Just like adults, adolescents still have negative attitudes towards mental illness and lack knowledge about depression. Public awareness campaigns proved to be effective in adults, but education and antistigma campaigns focussing on adolescents are rare. We developed an information booklet on depression as a first step towards a bigger campaign for youths. We investigate whether this booklet increases knowledge about depression and reduces stigmatised attitudes. Furthermore, we analyse the adolescents’ assessment of our booklet.

In a pilot study, the booklet will be evaluated in 100 9th grade pupils in Munich, aged between 14 and 16. Knowledge and attitudes about depression are investigated in a pre-post-design. Adolescents’ assessment of the booklet is rated on four-point rating scales which serve as a basis for a revision of the booklet after the pilot study. Data are collected using questionnaires specifically designed for the study.

The pilot study is ongoing until December 2009. Baseline data about depression knowledge and attitudes are presented. The pre-post comparison of knowledge and attitudes is pointed out. Further, the adolescents’ assessment of the depression booklet is illustrated.

Based on the findings of the pilot study, the booklet will be revised. Afterwards, it will be evaluated on a sample of 500 pupils in a pre-post-follow-up design covering stability of the changes for a one month period. In the long run, the booklet shall be spread to a wider public using synergistic effects with local campaigns such as the “Munich Alliance Against Depression”.

Depression is highly prevalent, but often unidentified in pediatric primary care. Without treatment, early-onset depression often leads to psychosocial impairment and is associated with a high risk of recurrence, chronicity and comorbid mental illnesses. While depression screening is recommended for adults in the primary care setting, screening instruments for children and adolescents are still rare. Therefore, the study group developed two depression screeners in German language, specifically designed for this age group. In a pilot study, psychometric properties of these screeners are computed.

This is a cross-sectional study of a pediatric clinic sample of 100 children and adolescents aged 9-16 years. To assess screener performance, item analysis and realibility measures were calculated. Further, validity measures were computed, using a standardized clinical interview as gold standard criterion for depression diagnosis.

The pilot study is ongoing until January 2009. Items analysis results are presented as well as internal consistency. Validity measures are illustrated by ROC curve analyses.

Based of the results of the pilot study, the screening instruments will be revised. To confirm our preliminary findings, the screeners will be tested in a larger sample during the main study. If the depression screeners have proven to be reliable and valid, in the long run they can be implemented in pediatric primary care as a diagnostic aid.

To investigate the relations between acting the bully, being bullied, seeing someone bullied and depression in children.

108 children (6 to 13 years of age, students of one school - 1st to 7th grade) participated in this study. They completed questionnaires regarding acting the bully, being bullied and seeing someone bullied. The questionnaires include 5 psychological bully questions respectively, and they consist of 15 questions. The Center for Epidemiologic Studies Depression Scale (CES-D) Japanese-version was also completed by the children.

12 children scored 16 or higher on CES-D. The children were supposed depression. 50 children answered “yes” to one or more question of 5 ones with regard to acting the bully. They were supposed acting the bully. 67 children and 75 children were supposed being bullied and seeing someone bullied respectively. Logistic regression analysis was performed to determine whether acting the bully, being bullied and seeing someone bullied were associated with depression.Being bullied was significantly associated with depression [Odds ratio 21.82 (95% confidence limits 1.86-256.20)]. Acting the bully was associated with depression [Odds ratio 4.681(95% confidence limits 0.767-28.580)]. Seeing someone bullied had no association with depression [Odds ratio 0.10(95% confidence limits 0.01-0.74)].

Being bullied greatly affected the emotion. Younger children are said to be more likely to be victims of bullying. Appropriate interventions in the school children are needed.

To study the role of child abuse in genesis of criminal and aggressive behavior in adolescents.

650 adolescents that underwent forensic psychiatric evaluation in the Serbsky Centre were examined by complex clinical psychopathological, pathopsychological and instrumentally diagnostic methods. The average age of patients was 16.7 years old.

The research has revealed that 60.5% adolescents have committed aggressive and violent crimes (murder, sexual assault), 86% adolescents of the sample were brought to trial for murder and grave bodily injuries that resulted in death of the victims, 12% have committed sexual crimes. Examination of the micro social factors showed that 80% of the adolescents were brought up in disadvantaged families under conditions of emotional deprivation, 55% of them were physically abused and 30% of them were victims of sexual abuse.

Our research proves that a factors of “learning of violence” at home play a great role in aggressive behavior formation in children and adolescents. Continuous chain of violence and abuse that a child suffers at home leads to abnormal personal development, distortion of socialization and formation of delinquent behavior.

Various epidemiological studies indicates that emotional & behavior problems in children are equally prevalent in developing & developed countries. In a developing country such as Bangladesh the daily livelihood & combating common childhood diseases are the foremost concern, and the mental health of children is often neglected.

This study will review an overview of child psychiatry in a developing country, focusing on the lack of existing infrastructure, challenges facing children mental health services & what steps to be taken to develop mental health services in Bangladesh.

Critical review of various literature on the topic.

Child psychiatry is gravely under recognized & underdeveloped in Bangladesh. There is lack of basic infrastructure in the field of child psychiatry. Top most mental disorders amongst children in Bangladesh are behavior disorders & anxiety disorders. These problems are not just restricted to urban regions of Bangladesh; there is also significant levels of emotional problems amongst children in rural areas of Bangladesh.

Poverty, malnutrition, illiteracy, & in recent years, through rapid urbanization of the country, the social & family structure is breaking down, which is contributing in development of mental health disorders amongst children. There is definite lack of infrastructure, awareness & availability of mental health services for children. However, plenty of avenues exist, through which child psychiatric services can be developed in the country.

Traumatic events such as tsunamis, wildfires, war, cyclones, etc. have a lasting effect on children's emotional well-being. The psychological impacts are multifactorial & reaction is also varied depending on the individual.

This study will review the psychological impact on children's minds following exposure to traumatic events & will identify the evidence based psychosocial approach of intervention.

Critical review of literature on the topic.

The severity of impact depends on exposure to the traumatic event, but minimum exposure can also be harmful. The level of trauma, proximity, duration of exposure, evidence of psychopathology before trauma exposure & disruption in social support networks consistently emerge as strong predictors of psychopathology following exposure to trauma with response to mood, anxiety or behavioral manifestation. Socioeconomic disadvantages that follow disaster predict long-term problems. A positive correlation between children's & parents symptomatology has been noted. Intervention strategies include screening children at risk,triage & referral,community based intervention & trauma focused treatment programs. CBT emerges as the best validated therapeutic modalities for children experiencing trauma related mood & anxiety symptoms.

Psychological impact resulting in trauma to children could be enormous. Good psychosocial management following a disaster with effective follow through & broad care planning may lessen the long term impacts.

Until now, no studies have been published about the prevalence and needs of children with a mentally ill parent nor about interventions for this vulnerable group in the federal state of Saxony, Germany.

Therefore, the multi-centre study HELP-S for Children was initiated by the University of Leipzig in cooperation with the Technical University of Dresden. The aim of HELP-S for Children is to identifiy the prevalence and specific needs of children with a mentally ill parent.

All psychiatric outpatients of Leipzig and Dresden at an appointed date will be asked to participate in the study. Patients with minor children will be asked to fill out a detailed questionnaire about the perceived needs of their children and the existing and lacking support possibilities. Because there is no adequate instrument to assess the needs of the children with a mentally ill parent, we will develop a standardized questionnaire by using expert interviews and a pre-test with mentally ill parents.

The standardized questionnaire, which we will develop for this study, will be useable in other studies about needs of children with a mentally ill parent. Furthermore, we will gather information about the prevalence of children of mentally ill parents who are outpatients and about the specific needs of these children in the age of 0 to 18. These results will be presented and discussed during an expert workshop at the end of the project to explore ways to improve the situation of children with a mentally ill parent.

Although the Peritraumatic Distress Inventory (PDI) and Peritraumatic Dissociative Experiences Questionnaire (PDEQ) are both useful for identifying adults at risk of developing acute and chronic post-traumatic stress disorder (PTSD), they have not been validated in school-aged children. The present study aims at assessing the psychometric properties of the PDI and PDEQ in a sample of French-speaking school children.

One-hundred and thirty-three school-aged victims of road traffic accidents were consecutively enrolled into this study via the emergency room. Mean(SD) age was 11.7(2.2) and 56.4% (n=75) of them were of male gender. The 13-item self-report PDI (range 0-52) and the 10-item self report PDEQ (range 10-50) were assessed within one week of the accident. Symptoms of PTSD were assessed 1 and 6 months later using the 20-item self-report Child Post-Traumatic Stress Reaction Index (CPTS-RI) (range 0-80).

Mean(SD) PDI and PDEQ scores were 19.1(10.1) and 21.1(7.6), respectively, while mean(SD) CPTS-RI scores at 1- and 6-months were 22.6(12.4) and 20.6(13.5), respectively. Cronbach's alpha coefficients were 0.8 and 0.77 for the PDI and PDEQ, respectively. The 1-month test-retest correlation coefficient (n=33) was 0.77 for both measures. The PDI demonstrated a 2-factor structure while the PDEQ displayed a 1-factor structure. As with adults, the two measures were inter-correlated (r=0.52) and correlated with subsequent PTSD symptoms (r=0.21−0.56; p< 0.05).

The PDI and PDEQ are reliable and valid in school-aged children, and predict PTSD symptoms.

It remains unknown whether peritraumatic reactions predict PTSD symptoms in younger populations. To prospectively investigated the power of self-reported peritraumatic distress and dissociation to predict the development of PTSD symptoms at 1-month in school-aged children.

A sample of 103 school-aged children (8-15 years old) admitted to an Emergency Department after a road traffic accident were consecutively enrolled. Peritraumatic distress was assessed using the Peritraumatic Distress Inventory (range 0-52) and peritraumatic dissociation was assessed using the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) (range 10-50). PTSD symptoms were measured at 1-month by both the child version of the clinician-administered PTSD Scale (CAPS-CA) (range: 0-136) and the Child Post-traumatic Stress Reaction Index (CPTS-RI) (range 0-80).

Mean(SD) participants’ age was 11.7(2.2) and 53.4% (n=55) of them were of male gender. At baseline, mean PDI and PDEQ scores were 21.4 (SD=7.8) and 19.2 (SD=10.2), respectively. At 1-month, mean self-reported (CPTS-RI) and interviewer-based (CAPS-CA) PTSD symptom scores were 23.2 (SD=12.1) and 19 (SD=16.9), respectively. According to the CAPS-CA, 5 children (4.9%) suffered from full PTSD. Bivariate analyses demonstrated a significant association between peritraumatic variables (PDI and PDEQ) and both CAPS-CA and CPTS-RI (r=0.22-0.57; all p< 0.05). However, in a multivariate analysis, PDI was the only significant predictor of acute PTSD symptoms (Beta=0.33, p< 0.05).

As has been found in adults, peritraumatic distress is a robust predictor of who will develop PTSD symptoms among school-aged children.

To investigate economical and psychosocial impact on bullying in schools of Kaunas.

We investigated pupils from the 6, 7, 8 classes from 11 to 16 years old. The study was performed in the randomly chosen different schools of Kaunas. 527 pupils (270 boys and 257 girls) were questioned during this research. The results showed that more than a half of the pupils (67,6 per cent) are becoming victims of bullying in schools of Kaunas. frequency of bullying among boys and girls is almost equal (55,2 per cent boys and 48,8 per cent girls responded that they are bullying at school)(p=0.025, x2=9,317, df 3); most of pupils experience affection in their family (61,9 per cent) and 83,7 per cent of these children think that bullying at school is not the right thing to do (p=0.025, x2=9,317, df 3).

Majority of children who get free lunch (welfare recipients) at school think that financial situation (of the child family) has no influence for bullying (54, 2 per cent). Most of children who are not getting the free lunch at school think that financial situation is important for the bullying to appear (69,7 per cent) (p=0.965, x2= 0,002, df 1).

Frequency of bullying among boys and girls is almost equal; children with better welfare conditions are more inclined to bully; financial situation for bullying to appear has more influence among girls than boys; better family relationships influence negative point of view towards bullying.

The children and youth mental health is a dynamic and developing process that is result of their interactions with family, school, community and surrounding. The goal is to show the influence of family disfunction on behavior disorders among children and youth, especially the presence of negligence and abuse of children. The aim of this research is to show the presence of comorbid diseases and influence of low socio-economic family status as well.

The research is retrospective study taken by 64 patients (36 girls and 28 boys), age between 7 and 18, at Department of child and adolescent psychiatry in Banja Luka. We analised socio-demografic status, comorbid diseases, the presence of negligence and abuse among youth and behavior disorders. Our own questionnaire, made for this research, socio-psychiatric and clinical records and case history are used in this study. The results are analised by graffics and tables.

There is significant higher number of boys, age under 14 years old, statistic lower socio-economic status, the presence of family violence, school dificulties, quiting the school. There is significant number of girls with comorbid disease.

Family can influence on apperance of mental disorders in their children through family disfunction, frequent conflicts, negligence and family violence, the presence of severe diseases, low socio-economic status, psycho-traumatic events and stressful situations.

To evaluate factors associated with the use of restrain and its duration among psychiatrically hospitalized adolescents.

Retrospective, chart-based analysis of patients treated during a 2-year period in Department of Adolescent Psychiatry with average number of patients of 22.6±4.7 and an average admission rate of 320/year.

There were 543 events of restrain during a 2 year period in 164 patients (27/10000 patient days).Restrain was used during 413 (28%) out of 1462 of 12-hour-long analyzed duties. Median duration of restrain per patient was 240 (IQR 90-465) minutes. Factors associated with the risk for restrain in multivariate model were: nurse workload (OR 1.17; 95%CI: 1.09-1.26), fraction of female patients in the unit (OR 3.26; 95%CI: 1.06-10.07), weekday duty (OR 1.67; 95%CI: 1.30-2.13), spring or autumn season (OR 1.51; 95%CI: 1.19-1.93). Child and adolescent psychiatrist on duty (beta= -0.10; p< 0.001) and greater nurse workload (beta= -0.11; p< 0.01) were associated with shorter duration of restrain per patient. Night-time duties were associated with longer use of restrain than day-time ones: 270.0 (25%-75% 92.5-558.8) vs 225.0 (25%-75% 90.0-360.0) minutes. Similarly weekend 292.5 min (120.0-555.0) vs weekday 206.3 min (90.0-427.5) or spring/autumn 295.0 min (25%-75% 105.0-510.0) vs summer/winter 180.0 min (25%-75% 75.0-408.8) duties were associated with highly statistically significant (p< 0.01) longer duration of restrain per patient.

Health service-related factors are important predictors of the use and duration of restrain. Adequate number of well-qualified nursing staff should be consider as means to counter this problem.

Most of the studies about Eating Disorders in adolescents have been typically focused on females, only to conclude that the approach should be similar in males. It has been stimated that 5-10% of patients with Anorexia Nervosa are males. Later age of onset and higher prevalence of premorbid overweight are considered among the main differences with female patients.

Analysis of the anthropometric variables of a sample of males with diagnosis of Restrictive Eating Disorder.

Naturalistic, Descriptive and Retrospective study

1. - Sample: 22 male adolescents

2. - Inclusion criteria: males with Restrictive Eating Disorder diagnosis (according to DSM-IV criteria) admitted to an Eating Disorder ward during 2007 and 2008

3. - “ad hoc” questionnaire (15 items)

4. - Analysis: PASW statistics 18

Age range: 7-14years (medium age=14,79±2,50years).11 patients (50%) were older than 16 years-old

1. - Medium BMI (Body Mass Index) at the beginning of the admission was 17,79kg/m2.

medium weight loss: 13,5±7,02kg/m2 (corresponding to a reduction of 22,24±7,52% of the previous weight)

1. - Medium speed of weight loss: 0,92±1,1kg/54

2. - BMI at discharge: 18,69 ±3,43 kg/m2

3. - 19/22 patients (86%) had a premorbid history of overweight

4. - Binge eating: 8 patients (36,4%)

5. - Purgative behaviour: 10 patients (45%)

6. - Laxatives use: 4 patients (18%)

7. - Intense physical exercise: 21 patients (95,5%)

8. - Average duration of current restrictive episode: 13,7 months

In the studied sample we observed:

1. - High prevalence of premobid overweight

2. - Very high frequency of compulsive exercise

3. - Drastic weight loss and loss of a very high percentage of the previous weight, in short periods of time, reaching very low BMI.

The etiologies of autism are complex and presence of a wide variety cytogenetic abnormalities are providing us with extremely valuable information about the role played by genetics in autism and collaboration with psychiatrists. Such recognition and understanding will help clinicians implement syndrome-specific treatments of patients identified with a genetic cause of autism spectrum disorder. Early identification of this genetic disorder is critical not only to the individual patient but for the entire family.

Health care policies should be implemented to provide the proper care for children with mental health disorders and there is a need for improved infant and early childhood mental health assessment. In this paper we examine how system data reflecting program practice meet to inform advances in developing infant mental health policy.

Data from the Collaborative Mental Health Care (CMHC) program, a consultation based service in the focusing on the early identification of children (aged 0-5) at significant risk for developing mental health problems, was analyzed in comparison to those not coming into contact with such specialized services.

Compared to others of the same age, those with CMHC involvement waited less time [mean days 13.7 (S.D. 32.3) vs. mean days 69.3 (S.D. 180.3] and had shorter lengths of stay [mean days 139.9 (S.D. 119.3) vs. mean days 232.4 (S.D. 329.7] and proportionately fewer registrations.

Early identification of children's mental health concerns through supporting the community through specialized consultation and promoting resiliency can significantly reduce mental health service utilization by offering more specific and specialized information, referral or treatment services for infants and very young children. The policy implications are self-evident: All provinces require specialized mental health services for infants and very young children in order to better serve children and increase service capacity.

Continuous client feedback aims to increase the effectiveness of therapy by emphasizing common factors in treatment across theories that contribute the most to change. In this paper, we present data using two independent measures, which appears to isolate the influence of social desirability on treatment outcomes.

Continuous client feedback data was collected in the Student Health Partnership program and compared with independent data reflecting client function (Child Global Assessment of Function). Data was collected at two times by the same staff using two sampling methods. In the first sample, staff preferentially assigned clients to case (continuous client feedback) and comparison treatment as usual) on the basis of preference and convenience whereas in the second sample assignment to case and comparison was random.

When the data from the two sample frames was compared, systematically different trajectories in the measured outcomes reflecting continuous client feedback and function were obtained with those in sample one being substantially higher than comparisons or population reference values.

The difference in results emerging from the two sampling frames is explained in terms of social desirability. Outcomes for clients were much better in the first sample, where staff choose clients they apparently liked for specialized treatment.

Using baseline and outcome data collected in the Calgary Region Children and Adolescent Mental Health Program (CAMHP) over the last six years, a profile was developed for those who are at risk for poor treatment outcomes.

Based on the data collected in CAMHP, 6229 completed measurable treatment plans (MTP) were analyzed for consistency (by year) and theoretical meaningfulness (by clinical level). A table was developed to describe by quartiles those who improved and those who got worse in terms of problem severity and function. A multi-variable linear regression model was developed for function with linked data that predicted the profile of those at risk for poor treatment outcomes.

MTP scores reflecting problem severity and function were consistent over time. Further, MTP scores were theoretically meaningful (e.g., inpatients were more severe on admission than those receiving community or day hospital-based treatment). In total, 659 MTPs indicated no improvement for a negative state and an additional 830 changed negatively in problem severity and Children's Global Assessment Scale (C-GAS) scores. The multivariable model based on admission data provided a risk profile for this group that accounted for 52% of the variance for discharge function.

The baseline and outcome data gathered from the Regional Access and Intake System (RAIS) serving CAMHP may be used effectively to predict clinical outcomes in ways that can draw attention to those at risk for poor outcomes.

According to European Statistical Office EUROSTAT, Romania represents the second source of immigrants in the European Union. Off the record, more than 2 million people work out of the country, sex ratio for immigrants being quite equal.

Parents’ immigration seems to become a new mode of abuse against children. The most optimistic statistics highlight that almost 100,000 of children have been abandoned by one or both parents, the majority being ascertained to older family members.

We followed-up 96 teenagers registered in Mental Health Center and University Clinic of Psychiatry Craiova, aged between 15.4 and 19.8 (mean age 17.4 years).

Of the 96 subjects included in the study, 59 were boys and 37 girls. Their mean age at parents’ departure was 8.2±1.9 years. In the total sample, the most prevalent symptoms at the onset were non-specific symptoms of stress response (i.e. exaggerated startle response, difficulties getting to sleep, difficulty in concentrating). Symptoms released after a delay of at least 6 months after the departure (more quickly at boys) and remaining members of the family decided to accompany the child to the psychiatrist more later, in several cases even at two years distance since the onset (earlier at boys, in which emotional response to abandon was noisier, often with dissocial behavior). Intensity of symptoms varied from mild to severe.

Home alone generation begins now, after several years of opening to European world, to be a problem that us, Romanian adult psychiatrists, haven’t encountered before.