As used style Troubleshooting reduces test anxiety, the tendency of these two variables is negative (P = 0.01). Implement the style Relating to others it will decrease test anxiety, the tendency of both variables is negative and statistically significant (P > 0.05). Stress in young people increases as gets underway unproductive type (P = 0.00). The results are consistent with the literature that suggests that late adolescents in academic challenges cause such hardship (Marote et Martínez, 2001).

The authors have not supplied their declaration of competing interest.

So far, autism etiology is not known yet, it is believed that is due a combination of neurobiological, structural, genetic and environmental factors. This disorder is characterized by social interaction and communication impairments and presence of restricted and repetitive behaviors. Some authors have spoken about Sensorial Perception Theory that tries to explain how sensorial impairment of people with autism causes “strange” conducts, as a protective mechanism to stimuli they perceive as disturbing.

To highlight the role of sensorial perception in people with autism in their way of interacting over the environment.

systematic review of the literature in English (PubMed), with the following keywords: “Autism”, “sensory perception”, and “Asperger syndrome”.

According to Sensorial Perception Theory, people with autism perceive sensorial information from environment in different ways. It is believed that each sense operates as a hyper or hyposensitive sense, according to the intensity and the moment the stimulus is produced. This fact provokes “abnormal” responses as repetitive or restricted behavior, in order to protect themselves form the disturbing stimuli.

Sensorial hyper o hyposensitive may be related to the strange behavior that can be present in people with autism. If we could interpret such conducts, we will be able to imagine how patients are perceiving the world and then we could help them to develop strategies in order to function more properly.

The authors have not supplied their declaration of competing interest.

The professionals in charge of children and adolescents with attention deficit disorder and hyperactivity disorder (ADHD) should be prepared to treat a wide variety of psychiatric symptoms, as most have at least one comorbid psychiatric disorder.

Sometimes the differential diagnosis between ADHD and bipolar disease is difficult because of overlapping symptoms between the two disorders (Geller et al., 1997; Biederman et al., 2000; Singh et al., 2006).

A literature review about the comorbidity between ADHD and bipolar disorder in children and adolescents was performed.

According to different studies, between 60 and 90% of children and adolescents with ADHD have comorbid bipolar disorder. However, the percentage of children and adolescents with ADHD that has comorbid bipolar disorder varied from 10 to 22% (puedes poner from 60 to 90% si no quieres repetir el and).

The prevalence of bipolar disease, particularly among adolescents, is between 1 and 7%. This percentage is higher if all forms of bipolar spectrum are included. Some personal and family factors increase the probability of a patient having ADHD present bipolar disease: decreased IQ, delayed development, family history of ADHD or bipolar disease, and the combined subtype.

The authors have not supplied their declaration of competing interest.

Cerebral Palsy is a movement, posture or muscle toning disorder caused by an insult to the immature, developing brain, most often before birth. It is a leading cause for serious disabilities in childhood and a risk factor for the development of psychiatric disorders, particularly in adolescents. Moreover, according to DSM-5, a Brief psychotic disorder is a short-term illness with psychotic symptoms, which arise suddenly, but last for less than one month, after which the person recovers completely.

The authors aim to present a case of an adolescent with cerebral palsy who has developed secondary psychotic symptoms, a rare and sparsely understood phenomenon.

A non-systematic review of English scientific literature was conducted through research in the PubMed search engine, using the keywords “Cerebral Palsy” and “Brief Psychotic Disorder”.

A 16-year-old female adolescent with history of Cerebral Palsy (due to neonatal anoxia) was admitted in the paediatric ward due to behaviour disorder characterized by incoherent speech, full insomnia, agitation and auto/alo-aggression. A complete clinical investigation was performed, in which trauma, organic brain injury, degenerative and inflammatory diseases, infection or toxic ingestion were all excluded. The hypothesis of an acute psychotic disorder was considered and after antipsychotic treatment, a total remission of the symptoms was obtained.

Although rare, the association between cerebral palsy and psychotic disorders should be considered in the diagnostic investigation of behavioural changes. Early identification allows a proper therapeutic intervention and a better quality of life.

The authors have not supplied their declaration of competing interest.

Psychiatric disorders in epilepsy have a multifactorial etiology, being pharmacotherapy only one of many risk factors, which can be both biological and psychosocial. The adverse effects of antiepileptics (AEDs) embrace all categories of psychiatric symptomatology, including disturbances of consciousness, psychotic state, neurotic state, behaviour and character disorder. In fact, Psychotropic effects of AEDs require further research because many relevant parameters related to pathological mechanisms, frequency, psychopathology, and prognosis are not well understood.

The authors aim to present a case of an adolescent with epilepsy who has developed secondary psychiatric symptoms.

To understand and deal with the most common Psychiatric side effects of AEDs.

A non-systematic review of English scientific literature was conducted using keywords “Epilepsy” and “antiepileptic side effects”.

A 14-year-old female adolescent with history of seven years of Epilepsy (usual medication: carabamazepine 45 mg/kg/day, Lamotrigine 8 mg/kg/day; pregabaline 8 mg/kg/day) was admitted in the paediatric ward due to behaviour disorder characterized by agitation, anxiety and seizures-like symptoms. A therapeutic adjust was made (Fenetoíne and Levetiracetam). After this medication change, the adolescent presented psychotic symptoms namely auditory and tactile hallucinations. A complete clinical investigation was performed and the hypothesis of drugs side effects was considered. After AEDs reduction, a total remission of the symptoms was obtained.

Psychiatric disorders in epilepsy have a multifactorial etiology and are not yet well understood. Behavioural side-effect profiles of AEDs (both negative and positive effects) should be considered in the choice of the optimal drug for each patient.

The authors have not supplied their declaration of competing interest.

Anti-NMDA encephalitis normally appears as a characteristic syndrome with typical symptoms that undergoes with multiphase evolution. However, it sometimes develops atypical symptoms so we must perform a careful differential diagnosis.

To conduct a current review of detection and management of anti-NMDAr encephalitis, and psychiatric manifestations.

Systematic review of the literature in English (PubMed), with the following keywords: “Autoimmune encephalitis”, “psychosis”, and “NMDA receptor”.

We present the case of a 15-year-old boy referred to evaluation for a first psychotic episode. He had no past history of psychiatric illness or substance abuse. The only relevant antecedent is multiple sclerosis in a first degree relative. For the last months, he presented high levels of anxiety symptoms apparently related to college stressful events and fluctuating hypoesthesia of left cranial side. Days later, it appeared autolimited gastrointestinal symptoms, headache and fever. During the next days it appeared psychomotor retardation, choreic movements, suicide ideation and mood-congruent paranoid and nihilistic ideation, auditory and visual hallucinations, perplexity and catatonic symptoms so he was hospitalized. We observed cognitive functions impairment, unsteady gait, dysartria, dysphasia, clonus and left babinsky sign. EEG showed slow waves on right frontal area. CFS showed protein elevation and immunologic study revealed positive anti-NMDA antibodies. Treatment with methylprednisolone and gammaglobuline was started with partial response, needing addition of rituximab.

In this case, we highlight the importance of early detection and a detailed differential diagnosis, to determine whether the etiology of psychiatric symptoms in order to achieve an accurate and early treatment.

The authors have not supplied their declaration of competing interest.

There is currently a resurgence of handwriting difficulties in school-age children. Researches in literature focus on kinematics temporal and spatial measures of letters in the writing process and on clinical performances such as the handwriting scale (BHK). This assessment doesn’t consider the organization and the maturation of the handwriting gesture.

We aim to study the developmental organization of the handwriting gesture to provide developmental standards of reference in order to complete performances measures allowing a better understanding of handwriting disabilities.

Healthy children of elementary school aged between 6 and 11 years old are eligible for inclusion. All children are assessed with neuropsychological and neuropsychomotor evaluations and with handwriting assessment (BHK). Two groups are established, the one with handwriting difficulties and the other one (control group) without writing disorder or learning disabilities. The children were matched for age, gender and school level. All children are filmed with a camera suspended over to observe with specific handwriting tasks, the upper limb gesture about segmental organization of fingers, hand, forearm, arm, shoulder and postural organization.

Preliminary findings show significant differences of the segmental organization of the writing gesture between the two groups. We will discuss the identified causes of the handwriting disorders with the analysis of neuropsychomotor and neurological assessments data in correlation with gesture segmental organization.

Developmental organization of the writing gesture is a possible underlying mechanism of handwriting disabilities. Practically, it appears important to improve news tools of evaluations with gestural writing consideration and to implement it in intervention process.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Conversion disorder (CD) is an uncommon but highly disabling condition. Affected children and adolescents are often severely impaired and at risk of serious long-term physical and psychosocial complications. Despite the enormous personal suffering and health resource implications of CD, little research has been done.

To update our knowledge about CD in adolescents, with a comprehensive review of the literature with special focus in prevalence, psychosocial factors, diagnosis, treatment and outcome.

To present the most relevant data of our review with a clinical illustration that provides a practical vision of this disorder.

A systematic literature review was performed in MEDLINE, with particular interest in papers published in the last 10 years. Clinical illustration is provided by a case selected from an outpatient child and adolescent mental health service.

Few reliable prevalence data are available; the range goes from 0.2 in a German study to 31% in non-western clinical settings. Diagnosis is based on a constellation of features and treatment should involve several heath care professionals. CD has a favourable outcome in children and adolescents. However, mood and/or anxiety disorders are encountered at a considerable rate even after recovery from conversion symptoms. Long clinical follow-up seems appropriate.

The expression of emotional distress in the form of physical complaints is common in children. Nevertheless, the most severe presentation of physical symptoms is not a common topic in literature. More research should be done to improve our understanding of this disabling disorder.

The authors have not supplied their declaration of competing interest.

Hoarding disorder is described in the DSM-5 as a new clinical entity whose essential characteristic is the persistent difficulty discarding or parting with possessions, regardless of their actual value, arguing reasons of utility, aesthetics, attachment or strong fear of losing Information.

We present the case of an 11-year-old male patient brought to the Health Mental office when his mother found in the school bag debris that he had collected from the garbage, and useless objects in a bedroom drawer. The patient recognizes the nonsense of his behaviour but is unable to get rid of these objects but he allows his mother to do it. He had lowered school performance and showed irritable, shy and solitary, difficulties to sleep and cried often without apparent reason. They also noted since six months before, strange movements with the neck and eyes.

After ruling out, underlying organic pathology, we started treatment with sertraline 50 mg, aripiprazole 2.5 mg and cognitive behavioural therapy, with complete disappearance of symptoms including the movement disorder.

Obsessive compulsive disorder 300.3 (F42); Hoarding disorder 300.3 (F42); Provisional Tic disorder 307.21 (F95.0).

Hoarding behaviour of strange objects is very unusual in Hoarding Disorder but more common in the Obsessive-Compulsive Disorder. In this case report, we consider the possibility of both disorders.

The authors have not supplied their declaration of competing interest.

The diagnosis of schizophrenia in children is rare. Less than 4% of schizophrenic patients begin before age 15 being much less stable than in adults as an entity in time. It is estimated that only 50% of diagnoses of schizophrenia in patients under 15 years are maintained over time. The most frequent differential diagnoses are bipolar disorder, post-traumatic stress disorder and dissociative disorder.

A case of a patient of 18 years old admitted in our service with diagnosis of paranoid schizophrenia due to the presence of delusional symptoms at age of 14 and due his evolution with impaired overall performance is presented. Upon arrival he presented delusions, self-referentiality and a strange phenotype with a pitched voice. Clinical history included presence of sexual abuse prior to debut of psychotic symptoms and rare medical comorbidity (diagnosed at age 15 of hypertension and paroxysmal sinus tachycardia). A kariotipe was done in a previous admission with normal results.

During hospitalization symptomatic remission was achieved in just two days by decreasing antipsychotic potency of the treatment, he also presented elevated metanephrines and also elevated plasma aldosterone and renin in blood tests.

We discuss the differential diagnosis including schizophrenia, post-traumatic stress disorder with dissociative symptoms and endocrine pathology (pheochromocytoma and hyperaldosteronism).

L. Galindo is a Rio Hortega fellowship (ISC III; CM14/00111).

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Cystic fibrosis (CF) is an autosomal recessive disease characterized by abnormal airways secretions, chronic endobronchial infection, and progressive airway obstruction. In Portugal is estimated 30–40 born children with CF per year. The prognosis of CF has changed over the last decade, death in childhood is now rare, and children born today are likely to have a mean life expectancy of over 40–50 years. An understanding of the psychiatric aspects of CF is more important than ever.

Review published and referenced scientific articles on MedLine/PubMed.

Researchers found CF can affect the patient and their family in many ways. Physical and social restrictions, the rigorous medical regimen, hospital admissions, concerns about illness, and uncertainties of the future can create anxiety and depression in patients and parent alike. They also may have problems with interpersonal relationships resulting in isolation and social maladjustment. Some studies also reported an increased risk of develop an insecure attachment and less adapted eating behaviors. The essential responsibilities of psychiatrist are: evaluating the psychiatric effects of living with CF, comprehensive assessment and intervention when emotional, behavioural and psychological difficulties arise and providing support.

Awareness of types of emotional strain experienced by these children and their families can be of use to avert potential problems which may seriously impair therapeutic effectiveness and the patient's well being. Management requires an interdisciplinary team to maximise longevity and quality of life. All patients and their families must be offered the opportunity to meet with a Child and adolescents psychiatrist.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Fear is a distressing emotion aroused by a risk or a damage, real or imaginary. Fears have a warning function against dangers. Nevertheless, fear can also become in one of the most limiting elements of a person's life.

To characterize the profile of fears presented in a sample of 19 children, aged between 8 and 13 years old, who had previously been diagnosed with one of the following: Generalized Anxiety Disorder, Separation Anxiety Disorder or Social Phobia.

The sample was taken from patients who participated in a cognitive-behavioral group therapy. The Spanish version of the Fear Survey Schedule for Children-Revised (FSSC-R) questionnaire was employed. The FSSC-R asks children to indicate on a 3-point scale (‘none’, ‘some’, ‘a lot’) how much they fear 80 specific stimuli or situations. Five basic categories of fears can be stablished: failure and criticism (17 items); the unknown (17 items); minor injury and small animals (13 items); danger and death (16 items); medical fears (5 items).

The sample includes 19 children: 12 boys (63.2%) and 7 girls (36.8%). The median age is 10.74 years. The sample shows 15 excessive fears on average (those scored as ‘a lot’). Girls show higher rates of excessive fears than boys: 19 versus 13. The most common fears were ‘being hit by a car or truck’, ‘bombing attacks. Being invaded’, ‘a burglar breaking into our house’ and ‘falling from high places’.

Most common excessive fears belong to danger and death category. Females report more fears than males.

The authors have not supplied their declaration of competing interest.

Adolescents in Nigeria tend to report feelings of mental, physical and general fatigue without having correspondingly exerted themselves to trigger this. This tiredness has been observed to also affect their sleep habits.

We set out to investigate how the report of tiredness by in-school adolescents tends to affect their sleep habits both on weekdays and weekends.

The Tripartite Fatigue Scale (TFS) and a modified version of the School Sleep Habits Survey (SSHS) were administered on 606 (272 males and 334 females) secondary school adolescents in Lagos and Ogun states of Nigeria aged between 12–19 years (χ2 = 15.24; SD = 1.42) in their classrooms.

A multivariate analysis of variance (MANOVA) was used to analyse the effect of fatigue on the sleep habits of adolescents. The result shows that fatigue significantly affects the sleep habits of adolescents during weekends and weekdays, F (3, 602) = 20.068, P ≤ 0.01; Pillai's Trace = 0.91, partial η2 = 0.91. The adolescents also reported general inadequate sleep (χ2 = 6.29 SD = 2.32), less than the required amount of adequate sleep their age. Additional Analysis of Variance (ANOVA) result showed that fatigue significantly affected the students self-reported grade F (3, 605) = 5.32, P = 0.01.

The present study has empirically highlighted that the consistent complaint of tiredness by secondary school adolescents in Nigeria emanates from fatigue marked mostly by insufficient sleep.

The authors have not supplied their declaration of competing interest.

Cognitive impairment is present from the early stages of psychotic disorders. Alterations are found mainly in areas of attention, memory work and executive functions. During adolescence, ADHD patients often suffer from secondary disorders to lack of efficient procurement processes information by the poor development of executive functions.

Evaluation of a patient whose diagnosis of ADD evolve to acute psychotic episode.

Review by clinical and psychometric tests developments in executive functions disorders.

Twelve years old patient who comes to the hospital since 2012, was initially diagnosed with literacy difficulties and low academic performance, after MFF-20 speaks of Learning Disabilities. It presents lack of motivation, apathy, difficulty in scheduling and organization and adherence to schedules, so they diagnosed ADD. It is given treatment with methylphenidate and atomoxetine, presenting erratic path.

After a year without treatment and the presence of a major stressful life event, at 17, has a first episode, consisting in mutiste attitude, phenomena of self-referenciality, experiences of control, enforcement and dissemination of ideas and auditory hallucination imperative type.

The presence of emocional dysregulation and alterations in the executive functions atribuyen to ADD, in this case, were premorbid symtomatology of a first psychotic episode. The presence of positive symptoms allows to clarify the diagnosis.

The authors have not supplied their declaration of competing interest.