Suicide is one of the most leading cause of death for teenagers in the world. Suicide ideation is known risk factor for suicide completion. Suicidal adolescents rarely asked for help. The contact with the health care system is an opportunities to screen for suicidal ideation.

The aim of this study is to examine the prevalence and the risk factors of suicidal ideation among adolescents consulting in emergency.

Our study was a transversal type, descriptive and analytic. It was conducted with 106 adolescents consulting in emergency for somatic complains. Each participant filled out demographic questionnaire and suicidal ideation questionnaire (SIQ). The SIQ is a self-report instrument for suicidal ideation, appropriate for adolescents. The SIQ has 30 items. The respondent is asked to choose from a 7-point continuum (6 = “Almost every day” to 0 = “I never had this thought”) to assess the frequency of that particular thought within the last month. Cut-off score for the SIQ is a sum of 41 and higher, indicating the presence of serious suicidal ideation.

Adolescents were aged between 12 and 19 years with an average age 16.34 ± 2.54 years; 47.2% were boys. According to the SIQ, the prevalence of suicide ideation during the last month were 14.2%.

The risk factors for suicidal ideation among Tunisian adolescents were the female gender, middle school level, low family income, parents’ divorce, parental neglect, family conflicts and previous psychiatric disorder.

General physicians should regularly screen for suicidal thoughts in their adolescent patients with these characteristics.

The authors have not supplied their declaration of competing interest.

Amongst adolescents, depression is a common mental health problem. Adolescent depression is associated with distress, functional impairment and difficulties in relationships with peers and family members. Depressive symptoms, even if sub-threshold to meet diagnostic criteria for a depressive disorder, are also risk factors for these difficulties. Adolescents rarely consult for their psychological distress. Emergency departments, which are often used by adolescents in this context, constitute a privileged place to detect this suffering.

The objective of this study was to estimate the prevalence and correlates of psychological distress among adolescents seen in emergency department.

Our study was a transversal type, descriptive and analytic. It was conducted with 106 adolescents consulting in emergency department. All adolescents completed a sociodemographic data and the Adolescent Depression Rating Scale (ADRS), a screening questionnaire for depression.

The study included 106 adolescents. All of them consult for a somatic complain and none of them goes to the emergency department for a psychiatric reason. The mean age was 16.34 ± 2.54 (12→19 years). Sex ratio (♂/♀) = 0.89. The ADRS score was considered normal (score < 4) for 54.7% of the sample (n = 58) and 45.3% of adolescents (n = 48) had depressive symptoms (score ≥ 4). Depression was significantly correlated to bad school results (P = 10−3), tobacco use (P = 0.014), personal psychiatric history (P = 10−3) and family problems (P = 10−3).

Depressive symptoms are frequent among adolescents. Their consultations within emergency department provide a potential opportunity for their identification and for signposting to appropriate specialist services.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

We report the case of a 19-year-old male who was brought to our psychiatry consultation by his family for behavioural disorders and poor school performance of years of evolution.

We found ourselves before a tall, thin, childish, suspicious, perplex, inhibited and minimizer patient, so we sent him to our hospital for psychiatric admission, where he showed a flowery delirium of mystic, religious and megalomaniac content; complex visual and auditory hallucinatory phenomena; and where he was diagnosed of acute polymorphic psychotic disorder and autism spectrum disorder with marfanoid habit. Therefore, we suspected a Lujan–Fryns syndrome and requested genetic confirmation. Risperidone was prescribed as solo treatment, with a rapid control of the symptoms.

Lujan–Fryns syndrome, first described in 1984, corresponds to a sequence mutation in exon 22 of med12 gene of chromosome X. It is hard to suspect and diagnose before puberty. Those affected have marfanoid habit and also other psychiatric manifestations such as autistic behaviour, mild-moderate mental retardation (there are some reported cases with normal intelligence), language disorders, emotional instability, aggressiveness, hyperactivity, shyness which can be extreme, obsessive-compulsive disorder, isolation, delusions, visual and auditory hallucinations, and there are cases that describe schizophrenia. Its diagnosis requires adequate physical and psychopathological examination, and it is established with clinical suspicion and genetic confirmation. There are very few cases described and there is little bibliography available about Lujan–Fryns syndrome [1].

The authors have not supplied their declaration of competing interest.

Adolescence has significant effect on parental relationship. Group therapy in transactional analysis method is an effective method for the treatment program.

Therefore, in this study, transactional analysis group therapy to improve the quality of parent–child relationship in adolescent female, were used.

The sample was 40 adolescence high school girls were divided randomly into an experimental group and a control group. Both groups responded to measures of parent–child relationships. Eight sessions of one and a half hours, the components of the experimental group was trained in transactional analysis. The results were analyzed using t-test.

The results showed significant effect of transactional analysis group therapy on parent–child relationship adolescence, compared with the control group.

Transactional analysis in the area of parent–child relationship requires further attention.

The authors have not supplied their declaration of competing interest.

The present research have done with concentration on examining the impact of selected and divided attention-shaping training in reinforcing attention and the academic improvement and self-efficacy of primary school children with attention deficit-hyperactivity disorder.

The research method was a quasi-experimental design with per- and post-test and follow-up with control group. Statistical society contained all of the primary school children with attention deficit-hyperactivity disorder in Rafsanjan City. Forty children with attention deficit-hyperactivity disorder were chosen by the method of random sampling and randomly assigned in control and experimental groups (20 children in experimental group and 20 children in control group). At first in pretest stage used academic self-efficacy questionnaire and the software of selected and divided attention. For measurements of academic improvement were used the scores of a teacher build test mathematic and spelling. Then, experimental group take 8 sessions education of selected and divided attention-shaping Training. The data were analyzed by analysis of variance with repeated measurement test.

Results of this research show that selected and divided attention training improved the amount of divided and selected attention and academical improvement of children < but it's not effective significantly on reaction time and academic self-efficacy of children with attention deficit disorder-hyperactivity.

Attention training can be effective to increase attention and academical achievement in children with ADHD.

The authors have not supplied their declaration of competing interest.

Actually psychiatrists around the world are treating children and adolescents (despite limited medical indications in this age group) with atypical antipsychotics at increasing rates for a range of psychiatric illnesses (schizophrenia, bipolar disorder, behavioral changes…). Over the last few years, a number of new long-term injectable treatments (ILD) have emerged, the advantages of which are found in adult (adherence, functionality, consistent blood level without daily peaks…) but we do not have enough data in minors.

Discuss utility of ILD in adolescents.

We expose a case report about a 17-year-old man, when he was a child he was diagnosed with attention deficit disorder and autism spectrum disorder and also he had a story of disrupted behavioural and aggressively. After been hospitalized in our hospital we remake his clinic history and he was diagnosed with schizophrenia. Before the injectable treatment (ABILIFY MAINTENA®) this patient tried various treatments (mood stabilizers, antidepressants…) and many hospitalizations.

After the ILD, our patient has good functionality, he is now living with his parents and studying in the high school. He has not needed another hospitalization after the last one.

The ILD in adolescents must be a therapeutic option in mental disease, in this group is very difficult the complementation of the treatment, it's frequent the comorbid use of substances, this population are not used to take medications… so every treatment that facility this kind of problems must be a perfect weapon to improve their mental health and to prevent relapse and hospitalization.

The authors have not supplied their declaration of competing interest.

A. is a 10-year-old girl of Moroccan origin appearing in pediatric specialist of A.P repeatedly by unspecific stomachache, nausea and vomiting. After several visits to the same reason for consulting an exploratory interview alone with the patient in that regard that “sometimes when calms nervous scratching the walls and eating them” is performed. The mother says intrafamily difficulties. Information reported by the patient's mother confirms next visit also providing pictures on the wall of your room is returned. Referral to child and adolescent mental health is decided.

There is no single test for pica. It is carried out systematic blood, biochemical (iron, zinc, lead…) to assess toxic substances and nutritional levels. Abdominal Rx. Both normal.

Pica (F98.3).

Ingestion of nutrients can occur in the course of other mental disorders (for example, a pervasive developmental disorder, schizophrenia), mental retardation, in the Kleine–Levin syndrome… In these cases, should only be established an additional diagnosis of pica if the feeding behavior is sufficiently severe to warrant independent clinical attention.

Pica disorder has been studied by pediatricians, gynecologists, dermatologists, psychiatrists, psychologists, nutritionists, anthropologists, etc., which has been interpreted as a conduct disorder, food, mental illness, poverty, hunger… but really the cause it is unknown. Although morbidity and mortality is unknown and difficult to study, include poisonings, parasitosis and surgical abdomen as serious complications. Finally, like all other eating disorders, the overall management of this entity requires the coordinated intervention of various professionals.

The authors have not supplied their declaration of competing interest.

Patient 10-year-old pediatrics sent from service due to history of frequent admissions for recurrent abdominal pain. In the bypass request indicate that this is a patient of perfectionistic traits; detect dysfunctional family dynamics highlighting the rivalry in the phratry, and with an equal difficulty in the field. From 2010 to 2016, he has made more than 30 visits to hospital emergency combined intervention of psychiatry and psychology and multidisciplinary service available with a pediatric surgery and pediatrics is performed.

From 2011 to 2016, it has made 44 blood tests, sonograms 9 full abdomen, abdominal renal scintigraphy without significant findings.

F45.5 pain disorder.

Symptoms due to a medical condition. Other symptoms substance-induced mental disorders: non-specific conversion disorder, pain disorder, hypochondriasis, body dysmorphic disorder, somatization disorder, simulation, factitious disorder, medical symptoms…

Psychosomatic disorders are one of the most common clinical forms of mental disorders in childhood and adolescence expression. Knowing the stages of development and operating characteristics. In clinical practice, mainly in primary care, tend to find an organic cause somatic complaints in children, so prevalence data and/or referral to specialized services vary depending on mental consulted sources is critical to understand the pathogenesis of these disorders.

The authors have not supplied their declaration of competing interest.

To know the magnitude and characteristics of the use of legal drugs (alcohol and snuff) and illegal (marijuana, cocaine, heroin, inhalants) in the – adolescent/child – population who come regularly to addictive behavior unit of a rural environment.

Descriptive study of a sample of adolescent patients (n = 30) who came in the past two years to addictive behavior unit. Data collection of such patients is performed by assessing sociodemographic characteristics (age, sex, population, education level…), age of onset and type of use of psychoactive substances, and comorbidity of psychiatric disorders.

The average age of the adolescent patient is 14.5 years (SD 1.09) with an age of onset in the consumption of toxic 13.6 years (SD 1.03). As for sex, 20% were women. The dropout among adolescents of this sample is 43.3% (SD 1.05). A complete prevalence of marijuana use (100%), and mono-consumers only 10% was observed. Seventy percent of the sample has associated psychiatric disorders and 46.15% in psychiatric family history there; 38.4% up to legal problems are collected.

The authors have not supplied their declaration of competing interest.

C. is a 14 teenager who comes to a mental health center for the first time a year ago for having numerous self-injuries in the forearm. She says that she cannot avoid doing so in moments of anxiety and that, in addition, when she is hurt she calms down. Throughout the interviews, C. relates that after the death of her best friend in a traffic accident she is alone and with episodes of anxiety.

It is important to analyze the risk factors of self-injurious behaviors in adolescence such as:

– personal characteristic;

– psychiatric disorders;

– family characteristics;

– mass media.

Depressive episode (F32).

In general, self-injury is considered as a symptom or characteristic of a specific psychiatric disorder. Stereotyped self-injury is characteristic of processes of cognitive deficit of the level of severe and profound mental retardation. Compulsive self-harm involves symptomatic habits such as severe scratching of the skin or already differentiated psychiatric entities, such as trichotillomania, onicofagia or delusional parasitosis… Important psychotic disorder.

Following the Task Force's criteria, in relation to probably effective therapies, it can be concluded that the therapy based on mentation for adolescents (MBT-A) is the first effective treatment for the treatment of self-harm in adolescents.

The authors have not supplied their declaration of competing interest.

Epidemiological studies have established that teenager's prevalence rates of major depression are significant (10%). The media has given a good deal of attention to the potential risks of antidepressants and their connection to increased suicidality (especially in children and adolescents). These concerns have had a significant impact on both the prescribing of antidepressants and the parental fears about their use. It is interesting to note that in large groups’ studies of adolescents treated with selective serotonin reuptake inhibitors there have been no evidence of increased suicidal risk.

Understand if there is a significant association between antidepressant treatment and suicidality in a 3-months follow-up study of the adolescent's consultation of Centro Hospitalar Lisboa Norte.

Analysis of 81 adolescents with an initial diagnosis of major depression treated with an antidepressant for at least 3 months.

After the follow-up period there has been an improvement in sadness in 92.6% of the adolescents, a remission of death thoughts in 98.8% and an absence of suicides attempts. In 61.7%, it was necessary to introduce also an antipsychotic in a low dose and in 12.3% another antidepressant with a hypnotic effect.

It is clear that untreated major depression carries significant suffering and disability. Although treatment with antidepressants may take several weeks before clinical improvement appear and depression may worsen in the first days, its therapeutic effect should not be underestimated even if becomes necessary to add another medication in the first days. In evaluating these kinds of concerns, we must always differentiate between media hype and scientific data.

The authors have not supplied their declaration of competing interest.

Since the mid-1990s, the diagnosis of bipolar disorder has increased significantly: two-fold among adults, four-fold among adolescents and 40-fold among children. Mood instability is a hallmark symptom of many psychiatric disorders but does not imply necessarily a diagnosis of bipolar disorder. Misdiagnosis is not just an academic issue: mood stabilizers have significant adverse effects and expose patients to side effects that range from mild to potentially life-threatening.

Discuss the potential overestimation of bipolar diagnosis in the adolescent population through a statistical analysis of a sample from the adolescence's consultation of Centro Hospitalar Lisboa Norte.

Analysis of 106 patients taking into account the initial diagnosis and the diagnostic stability over 6 months. Non-systematic review of the literature.

From this sample, 39.2% of the adolescents have a diagnose of unipolar affective disorder, 0.02% of bipolar disorder and 0.1% of disruptive mood disorder. These diagnoses did not change over the follow-up period.

It is important to try to understand the reasons of this potential discrepancy (influence of pharmaceutical company marketing, of parents’ desire, of doctors’ fear) to reduce controversy and confusion and to adjust treatment.

The authors have not supplied their declaration of competing interest.

In the last decade, international study attention to the problem of risk of sexual behavior in adolescents has grown. Some research has shown emotion dysregulation to be an important predictors of forbidding outcomes for example alcohol and drugs abuse or risky sexual behavior.

The aims of this study are analyze emotion dysregulation in adolescents and their belief regarding sex working of adolescents.

The sample is composed by 123 participants (58 male adolescents, and 65 female adolescents, they is 14–15 years). All participants completed a self-report questionnaire, Difficulties in Emotion Regulation Scale. Them, participants responded to questions on prostitution.

Frequency analysis showed that 78% of participants believe that prostitution is wrong; 1.4% of adolescents believe that the voluntary prostitution is not wrong; 2.4% believe that prostitution is not wrong if it can economically help their parents; and 4.9% believe that prostitution is wrong only if the customer is an adult. Regarding emotion dysregulation, test t analysis highlights some differences between male and female. The female presents difficulties (P = 0.025) to strategies respect male adolescents and they manifest a tendency to significative difference in impulse (P = 0.061) and goals (P = 0.067).

These preliminary results show that females may experience greater difficulties to take functional strategies to regulate emotions and could risk adopting risky sexual behavior such as prostitution.

The authors have not supplied their declaration of competing interest.

Autism is a lifelong disability that impairs 3 main areas; communication skills, social interaction and behavioral patterns.

To investigate the repetitive behavior in autistic children 3–10 years old.

Comparison of repetitive behavior between autistic children with a control group of clinically healthy children matched for age and sex.

Repetitive Behavior Scale (RBS-R) questionnaire was translated, validated and provided to examine children (n = 70) in each group.

Children with autism show significant behavioral problems as compared to healthy children in all subscales and the full RBS-R. Results of the t-test for independent samples indicated a significant difference in mean score for the children with autism of age 3–6 year old (M = 53.1) and for control group (M = 11.9), t = −13.3, P < 0.01. Also, the mean score of children with autism of age 7–10 year old (M = 54.9) is significantly higher, compared to control group (M = 13.7), t = −12.2, P < 0.01.

This comparison provides information on particular forms of repetitive behavior to further our understanding on these important symptoms.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The aim of this literature review is to explore the range of factors that influence the degree of access to health care services by children and young people with learning disabilities.

Children with learning disabilities are at increased risk of a wide range of health conditions comparing with their peers. However, recent reports by UK government as well as independent charities working with children and young people with learning disabilities demonstrated that they are at risk of poor health outcomes as a result of barriers preventing them from accessing most appropriate services.

Comprehensive searches were conducted in six databases. Articles were also obtained through review of references, a search of the grey literature, and contacting experts in the field. The inclusion criteria were for studies evaluating access to healthcare services, identification and communication of health needs, organisational aspects impacting on access and utilisation, staff attitudes where they impacted on access, barriers, discrimination in patients with intellectual disabilities age 0–18. The literature search identified a sample of 36 papers. The marked heterogeneity of studies excluded conducting a meta-analysis.

Barriers to access included problems with identification of healthcare needs by carers and healthcare professionals, communication difficulties, the inadequacy of facilities, geographical and physical barriers, organisational factors such as inflexible appointment times, attitudes and poor knowledge base of healthcare staff.

The factors identified can serve as a guide for managers and clinicians aiming to improve access to their healthcare services for children and young people with intellectual disabilities.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The concept of mental toughness has gained increasing importance among non-elite athletes for its psychological importance and explanatory power for a broad range of health-related behaviors. On the flip side, no study has focused so far on the psychological origins of mental toughness. Therefore, the aims of the present study were three-fold: to explore, to what extent psychological profiles of preschoolers at the age of five years predicted mental toughness scores and sleep disturbances at the age of 14 years, and to explore possible gender differences.

Nine years after their first assessment at the age of five years (preschoolers), a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females) took part in the present follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ), covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, mental toughness, and sleep disturbances.

Preschoolers with high prosocial behavior and low internalizing and externalizing problems, as rated by parents and teachers, at the age of 14 years self-reported higher mental toughness and lower sleep disturbances. At the age of 14 years, and relative to their male counterparts, female participants reported lower MT scores and higher sleep disturbances.

The pattern of results suggests that mental toughness traits during adolescence have their origins during pre-school years.

The authors have not supplied their declaration of competing interest.

Voluntary asphyxiation by practicing unsafe games such as choking, hanging, strangulation or other means of inducing hypoxia/anoxia is not uncommun among adolescents and can lead to unintended death but it stills not very well-known so underestimated by parents and underdiagnosed by health professionals.

Study of clinical, psychological and psychopathological features in adolescent practicing unsafe games through a case report and a literature review.

We will present the case of a 14-year-old boy followed up in the Child and Adolescent Psychiatry Department of Mongi Slim Hospital (La Marsa, Tunisia) for behavioral disorders and recurrent syncope. This case report will be supported by a literature review.

S.B., 14-year-old boy, unique child of two divorced parents, with precarious family socio-economic conditions, no apparent medical problems and no known history of drug or alcohol abuse, suicidal ideation or suicide attempts, consulted first time in the department for behavioral disorders. The diagnostic of dysthymia was made. Seven months later, he was hospitalized in the medical intensive care unit for postictal coma. All medical investigations were normal. In the following, S.B. revealed that he used to practice voluntary asphyxiation by compressing the two carotids using his fingers until loss of consciousness. The diagnosis of paraphilia (DSM-5) was established.

Early recognition of such cases and awareness of psychological and psychopathological motivations might prevent serious complications and lethal outcome for these “unsafe-young-players”.

The authors have not supplied their declaration of competing interest.