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Objectives: To identify factors that predict which patients, when referred by their GP, make a first appointment at a Mental Health Centre and then fail to attend. Method: Sequential observational study in which data was collected for one year on all the people (1311) with an arranged date for an initial appointment at an urban Community Mental Health Centre. Results: Approximately 25% of patients who request an initial appointment fail to attend. The variables that predict nonattendance are: the lack of a telephone number for contact, the time lapse before the appointment, and when drug-addiction is the reason for requesting the appointment. One variable that results in a specific kind of behaviour is the timing of the initial appointment, since males and females tend to miss at different times. We also found that missing the appointment followed a seasonal pattern. Conclusions: In order to optimise the service, it is necessary to discover the proportion of probable misses, and aim to arrange the appointment with the shortest possible time lapse and to take into consideration the sex of the patient when fixing the time of the interview.

This paper studies the introduction of the new physical therapies in the years prior to the Second Spanish Republic. It concludes that the physical treatments in force in the international literature were introduced early in Spain and were put into practice by the most important psychiatrists, although in few cases. Given the generalized criticism on the efficacy of psychiatry as a specialty, there was a general bias towards a positive evaluation of the efficacy of the physical therapies by the new generation of Spanish psychiatrists that did not occur in other countries of our setting. The psychiatrists who disagreed professionally with the above-psychiatrists opposed this tendency, there not being sufficient empirical support for the opinion of any group. [ABSTRACT FROM AUTHOR]

This study presents the psychometric properties of the Multidimensional Perfectionism Scale (MPS; Hewitt & Flett, 1991) after adapting it to Spanish language. The MPS has 45 items that assess three dimensions of perfectionist behaviour: self-oriented perfectionism, socially prescribed perfectionism and other-oriented perfectionism. The MPS and the EDI perfectionism subscale (Garner, 1998) were administered to a sample of 356 Spanish university students (18 to 42 years old), and a subgroup (n= 276) completed retest with a 5-week gap. Results replicated the original three factor structure for perfectionism, with acceptable internal consistency, similar to the original study. Convergent validity and temporal stability coefficients were satisfactory. Two perfectionism dimensions were associated with distress, suggesting that other-oriented perfectionism has an adaptive component to it. The Spanish version of the MPS can be regarded as a reliable scale for the assessment of perfectionism among university students. [ABSTRACT FROM AUTHOR]

Eating disorders (ED) are severe mental disorders that may result in significant functional impairment and disability. Neuropsychological studies have consistently found impaired executive function (EF) among ED patients. EF is particularly involved in fundamental skills of daily living and in behavioral and emotional regulation. In this study, impairment of executive functioning is investigated in patients with eating disorders and the associations with clinical features and clinical subtypes are analyzed., Method: 75 female patients (m = 22.01 years, sd = 9.15) with eating disorder (43 restrictive anorexia, 30 binge-eating anorexia and 13 bulimia nervosa) and 37 healthy controls (m = 18.54 years, sd = 4.21) were included in the study. An extensive assessment of executive function domains (verbal fluency, set shifting, attention span, selective attention, working memory, inhibitory control and processing speed) was carried out in both groups. Clinical scales for food intake restriction, binge-eating/purging, depression, anxiety and impulsivity were also administered and correlated with scores on executive function tests., Results: Patients with an ED had significantly lower scores than healthy controls in performance of several executive function tests, particularly in set shifting, interference control and processing speed (p < .01, in all three domains). Executive function impairment was related to anxious, depressive and eating disorder symptoms (p < .05), regardless of clinical subtype., Conclusions: Executive function impairment in eating disorders is associated with greater ED symptomatic severity and might involve a negative treatment outcome. Therefore, cognitive remediation techniques should probably be considered in a number of severe patients with ED., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Disordered eating, unhealthy weight-control behaviours and body dissatisfaction are associated with diminished mental health. A key aspect that has been identified for the development of disordered eating behaviours and body dissatisfaction is to be teased. Additionally, the literature suggests that weight may affect the relationship between weight-teasing and disordered eating and body dissatisfaction, although this pattern is unclear. This study presents two cross-sectional studies with an adult and an adolescent sample. The adolescent sample comprised 15,224 participants, and the adult sample comprised 321 participants, all from Spain. Hierarchical regression analyses were conducted. Aims: to assess the relations among disordered eating, body dissatisfaction, weight, and weight-teasing among adolescents and adults; and to examine whether weight-teasing, weight, age, and gender predict disordered eating and body dissatisfaction in adults and adolescents. The results showed that adolescent girls presented greater effects, and all interactions were significant between weight-teasing and eating disorders. Adults also showed greater effects for women, and only eating disorder interactions were significant. Weight-control behaviours did not show any relationship with weight-teasing. Conclusion: Different approaches may be used in the prevention of eating disorders. Our results show that weight-teasing affects adults differently from adolescents.

Substance-related disorders are the most frequent comorbidity in schizophrenia. Concretely, alcohol is the most commonly consumed substance after tobacco. Patients with schizophrenia with this comorbidity have a worse clinical course and can develop serious neuropsychiatric complications. One of them, Marchiafava-Bignami disease (MBD) can be incorrectly diagnosed as a decompensation of their mental disorder.

Objectives: The study aimed to examine whether dissociation and attitudes towards change were associated with the psychopathology in patients with eating disorders (EDs) at 1-year follow-up., Method: The study included 110 females with anorexia nervosa and bulimia nervosa (48 and 62 respectively). At the beginning of the study and 1 year later, they were assessed by means of the following questionnaires: Dissociative Experiences Scale, Attitudes Towards Change (ACTA), State-Trait Anxiety Inventory, Rosenberg Self-Esteem Scale, Beck Depression Inventory, Eating Attitude Test, Bulimic Investigatory Test Edinburgh and Body Shape Questionnaire (BSQ)., Results: No statistically significant differences were found between both diagnostic groups regarding dissociation scores. The ACTA at baseline, specifically for patients in the contemplation stage, mediate the effect of dissociation on the psychopathological outcome., Discussion: These findings suggest that dissociation might be a transdiagnostic feature related to the EDs outcome. The psychotherapeutic framework must take it into account, particularly in patients in the contemplation stage., (© 2020 Eating Disorders Association and John Wiley & Sons Ltd.)

During the present decade a large body of research has employed confirmatory factor analysis (CFA) to evaluate the factor structure of the Strengths and Difficulties Questionnaire (SDQ) across multiple languages and cultures. However, because CFA can produce strongly biased estimations when the population cross-loadings differ meaningfully from zero, it may not be the most appropriate framework to model the SDQ responses. With this in mind, the current study sought to assess the factorial structure of the SDQ using the more flexible exploratory structural equation modeling approach. Using a large-scale Spanish sample composed of 67,253 youths aged between 10 and 18 years ( M = 14.16, SD = 1.07), the results showed that CFA provided a severely biased and overly optimistic assessment of the underlying structure of the SDQ. In contrast, exploratory structural equation modeling revealed a generally weak factorial structure, including questionable indicators with large cross-loadings, multiple error correlations, and significant wording variance. A subsequent Monte Carlo study showed that sample sizes greater than 4,000 would be needed to adequately recover the SDQ loading structure. The findings from this study prevent recommending the SDQ as a screening tool and suggest caution when interpreting previous results in the literature based on CFA modeling.

Overweight during childhood constitutes a high-risk factor for adult obesity. An abnormal attention to food stimuli (i.e., a bias) has been suggested as an underlying mechanism to the onset and/or maintenance of obesity. Previous literature supports the existence of a biased attention toward food stimuli in adults with obesity. However, it is unknown whether this attentional bias occurs in high-risk children for adult obesity. We aimed to examine attentional biases to food at different stages of attention processing in overweight children. A dot-probe task was applied to 25 children with overweight and 25 healthy-weight children (8-12 years old). Attentional preference to or avoidance of pleasant food stimuli, which were displayed simultaneously with pleasant non-food stimuli (matched in valence and arousal), was examined at 100-ms (initial visual orienting), 500-ms (attention engagement), and 1500-ms (maintained attention) presentation rates. Both children with overweight and healthy-weight children showed an attentional bias toward food images at a 100-ms presentation rate. However, unlike healthy-weight children, those with overweight showed an attentional preference toward food images at 500- and 1500-ms presentation rates. A biased initial orienting to food cues can be found regardless of weight. However, a biased attention engagement and a biased maintained attention toward food cues are characteristics of children with overweight. Therefore, as in adults, children at risk of adult obesity have an abnormal attentional processing of food stimuli., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Introduction: The inability to identify, express feelings, and not distinguish between emotions and bodily sensations, is known as alexithymia. In 1988, it developed The Toronto Alexithymia Scale (TAS-20), consists of 20 items and three factors: a) difficulty of identifying feelings and differences between feelings and bodily sensations; b) difficulty of describing feelings; and c) externally oriented thinking. It's considered that people with eating disorders have specific deficits in identify and communicate their feelings., Objective: The present study has as purpose to the instrument validation., Methods: It was a cross-sectional study and psychometric character design of a single sample, formed of 435 persons suffering eating disorder (ED), with an age range of 12-68 years, of which 91% were women and 9% were men. To obtain the reliability of the instrument, applies internal consistency test, which resulted in an alpha of 0.89, then applied a factor analysis of principals components with oblimin rotation., Results: According to statistical analysis, were eliminated six items, so the scale finished with 14 items, and to analyze it observed that these items correspond with the two main factors of the original scale. The ED patients present alexithymia., Discussion: The scale satisfies the criteria of validity necessary for use in this population., (Copyright: © 2019 Permanyer.)

Objective: The determination of soft signs can be a conducive practice to understand the differential etiology between depression and anxiety. This study aims at examining malleolar hypoesthesia role in distinguishing between patients with generalised anxiety disorder (GAD) and major depression disorder (MDD). Methods: This study examines the presence of malleolar hypoesthesia in patients with GAD ( n  = 47) compared to patients with MDD ( n  = 48) and healthy individuals (controls; n  = 99). The Wartenberg wheel, a medical device for neurological use, was employed to determine the presence of hypoesthesia on both sides of the ankles. Results: The data revealed: i) MDD patients showed higher hypoesthesia than GAD patients ( p  = .008), ii) participants with hypoesthesia had higher anxiety and depression scores than participants without hypoesthesia (all p  < .001) and iii) logistic regression model indicated that hypoesthesia can be a predictor of MDD relative to GAD diagnosis (Odds Ratio: 17.43 (1.40-217.09; p  = .026)). Conclusions: Malleolar hypoesthesia was higher in MDD than GAD. The detection of hypoesthesia may help to investigate the differential etiology between MDD and GAD diagnosis.

significantly increase during puberty. The goal of this research is to evaluate changes during puberty which could have genetic and environmental influences on a broad spectrum of disordered eating attitudes and behaviors. Methods. Participants were 158 pairs of adolescent female twins, categorized in two groups according to menarche stage (pre or post). ED measures: Disordered eating attitudes and behaviors were assessed by means of the Children&#8217;s Eating Attitudes Test and four sub-scales of the Eating Disorders Inventory: Drive for thinness, Body dissatisfaction, Ineffectiveness, and Perfectionism. Intra-class correlations in monozygotic (MZ) and dizygotic (DZ) twins were calculated separately in premenarche and premenarche group for each ED subscale Results. 48 premenarche twins (30 MZ twins and 18 DZ twins) and 110 premenarche twins (66 MZ and 44 DZ twins) were included. The intra-class correlations suggested no genetic influence on the total ChEAT score of participants at the premenarche stage. For the premenarche participants, however, sources of variance suggested a very high heritability. Regarding the EDI sub-scales, only the trait &#8220;Ineffectiveness&#8221; exhibited a moderate heritability among premenarche subjects, while all the four eating sub-scales showed moderate heritability estimates in the premenarche stage group. Conclusions. Our findings reveal that there are significant differences in genetic and environmental effects on eating attitudes and behaviors depending on being in a premenarche or premenarche stage. Therefore, clinicians should pay attention to female adolescents at high risk of developing ED, especially during the critical period of menarche.

Objective: Clinical research on cortisol response to stress in patients with eating disorders has provided controversial and even contradictory results. As this might be the consequence of the inclusion in the studies of heterogeneous clinical populations, 3 highly selected samples were studied., Methods: Dexamethasone suppression test was performed on 15 restricting anorexia nervosa patients without history of bulimia nervosa (BN), 17 BN patients with normal weight and no history of anorexia nervosa, and 22 healthy controls. Three days later, the Trier Social Stress Test was applied, and 8 saliva samples were collected along the trial for cortisol assessment., Results: When the patients were considered as a single group, a slightly blunted cortisol response to stress was observed, but when the 3 groups were considered separately, the blunted response was observed only in the BN patients., Discussion: The results support the association between blunted cortisol response and bulimic features., (Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.)

Introduction: The inability to identify, express feelings, and not distinguish between emotions and bodily sensations, is known as alexithymia. In 1988, it developed The Toronto Alexithymia Scale (TAS-20), consists of 20 items and three factors: a) difficulty of identifying feelings and differences between feelings and bodily sensations; b) difficulty of describing feelings; and c) externally oriented thinking. It's considered that people with eating disorders have specific deficits in identify and communicate their feelings., Objective: The present study has as purpose to the instrument validation., Methods: It was a cross-sectional study and psychometric character design of a single sample, formed of 435 persons suffering eating disorder (ED), with an age range of 12-68 years, of which 91% were women and 9% were men. To obtain the reliability of the instrument, applies internal consistency test, which resulted in an alpha of 0.89, then applied a factor analysis of principals components with oblimin rotation., Results: According to statistical analysis, were eliminated six items, so the scale finished with 14 items, and to analyze it observed that these items correspond with the two main factors of the original scale. The ED patients present alexithymia., Discussion: The scale satisfies the criteria of validity necessary for use in this population., (Copyright: © 2018 Permanyer.)

Introduction: The heritability of eating disorders has been estimated to range from 22% to over 62%.The aim of this study is to determine the relative influence of genetics and environment that contribute to the drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness, by evaluating sex differences in a sample of adolescent twins from Valencia, Spain., Material and Methods: Five hundred eighty-four pairs of adolescent twins between 13 and 18 years of age completed the study. To determine zygosity, teachers responded to a questionnaire on physical similarity. Psychological traits of eating disorders were assessed with four sub-scales of the Eating Disorder Inventory (EDI); drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness. Twin models were used to assess genetic and environmental (common and unique) factors affecting these four psychological traits., Results: All four traits showed significant genetic contributions among girls, with heritability estimates of 37.7% for ineffectiveness, 42.8% for perfectionism, 56.9% for drive for thinness, and 65.5% for body dissatisfaction. Among boys, body dissatisfaction showed no additive genetic contributions, indicating significant shared and individual specific environment effects. The three other traits in boys showed significant additive genetic contributions, but were lower than in girls., Conclusions: With the exception of body dissatisfaction in boys, psychological traits of eating disorders show heritability patterns that differ according to sex., (Copyright © 2014 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.)

This study examined the presence of neurological soft signs, an accessible diagnostic instrument, in patients with anxiety. Individuals with anxiety were more likely to manifest hypoesthesia than healthy controls, and patients who showed hypoesthesia exhibited greater symptoms of anxiety and depression.

Background and Objective: Twin and family studies support large genetic influences on variability in body mass index (BMI), with heritability estimates ranging from 47% to over 90%. Our objective was to study the relative contributions of genetics and environment to BMI, evaluating sex differences, in an adolescent twin sample from Valencia, Spain., Material and Methods: Five hundred eighty-four pairs of adolescent twins between 13 and 18 years of age completed the study (82 monozygotic [MZ] and 87 dizygotic [DZ] pairs of male twins, 118 MZ and 102 DZ pairs of female twins, and 195 opposite-sex pairs of DZ twins). To determine zygosity, teachers responded a questionnaire on physical similarity. They also measured the participant's height and weight. BMI was calculated and weight status was determined according to age. We used twin models to assess genetic and environmental (common and unique) factors affecting BMI., Results: There was a 7.1% frequency of overweight and 2.8% of obesity. The estimated heritability of BMI was 88.0% in boys and 72.1% in girls, with the remaining variance attributable to non-shared environment in boys (12.0%) and 8.8% in girls. It was only in girls that common environment had an effect on BMI., Conclusions: Genetics appears to play an important role in explaining the variability in BMI in the adolescence, with slight variations between boys and girls. Common environmental factors exert their influence on BMI only in girls., (Copyright © 2014 Elsevier España, S.L.U. All rights reserved.)

The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and non-randomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in order to detect ED new cases and find associations with previous psychiatric disorders. The ED prevalence was 3.6%. Cross-sectional analysis revealed that 62.9% of individuals with an ED had comorbid disorders: anxiety disorders (51.4%), Attention Deficit Hyperactivity Disorder (31.4%), oppositional defiant disorder (11.4%), and obsessive compulsive disorder (8.6%). Prospective longitudinal analysis showed an ED incidence rate of 2.76% over the course of 2 years. 22.2% of new cases had received previous psychiatric diagnoses, of which all were anxiety disorders. Thus, ED exhibited a high comorbidity rate among adolescent populations and anxiety disorders were the most common comorbid diagnosis., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

The study was aimed at analysing the reciprocal relationships of several clinical and neurobiological items in order to predict alcohol misuse in patients with bulimia nervosa (BN). Seventy BN patients and 70 healthy controls were assessed for depression, impulsivity, borderline personality traits and self-defeating behaviours using specific scales; serum cortisol and 24-hour urinary excretion of serotonin and 5-hydroxiindolacetic acid were also assessed. The study confirmed the implications of these clinical factors for alcohol misuse in BN patients, but the results suggested that depressive symptoms and hypercortisolism could lie behind these relationships., (Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.)

Introduction: The aim of the study was to identify the relationship between perceived rearing styles and the clinical expression of Eating Disorders (ED)., Methods: One hundred and ninety-six patients diagnosed of an ED and 127 healthy student as controls selected from the Nursing College were evaluated for general psychopathology (STAI, BDI II, RSE), and for abnormal eating attitudes (EAT, EDI-II, BITE). The EMBU (&#8216;my memories of upbringing&#8217;) was administered for the assessment of perceived parental rearing styles and was used a questionnaire to assess familial variables., Results: In relation to the control group, patients with ED perceived greater rejection, overprotection and less warmth than the controls. Patients who perceived greater paternal favoritism, maternal overprotection and low paternal emotional warmth, showed higher levels of anxiety. Paternal affection and maternal attitudes of rejection, overprotection and favoritism were related to lower self-esteem. Regarding abnormal eating attitudes, body dissatisfaction inversely correlated with paternal emotional care and maternal favoritism. The EDI subscales: ineffectiveness, perfectionism and ascetism were associated to parental rejection. Maternal rejection also related with drive for thinness, interoceptive awareness and impulse regulation. Perceived emotional warmth was related with perfectionism. Bulimia subscale and BITE scores were inversely associated to paternal overprotection and affection, and scored significantly higher in paternal favoritism and rejection from both parents., Conclusions: Perceived parental bonding is different in the various subtypes of EDs. Patients diagnosed of Bulimia Nervosa or Eating Disorders Not Otherwise Specified perceived greater rejection, less affection and a greater overprotection than Anorexia Nervosa patients and controls.

Objectives: The aims were to see which temperament and character dimensions were associated with depression, mainly with its outcome at two-year follow up in eating disorders (EDs)., Methods: Participants (N=151) were 44 Anorexia nervosa (AN), 55 Bulimia nervosa (BN) and 52 Eating disorders not otherwise specified (EDNOS) patients. The Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self Esteem Questionnaire (RSE), Eating Disorder Inventory (EDI-2) and Temperament and Character Inventory (TCI) were administered., Results: Depression at the beginning (t0) was severe in 22% of the cases. Harm Avoidance and Novelty Seeking had an effect on depressed mood at t0, mediated by Ineffectiveness. Responsibility (SD1) was associated with scores on the BDI at two-year follow up (β=-0.37, 95% CI -2.6, -0.6, p<0.01)., Conclusion: The evaluation of personality dimension in EDs has therapeutic and prognostic implications: To enhance self-efficacy and self-directness is crucial for good clinical outcome., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Introduction: The study aimed to analyze the role of depression and impulsivity in the psychopathology of bulimia nervosa (BN)., Materials and Methods: Seventy female patients with DSM-IV BN, purging subtype, were assessed for eating-related symptoms, body dissatisfaction, affective symptoms, impulsivity, and personality traits. Factor analysis and structural equation modeling methods were used for statistical analysis., Results: BN appeared as a condition which incorporated 5 general dimensions: a) binge eating and compensatory behaviours; b) restrictive eating; c) body dissatisfaction; d) dissocial personality traits; and e) a cluster of features which was called «emotional instability» The 5 obtained dimensions can be grouped into 2 basic factors: body dissatisfaction/eating behaviour and personality traits/psychopathology. The first one contains the clinical items used for the definition of BN as a clinical condition in the DSM-V and the International Classification of Diseases 10, and reflects the morphology and the severity of the eating-related symptoms. The second dimension includes a cluster of symptoms (depressive symptoms, impulsivity, and borderline, self-defeating and dissocial personality traits) which could be regarded as the «psychopathological core» of BN and may be able to condition the course and the prognosis of BN., (Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.)

The purpose of this study is to investigate the associations between peer teasing and body dissatisfaction (BD), emotional symptoms, drive for thinness (DT), and abnormal eating behaviors, as well as to analyze the mediating role of gender and body mass index (BMI) in such disorders. We screened 57,997 school children between 13 and 16 years of age. Scores in weight-related teasing and competency-related teasing were higher among girls, as well as overweight or obese individuals. Weight-teasing correlated more strongly with abnormal eating attitudes and behaviors, whereas competency-teasing correlated with emotional symptoms. Multiple linear regression analysis showed that weight-teasing is significantly and independently associated with BD, especially in boys. Multivariate analysis revealed a significant association between weight-teasing and abnormal eating in girls, although its predictive value was very low (Exp(B) = 1.009). Mediation analysis and Path analysis showed the mediating role of DT in this association. Interventions on teasing do not seem to be a priority in eating disorder prevention programs.

Amazing advances have been made in medical sciences since the first international conference on eating disorders (ED) was held in the 1970s, and there have been remarkable changes in the field of ED itself. Back then, virtually all that was talked about was anorexia nervosa; clinicians and researchers were mainly concerned about the possible hypothalamic and endocrine factors that seemed to be involved and there had been no epidemiological studies or controlled trials with psychiatric drugs or psychotherapy. Although the picture today is quite different, there are still significant gaps which even affect the classification of these disorders, as well as their neurobiological bases and both the pharmacological and psychological treatments which should be used. This paper gives a brief summary of these gaps and discusses the need to find endophenotypes which may help in categorising and directing research into these disorders. Mention is made of possible contributions from other fields for the benefit of greater progress in understanding eating disorders. Specific reference is made to the addictive model, out of which neuropsychology and animal models may provide data transferable to our area of expertise. Lastly, the current state of ED treatment is discussed with pointers as to from what perspective it would be most useful to seek improvements., (Copyright © 2011 SEP y SEPB. Published by Elsevier Espana. All rights reserved.)

The paper describes two case studies of patients with anorexia nervosa who suffer from auditory hallucinations as the only psychotic symptom. A review of the literature regarding clinical cases of anorexic patients with hallucinations is discussed. Hallucinations in anorexic patients are conceptualized according to different theoretical models which point to a dimensional view of eating disorders., (Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.)

Objective: To validate the Spanish version of the Children's Eating Attitudes Test (ChEAT)., Method: The factor structure and other psychometric characteristics of the questionnaire were examined using the answers of 38,554 schoolchildren. Diagnostic efficiency was based on a standardized clinical interview of 968 schoolchildren who had previously completed the questionnaire., Results: Five factors ("preoccupation with thinness," "dieting," "social pressure to eat," "purging," and "preoccupation with food and oral control") explained 46% of the variance. Cronbach's α was .858 for the total scale. The area under the receiver operating characteristic curve was .851. Sensitivity (SE) was 27% and specificity (SP) 96% for a cut-off of 20. A more appropriate cut-off was 15, where SE and SP were 62% and 90% respectively, and the positive and negative predictive values 27 and 98%., Discussion: The ChEAT psychometric characteristics are adequate. The questionnaire is valid. A cut-off point of 15 is recommended for adolescents., (Copyright © 2010 Wiley Periodicals, Inc.)

Objective: This study aimed to determine the prevalence of the use of medicines, particularly over-the-counter medicines (OTC medicines), and to analyse its association with different personal and lifestyle aspects., Setting: The study sample was an adolescent population in the Valencian Community (East Spain) aged 14-17 years., Method: A total of 23,349 adolescents from 229 schools completed a questionnaire (response rate 89.54%). We analysed adolescents who were taking prescribed medicines at the time of the questionnaire, and who were users of OTC medicines that had not been prescribed by a doctor for a particular illness. We estimated this association with several personal and lifestyle factors using simple and multivariate analyses and logistic regression., Results: A total of 15.18% of the participants reported that they were taking prescribed medicines when they answered the questionnaire, and 45.38% of the participants reported a frequent use of OTC medicines. Prescribed medicine use is more likely in older adolescents [Relative Prevalence Ratio adjusted by confounding factors (RPRa) 1.05, 95% CI:1.01-1.10], in those who had tried to lose weight by dieting in the last year (RPRa 1.23, 95% CI: 1.11-1.37), in current smokers (RPRa 1.13, 95% CI: 1.02-1.27), in those who had a serious emotional problem (RPRa 1.85, 95% CI:1.60-2.16) and in people who presented a chronic pathology (RPRa 8.24, 95% CI: 7.45-9.11). Respondents who reported a frequent use of OTC medicines were more likely to be older (RPRa 1.03, 95% CI: 1.00-1.06), have tried to lose weight by dieting in the last year (RPRa 1.15, 95% CI:1.06-1.24), be a current smoker (RPRa 1.19, 95% CI:1.10-1.28), have a serious emotional problem (RPRa 1.48,95% CI: 1.31-1.67), and watch TV (RPRa 1.24, 95% CI:1.16-1.32)., Conclusions: We noted an extensive use of medicines, especially OTC medicines, in adolescents, and an association with some personal and lifestyle factors. We conclude that prevention and early education of a responsible use of medicines should be a public health priority.

Objectives: Nowadays, the use of the Life-Chart Methodology is common in bipolar disorder clinics. Our aim was to present a chart from the Archives of the University Heidelberg (Germany)., Methods: The clinical case records dating from Emil Kraepelin's direction of the Psychiatric Clinic at Heidelberg were systematically screened., Results: Among the clinical records of patients suffering from manic depressive illness we located one record with a detailed charting of the clinical course., Conclusions: The chart reviewed shows that the Life-Chart Method was used more than a hundred years ago and for the same purpose, as an aid to clinicians.

Introduction: The aim of the present study is the translation, adaptation and validation in the Spanish environment of a self-rating of mania scale, the Altman Self-Rating Scale for Mania (ASRM), to fulfill a need in our environment in the self-rating of mania., Methods: The scale was translated, and then a back translation was done. This was sent to the author of the original scale. The scale was administered to a sample of 74 patients with bipolar disorder, divided into two groups, one formed by patients with acute mania (n=35) and the other one constituted by asymptomatic patients (n=39). Concurrently we applied the Clinician Administered Rating Scale for Mania (CARS-M) and the Numeric Evaluation Scale (NES)., Results: High internal consistency, high and significant correlation with the CARS-M mania sub-scale, as well as with the NES and very significant differences between the two groups in the scale score were found. The ROC curve indicates excellent adjustment of the scale, when discriminating among bipolar patients with and without manic symptoms. The factorial analysis provided a single factor that accounts for 62% of the total variance., Conclusions: The Altman Self-Rating Mania Scale is shown to be a reliable and valid self-rating instrument to assess the presence and intensity of manic symptoms. It makes it possible to carry out simple and quick assessments of the patient's state, can be used for research as clinical objectives and can also be a screening instrument.

Introduction: The use of new mood stabilizers in the treatment of bipolar disorder has supposed a revolution, especially due to its more favorable profile in many aspects. Nevertheless, therapeutic decisions on treatment during pregnancy and the breastfeeding period are still being debated. Since these new anticonvulsants appeared in the decade of 1990, less naturalistic experience in its use exists during these periods than with other older anticonvulsants., Methods: A Medline and Embase search was conducted from 1970 to 2003 to review the articles published on the use of the new mood stabilizers during pregnancy and breastfeeding, and its effects on contraception. Neurology and psychiatry text chapters and abstracts of the Annual Meeting of the American Psychiatric Association (years 2001-2003) were also reviewed., Results: Although some recent articles suggest that new mood stabilizers could have a smaller risk of congenital defects, and therefore could be used with smaller risks in women in fertile age, most of articles reviewed indicate that there is not enough knowledge on the safety of the new mood stabilizers in pregnancy and breastfeeding., Conclusions: The risks and benefits of continuing with the new mood stabilizers during pregnancy and breastfeeding must be weighed carefully, and the severity of the disease and the previous answer to treatment should be taken into account.

The present paper focuses on two patients suffering from delusional jealousy with an uncommon feature. Both cases are women who developed a homosexual delusional jealousy, that is, 'the phantom other' is a person of the same gender as the individual supposedly having an affair. The discussion centres on the possible sociological aspects and changes in the 'Zeitgeist' that may have favoured the onset of the two reported cases., (Copyright 2003 S. Karger AG, Basel)

Introduction: [corrected] Psychoeducation programs for bipolar patients try to give them a theoretical and practical system to understand and cope with the consequences of this disorder. The published studies reviewed support the idea that patients included in this therapeutic approach present higher treatment compliance., Methodology: The purpose of our study is to specify the benefits of the psychoeducation programs, comparing the degree of knowledge of the illness (Measured by means of the Understanding Mood Disorder Questionnaire Gavazzi et al, 1997, Spanish version of Livianos and Rojo, 1998) of 10 patients included in our program with that of another 10 patients who attended the same lithium clinic, but were not included in the psychoeducation program., Results: There are statistically significant differences in the total of the scale as well as on the mania scale and known facts, but no differences on the depression scale., Conclusion: The results allow us to stress the impact of the psychoeducation programs on the knowledge of illness.