Organised by the EPA Section on Child and Adolescent Psychiatry. Diagnosis of autism spectrum disorder (ASD), especially in adolescence and adulthood, can be a challenge even for experienced clinicians. ASD is manifested in a very heterogeneous way, even with the defined diagnostic criteria. Moreover, symptom formation in the same person also changes over time. Moreover, clients with ASD but not diagnosed often turn to psychiatric care with other diagnostic questions, and this often means that interacting and overlapping symptoms make it difficult to recognize the ASD behind surface. Consistent with research, the Diagnostic and Statistical Manual of Mental Disorders allows additional diagnoses among individuals with ASD. The prevalence of comorbid disorders among people with ASD varied across studies: it is suggested that 54-70% of children and adolescents with ASD have an associated psychiatric disorder, 41% of them have two or even more comorbidities and above 18 years even a higher prevalence of psychiatric comorbidity (up to 94%) is described compared to younger people with ASD. Comorbid psychiatric disorders are anxiety, mood-, eating- , obsessive-compulsive - , disruptive -, impulse-control - and conduct disorder, substance use, attention-deficit/hyperactivity,schizophrenia and suicidal behavior. Comorbid psychiatric disorders cause high burden to people with ASD.Therefore, it is insufficient not only to have adequate knowledge of the diagnostic aspects of ASD, but also to have a comprehensive picture about the associated psychiatric disorders and their interaction with ASD. The aim of our course is to help deepen the diagnostic process and aspects of ASD, also in connection with possible comorbid psychiatric disorders.

"This symposium is proposed by the Hungarian Psychiatric Association, the host of EPA-2022. Chairs: Judit Balazs, the President of the Hungarian Psychiatric Association and Danuta Wasserman, former president of the EPA, currently the president elect of the WPA. Speakers: Katalin Szanto (University of Pittsburgh, Psychiatry, Pittsburgh, United States of America), Danuta Wasserman (Karolinska Institutet, Stockholm, Sweden Stockholm, Sweden), Judit Balázs (Eotvos Lorand University, Budapest, Hungary and Bjørknes University College, Oslo, Norway), Zoltán Rihmer (Semmelweis University, Budapest, Hungary). In the previous century Hungary led the suicide statistics of the world, and though it decreased a lot, it is still the 3rd highest in the EU. Before the Covid-19 pandemic over 800 000 people died each year by suicide in the world. The rates of suicide did not raise during the first 4-6 months of the pandemic, however the prolonged isolation, uncertainty, economic hardship cause long-term stress which can lead to several psychiatric disorders, e.g. anxiety, depression, psychoactive substance use, which all can increase the risk of suicide well beyond the duration of the pandemic. The heterogeneity and the complex relations of suicide risk factors make research on suicide highly important. In this symposium, we will give an update on suicide research. Firstly, we will hear from Katalin Szanto about two possible dimensions of suicide heterogeneity, a) chronological age of the suicide attempter, b) age-of onset of first suicidal behavior. Next, Danuta Wasserman will speak about how the pandemic affects risk and protective factors of suicide and offers recommendations for appropriate evidence-based preventative measures. Then, we will hear from Judit Balazs about nonsuicidal self-injury, which is highly prevalent in adolescents. Moreover, several studies have supported both the distinction and the strong association between NSSI and suicidal behavior. Finally, Zoltán Rihmer will give and overview on ‘Hungarian suicide’ presenting the main descriptive epidemiological features of suicidal behavior in Hungary including trends over time and the main factors that may have influenced Hungarian suicide rate. In conclusion, the symposium highlights the possibilities, and the future tasks of suicide prevention."