Problematic Internet use among adults: A longitudinal European study. / Uso problemático de internet entre adultos: Un estudio europeo longitudinal.

There are few cross-cultural studies utilizing longitudinal analysis to explore problematic internet use (PIU), and almost none among adults. The present follow-up study compared three waves across 12-month period every six months and observed the natural course and trajectory of PIU in a European multi-country sample of adults from 11 countries (Finland, Germany, Italy, Spain, France, Switzerland, Hungary, Poland, UK, Norway, Belgium). A total of 139 participants (45.5% females) provided data across all three waves with an average age of 26.14 years (SD = 5.92). There were longitudinal effects in PIU, with statistical differences between at-risk users compared to healthy users in Waves 1 and 2, and Waves 1 and 3. The analyses of variance showed a longitudinal effect of waves on the PIU symptoms. PIU was significantly affected by time and type of user, with those classed as at-risk having higher scores than healthy users, although PIU decreased over time. In addition, the type of PIU detected in adults contained mild addictive symptoms. In conclusion, this study demonstrated that PIU was generally low among European adult population and tended to decrease over the one-year period, what contrasts with adolescent population findings.

Existen pocos estudios transculturales que utilizan análisis longitudinales para explorar el uso problemático de internet (PIU), y apenas existen estudios en población adulta. El presente estudio de seguimiento ha comparado tres observaciones a lo largo de un período de 12 meses, una cada seis meses. Se observó el curso natural y la trayectoria del PIU en una muestra europea de adultos de 11 países (Finlandia, Alemania, Italia, España, Francia, Suiza, Hungría, Polonia, Reino Unido, Noruega, Bélgica). 139 participantes (45,5 % mujeres) con una edad promedio de 26,14 años (DE = 5,92) proporcionaron datos en las tres observaciones. Se detectaros efectos longitudinales en el PIU, con diferencias estadísticas entre usuarios en riesgo en comparación con usuarios sanos en las observaciones 1 y 2, y las correspondientes a las observaciones 1 y 3. Los análisis de varianza mostraron un efecto longitudinal de las observaciones en los síntomas del PIU. Se halló que el PIU fue significativamente afectado por los factores del tiempo y del tipo de usuario, y aquellos participantes clasificados como en posible riesgo de PIU obtuvieron puntuaciones más altas que los usuarios sanos, aunque el PIU disminuyó con el tiempo en ambos grupos. Además, el tipo de PIU detectado en adultos contenía una sintomatología adictiva leve. En conclusión, este estudio demostró que el PIU fue generalmente bajo entre la población adulta europea y, además, tendió a disminuir durante el período de un año, lo que contrasta con los resultados en población adolescente.

Management strategies for antidepressant-related sexual dysfunction.

Antidepressant-related sexual dysfunction is one of the most frequently met adverse effects for individuals suffering from major depressive disorder. When primary prevention by non-pharmacological measures fails, empirical coping strategies might be proposed. In this article, we present a brief overview of pharmacological strategies for antidepressant-related sexual dysfunction, considering antidepressants and conceivable corrective medications. We suggest dividing these strategies into three groups: (1) tapering (dose reduction, therapeutic window or short-term treatment interruption); (2) maintenance (focusing on spontaneous remission); (3) optimizing treatment (substitution for another antidepressant or addition of treatments to correct sexual side effects). Whichever strategy is selected, we encourage the clinician to propose the most adequate therapeutic option for the patient, while considering the efficacy and overall tolerance of the current antidepressant strategy, the affected phase of sexuality and patient preferences and gender. This summary is limited to antidepressant treatments and correctors marketed in France and aimed at a clinician reading to help manage patients suffering from antidepressant-induced sexual dysfunction.

[Anorexia nervosa, a familiar and complex pathology]. / L'anorexie mentale, une pathologie familière et complexe.

Anorexia nervosa affects people of all ages, and has the highest mortality rate of all psychiatric disorders, following medical complications inherent in the disease or suicide. Early and appropriate treatment is crucial to prevent the risk of chronic disease, which may affect one in two anorexics. Severe undernutrition linked to a complex psychopathology calls for the necessary theoretical and clinical knowledge on the part of the caregiver, applied to the dynamics of care, ideally conceived in a transdisciplinary way and involving nursing teams.

[Anorexia nervosa and music therapy]. / Anorexie mentale et musicothérapie.

Supporting people suffering from anorexia nervosa remains a challenge. While traditional treatment focuses more on speech and its emergence for the patient and family, non-medicinal and non-verbal therapies are used more systematically, sometimes as a last resort. Yet, as a non-verbal mediated therapy, music therapy can find a legitimate place and complement all the psychiatric, psychotherapeutic, somatic, dietetic and nursing areas where speech already circulates.

Orthorexic eating behaviors are not all pathological: a French validation of the Teruel Orthorexia Scale (TOS).

As no French validated measurement tool distinguishing healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) currently exists, this study aimed at examining psychometric properties of the French version of the Teruel Orthorexia Scale (TOS). A sample of 799 participants (Mean [SD] age: 28.5 [12.1] years-old) completed the French versions of the TOS, the Düsseldorfer Orthorexia Skala, the Eating Disorder Examination-Questionnaire, and the Obsessive-Compulsive Inventory-Revised. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were used. Although the bidimensional model, with OrNe and HeOr, of the original 17-item version showed an adequate fit, we suggest excluding items 9 and 15. The bidimensional model for the shortened version provided a satisfactory fit (ESEM model: CFI = .963, TLI = .949, RMSEA = .068). The mean loading was .65 for HeOr and .70 for OrNe. The internal consistency of both dimensions was adequate (αHeOr = .83 and αOrNe = .81). Partial correlations showed that eating disorders and obsessive-compulsive symptomatology measures were positively related to OrNe and unrelated or negatively related to HeOr. The scores from the 15-item French version of the TOS in the current sample appears to present an adequate internal consistency, pattern of associations in line with what was theoretically expected, and promising for differentiating both types of orthorexia in a French population. We discuss why both dimensions of orthorexia should be considered in this area of research.

Orthorexia ('right appetite', from the Greek) covers two dimensions: (1) orthorexia nervosa (OrNe), a strong preoccupation with healthy diet with negative emotional, cognitive, and/or social consequences while trying to approach this goal and when the eating behavior deviates from it, and (2) healthy orthorexia (HeOr), which can be defined as a healthy interest in diet, (self-assessed) healthy behavior with regard to diet and eating healthily as part of one's identity. OrNe is not yet indexed into mental disorder classifications. Some prominent measurement tools in the area of orthorexia present important limitations: it is unclear if they validly assess OrNe and they do not tap HeOr by design. To overcome these limitations, a promising self-reported instrument was developed: the Teruel Orthorexia Scale (TOS), a bidimensional questionnaire whose structure has been replicated in different samples. Our research based on 799 participants aimed to adapt this instrument in a French speaking population. The results revealed that the French version of the TOS is an empirically supported tool allowing to differentiate both forms of orthorexia (healthy and nervosa). It also suggests that OrNe is associated with psychopathological symptoms while opposite patterns were found with HeOr. We discuss the importance of measuring both orthorexia dimensions.

Problematic Internet Use among Adults: A Cross-Cultural Study in 15 Countries.

BACKGROUND: The present study compared adult usage patterns of online activities, the frequency rate of problematic internet use (PIU), and risk factors (including the psychopathology associated with PIU, i.e., distress and impulsivity) among adults in 15 countries from Europe, America, and Asia. METHODS: A total of 5130 adults from Belgium, Finland, Germany, Italy, Spain, France, Switzerland, Hungary, Poland, UK, Norway, Peru, Canada, US, and Indonesia completed an online survey assessing PIU and a number of psychological variables (i.e., depression, anxiety, stress, and impulsivity). The sample included more females, with a mean age of 24.71 years (SD = 8.70). RESULTS: PIU was slightly lower in European countries (rates ranged from 1.1% in Finland to 10.1% in the UK, compared to 2.9% in Canada and 10.4% in the US). There were differences in specific PIU rates (e.g., problematic gaming ranged from 0.4% in Poland to 4.7% in Indonesia). Regression analyses showed that PIU was predicted by problematic social networking and gaming, lack of perseverance, positive urgency, and depression. CONCLUSIONS: The differences in PIU between countries were significant for those between continental regions (Europe versus non-European countries). One of the most interesting findings is that the specific PIU risks were generally low compared to contemporary literature. However, higher levels of PIU were present in countries outside of Europe, although intra-European differences existed.

Perceptions Underlying Addictive Technology Use Patterns: Insights for Cognitive-Behavioural Therapy.

Cognitive-Behavioural Therapy (CBT) is considered the 'gold standard' in the treatment of addictive disorders related to excessive technology use. However, the cognitive components of problematic internet use are not yet well-known. The aim of the present study was to explore the cognitive components, that according to problematic users, can lead to potential internet addiction. A total of 854 European adults completed an online survey using a mixed-methods design. Internet problems and attachment styles were assessed, prevalence rates estimated, correlations, chi-squared automatic interaction detection, and content analysis were performed. Self-reported addictions to social networking, internet, and gaming had a prevalence between 1.2% (gaming) to 2.7% (social networking). Self-perception of the addiction problem and preoccupied attachment style were discriminative factors for internet addiction. In an analysis of qualitative responses from self-identified compulsive internet users, a sense of not belonging and feeling of disconnection during life events were perceived as causes for internet addiction. The development depended on a cycle of mixed feelings associated with negative thoughts, compensated by a positive online identity. The severity of this behaviour pattern produced significant impairment in various areas of the participants' functioning, suggesting a possible addiction problem. It is suggested that health professionals administering CBT should target unhealthy preoccupations and monitor mixed feelings and thoughts related to internet use to support coping with cognitive distortions.

Translation and Validation of a State-Measure of Body Image Satisfaction: The Body Image State Scale.

The aim of the present study is to test the validity and reliability of the French Body Image State Scale (F-BISS). The scale was translated using a back-translation technique, with discrepancies being settled through consensus. Three hundred and twelve female participants were recruited. Convergent validity was assessed using eating disorder evaluation and social comparison. Exploratory and confirmatory factor analyses were also conducted. The translated Body Image State Scale (BISS) demonstrated good psychometric properties, with good internal consistency (α = 0.83), and adequate goodness-of-fit. The translated BISS presented a unifactorial structure, with one factor explaining 56% of the variance. The exploratory factor analysis led to the removal of a single item due to insufficient factor loading (<0.45). Its convergent validity seems consistent with previous literature. Discriminant analyses showed a significant difference in F-BISS score between participants relative to eating disorder symptomatology (t = 11.65; p < 0.001). This translation could prove useful in both research and clinical settings to assess state body satisfaction in French populations.

Psychological characteristics of patients seeking bariatric treatment versus those seeking medical treatment for obesity: is bariatric surgery a last best hope?

PURPOSE: Bariatric surgery (BS) is considered the most effective treatment for severe obesity. Nevertheless, long-term studies have identified some concerning issues, such as increased postoperative rates of suicide and substance use disorders. Some investigators have postulated that these postoperative issues might result from differences in psychological characteristics between patients with obesity seeking BS and those seeking non-surgical (medical) care. The aim of this study was to explore the psychological differences between patients seeking BS and those seeking non-surgical care. METHODS: 151 patients seeking BS (BS group) and 95 patients seeking medical care (non-surgery group) completed questionnaires measuring depression, anxiety, self-esteem, body dissatisfaction, hopelessness and weight-loss expectations (WLE). RESULTS: There were no differences between the BS and non-surgery groups in depression, anxiety or self-esteem. Body dissatisfaction and WLE were greater in the BS group than in the non-surgery group. Contrary to our hypothesis, the non-surgery group showed higher levels of hopelessness than the BS group. Correlation analyses revealed very similar associations between psychological characteristics for both groups. Hierarchical regression and moderation analyses identified self-esteem as the factor most predictive of hopelessness in both groups. CONCLUSIONS: We found few differences in psychological characteristics between groups. The lower level of hopelessness in the BS group might be seen as a form of protection leading up to surgery but may result from the patient's view of BS as their "last best hope". Further studies are needed to understand the evolution of these psychological characteristics after surgery and their possible effects on postoperative outcomes. LEVEL OF EVIDENCE: Level III, case-control analytic studies.

"I Want to Lose Weight and it Has to Be Fair": Predictors of Satisfaction After Bariatric Surgery.

PURPOSE: Bariatric surgery (BS) is the most effective technique used to help patients with obesity achieve long-term weight loss. Although many patients report high levels of postoperative satisfaction after BS, some remain unsatisfied with their outcome. Studies of factors that predict postoperative satisfaction have yielded varying results. Weight loss has been identified as a predictor of satisfaction after BS, but debate remains concerning the impact of preoperative expectations and psychological variables. Furthermore, the relevance of attribution and perception of equity to postoperative satisfaction has not been evaluated in patients undergoing BS. MATERIALS AND METHODS: We assessed preoperative expectations and the levels of body dissatisfaction, anxiety, and depression in 80 patients undergoing BS. Satisfaction, attribution, feeling of equity, and psychological variables were evaluated 6 months, 1 year, and 2 years after BS. RESULTS: Weight loss and equity were the two predictors of satisfaction 6 months after BS. Body dissatisfaction was the main factor predicting satisfaction 1 year after BS, with equity and anxiety having smaller influences. Weight loss and equity were the factors predicting satisfaction 2 years after BS. CONCLUSION: Our findings support previous results concerning the influence of weight loss on satisfaction after BS. The identification of equity as a factor associated with postoperative satisfaction raises questions regarding the impact of the comparisons made by the patient with others and the consequences of the messages they receive about BS. Moreover, our results underscore the importance of considering the patient's personal experience after BS and not just their weight loss.

Contributing of Cognitive-Behavioral Therapy in the Context of Bariatric Surgery: a Review of the Literature.

Bariatric surgery is the most effective treatment for obesity. Reported benefits include major weight loss, improvement in diseases associated with obesity, and better quality of life. Nevertheless, there is a long-term risk of deleterious physical and psychological effects: regained weight (30% of patients), depression, and body image dissatisfaction. The purpose of this review of the literature is to identify the contribution of cognitive-behavioral therapy (CBT) in the context of bariatric surgery. Eligible articles and published since 2003 were systematically searched in electronic databases (PsychoINFO, MEDLINE, PubMed and Academic Search). Among the 98 citations, eleven cross-sectional and longitudinal studies concerning bariatric surgery patients who participated in CBT programs fulfilled the inclusion criteria. The therapeutic efficacy of CBT was demonstrated in ten of the eleven studies. An improvement in eating behavior, comorbid psychological conditions, and body weight were reported in patients who participated in CBT group sessions before and/or after bariatric surgery. The beneficial effect of CBT in the context of bariatric surgery suggests interesting therapeutic perspectives. Further research is however needed to consolidate these early findings and to provide longitudinal follow-up data beyond 2 years post-surgery.

[Othorexia: A new type of Eating Disorder?] / L'orthorexie : une nouvelle forme de trouble des conduites alimentaires ?

Othorexia Nevrosa is defined as an obsessive though regarding healthy food consumption, food properties and cooking tools. Orthorexia Nevrosa is not mentioned in the psychiatric nosography and is not considered as a disorder. While no formal diagnostic criteria currently exist, screening tools have been developed to explore characteristics of Orthorexia Nevrosa. While Orthorexia Nevrosa has specific characteristics, an overlapping exists with Eating Disorders (ED) and Obsessive Compulsive Disorder (OCD) symptoms.

Does Repetitive Negative Thinking Influence Alcohol Use? A Systematic Review of the Literature.

Over the past 20 years, researchers have used various methodologies to assess different forms of repetitive negative thinking (RNT) and their influence on alcohol consumption. Contrasting results between clinical and general populations were observed. To summarize the current literature on RNT and alcohol use, a systematic review was conducted according to the Preferred Reporting for Systematic Review and Meta-Analysis (PRISMA) guidelines (Moher et al., 2009). Among the 27 included studies, the seven conducted among patients with alcohol use disorder (AUD) and the three focusing on other adult samples demonstrated a strong positive association between RNT and alcohol use or alcohol-related problems, regardless of the form of RNT. The results were more heterogeneous in the 17 studies conducted among adolescents and students, leading the authors to conclude that the results varied as a function of the severity of alcohol use. The results of this study suggest to focus on RNT from a transdiagnostic perspective in AUD. This processual approach may improve AUD treatment and relapse prevention. Finally, some gaps in the literature must be addressed: (1) the gender differences in the link between RNT and alcohol use and (2) the specific influence of RNT on alcohol use among young adults.

Cross-Cultural Validation of the Compulsive Internet Use Scale in Four Forms and Eight Languages.

The 14-item Compulsive Internet Use Scale (CIUS) is one of the most frequently internationally adapted psychometric instruments developed to assess generalized problematic Internet use. Multiple adaptations of this instrument have led to versions in different languages (e.g., Arabic and French), and different numbers of items (e.g., from 5 to 16 items instead of the original 14). However, to date, the CIUS has never been simultaneously compared and validated in several languages and different versions. Consequently, the present study tested the psychometric properties of four CIUS versions (i.e., CIUS-14, CIUS-9, CIUS-7, and CIUS-5) across eight languages (i.e., German, French, English, Finnish, Spanish, Italian, Polish, and Hungarian) to (a) examine their psychometric properties, and (b) test their measurement invariance. These analyses also identified the optimal versions of the CIUS. The data were collected via online surveys administered to 4,226 voluntary participants from 15 countries, aged at least 18 years, and recruited from academic environments. All brief versions of the CIUS in all eight languages were validated. Dimensional, configural, and metric invariance were established across all languages for the CIUS-5, CIUS-7, and CIUS-9, but the CIUS-5 and CIUS-7 were slightly more suitable because their model fitted the ordinal estimate better, while for cross-comparisons, the CIUS-9 was slightly better. The brief versions of the CIUS are therefore reliable and structurally stable instruments that can be used for cross-cultural research across adult populations.

Measurement Invariance of the Short Version of the Problematic Mobile Phone Use Questionnaire (PMPUQ-SV) across Eight Languages.

The prevalence of mobile phone use across the world has increased greatly over the past two decades. Problematic Mobile Phone Use (PMPU) has been studied in relation to public health and comprises various behaviours, including dangerous, prohibited, and dependent use. These types of problematic mobile phone behaviours are typically assessed with the short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ⁻SV). However, to date, no study has ever examined the degree to which the PMPU scale assesses the same construct across different languages. The aims of the present study were to (i) determine an optimal factor structure for the PMPUQ⁻SV among university populations using eight versions of the scale (i.e., French, German, Hungarian, English, Finnish, Italian, Polish, and Spanish); and (ii) simultaneously examine the measurement invariance (MI) of the PMPUQ⁻SV across all languages. The whole study sample comprised 3038 participants. Descriptive statistics, correlations, and Cronbach's alpha coefficients were extracted from the demographic and PMPUQ-SV items. Individual and multigroup confirmatory factor analyses alongside MI analyses were conducted. Results showed a similar pattern of PMPU across the translated scales. A three-factor model of the PMPUQ-SV fitted the data well and presented with good psychometric properties. Six languages were validated independently, and five were compared via measurement invariance for future cross-cultural comparisons. The present paper contributes to the assessment of problematic mobile phone use because it is the first study to provide a cross-cultural psychometric analysis of the PMPUQ-SV.

Effects of induced rumination on body dissatisfaction: Is there any difference between men and women?

BACKGROUND AND OBJECTIVES: Rumination is a factor in the development and maintenance of body dissatisfaction. However, no study has yet investigated the impact of the type of rumination on body image. The first aim of this study was to examine whether the induction of analytic-abstract vs. concrete-experiential rumination affects body dissatisfaction following an induction of negative body image. The second objective was to examine gender differences in these effects. METHODS: Following induction of negative body image, 102 university undergraduates were randomly assigned to one of three experimental conditions-distraction, concrete rumination or abstract rumination. RESULTS: As expected, there were significant main effects of gender and condition, and a significant interaction between gender and condition on change in body dissatisfaction. In women abstract rumination predicted the highest increase in body dissatisfaction, whereas concrete rumination predicted the highest increase in body dissatisfaction in men. LIMITATIONS: Given that our sample consisted of undergraduate students, our findings cannot be generalized to clinical sample suffering from eating disorder. CONCLUSIONS: The different types of rumination seem to impact differentially body dissatisfaction in men and women.

A New Understanding of Quality of Life in Children and Adolescents with Obesity: Contribution of the Self-determination Theory.

PURPOSE OF REVIEW: Preservation of Quality of Life (QOL) is now a major determinant of obesity management, but little is known about variables predicting QOL. Identifying these predicting variables of QOL would provide further understanding of the QOL concept and help draw clinical implications. The Self-determination Theory (SDT) is a promising understanding perspective of the QOL. RECENT FINDINGS: The SDT postulates that well-being and motivation are determined by the satisfaction of three needs: autonomy, competence, and relatedness. Many researches have confirmed the relationships between these SDT's needs and well-being, but this theory has little been applied to the problem of QOL in obese children and adolescents. Literature results and theoretical implications of the SDT in understanding of QOL in youth obesity are discussed. New clinical applications could be drawn: in children with obesity, interventions promoting high satisfaction of the SDT's needs could improve their QOL and help them break the vicious circles of overweight.

Self-reported dependence on mobile phones in young adults: A European cross-cultural empirical survey.

Background and aims Despite many positive benefits, mobile phone use can be associated with harmful and detrimental behaviors. The aim of this study was twofold: to examine (a) cross-cultural patterns of perceived dependence on mobile phones in ten European countries, first, grouped in four different regions (North: Finland and UK; South: Spain and Italy; East: Hungary and Poland; West: France, Belgium, Germany, and Switzerland), and second by country, and (b) how socio-demographics, geographic differences, mobile phone usage patterns, and associated activities predicted this perceived dependence. Methods A sample of 2,775 young adults (aged 18-29 years) were recruited in different European Universities who participated in an online survey. Measures included socio-demographic variables, patterns of mobile phone use, and the dependence subscale of a short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ; Billieux, Van der Linden, & Rochat, 2008). Results The young adults from the Northern and Southern regions reported the heaviest use of mobile phones, whereas perceived dependence was less prevalent in the Eastern region. However, the proportion of highly dependent mobile phone users was more elevated in Belgium, UK, and France. Regression analysis identified several risk factors for increased scores on the PMPUQ dependence subscale, namely using mobile phones daily, being female, engaging in social networking, playing video games, shopping and viewing TV shows through the Internet, chatting and messaging, and using mobile phones for downloading-related activities. Discussion and conclusions Self-reported dependence on mobile phone use is influenced by frequency and specific application usage.

Perseverative Thinking Questionnaire (PTQ): French Validation of a Transdiagnostic Measure of Repetitive Negative Thinking.

Repetitive negative thinking (RNT) is a transdiagnostic process involved in the onset and maintenance of many psychological disorders. The Perseverative Thinking Questionnaire (Ehring et al., 2011) is a content-independent scale composed of 15 items that assesses RNT from a transdiagnostic perspective in both clinical and general populations. The aim of the current research was to translate and validate the French version of the PTQ through two studies (total N = 1016) following the steps for the trans-cultural validation of psychometric instruments (Hambleton et al., 2006). An exploratory factor analysis conducted on a first community sample revealed a latent structure composed of 10 items distributed on one common factor, labeled RNT, and three subfactors that evaluated the repetitive characteristic of RNT, the intrusiveness of RNT and the effect of RNT on mental resources. This factorial structure was confirmed in two confirmatory factor analyses in community and clinical samples. Scale score reliability indices were good and confirmed the validity of the instrument. The French version of the PTQ is a good content-independent instrument to assess RNT in general and clinical populations of French speakers.

Medication in nursing homes in Alsace: a preferential list of drugs obtained by consensus.

ABSTRACT: In order to improve patient care, OMEDIT (Observatory of drugs, medical devices and therapeutic innovation) Alsace, conducted a study to develop a Preferential list of Drugs adapted to the Elderly (PDE list) in nursing homes. The study conducted from December 2011 to June 2012 was organized in 4 phases: 1) creation of a preliminary list of drugs from those currently used in nursing homes in Alsace, 2) application of a two-round Delphi process to evaluate the preliminary list involving mobilization of experts from different backgrounds (geriatricians, general practitioners, pharmacists …), 3) identification of molecules considered in literature as potentially inappropriate, 4) generation of a final PDE list, including information concerning proper use of drugs for prescription and administration. 53 experts participated in the study. In the first round, 338 drugs were on the preliminary list, 246 were considered as appropriate by experts and 28 as inappropriate. 64 drugs without consensus were submitted to a second round. 32 of them were considered as inappropriate and 32 others remained on the list with no consensus. These last 32 were evaluated by OMEDIT and 3 were considered as appropriate drugs for the elderly. Totally, 252 drugs constitute the final PDE list from our study. The PDE list constitutes a new guide for optimization of both prescription and administration of drugs in nursing homes and could help reduce misuses and poly-medication, which are constant preoccupations to avoid adverse drug reactions in elderly. KEY POINTS: ● The study was carried out with the aim to create a Preferential list of Drugs adapted to the Elderly (PDE list) in nursing homes using a modified Delphi method. ● The PDE list constitutes a new guideline to harmonize practices in nursing homes and to help physicians and nurses to achieve best possible care management.