Adoption constitutes a discontinuity in child care trajectory, that falls into a separation and a lost of reference figures, and therefore, the need to set up new attachment figures into a suitable familiar atmosphere.

This case is a review of how a child adoption process, that can be something positive at first, can also produce many problems in the future, added to dificulties in order to regulate stressing situations and also solving problems.

The clinical case consists in a 25-year-old woman, who suffers from anxiety and self-injure behaviour. She has a diagnosis of non-specified personality disorder with limit characteristics. The patient was adopted a few months after her birth. At the moment she's living with her adoptive father, her adoptive mother passed away when she was 4. At the age of 21, the patient meets her biological mother and since that moment she spends most of the weekends with her. After a few medical appointments, she admits that she has allowed sexual relationships with her biological mother since six months ago.

It's important to appreciate the value of familiar atmosphere, and in addition, the attachment between child and his parental figures. The quality of the attachment is going to have influence in emotional regulation.

Children who have suffered neglect from their biological parents and have been adopted develop attachment behaviours characterized by negative experiences. In spite of being in a good familiar environment, they feel vulnerable and insecure. Early and appropriate attachment experiences can improve relationships between children and their new family.

The authors have not supplied their declaration of competing interest.

It is well known that youth in foster care are at high risk for psychiatric disorders, recently reported in up to 89%, with over 55% exhibiting ADHD in one sample (Linares et al., 2013). Psychotropic medication use was reported in 59% of foster care youth within a 2-month period (Brenner et al., 2013). The psychotropic medication consent process in Los Angeles for dependent children is multidisciplinary, starting with the treating psychiatrist's written authorization request to Children's Dependency Court. Once received, it is distributed to the child's attorney, social worker, and Juvenile Court Mental Health Service (JCMHS). JCMHS reviews and provides recommendations to the judicial officer who ultimately approves, modifies, or denies consent.

To present the steps and reasoning in the process of review, consultation, recommendations and decisions in psychotropic medication consent for dependent youth.

To provide an understanding of the multidisciplinary review process involved in determining psychotropic medication consent in foster care youth.

Presentation of a timeline, forms and guidelines used in the process including the “Psychotropic Medication Authorization Form” (PMA) (Judicial Council of California, 2008).

Categories of recommendations and approvals provided to the judicial officer will be presented and rationales for in-person consultations.

The psychotropic medication consent process for foster care youth is a complex multidisciplinary process which includes a clinically significant set of recommendations from JCMHS to the judicial officer to aid in making informed decisions regarding psychotropic medication.

The authors have not supplied their declaration of competing interest.

Catatonia is a potentially life-threatening but treatable neuropsychiatric syndrome. The prevalence of catatonia in children and adolescents is probably underestimated since investigation on this matter is still lacking. Different studies have led to the recognition of catatonia as a separate psychiatric entity, as reflected in DSM-5, renewing interest on this subject. While in the adult population there is evidence highlighting the strong association between catatonia and affective disorders, this has been poorly reflected in child and adolescent psychiatry literature. In fact, most of the research in this population focuses on associations with organic, psychotic or developmental disorders.

We aim to illustrate the diagnostic challenges when facing an adolescent with catatonia encompassing psychiatric, neurologic and immunologic factors known as possible causes for this condition. We aim to explain the diagnostic procedure and the possible clinical results of this workup, as well as raise the discussion around treatment options.

We used a clinical case vignette of a 14-year-old adolescent, presenting with a stress-induced catatonic syndrome and depressive symptoms without any prior organic or psychiatric condition. We reviewed the most relevant literature in order to contextualize our clinical case.

Catatonia is an under-recognized condition in children and adolescents without a prior medical or psychiatric condition, especially when associated with affective disorders. The inclusion of catatonia as a specific syndrome in the psychiatric nosography may help its recognition. Case reports on this matter are therefore especially important as a way of pushing clinical investigation on this matter forward.

The authors have not supplied their declaration of competing interest.

Despite categorical differentiation, autistic and psychotic disorders are historically related diagnostic entities and there is still much controversy regarding their limits and developmental course. Particularly in children, the presence of idiosyncratic fears, difficulties in the social sphere and thought disorder are important factors in the differential diagnosis. There are some research-derived clinical constructs that operationalize symptomatology aiming to highlight the interfaces and the overlap between such disorders. Their clinical implications can be extremely relevant in the face of the limits of current nosology.

To phenomenologically describe differentiating parameters and high-risk clinical profiles for the development of psychosis in children with autism spectrum disorder.

Selective review of the literature in PubMed (MEDLINE). Illustration with a clinical case vignette.

The clinical case reflects well the difficulties posed in the differential diagnosis due to the multiple interfaces between autism and psychosis. Constructs such as “multiple complex developmental disorder” or “multidimensionally impaired syndrome” allow a clearer and more practice-friendly characterization of such individuals.

The constelation of symptoms identified in these criteria may become useful through the definition of subgroups of autism spectrum disorder individuals with complex psychopathology. Studies in this regard are still scarce, but the validation and reproduction of the positive results observed in the near future can help optimize the clinical approaches in these children.

The authors have not supplied their declaration of competing interest.

Pediatric obsessive-compulsive disorder (OCD) is a multifaceted clinical entity. Rage attacks have been repeatedly described in the phenotype of anxiety disorders in children and adolescents. It has been acknowledged that anxious youth who display rage have more severe clinical profiles and increased levels of dysfunction in most domains, consistent with the notion that rage is a marker of more severe psychopathology. However, this matter remains largely underappreciated in pediatric OCD. Namely, the role and functions of rage in pediatric OCD in relation to family accommodation and illness severity have highly relevant clinical management and treatment implications.

We aim to discuss how does rage look like in pediatric OCD, what are its associated features and its contributions to additional functional impairment. We examine the central role of family accommodation mediating clinical outcomes and review highly relevant diagnostic and treatment challenges.

Selective review of the literature in PubMed (MEDLINE). Illustration with a clinical case vignette.

Rage attacks are relatively common in pediatric OCD, have a negative impact on illness presentation, and contribute to functional impairment above and beyond obsessive-compulsive symptom severity. We hereby illustrate that rage may contribute to family accommodation of symptoms, which may further affect and perpetuate obsessive-compulsive symptom severity and impairment. There is a need to avoid misdiagnosis and to prioritize psychotherapeutic interventions and psychopharmacological treatment approaches. This provides important insights regarding the clinical validity of this component of OCD, aiming to capture further the attention of the clinical and research community.

The authors have not supplied their declaration of competing interest.

Encopresis is a not very common disorder. The prevalence of this disorder is about 1.5% after the age of 5 years old and decreased even more as age increased, being very rare in adolescence.

Here we present a clinical case of an 11-year-old girl, with a diagnosis of functional encopresis with constipation and overflow incontinence for 4 years.

In this case, we followed a program consisted of 12 sessions combining different techniques that are on experimental phase. The program we designed consist of toilet training, stablishment-token economy- of a diet high in fiber with a progressive remove of laxative medication and a family intervention with both parents that got divorced 4 years ago.

Having both parents the same frame the patient's problem easily started to decrease. In follow-up (6 and 12 months), we observed good toilet habits and not constipations episodes.

Even though all the techniques used were in experimental phase, we considered that because of the chronicity of this problem a multidisciplinary approach was the best option.

The authors have not supplied their declaration of competing interest.

Attention deficit hyperactivity disorder (ADHD) is a challenge in child and adolescent psychiatry. In the recent decades many studies with longitudinal designs have used neuroimaging with ADHD patients, suggesting its neurodevelopmental origin.

Study the findings of neuroimaging (MRI, fMRI, DTI, PET) techniques on ADHD patients from a longitudinal point of view, looking also for the potential influence of treatments and other predictors (i.e. genetics).

To provide a global perspective of all the recent findings on ADHD patients with the neuroimaging technics, focusing on longitudinal measurements of the changes in brain development.

We conducted a review of the literature in the databases Pubmed and ScienceDirect (terms ADHD, neuroimaging, MRI, fMRI, DTI, PET, functional connectivity, metilphenidate and cortical thickness). We focused on studies using neuroimaging techniques with ADHD patients, looking at their populations, methodologies and results.

The studies found abnormalities in the structure of grey matter, activity and brain connectivity in many neural networks, with particular involvement of the fronto-parietal and Default Mode Network. There is also convergent evidence for white matter pathology and disrupted anatomical connectivity in ADHD. In addition, dysfunctional connectivity during rest and during cognitive tasks has been demonstrated.

This evidence describe ADHD as a brain development disorder, with delays and disruptions in the global development of the central nervous system that compromises grey and white matters, most evident in the prefrontal cortex, parietal and posterior cingulate cortices, as well as basal ganglia, damaging activity and structural and functional connectivity of various brain networks, especially the fronto-striato-parietal and default mode network.

The authors have not supplied their declaration of competing interest.

Two thirds of adolescents with mitral valve prolapse (MVP) show signs of anxiety disorders. They display difficulty in emotion regulation (Van Der Ham et al., 2003; Scordo, 2007).

To investigate into emotion regulation strategies in MVP adolescents.

A projective study of emotion regulation was undertaken with our modified version of Rosenzweig Picture-Frustration Test (Zinchenko, Pervichko, 2014). Thirty-six adolescents with MVP (mean age was 17.1 ± 0.8 years) and 40 healthy adolescents (mean age was 16.7 ± 0.6 years) took part in the study.

MVP adolescents significantly more frequently (P < 0.001) would mark Rosenzweig's situations as potentially traumatizing. Ego-defence (E-D) and extrapunitive (E) reactions appear to be significantly (P < 0.05) more frequent among MVP adolescents. MVP adolescents are more than healthy subjects prone to avoid open verbal revelations of their thoughts and feelings that emerge in the situation of frustration. Content analysis of responses conditioned by cognitive control (when the task was to taper off arbitrarily the traumatizing effect of the situation) revealed that suppression of emotions was displayed by MVP adolescents in 52% of answers, and for healthy participants - 29% of answers (P < 0.001). Cognitive reappraisal strategy was displayed by MVP adolescents in 27% of answers, and for healthy participants – 38% of answers (P < 0.05). Twenty-one percent of answers of MVP adolescents and 33% of answers of healthy participants suggested cognitive transformation of emotional experience and actualization of new meanings in traumatic situations (P < 0.05).

MVP adolescents appear to be more sensitive of frustrations and differ from healthy peers in more frequent use of the strategy of suppression of emotions.

The authors have not supplied their declaration of competing interest.

The characteristics and the mental functioning of adolescent prostitutes were examined in several studies. Literature associates externalizing problems (i.e. impulsivity) with high rates of sexual activity and high rates of prostitution (Donenberg et al., 2005). Research has identified a link between psychopathology and high rates of health-risking sexual behavior and conduct problems. Despite the identification of psychopathology as a risk factor for the development of health-risking sexual, its role in prostitution has not been well examined.

Although the association between psychopathological disease and engagement in health-risking sexual behavior is documented, the specific nature of the cause or mechanism for the link between psychopathological disease and the development of these behavior problems is not known.

An extensive literature search for relevant published and unpublished studies was conducted on Medline, CINAHL Plus with Full Text, Psycoinfo and PsycArticle from inception through September 21, 2015. Additionally, we performed a search in Google Scholar and manually searched by the reference lists of included articles. Comprehensive search strategies were developed using the controlled vocabularies of each database. We systematically searched for relevant studies using a combination of Medical Subject Headings (MeSH) terms and corresponding free-text terms. Search term and keywords were altered as per specification of individual database.

Adolescent prostitution is one of the major public health problems and psychopathology plays an important part in it. Adolescent prostitutes’ shown elevated level of psychopathological disease that may reflect the possibility that their psychological functioning leads them to this particular environment.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The use of antipsychotics in children is controversial, one of the considerations to take into account is the possible effect on the values of fasting glucose, prolactin or weight gain are very important.

To study the effect of these drugs on metabolic rate in children.

We measured the weight, waist circumference, fasting glucose and basal prolactin in 6 children at Children's Hospital in the province of Huelva, diagnosed with bipolar disorder and early schizophrenia, atypical antipsychotics before starting treatment and 6 months later.

In the provisional results it is found that a there is not a significant weight gain (less than 3%), no impairment of glucose and only in one case basal prolactin was elevated.

The use of atypical antipsychotics in children should be reserved when strictly necessary. Once established, keep tight control of metabolic parameters, although the data of our study coincide with the literature, do not produce significant alterations.

The authors have not supplied their declaration of competing interest.

The “parental multiple-family school” was developed in Buenos Aires (Argentina) by E. Rotenberg, based on the theory and practice of J. García Badaracco's multiple-family psychoanalysis (which further expands on the classical psychoanalysis’ frame), applying it to the kids and their relatives. We will focus on the therapeutic group treating psychosomatic pathology, with the collaboration of the Dermatology department of the Hospital de Niños Dr. Ricardo Gutiérrez.

To highlight the importance of creating spaces to modify the psychic mechanisms and resources of the psychosomatic patient at an infant age.

We describe the “multiple-family parents school”, an open, weekly group, coordinated by two psychologists and assisted by a dermatologist, in which the theories of J. García Badaracco's multiple-family group analysis are applied. We also discuss the importance of applying this system in our clinical practice.

We observed, according to the Dermatology department, very positive and significative changes in every post-group, which could lead to the disappearance of dermatological diseases in different patients without a pharmacological treatment which was previously given as first option. Single-session groups had many advantages, including the removal of waiting lists, a better development of the emotional connection between kids and their families, and a reduction of the therapeutic and professional costs.

We think that starting interventions in multiple-family group therapy in Madrid in order to treat psychosomatic diseases in kids and teenagers should be encouraged after the very positive clinical experience in other cities.

The authors have not supplied their declaration of competing interest.

This study examined the emotional and behavioral functioning among 10–14 year-old children who were born with very low birth weight (VLBW, <1500).

Prospective and cross-sectional study of 90 VLBW (<1500 g) survivors born at the Hospital Universitario la Paz in Madrid, Spain, from 2000 to 2005 who were assessed by interviewers using the Strengths and Difficulties Questionnaire (SDQ). Parents also reported on their children's functioning. Children who showed an abnormal SDQ score on the total difficulties subscale or who had psychiatric history were also assessed using the K-SADS-PL.

The proportion of children with abnormal-self-rated-SDQ scores was as follows: almost 25% of children showed an abnormal score on hyperactivity, nearly 15% on emotional problems, 15% on conduct problems and 10% on peer problems. Overall, 15% of children showed an abnormal score on the total difficulties subscale. Most children (99%) showed a normal score on the prosocial subscale. These proportions were higher when the questionnaire was rated by parents. Thirty-eight percent of children were assessed using the K-SADS and very few of them meet the criteria for at least one psychiatric disorder. Biomedical variables were associated in the expected direction to children's SDQ scores such as birth weight, head circumference and Apgar scores.

To conclude, being born with very low birth weight seems to be related to the emotional and behavioral functioning that these children appear to show between 10 and 15 years later.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Criterion A2 causes many controversies in the diagnostic process of posttraumatic stress disorder (PTSD) among young children. Depending on the manner in which the trauma is indirectly experienced, clinical picture of disorder could be formed by different groups of symptoms. Profiles of symptoms groups are dependent of children ability to speak, describe or of play observation by expert.

The study included 8 children younger than 6 with PTSD diagnosis. Children were observed in a routine clinical practice.

Examinees under the age of six, whose can describe traumatic event, produce symptoms that represent compaction of a traumatic event, associated with fantasies and meanings related to previous traumatic experiences. Reexperiencing symptoms associated with A2 criterion (intrusive thoughts, images, scenes of the traumatic event, recurring nightmares with oneiric sequences of the accident) were rare. Avoidance and inhibited reactions were attributable.

Manners in which children younger than 6 experienced the trauma shows a large range from florid symptoms stated by the existing accepted classification. The results point out possible multifactorial cause of PTSD etiology.

The authors have not supplied their declaration of competing interest.

Telepsychiatry is increasingly utiilized to evaluate and treat diagnostically and geographically diverse youth. (Szeftel et al., 2012; Hilty et al., 2013). Important public health implications arise for US psychiatrically ill youth, most of whom receive no treatment, others depend on pediatricians without input from a child psychiatrist (Goldstein and Myers, 2014). Potential advantages of telepsychiatry include increased access to care from child psychiatrists directly, and through collaborations with pediatricians, and uniquely positive response in patients more communicative in this setting (Pakyrek et al., 2010).

– To present the effectiveness of Telepsychiatry in psychiatrically ill youth, and specific subgroups who especially benefit.

– To show increased access to psychiatric care occurs through collaborations between child psychiatrists and pediatricians.

To present the advantages of telepsychiatry for child and adolescent mental health and clinicians.

Review of selected published Telepsychiatric evidence-based research and best practice recommendations.

– Psychiatrically ill youth are effectively evaluated and treated using Telepsychiatry (Myers et al. (2011), Hilty et al., 2013).

– Very young children and youth with Autism Spectrum Disorders, or anxiety disorders respond particularly positively to Telepsychiatry (Szeftel et al., 2012; Pakyuerek et al., 2010: Myers et al., 2010).

– Telepsychiatry provides increased access to care through collaborations between child psychiatrists and pediatricians (Goldstein and Myers, 2014; Myers et al., 2011).

Telepsychiatry is a promising advantageous modality for youth based on effectiveness, broad administration and unique benefit for very young and socially impaired youth.

References not available.

The authors have not supplied their declaration of competing interest.

Research shows that individuals with Autism Spectrum Disorder, struggle with emotional competence as compared to their typically developing counterparts. This leads to internalizing (stress) and externalizing (anger management) problems in the affected population. The stress and anger management program (STAMP) designed by Scarpa et al. is a manualized treatment protocol with good clinical efficacy.

The objective of the present study is to test the feasibility and suitability of STAMP as a systematized treatment protocol in Karachi and to enable the sample population, to become emotionally competent.

The aim is to evaluate the effectiveness of STAMP on the reduction of symptoms in the sample population.

Ten children with high functioning autism spectrum disorder will be selected from various institutes in Karachi, and randomized to experimental and waitlist control group after pre-intervention assessment. Upon completion of the intervention with the experimental group, the waitlist control group will be offered the intervention. Both the groups will be assessed, immediately after the intervention, followed by a one-month follow up assessment.

It is expected that STAMP will significantly reduce the incidence of problem behaviours as measured by the standardized assessment questionnaires from the manual; as well as significantly reduce the severity of scores on the internalizing and externalizing components of the strength and difficulties questionnaire, in the experimental group as compared to the control group.

It is expected that the results of the present study could be utilized to train mental health professionals in Karachi for systematized treatment of ASD and related problems.

The authors have not supplied their declaration of competing interest.

Children of alcohol dependent individuals are affected by disturbed parent-child relationship and exhibit externalizing symptoms, arrhythmicity, negative mood and low persistence.

To assess the temperament and resilience of children of alcohol dependent individuals and to study their relationship with the father's severity and problems of alcohol intake.

To assess the psychological profile of children of alcohol dependent individuals.

Cross-sectional study conducted in a tertiary care centre from January to August 2015. Severity of alcohol dependence in father and problems related to it was assessed using ‘short alcohol dependence data’ and ‘alcohol problems questionnaire’; the temperament and resilience of their children (n = 31) was assessed using ‘temperament measurement schedule’ and ‘strengths and difficulties questionnaire’ respectively.

The sample comprised of 48% boys and 52% girls with mean age (SD) of 9.32 (3.02) years. Eighty-one percent belonged to lower socioeconomic status. Their fathers’ mean age (SD) was 37.13(4.9) years and duration of alcohol dependence being 16.32 (5.7) years, average use/day being 19.19 (14.9) units with moderate (45.2%) to high (41.9%) dependence. Significant association was observed between severity of alcohol dependence and temperamental domain-threshold of responsiveness (χ2 = 17.272, P value = 0.002) (Fig. 1). The average units of alcohol consumed/day were a significant predictor for the presence of emotional problems in the child (OR = 30.12; 95%CI 1.33–677.86).

There's a significant association between father's alcohol use and child's psychopathology which indicates the need for preventive and curative mental health measures.

The authors have not supplied their declaration of competing interest.

Pathogenetic mechanisms of hyperkinetic syndrome (HKS) or attention deficit hyperactivity disorder (ADHD) are not clear.

To elucidate some aspects of monoamine involvement in pathogenesis of disorder and response of monoaminergic systems to psychostimulant medication.

Levels of different monoamines, their metabolites and N-methylnicotinamide (end product of kynurenine pathway) were measured in daily samples of urine from children (7–11 years old) with mild and severe HKS using fluorimetric and chromatographic methods as well as platelet monoamine oxidase (MAO) activity. Thirty children with mild HKS received psychostimulant Sydnocarb 5–15 mg daily for 1–1.5 months (for ethical reasons children with severe HKS were not included in study).

HKS was accompanied by activation of dopaminergic and inhibition of noradrenergic systems. There were found metabolic differences between two forms of HKS. Compared with mild HKS, severe HKS was characterized by significant 2-fold increase of MAO activity and L-dopa, dopamine and adrenaline excretion. After sydnocarb treatment children's clinical status improved along with decrease of excretion of homovanillic, vanillylmandelic and 5-hydroxyindoleacetic acids and increase of N-methylnicotinamide.

Results indicate that dopaminergic and noradrenergic systems play important role in pathogenesis of HKS. Clinical improvement of HKS children was accompanied by significant increase of N-methylnicotinamide excretion. It is proposed that increased urine excretion of kynurenine metabolite–N-methylnicotinamide and N-methylnicotinamide/5-hydroxyindoleacetic acid ratio can serve as potential biomarkers for evaluation of efficacy of psychostimulant medication. We hypothesize that kynurenine system plays significant role in pathogenesis of HKS/ADHD.

The authors have not supplied their declaration of competing interest.

The incidence and prevalence of self-harm behaviour, with or without suicidal intent, is on the rise, both in other countries as well as in Croatia. Understanding the nature of patients who show self-harm behaviour can help us to better understand the components that contribute to their morbidity and mortality.

To expand the understanding of self-harm behaviour in adolescents as a contribution to the planning and implementation of preventive and curative programs.

To explore the psychopathological characteristics of adolescents with and without self-harm behaviour who seek psychiatric help for their mental health problems.

In this study participated 150 adolescents, aged 14–18 years, of which 52% showed some form of self-harm behaviour. During the initial examination of child and adolescent psychiatrist, participants completed self-reported questionnaires: functional assessment of self-mutilation (FASM, 1997) and the youth self report (YSR, 2001).

Statistically significant difference between groups of female adolescents with and without self-harm behaviour was observed in all of eight problem scales, while in male adolescents it was observed in five of them. This indicates considerably higher level of psychopathological features in the group of patients with self-harm behaviour.

It is necessary to intensify monitoring of adolescents who show self-harm behaviour because of the overall level of psychopathological symptoms and the comorbidity which significantly complicates the therapeutic process. It is particularly important to continuously assess the suicide risk.

The authors have not supplied their declaration of competing interest.