The age of onset of mental health problems is becoming younger and the severity of illness presentation throws lots of challenges for health professionals and service providers. Currently there are only four recognised Psychiatric intensive care units in England.

Little data is available regarding the characteristics of patients referred and treated in adolescentPICU's. This presents a challenge for clinicians and service providers for delivery of care for this patient group and developing care pathways. The main objective of this study to get a better understanding of the young people referred to help optimise care whilst in hospital and develop appropriate care pathwaysAimsThe study aims at identifying demographic, diagnostic characteristics and care pathways for young people admitted to an adolescent PICU.

A retrospective case note study was undertaken of all the patients admitted over three years since opening of the adolescent PICU at Cheadle Royal hospital.

Data was collected from all the young people admitted to the ward between April 2007 and April 2010.Information regarding demographics including age of presentation, gender characteristics, ethnicity and area of referral were looked. The authors looked at the care pathways including reasons for referral, where admitted from, risk issues on admission, diagnostic criteria and discharge pathways.

This study has highlighted the widely held impression that there are still gaps in adolescent crisis provisions and the need for further acute interventions. The study highlights the challenges for service providers the current gaps in care pathways for young people with multiple diagnosis and lack of adequate crisis interventions in the community.

It is known the prevalence of mental pathology among patients with connective tissue disorders and functional cardiopathies essentially exceeds their prevalence in the general pediatric population.

To study the clinic features of psychosomatic disorders in childhood in the cardiology clinic 26 children of 5–12 years with functional cardiopathies have been investigated.

Children were surveyed by psychopathological, neurological, pediatric methods. The clinical and biochemical blood tests, urine tests, ECG, ultrasonic cardiography, sono-encephalography, EEG were investigated.

In a mental condition of children the neurotic frustration which plot was defined by cardiac complaints acted. They aroused in 52, 3% against schizotipical disorders, in 47, 7% accentuations of psychasthenic and dissociative type. In 15, 3% cases were detected transient psychotic episodes with fragmented polymorphic psychopathology. More than half of 26 children, had family history of social factors, were brought under partial maternal deprivation. Detect violations of lateralization, visual perception and information processing with weakness predominantly right-brain functions were revealed. In 92, 3% identified functional abnormalities of the structure of the heart (more trabeculae, patent foramen ovale) without hemodynamic instability.

Thus, the violations constitute one of the variants of psychosomatic disorders in children masquerading cardiac pathology. Further studies will clarify the more subtle mechanisms of marked pathology, but now there is no doubt that in creating it plays the role of a range of factors.

The study of clinical features and prognostic significance of autonomic disorders are among the most pressing problems of modern medicine.

Dynamically within 5 years were observed 50 children at high risk for schizophrenia and 40 children with hypoxic-ischemic encephalopathy of the general population. Aims. Evaluation of prognostic significance of autonomic disorders in infancy for mental health in older age groups.

All patients were examined by clinical methods and EEG, neurosonografia, original screening tables for early childhood.

In the first year of life in children at high risk for schizophrenia observed mental and motor development within the syndrome of PDD.In infancy the vagotonic orientation prevailed 72, 5%. By 3 years it changed to the amphotonic orientation reaching 76, 0% of children, while the 10, 0% acquired sympathotony, the rest remained vagotonic.The mental state of 37 children to 5 years qualified as schizotipical disorder (F 21.8). In 13 children it was diagnosed schizophrenia, children's type (F20.8). Frequent and sudden changes in the type of tonus correlated with the deterioration of the mental state of a different nature.In the control group at the first year of life prevailed vagotonic orientation, which gradually to age of one year changed by eutonic. During the first 3–5 months of infancy revealed some unstable circulatory, sleep disorders.

The instability of autonomic tone and an abundance of vegetative violations indicate the risk of mental pathology.

Many women in fertile period of their lives experience some bothering mental and physical symptoms. After presentation of DSM-IV, these symptoms already known as Pre-menstrual syndrome (PMS) were called Pre-menstrual dysphoric disorder (PM DD).The prevalence of PMS has been estimated to be about 40% to 70% but severe signs (PMDD) have lower prevalence. This study has evaluated the frequency of PMS and PMDD and some related factors in girls’ high schools.

In this descriptive-analytic study, 800 students of girls’ high schools were chosen by randomized cluster sampling. A researcher made questionnaire assessing PMS and PMDD according to DSM.lV.TR criteria as well as a demographic questionnaire were administered to participants. Data were analyzed running SPSS software -version 11.5.

Frequencies of PMS and PMDD were 41.5% and 9.4% respectively. The disorder was more frequent in students older than 16 years old. Mood symptoms were the most frequent presentation, followed by physical and behavioral symptoms. There was a lower frequency of the disorder despite a higher frequency of the syndrome in students with highly educated mothers. The frequency of PMS was higher in students with positive family history.

Because of the potential adverse effects of PMS and PMDD on academic achievement and mental health of students, the high frequency of these problems need urgent attention. Planning mental health evaluations and interventions is necessary for these age group students. Diagnosis of severe cases and referring them should be considered in such programs.

Study of level of mental health of children with hearing disorder.

Schoolchildren of Tomsk Special (Correctional) General Boarding School № 15 of kind I, II where 165 children from 5 till 20 years study. At the moment 45 schoolchildren at the age of 10–20 years have been examined, from them 37 – hard-of-hearing (sensory-neural poor hearing of stage II- IV) and 8 deaf (sensory-neural deafness), consultations with parents have been conducted. 18 children are school leavers (16–20 years). All children have disability on basic disease.

Clinical, neuropsychological methods, Anxiety Scale SMAS, drawing tests, Luscher Test.

Children are well adapted in stable, familiar for them conditions of the boarding school and try to cut themselves off thoughts about their own perspectives. Revealed abilities of mental status require psychological and psychotherapeutic correction, in some cases administration of medication. Absence of complaints may be conditioned by speech disorders against the background of the basic defect, disturbances of emotional-volitional sphere as one of the basic characteristics of delay of mental development.

Accessibility of education for deaf and heard-of-hearing children in the collectives of hearing ones supposes opposite moving of the society and children with hearing disorder, which interests should be represented by parents and specialists.

ADHD is frequently associated with comorbid psychiatric disorders. However, epidemiologic studies in the general population are rare.

To evaluate associations between ADHD and comorbid psychiatric disorders using research-identified incident ADHD cases and population-based controls.

Subjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n = 5718). Among them we identified 379 ADHD incident cases and 758 age-sex matched non-ADHD controls, passively followed to age 19. Through a systematic, multistaged process, utilizing detailed, routinely collected data, all psychiatric diagnoses confirmed by medical professionals were identified (n = 314 ADHD cases, n = 712 controls with research authorization). For each psychiatric disorder, cumulative incidence rates for subjects with and without ADHD were calculated; corresponding hazard ratios (HR) adjusted for sex, mothers age/education, were estimated using a Cox model. Associations between ADHD status and Internalizing-Externalizing dimensions were estimated using odds ratios (OR).

ADHD was associated with significantly increased risk for adjustment disorders (HR = 3.82), conduct disorder/oppositional defiant disorder (HR = 9.45), mood disorders (HR = 3.57), anxiety disorders (HR = 2.95), tic disorders (HR = 6.41), eating disorders (HR = 5.52), personality disorders (HR = 5.49), and substance-related disorders (HR = 4.04). When psychiatric comorbidities were classified on the Internalizing-Externalizing dimension, ADHD was strongly associated with coexisting internalizing/externalizing (OR = 10.6, vs none), and externalizing-only (OR = 10.0), disorders. No significant gender x ADHD interactions were observed.

This population-based study confirms that children with ADHD are at significant risk for co-morbid psychiatric disorders. Besides treating the ADHD, clinicians should assess and monitor potential psychiatric comorbidities in children with ADHD.

Behavioural therapy often involves self-monitoring techniques to increase awareness about mood and stressful events. In turn, emotional self-awareness is likely to decrease symptoms of depression. Self monitoring also has potential as an early intervention tool for young people, particularly when mobile phones are used as a medium. Previous qualitative research indicates that self-monitoring via mobile phones increase emotional self-awareness with five categories proposed: awareness, identification, communication, contextualisation and decision-making.

This RCT investigates the relationships between self-monitoring, emotional self-awareness and depression using an early intervention mobile phone self-monitoring tool with young people at risk of developing depression.

Young people (between 14 and 24 years of age) identified by their GP as being at risk of depression were recruited by GPs in rural and metropolitan Victoria and randomly assigned to either the intervention group (where they monitored their mood, stress and daily activities) or the comparison group (where the questions about mood and stress were excluded). Participants completed baseline and follow-up measures of depression as well as measures of emotional self-awareness.

Results will be presented on the effects of self-monitoring on emotional self-awareness, the effects of self-monitoring on depression, anxiety and stress and the relationship between emotional self-awareness and depression, anxiety and stress.

Emotional self-awareness as a mediator in the relationship between self-monitoring and depression will be discussed focusing on the relationships between

1. (i) self-monitoring,

2. (ii) emotional self-awareness and

3. (iii) symptoms of depression, anxiety and stress.

Possible avenues for early intervention are suggested.

Co-morbidity is to be expected in autistic spectrum disorders directly or indirectly (1). 65% of children and adolescents with Asperger's suffer from an additional psychiatric disorder (2). Misdiagnosis or delayed diagnosis is a serious problem, and the average age at diagnosis of Aspergers is several years later than for autism (3).

A small yet significant number of offenders with autism who engage in illegal behaviour find themselves socially excluded or detained in secure provisions for prolonged periods(4).

Wider understanding of factors leading to inpatient admission in young people with Pervasive developmental disorder.

Early detection and management of mental disorder and risks, in order to meet complex needs in community.

Innovative and comprehensive assessment of mental health, psychological and social needs.

Risk assessment and management shared by multidisciplinary team and Community teams.

Retrospective case notes study of 11 patients admitted over 2 years.

81.8% presented with risk to others.54.5% had diagnosis of ASD on admission. 36.3% had forensic history. Average age of diagnosis was 14 years. 18.1%were misdiagnosed.

The review confirms that misdiagnosis and delayed diagnosis remains a problem. Also co-morbid substance misuse and risk taking behaviour get admitted to secure inpatient units. Inpatient assessment can in significant number of cases divert trajectory away from criminal justice system.

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood affecting approximately 3—5% of school age children (American Psychiatric Association). Some parent training in AD/HD is known to reduce external behaviors in theses children. One of them is Triple P (Sanders, 1999).

The goal of this study was to examine the effectiveness of the group positive parenting program (Triple p) on reduce to externalizing behaviors of children with Attention Deficit/Hyperactivity Disorder (ADHD) in Iranian families.

Randomized controlled trial in Iran with 22 mothers of children with AD/HD, of whom 10 received program, 12 group control. For carried out this research, authors were design the intervention program. The methodology of this study was quasi- experimental design with control group. Data were collected by child behavior checklist (CBCL) that reported by parents.

Results indicated that children's externalizing behaviors significantly reduced after training in triple p group.

Triple p- positive parenting program could be applied with pharmacotherapy as a supplement treatment in reduce and control of disruptive behaviors of children with ADHD.

Taking care of a child with Autism has been shown to place a significant burden on the caregiver's, especially mothers (Khodabakhshi Kooalee, 2008).

Propose of this study is to identify mental health distress in mothers with Autism children.

50 mothers who had a child with Autism (APA, 2002) and 50 mothers who had not a child with Autism (control healthy group) selected in present study. A total 100 mothers were answered General Health Questionnaire (GHQ) Persian version. The mean of age of children was 10.50 years old.

The results indicated health -related distress (GHQ) was markedly increased in comparison to healthy controls. Mothers with Autism children reported high level of depression and Anxiety disorder than healthy group. Also, 66% of mothers reports very low level social function.

According to the results, mothers with Autistic Children experiences high level of stress and mental health problems. It is noteworthy to noted, the psycho-educational family, social network and supportive psychotherapy are offer to these mothers and other member of family.

Childhood obesity is a major issue and puts children at risk of physical and psychological health complications. Some studies have evaluated obesity in autism in different countries. However there is few data on the rate of obesity in high-function autism (HFA).

To evaluate the weight status of children with HFA in Iran

This cross-sectional survey was carried out in autism specific schools of Tehran in 2010. In total 113 children with HFA ages 6–15 were evaluated. They were classified according to WHO references (2007) for body mass index (BMI) for age and sex as obese, overweight, healthy weight and underweight. We then examined the associations of weight status of these children with some variables and comorbodities.

The prevalence of obesity in children with HFA was 27.0%, overweight 13.0% and underweight 7.0%. There was a significant correlation between age and BMI (r = 0.26, Pvalue < 0.01). Underweight was associated with neurologic comorbidities (p < 0.05). The rate of obesity has not correlated with some other medical and psychiatric comorbidities, as well as sex, and parents’ weight status.

Prevalence of obesity in autistic children with high intelligence profile is high and at the same levels of both normal children and children with autistic spectrum disorders.

The A.P.P.A.C. has created, through years, a significant data base of clinical results derived from the systematic approach of a wide range of psychiatric diseases. The aim of this study was to evaluate the current state of psychiatric diseases and associated parameters with social impact.

Data was obtained from the Association of Psychology & Psychiatry for Adults & Children (A.P.P.A.C.) from January 2007 until December 2009. A sample N = 219 patients has been studied during the last 2 years. The mean age of patients was 35 years. Statistic analysis is based on z-criterion as well as X2-test.

P-values of 0.05 were considered to be statistically significant. 20% of the patients were diagnosed with 2 psychiatric diseases, 70% of widowers have been suffered from depression. 37,84% of patients with depression have hereditary predisposition. Therapeutic interventions to patients were made using psychotherapy, medication or both. The analogy of psychotherapy to medication is almost 1:2, while in 18.75% of the patients, who needed drug treatment, psychotherapy was mandatory. Finally, our study indicated that sex (females versus males) and hereditary predisposition are significant factors for depression in comparison to other psychiatric diseases.

Research carried out for determining the specificities of the psycho-social profile of adolescents with tattoos.

Research carried out on 80 adolescents of the age between 16 and 25 years, both sexes…A questionnaire with demographical data was used for the research, PIE (profile index of emotions Plucik), battery of the tests CON4.

Adolescents with a greater number of tattoos (2 or more) manifest a higher aggression, low frustration tolerance and impulsiveness, social disinhibition and they are emotionally without social fears, unpleasantness and shame. Young people with one tattoo don’t have a different profile, but a need of satisfying fashion trends and solving their developing uncertainties and depressiveness.

Young people with tattoos have a specific psycho-social profile, and a great number of tattoos is a screening for indicating behavioral disorders.

We wanted to show how the family secret of adoption can influence even second generation of members.

Girl 15 years of age, high school first grade lived in complete family with older brother and younger sister. Father was a rigid structure, difficult in communication with other family members except youngest daughter. For a first check up she had come with her mother (previously psychiatry treated of depression). Girl was very depressed (CDI 24), her appearance expressed hopelessness, repeatedly thought about suicide, did not accomplish anything she wanted, to study for nurse, or an actress. Two years ago looking through some papers, she had find out that her mother was adopted as a baby, that changed her all life, relationship toward grandparents, could not study, focus on anything else. Just a few days ago she admitted to her mother that she knows a secret about her origins. Her mother also find out that she was adopted when she was 14 (the same age when her daughter find it out), some girls in the school told that to her. Finding out the truth was very devastating for her too.

Trans - generational transfer of family secret came to resonance of unconscious and girl find out the truth almost in the same age as mother. It has had stressful effect, but also influence trust, and cause anger and feeling of exclusion. Silence has aggressive except protective function. Adolescence as vulnerable developmental age made this girl more sensitive for this.

Childhood-onset schizophrenia is onset prior to the age of 13 years. Although rare, people who suffer from schizophrenia at an early age appear to have a severe form of the illness with poor long-term prognosis. Antipsychotic medication is one way of managing this serious mental illness.

To examine the effects of antipsychotics for childhood-onset schizophrenia.

We searched the Cochrane Schizophrenia Group Trials Register, inspected references and contacted pharmaceutical companies and authors of trials. We included all randomised clinical trials.

From a total of 2062 citations, we identified six relevant trials. Three comparisons: atypical versus typical, atypical versus atypical and typical versus typical antipsychotic drugs. The only comparison to find any differences was atypical versus typical antipsychotic drugs. A few results from one study favoured the atypical antipsychotic clozapine over haloperidol in treating treatment resistant childhood-onset schizophrenia (n = 21, WMD CGAS 17.00 CI 7.74 to 26.26). Participants on clozapine, however, were three times more likely to have drowsiness (1 RCT, n = 21, RR 3.30 CI 1.23 to 8.85, NNH 2 CI 2 to 17) and half of the children receiving clozapine had neutropenia (1 RCT, n = 21, RR 12, CI 0.75 to192.86).

There are few relevant trials and, presently, there is little conclusive evidence regarding the effects of antipsychotic medication for those with early onset schizophrenia. Some benefits were identified in using the atypical antipsychotic clozapine compared with haloperidol but the benefits were offset by an increased risk of serious adverse effects. Larger, more robust, trials are required.

Evaluate the time-course, severity and resolution patterns of adverse events (AEs) occurring with long-term aripiprazole treatment for irritability associated with autistic disorder.

Participants were treated with aripiprazole in a 52-week, open-label, flexibly dosed (2–15 mg/day) study. Subjects had either completed one of two 8-week randomised trials or were de novo. AEs with an incidence of ≥10% were evaluated by incidence, peak first onset, severity, percent resolved and time to resolution.

A total of 330 subjects entered open-label treatment; 199 completed 52 weeks. Mean dose for the population stabilised at around 10 mg/day after approximately 4 months. Thirteen AEs had an incidence of ≥10%; most were mild or moderate in severity. Vomiting, diarrhoea and headache had an early first onset and tended to resolve fairly quickly.

Sedation, fatigue and insomnia also appeared early and resolved in a majority of cases, but not as quickly. Increased appetite appeared early (followed by increased weight) and fewer weight-related AEs resolved. More than half of the subjects increased their weight by at least one percentile category rank; nevertheless, only a small proportion of subjects with normal baseline metabolic or glucose measures had a treatment-emergent, clinically relevant laboratory abnormality. Nasopharyngitis, upper respiratory infection, cough, nasal congestion and pyrexia all had peak onset at variable times during the study, resolving in nearly all cases, with short time to resolution.

AEs were mostly mild or moderate and of variable duration. Increased weight was observed.

Attention Deficit Hyperactivity Disorder (ADHD) is a lifetime neuro-developmental disorder, which causes severe impairment in children and adolescents. A recent epidemiological study of children presenting with ADHD in France suggests an estimated prevalence of ADHD of 3.5-5.6%.

A survey was conducted to gather information from the families of children with ADHD about the care pathway in France in order to improve understanding of the needs in this field.

The survey was conducted between July and August 2009 via an online questionnaire, which was sent to 1217 families registered with the French ADHD association.

The survey response rate was 23% and key findings include the following. Symptoms at school were the key driver in healthcare demand in 77% of cases. Waiting time for an appointment with a specialist averaged 8.2 months. More than 80% of parents felt involved in the choice of care for their children, while only 41% of families considered themselves well-informed during the diagnostic process. Of the 70% of children receiving ADHD medication at the time of the survey, 97% showed good adherence to treatment on school days.

The survey results suggest that the care pathway for ADHD in France is lengthy, with the average time taken before a specialist consultation estimated to be about one school year. Recognition of ADHD appears to originate at school rather than in a preventive manner by the healthcare system.

The survey was supported by Shire Pharmaceuticals Ltd

To expose from the clinical and welfare expectation, the experience with injectable Risperidona of long duration with three cases clinical whose principal diagnosis is of Mental Delay Moderated with alteration of the associate behavior.

I marry 1: 14-year-old Teenager of age attended in our CSM for Mental Delay and Disorder of conduct to familiar and school level.

CI = 50. It has received diverse antipsychotic and stabilizing treatments of oral form being the discontinuous capture. For one year in treatment with injectable Risperidona 50 mgr/14 days, answering favorably to the treatment, diminishing the conducts heteroagresivas that he was presenting to the beginning.

I marry 2: 15-year-old Teenager of age late Mental and disorder of the disturbing behavior with episodes d excitation, irritability and loss of control.

Not clinical stabilization with oral treatment for lack of familiar adherence. We introduce injectable Risperidona, 7,5 mgr/14 days, pupil to the family to mint of the importance of the treatment and the facility of administration. It improved the adherence to the center and therefore, clinical improvement.

I marry 3: Preadolescente and 13 years and age with compatible symptoms late Mental Moderates do and autistic features with important estereotipias and autoaggressions. For a few months in treatment with Risperidona inyecable 37,5 mgr/14 days with clinical improvement.