This paper illustrates a psychometric approach of broad relevance to psychiatric research instruments. Many instruments include indicators related to more than one source of true-score variance due to the: (1) assessment of conceptually adjacent constructs; (2) the presence of a global construct underlying answers to items designed to assess multiple dimensions. Exploratory structural equation modelling (ESEM) is naturally suited to the investigation of the first source, whereas bifactor models are particularly suited to the investigation of the second source. When both sources are present, bifactor-ESEM becomes the model of choice. To illustrate this framework, we use the responses of 1159 adults [655 female, 504 male, mean age (M ) = 41.84] who completed the French Version of the Composite Scale of Morningness (CSM). We investigate the factor structure of the CSM, test the relations between CSM factors and body mass index, and verify the measurement invariance of the model across gender and age groups. Copyright © 2015 John Wiley & Sons, Ltd.

Results suggest that a total ASRS-ADHD score is meaningful, reliable, and valid in adults. (J. of Att. Dis. 2016; 20(6) 530-541).

ObjectiveThe first year of university is a particularly stressful period and can impact academic performance and students’ health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms.Materials and methodsBetween September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France) during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine) and included information about the students’ lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs). The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression.ResultsA total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly.ConclusionThe prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students’ health by implementing targeted prevention campaigns. Further research in other French universities is necessary to confirm our results.

The Strengths and Difficulties Questionnaire (SDQ) is used to measure psychopathological symptoms in children and adolescents from 4 to 17 years old, but its underlying structure is still a matter of debate. Indeed, on the basis of a systematic review of English and non-English articles conducted using multiple databases, 54 studies reporting on the factor structure of the SDQ were located. The original 5 first-order factor structure is generally supported by exploratory procedures, but support based on confirmatory factor analyses is not clear. We analysed data from 889 youths from the general French population, rated on the SDQ by their teachers. We tested the original model, hierarchical models and bifactor models. The best-fitting model is a bifactor model with the five a priori factors grouped in two global factors (Externalizing Disorders-Hyperactivity and Conduct-and Internalizing Disorders-Peer relationships and Emotions) and one Strength/Prosocial factor. However, we show that the Conduct-Specific factor should not be used in practice in its current state, that the Hyperactivity-Specific factor mainly covers hyperactivity rather than inattention, and that the Peer Problems-Specific factor mainly reflects a preference for solitude. Nevertheless, the measurement model proved to be fully invariant across gender and school levels (kindergarten, primary and secondary schools), with statistically significant differences in latent means between genders only. Beyond computing the five a priori scores when using the teacher ratings of the SDQ, our results prove the usefulness of computing Externalizing Disorders and Internalizing Disorders global scores.

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ObjectiveMidstream clean-catch urine is an accepted method to diagnose urinary tract infection but is impracticable in infants before potty training. We tested the bladder stimulation technique to obtain a clean-catch urine sample in infants.Materials and methodsWe included 142 infants under walking age who required a urine sample in a cross- sectional study carried out during a 3-months period, from September to November 2014, in the emergency department of the University Children’s Hospital of Nice (France). A technique based on bladder stimulation and lumbar stimulation maneuvers, with at least two attempts, was tested by four trained physicians. The success rate and time to obtain urine sample within 3 minutes were evaluated. Discomfort (EVENDOL score ≥4/15) was measured. We estimated the risk factors in the failure of the technique. Chi-square test or Fisher’s exact test were used to compare frequencies. T-test and Wilcoxon test were used to compare quantitative data according to the normality of the distribution. Risk factors for failure of the technique were evaluated using a multivariate logistic regression model.ResultsWe obtained midstream clean-catch urine in 55.6% of infants with a median time of 52.0 s (10.0; 110.0). The success rate decreased with age from 88.9% (newborn) to 28.6% (>1 y) (p = 0.0001) and with weight, from 85.7% (<4kg) to 28.6% (>10kg) (p = 0.0004). The success rate was 60.8% for infants without discomfort (p<0.0001). Heavy weight and discomfort were associated with failure, with adjusted ORs of 1.47 [1.04–2.31] and 6.65 [2.85–15.54], respectively.ConclusionBladder stimulation seems to be efficient in obtaining midstream urine with a moderate success rate in our study sample. This could be an alternative technique for infants before potty training but further randomized multicenter studies are needed to validate this procedure.

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Frey syndrome in childhood is a rare but benign condition with mild symptoms and a favorable outcome in most cases. Unilateral forms are mostly associated with instrumented delivery. Pediatricians should be familiar with this disorder in order to avoid misdiagnosis, mainly as food allergy, and unnecessary referrals and tests.