Background To compare patterns of alcohol consumption and alcohol-related harm from a survey of university students sampled from universities in Denmark, England, Germany, Italy, Portugal and Switzerland. Methods A total of 2191 university students (70% female, 90% white ethnic group, age range 18–25) completed the survey. Participants completed measures of demographic variables (age, age of onset, ethnic group and sex) and the Alcohol Use Disorders Identification Test (AUDIT), which was the primary outcome. Results Sixty-three percent of the sample scored negative for harmful drinking on the AUDIT (<8), with 30% categorized as hazardous drinkers, 4% harmful drinkers and 3% with probable dependence. Analysis of variance, including demographic factors as covariates, identified a main effect of country on AUDIT scores F(5, 2086) = 70.97, P < 0.001, partial eta square = 0.15. AUDIT scores were highest in England (M = 9.99; SD = 6.17) and Denmark (M = 9.52; SD = 4.86) and lowest in Portugal (M = 4.90; ° = 4.60). Post hoc tests indicated large effect size differences between scores in Denmark and England and scores in all other countries (0.79 < d < 0.94; all P’s < 0.001). Conclusions European university students in our sample mainly reported low risk patterns of alcohol consumption and alcohol-related harm. However, students from Northern European countries had significantly higher AUDIT scores compared with students from Central and Southern European countries. Research is needed to replicate the present study using nationally representative samples to estimate the prevalence of alcohol use disorders among university students in different European countries.

Las tasas de reclutamiento de los padres para las intervenciones familiares son generalmente muy bajas, aunque pueden variar según el tipo de prevención (universal, selectiva o indicada) o la población objetivo (niños, padres, maestros). Así, en futuros estudios se podrían revisar las características específicas de cada intervención.

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Dear Editor, Substance use and dependence remains a very serious health problem in developed countries. Therefore, evaluating and monitoring the efficacy of substance use treatment programmes has become a matter of growing concern. The use of brief and multi-dimensional instruments has been indicated as a possible solution 1,2 , since it allows a swift diagnosis of the individual and the services one was provided with, enabling the adjustment of the interventions according to the users' needs and comorbidities [3][4][5][6][7][8][9] . In order to evaluate and monitoring the efficacy of substance use treatments, a pilot study was undertaken for the Portuguese population based on a brief multi-dimensional instrument, the Texas Christian University -Client Evaluation of Self and Treatment -TCU -CEST 1 . The choice of this instrument was based upon four basic criteria: (a) adequate values of validity and fidelity found in the original instrument 1 , (b) applicability to a variety of dependence treatment programmes, (c) wide evaluation of the efficacy indicators diversity, and (d) confirmed utility in the clinical practice 1,10 . The instrument is composed of a total of 130 items that are grouped into four dimensions: (a) motivation for treatment, (b) psychological functioning, (c) social functioning, and (d) therapeutic process 1,4,10 . At first, the translation and back--translation were done by a bilingual specialist. This was followed by the spoken reflection with 30 users aimed at evaluating the items' understanding and adequacy and individual pilot interviews with 8 professionals of 4 specialties (2 social work assistants, 3 psychologists, 2 psychiatrists and 1 nurse). As a second step, the questionnaire was administered to a convenience sample of 120 users (75% in a programme of opioid replacement therapy with methadone), in 028-.083, α = .329-.655); and, in terms of internal consistency, the subscales Self-efficacy (α = .542), Risky behaviour (α = .665) and Social conscience (α = .406). The small size of the sample and its specificity (75% in a programme of opioid replacement therapy with methadone) may have contributed to the reported results. As so, given the inadequacy of some items of the dimension Motivation for the treatment, we have suggested the elimination of this dimension in future applications of the TCU-CEST -Portuguese version 2 . The results of this study also underscore the need to revising the subscales Self-efficacy, Risky behaviour and Social conscience, as to achieve a closer cultural adaptation to the Portuguese context. Finally, further research should be undertaken in order to assess the validity of the instrument TCU-CEST, by examining its adequacy with samples of users dependent on other drugs and users in different treatment programmes.

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Background: Practitioners need brief instruments to monitor outcomes in both treatment of drugs and alcohol addiction because they are useful to guide decision making in a short time. Objectives: This study aims to develop a brief questionnaire, based on Client Evaluation of Self and Treatment, to evaluate the treatment effectiveness in drug and alcohol addiction treatment settings. Methods: A cross-sectional study using a convenience sample (N = 608) recruited from Division for Intervention on Addictive Behaviours and Dependencies (DICAD -ARS North). Results: The results show a new four-factor solution that accounted for 54.4% of the total variance and that provides the best fit to the data (c 2 /df = 1.72, CFI = .94, GFI = .91, RMSEA = .048 [.040-.057]; prmsea = .623). It also revealed a high internal consistency (a = .82). It was found a significant negative correlation (r = -.52, p < .01) between the final version of the instrument and a self report measure of psychopathology symptoms. Discussion: This brief questionnaire, with good psychometric properties, can be useful to provide a viable and rapid feedback of treatment outcomes. Further studies should be performed to continue the evaluation of the reliability of this measure.

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For each model, a description of the main preventive strategies and its rationale is presented. Attention is also given to the results of evaluation studies concerning the impact of these strategies on attitudes and drug related behaviors.The Informative Communicational model Historically, the interventions designed to prevent alcohol and drug abuse emerged in educational contexts. It is not then surprising that they had stressed 'didactic' and informational components. In fact, since the beginning of this century (Roe, 1943) several European countries and the US included basic information about the negative effects of alcohol abuse in their school programs.However, it is very difficult to accept, before the 1960s, the existence of a model that might have given a solid theoretical support to the preventive strategies developed in this area. The vicissitudes and fluctuations that occurred during this period were almost exclusively related with the specific characteristics and 'styles' associated with the process of information dissemination.For example, in north European countries and also in US, where temperance movements were strong, alcohol education followed a abstinence-oriented philosophy, expressed, at a pragmatic level, in "reliance on authoritarian statements, one-sided presentation of information and fear appeals" (Blane, 1977, p. 551). The growing influence of sociological perspectives about alcohol use/abuse as well as the emergence of socialization theories to explain adolescent drinking behavior (see, for example, Alexander & Campbell, 1967;Jessor & Jessor, 1975;Barnes, 1977), seem to have contributed to a gradual shift from a abstinence-oriented model to a 'responsible-use' approach, with strong emphasis in the transmission of accurate and 'scientific' information about alcohol effects.Those transformations were not associated to any relevant theoretical develop-