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Introduction: Inpatient Treatment (IT) is the treatment of choice for moderate or severely ill adolescents with Anorexia Nervosa (AN). Nevertheless, it is expensive, and the risk for relapse or readmissions is high. A less costly alternative to IT is Day Patient Treatment (DP), which may also help to avoid relapses and readmissions because facilitates transition from hospital to community treatment., Aim: To assess the effectiveness of the 11-hour DP program for Eating Disorders (DP-ED-11h), a new intensive DP treatment for adolescents with AN, with respect to weight recovery, avoidance of hospital admission and decrease of Length of Stay (LoS)., Method: A longitudinal, naturalistic study was carried out analysing clinical and sociodemographic variables from 77 patients with AN who were consecutively discharged from DP-ED-11h, during years 2015-2016., Results: There were 77 discharges. The average age was 14.4 years old (SD: 1.62). The LoS at DP-ED-11h was 28.9 days (SD: 18.5). The mean body mass index increased significantly at discharge (17.2 vs. 17.9, p<0.001) and at 12 months follow- up (17.9 vs. 19.3, p<0.001). Twenty nine (70.8%) of the patients treated at DP-ED-11h, who came from a less intensive setting, avoided an admission. Fourteen (18.2%) required readmission at DP-ED-11h within two years. The LoS at IT was significantly reduced (from 33 to 24 days, p<0.043)., Conclusion: DP-ED-11h has shown to be an effective resource as an alternative to IT for adolescents with moderate to severe AN. This new model has cost-effectiveness implications as it is a safe resource and is less costly than IT.

Introduction: The presence of suicidal thoughts and self-injurious behaviors in patients with eating disorders (ED) is well-known; however, this association is currently not defined empirically. The aim of the study is to determine the prevalence of suicidal ideation and self-harm in adolescents with eating disorders. A second objective is to study the association between self-injurious behavior and suicidal ideation, severity of eating disorder symptoms and symptoms of depression and anxiety, motivation to change and perfectionism., Methodology: We evaluated 109 patients (mean age, 14.74 years (SD: 1.53); 87.2% female) using the Eating Disorder Inventory (EDI-2), the Beck Depression Inventory (BDI-II), the State-Trait Anxiety Inventory (STAI), the Child and Adolescent Perfectionism Scale (CAPS) and the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)., Results: Forty-seven patients (43.1%) had suicidal ideation and 34 (31.2%), self-injurious behavior. The presence of suicidal ideation did not discriminate between patients with or without self-injurious behavior. Patients who self-harm had significantly higher scores on all scales of the EDI-2, except for &#8220;maturity fears&#8221;, in the total scores of BDI-II, STAI and CAPS. An association between selfinjurious behavior and motivation to change was found., Conclusions: A significant percentage of adolescents with eating disorders present suicidal ideation and selfinjurious behavior, making the psychopathological profile of these patients more severe. The presence of suicidal ideation in adolescents with eating disorders does not necessarily imply that they have self-injurious behavior; rather, such behavior could be a result of the need to regulate intense negative emotions.

Introduction: The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a significant revision of Eating Disorders (ED). The objective of this study is to compare the distribution of diagnosis of ED in adolescents according to DSM-VI-TR and DSM-5 criteria. A second objective is to study the psychopathological differences between patients with ED (based on DSM-IV-TR) and those whose diagnosis changed by applying DSM-5 criteria., Methodology: One hundred and one adolescents diagnosed with ED (mean: 14.68 years; SD: 1.46) were evaluated with clinical interviews and scales for eating psychopathology, perfectionism, anxiety, and depression., Results: Applying the DSM-5 criteria led to a significant decrease in the diagnosed cases of Eating Disorders Not Otherwise Specified (EDNOS) (from 34.7% to 23.8%; p<0.001) and to a significant increase in those of anorexia nervosa (AN) (from 58.4% to 66.3%; p<0.001) and of bulimia nervosa (BN) (from 6.9% to 8.9%; p<0.001). No significant psychopathological differences were found between patients diagnosed with AN and BN based on DSM-IV-TR criteria and those newly diagnosed with AN and BN based on DSM-5 criteria., Discussion: Using DSM-5 criteria for adolescents with ED leads to a significant decrease in the frequency of an EDNOS diagnosis. As similar psychopathological characteristics were observed between ED patients diagnosed based on DSM-IV-TR and those who were switched from EDNOS to AN or BN based on DSM-5, we conclude that the new criteria for ED in DSM-5 are valid for an adolescent population.

Introduction: The CONCOR study aimed to determine the predictive value of the SNAP-IV screening tool for ADHD relative to the pediatricians' clinical global impression of the presence of ADHD in children attending their practice., Methods: In this multicentre, cross-sectional, case-control study participated pediatricians from all over Spain and each pediatrician enrolled at least six children over the age of 6 years who had no previous diagnosis of ADHD, three whom they considered to have symptoms characteristic of ADHD (DSM-IV criteria) and three children who did not. Screening with the SNAP-IV tool was completed by parents in the waiting room prior to a consultation (for any reason) and results were compared with the pediatrician's clinical global impression., Results: Results for 7263 Spanish children (>6 years of age) showed 'good' concordance between the SNAP-IV screening tool and the pediatricians' clinical impression of ADHD (kappa concordance index 0.6471; 95% confidence intervals: 0.6296-0.6646), with acceptable sensitivity and specificity (82.3% and 82.4%, respectively). Based on an estimated ADHD prevalence of 3-10%, the negative predictive values of SNAP-IV were 97.7%-99.3% and positive predictive values were 12.6-34.2%., Conclusions: SNAP-IV is a useful screening tool that identifies children who are unlikely to have ADHD, and brings those in whom there is a high possibility of ADHD to the attention of the pediatrician for clinical evaluation.

Introduction: Attention deficit hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children and adolescents, and has a great impact on the psychological development of affected patients. Even though its efficacy is proven, the use of medication for ADHD has several limitations, and non-pharmacological interventions are considered a necessary component of treatment., Methodology: This work is a review of evidence-based non-pharmacological treatments with demonstrated efficacy for ADHD in children and adolescents, analyzed by age groups., Results: Non-pharmacological treatments that have shown scientific evidence of efficacy are psychological and psychoeducational interventions. Psychological interventions include behavioral therapy, parent training (PT) and social skills training. Psychoeducational interventions include a set of practices to improve learning and are carried out in the school setting. Scientific evidence of efficacy in preschool children is limited to PT, while different psychological and psychoeducational interventions have been shown to be beneficial in school-age children. The available evidence for non-pharmacological treatment in adolescence is so far insufficient., Conclusions: Though more randomized controlled trials are necessary for non-pharmacological interventions to become established practices, there are clear indications of their efficacy. For more severe cases of ADHD, a combination of non-pharmacological and pharmacological treatment is recommended.