Precocious puberty is defined as the appearance of secondary sexual characteristics before the age of 8 in girls and 9 in boys. It can be classified into central precocious puberty (dependent on the hypothalamic-pituitary-gonadal axis) and peripheral precocious puberty. Attention Deficit Hyperactivity Disorder (ADHD) occasionally co-occurs with precocious puberty, complicating its management. This case focuses on a 9-year-old girl diagnosed with idiopathic central precocious puberty, treated with both GnRH analogues and stimulant medication, showing significant improvement in symptoms.

The primary objective is to explore the relationship between these two conditions through the presented clinical case. Additionally, the study aims to evaluate the impact of hormone-suppressing medications and ADHD treatment on the patient’s social and academic functioning.

A 9-year-old girl with precocious puberty and ADHD symptoms, diagnosed through hormonal tests and ADHD scales administered to parents and teachers, as well as clinical assessments of emotional status. A multidisciplinary approach is essential for managing complex cases involving idiopathic central precocious puberty and ADHD. Follow-up was conducted every 3 months to assess pubertal status, ADHD symptoms, and psychosocial adjustment.

GnRH analogue therapy successfully arrested pubertal progression, with bone age stabilization and normalized growth velocity.ADHD symptoms improved significantly with extended-released methylphenidate, leading to better attention, reduced hyperactivity, and improved classroom behavior.The patient demonstrated enhanced self-esteem, better peer relationships, and a positive psychosocial outlook.

The relationship between ADHD and precocious puberty may be due to a combination of hormonal, neurobiological, and psychosocial factors. Although the precise connection has not been fully determined, there appears to be an interaction between the neuroendocrine system and brain pathways that regulate behavior and development.

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder that appears in early childhood. The diagnosis is based on a clinical dyad: impaired social communication and restricted and repetitive behavior. From the age of 13, children with ASD are integrated into the “Erraihan” therapeutic farm.

The aim of our study is to describe the clinical profile of adolescents with ASD followed at the “Erraihan” therapeutic farm.

This is a descriptive and analytical cross-sectional study of 43 parents of adolescents with ASD treated at the therapeutic farm.

The “Erraihan” therapeutic farm is a center that takes in adolescents aged over 13 with ASD.

A questionnaire using a pre-established form was administered to the parents by the same doctor to collect data relating to the adolescent.

Forty-three adolescents followed for autism spectrum disorder were included in our study. Their mean age was 17.79±2.29 years (min=13; max=20) with a male predominance 79.1% (n=34). Adolescents with autism were older in 48.8% of cases. They suffered from a chronic illness in 44.2% (n=19) of cases. The most frequently reported somatic antecedent was epilepsy (n=17).

Psychiatric comorbidity was found in 55.8% of adolescents. It was mainly mental retardation (n=22). Adolescent age at first consultation ranged from 1 to 4 years, with an average of 1 year 6 months. Age at diagnosis ranged from 3 to 6 years, with an average of 3 years 3 months.

Time to diagnosis ranged from 0 to 24 months, with an average of 5 months. Twenty-three adolescents (53.5%) communicated with poor speech intelligibility.

Behavioral problems were present in 72.1% of adolescents. Medication was prescribed in 62.8% of cases. The most commonly prescribed drug was risperidone (44.2%).

Sphincter autonomy was acquired in 69.8% of adolescents. Thirty-four adolescents (79.1%) had received speech therapy in childhood.

Almost half (44.2%) had entered kindergarten at an early age, and only 14% had started school and then withdrawn.

This study sheds light on the clinical profile of adolescents with autism spectrum disorders at the “Erraihan” therapeutic farm. The results underline the importance of early and appropriate care. Although the majority of adolescents have acquired certain skills, such as sphincter autonomy and access to speech therapy, challenges remain, particularly in terms of communication and behavior. This information underlines the need for ongoing follow-up and personalized approaches to improve the quality of life of these young people within their therapeutic environment.

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Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that begins in early childhood. For the young people with ASD Adolescence is a particular time of life, in which they are facing physical and mental changes and for their parents who have to cope with the challenges associated with their child’s development. The effect of these different stressors on caregivers represents the burden.

The aim of our study was to assess the level of burden experienced by parents of adolescents with ASD and to investigate the factors associated with it.

Our study was cross-sectional, descriptive and analytical conducted in the form of a survey during the month of May 2024. It concerned the parents of adolescents with ASD followed at the “Erraihan” therapeutic farm in Sfax. All data relating to adolescents and parents were processed solely by the interviewer.

The form included a section for collecting data relating to the adolescent and the parent, and one to measure caregiver burden via the Zarit Burden Interview (ZBI).

Our population was comprised of 43 parents with a sex-ratio equal to The mean age of parents was 50.6 ±7.93 years, with extremes of 36 and 81 years.

As for the adolescents, the mean age was 17.79 ±2.29 years (min=13; max=20).

Psychometric assessment of parental burden showed that the mean Zarit score was 24.6±20.14, with extremes of 0 and 48. The results showed that 62.80% of parents felt a burden of severe intensity.

The level of parental burden increased with the presence of at least one history of somatic illness (p=0.03).

Similarly, severe burden was significantly associated with the presence of more than two children in the family (p=0.02) and the presence of sibling rivalry (p=0.04).

With regard to adolescent characteristics, the level of severe burden was significantly associated with male gender (p=0.03) and rank as the eldest sibling (p=0.01).

The presence of severe burden in the parents was significantly associated with the presence of self-aggressive behavior in the adolescent (p=0.02).

With regard to therapeutic characteristics, the use of risperidone and sodium valproate was significantly associated with an absent to moderate level of burden(p= 0.01 for both cases).

Similarly, the adolescent’s previous integration into school was significantly associated with an absent to moderate level of burden (p=0.01).

The results suggest that parents of adolescents with autism need more support to cope with the burden generated by the adolescent’s behavior. It is therefore necessary to adjust the support provided to parents in order to optimize the quality of care provided for their adolescents.

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Adolescence in young people with autism spectrum disorder (ASD) is a special time of life, for them facing physical and mental changes, and for their parents who must cope with the new challenges associated with their child’s development. Research has shown that the severity, violence and behavioral disorders help to explain the major difficulties encountered by these families.

To cope with these difficulties, parents often use a variety of coping strategies. These coping strategies encompass all an individual’s cognitive and behavioral efforts, which are constantly evolving, to manage a situation perceived as stressful.

Our study aimed to assess the coping strategies adopted by parents of adolescents with ASD, their level of burden and to determine the relationship between these two variables

We conducted a descriptive and analytical cross sectional study among parents of adolescents with ASD followed at the “Erraihan” therapeutic farm in Sfax during the period of May 2024.

The hetero-questionnaire used a pre-established form for collecting data relating to parents and adolescents and two psychometric scales:

• - The BRIEF-COPE scale: to assess coping mechanisms in parents, of which there are four: problem-focused mechanisms, avoidance-focused mechanisms, social support-focused mechanisms and emotion-focused mechanisms.

• - The zarit Burden Inventory (ZBI): used to assess the level of burden.

Forty-three parents were enrolled. Their mean age was 50.6 ±7.93 years (min=36; max=81). The average age of the adolescents was 17.79 years, with extremes of 13 and 20 years.

Emotional focus (mean score=2.54) was the coping mechanism most used by parents, followed by problem focus (mean score=2.50) and social support (mean score=2.45).

Avoidance was the least-used coping mechanism (mean score=1.63). Assessment of parental burden showed that the mean Zarit score was 24.6±20.14, with extremes of 0 and 48. Twenty-seven parents (62.80%) felt a burden of severe intensity.

In our study, only the humor-based emotion-focused coping strategy was more important in parents with absent to moderate levels of burden (1.98 versus 1.41; p=0.02). For the other coping strategies, there was no significant association with level of burden. Social support scores between parents with absent to moderate and severe levels of burden were close.

Our results show that parents feel the heavy burden of caring for their sick adolescent. Indeed, ASD generates a great deal of stigmatization in the parent, who avoids discussing the illness with those around him, for fear of suffering further stigmatization. This vicious may explain the absence of a link between the level of burden and coping strategies centred on social support.

Thus, the question of the role of family support and associations for autistic families, proves crucial.

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Synchronization refers to the coordinated physiological, biological, and behavioral changes during interpersonal interactions.

The project aims to assess correlations between pre-term physiological synchrony and post-birth behavioral synchrony between mothers, fathers, and their anxiety, depression levels, and attachment styles. Since the development of early synchronization remains unclear, the project investigates its initiation between mother and fetus, with a focus on including fathers in early attachment and synchrony research. It is hypothesized that synchrony plays a key role in predicting a child’s attachment style.

BIOPAC Student Lab MP36 measures ECG data from parents, while cardiotocography records the fetus’s heartbeat. Women in their 24-36th weeks of their first pregnancy without any chronic illnesses and their partners are being included in the study. Surveys for the participants cover sociodemographic scales, Beck Anxiety (BAI) and Depression Inventories (BDI) and The Relationship Scales Questionnaire. The recordings last fifteen minutes, with the first and last five minutes taking place in a non-stimulatory environment. During the middle five minutes, the fetus’s heartbeat is projected for the parents. ECG data are analyzed in Matlab for synchrony. At 3 months, parent-infant interactions will be videotaped and analyzed via Ruth Feldman’s Coding Interactive Manual for behavioral synchrony. Triads who show higher levels of physiological synchrony during pregnancy will be expected to show corresponding levels of behavioral synchrony at three months old.

The ECG and survey data of 16 participants have been collected. BAI results have shown the mean anxiety results of the mothers and the fathers to be 14.6 (mild anxiety), 4.9 (minimal anxiety), respectively, whereas BDI yielded mean depression results of 7.3, 6.3, both minimal depression for mothers and fathers. Out of 8 mothers, 4 showed secure and 4 showed dismissive attachment. 2 of the mothers with dismissive attachment showed moderate and severe levels of anxiety as expected whereas the other 2 mothers showed mild anxiety. The mothers with dismissive attachment showed higher anxiety levels and are expected to show lower physiological synchrony levels with their partners and babies. Among fathers, the most prevalent attachment style was secure, observed in 3 (37.5%), with the second being Dismissive attachment identified in 3 fathers (37.5%). One father exhibited a preoccupied/dismissive style, (12.5%)while one father showed a mixed secure/dismissive pattern(12.5%).

The ECG data of the 16 participants are currently being evaluated for physiological synchrony between the triad and recruitments are still ongoing. After the infants are 3 months old, behavioral and physiological synchrony within the triads will be evaluated and analyzed for further relationships.

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Suicide is a leading cause of death among adolescents and its prevalence among young people has steadily increased in recent years.

This study aimed to identify patterns of risk factors that differentiate adolescents who experienced suicidal thoughts from those who attempted suicide using six different machine learning (ML) algorithms for Korean adolescents using data from online surveys.

Data were extracted from the 2011−2018 Korea Youth Risk Behavior Survey (KYRBS), conducted annually since 2005 by the Korean Ministry of Education, Ministry of Health and Welfare, and Korean Disease Control and Prevention Agency. The pipeline was solely generated from classic ML (CML) methods, namely logistic regression (LR), random forest (RF), artificial neural networks (ANN), support vector machines (SVM), and extreme gradient boosting (XGB).

Among the 69,840 adolescents included in the analysis, 13,288 cases (19.0%) were identified as having made a suicide attempt. Prediction models using seven relevant features calculated by Boruta algorithm was developed and five features (drug experience, current smoking, grade, current alcohol drinking and sadness or hopelessness) were identified as the most important predictors. The performance of the six ML models on the balanced testing dataset was good, with area under the receiver operating characteristic curve (AUROC) and area under the precision−recall curve (AUPRC) ranging from 0.66 to 0.73.

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The developed and validated SA prediction models can be applied to detect high risks of SA. This approach could facilitate early intervention in the suicide crisis and may ultimately contribute to suicide prevention for adolescents.

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Language Disorder, a prevalent developmental disorder, impedes children’s communication skills, with genetic and environmental factors playing pivotal roles in its pathomechanism.

This study aims to investigate the involvement of sequence variations in SETBP1 and CNTNAP2 genes, along with environmental variables, in Language Disorder’s etiology.

Between September 2022 and March 2023, thirty children aged 2-7 diagnosed with language disorders according to DSM-5 criteria, and evaluated using the Ankara Developmental Screening Inventory, were studied to identify genetic and environmental factors contributing to etiology.Thirty healthy children with similar age were included as a control group. DNA samples isolated from peripheral blood of both groups were analyzed for SETBP1 and CNTNAP2 genes using next-generation sequencing (custom design panel). The frequencies and clinical significance of the identified variants was evaluated, and variant verification and segregation analyses were performed by Sanger sequencing. The obtained data were compared using appropriate statistical methods.

Language Disorder showed a male-dominant distribution. The SETBP1 rs11082414-CC genotype frequency was significantly higher in patients (p=0.024), and two rare variants (CNTNAP2: c.973C>G:p.P325A; CNTNAP2: c.2236G>A:p.D746N) were exclusive to cases. In silico analyses yielded conflicting results for rare variants, inherited paternally from unaffected parents. Among non-genetic factors, patients had higher birth weights (p=0.043) and shorter lactation durations (p=0.044).

Homozygosity for SETBP1 rs11082414 polymorphic variant increases Language Disorder susceptibility. This study underscores the genetic dimension of Language Disorder, urging physicians’ awareness and early intervention strategies to mitigate its impact.

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Behavioral dysregulation and aggression pose substantial challenges in treating adolescents within youth justice systems, particularly in cases with complex psychiatric histories and diagnostic ambiguity. Autism spectrum disorder (ASD) is often underdiagnosed due to its different presentations, particularly in females. Many girls with ASD show strong desire for social interaction, but due to difficulties in navigating social relationships, they frequently experience frustration, resulting in explosive and auto and heteroaggressive behaviors. For those ASD patients with comorbid conduct disturbances, standard antipsychotic treatments can be insufficient, being necessary to try alternative pharmacological approaches.

To explore the therapeutic impact of low-dose clozapine on severe conduct dysregulation and auto/heteroaggression in this minor with ASD, and to assess clozapine’s effectiveness in reducing anxiety and improving adaptability within a structured therapeutic environment.

We present a 17-year-old female patient with a history of severe behavioral disruptions with aggressiveness, initially diagnosed with various psychiatric conditions and treated with high-dose antipsychotics without clinical improvement. The case follows her through two separate admissions to a youth justice center’s therapeutic unit, where a retrospective review of her history and a longitudinal study of her diagnosis were made. After conducting a review of clozapine’s effects on reducing aggression, low doses of clozapine are finally tried, with the goal of stabilizing behavioral disturbances and reducing the patient’s associated distress.

When low-dose clozapine (up to 150 mg/day) was introduced, improvements in conduct regulation and emotional distress were documented. A treatment interruption occurred between admissions due to a lapse in its administration, followed by relapse in behavioral symptoms. Upon re-initiation of clozapine in the second admission, the patient’s symptoms stabilized again, with substantial behavioral improvement and reduced anxiety, enhancing the patient’s ability to function within the structured environment of the therapeutic unit. The patient achieved sustained clinical stability for over two months, a period marked by the absence of pharmacological rescue interventions or containment measures.

Low-dose clozapine may be a viable option for managing severe behavioral disturbances in adolescents with ASD within youth justice settings, especially when other treatments prove ineffective. This case underlines the potential of clozapine not only to mitigate aggression but also to facilitate better adaptive functioning and reduce anxiety, contributing to a more stable therapeutic experience. Further investigation into clozapine’s role in treating conduct dysregulation in ASD is warranted.

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A frequent developmental problem known as attention deficit hyperactivity disorder causes inattention, which may or may not be accompanied by hyperactivity.

Having trouble focusing, engaging in excessive activity, and acting in ways that are inappropriate for one’s age are all signs of ADHD.In the United States, research on the use of EEG to diagnose ADHD is still underway. The FDA has authorized the use of EEG to assess the illness’s morbidity alone.According to a different study, the EEG theta/beta ratio cannot definitively distinguish between people who have ADHD and those who do not.

the purpose of this study was to determine whether children with ADHD had altered EEGs.

study was carried out from January to June 2024 on sixty non-epileptic children with ADHD (8–18 years old) at Al Hussian university hospital, Egypt.

This study was authorized by the Al-Azhar Faculty of Medicine’s Ethical Committee. Following an explanation of the purpose of the study and the acquisition of verbal agreement, all children underwent semi-structured clinical interviews and were excluded from any other neuropsychiatric or medical disorders. All study children have been diagnosed with ADHD according to the DSM IV criteria SCID, Conner’s scale for ADHD was applied for all the study’s children. EEG was obtained for all the children in the study. SPSS version 20.0 was employed. Numbers and percentages were used to characterize the qualitative data, and the significance of the outcomes was assessed at the 5% level.

The research involved 60 children with ADHD diagnoses, of whom 70% were younger than 8 years old, 71.7% of whom were male, 28.3% of whom were female, and 53.3% of whom were in rural settings.Based on study statistics, the mixed form of ADHD was the preponderance kind, with 56.7% of participants having ADHD. Oppositional defiant disorder (ODD) was a co-morbid disorder. the study indicates a strong statistical correlation (P value<0.001) between the combined type of ADHD and the individuals’ educational attainment.Accompanied conditions and male ADHD children were shown to have a high statistical significance (P<0.005), as was age less than 8 years old (P=0.026)

Only 10% of the non-epileptic ADHD children in the study had aberrant EEG readings, and there was no statistical correlation between them. there is a significant correlation (P<0.007) between co-morbid conditions and ADHD children, irrespective of their kind.

Attention deficit Hyperactivity, EEG and accompanied disorder

The diagnosis of ADHD in children was not strongly correlated with changes in EEG.

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The concept of dealing with stress refers to different forms of behavior that an individual uses in response to stressful situations, with the aim of reducing the effects of those stressful events or situations. Ways of coping are important as a prerequisite for positive growth and development and can be a significant factor in the etiology of psychological and somatic problems. Coping strategies include all those behaviors that are used to overcome difficulties in stressful situations. They refer to emotional, cognitive and behavioral responses to stressful situations that vary with time and characteristics of a specific stressful situation. In adolescence, the child encounters various forms of life situations and stresses, without yet having developed a wide range of coping strategies on which to rely. Children’s growth and development and the influence of sociodemographic factors represent certain risks that can directly or indirectly affect stress coping strategies.

The aim is to determine ways of coping with stress in early adolescents and their connection with sociodemographic risk factors.

We analyzed a group of 240 early adolescents (11-15 years) from Tuzla Canton, Bosnia and Herzegovina, in the general population. The sample was chosen because the early adolescent period is vulnerable in children’s growing up and psychological development. The Kidcope coping scale for children and adolescents was used to assess the way of coping. The data were processed using the method of descriptive statistics. Pearson’s correlation test was used to assess the association between sociodemographic risk factors and coping methods.

On the coping scale, early adolescents showed a statistically significantly higher level of self-blame and blaming others. On the questionnaire of psychosomatic symptoms (PS), the obtained results show that living in a rural area leads to frequent blaming of others as a way of coping (p<0.05), as well as a significantly higher level of prayer (p<0.05). Higher economic status and higher monthly income are significantly positively associated with resignation (p<0.01). Higher educational status of the mother and better living conditions are also positively related to resignation as a way of coping with stress (p<0.05). Disturbed family relationships are associated with a higher frequency of distraction (p<0.05).

Early adolescents show significant levels of various stress coping strategies. There is a significant correlation between sociodemographic risk factors (place of residence, economic status of the family, disturbed family relations) and psychosomatic symptoms in early adolescents.

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Screening children for the potential development of psychosis is challenging, resulting in a suboptimal healthcare transition from pediatrics to psychiatry.

In this prospective study, we aimed to evaluate the predictive ability of the Child Psychosis-Risk Screening System (CPSS) for schizophrenia spectrum disorder (SSD) by observing the outcomes of pediatric and psychiatric outpatients.

A total of 478 outpatients aged 6–18 years visiting the pediatric and psychiatric departments of university and community hospitals were enrolled in this study. Assessments included the Child Behavior Checklist (CBCL) and clinical data (sex, age, birth month, chief complaint, diagnosis, abuse, bullying, and withdrawal). The CPSS calculated the risk of developing SSD using eight CBCL subscale scores. The presence of SSD was confirmed after one year. Receiver operating characteristic (ROC) curve analysis was used to evaluate the accuracy of the CPSS in predicting SSD onset. Light-gradient boosting machine (LightGBM) learning algorithm was used to calculate the importance of each clinical data point for SSD onset prediction.

ROC analysis demonstrated that CPSS showed adequate predictive power for determining SSD onset (area under the curve = 0.902, 95% confidence interval: 0.866–0.939). LightGBM revealed that the importance of the CPSS risk% in predicting SSD onset exceeded other variables, including the CBCL Thought Problems subscale.

The CPSS demonstrated adequate predictive power for SSD development and may serve as an objective adjunctive diagnostic method to screen children at risk for SSD who require early psychiatric referral. As a simple screening system utilizing common clinical practice CBCL data, we advocate CPSS implementation in pediatric-to-psychiatric healthcare.

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Children with Attention Deficit Hyperactivity Disorder (ADHD) often experience comorbid anxiety. While their anxiety is typically assessed through both children’s and parents’ reports, discrepancies between these reports are common and poorly understood. Children with ADHD also present sensory-motor dysfunctions, of which explicit expressions may mask children’s emotional state.

Here, we test whether parents of children with sensory-motor dysfunctions may underestimate their children’s anxiety levels.

Participants were 85 children: ADHD-only (n=28), ADHD+DCD (n=38), and typically developing (TD; n=19). Hyperactivity/Impulsivity was assessed by DSM-V. Anxiety was assessed by children and parents using the Screen for Child Anxiety-Related Disorders questionnaire (SCARED-C/P). Sensory-motor functions were evaluated using the Movement Assessment Battery for Children (MABC-2), balance subtest of the Bruininks Osteresky Test of Motor Proficiency (BOT-2), and vestibular tests of Dynamic Visual Acuity (DVAt) and standing posturography.

Anxiety ratings were higher by children with ADHD than TD children (t-tests, 0.001<p<0.05). Anxiety ratings were higher by children than their parents (t-tests, 0.001<p<0.05), and the correlation between child and parent anxiety ratings was lower in ADHD dyads (0.22<r<0.33, p<0.05) compared to TD dyads (0.60<r<0.70, p<0.01). Panic anxiety ratings by children correlated positively with vestibular dysfunction (r=0.22, p<0.05), indicating that anxiety ratings increase with vestibular dysfunction. Anxiety ratings by parents correlated negatively with motor dysfunctions on the vestibular, postural stability, balance, and motor function tests (-0.36<r<-0.22, p<0.05), indicating that anxiety ratings decrease with motor deficiency. Finally, the ADHD cohort was assigned to an “agreement” cluster (55%) with comparable child-parent anxiety ratings and to a “disagreement” cluster (45%) with anxiety ratings lower by parents than children. Children in the “disagreement” vs. “agreement” cluster demonstrated higher hyperactivity/impulsivity scores by DSM-V (p<0.05) and lower motor performance by MABC-2 (p<0.05).

Findings suggest that parents of children with ADHD underestimate their child’s anxiety, mainly when children’s sensory-motor symptoms are prominent. We summarize these results under the term “blinding effect,” which implies that parents’ primary concern is the child’s sensory-motor dysfunction, thus neglecting the expressions of anxiety. This “blinding effect” should be studied in the context of additional neurodevelopmental disorders sharing sensory-motor dysfunctions, and clinicians should be aware of the potential child-parent bias in reporting anxiety.

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COVID-19 has had a major impact on public health globally, prompting mass vaccination campaigns to curb virus transmission and severe disease outcomes. Vaccination uptake among young adults, including university students, plays a crucial role in achieving herd immunity. However, perceptions about vaccine safety, effectiveness, and necessity influence vaccination rates and acceptance.

Assessing the prevalence of COVID-19 vaccination among students at the Higher Institute of Technological Studies in Ksar Hlel, Tunisia, and exploring their perceptions regarding vaccination, including willingness to receive future doses and attitudes toward vaccine mandates.

This is a cross-sectional descriptive study conducted from the 6th to the 15th December 2021, involving a sample of students from the Higher Institute of Technological Studies (ISET) in Ksar Helal, Tunisia, using a pre-established questionnaire. Data entry and statistical analysis were performed using SPSS software, version 22.

Our sample consists of 315 students, of whom 43.5% were aged between 18 and 20, and 42.9% were in their first year. The sex ratio was 0.53. Ninety-nine students (31.4%) had contracted COVID-19, with 76 rapid or PCR tests (24.1%) conducted. COVID-19 had affected 190 of the students’ family members (60.3%). COVID-19 vaccination coverage among the students was 76.8% (242 students). Among the vaccinated, 135 students (55.8%) received one dose, and 107 (44.2%) received two doses. Regarding the reasons for vaccination, 183 students (75.6%) accepted the vaccine to prevent transmitting COVID-19 to their family or friends, 179 students (74%) to protect themselves from the virus, and 152 (62.8%) to help end the COVID-19 pandemic. Adverse effects from vaccination were reported by 86% of students (208) including headaches (97.9%), arm pain (68.4%), and fever (58.3%). In our sample, 202 students (64.1%) were convinced of the benefits of vaccination, while 176 (55.9%) opposed mandatory vaccination, and 228 (72.4%) were against receiving a third dose. Among the unvaccinated students, 11 (15.1%) expressed confidence in the vaccination and indicated willingness to get vaccinated in the future.

The study reveals a high prevalence of COVID-19 vaccination among students, with a majority expressing confidence in the vaccine’s benefits. However, there is notable resistance to mandatory vaccination and additional doses, indicating mixed perceptions and lingering concerns.

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Cyberbullying has emerged as a significant concern in today’s digital age, particularly among adolescents. As technology becomes increasingly integrated into daily life, the prevalence of online harassment has risen, impacting the mental health and well-being of students.

This study aims to explore the prevalence of cyberbullying among Tunisian schoolchildren and to identify the associated factors that contribute to its occurrence.

This is a cross-sectional descriptive and correlational study among students from two public middle schools in the Sousse governorate (Tunisia) for the year 2020/2021 using an information sheet concerning: Socio-demographic data, schooling, peer relationships, child’s use of the Internet and also the ‘Cyberbullying Screening Test’ which is a self-administered questionnaire designed to assess cyber-bullying behaviour among young people aged 12 to 18.

We included 238 middle-school students.63.6% of the population were girls, with a sex ratio of 0.57. The majority of participants (83.1%) was between 13 and 15 years old. More than half of middle school students (51.3%) reported having been cyberbullied at least once and 30.2% having been sexually harassed at least once by cell phone or on the Internet. We identified a significant association between cyberstalking and the mother’s level of education (P=0.041). There was a statistically significant relationship between cyberbullying and the student’s place of residence (P=0.023). School repetition among students was also associated with cyberbullying with a strong significance (P=0.002). A notable relationship was found between cyberstalking and the frequency of digital technology use on weeends (P=0.055).

The findings of this study reveal a significant prevalence of cyberbullying among Tunisian middle school students, with notable associations linked to many environmental and individual factors. These results emphasize the urgent need for comprehensive strategies to combat cyberbullying and support affected students in educational environments.

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Attention deficit disorder with or without hyperactivity (ADHD) is a neurodevelopmental disorder. It represents the most common psychiatric disorder in pediatric population. Children with ADHD can experience academic and social difficulties, as well as psychological complications.

The objective was to determine the prevalence rate and the clinical profile of children with ADHD symptoms in the governorate of Monastir (Tunisia) and to study the comorbid symptoms.

We carried out a cross-sectional study, applying the Strengths and Difficulties Questionnaire (SDQ) scale and the short versions of Conners 3 to parents and teachers of 435 school children in a sample of 18 public and private schools randomly selected from 6 delegations in the governorate of Monastir.

The prevalence of ADHD symptoms was 12% of which 51.9% were boys and 48.1% were girls. The average age was 9.8 [9.2;10.4] years.

We found a predominance of the inattentive form with a frequency of 57.7% compared to the impulsive-hyperactive and combined forms which have a frequency of 17.3% and 25% respectively.

In 40% of the ADHD group, an emotional disorder was found, and in 54% of cases there were behavioral disorders, with a statistically significant difference. Relationship problems rise to 74%, but with no statistically significant difference.

The prevalence of ADHD symptoms in the governorate of Monastir is similar to the rate found in other parts of the world. Identifying predisposing factors helps early intervention, which in turn reduces the psychosocial impact of this disorder.

None Declared

This report presents a case involving a patient diagnosed with a 16p12.2 microdeletion and associated psychotic symptoms.

Throughout the course of this case, we will develop a deeper understanding of the symptoms associated with this chromosomal anomaly.

The case is described below: A 15-year-old woman was admitted to the psychiatric unit at Puerta de Hierro Hospital due to behavioral disturbances. The patient was born with plagiocephaly, experienced learning difficulties, and has a documented history of a 16p12.2 microdeletion, epilepsy, and obesity. Her first contact with mental health services occurred in 2017 due to disruptive behaviors, and she began treatment with risperidone. Her condition worsened in 2020, leading to three hospital admissions and treatment changes, including aripiprazole, clozapine, and paliperidone, under the diagnosis of an unspecified psychotic disorder related to the 16p12.2 microdeletion. Currently, she is on sertraline (200 mg), paliperidone (12 mg), and valproic acid (600 mg).

The patient lives with her parents and twin sister, who has the 16p12.2 microdeletion and schizophrenia. Recently, she has shown increased irritability, heteroaggressiveness, insomnia, and difficulties with emotional regulation. The diagnosis is behavioral disturbances in the context of the 16p12.2 microdeletion.

Upon admission, the valproic acid dosage was increased to 900 mg, and olanzapine 2.5 mg was introduced. This was accompanied by therapy and a structured environment. The result was progressively more syntonic behavior and an improved capacity for self-regulation.

Most genomic disorders result from non-allelic homologous recombination (NAHR) between segmental duplications. The clinical presentation of the 16p12.2 microdeletion is highly heterogeneous and includes developmental and growth delays, craniofacial anomalies, epilepsy, sleep disorders, learning difficulties, hypotonia, cardiac malformations, and psychiatric and behavioral disturbances. Diagnosis is established through chromosomal microarray analysis or other genomic tests. Treatment is directed at addressing the specific problems identified.

None Declared

Atypical eating behaviors are more common in children and adolescents with Autism Spectrum Disorder (ASD) compared with neurotypical development. Cognitive inflexibility in ASD can result in rigid food-related rules and preoccupation with eating, similar to Eating Disorders (ED). Several studies have focused on cataloging these atypical eating behaviors, such as Zickgraf H. et al. (2019). [Figure 1].

Case presentation attended at the outpatient clinic of the Hospital Universitario Nuestra Señora de Candelaria (Tenerife).

Literature review on atypical eating behaviors in ASD patients and their comorbidity with EDs.

A 14-year-old male, with no prior mental health history, showed normal social and academic adaptation but had a notable deficit in social smiling and persistent food texture rejection. He lives with his mother and has a close relationship with his paternal uncle, a personal trainer and role model.

He was referred to mental health services after multiple episodes of agitation, triggered by disruptions in his eating and exercise routines. Over the past year, he developed an intense focus on physical training practicing calisthenics several times a day, in addition to rejecting high-calorie foods, opting for vegetables (carrots and pumpkins). A conversation with soccer teammates, where comments about his body were made, may have acted as a trigger.

Physical Examination: Yellowish skin pigmentation, particularly on palms and nasolabial folds, not affecting sclera.BMI: 21.7.

Mental Status Examination: Aprosodic speech, limited eye contact. Marked rigidity with daily routines; severe anxiety when disrupted. Irritability related to eating and exercise. Food restriction focused on fruits and vegetables (carrots, pumpkins); interest in “being healthier” (muscle gain, fat loss).No purging or binge eating behaviors.

Psychometric Tests: ASSQ, ASAS, WISC-R suggest Autism Spectrum Disorder, Level 1, with average intellectual functioning.

Differential Diagnosis: Biochemical tests ruled out jaundice, liver disease, hypothyroidism, and diabetes. Diagnosis of carotenemia made by exclusion.

Diagnostic Interviews (EDI-III):Symptoms consistent with Avoidant/Restrictive Food Intake Disorder (ARFID).

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The relationship between ASDs and EDs is common. Brede et al. (2020) proposed that certain autism traits, such as sensory sensitivities, social difficulties, identity issues, and the need for control, may contribute to restrictive eating behaviors. Westwood et al. (2018) [Figure 2] found a high prevalence of autism symptoms in adolescents with severe anorexia nervosa. Additionally, studies like Keski-Rahkonen et al. (2023) [Figure 3] report a significant prevalence of Avoidant/Restrictive Food Intake Disorder (ARFID) in individuals with ASD and their relatives. Further research is crucial to improve treatment approaches for these comorbid conditions.

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Adoption is a process which aspires to protect the children and provide them a secure home. Nevertheless these minors present very often in their new environment a wide range of different difficulties, that enhances them to adapt in their personal and academic spaces. ADHD is one of the most prevalent neurodevelopment diseases among adopted children (Mulas et al., 2016; Doom et al., 2016).

The objective of this review is to shed light on the association between ADHD and adoption.

A literature review has been carried out of scientific studies on the prevalence and risk factors for developing ADHD among adopted children from different countries of origin. Systematic reviews of papers and studies on new developments in the etiology of ADHD were also consulted.

The prevalence of ADHD in adopted children is estimated to be around 25-50% (Mulas et al., 2013; Enriquezet. al., 2017). However, this percentage varies considerably depending on the origin of the children (Eastern Europe (de Maat et al., 2018), versus China (van Ginkel et al. 2016)). However, adopted children are more easily referred to a mental health specialist, as a consequence of the fact that adoptive parents are often particularly focused on the adaptation of these children (Sánchez et al., 2012).

The postnatal environment of adopted and institutionalized childrenchildren is often marked physical, emotional, sexual or other types of abuse (Doom et al., 2016). The quality of these orphanages and foster homes contributes to the lack of stimuli that children should receive in the first 2 to 3 years of life (Mullas et al., 2015). Consequently, this social and emotional deprivation among adopted children has been related to attachment disorders and ADHD (Elovainio et al., 2015).

On the other hand, other pre- and perinatal risk factors that influence the etiology of this disorder are especially prevalent in adopted children: premature birth, low birth weight and exposure to alcohol during pregnancy (Macke et al., 2020).

The role of culture as a possible protective factor is supported by research, with immigrants showing lower rates of ADD than adopted children of the same age range (Tan et al., 2016).

Finally, early foster care in adoptive families and the promotion of family bonding and appropriate parenting strategies can help adopted children improve their regulatory skills and other typical ADHD symptoms (Barca et al.,2017).

The deprivation of affective care and the lacking opportunity to establish a relationship with a main caregiver experienced by institutionalized children can lead to the expression of this disease in genetically predisposed individuals. These fenomenon reveals the importance of connection to family and culture to promote better mental health.

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Xp11.22 duplication syndrome, a rare genetic condition first identified in 2009, has fewer than 100 documented cases in the literature. To date, little is known about the genotype-phenotype relationship in this rare genetic syndrome and there is a paucity of data specifically regarding catatonia in this condition.

The primary aim of this case report is to provide a comprehensive description of the clinical presentation, diagnostic approach, and management strategies employed in a case of catatonia occurring in the context of Xp11.22 duplication syndrome and ASD.

Methods of this case report include assessment of the patient via thorough psychiatric and medical evaluation, as well as additional information obtained through chart review and collateral sources.

Our patient, a 15-year-old Caucasian male, was diagnosed with Xp11.22 duplication syndrome at age 3 due to speech and motor delays. At 14, he experienced sudden behavioral and motor changes, including withdrawal, repetitive speech, slowed gait, and repetitive motor behaviors like “rewind” actions. Over 3 months, symptoms included emotional lability, self-injurious behaviors, and significant disruption to daily functioning. Outpatient management with olanzapine and quetiapine worsened agitation. Referred to a specialist, he was started on lorazepam up to 12 mg daily for suspected catatonia. ECT was considered, but further workup ruled out seizure disorder and autoimmune encephalitis. Pediatric neurology found no alternative etiology and recommended ECT. On admission, BFCRS score was 14, showing catatonic symptoms like automatic obedience, mutism, and immobility. Lorazepam was reduced to 2 mg three times daily, and amantadine 100 mg twice daily was continued. An acute ECT course of 12 bilateral treatments over four weeks reduced catatonic symptoms, improving mutism, motor speed, and daily activities. During a 56-day hospitalization, he received 7 maintenance treatments. Upon discharge, BFCRS decreased to 7, and he continued lorazepam and amantadine.

This case report underscores the complexity of managing catatonia in patients with Xp11.22 duplication syndrome and ASD, highlighting the potential need for multimodal treatment approaches. The significant improvement observed with the addition of ECT to the treatment regimen emphasizes the importance of considering this option in cases of refractory catatonia, even in patients with complex genetic and neurodevelopmental backgrounds. This case raises important questions about the underlying neurobiological mechanisms of catatonia in the context of Xp11.22 duplication syndrome and ASD.

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The World Health Organization (WHO) defines adolescence as the developmental stage between childhood and adulthood, spanning ages 10 to 19. This period is characterized by significant physical, cognitive, and psychosocial growth.

This study aims to understand the clinical profile of adolescents hospitalized for the first time in the psychiatric department.

• - It’s a retrospective and descriptive study covering the files of patients who consulted the Avicenna Psychiatry department of Razi hospital aged under 18, during the year 2023.

• - The collection of anamnestic and clinical data was established using a pre-established form

Our study included 24 patients aged between 16 and 18 years, with a mean age of 17 years, comprising 13 males and 11 females.

Patients presented voluntarily in 42% of cases, were brought in by law enforcement in 25%, and were referred by a private psychiatrist in 17% of cases. The reasons for consultation were as follows: behavioral disturbances in 63% of cases, a suicide attempt in 21%, and incoherent statements in 8% of cases. 60% of cases used medication ingestion as the method during the suicide attempt. A family history of psychiatric disorders was found in 50% of cases, as well as a family history of suicide attempts in 13% of cases. Additionally, 71% of cases had prior follow-up with a private psychiatrist, 21%of cases had previously attempted suicide, and 33%of cases had personal somatic histories.

The onset of disturbances was progressive in 71% of patients. Upon hospitalization, anxious symptoms were noted in 25% of cases, while depressive symptoms with suicidal ideation were recorded in 29% of patients. hallucinations and delusions were noted in 50% of cases, and behavioral eccentricity was observed in 25% of cases.Instinctual disorders were present in 75% of cases, with sleep disturbances observed in 71%of cases, sexual disorders in 25%of cases, and appetite disorders in 13 %of cases.

Verbal hetero-aggression was identified in 83% of cases, while physical hetero-aggression was noted in 67%of cases. Self-harming behaviors were recorded in 48% of patients.

The diagnoses made according to DSM-5 criteria were distributed as follows: bipolar disorder in 29% of cases, schizophrenia in 17%of cases, and 13%of cases related to a life stage.

Adolescent psychiatric hospitalizations are rising, emphasizing the need to understand clinical characteristics of this population. This study analyzes clinical aspects of adolescents admitted to a psychiatric unit over one year. The findings aim to enhance treatment strategies and patient outcomes.

None Declared