Introductiontrauma affects not the child but the whole family. how would the parents’ reaction to trauma influence the child’s resilience capacities?Objectivesstudy the mental health status of parents of children consulting the trauma and resilience unit.MethodsDescriptive and retrospective study of 20 consultants in the trauma and resilience unit at Mongi Slim hospital between January and April 2022. The evaluation of depressive symptoms in children was made by Children's Depression Inventory (CDI). The Hamilton Depression and Anxiety Scales were used to assess anxiety and depressive symptomatology in the parents of the consultants.ResultsThe mean age of the children was 10.46±3.24.The traumatic event was related to an assault in 75% of cases, 45% of which were intrafamilial, road accident and death of a relative in 10% respectively, 5% domestic violence.Five consultants had a CDI score ≥8 and 15 had a score >10. Only parents of children with a CDI score>19 had moderate to severe symptoms according to hamilton scales.The diagnosis of adjustment disorder was made in 45% of cases, post-traumatic stress disorder 20%, acute stress disorder 10% other 15%ConclusionsThe parents’ reaction to the tragedy would play a modulating role on the children’s resilience capacities. less anxious and depressed parents would help their child build his/her coping mecanisms.Disclosure of InterestNone Declared

IntroductionPseudoneurological symptoms are frequent among children consulting in neuropediatrics. Psychogenic origin is often unrecognized, which may cause a major disruption and an increase of medical care expenses.ObjectivesThe purpose of this study was to identify clinical features of pseudoneurological symptoms through patients admitted in neuropediatrics.MethodsA descriptive retrospective study of a population of 19 children and adolescents hospitalized in the neuropediatrics department at the National Institute of Neurology in Tunis, between January 2015 and April 2019, having recieved the diagnosis of psychogenic symptoms.ResultsTwelve girls and seven boys were included in this study.The averge age were 11.5 years. All patients had normal cogntive and motor development. In most cases (84%), patients had a history of somatic illness. Only three patients had a history of psychiatric disorders. Family history of somatic disorders was found in 42 % of the sample and psychiatric disorders in three patients. Negative pseudoneurological symptoms such as loss of function, were detected in 60 % of patients, paraparesis and paraplegia were the most recurrent. Only one patient had pseudo-epileptic symptoms. Further investigations were performed in all patients, averaging 4 tests per patient. The average term between the beginning of the symptoms and the established diagnosis of psychogenic symptoms was 72 days with an average stay at hospital of 4 to 7 days. All patients had conversion disorder according to DSM V.ConclusionsIt is recognized that somatization could be a warning sign of psychological distress mainly among children. Conversion disorder, rarely seen in children, presents frequently as pseudo neurological symptoms.

IntroductionBipolar disorder in children and adolescents is distinguished by a variable and complex clinical expression. Mood is difficult to assess, mood symptoms are often masked and signs of disorganization may be in the limelight. This can be more difficult when adolescents have intellectual disability (ID).ObjectivesThis work aims to describe diagnostical and therapeutical features of bipolar disorder in adolescents with ID.MethodsCase reports about five patients who have been diagnosed with bipolar disorder associated to ID, all seen and treated in child and adolescent psychiatry department of Razi Hospital, in Tunis.ResultsThe study focused on three girls and two boys, all with mild to moderate ID. Four patients had psychiatric family history of bipolar disorder and ID. Only one patient was followed since childhood for mixed ADHD. The average age of onset of bipolar disorder was 14 years. Four cases were inaugurated by manic access; the fifth was a depressive disorder followed by a manic shift under sertraline. Only one case was rapidly favorable, under 10mg of Olanzapine, without any recurrence or relapse during 18 months of follow-up. Another case was slower but also favorable, under 10mg of Olanzapine. We found resistance to usual treatments for 2 patients; these did not evolve well under conventional thymoregulators, or different antipsychotic molecules, nor with combinations of two thymoregulators + an antipsychotic. One of them benefited from a combination of clozapine and lithium with excellent response.ConclusionsBipolar disorder comorbid with ID in adolescents is a difficult diagnostic entity and particularly hard to manage.DisclosureNo significant relationships.