Until now, no studies have been published about the prevalence and needs of children with a mentally ill parent nor about interventions for this vulnerable group in the federal state of Saxony, Germany.

Therefore, the multi-centre study HELP-S for Children was initiated by the University of Leipzig in cooperation with the Technical University of Dresden. The aim of HELP-S for Children is to identifiy the prevalence and specific needs of children with a mentally ill parent.

All psychiatric outpatients of Leipzig and Dresden at an appointed date will be asked to participate in the study. Patients with minor children will be asked to fill out a detailed questionnaire about the perceived needs of their children and the existing and lacking support possibilities. Because there is no adequate instrument to assess the needs of the children with a mentally ill parent, we will develop a standardized questionnaire by using expert interviews and a pre-test with mentally ill parents.

The standardized questionnaire, which we will develop for this study, will be useable in other studies about needs of children with a mentally ill parent. Furthermore, we will gather information about the prevalence of children of mentally ill parents who are outpatients and about the specific needs of these children in the age of 0 to 18. These results will be presented and discussed during an expert workshop at the end of the project to explore ways to improve the situation of children with a mentally ill parent.

Although the Peritraumatic Distress Inventory (PDI) and Peritraumatic Dissociative Experiences Questionnaire (PDEQ) are both useful for identifying adults at risk of developing acute and chronic post-traumatic stress disorder (PTSD), they have not been validated in school-aged children. The present study aims at assessing the psychometric properties of the PDI and PDEQ in a sample of French-speaking school children.

One-hundred and thirty-three school-aged victims of road traffic accidents were consecutively enrolled into this study via the emergency room. Mean(SD) age was 11.7(2.2) and 56.4% (n=75) of them were of male gender. The 13-item self-report PDI (range 0-52) and the 10-item self report PDEQ (range 10-50) were assessed within one week of the accident. Symptoms of PTSD were assessed 1 and 6 months later using the 20-item self-report Child Post-Traumatic Stress Reaction Index (CPTS-RI) (range 0-80).

Mean(SD) PDI and PDEQ scores were 19.1(10.1) and 21.1(7.6), respectively, while mean(SD) CPTS-RI scores at 1- and 6-months were 22.6(12.4) and 20.6(13.5), respectively. Cronbach's alpha coefficients were 0.8 and 0.77 for the PDI and PDEQ, respectively. The 1-month test-retest correlation coefficient (n=33) was 0.77 for both measures. The PDI demonstrated a 2-factor structure while the PDEQ displayed a 1-factor structure. As with adults, the two measures were inter-correlated (r=0.52) and correlated with subsequent PTSD symptoms (r=0.21−0.56; p< 0.05).

The PDI and PDEQ are reliable and valid in school-aged children, and predict PTSD symptoms.

It remains unknown whether peritraumatic reactions predict PTSD symptoms in younger populations. To prospectively investigated the power of self-reported peritraumatic distress and dissociation to predict the development of PTSD symptoms at 1-month in school-aged children.

A sample of 103 school-aged children (8-15 years old) admitted to an Emergency Department after a road traffic accident were consecutively enrolled. Peritraumatic distress was assessed using the Peritraumatic Distress Inventory (range 0-52) and peritraumatic dissociation was assessed using the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) (range 10-50). PTSD symptoms were measured at 1-month by both the child version of the clinician-administered PTSD Scale (CAPS-CA) (range: 0-136) and the Child Post-traumatic Stress Reaction Index (CPTS-RI) (range 0-80).

Mean(SD) participants’ age was 11.7(2.2) and 53.4% (n=55) of them were of male gender. At baseline, mean PDI and PDEQ scores were 21.4 (SD=7.8) and 19.2 (SD=10.2), respectively. At 1-month, mean self-reported (CPTS-RI) and interviewer-based (CAPS-CA) PTSD symptom scores were 23.2 (SD=12.1) and 19 (SD=16.9), respectively. According to the CAPS-CA, 5 children (4.9%) suffered from full PTSD. Bivariate analyses demonstrated a significant association between peritraumatic variables (PDI and PDEQ) and both CAPS-CA and CPTS-RI (r=0.22-0.57; all p< 0.05). However, in a multivariate analysis, PDI was the only significant predictor of acute PTSD symptoms (Beta=0.33, p< 0.05).

As has been found in adults, peritraumatic distress is a robust predictor of who will develop PTSD symptoms among school-aged children.

To investigate economical and psychosocial impact on bullying in schools of Kaunas.

We investigated pupils from the 6, 7, 8 classes from 11 to 16 years old. The study was performed in the randomly chosen different schools of Kaunas. 527 pupils (270 boys and 257 girls) were questioned during this research. The results showed that more than a half of the pupils (67,6 per cent) are becoming victims of bullying in schools of Kaunas. frequency of bullying among boys and girls is almost equal (55,2 per cent boys and 48,8 per cent girls responded that they are bullying at school)(p=0.025, x2=9,317, df 3); most of pupils experience affection in their family (61,9 per cent) and 83,7 per cent of these children think that bullying at school is not the right thing to do (p=0.025, x2=9,317, df 3).

Majority of children who get free lunch (welfare recipients) at school think that financial situation (of the child family) has no influence for bullying (54, 2 per cent). Most of children who are not getting the free lunch at school think that financial situation is important for the bullying to appear (69,7 per cent) (p=0.965, x2= 0,002, df 1).

Frequency of bullying among boys and girls is almost equal; children with better welfare conditions are more inclined to bully; financial situation for bullying to appear has more influence among girls than boys; better family relationships influence negative point of view towards bullying.

The children and youth mental health is a dynamic and developing process that is result of their interactions with family, school, community and surrounding. The goal is to show the influence of family disfunction on behavior disorders among children and youth, especially the presence of negligence and abuse of children. The aim of this research is to show the presence of comorbid diseases and influence of low socio-economic family status as well.

The research is retrospective study taken by 64 patients (36 girls and 28 boys), age between 7 and 18, at Department of child and adolescent psychiatry in Banja Luka. We analised socio-demografic status, comorbid diseases, the presence of negligence and abuse among youth and behavior disorders. Our own questionnaire, made for this research, socio-psychiatric and clinical records and case history are used in this study. The results are analised by graffics and tables.

There is significant higher number of boys, age under 14 years old, statistic lower socio-economic status, the presence of family violence, school dificulties, quiting the school. There is significant number of girls with comorbid disease.

Family can influence on apperance of mental disorders in their children through family disfunction, frequent conflicts, negligence and family violence, the presence of severe diseases, low socio-economic status, psycho-traumatic events and stressful situations.

To evaluate factors associated with the use of restrain and its duration among psychiatrically hospitalized adolescents.

Retrospective, chart-based analysis of patients treated during a 2-year period in Department of Adolescent Psychiatry with average number of patients of 22.6±4.7 and an average admission rate of 320/year.

There were 543 events of restrain during a 2 year period in 164 patients (27/10000 patient days).Restrain was used during 413 (28%) out of 1462 of 12-hour-long analyzed duties. Median duration of restrain per patient was 240 (IQR 90-465) minutes. Factors associated with the risk for restrain in multivariate model were: nurse workload (OR 1.17; 95%CI: 1.09-1.26), fraction of female patients in the unit (OR 3.26; 95%CI: 1.06-10.07), weekday duty (OR 1.67; 95%CI: 1.30-2.13), spring or autumn season (OR 1.51; 95%CI: 1.19-1.93). Child and adolescent psychiatrist on duty (beta= -0.10; p< 0.001) and greater nurse workload (beta= -0.11; p< 0.01) were associated with shorter duration of restrain per patient. Night-time duties were associated with longer use of restrain than day-time ones: 270.0 (25%-75% 92.5-558.8) vs 225.0 (25%-75% 90.0-360.0) minutes. Similarly weekend 292.5 min (120.0-555.0) vs weekday 206.3 min (90.0-427.5) or spring/autumn 295.0 min (25%-75% 105.0-510.0) vs summer/winter 180.0 min (25%-75% 75.0-408.8) duties were associated with highly statistically significant (p< 0.01) longer duration of restrain per patient.

Health service-related factors are important predictors of the use and duration of restrain. Adequate number of well-qualified nursing staff should be consider as means to counter this problem.

Most of the studies about Eating Disorders in adolescents have been typically focused on females, only to conclude that the approach should be similar in males. It has been stimated that 5-10% of patients with Anorexia Nervosa are males. Later age of onset and higher prevalence of premorbid overweight are considered among the main differences with female patients.

Analysis of the anthropometric variables of a sample of males with diagnosis of Restrictive Eating Disorder.

Naturalistic, Descriptive and Retrospective study

1. - Sample: 22 male adolescents

2. - Inclusion criteria: males with Restrictive Eating Disorder diagnosis (according to DSM-IV criteria) admitted to an Eating Disorder ward during 2007 and 2008

3. - “ad hoc” questionnaire (15 items)

4. - Analysis: PASW statistics 18

Age range: 7-14years (medium age=14,79±2,50years).11 patients (50%) were older than 16 years-old

1. - Medium BMI (Body Mass Index) at the beginning of the admission was 17,79kg/m2.

medium weight loss: 13,5±7,02kg/m2 (corresponding to a reduction of 22,24±7,52% of the previous weight)

1. - Medium speed of weight loss: 0,92±1,1kg/54

2. - BMI at discharge: 18,69 ±3,43 kg/m2

3. - 19/22 patients (86%) had a premorbid history of overweight

4. - Binge eating: 8 patients (36,4%)

5. - Purgative behaviour: 10 patients (45%)

6. - Laxatives use: 4 patients (18%)

7. - Intense physical exercise: 21 patients (95,5%)

8. - Average duration of current restrictive episode: 13,7 months

In the studied sample we observed:

1. - High prevalence of premobid overweight

2. - Very high frequency of compulsive exercise

3. - Drastic weight loss and loss of a very high percentage of the previous weight, in short periods of time, reaching very low BMI.

The etiologies of autism are complex and presence of a wide variety cytogenetic abnormalities are providing us with extremely valuable information about the role played by genetics in autism and collaboration with psychiatrists. Such recognition and understanding will help clinicians implement syndrome-specific treatments of patients identified with a genetic cause of autism spectrum disorder. Early identification of this genetic disorder is critical not only to the individual patient but for the entire family.

Health care policies should be implemented to provide the proper care for children with mental health disorders and there is a need for improved infant and early childhood mental health assessment. In this paper we examine how system data reflecting program practice meet to inform advances in developing infant mental health policy.

Data from the Collaborative Mental Health Care (CMHC) program, a consultation based service in the focusing on the early identification of children (aged 0-5) at significant risk for developing mental health problems, was analyzed in comparison to those not coming into contact with such specialized services.

Compared to others of the same age, those with CMHC involvement waited less time [mean days 13.7 (S.D. 32.3) vs. mean days 69.3 (S.D. 180.3] and had shorter lengths of stay [mean days 139.9 (S.D. 119.3) vs. mean days 232.4 (S.D. 329.7] and proportionately fewer registrations.

Early identification of children's mental health concerns through supporting the community through specialized consultation and promoting resiliency can significantly reduce mental health service utilization by offering more specific and specialized information, referral or treatment services for infants and very young children. The policy implications are self-evident: All provinces require specialized mental health services for infants and very young children in order to better serve children and increase service capacity.

Continuous client feedback aims to increase the effectiveness of therapy by emphasizing common factors in treatment across theories that contribute the most to change. In this paper, we present data using two independent measures, which appears to isolate the influence of social desirability on treatment outcomes.

Continuous client feedback data was collected in the Student Health Partnership program and compared with independent data reflecting client function (Child Global Assessment of Function). Data was collected at two times by the same staff using two sampling methods. In the first sample, staff preferentially assigned clients to case (continuous client feedback) and comparison treatment as usual) on the basis of preference and convenience whereas in the second sample assignment to case and comparison was random.

When the data from the two sample frames was compared, systematically different trajectories in the measured outcomes reflecting continuous client feedback and function were obtained with those in sample one being substantially higher than comparisons or population reference values.

The difference in results emerging from the two sampling frames is explained in terms of social desirability. Outcomes for clients were much better in the first sample, where staff choose clients they apparently liked for specialized treatment.

Using baseline and outcome data collected in the Calgary Region Children and Adolescent Mental Health Program (CAMHP) over the last six years, a profile was developed for those who are at risk for poor treatment outcomes.

Based on the data collected in CAMHP, 6229 completed measurable treatment plans (MTP) were analyzed for consistency (by year) and theoretical meaningfulness (by clinical level). A table was developed to describe by quartiles those who improved and those who got worse in terms of problem severity and function. A multi-variable linear regression model was developed for function with linked data that predicted the profile of those at risk for poor treatment outcomes.

MTP scores reflecting problem severity and function were consistent over time. Further, MTP scores were theoretically meaningful (e.g., inpatients were more severe on admission than those receiving community or day hospital-based treatment). In total, 659 MTPs indicated no improvement for a negative state and an additional 830 changed negatively in problem severity and Children's Global Assessment Scale (C-GAS) scores. The multivariable model based on admission data provided a risk profile for this group that accounted for 52% of the variance for discharge function.

The baseline and outcome data gathered from the Regional Access and Intake System (RAIS) serving CAMHP may be used effectively to predict clinical outcomes in ways that can draw attention to those at risk for poor outcomes.

According to European Statistical Office EUROSTAT, Romania represents the second source of immigrants in the European Union. Off the record, more than 2 million people work out of the country, sex ratio for immigrants being quite equal.

Parents’ immigration seems to become a new mode of abuse against children. The most optimistic statistics highlight that almost 100,000 of children have been abandoned by one or both parents, the majority being ascertained to older family members.

We followed-up 96 teenagers registered in Mental Health Center and University Clinic of Psychiatry Craiova, aged between 15.4 and 19.8 (mean age 17.4 years).

Of the 96 subjects included in the study, 59 were boys and 37 girls. Their mean age at parents’ departure was 8.2±1.9 years. In the total sample, the most prevalent symptoms at the onset were non-specific symptoms of stress response (i.e. exaggerated startle response, difficulties getting to sleep, difficulty in concentrating). Symptoms released after a delay of at least 6 months after the departure (more quickly at boys) and remaining members of the family decided to accompany the child to the psychiatrist more later, in several cases even at two years distance since the onset (earlier at boys, in which emotional response to abandon was noisier, often with dissocial behavior). Intensity of symptoms varied from mild to severe.

Home alone generation begins now, after several years of opening to European world, to be a problem that us, Romanian adult psychiatrists, haven’t encountered before.

The aim of this study was to examine whether the presence of risk alleles of the norepinephrine transporter gene (SLC6A2) polymorphisms is associated with differences in regional cerebral blood flow (rCBF) measured by 99mTc-HMPAO single photon emission computerized tomography in a Korean sample of ADHD.

The present study included 24 children with ADHD (9.5±2.4 years), consisting of 20 boys and 4 girls, aged 6-16 years. We investigated the G1287A and -3081(A/T) polymorphisms of the SLC6A2. The rCBF was compared between the ADHD subjects with and without risk alleles at the G1287A polymorphism and at the -3081(A/T) polymorphism. Image analyses were performed with voxelwise t-statistics using SPM2.

1. 1) The ADHD subjects with the A allele (risk allele) at the G1287A polymorphism showed reduced perfusion in the left middle frontal gyrus, left inferior parietal lobule, precuneus, right superior frontal gyrus, and right superior parietal lobule as compared with ADHD subjects without the A allele (p< 0.001).

2. 2) The ADHD subjects with the A allele at the G1287A polymorphism showed increased perfusion in the right middle frontal gyrus, right middle temporal gyrus, right superior temporal gyrus, right fusiform gyrus, right precentral gyrus, and right anterior lobe of cerebellum as compared with ADHD subjects without the A allele (p< 0.001).

3. 3) No significant perfusion differences were found between ADHD subjects with and without the T allele (risk allele) at the -3081(A/T) polymorphism.

Our findings suggest that the SLC6A2 G1287A polymorphism might exert differential effects on rCBF in children with ADHD.

Intellectual disability (ID) is defined as significantly subaverage intellectual functioning with deficits in adaptive behavior. For ∼40% of individuals, cause for disability remains unknown and these are categorized as idiopathic ID (IID). Various behavioral problems co-occur with ID and thus serotonergic neurotransmission, known to control emotion, mood and drive, has received immense attention. Synaptic serotonin (5-HT) level is primarily maintained by metabolizing enzyme MAOA and serotonin transporter (SLC6A4) which helps in reuptake of the neurotransmitter. Since functional genetic polymorphisms have a potency to affect activities of these proteins, in the present investigation polymorphisms in these genes (MAOA-u VNTR, rs6323, 5-HTTLPR and STIN2) have been analyzed in IID individuals associated with various behavioral problems.

Families (N=189) with IID probands were recruited following DSM-IV. After obtaining informed written consent for participation, peripheral blood was collected for isolation of genomic DNA used for PCR-based genotyping of target sites followed by family-based statistical analyses of data.

Significant association of MAOA rs6323 “T” allele with female IID (P=0.016) and a trend towards association with female IID patients exhibiting behavioral problems (P=0.046) was noticed. Non significant over transmission of the 5-HTTLPR “L” allele was also observed in female IID probands with behavioral problems (P=0.076). Synergistic epistatic interaction, with a sex-bias, was noticed between MAOA and 5-HTT (P< 0.05).

From the data obtained it could be summarized that serotonergic system may have some role in the etiology of behavioral problems of female IID individuals.

Travellers have historically suffered from discrimination in Ireland and their children have been marginalised as a result.

Review relevant online and hardcopy literature pertaining to special needs of Traveller Children and Adolescents

1. 1/ Assess/evaluate impact of socio-cultural context and environment upon treatment for psychiatric problems of Traveller children/adolescents in Ireland.

2. 2/ Assess/evaluate coverage of mainstream knowledge and understanding of Traveller family and community culture; categorisation of traveller children/adolescents affected by cultural/social misunderstandings; communication issues due to cultural differences with settled community; impact of sense of exclusion and/or discrimination upon traveller children/adolescents; role of ‘racism’ in tendency to believe traveller children/adolescents have mental problems more quickly than those from settled community; apprehension of involvement in treatment process; different expectations of traveller families from mainstream specialists with respect to treatment process and objectives.

Rigorous review of relevant and applicable hardcopy/internet literature in English since 2000 with particular emphasis on traveller children/adolescents in Ireland.

Problems associated with traveller children/adolescents generally multi-dimensional and require additional assistance through family and community oriented mental health services that respect and understand cultural values and way of life of the traveller population. Furthermore, awareness of discrimination and exclusion that has been and is suffered by the travelling population is essential in responding to psychiatric needs of traveller children/adolescents.

History of discrimination and exclusion together with lack of cultural understanding and empathy have often hampered effective treatment of traveller children/adolescents in Ireland. Need for greater involvement of travelling communities in psychiatric treatment process.

To determine the metacognitive deficits and behavioural and emotional regulation deficits among a group of children undergoing treatment for ADHD and to compare these with the hyperactivity/inattentive and behavioural assessments which contributed to the diagnosis.

Children and adolescents referred for ADHD assessment to a community Child & Adolescent Mental Health Service were assessed using clinical assessment, SNAP-IV, FTF and BRIEF rating scales. Comorbidities were assessed using clinical assessment and screened using the FTF. Clinical assessment included interview of parents, relatives and relevant school supervisors. The BRIEF scale was used to advise on specific executive function difficulties.

A total of 25 children and adolescents had complete assessments as part of routine clinical practice. There were particular groups which demonstrated elevated behavioural regulation difficulties; in the group with higher metacognition scores, groups were identified that had higher initiation and working memory deficits, higher planning and organisational deficits, or a mixture of all 5 items being elevated.

It is advantageous to complete an executive function assessment as part of ADHD assessment in clinical practice as it allows more detailed management advice to be given to teachers and support/special needs teachers and parents. It may also demonstrate successful patient-specific indicators of treatment response and outcome measures among those children who have high ADHD-related executive function deficits but whose core ADHD Hyperactive/Impulsive symptoms remain highly rated.

Childhood ADHD typically presents with comorbidites. Assessment tools for developmental screening vary greatly in length and complexitity, and parental preference has an impact on the usefulness of clinical tools in routine practice.

To determine among a group of children which ones may benefit from occupational therapy, speech and language therapy and educational progress re-assessment as part of routine clinical assessment for ADHD with the intention to improve service delivery.

Children were referred on a routine basis to a community clinic for ADHD assessment. SNAP-IV, FTF and BRIEF rating scales were administered. The FTF was used as a parent-rated screen for general development; it is a 200-item questionairre and includes sections on motor skills, speech and language skills and variety of other areas.

A review of freely available developmental questionaires was conducted. The FTF was introduced on a trial basis as a balance between the typical shorter scale of the SDQ and longer time needed for the DAWBA.

The parents of 25 children completed the FTF as part of routine clinical assessment for ADHD. Along with identifying groups of children who could benefit from further allied-healthcare assessment, the majority of parents had no difficulty with the length, although minority did report difficulty with understanding the language. Diagnoses were confirmed using SNAP-IV and clinical interview and assessment. Executive function scores were compared to FTF executive function screening scores.

Routine screening of developmental comorbidities may help with the development of patient -related outcome measures.

To examine the reasons for non attendance at clinic appointments, and to identify any ways in which these rates might be reduced.

We examined the records of those patients who, having consented to a referral to a child and adolescent psychiatry service, then either failed to attend any appointments, or who ceased to attend after having attended one or more appointments, but without being discharged, over an 18-month period. The parents of these children were contacted by telephone and a semi-structured interview was conducted to ascertain the reason in each case for defaulting on the appointment.

The reasons given by the parents of the patients for missing appointments included their opinion that the referral was unnecessary (31.8%), resolution of the problem which led to the referral (22.7%), the child refusing to attend (22.7%) and problems with clinicians (9%). In the majority of cases where the parent did not consider the referral necessary, the referral had been made by the child's school (71%), with the parent reporting that they had felt pressurised into consenting to the referral.

The high levels of non-attendance at clinics have serious implications, especially if it means that those in need of services are not accessing them. The factors which we have identified in this study are chiefly patient rather than service factors, which are likely to be related to socio-economic factors.