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Trichotillomania (TTM) is associated with great psychosocial impairment and reduced quality of life and the lifetime prevalence is 1-3 %. The purpose of this review is to give an up-to-date overview of TTM. It describes the genesis and epidemiology of trichotillomania (TTM), including prevalence in terms of age and gender. The knowledge on the aetiology, phenomenology, and comorbidity of TTM is reviewed. The state of treatment options and implications, the effect of these and the clinical and research related perspectives are presented.

ADHD is a prevalent neuro-developmental disorder, and with onset often occurring in early childhood. It impacts daily functioning across a range of domains and is predictive of long-term burden to families as well as health, social, education and criminal justice systems. Parent training (PT) is recommended as first-line treatment for pre-school children with ADHD. This review outlines the clinical presentation of preschool ADHD and presents the evidence for three different PT programmes available in Denmark and evaluated in RCTs with preschoolers.

The knowledge of obsessive-compulsive disorder (OCD) and its treatment has advanced in the latest years and is summarised in this review. Child and adolescent OCD is a chronic condition, and if it is left untreated, it often continues into adulthood with debilitating effect on the quality of life. Cognitive-behavioural therapy (CBT) is the recommended first-line treatment for children and adolescents, and continued CBT or selective serotonin reuptake inhibitor treatment can be effectively given to non-responders to initial CBT. There is also emerging evidence supporting the long-term effect of CBT in this group of patients, and new variations of CBT are being investigated.

Many school children complain about recurrent abdominal pain. These children have diminished quality of life, increased school absence and functional disability. Despite the high prevalence and well-documented consequences for patients, their families and society, there is a remarkable lack of evidence-based treatments available. Hypnotherapeutic treatment (HT) has shown promising results. In this review, we discuss current research on HT of these patients. In conclusion, further studies are needed to confirm the effect of HT on functional abdominal pain disorder and to optimise the treatment format.

Despite regulatory initiatives, psychopharmacological treatment of adolescents is challenged by missing trial data on efficacy and safety. In Denmark, an estimated mean off-label prescription rate of 30-40% in clinical child- and adolescent mental health services has been found in recent studies. The lowest rates were found for drugs treating ADHD (2-3%), and the highest for antipsychotics (96%) and melatonin (100%). The use of melatonin is growing, while the use of other psychopharmacological drugs appears to be stabilizing or decreasing, in spite of an increased number of adolescents treated in Danish mental health services.

ADHD, affecting 2-3% of children, is characterised by problems with attention, hyperactivity and impulsivity. Co-morbid psychiatric problems are very frequent. Causal factors are primarily genetics but environmental influences such as smoking during pregnancy or preterm birth are contributing factors. For children and adults psychoeducation is essential, for younger children training of the parents are recommended. The most efficient psychopharmacological treatment is with central stimulants or atomoxetine.

Restless legs syndrome (RLS) and attention deficit hyperactivity disorder (ADHD) have consistently been found to coexist frequently. The cause for the relationship of these co-morbid disorders is contradicting, but both disorders are associated with a common dopaminergic dysfunction, low iron status, sleep disruptions and genetic linking. Well-known diagnostic criteria are necessary for early diagnosis and optimal treatment. Further investigation is needed to identify the pathogenesis, the genetic background and better validated treatment options. So far, oral iron treatment can reduce RLS symptoms, while treatment with e.g. central stimulants can reduce ADHD symptoms.

Obsessive compulsive disorder (OCD) is a frequent condition. First-choice psychopharmacological treatment includes SSRIs where the choice of drug depends on the occurrence of side effects. If remission is obtained, continued treatment is recommended for at minimum of one year. If only a partial or no response is obtained, augmentation treatment with atypical antipsychotics may be attempted. However, only few studies have examined the effect and side effects of augmentation treatment in children and adolescents. The aim was to provide a summary on the current knowledge on psychopharmacological treatment of children and adolescents with OCD.

According to epidemiological surveys 1-2% of the adult population fulfil the criteria for attention-deficit hyperactivity disorder. Some need treatment which they are not currently offered. The effect of either central stimulants or atomoxetine is well established. Many patients need psychosocial intervention as a supplement to medication. Because of the differential diagnostic problems and the frequent occurrence of comorbid symptoms, examination is a specialist assignment in most cases.

Obsessive-compulsive disorder (OCD) is a frequent disorder and glutamate seems to be an important transmitter. The effect of glutamate depends on the level as well as the effect mediated through glutamate receptors. The level is altered in brain areas that are involved in OCD. Genes encoding receptors, enzymes involved in the metabolism and transport proteins are located in regions that are related to OCD. Pharmacogenetic studies examining the genetic variations in the glutaminate system are lacking. The aim was to examine the current knowledge on the glutaminate system in the development and maintenance of OCD.

Recurrent abdominal pain affects 10-20% of schoolchildren and is responsible for 2-4% of all pediatric office visits. In about 90% of cases the pain is termed functional as it cannot be explained by structural or biochemical abnormalities and medical treatment has only modest efficacy. Cognitive behavioural therapy of functional abdominal pain in children is a more recent treatment. A systematic literature review identifies only 5 randomised, controlled trials. The results from these studies indicate that the treatment reduces pain intensity and the frequency of pain episodes.

Depression in children and adolescents is relatively prevalent and may have serious consequences. Treatment of depressive disorders may be psychotherapeutic or psychopharmacological. A systematic literature search was performed and the evidence for a psychopharmacological treatment of depressive disorders in children and adolescents was described. Emphasis is put on treatment with selective serotonin reuptake inhibitors as these are the best-documented agents in the treatment of depression in children and adolescents.

Depression in children and adolescents is relatively prevalent and may have serious consequences. Treatment of depressive disorders may be psychotherapeutic or psychopharmacological. A systematic literature search was performed, and the evidence for treatment of depressive disorders in children and adolescents with cognitive behavioural therapy is described.

This article reviews the recent literature on depression in children and adolescents. We describe the current knowledge about clinical presentation, epidemiology, prognosis and risk factors with a focus on the differences from depression in adults.

Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder occurring in approximately 3-6% of the population. The high prevalence of the disease and the fact that it has an onset early in life emphasise the importance of adequate treatment. This article focuses on the largest long-term treatment study of ADHD, the Multimodal Treatment study of Attention Deficit Hyperactivity Disorder (MTA), taking into consideration especially the limitations of the design and their impact on the outcome of the study. Primary among these is the fact that outcome was measured 4-6 months after the most intensive phase of behavioural treatment but while medication was still active. This may have had an impact on the study results, especially since the MTA study did not indicate a significant difference between combined and strictly pharmacological treatment.

OCD (obsessive-compulsive disorder) is characterised by the presence of annoying, unwelcome and intrusive obsessions and compulsions. The obsessions appear over and over and the child recognize them as something strange and unwelcome, but at the same time they are clearly a product of his/her own mind and not a hallucination or a thought disorder as seen in psychotic disturbances. Compulsions are imposed actions that the child feels it has to perform, often in a certain pattern. Both children and adults can suffer from OCD. Almost 2/3 of adults with OCD report onset of their OCD symptoms in childhood or early adolescence. Previously, OCD among children and adolescents was considered to be rare, but newer epidemiologic surveys show that 1-1% of children and adolescents suffer from OCD in such a degree that they fulfil the diagnostic criteria. The prevalence varies surprisingly little in various countries regardless of cultural background.

Elective mutism is a relatively uncommon disorder characterized by consistent failure to speak in specific social settings, such as in school, despite speaking fluently in a variety of other situations. Elective mutism is a very debilitating disorder for the affected child, as well as for their families, with detrimental implications for the development of social skills and learning if not offered appropriate support and treatment. The most promising treatment results have thus by far been achieved through a combination of cognitive behaviour therapy and supportive cooperation between parents, the school, and the treating child psychiatrist, occasionally supplemented with pharmacological treatments such as selective serotonin reuptake inhibitors. The available literature on this disorder is still very limited and consists predominantly of case reports. In recent years, however, there has been a growing focus on the etiology and general understanding of the disorder. While still disputed, it has been suggested that elective mutism might be understood as an emotional disorder on a par with e.g. separation anxiety and social phobia. Studies looking at the long-term course of the disorder are urgently required to elucidate whether children presenting elective mutism will be more likely to suffer from emotional disorders in adulthood, and may also ultimately lead to improved treatments for this disabling psychiatric disorder of childhood.

The present review describes the theory of a spectrum of obsessive-compulsive disorders (OCD). This spectrum includes such disorders as trichotillomania, eating disorders, body dysmorphic disorder, and possibly pervasive developmental disorders. OCD with an onset in childhood is presented as a specific subtype, with more boys affected and frequently co-morbid with tics and Tourette's syndrome. Furthermore, it seems to be more genetically determined and have more significant deviations, as measured by neuro-imaging studies, than has OCD with an adult onset. The PANDAS theory (paediatric autoimmune neuropsychiatric disorder associated with streptococcal infections) is described. This subtype of OCD is, still on a speculative basis, connected to infections with beta-haemolytic streptococci. The obsessive-compulsive symptoms are characterised by a sudden onset, "sawtoothed" course with relapses and remissions, and are associated with neurological abnormalities. There are still no clinical consequences in terms of penicillin treatment of this PANDAS subtype of OCD.