Medication prescribing in children has been increasing worldwide and as a result the rate polypharmacy as well as off label prescribing in Child and Adolescent psychiatry became common practice rather than an exception.

The aim of this audit was to evaluate the prescribing trends, the use of polypharmacy, and use of unlicensed medications in Central Manchester District Child and Adolescent Mental health (CAMHS) service as well as to compare those rates were possible to the rates found in 2005 audit.

We reviewed all case notes open to Child and Adolescent psychiatry department between March-June 2011 and data were collected using special proforma covering general demographic data, diagnosis and medication used. Data were analysed using descriptive and inferential statistical methods using SPSS 16.0.

Our results showed a general increase in use of pharmacological treatments from 19% in 2005 to 44% in 2011 (172 out of 388), with the rate of polypharmacy of 30% in 2011. the main symptom triggering use of additional medication was insomnia especially in those on stimulant medication. the rate of medications used outside their license was 44% and it did not change from that found in 2005 (46%).

The results of this audit confirmed earlier findings showing increase in psychotropic prescribing, polypharmacy and of ‘off label’ medication use in children. Thus it is important to emphasise the need of thorough documentation and close monitoring for side effects in this population.

Attention Deficit - Hyper Activity Disorder.

(ADHD) is a heredity and psychological disorder that often continues to adulthood and causes great number of emotional, social, educational and occupational problem for college students.

We think there is a meaningful relation between ADHD and people's jobs and conditions.

The aim of this study is determine the prevalence of ADHD among students reside in hostel of Ardabil University of Medical Sciences.

In this cross sectional study selected all students in hostel of Ardabil University of Medical Sciences and all of them fill the Self reporting Conners ADHD questionnaires and the data were extracted and analyzed with SPSS.

During this study the prevalence of ADHD is 8.6 percent, and the male gender shows more involvement rate than female and the involved Students show more incidences of smoking and psychotropic drug consumption.

According to the high prevalence of ADHD among college Students, diagnosis and treatment of ADHD as soon as possible appears is necessary.

One of the social consequences of the Romanians emigration (generated by he poor socio-economic conditions from Romania) are the children from these families who are left in the country and who can develop different reactions more or less adaptive, depending on the previous psychopatological background of the child and the level of attachment.

This research aims to analyze parent emigration as a precipitant factor in the appearance of anxiety disorders in children coming from these families. Through this study it has been followed the presence of possible associations between the anxiety of the child and its gender, the emigrant parents, the caregiver, the period of absence of the parent.

For the study we analyzed two groups of 43 children each. the two groups correspond in age and location (Maramures County), the dependent variable of the study is represented by the anxiety level. the exclusion criteria were: the presence of the psychiatric diagnosis and the major life events generating stress. to identify the level of anxiety, STAIState Trait Anxiety Inventory (Charles D. Spilberger et al.1970) scale was used. Obtained data were analyzed through statistical program SPSS, version 17.

65.12% from the children with emigrated parents had both parents abroad.

4.65% from the children with the parents abroad had higher levels of anxiety comparative with the children with parents at home.

There is a statistical valid correlation between the level of anxiety in children and the parent emigration.

Valuable child care research is frequently not applied in care practices. the project aim is to prevent early deprivation and subsequent child- and adulthood personality disorders in orphans by a free online education in attachment based care. to transform child research into practical professional education programs, applicable in local culture. Enhancing relations based practices to improve care quality without increasing care setting budgets. to support the qualification of local caregivers rather than rely on external aid intervention.

based on a researcher's network, an EU funded 2 year pilot study involving 7 countries ran 2008–2010: to develop, test and provide free e-learning program for care giver education and organizational development in orphanages and foster family management.

: infant stimulation practices, attachment theory based care and social organization development was transformed into 15 staff and leader sessions online, including video practice demonstrations, data from various studies integrated in program.

Program was launched in 8 languages, and thanks to volunteer professionals, 16 more language versions are on their way. Researchers McCall & Groark of Pittsburgh University are planning effect studies with author. Program is now standard education for all staffs in the 8000 Indonesia orphanages. A second EU project, TRANSFAIR, is currently running to spread the education in Eastern Europe orphanages and foster families.

Rotelli (1988), the deinstitutionalization process today does not lie in removing the symptoms, but the production possibilities of life and freedom.

To evaluate the establishment and implementation of therapeutic residences at a public institution of São Paulo (Center for Integral Health), Clemente Ferreira Lins - SP. We conducted a comparative study of the model deployed by Santos and Trieste, Italy, evaluated the effect of “deinstitutionalization.” the methodology used was action research, which involves observation, reflection and change. the core of research participants consisted of 04 residents with mental impairment, abandoned by their families in mental institutions as children. It's boys, aged 19 to 24 years, semidependent. the first stage of the study was the establishment in 2007, a pilot residence within the geographic area of the CAIS. in 2009, they went to a therapeutic residence in the city of Lins-SP.

The study analyzed the trajectory of residents in two homes. Today they take their place in the city. Although freedom, were for many years about their rights and exercise their capabilities, which today require accompanying the movements of social interactions. Positive results have driven the institution in 2010 to build two homes on the waterfront, with the role of halfway house for eight residents.

In the reconstruction from the perspective of health, not “crazy,” has been the redemption of subjectivity and dignity of individuals, as subjects who build their history and social memory, is de-institutionalized.

The aim of this study is to compare the Persian version of the two tests, to determine the correlation among their scales and to evaluate the probable concurrent validity of these tests in patients with learning disorders.

162 children with learning disorder who were presented at Atieh Comprehensive Psychiatry Center were selected in a consecutive non-randomized order. All of the patients were assessed based on WISC-IV and CAS scores questionnaires. Pearson correlation coefficient was used to analyze the correlation among the data and to assess the concurrent validity of the two tests. Linear regression was used for statistical modeling. the type one error was considered 5% in maximum.

There was a strong correlation between total score of WISC-IV test and total score of CAS test in the patients (r = 0.75, P < 0.001). the correlations among the other scales were mostly high and all of them were statistically significant (P < 0.001). A linear regression model was obtained (α = 0.51, β = 0.81 and P < 0.001).

There is an acceptable correlation between the WISC-IV scales and CAS test in children with learning disorders. A concurrent validity is established between the two tests and their scales.

The aim is to analyze the connection between emotional and behavioral problems in children of fathers - war veterans who show the symptoms of post-traumatic stress disorder (PTSD).

We analyzed a group of 120 children of school age (10–15 years) whose fathers were veterans of the war. the children were divided into two groups according to the presence of PTSD in fathers - war veterans. Symptoms of PTSD in fathers - war veterans were estimated using the Harvard Trauma Questionnaire-Bosnia and Herzegovina version (Allden et all, 1998). for the assessment of children's emotional and behavioral problems, the Strengths and Difficulties Questionnaire -SDQ (Goodman, 2001) is used. Data were processed by descriptive statistics.

Children of fathers whit PTSD symptoms showed significantly more emotional and behavioral problems comparing to children whose fathers do not show symptoms of PTSD (p < 0.01). There was a positive correlation between post-traumatic stress disorder of fathers - war veterans and emotional problems (p < 0.05), dealing with problems (p < 0.01), hyperactivity of children (p < .01), problems with peers (p < 0.01). Data were analyzed with descriptive statistics.

The obtained results of this study indicate that children of war veterans with PTSD symptoms showed more significantly behavioral problems and that there is correlation between behavioral problems of children and post-traumatic stress disorder of war veterans.

Adolescence is a period for large (extensive) changes including rapid (fast) emotional, physical, and social changes. in children whom parents have divorced, affectionate concerns (upsets), fear, inclination towards risky behaviors and in confidence are seen (observed). It seems that psychological balance of children and adolescents more than other members of family, is damage by parents divorce.

This study is of causative - comparative kind. the given sample was selected from 100 students from discrete families and 100 students from indiscrete families by simple randomized sampling method.

Data collection was performed using of a questionnaire consisted of three parts (sections) including personal- social characteristics, questionnaire for shifters' parents methods for children- rearing and the scale of adolescents risk ability. for data analysis, descriptive statistics and statistical test for unidirectional variance analysis were used.

More precise study about means differences represents this that the difference between despotic and careless (inattentive) child-rearing methods in comparison to easy-taking and authorized families is meaningfully higher.

Research shows the method of authority-based child-rearing of indiscrete (unified) family kind, is one of the effective mechanisms to prevent and protect the adolescents against risky behaviors and ignorance-based child- rearing method from discrete family kind in which enough control and warmth are not presented, are followed by higher levels of risk ability.

Adolescence is one of critical period of life with a variety of developmental changes, conflicts and concerns. to be most effective, adolescent health promotion efforts must in-corporate adolescents' perspectives on what health concerns means.

Sixty-seven female adolescents (12–19 years) and 11 key informants, recruited from urban and rural areas from Sari in the North of Iran using non-probability sampling, participated in eight focus group discussions and semi structured interviews. All tape-recorded data was fully transcribed and thematic analysis was done to identify key themes.

Findings of this research around the adolescents' reproductive health services needs emphasized on 5 overarching themes including: Concern about the joint life with spouse, Concern about find a suitable job in accordance to her major, Poor self-image and Contradiction between truth and reality.

This study shows that subjects such as education, finding a job, common life in the future are the most concerns of Iranian female adolescents which could not ignore them easily and all from parents to policy makers should try enough efforts to solve them.

Undoubtedly any health care system could not meeting all of needs of people. so prioritizing of the needs is necessary. Needs assessment does not mean one need is superior to another perfectly. It is determing the most important needs, determing common needs and importance of each need in health care planning. the aim of this study is to assess psycho- Emotional needs of female adolescents.

In this cross-sectional study 2010 middle and high school female adolescents were recruited from randomly selected schools in Mazandaran province-Iran. Psycho- Emotional needs of participants were assessed by completing a self-administrated culturally-sensitive Iranian Female Adolescents Health Needs Questionnaire (IFAHNQ). Data were analyzed using Pearson Correlation Coefficient, Independent T-Test, One-Way Anova and Multivariate regression.

There was a meaningful relationship between psycho- Emotional needs' score of adolescents with their age and their mothers' education. Mean score of needs of urban adolescents was significantly higher than rural.

Ignoring adolescnts' psycho- Emotional needs and not to attempting for meeting them could lead to irrecoverable serious problems in the future of adolescent mental health.

The impact of raising a child with autism on parents' quality of life (QOL) is not yet fully understood. Studies have shown that parents of children with autism have lower QOL than general population and that theirs QOL is influenced by the level of child functioning impairment, the received social support and by the use of maladaptive coping mechanisms.

To evaluate the QOL of the families of children with autism compared with that of families of children diagnosed with ADHD.

To analyze the factors which influence the QOL of these families.

We used data from 60 children, aged between 2 and 18 years, diagnosed with ASD or ADHD, according to DSM IV-TR and ICD-10 and their parents. Tests were administered to assess the presence of autism symptoms, the symptoms of internalization / externalization and the parents’ emotional regulation mechanisms. FQOLS (Family Quality of Life Survey) was used to assess the subjects and their families’ quality of life.

The areas with the lowest scores in terms of FQOL were the financial status, the support from others and the support from services. These results were similar for the families of children with ASD and ADHD. the level of parental distress was associated with the level of child internalizing problems.

By understanding how the FQOL is affected by these disorders, the needs of the children with developmental disorders and their families will be better recognized and healthcare and support services would be appropriately developed.

Asperger syndrome (AS) is still misdiagnosed. It has also not many papers devoted to its course and outcomes.

To investigate the course of AS in different ages as well as identify the predictors of poor prognosis.

We have sorted out 87 outpatients (78 males and 9 females) with the diagnosis of “Asperger syndrome” according to the DSM-IV. the research was naturalistic. We have also used the following rating scales: Asperger syndrom diagnostic interview (ASDI), a screening questionnaire of autism spectrum disorders (ASDASQ), Adult ADHD Self- Report Scale (ASRS) Symptom Checklist.

We have identified two groups of patients with AS. One group (55 persons) was characterized by predominance of different conduct disorders in their childhood. the symptoms of AS overlapped with ADHD signs. Most patients were treated then with psychotropic medicines as well as more than one third (35%) have been hospitalized. During adolescence a lot of symptoms were gradually decreasing except mild neurotic signs that did not lead to either inpatient or outpatient psychiatric service.

Another group (32 persons) was characterized in the childhood by only separate symptoms of attention deficit syndrome without taking any psychiatric drugs. However, in adolescence some affective and neurotic disorders have been exacerbated. Most individuals took psychotropic drugs (81%) and/or being hospitalized (38%). Symptoms of AS had declined that was accompanied with better prognosis.

Course of AS mainly depends on the age of individual and comorbid psychiatric disorders.

To quantify knowledge among the general Spanish population of attention deficit hyperactivity disorder (ADHD).

We developed a telephone-administered questionnaire to ask about ADHD (acronym and full name) on a spontaneous and suggested basis. Questions were asked relating to myths, symptoms, treatment, implications and healthcare professionals involved in the disease.The study sample was 770 adults (sample precision at national level 3.5) with no personal, familial or professional relationship to ADHD.

Only 4% of the subjects spontaneously answered the question about what ADHD means, while 85.3% identified the disease after we suggested what “ADHD” meant. Only 50% admitted that the disease represents a probably genetic brain disorder. A total of 39.6% believed that there was no treatment or healthcare intervention for ADHD. the intervention most often cited as being adequate was psychological treatment (48%), followed by multimodal therapy (44%). Only 12% mentioned medication. Thus, psychological intervention was regarded as the most effective option, followed by psychoeducational measures. Most of the subjects identified the psychologist as the professional indicated to treat ADHD, followed by the pediatrician, psychiatrist and neuropediatrician. Reasonable knowledge was observed in reference to affirmations / myths in ADHD (78.3–95.3%).

There are areas for improvement among the general population regarding knowledge of ADHD, its implications and treatment.

Lisdexamfetamine dimesylate (LDX) is the first long-acting, prodrug stimulant, and is approved in the USA, Canada and Brazil for the treatment of attention-deficit/hyperactivity disorder (ADHD).

To evaluate the effect of LDX on functional impairment in patients with ADHD, using the Weiss Functional Impairment Rating Scale-Parent (WFIRS-P).

A randomized, double-blind, placebo-controlled trial of an optimized daily dose of LDX was conducted in children and adolescents (6–17 years) with ADHD in Europe. A 4-week dose-optimization period was followed by 3-weeks of dose-maintenance. the WFIRS-P was completed at baseline, day 28 and endpoint. A decrease from baseline indicated an improvement in functional outcomes. Osmotic-release oral system methylphenidate (OROS-MPH) was included as a reference treatment arm.

of 336 randomized patients, 317 were included in the full analysis set and 196 completed the study. Baseline mean (SD) WFIRS-P total scores were similar across treatment groups: LDX, 1.01 (0.45); placebo, 1.10 (0.46); OROS-MPH, 1.07 (0.44). the least squares (LS) mean decrease (95% confidence intervals) in WFIRS-P total score from baseline to endpoint was statistically significantly greater with LDX than with placebo (difference of −0.3 [−0.4, −0.2], p < 0.001), with an effect size of 0.924 for LDX. the difference in LS mean change from baseline to endpoint between OROS-MPH and placebo was −0.2 (−0.3, −0.1; p < 0.001) in favour of OROS-MPH (effect size, 0.772).

LDX was more effective than placebo in improving functional impairments in children and adolescents with ADHD.

By funding from Shire Development Inc.

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral developmental disorder usually diagnosed in children, with appearance of the first symptoms before the age of seven years. It is diagnosed twice more often in boys than in girls. the disorder is characterized by inattention and/or impulsivity and hyperactivity that can seriously affect many aspects of behavior and performance at school.

The study was done on a sample of 400 schoolchildren. Presence of ADHD symptoms was estimated using the Vanderbilt Assessment Scale, with teachers and parents as informants, and a specifically designed questionnaire for collecting socio-demographic data. There were 211 boys and 189 girls. Information about the pupils was collected from the pupils’ teachers and parents.

Our results showed that boys more often have ADHD symptoms compared to girls-59boys and 25 girls(boys:girls ratio = 2:1). Our results showed that Roma children significantly more often had ADHD symptoms compared to other ethnicities.

The TAS-20 is a psychometrically validated instrument for assessing alexithymia in adult populations. However, the instrument is not well-established in adolescents.

The objective of this study was to validate the Chinese version of the TAS-20 (TAS-20-C). Two studies aimed to produce a short form of the TAS-20-C and evaluate its subsequent factor structure in a sample of Chinese adolescents across different grade levels using confirmatory factor analysis (CFA).

The Mandarin version of the TAS-20-C was modified with respect to the local colloquial and was tested in two separate samples of Chinese adolescents. in Study 1 (n = 500), Rasch modelling and principal component analysis (PCA) were performed to generate a short form of the TAS-20-C and to assess the psychometric properties of the scale. in Study 2 (n = 1294), CFA assessed the fit of the factor structure derived from Study 1. Factorial invariance was also examined across grade levels using multigroup CFA.

Results of Rasch analysis showed 9 items of the TAS-20-C retained the concepts of the original scale, resulting in a 9-item short form (TAS-9-C). PCA yielded a one-factor solution (accounting for 38% of the total variance, r>/ = 0.40). in addition, results of CFA confirmed the one-factor model and its invariance across different grade levels (CFI>/ = 0.959). Internal consistency was good in the entire sample (alpha = 0.83).

The TAS-9-C is a reliable and valid instrument for use in adolescents across different grade levels. Future research on the specific role of alexithymia in explaining childhood psychopathology is desirable.

Tam & Wong (accepted)[1] recently reported the invariance of the one-factor model of the Chinese version of the Toronto Alexithymia Scale-Short Form (TAS-9-C). This study sought to further examine the item-level equivalence of the TAS-9-C in a sample of Chinese adolescents across grade levels.

The present study is a sub-analysis of data collected between September 2008 and September 2009 (Tam & Wong, accepted). the TAS-9-C was administered to 500 Chinese adolescents. Differential item functioning (DIF) analysis was performed to identify any uniform and non-uniform difference on the nine TAS-9-C items among adolescents across different grade levels.

After a Bonferroni adjustment of p value (=0.0008, i.e., 0.05/63), results of DIF analyses showed that there is no uniform (all Fs ranging from 0.02–2.26, ps > 0.08) or non-uniform (all Fs ranging from 0.60–1.27, ps > 0.19) difference on the nine TAS-9-C items.

The four different grade level groups use the scale comparably, without showing any difference on item properties. Consistent with previous findings, no difference was observed in the performance on the nine TAS-9-C items among adolescents across grade levels. These findings further substantiate the use of TAS-9-C as a valid and reliable instrument among adolescents from a wide range of grade levels.

[1] Tam, B. K. H. & Wong, W. S. (accepted). Rasch analysis and item reduction of the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20-C) for adolescents. Paper to be presented at the 20th European Congress of Psychiatry, Prague, Czech Republic, 2012.