Psychiatric symptoms of children and adolescents’ people whose families have joined the Islamic State of Iraq and Syria (ISIS) for various reasons, lived under the threat of terrorism in or outside Turkey, lost their parents or were separated for various reasons, are not clearly known.

This research aims to psychiatrically evaluate children and adolescents who are victims of various reasons due to their families joining the ISIS.

31 children and adolescents living with or without parents in Turkey, whose parents had joined ISIS, were included in the study. The sociodemographic data of the participants, the country they were in during their time in ISIS, the current situation of their parents, their exposure to terror attacks, their stay in prison were determined. Psychiatric diagnoses of the participants were determined according to DSM-5. Afterwards, the participants and caregivers were asked to fill out the Revised Child Anxiety and Depression Scale Child and Parent Form (RCADS-C, RCADS-P), Child Post Traumatic Stress Disorder Reaction Index Scale (CPTS-RI), Child and Youth Resilience Measure (CYRM) and Conners Parental Rating Scale Revised Short Form (CPRS-SF)

14 (45.2%) of the participants were boy and 17 (54.8%) were girl. The mean age of the participants was 10.55±3.79. The average age of the participants’ families at the time they joined ISIS was 4.81±3.37 years. The average age of the participants to return to our country was 8.87±3.99. All of the participants remained in Iraq. 25 (80.6%) of the participants stayed at home and 6 (19.4%) of them stayed in the camp. 19 (61.3%) of the participants were exposed to at least one conflict, 12 (38.7%) witnessed at least one terror attack, 5 (16.1%) were injured, 26 (83.9%) were not injured. It was found that 28 (90.3%) of the participants remained in prison and 3 (9.7%) did not. Participants’ RCADS-C scores were 23.42±15.96, RCADS-P total scores were 16.25±16.12, CPTS-RI scores 20.3±14.56. CYRM total scores were 46.65±9.04, and CPRS-SF total scores were 19.74±16.55.

It has been revealed that there are various psychiatric problems of varying severity in children and adolescents who are victims of ISIS in Turkey.

None Declared

The term “neurodevelopmental disorders” was first used in DSM-5. The ICD-11 retained this term, with some changes in the classification compared to DSM-5 and ICD-10.

To identify changes on neurodevelopmental disorders in three classifications.

Review of neurodevelopmental disorders in ICD-10, DSM-5 and ICD-11.

Neurodevelopmental disorders applie to a group of disorders with early onset that affect cognitive and social development. ICD-10 doesn’t have a dedicated group for neurodevelopmental disorders and uses different terminology for specific conditions. DMS-5 replaced term “Mental Retardation” with less stigmatizing “Intellectual Disability”, while ICD-11 proposes term “Disorders of intellectual development”. They continue to be defined on basis of significant limitations in intellectual functioning and adaptive behaviour. In recognition of lack of access to locally appropriate standardized measures and due to importance of determining severity for treatment planning, ICD‐11 provide a comprehensive set of behavioural indicator tables. Another big change is made with hyperkinetic disorder, that is classified among behavioural disorders in child and adolescent age in ICD-10. In DSM-5 and ICD-11 is among neurodevelopmental disorders, replaced with term “Attention deficit hyperactivity disorder”. Pervasive developmental disorders that is consisted of eight different subtypes in ICD-10, in DSM-5 and ICD-11 is replaced with “Autism spectrum disorders” category. Guidelines for autism spectrum disorder have been substantially updated to reflect the current literature. According to ICD-11, autism spectrum disorders and ADHD may coexist in an individual, which is useful since there is good evidence that children with this comorbidity can benefit from stimulant medications. Finally, tic disorders in ICD-11 are classified under the Diseases of the nervous system, while in DSM-5 they are placed within neurodevelopmental disorders.

ICD-11 doesn’t deviate significantly from DSM-5 when it comes to neurodevelopmental disorders, which is in accordance with the goal of WHO and APA to harmonize two psychiatric classifications.

None Declared

Posttraumatic stress disorder in the paediatric population has clinical features. The Clinician-Administered PTSD Scale for DSM-5,child and adolescent version (CAPS-CA-5) is the gold standard for the positive diagnosis.

The objectives of our work were to translate the CAPS-CA-5 into Tunisian dialectal Arabic and to validate it in our Tunisian sociocultural context.

This is a descriptive cross-sectional study conducted in the child psychiatry department of Mongi Slim Hospital and the forensic medicine department of Charles-Nicolle Hospital (Tunisia), among children older than seven years who were exposed to a potentially traumatic event at least one month before. We validated the tool through translation, content, construct validity and reliability. The statistical processing for this data was carried out using SPSS 26 software.

We conducted our study with 150 patients. The validation was made on 146 records after the exclusion of 4 incompleted assessments.

We initially translated the CAPS-CA-5 into Tunisian dialect. We validated the content through pre-test and scientific committee evaluation.

Afterwards, we validated the construction. We calculated the Bartlett’s sphericity test (p<0.001) .The KMO index that was 0.766.

Concerning the reliability study, we found a Cronbach’s alpha coefficient equal to 0.92. We studied also the inter-raters reliability; we found an intra-class coefficient between 0.8 and 1

We validated the first Tunisian diagnostic tool for PTSD in children according to the DSM-5 criteria with satisfactory psychometric qualities.

None Declared

Posttraumatic stress disorder in the paediatric population has clinical features. The Clinician-Administered PTSD Scale for DSM-5,child and adolescent version (CAPS-CA-5) is the gold standard in positive diagnosis

The objectives of our work was to study the clinical characteristics of the paediatric population with the diagnosis of PTSD.

This is a descriptive cross-sectional study conducted in the child psychiatry department of Mongi Slim Hospital and the forensic medicine department of Charles-Nicolle Hospital, among children older than seven years who were exposed to a potentially traumatic event at least one month before. We made clinical assessment for PTSD using CAPS-CA-5 which is currently being validated in Tunisian dialect. Then We investigated the clinical characteristics of PTSD according to age, gender, history, and event specifics.

We conducted our study with 150 patients . The diagnosis of PTSD according to DSM 5 criteria was retained in 56.2% of patients (N=80).

The average age was 12.4 years with extremes ranging from 7 to 17 years. We noted a female predominance at 58.8% (n=47)

Male gender was significantly associated with persistent avoidance (p=0.03). Sexual assault was significantly associated with the severity of flashback symptoms (p<10-3) and reckless and self-destructive behaviors (p<10-3) and with the frequency of dissociative symptoms (p<10-3).

We also noted in our work that dissociative symptoms were significantly more frequent in victims with no personal psychiatric history with a p value of 0.021.

In our population, we found a predominance of hypervigilance and a greater severity of exaggerated startle reactions in the absence of a family psychiatric history with a p value of 0.048 and 0.008 respectively.

We noted a significant predominance of exaggerated startle reactions in relation to the absence of exposure to previous traumatic events with a p equal to 0.043

The specificities identified in relation to the child should be taken into consideration during further evaluations and further analysis in the general population.

None Declared

Most mental illness of adult life begin in late adolescence, affecting young people when they require transition to adult services. In <18 years old patients is more difficult to establish a definitive diagnosis, so diagnoses are often unstable and temporary. In young patients, understanding diagnostic stability may help in clarifying the course, developmental changes, and long-term prognoses of psychiatric disorders. Little research has explored the diagnostic adjustments that occur in child and adolescent mental health services, however previous studies reported that moods disorders and schizophrenia showed more stability than other diagnoses.

Understanding diagnostic trajectories is necessary to improve developmental psychopathology, in order to acquire more discrete diagnostic entities, and clinical judgements, regarding risk and prognosis.

as the evidence of diagnostic stability from childhood (child and adolescent mental health services) to adulthood (adult services) is limited, the aim of this study is to describe the clinical features in patients from child and adolescent mental health services in transition to adult services and to compare the main diagnosis of these patients made in both services.

all individuals, between 18 and 25 years old, admitted to our outpatient clinic specialized in prevention, diagnosis and treatment of mental illness in adolescents (ASST Grande Ospedale Metropolitano Niguarda, Milan), referred to our service between 2021 and 2022. Clinical Diagnosis were establish using ICD-10 criteria.

301 new patients were admitted in our outpatients service: 171 in 2021 and 130 in 2022 (until October). The mean age was 21,08. The 30.2% of patients come from child and adolescent mental health services (29,2% in 2021 and 31,5% in 2022). The main diagnosis of these patients were: first reaction to severe stress and adjustment disorders (F43), second specific personality disorders (F60) and thirst eating disorders (F50). The main diagnosis made in our services were: first specific personality disorders (F60), second first reaction to severe stress and adjustment disorders (F43), thirst other anxiety disorders (F41). 56,1% of patients have the same diagnosis in both services and 43.9% have a different diagnosis. There were not differences in sex (60,5% female and 39,5% male). Patients from child and adolescent mental health services were youngers (19,68 vs 21,69), not statistically significant.

Further research is required to understand diagnostic trajectories, especially longitudinal studies in minors during transition period to adult services, in order to find patterns of diagnostic adjustments.

None Declared

In adolescence, the person transitions from the reality of childhood, where he is mostly dependent on his parents, to the reality of adult life, which necessitates the acquisition of adult role systems, established autonomy, and ability to accept responsibility. The most important feeling during that time is that of maturation into adulthood.

This study was designed to investigate the impact of new cognitive formations on the maturation of young adults’ self-consciousness from the perspective of a subjective evaluation of the experience of becoming an adult, particularly its cognitive component.

The study was based on Akimova’s Adult Practical Thinking Scale (Akimova et al., 2008), Zack’s Theoretical Thinking Scale (Zack, 2010), Personal Differential Test (Bazhin & Etkind, 1983), Szustrowa’s Egocentric Associations Scale with content analysis applied (Szustrowa, 1976), The Feeling of Becoming an Adult Expression Scale (Andriushchenko et al., 2014) and included 64 participants aged 18-22 years. The approbation group had 12 participants and the core group had 52 participants.

The IBM SPSS 22 statistical rank correlation analysis provides support for: negative moderate correlation between (1) the reflective type of theoretical thinking and personal egocentrism (rs=-.31; p=.024), (2) adult practical thinking level and awareness of a new position in adolescents-adults relations self-consciousness component (rs=-.28, p=.048); positive moderate correlation between (1) social intelligence and the feeling of becoming an adult expression degree (rs=.39; p=.004), (2) orientation to autonomous educational and intellectual activity (self-consciousness component) and subjective attitude towards oneself and other people (rs=.29, p=.04), orientation to autonomous educational/intellectual activity and Egocentrism Index (rs=.37, p=.007).

According to the study’s findings, there is a strong correlation between young adults’ cognitive traits (such as content-related reflection for formal operational thinking and social intelligence), their expression of the feeling of becoming an adult, and some aspects of self-consciousness. It indicates that the feelings of becoming an adult manifest themselves as an orientation to autonomous educational and intellectual activity and new forms of cooperation with adults that develop step by step through time, but not as a process of individualization based on egocentric attitudes.

None Declared

Impulsivity in adolescents has been largely studied as it is frequently observed in that phase. However, the relationship between impulsivity and emotion regulation has been rarely explored.

Our study aimed to assess impulsivity and emotional regulation in medical students as well as to explore the link between them.

This was a descriptive and analytical cross-sectional study conducted from September to December 2017, among first and second year students of the medical school of Sfax who were aged between 18 and 19 years. We collected sociodemographic as well as clinical data of the participants. “Barratt Impulsivity Scale” (BIS) and “Difficulties in Emotion Regulation Scale” (DERS) were used to assess impulsivity and emotion regulation respectively.

One hundred students were included in our study, with a mean age of 18 years and a sex ratio of 0.81. Among them, 62% were smokers with an average consumption of 19.6 packets year. Alcohol and cannabis use was reported by 9% and 5% of the students respectively.

The mean impulsivity score on the Barratt scale was 66.78 ± 9.44 with scores ranging from 40 to 112. Among our participants, 25% had a high level of impulsivity (score > 72). Unplanned impulsivity was the dimension with the highest mean score (23.74±4.64). Our results showed that impulsivity was significantly associated with the male gender (p=0.002) and smoking (p<10-3).

As for emotion regulation, the mean score on the DERS scale was 78.8 ±17. The majority of the students (64%) had a moderate difficulty in regulating emotions.

Our results showed a positive correlation between impulsivity and emotional regulation with a moderate link (p=10-3; r= 0.57).

The high emotion dysregulation group had a significantly higher score on the two dimensions of impulsivity: attentional impulsivity (p=10-3) and unplanned impulsivity (p=0.047).

Our study highlights the relationship between emotion dysregulation and impulsivity, suggesting that emotion regulation may be an important factor to consider when assessing impulsive adolescents.

None Declared

Adolescents with emotional dysregulation are at risk for self-injury. Antipsychotics are often used to manage these symptoms.

The aim of the present case is to show the use of cariprazine as an effective drug for emotional dysregulation and impulsivity in a 17-year-old adolescent girl

Case report

The patient was a 17-year-old female admitted to in patient psychiatric unit for a self-harm attempt due to sertraline overdose. She was being followed up for self-injury, anxiety and eating disorder symptoms. Her treatment was sertraline 200 mg, diazepam 20 mg per day and olanzapine 15 mg per day. With this medication she had gained up to 7 kgs in 4 months. A progressive change was made with cariprazine up to 3 mg and olanzapine was reduced to 2.5 mg at night. With this adjustment the patient did not present worsening in anxiety levels, with adequate impulse control and being able to perform emotional regulation strategies.

Although it has no indication in patients under 18 years of age, it shows a case of good tolerance and efficacy for the management of impulsivity by improving emotional regulation. Cariprazine is an atypical antipsychotic that works through partial agonism on dopaminergic receptors, serotonin 5-HT1A receptors and an antagonist at the 5-HT2B receptors, with moderate affinity for adrenergic, histaminergic, and cholinergic receptors reducing the likelihood of side effects

None Declared

We often find it challenging to manage hyperactivity, low frustration tolerance and angry outbursts in patients with ASD and comorbid ADHD. Fewer drugs are approved for these disorders and these patients are more likely to develop adverse effects.

The aim of this case is to show how the combination of lisdexamfetamine together with guanfacine has very positive effects on anger outbursts and boundary heteroaggressiveness in patients with ASD and ADHD.

Case report and literature review

This is a 14-year-old minor admitted to the psychiatric unit after physical aggression against his family due to anger after removal of video games, requiring police intervention. He has been diagnosed since he was 11 years old with ADHD and Autism Spectrum Disorder. He was being treated with methylphenidate 54 mg and aripiprazole 10 mg. Since the beginning of the admission, the following pharmacological adjustment has been made: Methylphenidate is substituted by lisdexamfetamine up to 50 mg per day. Guanfacine has been started up to 4 mg per day and the dose of aripiprazole has been maintained. The patient had no adverse effects with adequate tolerance without sedation, hyporexia or hypotension. With this adjustment, improvement was found in the levels of restlessness and hyperactivity. The patient expressed a subjective improvement in the levels of restlessness and with a notable improvement in attention in the hospital classroom. An improvement in emotional regulation was also observed, with more tolerance to the imposition of limits, without an explosion of anger in the face of any rule during admission

The management of hyperactivity and episodes of low frustration tolerance in patients with ASD and ADHD is complex. Many studies point out the time-limited use of some antipsychotics such as risperidone or aripiprazole. This work aims to show guanfacine in combination with lisdexamfetamine as an excellent combination for the management of agitation and rage explosion in these patients. In addition, the profile of adverse effects at metabolic level is much better than that of atypical antipsychotics.

• - Extended-Release Guanfacine for Hyperactivity in Children With Autism Spectrum Disorder. Lawrence Scahill et al. Am J Psychiatry. 2015 Dec.

None Declared

Vaccine hesitancy is a known phenomenon predating the COVID-19 pandemic. Vaccine hesitancy is a significant factor effecting the control and spread of the COVID-19 Virus. Hesitancy of parents choosing not to vaccinate their children is studied here. Also studied is the effect of a brief motivational interviewing intervention on the parent’s decision to vaccine their child, or not. What was found was a myriad of beliefs and values in the parents, and varied reactions and outcomes in response to the motivational interviewing.

The aim of our study is to determine whether motivational interviewing techniques can be used as an effective tool to educate patients and their families about the benefits of vaccination against COVID-19 and increase vaccinations rates. In our urban community hospital-based child and adolescent psychiatry outpatient clinic, we found a high level of vaccine hesitancy among our patient population. As motivational interviewing is an evidence-based approach to addressing ambivalence and behavior change, we sought to engage parents with this approach.

This is a quality improvement project where chart review of all pediatric patients currently enrolled in our clinic was performed to determine which patients are unvaccinated for COVID-19. Telephone contact was made to reach parents to obtain verbal consent and to deliver the intervention consisting of standardized motivational interview techniques followed by brief educational points about the vaccines. Follow up calls were made one week later to determine whether there was any change in readiness to consider vaccination on a scale from 1-10. We reached a total of 29 parents on initial outreach, and 11 parents during the follow up phase. Many were lost to follow up due to unavailability or refusal to participate further.

Parents (N = 11, 5- African American, 6- Hispanic) reported on their decision to have their child (mean age=12.2, 55% Female) receive the covid-19 vaccine. Preliminary findings show an increase in readiness on a scale from 1-10 to receive the vaccine following a one week interval post intervention (t(10)=2.096, p=.06), with the most common barriers that subjects endorsed being fear of side effects, skepticism regarding the speed at which the vaccines were developed, and wanting to allow their children to decide for themselves.

We found that there was an overall improvement in vaccine hesitancy following our intervention, though it did not cross the threshold of statistical significance. We also identified common reasons given for hesitancy within our community. Motivational interviewing is a promising intervention to address vaccine hesitancy. Further study is warranted as expanding the reach of such interventions could lead to more robust data as well as broader vaccine acceptance.

None Declared

Adolescence presents itself as a phase of life marked by rapid changes produced by different social contexts and in many cases, it can be configured in a stressful situation. The development of a psychosocial support network is of fundamental importance for adolescents to cope with the pressures of life in challenging situations. Many students, especially living in poor communities, face school problems especially because the curriculum fails to provide relevant knowledge to students in a way it can be meaningful and easier to be taught by teachers and learned by students. When students fail at school usually, they tend to blame themselves and as a result they may develop anxiety, social isolation and even depression.

Through the Bioecological Theory of Human Development, we sought to understand the psychosocial support networks of adolescents, whether or not experiencing school problems, considering this to be a challenging event.

In this research it was used the Five Fields Map, an instrument that evaluated the psychosocial support network for adolescents. The students with and without school problems filled the map in the beginning of the year and then at the end of the same year while facing a school problem as repeating the whole year because of insufficient grades.

The number of relationships between students facing and not facing school problems was not different, however, failing students had fewer relationships in the school-church Mesosystem, fewer relationships in the second and third levels in the first and second moments of data collection, and more relationships in level 5 in the second moment.

Both group of students showed great strength of proximity in their psychosocial support networks, indicating that it provided sufficient support so that the outcome of the failure experience was positive.

None Declared

Children with Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction, engagement, and behavior. The DIR/Floortime model is one of the ways of intervention and is based on the child’s Functional Development, Individual differences, and Relationships. It aims to build the foundation for the social, emotional, and intellectual skills of children, instead of having the focus only on isolated behaviors. The model was developed by Stanley Greenspan and Serena Wieder in the United States and is the result of many years of observations and studies on child development since the 1950s. In the 1980s, they unified knowledge from several related studies on child development and mental health and recognized the importance of relationships and affection for learning. One of the considerations of the DIR/Floortime model on children with autism is the individual profile, that is, their individual differences (the I of the DIR). Each child has a unique way of perceiving the world (sight, sounds, touch) and responding to it. They may have difficulties in processing or responding to sensory information. Their individual differences need to be well known so that we can draw up a therapeutic plan to obtain the best developmental evolution.

Recognize and analyze the individual differences of each child, so that the appropriate therapeutic plan can be traced for the development of their potential.

Participated in the study 63 children with ASD, 12 girls (19%) and 51 boys (81%). Global Development Assessment questionnaires were used, based on the FEDC and the FEAS scale of the DIR/Floortime.

All 63 children presented sensory alterations such as proprioceptive, visual, and vestibular search or hyper-reactivity, directly impacting abilities such as visuospatial processing and motor planning. In addition, 85% of children have low body tone. Regarding the sensory need for visual search, presented by 86% of the children, as well as the vestibular (90%), a recommended therapeutic strategy is mapping the place, with fewer objects. The therapist needs to be in a fixed position and maintain a pleasant, lower tone of voice. The routine framework for motor and action planning, anticipating, and giving the necessary waiting time for the child to get organized. Motor circuits can also help to work with the tone, as well as with praxis.

The DIR/Floortime model aims to make the child develop the ability to interact meaningfully and connect with the outside world. The individual differences of the child need to be known so that this work can take place effectively and so that the therapist can better organize the therapy, providing the best development for the child.

None Declared

Autism can be described as a mental disorder that displays social interactions and communication impairments as well as a restricted range of activities or interests. Since autism is different for each individual, possible treatments are challenging and should consider individual characteristics at all times. Interactions with peers, family, and teachers are challenging for those with autism as they usually lack behaviors such as eye contact, playing, and talking with other people. It is common to observe sensorial issues as hypersensitivity in these individuals. Patients may have visual, auditive, or even tactile dysfunctions.

Dir/Floortime is a comprehensive model that gives theoretical support and methodological approach to lead to development focusing on the development of individual capacities for sensorial organization, motor planning, language, and many abilities that provide a development trail that will help individuals to achieve essential milestones to infants and adolescents. The DIR/Floortime is based on the development as a lifespan event, individual differences, and relationships established with peers and any other people in the child´s context.

The aim of this study was to demonstrate that the DIR/Floortime is a comprehensive method of study and intervention since it matches all necessary characteristics to produce development.

It was performed a theoretic approach of both DIR/Floortime and Biological Theory of Human Development in search of basis in a contextualist theory to explain a practical method of intervention.

Psychological theories about human development are important tools for understanding the way individuals interact with their context and produce changes in biopsychosocial characteristics. The Bioecological theory of Human Development is a contextualist theory that considers the interactions established between individuals through a model called PPCT, with their characteristics with people, objects, and symbols through interactions known as proximal processes, considered to be meaningful interactions, occurring frequently, through a long time.

The TBDH through the PPCT model can show that the DIR/Floortime presented itself as an efficient method for the treatment of autism since it considers the personal characteristics of the patients, especially their sensory and motor characteristics (Personal Characteristics such as Resource, Demand, and Force). This method has in significant interaction the most efficient way to produce development (equivalent to proximal Proximal Processes), takes into account the contexts where the developing individual attends, especially home, school and therapy, and has time as an essential factor for development to occur.

None Declared

Contemporary evidence has established that stunted vitamin D levels are associated with depression, poor mood and other mental disorders.Vitamin D supplementation might play a significant role in depression.

To assess the role of supplementation of Vitamin D on depression scores among rural adolescents

It is a Cluster Randomized Control Trial carried out for a period of two years. 10 Government rural schools were taken as clusters and sample size was calculated using previous literature.(Libuda.et al:EJN. 2020; 27:1-0) 150 was the final sample size in each group. Adolescents aged 11-18 years were included and with any pre-existing mental health illness, renal abnormalities and confirmed neurological disorders (Epilepsy) were excluded. Intervention group received 2 months of 2000 IU per day for 9 weeks and Control arm received 500 mg of Calcium and low dose (250 IU) of Vitamin D. To assess socio-demographic status a pretested semi structured questionnaire was used. To assess depression, Becks Depression Inventory (BDI-II) was used. Venous Blood was taken by experienced lab technician and analyzed in Central Diagnostic Laboratory Services, Biochemistry Department, SDUMC, SDUAHER, Kolar, Karnataka, India. Study was started after Central ethics Committee approval. This study is intramural funded project (Rs.6,12,000/). Clinical Trials Registry number: CTRI/2021/07/034654: REF/2021/03/042355. All the data collected entered in Microsoft excel and analysed using SPSS v 22(IBM corp,USA). Pre-intervention and post intervention difference assessed with t-test summarized as Mean and Standard deviation (SD) with statistically significant difference defined with p value less than 0.05. Both Intention-To-Treat analysis and Per Protocol analysis done and reported separately.

Comparing Becks Depression scores before and after intervention, Vitamin D arm showed statistically significant reduction in Becks Depression scores. Intention to treat analysis showed that Vitamin D arm had statistically significant reduction in Becks Depression scores.

Vitamin D supplementation had reduced Depression scores among rural adolescents significantly. Vitamin D toxicity was not noted inspite of High dose of Vitamin D supplementation

P. Satyanarayana Grant / Research support from: SDUAHER Intramural research , R. Suryanarayana: None Declared, S. TY: None Declared, S. Reddy: None Declared, N. AG: None Declared

About the term cognitive-behavioral minority disease or rare disease are a group of diseases that affect between 6-8% of the populatio. It is estimated that there are more than 7000 in the world, the majority with a genetic basis and affect various organs and systems, they also present psychiactric comorbidities and cause a physical or mental disability. Given its definition, it is difficult to see a large number of these patients in our usual clinical activity, so their management can be complicated.

To evaluate the prevalence of psychiatric comorbidity and the prevalence of psyhcopharmacological treatment in children and adolescents whe present a minority disease.

This is a descriptive, controlled, retrospective cross-sectional study of a sample obtained by non-probabilistic sampling, which is representative of the study population.

The statistical analysis was made using the statistical program SPSS V22 (2013).

With a sample of 114 patients, of which 26,6% presented fragile X syndrome, secondly 25,3% presented Prader-Willi Syndrome and 48,1% other chromosomal abnormalities.

By subgroups (male:female): in Prader-Willi syndrome 6:14 (30%:70%), in Fragile X syndrome 12:9 (57,14%: 42,86%) and in other diseases 25:13 (75,69%: 34,21%).

The creation of clinical expert units makes the possibility to increase knowledge of diseases whose prevalence in the population, thanks to technological advances, is increasing and where scientific knowledge is still limited.

These units are also important, in order to be able to offer personalized intensive treatments in order to reduce polypharmacy. There is not a great difference between the minority diagnosis and polypharmacy, although there is less polypharmacy than expected, which may be the result of the success of the most intensive and personal psychotherapeutic intervention in the unit.

None Declared

Non-suicidal self-Injury (NSSI) and suicidality are common reasons for emergency presentations in child and adolescent psychiatry (1). NSSI is defined as intentional destruction of one’s body tissue without suicidal intent and has a prevalence rate in adolescents of approximately 30–40% in clinical samples (2). Suicide prevalence is around 24–33% (3).

There are many factors leading to suicidal or self-harming behavior. A prior history of self-injurious behavior is one of the strongest predictors of future suicidal behavior, both cross-sectionally and longitudinally (6) . Additionally, longitudinal studies have found that a previous suicide attempt increases the risk of a future suicide attempt threefold.

Suicide and NSSI have a significant impact on families and communities. Hence, considerable required clinical attention is warranted to develop preventive strategies.

The aim of this study is to investigate the prevalence of non-suicidal self-Injury (NSSI) and suicidality among children and adolescents presenting in emergency department of the tertiary psychiatric services and to study their demographic and clinical characteristics.

This is a retrospective cross-sectional analytical study included all children and adolescent patients attended the emergency department at Sultan Qaboos University Hospital between June 2021 to March 2016. The data was collected using the hospital´s electronic database to retrieve the medical records of children and adolescents who visited the emergency department. Patients who were 18 years of the age or younger were included in the study. The included patients must had been evaluated by psychiatrist during their presentations in the emergency department.

During the 63 months of observation, 114 patients attended the emergency department and required psychiatric evaluation, 44.7%(n=51) of patients presented with NSSI and/or SA. The mean age was 15.7. 80.4%(n=41) were females while 19.6%(n=10) were males. 37.3% had a primary diagnosis of major depressive disorder (MDD) and 21.5% had comorbid medical illness. 44% of suicidal attempts were with drug overdose, mostly paracetamol overdose, while the most used method for NSSI was cutting the body with a razor, 57%.19 patients had a primary diagnosis of major depressive disorder, 17 patients had no clear diagnosis at presentation.22% of the patients had other medical comorbidities, 5 patients with epilepsy. 51% of the patients had positive family history of mental illness.

Considering that NSSI and suicidality were found to be the main reasons for presenting to a child and adolescent emergency psychiatric service, it seems crucial for physicians at PEDs to provide proper crisis intervention and referral to mental health services when appropriate. Early identification of risk factors is highly recommended.

None Declared

trauma affects not the child but the whole family. how would the parents’ reaction to trauma influence the child’s resilience capacities?

study the mental health status of parents of children consulting the trauma and resilience unit.

Descriptive and retrospective study of 20 consultants in the trauma and resilience unit at Mongi Slim hospital between January and April 2022. The evaluation of depressive symptoms in children was made by Children's Depression Inventory (CDI). The Hamilton Depression and Anxiety Scales were used to assess anxiety and depressive symptomatology in the parents of the consultants.

The mean age of the children was 10.46±3.24.

The traumatic event was related to an assault in 75% of cases, 45% of which were intrafamilial, road accident and death of a relative in 10% respectively, 5% domestic violence.

Five consultants had a CDI score ≥8 and 15 had a score >10. Only parents of children with a CDI score>19 had moderate to severe symptoms according to hamilton scales.

The diagnosis of adjustment disorder was made in 45% of cases, post-traumatic stress disorder 20%, acute stress disorder 10% other 15%

The parents’ reaction to the tragedy would play a modulating role on the children’s resilience capacities. less anxious and depressed parents would help their child build his/her coping mecanisms.

None Declared

Little is known about the perceived acceptability and usefulness of supports that adolescents have accessed following self-harm, especially since the onset of the COVID-19 pandemic.

We aimed to examine the utilisation and acceptability of formal, informal, and online support accessed by adolescents following self-harm before and during the pandemic.

Cross-sectional survey (OxWell) of 10,560 secondary school students aged 12-18 years in the south of England. Information on self-harm, support(s) accessed after self-harm, and satisfaction with support received were obtained via a structured, self-report questionnaire. No tests for significance were conducted.

1,457 (12.5%) students reported having ever self-harmed and 789 (6.7%) reported self-harming during the first national lockdown. Informal sources of support were accessed by the greatest proportion of respondents (friends: 35.9%; parents: 25.0%). Formal sources of support were accessed by considerably fewer respondents (Child and Adolescent Mental Health Services: 12.1%; psychologist/ psychiatrist: 10.2%; general practitioner: 7.4%). Online support was accessed by 8.6% of respondents, and 38.3% reported accessing no support at all. Informal sources of support were rated as most helpful, followed by formal sources, and online support. Of the respondents who sought no support, 11.3% reported this as being helpful.

More than a third of secondary school students in this sample did not seek any help following self-harm. The majority of those not seeking help did not find this to be a helpful way of coping. Further work needs to determine effective ways of overcoming barriers to help-seeking among adolescents who self-harm and improving perceived helpfulness of the supports accessed.

None Declared

Pregnancy interval may have various impacts on psychiatric and psychologic disorders of the offspring.

This systematic review aimed to assess the relationship of short and long inter-pregnancy intervals (IPIs) with the risk of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).

We performed a systematic search on electronic databases including Pubmed, Web of Science, Scopus, and Embase. We included observational studies that evaluated the association between IPIs and the risk of ASD and ADHD. Two reviewers independently screened and then extracted data on study characteristics, IPIs/ birth intervals, and outcome measures. The methodological quality of the included studies was evaluated following the Joanna Briggs Institute (JBI) critical appraisal checklist.

At the final step, 19 out of 161 studies were included in our systematic review. Among them, 16 and 5 studies assessed the association between IPI and the risk of ASD and ADHD, respectively. In 9 studies, findings supported the association between short intervals and an increased risk of ASD. In addition, 7 studies reported significant association between both short and long intervals and an increased risk of ASD. Moreover, 3 studies demonstrated an association between short intervals and ADHD risk, while long birth interval was merely assessed in 2 studies with conflicting results.

This systematic review strongly confirmed the association of short and long birth intervals with ASD and ADHD. Future studies should investigate the mechanisms underlying these associations and the possible modifiers to decrease the risk of such disorders.

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CD is characterized by at least three features: its duration is prolonged, it does not resolve spontaneously and it is rarely completely cured. Approximately 10-15% of young people have CD. Adolescents with CD often have emotional and behavioral problems.

To assess risk factors, derived psychiatric pathologies and coping strategies for a CD diagnosis in adolescence.

An extensive literature review was carried out on the subject in question, extracting information mainly from scientific articles, manuals and books.

The main risk factors are those related with the CD in question, physical sequelae, the need for long-term hospital admissions or the use of drugs whose side effects include affective or behavioral symptoms; those related to the personality traits of the affected child or adolescent. In addition, as far as the family is concerned, the presence of a low level of education, lack of support or communication, as well as the presence of psychiatric disorders or serious medical conditions in parents. Among the most frequent psychiatric disorders associated with CD are affective and anxiety disorders, adaptive disorders, somatoform disorders, eating disorders and behavioral disorders. Whatever the CD is, it generates high levels of stress and uncertainty in the patient and family, which must be dealt together from a flexible perspective, allowing child or adolescent to adapt to the changes, reorganize and facing them with adaptive patterns of behavior. For this, it will be essential to have adequate social and family support with relational style based on communication, trust and acceptance.

In general, both adolescents with CD and their families have an adequate capacity to adapt to the repercussions and effects derived from the disease. Nevertheless, in case of possible emotional difficulties that may appear, a comprehensive and individualized approach to these adolescents and their families is necessary to provide them resources and coping strategies in different areas and contexts in which the disease debuts.The comprehensive therapeutic approach will consist of interventions at the individual and family level. Among the main objectives of these interventions are to achieve acceptance and adaptation to CD provinding adequate psychosocial support to enable them to cope with CD in the best possible way and to detect and address the emotional implications, even coexisting psychopathology.

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