Aim: Appropriate social integration has
been shown to be a protective factor
against substance use among adolescents
and associated negative consequences.
Promoting social integration
through early intervention with adolescents
using substances is thus necessary
and is the aim of the Identification,
Assessment and Follow-up of Adolescents
with SubstanceUse (in French, Dépistage
- évaluation - parrainage d’adolescents
consommateurs de substances (DEPART)
programme. The present study aimed to
describe this programme and its
participants from 2009 to 2013 as well as
to assess its effects on social integration.
Methods: Data from 398 adolescents
using substances who attended the
DEPART programme were analysed.
Results: The results showed that
almost 80% of the adolescents admitted
to the DEPART programme
were boys, with a large proportion
using cannabis. Globally, social integration
did not increase from
admission to discharge from the
programme, but a shift was observed
for school and professional integration.
Additionally, after the intervention, we
observed that social integration was
more important in younger patients.
Conclusions: This study showed that
adolescents with problematic substance
usemostly consumed soft drugs
and that those who were integrated
into the DEPART programme at a
younger age were more likely to be
socially integrated at the end of the
programme.

Objective
Treatment goals for individuals with attention-deficit/hyperactivity disorder (ADHD) include the long-term management of symptoms in parallel with good tolerability. Here we evaluate the safety and efficacy of lisdexamfetamine dimesylate (LDX) in children and adolescents with ADHD over the course of a 2-year clinical study (SPD489-404).
Methods
Participants (children, 6–12 years; adolescents, 13–17 years) received dose-optimized, open-label LDX (30, 50, 70 mg/day) for 104 weeks (dose optimization, 4 weeks; dose maintenance, 100 weeks). Long-term safety was assessed as the primary study objective, with evaluations including the monitoring of treatment-emergent adverse events (TEAEs). The secondary objective was assessment of the long-term efficacy of LDX using the ADHD Rating Scale IV (ADHD-RS-IV) and Clinical Global Impressions-Improvement (CGI-I; improvement defined as a score of 1 or 2).
Results
Of 314 patients enrolled, 314 were included in the safety population and 299 in the full analysis set (FAS), and 191 completed the study. TEAEs were reported in 282/314 participants (89.8%), led to discontinuation in 39/314 (12.4%) and were reported as serious in 28/314 (8.9%). In the safety population, TEAEs reported in ≥10.0% of participants were decreased appetite, nasopharyngitis, headache, weight decreased, insomnia, initial insomnia, irritability and pyrexia. When categorized by age, TEAEs were reported in similar proportions of children (181/202 [89.6%]) and adolescents (101/112 [90.2%]). The mean change from baseline to last on-treatment assessment (LOTA) in ADHD-RS-IV total score was –25.8 (95% confidence interval; –27.0, –24.5) in the FAS and –26.3
(–27.9, –24.6) and–24.9 (–26.9, –23.0) in the child (n=189) and adolescent (n=110) subgroups, respectively; all p<0.001. The percentage of participants with CGI-I scores of 1 or 2 at LOTA was 77.9% in the FAS, 78.8% in children and 76.4% in adolescents.
Conclusions
Similar proportions of children and adolescents experienced TEAEs in this 2-year, open-label study of LDX, and these findings were consistent with those reported in previous LDX studies. LDX treatment for up to 2 years was associated with similar symptomatic improvements from baseline to LOTA in both children and adolescents with ADHD.

Study funded by Shire Development LLC.

Objectives
To assess the long-term safety and efficacy of GXR in subgroups of children (6–12 years) and adolescents (13–18 years) with ADHD in study SPD503-318.
Methods
SPD503-318 was a phase 3, single-arm, open-label extension study for European participants of GXR trials SPD503-315 and SPD503-316. Participants received dose-optimized GXR for up to 2 years (maximum permitted dose: children, 4 mg/day; adolescents, 4–7 mg/day depending on weight).
Results
Of 215 enrolled participants, 214 were included in the safety population (131 children, 83 adolescents) and 133 completed the study (79 children and 54 adolescents). At baseline, there were more males among both children and adolescents (80.2% of children, 63.9% of adolescents) and symptom severity was worse in children than in adolescents (mean ADHD Rating Scale-IV [ADHD-RS-IV] total score of 40.1 compared with 31.4). Prior to taper, mean daily exposure was 3.2 mg (0.073 mg/kg) in children and 4.3 mg (0.067 mg/kg) in adolescents. Over the 2-year study, the frequencies of treatment-emergent adverse events (TEAEs) were similar in children (84.7%) and adolescents (79.5%). In both age groups, TEAEs reported in >10% of participants were somnolence, headache and fatigue. The frequencies of serious TEAEs and TEAEs leading to early termination were low in both age groups (<7% of participants). There were no deaths. Mean height z-scores were similar across age groups at baseline, but mean z-scores were qualitatively higher for adolescents than for children at final assessment. In both age groups, mean z-scores for weight and BMI were stable throughout the dose-maintenance period, although mean z-scores for BMI were slightly higher for children than for adolescents throughout the study. At all post-baseline visits, improvements in ADHD-RS-IV total score were similar in both age groups, and at final assessment, mean changes from baseline in ADHD-RS-IV total score were nominally significant in both children (–20.2; p<0.0001) and adolescents (–19.3; p<0.0001).
Conclusion
In this subgroup analysis of SPD503-318, GXR was well tolerated in both children and adolescents with ADHD, with a safety profile similar to that observed in previous studies. In both age groups, mean z-scores for height, weight and BMI were stable throughout treatment. ADHD symptom reduction was maintained over the 2-year GXR treatment period and the degree of improvement was similar in both children and adolescents.
Study funded by Shire Development LLC

Objectives
In the Netherlands, an elevated number of adolescents enter substance abuse treatment because of video gaming addiction. Since assessment and treatment of this type of addictive behavior is still in its infancy, more research is needed on symptoms and characteristics related to problematic gaming. As a first step, we examined baseline characteristics of adolescents and young adults receiving treatment at a large youth addiction care facility in the Netherlands and tested differences between clients seeking help for compulsive gaming versus clients who sought help for substance-related disorders.

Methods
Treatment registry data were used of all clients who, in 2015, received at least 1 day of treatment at the youth department of Brijder Addiction Care. A total of 1,078 clients with either compulsive gaming or a substance-related disorder as primary diagnosis were included. In addition, complete Routine Outcome Monitoring data were available for 65% of the sample (n=705) which included clinical and demographic characteristics and self-reported psychosocial problems (Strengths and Difficulties Questionnaire, SDQ) at beginning of treatment. Data on self-reported quality of life based on the Kid Screen-27 were available for 43% of the sample (n=464). Differences between clients with compulsive gaming and those with substance-related disorders were examined with Chi-Square tests, T-tests and multivariate logistic regression analyses.
Results
Compulsive gamers were more likely to be male, younger, higher educated and living with parents, than clients with substance-related disorders. Although both client groups showed high rates of co-morbid disorders, compulsive gamers were more likely to show pervasive developmental disorders but less likely to show ADHD, mood disorders, and conduct disorders than their counterparts with substance-related disorders. Results based on the SDQ and Kid-screen suggested that, at beginning of treatment, both groups reported high levels of psychosocial problems and low quality of life. However, compulsive gamers reported less emotional problems, ADHD and behavior problems and were more positive about their psychological well-being than clients with substance-related disorders.
Conclusion
Clients in treatment for compulsive gaming at a youth addiction care facility showed different demographic and clinical characteristics than their counterparts with substance-related disorders. Implications of these findings will be discussed.

Introduction: Alcohol use and alcohol abuse among adolescents and young people is a serious social and public health problem, particularly in developing countries.
The aim of this study was to obtain the data regarding alcohol consumption among adolescents. We surveyed the initiation, frequency, quantity and type of alcohol consumed. It was also important to examine the situations in which young people drink, their beliefs about the effects of alcohol and the reasons for alcohol consumption.
Method: The sample consisted of 232 adolescents (146 boys and 86 girls) aged 14 to 18 who attend primary and secondary school. A questionnaire, which consisted of 26 questions was designed especially for this study. The obtained data were processed in the statistical SPSS program.
Results: The age of the first contact with alcohol among the largest number of adolescents was between 14 and 16 (47%) and from 10 to 13 (35.3%). The younger adolescents report having consumed their first drink at home (offered by the father or other family member), whereas the first drinking experience of the older respondents involves other social contexts. The current drinking rates among adolescents are 93.8%, of which 91.5% girls and 95.1% boys. The majority reported drinking several times a month and once a month (57%). Two to three drinks on one occasion drink 40.5%, and more than four drinks 20.9%. Beer is the most common choice (29.4%), followed by wine (18.6%) and strong alcoholic beverages (19.1%). Alcohol is mostly drunk at parties (52.9%) and birthdays (32.2%). A number of respondents reported not drinking when in the company of non-drinkers (53%). Most of respondents drink to relax (40.9%), to accommodate “better” communication or to avoid facing problems. Only 20.5% believe that alcohol has no positive effects. 80.1% consider themselves sufficiently informed about alcoholism, and 76.3% would like to attend lectures on substance abuse.
Conclusion: Alcohol consumption in Serbia is widely accepted social behavior and a part of the tradition, customs and culture. The data on the frequency and intensity of drinking showed no significant gender differences indicating that the current trend of much greater representation of consumption in the male population changes. We believe that it is necessary to create and organize an early educational guidance that could contribute to alcohol abuse prevention.

Objectives: Over the last decade, clinical practice guidelines for diagnosing and treating severe behavioural problems (SBPs) in children have been developed around Europe as an important tool. First, they would help coordination of care across the multiple agencies that need to be involved in the management of children with SBPs. Second, they would assist health and non-specialist health, social care, and educational services in choosing interventions supported as efficacious. This study provides an overview of experts’ perspectives on the current prevalence and implementation of clinical guidelines for SBPs in children across Europe. Additionally, it discusses the pros and cons for further developing national and/or European clinical guidelines for this group. Methods: An online semi-structured interview was completed by 28 academic experts from 23 countries. Results: One third of the European countries included have developed official clinical guidelines for SBPs, and just over a half have at least some unofficial documents. Although the content of guidelines was perceived as beneficial for daily practice, experts called for more specific recommendations, including severe aggression management, legal and forensic aspects, to better cater for real-life practice demands. Additionally, their implementation was described as one of the most salient challenges at present. Similarly, unofficial documents were considered useful for clinicians, but experts stressed the need for change towards more comprehensive evidence-based clinical practices, by means of developing national and particularly European clinical guidelines for SBPs. Such guidelines were believed to increase accessibility to evidence-based and early intervention, harmonise practices and provide a shared understanding of SBPs. Conclusions: Based on the consensus on the need for developing official guidelines reached by experts, this study creates an appropriate momentum for a transition towards European clinical practice guidelines for this population. Such guidelines would facilitate cross-disciplinary collaboration both within and between countries. Increasing global exchange may further stress the prioritization of SBPs and reinforce implementation of guidelines in practice. Moreover, joining efforts could also reduce costs, time, and resources required for the creation of national guidelines, all of these tackling the current barriers encountered by professionals when treating these children.