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Objective Anxiety disorders (AD) are known for its comorbidity and negative impact on the course of adult bipolar disorder (BD). However, there is limited research on AD comorbidity in pediatric BD (PBD). Here, we aimed to conduct a meta‐analysis and meta‐regression study about the comorbidity and covariates of AD and PBD. Method We systematically searched relevant articles published until May 2019, as defined in PRISMA guidelines. Variables for associated features and prevalence of AD were extracted. Results Thirty‐seven articles represented data for the analysis. Lifetime any AD comorbidity was 44.7%; panic disorder (PD) was 12.7%; generalized anxiety disorder (GAD) was 27.4%; social phobia was 20.1%; separation anxiety disorder (SAD) was 26.1%; and obsessive–compulsive disorder (OCD) was 16.7%. Childhood‐onset studies reported higher GAD and SAD comorbidity, while adolescent‐onset studies reported higher PD, OCD, and social phobia. Age of onset, gender, comorbidity of ADHD, substance use, oppositional defiant disorder and conduct disorder affected each anxiety disorders’ comorbidity with PBD differently. Conclusion Anxiety disorders are highly comorbid with PBD. Early‐onset PBD increases the risk of AD. Biopsychosocial aspects of this comorbidity and its course needs to be evaluated further.

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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...

Objectives: The well-being of healthcare workers is a critical indicator in the provision of high-quality care. Although researchers have stressed the importance of social interactions and social support, scarce data exist about their effects on healthcare workers’ well-being. In this study, we aim to advance the research on the relationships between social network diversity (SND), social support and thriving. Methods: In a cross-sectional design, an anonymous online link was shared among healthcare workers in a university hospital. The survey included questions on demographics, medical diseases, as well as items from the SND index, the multidimensional perceived social support scale, and the brief and comprehensive inventories of thriving scales. Results: A total of 103 individuals participated in the study (mean age ± standard deviation = 33±7.2; male/female = 33/70). Men and women did not differ in SND, perceived social support, or thriving scores. Healthcare workers older than 38 years exhibited higher scores in belonging (p=0.032), skills (p=0.006), self-worth (p=0.048), meaning and purpose (p