Generalized anxiety in young adults during college career is a serious public-health problem that untreated has a chronic course. Research has shown that the self-report questionnaire generalized anxiety disorder-7 (GAD-7) is a reliable and valid measure to assess generalized anxiety symptoms severity in heterogeneous psychiatric samples. However, GAD-7 is not available for non-clinical populations and their factor structure has not been re-examined.

Our objective was to examine factor structure and measurement invariance of the GAD-7 among college students testing two alternatives models.

The original model fit of single-factor was compared to two-factor model that considered in comprehensive approach of generalized anxiety the assessment of cognitive-emotional nature and somatic symptoms.

In this cross-sectional study the GAD-7 was administrated to college students (n = 1031) recruited in the six schools which compose the Polytechnic Institute of Coimbra, Portugal. Confirmatory factor analysis was used testing two models.

Among college students, 32.8% reported significant generalized anxiety symptoms. The original unidimensional structure of GAD-7 was confirmed but the two-factor model comprising cognitive–emotional and somatic factors presented better fit to the data (χ2(1) = 21.01, P < 0001). This latent factor were positively associated (r = 0.51, P < 0.001) and presented a good internal consistency (α = 0.85 and α = 0.86 for cognitive-emotional and somatic items, respectively). The invariance factor of two-factor model across gender was also confirmed.

Results indicate that within college communities the GAD-7 integrates two stable generalized anxiety factors related but independent structure. The GAD-7 can be an adequate measure to detected generalized anxiety symptoms in this population.

The authors have not supplied their declaration of competing interest.

Orthorexia nervosa (ON) is an excessive fixation on the consumption of healthy food and an obsession with its biological purity. The aim of this study was to assess the prevalence of ON in a population of Polish urban adolescents and some possible contributory factors.

Validation and adaptation of the ORTO-15 Questionnaire was made in the group of 399 participants (15–21 years old). The validation procedure incorporated three basic methods to be applied in the reliability analysis. The reliability analysis of the ORTO-15 Questionnaire based on repeatability of the responses presents a very good (kappa: 0.81–1.00 for 5 items) and a good repeatability (kappa: 0.61–0.80 for 10 items). The reliability analysis based on the value of the Cronbach's α reached a satisfactory level (0.7–0.9). The ORTO-15 questionnaire was considered a reliable tool to identify the risk of ON in population studies in the group of urban youth aged 15–21. Assessment was made among 1899 high school students, 992 girls, and 907 boys, aged 15–21 years.

The mean value of the ORTO-15 was 39.2 ± 3.6 points, with no sex difference. The main factors connected with orthorexia, according to the “Orthorexia 35” definition were excess weight, sporting activities, out-of-school activities, smoking status, working parents and a high family income.

This study, of a large number of adolescents, showed a prevalence of ON similar to that recorded in adult populations. This is a first assessment of orthorexia among adolescent population.

The authors have not supplied their declaration of competing interest.

Adolescent online behavior is an urgent public health problem in different countries of the world due to the possibility of developing Internet addiction.

To study the prevalence of different types of online behavior and Internet addiction in Siberian adolescents, depending on gender and age.

During the period from January to May 2019, 2950 adolescents aged 11-18 years living in the urban area of Central Siberia (Krasnoyarsk) were examined, of them 1348 boys and 1602 girls. The Chen Internet Addiction Scale (CIAS) with a cut-off level of 65 points was used. Internet users are divided into three groups: Adaptive Internet Users (AIU) (27–42 points); maladaptive Internet users (MIU) (43–64 points); pathological Internet users (PIU) (score ≥ 65).

The AIU group comprised 50.3% (55.9% boys and 45.6% girls, p <0.001). The share of adolescents aged 11-14 is 52.0%, the share of adolescents aged 15-18 is 48.4% (p = 0.04). The MIU group constituted 42.9% (46.3% were girls and 38.9% boys, p <0.001). The share of adolescents aged 11-14 is 42.1%, and those aged 15-18 is 43.8%, p > 0.05. The PIU group constituted 6.8% (5.1% boys and 8.2% girls, p <0.001). The share of adolescents aged 11-14 is 5.9% and those aged 15-18 is 7.8% (p = 0.04).

Among adolescents in Central Siberia the prevalence of AIU consist 50.3%, MIU 42.9%, PIU 6.8%. The prevalence of PIU is more common in girls. The increase in PIU was marked in the older age group. The study was funded by RFBR project № 18-29-2203218.

The reported study was funded by RFBR project № 18-29-22032\18.

The aim of study is to determine ethnics differences related to the knowledge, attitude and beliefs towards Mental Health Illness in a traditional fast developing country.

A cross-sectional survey.

Primary Health Care (PHC) Centers.Subjects: A representative sample of 3000 Qatari and other Arab expatriates above 20 years of age and 2514 subjects (83.8%) expressed their consent to study.

A specific questionnaire was designed to assess the knowledge, attitude and beliefs towards mental health illness.

Among the 2514 studied subjects, 50.3% were Qataris’(males 39.8% and females 60.2%) and 49.7% were Arab expatriates (58.6% males and 41.4% females). 50.6% Qatari and 44.5% Arabs believe that mental illness could be the result of punishment from God or, thought as it was due to the possession of evil spirits (40.5% Qatari's and 37.6% Arabs). More than half of Qatari's and Arabs think that psychiatric medication will cause addiction and consider mental illness as dangerous. 75.3% of Qatari's and 83.4% of Arabs respondents had no problem to visit a Psychiatrist for their emotional problem, and 42.3% of Qatari's and 36.4% of Arabs agreed to visit a healer for their problem. Less than half of the population are disturbed to work with someone who has mental illness and are afraid if anybody with mental illness are staying in next door. The common mental illness among Qatari's and Arab Populations described are: schizophrenia, depression, autism, anxiety, epileptic, obsession, and other reported mental illnesses.

People's knowledge and attitude about understanding the mentally sick were of negative impact.

Sleep complaints are common in patients with major depressive disorder (MDD).Venlafaxine is an antidepressant of the serotonin -norepinephrine reuptake inhibitor class. Mirtazapine is a tetracyclic antidepressant (TeCA) used primarily in the treatment of depression. This study compares the effects of venlafaxine and mirtazapine on sleep continuity measures in DSM-IV MDD patients with insomnia.

Patients (N = 37) received initial baseline polysomnography evaluations over 2 consecutive nights.Subjects were randomly assigned to either venlafaxine (75–150 mg/day) or mirtazapine (15–45mg/day)treatment for an 8 week,double -blind,double -dummy treatment trial.Single-night polysomnograms were conducted at weeks 1,2,and 8, with depression ratings assessed at baseline and weeks 1,2, 3,4, 6,and 8.

Patients receiving mirtazapine (N = 20) had significant improvement in objective sleep physiology measures at 8 weeks.Improvement in sleep latency,sleep efficiency,and wake after sleep onset were significant after only 2 weeks of mirtazapine treatment.No significant changes in sleep continuity measures were observed in the venlafaxine group (N = 17).Both groups improved clinicaly in mood and subjective sleep measures from baseline, with no differences between groups.

These date demonstrate the differential effects of mirtazapine and venlafaxine with significant improvement in favor of mirtazapine ,on objective sleep parameters in MDD patients with insomnia.

A retrospective study in India had showed high rate of comorbid disruptive disorders in children with Attention deficit hyperactivity disorder, but not depression and anxiety disorders as opposed to western literature. Studies using structured assessment tools are lacking in Indian population and thus valid data on prevailing pattern of comorbidities in ADHD children is lacking.

To study the pattern of co-morbidities in Indian children & adolescents (subjects) with ADHD and to compare the degree of functional impairment between ADHD subjects with and without comorbidities.

60 consecutive subjects aged 6 to 16 years diagnosed as ADHD based on DSM IV TR were recruited with informed consent, from a tertiary care centre during a period of 6 months. Kiddie-SADS - PL was applied to identify comorbidities in these subjects. Global functioning was assessed by Children Global Assessment scale (CGAS) in all these subjects.

55% of recruited subjects had comorbidity, the most highly prevalent lifetime disorder being Oppositional Defiant disorder (25%), followed by conduct disorder (13.3%), Bipolar affective disorder (13.3%), Major depressive disorder (10%), Communication disorder (10%), Substance use disorder (8.4%), Obsessive compulsive disorder (8.3%), Tic disorder (5.4%), Learning disorder (5%), Elimination disorder (3.3%), Social phobia (1.7%) and Separation anxiety disorder (1.7%). Subjects with comorbidities had poorer global functioning (41.58 ± 0.45) when compared to ADHD subjects without comorbidities (47.67 ± 8.57) (p = 0.018).

Our study points out that Comorbid disorders like anxiety disorders are not as low as projected by the earlier Indian studies.

The authors have not supplied their declaration of competing interest.

GXR, a selective α2A-adrenergic agonist, is a non-stimulant ADHD treatment approved in the USA for children and adolescents, and in Canada for children.

To evaluate long-term maintenance of efficacy of GXR in children and adolescents with ADHD who respond to an initial open-label, short-term trial.

To determine if there is a higher rate of treatment failure for placebo vs GXR during the double-blind randomised-withdrawal phase (RWP) (NCT01081145).

Patients (6–17 years) meeting DSM-IV-TR criteria for ADHD, baseline ADHD Rating Scale-IV (ADHD-RS-IV) ≥32 and Clinical Global Impressions-Severity (CGI-S) ratings ≥4 were enrolled. Following 7-week dose optimization and 6-week maintenance periods on open-label GXR (1–7 mg/day), eligible patients entered a 26-week, double-blind, RWP with GXR or placebo. The primary endpoint was rate of treatment failure (≥50% increase in ADHD-RS-IV total score and ≥2-point increase in CGI-S at two consecutive visits, compared to the RWP baseline). The key secondary endpoint was time-to-treatment failure. Safety assessments included treatment-emergent adverse events (TEAEs), electrocardiograms and vital signs.

Of 528 patients enrolled, 316 (60.0%) entered the RWP. At study end, 49.3% (GXR) and 64.9% (placebo) (95%CI; −26.6, −4.5, p<0.01) of patients had relapsed (Figure). Time-to-treatment failure was 56 days (placebo) versus 218 days (GXR), p=0.003. During the RWP, the most common GXR TEAEs (≥5% patients) were headache, somnolence and nasopharyngitis.

GXR demonstrated long-term maintenance of efficacy versus placebo in children and adolescents with ADHD.

Cross-sectional population studies often suffer from unobserved individual heterogeneity (e.g. genetics or unobserved predisposition to adopt healthy lifestyle) contaminating the estimate of social inequalities on well-being. Accurate estimates of risk factors for impaired quality of life using large epidemiological studies may help to develop services for older people in the community.

We examined the effect of socio-demographic characteristics, lifestyle choices, smoking status and their impact on quality of life in non-institutionalised older people in six-year follow-up.

English Longitudinal Study of Ageing is current and ongoing longitudinal population studies in England over three waves (2002 = 9,953; 2004 = 8,411; 2006 = 8,411) were recruited. The study collected data on the personal, economic, psychological, and social circumstances of aging from a national sample of the non-institutionalised adults aged 50 years or more living in England. Quality of Life was measured using the CASP-19.

Determinants of quality of life using CASP-19 as the dependent variable were: female gender (beta = 1.19, p < 0.0001), younger age (beta = -0.56,p < 0.001), self-reported health (beta = -4.34, p < 0.0001), separation/divorce (beta = 0.81 p < 0.0001), monthly income (beta = -0.91, p = 0.01), accumulated wealth (beta = -0.094, p = 0.01), current smoker (beta = 0.34, p = 0.01 and socioeconomic ladder (beta = -0.115, p = 0.001).

Female gender, younger age, poor self-health reported status, family disruption, active smoking and income were predictors of impaired quality of life. Studies are needed in how to address these socio-economic related factors, social habits and smoking to improve the well-being of older people.

Excessive tobacco consumption among students has negative repercussions on their health and education. Medical students are no exception. Numerous studies have demonstrated the relationship existing between smoking and depressive disorders.

To study the relationship between depression, anxiety and students smoking.

We conducted a cross-sectional, descriptive and analytical study which included 80 students of the Faculty of Medicine of Sfax in Tunisia: 40 smokers and 40 no-smokers.

We used the Hospital Anxiety and Depression Scale (HADS) for screening depressive and anxious symptoms. The evaluation of tobacco dependence was performed by Fagerstrom test.

The average age of the participants was 23 years with a male predominance (SR=1,66). The smokers were in 80% of cases males and in 55% of cases dependents. Thirty-one percent (31%) of our population were depressed and 28.7% were anxious. A statistically significant correlation was found between smoking and the presence of depression (p = 0.025) on one hand, and anxiety (p = 0.022) on the other hand. Tobacco dependence was related to male sex (p = 0.04) and depression (p = 0.03). There was no link between the same variable and anxiety.

It appears from our study a statistically significant relationship between smoking and anxio-depressive disorders. The degree of dependence is particularly related with depression. This dimension has to be considered in the therapeutic withdrawal project.

This study was performed to investigate the association between the mid-brain serotonin transporter (SERT) availability and intelligence quotient (IQ).

One hundred and thirteen healthy participants, including 52 male and 61 female subjects, were recruited. We used SPECT with [123I]ADAM images to determine the SERT availability in the mid-brain, and measured the subjects’ IQ using the WAIS-R.

We found a significant positive correlation between the mid-brain SERT availability and the IQ of the participants. Even when controlling for age and sex, the significant association still existed.

This result implied that the higher the SERT binding in the mid-brain, the better the IQ in healthy participants.

Hyperprolactinaemia is a common side effect of some APS, associated to important clinical manifestations (sexual dysfunction, breast disturbances and even increase of certain types of cancer risk).

To evaluate the levels of prolactinemia associated to different APS, including the newest ones, and its association with sexual dysfunction (SD).

Observational cross-sectional study. Adult patients treated with one APS for at least 4 weeks and with no other PRL-rising treatment were included. Hyperprolactinaemia was defined as 20 microgr/L in women, 18 microgr/L in men. SD was evaluated with the specific SD questionnaire PR-Sex-DQ-SALSEX (Montejo et al, 2001).

288 patients were evaluated, with the following APS treatment distribution: aripiprazol (22.2%), risperidone (17.01%), olanzapine (16.67%), quetiapine (7.99%), long-acting paliperidone (6.25%), long-acting risperidone (4.51%), oral paloperidone (4.17%), oral risperidone (4.17%) and others (21.18%; APS with N<10 were not evaluated). Paliperidone was associated with the higher mean PRL levels (98.28 and 71.48 microgr/L for LAP and OP respectively), followed by oral risperidone (71.36 microgr/L). Aripiprazol, oral olanzapine and quetiapine showed the lowest PRL levels (13.25, 27.10 and 28.55 microgr/L respectively). More than 70% of the sexually active patients treated with paliperidone or risperidone presented SD, less frequent in non PRL-raising APS.

In our sample paliperidone and risperidone were associated to higher mean PRL levels and sexual disfunction, while quetiapine, olanzapine and aripiprazol were the less PRL-raising APS. This might be taken in consideration when electing a long-term antipsychotic treatment for patients, given the important clinical consequences associated to sustained hyperprolactinaemia.

Bipolar patients show a significant degree of psychosocial disfunction even in euthymia. Recent studies have reported deficits in Theory of Mind and emotion recognition in BD. Our hypothesis is that social cognition deficit could be associated with a poor general functioning and psychosocial disadvantage in BD.

A sample of 27 euthymic bipolar patients were recluted. Based on Global Assessment of Functioning, they were divided into two groups: good or low general functioning. Euthymia was defined as YMRS < 6 and HDRS < 8, during a 3-month period. Patients with high (n 18) and low (n 9) functioning were compared on several clinical variables and on social / general cognitive measures. Both verbal and non verbal Theory of Mind capacities were assesed (faux pas test and face emotion recognition test). Finally, sustained attention and executive functions were evaluated (Asarnow Test and WSCT).

High- and low-functioning groups did not differ with respect to demographic and clinical variables (age, sex, age at onset, years of evolution of illness, history of prior psychotic symptoms; p = n.s.). However, low-functioning group showed poorer performance than high-functioning group both in faux pas test (U Mann Whitney; p=0.035) and face emotion recognition (U; p = 0.021). In addition, low-functioning group also showed a significant impairment in general cognitive funtions such as sustained attention (U, p = 0.007) and executive funtions (U, p = 0.046).

Social cognition deficit is associated with a poorer general functioning and psychosocial disadvantage.

Depression and apathy are common behavioral symptom of Alzheimer's disease (AD) and antidepressants, despite their role in improving depression have a minimum impact in improving apathy. Agomelatine has been shown to be effective in alleviating depression and reversing treatment emergent apathy.

The purpose of the current pilot study is to determine the efficacy of agomelatine in depressed patients with AD and comorbid apathy.

In this prospective 4 month study, twenty depressed elderly AD patients (age 65-85) who had been treated with SSRI and/or SNRI and shown a partial response to the antidepressant prescribed, in terms of apathy, were switched to agomelatine. Subjects were monitored for depression (Hamilton Rating Scale for Depression, HDRS), cognitive functions (Mini–Mental State Examination, MMSE) and apathy (Neuropsychiatric Inventory –apathy item, NPI-a).

Within groups, differences of HDRS, CSDD, MMSE and NPI-a scores at baseline, 2nd and 4th month of agomelatine treatment were estimated with repeated measure analysis of variance.

Following agomelatine, a numeric but not statistically significant improvement was observed in depression scores (8.2±3.5 vs 7.8±3.1, p=0.234, 7.8±3.1 vs5.8±2.3, p=0.421). A marked improvement in MMSE score was observed at both 2nd (22.2±4.9 vs 20.9± 5.4, p=0.05) and 3rd assessment(22.2±4.9 vs 23.9±4.9, p<0.05). Apathy score was also improved over the consecutive assessments (25.3±5.9 vs 18.6±3.9, p<0.05 and 18.6±3.9 15.5±4.3, p<0.05).

The present study demonstrated a good therapeutic response to agomelatine in elderly AD patients with depression and apathy symptoms in terms of alleviating apathy.

Research has shown the importance of social support on mental health, however, this investigation has not been done in elder population.

Our aim is to study the relationship between perceived social support, satisfaction with life, anxiety symptoms and depressive symptoms.

We collected a sample of 46 institutionalized elderly aged between 65 and 95 years old. We used the Geriatric Anxiety Inventory (GAI) and Geriatric Depression Scale (GDS) to assess anxious and depressive symptoms. To assess social support we used the Older Americans Resources and Services Program (OARS), which evaluated the social resources, and to assess the life satisfaction we used the Satisfaction With Life Scale (SWLS).

We found that 91.3% of subjects were illiterate or with low education and only 4 (8.7%) had studied beyond the fourth grade. The elders showed an high average of anxiety and depression symptoms, and dissatisfaction with life. Regarding the perception of social support, the elderly essentially reveal high dissatisfaction with the extent of contact with others and the availability of help. We also found that perceived social support is related with GAI, GDS, and SWLS.

Intervention strategies should involve the integration of elder population in social life.