Psychiatric disorders are frequent among patients with epilepsy. The association between epilepsy and mood disorders is recognized since the classical antiquity. Recent studies demonstrated that the prevalence of bipolar symptoms in epilepsy patients is more significant than previously expected. In the first half of the twentieth century, Kraeplin and Bleuler were the first to describe a pleomorphic pattern of symptoms claimed to be typical of patients with epilepsy and recently Blumer coined the term interictal dysphoric disorder to identify this condition. Although for some authors, the existence of this condition as a diagnostic entity is still doubtful, for others, it represents a phenotypic copy of bipolar disorder.

In this work, we start from the phenomenological similarities between the interictal dysphoric disorder and the bipolar disorder, to explore the neurobiological underpinnings that support a possible link between epilepsy and bipolar disorder.

Research of articles published in PubMed and other databases.

Interictal dysphoric patients have features that resemble the more unstable forms of bipolar II disorder and benefit from the same therapy used in bipolar depression. Epilepsy and bipolar disorder share features like episodic course, the kindling phenomenon as possible pathogenic mechanisms and the response to antiepileptic drugs. The study of possible common biological processes like neurogenesis/neuroplasticity, inflammation, brain-derived-neurotrophic-factor, hypothalamus pituitary adrenal axis, provided promising but not consensual results.

Further efforts to understand the link between epilepsy and bipolar disorder could provide the insight needed to find common therapeutic targets and improve the treatment of both illnesses.

The authors have not supplied their declaration of competing interest.

The medical treatment of acute mania today mainly includes atypical and typical antipsychotics, lithium or valproat. Atypical antipsychotics are often used as first-line treatment, while typical antipsychotics come with the risk of severe long-term side effects and less used today. However, typical antipsychotics may lead to a faster reduction in the severity of mania or a faster remission of symptoms.

To investigate whether the acute effect of typical antipsychotics differs from atypical antipsychotics measured by a daily mania rating-scale (MAS-M) and duration of treatment in a real-life clinical setting.

To help determine if short-term treatment with typical antipsychotics may still be of benefit in the acute treatment of mania.

This is a retrospective case record study. Patients admitted to an acute hospital ward with acute mania between 2012 and 2015 were included (n = 100). The daily use of atypical and typical antipsychotics will be compared by daily change in Bech-Rafaelsen Modified Mania Scale (Mas-M) score and time to discharge. The change in mania over time is presented visually using graph curves.

The data extraction and data handling will be executed in the winter 2015–2016.

Any preliminary findings will be presented at EPA 2016.

Metacognition is described as the set of human abilities that allows us to recognize and think about own and other people's mental states. We use these skills in order to overcome psychological and interpersonal issues and to cope emotional, cognitive and behavioral suffering. Studies that focusing on metacognition in bipolar disorder (BD) are still limited and data are controversial. Our purpose is investigating the difference between BD patients and BD patients with alcohol addiction (BD + A), in terms of metacognitive functions. In addition, we want to assess among BD + A whether the increase in metacognitive functions mediates the relationship between symptoms at T0 and T1.

Forty patients were recruited for this study. A set of tests was performed on each patient to formulate a metacognitive and clinical evaluation. A single measurement was performed on 20 BD patients. Two measurements (T0–T1) were carried out on the 20 BD + A patients, after an integrated treatment.

Data shown significant differences between these two groups. As regards the treatment of BD + A patients, differences were found between T0 and T1. Among the BD + A patients, reduction in the Beck Cognitive Insight Scale (BCIS-SC, P 0. 042) scores between T0 and T1, leads to the prediction of symptom improvement.

Our results confirm the existence of a specific profile of metacognitive functioning in these patients. Our results reveal that the metacognitive functions appear to be predictors of the improvement in the remission of symptoms.

The authors have not supplied their declaration of competing interest.

This is a case-control study which was conducted in children below 12 years of age from June 2013 to May 2014 at outpatient child psychiatry clinic at Elhussin Hospital Al-Azhar University, Cairo, Egypt.

The study was based on 62 cases and 30 controls. The data collection instrument included socio-demographic & Children Attention and Adjustment Survey (House form){CAAS}. And interview by (Diagnostic Interview Kiddie-Sads-Present and Lifetime Version (K-SADS-PL) to exclude other psychiatric morbidity. clinical data, serum 25(OH) Vitamin D. Descriptive statistical analysis were performed, Pearson Chi2 test (χ2) and Student (t) test.

1-Vitamin D level was much lower in ADHD children compared to healthy children, and was a significant difference in the mean values of vitamin D between ADHD(23 ± 13) and control group means (44 ± 12) and P value was > 0.001 and was significant difference between subgroup of ADHD, means of inattentive subtype was(20 ± 13) hyper active subtype (30.1 ± 5)and combined subtype(24.04 ± 4). P value 0.011*.

Children with ADHD had significantly lower levels of VITAMIN D than healthy, and inattention subtype than other types of ADHD.

The authors have not supplied their declaration of competing interest.

Most children experience some degree of fear during their development. Excessive fears can create serious obstacles to children. The aim of this study was to identify the most common fears in a sample of children and adolescents and examine the socio-demographic correlates of fears.

This cross-sectional study was conducted during the period July 2010 to February 2012 at Public and Private Schools of the Ministry of Education and Higher Education, in Qatar. Out of 2188 students approached, 1703 students agreed to participate in this study, with a response rate of 77.8%. The questionnaire includes socio-demographic information, academic performance, behaviour at home and various fears.

More than half of the children experienced fears (56.7%). Most of them were in the intermediate level, 12–15 years old (46.1%). Overall, reported fears were significantly more frequent in girls (62.6%) than boys (37.4%) (P < 0.001). A significant difference was observed between girls and boys who experienced fears in their age group (P < 0.001), education of mother (P = 0.04), household income (P = 0.008) and academic performance (P < 0.001). The most frequent reported fears were fear of someone dying in the family (85.2%), parents getting divorced (84.5%), breaking religious law (82%), being kidnapped (78.2%), family members ill (78%) and dying (76.7%).

The study findings revealed that fears were highly prevalent in Arab children and adolescents in Qatar. Girls reported more fears than boys. There was a significant difference observed between girls and boys in their age group and academic performance for the reported fears.

The author has not supplied his/her declaration of competing interest.

This is a mixed method study. Firstly, a series of in depth interviews addressed French youth psychiatrists’ opinions towards prognosis. Participants worked in a variety of settings, public institutions, private practice, and student help. Secondly, an online survey investigated French psychiatrists’ opinion toward prognosis. The survey consisted of the presentation of a clinical vignette in which a psychiatrist communicates on prognosis to a young patient with acute psychotic symptoms. The vignette was randomly shown in four versions with different predictions and outcomes. Respondents were then asked questions regarding prognosis communication.

Qualitative analysis stresses psychiatrists’ uncertainty in their daily work with teenagers presenting unclear symptoms that might be the sign of a beginning psychotic process or might as well reflect adolescent unease. Psychiatrists are reluctant to commit into prognosticating or using standardized tools. The contradiction between the expectations that psychiatrists be able to predict what will happen to a young patient and their impossibility to do so, raises an ambivalence that is only managed through a deep emotional involvement. The survey received more than 400 answers, and statistical analysis is in progress.

The author has not supplied his/her declaration of competing interest.

Somatic symptoms disorders (SSD) are one of the most neglected areas in child and adolescent psychiatry (Mohapatra et al., 2014). SSD are characterized by multiple and variable physical symptoms without demonstrable pathophysiological processes. Literature has investigated the role of several psychological variables in SSD, with inconclusive data. Moreover, there is a paucity of studies on middle-childhood and early adolescence in this clinical condition.

We focus on the role of attachment and on psychological aspects in children with SSD.

The aims are to verify the presence of:

– an overrepresentation of attachment disorganization in these children;

– an overrepresentation of psychological symptoms.

Fifty-six consecutive Italian patients with SSD, aged from 8 to 15, were administered Child Behavior Checklist (Achenbach, 1991) and Child Attachment Interview (Shmueli-Goetz et al., 2000).

Findings showed:

– a significant presence of disorganized attachment with respect to both parents;

– high levels of anxiety and depression.

This study extended previous research in middle-childhood and early adolescence in SSD. The findings support the influence of the disorganization aspects and the psychological problems surrounding the SSD. The clinical implications for future research directions are discussed.

The authors have not supplied their declaration of competing interest.

An overlap between autism spectrum disorder (ASD), in particular Asperger Syndrome (AS), and high intellectual potential (HIP–Total IQ > 2 SD) is often discussed.

Explore differences between homogeneous and heterogeneous Wisc-profiles among HIP children, and between HIP and ASD children, on cognitive and clinical assessments.

Forty-nine participants (mean age 11.2 years) were divided in 4 groups: High Functioning Autism (HFA), AS, Homogenous HIP and Heterogeneous HIP. Data of WISC-IV and questionnaires – Autism Quotient (AQ), Empathy Quotient (EQ), Systemizing Quotient (SQ), Children's Communication Checklist (CCC) – were compared.

On the WISC-IV, the Z scores curves follow similar trajectories but highlight quantitative differences between AS and heterogeneous HIP: verbal comprehension is the highest index (+1,6 SD in AS; +3,1 SD in heterogeneous HIP) followed by perceptual reasoning, working memory, and processing speed indexes (–1,2 SD in AS; +0,5 SD in heterogeneous HIP), respectively. The questionnaires show that scores of Homogenous HIP children are all in the average. Heterogeneous HIP children score 2,1 SD above average on the AQ (+1,6 SD on “Social Skills” and +1,3 SD on “Local Detail” subscales), whereas ASD children score 4 SD above average on the AQ. In addition, heterogeneous HIP children show pragmatic difficulties (–2,4 SD on the CCC, with a peak on “Area of Interest” subscale), also present in ASD children (–4 SD).

AS and heterogeneous HIP children show similar cognitive profiles on the WISC-IV. Furthermore, heterogeneous HIP children exhibit high scores on the AQ and have pragmatic difficulties.

The authors have not supplied their declaration of competing interest.

Many research focus on the study of language in ADHD children. However, the discourse is beyond the language and provides access to child representations of the world, to its own history. The aim of our study was to compare and analyze the self-narratives during a family meal.

Speeches of 5 children (6–10 years) were recorded, analyzed and then compared to a strictly matched control group. Once transcribed, the data were morphosyntactically annotated and processed using multivariate exploratory techniques. A thematic analysis was also realized to understand how ADHD children moved from one conversation topic to another.

Our first results showed that ADHD children have more difficulty in producing self-narratives while they are doing something else (eat). Moments of sharing common stories are less frequent compared to the control group. The transition from one topic to another is made by direct associations (e.g. the child talks about what he is eating, and this leads him to think about the next day's dinner). The construction of the self-narratives is poorer compared to the control group, both in content and in length of utterances.

Interestingly, concerning ADHD children, it appears:

• – That these self-narratives exist;

• – but also that they are poorer;

• – that they allow, less frequently than in the control group, projections into the future or recollection of past events.

If ADHD children cannot access to these moments, special attention should be paid to this sharing of family history outside of daily activities.

The authors have not supplied their declaration of competing interest.

Trauma experiences during childhood and adolescence (Gibb, 2002; Ansel et al., 2011; Musliner et Singer, 2014; Hopwood et al., 2015), the experience of shame (Rubeis et al., 2008; Cunha et al., 2012; Rosso et al., 2014; Stuewig et al., 2015) and gender (English et al., 2004; Rosso et al., 2014) had been considered as predictors of depressive symptoms.

To observe intra-indidual variability of trauma, external shame, gender (as predictors) and depressive symptoms (as dependent variable).

To test the predictive value of trauma, external shame and gender on depressive symptoms at 6 months, in adolescents.

A sample of 325 adolescents (ages ranging from 12–18) completed the Child Depression Inventory, the Childhood Trauma Questionnaire and Other as Shamer, adolescents version. The results were analysed by the hierarchical multiple regression method (SPSS Inc., 22).

The model – shame (b = 0.63; P < 0.001); affective abuse (b = 0.15, P = 0.001), gender (b = 0.12; P = 0.001), sexual abuse (b = 0.12, P = 0.002), and emotional neglect (b = 0.10; P = 0.013) – explained 63% of depressive symptoms variance.

The data indicate that the higher the level of shame and trauma, the higher the level of depressive symptoms at 6 months. The present study can add important information that sheds light to the role of mechanisms underlying the vulnerability to depressive symptoms and that might have impact in the existing therapeutic interventions.

The authors have not supplied their declaration of competing interest.

During last 10 years, the number of non-suicidal self-injury patients (NSSI patients) in Department of Adolescent Psychiatry of Medical University in Łódź has doubled (from 20 to over 40%). According to DSM-5 criteria, NSSI are deliberate and superficial skin injuries. Such behaviours should be distinguished from suicidal behaviour disorder (SBD). However, the two display the high rate of co-occurrence.

The study covered 1300 patients (12–19 years of age) hospitalized during last 6 years. The analysis included various variables, e.g. demographic, familial, problems related to school and to peer relations, and variables describing NSSI.

The analyzed group consisted of 60,4% girls and 39,6% boys. Out of 43% of patients who performed NSSIs, 45% also confirmed BDS. The patients with diagnosed mental retardation and with schizophrenic psychoses performed significantly fewer NSSIs. The instrumental motive was the most frequently declared reason of self-injury (76%). The reactive (65%), and the illness-related motives (only 15%) were less frequent. In comparison to patients without self-injuries, the NSSI patients significantly more frequently (P < 0.05) experienced physical violence, unreciprocated love, played truant and repeated grades. Conflicts, delinquency, divorce, and lack of a sense of support were significantly more frequent in the family systems of NSSI patients. They more often experienced loss of their parent before age 15 and had close relatives suffering from mental disorders.

NSSI is a multi-dimensional issue that requires further research. Indicating potential risk factors allows for implementing efficient prophylactic, diagnostic and therapeutic actions.

The authors have not supplied their declaration of competing interest.

One in ten children and adolescents experience mental health difficulties at any given time, yet only one third of those suffering access treatment. Untreated mental illness predisposes to longstanding individual difficulties, and presents a great public health burden. Large scale initiatives to reduce stigmatization of mental illness in children and adolescents, identified as a key deterrent to treatment, have had limited success, and research is scarce.

To gain a better understanding of the stigma experienced by children and adolescents with mental health difficulties.

We conducted a systematic review of the literature examining stigma and self-stigma towards children and adolescents with mental health difficulties, in order to better understand the extent and type of discrimination directed towards this particularly vulnerable group.

Following PRISMA guidelines, the databases Pubmed, PsychINFO and Cochrane were searched for original research published between 1980 and 2014, assessing public stigma (i.e. the reaction of the general public) and self-stigma (i.e. internalized public stigma) towards children and adolescents with mental health difficulties.

Thirty-seven studies were identified, confirming that stigmatization towards children and young people suffering mental health difficulties is a universal and disabling problem. There was some variation by diagnosis and gender, and stigmatization was for the most part unaffected by labelling. Self-stigmatization led to more secrecy and avoidance of interventions.

The findings confirm that stigmatization of mental illness is poorly understood due to a lack of evidence and methodological discrepancies. Implications of the findings are discussed, and suggestions made for future research.

The authors have not supplied their declaration of competing interest.

The purpose of the study was to evaluate burden of main caregivers in children with epilepsy and to identify factors associated with caregiver burden.

Main caregivers of pediatric patients with epilepsy were enrolled four general hospitals in several cities of Korea. One hundred and twenty-fou caregivers of patients were included in this cross-sectional study. Sociodemograhic/clinical characteristics of patients and sociodemographic characteristics of caregivers were collected. The caregivers were assessed using the Korean version Zarit burden Interview (ZBI), Center for Epidemiological Studies of Depression Scale (CES-D) and social support/conflict scale. Multiple linear regression methods were used to evaluate factors contributing to burden of caregivers.

Of the 124 participants, 98(81.7%) were the mothers. The mean score on the ZBI and CES-D were 23.66 (± 19.15) and 13.87 (± 12.95) points, respectively. Factors affecting of caregiver burden were the number of antiepileptic drugs (AEDs), which patients are taking, and CES-D score by multiple linear regression analysis.

Higher number of AEDs prescribed and depression of caregivers are main factors contributing to burden of caregivers in children with epilepsy.

The authors have not supplied their declaration of competing interest.

Weakness in grammar understanding is key future of specific language impairment (SLI) in children. There has been a considerable amount of work on the language abilities of children with SLI, but we still know relatively little about their other cognitive abilities –in particular their non-linguistic cognitive strengths and weaknesses.

The aim of this research was to examine the hypothesis that Russian-speaking children at the age of 4 with deficit in executive abilities have a risk for emerging weakness in grammar understanding at the age of 6.

One hundred and twenty-five children at the age of 4 were assessed with the NEPSY to reveal children with different level of executive abilities. We have revealed 21 children with deficit in executive abilities. The control group included 21 children with typical level of executive abilities. The children from experimental and control group were matched for IQ and gender. In the framework of longitudinal research, children at the age of 6 from both groups were assessed by Grammar Understanding Test from Luria's neuropsychological assessment technique.

Two-way ANOVAs with repeated measures revealed significant differences between groups for scores in the Grammar Understanding Test. Children from experimental group had weakness in grammar understanding.

We have revealed that children at the age of 4 with weakness in executive abilities have a risk for emerging weakness in grammar understanding at the age of 6. In view of the obtained results, it can be assumed that executive abilities have influence on the development of grammar understanding in preschool children.

The author has not supplied his/her declaration of competing interest.

Neurocognitive deficits are assumed to be underlying the behavioral symptoms of ADHD. Research over the years has identified a host of these neurocognitive deficits, but no single one deficit appears to be dominant or pervasive in all ADHD children. This raises the query whether there can be further subgrouping of ADHD children at the neurocognitive level.

This study aims at disentangling the heterogeneous neurocognitive deficits underlying ADHD. To achieve this, we explore if there are separable neurocognitive subgroups in ADHD children.

One hundred and sixty-four Chinese ADHD boys and 163 typically developing controls, aged 6 to 12, were recruited in Hong Kong. A neurocognitive battery of executive function (EF) measures was administered. Cluster analysis was first conducted to identify subgroups of ADHD children based on their neurocognitive functioning. MANOVA was then employed to further explore the differences between subgroups.

Two ADHD subgroups were identified. One subgroup showed multiple EF deficits, including disinhibition, impaired interference control, distorted temporal information processing, slow processing speed, and delay aversion. The other subgroup, on the contrary, had intact EF but increased response variability. Both subgroups had comparable ADHD phenotypic severity and comorbidity pattern. However, ADHD children in the EF deficits subgroup were more responsive to medication (i.e., methylphenidate).

Results support the neurocognitive heterogeneity of ADHD. EF deficits and response variability are two separable neurocognitive profiles underlying and subgrouping ADHD children of comparable severity. This subgrouping has implication for medication response and offers candidate endophenotypes for neuroimaging and genetic study.

The authors have not supplied their declaration of competing interest.

Studies on relationships between music, visual imagery or therapeutic techniques, like mindfulness and emotions have been undertaken with varying success in predominantly adult populations. Their role in the child and adolescent population remains unclear.

We undertook a systematic literature review to assess current evidence in the use of music, guided imagery with/without therapeutic techniques for emotional processing in adults, children and adolescents.

We identified 87 relevant papers (JSTOR, OVID Medline, Cochrane, PubMed, Science Direct, Taylor & Francis and Wiley). We excluded non-English papers and qualitative analyses. Nine studies used quantitative techniques (Neuroimaging) for assessing emotional change using musical and non-musical stimuli (n = 77). Of these, four studies used fMRI and two used PET scans.

fMRI demonstrates a significant relation between amygdalar activation and emotional response to visual imagery (P < 0.05, n = 45). Early information using PET scanning shows a significant association between activation of different parts of brain with varied visual imagery (one study, n = 5) and varied music (one study, n = 10). There is similarity in the activation of specific cortical areas using musical and non-musical stimuli. Two separate studies of patients with damaged amygdala due to disease (n = 6) showed significant impairment of emotional processing and response.

There is early encouraging data providing evidence of possible relationships between music and visual imagery in emotional processing. Further studies are needed to examine these in detail, especially in children/adolescents. Music with visual imagery may be a useful adjunct in the self-guided processing of milder emotional disorders with components of anxiety, depression, adjustment and emotional dysregulation.

The authors have not supplied their declaration of competing interest.

The long-term safety and efficacy of lisdexamfetamine dimesylate (LDX) in children and adolescents with attention deficit/hyperactivity disorder (ADHD) was evaluated in a European 2-year, open-label study (SPD489-404).

To evaluate the time-course of treatment-emergent adverse events (TEAEs) in SPD489-404.

Participants aged 6–17 years received open-label LDX (30, 50 or 70 mg/day) for 104 weeks (4 weeks dose-optimization; 100 weeks dose-maintenance).

All enrolled participants (n = 314) were included in the safety population and 191 (60.8%) completed the study. TEAEs occurred in 282 (89.8%) participants; most were mild or moderate. TEAEs considered by the investigators as related to LDX were reported by 232 (73.9%) participants with the following reported for ≥ 10% of participants: decreased appetite (49.4%), weight decreased (18.2%), insomnia (13.1%). TEAEs leading to discontinuation and serious TEAEs occurred in 39 (12.4%) and 28 (8.9%) participants, respectively. The median (range) time to first onset and duration, respectively, of TEAEs identified by the sponsor as being of special interest were: insomnia (insomnia, initial insomnia, middle insomnia, terminal insomnia), 17.0 (1–729) and 42.8 (1–739) days; weight decreased, 29.0 (1–677) and 225.0 (26–724) days; decreased appetite, 13.5 (1–653) and 169.0 (1–749) days; headache, 22.0 (1–718) and 2.0 (1–729) days. Reports of insomnia, weight decreased, decreased appetite and headache were highest in the first 4–12 weeks.

TEAEs associated with long-term LDX treatment were characteristic of stimulant medications, with the greatest incidence observed during the first 4–12 weeks.

The authors have not supplied their declaration of competing interest.

The problem of children's mental health in Ukraine – it is one of the most pressing problems in the country's health. This is due to the increasing number of extreme situations (military operations in the territory of Ukraine) for the last time that calls for the training of specialists capable of carrying out psychosocial rehabilitation to victims of “anti-terrorist operation”(ATO).

The mental and behaviour disorders in children affected of ATO. We studied 261 families: 107 adults and 154 children. The aim of the project was to optimize the provision of psycho-social support for children and adolescents with problems of the psychic sphere by developing a system of psychological adjustment and social education at the Centre for psychosocial rehabilitation of children, as well as the creation of the necessary conditions that expand the comfort and a safe space for the child to enhance positive impacts and mitigate negative impacts of the social environment.

The leading role was played by a combination of two areas of work, namely the psychocorrection (trainings, art-, individual-, family-, hyppo-therapy) and social work.

In 85.4% of the children showed stabilization of mental and emotional state, reducing aggression, increasing motivation to social activity. In 56.3% of families – reducing conflict relations.

The non-standard way of psycho-correction allowed organizing a fruitful and creative leisure, which resulted in the reduction of aggression and anxiety, increased motivation for the successful development of new activities and problem-solving skills and conflict situations with peers and family members.

The authors have not supplied their declaration of competing interest.

The move from Child and Adolescent Mental Health Services (CAMHS) to adults’ services (AMHS) is likely to coincide with other transitions in the adolescents’ life. Barriers affecting this transition have been referred in most countries, but there is a lack of studies on this matter.

To evaluate the transitional process from CAMHS to AMHS in Portugal, focusing on four criteria: continuity of care, parallel care, a transition planning meeting and information transference. The continuity/discontinuity of the diagnosis and therapeutic plan made at CAMHS has also evaluated.

Identification from a sample of adolescents transferred from Clínica da Juventude (adolescents’ clinic) to 3 major AMHS, collecting information regarding the quality of the transition between these services.

Fifty-nine adolescents were discharged in 2014, average of 16.5 years old, after being followed in our clinic for an average of 7.44 months. Ten continued being followed in adult psychiatric services (17.5%), with different disorders: 4 depressive, 2 personality, 1 anxiety, 1 bipolar, 1 addiction to psychoactive substances, and 1 oppositional defiant disorder. Even in those cases the transition was far from optimal, with 4 of those presenting the need to use adult emergency facilities.

Several barriers between CAMHS and AMHS might account for the ongoing problem with the transition between services. In addition, considering that the onset of severe and recurring mental disorders begins generally before the age of 25, this raises the discussion around the present distinction between child and adolescent mental health services and adult services at 18 years old.

The authors have not supplied their declaration of competing interest.

The needs of people with Autistic Spectrum Conditions (ASC) are varied and complex. In order to improve outcomes for Adults with Autism, it is important to understand and evaluate the transition planning process and current services for adolescents/young Adults with ASC.

Aim was to undertake the needs assessment audit of all young people (ages 16–19) open to a Child and Adolescent Mental Health Service. Objectives was to ensure that transition/discharge plan was in place for all the open cases and also identify any gaps in service provision.

A retrospective case-note review of all open cases (n = 41) aged 16–19 was undertaken. Data was obtained on diagnosis, co morbid problems, educational status, and transition/discharge plans.

Twenty-two percent of the cases had co morbid moderate to severe Intellectual Disability. Transition was not an issue for this group, with entitlement of support from secondary-care-teams. Seventy-eight percent of the cases had diagnosis of Asperger's Syndrome (AS)/high functioning autism (HFA). Seventy-five percent had co-morbid depressive/anxiety disorders, 12% had ADHD and 10% presented with repeated self-harm/suicidal behaviour. Nature of the co-morbid problems/risks did not meet thresholds for Community Adult Secondary Mental Health Services resulting in discharge to Primary Health Care Services.

Better training to equip primary care staff, such as General Practitioners is needed to support the growing numbers of young adults with HFA/Asperger's syndrome being discharged to their care. Costs/benefits of providing specialist adult services for people with HFA and AS to be considered in order to improve outcomes for adults with autism.

The author has not supplied his/her declaration of competing interest.