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.

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.

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.

Patients with hyperprolactinemia offer a unique opportunity to investigate the effects of prolactin on psychological states. Hyperprolactinemia has been classically associated with gonadal dysfunction. However, attention was drawn to its association with psychological symptoms. Anxiety, somatization, hostility and depression were related to hyperprolactinemia.

To review the literature on the relationship between psychiatric symptoms and hyperprolactinemia.

A literature review was made by searching for articles in PubMED.

There is evidence of robust effects of prolactin on behavior in several animal species. The association between hyperprolactinemia and psychiatric symptoms is described. The first symptom described was anxiety, preceding the onset of menstrual irregularity associated with hyperprolactinemia. Other authors have confirmed an increase in anxiety and somatization in women with hyperprolactinemic amenorrhea, as well as hostility and depression. Compared to controls, hyperprolactinemic men also showed more anxiety. There are reports of reduced anxiety and improved well-being by decreasing prolactin levels through the use of bromocriptine, as well as an improvement of depression with bromocriptine or pergolide.

We recommend measuring the serum prolactin levels of women with depression, hostility, anxiety, and symptoms or signs suggestive of hyperprolactinemia. More studies are needed to evaluate the effect of treatment of hyperprolactinemia on psychiatric manifestations.

Hyperprolactinemia is a common adverse effect of typical and some atypical antipsychotics and can induce side effects associated with decreased quality of life and poor adherence to treatment.

Management options are limited and can lead to decompensation of the patient.

Aripiprazole is a recent antipsychotic with partial agonist activity over the dopamine D2 receptors which can be effective in reducing hyperprolactinemia in patients treated with antipsychotics.

Review the existing literature about the effect of adjunctive treatment with low doses of aripiprazole on antipsychotic-induced hyperprolactinemia.

Search for literature about the topic in PubMed and Goocle Scholar databases using “hyperprolactinemia” and “aripiprazole” as keywords.

We found 6 case reports with 8 patients treated with risperidone, paliperidone, zuclopenthixol and fluphenazine that, with 2,5-10mg of aripiprazole, showed a decrease in serum levels of prolactin. 4 open label studies, with a total of 69 patients, all treated with risperidone, also showed a decrease in prolactin levels for adjunctive treatment with 3-10mg of aripiprazole. Two double-blind and two single-blind RCT vs placebo was found, with a sample of 297 patients treated with risperidone or sulpiride and 5-10mg of aripiprazole, and showed decrease in serum levels of prolactin. In all studies treatment with aripiprazole was not significantly associated with an increase in adverse effects or worsening of clinical symptoms.

The antipsychotic-induced hyperprolactinemia could be partially or totally reversed after adding low doses of aripiprazole to current treatment. It seems to be an effective, safe and well tolerated option.

Extensive research indicates that obesity, defined by a body mass index (BMI) greater or equal to 30, is common in patients treated with antipsychotic drugs and is frequently associated with carbohydrate and lipid abnormalities leading to metabolic syndrome and diabetes. In contrast, the metabolic health of overweight patients (BMI = 25–29.9) without metabolic syndrome or diabetes has not been thoroughly investigated.

To assess the metabolic health of overweight patients receiving antipsychotic drugs.

We compared standard metabolic parameters (BMI; waist circumference; hemoglobin A1c; fasting lipids; and fasting and post-challenge glucose and insulin) of normal weight, overweight and obese individuals from a consecutive cohort of antipsychotic-treated patients without metabolic syndrome and/or diabetes.

Compared with the normal weight subjects (n = 286), overweight patients (n = 212) had higher fasting insulin resistance as assessed with the homeostatic model (P = 0.023), insulin secretion during the oral glucose tolerance test (P = 0.0037), triglycerides (P = 0.0004) and low-density lipoprotein cholesterol (P = 0.0089), and lower levels of high-density lipoprotein cholesterol (P = 0.0014). The obese (n = 50) were different from the overweight subjects only with respect to higher post-challenge insulin levels (P = 0.0002). The average fasting glucose, post-challenge glucose, and hemoglobin A1c, severity of psychiatric disorders and antipsychotics used were similar in the three groups.

Overweight (BMI = 25–29.9) patients receiving antipsychotics are metabolically closer to the obese than to normal weight counterparts. The findings suggest that interventions promoting weight loss and metabolic health are required for overweight patients even in the absence of metabolic syndrome or diabetes.

The term “revolving door” describes a subpopulation of chronically mentally ill patients frequently readmitted to psychiatric units. Policy of deinstitutionalization in mental health services during the past decades has highlighted the theme. Literature review indicates that patients at higher risk for revolving-door phenomenon are more likely to be younger, single males, with a diagnosis of a psychotic illness and high number of previous admissions. Patients with poor support networks, lower levels of education and challenging social environments are likely to remain well for shorter periods. Non-adherence to prescribed medications contributes significantly to relapse rates. the most consistently identified predictor is the number of previous hospitalizations.

Authors pretend to identify patients with a high number of admissions to Coimbra University Hospitals (CUH), analyze their clinical and socio-demographic characteristics, causes of readmission and social network, and give examples.

Retrospective cohort study, in which the medical records of individuals admitted to CUH during the last year were analyzed to identify those with the highest frequency of inpatient admissions (at least more than two within 18 months).

Our preliminary results are consistent with those from the literature, regarding the clinical and social characteristics of patients with revolving-door phenomenon, however the most severe cases are found between female patients.

Considering the social burden and the pressure on inpatient services caused by revolving door patients, it is important to understand the factors that may contribute to this phenomenon to develop interventions that could reduce the prevalence of recidivism.

The authors have not supplied their declaration of competing interest.