Attention deficit hyperactivity disorder (ADHD) is still underdiagnosed in many EU countries. Despite its relevance in terms of public health, the incidence and prevalence of this disorder is not well researched.

The national incidence and prevalence of ADHD diagnosis in children and adolescents has not yet been reported in any South Eastern European country.

The main aim of this study was to investigate the incidence and prevalence of ADHD diagnosis among children and adolescents in Slovenia in 2012, based on national data from 1997 to 2012. Different epidemiological models were built.

The data from the National Institute of Public Health of the Republic of Slovenia for the years 1997–2012 were analyzed. The yearly database includes all newly diagnosed outpatients with ADHD in Slovenia.

In 1997, the annual incidence rate of ADHD diagnosis was 0.0317 % and increased to 0.0469 % in 2000 and to 0.0823 % in 2012. The prevalence rate of ADHD diagnosis was estimated between 722 and 767 per 100,000 children and adolescents. If the increase persists, the prevalence of ADHD diagnosis in 2020 will be 6.3-fold higher than in 1997 and 1.3-fold higher than in 2012.

ADHD is a common mental health disorder in Slovenia, but it is still underdiagnosed in comparison with Western countries. Results indicate a need for improved timely interventions in Slovenia, not only in child and adolescent psychiatry but also in primary settings and adult psychiatry, where ADHD should be recognized efficiently.

Symptoms of attention-deficit/hyperactivity disorder (ADHD) appear in childhood, but often persist into adulthood. The prodrug lisdexamfetamine dimesylate (LDX) is an effective once-daily treatment for the symptoms of ADHD in children, adolescent and adults.

To evaluate post hoc the impact of ADHD medication history on the efficacy of LDX in adults.

In this phase 4, double-blind, dose-optimized study, patients aged 18–55 with ADHD and impaired executive function were randomized (1:1) to LDX or placebo for 10 weeks. Patients well controlled on current ADHD medication with acceptable tolerability were ineligible. Self-reported, lifetime ADHD medication histories were recorded at screening. Investigator-rated ADHD Rating Scale IV with adult prompts (ADHD-RS-IV-Adult) was a secondary efficacy measure. Primary efficacy and safety outcomes have been published (J Clin Psychiatry 2013;74:694–702).

Baseline characteristics were similar across treatment arms and previous ADHD medication subgroups. Differences between LDX and placebo in mean change from baseline to endpoint in ADHD-RS-IV-Adult total score were observed in the overall study population (n=154; –11.1 [95% confidence interval: –14.96, –7.32]; effect size, 0.9), treatment-naïve patients (n=80; –11.4 [–16.81, –5.96]; 0.9) and patients previously treated with: any ADHD medication (n=74; –10.9 [–16.50, –5.30]; 0.9), methylphenidate (n=40; –9.9 [–17.44, –2.45]; 0.9), amfetamine (n=38; –13.8 [–20.86, –6.75]; 1.3) and atomoxetine (n=21; –8.4 [–21.97, +5.26]; 0.6).

In these post hocanalyses, the response to LDX was similar in the overall study population and subgroups of patients categorized by ADHD medication history.

Study funded by Shire Development LLC.

The main aim of the study is The Survey of Socio-economic Factors Related to Rate of child Abuse in the Family of Karaj Hesarak province of Iran.

This research has followed a survey method using questionnaires. The participant of this study was families living in Karaj Hesarak. Data were collected by a structured questionnaire from 400 Family who were systematic-randomly selected.

According to result, a significant correlation was found between a age, sexuality, income, level of education, family size, Social capital, Mental health and religious orientation to Rate of child Abuse in the Family. The results of regression equation showed that, factors including: Mental health, family size, Social capital, income and religious orientation influence on child Abuse in the Family.

These factors explain 57 percent of the variation changes in the dependent variable. According to the model path analysis, among these variables mental health has a highest impact on the dependent variable.

Genealogical and cytogenetic analysis has been carried out in 114 children with depressive disorders (DD), aged 7 to 17 years. Statistical treatment: SPSS Statistics 17.0.

The main objective was to study familiar and cytogenetic risk factors of DD in children.

A hereditary burden on mental diseases has been registered in 66.0 %, and on DD in 56.0 % of the families under investigation. Family accumulation of mental and noninfectious diseases in the genealogy of patients with DD has been established in the study. Hereditary transmission of pathological symptoms in a number of generations of probands with depressive disorders took place 1.8 more often on the maternal than on the paternal line, and it was 3.6 more frequent than on both lines simultaneously. A sevenfold increase in the spontaneous level of chromosomal aberrations has been registered in our patients as compared with their healthy age-mates, indicating destabilization of the genome in probands with the disease. A significant rise in chromosomal anomalies level, related with gender, age, type of the disease and hereditary burden on mental diseases, has been registered in patients with depression. Some informative prognostic symptoms for revealing persons of high risk as regards disorders in the chromosomal apparatus in children and adolescents with depressive disorders have been defined. The effectiveness of the proposed prognostic signs comes to 84.8%.

Impulsivity refers to a predisposition toward rapid and unplanned reactions to internal or external stimuli, without regard to the negative consequences. It is recognized to be a contributing factor to the high rate of substance abuse and suicide risk in bipolar patients.

It is one of the most frequent typical symptoms in bipolar adolescents.

The aim of this study was to examine aspects of impulsivity in adolescents with bipolar disorders

We assessed impulsivity in 30 euthymic adolescents with bipolar disorder and we evaluated its association with the following clinic characteristics: suicide attempts, childhood trauma history and substance use history. Impulsivity and childhood trauma history were respectively assessed using the Barratt Impulsiveness Scale (BIS-10), and Childhood Trauma Questionnaire (CTQ) in validated Arabic versions. Patients were compared with 30 age and gender matched healthy controls.

The total impulsivity scores as well as subscores of motor and cognitive impulsivity in subjects with bipolar disorder were higher than in control subjects. There was a statistically significant difference between bipolar adolescent and controls regarding the CTQ total.

Our findings suggest that trait impulsivity is increased among adolescents with mood disorders and is associated with traumatic events in childhood. Therefore the dimension of impulsive aggression and childhood trauma should be systematically assessed in mood disorder patients to address the risk of suicide and addictive behavior.

Attitudes, and in some cases legislation, make it decreasingly acceptable to admit people younger than 18 years to adult psychiatric inpatient units. One strategy to reduce the number of under 18s admitted to adult psychiatric units is the commissioning of specialist Child and Adolescent Mental Health (CAMHS) inpatient units.

Map the flow of admissions toacute adult psychiatric inpatient units and paediatric medical units in the years before and after the opening of specialist CAMHS inpatient units.

Determine if opening CAMHS inpatient increases or decreases the flow of admissions to acute adult psychiatric inpatient units and paediatric medical units

Analysis of statewide admission data for under 18s to specialist CAMHS inpatient units, acute adult psychiatric inpatient units, and paediatric medical units for the period January 2001 to December 2013 in New South Wales, Australia.

Five of 8 health districts experienced an increase in juvenile admissions to adult units in the year of opening a CAMHS unit. Admissions to related paediatric medical units increased in 3 of 7 health districts. Admissions to adult and paediatric units rose with time but there was no interaction between time and health district type (with/without CAMHS unit).

Opening CAMHS units may temporarily increase the number of juveniles admitted to adult units, but does not influence the flow of patients to non-CAMHS facilities in the longer term. CAMHS units appear to fulfil an additional as opposed to replacement role in the care pathway for young people with mental illness.

HAJRI M., HALAYEM S., LAKHAL M.H., MANSOURI A., ABBES Z., OTHMAN S., BOUDEN A.

Advancements in human genetics are revealing a large number of genetic variants involved in Autism spectrum disorder (ASD). This genetic variability affects mostly proteins involved in synaptic function.

The Medline database was searched using the following keywords: ‘synapses’; ‘autism’. Animal as well as human models of ASD were included.

Nowadays, ASD are considered genetically influenced neurodevelopmental disorders, with abundant evidence pointing to dysfunction at the level of the synapse in the early stages of cerebral development. Potential mechanisms underlying ASD are neuroanatomical abnormalities, extracellular factors, excitatory and inhibitory imbalance and synaptic signaling.

Mutations of Tsc1 (tuberous sclerosis 1) and nlgn3 (neuroligin3) lead to alterations of synapses in the cerebellum and could explain signs of autism in mice.

Growth factors and neurotrophic factors are associated with ASD such as: HGF, BDNF and WNT2.

Defects in synaptic proteins would lead to defective transmissions at excitatory and inhibitory synapses, a key mechanism implicated in ASD. Synaptic molecules involved: neuroligin, neurexin, shank, but also Glutamatergic system, GABAergic system and Serotonergic system.

NF1 (Neurofibromin 1), TSC1/TSC2 (tuberous sclerosis complex 1 and 2), and PTEN(phosphatase end tensin homolog) are tumor suppressors genes associated with ASD.

An alternative but not mutually exclusive hypothesis is that environmental factors interact with genetic susceptibilities to influence ASD risk, clinical phenotype and/or treatment outcome.

"Hikikomori” is known since the 80s and was described by Saito in 1998 as a different clinical picture from any current diagnostic category, being social withdrawal the most important aspect. Young hikikomoris, more than a million in Japan (Teo2010), withdraw in their room for at least six months, interrupting communication with the outside world. This picture was described by many international scholars (Watts 2002; Zielenzinger 2008; Teo 2010; Piotti et al.2014). Part of international literature, after DSMIV-TR, defined hikikomori as a culture-bound syndrome (Agugliaetal.,2010). However, recently similar cases were described in different contexts, both in Asia and Western world (Kato et al.,2012), highlighting peculiar clinical signs influenced by the context, although maintaining a common matrix referred to Saito framework.

This literature review aims to gather descriptions of hikikomori in different cultures, to identify cross-cultural variables on which the phenomenon is based and to analyse any differences in clinical manifestations.

Eighty-two articles which contained ‘hikikomori” in the title or abstract were reviewed and searched using online databases (PsycINFO, PubMed, googleschoolar)

The scientific literature was divided by year of publication and by three phases:

1. The articles are mostly Japanese

2. Western articles, referring to Japanese contexts

3. The Hikikomoriconcept isclosely related tosocial withdrawal (sources from many countries).

The literature shows a tendency to consider hikikomori a phenomenon which exceeds cultural context (although influenced by it), rather than a culturally characterized syndrome.

Previous research has confirmed that various types oftrauma, related to both wartime and peacetime, can negatively affectpsychological development and promote the occurrence of mental disorders inyouth and adults. Results of previous studies in the field of post-conflictmental health suggest that certain psychological consequences can persist foryears after traumatic events.

For this reason we have decided to investigate thepresence of anxiety and depression in young people who were exposed towar-related trauma during childhood. Special emphasis is given to clinicallysignificant forms of these emotions.

The aim of the study was todetermine the differences in intensity and frequency of clinically relevantanxiety and depression in students exposed to warfare during childhood.

The study comprised 324students from Serbia and Kosovo, aged 18-25, exposed to war-related events(WREs) during childhood. We used the Generalquestionnaire, the Beck Depression Inventory I (BDI-I), and the BeckAnxiety Inventory (BAI).

Approximately 2/3 of all of the examinees had clinicallysignificant anxiety, while 1/3 had clinically significant depression. Thefemales had higher intensity of anxiety (16.22 vs. 11.6; p<0.001) anddepression (9.57 vs. 7.05; p=0.004) than males. The examinees who reported WREsfrom two or three types of events had more intense anxiety (p=0.013) anddepression (p=0.013) than a group with one or no WREs.

There is an association between WREs duringchildhood and anxiety as well as depression in adolescence, more prominent infemales.

Childhood depression is a serious medical problem that causes an agonizing feeling of sadness and loss of interest in activities. It affects adolescents thinking, feeling and behavior, and it can cause emotional, functional and physical problems. Although mood disorders, such as depression, can occur at any time in life, symptoms may be different between teens and adults.

This cross section study assessed the prevalence of childhood depression from age 12 through 16 years and examined using Revised behavioral problem checklist (RBPCL) as a screening instrument. Prevalence rates were estimated on the basis of clinical diagnoses and other measures as MINI-KID and Childhood Depressive Inventory (CDI).

A representative population sample of 739 children and adolescents aged between 12 and 16 years were assessed for ICD 10 fordepressive disorders

From the sample studied results reveal that 353 males and 386 females and was divided according to the presence or absent of depressive symptoms into Group 1 without depression (89%) and Group 2 (10.5%) with depressive symptoms according RBPCL . further analysis of group 2 showing that mean age was (14±1)year, where (67%) were males (33%) females regarding the academic achievement of depressed adolescents denoting that (74%) were average, (20.5%) below average,(5%) failed in academic records. Using CDI for assessing severity of depression revealing that(40%) have mild, 24% moderate, 36% severe depression

The prevalence rates obtained vis-a-vis the availability of mental health services in Egypt reflected a major public health problem

This is a 6 month outcome study of children referred from the pediatric ED for urgent psychiatric consult at a university hospital. Data was gathered on demographic variables, reason for referral, presenting complaints, developmental variables and Family history, previous diagnosis, treatments, psychiatrists diagnosis and disposition, admission rates, ER visits and referral to other psychiatric clinics. Paediatricians provided feedback. Data analysis was conducted using descriptive statistics.

Common reason for referral was aggression, grade 3 males predominated, the commonest diagnosis was ADHD/ADD followed by anxiety disorder. 67% had previous diagnosis and had a trial of medication, more than a quarter had LD, positive family history for ADHD/ADD or antisocial PD. There was 67% agreement between Pediatrician and psychiatrist on diagnosis.

Amongst children that present to pediatric ER, there are a number of children who, by virtue of their neurodevelopmental vulnerabilities and consequent emotionla/behavioral dyscontrol, require expediated psychiatric assessment and management. Timely access to this service reduces the need for ongoing hospital based services and presentation to ED.

Attention-deficit/hyperactivity disorder (ADHD) affects 5%-10% of school-aged children. Treatment includes medical use of stimulants. However, treatment of non-stimulant drugs should be considered as an alternative. The efficacy of Modafinil, a centrally acting agent that is structurally and pharmacologically different from stimulants in the treatment of ADHD was studied and abrupt discontinuation was not associated with symptoms of withdrawal or with rebound of symptoms of ADHD.

To assess the evidence from randomized controlled trials the effect of Modafinil compared with placebo in the treatment of patients with Attention-deficit/hyperactivity disorder (ADHD) .

Meta-analysis of 3 randomized trials identified through Medline/Pubmed and Cochrane Library (as of September 2012). Summary of the outcome variables was computed using difference of two means of the ADHD-R Scale-IV and their corresponding standard error of the means under random effects models. Statistical analysis was done using Revman version 5.

A total number of 932 participants with ADHD were represented. All studies included were randomized and placebo controlled. The main outcome measure is Change in Home and School Version of ADHD-R Scale – IV scores from baseline. Results showed mean difference between Modafinil and placebo using the Home Version is -10.13 (95% CI -14.11, -6.14). The overall effect was statistically significant (z=4.98; p<0.00001) in favor of Modafinil. The mean difference between Modafinil and placebo using the School Version is -9.27 (95% CI -12.62, -5.92). The overall effect was statistically significant (z=5.42; p<0.00001) in favor of Modafinil.

Modafinil is effective in improving symptoms in ADHD.

ADHD is most common behavioral disorder that affects children. The family has a very important role in the management of these children. The aim is parenting style and parental mental health status in children with attention deficit and hyperactivity disorder

This study is a descriptive study and study is ADHD children referred to psychiatric clinics in 5th Azar and Taleghanis hospital. The case group (64 children with ADHD) are based on random sampling. The control group selected of 64 school children in Gorgan based on the multi-stage cluster sampling. The description provided to parents of children then demographic questionnaire, DSM-IV, Bamrynd and GHQ will be provided. After data collection we analyzed Descriptive statistics and Chi-square

47 male and17 females werein each group, subscales of physical symptoms, maternal anxiety and depression one the base of GHQ questionnaires was a significant relationship between on ADHD and control groups. This means that maternal ADHD children are more anxious and depressed and have poorer health than the others. GHQ score of the two groups was also significant in the sense that the mother's mental health is impaired ADHD. Authoritative parenting style out of the case and control groups showed no statistically significant difference

The results of this study appear to be the outcomes of the four factors of ADHD, maternal education, GHQ mother and maternal age on the sheer style of ADHD is more effective than the GHQ. Thus, the second factor that is important for the mental health of families: 1 – treatment ADHD 2. ADHD- level of education

To explore health care providers' perception towards adolescents' reproductive health education needs in order to improve health care services for adolescents.

In this cross-sectional study, 72 health care providers (including: 43 midwives, 23 family health practitioners and 6 family physicians) who were recruited by senus method completed an anonymous, self-administered questionnaire. Participants were selected from all of the urban health care centers (14 centers) in Sari city, in the North of Iran in 2011. Topics covered the participants' attitudes towards reproductive health needs' of adolescents in 5 Likert- scale types.

Mean age of participants was 36.74±6.51 years and 90.32% were female. Findings revealed from health care providers' views; the highest mean score was assigned to “Education about prevention of sexual high risk behavior” (4.72±0.48) which was followed by “Education about life skills” (4.58±0.70) and “Education about undesired consequences of relationship with boyfriends” (4.57±0.74). The majority (62.5%) of participants stated if a female adolescent who was raped will refer to him/her in order to elective abortion, she/he will explain the side effects of this procedure for her. Finally, 52.7% of health care providers agreed if an adolescent will refer to him/her for receiving condom, he/she will provide it without any question.

The findings suggest a need for participation, support, and leadership of health care providers in formulation and implementation of policies related to adolescents' health.

One proposed strategy to improve youth health is needs assessment, a process for determining and addressing needs of individual groups. The aim of this study is to explore the attitudes and perceptions of Iranian university students toward reproductive health need to promote the provision of reproductive health services.

A cross-sectional survey was conducted among 548 students randomly selected from eight universities in Sari city, Iran, using an anonymous self-administered questionnaire. Topics covered the participants' attitudes towards reproductive health needs as well as their opinion about proper source of information in this area in 5 Likert- scale type.

Mean age of participants was 21.57 years and 57.82% were female. The maximum score of reproductive health needs in point of view of participants was related to “be informed about appropriate behavior with my spouse” and the majority of students (82.82%) supported family-based reproductive health education with emphasis on mothers' role. Although 65.14% of participants agreed that “when a young has been raped, it's better that she/he counsel with her/ his family, 11.67% of them stated that she/he must hide the problem. Finally, we found that 60.40% of students preferred someone in a health care center explain how to use any contraception which may be provide for them.

Taken as a whole, these findings support the critical importance of programming for university students as part of a comprehensive strategy to improve the health and development of young adult.

Children with autism have developmental motor profile that differ from other healthy children. This is evident since early childhood, sometime noted by parents and neglected by clinicians. These motor deficits are related to other domains of dysfunction in children with autism as social and language skills. Improving motor deficits can help better prognosis for these children.

To detect motor deficits in a sample of autistic children and correlate them with the severity of autistic symptoms.

We recruited 20 autistic children ranging from 3 to 6 yrs from the Institute of psychiatry outpatient child psychiatry and rehabilitation clinics of Ain-Shams university hospital. We excluded patient with total intelligence less than 75 or having other developmental disorder. We matched them with healthy controls for age and sex and compared both motor development and self help skills using Brigance scale. We confirmed diagnosis of autism in each patient by applying ICD-10 criteria of autism by a senior psychiatrist and by having a Childhood Autism Rating Scale (CARS) score above 30. Relation of autism severity and motor deficits was assessed later by Correlation co-efficient test.

Compared to controls, autistic children showed statistically significant low Brigance test scores on; gross movement, fine movement and self-help skills subdomains. Motor delay was significantly correlated with the severity of autism.

Motor deficits were evident in autistic patients and could indicate severity

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood. Around 25-50% of these children suffered from some kind of sleep disorder especially with chronic form of insomnia. Nowadays, we know that there is a noticeable relationship between ADHD and sleep disorders and by improving these children's sleep, not only the daily functions of them improve, but also the symptoms of ADHD maybe become better. This research evaluates the effects of melatonin on improvement of Sleep quality in children with ADHD whom received Ritalin

Participants included 22 children suffered ADHD and concomitant sleep problems patients who underwent melatonin prescription and placebo at night in two sequencial periods. The effects of the melatonin were compared with placebo on the sleep problem improvements in each one.

Although sleep onset, total sleep time and sleep quality advanced with melatonin, wake up time and the time to go to bed had not significant difference between the melatonin and placebo group. In addition, there were significant effects on attention, hyper activity index and impulsivity of the patients in the melatonin group.

Melatonin advanced circadian rhythms of sleep-wake and not only enhanced total time asleep in children with ADHD and chronic sleep onset insomnia, but also can improve the quality of life of these patients.

There are different age periodizations of human psychological development, but most researchers believe that over time learning in high school matches during youth and early adulthood.

The aim of our research was to investigate the phenomenon of age-perfectionism of medical students.

Materials and methods. The study participated 275 students 1 and 5 courses of different faculties in medical university. The average age of students was expected 1st year lower than students of the 5th year: 18,00 ± 0,11 g. vs 21,41 ± 0,12 g., p <0.001. To analyze the phenomenon of perfectionism was used the questionnaire of Kholmogorova and Garanian (2001).

Discussion. Age was significantly negatively correlated with the rate in the general makeovers cohort study (R = -0,28, p <0.001), lower rate of perfectionism of older students. Indeed, the average score of perfectionism in students age 22 and older was significantly lower compared with other age ranks (p <0.01) (see Fig. 2). In a separate analysis of possible relationships between age and index makeovers at 1 and 5 course reliable correlation was found (R = -0,12, p = 0,16, R = -0,02, p = 0.82).

Study of the phenomenon of perfectionism and its age features obtained significantly negative correlation of age with the index of perfectionism in the overall group. The level of students perfectionism in early adulthood was significantly lower compared with other age grades.