[Validity of the Child Psychiatric Hospital Teacher Questionnaire for the assessment of ADHD. Teacher's version]. / Estudio de validez del Cuestionario para trastorno por déficit de atención y trastorno de conducta. Versión Maestros.

INTRODUCTION: Teacher's rating scales for the evaluation of attention deficit and superactivity disorder (TDAH) and conduct disorders have been shown to be useful and valid tools. The Child Psychiatric Hospital Teacher Questionnaire (CPHTQ) of the Hospital Psiquiátrico Infantil Dr. Juan N. Navarro was designed for the assessment of ADHD symptoms, externalizing symptoms and school functioning difficulties of children and adolescents. METHODS: Internal consistency, criterion validity, construct validity and sensitivity of the scale to changes in symptom severity were evaluated in this study. RESULTS: The scale was administered to 282 teachers of children and adolescents aged 5 to 17 years who came to a unit specialized in child psychiatry. The validity analysis of the instrument showed that the internal consistency measured by Cronbach's alpha was 0.94. The factorial analysis yielded 5 factors accounting for 59.1% of the variance: hyperactivity and conduct symptoms, predatory, conduct disorder, inattentive, poor functioning and motor disturbances. The CPHTQ scores on the scale showed positive correlation with the Clinical Global impression (CGI) scale in the patients' response to drug treatment. CONCLUSIONS: The CPHTQ shows adequate validity characteristics that demonstrate its utility in the evaluation of patients with ADHD and its comorbidity with other behavior disorders.

Reliability study of the translation into Spanish of the PRIME Screen Questionnaire for Prodromic Symtoms.

INTRODUCTION: A fundamental precondition for early intervention in schizophrenia is accurate detection of prodromal states, that is, sign and symptom constellations that predict the onset of psychosis in persons with no prior background. Several structured interviews have been designed for the detection of prodromal subjects. OBJECTIVE: To translate and determine the reliability of the PRIME Screen in an adolescent community sample in México City. METHOD: A total of 532 adolescents of a technical-industrial educational center of México City were included for the study. All the subjects were administered the PRIME Screen Questionnaire of Prodromal Symptoms. RESULTS: A total of 98 subjects (18.4%) reported one or more prodromal symptoms. The results of the factorial analysis showed that the PRIME Screen questionnaire is conformed by three factors that explained 59.3% of the variance. Internal consistency of the instrument was of 0.88. DISCUSSION: Our results on the exploratory factor analysis show that the items of the questionnaire are grouped into three main areas called: a) alteration of setting; b) sensorial-perceptual abnormalities, and c) alterations of self-skills. The Prodromal Symptoms Screen Questionnaire is an instrument with adequate clinimetric behavior that may be effective to conduct community-wide screening of adolescents for prodromal symptoms.

[Psychopathology associated to attention deficit hyperactivity disorder in school age children]. / Psicopatología asociada al trastorno por déficit de atención e hiperactividad en niños de edad escolar.

INTRODUCTION: Attention Deficit Hyperactivity Disorder (ADHD) represents a frequent and highly comorbid disorder in children and adolescents. Comorbidity differs according to ADHD subtype and gender and has been reported to have a direct effect on the severity of ADHD. METHODS: A descriptive, cross-sectional study was designed to determine the patterns of ADHD comorbidity in 102 children, aged 6 to 12 years, who attend the outpatient services of a child psychiatric hospital in Mexico City. The evaluation was performed using the Child Behavior Checklist (CBCL). RESULTS: The sample had about five comorbid disorders. The hyperactive-impulsive subtype had more severe externalizing symptoms, while the combined subtype had a higher severity of anxious depressive symptoms, delinquent behavior and internalized symptoms. Somatic complaints were more frequent in boys. A linear regression analysis showed that the severity of attention problems was influenced by the severity of aggressive behavior. CONCLUSIONS: School age children who came to psychiatric attention services with ADHD are highly comorbid. The comorbidity increases the severity of attention problems, particularly in patients with the hyperactive-impulsive or combined subtypes.

[Interrater reliability of the Spanish version of Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL)]. / Estudio de fiabilidad interevaluador de la versión en español de la entrevista Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL).

INTRODUCTION: The K-SADS-PL diagnostic interview is useful for the cross-sectional and longitudinal evaluation of psychopathology in children and adolescents. The objective of this article was to describe the interrater reliability of the Spanish version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL). METHOD: The interview was translated, back-translated and adapted to Spanish. Forty psychiatric outpatients (aged 6 to 17 years) were evaluated. The interviews were videotaped and scored by three independent raters. All of them included both the child's and parent's interview. Interrater reliability was obtained for affective, anxiety and conduct disorders using the Cohen's kappa coefficient. RESULTS: Kappa coefficients were between the good and excellent range for present and lifetime disorders (major depressive disorder kappa = 0.76, any anxiety disorder kappa = 0.84, attention deficit hyperactivity disorder kappa = 0.91 and conduct disorder, kappa = 1). CONCLUSION: The Spanish version of the K-SADS-PL is a reliable instrument for the assessment of psychopathology in children and adolescents.

[Validity and reliability of the Spanish version of Yale-Brown obsessive-compulsive rating scale for children and adolescents]. / Estudio de validez y confiabilidad de la versión en español de la escala Yale-Brown del trastorno obsesivo-compulsivo para niños y adolescentes.

INTRODUCTION: The Children Yale-Brown Obsessive- Compulsive Scale (CY-BOCS) constitutes a very good instrument for the evaluation of obsessive-compulsive disorder (OCD) symptoms, by a clinical interview administered to the patient and parent, that includes summary score of the clinician. OBJECTIVE: We are proposing a Spanish version of instrument, which is rated during a brief clinical interview to the parents and the patients. We are presenting data reliability and validity using two out-patient samples. METHODS: After the translation to Spanish, a back translation and adaptation to Spanish of the CY-BOCS, twenty eight out-patients (75 % male) with a mean age 12.1 (+/- 2.7) from two clinical settings on Mexico City evaluated. Reliability was evaluated by computing the internal consistency (Cronbach's alpha) on all interviews. assess interrater agreement, the interviews were videotaped and scored by three independent raters and all of them included both the child and the parent interview. The CY-BOCS total scored was correlated with the K-SADS-PL diagnosis. RESULTS: The CY-BOCS total score for all subjects was 16.5 +/- 9.8. Cronbach's alpha coefficient was 0.87; Pearson correlation of total CY-BOCS score with the K-SADS-PL diagnosis was 0.60 (p < or = 0.05). The intraclass correlations coefficients for the parents, youngsters and clinician 0.96, 0.94 and 0.92, respectively. CONCLUSIONS: The Spanish version of the CY-BOCS reliable and valid instrument, useful for both clinicians and researchers in child and adolescent OCD assessment.

[Premorbid functioning by gender and its relationship with duration of untreated psychosis in first psychotic episode]. / Funcionamiento premórbido por género y su relación con la duración de la psicosis no tratada (DPNT) en el primer episodio psicótico.

INTRODUCTION: There are two phenotypes proposed for the psychotic disorders based on premorbid functioning and probably related with the duration of untreated psychosis (DUP). The aim of this study was to compare the clinical features, premorbid functioning and its relationship with DUP by gender in a group of first episode psychosis patients. METHODS: We included 77 patients in their first admission to a psychiatric facility. A clinical evaluation was performed with the PANSS, Calgary Depression Scale,Hamilton Depression Scale and Mania Rating Scale. Premorbid functioning was rated with the Premorbid Adjustment Scale. RESULTS: There were no clinical differences between men and women. Men had greater impairment in their premorbid functioning. Patients with short DUP (< 28 weeks) showed better premorbid functioning compared to those with long DUP (> 28 weeks). CONCLUSION: Duration of untreated psychosis is determined by premorbid functioning and it is possible that male patients, who show a higher frequency of poor premorbid functioning, have a longer delay in seeking treatment, that conditions a longer duration of untreated psychosis.

Age differences in the sensitivity to clomipramine in an animal model of obsessive-compulsive disorder.

RATIONALE: Subtypes of obsessive-compulsive disorder (OCD) related to age could determine differential response to treatment. OBJECTIVES: To explore possible age differences in the effect of clomipramine in an animal model of OCD. METHODS: The deficits on spontaneous alternation produced by 8-OH-DPAT and the preventing actions of clomipramine, desipramine and WAY 100635 were compared between young and adult rats. RESULTS: No age differences were found in spontaneous alternation. The 5-HT(1A) agonist, 8-OH-DPAT (0.031, 0.125, 0.5 and 2.0 mg/kg, -15 min) produced perseveration in young and adult rats. However, young rats were sensitive to a lower dose of 8-OH-DPAT. Clomipramine (10 mg/kg per three administrations) completely prevented the action of 8-OH-DPAT (0.5 mg/kg) in adult rats. However, this treatment as well as higher doses (15 mg/kg 3 administrations) or injected for longer periods (10 mg/kg 5 administrations) produced weak protective effects (versus 0.125 mg/kg 8-OH-DPAT) or had no action (versus 0.5 mg/kg 8-OH-DPAT) in young animals. WAY 100 635 (0.5 mg/kg) blocked the action of 8-OH-DPAT (0.5 mg/kg) in both young and adult rats. Desipramine (10 mg/kg/3 administrations) lacked of a preventive effect on the 8-OH-DPAT (0.5 mg/kg) action. This result indicated that the 5-HT(1A) receptor is involved in the deficits on spontaneous alternation produced by 8-OH-DPAT. CONCLUSIONS: The present data shows important age differences in the effect of clomipramine in a model of OCD. Such differences could be relevant for the age variations in the response to treatment in clinical practice.

Psychosis in a pediatric mood and anxiety disorders clinic: phenomenology and correlates.

OBJECTIVES: To examine the demographics and phenomenology of psychosis in a sample of children and adolescents referred to a mood and anxiety disorders clinic. METHOD: Patients (N = 2,031) were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode version and classified as definite, probable, or nonpsychotic. Clinical and demographic characteristics of the groups were compared,and symptoms of psychosis were analyzed using factor analysis. RESULTS: Definite psychotic symptoms were seen in approximately 90 (4.5%) patients: 80% of these reported hallucinations (mainly auditory), 22% delusions, and 3.3% thought disorder. Of the patients with definite psychotic symptoms, 24% had bipolar disorder, 41% had major depression, 21% had subsyndromal depression, and 14% had schizophrenia spectrum disorders (schizophrenia and schizoaffective disorders). Factor analysis of the definite psychotic symptoms yielded 4 factors: hallucinations, thought disorder, delusions, and manic thought disorder. Psychotic patients had a higher frequency of comorbid disorders and suicidal ideation than nonpsychotic patients. CONCLUSIONS: Outpatient youngsters with mood disorders frequently present with psychotic symptoms, in particular auditory hallucinations. These patients commonly have comorbid psychiatric disorders and suicidal ideation.

Clinical outcome after short-term psychotherapy for adolescents with major depressive disorder.

BACKGROUND: Cognitive behavioral therapy has been shown to be more efficacious than alternative psychosocial interventions for the acute treatment of adolescents with major depressive disorder. However, the long-term impact of brief psychosocial interventions on the course of adolescent depression is not well established. METHODS: One hundred seven adolescents with major depressive disorder randomly assigned to 12 to 16 weeks of cognitive behavioral therapy, systemic behavioral family therapy, or nondirective supportive therapy were evaluated for 2 years after the psychotherapy trial to document the subsequent course and predictors of major depressive disorder. RESULTS: There were no long-term differential effects of the 3 psychotherapies. Most participants (80%) recovered (median time, 8.2 months from baseline), and 30% had a recurrence (median time, 4.2 months from recovery). Twenty-one percent were depressed during at least 80% of the follow-up period. Severity of depression (at baseline) and presence of self-reported parent-child conflict (at baseline and during the follow-up period) predicted lack of recovery, chronicity, and recurrence. Despite the similarity to clinically referred patients at baseline, patients recruited via advertisement were less likely to experience a recurrence. CONCLUSIONS: There were no significant differences in long-term outcome among cognitive behavioral therapy, systematic behavioral family therapy, and nondirective supportive therapy. While most participants in this study eventually recovered, those with severe depression and self-perceived parent-child conflict are at greater risk for chronic depression and recurrences.