Delays in youth mental health care are well documented, but most research treats them as logistical barriers rather than lived experiences. Little is known about the implicit messages that delays communicate to young people about worthiness or priority, and how these meanings influence trust in services and future engagement.

To examine how young people interpret delays or unclear processes when seeking mental health support, and how these interpretations affect motivation, trust, and engagement.

An anonymous online survey was conducted with participants aged 18+, reflecting on help-seeking attempts between the ages of 14–25. The mixed-methods design included quantitative items on trust, fairness, and help-seeking persistence, together with open-ended questions on the meaning of the process. Descriptive statistics summarise quantitative responses, and thematic analysis is applied to qualitative data.

Preliminary findings suggest that delays and unclear processes reduce motivation to persist with help-seeking and can contribute to disengagement. Qualitative analysis highlights recurring narratives of feeling “not sick enough”, questioning the adequacy of services, and withdrawing to cope alone.

Delays and unclear processes not only slow access — they also appear to convey implicit messages that shape young people’s sense of deservingness and their trust in care systems. Understanding these meanings is critical for youth-centred service redesign and mental health policy.

None Declared

Violence in mental health hospitals has been on the rise, yet little research has focused on violence within child and adolescent mental health wards. Such exposure is associated with increased stress and occupational strain, negatively impacting the professional performance and the perceived safety of caregivers.

This study explored the impact of child and adolescent violence on healthcare staff in mental health wards, focusing on its relationship with emotional labor, PTSD symptoms, and physical and mental fatigue.

A cross-sectional design was employed with 113 healthcare professionals from a large mental health hospital, including physicians, nurses, social workers, occupational therapists, and psychologists. Data were collected using a five-part questionnaire assessing self-reported exposure to violence, post-traumatic stress disorder (PTSD) symptoms, emotional labor, multidimensional fatigue, and demographic variables. Hierarchical linear regression and moderation analyses were conducted using PROCESS software (v.4).

Participants reported high levels of verbal (93.8%) and physical (74.3%) violence from children and adolescents under their care. No direct association was found between violence and emotional labor, possibly reflecting staff normalization of violent behavior due to the complex backgrounds of their patients. Significant correlations were found between PTSD symptoms and both verbal (r = .37, p < .001) and physical (r = .50, p < .001) violence, as well as between emotional labor and physical/mental fatigue (r = .27, p = .004). PTSD symptoms moderated the relationship between exposure to violence and fatigue (β = .21, CI: 0.11–0.32).

While emotional labor assists staff in regulating emotions, it also contributes to fatigue, particularly in the context of trauma. Interventions should focus on reducing violence in child and adolescent mental health wards and increasing awareness of post-traumatic symptoms among healthcare professionals.

None Declared

Working memory (WM) deficits are a core cognitive feature of Autism Spectrum Disorder (ASD), contributing to significant functional impairments. Computerized cognitive training, such as the dual n-back task, represents a promising intervention, but evidence from rigorous randomized controlled trials (RCTs) in ASD is scarce.

To investigate the efficacy and durability of a dual n-back training program on WM function in children and adolescents with ASD.

In this registered RCT, 69 participants with ASD (aged 10-15) were randomly assigned to either an intervention group (n=35), which completed adaptive dual 2-back training, or an active control group (n=34), which completed a 0-back task. Training was conducted daily for two weeks. Outcomes were assessed at baseline, post-intervention, and at a 3-month follow-up using performance-based WM measures (Dual N-Back Task, Digit Span) and parent-reported executive functioning (Behaviour Rating Inventory of Executive Function, BRIEF).

Intent-to-treat analysis revealed significant and sustained improvements in the intervention group compared to the active control. The intervention group showed significantly greater gains in both verbal and visuospatial WM accuracy on the dual n-back task (all p < 0.05). These near-transfer effects were maintained at the 3-month follow-up. Furthermore, parents of children in the intervention group reported significant improvements in everyday working memory and emotional regulation on the BRIEF (p < 0.001), with large effect sizes. In contrast, minimal changes were observed on broader behavioural symptom measures.

Dual n-back training is an effective and durable intervention for enhancing working memory capacity and everyday executive functioning in children and adolescents with ASD. This training protocol shows promise as a targeted cognitive intervention within a comprehensive treatment plan.

None Declared

Attention-deficit/hyperactivity disorder (ADHD) is associated with alterations in executive function and prefrontal cortical activity. Functional near-infrared spectroscopy (fNIRS) provides a non-invasive method to assess task-related hemodynamic changes, yet developmental differences in drug-naïve ADHD populations remain insufficiently understood.

This study aimed to investigate prefrontal activation patterns during executive function tasks in drug-naïve individuals with ADHD compared with healthy controls, and to explore age-related differences across childhood, adolescence, and adulthood.

We enrolled a total of 48 drug-naïve patients with ADHD (children, adolescents, and adults) and 50 healthy controls between March 2019 and February 2022. Participants were recruited from the outpatient clinic of the Child and Adolescent Psychiatry Department. All participants underwent standardized assessments, including IQ testing, ADHD symptom rating scales, and the Computerized Attention Test (CAT). Prefrontal cortical activation was measured using functional near-infrared spectroscopy (fNIRS) during the Trail Making Test A and B. Group comparisons were conducted between ADHD and control participants, as well as across age groups. The study was approved by the Ethical Committee (No. MJH 2010-08-025-001).

ADHD participants showed significantly higher symptom severity compared with controls (all p < 0.001), as well as lower performance on the Computerized Attention Test (CAT) (p = 0.009) and reduced working memory and processing speed indices of IQ (p < 0.01) (Fig 1). fNIRS analyses during the Trail Making Tests revealed distinct activation patterns across groups and age strata.(Fig 2) While overall group-level effects were limited, exploratory ROI-level analyses indicated a significant difference in oxygenated hemoglobin response at ROI4 under specific task conditions, suggesting localized prefrontal hypoactivation in ADHD (Fig 3).Image 1:

Drug-naïve individuals with ADHD demonstrated marked clinical and cognitive impairments compared with controls. Although global group differences in prefrontal activation were subtle, the presence of localized alterations such as ROI4 highlights the potential of fNIRS to capture specific neural dysfunctions in ADHD. These findings underscore the importance of developmental context and support the need for larger-scale studies to validate ROI-specific effects.

S. Lee: None Declared, W. S. Kang: None Declared, M. Hong Grant / Research support from: Supported by National Research Foundation of Korea

The widespread recognition of Attention-Deficit/Hyperactivity Disorder (ADHD) has led to a simplified, predominantly symptomatic approach, often initiated by non-specialized mental health staff (e.g., educators, primary care physicians). However, recent research highlights the need for a more refined perspective, emphasizing neurobiological underpinnings—executive dysfunction, arousal dysregulation, delayed reward processing—and the differentiation between primary ADHD and secondary ADHD-like presentations stemming from complex trauma, attachment disturbances, or emotional dysregulation.

To analyze the main neurobiological hypotheses underlying ADHD (executive dysfunction, arousal regulation deficits, intolerance to reward delay), to explore the clinical overlap with trauma- and attachment-related disorders during childhood and adolescence, and to examine longitudinal outcomes and differential pharmacological responses in primary versus secondary ADHD.

A narrative synthesis of recent neurobiological and clinical findings was conducted, focusing on: (1) competing neurobiological models (fronto-striatal dysfunction, aberrant arousal regulation, and reward delay intolerance); (2) symptom overlap with trauma-related and attachment disorders in children and adolescents; (3) longitudinal outcomes across developmental stages; and (4) differential response to stimulant medication in primary versus secondary ADHD.

Evidence supports the heterogeneity of ADHD trajectories. Neurobiologically, individuals with impaired arousal regulation or delayed reward processing show distinct profiles compared to those with inhibitory deficits, suggesting that uniform pharmacological approaches may be insufficient. Longitudinal studies show that about one-third of girls and one-fourth of boys no longer meet ADHD criteria by adolescence without intervention, highlighting the role of maturational processes. Moreover, children diagnosed with ADHD often evolve into divergent adult diagnoses (e.g., mood, anxiety, substance use disorders), underscoring the nonspecificity of early symptoms. Importantly, stimulant response differs: primary ADHD typically shows robust benefit, whereas secondary ADHD-like presentations linked to trauma or relational disturbances present attenuated or paradoxical responses.Image 1:

Complex trauma in early development induces neuroadaptive changes in arousal and reward systems that may mimic ADHD phenotypes. Treating these cases solely with stimulants risks chronicity and progression to comorbidities such as addictions, mood, or anxiety disorders in adolescence. Therefore, a comprehensive assessment distinguishing between primary neurodevelopmental ADHD and secondary ADHD-like syndromes is crucial. Integrating trauma- and attachment-focused interventions alongside or instead of stimulants offers a more tailored, prognostically favorable approach.

None Declared

An increasing number of adolescents present to mental health services with anxiety, depression, or self-harming behaviors. In a significant subset, these symptoms conceal undiagnosed neurodevelopmental conditions—such as borderline intellectual functioning (BIF), mild intellectual disability (ID), or autism spectrum disorder (ASD)—that were not identified during childhood. Many of these youths advanced academically and socially despite substantial effort, which delayed recognition by pediatricians and schools. Without acknowledging these hidden developmental profiles, clinicians risk applying symptom-focused therapies that are ill-suited to the adolescent’s cognitive and adaptive capacities.

(1) To highlight the impact of missed childhood diagnosis of BIF, mild ID, or ASD in adolescents presenting with emotional or behavioral symptoms. (2) To demonstrate how undetected neurodevelopmental conditions undermine standard psychotherapeutic approaches. (3)To propose systematic neurodevelopmental screening prior to intervention initiation in adolescent mental health care.

We conducted a narrative review (2023–2025) of recent meta-analyses on adapted psychotherapy in ASD and ID, conceptual reviews of BIF, and major international guidelines (NICE, NHS England). We analyzed recommendations on neurodevelopmental screening and psychotherapeutic adaptations for adolescents.

1. (1) Missed in childhood: Many adolescents with low IQ or autistic traits escaped earlier detection, progressing academically at the cost of hidden distress.

2. (2) Secondary presentations: In adolescence, they present with anxiety, depression, or self-harm, symptoms that overshadow the underlying condition.

3. (3) Therapy works—when adapted: Evidence supports the efficacy of adapted psychotherapies (simplified CBT, visual supports, structured pacing, family involvement) when neurodevelopmental conditions are recognized.

4. (4) Guideline gap: Although guidelines recommend adaptations, they rarely require clinicians to systematically rule out neurodevelopmental conditions prior to starting standard therapy.

The failure to detect neurodevelopmental disorders early partly explains why many adolescents show poor response to conventional, symptom-focused treatments. Unless mental health services incorporate routine cognitive and adaptive screening before pychotherapy or pharmacotherapy, treatments risk addressing symptoms while ignoring root causes. This raises a necessary debate: should adolescent mental health care continue to apply one-size-fits-all protocols, or move toward precision psychotherapy tailored to each individual’s neurodevelopmental profile?

None Declared

Attention Deficit/ Hyperactivity disorder is a neurodevelopmental disorder characterised by persistent pattern of hyperactivity, impaired attention and poor organization. ADHD is associated with multiple neurophysiological deficits leading to impairment in sustaining attention, reward processing and regulation of behavior. There is marked intra- individual variation in presentation due to the diagnostic, developmental and neurobiological heterogeneity which can make treatment challenging. Identifying biological predictors of treatment response becomes imperative to develop personalized regimens for the various subsets. Evoked response potentials (ERP) allow the assessment of sensory and cognitive processes and can be potentially useful.

This study endeavors to explore the potential Evoked response potentials in predicting medication response.

Longitudinal observational study, with sample size of 30 male cases of ADHD aged between 8-16 years who were planned to be started on Methylphenidate by their treating psychiatrist. Informed consent from parents and assent from the study participants were taken. Severity of ADHD was assessed using Conner’s parent rating scale (CPRS). Prior to starting treatment, a 32 channel electroencephalograph (EEG) recording was taken while the participants were performing an auditory oddball task. Amplitude and latencies of P300 and N200 (evoked potentials) were extracted from the EEG data for 3 central channels (Cz, Oz, Pz) . Participants were divided into good and poor responders following 4 weeks of treatment and baseline ERP data was compared between both groups.

P300 amplitude and latency across Auditory Oddball task did not reveal significant differences between Good and Poor Responders except P300 latency of the target stimuli over Cz channel location, participants who responded better to medication had significantly lesser latency as compared to the other group. P300 amplitude at Cz and Pz of non target stimuli correlated negatively with improvement in hyperactivity and total symptom score on CPRS- lower P300 amplitude predicted better improvement (p=0.02, 0.04 at Cz and Pz respectively).

N200 of non target stimuli had a significantly smaller amplitude in good responders as compared to poor responders in our study. A significant correlation was found between the amplitude and improvement in inattention score (rho 0.45, p-0.01) on Cz location. N200 latency was also found to be significantly longer in good responders and correlated with improvement in CPRS scores at all three channel locations.Image 1:

There are differences in Evoked response potentials in Cz and Pz channels between good and poor responders. This underscores the importance of further research on neurophysiological markers as a predictive biomarker to various treatment modalities for ADHD.

None Declared

Autism Spectrum Disorder (ASD) is a common neurodevelopmental condition characterized by challenges in social interaction, communication, and repetitive behaviours. Early identification through school-based screening for ASD has the potential to enhance educational and health outcomes for affected children.

This review examines school-based screening tools for identifying children and young people with ASD, and assess the differences and challenges in effectiveness across various socio-demographic groups.

We conducted a narrative systematic review and searched EMBASE, MEDLINE, PsychINFO, Cochrane, and Scopus electronic databases (2011-2024) in October 2024 to identify studies on school-based ASD screening for children aged 4 to 16 years. Two independent researchers screened the papers and extracted the data. Data extracted included country, age, gender, socio-economic status, ethnicity, type of screening tool, informant details, and outcomes (prevalence of screen positives, sensitivity, and specificity).

Of 7,311 eligible articles, 14 studies were included in this review. Eight different ASD school-based screening tools were identified. Study populations ranged from 103 to 16,556 participants, with varying sensitivity and specificity depending on the population age group, setting, and ASD prevalence. The prevalence of screening positive for ASD ranged from 0.7% to 8.5%. Most studies were conducted in European countries (n=6) followed by Western Pacific (n=4), Americas (n=3) and Eastern Mediterranean (n=1) countries. No studies evaluated outcomes based on ethnicity or socioeconomic status.

There is a broad range of school-based ASD screening tools available globally, but their use is inconsistent and lacks robust validation. Evidence on diagnostic accuracy remains limited, and the dearth of data on ethnicity and socio-economic status risks exacerbating health inequalities. Consensus on tool selection and validation, alongside collaboration between education systems, researchers, and policymakers, is needed to ensure ASD screening approaches are equitable and effective.

None Declared

Epidemiological data indicate that lifetime self-harm is reported by approximately 16% of adolescents (Farkas et al.ECAP 2023 (10):3439-3458). A proportion present to hospital emergency departments (A&E) in a crisis self-harm presentation such as overdose, attempted hanging, self-injury or jumping. These attendances are often misinterpreted as evidence of a primary mental illness; in many cases, factors other than mental illness are the drivers of crisis. Over-attributing crisis to “mental illness” can prompt reactive interventions that miss root causes, waste resources, and fail to improve emotional stability or functioning in children and young people (CYP).

Evaluate crisis presentations to Berkshire Child and Adolescent Mental Health (CAMHS) Rapid Response Team (1 Feb–30 Apr 2022); describe demographics and presenting features; identify drivers of crisis; and outline implications for multi-agency responses and care to support optimal outcomes for CYP.

Mixed-methods retrospective case-note review of all CYP referred to Berkshire CAMHS Rapid Response from two acute hospitals after A&E mental-health presentations (Feb–Apr 2022). Data source: electronic records. Qualitative: narratives describing the main contributing factor for attendance were coded and thematically analysed to identify patterns. Quantitative data included age, sex, presenting reason, self-harm type, autism/ADHD diagnosis or waitlist, other psychiatric diagnoses, CAMHS involvement, other service input, family adversity and education. Inter-rater reliability was checked on 10 cases, with unclear cases reviewed by two clinicians to reach consensus.

213 self-harm crisis presentations were evaluated. Crises were largely associated with environmental factors, led by school (37.5%) and family factors (23.5%). Overall, 71% did not require ongoing CAMHS input (29% did). 55% were referred to other services, 39% were already receiving support, and 47% required multi-agency liaison. Neurodevelopmental needs were common: 22% had a diagnosis of autism or ADHD and a further 28% were awaiting assessment/referred on—indicating potentially 50% of CYP with neurodevelopmental profiles.Image 1:

Emergency and crisis services should recognise that self-harm presentations in children and young people are heterogeneous: some presentations reflect mental illness, but many are driven by environmental stressors or unmet neurodevelopmental needs. Risk-led and premature mental-health interventions risk missing root causes, wasting resources and yielding poor outcomes. Responses from acute services should prioritise a holistic, needs-led assessment to distinguish psychiatric illness from contextual/developmental drivers. Where these predominate, CAMHS should provide targeted liaison to partner agencies to activate and steer relevant interventions addressing social, family, educational and developmental needs.

None Declared

National Institute of Clinical Excellence (NICE) guidelines recommend that children and adolescents presenting with self-harm have a psychosocial assessment that includes an enquiry of social media, focussing on its use to connect with others, and any effects on mental health (NICE, 2022). This is supported by evidence of associations between social media use and self-harm (Chen et al. Psychiatry Research 2024; 338 115991) including temporal associations between exposure to specific themes and self-harm presentations (Hamilton et al. JAACAP Open 2025; 3 431-438). We present a clinical audit of cases referred to our crisis team in England.

To complete a clinical audit of assessments of self-harm cases, assessing adherence to NICE guidelines as part of clinical governance to inform the state of assessment quality within our service.

Retrospective review of cases referred over a month. We included children and adolescents 5-17 presenting with self-harm who underwent a full assessment. We adopted the NICE definition of self-harm - “self-poisoning, self-injury, suicide attempts and non-suicidal self-injury” (NICE, 2025). We used the NHS England definition of social media - any online medium allowing communication and interaction between people, groups or organisations for a variety of reasons, including dissemination of information (NHS England, 2025). We excluded cases where a full assessment was not conducted. We collected data on 1. type of self-harm 2. if social media was enquired about, 3. if social media was used to connect with others and 4. if social media was thought to impact on mental health.

Out of 103 referrals, 50 were for self-harm. Table 1 shows the types of self-harm, with the most common being self-poisoning (48%). In terms of adherence to guidelines: A. Social media enquiry - 72% compliance, B. Social media used to connect with others - 14% and C. Social media impact on mental health - 8%, see figure 1 and table 2. Of the 72% of compliant cases, 97% used social media. While only 8% of assessments explored the impact of social media on mental health, 100% of these assessments revealed a negative impact from social media use.Image 1:

Our audit demonstrated deviation from NICE standards in our service. Lower compliance with secondary questions (14% and 8%) could reflect an underappreciation of the relevance of in-depth exploration of social media use. To complete this audit cycle, we will present results, provide training and complete a reaudit. 35 (97% of those asked) children and adolescents who self-harmed were accessing social media, with 4 (100% of those asked) reports of social media impacting on mental health. Therefore, two strands of further work are indicated - research into the association between social media use and self-harm and quality improvement work to improve adherence to guidelines.

None Declared

In the US, commonly used long-acting injectables include derivatives of aripriprazole and paliperidone for the treatment of psychosis, especially in the inpatient setting, given their associated decreased rate of rehospitalization. This study aims to determine if there are baseline differences (sociodemographic or clinical) between youth receiving aripiprazole vs paliperidone/risperidone long-acting injectables (LAIs), and to determine if there are independent predictors of which LAI patients may receive.

Patients who receive aripiprazole LAI vs paliperidone/risperidone LAI have some differing baseline sociodemographic and clinical characteristics.

Certain clinical indicators suggest when a patient is more likely to receive aripiprazole LAI vs paliperidone/risperidone LAI.

This IRB-approved retrospective review examined 190 inpatients in Unted States based hospital system across three different hospitals. It included patients 25 years old or younger who received either aripiprazole LAI (n = 61) or paliperidone/risperidone LAI (n = 129). T-tests and chi-squared tests were calculated to compare sociodemographic and clinical characteristics, and logistic regression was used to predict which LAI patients received. Effect sizes were calculated for significant results.

The aripiprazole group had a greater proportion of patients with history of nicotine use (χ2 = 4.56, df = 1, p = 0.03, V = 0.16), sedative-hypnotic use (χ2 = 10.86, df = 1, p<0.001, V = 0.24), family history of psychiatric illness (χ2 = 4.08, df = 1, p = 0.04, V = 0.15), and history of non-suicidal self-injurious behavior (NSSIB) (χ2 = 5.110, df = 1, p = 0.02, V = 0.16). The paliperidone/risperidone group had a greater proportion of patients with prior psychiatric emergency visits (t = −2.304, df = 188, p = 0.02, d = −0.29). A greater proportion of the aripiprazole group presented for suicidality while a greater proportion of the paliperidone/risperidone group presented for psychosis (χ2 = 15.250, df = 2, p < 0.001, V = 0.28). Logistic regression found that history of NSSIB decreased odds of receiving paliperidone/risperidone LAI by 0.44x (95% CI 0.21-0.92), while each prior psychiatric emergency visit increased odds of receiving paliperidone/risperidone LAI by 1.39x (95% CI 1.04-1.85).

Aripiprazole LAIs may be more frequently used when there is history of suicidal behavior or mood disturbance, while paliperidone/risperidone LAIs may be more frequently used in psychosis or prior contact with the psychiatric healthcare system. Limitations of this study include its retrospective nature and multiple comparisons. While this study demonstrates there are predictors to suggest which LAI a patient will receive, further research should investigate if the chosen LAI is effective by looking at length of hospital stay, time to readmission, and number of psychiatric ED visits/readmissions within one year.

None Declared

Dietary factors have gained increasing attention for their potential role in the development and management of psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD). This review aims to assess whether tailoring nutritional interventions to specific patient phenotypes enhances therapeutic efficacy in pediatric ADHD and to evaluate the impact of nutrition and diet on ADHD management in youth.

Determine whether tailoring nutritional interventions to specific patient phenotypes will enhance therapeutic efficacy in pediatric ADHD treatment.

Evaluate how nutrition and diet can impact the management and treatment of ADHD in youth.

A literature review was conducted using Google Scholar and the National Institutes of Health PubMed database. Search terms included cross sections between “ADHD,” “attention deficit hyperactivity disorder,” and “nutrition” or “diet”, with “youth,” “adolescents,” “children,” and “pediatric” in various permutations. Of 621 search results, 83 articles relevant to the topic were included.

The few-foods diet (FFD) has been shown to significantly reduce somatic symptoms in children with ADHD, including eczema, diarrhea, and sleep disturbances. Nutritional supplements, particularly omega-3 fatty acids, have demonstrated efficacy in improving inattention, hyperactivity, and impulsivity. Micronutrient supplementation with iron, zinc, and magnesium has been linked to improvements in inattention and emotional dysregulation, particularly in those with deficiencies. These effects may be mediated by changes in the gut microbiome, as supplementation alters microbiota composition and evenness, with specific bacterial shifts associated with treatment response. Beyond FFD and supplementation, adherence to overall dietary patterns, including the Mediterranean diet, has been correlated with reduced odds of ADHD in children.

Nutritional interventions show promise in pediatric ADHD, with emerging evidence that clinical phenotypes may guide treatment selection. Targeted supplementation may be more effective in children with micronutrient deficiencies or low omega-3 levels. The FFD may provide greater benefit in children with atopic comorbidities, while Mediterranean diets show modest effects broadly across ADHD populations. Further randomized controlled trials specifically designed to validate differential responses across ADHD subgroups are warranted to improve the precision-based dietary guidelines.

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.

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

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

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

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.

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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.

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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

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.

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