DCD is a motor skill disorder thatinterferes with children's (majority boys) ability to perform day to day activities. In addition to theirmotor coordination problem it generally interferes with academic performance, socialintegration and self esteem.

16healthy boys, age8-12 yrs with DCD. Inclusion Criteria: Diagnosis of DCD, basedon DSM IV criteria and a score below the suspected clinical cutoff on the Parent-reported Movement Assessment Battery for Children-Checklist for DCD (<15thpercentile). Exclusion Criteria: 1) Intellectual disability; 2) ADHD; 3) orthopedicor rheumatologic impairments; 4) Tic disorders; 5) acquired brain injury; 6) severesensory loss (visual /auditory); 7) other psychiatric disorders.

Participantswere randomly divided into 2 groups. One who would receive (10mg/day) Fluoxetine(Experimental) and the other who would receive Placebo (Control).

Participantswere assessed using CGAS at the beginningand end of the study period (3 months) and were statistically analyzed.

There was no significantdifference between mean global score of the control group before and afterplacebo administration. When t score was computed in the experimentalgroup before and after administration of Fluoxetine, statistically significantdifference in the mean global score was noticed.

It is an established fact that DCD doesn't really improve on pharmacotherapy. Hence, Fluoxetine, an SSRI cannot beexpected to bring any change in the motor functionality of the childrensuffering from DCD, but, as the present study suggests, it may help the victimscope with the disorder better, probably by boosting self esteem.

More same-sex couples become parents by having children in previous heterosexual relationships, through donor insemination, adoption, fostering or surrogacy. Does the parents’ sex impact on the offspring's psychological development?

Literature review on Pub-Med.

Research shows that the warmth and closeness between parents and children –including adolescents- is what counts for the offspring's psychological development and not their parents’ sex. Children's cognitive abilities, sexual orientation and gender identity seem also unrelated to their parents’ sex. Positive outcomes have been observed both for gay and lesbian-parented families. Even though the children of gay and lesbian couples may be exposed to discriminatory sentiments against their parents, their influence on the children's long-term psychosocial adjustment appears debatable. They may even be more tolerant towards marginalized groups but they also describe concerns about becoming friendless and tend to conceal their parents’ sexual orientation. Furthermore, the children seem to be negatively influenced when their parents are not allowed to marry. Marriage could increase stability within a couple and also assist in lessening the stigma and social discrimination faced by many same-sex parents. Future research should address the weaknesses of the existing studies (small samples of white, well-educated and affluent gay and lesbians).

Based on the available data, what counts for the children's normal psychological development seem to be the quality of parenting rather than their parents’ sex. Parenting stress appears to be more predictive of children's psychological problems. The social prejudice and legal discrimination against same-sex parented families seem to lack scientific validation.

Emotional dysregulation is a characteristic present in many child adolescent mental pathologies. It can be found in Eating disorders(ED), and in the bipolar spectrum too. Highlighting similarities between a softer bipolar spectrum in its sub-threshold forms and eating disorders syndromes and sub-syndromes in adolescents.

Evaluate the emotional dysregulation (measured by the HCL-32),and eating habits (measured through the BEDS),in a population with:ED.

This is a transversal, observational study in a group of 40 patients between 12 and 19 years of age, all of whom were diagnosed with ED before they turned 18 and receive inpatient treatment. The group was divided into two subgroups: Group-I:Anorexia Nervosa-AN (n=17), and Group-II: Bulimia Nervosa-BN (n=23). They were evaluated with two scales: Hypomanic Checklist (HCL-32) and Barcelona-Bipolar-Eating-Disorder-Scale(BEDS); with different clinical and sociodemographic characteristics.

Group I-AN showed higher scores in HCL-32, which was not correlated with the BEDS total score. Group-II presented high scores in HCL-32,showing a positive correlation with the BEDS total score (r=0,518;p=0,011), mainly in the subscale symptoms of hypomania associated with a lack of inhibition, self-control and attentional capacity.(r=0,461;p=0,027).

Emotional dysregulation is a factor to be considered in the diagnosis and clinical management of patients with ED, and may imply other comorbid conditions. Furthermore,Bulimia Nervosa,especially in cases with emotional dysregulation could be related to hypomania or a bipolar spectrum.

BEDS Scale may be related to emotional dysregulation in patients diagnosed with Bulimia Nervosa and high score in the scale of hypomania HCL-32, not so for the Anorexia Nervosa.

Lazarus & Folkman (1984) stated that coping strategies are defined as constantly changing cognitive and behavioral efforts that are mobilized to deal with domestic demands and or external to the individual assessed as surplus. It has been suggested gender differences in relation to coping strategies.

The total sample of n = 216 university students (m = 17.32, SD = 0.70). The subjects answered the ACS which evaluates 18 strategies and 3 coping styles in young people (Frydenberg, 1997). The results were compared by gender using a T-test using the statistical SPSS 21.0.

Within the style Solving the Problem, the most used strategy was Problem Solving. The trend showed that it was more used by women, however, the differences were not sufficient to reach significance (F = 0.08, P = 0.76). Style Relating to People, the most commonly used strategy was close friends, the trend indicates that their behavior does not differ between gender (F = 0.69, P = 0.40). Then membership strategy showed a slightly higher tendency in women. The differences did not allow statistical significance (F = 2.47, P = 0.11) was achieved. The strategy wishful thinking was the most used within the Unproductive Style. This tended to be used by men, but no significant differences (F = 2.37, P = 0.10) were achieved. Only unproductive style was statistically significant (F = 3.86, P = 0.05), being lower in men. Results are discussed in relation to literature.

Despite an expanding body of research pertaining to Borderline Personality Disorder (BPD) in child and adolescent populations, controversy remains regarding the validity of youth BPD.

To determine the aetiological and psychopathological validity of youth BPD.

Electronic databases were searched for studies examining the aetiological (i.e., the extent to which youth and adult BPD share common risk factors) and psychopathological (i.e., the extent to which youth and adult BPD share common symptoms and associated behaviours) validity of BPD in populations under 18 years of age. Forty-three studies were identified satisfying the predetermined inclusion criteria for meta-analysis.

Statistically significant pooled associations with youth BPD were observed for sexual (OR=4.90; 95% CI=3.12, 7.70) and physical (OR=2.82; 95% CI=1.95, 4.07) abuse; maternal hostility/verbal abuse (OR= 3.28; 95% CI= 2.39, 4.51); and neglect (OR=3.45; 95% CI= 2.26, 5.28). Several psychopathological features were also associated with youth BPD, including comorbid mood (OR= 3.29; 95% CI= 2.36, 4.59), anxiety (OR= 2.13; 95% CI=1.45, 3.14) and substance use (OR=4.59; 95% CI=2.84, 7.43) disorders; self-harm (OR: 5.53; 95% CI=2.59, 11.81) and suicide ideation (OR=3.71; 95% CI =2.22, 6.21).

Findings indicate that adult and youth BPD share common aetiological and psychopathological correlates. This indicates some diagnostic validity of youth BPD and supports clinical recognition in this age group.

The present study aims to assess the prevalence of depression and anxiety in a clinical sample of adolescents and also examine the relationship between depression levels, anxiety, hopelessness, and self-esteem.

It is a cross-sectional correlational study conducted in a clinical sample of 91 adolescents (Mage=14.56, SD=2.376) referred in the Mental Health Unit for Children and Adolscents in Prizren. The measures used include The Revised Children Manifest Anxiety Scale, Depression Self-Rating Scale for Children, Self-esteem Rosenborg Scale dhe Hopelessnes Children Scale (Kazdin).

Results showed a prevalence rate of 28.6% for depression (26 cases) and 31.9% for anxiety (29 cases). Low self-esteem was prevalent at a rate of 48.3% (42 cases) and hopelessness at a rate of 18.4% (16 cases). Depression correlates positively with age (r=.284, p<.006), hopelessness (r=.460, p<.000) and anxiety (r=.659, p<.00). The logistic regression by gender, age, residence, hopelessness, self-esteem, and anxiety for predicting depression, produced a significant model X2(6,N=91) =34.159, p<.000, which classified correctly 80.1 % of the cases. However, out of all variables only anxiety levels contributed significantly to the model (odds ratio = 1.327). The logistic regression on the same variables (plus depression) for predicting anxiety resulted in a significant model, X2(6,N=91) =32.097, p<.000 (variance 30.9 – 42.8 %) and classified correctly 77 % of the cases. Only depression contributed significantly to the model (odds ratio=1.211).

The best predictor for depression levels are anxiety levels, and vice versa. These findings have important practical implications for clinical work.

In an effort to avoid the progression to a psychosis, there is a tendency nowadays to bend psychotherapeutic interventions on the prodomic period . However, there is no unanimity in what the treatment should consist of.

OBJECTIVES: To describe an appealing case, in which Systemic Therapy is used to work from a familiar perspective of a problem identified in only one member of the family.

This clinical case is about a 12 year old male, he was brought to the Child and Adolescent Unit of Mental Health by behavioral alterations that express the rejection to his father. The family reports that the onset of these behaviors occurred insidiously, presenting regressive attitudes, strange behaviors and social isolation. The patient was admitted to the Children and Youth Hospital Day and received multidisciplinary treatment: pharmacological and Systemic Family Therapy.

Through the nine Systemic Family Therapy sessions that the family has attended, the conflict in the marital subsystem has become evident, showing a triangulation of both parents with the patient.

Even though it cannot be stated, the child’s pathology is supported by a prodromal state of psychosis. Professionals are still working through therapy with the family and the patient, awaiting for the progression of other symptoms.

There are concerns that children in out-of-home care take psychotropicdrugs at a much higher rate than other children and that some treatmens mightbe inappropriate.

To study the prescription of psychotropic drugs to children in out-of-home care in Sweden.

To describe the prevalent use of psychotropic drugs among children in out-of-home care in Sweden and pinpoint possible inappropriate treatment.

Data on drugs dispensed from the national Swedish Prescribed Drug Registerfor 2013. Individuals with at least three dispensations were defined as usersand included in the study.

A widespread use of different types of psychotropic drugs was foundamong children in out-of-home care in Sweden. The concurrent use of methylphenidateand antipsychotics was notable – about 20% of the children were simultaneouslytreated with these drugs.

Children in out-of-home care take psychotropic drugs at a much higherrate than other children in Sweden. Evidence supporting effectiveness andsafety of certain treatments is lacking.

The increasing psychiatric diseases in adolescence and the earlier age of symptom onset requires new treatment strategies, based on a better inter-institutional interaction.

The latter evolution of psychodynamic approach leads to flexible and effective new therapeutic pathways for teens with serious emotional and behavior disorders.

Observing clinical outcome in the global care-net work with adolescents, analyzing the specific therapeutic approach of the team, the emotional reliability and the capacity of working together of the various professionals involved and the value of a common language and a common emotional context, involving different institutions related to the care process.

Longitudinal case reports, lasting from one to three years.

Day Center and Therapeutic Community with psychodynamically oriented programs, assessing emotional, behavioral, medical, educational, social and leisure needs; individualized planning; individual and group therapy; psychiatric care; environment involvement.

Inpatient Psychiatric Unit with psychodynamic integrated approach, where each intervention (pharmacotherapies, medical examinations, psychological interviews, milieu therapy, etc) came from the same key to understanding.

Working in alliance and by same therapeutic methods, it’s possible integrate patients needs fragments, so responding to their holding and care request.

It represents an organization function for their personality structure; an affordable and integrated ‘container” (W.R. Bion; 1988), in perspective of continuum of care for young patients and their family.

Therapeutic relationship may represents cornerstone for psychological transformations or changes so profound. Social, medical and psychotherapeutic aspects were incorporated into this model,so that patients are not passivated, thanks to the care network.

Extensive evidence that people with severe mental illness have higher rates of morbidity and mortality for common physical illness than general population. Therefore it is very important to monitor the physical health in children and adolescent who are on antipsychotics which can cause significant physical side effects

To assess physical health monitoring in children and young people who are on antipsychotic medications within CAMHS Knowsley and St Helens

To improve the monitoring of physical health on initiation and throughout treatment with antipsychotic medications

5 Boroughs Partnership NHS trust recommendation, Sept 2012:

FBC, UE,LFT, Prolactin: Baseline, 6 weeks, 6 months, yearly

Lipid, glucose, weight: Baseline,6weeks, 3months, 6 months and yearly

ECG: Baseline,6 weeks, yearly

Pulse, BP: Baseline,regularly

Target: 100% compliance

In March 2014, using a comprehensive audit tool approved by local Research and Audit Governance Group, data collection was completed by retrospective case analysis

All patients (n=9) within CAMHS Knowsley and St Helens who are on antipsychotics since September 2012 were included

Pulse and BP was monitored in 60% cases at baseline which dropped subsequently. Baseline blood test was done in 20%cases with some improvement at the end of one year to 33%. Again only 15% had baseline ECG with no further follow up

The study demonstrates that the standards set by the trust is not met in current practice. Recommendation is to promote greater awareness of the importance of monitoring of physical health within the service

For a long period ADHD was considered to be a diagnostic limited to childhood. In the 1970s, clinical evidence showed symptoms in adults diagnosed with ADHD in childhood. Evidence shows that 15-20% of the parents of children with ADHD could also qualify for this diagnostic.

The aim of this study was to see whether parents of children diagnosed with ADHD have traits significant for this pathology and how these symptoms correlate with the ones experienced by their children.

Inattention and hyperactivity/impulsivity symptoms were assessed in parents of children diagnosed with ADHD and the most severe traits found were compared with those of their children.

In the study were included 93 parents of 50 children diagnosed with ADHD by a specialist in Child Psychiatry. For each child parents completed the ADHD-Rating Scale and for assessment of their symptoms, the Diagnostic Interview Voor ADHD (DIVA) was applied to parents.

34% of parents of children diagnosed with ADHD fulfill criteria for Adult ADHD. The most significant correlation was found between ADHD-RS scores for hyperactivity/impulsivity and DIVA scores for this kind of symptomatology. The little number of subjects represents a clear limitation, as this was performed as a pilot study.

Considering the high prevalence of ADHD in parents of diagnosed children and also the impact of their impairment over their children’s education, it is important to quantify this risk and rise awareness of the need for ADHD screenings in parents of children diagnosed with this pathology.

Depression is a common psychiatric disorder that often begins in childhood or adolescence. The child and adolescent depression can have a varied and so different from the adult presentation. It can be seen attitudes of isolation, sadness, withdrawal, restlessness and irritability. And we can relate it to emotional disorders such as hyperactivity, aggressive behavior, psychosomatic disorders, hypochondriasis and tendency to antisocial behavior.

Illustrated by a case the variables that influence the clinical course and therapeutic management of the case

Exhibition of a case and a brief review of the literature.

We describe the case of a teenager 12 years old with a history of OCD, which is entered in day child and adolescent Hospital, to present a picture of silence and a retracted and bent on itself attitude, without lifting your face or fix the look, making interpretations and delusional perceptions of prejudice structured and focused on the family.

Early identification and effective treatment and may reduce short-term morbidity of depressive disorders in adolescence, and improve long-term outcomes.

Clinical psychologists and psychiatrists consider the social withdrawal and the loss of interest in the human environment as potential signals of distress and mental illness. A particular form of social withdrawal is the hikikomori sindrome, identified in Japan (Saito, 1998). The hikikomori are called “family heremits” or “bedroom heremits”.

The UFSMIA Arezzo has received during last years a number of requests to take care of hikikomori adolescents. The research collects clinical data useful to the assessment.

The research analyzed a number of clinical cases focusing the interest on five early adolescents in treatment. The researchers compared the different anamnesis, the symptomatology, likeness and difference in the teenagers life style.

The work identifies some aspects in common from the five subjects of the study. These characteristics can be used as signals of the hikikomori sindrome among early adolescents in a Italian cultural context. The hikikomori’s life style is centered on the own home; he/she presents an extreme withdrawal from peer group and a refusal of school; there is not a diagnosis of other significant psychiatric disorders; it is always present a distortion of the sleep-wake cycle and a conflict with parents.

The phenomenon of hikikomory sindrome appears also with the beginning of adolescence. The signs of disease are in large part similar to the Japanese descriptions, although if the researchers noticed some aspects tipical of the italian cultural context.

Social withdrawal is a potential signals of distress and mental illness such as psychosis, mood disorders, anxiety (Kirkcaldy & Siefen, 2012). The term 'hikikomori” defines a particular form of social withdrawal recognized in Japan at the end of the last century (Saito, 1998). At the moment in all the west world (United States, France, United Kingdom, Spain, Italy) there is an increasing frequency of adolescents and young people who show symptoms of hikikomori like a life style centered on the own home and refusal of the school.

Requests to take care of social withdrawal teenagers (hikikomori) are increasing. This work describes two cases in treatment of early adolescents.

Authors analyse the terapeutic steps of the clinical treatment of two very young teenegers arrived to the Public Health Service because their extreme social withdrawal. The work focusses the attention on the relationship with the patients, the families and the social context.

The two cases show that the treatment of hikikomori sindrome is complex. A single type of approach (e.g. individual psychoterapy or family therapy) is not sufficient. Combining different patterns it is possible to create a network of treatments able to promote the resources of subject and of his/her familiar and social context.

Results underline the necessity of increasing the clinical knowledges on the social withdrawal sindrome and creating new protocols useful for the treatment.

The Japanese Saito coined the term “hikikomori” to define an extreme form of social withdrawal, particularly present in Japan (1998). In the West there is an increasing frequency of adolescents hikikomori.

The UFSMIA Arezzo has received a number of requests to take care of adolescents bearing strong similarities to hikikomori teenagers or “on the way of the social withdrawal”. These admissions have led to an epidemiological study in order to quantify these behaviors among very young teenagers in a Italian town.

The research used a questionnaire addressed to the coordinator teachers of the middle schools of Arezzo (2694 students). The questionnaire collected information on the single student absent from school for more than 40 days asking reasons for the absence.

Absents from school for more than 40 days not for an illness were 27. The average age was 14,5 years, 59,3% males, 40,7% females. The 66,6% of the students repeated one or more times a year of school. The teachers do not know the reasons for the absences for 29,6% of students but for 51,9% they indicate psychological problems as the main reason of the absences. The 40,7% of students showed difficulty waking up, leaving home, coming to school, difficulty in relating to others and low self-esteem. These signs could bring to identify hikikomori subjects.

The research shows that the school is not able to recognize a student hikikomori, but it can provide valuable informations to identify a teenager with social withdrawal.

The Dynamic-Maturational Model (DMM) (Crittenden, 2008) considers attachment as a selection process of external informations, especially from care givers, made by CNS. In the DMM, the variability of information processing is caused by the integration of cognitive and affective informations. This kind of integration leads to secure attachment; instead, a prevailing mode will lead to an avoidant attachment (“cognitive”) or ambivalent (“affective”), with potential clinical implications. CARE-Index analyses the interactions between children and adults before the structuring of attachment and the “dyadic sensitivity” (a dyadic construct composed of any behaviour pattern which pleases the child, increases his/her well-being and focus and reduces his/her discomfort and disengagement).

The aim of this study is to investigate the extent to which stressor life events of care givers can influence/change dyadic sensitivity and thus the structure of children attachment.

We will use a modified version of Social Readjustment Rating Scale (Holmes, 1967), which will be administered to 40 parents whose relationship with the child was assessed by CARE-Index. The changes made to the scale classify life events by type (Family, Personal, School) and age group in which the event occurred.

We expect to find a correlation between stressful life events and specific patterns of attachment.

If this kind of correlation is detected, risk situations can be recognised and treated at an early stage.

In child and adolescent psychiatry antipsychotics are used in large and increasing quantities for a wide range of disorders and psychopathology, including psychotic, mood and disruptive behaviour disorders.

The European Medicines Agency (EMA) has approved Paliperidone for the treatment of schizophrenia in adolescents from 15 years old.

To present our clinical experience with Paliperidone in the treatment of psychotic symptoms and other psychopathological disorders in adolescents.

To describe with data from clinical practice the potential usefulness of Paliperidone in adolescent disorders beyond Schizophrenia.

Five patients from an outpatient child and adolescent mental health service, on treatment with Paliperidone during 2014, were selected as clinical illustration. Case reports describe personal and family history, clinical presentation, management and treatment, course and outcome, with especial focus in treatment tolerance.

We present 3 males and 2 females, age between 15 and 17 years. Diagnoses were: autism, borderline personality disorder, schizotypal personality disorder, personality disorder not otherwise specified and schizophrenia. Prescribed dose was 3-9 mg/day, and actual mean time of treatment duration is 5,8 months. In 4 cases Paliperidone was initiated as a change from other antipsychotic. There were no adverse effects that required discontinuation and in all cases symptoms improved.

Our clinical experience evidences that Paliperidone is a valuable therapeutic option on behalf of its effectiveness and tolerance.

In our practice the symptoms that respond better to Paliperidone are: hallucinations, reference ideation, irritability, aggression, disorganized behaviour and stereotypies.