Self-injurious behavior (SIB) among adolescents has become a hot topic in psychiatry. Despite the consensus that the prevalence of SIB is high, 26-22% among adolescence, there are conflicting results about whether it has increased in the 21st century and about the global distribution of the prevalence.

The aim of the current study was to make a systematic search and meta-analysis of publications from the last 5 years on the prevalence of SIB in adolescents and to examine definitions and assessments of SIB, gender, continental, and year differences. The hypotheses were the following: 1) the prevalence of SIB did not change over time between the examined period for both girls and boys; 2) girls reported a higher prevalence of a history of SIB than boys.

The systematic search was made in June 2020. Six databases were used. The main search terms were “self-injurious behavior”, “prevalence” and “adolescence”. First the titles and abstracts of the relevant articles were checked, then the full texts were read and collected those papers that met the inclusion criteria. The inclusion criteria were the following: published between 01/01/2015, and 06/18/2020, focused on community sample, and written in English. Comprehensive Meta-Analysis software was used to conduct the analyses.

In sum, a total of 97 articles were included in the meta-analysis with data from 439 818 participants. The overall average SIB prevalence was 16.0% in these studies. The first hypothesis was only partially confirmed. When all data that were published between 2015 and 2018 were considered, x significant increase was found in the prevalence of SIB between 1998 and 2018. However, when the analysis was restricted to the time frame between 2013 and 2018, no change in prevalence was found. The second hypothesis was fulfilled, girls reported a significant higher prevalence than boys (19.4% and 12.9%, respectively). A significantly higher prevalence was found when suicidal intent was excluded (18.3%), than when it was not excluded (11.3%) from the definition of SIB. The largest prevalence was found when measurement instruments were used that had been validated for SIB (18.9%). A significantly higher SEB prevalence was found among Asian articles than those from other continents (19.5% and 14.7% respectively).

The current systematic review and meta-analysis draw attention to the high prevalence of SIB among adolescents, especially among girls and those living in Asia. It is important to address this behavior, in terms of prevention and intervention as well.

None Declared

The Childhood Mental Disorders Research Group of ELTE began helping displaced children and their families immediately after the outbreak of war in Ukraine in March 2022. This work is still being carried out on a voluntary basis. According to the current needs, they organize "playgroup" for children and their families several times a week both at a fixed location at the ELTE and at external locations in shelters where they work with many children and their families at the same time. The main focus of the groups is the prevention of mental illness.

In this presentation, the work of the Research group will be presented, which has been done in a shelter that accommodates mainly families with Roma ethnic backgrounds from the Transcarpathia region fleeing the Russian-Ukraine war.

None Declared

Several studies showed the high suicide risk of patients with attention deficit and hyperactivity disorder (ADHD), however most of these studies had cross-sectional design.

The aim of the current study was to review systematically those studies which investigated the suicide risk among ADHD patients with longitudinal design.

The systematic search was made on OVID Medline, PsychInfo, PubMed, Scopus, and Web of Science. The search terms were (ADHD OR attention deficit hyperactivity disorder) AND (suicide OR suicidal OR suicidality) AND (follow-up OR longitudinal study OR prospective study). Inclusion criteria were: written in English; participants under 18 years at the baseline; longitudinal, prospective studies; ADHD population at the baseline and at the follow-up; suicide behavior as primary outcome. Exclusion criteria were: the study did not contain empirical data, and reviews/meta-analyses and studies which aimed to investigate the drug treatment efficacy of ADHD.

18 papers were included in the systematic review. 10 articles were published in the last 5 years. 9 studies enrolled children aged under 12 at baseline. The follow-up periods varied between 2 and 17 years. 17 studies found a significant positive association between ADHD diagnosis at baseline and the future suicidal behavior and/or attempts at the follow-up. The affective comorbidity showed an association with the future suicide risk.

These results highlight the importance of screening suicidality in patient with ADHD and consider it during treatment. Further studies are needed to clarify the role of the treatment and comorbidities of ADHD in the increased suicide risk.

No significant relationships.

Previous studies underline the importance of internalising disorders as risk factors of nonsuicidal self-injury (NSSI), meanwhile only a few research draw the attention to the role of externalising disorders. The possible association between NSSI and pathological internet use (PIU) is also understudied.

The purpose of this study was: 1) to investigate the frequency of NSSI among adolescents with different psychopathology and in different internet user groups of adolescents, 2) to understand the mediator role of psychiatric disorders between NSSI and PIU.

Adolescents were enrolled from a clinical (Vadaskert Child Psychiatric Hospital, Budapest, Hungary) and a school based population (high schools in Budapest, Hungary). The used measurements were: Strengths and Difficulties Questionnaire (SDQ), Deliberate Self-Harm Inventory, Young Diagnostic Questionnaire for Internet Addiction, Mini International Neuropsychiatric Interview Kid.

There was significant difference in the frequencies of NSSI in SDQ subgroups (U=2127.000; z=-6.170; p <0.001). There was also significant difference in NSSI frequency between normal- and pathological internet users (U=2020.000; z=-2,501; p <0.017 p=0.012). According to the mediator model there was no direct association between PIU and NSSI, however it was mediated by different psychiatric disorders (affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, conduct disorder, opposition defiant disorder, psychoactive substance abuse/dependence, psychotic disorders, suicidal behavior).

The results strengthen that both internalising- and externalising psychopathology are associated with NSSI. Moreover this study underlines the importance of careful screening and treating of comorbid disorders with PIU, which can have a role in the prevention of NSSI and suicide as well.

No significant relationships.

Previous research highlighted that adolescents with attention-deficit/hyperactivity disorder (ADHD) are four times as vulnerable to suicidal behavior as the healthy population. Maladaptive perfectionism is also viewed as an important risk factor for suicide. Yet, there are no studies which focused on the relationship between perfectionism and suicide among adolescents with ADHD.

The objective of the present study was to explore if perfectionism may be a risk factor for suicidal behavior in adolescents with ADHD.

The clinical group was recruited from outpatient clinics, while the non-clinical group was recruited from high schools around Hungary. The clinical group’s inclusion criterion was ADHD diagnoses, while the non-clinical group required the absence of any current or past psychiatric treatment or diagnoses.

In the ADHD group 88 adolescents participated, and 96 adolescents participated in the non-clinical group. There was no difference regarding the level of perfectionism in the groups, except one dimension of perfectionism, which is ‘Organization’. The ADHD group had significantly higher level of suicidal behavior than the control group ((χ2 (1) = 11.222, p < .001, V = 0.25). Among the ADHD group adaptive perfectionism was significantly negatively correlated with suicidal behaviour.

Adolescents with ADHD did not have a different level of perfectionism than the healthy control group only in ‘Organization’ trait. This result could add to the therapeutic work with adolescents diagnosed with ADHD with underlining the importance to focus on organizational skills. The result highlights that adaptive perfectionism appears to be a protective factor against suicidality.

No significant relationships.

In recent years, physical activity as a potential intervention for attention-deficit hyperactivity disorder (ADHD) became into the focus of researchers, however the results are conflicting.

Our aim was to investigate the effect of acute moderate physical activity on executive functions requiring inhibition.

The study included 50 treatment-naïve ADHD children, 50 medicated children with ADHD and 50 typically developing children, aged 6–12 years. To diagnose ADHD, we applied the Mini International Neuropsychiatric Interview for Children and Adolescents. To measure executive functions, the pediatric version of the Test of Attentional Performance (KiTAP) was used. Half of the children in each study group participated in a 20-minute, moderately intense exercise while watching a cartoon video. In the control intervention, the other half of the children from all three study groups watched the same cartoon video in a sitting position for 20 min.

Regarding distractibility, flexibility and inhibition, physical activity had a significant positive effect on two of 10 parameters (number of total errors and errors when distractor was presented, both in the distractibility task) in the treatment-naïve ADHD group.

Our results suggest that moderate acute physical activity has some significant positive effects on certain executive function parameters among children with ADHD. Future studies should consider determining the optimal form, intensity, and duration of physical activity to become a potential adjunctive intervention for children diagnosed with ADHD.

No significant relationships.

Nonsuicidal self-injury (NSSI) is highly prevalent in clinical and non-clinical adolescent populations. Non-clinical studies focus on high school students thus vocational school students are underrepresented in research and prevention programs, despite being exposed to higher levels of stressful life events, a factor associated with NSSI and suicide.

This study aimed to explore NSSI, suicidal behavior and life events among adolescents in clinical and non-clinical, i.e. both high school and vocational school settings.

A clinical (n=202) and non-clinical (n=161) sample of 13-18-year-old adolescents were assessed with the Mini International Neuropsychiatric Interview Kid, the Deliberate Self-Harm Inventory, and the Life Events List. Data were analyzed with R version 3.6.1., using Wilcoxon tests and negative binomial regression models.

The prevalence of suicidal behavior (W=7.306, p<.001), NSSI (W=9.652, p<.001), and life events (W=10.410 p<.001) were significantly higher in the clinical than in the non-clinical group. The relationship between NSSI and suicidal behaviour was significantly stronger in the clinical group (95% CI: [.56,.72]) than in the nonclinical group (95% CI: [.24,.52]). The interaction between NSSI and life events (Χ2(1)=10.49, p<.01) was associated with suicidal behavior. Interpersonal events were associated with both suicidal behavior and had a moderating effect on the NSSI–suicidal behavior relationship.

NSSI is highly prevalent and is strongly associated with suicidal behavior in clinical and non-clinical adolescent populations. Our result call attention to the necessity of including adolescents from various educational settings in NSSI research and prevention projects during which life events, especially interpersonal events, might require special attention.

No significant relationships.

Adolescents have to cope with several challenges and restrictions due to the COVID-19 pandemic, with many of those incongruent with the typical developmental tasks of adolescent age. Some adolescent might be particularly vulnerable in this situation.

This study aimed: 1) to collect data on the mental health and quality of life of adolescents during/after the pandemic; 2. to improve adolescents’ mental health by providing an online prevention program that addresses their actual needs; 3. to accelerate the development of culturally adapted prevention programs by involving an international team, and 4. to contribute to adequate preparation for any similar situation in the future.

Participants aged 11-18 years and their parents/caregivers were recruited online. Data has been collected regularly in a follow-up study by Inventar zur Erfassung der Lebensqualitat and Strengths and Difficulties Questionnaire. The baseline data collection was in March 2020 at first restrictions of the COVID pandemic in Europe

In the baseline data 428 adolescents (29.7% boys;70.3% girls) were included. Adolescents reported significantly lower quality of life during the pandemic (F (1,557) = 29.11; p <0.001; R2 = 0.048). There was no significant difference in quality of life according to whether the adolescents live in a household with their siblings ( F (2, 356) = 0.785 p = 0.457; η2 = 0.004), and whether the adolescents have symptoms of hyperactivity (ß = 0.105; p = 0.295).

Prevention based on the results of this study is expected to contribute to maintaining adolescents’ mental health during and after the COVID pandemic.

No significant relationships.

Depression and suicidal behaviour are major public health problems everywhere but particularly in Hungary where until 2000 the suicide rate was among the highest in the world.

To analyse the possible causes of declining national suicide rate of Hungary.

Review of the scientific literature on Hungarian suicide scene published in the last 40 years.

The peak of Hungarian national suicide rate was in 1985 (46/100.000) but due to a steady and continuous, year by year decline, in 2019 it was only 16/100.000, which represents a more than 65% decrease. Rate of unrecognised/untreated mood disorders, availability of health/psychiatric care, antidepressant and lithium prescription, unemployment, smoking and alcohol consumption as well as lithium and arsenic contents of drinking water were the most investigated possible determinants of suicide mortality of the country. More widespread and effective treatment of psychiatric/mood disorder patients, decreased rate of unemployment and smoking as well as the continuously improving living standards were the most important contributors to the great decline of the national suicide rate. However, in 2020 – the first year of the COVID-19 pandemic – the national suicide rate rose by 16%, which was almost totally accounted for by the increase of suicides among males.

Suicidal behaviour is preventable in many cases, but as it is a complex, multicausal phenomenon, its prevention should involve several medical/psychiatric, psychosocial and community interventions.

No significant relationships.

Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.

The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.

We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.

We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

The relationship between psychiatric disorders and adolescent suicide is well established. The aim of the present study was to examine gender differences in suicidal behavior among adolescents.

A structured diagnostic interview (Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid)) was used to determine 25 psychiatric diagnoses defined by the DSM-IV and suicidal behavior (having any current suicidal ideations or suicide attempts). The study population consisted of adolescents (aged 11-18), who were consecutively, first time admitted patients with suicidal behavior (according to the M.I.N.I. Kid) into the Vadaskert Child Psychiatry Hospital, Budapest.

Altogether 81 adolescents (46 girls (56.8%) and 35 boys (43.2%)) met the inclusion criteria. The most common psychiatric disorder of suicidal boys (n=35) was attention deficit hyperactivity disorder (ADHD) (n=17; 48.6%), followed by oppositional defiant disorder (ODD) (n=16; 45.7%) and generalized anxiety disorder (GAD) (n=13; 37.1%). Among girls (n=46) the most common psychiatric disorder was dysthimia (n=23; 50%), followed by GAD (n=22; 47.8%) and ODD (n=20; 43.5%).

This study examined an inpatient population with suicidal behavior, generalizations about outpatient and community samples cannot be made.

Based on the present study in adolescent suicide prevention, in both sexes professionals have to pay attention to externalization and internalization disorders as well. The striking finding is the very high prevalence of ADHD among suicidal boys. It's important to emphasizes the important role of GAD and ODD as risk factors of suicidal behavior in both sexes and dysthymia among suicidal girls.

Suicide among adults have been associated to subthreshold psychiatric illnesses as well; however it is little known about the role of subthreshold mental disorders in suicide risk among children/adolescents.

Using the Mini International Neuropsychiatric Interview Kid the authors examined 105 hospitalized children/adolescents in the Vadaskert Child Psychiatric Hospital, Budapest. Current suicide behavior was defined as giving positive answer to any of the following questions: “In the past month did you: think you would be better off dead or wish you were dead? want to hurt yourself? think about killing yourself? attempt suicide?”

We report data on 105 hospitalized children/adolescents, 76 (72.4%) boys and 29 (27.6%) girls. The mean age of the subjects was 11.4 years (SD = 3.43, min: 5, max: 17). Current suicide behavior was present in 18 cases (17.1%). There were one person with current suicide behavior, who did not have any current DSM-IV disorder, but he/she had current subthreshold disorder. The majority (n = 16, 88.8%) of the children/adolescents with suicide behavior had both current subthreshold and DSM-IV disorders. Eight children/adolescents (44.4%) with current suicide behavior had current DSM-IV major depressive episode and further 5 children/adolescents (27,8%) had current subthreshold major depressive episode. The prevalence of DSM-IV and subthreshold major depressive episode was significantly higher among hospitalized children with suicide behavior (n = 18), than among hospitalized children without suicide behavior (n = 87) (X2 = 5,272, df = 1. p = 0,022).

Subthreshold forms of pediatric psychiatric disorders need to be taken into account as well in suicide prevention.

Previous reports have demonstrated that depressive mixed state (DMX) (major depressive episode + 3 or more co-occurring intradepressive hypomanic symptoms) and agitated depression are overlapping conditions. The aim of the current study was to examine the relation of DMX and suicide attempt.

Using a structured interview (modified Mini International Neuropsychiatric Interview) and determining all the symptoms of 16 Axis I psychiatric diagnoses defined by the DSM-IV, the authors examined 100 consecutive nonviolent suicide attempters (aged 18-65) within 24 hours after their attempts. Results. DMX was present in 63.0% in the total sample and in 71% among the 89 depressive suicide attempters. More than 90% of the patients with DMX had the symptoms of irritability, distractibility and psychomotor agitation. The rate of DMX was significantly higher among the 29 bipolar (I+II) than in 37 unipolar depressive suicide attempters (90% vs 62%).

This study included suicide attempters who had presented self-poisoning, but not individuals with very high risk of fatality.

In suicide attempters there is a very high prevalence of DMX, especially among bipolar depressive suicide attempters. This study underlines the importance of detecting and appropriate treating DMX and especially depressive bipolar mixed subgroup in suicide behaviour prevention.

There are few data on the prevalence of subthreshold pediatric psychiatric disorders, when the child/adolescent doesn't qualify for any mental disorder according to the classification systems (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) and International Classification of Mental and Behavioral Disorders 10th Edition (ICD-10)), however the symptoms cause difficulties in the everyday life of the child/adolescent. The aim of the present study was to estimate the prevalence of subthreshold eating disorders among hospitalized children.

We examined 106 hospitalized children/adolescents aged under 18 in the Vadaskert Child and Adolescent Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary. Threshold (DSM-IV) and subthreshold disorders were evaluated with the Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid).

There was no single child hospitalized due to threshold eating disorder during the study period, but 7.5% of them had the diagnoses of current subthreshold eating disorder. In all cases it was subthreshold bulimia nervosa. Subthreshold bulimia nervosa was always a comorbid condition with a threshold disorder.

Our findings indicate, that clinicians should think about the presence of subthreshold eating disorder as a comorbid condition among hospitalized children.

The researches show a rapid growth of mental disorders among adolescents and young adults that often cooccurs with risk behaviours, such as suicide, which is one of the leading cause of death among young ages 15-34. Therefore it's necessary to use some tools that can promote mental health getting to young lives such as Internet and media.

SUPREME (Suicide Prevention by Internet and Media Based Mental Health Promotion) is aimed to increasing the prevention of risk behaviours and mental health promotion through the use of mass media and Internet.

The main expected outcome is to improve mental health among European adolescents.

In each European countries a sample of 300 students (average age of 15 years) will be selected. The prevention program will be a highly interactive website that which will address topics such as raising awareness about mental health and suicide, combating stigma, and stimulate peer help. The program will use different means of referral to the intervention website: “Adolescent related” and “Professional related”. A questionnaire will be administered to the pupils for require the data on lifestyles, values and attitudes, psychological well-being, familiar relationship and friendship.

Some web-sites, managed by mental health professionals, produced encouraging results about their use in prevention of risk behaviours and in increase well-being, especially in youth with low self-esteem and low life-satisfaction. With the implementation of the SUPREME project we will be able to identify best practices for promoting mental health through the Internet and the media.