Oxidative stress suposses an imbalance between oxidants and antioxidants molecules. Negative and positive family environment have been related with worse and better outcomes respectively in schizophrenic patients.

Our objetive is to determine antioxidant defense in healthy controls and unaffected relatives of early onset psychosis patients and to asses its relationship with familiar environment.

We included 82 healthy controls (HC) and 14 healthy controls with second degree family history of psychosis (HCWFHP), aged between 9 to 17.

Total antioxidant status and lipid peroxidation test were determined in plasma and antioxidant enzime activities and glutathione levels were determined in erytrocytes.

We used the Global Assesment Functioning scale (GAF) and the Family Environment Scale (FES). The FES is made up of ten subscales: cohesion, expressiveness, conflict, independence, achievement, intellectual-cultural, social, moral, organization and control.

The analyses showed a significant decrease in total antioxidant level in HCWFHP compared with the HC (U Mann Withney = 281.00, p=0.009, effect size= -0.78).

HC and HCWFHP did not differ in the GAF scale, nevertheless the scores of HCWFHP were significantly higher in cohesion and intellectual-cultural dimensions of the FES (p=0.007, p=0.025).

Adjusting by this two FES dimensions, antioxidant status remained significantly different between groups: OR= 10.86, p=0.009.

Although we cannot induce causative relations, we can state that family environment is not playing a role in inducing oxidative stress in these subjects. It could be hypothesized that families with affected relatives protect themselves with positive envionmental factors such as cohesion and intellectual-cultural activities.

This is a comprehensive, non-systematic review of the literature addressing the following issues:

1. a) differentiation normality/presence of the disorder;

2. b) clinical relevance of the age-of-onset of impairment criterion;

3. c) frontiers with Bipolar Disorders (BD);

4. d) guidelines for treatment when the disorder is associated with comorbidities.

Clinical tips are presented to make the diagnosis without significantly increasing the proportion of false positives, as well as to help in both the differential diagnosis with BD and the pharmacological management of the disorder associated to comorbidities.

The precise diagnosis, avoiding very flexible criteria, is crucial in a disorder with a dimensional construct in the population, as well as the adequate use of medication for a highly comorbid disorder.

The Child Behaviour Checklist (CBCL), Teacher Rating Form (TRF), Youth Self Report (YSR) by Achenbach, 1991 and the style of explaining events (measured by Seligman's Attributional Style Questionnaire) were administered to a cohort of ADHD outpatients boys (34) and randomly matched-paired community reference sample of primary school male pupils. The results were statistically proved.

Adolescence of boys with ADHD was overfilled in a characteristic way with pessimism more than in healthy boys. The boys had more externalized and internalized disorders, however, only the externalized disorders indicated direct correlation with pessimistic attribution. The intensification of internalized disorders didn’t change the coloring of adolescence neither among boys with ADHD nor among healthy boys.

Pessimistic way of interpreting the world that is distinctly present among boys with ADHD is closely connected with the intensification of behavior disorders.

This study aimed at assessing the putative association between the fingertip patterns of right and left digits II and intellectual functioning.

The study involves the evaluation of dermatoglyphic patterns on right and left digits II in 342 adolescents (144 talented ones, 102 normal individuals and 96 subjects with learning disabilities) from the Shahrekord city in Iran. Comparisons between the frequencies of fingerprint patterns of each digit were made on the basis of two groups at a time employing Chi-square test.

The most frequent dermatoglyphic pattern was whorl on both fingers in the 3 groups. An observation of right digit II revealed that the normal adolescents in comparison to the talented ones had a greater number of the whorl patterns (P=0.02), while the latter had more ulnar loops than the former (P=0.09). Group comprising those with learning disabilities had more ulnar loops than the group composed of the normal adolescents (P=0.09), and there was a predominance of radial loops among the talented subjects as opposed to those among the individuals with learning disabilities (P=0.002). There was no significant association in the relative frequencies of different finger patterns on left digit II between the groups (P>0.05).

Our results support an association between some dermatoglyphic patterns observed on right digit II with IQ level in adolescents. Further researches, needless to say, especially employing various quantitative dermatoglyphic indices and larger-sized samples are recommended.

Current study aimed to assess the possibility of prediction of continuous performance test in primary school children with attention deficit hyperactivity disorder, with parents and teacher reports of inattention, hyperactivity and oppositional behavior.

Fifteen school aged children with Attention Deficit Hyperactivity Disorder without co-morbid psychiatric disorders were selected from Roozbeh child and adolescent psychiatry clinic. Teachers and parent Conner's questionnaires, Continuous Performance Test and 4 class dictation scores were registered from each subject.

Commission errors were correlated with hyperactivity scale in the parent report (r=-0.50, p< 0.05), and with ADHD score (r=-0.49, p< 0.05). Omission error was correlated with inattention (r=0.66, p< 0.05) and ADHD score (r=0.51, p< 0.05) on teachers report. Reaction time was correlated with oppositional (r=0.51, p< 0.05) subscale in parents Conner's questionnaire. Dictation scores were correlated with inattention on parents report (r=-0.52, p< 0.05) and omission on Continuous Performance Test (r=-0.79, p< 0.05).

Current study reported a significant correlation between neuropsychological tests and questionnaires, in ADHD.

The aim of the current study was to assess the impact of computer games and computer-assisted type instruction on dictation scores of elementary school children with attention deficit - hyperactivity disorder (ADHD).

In this single-blind clinical trial, 37 elementary school children with ADHD, selected by convenience sampling and divided into group I (n=17) and group II (n=20), underwent eight one-hour sessions (3 sessions per week) of intervention by computer games versus computer-assisted type instruction, respectively. 12 school dictation scores were considered: 4 scores preintervention, 4 scores during interventions, and 4 scores post-intervention. Dictation test was taken during each session. Data was analyzed using repeated measure ANOVA.

Two groups were matched for age, gender, school grade, medication, IQ, parent's and teacher's Conners’ scale scores, having computer at home, history of working with computer, and mean dictation scores. There was no significant difference in dictation scores before and after interventions and also between the study groups. The improvement in school dictation scores had no significant correlation with age, gender, Ritalin use, owning a computer at home and past history of computer work, baseline dictation scores, Ritalin dose, educational status, IQ, and the total score of parent's and teacher's Conners’ rating scale.

Absence of significant improvement in dictation scores in study groups may be due to the confounding effect of other variables with known impact on dictation scores. Further studies in this field should also assess the change of attention and memory.

Individuals who report psychotic-type experiences are at increased risk of future clinical psychotic disorder. They constitute a ‘at-high risk’ group for studying the trajectory to schizophrenia and related illnesses. Psychotic disorders are a significant risk factor for suicide, especially young people. Previous research has used screening instruments to identify this high risk group but few studies have followed up by an in-depth clinical interview to assess the relationship between psychotic symptoms and suicidality or other psychopathology.

As part of a community study, a 50-minute self -reported screening questionnaire which included one item designed to assess psychotic symptoms (auditory hallucinations) was administered to 900 adolescents aged 14 years in community schools, in Cork, Ireland. The following question (“Have you ever heard voices or sounds that no one else can hear?”) was used as it has been shown previously to have best predictive power (Kelleher., 2009). Other screening questions assessed suicidality and other psychopathology. Detailed clinical interviews by experienced child and adolescent psychiatrists were subsequently carried out with some of these adolescents who endorsed a positive answer to screening questions.

We plan to calculate the sensitivity and specificity and positive predictive value for the specific screening symptom on auditory hallucinations and its relationship to psychopathology as verified on clinical interview.

Our results will be of value to those engaged in treating children and adolescents with psychiatric disorder and will inform on the clinical significance of a positive answer to a screening question on auditory hallucinations in adolescence.

Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.

78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).

ADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.

ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.

The ADHD prevalence in our sample of BD and relatives weren’t higher than general population.

:

- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.

- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.

Singh MK, DelBello MP, Kowatch RA, Strakowski SM.Review Article Bipolar Disorders 2006: 8: 710-720

Self-mutilation refers to a variety of behaviors in which individuals deliberately inflict body lesions against themselves, with not accepted or even socially reproved purposes, but with no suicidal intent. Adolescence is a known risk factor for these behaviors.

Clinical and bibliographic review of self-mutilation in adolescence.

Review of medical files of adolescents followed in the Department of Child and Adolescent Psychiatry. Bibliographic review of papers about self-mutilation in adolescents.

The authors present 5 clinical vignettes (4 girls and 1 boy) of adolescents presenting with self-mutilations. Proposed theoretical models explaining the causes of these behaviors and their alleged functional role for the individual are presented based on the bibliographic review. Implicated psychosocial factors (predisposing and precipitating), associated symptoms and psychiatric syndromes (eg.: depression, personality disorders) and relation to suicide are discussed. Finally, different therapeutic approaches are presented as well as the major challenges to intervention in these situations.

: Self-mutilation represents a heterogeneous clinical condition with a multifactorial and complex pathophysiology requiring a comprehensive biopsychosocial intervention.

To evaluate the reason of major behavioral problems in patients with alopecia universalis, we tried to examine by way of the Millon's MCMI- III whether these signs are transient or ingrained.

Patients with alopecia universalis (279 consecutive) were studied before and 3 months after treatment with MCMI-III and scheduled psychiatric interview. They were stratified in regard to sex, age, socioeconomic class, age of onset of alopecia (before or after 18yrs.) and response. The results were compared with 3000 normal examinees.

There was significant preponderance of personality disorders among patients with early onset (p< 0.003) but not late onset (p=0.1) alopecia including schizotypal, schizoid, self defeating, borderline and avoidant personalities compared to the general population. This was not affected by treatment. (p< 0.004) All alopecia patients showed higher scales in axis II disorders including depression, anxiety, drug abuse, alcohol abuse in addition to major thought disorders. (Overall p< 0.02) These were ameliorated with treatment of alopecia. These data were confirmed by scheduled interviews.

This is the first report of severe personality disorder in the context of a medical condition. We conclude that childhood onset chronic illnesses can cause serious personality disorders that are a stronger predictor than genetics or learned behavior encompassed in previous theories on personality. Alopecia universalis has a more sustained effect due to jeopardizing the development of self image.

Diagnostics of level of uneasiness at children with damage intrafamily relations and working out of the recommendation about the most effective methods of psychocorrectional work.

64 persons took part In research. From them 38 maidens. (59,3%), 26 it is small. (40,6%). The age of the surveyed has made from 6 till 10 years.

1. 1) a technique of measurement of level of uneasiness of Taylor (adaptation by Norakidze),

2. 2) projective techniques: «family Drawing», and «the Nonexistent animal».

At 46 people (71,8%) high level of uneasiness is revealed; at 18 foreheads (28,1%) the uneasiness average level-was revealed; uncertainty in and a low self-estimation (р≤0,05).

More often the surveyed mark such features in intrafamily mutual relations as: verbal aggression from members of a family to the examinee, critical noticed and neglect interests of the child, and as absence of joint activity with parents.

Presence of uneasiness, a low self-estimation and sensation of emotional isolation, specify on family desadaptation and use of inadequate approaches in education. In system of complex psychocorrectional work with children of the given contingent, it is expedient to apply a method of group psychotherapy with relaxation elements (respiratory and muscular), dreams therapy.

This recent demographic and epidemiologic study includes the prevalence of nocturia among the primary school children in Ardabil, Nocturia causes irretrievable damages in children's mentality and may have results such as being shy, offensive and lying on children.

In this study, about 500 students were determined but regarding to different cultural issues. questionnaires were distributed among the students in clustery ways which were answered by the parents of the students. Information and statistics were analyzed by using SPSS software out of 640 filled papers.

The prevalence of nocturia among the children in Ardabil is 17/18% which 7/49% were girls and 9/68% were boys. 83/5% of them had the primary nocturia and 15/6% the secondary one. The most prevalence was in age-groups between 8 to 10 with 41/8%. 60/6% of them nocturia were the first or second one in the family. 31/2% of them had precedent of using horrible movies.23/1%coming a newborn baby.20/4%had the precedent of snoring at nights and a stuff feeling during sleep. 18/2%had inadequate physically growth. 13/8% had the prevalence of UTI, 13/1% the mothers employed, 7/5% had constipation, 3/7% spinal trauma, 2/7% congenital kidney diseases and 0/9% had

Myelic problem.

The goal of this study is finding the number of children having nocturia in Ardabil in primitive age groups regarding the separation of girls and boys and looking into the reasons that cause nocturia in order to find effective strategies against the problem.

A percentage of children with learning difficulties (LD) in reading and calculating have behavioral problems (BP), too. Two LD groups - having (GA) and not-having (GB) behavioral problems according to their teachers - were studied.

Child Behavior Checklist (CBCL) was filled by the teachers of 236 LD children, 45 of them having BP complaints. Factor Analysis was employed to analyze CBCL data.

Two Factors accounted for more than 70% of the total data variance on both GA (F1 and F2) and GB (F3 and F4 in Table 1) groups.

Table 1

ATE - attention deficit; HIP - hyperactivity; OPO - opposition-defiant; SOC - sociability; ANX - anxiety; AFE -affective complaints; SHY - shyness; AGR - aggressiveness; SOM - somatic complaints.

According to the DSM-V and the above results, GA children have a CBLC profile compatible with Generalized Anxiety Disorder (GAD - F1) or Attention Deficit/Hyperactivity Disorder (ADHD), Combined Type (F2), whereas GB students are either ADHD, Predominantly Hyperactive-Impulsive Type (F3) or ADHD, Predominantly Inattentive Type (F4).

The results indicate that teachers tend to consider either ADHD/Hyperactive-Impulsive (F3) or ADHD/Inattentive (F4) as not having BP and to consider misbehavior associated with GAD (F1) and ADHD/Combined (F2).

About 27% of teenagers have some type of mental health disorder such as anxiety, depression and substance abuse. Depression is a serious disorder, most common in teenagers and often goes unnoticed. However, they can be detected early by teachers and we have effective treatments. Studies in European countries estimated the prevalence of adolescent depression around 12.55%, being more frequent in women. The prevalence increases with age and there are population studies that suggest that the high prevalence of depression is common in adolescents. One of the most important and most frequently associated with depression is suicide, becoming a serious health problem and constitute the third leading cause of death among adolescents between 15 and 24.

To estimate the prevalence of depression in adolescents in Spain. Rate sociodemographic variables associated.

Study desing: Observational, descriptive.

Study scope: Primary Care Health.

Subject of the study: Spanish students of 14 to 18 years old.

Variables to measure: Depression: Beck's depression index. Sociodemographics: Age, sex, course, repeater, number of siblings, smoker, drinker, toxic consumer, marital status of parents.

Sample size: It is calculated by accepting a signification level of 95%. A sample size of 2347 patients is estimated, including losses.

We will do an univariate analysis of qualitative variables by frequency and quantity by the mean, median and standard deviation. We will do a bivariate analysis using chi-square for qualitative variables and t test and ANOVA for qualitative as quantitative. Logistic regression will assess the factors that are associated with depression.

To describe a cohort of adolescents presenting to an emergency department with mental health problems.

An Emergency Department (ED) computerized record system and hospital records were used to obtain data on adolescents aged from 12 to 17 years who presented to an ED of a General Hospital with emotional or behavioural problems.

There were 213 presentations of 182 adolescents in a 12-month period. 77% were female, 56% were 16 or 17 years old, 8% did not live with immediate or extended family. There was a wide variety of presenting symptoms including anxiety, self-harm, suicide attempts (14,5% presented with suicidal behaviour), behavioural disorders, depression, eating disorders, acute psychosis, developmental disability, substance abuse. Psychosocial problems were frequent. Medication was prescribed in 38% of the presentations and 7.5% of the cases were admitted to a psychiatry ward. 54% had no previous psychiatric history.

Many adolescents with mental health problems had no previous or current treatment and were referred to local mental health resources for further evaluation. Psychiatric ED evaluations are an opportunity for recognition of risk factors, screening and early intervention in youth with mental health disorders and their management involves collaborative efforts with multidisciplinary services.

To evaluate the diagnostic and therapeutic applications of playrooms implemented in care services of children's health, while waiting for a consultation appointment.

A playroom was developed in a child psychiatry outpatient service in a University Hospital, where spontaneous approaches, without educational or psycho-specific directing, were conducted by members of a multidisciplinary team of this service. The children had their attitudes and behaviors observed by these professionals during the playful waiting time in the playroom. Therefore, all observations have been used in subsequent discussions with the professional directly responsible for the child's care, in order to enrich and supplement the case's supervision.

In spite of the spread of the playrooms, there are few studies about them, their objectives and key aspects for their creation and maintenance. It not only adds new elements to those given by family, teachers and patients, but also allows a free observation of the latent unspoken aspects that emerge during play and complement or even change the caregiver first impressions.

The experience of a playroom implemented in a child psychiatry outpatient service in a University Hospital agrees with the studies that indicate that through playful-creative activities children can make discoveries their own way, develop relationships and elaborate affective aspects of their psychic space. Rescue strategies in spontaneous play are essential elements for the children's integral development, creativity, learning and socialization. Above all, playrooms also have a therapeutic and diagnostic role in children's care.

Attention Deficit Hyperactivity Disorder (ADHD) is among the most commonly diagnosed behavioural disorders. There is a glaring paucity of published data on current practice in ADHD Clinics in UK. Following on from recommendations of the European Clinical Guidelines for Hyperkinetic Disorder, NICE guidelines, American Academy of Child and Adolescent Psychiatry, it is practice that an appropriately qualified healthcare professional only should make a formal diagnosis of ADHD, with the assessment process involving a multidisciplinary team approach. A specialist ADHD clinic was started in Hemel Hempstead in 2005 conducted on a monthly basis.

The present work aims to collate the demographics of the referrals to the Specialist ADHD clinic, and compare it to the National figures. Theories and ideas relevant to improvement could be deduced from this data.

Literature review has been conducted to have national figures for comparison. Data will be collated from monthly appointments to ascertain the demographic facts. Further work will include looking at the outcome of the assessment. Data collection will involve review of notes, letters and recording of information and analysis will be done with use of excel and graphs.

Will show the number and characteristics of referrals; and the outcome of assessments. These will then be compared to national figures.

Recommendations will be extracted from the data available. These preliminary findings would help in understanding the disorder better, and add to the evidence base which could then be applied to effective management of attention deficit hyperactivity disorder.