The authors have not supplied their declaration of competing interest.

Nurturing children with neurodevelopmental disorders such as ADHD is associated with psychological burden to the caregivers. Oman has a pyramidal population structure with the bulk of the population are in the pediatric age group. Previous studies have indicated that ADHD is common in Oman.

To measure level of burden of care among caregivers of children with ADHD and the relationship between the degree of burden, subtypes of ADHD and socio-demographic factors.

A cross sectional study conducted in a tertiary hospital in Oman. Arabic-version of the Zarit Burden Interview (ZBI) was used to evaluate the level of burden among the caregivers. The severity and subtypes of ADHD were quantified using Vanderbilt ADHD Parent/Teacher Rating Scale. Socio-demographic background and clinical data were gathered from medical records.

The study included caregivers of 100 children with ADHD. The mean ZBI score was significantly high for the parents of children with ADHD. As for the relationship with socio-demographic background, mothers of children with ADHD reported a higher mean ZBI score compared to fathers. Factors such as income, number of siblings, and severity/subtypes of ADHD played significant roles.

To our knowledge, this is the first study of Arab/Islamic population exploring the burden of care for children with ADHD. Some of the risk factors appear to have direct effects. If this study will withstand further scrutiny, concerted effort is needed in emerging economies such as Oman to address the issue of burden among the caregivers of children with ADHD.

The authors have not supplied their declaration of competing interest.

Studies have shown that caregivers of children with (ADHD) are at a higher risk of mood disorders such as depression. The presence of mood disorders among the caregivers of children with ADHD has negative repercussion in terms of prognostic indicator, utilization of the health care service and the resultant quality of life.

To solicit the performance of indices of depression among caregivers of children with ADHD and to explore the relationship between severity of mood score, subtypes of ADHD and socio-demographic factors.

A cross-sectional study conducted in a tertiary hospital in Oman dispensing child and adolescent mental health services. Arabic-version of PHQ-9 was used screen for the presence of depression among the caregivers of children diagnosed with ADHD based on DSM 5. The severity and subtypes of ADHD were quantified using Vanderbilt ADHD Parent/Teacher Rating Scale. Socio-demographic background and clinical data were gathered from medical records or attending caregivers.

The study included 100 caregivers of children with ADHD. Most of the primary caregivers were mothers (92%). Using the cutoff score of 12 on the PHQ-9, rates of depression for the mother was 14%. Some socio-demographic factors were strongly associated with severity of depressive symptom.

This study suggests that depressive symptoms as elicited by PHQ-9 are common among caregivers of children with ADHD. The rate of depressive symptoms is higher compared to the general population in Oman. This study lays groundwork for contemplating mechanisms to mitigate depressive symptoms among caregivers of children with ADHD.

The authors have not supplied their declaration of competing interest.

ADHD is one of the most common neurodevelopmental disorder among children. It is described as a chronic impairing disorder that negatively affects the academic attainment and social skills of the child. Furthermore, ADHD symptoms continue into adulthood in 30–60% of affected children. Consequently, they will most likely be missed from employment many times.

Determine the prevalence of attention deficit hyperactivity disorder among children in Saudi Arabia.

Determine the prevalence of attention deficit hyperactivity disorder among both governmental and private primary Saudi school children aged 6–9-year-old. And to measure the gender difference of ADHD prevalence. Also, to determine any association between the socio-demographic characteristic of parents of children with ADHD.

An observational cross-sectional study of 1000 primary school children belonging to 1st, 2nd and 3rd grade. The selected students were screened by the ADHD rating scale using multistage sampling technique. The first stage was selection of 20 schools from all Riyadh regions by simple randomization. The second stage was choosing children whom serial numbers were multiplies of five in each class. The ADHD rating scale was filled by both parents and teachers along with a socio-demographic questionnaire for the parents.

The estimated prevalence of ADHD was 3.4%. ADHD manifestations affect boys more than girls. In addition, ADHD was more frequent among children of illiterate mothers. Finally, ADHD was significantly more prevalent among first grade children.

This epidemiological study filled the data gap of ADHD prevalence in Riyadh. The study's findings go in line with many nearby and global studies.

The authors have not supplied their declaration of competing interest.

The increasing intake of psychotropic medication by children and adolescents is a reality that worries many mental health professionals. Recently, european school survey project on alcohol and other drugs showed that tranquillizers and sedatives were mainly consumed by Portuguese youth, without medical prescription, bringing this topic to medical and health stakeholders’ attention.

Characterize benzodiazepine prescription in the youth population followed in a psychiatric consultation at centro hospitalar Lisboa Norte psychiatric department.

Discuss Portuguese trends in mental health among youths.

Analysis of 127 adolescents, seen for the first time from January to December of 2015, using Microsoft office excel.

Our sample is comprised by adolescents from 12 to 20 years old, 81 female and 46 male. Only 16% of the adolescents were medicated with benzodiazepines, although low neuroleptic doses were often required, and 30% carried out psychotherapy. Sixty-five per cent of the diagnosis corresponds to anxiety, depressive and impulse control disorders.

Although trends in Portuguese youth mental health seem to be encouraging, as highlighted by local reports, European Union Joint Action on Mental Health and Well-Being recommends community and school active roles in primary and secondary prevention. Our experience shows that benzodiazepines’ use is rarely necessary and symptoms as anxiety, impulsivity and insomnia decreased with other strategies. Coping strategies must be discussed with the adolescents, in formal psychotherapy or in a supportive and containing therapeutic relationship, as well as discussed in family interventions. Community initiatives promotion and increased mental health care services accessibility should be priorities.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Among great variety of the manifestations of juvenile deviation of behavior, with its social significance, delinquency draws a special attention, in particular, with its aggressive manifestation.

Our task is specification of psychopathological peculiarities of two forms of aggressive behavior of delinquency.

Fifty delinquent juveniles from 14 to 18 years of age (inclusive) have been examined. Two forms of aggressive manifestations have been picked out: non-pathological: 36 (72%) and pathological: 14 (28%).

Non-pathological aggression basically is conditioned by the influence of micro-social negative conditions and stress situations. The contents of aggressive acts are closely connected with the peculiarities of characterological features; aggressive behavior is characterized with an episodic appearing, less severity and is often manifested in threatening. Marked cruelty, sadism and vandalism are found comparatively seldom. The violation of social adaptation is found in them in stresses, stipulated with negative micro-social factors; they are more manageable and comparatively quickly regress.

The peculiarities of pathological aggression are represented by super valuable and sadistic manifestations, comparatively seldom–with signs of dysphoria. The aggression, stipulated by pathocharacterological reactions is manifested in the form of pathologically super valued and affective situational acts of behavior.

Aggressive behavior of delinquency is chiefly observed in its non-pathological form, which can be explained by the hard social-economical background, visible growth of aggressiveness in an immense part of population, moral and ethic deprivation and frustration. The society itself is a certain indicator of aggressiveness.

The authors have not supplied their declaration of competing interest.

Many authors have agreed on the clinical importance of sensory regulation for a child's cognitive, affective and social development. Sensory regulation abilities are fundamental for an efficient modulation of internal states and the development of appropriately graded responses to the constantly changing sensory experiences. Sensory modulation deficit is an essential feature of regulation disorders of sensory processing (RDSP), that is characterized by difficulties in regulating emotions, behaviors and motor abilities, in response to sensory stimulation and lead to impairment in functioning. We also know that, through daily interactions and early relationship (child's attachment), parents play a crucial role on child's regulation in terms of their emotional and physical availability and how they interpret and respond to child needs.

The authors will present a clinical case of a two-year child who has been diagnosed with RDSP, highlighting the main features, types (hypersensitive; hyposensitive/under-responsive; sensory-stimulation seeking/impulsive) and challenges of this disturb.

Explore the association between sensory regulation difficulties, RDSP and child attachment.

Systematic literature review.

Recent studies showed the high prevalence of sensory regulation difficulties (33–76%) and insecure attachment (80%) in children with psychiatric disorders. Results also revealed that children with greater sensory impairment were significantly more likely to show elevated scores of insecurity (avoidance and dependence) to their caregiver.

This work underscores the caregiver's role as a facilitator of child integration and response to sensory stimuli and its importance on the development of behavioral and emotional disorders. This can help early diagnosis and better treatment who prevent future psychiatric conditions.

The authors have not supplied their declaration of competing interest.

Pediatric autoimmune neuropsychiatric syndrome (PANS) is a term used to describe a clinical picture which includes sudden onset of psychiatric symptoms and a possible autoimmune genesis. The sudden decline in neuropsychiatric functioning as well as the multiple combinations of symptoms may lead to a clinical phenotype similar to that in infantile autism (IA) with regressive features. We are conducting a study with the aim to evaluate a diagnostic test for PANS currently marketed by Moleculera Labs. All patients in Sweden who had taken the test (n = 154) were invited to the study.

The aim of the study is to characterize a subgroup of patients with IA within the PANS diagnosis study.

Participants (n = 53) were examined for psychiatric and somatic symptoms and evaluated for PANS caseness by an experienced psychiatrist. Because the criteria for entering the study was having taken the diagnostic test for PANS, the participants in the study comprise a group with mixed symptoms.

Twelve participants had IA. Eleven of these reported a developmental regression with loss of abilities. Two of the IA patients also fulfill criteria for PANS. Eight of the IA patients had been treated with antibiotics for psychiatric symptoms and 4 reported a positive effect of this treatment. Nine of the patients had elevated test results suggesting possible PANS according to Moleculera Labs.

Very early onset on PANS may be phenotypically similar to IA with regressive features. Further analysis of the immunological attributes of patients with autism with regressive features is warranted.

The authors have not supplied their declaration of competing interest.

Caring for a child with autism is a stressful experience for parents. The daily stress of this handicap has a major impact and triggers in the parents a series of adverse psychological reactions.

To reveal sociodemographic characteristics of parents of autistic children and to estimate the prevalence of anxiety and depressive symptoms among these parents.

A cross-sectional study conducted among parents of autistic children supported by four of autistic children rehabilitation centers under the Tunisian Association for the Promotion of Mental Health. Data were collected through a questionnaire to explore the sociodemographic data of parents of autistic children. Depressive symptoms were assessed by the Beck scale and anxiety symptoms by the Hamilton scale.

Fifty-two parents were collected. The middle age was 35.73 years. They lived in an urban area in 96% of cases. The majority had an average socioeconomic level (88.4%). The respective rates of depressed or anxious parents as Beck scales and Hamilton were 48% and 23%. The association between depressive and anxious symptoms was found in 19%. In addition, depression was more common in mothers (P < 10−4) and anxiety was also more evident among mothers (P = 0.01).

The presence of an autistic child causes profound changes in families and can be a source of tension and stress. The anxious and depressive impact on parents is important and frequent. The intervention that designs the psychiatrist to help children with autism should necessarily include an action for parents.

The authors have not supplied their declaration of competing interest.

Anxiety and mood disorders are common in adolescence and predict poor mental health outcomes and low quality of life in adulthood. Although early intervention seems to be critical, dropouts in the early stages of treatment are frequent and associated with low insight and severe symptoms. Therefore, a diagnostic assessment phase aimed to increase insight and early reduce symptoms appears to be essential in adolescents.

The objective of this study is to demonstrate that the diagnostic method Cooperative Assessment is able to early reduce symptoms in adolescents with anxiety and mood disorders.

A sample of 88 patients, aged 14–19 years were included. All were recruited at the first visit and evaluated with the Cooperative Assessment. This manualized procedure was created from principles of collaborative and therapeutic assessment and aim to involve the patient in a co-developed diagnosis thorough the collaborative use of test results. Patients were evaluated before (T0), in the middle (T1) and after (T2) the assessment using CGI, GAF, HAM-A, HAM-D and MRS scales.

Eighty-eight adolescents, 56.8% females, diagnosed with anxiety (47.7%) and mood disorders (52.3%) completed the protocol. HAM-A, HAM-D, MRS, CGI and GAF significantly improved at T1 and T2 with respect to T0 (T0: HAM-A 17.31 ± 8.22; HAM-D 16.97 ± 8.37; MRS5.78 ± 6.17; GAF 59.3 ± 11.06; CGI 3.63 ± 1.35; T2: HAM-A 11.41 ± 6.82; HAM-D 11.1 ± 6.91; MRS3.82 ± 3.87; GAF 67.5 ± 10.76; CGI 3.03 ± 1.26; P < 0.001; Wilcoxon signed-rank test for repeated measures).

Cooperative assessment is able to early improve symptoms in adolescents with mood and anxiety disorders.

The authors have not supplied their declaration of competing interest.

In addition to problems with inattention and hyperactivity, children with ADHD show poor organizational skills required for managing time and materials in academic projects. Poor organizational skills are associated with academic underachievement as well as psychosocial, occupational and economic difficulties. Behavioral approaches for ADHD are effective in reducing hyperactivity symptoms and behavioral problems, but the effects on academic functioning have been modest. An increasing emphasis on treatment of organizational skills has emerged in recent years, as difficulties with time management and organization of materials tend to persist and increase with age despite medication and behavioral treatments.

The primary objective is to investigate whether organizational skills training has a positive effect on organizational skills. The secondary and exploratory objectives are to investigate the effect on ADHD symptoms, adaptive functioning, academic performance and cognitive functions with a 24 weeks follow up.

Our goal is to provide cost-effective group-based treatment for children with ADHD and their parents. This will be the first randomized and controlled trial of organizational skills in Denmark.

Participants are included in two sites in Southern Denmark and will be randomized to Organizational skills training or treatment as usual. Organizational skills training will be provided in a group format for children and parents over 10 weeks.

Perspectives Given the strong association between organizational skills and functional outcome, it is very important to address organizational skills in children and adolescents with ADHD as organizational skills deficits hinder the academic performance of even gifted students with ADHD and increase with age.

The authors have not supplied their declaration of competing interest.

The quality of adult-infant interactions represents a critical context in which child adaptation problems could evolve, and child psychopathology could develop. Literature has investigated the role of attachment to caregivers, nevertheless, there is a paucity of studies on middle-childhood and early adolescence in patients with somatic symptoms disorders and disruptive behavior disorders.

This study investigates the attachment to caregivers in children with somatic symptoms disorders and disruptive behavior disorders, focusing on the role of Anger to mothers and fathers.

The aims are to verify the presence of: – high frequency of insecure attachment;

– an overrepresentation of attachment disorganization;

– high levels of Anger to caregivers.

Fifty-six patients with somatic symptoms disorders, and 42 patients with disruptive behavior disorders, aged from 8 to 15, are administered the child attachment interview.

Findings show: – Insecure attachment in more than half of the patients;

– a significant presence of disorganized attachment with respect to both parents;

– higher levels of anger to father in children with somatic symptoms disorders.

Considering the attachment to have a regulatory function, the knowledge of the different attachment strategies in middle-childhood and early adolescence may enhance our understanding and improve the management and the treatment of patients with somatic symptoms disorders and disruptive behavior disorders.

The author has not supplied his/her declaration of competing interest.

In line with a consistent literature, young patients with disruptive behavior disorders in childhood and adolescence have experienced some traumatic events, such as abuse, rejection and violence assisted. Recent studies are focusing the attention on the role of attachment and post-traumatic symptomatology for a better evaluation of this clinical condition.

This study investigates attachment models and post-traumatic symptomatology in young patients with disruptive behavior disorders.

The following objectives are set by the present study: – to evaluate attachment models in a group of children diagnosed with disruptive behavior disorders;

– to evaluate their post-traumatic symptomatology;

– to test the extent of the association between post-traumatic symptomatology and attachment organization in young patients with disruptive behavior disorders.

Forty-two Italian patients aged from 8 to 15 previously diagnosed with disruptive behavior disorders are compared to 42 healthy control subjects. We administer the child attachment interview and trauma symptom checklist for children-adolescent.

Insecure attachment are found in more than half of the patients diagnosed with disruptive behavior disorders and disorganization are highly over-represented. Furthermore, low levels of post-traumatic symptoms are found in young patients with disruptive behavior disorders.

This study suggests that attachment organization may be a fundamental element to be assessed in the evaluation of disruptive behavior disorders in children and adolescents. Nevertheless, traumatic experiences do not seem expressed through psychic symptoms. The clinical implications are discussed.

The author has not supplied his/her declaration of competing interest.

However, impulsivity is more likely to be present in externalizing disorders, little focus seems to have been made on the research of impulsivity in depression.

On this study, we sought to investigate impulsivity among adolescent with Depressive disorder compared to a control sample.

Employing a matched case-control study, participants included 100 adolescents divided into two groups: 30 adolescents (12 to 17 years) with depressive disorder and a control sample of 70 adolescents. Participants were recruited during a period of 2 years (2015, 2016). Depressive disorder patient were drawn from the consultation unit or inpatient unit of the department of child psychiatry in Sfax, Tunisia. Controls were recruited from two secondary schools and they haven’t depressive symptoms according to the child depression inventory (CDI). Impulsivity was evaluated in the two groups by the Barratt Impulsiveness Scale (BIS-11), an instrument designed to measure trait impulsivity.

Adolescents with depressive disorder displayed significantly higher total BIS-11 impulsivity scores than controls (71.6 ± 16 vs 61.6 ± 9; P = 0.003). They scored significantly higher than the controls on motor (P = 0.0001) and attentional impulsivity (P = 0.006). There was no difference in non-planning Impulsivity between the two groups. Motor impulsivity was high in adolescents with history of suicide attempt.

Our findings suggest that trait impulsivity is increased among adolescents with depressive disorder. Impulsivity seems to be a risk factor for suicide attempts, so it that should be systematically evaluated in depressive disorder.

The authors have not supplied their declaration of competing interest.

Patients with inflammatory bowel disease (IBD) report increased mental health issues, poorer sleep quality and less engagement in physical activity (PA). Standard treatment consists of immune modulating pharmaceuticals, though evidence is growing that aerobic exercise training (AET) might serve as adjuvant option to reduce disease symptoms and improve mental health. The aim of the present study was to investigate possible AET effects on psychological functioning, depressive symptoms, sleep and PA behavior in paediatric patients with IBD.

Twenty-one paediatric patients with IBD and 23 gender and age-matched healthy controls (HC) were assessed. The IBD group was split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7). All participants completed an 8-week AET exergame intervention reaching 60–80% of maximal heart rate for 5 days per week. At baseline and after 8 weeks, psychological functioning, depressive symptoms, objective sleep EEG, subjective sleep and objective and subjective PA were assessed.

AET significantly improved the exercise capacity of all participants. Self-reported fitness and daily PA behavior significantly increased in IBD-AD, but not in IBD-RE and HC. No improvements were observed for psychological functioning, depressive symptoms and subjective or objective sleep dimensions. Descriptively, the IBD-AD group reported lower psychological functioning and poorer subjective sleep quality.

Results suggest that children and adolescents in an active disease state were at increased risk to descriptively report lower scores of psychological functioning and sleep. Further, an exergaming intervention has the potential to improve exercise capacity, self-reported fitness and daily PA.

The authors have not supplied their declaration of competing interest.

Attention-deficit-hyperactivity-disorder (ADHD) is a frequent psychiatric disorder present in childhood, where sleep-problems are a prominent, pervasive and clinically important feature. However, our understanding of whether sleep-problems mimic or exacerbate daytime ADHD-symptom expression remains insufficient.

Research examining sleep and daily activity in toddlers with early signs of ADHD might help identify early risk factors.

To investigate whether disturbed sleep patterns and daily activity level is associated with early signs of ADHD in toddlers.

Twenty-four toddlers from the Danish Odense Child Cohort scoring above the 93rd percentile on the ADHD scale of the Child Behaviour Checklist for ages 1½–5 were categorized as cases and compared to 25 age and gender-matched controls scoring below the 50th percentile. Daytime and nocturnal activity for 49 toddlers were assessed through seven days of actigraphy. Parents completed Children's Sleep Habits Questionnaire (CSHQ) and the ADHD Rating Scale IV Preschool Version (ADHD-RS).

Actigraphic data revealed an increased night-to-night variability, prolonged total sleep time, fewer sleep interruptions and fewer minutes in moderate-to-vigorous-physical activity (MVPA) in cases compared to controls. Increased night-to-night variability was found significantly associated with higher total scores on both the CSHQ and ADHD-RS. Further, fewer minutes in MVPA were associated with a higher parent-reported motor activity on the ADHD-RS.

Findings show that early signs of ADHD are associated with irregular sleep patterns and lower daytime activity, as illustrated by actigraphy. Studies investigating early ADHD risk factors could lead to a preschool ADHD risk index to help guide future early intervention.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

In adolescence experiencing weight and physical appearance concerns is common. These body and weigh-related preoccupations are associated with anxiety and may lead adolescents to avoid social situations where their body image is exposed.

The present study aimed to conduct an exploratory factor analysis and explore the psychometric properties of a new measure of social situations discomfort and avoidance due to weight or physical appearance (DASSWPA) in a sample of adolescents.

The sample comprised 357 adolescents aged between 12 and 18-years-old, 195 males and 162 females, with a mean age of 14.69 (SD = 1.68). Participants completed a set of self-reported questionnaires concerning anxiety, stress and depression symptoms (DASS-21), bullying experiences (BIVES-A) and body image related shame feelings (BISS).

The DASSWPA is comprised of two separate scales: one regarding discomfort/anxiety and another one related to avoidance of social situations. Results suggested that both scales presented a similar two-factor structure. Both scales revealed good psychometric properties, including high internal consistency (α = 0.91) and an excellent temporal stability. Moreover, DASSWPA showed significant and positive associations with body image related shame feelings, victimization experiences, and anxiety, stress and depressions symptoms. Gender differences were also found, with girls presenting significantly higher levels in the anxiety/discomfort scale than boys.

The DASSWPA proved to be a reliable and stable measure to assess anxiety and avoidance of social situations due to one's physical appearance and weight in adolescents.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.