Mental illness is a growing problem among adolescents. Adolescents are sensitive and at increased risk of developing a first depression. There are knowledge gaps about the long-term effects of prevention programs against depresson for adolescents.

A randomized controlled study among Swedish adolescents in eighth grade, who are at risk of developing depression. The study examines the long-term effects of the “Thoughts and Health” prevention program and whether it is as effective Online as In Real Life (IRL).

In a first step, about 20 junior high schools in the Västra Götaland region will be recruited and randomised into one of three groups.

The adolescents are screened for depression at school

Group 1 - Adolescents at risk of developing depression receive the course program “Thoughts and Health” Online.

Group 2 - Adolescents at risk of developing depression receive the course program “Thoughts and Health” IRL.

Group 3 - Adolescents at risk of developing depression receive the usual school health care (control group).

Psychologists decide inclusion after a diagnostic interview. OUTCOME VARIABLES

Quantitative

- development of depression is measured via self-assessment instruments and follow-up assessment, by a psychologist.

- school attendance and full grades at the end of compulsory school.

- biomarkers

Qualitative

Adolescent’s experiences and perceptions of the course program.

Will create evidence for prevention programs against depression and be used to develop primary prevention for adolescents Online and IRL, which will be of great importance to public health.

Thoughts and Health can be a useful tool to prevent depression among adolescents

No significant relationships.

Cancer is often a diagnosis that generates instability in many Tunisian families. Children of parents with cancer may respond differently to the treatment. Communication about cancer in Tunisian families needs sometimes professional intervention mainly with children.

We aimed to assess psychological impact of cancer parents on their children.

We interviewed 103 parents of children aged 6-18 years between July and December 2020. Children were not interviewed as they were not allowed into the chemotherapy treatment rooms. The questionnaire included items about emotional and behavioral impact on children.

Patients’ characteristics are are shown in Table 1. In our study, 85 patients (82.5%) told their children they were « sick ». Among the children who were not aware of their parent’s condition, there were significantly more preschoolers, p=0.001. The reasons given by the parents in these cases were the young age of their children (60%) and the fear of generating emotional and behavioral trauma and threatening their psychosocial equilibrium (40%). In our participants 88.3% reported communication disorders with their children when referring to the parental illness.

Parental cancer may have unexpected consequences on children’s behavior which should be handled by a specialist , hence efforts should be made for early detection and better understanding of these disorders.

No significant relationships.

Youth integrated care services were developed to overcome common barriers to mental health treatment. Satisfaction is key for services utilization and engagement.

To study users satisfaction with youth integrated care service, “Headspace”, throughout the course of treatment and its correlation with clinical and demographic characteristics and service utilization.

A sample of 112 participants ranging between ages 12-25 who attended the Headspace clinic between March 2016 and June 2018 were assessed in the middle (after 7 sessions) and end of treatment (n=71).

Participants expressed high levels of satisfaction across all service aspects at the middle and end of treatment. The highest rate of satisfaction was with the centre’s staff and the lowest with personal outcomes. A repeated measures ANOVA analysis revealed that only satisfaction with personal outcomes improved significantly over time Length of wait to begin treatment and parental engagement y were negatively correlated with youth satisfaction.

Satisfaction rates of Headspace among youth are high from the start and with their outcomes increase over time. Youth satisfaction with the staff’s attitude and approach and satisfaction with accessibility suggest the service achievement in addressing barriers of help seeking in youth.

No significant relationships.

Autism spectrum disorders (ASD) are associated with high services use, but European data on costs are scarce.

Utilisation and annual costs of 385 individuals with ASD (aged 4-67 years; 18.2% females; 37.4% IQ < 85) from German outpatient clinics were assessed.

Client Service Receipt Inventory

Average annual costs per person were 3287 EUR, with psychiatric inpatient care (19.8%), pharmacotherapy (11.1%), and occupational therapy (11.1%) being the largest cost components. Females incurred higher costs than males (4864 EUR vs. 2936 EUR). In a regression model, female sex (Cost Ratio: 1.65), lower IQ (1.90), and Asperger syndrome (1.54) were associated with higher costs.

In conclusion, ASD-related health costs are comparable to those of schizophrenia, thus underlining its public health relevance. Higher costs in females demand further research.

No significant relationships.

Attention-Deficit/Hyperactivity Disorder (ADHD) runs in families; however, there are mixed results on the interaction effects of parent’s and child’s psychopathology on parenting qualities. Cognitive/schema therapy is a promising treatment approach for adult ADHD; we know little about the effect of cognitive factors on parenting, however.

We aimed to fill this gap by exploring the role of dysfunctional schema modes in the associations between adult ADHD symptoms, child’s externalizing symptoms, and perceived parental competence in a dimensional approach.

A community sample of parents (N=100, mean age=38.25 years, SD=5.73) filled out online questionnaires assessing ADHD symptoms (Adult ADHD Self-Report Scale), dysfunctional schema modes (Schema Mode Inventory), perceived parental competence (Parental Sense of Competence Scale), and child’s psychopathology (Strength and Difficulties Questionnaire).

In a multivariate model, higher levels of parental ADHD symptoms were related to higher levels of dysfunctional schema modes. However, neither the child’s externalizing symptoms nor the interaction term of parent’s symptoms by the child’s symptoms had any effect on dysfunctional schema modes. Furthermore, the child’s externalizing symptoms had a direct negative association with parental self-efficacy beliefs, whereas the relationship between adult ADHD symptoms and parental self-efficacy was mediated by the detached and overcompensating dysfunctional schema modes.

Our results suggest that the activation of dysfunctional schema modes is related to the parent’s but not the child’s psychopathology. The activation of dysfunctional schema modes may play an important role in the self-efficacy beliefs of parents with ADHD. Targeting that cognitive factors may enhance the effect of behavioral parent training programs.

This research was supported by National Research, Development, and Innovation Office (NKFIH) OTKA-PD-134849 grant.

Good quality parenting in early childhood is reliably associated with positive mental and physical health over the lifespan.

The hypothesis that early parenting quality has significant long-term financial benefits has not been previously tested.

Design: Longitudinal study with follow-up from 2012 to 2016; UK multicentre study cohort. Participants: 174 young people drawn from 2 samples, one at moderate risk of poor outcomes and one at high risk, assessed aged 4–6 years then followed up in early adolescence (mean age 12.1 years). Measures: The primary outcome was total costs: health, social care, extra school support, out-of-home placements and family-born expenditure, determined through semistructured economic interviews. Early parenting quality was independently assessed through direct observation of parent–child interaction.

Costs were lower for youths exposed to more sensitive parenting (most sensitive quartile mean £1,619, least sensitive quartile mean £21,763; p < .001). Costs were spread across personal family expenditure and education, health, social and justice services. The cost difference remained significant after controlling for several potential confounders. These included demographic variables (family poverty, parental education); exposure to child abuse; and child/young person variables including level of antisocial behaviour in both childhood and adolescence, IQ and attachment security.

This study is the first showing that more sensitive early parental care predicts lower costs to society many years later, independent of poverty, child and youth antisocial behaviour levels and IQ. The findings provide novel evidence for the public health impact of early caregiving quality and likely financial benefits of improving it.

No significant relationships.

Previous studies have shown elevated levels of depressive symptoms in parents of children with ASD. However, few studies have assessed depressive symptoms in neurotypical ASD-siblings and most have done so, within a broad age range, while studies focusing on a certain developmental stage (middle childhood in particular) using a self-report depression-specific assessment tool are sparse.

This study aimed to investigate the depressive symptoms of Greek school-age neurotypical siblings of individuals with an Autism Spectrum Disorder through a self-reported questionnaire.

The sample included 85 school-age neurotypical ASD-siblings (8-13 years old). The Children’s Depression Inventory (CDI) and a demographics questionnaire were administered to all participants.

Results showed that a considerable percentage of the sample (15.3%) scored twice as high as the mean score. ASD-siblings in the present study scored higher (mean total score in CDI was 7.24±6.27) than children of similar age and nationality. Further, 5.9% of the siblings in the present study exhibited severe depressive symptoms (using 19 as a threshold) whereas 12.9% of ASD-siblings scored above 15 and therefore should be further evaluated by mental health services.

The results of the present study documents a relatively high prevalence of depressive symptoms in neurotypical siblings of individuals with ASD. ASD-siblings showed higher levels of depressive symptoms compared to normative data. This is the first study addressing depressive symptoms in siblings of autistic children conducted in the Greek cultural context. The present study highlights the need for the development and implementation of appropriate and effective interventions within the Greek healthcare system for ASD-siblings.

No significant relationships.

Ziprasidone is an atypical antipsychotic that has demonstrated efficacy for the treatment of bipolar disorder and schizophrenia. There is some preliminary evidence for Ziprasidone use in children and adolescents with several open label studies and some randomized control trials, therefore it is advantageous to understand where Ziprasidone lies in the treatment algorithm of children and adolescents.

The aim of our study is to examine the efficacy and tolerability of Ziprasidone in children and adolescents.

We conducted a literature search consisting of open label or randomized control trials (RCT) that report on Ziprasidone use in children on the PubMed database. We found 13 studies (11 open label and 2 RCT) that met our inclusion criteria. Our outcome measures included efficacy measures such as BPRS, YMRS, CGI-S and adverse effects such as weight gain, increase in BMI, QTc prolongation, sedation, dizziness and EPS.

Data from thirteen studies was meta-analyzed (Total n= 560, mean age=13.16 years, male= 70.35% that reported the use of Ziprasidone in children and adolescents. We found that Ziprasidone was efficacious in children and adolescents in measures of BPRS (-13.493, p<0.05), YMRS (-14.225, p<0.05), CGI-S (-1.430, p<0.05). In measures of adverse effects, Ziprasidone was not found to cause any significant weight gain (0.164, p>0.05) or change in BMI (-0.159, p>0.05). QTc prolongation was found to be significant (13.122, p<0.05).

Ziprasidone is an efficacious in children and adolescent population. It does not cause significant weight gain, however QTc prolongation and sedation were found to be the most significant side effects .

No significant relationships.

As part of the full-sized personal examination of persons, living in residential facilities for mentally disabled people (Kekelidze, 2020) 621 children, living in 3 asylums “for children with mental retardation” of Krasnoyarsk region were examined. In 134 cases diagnosis “Moderate or severe mental retardation” wasn’t confirmed. In 2020 a full examination of 47 children with non-confirmed diagnoses was carried out in one of the asylums.

The main purpose of this investigation is to present the results of this full examination and sum up the main problems of the system of institutional care for children with intellectual and developmental disabilities in Russia.

Clinical and psychological examination, Wechsler Intelligence Scale for Children (WISC-II), analysis of pedagogical characteristics.

Figure 1 presents the results of cluster analysis of WISC-II. In 37 cases diagnoses were reversed to Mild intellectual disability. In one case – 10 y.o. boy - to developmental delay through social-pedagogic neglect.

In the beginning of 2021 32 children were transferred to boarding schools with educational programme for children with mild intellectual disabilities. 13 children adapted to new developmental and educational conditions relatively successfully, 4 children – unsuccessfully and were returned to the first institute.

The success of adaptation did not depend on IQ, but on the age of the child and the severity of emotional and behavioral disorders, as well as on the willingness of the institution to provide personalized assistance to the child. The results identify the main problems of the system of institutional care for children with developmental disabilities in Russia.

No significant relationships.

Successful adolescence depends on ability to correctly understand emotionally expressive gestures, especially symbolic (same meaning for everyone) and expressive (individual understanding). Presence of an internal mismatch in adolescent’s self-esteem between what he shows in society and what he really feels can lead to difficulties in forming an adequate adult self-esteem.

Adolescents with affective disorders (F31) -12, normal adolescents - 32. Ages 12-17.

Recognition of emotionally expressive movements: postures&gestures (gestures-test), direct self-esteem by Dembo-Rubinstein test and indirect self-esteem by color attitude test by Etkind.

The Mann-Whitney test showed significant differences between samples in terms of self-esteem gap - “mind” (U=270,000, p<0.37), “character” (U=279,000, p<0.20), “happiness” (U=288,000, p<0.01 ), gestures-test “symbolic” (U=301,000, p<0.003), “expressive” (U=292,000, p<0.007), “emotions” (U=109,000, p<0.028). Cluster analysis divided each of groups into two distinct clusters. Normal: Cluster1 small self-esteem gap, good gesture recognition, negative pole of emotions prevails. Cluster2 small self-esteem gap, worse gesture recognition, pole of emotions is closer to positive. Affective: Cluster1 large self-esteem gap in “mind”, good gesture recognition. Cluster2 large self-esteem gap in “character”, good gesture recognition and bright negative pole of emotions.

Gestures recognition in normal group is significantly higher than in affective disorder group. Normal adolescents clusters are distinguished by change in gaps throughout self-esteem and pole of emotional recognition. Affective disorder clusters differ by significant gap in one of self-esteem parameters, as well as in the degree of emotional recognition. Those with the largest “character” gap are more likely to attribute negative emotions to gestures than those with larger “mind” gap.

No significant relationships.

Adolescents (especially frequently ill) from families where parents show high concern for their health, often themselves make complaints about their health status that do not receive medical confirmation (Kovalenko, 1998; Dielman et al., 1991). A study by T. Dillman and colleagues (1991) revealed a direct link between the perception of the disease in parents and children – the more seriously the parent perceives the child’s condition, the more seriously the child treats it, and the more complaints he has.

To study the influence of family on health anxiety in frequently ill adolescents.

The sample: 98 adolescents (mean age 16.1±0.9), 84 their parents (mean age 44.5±5.0). We used: “Short Health Anxiety Inventory” (SHAI; Salkovskis et al., 2002), The “Research on health-saving activities” (RHSA) questionnaire (Yakovleva, 2014), Questionnaire “Index of attitude toward health” (Deryabo, Yasvin, 1999).

The results of multiple regression analysis showed that health anxiety in adolescents is determined by the following parent’s features: goal-setting in the field of health-preserving activity (-0.661, p=0.036), standards of health (0.518, p=0.028), self-efficacy in the field of health-preserving activity (0.892, p=0.010), cognitive scale of attitude toward health (0.586, p=0.032) and scale of actions (0.059, p=0.002). It is also determined by parents’ vigilance to bodily sensations (0.815, p=0.000).

Health anxiety in adolescents is influenced by both cognitive, motivational and behavioral components of the attitude toward health of their parents, and also sensory (negative physical sensations and symptoms in parents form anxiety about health of their children). Research is supported by the Russian Science Foundation, project No. 21-18-00624.

Research is supported by the Russian Science Foundation, project No. 21-18-00624.

The Nordic countries have similar health care and welfare systems, and rather homogenous populations. Therefore, it is reasonable to expect similar use of psychotropic drugs. However, recent studies show marked differences in a range of psychotropic drug classes among children and adolescents in Sweden, Norway, and Denmark.

To review the literature regarding psychotropic drug use among children and adolescents in the Nordic countries.

We performed a critical systematic literature review according to PRISMA guidelines and registered the study protocol at PROSPERO. Three scientific databases were used: PsycINFO, EMBASE and PubMed. Inclusion criteria were: 1) Age: 3-19 years, 2) Country: Denmark, including Faroe Islands and Greenland, Sweden, Norway, Finland, including Aland, and Iceland, 3) Drug of interest: Psychotropics, including Antidepressants, ADHD medication, antipsychotics, hypnotics, anxiolytics, 4) Population based study sample, 5) Observational study design, 6) Original data, 7) English language, 8) Publication date: 2010-2021. The review process was performed by four reviewers in three steps: 1) title/abstract screening, 2) full text screening, and 3) data extraction, including risk of bias assessment. Before study initiation, acceptable interrater reliability was ensured by pilot tests.

The literature search was conducted October 6th, 2021. The PsycINFO database gave 285 hits, EMBASE 1190 hits and PubMed 2185 hits. In total, the literature search gave 3660 hits, of which 294 were duplicates, leaving us with 3366 references. The first screening phase is in process and results will be presented at the EPA conference.

The results of the systematic review will be interpreted and discussed.

No significant relationships.

Parents today can be important members of a multi-professional team, helping children with mental illness. The well-being of the parents is an important factor in successfully helping the child and willingness to cooperate with specialists.

To investigate the experiences of parents undergoing family psychotherapy on an outpatient basis and during a child’s hospitalization.

86 parents who applied for family therapy on an outpatient basis and 80 parents (main group) of hospitalized children took part in the study. Participants were offered the following questionnaires: Beck Hopelessness Scale, modified scales of the Dembo-Rubinstein, GAD-7, PHQ-9, Quality of Life Enjoyment and Satisfaction Questionnaire. The study was conducted from 04/01/2021 to 04/14/2021.

The main group significantly differs from the outpatient group in the following parameters (according to the t-test): the level of depression (M=18,34 and M=11,61 respectively) and anxiety (M=12,07 and M=7,96 respectively), the quality of life in the sphere of emotional well-being, social sphere, activity and free time, as well as the happiness self-assessment scales. The results on the scales of depression and hopelessness are inversely significantly associated with the willingness of parents to participate in family psychotherapy (r=-0,74, p=0,01) visit the child (r=-0,58, p=0,05), and regularly contact a doctor (r=-0,61, p=0,05).

Depending on the well-being of family members and the tasks facing the family, family assistance may differ depending on the stage of treatment of the child.

No significant relationships.

With measures of COVID-19, activities that cover a large part of life have started to be carried out via videoconferencing. Videoconferencing can be disadvantageous for individuals with social anxiety due to increased social presence, decreased mutual understanding and consequently causing awkward communication.

This study aims to develop a scale to explore the difficulties experienced by individuals with social anxiety during videoconferencing.

598 children and adolescents between the ages of 11-18 participated in the study. The data were collected with Sociodemographic Information Form, Videoconference Anxiety Scale and Liebowitz Social Anxiety Scale.

According to correlation analysis, all correlations between Videoconference Anxiety Scale and Liebowitz Social Anxiety Scale total score and subscale scores are above 0.50. According to EFA, the scale consisted of 25 items and a single factor. Factor loads were between 0.62 and 0.81, the single factor explained 52.95% of the variance. Model fit indices after CFA were as follows: X2/df:3.360, GFI:.850, IFI:.900, TLI:.890, CFI:.900, RMSEA:.078, SRMR:.0475. Convergent and discriminative validity of the scale was tested. Standardized factor loads of all items were higher than 0.50. AVE value was 0.47, while CR value was 0.96. Cronbach’s alpha coefficient of 25-item VAS is 0.96.

This study showed that Videoconference Anxiety is a phenomen which is higly correlated with social anxiety and Videoconference Anxiety Scale is a valid and reliable instrument for Turkish children and adolescents.

No significant relationships.

Self-Harm (SH) is any act of self-injury carried out by somebody irrespective of motivation. SH most commonly functions to relieve negative affect (NA). Tentative evidence suggests reward processing is altered in SH. NA may trigger reward hypersensitivity and therefore SH. Whether NA influences reward processing in SH remains unclear.

To investigate whether self-harmers differ in motivation to obtain SH stimuli than healthy controls (HCs) following NA induction.

After NA induction, SH participants will have a significantly shorter reaction latency (RL) and greater reaction accuracy (RA) than HCs in the SH condition of the Incentive Delay (ID) task.

16-25-year-old SH (n=35) and HC (n=20) participants were recruited online and underwent the Trier Social Stress Test, to induce NA, followed by the ID task, where participants were cued to respond to a target as quickly as possible. On responding, an image of either a SH act (SH Condition), people socializing (Social Condition) or money (Monetary Condition) appeared. Each condition included control trials showing a neutral image. RA was the percentage of trials responded to within the target’s presentation time. RL was the time (seconds) between target appearance and participants’ response.

There was no significant main effect of group, condition or group x condition interaction for RL. There was a significant main effect of condition (p < 0.05) but not of group nor a group x condition interaction for RA.

Reward processing did not differ in the SH group compared to HCs post-NA induction. Future studies could investigate reward processing in longitudinal and larger SH samples.

No significant relationships.

Cyclical psychosis related to the menstrual cycle is an entity not included in the DSM-V and ICD-10 classifications, however there are data collected in the literature on cases that agree with this diagnosis. When reviewing cases, psychotic symptoms of sudden onset are described a few days before menstruation, with the symptoms resolving in a self-limited way when the bleeding ends. The end of psychotic symptoms is not directly related to the use of antipsychotics. The complete clinical picture is nonspecific and fluctuating. With acute onset, short duration, cyclical repetition, with psychotic symptoms (mutism, confusion, delusions, hallucinations) or a manic episode. We present the case of a 14-year-old adolescent with a history of epileptic seizures in childhood, without current treatment. She goes to the emergency department brought by her father and brother presenting psychomotor agitation, verbiage, flight of ideas, loss of the common thread in the speech, referring delusional ideas with experience of harm. His relatives report that he has not slept for a few days, with soliloquies, unmotivated laughter. They refer that the picture has been repeated in recent months during the days of menstruation.

Knowing a diagnosis not included in the current classifications.

Imaging tests and neurological evaluations rule out organic picture.

Given the periodicity of the condition, the symptoms are self-limiting at the end of menstruation, without a clear relationship with psychopharmacological treatment (although agitation improves).

Cyclical menstrual psychosis approximates affective disorders, especially bipolar disorder in adolescence. The role of psychotropic and hormonal treatment is debatable.

No significant relationships.

The COVID-19 pandemic has disrupted numerous fundamental systems ranging from businesses to education system. The long-term consequences of the Pandemic, namely virtual learning and prolonged social isolation are coming to fruition in Child/Adolescent-Psychiatric Emergency-Rooms (CAP-ER). Discontinuity of in-person attendance of schools has poorly impacted the mental health of children and adolescents (C&A) of low-socioeconomic areas, who often rely on schools for meals, physical activity, and mental-health support. An increase in agitation, suicidal ideation, and a declining school performance has been observed in such situations.

The primary objective of this study is to explore the increase in these symptoms as the presenting complaint in the psychiatric ER.

Between April to June 2021 a cross-sectional quality improvement (QI) study was done on children presenting to CAP-ER BronxCare-Hospital NY with psychiatric complaints. Concomitant substance use disorder was determined using CRAFT questionnaire.

Our data comprised 209 patients (84 M/125 F) with 79 children and 130 adolescents. Ethnicity: 116 Hispanics (56%), 84 African Americans (40%), and 9 others. The most common presenting complaints were aggression (111, 53%), suicidal ideation/suicide attempt (50, 24%), acute exacerbation of chronic illness (7, 3.3%), accidental overdosage (5, 2.3%) and others (36, 17.4). Marijuana was the most used substance (34 patients).

There has been a surge in severity of presentation of psychiatric disorders among children and adolescents, aggression so far, the most prevalent. Further studies are needed to delineate the social links with this high emergent load and pandemic.

No significant relationships.

Functional somatic disorders (FSDs) are characterized by persistent and disabling physical symptoms that cannot be attributed to well-defined somatic disorders. In adolescents, the prevalence is around 4-10%. Evidence from adult populations suggests that cortisol plays a role in the development and perpetuation of FSDs, but little is known regarding adolescents. As cortisol accumulates in hair over time, hair cortisol concentration (HCC) is a promising new biomarker for long-term physiological stress. Moreover, adult studies have found associations between HCC levels and self-perceived stress.

To compare HCC levels between adolescents with severe FSDs and adolescents from the general population. Furthermore, to investigate the association between HCC and self-perceived stress.

The data are retrieved from two projects: the AHEAD trial, including 91 15-19-year-old adolescents diagnosed with a severe FSD, and the Copenhagen Child Cohort 2000 (CCC2000), including data on 1455 16-17-year-old adolescents. Hair samples were collected for HCC analysis, and web-based questionnaires were used to asses self-perceived stress. Functional somatic symptoms were assessed with the Bodily Distress Syndrome (BDS) checklist.

The data have been collected and will be analysed and presented at the congress.

This study can contribute with knowledge about the potential role of cortisol in FSDs in adolescents, and whether self-perceived stress can be used as a marker for physiological stress measured by HCC. Treatments for adolescents with FSDs still need to be improved. The current study may help to understand whether future treatment strategies should include a greater focus on stress management.

No significant relationships.

Parent Child Interaction Training PCIT (Zisser & Eyberg, 2010; Briegel, 2016) is an evidence-based treatment of oppositional defiant disorder in preschool children. However, it is implemented in few institutions in Europe. The advantage of PCIT is the involvement of both child and parents with direct coaching of the parents.

We will give an overview of 20 treatment courses we have conducted since the introduction of PCIT at the Zurich University Hospital for Child and Adolescent Psychiatry. First, a descriptive analysis of our sample will be conducted. The influence of sample characteristics and intensity of training on the reduction of behavioral problems will be analyzed.

Parents attend the training for at least 6 months with regular sessions. The transfer into everyday life is achieved by daily homework. We use the Eyberg Child Problem Behavior Inventory as pre-post measurements. The ECBI is filled out by the parents before each session and also enables a progress analysis.

Three times more boys participated than girls. Problem behavior was significantly reduced after the play training phase. There was also a significant overall pre-post effect. The effect seemed to be independent of the parental problem score before training and of the number of play-training sessions.

Parents and children clearly benefit from the play training. For the following cooperation training, the problem load experienced by the parents seems to be more relevant than the intensity of the child’s problem behavior as assessed by them. This is to be examined in the future.

No significant relationships.

The significant clinical efficacy of lithium and lamotrigine in the described patients is consistent with the hypothesis that microdeletion of the SHANK3 gene may be associated with bipolar disorder.

The described phenotypes were characterized by intellectual disability, general speech underdevelopment, muscle hypotonia, and developmental dyspraxia. Their causal relationships with epileptic encephalopathy, schizophrenia, bipolar and hyperkinetic disorders have been analyzed.

Prospective studies of two patients with Phelan McDermid syndrome (22q13.3 microdeletions of the SHANK3 gene) within 10-12 years after genome scanning allowed describing the clinical polymorphism of developmental disorders. The sensitivity of psychotic symptoms to antipsychotic and mood stabilizer therapy has also been studied.

Manifest psychotic disorders in patients did not reveal an affinity for therapy with amisulpride, haloperidol, quetiapine, which demonstrated a partial therapeutic response to treatment with aripiprazole, which cast doubt on the possibility of qualifying psychotic symptoms in patients as the debut of schizophrenia. The partial therapeutic efficacy of combination therapy with aripiprazole and benzodiazepines (clonazepam/diazepam) qualified psychotic episodes in two patients with 22q13.3 syndrome as pediatric delirium. The significant clinical efficacy of lithium and lamotrigine in the described patients is consistent with the hypothesis that microdeletion of the SHANK3 gene may be associated with bipolar disorder.

The combination of lithium and lamotrigine may be recommended for the treatment of polymorbid mental disorders in patients with ASD and 22q13.3 syndrome. If lithium salts are poorly tolerated, a combination of lamotrigine and aripiprazole may be used to treat polymorbid mental disorders with confusion and catatonic symptoms in ASD.

No significant relationships.