The main pharmacotherapy of Attention Deficit Hyperactivity Disorder (ADHD) is stimulants, especially methylphenidate (MPH). MPH efficacy is assessed by subjective measures. The Test of Variables of Attention (TOVA) is a known objective assessment measure. In order to assess the accuracy of patients' reports, we used Clinical Global Impression – Compared (CGI-C-C) before and after MPH challenge comparing to the objective TOVA alterations.

165 children and adolescents, who were referred to the ADHD unit and were diagnosed as ADHD were included. TOVA was done before and after MPH challenge (0.3 mg/Kg). All patients filled CGI-C-C blind to the TOVA results.

165 patients participated in the study, M:F ratio 67%:33% respectively. Average age was 11.09+3.43 yrs. ADHD mixed type: ADHD inattentive type, 50.6%:48.1% respectively. A significant inverse correlation was found between CGI-C-C and the Commission (C) score of TOVA (r=-0.32, p< 0.01), but not for any of the other scores. Age had a significant role in the accuracy of estimation. A significant negative correlation between the age and the tendency to assess improvement was found (r = -.210, p<0.01). There were no differences by gender or diagnosis. A dependence was found between consistent normal results of ADHD score change and self assessment of improvement (F = 4.22, p<0.05).

A partial correlation was found between subjective and objective measures with regard to response to MPH, mostly for the behavioral aspects. The older the patient the more likely he/she is to estimate improvement, but the role of a placebo effect cannot be ruled out.

The proposed course targets a major international public health issue: the cause of death of about 100, 000 children and adolescents world-wide each year, suicide. It is the second leading cause of death in that age group in many European countries. There are over three million suicide attempts made by adolescents annually. Although genetic and family risk factors are highly associated with both suicide and with suicide attempts, the specific genetic alleles that transmit this vulnerability between generations have yet to be identified.

Some risk factors for teen suicide attempts and completion have been identified and will be discussed, including an Axis I psychiatric disorder (e.g. mood disorder), family discord, aggressive-impulsive traits and physical and sexual abuse. One key factor consistently associated with suicide and suicidal behavior and will get a special attention in the course is a family history of suicidal behavior. This is as strong a risk factor as major depression, and stronger than environmental factors such as abuse. Suicidal behavior runs in families, independently of axis I or II diagnosis. Gene-environment interaction models in children and families will be presented and discussed. We will propose a stress-diathesis model of suicidal behavior and a practical tool for risk assessment for the clinician.

The aim of the course is to give adult psychiatrists some basic knowledge in infant psychiatry that has become in the recent years, very relevant to the understanding the link between brain development, early childhood experiences, pathophysiology of personality disorders in adulthood, and psychotherapeutic transferential processes.

The course will be built as follows:

The first part will cover very recent data on the impact of early experiences in general, and attachment experiences in particular, on brain development and development of a theory of mind and empathy. Concepts of resilience, vulnerability, bio-psycho-social risk and protective factors will also be explored in length. Through these basic concepts, we will show how infant psychiatry is linked to prevention of adult psychopathology, and how the early attachment experiences reflect themselves in the psychotherapeutic process.

The second part will be clinical and will illustrate the basic concepts learned in the first part. A clinical case will be presented to show the development of borderline personality disorder from early childhood to adulthood, its transgenerational transmission to the offspring through disturbed attachment relationship, and some of the processes that took place during the dyadic mother-infant psychotherapy. We will show how parenthood can become a new motivation for change.

The course applies who any adult psychiatrist who is interested in the field of developmental psychopathology, and no previous experience with young children is needed. Clinical experience with personality disordered patients will be an advantage.

Adolescent suicide is a worldwide troubling phenomenon that has high comorbidity, including impulsivity, depression, and personality disorders. Attention Deficit Hyperactivity Disorder (ADHD) includes attention, impulsivity and hyperactivity. Comorbidity includes depression and substance abuse, and has a higher rate in adolescents and adults. Studies considering the association between these phenomena are surprisingly rare. This pilot study estimated the percentage of ADHD in a population of adolescents who attempted suicide. Population included all adolescents (12-18 yrs.) who were brought to local ER after attempting suicide. Assessment included an interview according to the DSM-IV criteria, the Strengths and Difficulties Questionnaire parents (SDQ-P) the Conners' Rating Scale parents (CRS-P), and Kiddie-SADS. Test Of Variables of Attention (TOVA) with methylphenidate (MPH) challenge was done after the clinical evaluation to those diagnosed as ADHD.