Menke-Hennekam syndrome (MHS) is a relatively new genetic condition characterized by intellectual disabilities, autistic behavior, auditory defects, recurrent upper respiratory tract infections, microcephaly and short stature. Facial characteristics include short palpebral fissures, telecanthus, depressed nasal bridge, short nose, anteverted nares, short columella, and long philtrum. The genetic defect is represented by missense variants of CREBBP gene, located on exons 30 or 31. There are only around 30 cases reported by now.

The aim of the paper is to report a new case of MHS.

The case is a 3-year-old boy admitted in our department for developmental delay. The clinical examination revealed dysmorphic features; severe speech delay, mild intellectual disability, autistic behaviour.The patient had a personal history of recurrent respiratory infections, visual defect and bilateral sensorineural hearing loss. Other investigations included EEG, abdominal echography, and cerebral MRI all were normal. The genetic studies included array CGH and WES.

The array CGH was normal. WES identified a pathogenic heterozygote variant c.5600G>A in the exon 31 of CREBBP gene, confirming MHS.

Overall, the features of our patient are consistent with those reported in the previous reports, including developmental and speech delay, autistic behavior, dysmorphic features, recurrent upper way infections, sensorineural hearing loss, and visual defects. Other common features, such as growth delay and microcephaly were not present in our patient. Our case contributes to the clinical characterisation of the new syndrome. Funding: The research leading to these results has received funding from the EEA Grant 2014-2021, under the project contract No 6/2019.

No significant relationships.

Since Kraepelin and Bleuler, schizotypy was understood as a mild expression of psychosis, a latent form with the same trajectory but different severity. They pointed characteristics such as being eccentric, unreasonable, supersticious or hipersensitive, interpersonal aversiveness (often related to suspiciousness and expectation of rejection), ambivalence, anhedonia,… and psychosis-like features that don’t usually lead to help-seeking.

To do a case review

We report a case of a 17 years old boy with a childhood trauma history who started psychiatric consultations a year and a half ago because his “usual” (as his mother referred) strange behaviour got worse, which was perceived by his

ENT specialist. During the appointments, the patient showed suspiciousness, odd speech, inappropriate affect, tendency to social withdrawal, obsessive ruminations with sexual content and occasional perceptual experiences (such as depersonalization, derealization and auditory hallucinations).

Psychosis and schizotypy are linked historically and phenomenologically, which is evidenced by their placement in non-affective psychosis in the ICD-10 and DSM-5, and it is known that the direct observation (by clinicians or family members) during the childhood and adolescence are key for a correct diagnosis. In fact, this construct reflects a phenotypic expression of vulnerability to schizophrenia, and during childhood or adolescence it may be understood as an early mental risk state.

In contrast to models of psychosis that mainly rely on positive features and assume a progression of them, the positive traits of schizotypy seem to be beneficial and related to a “benign or happy schizotypy” according to the articles we reviewed.

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Although autism is only twice more common in men than women in general population, in clinical samples women are underrepresented. This difference may be due to a poor sensitivity of current diagnostic criteria of autism related to females. We present a 13-year-old woman referred to the adolescent psychiatric unit for anxiety, self injuries and suicidal ideation. After careful assessment of current symptoms and neurodevelopmental milestones, deficits in emotional-comunicational reciprocity, nonverbal comunication and relationships emerged, as well as inflexible adherence to routines and restricted interests. The diagnose of autism spectrum disorder was made and the patient started a specific treatment.

To review the clinical features of autism spectrum disorders in adolescent females and its differential diagnosis.

Review of the literature on autism spectrum disorders in female and its specific features.

The “Female Autism Phenotype” is a group features that are more common in autistic women, as opposed to the classic symptoms of autism in men. Some of these differential characteristics are: fewer social impairments and higher levels of social motivation; more age and gender appropriate restricted and repetitive interests; more internalizing rather than externalizing symptoms; and a tendency towards camouflaging

- Autism in women is frequently underdiagnosed. - Females express autism in ways that not allways meet the current diagnostic criteria. - The “Female Autism Phenotype” has been proposed as an specific way of expression of autism in females.

No significant relationships.

We present a 9-year-old girl with celiac disease who attends a Health Center referred by her pediatrician for rituals. Her mother describes rituals from early childhood that have been intensified by the death of her grandmother from pancreatic cancer. Since then, thoughts of gluten contamination and behaviors aimed at avoiding such contamination have increased. For example, not using the common household towel and not eating until all the guests have washed their hands. If the patient does not carry out these actions, she presents significant discomfort, crying and screaming until it is done. In addition, such behaviors take up a significant amount of time.

To review the literature of Obsessive-Compulsive Disorder (OCD) in children.

Literature review of scientific articles searching in Pubmed. We considered articles in English and Spanish.

Cognitive Behavioral Therapy and Sertraline up to 50mg were started. After several weeks the frequency of behaviors aimed at avoiding gluten contamination begins to decrease; as well as the anguish if these are not carried out.

OCD in childhood can present characteristics that differentiate it from OCD in adulthood, such as difficulty detecting obsessions and that children do not usually consider thoughts as unreal or excessive. Therefore, it is a real challenge, having to carry out an adequate differential diagnosis with other entities such as specific phobias, for adequate subsequent management.

No significant relationships.

A psychotic episode might stem from various psychiatric disorders, such as Major Depressive Disorder, Mania, Autism Spectrum Disorder, it might lead to Schizophrenia, or it might be a single event.

The study aimed to assess the main comorbidities encountered in the onset of psychotic episodes in children and adolescents, who were hospitalized in a pediatric psychiatry department for at least one night. Furthermore, another objective was to establish whether a family history of mental illness or a poor socio-economic status have bigger impact on the evolution of these patients.

To analyze the objectives, it was used an observational study, based on patients with the onset of a psychotic episode and associated diagnosis according to ICD-10, evaluated in Child and Adolescent Psychiatric Department of “Prof. Dr. Al. Obregia” Hospital, between 2015-2019. Patients with psychotic episodes with onset related to Major Depressive Disorder and Mania or a personal history of Schizophrenia were excluded.

The most frequent associated comorbidity was Autism Spectrum Disorder. In terms of long-term evolution, patients with comorbidities have poorer outcomes, more relapses and hospitalizations. Family history of mental illness, low socio-economic status, the age of onset were found to be prognostic factors and have an important impact on the outcome.

This study compared patients with psychotic episodes with and without comorbid conditions associated, considering the length of hospitalization period, the evolution and the number of relapses. The presence and the type of comorbidities are important factors of evolution and prognostic for these patients.

No significant relationships.

Loneliness is a critical issue of adolescents that has grown severe during the last decade. Social media use is often regarded as negative factor of loneliness experience in connection with escapism. At the same time social media is an important part of adolescents’ communication sphere. The present study aims to explore positive functions of social media which can help adolescents cope with loneliness.

The present research studies features of loneliness representation in adolescents with different behavior in social media.

Multidimensional Inventory of Loneliness Experience; Cognitive Processing of Social Information in Internet Questionnaire; Method of unfinished sentences about loneliness and social media; Questionnaire about social media were used in the study with 44 adolescents, aged from 13 to 18.

Adolescents have a higher level of loneliness (M = 29.6) than the results in 2013 (M = 17.7) show. Context analysis of unfinished sentences shows that 21% of adolescents have a various representation of loneliness, 71% perceive loneliness as negative. General feel of loneliness tends to show negative correlations with adequate perception of information in social media (k = - 0.317; p = 0.038). Negative attitude to loneliness is negatively correlated with interpretation adequacy of social media content (k=-0.568, p<0,001). Adolescents with low levels of holistic social media perceptions have higher levels of loneliness. Use of social media can reduce feelings of loneliness (p = 0.002).

Social media expand adolescents’ representation of loneliness. Productive use of social media can help adolescent cope with loneliness.

No significant relationships.

Psychiatric symptoms are a common comorbid feature of hypothalamic hamartoma(HH) with epilepsy. They are a significant challenge for patient and their families. Most common psychiatric symptoms are externalizing behaviors such as aggression and defiance.

To outline an atypical presentation of HH in form of development of ADHD post-surgery.

A 6-year old child born out of non-consanguinous marriage, with history of hyperemesis gravidarum and depression in mother in ante-natal period, delivered by NVD at term(did not cry at birth and was hospitalized for 3 days) with birth weight of 2.25 kg, currently presented to Neurology with global developemental delay and history of gelastic seizures since 3 years of age. Patient was diagnosed with pituitary hamartoma(through MRI) and precocious puberty that time and was operated for it after which he started having behavioural issues like irritability, aggression, hyperactivity and lack of appropriate social behaviour with peers along with defiance towards parents. Child was then refered to Psychiatry. On MSE patient did not interact with interviewer and was noticed to shout loudly when confronted for using mobile phone. MRI brain(2 months back) showed post-op changes with cystic lesion in suprasellar region. IQ assessment showed borderline intelligence.

Patient was started on Risperidone(upto 1.5 mg) which lead to some improvement. However antiepileptics are being rationalized to prevent behavioural issues secondary to epilepsy

Patients of HH with epilepsy, present with varied psychiatric symptoms which usually improve after surgery. However we came across a child with worsening of psychiatric symptoms after he was operated for above lesion.

No significant relationships.

Dyskinesias are motor disorders that occur as a side effect to treatment with typical and less frequently with atypical antipsychotic drugs. They are more frequents in child population. Treatment usually consists of decrease the dose of drug or replace it with a better profile tolerability antipsychotic. Clozapine is an antipsychotic drug indicated as second-generation treatment of motor disorders that appear as side effects to treatment with neuroleptics.

Demonstrate the efficacy and tolerability of clozapine in the treatment of dyskinesias in childhood.

The patient 12 year-old boy, has episodes of psychomotor agitation once a month. This will alternate with quiet moments in which dyskinetic movements are observed in upper limbs, without being able to detect any type triggering environmental factor. Personal history: hydrocele, diagnosed at 8 years becomes neurodevelopmental disorder considered. Neurosurgery tracking for Subarachnoid cyst. Psychopathological examination: Child presents psychomotor restlessness, disruptive behavior, impairments in communication, movement disorder, stereotypies and dyskinetic movements in shoulder and neck.

In the patient suffering from an autistic disorder, stereotypies and other motor symptoms were observed, the predominant and most relevant being dyskinetic movements in the shoulder and neck, which appeared one month after starting treatment with risperidone and worsening psychomotor skills. Treatment of dyskinesia with clozapine improved the motor symptoms presented by the patient.

Clozapine should be the treatment of choice in the event of dyskinesias as a secondary effect to other antipsychotic treatments, proving effective in controlling them as well as well tolerated in both adults and children.

No significant relationships.

There is a lack of instruments evaluating self-stigma among adolescents with mental health issues in the Russian language for today. The questionnaire developed by Tally Moses (Moses, 2009) is convenient to fill that lack.

The study aims to compare the main parameters of the original questionnaire to that of the version translated in Russian.

The original questionnaire was translated into Russian and administered to 40 adolescents (21 males, aged 12 to 17) with mental disorders except for severe cognitive deficits or pervasive developmental disorders. Means and Cronbach’s alpha for each of the four scales were assessed and compared to the author’s questionnaire values.

Reliability analysis revealed similar Cronbach’s alpha for 3 of 4 scales (table 1) except the Secrecy scale (1 of 6 questions showed low consistency; its exclusion increased α from 0.63 to 0.74).

The means for each scale were compared with original data using a one-sample t-test. Only the Personal Rejection scale was significantly low on average than the original data.

Preliminary results showed that Russian adolescent patients perceived the translated questionnaire much the same way as American ones. Thus, our findings provide optimistical perspectives of further adaptation of the questionnaire.

No significant relationships.

During several years in Ukraine have been actualized problem with autoaggressive behavior amoung young people. Due to not enough support at ambulatory psychiatric and social systems these patients have hospitalizations. And its duration could be for month and longer. The problem seems like if hospitalization can be ling, will be it affective while there are no community support after it. Even having good results can not give long “remission” because patients come to the same family/social situation.

Examine autoaggressive behavior in adolescents and find criteria for hospitalization for this category.

We took 173 patients with autoaggressive behavior at age 18-25. We formed theory for research that, on our opinion, include information that give chance to find criteria while hospitalization isn’t recommended.

First results have shown a high level of comorbidity personality disorders with neurotic and depressive disorders. High levels of self-harm are associated with episodes of sexual and psychological abuse and characterized with trauma. The next parts of the research will show deep indications for in- and out-patient treatment.

Criteria for hospitalization adolescents with self-harm are hard to form because of differences of reasons, comorbidities and risk of suicide among adolescents. But not all in-patient treatment gives expected results. Mostly it can work like a traumatic experience on this group. Scientific research can help to make the psychiatric systems friendly to adolescents with complex problems. The authors have not supplied a conflict-of-interest statement

No significant relationships.

Autism is a lifelong complex neurodevelopmental condition that affects brain development and behaviour with significant consequences for everyday life (WHO, 2018). Despite its personal, familial and societal impact, there is still a European-wide lack of harmonised guidelines about the support needed from early stages, the most sensitive time to gain positive future outcomes (Berajamo-Martin et al, 2019).

The objectives were: 1. To analyse autistic children care pathway and patient/carer journey in three European countries: Italy, Spain and U.K. 2. To propose policy recommendations on how to improve this pathway.

To identify major barriers and treatment gaps, we conducted a rapid literature review of the care pathway in Europe and a survey aimed at parents or carers of autistic children ages 0 to 18 living in the three countries. The survey gathered information on screening, diagnosis, accessibility and support received before, during and after diagnosis. Members of the working group met to discuss results and propose policy recommendations.

1. Current care pathway analysis showed the following treatment gaps: Long waiting time from first concerns until screening visit and confirmed diagnosis. Delayed or no access to intervention once diagnosis has been confirmed. Overall limited information about autism and how to access early detection services. Overall deficient support to families. 2. Please see Box 1 for our proposed policy recommendations.

Box 1. Policy recommendations

Our findings and recommendations will inform policy harmonisation in Europe to shorten long waiting times, diagnosis process and intervention, and therefore, improve autistic people and their families’ journey experience and quality of life.

No significant relationships.

Externalizing disorders involve undercontrolled, impulsive, or aggressive behavior. Included in this category are Conduct Disorder, Oppositional Defiant Disorder, and Attention deficit hyperactivity. Difficulties with emotion regulation are a core feature of externalizing disorders in children and adolescents. Yet, no studies to date have compared the relative efficacy of an ECBT program in this population.

to investigate the effectiveness of an ECBT inspired program in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD)

We conducted an experimental study with a pretest posttest design and a control group. 50 subjects with either ADHD, ODD or CD were selected and assigned to the experimental and control group. 25 patients ages 9–18 (13 boys, 12 girls) were enrolled in the ECBT-inspired program with 19 completing treatment. Comparison of pre- and post-test results for each sub-group was performed using the Wilcoxon test.

showed that youths in the ADHD and ODD groups demonstrated a significant reduction in externalizing behavior problems measured by the Child Behavior Checklist (CBCL). In terms of emotional regulation, only the group of patients with ODD showed a significant improvement in the cognitive reappraisal subscale of the emotional regulation questionnaire(ERQ- CA ). Only in the ODD group, significant improvement was found in the identification and external oriented thniking subscale scores of the alexithymia questionnaire for children (AQC).

Such comparisons are necessary to determine the clinical profile of patients who might most benefit from such an intervention.

No significant relationships.

The emotional, behavioral and psychosocial effects of chaotic environments following wars and armed conflicts in terms of exposure to trauma and displacement is well recognized. School-age children who are directly exposed to or witnessed negative effects of armed conflicts show an array of emotional and behavioral problems.

Our study aimed to examine the mental health conditions of children living in war and conflict zones and attending primary schools in Agdam.

The study sample comprised of 617 children (mean age 8.9, SD 1.24; 50.7% female), residing in the conflict areas in the southwestern of Azerbaijan. The children were evaluated with the previously validated Azerbaijani version of the Strengths and Difficulties Questionnaire (SDQ) Teacher Form.

About a third of children (32.7%) had abnormal total scores, and a fifth (21.4%) were in borderline range. The SDQ subscale scores included emotional problems (19.4%); conduct problems (20.3%), hyperactivity/inattention (12.2%), peer relationship problems (31.1%), and pro-social behavior difficulties (13.1%). As a result, externalizing problem scores were higher in males (p<.001) and internalizing problems in females (p<.05). Due to correlation analysis, age is negatively and significantly related with externalising (p<.05), internalising (p<.01), and total difficulty (p<.05) scores.

The findings of the study show that more than half of the children living in the war zone in Azerbaijan suffer from mental health problems and highlight the need for child mental health services and family supports in the region.

No significant relationships.

Difficulties in mentalizing (i.e., the ability to reflect on self and others’ internal mental states, operationalized as reflective functioning [RF]; Fonagy et al., 2012) have been associated with psychological symptoms (Luyten et al., 2020), including somatic symptoms (Bizzi et al., 2019). Therefore, the assessment of its dimensions may be clinically relevant for young patients with somatic symptoms, as with Primary Headache (PH), representing one of the most common somatic complaints in children and adolescents.

This study aimed to assess RF with a multi-method approach, exploring its relation with somatic symptoms.

48 adolescents diagnosed with PH (Mage=14.83, SD=2.81; 67% females) were recruited from an Italian Child Neuropsychiatry Clinic. RF was measured both through the Child and Adolescent Reflective Functioning (CRFS) applied to the Child Attachment Interview transcripts and the self-report Reflective Functioning Questionnaire (RFQ), while the Children’s Somatization Inventory (CSI-24) was used to measure the perceived severity of somatic symptoms.

Different relations with somatic symptoms depended on the method used to evaluate RF: no significant correlations were found with the CRFS subscales (General, Other, Self), while a negative significant correlation was found with the RFQ subscale Certainty about mental states (RFQ_C) (r=-.46, p=.016). All subscales of CRFS were negatively correlated with RFQ_C (p=.05), but not with the other RFQ subscale (Uncertainty about mental states; RFQ_U).

This suggests that two measures may lead to different dimensions of the same construct, thus a multi-method assessment of RF would be advisable in clinical practice.

No significant relationships.

ATR for children has successfully increase survival to adolescence. Health-related quality of life (HRQoL) is relevant to evaluate the impact of the disease on well-being in adolescents living with HIV (ALH). Kidscreen-52 questionnaire is validated in mexican adolescents to measure HRQoL

To evaluate health related quality of life in a sample of 22 mexican ALH

A sample of ALH in treatment at the HIV Clinic during 2021, were evaluated with Kidscreen-52 by a child psychiatrist. Statistics included non parametric tests and Cohen “d” and “r” size effect to compare T means between ALH and Kidscreen-52 standardized scores.

Mean age:14.4+2.5. Gender: 11(50%)boys, 11(50%)girls. ALH showed significantly lower scores in all domains. Girls reported lower scores in physical well-being(p=0.047) and autonomy (p=0.023). Orphan ALH had lower scores in mood and emotions (p=0.021)

- HRQoL were significantly lower in ALH. -Girls showed significantly lower scores in physical well-being and autonomy. - ALH orphans showed significantly lower scores in mood and emotions domain

No significant relationships.

Deficient emotion regulation is a common and impairing area of difficulty among children and adolescents with externalizing disorders. Emotion focused cognitive behavioral therapy ECBT is a form of CBT that is suggested to be employed to improve dysregulation of anxiety and other kind of emotions in anxious youth.

Examine the efficacy of an Emotion-focused Cognitive-Behavioral Therapy (ECBT) inspired program on emotional regulation difficulties and behavioral problems in children and adolescents with externalizing disorders

We conducted a cross-sectional comparative experimental study. Subjects were 50 patients exhibiting behavioral disorders aged 9 to 18 years , with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD).Participants were assigned to ECBT and control groups. ECBT group contributed in 12-h weekly sessions within ECBT-inspired program. The control group received standard care. To assess emotion-related competencies, children were administered the emotion regulation questionnaire (ERQ-CA) and the alexithymia questionnaire for children(AQC). Parents completed the Child Behavior Checklist(CBCL) to measure youth externalizing problems. Tests were administered in pre- and post-test to all subjects. Both groups were matched for age, sex and educationnal level. Comparison of pre- and post-test results was performed using the Student’s t-test.

ECBT demonstrated a significant difference in the reduction of behavioral problems. ECBT effectively increased adaptive emotion regulation strategies (cognitive reappraisal) in the post-test. ECBT also reduced alexithymia scores, particularly difficulty identifying feelings, and externally oriented thinking.

ECBT demonstrated promising initial effectiveness in addressing emotion regulation deficits of children with externalizing behaviors

No significant relationships.

Adolescent mental health problems may have increased after COVID-19 worldwide pandemic. Therefore it seems necessary to study the state of mental health inpatient adolescent units.

Adolescent mental health problems may have increased after COVID-19 worldwide pandemic. Therefore it seems necessary to study the state of mental health inpatient adolescent units.

An observational and descriptive analysis of the sample of patients between 12 and 17 years-old, that were admitted to the inpatient mental health unit since its opening on April 2021.

A total of 205 patients were admitted from April 2021 until October 2021. We have observed sex diferences within patients admitted, as the 82.9% of them were female. The mean age was 14.7, being 14.6 for girls and 15.3 for boys. The most common reason for admission (RFA) were suicidal ideation/attempt, eating disorders, affective disorders, conduct disorders/challenging behaviors and psychosis. Suicidal ideation/attempt was the most common RFA (57.07%) in both sexes, being higher among females (60.3%) than males (42.9%). Eating disorders were the second most common RFA in girls (17.7%) while psychosis (17.1%) and mood disorders (17.1%) were the second most common RFA within boys.

Findings on how COVID-19 affected adolescents mental health are controversial in the literature, our data suggest that there is a need of developing quality studies that analyse how the pandemic might be influencing adolescents suicidal ideation/attempt and its protective and risk factors.

No significant relationships.

Primary Headache, including Tension-Type Headache (TTH), represents one of the most common somatic disorders in children and adolescents with a strong impact on quality of life. Several risk factors, as environmental, familiar, and psychological features, including personality traits, are related to the development of Primary Headache. However, studies on specific subgroups of TTH are relatively few in early adolescents.

Therefore, this cross-sectional pilot study aims at exploring the role of anxiety and alexithymia in early adolescents with and without TTH.

A sample of 70 early adolescents (Mage=14.59, SD=1.85; 71% females) consisting of a clinical group (31 with TTH) enrolled in an Italian Child Neuropsychiatry Clinic and a comparison group (38 without TTH) enrolled in schools, matched on gender and age, completed: 1) Multidimensional Anxiety Scale for Children (MASC) to detect the Total levels of Anxiety, also in their factor of Physical Symptoms, Social Anxiety, Harm Avoidance, and Separation Anxiety; 2) the Toronto Alexithymia Scale (TAS-20) to detect the Total levels of Alexithymia, also in their factor of Difficulty to Identifying and to Describing Feelings and Externally Oriented Thinking.

TTH outcome positively correlated with Harm Avoidance (rho=.68, p<.001) and Total Alexithymia (rho=.72, p<.001). In a logistic regression, Harm Avoidance and Total Alexithymia predicted 69% of the variance in TTH outcome (p<.032).

This disorder may be a maladaptive strategy to cope with problems and feeling emotions, then early adolescents could be fostered in the acquisition of more adaptive emotion regulation abilities.

No significant relationships.

The family of a child with a mental illness is a significant source for his support in harmonizing his development and achieving successful socialization.

The objective of the survey is to develop a psychoeducational program for parents.

Questionnaire “Parental attitude to children’s illnesses” (V.E. Kagan, I.P. Zhuravleva) Parents of 39 (22 mothers and 17 fathers) children aged from 3 to 6 with ASD - autism spectrum disorders (F84.01; F84.02; F84.11).

Parents of children with ASD often do not realize the morbid nature of changes in the children`s behavior and interpret them as spontaneity, pamperedness or even giftedness. Most parents underestimated the doctor’s recommendations for compliance with the treatment regime. Taking into account the parents` complaints and the difficulties of understanding the child`s problems, a psychoeducational course was developed, including 7 sessions: 1. acquaintance; 2. the concept of ASD, etiological factors, features of manifestation; 3. the role of the family in the treatment and rehabilitation process; 4. development of mental functions in children with ASD; 5. emotional development of children with ASD; formation of communication skills and social adaptation; 6. training organization and correctional and developmental classes for children with ASD; 7. summing up. The psychoeducational course is carried out in the form of group thematic seminars 7 meetings once a week for 1.5-2 hours. After completing the course, some families remain on individual psychological follow-up.

Completing a psychoeducational course makes it possible to fill the lack of information regarding the disease and treatment tactics, increases compliance and harmonizes parent-child relationships.

No significant relationships.

Assessment and management of bipolar disorder, and particularly manic episodes in adolescents means a challenge. The presence of comorbid disorders, and divergent interpretations of manic symptoms in the context of the adolescent natural inmaturity, can make diagnosis and treatment hard goals to achieve. The existence of juvenile specific criteria for bipolar disorder is a debate topic. This concept emerged from an attempt to solve diagnosis issues and involves a wide range of definitions for mania.

Literature review concerning bipolar disorder in young population: Main comorbidities, psychosocial problems, prognosis. Clinical presentation: Shared and specific features compared to adult population. Available treatment options. Issues related to safety and tolerability.

We present a case of a 16 year old woman diagnosed with bipolar II disorder, hospitalised in an inpatient adolescent unit in 2021. Review of the literature available (clinical guidelines, PubMed).

Patient initially oriented as a Bipolar II disorder, after depressive episodes followed by hypomanic symptoms in the past years. The following clinical course was conditioned by personality traits. Emotional disregulation and a complex family environment made affective symptoms difficult to evaluate, leading to a diagnostic hypothesis of personality-related disorder. After a period of outpatient treatment in a day hospital, she debuted with a clinical picture of manic symptoms, mixed features and rapid mood cycling.

After an initial trial, stabilization was achieved with aripiprazole and asenapine. Combination therapy might be necessary in longer-term treatment, according to existing evidence. Diagnosis and treatment concerns are interfered by the limited number of trials.

No significant relationships.