To evaluate the extent of hypomanic symptoms in patients presenting with a current major depressive episode (MDE) and to identify characteristics differentiating patients with hypomanic symptoms from those with pure unipolar depression, using the HCL-32 self-assessment tool.

This cross-sectional diagnostic study was performed in eighteen countries. Community- and hospital- based psychiatrists included consecutively all consulting adult patients with a diagnosis of MDE and completed a questionnaire on sociodemographic variables, diagnosis, medical history, treatment and comorbid psychiatric disorders. Each patient completed the Hypomania Self-Rating Scale (HCL-32 R2), and those scoring ≥14 were assigned a diagnosis of bipolar disorder. The frequency of study variables in the bipolar disorder (BD) and unipolar depression subgroups were compared.

A total of 5635 patients were included. Overall, 1645(39%) had received a diagnosis of BD, 703(16%) fulfilled DSM-IV-TR criteria for BD and 2942(54%) scored ≥14 on the HCL-32. Patients scoring ≥14 on the HCL-32 were significantly more likely to have experienced a mood switch in response to antidepressants (OR:3.4), a family history of bipolarity (OR:2.4), comorbid substance abuse (OR:2.1) or borderline personality disorder (OR:1.7) and current mixed-state symptoms (OR:1.5).

In patients with DSM-IV MDE self-assessed, hypomanic symptoms were present in 54% of patients, whereas only 16% fulfilled DSM-IV criteria for bipolar disorder. However, these patients presented features recognised to be associated with bipolar disorder. The presence of bipolarity in patients presenting with a major depressive disorder may be frequent and use of this questionnaire would contribute to improve awareness and prompt better diagnosis.

Dysregulation of motivation and altered processing of reward represent important diagnostic criteria of bipolar disorder and have been proposed as a trait marker of the disorder. Until now, only few studies investigated the processing of reward and learning through reward and punishment in euthymic bipolar patients (BP).

Two studies were conducted to investigate mechanisms of reward learning and processing in euthymic BP and healthy individuals (HC).

In the first study, 23 euthymic BP, 15 remitted patients with Major depression (MD) and 16 HC participated in an associative learning task, assessing the efficiency of contingency learning as well as the preference to learn through positive or negative feedback. In the second study, a probabilistic reversal learning task was conducted during functional magnetic resonance imaging. Here, the neural correlates of reward and punishment were assessed in 22 euthymic BP and 21 HC.

We observed no group differences for the efficiency of contingency learning. However, euthymic BP with a manic episode prior to remission learned better from positive feedback whereas euthymic BP with a depressed episode prior to remission and remitted MD patients learned better from negative feedback. HC did not show such preferences in learning. In addition, bipolar patients exhibited increased orbitofrontal and parahippocampal activity in response to reward but no differences in response to punishment.

Interestingly, the last episode seems to differentially affect emotional and learning processes during euthymia. On a neural level, euthymic BP seem to be more sensitive to reward than healthy individuals.

Mefloquine is being used as malaria prevention by Plasmodium Falciparum in chloroquine-resistant zones. We describe a woman who developed a manic episode with psychotic symptoms during mefloquine treatment.

The case describes a 26-year-old Spanish woman who had been working in Mali for the last six months and had started antimalarial prevention with mefloquine. In Mali, the clinical picture had a sudden debut and she related: excessive happiness, incapacity to sleep, and megalomania (she believed to have special powers and to be the mother of all the children). She was admitted in a hospital in Mali for seven days and received treatment with haloperidol and chlorpromazine. Then, she was repatriated to Spain without treatment and she continued suffering the same symptoms. After 15 days, she went to our hospital and she was admitted. Treatment started with risperidone (up to 6 mg/day) and clonazepam (up to 1.5 mg/day). At admission Young Mania Rating Scale (YMRS) was 25 points. Physical examination and complementary tests were normal, and was orientated as a manic episode with psychotic symptoms secondary to mefloquine. She had a quick symptomatic improvement (after 7 days of treatment YMRS was 5 points) and was discharged after 15 days.

Mefloquine more frequent adverse neuropsychiatric effects are: dizziness, vivid dreams and insomnia. Others are confusion, and auditory hallucinations. Side effects are dose dependent. Psychotic symptoms are frequently auto-limited when mefloquine is suppressed but treatment with atypical antipsychotics is often needed. MDR1/ABCB1 polymorphisms may play a role in neuropsychiatric side effects.

Estimate efficacy of the escitalopram in treatment of disability and impairment in social, professional and family life in patients with MDD.

This prospective clinical study included 110 patients with MDD diagnosed by ICD-10 criteria for MDD, who are randomly divided into control (40 patients) and experimental group (70 patients). Antidepressants were tested, for 6 months in hospital and outpatients conditions, according to specially designed protocol, which included Hamilton Depression Rating Scale (HAMD) and Sheehan Disability Scale (SDS). Control group was treated with mianserine (30-90 mg/24h) and experimental group was treated with escitalopram (10-20 mg/24h).

Escitalopram therapy influenced on HAMD score with high statistical significance vs. Mianserine, p=0.000. Escitalopram therapy improves all SDS scores after 6 months in comparison to Mianserine therapy with high statistical significance in Social life p=0.000, Family life/home responsibilities p=0.000, Days lost p=0.036 and Days unproductive p=0.003. Percentage of adverse effects is significantly lower in Escitalopram (10.76%) than in Mianserine (26.67%) group.

Escitalopram has significantly better efficacy in treatment of MDD and disability and impairment in MDD patients comparing to Mianserine, with significantly lower adverse effects rate.

Social anxiety disorder (SAD) is characterized by anxiety in situations in which one may be evaluated or be in focus of attention by others. Functional neuroimaging studies revealed hyperactivity of the amygdala in response to social cues like faces in patients with SAD. To date, little is known about the neuroarchitecture of SAD. We hypothesized structural alterations in white matter regions projecting to or from the amygdala such as the uncinate fasciculus.

Diffusion tensor imaging (DTI) was applied in 26 patients with SAD and 24 healthy controls (HC). White matter integrity was assessed by fractional anisotropy (FA), a measure of fiber coherence and integrity. In addition, individual scores of trait anxiety were correlated voxel-wise with FA values.

Patients with SAD showed reduced global mean FA across the whole brain and locally in regions near the left amygdala, thalamus, cerebellum, cingulate cortex/corpus callosum, and in the corticospinal tract. Furthermore, trait anxiety correlated negatively with FA in a similar region as in the group comparison near the left amygdala, probably representing the left uncinate fasciculus.

Reduced white matter integrity in patients with SAD was found globally as well as locally in different brain regions. The region near the left amygdala/uncinate fasciculus was the only one yielding significance in both the FA group comparison and voxel-wise correlation with trait anxiety. This points to a functional role of this fiber tract in anxiety and emotion regulation, for instance in top-down inhibition of the amygdala by the frontal cortex.

There is evidence that the antioxidant enzyme glyoxalase-1 (Glx-1) may play a role in anxiety-related behaviour. However, discordant findings between Glx-1 expression and anxiety-related behaviour have been observed in animal models. Because no data are available on the relation between Glx-1 mRNA expression and human anxiety so far, we investigated the expression of Glx-1 mRNA in peripheral red blood cells in relation to cholecystokinin-tetrapeptide (CCK-4) induced anxiety in healthy subjects.

Twenty-three healthy subjects underwent challenge with CCK-4. Glx-1 mRNA expression was assessed by quantitative real-time polymerase chain reaction prior to CCK-4 injection. Baseline anxiety was assessed with the State-Trait-Anxiety-Inventory (STAI) and panic response was measured with the Panic Symptom Scale (PSS).

CCK-4 elicited a marked anxiety response accompanied by a significant increase in heart rate. Glx-1 mRNA expression correlated significantly with severity of CCK-4 induced anxiety. In contrast, Glx-1 activity did not correlate with state or trait anxiety.

The positive correlation between Glx-1 mRNA expression and CCK-4 induced panic severity suggests that Glx-1 is involved into the acute anxiety response to CCK-4. Our preliminary findings support preclinical findings and point towards a role of Glx-1 for human anxiety.

Biomarkers for psychiatric disorders are critical for patient stratification, premorbid diagnosis and personalized treatment. Our aim is to identify protein biomarkers for anxiety disorders by comparing the synaptic proteomes of a well-established mouse model of high (HAB), normal (NAB) and low (LAB) anxiety-related behavior.

We have compared protein expression levels using 15N metabolic labeling and quantitative proteomics. Mice were metabolically labeled through feeding with a 15N-enriched diet. Synaptosomes from unlabeled HAB and LAB mice were then compared with synaptosomes from 15N labeled NAB mice by quantitative mass spectrometry. Protein expression differences were validated with Western blots, enzymatic assays and in silico pathway analysis.

We have identified numerous protein expression differences between HAB and LAB synaptosome proteomes. We observed alterations in energy metabolism pathways such as the Krebs cycle as well as in mitochondrial function. Furthermore, we detected changes in transport and phosphorylation processes.

We present an accurate proteomics platform for biomarker discovery in psychiatric disorders. We identified candidate biomarkers and pathways involved in anxiety pathophysiology. Our data provide the basis for the establishment of a biomarker panel that will shed light on anxiety pathophysiology and can be applied for optimal therapeutic intervention.

Selective serotonin re-uptake inhibitors (SSRI), such as escitalopram, are currently the pharmacological treatment of choice for patients suffering from panic disorder.

Serotonergic modulation of experimental panic in healthy human volunteers by such medication, however, has not been investigated as yet.

We intended to study the effects of chronic treatment with the SSRI escitalopram on the panic response to a cholecystokinin-tetrapeptide (CCK-4) challenge.

In a double-blind, placebo-controlled, randomized, within subject cross-over design thirty healthy young men, 15 each with the long/long or short/short genotype for the serotonin transporter linked polymorphic region (5-HTTLPR), were pre-treated with 10 mg/d of escitalopram for 6 weeks and then challenged with 50 μg of the panicogen CCK-4. Primary outcome measure was the increase of Acute Panic Inventory ratings by CCK-4.

A significant treatment by genotype effect on the increases of Acute Panic Inventory ratings emerged. CCK-4 panic was significantly more pronounced in the short/short genotype subjects under escitalopram versus placebo pre-treatment. Contrary to our expectation, no inhibitory effect of escitalopram upon panic symptoms elicited by CCK-4 could be demonstrated in healthy men.

Our findings do not support the usefulness of this panic model for proof-of-concept studies in volunteer translational research, at least concerning serotonergic agents.

(Supported by a grant from Deutsche Forschungsgemeinschaft (DFG), Ke 595/7-1)

Findings about dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulphate (DHEA-S) in patients with post-traumatic stress disorder (PTSD) have been inconsistent and confusing.

Although its impact on the regulation of the hypothalamic-pituitary-adrenocortical axis has been demonstrated, the potential effect of severe childhood adverse events has not been considered regarding DHEA and DHEA-S data in PTSD.

We investigated whether a history of severe childhood traumatisation affects these steroids in PTSD patients.

33 patients with chronic PTSD (15 with and 18 without sexual and/or severe physical abuse before age 12) were studied in a combined low dose dexamethasone/corticotropin-releasing hormone (CRH) test. Mean pre-CRH levels of both plasma DHEA and DHEA-S were significantly increased in the subgroup with childhood abuse, the respective ratios with plasma cortisol were significantly lower. In the entire population of PTSD patients significant amounts of the variation of these parameters could be explained by childhood trauma history.

Further studies are needed to clarify the potential role of DHEA and DHEA-S as biomarkers for severe early adverse events in patients suffering from PTSD and in other stress-related disorders.

The DSM-IV indicates severity of social phobia (SP) by the “generalized subtype”, when “most social situations” are feared. This specifier refers to the number of feared social situations, perhaps ignoring quantitative differences. We therefore compared specific and interaction-related vs. performance-related social fears according to clinical (age of onset, avoidance, impairment, comorbidities) and vulnerability characteristics (behavioural inhibition (BI), parental psychopathology and rearing).

Six social situations and SP along with their clinical characteristics were assessed using the Munich-Composite International Diagnostic Interview (DIA-X/M-CIDI) in a population-based sample of N=3,021 14-24 year olds. BI and parental rearing were assessed using self-report questionnaires. Parental psychopathology was assessed directly in parents via DIA-X/M-CIDI, supplemented by offsprings’ family-history reports.

Isolated social fears were rare, except for fear of taking tests and public speaking. The majority reported to fear two or more social situations. Compared to isolated fears of either interaction or performance situations, their co-occurrence was associated with lower age of onset, severe avoidance and impairment, more comorbid anxiety and depressive disorders. All social fears (in particular interaction-related fears) were associated with higher BI. Associations with parental psychopathology and unfavourable rearing were less consistent, albeit strongest for interaction-related fears.

Interaction-related fears may represent a more familial form of SP, while performance-related fears might be less impairing and originate from non-familial factors. The DSM-IV specifier of SP may overlook these differences when individuals with predominantly interaction-related fears are categorized as generalized SP-cases. Findings suggest considering alternative specifiers for SP in future diagnostic systems.

Depersonalization (DP) is a common and complex clinical phenomenon in neurology and psychiatry. It is defined as an experience in which the individual feels a sense of unreality and detachment from him/herself. Prevalence and clinical correlates of dissociative symptoms in general, and DP in particular have been associated to panic disorder (Hunter et al., 2004). Moreover, DP has been associated with certain personality traits, specifically “harm-avoidant” temperament dimension, immature defenses, and overconnection and disconnection cognitive schemata (Simeon et al., 2002).

To investigate the prevalence of DP syndrome in panic disorder and its relationship with personality.

One-hundred-four consecutive adult patients with panic disorder were assessed with the Semi- Structured Clinical Interview for DSM-IV-Axis I and II. All participants were evaluated with the Cambridge Depersonalization Scale (Sierra and Berrios, 2000) and the Cloninger Temperament and Character Inventory. The severity of panic disorder was measured with the Panic and Agoraphobia Scale.

Seventeen patients (16.3%) had a DP syndrome. There were not socio-demographic differences between both groups with and without DP syndrome. Patients with DP syndrome showed a higher score in “self-transcendence” character dimension (p< .001), higher prevalence of personality disorders (p=.007) and greater severity of panic disorder (p=.007). A logistic regression analysis showed that severity of panic disorder (p=.031) and higher “self-transcendence” personality dimension (p=.019) predicts DP syndrome in panic disorder patients. The Hosmer-Lemeshow test showed the goodness-of-fit of the model.

The study confirms the association of DP syndrome with panic disorder and their relationship with “self-transcendence” personality dimension.

To elucidate the consequences of broadening DSM-IV criteria for generalized anxiety disorder (GAD), we examined the evolution of GAD symptoms in two groups of newly diagnosed patients; one group according to DSM-IV criteria and the other, according to broader criteria.

Multicentre, prospective and observational study conducted in outpatient psychiatric clinics. Patients with GAD according to DSM-IV criteria and subjects with anxiety symptoms fulfilling broader criteria were compared. Broadening criteria was considered 1-month of excessive or non-excessive worry and only 2 associated symptoms listed on DSM-IV for GAD. Socio-demographic data, medical history and functional outcome measures were collected three times during a 6-month period.

3,549 patients were systematically recruited; 12.8% excluded because not fulfilling inclusion criteria, 1,815 patients in DSM-IV group (DG) and 1,264 in broad group (BG). Both groups were similar on their sociodemographic characteristics at baseline and most patients (about 80%), even newly diagnosed were exposed previously to pharmacological therapies (mainly benzodiazepines) of their anxiety symptoms. As a result of treatment at psychiatric clinics, the percentage of patients without symptoms of anxiety as per HAM-A scale were 49.0% and 58.0%, respectively at the 6 month visit (p=0.261). Similarly, responder rate (≥ 50% reduction of baseline scoring) were, respectively, 59.7% and 67.7% (p=0.103). Improvement in MADRS scores were observed in both group to a similar extent; 12.1 and 12.5 points average reduction respectively (p=0.264).

Broadening of GAD criteria could lead to earlier diagnosis that will benefit patients by starting appropriate treatment sooner.

To analyse the consequences of broadening DSM-IV criteria for generalized anxiety disorder (GAD) on the utilization of health care resources and corresponding costs.

Multicentre, prospective and observational study conducted in outpatient psychiatric clinics selected at random and weighted by geographical density of population. Patients with GAD according to DSM-IV criteria and subjects with anxiety symptoms fulfilling broader criteria were compared. Broadening criteria was considered 1-month of excessive or non-excessive worry and only 2 associated symptoms listed on DSM-IV for GAD. Socio-demographic data, medical history and health care resources and corresponding costs were recorded during a 6-month period.

A total of 3,549 patients were systematically recruited; 12.8% excluded because not fulfilling inclusion criteria, 1,815 patients in DSM-IV criteria group (DG) and 1,264 in broad criteria group (BG). Both groups were similar on their sociodemographic characteristics at baseline. Type of treatments prescribed at psychiatric clinics during the study were similar in frequency; anti-depressives (77.0% in DG vs. 75.3% in BG, ns), benzodiazepines (71.5% vs. 67.2% respectively, ns), and anti-convulsants (72.1% vs. 67.0% respectively, ns). Health care resources utilization were statistically reduced to a similar extent in both groups as a consequences of treatments yielding to a cost-of-illness in the 6-month period of 1,196 (1,158) and 1,112 (874), respectively; p=0.304.

In a large sample of subjects, broadening of GAD criteria could lead to earlier diagnosis that would not be associated necessarily to an increase in health care resources utilization or costs to the National Health System.

Emergency department staff and emergency medicine personnel in particular are at risk of various types of occupational stresses such as mental traumas. Little information is available about possibility and rate of PTSD among emergency medicine staff in Iran and the world as well. This study is to cover the prevalence of and affecting factors on the PTSD among the EM personnel in Iran.

In an analytic-descriptive study in 2009, 150 emergency medicine personnel of Kashan and Arak city were investigated to estimate both the PTSD rate and severity of mental traumas. Standard questionnaires of IES 15 and PTSS 10 along with DSM- IV criteria were utilized in this regard.

121 out of 150 subjects answered the questionnaires. All the clients were examined in terms of DSM- IV criteria in which 44 (36.4%) ones met the PTSD diagnostic criteria. In the IES scale, one third of the EM staff belonged to the event severely affected group. 11 (9%) subjects received a 5 or more PTSD score demonstrating a relatively severe reaction in them. Marital status had a meaningful correlation with PTSD condition, so that the single were more likely to meet the PTSD criteria.

According to the study, rate of PTSD and severity of the traumas resulted among the emergency medicine personnel were both high to a great extent. It seems that these individuals are severely exposed to occupational stress and the pertinent complications, and further attention should be given to their psychological condition then.

Suicide is one of predominant causes of death among young Europeans. Recent statistical data on suicide proves that Lithuania is one of the leading countries in this domain. The goal of this study is to define and compare the peculiarities of suicidal behavior among teenage boys and girls.

109 teenagers of the age 14 to 17 years old (52 boys and 57 girls), who were treated in Kaunas University of Medicine Psychiatry Clinic Children - Teenagers’ Department after suicide attempts, took part in the study. Medical documentation and structured questionnaire designed by the authors were used.

The incidence of suicidal thoughts among teenagers who attempted suicide was compared according to gender. It was determined that almost one fourth of the boys (23,1%) and one sixth of the girls (17,5%) have never thought about committing suicide before they attempted to do that. Almost every other boy (48,1%) and 40,4% of the girls have had suicidal thoughts a few times a year. One fourth of the boys (28,8%) and one third of the girls (36,8%) have had suicidal thoughts a few times per month or per week. And only a few girls (5,3%) still had suicidal thoughts after a suicidal attempt (X2=4,04, df=3, p=0,3).

No statistical gender differences were found in estimating the incidence of suicidal thoughts among teenagers who attempted suicide.

We assessed parents’ perceptions of and satisfaction with daily lisdexamfetamine dimesylate (LDX; Vyvanse®, US tradename, Shire US Inc.) treatment for their children with attention-deficit/hyperactivity disorder (ADHD) previously treated with osmotic-release oral system methylphenidate (OROS-MPH).

Parents of children with ADHD were surveyed via telephone or Internet about their child's experience before and approximately 6 weeks after initiating LDX treatment. Participants received a $25 coupon toward their child's next LDX prescription after survey completion. Post hoc analyses using the Wilcoxon signed rank test were performed.

School time was the most frequently reported most bothersome time of day at baseline (41%), followed by homework time (23%). At follow-up, most parents reported improvement during their child's most bothersome time of day. Significantly less interference from ADHD symptoms with school activities, family interactions, homework, and social interactions was reported (all P< .01). LDX tolerability and convenience were rated, on average, 7.1 and 8.0, respectively (1=not at all well tolerated/convenient, 9=very well tolerated/convenient). Satisfaction with LDX was significantly higher than satisfaction with OROS-MPH treatment (6.9 and 5.0, respectively, P< .01 [1=not at all satisfied, 9=very satisfied]). Eighty-four percent of parents reported that they intend for their child to continue taking LDX.

Parents of children with ADHD who were previously treated with OROS-MPH and currently taking LDX reported less interference of ADHD symptoms with daily activities after LDX treatment and high satisfaction with LDX. LDX was also well tolerated and convenient to use.

Supported by funding from Shire Development Inc.

To examine the association between advancing pubertal status and the emergence of depressive symptoms in boys and girls from a UK cohort.

Self-reported depressive symptoms were assessed using the Short Mood and Feelings Questionnaire at three time-points (10.5, 13 and 14 years). We derived trait measures of depressive symptom level at each time-point using confirmatory factor analysis and compared the 3 depressive symptom factors with pubertal status (using regular self-reported Tanner assessments from 8-14 years) separately in boys (n=2902) and girls (n=2886). Main effects were estimated, adjusted for time lag between assessment of pubertal status and depressive symptoms, and then further adjusted for confounders (social class, maternal education, parental separation, financial problems, housing tenure).

For girls at age 10.5 years, there was little evidence of a relationship between pubertal status and depressive symptoms, with an increase in symptoms of 0.025 SD's for each additional pubertal stage (indicated by Tanner stages 1 through 5) for breast development and 0.023 SD's for each additional stage for pubic-hair development. With increasing age, the association between pubertal stage and depressive symptoms in girls strengthened. At age 14 years, advancement of each pubertal stage represented an increase in 0.13 SD's of depressive symptoms for breast development and 0.10 SD's for pubic hair development. For boys, there was no clear relationship between pubertal development and depressive symptoms at any time-point.

More advanced pubertal status was associated with an increased level of depressive symptoms in girls in early/mid adolescence but not boys.

The main objective was to examine agreement between the internet based Development and Well-Being Assessment (DAWBA) generated diagnoses and clinical diagnoses. Second, we aimed to explore how disclosure of the DAWBA-diagnosis before clinical decision making influenced the clinicians diagnosis. Third, whether there were differences of influence for different categories of disorders. Last, we examined how the use of DAWBA information affected identification of co-morbidities.

315 patients from outpatient clinics were randomised into two groups. In 177 cases the clinician was informed about DAWBA diagnosis, in 155 cases the clinican was blind to DAWBA information. DAWBA is an internet based package of questionnaires and rating techniques designed to generate psychiatric ICD10 or DSM IV diagnoses for 5- 17 year old children and adolescents. Information from parents, teachers and self-reports are brought together by a computer programme that predicts likely diagnoses. An expert rater decides on the diagnosis by synopsis of these different inputs.

DAWBA diagnoses and clinical diagnosis without information from DAWBA showed acceptable agreement with Cohens kappa 0,26 for emotional disorders, kappa of 0,29 for hyperactive disorders and kappa of 0.31 for disruptive disorders.

There was a significant effect on clinical diagnoses for emotional disorders for disclosure of DAWBA (kappa of 0.26 without DAWBA information versus kappa of 0,52 with information, Fishers z of p< 0,05)

There was no significant effect of information about DAWBA-diagnosis considering comorbidities.

DAWBA showed the most pronounced effect on clinical diagnoses for emotional disorders in children and adolescents.

Available data suggest that sex hormone levels during puberty may affect symptom onset and expression, treatment responsiveness and outcomes in schizophrenia, whereas post-pubertal adolescents may have a similar clinical presentation and treatment response compared to adults with schizophrenia.

Post-hoc analyses were conducted to assess the similarity of short- and long-term efficacy between post-pubertal adolescents and adults with schizophrenia treated with aripiprazole.

Based on available European epidemiologic data, a cut-off age of 15 years was used to isolate a subgroup of mostly post-pubertal adolescents with schizophrenia in aripiprazole clinical studies. Outcome measures from this subgroup (ages 15-17; n=147) were then compared to outcomes from one adult study (n=853) on short and long-term measures of efficacy, including PANSS scores, response rates, and remission rates.

Comparable short and long-term treatment effects were observed on the PANSS total and subscale scores, demonstrated by overlapping 95% confidence intervals (mean change from baseline in PANSS total score (OC dataset): at week 6 in adults: -27,7; in adolescents 15-17 yr: -29,6; at week 30 in adults: -39,2; in adolescents 15-17 yr: -36). Percent of adolescents achieving response (defined as ≥ 30% decrease in PANSS total score from baseline) at 32 weeks (80,2%) on open label treatment was similar to that in adult studies at week 34 (80%) on double blind treatment (OC dataset).

Adolescents with schizophrenia (ages 15-17, mostly post-pubertal) demonstrate a positive treatment response in short-term and long-term studies which is similar to that observed in the adult patient population.

Our study aims to assess the prevalence of behavioural addictions in an adolescent populations, evaluating the effects of gender and age, and to assess the correlations and associations between different behavioural addictions.

A population of 2853 students (1142 F and 1711 M, mean age 16.7± 1.9) was assessed in order to evaluate the prevalence of behavioural dependences such as Pathological Gambling (PG), Compulsive Buying (CB), Exercise Addiction (EA), Internet Addiction (IA), and Work Addiction (WA). The South Oaks Gambling Screen-Revised Adolescent, the Compulsive Buying Scale, the Exercise Addiction Inventory, the Internet Addiction Test, and the Work Addiction Risk Test, were compiled anonymously by the students.

Overall prevalence was 7.0% for PG, 11.3% for CB, 1.2% for IA, 7.6% for WA, 8.5% for EA. PG, and EA were more common among boys, while gender had no effect on the other conditions. CB was more common among younger (< 18 years old) students. Each of these conditions showed a strong association with others, and the scores of all of these scales were correlated.

In line with previous studies our results indicate that behavioural addictions are quite common among adolescents. The strong association between behavioural addictions stresses the concept that treatment for one of these conditions should involve assessment and treatment for the others.