Alterations in redox modulation are consistently reported in bipolar disorder (BD). MicroRNAs are targeted regulators of gene expression.

We aimed to examine if microRNAs that target redox modulators can discriminate between BD and healthy controls.

Data from brains of individuals with and without BD were obtained from Array Collection datasets. MicroRNAs targeting redox modulators were assessed for their ability to discriminate BD from the control group using machine-learning algorithms. Methylation of microRNAs, expression of their transcription factors and redox targets were assessed with ANCOVA with FDR correction. For validation, we acquired plasma samples belonging to 2 families of individuals with and without BD (n = 9). Plasma microRNAs were sequenced using the Ion Total RNA Sequencing Kit (Thermo Fisher Scientific), and microRNAs identified from the in silico analysis were examined in the validation dataset.

We identified 5 miRNAs (hsa-miR-299, hsa-miR-125a, hsa-miR-145, hsa-miR-30b, hsa-miR424) that were common in two of the four in silico datasets. Target genes glutathione peroxidase 4, ATP5A1, ATP5G1, NDUFS1, NDUFC2, and catalase were expressed at different levels between BD and the control group. Furthermore, our results showed that transcription factors CTCF and USF1 might control the expression of hsa-miR-145, while methylation differences were not found. Finally, hsa-miR-30b was significantly increased in the plasma of patients with BD compared to controls in the validation experiment.

Our study demonstrates that microRNAs may have an important role in the initiation of redox changes in BD.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

Several studies suggest that in severe bipolars there is a long-term benefit in continuing antipsychotic therapy plus a mood stabilizer also after remission from a manic episode. Nevertheless, the long-term use of antipsychotics is associated with significant side effects which can interfere with patient global functioning. In this sense, antipsychotics should not be continued unless the benefits outweight the risks.

The present study describes the course of illness between bipolar patients remitted from a manic episode, in continuation treatment with or without antipsychotic therapy during a 12-months follow-up period.

Cinquante-six bipolars (22 male and 44 female) remitted (Young < 12) from a severe manic episode were observed during a 12-months follow-up. According to clinical judge, as continuation treatment, 21/56 (37.5%) took antipsychotic plus mood stabilizer (AP + MS); 35/56 (62.5%) took mood stabilizers monotherapy (MS). During follow-up period YMRS and HAM-D were administered at 6th and 12th month to verify remission.

At the end of follow-up up, 33/56 patients (58.9%) maintained remission, 23/56 (41.1%) relapsed (56.5% depressive, 31.4% manic). The greater number of relapses occurred within 6th month: 16/56 (28.8%). In AP + MS group 12/21 patients relapsed (57.14%); in MS group 11/35 patients relapsed (31.4%). No statistical difference between the two continuation treatment strategies was observed (Chi-square = 3.586; P = 0.06).

Our data confirm the efficacy of mood stabilizers monotherapy in long-term treatment of our severe (psychotic features, revolving-doors) bipolar patients. In fact, once the remission was obtained, the clinical choice of discontinuing antipsychotic therapy did not worsen the course of illness without a higher risk of relapse.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Nurturing children with neurodevelopmental disorders such as ADHD is associated with psychological burden to the caregivers. Oman has a pyramidal population structure with the bulk of the population are in the pediatric age group. Previous studies have indicated that ADHD is common in Oman.

To measure level of burden of care among caregivers of children with ADHD and the relationship between the degree of burden, subtypes of ADHD and socio-demographic factors.

A cross sectional study conducted in a tertiary hospital in Oman. Arabic-version of the Zarit Burden Interview (ZBI) was used to evaluate the level of burden among the caregivers. The severity and subtypes of ADHD were quantified using Vanderbilt ADHD Parent/Teacher Rating Scale. Socio-demographic background and clinical data were gathered from medical records.

The study included caregivers of 100 children with ADHD. The mean ZBI score was significantly high for the parents of children with ADHD. As for the relationship with socio-demographic background, mothers of children with ADHD reported a higher mean ZBI score compared to fathers. Factors such as income, number of siblings, and severity/subtypes of ADHD played significant roles.

To our knowledge, this is the first study of Arab/Islamic population exploring the burden of care for children with ADHD. Some of the risk factors appear to have direct effects. If this study will withstand further scrutiny, concerted effort is needed in emerging economies such as Oman to address the issue of burden among the caregivers of children with ADHD.

The authors have not supplied their declaration of competing interest.

Studies have shown that caregivers of children with (ADHD) are at a higher risk of mood disorders such as depression. The presence of mood disorders among the caregivers of children with ADHD has negative repercussion in terms of prognostic indicator, utilization of the health care service and the resultant quality of life.

To solicit the performance of indices of depression among caregivers of children with ADHD and to explore the relationship between severity of mood score, subtypes of ADHD and socio-demographic factors.

A cross-sectional study conducted in a tertiary hospital in Oman dispensing child and adolescent mental health services. Arabic-version of PHQ-9 was used screen for the presence of depression among the caregivers of children diagnosed with ADHD based on DSM 5. The severity and subtypes of ADHD were quantified using Vanderbilt ADHD Parent/Teacher Rating Scale. Socio-demographic background and clinical data were gathered from medical records or attending caregivers.

The study included 100 caregivers of children with ADHD. Most of the primary caregivers were mothers (92%). Using the cutoff score of 12 on the PHQ-9, rates of depression for the mother was 14%. Some socio-demographic factors were strongly associated with severity of depressive symptom.

This study suggests that depressive symptoms as elicited by PHQ-9 are common among caregivers of children with ADHD. The rate of depressive symptoms is higher compared to the general population in Oman. This study lays groundwork for contemplating mechanisms to mitigate depressive symptoms among caregivers of children with ADHD.

The authors have not supplied their declaration of competing interest.

ADHD is one of the most common neurodevelopmental disorder among children. It is described as a chronic impairing disorder that negatively affects the academic attainment and social skills of the child. Furthermore, ADHD symptoms continue into adulthood in 30–60% of affected children. Consequently, they will most likely be missed from employment many times.

Determine the prevalence of attention deficit hyperactivity disorder among children in Saudi Arabia.

Determine the prevalence of attention deficit hyperactivity disorder among both governmental and private primary Saudi school children aged 6–9-year-old. And to measure the gender difference of ADHD prevalence. Also, to determine any association between the socio-demographic characteristic of parents of children with ADHD.

An observational cross-sectional study of 1000 primary school children belonging to 1st, 2nd and 3rd grade. The selected students were screened by the ADHD rating scale using multistage sampling technique. The first stage was selection of 20 schools from all Riyadh regions by simple randomization. The second stage was choosing children whom serial numbers were multiplies of five in each class. The ADHD rating scale was filled by both parents and teachers along with a socio-demographic questionnaire for the parents.

The estimated prevalence of ADHD was 3.4%. ADHD manifestations affect boys more than girls. In addition, ADHD was more frequent among children of illiterate mothers. Finally, ADHD was significantly more prevalent among first grade children.

This epidemiological study filled the data gap of ADHD prevalence in Riyadh. The study's findings go in line with many nearby and global studies.

The authors have not supplied their declaration of competing interest.

The increasing intake of psychotropic medication by children and adolescents is a reality that worries many mental health professionals. Recently, european school survey project on alcohol and other drugs showed that tranquillizers and sedatives were mainly consumed by Portuguese youth, without medical prescription, bringing this topic to medical and health stakeholders’ attention.

Characterize benzodiazepine prescription in the youth population followed in a psychiatric consultation at centro hospitalar Lisboa Norte psychiatric department.

Discuss Portuguese trends in mental health among youths.

Analysis of 127 adolescents, seen for the first time from January to December of 2015, using Microsoft office excel.

Our sample is comprised by adolescents from 12 to 20 years old, 81 female and 46 male. Only 16% of the adolescents were medicated with benzodiazepines, although low neuroleptic doses were often required, and 30% carried out psychotherapy. Sixty-five per cent of the diagnosis corresponds to anxiety, depressive and impulse control disorders.

Although trends in Portuguese youth mental health seem to be encouraging, as highlighted by local reports, European Union Joint Action on Mental Health and Well-Being recommends community and school active roles in primary and secondary prevention. Our experience shows that benzodiazepines’ use is rarely necessary and symptoms as anxiety, impulsivity and insomnia decreased with other strategies. Coping strategies must be discussed with the adolescents, in formal psychotherapy or in a supportive and containing therapeutic relationship, as well as discussed in family interventions. Community initiatives promotion and increased mental health care services accessibility should be priorities.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Among great variety of the manifestations of juvenile deviation of behavior, with its social significance, delinquency draws a special attention, in particular, with its aggressive manifestation.

Our task is specification of psychopathological peculiarities of two forms of aggressive behavior of delinquency.

Fifty delinquent juveniles from 14 to 18 years of age (inclusive) have been examined. Two forms of aggressive manifestations have been picked out: non-pathological: 36 (72%) and pathological: 14 (28%).

Non-pathological aggression basically is conditioned by the influence of micro-social negative conditions and stress situations. The contents of aggressive acts are closely connected with the peculiarities of characterological features; aggressive behavior is characterized with an episodic appearing, less severity and is often manifested in threatening. Marked cruelty, sadism and vandalism are found comparatively seldom. The violation of social adaptation is found in them in stresses, stipulated with negative micro-social factors; they are more manageable and comparatively quickly regress.

The peculiarities of pathological aggression are represented by super valuable and sadistic manifestations, comparatively seldom–with signs of dysphoria. The aggression, stipulated by pathocharacterological reactions is manifested in the form of pathologically super valued and affective situational acts of behavior.

Aggressive behavior of delinquency is chiefly observed in its non-pathological form, which can be explained by the hard social-economical background, visible growth of aggressiveness in an immense part of population, moral and ethic deprivation and frustration. The society itself is a certain indicator of aggressiveness.

The authors have not supplied their declaration of competing interest.

Many authors have agreed on the clinical importance of sensory regulation for a child's cognitive, affective and social development. Sensory regulation abilities are fundamental for an efficient modulation of internal states and the development of appropriately graded responses to the constantly changing sensory experiences. Sensory modulation deficit is an essential feature of regulation disorders of sensory processing (RDSP), that is characterized by difficulties in regulating emotions, behaviors and motor abilities, in response to sensory stimulation and lead to impairment in functioning. We also know that, through daily interactions and early relationship (child's attachment), parents play a crucial role on child's regulation in terms of their emotional and physical availability and how they interpret and respond to child needs.

The authors will present a clinical case of a two-year child who has been diagnosed with RDSP, highlighting the main features, types (hypersensitive; hyposensitive/under-responsive; sensory-stimulation seeking/impulsive) and challenges of this disturb.

Explore the association between sensory regulation difficulties, RDSP and child attachment.

Systematic literature review.

Recent studies showed the high prevalence of sensory regulation difficulties (33–76%) and insecure attachment (80%) in children with psychiatric disorders. Results also revealed that children with greater sensory impairment were significantly more likely to show elevated scores of insecurity (avoidance and dependence) to their caregiver.

This work underscores the caregiver's role as a facilitator of child integration and response to sensory stimuli and its importance on the development of behavioral and emotional disorders. This can help early diagnosis and better treatment who prevent future psychiatric conditions.

The authors have not supplied their declaration of competing interest.

Pediatric autoimmune neuropsychiatric syndrome (PANS) is a term used to describe a clinical picture which includes sudden onset of psychiatric symptoms and a possible autoimmune genesis. The sudden decline in neuropsychiatric functioning as well as the multiple combinations of symptoms may lead to a clinical phenotype similar to that in infantile autism (IA) with regressive features. We are conducting a study with the aim to evaluate a diagnostic test for PANS currently marketed by Moleculera Labs. All patients in Sweden who had taken the test (n = 154) were invited to the study.

The aim of the study is to characterize a subgroup of patients with IA within the PANS diagnosis study.

Participants (n = 53) were examined for psychiatric and somatic symptoms and evaluated for PANS caseness by an experienced psychiatrist. Because the criteria for entering the study was having taken the diagnostic test for PANS, the participants in the study comprise a group with mixed symptoms.

Twelve participants had IA. Eleven of these reported a developmental regression with loss of abilities. Two of the IA patients also fulfill criteria for PANS. Eight of the IA patients had been treated with antibiotics for psychiatric symptoms and 4 reported a positive effect of this treatment. Nine of the patients had elevated test results suggesting possible PANS according to Moleculera Labs.

Very early onset on PANS may be phenotypically similar to IA with regressive features. Further analysis of the immunological attributes of patients with autism with regressive features is warranted.

The authors have not supplied their declaration of competing interest.

Caring for a child with autism is a stressful experience for parents. The daily stress of this handicap has a major impact and triggers in the parents a series of adverse psychological reactions.

To reveal sociodemographic characteristics of parents of autistic children and to estimate the prevalence of anxiety and depressive symptoms among these parents.

A cross-sectional study conducted among parents of autistic children supported by four of autistic children rehabilitation centers under the Tunisian Association for the Promotion of Mental Health. Data were collected through a questionnaire to explore the sociodemographic data of parents of autistic children. Depressive symptoms were assessed by the Beck scale and anxiety symptoms by the Hamilton scale.

Fifty-two parents were collected. The middle age was 35.73 years. They lived in an urban area in 96% of cases. The majority had an average socioeconomic level (88.4%). The respective rates of depressed or anxious parents as Beck scales and Hamilton were 48% and 23%. The association between depressive and anxious symptoms was found in 19%. In addition, depression was more common in mothers (P < 10−4) and anxiety was also more evident among mothers (P = 0.01).

The presence of an autistic child causes profound changes in families and can be a source of tension and stress. The anxious and depressive impact on parents is important and frequent. The intervention that designs the psychiatrist to help children with autism should necessarily include an action for parents.

The authors have not supplied their declaration of competing interest.

Anxiety and mood disorders are common in adolescence and predict poor mental health outcomes and low quality of life in adulthood. Although early intervention seems to be critical, dropouts in the early stages of treatment are frequent and associated with low insight and severe symptoms. Therefore, a diagnostic assessment phase aimed to increase insight and early reduce symptoms appears to be essential in adolescents.

The objective of this study is to demonstrate that the diagnostic method Cooperative Assessment is able to early reduce symptoms in adolescents with anxiety and mood disorders.

A sample of 88 patients, aged 14–19 years were included. All were recruited at the first visit and evaluated with the Cooperative Assessment. This manualized procedure was created from principles of collaborative and therapeutic assessment and aim to involve the patient in a co-developed diagnosis thorough the collaborative use of test results. Patients were evaluated before (T0), in the middle (T1) and after (T2) the assessment using CGI, GAF, HAM-A, HAM-D and MRS scales.

Eighty-eight adolescents, 56.8% females, diagnosed with anxiety (47.7%) and mood disorders (52.3%) completed the protocol. HAM-A, HAM-D, MRS, CGI and GAF significantly improved at T1 and T2 with respect to T0 (T0: HAM-A 17.31 ± 8.22; HAM-D 16.97 ± 8.37; MRS5.78 ± 6.17; GAF 59.3 ± 11.06; CGI 3.63 ± 1.35; T2: HAM-A 11.41 ± 6.82; HAM-D 11.1 ± 6.91; MRS3.82 ± 3.87; GAF 67.5 ± 10.76; CGI 3.03 ± 1.26; P < 0.001; Wilcoxon signed-rank test for repeated measures).

Cooperative assessment is able to early improve symptoms in adolescents with mood and anxiety disorders.

The authors have not supplied their declaration of competing interest.

In addition to problems with inattention and hyperactivity, children with ADHD show poor organizational skills required for managing time and materials in academic projects. Poor organizational skills are associated with academic underachievement as well as psychosocial, occupational and economic difficulties. Behavioral approaches for ADHD are effective in reducing hyperactivity symptoms and behavioral problems, but the effects on academic functioning have been modest. An increasing emphasis on treatment of organizational skills has emerged in recent years, as difficulties with time management and organization of materials tend to persist and increase with age despite medication and behavioral treatments.

The primary objective is to investigate whether organizational skills training has a positive effect on organizational skills. The secondary and exploratory objectives are to investigate the effect on ADHD symptoms, adaptive functioning, academic performance and cognitive functions with a 24 weeks follow up.

Our goal is to provide cost-effective group-based treatment for children with ADHD and their parents. This will be the first randomized and controlled trial of organizational skills in Denmark.

Participants are included in two sites in Southern Denmark and will be randomized to Organizational skills training or treatment as usual. Organizational skills training will be provided in a group format for children and parents over 10 weeks.

Perspectives Given the strong association between organizational skills and functional outcome, it is very important to address organizational skills in children and adolescents with ADHD as organizational skills deficits hinder the academic performance of even gifted students with ADHD and increase with age.

The authors have not supplied their declaration of competing interest.

The quality of adult-infant interactions represents a critical context in which child adaptation problems could evolve, and child psychopathology could develop. Literature has investigated the role of attachment to caregivers, nevertheless, there is a paucity of studies on middle-childhood and early adolescence in patients with somatic symptoms disorders and disruptive behavior disorders.

This study investigates the attachment to caregivers in children with somatic symptoms disorders and disruptive behavior disorders, focusing on the role of Anger to mothers and fathers.

The aims are to verify the presence of: – high frequency of insecure attachment;

– an overrepresentation of attachment disorganization;

– high levels of Anger to caregivers.

Fifty-six patients with somatic symptoms disorders, and 42 patients with disruptive behavior disorders, aged from 8 to 15, are administered the child attachment interview.

Findings show: – Insecure attachment in more than half of the patients;

– a significant presence of disorganized attachment with respect to both parents;

– higher levels of anger to father in children with somatic symptoms disorders.

Considering the attachment to have a regulatory function, the knowledge of the different attachment strategies in middle-childhood and early adolescence may enhance our understanding and improve the management and the treatment of patients with somatic symptoms disorders and disruptive behavior disorders.

The author has not supplied his/her declaration of competing interest.

In line with a consistent literature, young patients with disruptive behavior disorders in childhood and adolescence have experienced some traumatic events, such as abuse, rejection and violence assisted. Recent studies are focusing the attention on the role of attachment and post-traumatic symptomatology for a better evaluation of this clinical condition.

This study investigates attachment models and post-traumatic symptomatology in young patients with disruptive behavior disorders.

The following objectives are set by the present study: – to evaluate attachment models in a group of children diagnosed with disruptive behavior disorders;

– to evaluate their post-traumatic symptomatology;

– to test the extent of the association between post-traumatic symptomatology and attachment organization in young patients with disruptive behavior disorders.

Forty-two Italian patients aged from 8 to 15 previously diagnosed with disruptive behavior disorders are compared to 42 healthy control subjects. We administer the child attachment interview and trauma symptom checklist for children-adolescent.

Insecure attachment are found in more than half of the patients diagnosed with disruptive behavior disorders and disorganization are highly over-represented. Furthermore, low levels of post-traumatic symptoms are found in young patients with disruptive behavior disorders.

This study suggests that attachment organization may be a fundamental element to be assessed in the evaluation of disruptive behavior disorders in children and adolescents. Nevertheless, traumatic experiences do not seem expressed through psychic symptoms. The clinical implications are discussed.

The author has not supplied his/her declaration of competing interest.

However, impulsivity is more likely to be present in externalizing disorders, little focus seems to have been made on the research of impulsivity in depression.

On this study, we sought to investigate impulsivity among adolescent with Depressive disorder compared to a control sample.

Employing a matched case-control study, participants included 100 adolescents divided into two groups: 30 adolescents (12 to 17 years) with depressive disorder and a control sample of 70 adolescents. Participants were recruited during a period of 2 years (2015, 2016). Depressive disorder patient were drawn from the consultation unit or inpatient unit of the department of child psychiatry in Sfax, Tunisia. Controls were recruited from two secondary schools and they haven’t depressive symptoms according to the child depression inventory (CDI). Impulsivity was evaluated in the two groups by the Barratt Impulsiveness Scale (BIS-11), an instrument designed to measure trait impulsivity.

Adolescents with depressive disorder displayed significantly higher total BIS-11 impulsivity scores than controls (71.6 ± 16 vs 61.6 ± 9; P = 0.003). They scored significantly higher than the controls on motor (P = 0.0001) and attentional impulsivity (P = 0.006). There was no difference in non-planning Impulsivity between the two groups. Motor impulsivity was high in adolescents with history of suicide attempt.

Our findings suggest that trait impulsivity is increased among adolescents with depressive disorder. Impulsivity seems to be a risk factor for suicide attempts, so it that should be systematically evaluated in depressive disorder.

The authors have not supplied their declaration of competing interest.

Patients with inflammatory bowel disease (IBD) report increased mental health issues, poorer sleep quality and less engagement in physical activity (PA). Standard treatment consists of immune modulating pharmaceuticals, though evidence is growing that aerobic exercise training (AET) might serve as adjuvant option to reduce disease symptoms and improve mental health. The aim of the present study was to investigate possible AET effects on psychological functioning, depressive symptoms, sleep and PA behavior in paediatric patients with IBD.

Twenty-one paediatric patients with IBD and 23 gender and age-matched healthy controls (HC) were assessed. The IBD group was split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7). All participants completed an 8-week AET exergame intervention reaching 60–80% of maximal heart rate for 5 days per week. At baseline and after 8 weeks, psychological functioning, depressive symptoms, objective sleep EEG, subjective sleep and objective and subjective PA were assessed.

AET significantly improved the exercise capacity of all participants. Self-reported fitness and daily PA behavior significantly increased in IBD-AD, but not in IBD-RE and HC. No improvements were observed for psychological functioning, depressive symptoms and subjective or objective sleep dimensions. Descriptively, the IBD-AD group reported lower psychological functioning and poorer subjective sleep quality.

Results suggest that children and adolescents in an active disease state were at increased risk to descriptively report lower scores of psychological functioning and sleep. Further, an exergaming intervention has the potential to improve exercise capacity, self-reported fitness and daily PA.

The authors have not supplied their declaration of competing interest.