Schizophrenia is a chronic and severe psychiatric disorder characterized by relapses. Non adherence to medication is a major concern, with rates reported between 40% and 50%. Poor adherence is associated with relapse, increased hospitalizations, and a higher risk of suicide (Vega et al., Compr Psychiatry 2021;108:152240). Both direct (drug or metabolite measurement in biological fluids) and indirect methods (tablet counts, electronic monitoring, pharmacy records, etc.) have been used to assess adherence. However, research on biological markers of adherence remains scarce.

The aim of this study was to investigate whether serum interleukin-6 (IL-6) levels differ according to antipsychotic treatment adherence.

The sample included 43 patients who met ICD-10 criteria for paranoid schizophrenia and were in an acute psychotic phase. Blood samples were collected on the first day after admission at 12:00 h and 00:00 h by venipuncture. All patients were receiving antipsychotics due to clinical decompensation. Most patients (N = 15; adherence in the rest unknown) were admitted after treatment discontinuation, while a small subsample presented irregular adherence. Only a minority were strictly adherent (N = 7).

IL-6 was measured using ELISA techniques (Kikugawa et al., Anal Biochem 1992;202:249–55). Patients were treated in the Emergency Department of the University Hospital of the Canary Islands for acute psychotic decompensation and were admitted to the acute psychiatric unit between January 1 and June 1, 2006. Most patients were referred by Mental Health Units, family members, or emergency services; a small percentage (3.7%) presented on their own initiative. Informed consent was obtained either from the patient or, in cases of severe clinical status, from family members.

Comparisons between quantitative variables were performed using Student’s t-test for independent samples.

Serum IL-6 levels at 12:00 h on the day after admission were 0.39 (SD missing), while IL-6 levels at 00:00 h were 0.20 (SD missing).

Next table shows the comparison of serum IL-6 at 12:00 h and 00:00 h between adherent and non-adherent groups.Table 1.

Serum IL-6 levels at admission did not differentiate between patients who adhered to treatment and those who did not.

None Declared

Paliperidone palmitate 6-month (PP6M), 3-month (PP3M), and 1-month (PP1M) formulations have demonstrated efficacy in improving clinical outcomes and reducing risk of relapse in patients with schizophrenia. Real-world studies have shown that longer dosing intervals are associated with improved clinical outcomes, however, there is minimal evidence comparing the outcomes of these three formulations in clinical practice.

This study evaluated the effectiveness of PP6M vs PP3M and PP1M in delaying and preventing relapse among patients with schizophrenia and compared healthcare providers’ treatment satisfaction and healthcare utilization with longer dosing formulations.

Patient data (n=125) were collected using the MeMind digital ecosystem, covering the period from July 2014 to July 2024 across multiple hospitals in Madrid. Memind registry is representative of the population with schizophrenia that is attended in the participating hospitals. Given the fact that all-registered patients meeting eligibility criteria will be included, sample size estimation is not needed. The number of patients in treatment with PP6M is around 300.Two retrospective treatment phases were considered: one year of prior treatment with PP1M, PP3M, or a combination of both before initiating PP6M, and one year following the initiation of PP6M (1 year mirror image analysis). A Shapiro-Wilk test was performed to assess the normality of the distribution of differences. If the distributions were normal, paired t-tests were conducted to compare the matched cohorts (PP1M vs. PP6M and PP3M vs. PP6M). If the distributions were not normal, a Wilcoxon signed-rank test (nonparametric) was used.

The relapse rate during the PP1M–PP3M period was 9.6% (95% CI: 5.49–16.2), which was almost than double that observed during the PP6M period (4.8%; 95% CI: 1.05–8.55). The hazard ratio for relapse during the PP1M–PP3M period, compared to the PP6M period, was 2.07 (95% CI: 0.78–5.53). 34% of the patients were in monotherapy with PP1M, 49% with PP3M, and 53% with PP6M. The average satisfaction of psychiatrists with paliperidone palmitate long acting injectables was higher than 7.7 out of 10. Fewer visits to psychiatrists were required with PP6M treatment compared to PP1M and PP3M (p<0.001); attendance rates were almost 100%, and visits to mental health nurses’ offices also improved.

Paliperidone palmitate long-acting injectable formulations have shown low relapse rates in real-world settings, with PP6M demonstrating the lowest relapse rate. Combined with high treatment satisfaction and more efficient resource utilization, PP6M may enhance mental health service delivery for patients with schizophrenia.

E. Baca-Garcia Grant / Research support from: Janssen, Consultant of: Janssen, A. SERRA SEGURA Employee of: Johnson &Johnson, P. LOPEZ RENGEL Employee of: Johnson &Johnson, J. MEHAWEJ Employee of: Johnson &Johnson, J. ANTUNES Employee of: Johnson &Johnson Innovative Medicine, L. KILLION Employee of: Johnson &Johnson Innovative Medicine.

Knowledge on risk and protective factors for the long-term outcome of children and adolescents diagnosed with psychosis before age 18 (Early-Onset Psychosis, EOP) is essential to improve the outcomes in this patient group. Being in employment is a particular important outcome for individuals living with psychosis and for reducing the societal cost of illness. Identification of predictive markers for long-term occupational functioning can guide clinical practice and tailor treatment interventions to target modifiable predictors as well as strengthen the interventions for the patients at highest risk of poor outcomes.

To describe the long-term sociodemographic, functional, and clinical outcomes of EOP and healthy control (HC) participants, and explore predictors of occupational functioning.

The study sample consists of 205 participants with EOP and 199 HCs aged between 10 and 17 at baseline. Clinical baseline data were linked to register-based outcome data from the Danish National Registers a mean of 11 years (range 4.5 to 23.5 years) after baseline assessment. At baseline, parental socioeconomic status, psychosis symptoms, neurocognitive functioning, social functioning, and drug use were assessed. At follow-up, register-data on employment status, marital status, income, educational level, supported housing, psychiatric hospitalizations, somatic hospitalizations and deaths were retrieved, and compared for EOP and HC participants. Predictors of competitive employment were explored using univariable and multivariable logistic regression.

At follow-up participants were between 18 and 41 years of age. Register-based outcomes showed markedly poorer sociodemographic, functional, and clinical outcomes for individuals with EOP compared to HCs. At follow-up 47% of EOP and 94% of HC participants were in competitive employment. Being in competitive employment at follow-up was in univariable analyses predicted by higher household income and better neurocognitive functioning (estimated IQ; verbal fluency; and attention and information processing speed) at baseline. These baseline measures did not remain significantly associated with competitive employment in multivariate analyses.

The finding that almost half of individuals with EOP was in employment at follow-up is encouraging compared to previous literature. The study nonetheless emphasizes the importance in continuous efforts to improve outcomes in early-onset psychosis, as outcomes across sociodemographic, functional, and clinical outcomes remains significantly poorer than controls. The study points to neurocognitive functioning as a potential modifiable treatment target to improve occupational functioning.

None Declared

Cognitive impairments are observed in 75-80% of people with Schizophrenia, with a significant impact on everyday functioning, quality of life, treatment adherence, costs of care and rehabilitation outcomes.

The primary objective is to examine the efficacy of the combination of cognitive rehabilitation and pharmacological treatments with potential pro-cognitive action compared to stand-alone interventions. The next aims are to analyze the applicability context, the limitations of available scientific evidence and to determine future perspectives.

This study follows the guidelines of PRISMA Statement and of Cochrane Collaboration. The systematic research was conducted on electronic databases: PubMed, PsychINFO, Scopus, Cochrane CENTRAL. English, peer-reviewed papers were selected. A manual search was performed on Google Scholar. At least two revisors examined independently all papers. Methodological quality of included studies was evaluated using Clinical Trial Assessment Measure (CTAM). Inclusion criteria: randomized controlled trials (RCT) with baseline and at post-treatment outcome assessments, regardless of setting or duration; patients with diagnosis of Schizophrenia spectrum disorders, clinically stable and stabilized on antipsychotic therapy; combination of a cognitive rehabilitation intervention with a molecule with pro-cognitive function, tested against control groups treated with cognitive rehabilitation or with pro-cognitive molecules administered as stand-alone treatments; evaluation of efficacy on cognitive functioning, on psychosocial functioning and clinical symptoms, with validated assessment measures.

3126 studies were identified through electronic databases, 2073 excluding duplicates. 143 articles were identified with other resources. Totally 2216 papers were screened, 98 were examined and 25 papers related to 20 studies were included. Molecules investigated: atypical antipsychotics, d-serine, d-cicloserine, oxiytocin, modafinil, nicotine.

This review shows that available data are limited to specific settings of care and this might affect the results. The efficacy of combined cognitive rehabilitation and specific molecules on clinically stable individuals with schizophrenia is largely inconclusive. However, this issue is scientifically and clinically a topic of interest, warranting further research.

A. Ceraso: None Declared, R. Alberti: None Declared, R. Virgillito: None Declared, M. Fiore: None Declared, A. Rajkovic: None Declared, F. Coronelli: None Declared, E. De Leo: None Declared, S. De Bellis: None Declared, L. Pascariello: None Declared, U. Battelino: None Declared, G. Nibbio: None Declared, G. Deste Consultant of: -, S. Barlati Consultant of: -, A. Vita Consultant of: -.

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are increasingly recognised as neurodevelopmental conditions that frequently co-occur in paediatric populations, presenting significant diagnostic challenges. Research indicates a high frequency of this comorbidity, with overlapping symptoms hindering diagnosis and co-occurrence associated with greater functional impairment in children. Since both disorders typically emerge in early development, focusing on paediatric populations is essential to ensure timely identification and intervention. Epidemiological data demonstrate considerable heterogeneity, highlighting the need to explicitly cite meta-analyses when reporting such rates. This highlights the need to clarify comorbidity and shared mechanisms in youth.

This systematic review examines current evidence regarding ADHD-ASD comorbidity prevalence, underlying aetiological mechanisms, and neurobiological foundations.

This literature review was conducted using PubMed databases and Virtual Health Library searches spanning 2020-2025, focusing on ADHD-ASD comorbidity. Search strategies employed “ADHD”, “autism spectrum disorder”, and “comorbidity” using Boolean operator AND. Studies met inclusion criteria if they: (1) included paediatric samples, (2) were published in English or Portuguese, and (3) addressed prevalence, aetiology, neurobiology, or therapeutic interventions. Exclusion criteria comprised case reports, editorials, and studies lacking mental health focus.

Autism spectrum disorder and ADHD represent neurodevelopmental conditions with prevalence rates of 1.5-2% and 5-9%, respectively, according to (Hatch et al. Psychol Sch 2022; 60:295-311). Comorbidity rates vary: 53-78% of children with ASD exhibit ADHD symptomatology, whilst 21% with ADHD display autistic traits. Both conditions demonstrate substantial heritability: ADHD shows 70-80% whilst ASD ranges 37-90%, with approximately 40% genetic overlap indicating shared mechanisms. Neuroimaging reveals overlapping dysfunction across attention networks and executive control systems. Children with both conditions experience greater functional impairments, higher anxiety, increased academic difficulties, and reduced therapeutic responsiveness. Environmental risk factors include maternal stress and toxin exposures. Effective approaches require comprehensive multimodal interventions combining behavioural and pharmacological therapies.

The substantial phenotypic and genetic overlap between ADHD and ASD necessitates integrated diagnostic frameworks recognising shared presentations and mechanisms. Given significant genetic convergence and overlapping neurobiological pathways, these conditions may be conceptualised as related spectrum disorders requiring specialised therapeutic approach. Comprehensive assessment and multimodal interventions remain essential for optimal outcomes.

None Declared

Adolescent psychiatric inpatient units faced heightened service challenges during the COVID-19 pandemic, with rising admissions for deliberate self-harm (DSH) and suicide risk. Few studies have examined how systemic and contextual factors influenced risk within these units during the peak of service disruptions, and in the post-pandemic period.

This study presents a longitudinal analysis of incidents on an adolescent psychiatric inpatient unit in Sydney, Australia between January 2020 and December 2023. It aims to understand the effect of COVID-19 and associated practice changes on readmission and incident rates on the ward.

Poisson and binomial regression models tested temporal trends in DSH, aggression and absconding incidents across the study period. Patient-level (gender, age, admission history), ward-level (readmission rate, average length of stay, bed occupancy), and COVID-19 (community and ward lockdown status) variables were included.

Incident rates increased significantly over time, with the steepest rise observed for DSH, particularly among female patients and those with multiple admissions. A dose-response relationship emerged, with DSH incidents rising from 11% at first admission to 87% at nine or more readmissions. Aggression peaked during periods of strictest ward restrictions, while 28-day readmission rate was the strongest overall predictor of incident rate.

By leveraging COVID-19 restrictions as a naturalistic experiment, this study offers a rare temporal and contextualised insight into how systemic factors shape risk in inpatient settings. Findings suggest that loss of autonomy and community leave may increase aggression risk, and repeated admissions may signal escalating self-harm risk. The results underscore the need for further research and development of trauma-informed inpatient care models that support transition to community through flexible care planning and sustained post-discharge support.

None Declared

Problematic media use (PMU) is increasingly recognized as a behavioral concern in children, often linked to behavioral management and a lack of alternative activities. Existing research largely derives from high-income countries, leaving significant gaps in low- and middle-income contexts. Sri Lanka, a lower-middle-income country (LMIC) with expanding digital access but restricted recreational resources, offers a distinctive setting to examine PMU. Understanding these patterns is essential for developing culturally relevant and context-specific interventions

This study aimed to compare PMU between children with psychiatric illnesses and their peers without psychiatric diagnoses, and to examine sociodemographic correlates of PMU, including parental education and household income.

A cross-sectional comparative study was conducted at Lady Ridgeway Hospital, Colombo, in 2023. Participants were children aged 4–11 years: the study group comprised those attending Child and Adolescent Mental Health Services (CAMHS), while age- and sex-matched children from the Outpatient Department (OPD) served as controls. PMU was assessed using the Problematic Media Use Measure (PMUM), alongside a parent-completed sociodemographic questionnaire. Exclusion criteria included severe medical comorbidity, intellectual disability, or lack of parental consent. Written informed consent was obtained in the two local languages, and ethical approval was secured from institutional review boards.

The sociodemographic profiles of the two groups were broadly comparable, with no significant differences in age, gender, ethnicity, parental education, or household income. The study group (n = 214) included 120 children with ADHD (56%), 50 with Autism Spectrum Disorder (23.4%), 25 with anxiety disorders (11.7%), and 19 with depression (8.9%). Treatment modalities included medication only (60.7%), behavioural therapy only (23.4%), and combined treatment (15.9%). The comparison group comprised children without psychiatric diagnoses (n = 200). The mean PMUM score in the study group was significantly higher (23.5 ± 5.8) than in the comparison group (18.2 ± 4.3). Children with ADHD lower household income and lower parental education were significantly associated with higher PMUM scores.

Neurodivergence and socioeconomic disadvantage are associated with higher PMU in children, underscoring the need for routine screening and family-focused interventions in these groups.

None Declared

Priapism is a rare but potentially serious urological emergency, defined as a prolonged and painful erection unrelated to sexual stimulation. Although uncommon in children and adolescents, it can cause significant morbidity if not promptly recognized and treated. Among pharmacological causes, antipsychotics are relevant triggers, mainly due to alpha-1 adrenergic receptor blockade. In youth with Autism Spectrum Disorder (ASD), atypical antipsychotics such as risperidone, aripiprazole, and olanzapine are frequently prescribed for irritability and behavioral symptoms. Despite widespread use, reports of priapism in this population are scarce, limiting risk estimates and clear management guidance.

To present a case of antipsychotic-induced priapism in an adolescent with ASD and review available evidence on risk factors, management, and clinical implications.

Clinical information was obtained from medical records and caregiver interviews. A narrative literature review was conducted in biomedical databases using terms related to priapism, antipsychotics, children, adolescents and ASD.

A 16-year-old male with ASD, on long-term risperidone (4.25 mg/day), was prescribed olanzapine (2.5mg/day) for insomnia. Four days after daily use of olanzapine, he presented to the emergency department with priapism requiring surgical intervention. Both risperidone and olanzapine were discontinued, and aripiprazole plus benzodiazepines were initiated, leading to favorable clinical outcome without recurrence. Caregivers were counseled on warning signs and the need for urgent medical evaluation.

The literature indicates that priapism risk is linked to alpha-1 affinity: risperidone, quetiapine, ziprasidone, and chlorpromazine are considered higher-risk, while aripiprazole and olanzapine have lower but not negligible risk. Cases with risperidone have been reported even after long-term exposure or in combination with other psychotropics. Aripiprazole, due to its low alpha-1 affinity, is often viewed as a safer alternative. Reports emphasize that priapism can occur without immediate temporal association to treatment initiation, highlighting the need for continuous vigilance. Clinical monitoring should be proactive in ASD, given communication barriers that may delay detection. Professional guidelines stress education of caregivers and urgent referral to urology when symptoms arise.

Antipsychotic-induced priapism in adolescents with ASD is rare but clinically significant. The presented case illustrates the importance of early recognition, prompt discontinuation of the offending agent, and transition to lower-risk alternatives such as aripiprazole. Continuous monitoring, caregiver education, and collaboration between psychiatry, pediatrics, and urology are essential.

None Declared

Problematic Internet Use (PIU) is an increasing mental health concern, particularly among adolescents, and is associated with anxiety, depression, and impaired functioning. Emotional intelligence (EI) may serve as a protective factor, while physical activity (PA) supports psychological well-being. This study examined the relationships among PIU, psychological distress, EI, and PA across adolescents and adults.

This study aimed to (1) investigate associations among PIU, psychological distress, EI, and PA, and (2) compare patterns of vulnerability and protective factors between adolescents and adults.

A cross-sectional design was employed. Standardized self-report instruments were used: Kessler Psychological Distress Scale (K6) for psychological distress, Quality of Life Scale (QOLS) for well-being, Internet Addiction Test (IAT) by Young for PIU, Rapid Assessment of Physical Activity (RAPA) for PA, and an Emotional Intelligence Scale for EI. Descriptive statistics, correlation analyses, and group comparisons were conducted.

Among adolescents, 65% engaged in at least 30 minutes of moderate-intensity activity five times per week, and 67% reported vigorous activity at least three times weekly, reflecting relatively high PA levels. However, 72% displayed moderate PIU tendencies, with frequent loss of control over online time and emotional reliance on internet use. Distress levels were elevated: over 60% reported frequent sadness, hopelessness, or insignificance, with 38% scoring in ranges indicating risk for functional impairment. EI scores were low to moderate, particularly in recognizing others’ emotions (mean = 1.95/5).

Adults reported 53% meeting PA guidelines but lower engagement in vigorous exercise. 58% displayed moderate PIU, particularly difficulty disconnecting and using the internet to escape negative emotions. Psychological distress remained moderate to high, with 45% frequently reporting sadness or worry. EI scores were slightly higher than in adolescents (mean total = 12.65/25), yet still indicated gaps in stress regulation and empathy.

Correlational analyses revealed:

• - PIU was positively associated with psychological distress (r ≈ 0.45, p < .01).

• - EI was inversely correlated with both distress (r ≈ -0.40) and PIU (r ≈ -0.38, p < .01), indicating its protective role.

• - PA was negatively correlated with distress (r ≈ -0.30) and PIU (r ≈ -0.25, p < .05), supporting its moderating function.

• - Adolescents showed stronger associations between low EI, high distress, and PIU compared to adults, highlighting developmental vulnerability.

PIU is linked to higher distress and lower EI, particularly in adolescents. PA emerged as a protective factor. Interventions promoting EI and regular PA may reduce maladaptive internet use and improve mental health outcomes.

None Declared

Young British Bangladeshis experience a higher prevalence of mental health problems than their White British peers, yet are underrepresented in research and have less access to services. Cultural dissonance between Bangladeshi values and British norms, especially during the key developmental stage of 16–24 years, can intensify identity conflict and emotional distress. Despite these risks, uptake of talking therapies amongst this group remains low, potentially due to mistrust of formal services and reliance on informal support. This underutilisation of services highlights the need for culturally sensitive interventions that reflect the lived experiences of this population. Problem-solving therapy (PST), a structured, easily teachable cognitive-behavioural approach rooted in Lazarus and Folkman’s (1984) stress-coping model, offers a promising solution. PST promotes proactive coping by building stepwise problem-solving skills and has proven effective in diverse, low-resource settings. Its concreteness and flexibility appeal to youth, making it well suited for adaptation in high-income, multicultural contexts.

This study aims to culturally adapt a problem-solving intervention, originally developed in India, for British Bangladeshi youth through a participatory co-design process to improve its relevance, accessibility, and acceptability.

This study includes two co-design workshops with 32 British Bangladeshi youth (aged 16–24) to ideate and test the intervention, with prototyping taking place between the two workshops. The first workshop (ideate phase) was carried out (April 2025), involving seven focus group discussions with young people, generating key insights and ideas for the intervention. The ongoing (summer 2025) prototype phase involves iterative development of intervention materials in collaboration with a youth co-researcher. The user testing phase, scheduled for later in 2025, will assess the acceptability and usability of the prototype through further focus groups and observations.

Using the Ecological Validity Model (EVM), adaptations were identified across all eight dimensions: culturally appropriate language; preferred types of counsellor; culturally resonant metaphors; content grounded in lived experience; cultural framing of mental health and problem-solving steps; outcomes aligned with PST goals; delivery strategies suited to youth needs; and relevant community settings. These insights are shaping the intervention prototype.

This study shows how a problem-solving intervention can be co-designed with young people using participatory methods. It will yield a culturally tailored intervention for British Bangladeshi youth, with potential to increase engagement with evidence-based mental health support.

None Declared

Childhood maltreatment (CM) and mental disorders are often chronic conditions associated with poor health outcomes and increased mortality. Recent research indicates that those stressful conditions may accelerate biological ageing by means of epigenetic age acceleration. Little is known about how the exposure to CM and psychopathological symptoms contribute to biological ageing in children and adolescents recently exposed to such conditions.

i) to examine whether CM and psychopathological internalizing/externalizing symptoms impact the pace of ageing, and ii) to study the putative sex differences.

203 children and adolescents (7 to 17 y.o.) from the Epi_Young_Stress project were included. DNA methylation in PBMCs was quantified using the Illumina EPIC_array_v1. Epigenetic pace of ageing was estimated using DunedinPACE clock. CM was evaluated by TASSCV and internalizing/externalizing symptoms with CBCL. Linear regression models were used to test associations between epigenetic ageing, CM and internalizing/externalizing symptoms. Age, socioeconomic status (SES), ancestry and smoking were included as potential confounders.

Lower SES was strongly associated with an accelerated pace of ageing. Stratified analyses revealed sex-specific effects: among females, SES was the primary predictor of increased ageing, while neither CM nor internalizing/externalizing symptoms exerted significant effects. Among males, externalizing symptoms and smoking were significantly associated with an increased pace of ageing.

SES emerged as the strongest determinant of epigenetic ageing in children and adolescents. In males, externalizing behaviors and smoking further contributed to accelerated ageing, underscoring the relevance of lifestyle and psychosocial wellbeing in shaping ageing trajectories early in life.

None Declared

Early-life adversity, including pre/perinatal stress and childhood maltreatment (CM), is strongly linked to neurodevelopmental and psychiatric outcomes. However, the specific impact of these stressors and the differential effects in males and females remain poorly understood.

This study aims to investigate the relative and combined impact of maternal psychosocial stress during pregnancy, obstetric complications (OC), and CM on neurodevelopmental delays, emotional/behavioral symptoms, and DSM-5 diagnoses before puberty (12 y.o.), with a focus on sex differences.

211 participants aged 7–17 from the Spanish multicenter Epi_Young_Stress study were included (130 with psychiatric diagnoses and 81 controls). 26.06% of children presented a psychiatric diagnosis and 25.1% a neurodevelopmental disorder before puberty. Hierarchical and logistic regression models were used. Neurodevelopmental subdomains, CBCL dimensions, overall adjustment (CGAS), and DSM-5 diagnoses were the studied outcomes. Predictor variables included socioeconomic status, maternal distress during pregnancy, OC, CM, and IQ. Interaction effects between prenatal and postnatal stressors were tested.

OC were associated with motor and language neurodevelopmental delays and attentional problems and worst adjustment only in males. CM emerged as the most consistent and robust predictor of emotional/behavioral problems, worst overall adjustment and psychiatric diagnoses in both sexes. Interaction effects between OC and CM were found for language, reading and writing problems in males. Vocabulary IQ emerged as a consistent protective factor.

CM is a critical determinant of early psychopathology regardless child’s sex. OC contribute to neurodevelopmental and attentional problems only in males. Findings underscore the need for early identification and sex-specific interventions.

None Declared

Autism spectrum disorder (ASD) is a neurodevelopmental disorder influenced by common polygenic variation, rare high-impact genetic variants, and non-genetic factors. Gene–environment interactions are increasingly recognized as potentially relevant, although their precise role in ASD heterogeneity and variable expression remains incompletely understood. However, current research seldom provides a joint description of genetic, early-life factors, and clinical features, highlighting the need for more comprehensive studies.

To analyze prenatal, perinatal, and postnatal factors, along with clinical characteristics and findings from complementary assessments in a cohort of children with ASD.

A cross-sectional study was conducted at a Child and Adolescent ASD unit in a tertiary hospital. Inclusion criteria were a DSM-5 diagnosis of ASD and age up to 18 years. The exclusion criterion was insufficient information according to the study objectives. Of the 260 patients under follow-up, 224 were included in the analysis. Data collection encompassed prenatal, perinatal, and postnatal factors, clinical characteristics and findings from complementary investigations.

The study sample comprised 78% male and 22% female patients. The mean age was 9.8 years, with the majority falling between 5 and 10 years (48%), and the remainder distributed as 22% aged 11–15, 16% >15, and 14% <5 years. Regarding ASD severity, 53% of patients were classified as grade 1, 30% as grade 2, and 17% as grade 3. In addition, 41% had intellectual disability (mild:65%, moderate:23%, severe:12%) while 80% showed early childhood language impairments.

Concerning prenatal factors, mean maternal and paternal ages were 34 and 36 years, with most parents in the 30–39 year range (67% and 58%, respectively). Attention-deficit/hyperactivity disorder was the most frequently reported familial comorbidity, present in 86% of cases. Perinatal factors included cesarean delivery(31%), prematurity(21%) and eclampsia/preeclampsia(7%). Postnatal data showed a mean birth weight of 2870 g, with 22% classified as low birth weight (<2500 g).

Complementary investigations revealed pathological findings in 11% of genomic arrays, 9% of exome analyses and abnormal brain MRI in 86% of patients. Genetic testing predominantly yielded non-diagnostic results or variants of uncertain significance, with a higher pathogenic yield from copy number variants than from exome sequencing. ASD-relevant findings included NRXN1 deletions, SHANK3 variants, 16p11.2 duplications, 22q11.2 rearrangements and sex chromosome aneuploidies.

This cross-sectional study underscores that ASD is frequently associated with early-life complications, language impairments and neuroimaging abnormalities, while genetic testing yields both pathogenic and inconclusive findings. These findings reinforce the need for integrative approaches to advance precision in ASD.

None Declared

Autism spectrum disorders (ASD) are neurodevelopmental conditions marked by social communication difficulties and repetitive behaviors, affecting 1–2% of children and adolescents.

The endocannabinoid system (ECS), important for brain function, is altered in individuals with ASD. Cannabidiol (CBD), a non-psychoactive compound from cannabis, modulates the ECS and other systems, with anti-inflammatory, anxiolytic, and neuroprotective effects.

Though evidence is still limited, some studies suggest CBD may help improve behavior, anxiety, sleep, and hyperactivity in children with ASD, with generally mild side effects. CBD is emerging as a promising treatment option, but more research is needed.

General Objective

The main objective of this literature review is to gather and analyze the published evidence regarding the potential therapeutic uses of CBD in ASD in the child and adolescent population.

Specific Objectives

1. To investigate the clinical efficacy of CBD in ASD in the child and adolescent population.

2. To explore the side effects and safety associated with cannabidiol treatment.

A literature review was conducted following PRISMA guidelines, focusing on studies involving children and adolescents (0–18 years) with ASD treated with CBD, with or without low doses of THC. The search was carried out in PubMed and Scopus between October 2024 and February 2025, using Boolean operators and terms related to CBD, ASD, and the pediatric population. After filtering and removing duplicates, 12 articles were selected for review.

The therapeutic use of CBD for ASD in children and adolescents is a recent and emerging area. This review included 12 studies published between 2019 and 2025, mostly observational in nature, with only one randomized controlled trial.

A total of 1,026 participants, aged 2 to 18 years, were studied. Most studies used CBD combined with low doses of THC, and only one used purified CBD. Treatment was given alongside existing medications and sometimes allowed dose reductions.

Follow-up periods ranged from 3 to 28 months. Side effects were generally mild to moderate, including restlessness, irritability, and changes in appetite or sleep. Overall, CBD showed good safety and tolerability.

1. 1. CBD shows potential in improving symptoms of ASD, especially in enhancing social interaction.

2. 2. It may be a useful option for treatment-resistant cases or severe behavioral issues.

3. 3. Studies suggest benefits in managing common comorbidities like anxiety, hyperactivity, and sleep disturbances.

4. 4. Safety profile is generally good, with mostly mild side effects, but close monitoring is necessary.

5. 5. Current evidence is limited and heterogeneous; more rigorous, large-scale studies are needed.

6. 6. Future research should standardize protocols, explore long-term effects, and clarify dosing and drug interactions.

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) is a condition that leads to significant difficulties in functional living and is associated with excessive screen use, behavioral disturbances, and sleep disorders. Studies indicate that engaging in structured physical activity (PA) and quality of life (QoL) during childhood and adolescence may have a positive influence on cognitive and socio-emotional development.

ADHD, Quality of Life, Physical Activity, Childhood and Adolescence

To analyze the quality of life in a pediatric ADHD sample that engages in PA and to examine whether there are differences compared to those who do not engage in PA.

A cross-sectional, descriptive, and observational study was conducted with a clinical sample of 82 children and adolescents diagnosed with ADHD. Data were analyzed descriptively and stratified, and possible associations between variables were examined.

Of the sample, 30.49% engaged in PA. Physical activity was significantly associated with better quality of life (QoL), showing a strong positive correlation (r = .74; p < .01). Multiple regression analysis identified additional predictors of better QoL.

In this study, only one-third of ADHD participants engaged in PA and showed fewer comorbidities than those who did not. Furthermore, this group reported a better perception of their QoL. These findings support the need for longitudinal and interventional studies to evaluate the sustained and specific effects of different types of PA on QoL in this population.

None Declared

The emergence of self-identity (‘I’) represents a fundamental milestone in child development. In neurotypical children, self-recognition and differentiation from others typically precede more advanced processes of emotional and behavioral self-regulation. However, in children with Autism Spectrum Disorder (ASD), the trajectory of self-identity development often follows an atypical path, influencing both communication and regulatory processes.

To examine how alterations in self-identity development in children with ASD affect their capacity for emotional and behavioral self-regulation, and to discuss therapeutic implications for clinical practice in child psychiatry.

Clinical observations and therapeutic case studies of children aged 2–9 years with ASD were included in the analysis. The focus was on language acquisition, self-referential communication (use of “I”, “me”), and parental reports concerning self-awareness. Therapeutic interventions comprised structured speech and language therapy, parent-mediated strategies, and interdisciplinary collaboration with psychiatrists and psychologists.

Children who exhibited delayed or atypical self-identity development presented greater challenges in self-regulation, including difficulties in frustration tolerance, impulse control, and emotional expression. Conversely, interventions targeting early self-referential communication and identity development were associated with improved capacity for self-regulation, enhanced social reciprocity, and reduced behavioral crises.

The development of self-identity is a key factor in the regulation of emotions and behavior in children with ASD. Integrating speech and language therapy focused on self-awareness into psychiatric care can support both communication and clinical outcomes. An interdisciplinary approach is essential to address the complex interplay between identity, communication, and regulation.

None Declared

Motor dysfunction in ADHD is increasingly recognized as a core manifestation of neurodevelopmental disruption rather than an incidental problem. Yet there is no consensus gold-standard motor assessment, and most tools emphasize broad milestones rather than neuromuscular dysregulation.

Aim: Develop a Yoga-Based Motor Assessment Tool (Y-MAT) for children with ADHD.

Primary objectives: Develop and validate the tool; pilot test feasibility.

Secondary objective: Explore artificial intelligence and video-analytics for digitizing motor assessment.

Seven motor domains were identified through review of literature and mapped to Yoga-tasks through expert consensus (n = 6). The Y-MAT was administered to 11 children with ADHD and 10 controls by a trained psychiatrist, video-recorded, and scored by 2 blinded human raters. AI-based scoring was also implemented using Google’s MediaPipe and YOLOv8 for pose recognition and movement analysis. All children were also assessed using the ADHD Rating Scale (ADHD-RS) and the Vineland Social Maturity Scale (VSMS) to evaluate symptom severity and social functioning. Feasibility, Inter-rater reliability (Cohen’s kappa) and Concurrent Validity was measured.

The Y-MAT demonstrated high acceptability, engagement and a minimal dropout rate.The ADHD scores show a moderate negative correlation with both ratings, with slightly stronger associations for AI-based scoring, indicating that greater ADHD severity was associated with poorer neuromuscular regulation. Inter-rater reliability ranged from fair to moderate agreement, with Impulse Control of Vrikshasana (p = 0.0001) and Motor Sequencing of Surya Namaskar (p = 0.0032) exhibiting the strongest and statistically significant agreement. AI-based scores moderately correlated with human ratings.Table 1.

Selected Yoga-tasks mapped to their corresponding motor domains

The Y-MAT is a feasible and engaging approach to assess motor dysfunction relevant to ADHD. Preliminary evidence supports concurrent validity and the promise of AI-assisted scoring for scalable, real-time, objective evaluation.

None Declared

Circadian rhythm disturbances are increasingly recognized as relevant clinical features in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). Chronotype, defined as an individual’s biologically driven preference for timing of sleep and activity (morningness vs eveningness), has been associated with ADHD symptom severity, executive dysfunction, and emotional regulation. Despite growing interest in the interplay between chronotype and psychiatric conditions, data remain limited in adult ADHD populations

This study aimed to assess the distribution of chronotypes among adults diagnosed with ADHD according to ICD-10 criteria and to examine associations between chronotype, symptom severity, and sleep quality.

A total of 50 adults (aged 18–45 years) diagnosed with ADHD based on ICD-10 criteria were recruited through outpatient psychiatric services as part of a cross-sectional observational study. Participants completed the Morningness–Eveningness Questionnaire (MEQ) to determine chronotype. ADHD symptom severity was evaluated using the Adult ADHD Self-Report Scale (ASRS), and sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Statistical analyses included chi-square tests for distribution and Pearson correlations to explore associations between chronotype, symptom burden, and sleep quality.

Among 50 adults with ADHD, 64% were classified as evening chronotypes, 24% as intermediate, and 12% as morning types, based on MEQ scores. Evening-type individuals showed significantly higher ADHD symptom severity, particularly inattention (ASRS: 25.3 vs. 19.1 and 17.6), and reported later sleep onset (mean: 00:23 AM) and longer sleep latency (42.7 min). Sleep quality, measured by the PSQI, was poorest in evening types (mean: 9.8), with more frequent insomnia and non-restorative sleep. Functionally, evening chronotype was associated with greater daytime dysfunction, including difficulty initiating tasks, lower energy levels during standard work hours, and higher rates of reported emotional dysregulation, particularly irritability and low frustration tolerance. Correlational analysis showed a moderate negative association between morningness (MEQ score) and ADHD severity and sleep quality. Chronotype independently predicted inattention severity and sleep quality after adjusting for age and sex. No associations were found with comorbid anxiety or depression.

Evening chronotype is overrepresented in adults with ADHD and is associated with greater symptom severity and sleep dysfunction. Chronotype assessment may offer valuable insights for tailoring behavioral and pharmacological interventions, especially regarding sleep hygiene and treatment timing. Incorporating circadian rhythm evaluation into routine clinical practice may enhance diagnostic precision and patient outcomes in ADHD management.

None Declared

Tic disorders are neurodevelopmental conditions frequently presenting in childhood and adolescence. Management often requires a multidisciplinary approach, incorporating neurology, psychiatry and psychology. A structured care pathway for the management of Tic disorders in the community was introduced in North Staffordshire Child and Adolescent Mental health services in 2023. This was aimed to standardise assessment, provide psychoeducation, offer group therapy interventions and medication. Understanding real-world pathway performance is essential to identify service strengths and gaps.

A)Map referral patterns to the TIC Pathway and pre-referral neurology assessments. B) Evaluate waiting times from referral to initial assessment. C) Assess the provision of psychoeducation and therapy. D)Examine clinical outcomes following therapeutic interventions. E)Review psychiatric input within the pathway.

Patients with Tic disorder were identified from case notes. Sample included young people who were accepted into the service between April 2024 and March 2025.Data was collected using a semi-structured questionnaire.

26 patients (n=26) were identified as having Tic disorder across all the community CAMHS teams.

Referral sources: Most patients were referred by their GPs (62%) and paediatricians (19%). School nurses and self referrals constituted the rest.

Neurology assessment prior to referral: In 50% of the cases, this was not clearly documented. Amongst those recorded, this was completed in 77% of cases.

Time from referral to initial assessment: 54% of young people had to wait for more than 16 weeks for an initial assessment.

Provision of Psychoeducation after initial assessment: Only 2 patients received psychoeducation. In 88% (23 cases) this information was not recorded.

Psychiatric co-morbidities identified at initial assessment: 65% of patients had a psychiatric comorbidity. ASD was the commonest comorbidity (n = 17), with ADHD(6), anxiety (4) and OCD (2) making up the others.

Therapy: Nearly all patients were offered therapy (96%) following initial assessment. The most common intervention was the TREAT group (65%) and 31% had both TREAT group and individual therapy. Majority of patients (54%) reported improvement following therapeutic intervention. Only 15% did not show clear improvement.

Psychiatric input: Psychiatry input was requested for 35% of cases for diagnostic assessment of Tourette’s syndrome and comorbid ADHD. Medications were considered in only 17% of cases following psychiatric assessment.

The newly introduced Tic Disorder pathway successfully engaged patients, with high rates of therapy provision and evidence of clinical benefit. Only a minority of patients needed medication management for their tics.

None Declared

Peer bullying is one of the most common and destructive social problems experienced during childhood and adolescence,and it is a serious public health issue that negatively affects individuals’ psychological,academic,and social development.Research indicates that approximately 20-30% of school-aged children experience some form of bullying.Individuals who experience bullying develop serious psychological issues such as depression, anxiety,social isolation,and suicidal thoughts;their academic performance declines,and the rate of early school dropout increases.The effects of bullying are not limited to the victims but can also have long-term consequences for the bullies and students who witness the incident.Furthermore,bullies are more likely to engage in criminal behaviour,antisocial behaviour,and substance use,and they tend to have lower occupational success in later life.In this context,peer bullying should be addressed not only as an individual issue but also as a social problem;it should be evaluated through a comprehensive approach by education systems,families,and policymakers.Media content that focuses on the psychological effects and psychiatric consequences of bullying plays an important role in raising social awareness.

This study was conducted qualitatively to explain the media’s portrayal of peer bullying in Turkey.

Using the maximum diversity method,one of the purposive sampling methods,the relevant news from the top 10 most-read newspapers in Turkey from 2010,when peer bullying first came to the fore in Turkey,to the present day were examined.The first 8 newspapers were selected because they published news related to peer bullying,and a total of 53 news were examined and 9 main themes have been identified.

News content highlighted various factors that contribute to bullying, ranging from institutional shortcomings to socio-economic conditions, teacher attitudes to security gaps, and emphasised that constant exposure to bullying causes various negative emotions in individuals, such as withdrawal, feelings of worthlessness, guilt and anxiety,and in some cases, generates social reaction or awareness. Supportive factors such as families’ awareness levels, empathetic approaches, efforts to establish open communication, and school cooperation are key concepts in interventions against bullying. News content emphasises the need to raise awareness among teachers and parents in order to combat bullying. The content shows that bullying has not only psychological but also physical and behavioural consequences, and that high school is the level where bullying is most frequently experienced.

The serious consequences experienced by individuals exposed to bullying include death,permanent physical damage and psychological trauma.Media coverage of topics such as preventing peer bullying,providing guidance,and support systems can have a more positive impact on society.

D. Ocaklik Altunkiliç: None Declared, S. KÖKCEALAN Employee of: Contributed to the research process., A. Okanlı Consultant of: The researcher provided consultancy services for the study.