.9±2.7) and 155 healthy controls (80 boys, 75 girls; age 10.3±2.3) were recruited. Both (unmedicated for 48 hours) patients and healthy controls were assessed with Continous Performance Test (CPT).

Patients with ADHD made more errors and less hits than healthy control children, respectively (19.9±17.4 vs. 16.0±16.2; p=0.02) and (38.0±8.6 vs. 41.4±6.2; p< 0.001). In early school age (7-9 years) children with ADHD performed worse than healthy children in terms of reaction time, number of errors and number of hits, respectively (864.9±111.0 vs. 799.9±116.2; p< 0.001), (32.7±20.2 vs. 23.4±19.6; p< 0.001), (33.1±9.0 vs. 39.0±6.1; p< 0.001). In older school age (10-12 years) and in adolescence (13-17 years) significant differences were observed only in number of hits, respectively (40.3±7.5 vs. 43.0±6.0; p=0.002) and (41.3±6.7 vs. 44.9±2.0; p=0.03).

Young children with ADHD may show more pervasive cognitive deficits, than older children and adolescents. More specific neuropsychological dysfunction may be a trait of ADHD patients, irrespectively of age. These results may suggest existence of several attentional systems, which mature in different developmental periods.

Polymorphisms in dopamine transporter gene (DAT1) has been associated with ADHD in previous studies. Some data point also to the role of DAT1 gene in cognitive functions, such as attention, affecting ADHD phenotype.

Two hundred five children with diagnosis of ADHD (187 boys, 18 girls; age 10.9±2.7) and 155 healthy controls (80 boys, 75 girls; age 10.3±2.3) were recruited. DAT rs463379 SNP intron polymorphism was genotyped. Both (unmedicated for 48 hours) patients and healthy controls were assessed with modified Stroop Interference Test (SIT).

: Due to low number of patients with CC genotype, in analysis we combined CC and GC genotypes. In patients GG compared to CC + GC genotype was associated with lower number of errors in part A ST (2.5±3.3 vs. 4.1±4.7; p=0.01). In part B of SIT, controls and patients with GG performed better (made less errors) than individuals with GC and GG genotypes; respectively (0.4±0.7 vs. 0.5±0.9 vs. 1.3±1.0; p=0.02); (1.0±1.4 vs. 2.0±3.3; p=0.03). Part C of SIT was performed better (less errors and shorter time) in patients with GG genotype vs. patients with other genotypes, respectively (139.9±48.0 vs. 166.2±67.6; p=0.009); (6.8±5.6 vs. 10.1±8.5; p=0.009).

We observed association between polymorphism in intron of DAT1 gene and performance in SIT. GG genotype of rs463379 SNP may be related to better cognitive functioning (better inhibition) in patients with ADHD. This may suggest the role of inhibition as intermediate variable between genotype and clinical picture of ADHD.

The transition from a child and adolescent to an adult mental health service is necessary for young people whose mental health problems are likely to be both severe and enduring.

Adolescents between the ages of 10 and 20 make up 13-15% of the total population of the UK and they form a significant social group with major health needs.

The issue of concern is that some young people fail to make the transition, usually for reasons of service design, configuration and ethos.

The Trust transition protocol was developed to ensure that young people with continuing mental health problems, are effectively supported during the transition from child and adolescent mental health services (CAMHS) to adult mental health services(AMH) or other adult services.

To determine the compliance with trust guidelines in transfer of care from CAMHS to Adult mental health.

Consider practical and administrative issues that come up when implementing the current protocol.

Review of case notes of clients transferred to AMH between March 08 - July 09.

12 cases identified

All transfer had detailed written referral letter.In three-quarters of cases a care coordinator in AMH was allocated within 2-3 weeks of the referral, following which a formal transfer meeting took place in 75% of cases and during the transfer any crisis was managed by the CAMHS team.

GP & CMHT received a detailed discharge letter in majority of cases.However only 1/2 of cases had a planning meeting, and attendance at meetings was incomplete.

The issue of school attendance is currently the focus of intense activity in Schools & Local Educational Authorities in England. The latest figures from the Department for Schools, Children and Families shows the overall absenteeism as 6.26%, in England. It is thought approximately 1 to 5 percent of all school-aged children have school refusal (Fremont, 2003) and is one of the reason of School non attendance.

To investigate if the current practice regarding the assessment and management of school refusal is compliant with the local CAMHS School refusal protocol.

20 case notes of clients diagnosed with anxiety based school refusal were reviewed against standards

Majority (80%) of the patients attended their first CAMHS Clinic during which evaluations of Child (100%), family (100%) & school factors (70%) contributing to School refusal was carried out. We found anxiety disorders (83%) & depression (66%) as the main contributing child factors. We also found that nearly half of the children had parental mental illness as a signification contributory factor.

Following the initial assessment, school reports including attendance were requested in 84% of the cases. Unfortunately 33% of the patients who attended the 1st clinic did not attend further appointments. All the patients (67%) were offered gradual return to school, attendance at pupil referral unit and home tuition.25% were offered family therapy and 16% of the patients have their parents referred to the adult mental health unit. Individual works including behavioural and cognitive approach was undertaken in 42% of the cases.

The objective of this presentation is to present the experience from the first year of operation of the Specialized Outpatient Unit for Internet and PC Addiction created in the Department of Child and Adolescent Psychiatry of the Hippokration General Hospital of Thessaloniki, Greece.

We present data from the first 40 adolescents who attended our service. Demographics and PC / Internet usage statistics are presented along with final diagnosis and treatment where it was deemed appropriate, both for Internet addiction disorder but also any co-morbid psychiatric disorder. We describe the diagnostic tests that are employed and their appropriateness for this goal and the therapeutic methods including psychotherapy (a sixteen session CBT protocol) and pharmacotherapy. Recommendations for effectively setting up similar services are given.

All cases involved teenage boys (mean age 15 yrs) who abused the Internet primarily to play on-line games. In all cases it was the parents who initiated contact with our Unit. In 75% of the cases the primary concern was addiction to the Internet per se while in 25% of the cases it was the drop in school achievement that prompted the parents to seek a possible explanation in excessive Internet use.

During the first year of operations the Unit has treated with success a variety of cases of Internet addiction disorder and made an effort to alert the public to the new phenomenon. A need for similar services is becoming evident throughout Europe as they have already proliferated in Asia.

To determine the differential impact of gender and age on pathological internet use (PIU) in the island of Kos, birthplace of Hippokrates and cradle of Medicine.

We surveyed the entire teen population (aged 14-19) of the island of Kos for symptoms of Internet addiction using Young's brief diagnostic questionnaire (YDQ) and an expanded demographics questionnaire. The sample consisted of 1221 adolescents, 587 male and 634 females, with a similar age distribution among the sexes.

One-hundred fourteen teens (11,3% of Internet users) were classified as possibly addicted to the Internet. Results indicate that gender plays a more significant role than age in Internet abuse; there is a distinct pattern among the sexes with the girls scoring lower scores in the YDQ in all ages (chi square=22.758, p< .001) with a marked difference in the 17-19 age range. Although the symptoms of PIU in girls subside in that age range, boys’ symptoms increase dramatically. Furthermore boys in that age range with higher YDQ scores report a subjective feeling of happiness, showing that PIU can be ego-syntonic. Usage patterns of those Internet users reporting heavier use are analyzed and presented graphically.

The discontents of modern civilization have spread to the furthermost corner of Europe, an island isolated from the continent during winter time. Results indicate that gender tends to heavily mitigate the effect of age on Internet abuse, with females being only transiently affected as their scores tend to fall dramatically with the onset of adult life.

To investigate the effect of perinatal depression on birth weight, head circumference, length and infant behaviour in a group of Pakistani women living in the Greater Manchester area of the United Kingdom.

Using a prospective cohort design British Pakistani women were screened using the Edinburgh Postnatal Depression Scale (n=714), the Life events and Difficulty Schedule was used to measure social stress and the Schedule for Clinical Assessment in Neuropsychiatry interview to confirm the diagnosis of depression. Details of birth weight and height were taken from hospital records. Physical and cognitive development of the infants using the Bayleys Scale of Infant Development (BSID-111) was assessed at 6 months postnatal.

There was no significant difference in birth weight (p=0.0948) and head circumference (p=0.75) at baseline or at 6 months between the two groups. The length of the infants of depressed mothers at 6 months was significantly less (p=0.02) than the infants of non depressed mothers. There was also a significant difference between the two groups in adaptive behaviour in leisure (p=0.043) and health & safety (p=0.049).

Infants of depressed British Pakistani mothers are not more likely to weigh less at birth or 6 months when compared to infants of non depressed mothers. However they are more likely to be shorter at 6 months and score lower on the BSID on leisure and health & safety areas of adaptive behaviour.

It is well known that between two thirds and three fourths of children with autism also have intellectual disability. Some of these children were not diagnosed as to have autism due to diagnostic overshadowing between autism and severe forms of intellectual disability.

The objective of this research was to determine the capability of autism index (AI) to correctly identify individuals who have been already diagnosed as having autism.

The sample consisted of 64 participants with moderate, severe and profound intellectual disabilities who have been previously determined to meet DSM-IV-TR criteria for autism spectrum disorder. Autism index was derived by Gilliam Autism Rating Scale (GARS-2).

It was revealed that AI was very high in 39 (60.9%) participants meaning that they were very likely to have autism according to GARS-2. In addition, probability of autism in 18 (28.1%) participants was labeled as “possibly”. AI failed to detect 7 children with autism spectrum disorders.

Sensitivity of AI is quite acceptable (88.9%) providing all children with scores higher than 69 (possibly and very likely as having autism) are considered to have autism spectrum disorder.

Obsessive compulsive disorder is a separate diagnostic entity, but it occurs in a number of other psychopathological entities.

We will present 22-years old adolescent. Early psychomotoric development was ordinary. Because of father's insisting, and against his own will, the patient has intensively played tennis since the age of six until his seventeenth. He was achieving good results but the father was constantly objecting that he is not showing enough fight spirit. When he was seventeen, after verbal conflict with father, he broke his racket and he stopped playing tennis.His father continued to play tennis and “everything is infected with earth from tennis court”. He hasn’t achieved emotional relationship, social contacts with peers are insufficient. At the age of twenty he has looked for psychiatric help, in order to get acknowledgment that he needs “peace for study” which he couldn’t get from his parents because he has constantly needed to clean.

Of this case report is to show obsessive compulsive actions as a defense from psychotic decompensation.

Psychiatric interview, mental status examination, psychological testing, EEG.

In the April, 2008 he has been hospitalized because his mental condition was worse due to suicidality. In clinical picture compulsions were dominant (throughout the nights he was cleaning the house, he has given away all the cloths in orange color, he has even “get rid of” his hamster because it was orange). He was tense, elevated mood, outdistanced and erotized.

Obsessive compulsive actions helped our patient to delay psychotic decompensation.

Childhood subclinical characteristics have not been fully investigated in patients with schizophrenia. To elucidate the picture of them, and to find out indicators which predict later development of schizophrenia, childhood behaviors of the adult schizophrenia subjects were investigated in a questionnaire-based retrospective study.

Schizophrenia outpatients (n=20) in his/her twenties and normal healthy subjects (n = 120) were investigated. All patients are diagnosed according to DSM-IV-TR as schizophrenia, and who present now mainly negative symptoms after passing an acute stage. By modified use of the CBCL (Child Behavior Checklist) as a retrospective assessment questionnaire, the parents of the patients and of control subjects rated their childhood behavior.

The hit-rate when classifying the schizophrenic and normal subjects by discriminant function using all items of CBCL totaled 97.0%. Notable in an item-level analysis was an extremely attenuated aggression in personal relations in the schizophrenia subjects. Among eight subscales of the CBCL, those of Withdrawal, Social Problems, Attention Problems and Aggressive Behavior contributed most to the accuracy of the prediction of group membership.

It was suggested that subclinical behavioral and psychological characteristics of schizophrenia already exist in the patients’ childhood.

The 40 item Social Communication Questionnaire (SCQ) screens for autism spectrum disorder (ASD) and is quicker to administer than the (two hour) Autism Diagnostic Interview-Revised (ADI-R). A recent study, however, found that two questions on the SCQ were answered “autism positive” in 40% of a normal population children's sample. A modified SCQ (MSCQ) without these questions may be more specific than the SCQ.

To compare the performance of the MSCQ with that of the ADI-R.

42 children were recruited to the study, 22 from Mater CAMHS and 20 from St Paul's Hospital and Special School. 20 were diagnosed with autism, 10 with ASD, and 12 with other clinical diagnoses. The MSCQ was sent out as a postal questionnaire to be completed before attending for ADI-R interview. To assess the diagnostic validity of the MSCQ correlations between the MSCQ and ADI-R were calculated. Receiver operating characteristic (ROC) curves were then applied to assess its discriminate ability.

A strong correlation of 0.84 was found between ADI-RTotal and MSCQTotal scores. Using ROC Curves, a cut-off of 14.5 on the MSCQ had a sensitivity of 0.90 and a specificity of 0.82 for identifying ASD from other clinical disorders. A cut-off of 21.5 on the MSCQ had a sensitivity of 0.75 and a specificity of 0.77 for identifying autism from other diagnoses.

These preliminary findings suggest that the MSCQ is a clinically useful and accurate method of assessing for ASD.

To examine the personality variable of self disclosure, and its relationship to depression, anxiety, aggression in adolescents.

80 adolescent inpatients in four university affiliated hospitals and 57 healthy adolescent controls were evaluated. The following measurements were employed: Beck Depression Inventory, State and Trait Anxiety Inventory, The Impulse Control Scale, State and Trait Anger Expression Inventory, The Feeling and Acts of Violence Scale and Shulman Self Disclosure Scale.

There were significant negative correlations between depression, anxiety, impulsivity, and self disclosure to family members and significant positive correlations between control of anger and self disclosure towards family members, in the patient group.

The ability to self-disclose may be a protective variable. A focal point of intervention in preventing and treating psychopathology in adolescents may be fostering self- disclosure.

Prospective investigation of the intellectual development at the age of 6-7 years till age 15-16 years among persons exposed in utero following the Chernobyl accident.

250 persons from Belarus exposed in utero following the Chernobyl accident and a control group of 250 persons from non- and slightly contaminated regions. Рsychological examinations were performed among persons of both groups at the age 6-7 years, 11-12 years, and 16 years as well as dosimetrical analysis.

Mean antenatal internal dose to thyroid gland arising from the intake of 131I among persons of exposed group is 390±550 mGy (maximal dose - 4100 mGy), in control group - 35±65 mGy. Mean antenatal external dose among persons of exposed group is 10±13 mGy. At the age of 6-7 years the persons in the exposed group had a mean Full Scale IQ lower than the control group (89.6±10.2 vs 92.1±10.5, P=0.007). At the age of 11-12 years there was no statistically significant difference between the two groups (94.3±10.4 vs 95.8±10.9, P=0.117). Positive dynamics of intellectual development in persons of both groups has been observed up to age of 16 years (98.7±10.2 и 99.5 ± 10.5, P=0.171).

No statistically significant correlation was found in exposed group between individual thyroid dose as well as individual antenatal external dose and IQ at the different ages.

Studies suggest that psychosocial events (stressors) may play a role in the precipitation of the episodes of Depression. Some individuals become upset by one episode. Others do not feel stress. Such trait affects their feelings.

Subjects are 108 children. They are 6-13 years old. The subjects completed the Center for Epidemiologic Studies Depression Scale (CES-D) Japanese-version. They also completed “the Depressive Trait Questionnaire”. It consists of the descriptions of 12 events. Subjects were asked how they concerned themselves about each event, if the events occurred. Subjects marked as follows; 0: not at all, 1: a little, 2: deeply and 3: overly.

108 children completed the Center for Epidemiologic Studies Depression Scale (CES-D); mean score: 8.56, standard deviation: 8.87. The scores of CES-D of these children ranged from 0 to 54. Children whose CES-D were 16 and more were supposed to be with depression. Factor analysis was performed on the 12 item scores of “the Depressive Trait Questionnaire”. The items which loaded Factor 1 represent anxiety for interpersonal relationship. The items which loaded Factor 2 and Factor 3 represent the image of loss and the emotion of anger respectively. Using logistic regression analysis, Anxiety subscale was significantly associated with depression (odds ratio 1.48, 95% confidence interval 1.17-1.87).

Among children to age 13, high subscale score of Anxiety may increase odds of depression. Anxiety may lead children to depression. It is needed to help children deal with anxiety for interpersonal relationship.

To report a 9-year-old girl with semantic-pragmatic language disorder.

Clinical manifestations and neuropsychological findings of the girl are presented.

The difficulties have occurred in communication. The difficulties have interfered with peer communication since she was a toddler. She cannot find appropriate words to explain what she would like to do or what she had done. She has made vocabulary errors. It is sometimes to say incorrect grammar. She has had difficulty understanding words. Tasks involving memory (e.g., memorizing writing Kanji or Kanji compounds) has been excellent for her. Japanese children are made to study a lot of kanji. Kanji has a complex shape. Though she can read and write Kanji, she cannot understand the words. Qualitative impairment in social interaction or restricted, repetitive, and stereotyped patterns of behavior had not been found. She has also short attention span. She had been diagnosed with Attention-Deficit/Hyperactivity Disorder the Predominantly Inattentive Type when she was aged 5 years.

The Wechsler Intelligence Scale for Children (WISC-III) was administered to her (FIQ = 103, VIQ = 97 and PIQ = 108). The scores on Illinois Test of Psycholinguistic Abilities Japanese-version were substantially below those obtained from standardized measures of nonverbal intellectual capacity. There was a discrepancy between the abilities of verbal and non-verbal semantic comprehension.

Atomoxetin has been administered to her. Her mother and her teachers understood her manifestations. Using pictures or other concrete examples, she has been educated. Gradually, she became to be interested in the meaning of words.

ADHD is supposed to be a heterogenous disorder with a complex etiology. Polyunsaturated fatty acids (PUFAs) have been reported to play a role for a wide range of learning and mood disorders, including ADHD. Furthermore, various additional factors might be beneficial to the buffering effect of PUFAs, including zinc (Zn) and magnesium (Mg). Zn protects lipids against peroxidation by its antioxidative force, as well as it is necessary for the maintenance of fatty acid metabolism enzyme activity. Mg is known to be an indispensable element for fatty acid enzymes and neuronal activities.

In this study, lipid, Zn and Mg concentrations were analysed to investigate the pathological processes within the lipid metabolism in ADHD. We assumed that children displaying symptoms of ADHD would have lower concentrations of Mg, Zn and/or different lipoproteins, compared to controls.

Blood serum concentrations of Zn, Mg, total cholesterol (Chol), Apolipoproteins a and b (Apo a and Apo b), High density lipoprotein-Cholesterol (HDL) and Low density lipoprotein-Cholesterol (LDL) were analysed in nine boys with ADHS (8.2 ± 0.6 years) and 11 controls (7.9 ± 0.87 years), at three times under different stressful conditions.

Mg and HDL concentrations were significantly higher as Apo b concentrations were lower in ADHD compared to the control group. None of the other parameters did show differences between both groups.

Mg and lipoproteins may play a role in the etiopathogenesis of ADHD. Further investigations should prove the controverse findings about the interrelationships between Mg concentrations and ADHD symptoms.