Díez-Suárez, A. (Azucena)
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- Validación de la versión en español de la escala de evaluación del trastorno por déficit de atención e hiperactividad (ADHD-RS-IV.es) en una muestra española(Elsevier BV, 2019) Vallejo-Valdivielso, M. (María); Castro-Manglano, P. (Pilar) de; Marín-Méndez, J.J. (J. J.); Díez-Suárez, A. (Azucena); Soutullo-Esperón, C. (César Alejandro)Objetivos El objetivo de este estudio es validar la versión en castellano del ADHD-RS-IV (ADHD-RS-IV.es) en una muestra española. Métodos A partir de una muestra total de 652 niños y adolescentes (rango edad: 6-17 años; media [DE] = 11,14 [3,27] años), se incluyó a 518 pacientes con TDAH (criterios DSM-IV-TR) y a 134 controles sanos. Para la evaluación de la estructura factorial, la validez y la fiabilidad de la escala se realizó un análisis factorial confirmatorio (CFA) mediante structural equation modeling en una matriz de correlaciones policóricas, y usando el método de máxima verosimilitud para la estimación. Se calcularon la validez discriminante y su valor predictivo mediante curvas receiver operating characteristics. Resultados La escala en castellano mostró una consistencia interna elevada, tanto para la escala total como para sus subescalas. El coeficiente alfa de Cronbach era 0,94 para la escala total y ≥ 0,90 para las subescalas. Los valores alfa ordinales eran 0,95 para la escala total y ≥ 0,90 para las subescalas. El análisis CFA mostró un modelo de 2 factores (inatención e hiperactividad/impulsividad) intercorrelacionados. La escala ofrece buen poder discriminante (AUC = 0,97). Conclusiones La versión española del ADHD-RS-IV (ADHD-RS-IV.es) mostró una estructura bifactorial consistente con los modelos del DSM-IV-TR y DSM-5, y con el modelo propuesto por el autor de la escala original. Además, posee un alto poder discriminante, lo que lo convierte en un instrumento válido y fiable para medir la presencia y severidad de síntomas de TDAH en la población española.
- Self-injury and suicidal behavior in children and youth population: learning from the pandemic(2023) Díez-Suárez, A. (Azucena); Armero-Pedreira, P. (Paula); Bonetde-Luna, C. (Concha); García-Cruz, J. M. (José Miguel); Martínez-Sánchez, L. (Lidia); Notario-Herrero, F. (Felix); Rodríguez-Hernández, P. J. (Pedro Javier); Sánchez-Vázquez, A. R. (Ana Rosa); Vázquez-López, P. (Paula)Introduction: Suicidal behavior and self-harm are increasing in children and adolescents. Non-suicidal self-harm are a dysfunctional method of emotional regulation, and it must be distinguished from suicidal behaviors.Methods: Narrative review of the current situation on suicide and self-harm in Spain. Descrip-tive study of suicidal behaviors in pediatric emergencies.Results: Mental health consultations were analyzed (March-2019 to March-2020 and March -2020 to March-2021) in a multicentric study of the Spanish Society of Pediatric Emergencies (SEUP), finding a 122% increase of the diagnosis of << non-accidental drug intoxication >> and 56% of << suicide/suicide attempt/suicidal ideation >>. In another prospective analysis, 281 attempts were recorded, with the patient profile being: female (90.1%), 14.8 years old, 34.9% without previous psychiatric diagnosis; 57.7% with previous suicidal behavior. The presence of psychia-tric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behavior, although other factors are involved (family, personal or social). Pediatri-cians should be trained to deal with questions about suicide and acquire the skills to conduct an interview with a supportive and empathetic attitude. In Spain, suicide prevention plans are heterogeneous among communities, and there is not a unified national suicide prevention plan. Conclusions: Primary, hospital and mental health care resources for pediatric population should be strengthened to prevent suicidal behaviors. Specific training for school staff, and child and adolescent psychiatry training for pediatricians and nurses are crucial in the prevention of suicide in children and adolescent population.
- Clinical and neuropsychological predictors of methylphenidate response in children and adolescents with ADHD: A naturalistic follow-up study in a spanish sample(Bentham Science Publishers Ltd., 2019) Vallejo-Valdivielso, M. (María); Castro-Manglano, P. (Pilar) de; Marín-Méndez, J.J. (J. J.); Díez-Suárez, A. (Azucena); Soutullo-Esperón, C. (César Alejandro)Background: Methylphenidate (MPH) is the most commonly used medication for Attention-Deficit/Hyperactivity Disorder (ADHD), but to date, there are neither consistent nor sufficient findings on conditions differentiating responsiveness to MPH response in ADHD. Objective: To develop a predictive model of MPH response, using a longitudinal and naturalistic follow-up study, in a Spanish sample of children and adolescents with ADHD. Methods: We included all children and adolescents with ADHD treated with MPH in our outpatient Clinic (2005 to 2015), evaluated with the K-SADS interview. We collected ADHD-RS-IV.es and CGI-S scores at baseline and at follow up, and neuropsychological testing (WISC-IV, Continuous Performance Test (CPT-II) & Stroop). Clinical response was defined as >30% reduction from baseline of total ADHD-RS-IV.es score and CGI-S final score of 1 or 2 maintained for the previous 3 months. Results: We included 518 children and adolescents with ADHD, mean (SD) age of patients was 11.4 (3.3) years old; 79% male; 51.7% had no comorbidities; and 75.31% had clinical response to a mean MPH dose of 1.2 mg/kg/day. Lower ADHD-RS-IV.es scores, absence of comorbidities (oppositional-defiant symptoms, depressive symptoms and alcohol/cannabis use), fewer altered neuropsychological tests, higher total IQ and low commission errors in CPT-II, were significantly associated with a complete clinical response to methylphenidate treatment. Conclusion: Oppositional-defiant symptoms, depressive symptoms, and a higher number of impaired neuropsychological tests are associated with worse clinical response to methylphenidate. Other stimulants or non-stimulants treatment may be considered when these clinical and neuropsychological variables converged in the first clinical interview