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Melatonin is an indoleamine often used in children and adolescents. Melatonin is considered to be an effective clinical management for dyssomnias, sleep disorders present in children with attention-deficit hyperactivity, autism spectrum disorders, developmental delays. Quickacting capsules, controlled-release (CR) capsules, sublingual tablets and liquid forms are available. Melatonin is generally very well-tolerated in children and adolescents. The pharmacology, therapeutic applications, and side effects of melatonin are discussed. Although stimulants have been used most frequently in ADHD treatment their long term effects did not investigate well. Methylphenidate which is the most frequently prescribed stimulant's long term side effects on growth-development, cardiovascular, psychiatric and neurological systems are very important 2 . Stimulant diversion or misuse in long term has growing up in recent years and lead important consequences on community health 3 . Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) consortium was established in 2012 and experts on ADHD, drug safety, neuropsychopharmacology and cardiology developed a programme which investigates the long term possible side effects of stimulants 2 . In this presentation, long term side effects of stimulants (methylphenidate) will be reviewed through the perspective of ADDUCE work group study results.

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Objective: It has been proposed that anything does not kill you make you stronger. Although it might be true in adult cases, children whose psychological life begin in the parental mind and shaped by the experiences during the early period of life are not as strong as adult against adverse effects of stressful events. Internalization of objects and emerging of internally working models, concept of normality and abnormality that will be the main ground for the understanding of the world in later life are emerged during childhood. That is why anything does not kill a child will shape its mind that might have everlasting effects on child. The clinical characteristics and pharmacological treatment process of a 10-yearold boy with Autism Spectrum Disorder who had drug refractory self-injurious behaviour Hasan Cem Aykutlu and Işık GörkerDepartment of Child and Adolescent Psychiatry, Trakya University School of Medicine, Edirne, Turkey E-mail address: hasancemay@hotmail.com ABSTRACT Objective: Irritability is the most common co-occurring symptom and common target of pharmacotherapy in children with Autism Spectrum Disorders (ASD) [1][2][3]. FDA-approved agents risperidone and aripiprazole are commonly used in irritability and became the firstline treatment, but the growing evidence has shown that a group of children with ASD comorbid, especially with intellectual disability, do not respond to the treatment [1,3]. In a recent research, drug refractory behaviours in children with ASD defined as aggression, selfinjury, and tantrums requiring medication adjustment despite trials of risperidone and aripiprazole or three or more psychotropic drugs targeting irritability [1]. In this presentation, it is aimed to review current literature with the case report of a child with ASD who had drug refractory self-injurious behaviour. Case presentation: Ten-year-old boy, who diagnosed with ASD and attention-deficit/hyperactivity disorder (ADHD) and intellectual disability, has been followed in our outpatient clinic since he was 3 years old. He had been prescribed risperidone up to 2 mg/day for irritability and hyperactivity between 3 and 9 years old, and had responded well to the treatment. At age 10, his family described the increase in irritability, aggression, tantrums, and severe self-injurious behaviour with his ongoing treatment. His Clinic Global Impression (CGI)-Severity score was 7/7, Aberrant Behaviour Checklist (ABC)-Irritability score was 41/45 and ABC-Hyperactivity score was 40/48. Neurological and medical comorbidities were not detected in the examination. There was limited or no response to the treatment with various trials of risperidone, aripiprazole, haloperidol, zuclopenthixol, benzodiazepines, methylphenidate, atomoxetine, valproate, and PSYCHIATRY AND CLINICAL PSYCHOPHARMACOLOGY, 2018 VOL. 28, NO. S1, 297-391 https://doi.org/10.1080/24750573.2018 naltrexone. After the combined treatment of risperidone 2 mg/day with clonidine 0.3 mg/day, well and sustainable treatment response of irritability and self-in...

IntroductionSexual dysfunction (SD) is defined as the deterioration of sexual response cycles caused by anatomic, physiologic or psychologic reasons.ObjectivesWe believe that SD is closely related to self-esteem and childhood trauma (CT).AimIn this study, the level of self-esteem and CT in patients diagnosed with SD vs. controls are aimed to be compared. In addition, relationship between complaints of SD self-esteem and CT variable subgroups are planned to be investigated.MethodTwenty-four patients visited Prof. Dr. Mazhar Osman Psychiatric Hospital with matching defined criteria and 24 control counterparts statistically matching were taken sociodemographic data form, Rosenberg Self-esteem Scale (RSS) and Childhood Trauma Questionnaire (CTQ-28) was applied.ResultsCTQ-28 averages and RSS variables which are sensitivity to criticism, depressive mood, psychosomatic symptoms, feeling threatened in interpersonal relationships, degree to participate in discussions, relationship with father were higher in patients with SD (P < 0.05). Considering the relationship between complaints of SD and CTQ-28 subscales, physical abuse, emotional abuse, physical neglect, emotional neglect averages of patients were observed significantly different rooted by genitopelvic pain/penetration disorder and premature ejaculation and in emotional neglect by premature ejaculation and low libido combination (P < 0.05).ConclusionsIn literature, there are many studies that show CT leads to SD and several studies state that self-esteem is affected in patients with SD [1]. CT must be considered and determined in the goal of treatment of SD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Background Investigation of vaginal penetration cognitions and metacognitive beliefs in genito-pelvic pain and penetration disorder (GPPPD) could be important for understanding the underlying mechanisms of sexual disorders. Aim The aim of this study was to compare healthy controls and GPPPD women for vaginal penetration cognitions and metacognitions. Methods Outpatients with GPPPD (n = 135) and healthy controls (n = 136) were evaluated with Sociodemographic Data Form, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV (SCID-I), SCID nonpatient version, Golombok-Rust Inventory of Sexual Satisfaction Female Form (GRISS), Vaginal Penetration Cognition Questionnaire, Metacognitions Questionnaire (MQ), Hamilton Anxiety Rating Scale (HAM-A), SCID and Hamilton Depression Rating Scale (HAM-D). Outcomes The relationship between metacognitions and vaginal penetration cognitions was detected, and patients with GPPPD and healthy controls were compared for metacognitions. Results The MQ total score and all MQ subdimension scores other than positive beliefs about worry of GPPPD were found to be significantly higher in the GPPPD group than in controls. All Vaginal Penetration Cognition Questionnaire subdimension scores except positive cognitions for penetration score were significantly higher in patients with GPPPD than in controls. The total and frequency of sexuality, sexual communication between partners, avoidance of sexuality, nonsensuality, vaginismus, satisfaction, and anorgasmia subscores of the GRISS were significantly higher in the GPPPD group. Cognitive self-consciousness, need for controlling thoughts, and HAM-D values had a significant and independent effect on distinguishing the patients with GPPPD from the controls. Clinical Implications Our results may be important to address the metacognitions in the treatment of women with GPPPD. Strengths & Limitations The strengths are large-sample case and control groups, comparison with the control group using both clinical interviews and scale evaluations, diagnosis of GPPPD using clinical interviews and with 2 validated scales, exclusion of patients with depression and anxiety disorders, and evaluation of metacognitions not affected by concomitant disorders. The cross-sectional nature of our study and the fact that it was performed only in treatment-seeking groups and recruitment of hospital workers' relatives as a control group were limitations of the study. Conclusion In addition to the behavioral components of GPPPD treatment, the emphasis on metacognitions especially in the treatment process may have a positive effect on treatment.