bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trichotillomania with trichobezoar in 11-year-old girl - difficulties of recognizing the disorder and possible complications: case report
Authors: Klobučar A. , Dobrić L. T. , Drmić S. , Mišak Z. 
Published: August 2023

IntroductionTrichobezoar is a rare entity that primarily occurs as a complication of psychiatric disorders, most often in adolescent and young females suffering from trichotillomania (TTM) and trichophagia. In many cases, children with TTM unwillingly admit hair pulling, deny ingesting hair and often feel ashamed of their disease and try to hide it.ObjectivesOur main aim was to present an uncommon complication of TTM and trichophagia and to point out the importance of early diagnosis and prevention of complications of the disorder. Furthermore, we describe the role of a child’s psychological features and family dynamics in etiopathogenesis of TTM, as well as comorbidities and specific clinical presentation.MethodsCase report.ResultsAn 11-year-old girl was admitted to the pediatric department due to abdominal pain. After detailed pediatric differential diagnosis, trichobezoar was diagnosed and she was treated surgically. While she did not deny ingesting her hair, three months after surgery (TTM was dermatologically verified from the beginning of the treatment) she mentioned focused hair pulling for the first time. During individual cognitive behavioral psychotherapy the following was recognized in the patient: perfectionism traits, inhibition in expressing emotions, elements of depression, anxiety. During family psychotherapy elements of alexithymia were observed.ConclusionsCooperation among medical experts (pediatrician, dermatologist, child psychiatrist, pediatric surgeon etc.) and awareness of this disorder is important for recognizing it at an early stage and starting the treatment, especially considering habit-forming mechanism, psychiatric comorbidity, emotional distress and preventing other complications including trichobezoars.Keywordsadolescents, trichobezoar, trichophagia, trichotillomaniaDisclosure of InterestNone Declared
Treatment Options for Problematic Internet Use
Authors: Dell’Osso B. 
Published: August 2023

AbstractResearch investigating interventions for problematic usage of the Internet (PUI) remains at an early stage but is steadily developing. In terms of therapies assessed through randomized clinical trials, literature suggests that cognitive behavioral therapy may be the most effective intervention but definitive statements as to its benefits need more testing. In relation to pharmacological treatments for PUI, studies have largely examined the efficacy of agents such as antidepressants and stimulants with a potential therapeutic effect of escitalopram, bupropion, methylphenidate, and atomoxetine. Another emerging form of potentially useful treatment involves non-invasive neurostimulation techniques such as transcranial magnetic stimulation and transcranial direct current stimulation. These interventions are thought to mediate their effect in PUI via stimulation of cortical brain cells and modification of their related functions. In summary, although the limited available treatment evidence includes some promising findings, there is a need for higher-quality research to develop best practice guidelines and determine cost-effective options in PUI treatment. The presentation will provide a state-of the-art overview in the field of therapeutics for PUI.Disclosure of InterestB. Dell’osso Grant / Research support from: LivaNova, Inc., Angelini, and Lundbeck
Clinical improvement of teens participating in a dbt skills training
Authors: Ezquiaga Bravo I. , Rodríguez A. M. , Vilar A. , Salvador A. , Biempica M. , García K. M. , Martín L. M. , Batlle S. 
Published: August 2023

IntroductionDialectical behavioural therapy (DBT) developed by Linehan has been shown to be widely effective in improving emotional regulation capacity in patients diagnosed with borderline personality disorder in adults and adolescents, but also for other profiles of emotional dysregulation, even in the general non-clinical population through emotional regulation skills training programs in schools.ObjectivesThe objective was to describe psychopathological characteristics and to evaluate clinical outcome variables (self-harm, suicide attempts, admissions and emotional regulation difficulties) in young patients who participated in the DBT skills training group carried out by the child and adolescent psychiatry team of Hospital del Mar (Barcelona) between February 2020 and April 2022.MethodsProspective longitudinal study with two evaluations (before starting the group and after finishing it). The clinical variables were evaluated by reviewing the medical records, and the improvement in emotional regulation difficulties was evaluated through the Difficulties in Emotion Regulation Scale (DERS) adaptation to adolescents before and after the intervention.ResultsA total of 36 participants have been referred and assessed to participate in the previously mentioned emotional regulation program. The mean age was 15.6 years (14-17 years old). 100% of the participants were female. All of them met criteria for BPD according to the SCID-II questionnaire; but only 23 patients (63.9%) had BPD as their main diagnosis. 63.9% (n=23) presented psychiatric comorbidities, being 27.8% (n= 10) ADHD, 30.6% (n= 11) substance use disorder and 47.2% (n= 17) eating disorders,77.8% (n=28) had presented self-injurious behaviour, 52% (n=18) had committed a suicide attempt, requiring hospital admission in 36.2% (n=13) at some point in their lives before the therapy group. In the three months after the end of the group, admissions were reduced to 17% (n=6), suicide attempts to 14.8% (n=5) and non-suicidal self-injurious behaviours to 27.8% (n=10).The mean score of all participants on the DERS scale was 129.91 points before participating in the DBT skills group and 105 points right after the group finished. Higher scores translate into greater emotional regulation difficulties.ConclusionsThe reduction in DERS scores, self-injurious behaviours, suicide attempts, and admissions was notable for all participants. It remains to add the results of the groups currently in operation and perform the statistical analysis of all the results. It is necessary to continue studying and testing the benefits of DBT both in the clinical adolescent population and in the general child and adolescent population in order to generalize the promising results observed in our sample. At Hospital del Mar, we will continue to expand the DBT program so that more children and adolescents with emotional dysregulation can benefit.Disclosure of InterestNone Declared
Problematic video game use in adolescents and psychosocial functioning
Authors: Belabbes I. , Douk K. , Elmaataoui Z. , Kisra H. 
Published: August 2023

IntroductionVideo gaming is an extremely popular leisure activity, with over two billion users worldwide (Newzoo, 2017).Nevertheless, excessive video game playing exposes to potential dangers. The WHO reminds us that “every gamer should be aware of the time spent on games, especially if their daily activities are affected, as well as any physical or psychological, social and health changes that could be attributed to gaming behaviour.”ObjectivesThe aim of our study is to analyse the frequency of video game use, and to determine its relationship with psychological and social functioning and academic performance.MethodsA cross-sectional study was conducted in the child psychiatry department at Arrazi Hospital in Salé among adolescents aged between 10 and 17 years.For this, we used:
-A hetero-questionnaire on socio-demographic characteristics, reasons for gambling, type of gambling, satisfaction, self-esteem, ability to make friends and degree of social support, and school results-The DSM 5 criteria proposed in the appendix for the research-The K-SADSResultsSocio-demographic data-Our study was carried out on a sample of 57 adolescents aged between 10 and 17 years, with an average age of 13.47.-There was a predominance of males:Boys: 87.5 , Girls: 17.5All the adolescents are in school:Primary 26.3Middle school 59.6High school 14 %Social functioning and academic performance-54.4% reported having both real and virtual friends, 29.8% specified that all their friends are virtual, And 15.8% noted that they have no friends-Academic decline was noted by the parents of 61.1% of adolescents Psychological functioning-68.4% reported low self-esteem-31.6% reported being dissatisfied with their lives-0.5% met the diagnostic criteria for video game addictionConclusionsOur study finds that problematic video game use is related to male gender, low academic performance, difficulties with social interactions and also low self-esteem and satisfaction.Screening for psychiatric co-morbidities and vulnerability factors is essential for the management of this type of pathology.Disclosure of InterestNone Declared
Borderline personality disorder in adolescents: Descriptive study about a series of cases
Authors: Belabbes I. , Douk K. , Katir I. , Kisra H. 
Published: August 2023

IntroductionVideo gaming is an extremely popular leisure activity, with over two billion users worldwide (Newzoo, 2017).Nevertheless, excessive video game playing exposes to potential dangers. The WHO reminds us that “every gamer should be aware of the time spent on games, especially if their daily activities are affected, as well as any physical or psychological, social and health changes that could be attributed to gaming behaviour.”ObjectivesThe aim of our study is to analyse the frequency of video game use, and to determine its relationship with psychological and social functioning and academic performance.MethodsA cross-sectional study was conducted in the child psychiatry department at Arrazi Hospital in Salé among adolescents aged between 10 and 17 years. For this, we used :A hetero-questionnaire on socio-demographic characteristics, reasons for gambling, type of gambling, satisfaction, self-esteem, ability to make friends and degree of social support, and school results , The DSM 5 criteria proposed in the appendix for the research and The K-SADSResultsSocio-demographic data-Our study was carried out on a sample of 57 adolescents aged between 10 and 17 years, with an average age of 13.47.-There was a predominance of males: Boys: 87. ; Girls: 17.5All the adolescents are in school: Primary 26.3 , Middle school 59.6 , High school 14 % Social functioning and academic performance-54.4% reported having both real and virtual friends, 29.8% specified that all their friends are virtual, And 15.8% noted that they have no friends-Academic decline was noted by the parents of 61.1% of adolescents Psychological functioning 68.4% reported low self-esteem, 31.6% reported being dissatisfied with their lives and 0.5% met the diagnostic criteria for video game addictionConclusionsOur study finds that problematic video game use is related to male gender, low academic performance, difficulties with social interactions and also low self-esteem and satisfaction. Screening for psychiatric co-morbidities and vulnerability factors is essential for the management of this type of pathology.Disclosure of InterestNone Declared
Proactive psychiatry of addiction: toward the normalization of early prevention
Authors: Hendriks V. 
Published: August 2023

AbstractMost substance use disorders (SUDs) emerge in adolescence and young adulthood. Early interventions in young people may reduce the risk and severity of SUD and other mental disorders. However, we are not able to reach our young people early enough for prevention and treatment, and when we do, they often already show a high concentration of comorbid mental disorders and signs of a chronic intermittent course of SUD. Hence, we must reach our addicted young patients at an earlier stage, when symptoms are still mild or transient, or perhaps even before that – when they only show precursors of possible dysfunction.One of the most prominent precursors of dysfunction is our ability – or lack thereof – to control or "self-regulate" our behaviors, cognitions, and emotions. Many scientists argue that poor self-regulation is perhaps the core determinant of the development of mental health disorders, including addiction. Several prospective general population studies have shown that poor childhood self-control early in life is a strong predictor of many negative outcomes later in life, up to 20 to 30 years later in adulthood. Although correlational in nature, these findings suggest that early childhood interventions that are deliberately aimed at improving self-regulation may be effective in preventing these negative life outcomes, and that early prevention and intervention targeted at improving self-control may reduce the risk of a broad array of psychiatric and social problems, including addiction. Indeed, several recent large-scale systematic reviews have suggested that self-regulation skills are malleable and can be learned through instruction and practice, and perhaps most so in the early years, roughly around 3 to 6 years, when there is a steep increase in learning curve, when the plasticity of the brain is still high, and when self-regulation skills are still very much in development.This presentation provides an overview of the rationale and study findings of early prevention of substance use disorders and other mental health disorders. In terms of broad prevention, much can be gained by widespread, consistent implementation and normalization of early prevention at the pre- and elementary school level.Disclosure of InterestNone Declared
Suicidal crisis in the adolescent: About 3 clinical cases
Authors: Belabbes I. , Katir I. , Chtibi M. , Kisra H. 
Published: August 2023

IntroductionSuicide is the third most common cause of death among adolescents. It is linked to several mental pathologies. Early detection and effective and rapid management are essential elements to improve the mental health of the adolescent and prevent suicidal behaviour.ObjectivesOur objective is :-To discuss through these medical observations the risk factors and pathologies at high risk of suicide,-To detail the urgent course of action to be taken in the event of suicide attempts and-To underline the importance of early management to prevent suicide in adolescentsMethodsWe report hereafter the clinical cases of 3 adolescents followed in child psychiatry for the management of a suicidal crisis.Results1st clinical case :This is a 13 year old girl, brought back by the staff of the Lalla Meryem child protection centre, where she has been living since her separation from her family following abuse by her mother. She reports a reliving of scenes where her mother burned her private parts. She reports disturbed sleep with night terrors and nightmares. In addition, the centre’s staff reported irritability, crying spells and verbalized suicidal threats.2nd clinical case:This is a 15 year old girl referred by the paediatric service for management of a suicide attempt by ingestion of rat poison. She stopped her schooling 2 years ago to take care of her mother who had cervical cancer and died 6 months ago. Since then, she has experienced sadness of mood, low self-esteem with ideas of devaluation. During the first psychiatric interview, she did not criticize her suicidal act and said that she wanted to kill herself, which she considered the only solution to her suffering.3rd clinical case:This is a 12-year-old adolescent, followed in child psychiatry for conduct disorder with problematic use of tobacco, cannabis and benzodiazepines. He had stopped going to school since the third grade.He consulted for a suicide attempt by ingesting 30 antihypertensive tablets. After somatic care, he was referred to us from the medical emergency department for psychiatric care.ConclusionsSuicide among adolescents is on the increase in Morocco. It is necessary to take into account the risk of suicide in the face of any mental or somatic pathology. A rapid and urgent course of action is necessary to avoid recurrence.Disclosure of InterestNone Declared
Attachment, Emotion Regulation and Physiological Reactivity in middle-childhood: a pilot study
Authors: Tironi M. , Charpentier-Mora S. , Bizzi F. 
Published: August 2023

IntroductionAttachment, as an interpersonal motivational system, is the relational ground that allows emotions to be regulated through action on the Autonomic Nervous System resulting in better psychological outcomes during middle childhood. Emotion dysregulation and autonomic function are often connected to psychiatric symptoms observed in adolescence (e.g. borderline personality disorder traits) and thus middle childhood becomes a critical age for psychopathological trajectories.ObjectivesExamine the relationship between child’s attachment and both psychological and physiological emotional regulation.Methods20 children (Mage = 10.7, SD = 1.25; 65% males) were recruited from general population. Attachment was measured through the Child Attachment Interview (CAI), while emotional regulation was assessed with a multimethod approach, using questionnaires i.e. How I Feel (HIF) and Positive and Negative Affect (PANAS), and physiological measurements i.e. Heart Rate Variability (ratio between High Frequency and Low Frequency, HF/LF, labeled as the child’s sympathovagal balance) and Heart Rate (Beats Per Minute, BPM, as an index of physiological reactivity).ResultsStatistically significant correlations emerged between the HIF-Control scale and the Mother and Father Dismissal CAI scale, the PANAS-Negative Affect scale and the Mother and Father Preoccupied Anger CAI scale. Moreover, there was a non-significant but moderate effect (rs > .30) between HF/LF and the Emotional Openness and the Resolution scales of the CAI, and between BPM and the Emotional Openness scale.ConclusionsDespite the small sample size, more secure children are able to connect with their emotions and properly use them in solving relational problems. Consequently, they are likely to succeed in understanding and regulating emotions as they manage to find more adaptive strategies their own. On the contrary, the presence of dismissal or anger (insecure attachment) towards parents would appear to lead to higher levels of psycho-physiological dysregulation, a core feature of Borderline Personality Disorder dimensions starting to emerge later in adolescence. Future studies should consider physiological dysregulation as an additional factor linked to psychopathological developmental trajectories.Disclosure of InterestNone Declared
The psychological impact on parents of children with pyridoxine-dependent epilepsy
Authors: Boujelbene I. , Chaabane M. , Guirat M. , Ben Touhemi D. , Guidara S. , Moalla Y. , Kamoun H. , Ben Ayed I. 
Published: August 2023

IntroductionPyridoxine-dependent epilepsy (PDE) is a rare autosomal recessive disease usually associated with neonatal seizures that are sensitive to pyridoxine (vitamin B6). This disease can have a significant impact on family functioning, with significant psychological distress in parents. Post-traumatic stress disorder (PTSD), depression, and anxiety are the most common psychiatric outcomes in parents of children with PDE.ObjectivesTo investigate the prevalence of significant symptoms of depression, anxiety, and stress in parents of children with PDE.MethodsThe study consisted of a survey of parents accompanying their children diagnosed with PDE. The diagnosis was already confirmed by objectifying a homozygous or a compound heterozygous mutation in the ALDH7A1 gene in all siblings with heterozygous carrier parents. The Impact of Event Scale-Revised (IES-R) was used to assess parental post-traumatic stress, and the Hospital Anxiety and Depression Scale was used to screen for parental depression and anxiety.ResultsOur study included eight unrelated families with one infant presenting a confirmed PDE disease. The average age of the children with epilepsy was 4.18 years (8 months to 12 years) with equal representation of both sexes.Half of parents surveyed had depressive symptoms and about two thirds reported anxious symptomatology. These troubles are mainly related to the uncertain prognosis of the disease, even with vitamin B6 supplementation, and the high risk of recurrence in siblings, which led some parents to not have other children. A higher anxiety scores was reported in parents who claimed to have difficulties in providing the necessary vitamin supplements to their affected children on a regular basis. PTSD was diagnosed in three parents: most parents reported difficulties in dealing with stress, specifically in relation to the unpredictability of seizures and the unavailability of medical care for their child, which taxed their financial resources and made it difficult for them to perform their roles effectively.Besides, being an autosomal recessive transmission disease, the notion of responsibility/guilt was not reported by either parent, and both parents are equally involved in the care of their child.ConclusionsA significant proportion of children’s parents with pyridoxine-dependent epilepsy are suffering from depression, anxiety, and post-traumatic stress. A deeper understanding of the clinical expressions of these troubles could help practitioners to develop prevention and intervention strategies for these parents.Disclosure of InterestNone Declared