As mental health challenges among adolescents continue to rise, hospitalized Adolescents in psychiatric units often face complex and evolving challenge.A lot of current research aims to optimize treatment strategies for this vulnerable population.

This study aims to explore evolution and therapeutic approaches 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 19, 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.

Patient follow-up in our service was regular in 58.33% of cases, while 20.83% of patients were lost to follow-up.

Psychotherapy was recommended in most cases, and medication was prescribed in 100% of cases, with only 58.3% adhering to the treatment. Relapse with rehospitalization was observed in 45.8% of cases, with a range of 1 to 35 readmissions. Parents of these patients were cooperative and receptive to the care in 62.5% of cases, while 12.5% of parents remained rejecting.

Clinical outcomes showed improvement in 33.3% of cases and worsening of symptoms in 45.8% of cases.

Early and individualized therapeutic planning, in collaboration with family and social services can play a crucial role in preventing future hospitalization.

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Psychiatric hospitalization to manage acute symptoms of mental disorders in children and adolescents may be necessary, although there is a growing concern about the clinical and economic effectiveness of psychiatric admission in this population. This suggests the need for the implementation of new intensive family and community care models that would reduce hospitalization.

Home hospitalization provides an opportunity to offer the child or adolescent with intensive treatment within the infrastructure of their home and the supervision of their family or primary caregivers. It therefore requires fewer resources than traditional inpatient treatment while allowing the patient‘s immediate environment to be involved in the treatment, potentially reducing the risk of a failed transition to the home once the patient is discharged.

The main objective is to analyze the cost-effectiveness of two Mental Health Home Hospitalization interventions for adolescents as an alternative to traditional hospitalization in two hospitals in Madrid, Spain (La Paz University Hospital and Principe de Asturias University Hospital).

This is a quasi-experimental pre-post intervention study that examines two models of Mental Health Home Hospitalization as an alternative to full hospitalization. It will analyze various outcome variables, including clinical, functioning, satisfaction, quality of life, and costs /use of clinical resources.

Participants must be adolescents and young adults aged 12 to 18 years (inclusive), who present a psychiatric decompensation requiring an intensity of care similar to that provided in the hospital. Assessments, including CGI, HoNOSCA, C-SSRS, CSQ-8, EQ-5D-Y, will be conducted at the baseline visit, and at the end of the treatment. Resource use and costs will be recorded at the baseline and six months after the treatment.

Home-based mental health hospitalization for adolescents is an emerging area of interest in the treatment of acute symptoms of mental disorders in this population, but there are not standard protocols for such interventions. Several issues remain to be clarified, including the care pathways for adolescents in crisis who require hospital care and whether organizational differences between interventions impact the outcomes.

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Digital self-harm refers to the use of information and communication technologies (ICTs) to post or share self-deprecating or harmful content. This often occurs on forums or social networks, where the use of verbal and non-verbal codes (hashtags, emojis) complicates external monitoring. The rise in ICT usage and self-destructive behaviors online has raised concerns among mental health and education professionals, as these actions are linked to conditions such as depression, anxiety, and traditional physical self-harm in young populations.

To explore the phenomenon of digital self-harm and its effects on adolescents.

To examine the role of AI tools in addressing this issue through a clinical case.

A brief literature review on digital self-harm.

Analysis of a clinical case: A 15-year-old female with a history of multiple hospitalizations due to suicidal risk and self-harming behaviors. Under treatment with Venlafaxine and Aripiprazole, she is diagnosed with “emotion dysregulation disorder of adolescence” and “mixed adaptive disorder.” Her social interactions are mostly limited to online networks. She describes her self-harm as “addictive,” used not only as an anxiolytic but as a way to achieve “social positioning,” posting about it in forums and comparing herself with others. When she reported her self-harm impulse to an AI (artificial intelligence) chatbot for suicide prevention, emergency services were activated, leading to her hospital admission.

International studies indicate that between 6% and 9% of adolescents have engaged in digital self-harm behaviors. In Spain, reports from the ANAR Foundation and UNICEF have shown an increase in this phenomenon since the Covid-19 pandemic. These “online support communities” can foster dynamics of rivalry and become harmful, as they not only share images but also techniques to avoid detection or hospitalization. In the presented case, the patient’s initial isolation led her to use ICTs as a way to seek social affirmation and a sense of belonging. Upon encountering specific forums, self-harm, which initially served an anxiolytic function, evolved into a mechanism for achieving social relevance. On the other hand, the AI chatbot for suicide prevention facilitated early intervention in her case.

While the internet can provide social support for isolated adolescents, it also has the potential to normalize and even reinforce self-harming behaviors among vulnerable populations. Therefore, it is crucial to further investigate the psychosocial factors involved in digital self-harm and to develop new tools for mental health professionals. Additionally, AI could serve as an entry point and tool for younger generations, offering potential for both prevention and therapeutic intervention.

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Autistic spectrum disorders belong to the group of neurodevelopmental disorders, where the manifestations of the disorder differ depending on the severity of the autistic condition. These disorders are often associated with intellectual impairments and structural language disorders. In his patients, Asperger described cases with above-average intelligence as well as cases with low language and intellectual abilities. What they had in common was that they had significant disorders in social and affective communication. The diagnosis of autism spectrum disorders is usually made in childhood, but there are also cases where the diagnosis is made at an older age due to the later manifestation of symptoms.

To present a case report of 18 years old girl who was diagnosed with moderate intellectual disability in childhood, while later established with symptoms of Asperger’s syndrome and mild intellectual disability.

Psychiatric interview, medical history, psychological testing

An 18-year-old girl, accompanied by her mother, presented herself to psychiatrist for the first time due to affective disorders that manifested in the form of increased nervousness and outbursts of anger. Early psychomotor development was slow, she started walking at the age of 1.5 years and spoke at the age of two. From early childhood, stereotypies in movements and hypervigilant attention were observed, along with very poor social interactions. Due to difficulties at school, she was categorized at the age of 12 as having moderate intellectual insufficiency and IQ of 35. She underwent long-term speech therapy treatment and finished elementary and high school with the help of teaching assistant. Somewhere in high school, the patient’s pronounced talent for drawing was noticed. Observation during the psychiatric examination reveals emotional immaturity, stereotypes and rigidity in social interactions. The patient is referred again for psychological testing, results show IQ of 88 with a lag in emotional development and development of basic social skills. The patient is referred to another psychiatrist for an additional opinion, who agrees with diagnose of Asperger’s syndrome. Low dose of lamotrigine was included in therapy, after which affective state stabilized. The patient is referred again for categorization.

This case report that a diagnosis established in childhood period does not have to be definitive and that revision of diagnosis is necessary over time and as necessary, initially due to increase of patient’s IQ, as well as due to the later presentation of symptoms characteristic of certain disorder.

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Day hospitals for children and adolescents (DHCA) have experienced a notable increase in demand in the past few years, requiring an exploration of factors that predict treatment outcomes.

This study aims to investigate whether all patients derive equal benefit from intensive treatment in a day hospital or if diagnostic orientation and pre-admission severity influence therapeutic efficacy.

A retrospective pre-post admission study was conducted involving adolescents treated at the DHCA Litoral Mar in Barcelona between January 2022 and December 2023. The analysis focused on the association between clinical and functional improvement, as measured by the CGAS and HoNOSCA scales, and diagnostic orientation and clinical severity, indicated by the history of suicide attempts and prior admissions. Non-parametric tests, specifically Spearman’s correlation coefficient and the Kruskal-Wallis test, were used.

The study sample comprised 64 patients, with a mean age of 17.72 years (SD 1.39) and 70.3% female representation. The average length of stay was 130.64 days (SD 43.92). While no statistically significant differences in clinical improvement were observed across diagnoses, patients with psychotic disorders demonstrated the most substantial improvement, followed by those with behavioral disorders, emotional regulation difficulties, and mood disorders. More modest improvements were noted for anxiety disorders and autism spectrum disorders (ASD). A statistically significant positive correlation was identified between the number of previous suicide attempts and improvement on the HoNOSCA scale (p=0.002), with no significant correlation found with previous admissions.

The findings indicate that severe patients benefit most from intensive treatment in day hospitals, while a specific diagnosis is not a clear predictor for outcomes, probably due to the small sample size. These results underscore the importance of considering clinical severity and patient history to optimize treatment effectiveness in intensive care settings.

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Sudan is currently experiencing the largest child displacement crisis worldwide. Since the conflict erupted in 2023, over 4.6 million children have been internally displaced within Sudan, and nearly one million are seeking refugee in neighboring countries (UNICEF, 2023). The mental health of these children has been overlooked, and there is a noticeable lack of data on their psychological wellbeing.

To assess the prevalence of PTSD, anxiety and factors associated with them among internally displaced Sudanese children during war in IDP camps in Al Jabalain district, White Nile state, Sudan, 2024

A cross-sectional study was conducted among internally displaced Sudanese children in 11 camps in Al Jabablain district. Children were interviewed using a standerdised questionnaire consisting of the PTSD Civilian Checklist Version 5 abracic version and the Hamilton Scale arabic version to assess the prevalence of PTSD and anxiety. Data analysis was conducted using IBM® SPSS, version 26.0.

The sample included 223 children; age median was 12 years (IQR: 9-15). 127 (57%) of them were females, with majority 128 (57.4%) in primary school. Participants who met the criteria for probable PTSD were 23 (14.3%), (median: 32, IQR: 17-28). 150 (67.3%) participants had mild anxiety, with a median score of 11 (IQR: 9-14). Older children had higher levels of PTSD and anxiety. Also, both scales were significantly associated with gender, displacement frequency and separation from close ones (p value <0.05). Females were more likely suffer from anxiety 116/127(91%) in comparison to males 76/96(79%). Yet, 19(59.4%) of children with probable PTSD were males. Children displaced more than four times were more prone to PTSD symptoms and moderate to severe anxiety. Interestingly, recently displaced children were more likely to have higher PTSD scores and lower anxiety scores. Educational level was significantly associated with PTSD, with about one-third of high school students experienced PTSD symptoms. Anxiety scale was significantly associated with direct exposure to violence, as 13.6% of those exposed to violence experienced mild to moderate anxiety.

This study identified significant levels of PTSD and anxiety among internally displaced children in the Al Jableen camps, highlighting the urgent need for mental health interventions, which promotes resilience and coping skills. Factors such as age, gender, frequency of displacement, direct exposure to violence, and educational level significantly impact the development of these mental health conditions.

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Autism spectrum disorder(ASD) is a developmental disorder that includes social communication challenges, restricted interests, repetitive behaviors, and intellectual incapacity. The specific etiology of ASD is unknown. However, it is thought to be a combination of genetic and environmental factors. ASD has been linked to copy number variation (CNV), which alters chromosome structure at the submicroscopic level. 16p11.2 deletion is one of the most commonly documented cytogenetic causes of ASD, with an estimated incidence of 0.5% among ASD patients. (Ju et al. 2021; Frontiers in cellular neuroscience, 15, 718720.)

We investigated to explain the hereditary characteristics of a case of ASD that included intellectual disability and dysmorphic facial traits.

Our patient is 20 months old and applied to our clinic accompanied by his parents due to speech delay and with the story of forgetting a few words he had learned around 1 year old. When we evaluate it from a developmental perspective, he held his head at the 10th month, babbled at the 8th month, sat without support 13 the month, crawled at the 15th month, walked at the 17th month, said his first words at the age of one, but he has regression history around 1 year and 4 months old, and not completed his toilet training yet. At 18 months old, a genetic screening was conducted due to brachycephalic facial structure, prominent forehead ridge and protrusion in the frontal area, mild midface hypoplasia, hypertelorism (interocular distance of 2.9 cm), slightly slanted eye sockets, synophrys, anteverted nostrils, a small nose with a deeply set nasal bridge, mild prognathism, and deeply set, posteriorly rotated ears. The genetic screening revealed a 597.84 kb microdeletion in the short arm of chromosome 16(16p11.2) through CGH array analysis

During our examinations, it was observed that the child is generally passive, does not sufficiently use verbal and non-verbal communication, has inadequate eye contact, and responds inconsistently to their name. Based on the developmental tests and our evaluation, the child was found to be significantly behind in developmental milestones, leading to a consideration of autism and cognitive delay. It was recommended that the child begin special education.

The deletion of 16p11.2 may lead to developmental disorders and poor socio-cognitive performance by disrupting long-range prefrontal synchronization. This is supported by ASD-associated CNV and impaired macroscale connectivity. (Bertero et al. 2018; Brain, 141(7), 2055-2065) Deletions of 16q11.2 are associated with higher rates of psychopathology relative to familial controls, emphasizing the need for early identification, diagnosis, and intervention (Niarchou et al,2019; Translational psychiatry; 9(1), 8)

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Social media has become a powerful influence on adolescent body image. Platforms like Instagram and TikTok, which focus on appearance, often promote idealized body standards, leading young users to internalize unrealistic beauty ideals. This has resulted in increasing body dissatisfaction and negative mental health outcomes, as adolescents seek validation through likes and comments.

This review examines how social media exposure affects body image and emotional wellbeing in adolescents, particularly whether it contributes to negative outcomes like low self-esteem, body dissatisfaction, and mental health issues.

A review of international studies published in the last five years was conducted using PubMed and Google Scholar. Search terms included “social media,” “body image dissatisfaction,” “mental health,” and “adolescents.” A total of 26 studies that met the criteria were analyzed.

social media, body image dissatisfaction, adolescents, mental health, eating disorders, self-esteem, COVID-19

The studies consistently revealed a strong link between frequent social media use and negative body image. Both male and female adolescents reported increased body dissatisfaction, though most studies focused on females. Social media exposure was also linked to higher risks of eating disorders and a drive for thinness.

Frequent users of appearance-focused platforms experienced reduced self-esteem and heightened levels of anxiety and depression, with social comparison behavior worsening these effects. Adolescents’ body image was further influenced by peer and parental validation, with peer approval playing a critical role in shaping their self-perception. The negative impacts of social media were particularly exacerbated during the COVID-19 lockdown due to increased isolation.

Social media platforms centered on appearance have a significant negative impact on adolescents’ body image and mental health. These findings highlight the need for interventions promoting media literacy, critical social media engagement, and support from parents and educators to mitigate these effects.

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Children and adolescents with chronic cutaneous conditions are at risk of experiencing adverse psychosocial effects such as anxiety, depression, and loneliness. Children with psoriasis had significantly higher rates of any psychiatric disorder, but these are often unrecognised or under-recognised and not referred to mental health services. It is also clear that the well-being of these children’s families may also be impacted by their child’s condition.

The aim of this study was to review current knowledge of the comorbidity of psoriasis and psychiatric disorders in the paediatric population, which are often underdiagnosed and undertreated.

A narrative literature review was carried out in the PubMed, Cochrane and Embase databases, selecting only the articles published in the last 10 years, using the following keywords: psoriasis, psychiatric disorders, paedriatic population.

There is no doubt that psoriasis is one of the most debilitating chronic dermatological conditions affecting children from a quality-of-life perspective. Indeed, numerous studies have demonstrated that its impact is on par with that of other chronic conditions such as diabetes, asthma or epilepsy. Current research generally supports a positive association between paediatric psoriasis and the onset of anxiety and depression. However, it is difficult to establish a causal relationship as there is some evidence that psoriasis and psychiatric illness can exacerbate each other. Children with psoriasis had significantly higher rates of any psychiatric condition, particularly depression and suicidal ideation. Patients with higher disease severity (Psoriasis Area and Severity Index (PASI) and Body Surface Area (BSA) scores) and longer disease duration, are undoubtedly more likely to experience worse anxiety and depression. They may have other psychiatric comorbidities, such as excoriation (skin picking) disorder or obsessive-compulsive disorder (OCD), resulting in body-focused repetitive behaviours that exacerbate psoriatic plaques.

Paediatric patients with psoriasis appear to be more vulnerable to the psychosocial effects of their disease than adults, especially those diagnosed at a younger age, who had poorer lifetime outcomes due to less robust coping skills compared to other children. Young children may also not be able to understand or express their emotions associated with psoriasis, which is a significant barrier to conducting research. There is little research on supportive treatment, but psychological support (group or individual) during appointments has been reported positively by patients.

It is essential to consider the psychosocial impact of this particular pathology on children and their families, in order to improve their quality of life through a better understanding of their conditions and the implementation of interventions that help to mitigate these effects.

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The management of situations of behavioral dyscontrol is essential in hospitalization units. Strategies such as verbal or pharmacological restraint are the first steps to assist in the emotional regulation of a patient with a potentially escalating state of restlessness. In cases where this fails or is not possible, and there is a risk to the patient or others, physical restraints are a strategy for managing the agitated state. The Adolescent Short Stay Unit at Puerta de Hierro Hospital consists of 11 beds. The age of admission is 12 to 17 years.

To present data on the number of physical restraints placed in the Adolescent Brief Hospitalization Unit and the average time of placement from 2020 to 2023. The results from 2024 will be presented in the poster of this abstract.

Physical restraint data were reviewed through patient records and the physical restraint registry that is part of the unit’s protocol.

During 2020, physical restraints were placed on 8.7% of the patients admitted that year (21 of 240). In that year, a total of 110 physical restraints were placed for a total of 707.73 hours and an average of 7.06 hours. During the year 2021, 13.3% required physical restraint (30 of 2236). In that year 89 physical restraints were placed for a total of 470.25 hours and an average of 5.35 hours. In 2022, 6.4% of the patients admitted required physical restraint (15 of 236), 11 of whom were women. In that year a total of 100 physical restraints were placed with a total of 457 hours and an average of 4.57. It should be noted that that year, of the 100 restraints, 52 were on the same patient, with 19 restraints on the second patient requiring the most restraints. In 2023, 8.2% of patients required mechanical restraint (19 of 229), 14 of whom were women. A total of 169 restraints were placed for a total of 402 hours and an average time of 2.37 hours. This year, 2023, of the 169 restraints, 106 are on the same patient. From January to August 2024 restraints were applied to 10 patient. A total of 58 restraints were placed, with one patient requiring up to 30 restraints.

It should be noted that the patients who require the most physical restraints are patients with a diagnosis of autism spectrum disorder or patients with intellectual disabilities.

A decrease in the average restraint time has been observed(7.06 to 2.37), which we believe is due to greater training on the part of the nursing team. Patients with Autism Spectrum Disorder and patients with Intellectual Disability are those who have received more physical restraint, suggesting that their management requires a structure and intervention different from those offered by the short hospitalization units.

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Mental health issues in children and adolescents are often influenced by ineffective parenting strategies such as poor communication, harsh punishments, lack of positive reinforcement, and imbalance between relationship and regulation. Although effective parenting interventions exist, access is typically limited to institutional services. Net PAMA, an internet-based parent management training program, was created to improve access. However, only city-dwelling, educated parents were able to effectively learn from the platform. A combination of local facilitators and the internet-based program, called ‘Net PAMA Classroom’, was then proposed as means to reach out to underserved communities.

This study examines the success factors and challenges of ‘Net PAMA Classroom,’ a community-based Parent Management Training intervention conducted by non-professional facilitators, with the use of the internet-based standardized program.

We interviewed fifteen Net PAMA Classroom facilitators. We then performed data triangulation and thematic analysis using Braun and Clarke’s six-step approach.

Three key themes were identified: curriculum, facilitators, and classroom management. Participants valued the practical skills provided through structured lessons. Successful facilitators had backgrounds in child and family work, prior facilitation experience, and supported parents in applying new skills. Support from community leaders significantly impacted the program’s initiation, delivery, and sustainability. Recommendations include making the curriculum culturally relevant, flexible, and less internet-dependent. Addressing propriety issues is also crucial for the program’s long-term success.

The Net PAMA Classroom’s effectiveness relies on a robust curriculum, experienced facilitators, and effective classroom management. Enhancing cultural relevance and flexibility, reducing internet reliance, community support, and resolving propriety concerns are essential for sustainability and scalability.

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Obsessive-compulsive disorder (OCD) in children and adolescents presents similarly to that in adults, but with some particularities. In children, the most common obsessions are usually related to fears of contamination, harm to others, or catastrophic situations. The compulsions associated are often: excessive hand washing, repetitive checking, and the need for order.

Treatment of OCD is based on both pharmacological measures and psychological therapies. At the pharmacological level, it focuses on the use of selective serotonin reuptake inhibitors (SSRIs). In terms of psychological treatment, cognitive behavioural therapy (CBT) is the psychotherapeutic intervention of first choice for the treatment of OCD, and is considered the most effective intervention, both in monotherapy and in combination with pharmacological treatment. Within CBT, the most effective is Exposure with Response Prevention (ERP).

To present the adaptation of the different therapeutic interventions so that they are effective when applied to children, through a clinical case of a 10-year-old child with OCD.

Our patient first came to the emergency department due to intense anxiety, secondary to obsessive thoughts about suicide and sexual identity. Due to the incoercible anguish caused by these egodystonic thoughts and the secondary low mood, he was admitted to hospital. At the pharmacological level, sertraline was progressively administered up to a dose of 100mg/day and psychoeducation was provided. Despite the initial improvement in anxiety and hospital discharge, after a couple of weeks there was a further worsening, which persisted despite increasing the dose of sertraline. In successive outpatient consultations, psychoeducational intervention and review of confrontation techniques were carried out. The patient began with clinical symptoms typical of hypomanic turn, so SSRIs was lowered back to the initial dose, and aripiprazole 5mg was added. The importance of CBT was emphasised, teaching the parents to practice it daily with their child. In the next visits, psychotherapy work continued in the form of role-play, explaining the difference between distraction and confrontation, lowering the SSRI to 50mg and maintaining aripiprazole. Clinical stabilisation was achieved and has been maintained since.

We see with this case that pharmacological treatment, although necessary to obtain changes at the neuro-biological level, is not sufficient for clinical remission, and that intensive psychotherapy is the cornerstone of the intervention

In conclusion, in the treatment of childhood OCD, the combination of pharmacological and psychological interventions is essential. Although pharmacological treatment is important, it alone does not always guarantee complete remission, highlighting the need for a comprehensive therapeutic approach to achieve sustained results over time.

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Psychiatry focuses on disorders of affect, behavior, and cognition (ABC), with half of all psychiatric disorders emerging by age 14 and three-quarters by age 24. Disorders are categorized into four types: Type 1 (affective disorders like depression and anxiety), Type 2 (behavioral disorders like ADHD and ODD), Type 3 (developmental disorders like mental retardation and speech/language issues), and Type 4 (dysfunctional disorders, including psychotic illnesses and mood disorders). These categories—emotional, behavioral, cognitive, and dysfunctional—form the ABCD framework in child psychiatry.

The study aimed to categorize childhood and adolescent mental and behavioral disorders into four groups: developmental, disruptive, emotional, and dysfunctional. It also sought to examine intra- and inter-group comorbidities, and analyze the clinical variables of these groups and their comorbidities by age and sex.

This was an observational cross-sectional study conducted at Gauhati Medical College Hospital (GMCH), Guwahati, Assam, from September 7, 2018, to September 6, 2019. Existing diagnostic systems do not distinguish between child/adolescent and adult mental health, and there is a lack of a unified “common language” for childhood and adolescent mental and behavioral disorders. The study aimed to address this gap, particularly in the local geo-cultural context, where data for a new classificatory system is scarce. Participants included children and adolescents admitted to the Child Psychiatry Unit or attending the Child Guidance Clinic. Demographic (age, sex) and clinical variables (ICD-10 diagnoses) were studied, with diagnoses categorized into types 1–4.

Total sample size was 137. Adolescents (ten to 18 years of age) were almost double in numbers to that of children (below ten years of age). Boys outnumbered girls. Adolescents were more than children in both among girls and boys (even the single third gender was an adolescent). Most of the children and adolescents were having type 3 disorders, followed by type 1 and type 2 disorders. While majority had type 3 disorders below ten years of age (children), type 1 disorders were highest in the adolescents. Type 1 and type 3 disorders were almost equally distributed among girls, while boys predominantly had type 3 disorders. Within group comorbidity was maximum with type 3 disorders. Across group comorbidity was found mostly in type 2-type 3 disorders.

John Lennon “imagined” of having no countries and no religion too; thus, there will be nothing to kill and die for! Bono of U2 wanted to be there “where the streets have no name”! Likewise, we too dream of a land for child and adolescent psychiatry where if we cannot live without names then let us at least have a few and simple ones: ABCD!

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It is well established that living, or growing up, in poverty has a negative impact on both physical and mental health. The area our service covers includes Great Yarmouth and Lowestoft, 2 of the most economically impoverished areas of the UK. The vast majority of our patient group will have grown up in relative poverty. While there are associations between poverty and impaired physical health and increased risk of some mental health conditions, the actual causal link is unclear.

To explore if there appears to be a link between growing up in poverty and developing a significant mental illness.

Data anlaysis from Consultant caseload list.

We do know that there are some factors associated with both poverty and increased risk of mental illness and these include;

• - Parental drug or alcohol abuse

• - Parental mental health problems (if these are not well managed)

• - Early/premature death of a parent

• - Exposure to domestic violence

• - Physical abuse

• - Going into the Care System

• - Early drug or alcohol use

• - Early separation or loss of a parent

Findings

Total number of patients = 122

Number who have a specific factor associated with poverty =56

This equates to 46% of my current caseload.

Gender =35 female (62.5), male 21 (37.5%)

Summary of Findings – “The poor bear the greatest burden of mental illness” (2)

This would certainly seem to be the case, from the findings of this service evaluation. Our findings show that a significant percentage of our patient group have mental health issues directly related to poverty.

It is worth noting that the vast majority of my patient case load grew up in poverty, due the demographics of the area we work in (a quick analysis suggests about 97% of my case load are from working class, impoverished backgrounds). We abandoned recording “parental unemployment” in this analysis, because for all but a few, this was the case. Unemployment is an entrenched issue in this area, with the demise of the shipping and offshore industries, currently standing at 5.4% in Yarmouth and 3.5% in Lowestoft (3) (National average 3.8%). For those that are employed, poverty is a significant issue with many in low paid jobs. I have also not included here factors associated with poverty, such as poor diet, smoking, malnutrition, poor dentition, and obesity, but we know these are the case for many patients seen here.

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The emergence of the internet and social media has not only changed the way people communicate, but has also brought with it a new type of bullying: cyberbullying. This type of bullying causes negative effects on the quality of life of individuals, especially adolescents and young adults, and becomes a serious problem for their mental health.

The aim of our study was to examine various factors that may be related to cyberbullying in adolescents applying to child psychiatry outpatient clinics and the psychiatric diagnoses of adolescents.

A total of 174 patients aged 14-18 years who applied to the Department of Child Psychiatry and gave their consent to participate, were included in the study. The Cyberbullying Scale was applied to the youth, and the sociodemographic data form, cyberbullying study questions were applied to their parents.

The average age of the group was found to be 15.60±1.15. 122 (70%) participants were female and 52 (30%) participants were male. Of the 174 adolescents included in the study, 61 (35%) were found to be cybervictims, 29 (17%) were found to be cyberbullies, and 25 (14%) were found to be both victims and bullies. Cyber victimization was found to be significantly related to broken family type, mother’s exposure to cyberbullying on the internet, father’s internet usage time, and father’s exposure to cyberbullying on the internet. Cyberbullying was found to be significantly related to male gender, father’s low level of education, divorce, and mother’s and father’s internet usage time being between 0-1 hour/day. When the diagnoses of the patients were examined, 39 (22%) adolescents were diagnosed with neurodevelopmental disorders, 37 (21%) adolescents with mood disorders, and 68 (39%) adolescents with anxiety disorders. When the diagnosis groups were examined and the status of being a cyberbully or cybervictim, no significant difference was found in any diagnosis group. No significant relationship was observed between the adolescent’s diagnosis of any mental disorder and being a cyberbully or victim.

Cyberbullying is not an issue to be taken lightly, and because it often co-occurs with traditional bullying, prevention and intervention programs need to address both contexts. In our study, it was determined that the majority of cyber victims were also cyberbullies. This situation shows the importance of evaluating bullying situations even though adolescents apply as victims in the clinic interviews. The results suggest that parents do not have enough knowledge about safe internet use and cannot control and guide their children properly. Therefore, during clinical interviews, cyberbullying/victimization issues should be discussed with mothers and fathers and how they can provide information to their children on this issue and safe internet use should be discussed.

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Studies focusing on the relationship between chronotype, sleep disorders and temperament traits in Attention-Deficit/Hyperactivity Disorder (ADHD) are limited, particularly in the context of adolescents. In adolescents aged 11 to 18 diagnosed with ADHD, we hypothesize that chronotype, sleep problems, and temperament traits may be dynamically interrelated across a broad spectrum. Conducting in-depth studies to examine these relationships could enhance our understanding of ADHD treatment and management strategies, potentially leading to more effective interventions.

We aimed to explore the relationship between chronotype characteristics, sleep disturbances, and temperament traits among adolescents diagnosed with ADHD and to compare them with healthy controls.

Participants included 102 adolescents aged 11 to 18 years with an ADHD diagnosis from the Child and Adolescent Psychiatry outpatient clinic at Marmara University Pendik Training and Research Hospital, along with 101 age-matched controls from a secondary and a high school. Clinical assessments were conducted using the K-SADS-PL. Parents completed the Sleep Disturbance Scale for Children and Children’s Chronotype Questionnaire while adolescents completed the Junior Temperament and Character Inventory Revised. These assesments evaluated chronotype characteristics, sleep disturbances, and temperament traits.

Adolescents with ADHD demonstrated significantly higher rates of sleep disturbances and delayed chronotype compared to the controls. Additionally, adolescents with ADHD exhibited significantly higher levels of novelty seeking and harm avoidance scores, while the control group exhibited higher levels of persistence and self-directedness compared to the ADHD group. In the ADHD group, chronotype total score correlated negatively with self-directedness (r=-0.201, p=0.042) and reward dependence (r=-0.199, p=0.045). Novelty seeking was pronounced in those with an evening chronotype and positively correlated with severe sleep disturbances, including difficulties initiating and maintaining sleep (r=0.210, p=0.034). Logistic regression analyses indicated that novelty seeking significantly predicted evening chronotype, while linear regression revealed that both novelty seeking and chronotype scores significantly predicted overall sleep disturbance severity. (R2=0.112, p=0.006).

This study represents one of the initial investigations emphasizing the intricate relationships between chronotype characteristics, sleep disturbances, and temperament traits in adolescents diagnosed with ADHD. More profoundly underscoring these relationships and their clinical significance could be crucial for targeted interventions to improve ADHD management.

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Major depressive disorders (MDD) and bipolar disorders (BD) are strongly associated with suicide attempts in youth. However, little is known regarding the differences in prevalence and clinical-related features of suicide attempts between these two disorders.

The study aimed to examine the prevalence of suicide attempts and related factors in children and adolescents with major mood disorders and compare clinical features between BD and MDD patients who attempted suicide.

A cross-sectional study was conducted at the Child and Adolescent Psychiatry Department of the Institute of Psychiatry and Mental Health Gregorio Marañón. Patients with diagnosis of major mood disorder were included. All patients were evaluated with K-SADS, CGI (Clinical Global Impression), HDRS (Hamilton Depression Rating scale), YMRS (Young Mania Rating Scale), Conners Rating Scale and CGAS (Children’s Global Assessment Scale). Bivariate analysis was conducted to compare patients with and without suicide attempts and BD versus MDD attempters. Subsequently, a multivariate analysis was performed to assess the combined influence of suicide attempts related factors.

The sample included 145 patients (58 males, 87 females) aged 7 to 17 years (mean 15.15), with diagnosis of BD (55.2%) and MDD (44.8%). The prevalence of suicide attempts for MDD and BD were 58.5 % and 28.8 %, respectively (p< 0.001). 56,5 % of BD attempters reported medically serious suicide attempts versus 28.9% of MDD (p=0.03). 61 patients with suicide attempts were compared to 84 patients without suicide attempts. Suicide attempts were associated with female sex (p<0.001), internalizing disorders (p= 0.003), hopelessness (p=0.001), higher punctuation on HDRS score (p=0.03), suicidal ideation (p<0.001) and NSSI (p<0.001). In the multivariate analysis, it was found that female sex (p<0.001), suicidal ideation (p<0.001) and hopelessness (p=0.048) were independently related to suicide attempts. Comparing suicide attempters with BD versus MDD, BD patients showed higher impulsivity (p=0.04) and a more alcohol use proportion (p=0.04) than MDD patients.

Female sex, suicidal ideation and hopelessness are strongly related to suicide attempts in youth with major mood disorder. The findings revealed some differences between BD and MDD for patients with suicide attempts and accentuate the need for early identification of BD and accurate differentiation between BD and MDD in children and adolescents, to treat them adequately and minimize suicidal behaviors.

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Children with a history of acute leukemia may experience some deficits in their cognitive functions in the late period (Hewitt et al. Childhood Cancer Survivorship 2003).These deficits negatively affect their quality of life by impairing their academic, social and psychological functioning (Jacola et al. Lancet Psychiatry 2016; 3-10-965-972).

The aim of this study was to compare the cognitive functions of children with a history of leukemia compared to their healthy peers.

Our study was conducted with 42 cases with a history of leukemia who were followed up in the Pediatric Hematology outpatient clinic of Dokuz Eylül University Faculty of Medicine and 41 healthy controls who were admitted to the Child and Adolescent Psychiatry outpatient clinic of Dokuz Eylül University Faculty of Medicine.After obtaining informed consent from both parents and participants, the Wisconsin Card Sorting Test (WCST), Stroop Test-TBAG form, Trail Making Test (TMT) A and B forms were administered to all participants.The parents of all participants were given a sociodemographic data form and the Childhood Behavior Checklist (CBCL) and asked to complete it.The teachers of all participants were given the Conner’s Teacher’s Rating Scale-Revised Long form (CTRS-RL) and asked to complete it.

All sub-dimension CBCL scores of the case group were significantly higher than the control group (p<0.05).All sub-dimension CTRS scores of the case group were found to be significantly higher than the control group.The case group performed worse than healthy controls in WCST, Stroop-TBAG and Trail-Making Test. The mean Stroop2-time score was higher in the group that received cranial radiotherapy, whereas the Trail-Making-B-error score was higher in the group that did not.The group receiving the medium-high risk chemotherapy protocol performed worse overall on the Stroop test.Women in the case group performed worse on the WCST than men.Stroop5-error scores were higher in the group with a history of sequelae.It can be said that there is a negative correlation between age at diagnosis, age at the end of treatment and time elapsed after treatment and cognitive test performances.There was a moderate positive correlation between the duration of the treatment and the CBCL-attention problems score (r=0.348, p=0.024) and the CTRS-attention problems score (r=0.432, p=0.04).

In conclusion, it can be said that leukemia treatment may cause deficits in areas such as attention, memory, learning, processing speed, executive function and problem solving in the late period (Montour-Proulx et al. J Child Neurol 2005; 20 2 129-133).The difference in the severity of deficits in these areas between individuals can be explained by many biological, social and psychological factors (Duffner et al. J Pediatr Hematol Oncol 2014; 36 1 8-15).

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Developmental Coordination Disorder (DCD) is a motor skills disorder characterized by delayed motor development. It affects approximately 6% of school-aged children, limiting their ability to perform everyday tasks. DCD is often associated with Attention Deficit/Hyperactivity Disorder (ADHD) and executive functions prejudices, making it essential to conduct more detailed investigations.

To explore potential correlations and trends between suspected DCD and behaviors related to inattention, hyperactivity, and impulsivity, as well as performance on tasks that involve attention, cognitive flexibility, and working memory.

The study utilized data from a protocol for ADHD assessment conducted at Mackenzie Center for Research in Childhood and Adolescence in São Paulo, Brazil, with approval from the Ethics Committee. The protocol consists of neuropsychological, behavioral and psychiatric assessments. For this study, the following tests were considered: Rey Complex Figure Test and the Five-Digit Test (FDT) to assess cognitive flexibility and memory, Psychological Battery for Attention (BPA) to assess attention, Total index of the ADHD questionnaire based on DSM-5 criteria (total items of greatest severity), and DCD Questionnaire for DCD assessment. Twelve children aged between 6 and 15 years, who were referred for evaluation due to complaints of inattention and hyperactivity, participated in this study. Pearson correlation analyses were performed between the DCDQ and the other collected data.

The results revealed a significant positive correlation between the DCDQ and the Rey Complex Figure Test (r=0.840, p=0.009), suggesting that better motor performance is associated with improved planning and memory functions. There was also a marginally significant correlation between the DCDQ and the BPA divided attention test (r=0.646, p=0.083), which engages working memory abilities. A marginally significant negative correlation was found between the DCDQ and the FDT cognitive flexibility test (r=-0.637, p=0.065), indicating that higher DCDQ scores were associated with shorter times to complete the test. A negative correlation was also observed for the most severe items of the ADHD questionnaire related to hyperactivity and impulsivity. However, inattention complaints did not correlate with the DCDQ scores.

Developmental coordination disorders should not be overlooked in studies and assessment protocols for children with suspected ADHD. Further investigations are needed to identify the domains and characteristics most closely associated with DCD. This will provide evidence to support the development of care programs and intervention strategies for these children.

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Body esteem refers to an individual’s self-evaluation of their own body or appearance. It plays a critical role in the psychosocial development of adolescents, who become increasingly aware of their bodies and how they are perceived by others.

This study aims to examine the specificity of body esteem among Tunisian adolescents and its associated factors.

This cross-sectional study was conducted via a survey among adolescents attending middle and high schools during the 2023-2024 school year. Participants provided written consent and completed a demographic information sheet, the Body Esteem Scale for Adolescents and Adults (BESAA), and the Adverse Childhood Experiences-International Questionnaire (ACE-IQ).

The study population consisted of 1,005 adolescents, with a sex ratio of 0.73 and a mean age of 14.62 years. We found that 88,1% of adolescents had high body esteem while 11,9% had low body esteem. We found that body esteem is statistically correlated with : low socioeconomic status (p=0,033, OR=0,58 (95%CI [0,35-0,94])), with the history of organix disease (p<0,001, OR=0,415 (95%[0,265-0,650])), with BMI measurements (p<0,001) specifically with obesity (p=0,014, OR=0,497 (95%CI [0,292-0,846])). The findings suggested that selfie practice was significantly associated with body esteem (p=0,009, OR=1,819 (95% [1,18-2,8])) and that selfie posting on social media was statistically correlated to appearance esteem with p-value =0,027.

Additionally, we found that body esteem was directly and significantly associated with all the adverse childhood experiences except for collective violence. Detailed results are shown in the table below:

By understanding the associated factors of body esteem, this study contributes to a broader comprehension of adolescents’ well-being and offers insights for creating a safer and more supportive environment for young people in our country.

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