The traumatic effects of COVID-19 pandemic is well studied in community and fragile groups. The association between COVID-19 infection and development of severe mood disorders have not well studied.

Nonetheless the casual relation or stressor effects of Covid-19 pandemic on chronic psychiatric illness is not known yet. The present study is aimed to investigate the effects of pandemic as a triggering factor in first episode Bipolar disorder (BD) patients that onset after pandemic.

The study included a total sample of 55 patients diagnosed with first episode BD according to DSM-5 criteria.

The two groups of patients that illness onset was before (BP)and after pandemic (AP), were investigated and compared for psychopathology and life evet stressors. Impact of Event Scale-Revised (IES-R) for PTSD symptoms, Generalize Anxiety Disorder scale for anxiety symptoms, The Montgomery–Åsberg Depression Rating Scale (MADRS) to examine depressive symptoms; and Young Mania rating Scale (YMRS) for manic symptoms, Brief Psychiatric Rating Scale-18 (BPRS) was used for psychotic symptoms.

The statistical analyses were performed using the Statistical Package for Social Science, version 26. Thirty-five patients that illness onset before pandemic and 20 patients that illness onset after pandemic were compared.

The significant differences were come up in some clinical features between the two groups. The alcohol and substance abuse were higher in AP group. The severity of psychotic and manic symptoms were higher in AP group. The hospitalization was higher in AP group. The number of stressor events was higher and PTSD symptoms was more severe in the AP group also.

The effects of Covid-19 pandemic seems have a triggering role in onset of first episode BD. This effect whether cause biological or psychological stress in onset of illness is not known yet. The casual phenomenon of Covid-19 pandemic should be investigated for chronic psychiatric illness as BD in future studies.

None Declared

Lamotrigine(LTG) is a widely used medication for bipolar disorder(BD) maintenance treatment, bipolar depression, epilepsy, trigeminal neuralgia.1The well-known common side effects of LTG are rash,fatigue, gastrointestinal symptoms,dizziness,headache,insomnia.2While one of the most refrained side effects of LTG is Steven Johnson’s syndrome, there have been reports of blood dyscrasia,such as agranulocytosis, neutropenia, pancytopenia.3,4Unfortunately, the exact mechanism of the blood dyscrasias isn’t fully explained.Here we report a case of LTG-induced leucopenia in a patient with BD type 2 patient.We obtained the patient’s consent.

We report a case of a 56-year-old female patient, brought to the emergency unit with complaints of feeling unhappy, hopeless,having trouble sleeping and suicidal thoughts for two months.She attempted suicide a few days ago,had multiple suicide attempts in the last two years.She had 3 psychiatric hospitalizations due to depressive episodes and 1 hypomanic episode.Her mood was depressed.She had psychomotor retardation,no psychotic feature.Due to active suicidal ideation,we admitted her to the inpatient unit with the diagnosis of BD type 2.

Routine blood tests were within the normal range.We increased quetiapine XR 300 mg and venlafaxine 300 mg,which she had already taken;discontinued her aripiprazole treatment and added LTG 25 mg/d. 8 after initiation of LTG,there was a decrease in white blood coun(WBC) from a baseline level of 5.18x109/L to 3x109/L,while neutrophil count decreased from 3.8x109/L to 1.15x109/L in 12 days.Her medical records showed no sign of leucopenia.No pathology was detected in the peripheral smear or ultrasonography performed with the haematology consultation.Considering leucopenia might be an adverse drug reaction associated with LTG, we discontinued LTG treatment on the 9th day of administration. 9 days after discontinuation WBC was up to 4.22x109/L,neutrophil count was 2.78x109/L. We started valproate 500 mg/d and on the 27th day of her stay, she was discharged with a euthymic mood, having no depressive symptoms or suicidal thoughts.Her last treatment was venlafaxine 225 mg, quetiapine XR 300 mg, quetiapine IR 100 mg, valproate 500 mg, lorazepam 1 mg daily.

It is a retrospective review.

In this LTG naive patient,the WBC values were within the normal range at admission.There was a significant temporal relationship between the initiation of the LTG and the decrease in WBC values.The absence of other factors in the laboratory tests and examinations,the rapid increase of WBC levels after the LTG was discontinued suggests the observed effect may be a side effect of LTG.

Blood dyscrasies aren’t a very common side effect of LTG, but it might be helpful to see CBC, especially in older populations, on patients with polypharmacy regimens and with severe mental illness that may interfere with patient’s ability to express any subtle side effect.

None Declared

Functional impairment is a major target in the treatment of bipolar disorder (BD), but the magnitude and type of functional difficulties differ across patients.

The aim of this study was to assess functioning and identify factors associated with global functioning in euthymic patients.

It was a descriptive cross-sectional study. The population study consisted of patients diagnosed with BD (DSM 5), who were euthymic and followed up at the psychiatry department of CHU Hedi Chaker.

The Hamilton Depression Scale (HAM-D), the Young Mania Rating Scale (YMRS) and the Functioning Assessment Short Test (FAST) were used to assess depressive, manic symptoms and the functional impairment in bipolar patients respectively. All statistical analyses were performed using the SPSS software package v 18.

We collected 40 patients. They had an average age of 36 years and the sex ratio (M/F) was 1.

They had an educational level not exceeding primary studies in 46% of cases.

The average scores of HAM-D and YMRS were 4.57±4.58 and 3.43±2.89 respectively.

The average total functioning score of our patients was 19.13±16.5. Functional impairment was noted in 60% of them. The domains most affected were: occupational activity (62%), cognitive functioning (63%) and autonomy (50%). Fonctional impairement was associated with residual depressive and manic symptoms (p=0.013) and manic/hypomanic or depressive episodes with mixed features (p=0,005).

Greater efforts should be directed toward targeting functioning in patient care, as it constitutes the most meaningful endpoint of response to treatment, especially with occupational and cognitive rehabilitation, thus allowing patients to overcome the course of illness and carry fulfilling lives.

None Declared

Research on life stress in bipolar disorder largely fails to account for the possibility of a dynamic relationship between psychosocial stress and episode initiation. The kindling hypothesis states that over the course of recurrent affective disorders, there is a weakening temporal relationship between major life stress and episode initiation that could reflect either a progressive sensitization or progressive autonomy to life stress.

To explore the concept of the Kindling model applied to bipolar disorder and to present a clinical case of a bipolar patient whose latter mood episodes were caused by adverse life events.

We performed a non-systematic literature review using the most relevant papers found on the database PubMed with the keywords “kindling effect”, “allostatic load”, “bipolar disorder” and “prevention”. Description of the clinical case report.

The phenomenon of kindling was first discovered by Goddard in 1967 who described it in epilepsy. Later, Post applied it to the bipolar disorder, arguing that the initial episodes of both unipolar and bipolar affective disorders are often precipitated by psychosocial stressors, but after multiple recurrences, not only do precipitated episodes continue to occur, but so do spontaneous ones as well. We present the case report of a 62 years old woman, divorced, diagnosed with type 1 bipolar disorder since she was 20 years old. She always have had poor adherence to her medication and follow-up with Psychiatry consultation, with a non-containing sociofamily environment that does not promote clinical stability. Over the time, her admissions on the Psychiatry ward were more frequent and precipitated by adverse life events, mainly caused by the deteriorated relationship with her children.

The kindling model clarifies aspects of the longitudinal course of episode development, recurrence, and progression to spontaneity, as well as further conceptual and theoretical rationales for intervention in order to prevent illness progression.

None Declared

Comorbidity with Obsessive Compulsive Disorder (OCD) in patients with bipolar disorder (BD) affects from 10 to 20% of the clinical samples considered. The pharmacological treatment of these patients emphasizes the clinical issue of the use of serotonergic anti-obsessive agents, which may increase the risk of manic/mixed episodes or may accelerate a rapid cycle course. In some cases, the addition of a second stabilizer drug results in improvement in both mood disorder and comorbid obsessive psychopathology. Although off-label, the use of II generation long-acting injectable antipsychotics (LAI-2) in type I BD is widespread in clinical practice but data regarding their efficacy in improving obsessive symptoms of the eventual comorbid disorder are still lacking.

The aim of this open-label naturalistic study was to evaluate the efficacy and safety of adjunctive treatment with LAI-2 monthly paliperidone palmitate (PP1M-LAI) and monthly aripiprazole (ARI-LAI) in 24 bipolar type I BD patients with OCD comorbidity, in a real-world clinical setting of 3 outpatient services located in the 3 macro-areas of Northern, Central and Southern Italy.

Twenty-four patients diagnosed with type I BD and comorbid OCD were recruited and observed over a 24-week period after the add-on of PP1M-LAI or ARI-LAI to stabilizing therapy. Psychopathology assessment was performed by means of Yale-Brown Obsessive Compulsive Scale (YBOCS), Hamilton Depression Rating Scale (HDRS), Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Hamilton Anxiety Rating Scale (HARS). The mean PP1M-LAI dosage was 117.8 mg/month while that of ARI-LAI was 400 mg/month.

At the end of the observation period, all patients who completed the study demonstrated a consisten reduction in obsessive symptoms while maintaining effective mood stability in the absence of signs of hypomanic/manic change (YBOCS mean reduction 24,5 to 16,2, GLM r.m. p<0.001; HDRS mean reduction 19 to 10, GLM r.m. p<0.001; YMRS mean reduction from 23,2 to 6,3, GLM r.m. p<0.001). The relatively small number of patients recruited did not allow to detect significant differences in the performance of PP1M and ARI-LAI. Overall tolerability was good for both treatments, in line with the tolerability profiles of each drug.

While considering the limitations of the relatively small sample and the open-label design, the results of this study indicate that the two LAI-2, PP1M and ARI-LA,I can be considered an effective and well-tolerated treatment in type I BD patients with OCD comorbidity, confirming efficacy in mood stabilization and reducing obsessive symptoms. Further studies on larger samples will be needed to confirm these preliminary findings and to detect any performance difference between the two antipsychotics.

None Declared

Bipolar disorder or manic-depressive psychosis is a severe recurrent psychiatric disorder that, if left untreated, can lead to severe social harm, disability and neurotrophic changes in the brain. However, social and psychological factors play a key role in the onset and progression of the disorder. Therefore, a bio-psycho-social therapeutic approach in the form of an integrated model of “Collaborative Care” is recommended.

Determining the main factors interfering with the decision of fitness to work in bipolar disorders according to work requirements.

Clinical cases including health professionals (HP) was carried out. Cases were examinated at a specialized occupational health Clinics including HP between 2018 and 2022. Data was collected from medical records and by questioning patients directly in case of missing data.

Four HP were included in the study. All suffering from bipolar disorder. The average age was 37 years [28,49]. All were women. Two were divorced and one single. Two anesthesia technicians, a nurse and a cleaner. Two were smokers. Two were transferred to another department because non psycho-education of colleagues at work, dealing with patients, verbal and physical agressivness and cognitive disorders. The two anesthesia technicians were judged unfit for work because of their work responsability and the need for the integrity of all cognitive faculties in the workplace.

In order to decide the fitness to work, occupational physician must consider both bipolar disorder impact and workplace exigency. The adequacy between disease stability and others security is iteratively revised.

None Declared

The ASD Day Therapeutic Unit of the HUMT is an interdisciplinary reference center specialized in ASD, for the care of children and adolescents with this pathology, that offers care by programs with the aim of achieving functionality altered.

The main objective of this study is to know the clinical characteristics of the patients admitted to our center and to offer preliminary data on the functional improvement achieved in a pilot program that works by processes.

This is a prospective clinical study of patients with ASD, treated at the ASD Day Therapeutic Unit of the Hospital Universitario Mutua Terrassa (HUMT), since februay 2022 till nowadays. We compare the clinical improvement and functionality acquired through the evaluation through various scales: Conners scale, SRS, BRIEF and CBCL.

Our sample is made up of 19 patients with ASD who are admitted to the HUMT ASD Day Hospital. 13 belonged to the intensive care program, 5 to recovery of low-functioning functionality, and 1 to the differential diagnosis program. 84.21% (n=16) have preserved cognitive capacity. The median age is 13.1 years. 73.7% of the sample are men.

We observed that 89% of patients admitted to our unit presented comorbid symptoms with ADHD. more than 78.9% present isolation, anxiety/depression, altered thinking and attention difficulties. 13/19 present a SEVERE RANGE of affectation upon admission, in social area. Facing discharge, the CBCL shows us a general improvement in behavior and comorbidity in the total scale. The SRS shows us an improvement in social awareness, social communication, social motivation, repetitive behavior and stereotypes and in the total score.

Specific interventions in social skills, autonomy, social understanding, daily routines, and sensory integration in patients with ASD improve core symptoms, as well as associated behavior.

Specific interventions and working on social relationships during admission improve comorbidity derived from ASD.

More studies are needed to specify the most efficient interventions to improve the quality of life in children and teenagers with ASD.

None Declared

The Covid-19 pandemic has brought many changes to everyday life of adolescents. The purpose of this study is to evaluate the impact of restrictions due to Covid-19 pandemic on the mental health of adolescents: changes in everyday life that can potentially have an impact on their mental health, the prevalence and worsening of social anxiety symptoms and consequent depression symptoms

To evaluate the impact of restrictions due to Covid-19 pandemic on the mental health of adolescents: changes in everyday life that can potentially have an impact on their mental health, the prevalence and worsening of social anxiety symptoms and consequent depression symptoms

Anonymised questionnaires were used to collect the data. They were given to the patients staying in the department of psychiatry of Children’s Clinical University Hospital in Riga, Jugla as well as to some adolescents visiting child psychiatrist in outpatient settings from January till the end of April, 2022. The following personal data were collected - age, gender, family status - as well as information about different factors affecting the mental health of adolescents during the pandemic: how often they spent time with friends, whether or not they have lost any friends, distance learning, seeking help from mental health professionals, quality of sleep and a chance to receive emotional support. Patients also filled Liebowitz social anxiety scale and PHQ-9: modified for adolescents’ depression scale.

Restrictions due to pandemic mostly affect the participants negatively, promoting the worsening of social anxiety symptoms in 42% of the respondents with positive results of the Liebowitz scale. Statistically significant connection between social anxiety and depression symptoms was found. During the pandemic most of the patients were more often seeking professional help. Patients with worsening social anxiety symptoms were found to have statistically significant connection to losing friends during the pandemic. Most of the recipients with already diagnosed social anxiety were given this diagnosis during the pandemic (67% of the cases).

The restrictions due to Covid – 19 pandemics negatively affect adolescents including those with social anxiety, promoting the worsening of symptoms as well as prevalence of depression symptoms in these individuals. The results suggest that coping strategies must be implemented in order to decrease the consequences of the pandemic on adolescents.

None Declared

Trichobezoar is a rare entity that primarily occurs as a complication of psychiatric disorders, most often in adolescent and young females suffering from trichotillomania (TTM) and trichophagia. In many cases, children with TTM unwillingly admit hair pulling, deny ingesting hair and often feel ashamed of their disease and try to hide it.

Our main aim was to present an uncommon complication of TTM and trichophagia and to point out the importance of early diagnosis and prevention of complications of the disorder. Furthermore, we describe the role of a child’s psychological features and family dynamics in etiopathogenesis of TTM, as well as comorbidities and specific clinical presentation.

Case report.

An 11-year-old girl was admitted to the pediatric department due to abdominal pain. After detailed pediatric differential diagnosis, trichobezoar was diagnosed and she was treated surgically. While she did not deny ingesting her hair, three months after surgery (TTM was dermatologically verified from the beginning of the treatment) she mentioned focused hair pulling for the first time. During individual cognitive behavioral psychotherapy the following was recognized in the patient: perfectionism traits, inhibition in expressing emotions, elements of depression, anxiety. During family psychotherapy elements of alexithymia were observed.

Cooperation among medical experts (pediatrician, dermatologist, child psychiatrist, pediatric surgeon etc.) and awareness of this disorder is important for recognizing it at an early stage and starting the treatment, especially considering habit-forming mechanism, psychiatric comorbidity, emotional distress and preventing other complications including trichobezoars.

adolescents, trichobezoar, trichophagia, trichotillomania

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) and Dyslexia are among the most frequent developmental disorders in school-aged students, and both often cause an impact on scholar reading performance. Therefore, it is fundamental to trace the differential profile in reading performance in such diagnoses. Competent reading occurs through the interaction of several cognitive processes, such as decoding, fluency, and oral and reading comprehension, that should be assessed in an evaluation.

The study aimed to characterize the performance of students with ADHD and dyslexia.

We assessed 25 adolescents, aged between 11 and 14 years old, from 6th to 9th year of middle school of public and private schools in Brazil, divided into two groups: the group with ADHD (16 students) and the group with dyslexia (9 students). The diagnoses were established by a multidisciplinary center and there were no comorbidities for any case. The instruments used were: Comprehension Test of Words and Pseudowords II (TCLPP II) to assess decoding (indicate if the word is correct or incorrect); Reading Fluency Test (TFL) to assess fluency in single words and in text reading; Cloze Reading Comprehension Test (TCCL) to measure reading comprehension; and the WISC vocabulary subtest to assess auditory comprehension.

Non-parametric analyzes revealed statistically significant differences in measures of textual comprehension, especially in the tasks that involved decoding and fluency processes, evidencing superior performance of the group with ADHD in these tests. Participants with dyslexia had a significantly higher performance in relation to the number of word omissions, that is, they had lower omission errors. There was no significant difference between groups in auditory comprehension.

A differential profile was found in reading performance, consistent with the cognitive deficits classically pointed out in the literature for each diagnosis: phonological deficits in dyslexia, with problems in decoding and fluency; and attentional deficits in ADHD, with omission errors. In the comprehension measures, dyslexic group had significant lower performance than ADHD in the Cloze Reading Comprehension Test, but there was no difference in the Vocabulary subtest-WISC. An explanatory hypothesis is that, to understand the text, it is necessary to recognize the words previously, whereas, in the WISC, it is not necessary to read, since the questions are oral. These results corroborate the hypothesis that deficits in reading comprehension in dyslexia are more related to difficulties in word recognition and fluency skills than in general listening comprehension.

Financial support: CAPES Proex [grant 0426/2021, no. 23038.006837/2021-73]; CNPq [grant 310845/2021-1]

None Declared

Drawing represents mainly a motor activity of expression. Drawing represents a form of non-verbal language that is very important both cognitively and affectively. Therefore, it allows to hypothesise and evaluate the degree of neurodevelopment of individuals as well as their level of interaction with the environment.

Family sketches can be evaluated in a projective, neurocognitive and affective way to provide insights on the attachment system, degree of bonding, communication, social and affect interaction as well as difficulties or problems that have motivated emergency consultation.

This study evaluate the possible correlation between family dysfunction and irritability as cause of request of consultation in an emergency department of mental health in child & adolescents through the analysis of family drawings.

This is a retrospective, observational study of correlation between the reasons of emergency consultations, dysfunctional irritability and family difficulties represented through family drawing. It is based on a randomised sample of 30 reports of emergency appointments of children between 8 to 13 years old that have been examined in the Child & Adolescent Psychiatry Emergency Department at the Pitié Salpêtrière Hospital during two years for Emotional or Irritability dysfunction.

An adaptation of both Goodenough-Harris Drawing projective test and Corman test were used to evaluate findings from family drawings as well as neurocognitive parameters of drawing technics, sociodemographic dates, cognitive level and family dysfunction.

The degree of cohesion, identification and devaluation of adult figures have been important elements of interpretation in irritability dysfunction and family drawings.

The family environment could be a factor in the interpretation of chronic irritability and its manifestations on the child’s family drawings establish a clear correlation.

The adapted assessment of the family drawing could be an important tool in the nosological exploration of children’s mental health in emergency, especially on relational systemic representation and symbolization.

None Declared

Previous studies have showed that the type of early childcare can be associated with child behavioural difficulties though results vary across countries.

To investigate the link between early childcare from birth to 3 years and child behavioural difficulties at age 5.5 years, in the French context.

In this study (n = 9,699), parents participating in the French ELFE birth cohort reported their child main childcare type used between birth and three years of age (centre-based (22.6%), childminder (43.6%), informal (8.2%) or parents only [25.7%)), and the child’s behaviour through the Strengths and Difficulties Questionnaire (SDQ) at age 5.5 years. Scores were calculated for each SDQ subscale as well as the total SDQ scores. Logistic regression analyses were carried out adjusting on socio-demographic, parents’ and child’s characteristics to evaluate the association between early childcare type and abnormal SDQ total score (>16) as well as subscale scores.

In the study population, 584 (6.02%) children had abnormal SDQ total score, and 1,104 (11.4%) in the emotional subscale, 573 (5.91%) in the peer relationship subscale, 1,433 (14.8%) in behavioural subscale, and 1,097 (11,3%) in the hyperactivity subscale. After adjusting, compared to children who were looked after by their parents only, those who were in centre-based childcare had a lower likelihood of having an abnormal SDQ total score (ORa = 0.76 [95% CI: 0.58 – 0.99]), while there was no significant difference for children who were in a childminder’s care (ORa = 0.94 [95% CI: 0.75 – 1.17]) or in an informal childcare (ORa = 1.18 [95% CI: 0.86 – 1.63]). In additional analyses, we found that compared to children in parental care only, children in centre-based childcare had a decreased likelihood of having abnormal internalising subscales scores: emotional subscale, (ORa = 0.81 [95% CI: 0.67 – 0.99]) and peer relationship subscale, (ORa = 0.79 [95% CI: 0.61 – 1.02]). All other associations were not significant except for the informal childcare which was associated to a higher likelihood of abnormal behavioural subscale (ORa = 1.29 [95% CI: 1.03 – 1.62]).

In the French ELFE cohort, early centre-based childcare was linked to lower likelihood of having internalising problems in children at age 5.5 years. Further studies should focus on the possible mecanisms of this association. Family and childhood policies should aim to make centre-based childcare accessible to more children.

None Declared

Between January and May 2022, more than 78,248 complaints were registered in Brazil, involving children and adolescents in situations of abuse. (Ministry of Women, Family and Human Rights, 2022). Childhood maltreatment includes all forms of physical, emotional, sexual abuse or neglect. Literature has shown that individuals who are victims of abuse have more difficulties with social skills than their peers.

Quantitatively evaluate the social skills of adolescent victims of abuse.

Six adolescents between 12 and 17 years old participated in the study. The assessment of social communication skills was performed using the Social Skills Rating Scale (SSRS) protocol. At the time of data analysis, the following variables were taken into account: gender of the participants and type of abuse suffered, as stated in their medical records.

Male participants showed a better overall performance in social skills than female participants. However, this second group scored higher on assertiveness and empathy skills. Regarding the type of abuse, in both genders, victims of sexual abuse and neglect showed better results than those who suffered only neglect. The results are described in more detail in images 1 and 2.Table 1.

Female group results

Adolescents who are victims of abuse have considerable difficulties with social skills, which can impact the performance of their basic day-to-day activities. More studies about the impacts of mistreatments on the development of social skills are needed.

None Declared

Coping and emotional regulation mechanisms may play a significant role in the neurodevelopment and in the subsequent psychopathological trajectories, especially in youth. The boredom dimension may also have a pathoplastic role.

Considering the poor literature in adolescents and young people (15-24 years-old), our study aims at investigating the relationships between coping patterns and emotional dysregulation as well the mediatory role of boredom, by particularly focussing on a sample at early onset of mood disorders.

Cross-sectional, observational design study. Descriptive analyses were performed considering a set of socio-demographic and clinical variables (DERS, MSBS, COPE-NVI). Kruskal-Wallis, Spearman correlations and linear regression models were performed between DERS (dependent variable) and COPE-NVI (independent variable), together with mediation analyses (MSBS as mediator).

86 subjects (mean age=18.4±2.8) were enrolled. DERS score was 114.8±33.3, COPE-NVI was 129.1±22.1, MSBS was 136.22±45.8. Positive correlation between DERS total and avoidance strategies (r=+0.6,p<0.001) and negative correlation between DERS total and problem orientation strategies (r=-0.467,p=0.023) were found. Linear regression analyses showed statistically significant differences between DERS and COPE-NVI avoidance strategies (p<0.001) and COPE-NVI problem orientation (p<0.023). Mediation analyses confirmed the mediatory role of boredom dimension in the association between COPE-NVI avoidance subscale and DERS total (B=0.6849, p <0,001), between avoidance subscale and DERS lack of acceptance subscale (B=0.1286, p<0.001). Moreover, a mediatory role of MSBS inattention subscale was found in the association between COPE-NVI avoidance subscale and DERS lack of control subscale (B=0.1027, p<0.001).

Maladaptive coping strategies (particularly avoidance) were associated with increased DERS levels. A predominant use of more adaptive coping strategies (i.e., problem solving, planning) were associated with lower DERS levels. Their relationship appears to be mediated by boredom dimension.

None Declared

Existing evidence in the association between maternal pregnancy and pre-pregnancy weight and behavioural outcomes in children.

This study aimed to examine these associations at six developmental time-points between ages 3 and 16.

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), an ongoing population-based longitudinal pregnancy cohort study in Bristol, United Kingdom (UK). Data on behavioural outcomes were measured at ages 3.5, 7, 9, 11 and 16 years using the Strengths and Difficulties Questionnaire (SDQ). Over 7960 (at 3.5 years of age) and 4400 (at 16 years of age) mother-child pairs were included in the final analysis. Logistic regression analyses were used to examine the associations.

Pre-pregnancy BMI and gestational weight gain were associated with total behavioural difficulties in children across all age groups. In separate analyses using each SDQ subscale, however, we found that pre-pregnancy underweight was associated with emotional problems at ages 7 (OR = 1.66, 95% CI; 1.20 – 2.29), 11 (OR = 1.49, 95% CI; 1.02 – 2.18) and 16 (OR = 1.74, 95% CI; 1.16 – 2.60) years and hyperactivity/inattention problems at age 16 (OR = 1.96, 95% CI; 1.27 – 3.05). We also found an association between guideline-discordant gestational weight gain and peer relationship problems at age 9 and pro-social behaviour at ages 9 and 11.

Our findings highlight that pre-pregnancy underweight than overweight, obesity or gestational weight gain may influence the emotional health of children and adolescents.

None Declared

According to research there is a negative association between emotion regulation, mentalization difficulties and quality of life among adolescents, but former research did not examine the relationship between these 3 constructs in a Hungarian adolescent sample.

The aim of our study was to examine the relationship between mentalization and emotion regulation with quality of life among 14- to 18-year-old adolescents.

In our non-clinical, cross-sectional study 122 adolescents with informed consent answered a list of demographic questions, then completed the Reflective Function Questionnaire (RFQ-H), the Emotion Regulation Difficulties Questionnaire (DERS) and the Quality of Life Scale (ILK). In our mediator model we chose RFQ-H as the independent, DERS as the mediator and ILK as the dependent variable.

The first model was significant (F(1,120) = 28,79 p < 0,001, R2= 0,19), there was a significant relationship between mentalization disfunction and emotional regulation difficulties (a=0,39, p<0,01, β=0,44). The second model was significant as well (F(2,119= 30,48 p < 0,001, R2= 0,34), though the direct effect between mentalization difficulties and low quality of life was not significant (c’=0,02, p=0,73, β=0,03), the direct effect between emotion regulation difficulties and low quality of life was significant (b=0,58, p<0,01, β=0,57). The indirect effect between mentalization disfunction and low quality of life mediated by emotional regulation difficulties was also significant ab = 0,22 [0,13 – 0,33], β =0,25 [0,14 – 0,36]).

Our results - taking the limitations into account - imply that emotional regulation mediates the relationship between mentalization and quality of life among the present-day, non-clinical, Hungarian adolescent sample, which could have practical implications.

None Declared

Most previous research focused on the association between mentalizing and specific mental disorders, while less is known about the relationship between mentalizing and quality of life among adolescents.

This study aimed to validate The Reflective Function Questionnaire for Youth in the Hungarian language and evaluate the moderating influence of mentalizing on the relationship between psychopathology and quality of life.

A community sample of 384 youths of 12–18 years (72.7% females) completed the following questionnaires: The Reflective Function Questionnaire for Youth (RFQY), The Measure of Quality of Life for Children and Adolescents and The Strengths and Difficulties Questionnaire. First, we tested the different factor structures of the RFQY: the two-factor, the eight-item, and the five-item versions. We conducted a series of moderation analyses with quality of life as the dependent variable, higher-order symptom categories (internalizing or externalizing symptoms separately) as the independent variable, and mentalization as the moderator.

The confirmatory factor analysis supported the five-item version of the RFQY (Cronbach’s alpha .61) and resulted in a new, 10-item version of The Reflective Function Questionnaire for Youth on the Hungarian sample (Cronbach’s alpha .76). Mentalization had a moderator effect on the relationship between internalizing and externalizing symptoms and quality of life.

Our study provides the first psychometric support for the Hungarian version of the RFQY and underlines the importance of assessing the complex relationships between mentalization, quality of life and symptomatology. Targeting mentalization to improve the quality of life among adolescents might be a key factor.

None Declared

Fear was the primary construct for this study, however, knowing that high levels of anxiety can cause changes in sleep quality, it was considered opportune to study the relationship between these two concepts.

According to Marks (1969), “Fear is a normal response to active or imagined threat in higher animals, and comprises an external behavioral expression, an inner feeling and associated physiological changes”, almost all children experience some degree of fear during its development. Additionally, while these fears vary in frequency, intensity, and duration, they tend to be mild, age-specific, and transient.

According to a simple definition, sleep is a reversible behavioral state of perceptive disconnection and indifference to the environment (Carskadon & Dement, 1989).

Sleep quality perceived by children is inversely correlated with self-perception of fears

Participants

The study sample consists of 121 students from the 1st cycle of basic education, 65 (53.7%) attending the 3rd year of schooling and 56 (46.3%) attending the 4th year of schooling, 66 ( 54.5%) were female and 55 (45.5%) were male, aged between 7 and 10 years old (M=8.5; SD=0.61).

Sleep Self Report-PT (SSR-PT): The SSR-PT is a questionnaire designed to assess children from 7 to 12 years old regarding their self-perception of the quality of their sleep. Fear Survey Schedule for Children-Revised (FSSC-R): T. Ollendick (1978); Translation and adaptation: Pedro Dias & Miguel Gonçalves

The lower the sleep quality perceived by the children, the greater the self-perception of fears of the two factors with very strong significance .000 in both.

The lower the sleep quality perceived by the children, the greater the self-perception of fears of the two factors with very strong significance .000 in both.

None Declared

When we were children we all remember hearing expressions like: “Do not be afraid.”, “What are you afraid of?”, “You are strong, you are not afraid!”. This primary emotion is introduced in our development associated, most of the time, with a negative connotation. However, we know that fear, as a normal response to a real or imagined threat, is an integral part of human development (Sequeira, 2011).

The existence of research on fears is relevant for the definition of developmental patterns, characteristics such as frequency and intensity, but also for the identification of risk factors that may be at the genesis of the development of anxiety disorders (Ollendick, King & Murris, 2002).

In Portugal, studies on fears are scarce, contrary to what happens in other countries (Sequeira, 2011).

The study sample consists of 121 students from the 1st cycle of basic education, 65 (53.7%) attending the 3rd year of schooling and 56 (46.3%) attending the 4th year of schooling, 66 ( 54.5%) were female and 55 (45.5%) were male, aged between 7 and 10 years old (M=8.5; SD=0.61).

For each child, an adult, parents or parental figures also participated in the study, most of which were the mother (89.3%) and the remaining participants were the father (7.4%), father and mother (1.7%), grandmother (0.8% ) and brother (0.8%).

Fears are more frequent in females than males.

In general, anxiety disorders tend to be more prevalent in girls than in boys (Ollendick, King & Murris, 2002).

None Declared

Bipolar disorders (BD) in youths are strongly associated with lifetime suicidal ideation. Childhood trauma is a prominent environmental stressor associated with both BD diagnosis and suicide. Primary emotional systems (PES), proposed by Jaak Pansepp, are altered in adults with BD and may contribute to suicide risk in youths.

The aim of this study was to investigate the distribution patterns of PES and childhood trauma in youths’ BD with and without suicidal ideation (BD-IS, BD-NIS).

We assessed 289 participants, 103 youths with DSM-5 BD and 186 healthy controls (HCs). PES were obtained with the Affective Neuroscience Personality Scales (ANPS) and history of childhood trauma using the Childhood Trauma Questionnaire (CTQ). Suicidal ideation was assessed through the Columbia Suicide Scale for the Rating of Suicide Severity (C-SSRS). The distribution patterns of primary emotional systems and childhood trauma subtypes were tested using a multivariate analysis of variance (MANOVA), followed by a series of one-way ANOVAs and Scheffé post- hoc tests. The model was corrected for multiple comparisons. All the variables significantly different between the BD-IS and the BD-NIS group were subjected to a multivariate logistic regression model.

Over 48% of participants reported lifetime suicidal ideation. According to the MANOVA (Wilk’s Lambda=0.72, F=9.11, df=22, p<0.0001), BD-IS scored higher on the ANPS-ANGER and lower on ANPS-PLAY and ANPS-CARE than both HCs and BD-NIS, while BD-NIS reported higher and lower scores than HC. BD-IS and BD-NIS reported higher scores on ANPS-SEEK than HCs. BD-IS reported more emotional abuse, sexual abuse, physical abuse and emotional neglect than HCs, but only more emotional abuse than BD-NIS. ANPS-ANGER (OR=1.13, 95%CI=1.01-1.26, Wald=5.72) and CTQ-Emotional abuse (OR=1.26, 95% C.I.=1.04-1.52, Wald=5.72) were independent predictors of suicidal ideation in youths with BD (Nagelkerke R2=61%).

Findings support the importance of assessing primary emotional systems and childhood trauma, in particular emotional abuse, in youths with BD at risk for suicide.

None Declared