Epidemiological studies show that the variance in ADHD phenotype has a strong genotypic (75 to 80%) and environmental (10 to 25%) contribution. the environmental contribution is mainly due to non-shared environmental factors rather than shared environmental factors.

Case/control epidemiological studies are unable to distinguish between shared and non-shared environmental factors. Our intra-familial design reduces the number of confounding factors, thus giving a more reliable picture of the environmental and genotypic contributions to the phenotype.

To compare incidence of Pregnancy, Labor, Delivery and Neonatal Complication (PLDNC) between children with ADHD and their unaffected siblings matched for age and gender.

Children with ADHD were recruited at the Douglas Mental Health University Institute the Kinney Medical and Gynecological Questionnaire and the McNeil-Sjöstrom Scale were used to assess incidence of PLDNC. the study had one hundred and sixteen sibling pairs (n = 116) and a Mixed-Model Analysis of Variance (MMANOVA) was carried out.

Rank of birth and gender were significantly different between the two groups and these were taken as covariates. There was a significant difference in PLDNC between the two groups (F = 4.49, df = 1, p = .03). However, there was no significant interaction between the different stages of PLDNC and presence of ADHD.

PLDNC appear to be among the non-shared environmental factors implicated in ADHD. Children with ADHD have a higher prevalence of overall complications during pregnancy as compared to their non-affected siblings, and the period surrounding pregnancy might be of particular relevance to the aetiology of ADHD.

The study of suicidal behavior among minors has to date focused on the age group in which it is more prevalent: adolescents.

We hypothesized that suicidal behavior in children stems from a different diagnosis than suicidal behavior in adolescents and thus merits its own investigation.

We studied all minors who were referred to a psychiatric emergency department (ED) due to a suicide attempt or suicidal ideation (266 referrals) over a three year period.

There was an age- related difference in diagnostic distribution among minors who were referred to the ED due to suicidal behavior (χ2(7) = 24.297, p < 0.01). Attention deficit hyperactive disorder (ADHD) was more prevalent among children (under 12y old), whereas Mood disorders were more prevalent among adolescents (12–18y old).

The findings of this study highlight the need for a separate approach to suicidal behavior in children as distinct from adolescents.

To give a brief overview of developmentally related behaviours, common behavior scenarios which get misconstrued as aggressive.

To raise awareness of how certain behaviours can get misconstrued as aggressive and provide alternative explanations of aggression in autism individuals

The first part of the workshop will discuss the theoretical aspects of development, autism impacting on behavior and aggression regulation. the impact of the lack of emotional language and mind reading on aggression will receive special attention. Amalgamations of interventions wherein education, role modeling and psychomotor exercises are encorporated will be step by step explained.

To give an introductory of EMDR in autism children.

To establish the usefulness of this treatment.

The general method is after establishing a baseline of disturbance to work through the touchstone event or focus of the trauma/feared situation from image, feelings, self-judgment and bodily feelings. the preparation also consists of exploring the ability to work with imagery and understanding of feelings. Imagery is tailored to their special interest and at time bodily sensations and feelings are worked on together when no differentiation of these experiences exist 18 cases of the age of 9– 16 underwent the method. 11 had generalised but extreme anxiety issues, 5 had experienced bullying, 4 had aggression regulation problems, 1 had obsessive compulsive disorder, 1 had a spider phobia, one had a developing eating disorder. the level of disturbance went down in all cases. One relapsed. Three needed visual augmentation for the visualisation. Three could not bear physical contact and therefore required self-tapping. 12 cases needed only one session for the focussed treatment. 9 displayed continual improvement over the next 4 weeks and 5 were treated further under conventional therapy.

EMDR is a valuable therapy in autism children but requires specific modification.

To compare the diagnostic accuracy and cost-effectiveness of screening models based on glycated hemoglobin level (HbA1c) and psychometric measures in detecting mood disorders among children with type 1 diabetes (T1DM)

A random sample of 26% out of 632 available subjects aged 8–18 years with T1DM lasting longer than 12 months were enrolled to the study. All subjects were tested using a semi-structured clinical interview (KSADS-PL, duration = 120 mins/patient) as a standard of reference for the diagnosis of major depression disorders (MDD) and mood disorders (MD). Four screening approaches evaluated by the authors were: 1- Children Depression Inventory (CDI, duration = 30 mins/patient); 2- centile of HbA1c; 3- centile of HbA1c with CDI; 4- centile of HbA1c with Children's Depression Rating Scale (CDRS duration=40 mins/patient). All tests were performed in all individuals and cost-effectiveness of all 4 approaches was calculated as total time needed to successfully detect one case of MD or MDD.

The HbA1c+CDRS model was the best screening procedure for both MD and MDD. Diagnostic threshold for HbA1c was established at 93rd percentile (8.7%) for MD and 95th (9.0%) for MDD. Cut-off points for CDRS assessed after filtering by HbA1c percentile equaled 26 (MD) and 30 (MDD) points. Application of this procedure would result in a 76% workload reduction for one diagnosed patient with MD and 83% with MDD in comparison to standard screening with CDI.

Centile of HbA1c level with subsequent examination with CDRS is cost-effective procedure for screening individuals with T1D prior to psychiatric.

Child-to-parent physical aggression is a relevant problem. However, in contrast to the extensive literature on other forms of family violence, there are very few studies on this topic.

To study the profile of adolescents who are physically aggressive toward their parents.

Identify the risk factors of child-to-parent aggression.

Two samples participated in the study. A sample of 1427 adolescents (51.02% girls) from 10 schools, and a sample from an specialized center for adolescents who commit aggression against their parents. They completed personal and contextual measures (child-to-parent aggression, exposure to violence, discipline by parents, delinquent behavior, substance abuse, justification of violence, narcissism, self-esteem, depression, and social support).

The results indicated that 103 adolescents (7.2%) of the community sample had perpetrated some physical aggressive acts toward their parents. Aggressive adolescents scored higher than the rest on delinquent behavior, depression, substance use, impulsivity, justification of violence and grandiosity beliefs, and exposure to violence. Besides, they scored lower on self-esteem, social support, and showed deficits in discipline by fathers and mothers. These adolescents were compared with the sample of adolescents receiving residential attention and the profile was almost identical. the latter scored higher on substance abuse and exposure to family violence.

Findings from this study indicate that the prevalence of child-to-parent aggression is high. This type of aggression overlaps with other forms of aggressive behavior and behavior problems. Exposure to family violence and deficits in discipline are important risk factors, which represents an intergenerational transmission of violence.

Child and adolescent maltreatment is a severe problem which causes many psychological problems in them. of these problems, aggressive behavior is probably the best documented, and there are many studies that report higher prevalence of diverse types of aggressive behavior among adolescents who were maltreated.

To clarify the mechanisms through which exposure to violence leads to aggressive behavior in adolescents who were the victims of abuse and neglect.

To test whether cognitive schemas of justification of violence, expectations of maltreatment, and ideas of grandiosity act as mediators between exposure to violence and aggressive behavior.

A sample of 166 adolescents from child welfare and protection centers for victims of abuse and neglect completed measures of victimization and witnessing violence at home, schemas of justification of violence, mistrust, and grandiosity, proactive and reactive aggressive behavior, and depression.

Witnessing violence is more intensely associated with aggressive behavior than victimization, and that part of this association is mediated by schemas of justification of violence and grandiosity. Victimization, in contrast, was associated with less aggressive behavior and more depression, through the schema of mistrust. the results were somewhat different in the sample of girls because victimization in girls was associated with more aggressive behavior and, in general, exposure to violence was more intensely associated with aggressive behavior.

This study contributes to our understanding of the mechanisms through which transmission of violence takes place in maltreated adolescents. the contents of the schemas involved are themselves targets of intervention.

The traditional diathesis-stress model states that cognitive vulnerabilities in interaction with stressors predict the increase of depression. However, the relationships between these variables can be much more complex, with each variable influencing each other.

The present study is based on the transactional cognitive vulnerability to stress model (Hankin & Abramson, 2001) and assesses the bidirectional relationships between cognitions, depression and stressors over time.

To understand the dynamics between stress, depression, and cognitions.

1350 adolescents (47% girls & 53% boys; Age Mean = 15.86) were assessed at the beginning of the school year and at follow-up 6 months later. They completed measures of three cognitive vulnerabilities (maladaptive schemas, negative inferential style, and rumination), negative life events and depressive symptoms. A fully cross-lagged design panel was carried out.

Stressors and all cognitive vulnerabilities but rumination predicted the increase in depression at T2. Both initial levels of depression and cognitive vulnerabilities predicted the increase in dependent stressors. Initial levels of stressors predicted an increase in rumination, hopelessness inferences, and maladaptive schemas over time. Finally, initial level of depression predicted the increase in hopelessness inferences and maladaptive schemas. the bidirectional relationships between variables were very similar for boys and girls.

The study supports not only the role of some cognitive styles as vulnerabilities for depression, but also the stress generation and the scar hypothesis. the findings support a transactional model with reciprocal relationships between stress, depression and cognitive vulnerabilities.

The ability to predict clinical outcomes at the time of admission is an important consideration for treatment. Predicting clinical outcomes in children's mental health requires strategies for multivariable analysis using complex health information. Multinomial logistic regression was able to show that function and problem severity and Western Canada Wait List Child Mental Health Priority Criteria Score (www.wcwl.ca; WCWL-CMH-PCS) among demographic and system variables gathered on admission predict patient outcomes at discharge.

Based on data (n = 2752) drawn from our regional access and intake registration system, three groups emerged for each of the two variables - function and problem severity, which included patients who were judged clinically at outcome to be worse, the same, or improved compared to their admission baseline measurement. System (e.g. repeat admissions, comorbidity, etc) and demographic variables (age and sex) in addition to the total WCWL priority score were included in multivariable logistic regression analysis.

Compared to those who had no change or worsened in function or problem severity or both on discharge were distinct from the group that improved on discharge in one or both domains of function or problem severity in terms of admission WCWL-CMH-PCS. Additionally, neither demographic nor system variables contributed to the resulting model.

Future research is needed to determine the accuracy of the different profile groups, as well as the effect of increased intervention on those flagged at risk of becoming worse or not changing in function or problem severity at discharge.

Over the past few years antipsychotic medication are increasingly being used for non psychotic illnesses in young people. These have severe side effects and the long term consequences are unknown.

Identify the non psychotic conditions where an antipsychotic medication had been prescribed.

A survey was carried out in a community Child and Adolescent Mental Health Service to find the non psychotic conditions where an antipsychotic medication was prescribed and the reason and choice of the medication.

38 young people were identified from the electronic system that did not meet the criteria for a psychotic illness but had at least one DSM IV TR diagnosis of a non psychotic illness where an antipsychotic medication had been prescribed over the previous 6 months. the case notes of these patients were referred to identify;

1. ▪ The reason for prescribing an antipsychotic.

2. ▪ The antipsychotic that has been prescribed.

1. • Most common non psychotic condition where an antipsychotic was used was Attention Deficit Hyperactivity Disorder (25). Other conditions were Autism Spectrum disorder (2), Tourette's Disorder (2), Anxiety Disorder (1) and Obsessive Compulsive Disorder (1).

2. • It was mostly used to manage behavioural problems (22).

3. • Most common medication used was Risperidone (20) followed by Aripiprazole (7) and Haloperidol (3).

Antipsychotic medications are primarily being used to treat behaviour problems in young people who do not have psychotic illness. Further studies required to see if any other non pharmacological intervention may limit its use.

The Attention Deficit Hyperactivity Disorder (ADHD) has been regarded for years as a disorder of childhood and adolescence only, without being properly studied and deepened its implications in adulthood.

To determine the implications of cognitive, emotional and social aspects of ADHD throughout the life cycle and reflect on the continuity of the diagnosis and treatment of childhood and adulthood.

Review based on scientific papers published in the last 10 years using “Attention Deficit Hyperactivity Disorder” and “adult” as keywords (MeSH).

Epidemiological studies have shown that 50–80% of children who have ADHD remain the same difficulties in adulthood. the underdiagnosis of ADHD in adults is due to the mitigate of hyperactivity and impulsivity with the age. However, inattention continues to affect the adult presenting these difficulties academically or at work, as low frustration tolerance, sleep disturbances and higher levels of anxiety and depression than the general population. Other studies found that 20–40% of adults with ADHD have a history of substance abuse, especially illicit drugs and tobacco.

The ADHD causes significant and inadequate behavioral changes throughout life. Therefore, it is essential to a proper recognition and treatment of adults with ADHD as a good articulation between Child and Adolescent Psychiatry and Adult Psychiatry, in order to improve the prognosis and quality of life.

The objective of this study was to assess the levels of 10 toxic metals and essential minerals in hair samples of children with autism. Another purpose of this study was to evaluate whether the level of these elements could be correlated with the severity of autism.

The participants were 44 Autistic spectrum disorder (ASD) children according to Diagnostic and Statistical Manual of Mental Disorders 4th Edition, (DSM-IV). the age of 3 and 9 years. the severity of autistic symptomatology was measured by the Childhood Autism Rating Scale (CARS). Hair analysis was done to evaluate the long term metal exposure and minerals level. Sample preparation and testing were performed in Germany.

There was increase in some metal level such as: lead, aluminium, vandium and mercury. Also, the level of zinc, and iodine was deficient. There was a significant positive correlation between Arsenic & Fear and Nervousness (P = 0.020). Also, There was a significant negative correlation between Zinc & Fear and Nervousness (P = 0.022).

Several elements such as: lead, aluminium, vandium and mercury showed significant relationship, not only the etiology of autistic disorder but also, to the severity of the symptoms. Iodine and zinc seemed seem to have high nutritional value among autistic children.

Parental figures represent the primary and most important identification model for the entire mental development of children and consequently adolescents.

Determining the importance of mother and father figure by comparing the personality traits (trait of temperament and character) of adolescents and their parents and possible development of adolescent anxiety-depressive psychopathology.

The sample consisted of 25 adolescents, with anxious-depressive symptomatology, and their parents who were not diagnosed patients, but are potential carriers of psychopathology.

In order to assess the personality traits of adolescents and their parents we applied TCI questionnaire.

Using correlation analysis we found that mothers with well-developed communication skills set the limit to their adolescents making it easier to control their impulsivity (r = . 587).

Using same analysis we identified statistically significant correlations: fathers emphasized impulsivity interferes with adolescents spiritual development; their insensitivity, indifference and poor communication lines increased adolescent anxiety, lowers their self-esteem and hinder their spiritual growth (r = . 624 – .654).

The relationship between mothers and adolescents are described as non-dynamical and predictable. the relationship between fathers and adolescents are described as dynamic, with higher possibility for potentially negative impact of father figure to the psychological development of adolescents. the general tendency of development of psychopathology occurs through the relationship fathers - adolescents.

The gut brain theory and pathogenesis of autism has long been suggested. Thus we analyzed stools of autistic children for some of the expected intestinal pathogens.

Thirty children with autism were diagnosed using ICD 10 classification criteria and Childhood Autism Rating Scale and Gilliam Autism Rating Scale. Stool analysis for detection of antigens of Giardia Lambila, Entamebea Histolytica antigen, Helicobacter pylori antigen, Cryptosporidium, Rotavirus and Adenovirus was performed for all patients.

Antigen retrieval in stools of the autistic patients revealed 40.0% Giardia Lambila antigen, 26.7% EH antigen, 13.3% H Pylori antigen, Cryptosporodium antigen 3.33%, 10.0% Adenovirus antigen and 20.0% Rotavirus antigen.

By trial of retrieval of various pathogens from the stools of autistic patients as a reflection of the inflammatory reaction in the gut, we were able to partially disclose evidence of a link between the autistic disorder and active intestinal inflammation further proving the gut brain theory in autism.

Hopelessness and self-esteem are evaluated to be linked with psychopathology.

To look for sensitivity of scales who measure these components as premise for use in clinical work.

Measure the level of hopelessness and self-esteem of adolescents referred to clinic and the psychological difficulties;possible correlation with diagnosis, psychological difficulties and suicidality.

Referred adolescents to the clinic have been offered to fill out Hopelessness scale for children, Rosenberg self-esteem scale and SDQ questionnaire. All data has been analyzed by SPSS 14.0.

In the sample of 57 adolescents we found 14 (24,6%) case with high level of hopelessness; 42 (73,7%) cases with low self-esteem and 17 (29,8%) cases with suicidal thinking/behavior. We didn't found any significant association with diagnose.with psychological difficulties based on SDQ (n = 53) resulted 16 (28,3%) cases.We found significant negative association (x2 = 8.857,df = 1,N = 57, Fisher's exact test p < .007) between self-esteem and suicidality (suicidal cases have highest scores at self-esteem scale), where phi=−,394 indicates the strength of association to be medium. A Kruskal-Wallis Test revealed a statistically significant difference where higher hopelessness score correlate with higher means ranks of total difficulties, emotional symptoms, conduct problems, hyperactivity. the same link is with suicidality where we found higher hopelessness score in suicidal cases x2 = 6.578, df = 2,N = 57, p < .037.

Low self-esteem is much presented, but not associated with hopelessness and suicidality. High level of hopelessness and suicidality also are present nearly in third of sample and linked between. High level of hopelessness accompanies other psychological difficulties found (emotional, conduct, hyperactivity) but not with diagnose.

Prolonged non-nutritive suckling habits (finger and pacifier) (PNNSH) can indicate children's emotional and behavioral difficulties. Our aim was to evaluate the association of such habits with emotional and behavioral problems in schoolchildren, taking also into account birth and school age conditions.

Data were collected at birth and school age from children of two Brazilian cities, São Luís (SL) and Ribeirão Preto (RP). the Strength and Difficulties Questionnaire (SDQ) was applied to 790 schoolchildren in RP and 673 in SL to identify Emotional Symptoms, Conduct Problems, Hyperactivity and Peer Problems. the children were classified as “normal” and “abnormal” depending on the score for each scale. PNNSH were considered to be prolonged when they lasted 36 months or more. Crude and adjusted prevalence ratios (PR) were calculated by Poisson regression.

The overall proportion of PNNSH was 47.6% and 19.6%, and of the proportion of symptoms was 38.2% and 34.7% in RP and SL, respectively. Abnormal symptoms were: Emotional Symptoms, RP = 54.0%, SL = 57.4%; Conduct Problems, RP = 34.7%, SL = 48.0%; Hyperactivity, RP = 26.4%, SL = 32.5%; Peer Problems, RP = 27.2%, SL = 26.5%. After adjustment for socio-demographic factors, PNNSH was a risk factor for emotional symptoms (PR = 1.17), conduct problems (PR = 1.43) and hyperactivity (PR = 1.55) in RP and marginally for peer problems (PR = 1.33, 95%CI 1.00–1.77) in SL. Girls were protected against conduct problems and hyperactivity in both cities.

PNNSH were associated with behavioral and emotional symptoms at school age in RP children and borderline associated with peer problems in SL. Girls were protected from behavioral problems in both cities

The aim of this study is to investigate diagnostic changes in inpatient adolescents with psychotic disorder not otherwise specified (nos) subtype.

40 inpatients discharged from Bakırköy Profs. Dr Mazhar Osman Hospital of Mental Health and Neurology between 2006–2010 with the diagnosis of psychotic disorder nos subtype were enrolled in the study. Sociodemographic form, SCID-I, BPRS,SAPS, SANS and CGI scales were applied to the study group.

The mean age of patients was 20.55 ± 1.89, mean duration of education was 8.10 ± 2.50 years. 9 (%22.5) patients were female 31(%77.5) patients were male. Schizophrenia was the last diagnosis in %72.5 of the patients. Diagnostic stability of psychotic disorder nos type was %12.5.

Diagnostic stability of psychotic disorder nos type in adolescence is low. Early and correct differential diagnosis of psychotic disorders might be achieved with repeated structured diagnostic interviews.