Child psychiatric service is a novel approach in Bangladesh but has proved its efficacy within a short time.

To describe how a developing country has established sustainable child psychiatric services by using limited resources effectively.

Discuss the service delivery model and recent achievements in child psychiatry in Bangladesh as well as the limitations and strengths.

Effective policy making, capacity building and community based survey are the turning point of the development of child psychiatry in Bangladesh. The prevalence of child mental disorders found 18.4% in a community based survey. By the efforts of few visionary psychiatrists the wing of child psychiatry has established in Bangabandhu Sheikh Mujib Medical University (BSMMU) and separate department named ‘Child Adolescent and Family Psychiatry’ has formed in National Institute of Mental Health (NIMH), Dhaka. Center for Neurodevelopment and Autism in Children (CNAC) also established in BSMMU with the mission to serve the children with neurodevelopmental disabilities, to increase awareness and to train the professionals. From 2008 the Child Guidance Clinic of national Institute of Mental Health Dhaka served more than three thousand children with any mental disorders.

According to the current scenario we can comment that the future prospect of child psychiatry in Bangladesh is promising. In spite of very limited resources the child psychiatry is going ahead to set an example for other developing countries in the context of sustainable service delivery model.

Because autism may be a disease of early fetal brain development, maternal hypothyroxinemia (HT) in early pregnancy secondary to iodine deficiency (ID) may be related to etiology of autism.

to assess the iodine nutritional status in Egyptian autistic children and their mothers and its relationship with disease characteristics.

Fifty autistic children and their mothers were studied in comparison to 50 controls. All subjects were subjected to clinical evaluation, measurement of urinary iodine (UI), free triiodothyronine (fT3), free tetraiodothyronine (fT4) and thyroid-stimulating hormone (TSH) along with measurement of thyroid volume (TV). In addition, electroencephalography (EEG) and intelligence quotient (IQ) assessment were done for all autistic children.

Of autistic children and their mothers, 54%and 58%, respectively, were iodine deficient. None of the control children or their mothers was iodine deficient. UI was lower among autistic patients (p<0.001) and their mothers (p<0.001). Childhood Autism Rating Scale (CARS) score correlated negatively with UI (r=_0.94, p<0.001). Positive correlations were detected between autistic patients and their mothers regarding UI (r=0.88, p<0.001), fT3 (r=0.79, p=0.03), fT4 (r=0.91, p <0.001) and TSH (r=0.69, p=0.04). Autism had a significant risk for association with each of low UI (OR: 9.5, 95% CI: 2.15e33.8, p 50.02) and intake of noniodized salt (OR: 6.82, 95% CI: 1.36-34.27, p=0.031).

ID is prevalent in Egyptian autistic children and their mothers and was inversely related to disease severity and could be related to its etiology.

Most studies on suicide exclude subjects with autistic spectrum disorders, although they may be a risk group for suicidal behavior.

The present study aims to stress the importance of epidemiological and clinical peculiarities of the suicidal behavior in autistic spectrum disorders, targeting it‘s complex causal mechanisms.

This literature review has an informative purpose and also represents a warning sign, on a often ignored population that is at risk of suicide, while emphasizing on it‘s optimal prevention.

The current study collected all the data from Medline PubMed, by searching key words like autistic spectrum disorders, suicidal behavior, pervasive developmental disorders, Asperger's syndrome.

While studying the articles in PubMed we found out that approximately 21% of individuals with autistic spectrum disorders show suicidal behavior, especially suicidal ideation, but also failed or even accomplished attempts. Suicidal ideation is extremely common among teenagers and young adults with autistic spectrum disorders, more frequently in patients with forms of autism that include an increased overall functionality / Asperger's syndrome.

The causality of the suicidal behavior in autistic spectrum disorders is complex, starting from development specificities of the individuals enrolled in this group, continuing with it‘s relationship regarding depression or anxiety and also the presence of the socio-familial disturbing factors .

Identifying the risk factors for conduct disorder is important for the diagnosis, treatment and management of conduct problems. It is well-known that conduct disorder is associated with parental psychopathological conditions like maternal depression, paternal antisocial personality disorder, alcohol and drug abuse.

It's aimed to investigate the role of psychopathological characteristics like temperament, attachment styles and trait anger of parents in adolescents with conduct disorders and compare the results with respect to gender.

101 parents consisting of 35 mothers in both groups, 15 fathers in 35 female adolescents and 16 fathers in 35 male adolescents have been included in the study. Mothers and fathers in the sample group have been compared in terms of psychopathological characteristics. Parents included in the study have been evaluated using the Turkish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Questionnaire, Adult Attachment Scale, State Trait Anger Scale and Sociodemograhic Data Form.

Acumulative assessment has revealed that depressive and anxious temperaments, insecure attachment style are more common among mothers, compared to fathers. Anger-in scores in mothers were higher than the fathers. Hyperthymic temperament was more prevalent among fathers.

According to the obtained data, it can be said that, there are differences in the psychopathological characteristics of parents of adolescents with conduct disorder. The preservation, treatment and management of conduct disorder in adolescents requires an evaluation of the parents' Psychopathological characteristics.

Study group were divided into two groups according to the occurrence of suicidal thoughts. 28,8 % of respondents had suicidal thoughts (6,1%- often and 2,5% -very often). There was statistical significance between the occurrence of suicidal thoughts and gender, financial state of family, drug use, occurrence of chronic diseases, taking long-term medicaments, number of smoked cigarettes. 16% of respondents with suicidal thoughts have ever tried to commit suicide. 36,8% adolescents that took part in the study would look for help at specialist (29,8% at Psychologist, 7% at Psychiatrist).

There exists a need of educational campaign of the adolescents attending the secondary school, because about 1/3 do require observation due to the occurrence of suicidal thoughts. Risky behaviors (such as smoking, taking psychoactive drugs and legal highs), the worse financial situation, physical and mental condition coexist in the population with a higher occurrence of the suicidal thoughts, which is also higher in adolescents that met individuals with suicidal attempts and suicides within their environment and family.

Previous studies have revealed developmental problems in children of homeless families. The number of homeless families has increased by 5 in 10 years.

To estimate the adaptative behavior of homeless children aged 0-5 years old in Paris region and to analyze the impact of homelessness on children's development.

In 2013, a random survey was conducted among homeless families housed in emergency centres for asylum-seekers, emergency housing centres, social reinsertion centres and social hotels in the Paris region. A bilingual interviewer and a psychologist conducted the survey in 17 languages. A nurse took the anthropometric measures and collected health data from child health and immunization cards. For children aged 0-5 years old, mothers (or fathers when mothers were absent) were asked about the children's adaptative behavior using the Vineland Adaptative Behavior Scales, Second Edition (Vineland-II).

The built random sample consisted in 801 families including 557 in which the selected child was 0-5 years old, which represents 11448 children (95% CI = 10354 – 12541). The estimated mean of the composite score of Vineland-II is 76.98 (95% CI = 74.07 – 76.70) (SD = 12.03) which mean that 9259 children aged 0-5 years old (95% CI = 7684 – 10833) have a developmental delay. The most associated factor with the decrease of the Vineland-II score is the age (p<10-16) in the linear multivariate model.

ENFAMS survey reveals large developmental problems among homeless children in Paris region.More children are exposed to homelessness more the disorders are important.

The substance use disorder (SUD) is one of the most common disorders in adolescence. The lifetime prevalence is 3% to 32%. Alcohol and tobacco are the most used licit substance and cannabis is the most commonly used illicit substance. Studies indicate that approximately 75% of patients with SUD have psychiatric comorbidities such as conduct disorder, attention-deficit/hyperactivity disorder (ADHD) and affective d<a name="_GoBack"></a>isorder. Adolescents with SUD and comorbid mental disorder have high risk for continuing problems in adulthood. The costs of treating SUD and a psychiatric comorbidity is twice as high when treated separately.

To find the prevalence of psychiatric comorbidities in adolescentes with SUD.

The diagnostic instrument Kiddie-Schedule for Affective Disorders and Schizophrenia for School aged Children 6-18years (K-SADS-PL) was used to identify SUD and all psychiatry disorders in adolescents admitted to a clinic for SUD treatment.

In a sample of 30 adolescents with SUD, 8 adolescents (26,6%) has ADHD comorbid and 14 (46,6%) has conduct cisorder comorbid. Four (13,3%) patients has affective disorder comorbid.

Early diagnosis of a psychiatry comorbidity can improve the treatment in adolescence and prevent further complications such as legal and medical problems, suicide, learning difficulties, school dropout, unemployment and interpersonal relationship problems.

Infant Schizophrenia is a severe developmental disorder affecting most areas of children's adaptive functioning; especially the social field.

The objective of this work was to study the psychosocial implications of early onset schizophrenia.

We conducted a descriptive and retrospective survey on 58 children and adolescents who were hospitalized in the child and adolescent psychiatry department of Sfax for schizophrenia according to the DSM-IV TR criteria, during 14 years (from 1 January 2000 to 31 December 2013)

In this study, patients frequently showed disruption of family interactions. Indeed, the child's relationship with his parents was marked by the withdrawal in 26% of cases, the dominance in 19% of cases and rejection in 13.7% of cases. For their part, parents demonstrated attitudes of indifference in 29% of cases, hyper protection in 28% of cases and rejection in 24% of cases.

In addition, adjustment difficulties were noted in 63.3% of cases, a tendency of isolation in 43.6% of cases and a conflictual relationship with peers in 27.3% of cases.

Academically, patients had difficulties in school in 62% of cases. It was as type of school decline in 36% of cases, absenteeism in 36% of cases, school disinvestment in 30.5% of cases and grade repetition in 12% of cases.

This study shows that children and adolescents with schizophrenia had family, social and school adjustment difficulties; which joined the literature as to the severity of early onset schizophrenia whose prognosis is often unfavorable.

Depression is one of the main causes of disability in the Western countries. This evidence presents new challenges for somatic medicine, such as surgery.

To determine the influence of patients’ depression on (i) length of hospital stay (LOS, which is a proxy of recovery) after major surgery, and (ii) LOS anticipated by surgeon preoperatively.

To explore the influence of depression on recovery after major surgery, and whether and how surgeons take into account patients’ emotional and psychological status in the care of their patients.

Prospective multicentre observational study. Depression was assessed with HADS (HADS > 8 showing the presence of significant depression). Two cox PH models were fitted to evaluate the influence of depression on patients’ LOS (first model) and anticipated LOS (second model). Adjustment variables were (i) preoperative (age, sex, anxiety, diagnosis, BMI, biology), (ii) intraoperative (blood transfusion, length of intervention), (iii) postoperative (morbidity).

Of 372 recruited patients (which had undergone major liver surgery), 69 (18,5%) had HADS>8. After adjustment, depression was a risk factor for a prolonged LOS (HR 1.96, 95%CI 1.44–2.63). However, depression was unrelated to the anticipated LOS (HR 1.26, 95%CI 0.90–1.66).

1 in 5 patients presented a significant level of depression. Depression was independently associated to longer LOS (ie. longer recovery time after surgery). However this data was not taken into account by surgeons, which failed to integrate that in their previsions. A psychiatric culture and education need to be developed in surgery, as well as more collaboration.

Depression and obesity are highly prevalent major public health problems that frequently co-occur. Shared aetiological factors have been found between depression and obesity. The role of the fat mass and obesity associated (FTO) gene in body mass index (BMI) and obesity has been confirmed in many independent studies. Recently, we reported the first study implicating FTO in the association between depression and obesity.

We aimed to confirm these findings by investigating the FTO rs9939609 polymorphism in a meta-analysis of 13,701 individuals.

The sample consists of 6,902 depressed cases and 6,799 controls from five studies (Radiant, PsyCoLaus, GSK, MARS and NESDA/NTR). Common inclusion criteria were information available on a lifetime DSM-IV diagnosis of major depressive disorder (MDD), BMI and genotype data. Linear regression models for quantitative traits assuming an additive genetic model were performed to test for association and interaction between rs9939609, BMI and depression. Fixed and random-effects meta-analyses were performed.

Fixed-effects meta-analyses support a significant association between rs9939609 polymorphism and BMI (whole-sample: ß=0.07, p=1.29×10-12, depressive-cases: ß=0.12, p=6.92×10-12). No association was found in controls (ß=0.02, p=0.15). Meta-analyses further support a significant interaction between FTO, BMI and depression (fixed-effects: ß=0.13, p=3.087×10-7; random-effects: ß=0.12, p=0.027), wherein depressed carriers of the risk allele have an additional increase of 2.2% in BMI.

This meta-analysis demonstrates a significant interaction between FTO, depression and BMI, indicating that depression increases the effect of FTO on BMI. Depression-related alterations in key biological processes may interact with the rs9939609 FTO risk allele to increase obesity risk.

Modern diagnostic categorical systematics does not always distinguish separate mental disorders, and in case of depression and anxiety they often have comorbid character.

To investigate the correlation between the level of anxiety and depression with varying degrees of severity.

86 volunteer from the medical and pediatric faculties of the University. 16 – male and 70 – female. Mean age of the students was 21,5±2,48. There was used Sheehan's evaluative clinical anxiety scale and PHQ-9 scale to assess the probability of the presence and severity of depressive disorders. Statistical analysis was performed using the program SPSS 11.5 via Kruskal-Wallis, Mann-Whitney rank and Spearman rank tests.

There was performed comparison on severity of depression using PHQ-9 on the students with normal, subclinical and clinically significant level of anxiety by Sheehan scale and it was established that there are statistically significant differences between the three groups. According to results of PHQ-9 scale reveals a high level of depressive disorders – 30,2% (26). Students who have normal anxiety level did not show any marks of depression. Persons with a subclinical level of anxiety demonstrated indicators of clinical depression.

The resulting combination with a parallel increase of severity of depression and anxiety in students allow allocating anxious depression.

Finding the prediction factors for the risks of post-stroke depression (PSD) is important to stroke survivors. However, most existing studies focused only on general clinical data, which limited the predictive ability. To improve the predictive ability, this study proposed a comprehensive PSD risk prediction model with social psychological factors, neurological, cognitive functional factors and general clinical factors.

The study recruited 188 stroke patients. Patients were diagnosed by DSM-IV criteria. Predictors were collected within a week after stroke. Boosted regression trees (BRT) was used to classify these predictors, and then a predictive model was constructed based on the selected predictors. The receiver operating characteristic (ROC) curve was used to determine the performance of the predictive model .

The risk prediction model was constructed with 6 factors: Body Mass Index (BMI), cerebral infraction history (CI), Social Support Rating Scale (SSRS), Eysenck Personality Questionnaire-Neuroticism (EPQ-N), factor 1 of the 20 items Toronto Alexithymia Scale (TAS-F1) and Snaith-Hamilton-Pleasure Scale (SHARPS). In the contribution of risk prediction factors, social psychological factors was more than 0.60. ROC curve of prediction model was 0.826 (p<0.001; 95% CI) and the accuracy of prediction was 0.81 (p<0.001). Transforming the prediction model to a tree diagram, it was convenient to clinic operation.

A PSD risk prediction model with good prediction performance was constructed to achieve diagnose concisely and clearly. The social psychological factors play an important role for diagnosing PSD in the early period.

A course of bilateral ECT (mean number of applications 8.8+/-3.2) was applied to 22 patients (age 46.3±9.8; males 45.8%;IQ 97.2±11.6) with baseline HAMD 28.5±3.6, DASS 95±15, MMSE 29.1±1,1, who were tested by Sockings of Cambridge (SOC) tests (Cambridge Automated Neuropsychological Test Battery)at baseline (T0), immediately after ECT (T1) and one month later (T2). ECT was delivered with a modern square-wave machine with EEG and ECG monitoring. Modified treatment was performed in all cases.

The intensity of depressive symptoms (HAMD and DASS) was significantly reduced at T1 and T2 in comparison to baseline (p<.001) and MMSE was improved (p<.001). SOC improvement at both T1 and T2 in comparison to baseline was found in mean initial thinking time (p=.002) and mean subsequent thinking time (p=.003). Number of problems solved in minimum moves did not differ before and after ECT (range 7.8-8.2; p=.639).

ECT reduced depression without impairing executive function. As it is less likely that improvement in mean thinking time on SOC is directly associated with ECT, we suggest that improved execution is rather due to the decreased individual sensitivity to negative feedback during performing the task.

Patients with hyperprolactinemia offer a unique opportunity to investigate the effects of prolactin on psychological states. Hyperprolactinemia has been classically associated with gonadal dysfunction. However, attention was drawn to its association with psychological symptoms. Anxiety, somatization, hostility and depression were related to hyperprolactinemia.

To review the literature on the relationship between psychiatric symptoms and hyperprolactinemia.

A literature review was made by searching for articles in PubMED.

There is evidence of robust effects of prolactin on behavior in several animal species. The association between hyperprolactinemia and psychiatric symptoms is described. The first symptom described was anxiety, preceding the onset of menstrual irregularity associated with hyperprolactinemia. Other authors have confirmed an increase in anxiety and somatization in women with hyperprolactinemic amenorrhea, as well as hostility and depression. Compared to controls, hyperprolactinemic men also showed more anxiety. There are reports of reduced anxiety and improved well-being by decreasing prolactin levels through the use of bromocriptine, as well as an improvement of depression with bromocriptine or pergolide.

We recommend measuring the serum prolactin levels of women with depression, hostility, anxiety, and symptoms or signs suggestive of hyperprolactinemia. More studies are needed to evaluate the effect of treatment of hyperprolactinemia on psychiatric manifestations.

Agomelatine is a novel antidepressant whose role in the treatment of depression is growing. Brain-derived neurotrophic factor (BDNF) is a neurotrophin, acting on synaptic plasticity and maintaining midbrain dopaminergic and cholinergic neurons. Patients with depressive disorders exhibit diminished plasma BDNF levels, usually increased by antidepressant treatment.

Aim of the study was to investigate the effects produced by chronic agomelatine treatment on BDNF serum levels in depressed patients.

27 depressed patients and 29 healthy controls (HC) were enrolled in the study. Clinical assessment was performed at T0, T1 (after 2 weeks) and T2 (after 8 weeks). After screening period, patients were administered agomelatine (25 mg/day, per os); in the case of no clinical response, the dosage could be increased to 50 mg/day, At T0 and T2, venous blood samples were collected.

Mann-Whitney U-test was performed to compare baseline BDNF levels between patients and HC. Baseline BDNF levels were found to be significantly lower in depressed individuals. During the study period, Friedman's test showed significant changes in BDNF serum levels. Their increase was correlated with depressive symptoms, as measured by reduction in HDRS scores. Also, responders showed a significant difference in BDNF levels after 2-week agomelatine treatment, while non-responders showed no difference.

our study demonstrates that patients affected by Depressive Disorders show an increase in BDNF serum concentration after a two-weeks therapy with agomelatine, with the clinical improvement of depression, anhedonia and anxiety significantly correlated with the levels of the neurotrophin.

The study aims to assess the prevalence of depressive symptoms among Palestinian deaf adults.

A quantitative cross-sectional design was adopted to answer the research question for the study. The framework is based on factors derived from previous studies on the Patient Health Questionnaire PHQ-9 (Robert & Spitzer et al, 2001). The subject population was composed of 217 adults from three representative West Bank Palestinian cities. Participants ranged in age from 15 to 65 years divided as males (n=136) and females (n=81). All participants attend special deaf centers and use the Palestinian Sign Language (PSL).

The data analyzed using Statistical Package for Social Sciences (SPSS). We used mean, standard deviation, and multivariate logistic regression. According to the multivariate analysis results of the study showed, (OR=2. 0) (95% CI, 1.2-3.4) minimal depression, (OR= 1.7) (95% CI, 1.2-2.3) mild depression, (OR=1. 4) (95% CI, 1.1-1.9) moderate depression, and (OR=0. 9) (95% CI, 0.7-1.2) severe depression.

The concluded result of our study is that more than half of the respondents suffer from depression at varying levels, which is considered significant conclusion. Tendency for depression might be a common health problem among deaf adults attending primary health maintenance installations. Further research on socio-demographic characteristics and the force of depression on their health status is required.

Depression is a common among palliative care patients but the reported prevalence varies in studies. This is due to the overlapping of the conventional diagnostic criteria with the somatic symptoms in palliative patients. Alternative diagnostic criteria for major depressive disorder (MDD) were introduced. However, the standard method to diagnose depression in palliative setting has not been established.

The aim of this study is to determine the prevalence of MDD among palliative care patients by comparing between four sets of diagnostic criteria.

This is a cross sectional study conducted at two hospitals in Malaysia. Palliative patients were interviewed for presence of depression based on DSM – IV Criteria,Modified DSM – IV Criteria,Cavanaugh Criteria and Endicott's Criteria. They were also requested to complete the Hospital Anxiety and Depression Scale, Distress Thermometer and McGill Quality of Life Questionnaire.

The prevalence of MDD among palliative care patients was the highest for Modified DSM – IV Criteria (23.3%), followed by Endicott Criteria (13.8%), DSM – IV Criteria (9.2%) and Cavanaugh Criteria (5%). It was found that 9 items: DSM – IV Criteria Item 1, 2, 3, 4, 6, 7, and 8; and Endicott Criteria Item 6 and 7 have the ability to differentiate between depressed and non depressed patients. The prevalence based on these 9 items (which we named as ‘Revised’ Diagnostic Criteria) is 10.8%.

The prevalence of depression varies depending on the criteria used. A ‘revised diagnostic criteria’ was formed for more accurate determination of depression in palliative patients.

Depression is most prevalent psychiatric disorders that cause impairment in all of dimensions human life.

The aim of study was investigation the prevalence of depression among interns of Kashan University of Medical Sciences.

This analytical cross sectional study was carried out on all of interns (160) in Kashan University of Medical Sciences (2013). The instruments were Beck Depression Inventory (28) and a questionnaire consists of personal information and factors associated with depression. Data were analyzed using spss 16 software and Chi square or Fisher's exact test and t-student tests.

The mean depression score of interns was 10.26 ± 7.39. Forty five interns (28.1%) had mild depression, nineteen (11.9%) students had moderate depression, and 2 (1.2%) had severe depression. Prevalence of depression was 41.8%. There was significant relation between living location and severity of depression (p<0.05).interns who live in dormitory of university had higher depression score than interns who live out of dormitory. There were no significant relation between depression severity and sex, marital status (p>0.05).8.1% of interns had suicidal thoughts.

Our study showed that the prevalence of depression among interns was considerable. Living in dormitory and living without their families had stress for them. Screening depression, supportive interventions and prepare proper living situation are necessary for them.