L'Encephale[JOURNAL]
Sun
200 papers
Measuring antidepressant side effects in military personnel - Clinical validation of the French version of the UKU-SERS-Pat Scale: A comparative study of patient and clinician ratings.
Klause L, Catrin E, Lahutte B … +2 more , Baldacci A, Saguin E
Encephale · 2026 Jul · PMID 42392966 · Publisher ↗
INTRODUCTION: Antidepressants are widely used to treat depression, PTSD, and generalized anxiety disorder. However, the side effects of antidepressants, which may affect treatment adherence and patient prognosis, are cha...
INTRODUCTION: Antidepressants are widely used to treat depression, PTSD, and generalized anxiety disorder. However, the side effects of antidepressants, which may affect treatment adherence and patient prognosis, are challenging to manage due to their overlap with psychiatric symptoms. In the same way as in the general population, side effects seem to have an impact on compliance with antidepressant treatment in military personnel which in turn affects their health and operability. The Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale for Clinicians (UKU-SERS-Clin) is a comprehensive tool for evaluating side effects but is time-consuming for clinical practice. The UKU-SERS-Pat, a self-assessment version, could provide a more efficient method for side effect detection. OBJECTIVE: The present study aimed to translate and validate the UKU-SERS-Pat into French and assess its reliability and validity in patients with antidepressant prescription. METHODS: Thirty-two military patients completed both the UKU-SERS-Pat and UKU-SERS-Clin scales 4-8 weeks after starting antidepressant treatment. RESULTS: Spearman's correlations demonstrated strong agreement between UKU-SERS-Clin and UKU-SERS-Pat for psychic (ρ=0.671, P<0.001), neurological (ρ=0.737, P<0.001), and autonomic side effects (ρ=0.666, P<0.001). Patients tended to report side effects more frequently and severely than clinicians. Significant differences were noted for several items, including asthenia, failing memory, inner unrest and male sexual side effects (all P<0.01). CONCLUSION: The study confirmed the validity of the French UKU-SERS-Pat, demonstrating strong correlations with the assessments of clinicians. This tool is particularly valuable for identifying side effects that patients may underreport during clinical interviews, such as sexual dysfunction, and side effects like weight gain, or altered alertness which are of particular concern among military personnel. Further research with larger samples and diverse populations is recommended to confirm these findings and explore the scale's applicability in different clinical contexts.
[Empowerment in addictology].
Le Fol M, Romo L, Gomet R … +3 more , Fouques D, Frem Y, Thiercelin N
Encephale · 2026 Jun · PMID 42379958 · Publisher ↗
When we look at our recovery journey, it is essential to think of Empowerment which refers to the process by which individuals gain greater control over their treatments, their overall health, and their illness. This con...
When we look at our recovery journey, it is essential to think of Empowerment which refers to the process by which individuals gain greater control over their treatments, their overall health, and their illness. This concept, originated in sociology, is particularly important to study addictions, disorders which cause great suffering and difficulties that can impact various areas of a person's life. How can one regain a sense of control over their destiny and control over their life when they live with one or more addictive disorders which are primarily defined by loss of control and several physical, social, personal, and psychological consequences? In this article, we focus on the concept of Empowerment: its origins, theoretical models, and methods of evaluation, and on research conducted specifically in the field of addictology, while also discussing how our ideas and methods might help promote or develop it.
Evaluation of the links between smoking and conspiracy mentality.
Smitz AS, Jamart J, Smitz MF … +1 more , Galanti L
Encephale · 2026 Jun · PMID 42379957 · Publisher ↗
Conspiratorial thinking has been linked to lower acceptance of public health recommendations, including vaccination and disease prevention. However, the relationship between conspiracy mentality (CM) and smoking behavior...
Conspiratorial thinking has been linked to lower acceptance of public health recommendations, including vaccination and disease prevention. However, the relationship between conspiracy mentality (CM) and smoking behavior remains largely unexplored. This study investigates the association between CM and smoking status with a focus on perceptions of tobacco harm, industry conspiracy, and related beliefs. A total of 407 adults residing in francophone Europe completed a questionnaire assessing demographics, smoking status, COVID-19 vaccination status, conspiracy mentality (via the Conspiracy Mentality Questionnaire), and beliefs about tobacco. Smoking status was categorized as current smoker (S), former smoker (FS) or non-smoker (NS). Associations were analyzed using ANOVA, chi-square and correlation analyses. CM scores were significantly higher among S (35±10) compared to FS (31±10) and NS (28±8). Smokers were more likely to believe that substances such as vaccines, pesticides and antidepressants are more harmful than tobacco, and they were more likely to endorse the idea that tobacco is harmless due to its natural origin. High scores were also positively correlated with a belief in scientific data manipulation and the tobacco industry conspiracy and negatively associated with a belief in tobacco-related cancer risk, smoking bans and tobacco price increases. Individuals with higher CM were more likely to smoke and to minimize the risks associated with tobacco use. Their scepticism toward science-based health information and tobacco control measures suggests a need for adapted cessation strategies that consider conspiratorial beliefs.
Use of a relevance assessment tool in therapeutic residential care: A real world study.
Hirot F, Ali A, Hassler C … +6 more , Colin MM, Naddaf A, Huas C, Arrieu A, Himmelfarb E, Godart N
Encephale · 2026 Jun · PMID 42379956 · Publisher ↗
INTRODUCTION: In the FondationSanté desEtudiants de France (FSEF) "Soins-études" refers to therapeutic residential care. It concerns long-term psychiatric hospitalisations that include schooling provided by the national...
INTRODUCTION: In the FondationSanté desEtudiants de France (FSEF) "Soins-études" refers to therapeutic residential care. It concerns long-term psychiatric hospitalisations that include schooling provided by the national education system, the duration of which is often questioned. A tool for assessing the relevance of continuing hospitalisation for each patient was developed and scored during multidisciplinary meetings at various stages of the hospitalisation. The aim of this study was to describe the use of this tool in determining the extent to which the clinical decision to discharge is related to non-relevance scores and the clinical characteristics of the young people. MATERIALS AND METHODS: All young people hospitalised in therapeutic residential care at the FSEF clinic in Aire-sur-l'Adour between 01/01/2011 and 31/12/2017 were included. A composite indicator of non-relevance of hospitalisation was constructed from the clinical scores of the assessment tool. At each multidisciplinary meeting, the subjects were divided into three groups based on whether continuing hospitalisation was deemed relevant, and if not, whether discharge actually occurred. These three groups were compared based on their clinical characteristics using Kruskal-Wallis and Fisher's exact tests. RESULTS: The study included 219 young people, aged 16.7 years (± 1.4) and hospitalised for an average of 13.7 months (± 9.18). About half of the adolescents were discharged after their stay was deemed non-relevant according to the assessment tool. The relevance of continuing hospitalisation and discharge were linked to the psychiatric diagnosis at the first meeting and to age at the third meeting. CONCLUSION: Evaluating a non-relevance indicator enables hospitalisation duration to be regularly assessed to avoid prolonging care when the risk-benefit ratio is no longer favourable. This tool thus promotes the adaptation of care plans throughout hospitalisation.
Prevalence and characteristics of domestic violence in a sample of adult psychiatric outpatients: A cross-sectional study.
Picchi A, Chatton A, Küenzi N … +4 more , Meroni G, Kaiser S, Moy G, Bartolomei J
Encephale · 2026 Jun · PMID 42309939 · Publisher ↗
The relationship between domestic violence and mental health is intricate and complex. Domestic violence can be categorised into intimate partner violence and family violence. While most studies have focused on the forme...
The relationship between domestic violence and mental health is intricate and complex. Domestic violence can be categorised into intimate partner violence and family violence. While most studies have focused on the former, less is known about the prevalence and the characteristics of family violence among adult mental health patients. Moreover, data is lacking on the needs of mental healthcare users who are victims of domestic violence, in terms of specific (legal and social) support. The present study aims to assess the prevalence and the characteristics of recent (<12 months) domestic violence in its two forms among a population of adult outpatients undergoing intensive psychiatric follow up. The sample included 206 participants, mostly women (71%), aged 19 to 64 (mean age 36, SD 11.8). The extended version of the Hit, Insult, Threat and Scream Scale (E-HITS) was used to screen intimate partner violence and domestic violence. The prevalence of recent domestic violence was 29.1%. Specifically, 16.5% had been victims of intimate partner violence and 12.6% of family violence. Women showed a statistically higher risk of facing domestic violence. No significant differences were observed in other socio-demographic characteristics (living conditions, marital status, residence permit, employment, education) or in previous recourse to emergency care. FV was especially prevalent among young patients, even though statistical significance was not reached. While previous disclosure rates were surprisingly high among the victims of intimate partner violence and family violence (70%), the victims of family violence (7.7%) were given significantly less specific support than the victims of intimate partner violence (41%). These findings confirm the notion that domestic violence is highly prevalent in mental health settings, and that violence is not limited to couples. Clinicians should be careful when detecting family violence especially among young patients, whose self-protection could be hindered by psychological and material boundaries.
From representations to practice: how professionals describe supporting parents with psychiatric or somatic illness or disability.
Darmaillacq C, Truquin AC, de Fougieres S … +2 more , Boujut E, Wendland J
Encephale · 2026 Jun · PMID 42309938 · Publisher ↗
OBJECTIVE: To explore how professionals implement support for parenthood when a parent lives with psychiatric or somatic illness or disability, and to identify conditions that enable or hinder consistent, coordinated, an...
OBJECTIVE: To explore how professionals implement support for parenthood when a parent lives with psychiatric or somatic illness or disability, and to identify conditions that enable or hinder consistent, coordinated, and non-stigmatizing care. METHODS: A secondary qualitative analysis was carried out of a corpus of 51 semi-structured interviews with health and social-care professionals working in perinatal, psychiatric, and community settings. Sociodemographic data were summarized descriptively. An inductive thematic analysis was conducted by an independent researcher using NVivo software, with a focus on three domains: (i) characteristics of care provision; (ii) limits to care; and (iii) intra/interpersonal difficulties reported by professionals. RESULTS: Seven subthemes characterized care: multidisciplinary teamwork, imperative nature of intervention, listening and adaptation, anticipation (ideally antenatal), graded child-placement options (including partial/temporary arrangements), parental self-efficacy, and empowerment. Four constraints limited implementation: insufficient parent-infant-qualified structures and long waits, shifts to child-protection logics under perceived risk, limited compliance or disagreement with recommendations, and missed/irregular appointments. Professionals reported strong emotional reactions and feelings of powerlessness, being challenged by families, and - where teams were cohesive and trained - absence of difficulties. CONCLUSION: Professionals strive for protective, coordinated, and adaptive care, yet structural scarcity and engagement challenges narrow individualization of perinatal care. Priorities include strengthening network capacity (parent-infant -adapted care pathways and early antenatal referral), operationalizing shared decision-making, and embedding reflective supervision.
Alternative model for personality disorders and drug use among the homeless individuals.
Bourgoise C, Combaluzier S
Encephale · 2026 Jun · PMID 42309937 · Publisher ↗
OBJECTIVES: This article aims to examine the contribution of the Alternative Model for Personality Disorders (AMPD) in relation to social exclusion and substance use. Indeed, numerous studies converge in highlighting a h...
OBJECTIVES: This article aims to examine the contribution of the Alternative Model for Personality Disorders (AMPD) in relation to social exclusion and substance use. Indeed, numerous studies converge in highlighting a higher prevalence of personality disorders and substance use among homeless individuals. Since its publication in 2013 the DSM-5 has proposed an Alternative Model for Personality Disorders, allowing for an assessment of personality based on two criteria: the level of personality functioning (Criterion A) and pathological personality traits (Criterion B). The tools developed for this model - the Level of Personality Functioning Scale Brief Form and the Personality Inventory for DSM-5-Brief Form - have been validated in French, enabling their use in clinical research on French-speaking populations. METHODS: The LPFS-BF and the PID-5-BF were administered to 30 voluntary residents of social reintegration centers. Additionally, a control group of 30 individuals from the general population was selected to ensure gender and age homogeneity between the groups. Fisher's exact test, binomial logistic regression analysis, and linear regression analysis were conducted to explore the relationships between personality factors, substance use, and precariousness. RESULTS: The analysis of mean scores did not reveal significant personality differences between residents in social reintegration centers and the general population; only substance use was found to be significantly higher among homeless individuals (P>001). Fisher's exact test confirmed the relationship between social exclusion, substance use, and the risk of personality disorders (P>001). A high-risk score for personality disorders was associated with a more than ninefold increase in the likelihood of high-risk substance use (relative risk=9.63, 95% CI: 1.5-63.5) among homeless individuals. Binomial logistic regression analysis identified self-direction as a protective factor against precariousness, whereas disinhibition was identified as a risk factor. Specifically, the combination of low self-direction and high disinhibition appeared to increase the risk of homelessness. Finally, self-direction (P=0.012), negative affectivity (P=0.047), and detachment (P=0.034) were found to play a significant role in the risk of developing a substance use disorder (n=60). Self-direction emerged as a key factor in the relationship between substance use and precariousness. CONCLUSIONS: These results highlight the relevance of the Alternative Model for Personality Disorders (AMPD) in understanding the interactions among psychosocial difficulties, substance use, and personality. In particular, they emphasize that among homeless individuals an increased risk of personality disorders is closely associated with risky substance use. Furthermore, self-direction emerges as a key factor in mitigating vulnerability to precariousness, whereas disinhibition constitutes a risk factor. These findings offer promising avenues for the development of targeted interventions aimed at enhancing personal resources and reducing risky behaviors among this highly vulnerable population. The issue of the homeostatic function of personality also arises and warrants investigation in future research.
A phenomenological representation of neurodevelopmental disorders in children and adolescents: A graphic organization.
Douet Vannucci V, Crocq MA, Guigou Y … +2 more , Forestier M, Pisella LI
Encephale · 2026 Jun · PMID 42309936 · Publisher ↗
Psychiatric nosology serves both clinical and research needs by providing a common language and informing healthcare planning. However, a movement toward transdiagnostic approaches is growing for assessments and care man...
Psychiatric nosology serves both clinical and research needs by providing a common language and informing healthcare planning. However, a movement toward transdiagnostic approaches is growing for assessments and care management of neurodevelopment disorders. During childhood and adolescence, symptoms appear as developmental delays. They often overlap across disorders, making the diagnosis difficult. To account for the multidimensional symptomatology, we propose a visualization of neurodevelopmental disorders phenomenology that would make it easier to analyze an individual as a network of diagnostic criteria whose interactions can compensate for each other and determine a pathological, at-risk or healthy impact. Such spatial organization would allow for the diagnostic criteria to be ordered over time, prioritized, and shared more effectively beyond the categorial diagnosis. Symptoms for neurodevelopmental disorders were grouped according to a hierarchy of phenomenological and symptomatological terms found in the main reference manuals and in the didactic consensus reported in the latest international reviews. They fall into four major domains: cognition, emotion, behavior and motricity while the operational diagnostic criteria were organized into a multiscalar hierarchy with a notion of order following a circular tree structure: the 'sunburst'. A graphic, visual, dynamic and hierarchical organization was proposed to handle all the phenomenology terms used in children, adolescents and young adults (aged 5-25) more easily and to convey them to the parties involved. Far from being exhaustive, this visual representation aims to facilitate the use of psychiatric phenomenology while maintaining a critical, dynamic and evolving approach to scientific knowledge and clinical practice.
How Self-Determination Theory can contribute to the assessment of motivation in patients with schizophrenia: A narrative review.
Ahondo K, Oker A, Berjot S
Encephale · 2026 Jun · PMID 42309935 · Publisher ↗
Motivation is one of the important determinants of functional outcomes in schizophrenia, yet its conceptualization and measurement remain heterogeneous. The literature reflects two predominant orientations: a psychiatric...
Motivation is one of the important determinants of functional outcomes in schizophrenia, yet its conceptualization and measurement remain heterogeneous. The literature reflects two predominant orientations: a psychiatric (nosological) perspective which construes motivation primarily as a deficit linked to negative symptoms, and a psychological perspective, mostly grounded in Self-Determination Theory (SDT), which emphasizes intrinsic motivation, the quality of regulation, and the satisfaction of basic psychological needs - autonomy, competence, and relatedness. Psychiatric approaches often conflate symptoms and motivational states and lack specificity regarding the object of motivation (e.g., goals, tasks, social engagement), whereas SDT brings to light environmental and interpersonal determinants. Although both approaches document altered motivational profiles, intermediate forms of regulation and context-specific motivations remain underexplored. This narrative review synthesizes these perspectives, examines measurement approaches, and argues that integrating SDT principles can refine assessment, clarify mechanisms, and inform interventions to enhance engagement, well-being, and functional recovery in schizophrenia.
[Comorbidity of premenstrual dysphoric disorder and bipolar disorder: Characteristics and interactions].
Mongnet M, Korngold J, Masson M … +2 more , Sutter-Dallay AL, Gressier F
Encephale · 2026 Jun · PMID 42309934 · Publisher ↗
OBJECTIVES: Premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome, is characterized by cyclic emotional and physical symptoms affecting quality of life. Bipolar disorder (BD), on the other hand,...
OBJECTIVES: Premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome, is characterized by cyclic emotional and physical symptoms affecting quality of life. Bipolar disorder (BD), on the other hand, manifests itself through alternating manic, hypomanic and depressive episodes. This review aims to explore the comorbidity between PMDD and TB. METHODS: A systematic review of the literature (PRISMA) was conducted from PubMed and Embase data up to June 2025. RESULTS: Eighteen articles (13 original studies and five clinical cases) were included. PMDD and TB were frequently comorbid with notable consequences on the frequency and intensity of thymic episodes. The interactions appeared to be multifactorial and partly related to hormonal fluctuations, particularly variations in estrogen and progesterone. The effectiveness of pharmacological treatments and hormonal and psychotherapeutic approaches remain little studied. The analysis of the data highlighted the need for individualized care considering the cyclicality of symptoms. CONCLUSIONS: PMDD-BD comorbidity represents a clinically significant but still under-recognized condition with important prognostic implications. It seems essential to continue the exploration of this comorbidity by integrating both hormonal and mood-related dimensions, and to better diagnose and treat it so as to improve quality of life through personalized therapeutic strategies.
Proposals for immediate suicide risk management.
Ducher JL, de Chazeron I, Ducher L … +1 more , Llorca PM
Encephale · 2026 Jun · PMID 42309933 · Publisher ↗
Abstract loading — click title to view on PubMed.
Sleep and suicidal behaviors.
Romier A, Leseur J, Moroy A … +1 more , Geoffroy PA
Encephale · 2026 Jun · PMID 42301744 · Publisher ↗
BACKGROUND: Suicidal behaviors-including suicidal ideation, suicide attempts, and suicide deaths-represent a major global health concern. Identifying proximal, modifiable risk factors is crucial to improve early detectio...
BACKGROUND: Suicidal behaviors-including suicidal ideation, suicide attempts, and suicide deaths-represent a major global health concern. Identifying proximal, modifiable risk factors is crucial to improve early detection and prevention. Sleep disturbances have emerged as proximal and modifiable risk factor for suicide, yet their role is often underestimated in clinical practice. METHODS: This chapter synthesizes evidence from epidemiological, clinical, and neurobiological studies examining the associations between sleep disturbances and suicidal behaviors. Both subjective (insomnia, nightmares, sleep duration, daytime sleepiness) and objective markers (polysomnography, actigraphy, circadian misalignment) are discussed, alongside potential underlying mechanisms and therapeutic perspectives. RESULTS: Insomnia, nightmares, abnormal sleep duration, and circadian rhythm disruptions are consistently associated with suicidal ideation, suicide attempts, and suicide deaths, independently of psychiatric disorders. Objective sleep measures, such as nocturnal wakefulness and REM sleep alterations, further support the association with suicidal risk. Potential mechanisms involve inflammation, neurotransmitter dysregulation, impaired prefrontal-limbic connectivity, and psychosocial factors such as hopelessness and nocturnal isolation. Suicide risk assessment may be strengthened by incorporating sleep-related interview questions, validated questionnaires, and objective sleep measures such as actigraphy. Interventions targeting sleep-including CBT-I, sleep medications, and Imagery Rehearsal Therapy-show promise in reducing suicidal ideation. CONCLUSION: Systematic assessment and treatment of sleep disturbances may significantly improve suicide risk detection and prevention strategies.
Screening tools for sleep disorders in patients with psychiatric disorders.
Coelho J, Martin VP, Richaud A … +3 more , Quiles C, Philip P, Micoulaud-Franchi JA
Encephale · 2026 Jun · PMID 42301743 · Publisher ↗
Sleep and mental health are closely interconnected. Alterations in sleep patterns are frequent among patients with psychiatric disorders and can exacerbate symptom severity or interfere with treatment outcomes. Despite t...
Sleep and mental health are closely interconnected. Alterations in sleep patterns are frequent among patients with psychiatric disorders and can exacerbate symptom severity or interfere with treatment outcomes. Despite this, systematic sleep assessment is not consistently integrated into psychiatric practice. This review presents a comprehensive overview of the main questionnaires available to assess sleep and its disturbances in psychiatric populations. We propose a minimal sleep semiology framework that includes non-specific sleep complaints (satisfaction, non-restorative sleep), sleep symptoms (insomnia, hypersomnolence), sleep-related distress/impairments, specific sleep disorders (sleep-related breathing disorders, sleep-related movement disorders, parasomnias), sleep needs (chronotype, flexibility) and behaviors (duration, timing, regularity, hypnotic use). Generic questionnaires, such as the Pittsburgh Sleep Quality Index (PSQI) and the RU-SATED scale, provide a global view of sleep health, while disorder-specific instruments allow precise evaluation of particular dimensions. This review allows for the selection of the most appropriate tool for specific applications in both clinical and research settings. Integrating these questionnaires with patient history and environmental context enables a holistic approach, improving both diagnosis and management. Ultimately, combining these subjective measures with objective assessments while considering environmental, social, and behavioral factors facilitates the promotion of sleep health, thereby enhancing psychiatric care and potentially benefiting population-level mental health.
Pathophysiology and neurobiology of insomnia.
Solelhac G, Raffray T, Lombardi AS
Encephale · 2026 Jun · PMID 42301742 · Publisher ↗
Chronic insomnia, as defined by the DSM-5 and ICSD-3, is characterized by difficulties falling asleep, maintaining sleep, or waking up too early, occurring at least three times a week for more than three months, with day...
Chronic insomnia, as defined by the DSM-5 and ICSD-3, is characterized by difficulties falling asleep, maintaining sleep, or waking up too early, occurring at least three times a week for more than three months, with daytime consequences. Long considered a secondary symptom, it is now recognized as a distinct condition resulting from a persistent disruption of sleep-wake regulation. Genetic and epigenetic studies show substantial heritability, suggesting a strong biological influence. More than 500 loci have been identified, linking insomnia to both metabolic and psychiatric traits. Gene-environment interactions, particularly through DNA methylation, may explain how stress can durably alter sleep system reactivity and promote chronicity. Brain imaging research highlights hyperactivation of key regions such as the anterior cingulate cortex, thalamus, insula, and precuneus, which are involved in arousal, vigilance, and emotional regulation. Electroencephalography confirms increased cortical activity, particularly in the beta and alpha bands, reflecting a persistent state of wakefulness during sleep. Explanatory models describe a set of mechanisms in which conditioning, stress reactivity, and co-activation of sleep and wake networks maintain the disorder. Insomnia thus appears as a hybrid state between wakefulness and sleep. These advances underline the complexity of insomnia and the need for integrated therapeutic approaches combining cognitive, behavioral, and physiological interventions to restore normal sleep regulation.
Redefining hypersomnia disorders in the context of psychiatry.
Mignot E
Encephale · 2026 Jun · PMID 42297543 · Publisher ↗
Daytime sleepiness and excessive sleep are frequent symptoms. When these symptoms are recognized, they are often attributed to comorbid depression or, following ambulatory screening, to obstructive sleep apnea (OSA). Whi...
Daytime sleepiness and excessive sleep are frequent symptoms. When these symptoms are recognized, they are often attributed to comorbid depression or, following ambulatory screening, to obstructive sleep apnea (OSA). While OSA affects 20-50% of the population, more frequently in men, its contribution to sleepiness in the general population is modest, and subjective sleepiness shows stronger associations with depression, insufficient sleep, and shift work. As a result, mild OSA in the presence of sleepiness is often overtreated. Further, stimulants are used as adjunct therapy in depression despite limited evidence. When referred to sleep disorder specialists, after exclusion of OSA, these patients are typically evaluated using a daytime nap test, the Multiple Sleep Latency Test (MSLT). The MSLT is used to diagnose Narcolepsy or Idiopathic Hypersomnia. Problematically, the MSLT performs well only to confirm narcolepsy type 1, a disorder with cataplexy and caused by orexin deficiency. A high false positive rate occurs in the absence of cataplexy, leading to questionable diagnoses of narcolepsy type 2 and idiopathic hypersomnia. A return to four historical subtypes of central nervous system hypersomnolence independent of MSLT testing is proposed. Narcolepsy Type 1: cataplexy, refreshing naps, sleep-onset REM periods. It is caused by orexin deficiency, responds to oxybate, antidepressants, stimulants, and low dose orexin receptor 2 agonists (in development). Narcolepsy-like hypersomnolence: Irresistible sleep attacks with short, refreshing naps. Insufficient Sleep must be excluded. It is often responsive to modafinil. Idiopathic Hypersomnia with sleep inertia and unrefreshing sleep: Excessive sleep amounts, severe sleep inertia, and long, unrefreshing naps. Association with psychiatric comorbidities, notably resolved depression, is frequent. Sodium oxybate can be transformative. Kleine-Levin Syndrome: periodic extreme hypersomnia with apathy and derealization. Responds to lithium in ∼50% of cases. A pathophysiological overlap with bipolar disorder is likely. A greater collaboration between psychiatry and sleep medicine is needed considering the emergence of orexin receptor agonists as potential therapies for hypersomnia.
Sleep disturbances in Attention-Deficit/Hyperactivity Disorder: State of the art and management.
Bioulac S, Claret-Tournier A
Encephale · 2026 Jun · PMID 42297542 · Publisher ↗
Sleep disorders are a frequent comorbidity in patients with Attention-Deficit/Hyperactivity Disorder (ADHD), from childhood through adulthood. These disturbances include sleep-related complaints such as insomnia symptoms...
Sleep disorders are a frequent comorbidity in patients with Attention-Deficit/Hyperactivity Disorder (ADHD), from childhood through adulthood. These disturbances include sleep-related complaints such as insomnia symptoms and daytime sleepiness, as well as well-defined sleep pathologies such as sleep-disordered breathing, restless legs syndrome, and circadian rhythm disorders. These disturbances have a significant impact on cognition, emotional regulation, and patients' quality of life. Sleep disorders thus maintain a bidirectional relationship with ADHD: on the one hand, altered sleep can exacerbate ADHD symptoms, and on the other hand, ADHD also affects sleep regulation. Given these challenges, a precise characterization of sleep disorders - from a developmental perspective, spanning childhood to adulthood - is essential, particularly with regard to the timing of symptoms. Such an evaluation will in turn enable appropriate management of this comorbidity, using both pharmacological and non-pharmacological approaches.
The intersection of sleep, circadian rhythms and cardiometabolic comorbidity in severe mental illness.
Smith DJ
Encephale · 2026 Jun · PMID 42297541 · Publisher ↗
Abstract loading — click title to view on PubMed.
Obstructive sleep apnea and its relationship with psychiatric disorders.
Frija J, d'Ortho MP
Encephale · 2026 Jun · PMID 42297540 · Publisher ↗
Obstructive sleep apnoea-hypopnea syndrome (OSAHS) is characterized by the recurrent occurrence of apnoea and hypopneas during sleep. OSAHS is an independent risk factor for cardiovascular diseases, including hypertensio...
Obstructive sleep apnoea-hypopnea syndrome (OSAHS) is characterized by the recurrent occurrence of apnoea and hypopneas during sleep. OSAHS is an independent risk factor for cardiovascular diseases, including hypertension, coronary artery disease, arrhythmias, and stroke. The high prevalence of OSAHS among patients with psychiatric disorders, along with the reciprocal links between these two categories of conditions, deserve emphasis. This association indeed carries diagnostic, prognostic, and therapeutic implications. Diagnosis poses specific challenges, including difficulties to perform sleep recording, and intricated causes of excessive daytime sleepiness. Emphasis should be made on reducing daytime sleepiness, nocturnal symptoms, and psychiatric symptoms. Data exist on the efficacy of continuous positive airway pressure (CPAP) in reducing anxiety and depression.
[Psychosocial rehabilitation applied to children].
Doyen C
Encephale · 2026 Jun · PMID 42225468 · Publisher ↗
Based on a developmental approach, psychosocial rehabilitation (PSR) for children assumes that a combination of factors points to problems and, as for adults, focuses on recovery. It does not depend solely on the child b...
Based on a developmental approach, psychosocial rehabilitation (PSR) for children assumes that a combination of factors points to problems and, as for adults, focuses on recovery. It does not depend solely on the child but on a process involving supportive adults. Recovery in children supports the hope of the parents and builds a new form of parenthood to cope with the child's disability. To optimize psychosocial abilities of a child with a neurodevelopmental disorder (NDD), a personalized assessment and early interventions are needed. Promoting parental skills is the key to preventing additional disabilities. Several stakeholders (education system, healthcare, social services, family support, child protection services) must be involved for inclusion and psychosocial risk management. Three psychological theories emphasized developmental needs which depend on chronological age, environmental context, and the brain's inhibitory capacity. A fourth theory suggests the need for a cultural-eco-social approach. For adults supporting a child with an NDD, psychoeducational approaches include therapeutic education; and peer support will foster empowerment. The recent presence of family peer caregivers included within the healthcare teams provides parents with complementary and different support, bringing hope. Through regional platforms, PSR brings together neuropsychologists, nurses, rehabilitation and socio-educational professionals, and school or work integration managers. The principles of a PSR day hospital for adults are well known, but specifications for the organization of child and adolescent PSR day hospitalization are needed. Day care programs need to use validated interventions whose effectiveness should be assessed. They must promote school inclusion and the autonomy of both parents and children. Psychoeducation and therapeutic patient education (TPE) sessions are applied. A neurocognitive assessment of pre- and post-treatment determines and assesses the objectives of the intervention. The interventions consist of workshops focusing on social skills, executive functions, and emotional regulation. A psychosocial intervention plan is developed collaboratively with the parents, and a review of the objectives is annually conducted. To conclude, psychosocial rehabilitation for children is not yet consensual, and its effectiveness still needs to be evaluated. It is a demanding model due to the assessments it requires, their repetition, and the need of parental support that must foster empowerment. The approaches take into account advances in scientific knowledge of children's cognitive development. These approaches must evolve rapidly and be highly personalized. They are aimed at both parents and healthcare partners. As with adults, health policy must promote the use of psychosocial rehabilitation and encourage the training of professionals in this area.
Sexual dysfunction and attention-deficit/hyperactivity disorder: A systematic review of bidirectional associations.
Verney P, Faugère M, Achour V … +6 more , Gavat J, Maakaron E, Pailloux L, Van Der Putten L, Lançon C, Korchia T
Encephale · 2026 Jun · PMID 42225467 · Publisher ↗
BACKGROUND: Sexual dysfunction (SD) and attention-deficit/hyperactivity disorder (ADHD) are both prevalent in adults yet remain underdiagnosed, and their potential association has only recently received systematic attent...
BACKGROUND: Sexual dysfunction (SD) and attention-deficit/hyperactivity disorder (ADHD) are both prevalent in adults yet remain underdiagnosed, and their potential association has only recently received systematic attention. Emerging studies suggest a bidirectional link, but findings are heterogeneous across instruments, samples, and definitions. METHODS: We conducted a systematic search of PubMed/MEDLINE, ScienceDirect, and Google Scholar from inception to February 2025. We included observational studies of adults (≥18 years) reporting either SD in ADHD populations or ADHD in SD populations. Two reviewers independently screened and extracted data. Study quality was appraised with the modified Newcastle-Ottawa Scale. The review followed PRISMA guidance and was prospectively registered (PROSPERO CRD42024617591). RESULTS: Thirteen studies met inclusion criteria (sample sizes 64-943). In ADHD cohorts, the highest reported SD prevalences were 67.7% for female orgasmic dysfunction and 39% for premature ejaculation (PE) in men. In SD cohorts, ADHD prevalence reached 34.6% in women with orgasmic disorder and ∼42% in men with PE (versus 3.7-5% in controls). While most studies indicated a positive association, several reported no significant differences. Heterogeneity in measures and designs precluded quantitative pooling. CONCLUSIONS: Current evidence supports a probable bidirectional association between SD and ADHD in adults. Routine, reciprocal screening should be considered in psychiatric and sexual-medicine settings. Standardised, multicentre protocols using validated instruments and structured ADHD assessment are needed to refine estimates and clarify mechanisms.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe