The authors have not supplied their declaration of competing interest.

Criterion A2 causes many controversies in the diagnostic process of posttraumatic stress disorder (PTSD) among young children. Depending on the manner in which the trauma is indirectly experienced, clinical picture of disorder could be formed by different groups of symptoms. Profiles of symptoms groups are dependent of children ability to speak, describe or of play observation by expert.

The study included 8 children younger than 6 with PTSD diagnosis. Children were observed in a routine clinical practice.

Examinees under the age of six, whose can describe traumatic event, produce symptoms that represent compaction of a traumatic event, associated with fantasies and meanings related to previous traumatic experiences. Reexperiencing symptoms associated with A2 criterion (intrusive thoughts, images, scenes of the traumatic event, recurring nightmares with oneiric sequences of the accident) were rare. Avoidance and inhibited reactions were attributable.

Manners in which children younger than 6 experienced the trauma shows a large range from florid symptoms stated by the existing accepted classification. The results point out possible multifactorial cause of PTSD etiology.

The authors have not supplied their declaration of competing interest.

Telepsychiatry is increasingly utiilized to evaluate and treat diagnostically and geographically diverse youth. (Szeftel et al., 2012; Hilty et al., 2013). Important public health implications arise for US psychiatrically ill youth, most of whom receive no treatment, others depend on pediatricians without input from a child psychiatrist (Goldstein and Myers, 2014). Potential advantages of telepsychiatry include increased access to care from child psychiatrists directly, and through collaborations with pediatricians, and uniquely positive response in patients more communicative in this setting (Pakyrek et al., 2010).

– To present the effectiveness of Telepsychiatry in psychiatrically ill youth, and specific subgroups who especially benefit.

– To show increased access to psychiatric care occurs through collaborations between child psychiatrists and pediatricians.

To present the advantages of telepsychiatry for child and adolescent mental health and clinicians.

Review of selected published Telepsychiatric evidence-based research and best practice recommendations.

– Psychiatrically ill youth are effectively evaluated and treated using Telepsychiatry (Myers et al. (2011), Hilty et al., 2013).

– Very young children and youth with Autism Spectrum Disorders, or anxiety disorders respond particularly positively to Telepsychiatry (Szeftel et al., 2012; Pakyuerek et al., 2010: Myers et al., 2010).

– Telepsychiatry provides increased access to care through collaborations between child psychiatrists and pediatricians (Goldstein and Myers, 2014; Myers et al., 2011).

Telepsychiatry is a promising advantageous modality for youth based on effectiveness, broad administration and unique benefit for very young and socially impaired youth.

References not available.

The authors have not supplied their declaration of competing interest.

Research shows that individuals with Autism Spectrum Disorder, struggle with emotional competence as compared to their typically developing counterparts. This leads to internalizing (stress) and externalizing (anger management) problems in the affected population. The stress and anger management program (STAMP) designed by Scarpa et al. is a manualized treatment protocol with good clinical efficacy.

The objective of the present study is to test the feasibility and suitability of STAMP as a systematized treatment protocol in Karachi and to enable the sample population, to become emotionally competent.

The aim is to evaluate the effectiveness of STAMP on the reduction of symptoms in the sample population.

Ten children with high functioning autism spectrum disorder will be selected from various institutes in Karachi, and randomized to experimental and waitlist control group after pre-intervention assessment. Upon completion of the intervention with the experimental group, the waitlist control group will be offered the intervention. Both the groups will be assessed, immediately after the intervention, followed by a one-month follow up assessment.

It is expected that STAMP will significantly reduce the incidence of problem behaviours as measured by the standardized assessment questionnaires from the manual; as well as significantly reduce the severity of scores on the internalizing and externalizing components of the strength and difficulties questionnaire, in the experimental group as compared to the control group.

It is expected that the results of the present study could be utilized to train mental health professionals in Karachi for systematized treatment of ASD and related problems.

The authors have not supplied their declaration of competing interest.

Children of alcohol dependent individuals are affected by disturbed parent-child relationship and exhibit externalizing symptoms, arrhythmicity, negative mood and low persistence.

To assess the temperament and resilience of children of alcohol dependent individuals and to study their relationship with the father's severity and problems of alcohol intake.

To assess the psychological profile of children of alcohol dependent individuals.

Cross-sectional study conducted in a tertiary care centre from January to August 2015. Severity of alcohol dependence in father and problems related to it was assessed using ‘short alcohol dependence data’ and ‘alcohol problems questionnaire’; the temperament and resilience of their children (n = 31) was assessed using ‘temperament measurement schedule’ and ‘strengths and difficulties questionnaire’ respectively.

The sample comprised of 48% boys and 52% girls with mean age (SD) of 9.32 (3.02) years. Eighty-one percent belonged to lower socioeconomic status. Their fathers’ mean age (SD) was 37.13(4.9) years and duration of alcohol dependence being 16.32 (5.7) years, average use/day being 19.19 (14.9) units with moderate (45.2%) to high (41.9%) dependence. Significant association was observed between severity of alcohol dependence and temperamental domain-threshold of responsiveness (χ2 = 17.272, P value = 0.002) (Fig. 1). The average units of alcohol consumed/day were a significant predictor for the presence of emotional problems in the child (OR = 30.12; 95%CI 1.33–677.86).

There's a significant association between father's alcohol use and child's psychopathology which indicates the need for preventive and curative mental health measures.

The authors have not supplied their declaration of competing interest.

Pathogenetic mechanisms of hyperkinetic syndrome (HKS) or attention deficit hyperactivity disorder (ADHD) are not clear.

To elucidate some aspects of monoamine involvement in pathogenesis of disorder and response of monoaminergic systems to psychostimulant medication.

Levels of different monoamines, their metabolites and N-methylnicotinamide (end product of kynurenine pathway) were measured in daily samples of urine from children (7–11 years old) with mild and severe HKS using fluorimetric and chromatographic methods as well as platelet monoamine oxidase (MAO) activity. Thirty children with mild HKS received psychostimulant Sydnocarb 5–15 mg daily for 1–1.5 months (for ethical reasons children with severe HKS were not included in study).

HKS was accompanied by activation of dopaminergic and inhibition of noradrenergic systems. There were found metabolic differences between two forms of HKS. Compared with mild HKS, severe HKS was characterized by significant 2-fold increase of MAO activity and L-dopa, dopamine and adrenaline excretion. After sydnocarb treatment children's clinical status improved along with decrease of excretion of homovanillic, vanillylmandelic and 5-hydroxyindoleacetic acids and increase of N-methylnicotinamide.

Results indicate that dopaminergic and noradrenergic systems play important role in pathogenesis of HKS. Clinical improvement of HKS children was accompanied by significant increase of N-methylnicotinamide excretion. It is proposed that increased urine excretion of kynurenine metabolite–N-methylnicotinamide and N-methylnicotinamide/5-hydroxyindoleacetic acid ratio can serve as potential biomarkers for evaluation of efficacy of psychostimulant medication. We hypothesize that kynurenine system plays significant role in pathogenesis of HKS/ADHD.

The authors have not supplied their declaration of competing interest.

The incidence and prevalence of self-harm behaviour, with or without suicidal intent, is on the rise, both in other countries as well as in Croatia. Understanding the nature of patients who show self-harm behaviour can help us to better understand the components that contribute to their morbidity and mortality.

To expand the understanding of self-harm behaviour in adolescents as a contribution to the planning and implementation of preventive and curative programs.

To explore the psychopathological characteristics of adolescents with and without self-harm behaviour who seek psychiatric help for their mental health problems.

In this study participated 150 adolescents, aged 14–18 years, of which 52% showed some form of self-harm behaviour. During the initial examination of child and adolescent psychiatrist, participants completed self-reported questionnaires: functional assessment of self-mutilation (FASM, 1997) and the youth self report (YSR, 2001).

Statistically significant difference between groups of female adolescents with and without self-harm behaviour was observed in all of eight problem scales, while in male adolescents it was observed in five of them. This indicates considerably higher level of psychopathological features in the group of patients with self-harm behaviour.

It is necessary to intensify monitoring of adolescents who show self-harm behaviour because of the overall level of psychopathological symptoms and the comorbidity which significantly complicates the therapeutic process. It is particularly important to continuously assess the suicide risk.

The authors have not supplied their declaration of competing interest.

Children of depressed parents have an increased risk of developing mental disorders. While there are various studies concerning a pathogenetic perspective, fewer studies examined factors that protect mental health of these children. Knowledge about protective factors is necessary to establish prevention projects.

This systematic review gives an overview of protective factors for mental health of children of depressed parents.

Databases PsycINFO, Embase, Medline, PSYNDEX, PubMed, ISI Web of Science, and CINAHL were searched for relevant studies in German or English published until August 2014. Targets were epidemiological studies concerning protective factors for children up to the age of 21 years who have at least one depressed parent. Selection process and assessment of methodological quality of the studies were conducted by two reviewers using a checklist.

Out of 3526 screened studies, finally thirteen studies were included. Efficient stress management strategies – in particular primary and secondary control coping – were identified as protective factors for mental health of affected children. Children's social competences as well as parental positive parenting skills also seem to have a protective impact. Restrictions to specific search terms, databases, and languages could have caused missing relevant studies with other characteristics. Limitations could also result from possible publication bias as well as methodological and qualitative differences regarding included studies.

In the context of prevention projects, children of depressed parents should be supported in adequately and efficiently coping with stress. Moreover, practitioners should aim at the promotion of social competences and the involvement of parents within prevention.

The authors have not supplied their declaration of competing interest.

The role of psychological factors in the development and maintenance of encopresis is controversial.

Assessment of the psychosocial profile of encopretic children and their caregivers in relation to parenting style compared to controls.

The current cross sectional study comprised 90 Egyptian children classified into three groups: group I (encopresis without constipation and overflow incontinence), group II (encopresis with constipation and overflow incontinence), and group III (clinically healthy controls); each group included 30 children. Thorough clinical evaluation and psychometric assessment were carried out for all enrolled children while caregivers were evaluated for their parenting styles, anxiety, depression, and introversion scores.

Hardness, undue blaming, and indecisive parenting styles were significantly more prevalent among caregivers of group I. Encopretic children of group I & II had poorer self-esteem and higher prevalence of clinically manifest depression compared to healthy controls. Furthermore, there was a higher prevalence of clinically manifest paternal anxiety, depression, and introversion and maternal depression among caregivers of group II and higher prevalence of clinically manifest paternal anxiety and depression among fathers of group I.

The approach of toilet training, not the time of its initiation, seems to be the factor that really matters in predisposing to and perpetuating encopresis. Further exploration is needed to determine if the documented association of psychological disorders of enrolled encopretic children and their caregivers was causal or being just the impact of the child's encopresis.

The authors have not supplied their declaration of competing interest.

Clinical concepts regarding atypical psychosis such as the French bouffeé délirante, the German cycloid psychosis, and the Scandinavian reactive and schizophreniform psychoses are now under the category of F23 ‘Acute and transient psychotic disorders’ (ATPD) of the tenth revision of the International Classification of Mental and Behavioural Disorders (ICD-10).

The authors’ aim is to highlight the clinical and scientific relevance of atypical psychosis from the historical concepts to the current perspective.

A Pubmed database search using as keywords “atypical psychosis”, “acute and transient psychotic disorders”, and “brief psychotic disorder” and retrieved papers were selected according to their relevance.

Different psychiatric schools, often of a regional or national character, have provided concepts for transient psychotic states. The acute and transient psychotic disorders of ICD-10 and the brief psychotic disorder of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) reflect the diversity of the history of such concepts. The available evidence suggests that case identification and follow-up is difficult in ATPD due to the heterogeneous and infrequent nature of this clinical phenomenon. Furthermore ATPD has a low diagnostic stability and there are few studies focused on brief psychotic disorders.

The present definition of acute and transient psychotic disorders and brief psychotic disorder, while taking into account the history of the concepts involved, leave many questions open to further studies.

The authors have not supplied their declaration of competing interest.

Pheochromocytomas are rare catecholamine-secreting tumours from the adrenal medulla. The clinical presentations may mimic other disorders due to nonspecific symptoms produced by catecholamines in blood.

We report a case of undiagnosed pheochromocytoma in a 29-year-old woman with a two year history of anxiety. We undertook a literature review.

PubMed search using “pheochromocytoma”, “anxiety” as key words. Follow by a manual review of identified publication. We report a case of a 29-year-old with a two-year history of anxiety pharmacologically treated without success. She presents episodes of acute anxiety accompanied, sometimes, by nausea or headache, without high blood pressure. She presented a previous medical history of thyroid carcinoma. The patient was referred to the endocrinology service for thyroid review, postulated as potential source for drug resistance. High catecholamine levels were found and pheochromocytoma diagnosis was confirmed histopathologically.

The releasing catecholamine in blood can lead to a number of symptoms that can include paroxysmal hypertension, headache, palpitations, anxiety, chest/abdominal pain, nausea. Hypertension may not be the main symptom. These symptoms can be misinterpreted as psychiatric disorders, in particularly anxiety disorders. Elevated urinary catecholamine suggested the diagnosis of pheochromocytoma.

Pheochromocytoma should be included in the differential diagnosis of anxiety disorders, especially if pharmacological treatment is not effective. The suspected cases should be investigated, even in the absence of hypertension, due to the potential morbidity of untreated pheochromocytoma.

The authors have not supplied their declaration of competing interest.

First described by Sigbert Ganser in 1987, Ganser syndrome consists in a rare condition, characterized by the following four clinical features: approximate answers, dulling of consciousness, conversion symptoms and hallucinations.

To present a case suggestive of Ganser Syndrome and to review the literature with particular regard to the aetiology of this condition.

Literature review, using computerized databases (MEDLINE®, Medscape®). Articles were selected based on the content of their abstract and their relevance.

A 58-year-old woman was admitted to a Psychiatric Unit of a General Hospital for presenting behavioural abnormalities of acute onset. During hospitalization, the patient displayed indifference, incoherent speech with approximate answers, motor abnormalities and auditory psedudohallucinations. The patient was evaluated by a neurologist and various exams were performed (blood tests, CT, MRI, EEG) that showed no significant abnormalities. Pharmacological treatment consisted of antidepressant and antipsychotic medications. During the follow-up, there was a slow but gradual improvement of symptoms. Six months after hospitalization the patient decide to end up the follow-up.

Little is still known about Ganser Syndrome. The four aetiological perspectives consider: hysterical origin, malingering or factitious disorder, psychotic origin and organic origin. The lack of reports and information about Ganser syndrome made it worthwhile reporting this case.

The authors have not supplied their declaration of competing interest.

Several studies have suggested variations in the prevalence of schizophrenia spectrum disorders diagnosis across time. This could be due to a change in diagnostic practice motivated either for changes in DSM criteria as for local culture factors. The aim of this study is to explore the evolution of the schizophrenia spectrum disorders. We hypothesize that we would observe a transference from the schizophrenia diagnosis to psychosis not otherwise specified.

A retrospective review of all psychiatric discharges in acute unit in the INAD of Parc de Salut Mar of Barcelona, between 2002 and 2014 was performed, relating each discharge to its axis I psychiatric diagnostic. An ANOVA analysis was used to calculate the differences between the months and the frequency of the diagnosis.

We have not been able to observe any transference between diagnoses across years. We observe a decrease of the proportion of schizophrenic spectrum disorders in its prevalence at discharge from 2012 to 2014. The proportion of not otherwise specified psychosis remains quite constant as a third of the schizophrenia diagnoses.

The authors report no conflict of interest in this study. LG is funded by the Instituto.de.Salud.Carlos.III (CM14/00111).

Disruptive mood dysregulation disorder (DMDD) defined by DSM-V is characterized by severe and recurrent temper outbursts and persistently irritable or angry mood.

Our aim is to attract attention to an adult case with DMDD since the literature is lacking adult manifestations.

A 18-year-old boy have been on follow-up in our outpatient clinic since he was 12 with complaints of being increasingly irritable and angry during most of the day. He had temper tantrums six or seven times per week involving verbal rages, physical aggression and throwing things to friends and family members. There had never been a distinct period lasting more than one day during which the full symptom criteria, for a manic, hypomanic or a depressive episode had been met. He was also reported to be hyperactive, impulsive, and had difficulty concentrating and focusing since he was seven. Laboratory evaluations were within normal limits. Results of screening forms provided by parents and teachers supported the presence of attention deficit and hyperactivity disorder (ADHD). ASRS, YMRS, STAXI, SCID-I, Diagnostic Interview for Adult ADHD (DIVA) were the psychometric evaluations carried out in order better to characterize the clinical situation.

He was considered as fulfilling DSM-5 criteria for ADHD and DMDD, and started on sertraline 50 mg/day and OROS methylphenidate 36 mg/day. At the following visits, temper tantrums were much reduced and there were moderate improvement in ADHD symptoms.

By defining the adult manifestations of DMDD accurately, clinicians will be able to improve diagnosis and care.

The authors have not supplied their declaration of competing interest.

The term, acute and transient psychosis, is comprehended as a heterogeneous group of disorders, which share, as a common feature, the abrupt and brief deployment of typical psychotic behaviour, either polymorph, delusional, or schizophreniform. This diversity of symptoms may also be present in other psychotic disorders, for which, some authors question its reliability.

To analyse the clinical manifestations present in acute and transient psychotic disorders (ATPD), and determine the differences between its different subcategories.

Retrospective chart review study of adult patients admitted in our psychiatric unit between 2011 and 2015, with a mean diagnosis of ATPD at hospital discharge. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Symptoms were divided under operative procedures, as set out in psychopatologic descriptions. For methodological reasons, statistical analysis was conducted between polymorphic features group (PM) and nonpolymorphic group (NPM). Chi-squared test and Fisher's exact test (as appropriate) were performed, using MedCalc software.

Thirty-nine patients met the inclusion criteria. Acute polymorphic psychotic disorder with and without symptoms of schizophrenia (39%), acute schizophrenia-like psychotic disorder (20%), acute predominantly delusional psychotic disorder (23%), other and NOS (18%). There were statistically significant differences between PM and NPM groups in emotional turmoil (>PM, P = 0.0006), grossly disorganized or abnormal motor behaviour (>PM, P = 0.0038), and type of onset (sudden >PM, P = 0.0145).

Currently, the same concept encompasses two categories (PM and NPM) to be differentiated. The ATPD construct is under review, due its long-term instability.

The authors have not supplied their declaration of competing interest.

In the recent decades, there is a growing interest in gender differences in psychotic disorders. Also, in the field of acute and transient psychosis, according to various studies, women seem to have higher prevalence and long-term diagnostic stability.

To determine whether there are gender differences in clinical features of acute and transient psychotic disorders (ATPD).

Descriptive cross-sectional study in the adult patients with ATPD were admitted between 2011 and 2015 in our acute psychiatric ward. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Descriptive and inferential statistic procedures for clinical symptoms and diagnostic subcategories were performed, using the MedCalc software, version 15.8.

Thirty-nine patients met the inclusion criteria. Males were (MG) 41%, females (FG) 59%. There were some statistically significant differences between gender in the polymorphic features group (>FG, P = 0.048), and in the presence of acute stress (>FG, P = 0.0277). Length of stay was also different, but without statistical significance (>MG, P = 0.0607). In contrast, symptomatic sets, family history of psychosis, and type of onset (sudden or acute) were similar for both groups.

The gender differences seem to be in favour of a higher prevalence of polymorphic psychotic symptoms, in relation to stressful events in women. Somehow, these factors could be a condition, which would determine a greater diagnostic stability in female patients, even in cases of recurrences.

The authors have not supplied their declaration of competing interest.

The new edition of the DSM has introduced some changes involving differences, sometimes significant, in the conceptualization and classification of mental pathology. One of the most important has been the case of mental retardation.

Discuss, with a clinical and pragmatic perspective, the relevance of those changes in the diagnosis and classification of mental retardation in DSM.

A 45-year-old woman diagnosed with mental retardation is admitted in a psychiatric rehabilitation unit for behavioral disorders and psychotic symptoms. Once controlled the symptoms and studied the patient, a disability not corresponding with the diagnosis presented (mild mental retardation according to DSM IV) is shown. Clinicians start a reevaluation of the diagnosis.

A comprehensive rehabilitation program according to the pathology and deterioration of the patient is designed. With the diagnosis review is possible to find new resources and community programs, better fit for the patient needs.

DSM V changes in mental retardation diagnosis and classification allows a better perspective of the disease and its impact of functionality.

The authors have not supplied their declaration of competing interest.

The Tenth Revision of the International Classification of Diseases (ICD-10) introduced the category of Acute and transient psychotic disorders (ATPD), that assimilate clinical concepts such as the French Bouffée Délirante, Kleist and Leonhard's cycloid psychosis, and the scandinavian reactive psychosis.

The authors present a clinical case of ATPD and a literature review based on PubMed/MEDLINE, using the keywords: “acute and transient psychotic disorder”, “prognosis” and “diagnostic stability”, aiming to discuss the main challenges regarding the diagnosis, treatment and prognosis.

The patient is a male with 37 years old with two previous psychotic episodes (with 2.5 years of interval), both with an acute onset (of 7 and 3 days respectively), and a fast response to antipsychotic treatment, with periods of complete symptom's remission. He maintains treatment with 6 mg of paliperidone. In the literature, we found scarce information on ATPD. Though several variables have been described as having influence on the prognosis (gender, pre-morbid functioning, acute onset and presence of affective symptoms), this topic remains controversial. Another difficult aspect about ATPD seems to be its low diagnostic stability, with diagnosis changing mostly to Schizophrenia, Schizoaffective disorder and Bipolar disorder. Duration of treatment after complete remission of symptoms is another controversial aspect of this disease.

ATPD seems to have low diagnostic stability and poor research investment, and so it represents a challenge for psychiatrists on managing these patients in terms of treatment and follow-up plan. Further studies should be held regarding prognosis and treatment.

The authors have not supplied their declaration of competing interest.

The first reference to the shared delusions emerged in France in the nineteenth century. Shared delusions can be classified in three frames with different nosological value: simultaneous folie à deux, imposed folie à deux and communicated folie à deux.

A review of the structures of presentation of this psychiatric disorder through a case report and checking the categorization of the classic folie à deux in the current diagnostic manuals.

Discussion through a case report of delusional disorder among twins. After several interviews with the patients we found that both have a complex delusional system, structured and bizarre at the same time. There was a clearly paranoid tinge in the narration which main theme is religion.

Delusional clinical appears identically and simultaneously in both subjects with equal readiness and doesn’t give up after the admission of the patients in two different psychiatric hospitalization units.

In the ICD-10 and DSM-5, diagnostics would be different depending on the kind of folie à deux. In simultaneous folie à deux and communicated folie à deux the dominant partner would receive a diagnosis of delusional disorder with ICD-10 and DSM-5. The acceptor partner would receive a diagnosis of delusional disorder induced with the ICD-10 and a diagnosis of unspecified schizophrenia spectrum and other psychotic disorder with the DSM-5. In a simultaneous folie à deux, both subjects would have a diagnosis of delusional disorder in both manuals. We think that this is the right choice.

The authors have not supplied their declaration of competing interest.

The aim this presentation is present the results of the preparatory studies were presented at an international consensus conference, a multi-stage, iterative, decision-making and consensus process that took place 12–14 May 2015 in Barcelona, Spain. At this consensus conference, schizophrenia experts from different countries worldwide and working in a broad range of professions decided which ICF categories should be included in the first version of the ICF Core Sets for schizophrenia.

Four preliminary studies intend to capture the researcher's perspective, the patient's perspective, the expert's perspective and the clinician's perspective, respectively, on the most relevant aspects of functioning of persons living with schizophrenia. The final definition of ICF Core Sets for schizophrenia have been determined by integrating the results of preliminary studies in a consensus conference with international expert.

The experts included 97 categories in the Comprehensive ICF Core Set and 25 categories in the Brief ICF-CS. The specific categories of each ICF-CS are shown in this presentation. The Comprehensive ICF-CS can guide multidisciplinary assessments of functioning in persons with schizophrenia, and the brief version is ideal for use in both clinical and epidemiological research, since it includes a small and practical number of categories, but sufficiently wide for finding utility in clinical assessments.

ICF-CS are being designed with the goal of providing useful standards for research, clinical practice and teaching, and it will stimulate research and will improve understanding of functioning, health and environmental factors in schizophrenia.

The authors have not supplied their declaration of competing interest.