L'Encephale[JOURNAL]
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200 papers
[Eat well to live well: Is psychonutrition ready for clinical practice in mental health?].
Fond G, Masson M
Encephale · 2024 Dec · PMID 39643327 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Ethics, mental health and freedoms - The contribution of regional ethical reflection spaces].
Hazif-Thomas C, Donnart C, Tristchler-Le Maître MH
Encephale · 2025 Feb · PMID 39613697 · Publisher ↗
The action of the Regional Ethical Reflection Spaces does not only concern the field of contemporary bioethics but also affects many issues concerning mental health that we may have to face in clinical practice and teamw...
The action of the Regional Ethical Reflection Spaces does not only concern the field of contemporary bioethics but also affects many issues concerning mental health that we may have to face in clinical practice and teamwork. To keep trying to identify the conflicts of values in ethical issues is an absolute necessity, which implies that we support a "living together" relying on a "thinking together" for both the sake of each of us and for the sake of all of us. Our duty is then to resist collectively to prevent any possible deleterious excesses on both human and therapeutic points of view. Moreover, to focus on the principle of proportionality in complex medical decisions in the field of mental health requires at the same time a balance between the protection, the safety and the respect of the fundamental freedoms and a balance between the public interest and the individual needs. Such arbitration demands a strong focus on the ethical reflection so as to avoid decisions simply oriented towards the health dimension and recorded without any consideration for the health democracy. The referrals of the ethical support cells in Brittany and everywhere in France bring to light the challenges we met on the field. In particular those aroused during the COVID crisis concerning the institutional decisions, to take care of the mental health of patients at the end of their life or when facing treatment of resistant diseases. These situations raise some critical issues about the respect for the dignity and the humanity of the people we take care of. It thus seems necessary to respect an ethical code of human understanding, with poise and right balance, relying on a collegiate discussion. Besides, receiving end of life care will today requires the development of a palliative psychiatry in France, which becomes a priority. This could enable us to lead to fairer and equitable care, respectful of the individual freedoms, and a care better adapted to the specific needs of the patients in great psychological suffering. Especially in places where vulnerability is at stake, such as the retirement homes, to maintain a better articulation between the principles of beneficence and of nonmaleficence.
COVID-19 pandemic's impact on French Health Students' consumption of substances - a mixed analysis of their substance use.
Rolland F, Frajerman A, Falissard B … +5 more , Benyamina A, Diquet B, Vinchon F, Bertschy G, Marra D
Encephale · 2025 Oct · PMID 39581829 · Publisher ↗
OBJECTIVES: The COVID-19 pandemic had a huge impact on global mental health. Health care students, both as young people and regarding their student condition, were a more at-risk population. During the first and the thir...
OBJECTIVES: The COVID-19 pandemic had a huge impact on global mental health. Health care students, both as young people and regarding their student condition, were a more at-risk population. During the first and the third waves, two national surveys already found high levels of psychological distress (21 to 83% of severe psychological distress). This nationwide study focused on health care student changes in substance or treatment use during the pandemic. METHODS: We did an online national cross-sectional study addressing all health care students in France from April 4 to May 11, 2021. The questionnaire included sociodemographic and work conditions questions, Kessler 6 scale, and simple questions about psychotropic treatments or substance use. RESULTS: We obtained 16,937 answers, including 54% nurses and 16% medical students. Increased psychoactive substance use (alcohol, tobacco and cannabis) was associated with males, older students, those having financial difficulties and using more psychotropic treatments. Nursing students were more at risk than others. Increased psychotropic treatment use (anxiolytics, hypnotics) was associated with being a woman, older, having financial difficulties, having high psychological distress, and using more psychoactive substances. Medical, pharmacy, dental and midwife students were more at risk than others. The response rate was low (5,6%), and nursing students represented more than half of the respondents. CONCLUSIONS: Compared to our first national survey, substance use (21% versus 13%) and psychotropic treatment use (18% versus 7.3%) increased hugely. These results highlight the need to identify the specific causes of substance use by health care students to better support them. As future health professionals, this is a major public health issue.
Tardive seizure after electroconvulsive therapy: Prevalence and associated factors.
Lansari R, Souabni K, Ben Nasr Y … +3 more , Karoui E, Larnaout A, Melki W
Encephale · 2025 Oct · PMID 39581828 · Publisher ↗
INTRODUCTION: Tardive seizure refers to a spontaneous seizure, which occurs after electroconvulsive therapy (ECT). It is a rare and poorly understood phenomenon that can lead to other serious consequences such as status...
INTRODUCTION: Tardive seizure refers to a spontaneous seizure, which occurs after electroconvulsive therapy (ECT). It is a rare and poorly understood phenomenon that can lead to other serious consequences such as status epilepticus. Risk factors may be associated, and its management is by no means consensual. However, tardive seizure remains little explored in the absence of feedback and data sharing. The purpose of this study was to report the prevalence of late-onset seizures following ECT during the acute phase of treatment at the stimulation unit of Razi Hospital during its seven years of activity and to identify variables associated with this adverse event. METHODS: This is a descriptive and retrospective study that was carried out at the ECT unit of Razi Hospital, Tunisia, based on the medical records of patients treated with ECT between December 2015 and September 2023. Every recorded ECT session during the initial course of treatment with available EEG tracings was included in the study. Maintenance ECT sessions, undocumented sessions, those without clinical observations, and/or those without EEG tracings were all excluded. A tardive seizure was retained according to criteria that included both recorded motor manifestations such as "motor jerks" or "generalized tonic-clonic seizures" which began spontaneously after ECT and the resumption of a state of consciousness concurrent with an equivocal EEG tracing. RESULTS: A total of 162 patients received at least one course of ECT during the research period. Ultimately, we included 1931 well documented sessions that were completed for 157 patients in all. Of the 157 patients, seven had experienced at least one late seizure after receiving ECT, accounting for 4.45% of patients. Among the 1931 sessions, 11 late seizures were noted. The prevalence of tardive seizures in our series was 0.57%. Several factors have been associated to the onset of a tardive seizure, including being a male, the presence of a neurological lesion, treatment that lowers the epileptogenic threshold, anesthesia with etomidate, stimulation charge near seizure threshold or maximum electrical load, prolonged induced seizure, and poor post-ictal suppression on the induced seizure tracing. CONCLUSION: Despite the dearth of information, tardive seizure following ECT is considered to be a rare event. Risk factor management would be the first action to be taken to prevent such an event.
Social media addiction among college students in Tunisia.
Bergaoui E, Bouallagui A, Hkiri A … +4 more , Zrelli M, Moalla M, Amri G, Ghachem R
Encephale · 2025 Dec · PMID 39580320 · Publisher ↗
INTRODUCTION: Excessive use of social media can lead to addiction with adverse consequences for health. Through this work, we evaluated the prevalence of addiction to social media of college students from different field...
INTRODUCTION: Excessive use of social media can lead to addiction with adverse consequences for health. Through this work, we evaluated the prevalence of addiction to social media of college students from different fields and the associated factors. METHODS: We conducted a survey of 115 students by means of a questionnaire posted online during two weeks in groups of students aged between 19 and 30years from different fields in Tunisia. The questionnaire consisted of an information sheet and three self-administered questionnaires: Bergen social media addiction scale, Hospital Anxiety and Depression scale, and UCLA 3-item loneliness scale. RESULTS: Our population was 70% female. The average age was 25.1±3.5years. Regarding lifestyle habits, twenty-nine students (25.2%) were smokers, thirty-three students (28.7%) consumed alcohol, and nine students (7.8%) used cannabis. The average number of years of social media use was 11.77±3.28years. The average time on line per day was 3.8±1.81hours. The main social networks were Facebook (98.3%), Instagram (93%), Whatsapp (80.9%), Tiktok (28.7%), Snapchat (20%), and Twitter (19.1%). The use of social networks was the first action in the morning when waking up in 71.3% of the students and before sleeping in almost all students (94%). According to the results of the Bergen Social Media Addiction Scale, 31.3% of students had problematic social media use, defined by a score≥19/30. Thirty-three students (28.7%) had moderate to severe anxiety symptomatology and 41 students (35.7%) had moderate to severe depressive symptomatology. Sixty-two students (53.9%) were considered lonely according to the UCLA loneliness scale. Marital status was significantly associated with social media addiction score, with higher rates among single students. Smoking was also associated with higher social media addiction scores. Social media addiction scores were positively and significantly correlated with anxiety, depression, and loneliness scores. Frequency of going out with friends was negatively and significantly associated with social media addiction score, as well as depression and loneliness scores. CONCLUSIONS: This study shows that social media addiction is a major health problem. Therefore, it is important for college students to recognize a problematic social media use and take steps to use it in a healthy way.
Emotional information processing in depressed elderly with suicidal behavior.
Barsznica Y, Vandel P, Lambert B … +11 more , Monnin J, Nicolier M, De Pinho C, Hickel J, Richard-Devantoy S, Morgny C, Szymanska M, Haffen E, Laurent E, Chopard G, Noiret N
Encephale · 2025 Aug · PMID 39580319 · Publisher ↗
Elderly suicide is a public health problem, especially in the presence of unipolar depression. Very few tools have been developed to assess suicide risk in the elderly. Suicidal behaviors (SB) are often associated with p...
Elderly suicide is a public health problem, especially in the presence of unipolar depression. Very few tools have been developed to assess suicide risk in the elderly. Suicidal behaviors (SB) are often associated with perturbations of emotional information processing. Recent eye-tracking evidence has indicated specific visual exploration of emotional facial expressions based on age, pathological status, or type of facial emotion expression, which encourage the development of more specific and reliable tools to help in the detection of SB in depressed elderly patients. The aim of this study was to characterize emotional facial information processing in elderly depressed patients with SB vs. patients without SB. We assessed fixation time on their facial expressions (SB n=10 and with noSB n=11). Results showed that depressed SB patients spent more time on emotional regions (i.e. eyes and mouth) of disgust, fear and neutral emotions than did depressed noSB patients. Conversely, fixation time did not differ between the groups for angry, sad and happy emotions. We discuss the difficulties in disengaging attention from emotional information congruent with the patient's emotional state. Specific visual exploration observed in suicidal depressed patients could be used as novel risk factors to more accurately assess and predict suicide risk.
Does multimodal inpatient treatment help some adolescents with severe ARFID?
Guessoum SB, Loisel A, Fabrizio B … +4 more , Barry C, Albertelli T, Moro MR, Blanchet C
Encephale · 2025 Oct · PMID 39580318 · Publisher ↗
INTRODUCTION: Avoidant Restrictive Food Intake Disorder (ARFID) is a recently described disorder. Data on inpatient treatment is still scarce, ARFID mainly being an outpatient condition. The purpose of this study is to d...
INTRODUCTION: Avoidant Restrictive Food Intake Disorder (ARFID) is a recently described disorder. Data on inpatient treatment is still scarce, ARFID mainly being an outpatient condition. The purpose of this study is to describe a rare population of adolescents with severe ARFID receiving full-time multimodal inpatient care by examining their clinical characteristics, management, and evolution. METHODS: We conducted a retrospective study on a series of patients diagnosed with ARFID who were hospitalised from 2005 to 2022. This study was carried out at the Adolescent Medicine department of a University Hospital in Paris, France, specialising in the treatment of eating disorders. RESULTS: Sixteen adolescents aged 12 to 17 were hospitalised for severe ARFID associated with malnutrition, growth retardation, pubertal delay, and/or psychiatric comorbidities. All but one had body mass indexes less than -2 standard deviations. Mean BMI upon admission was 14,1 [standard deviation=1,8]. They benefited from multimodal treatment plans supported by a multidisciplinary team, including nutritional, somatic and psychiatric transdisciplinary assessment and care, residential care, and family involvement. Length of stay was five months on average, and 50% had achieved normal body mass index at discharge. CONCLUSIONS: Full-time inpatient care with multimodal and multidisciplinary interventions and tailored management can help restore normal weight for some adolescents. These interventions are aimed at patients with severe ARFID with major complications such as stunted growth and delayed puberty, and/or comorbidities such as depression. Specific subtypes of patients with severe ARFID need to be identified to delineate their characteristics, prognosis, and treatments effective for this group.
CYP2D6 and CYP2C19 ultrarapid metabolisms are associated with suicide attempts in schizophrenia.
Korchia T, Faugere M, Tastevin M … +10 more , Quaranta S, Guilhaumou R, Blin O, Lereclus A, Joober R, Shah J, Palaniyappan L, Lançon C, Fond G, Richieri R
Encephale · 2025 Aug · PMID 39547922 · Publisher ↗
INTRODUCTION: Genetic polymorphisms in genes encoding enzymes metabolizing psychotropics drugs result in various isoenzymes with different catalytic efficacies. Of particular interest, some of these isoenzymes are highly...
INTRODUCTION: Genetic polymorphisms in genes encoding enzymes metabolizing psychotropics drugs result in various isoenzymes with different catalytic efficacies. Of particular interest, some of these isoenzymes are highly catalytic leading to an ultrarapid metabolism (UM) of their substrate medication, which in turn results in lower medication concentrations and possibly poor clinical outcomes, including a higher risk for suicidal behavior. In this study, we investigate the role of CYP2D6 (metabolizing most antidepressant medications) and CYP2C19 (important in metabolizing antipsychotics) UM isoenzymes on suicidal behavior among a cohort of patients with schizophrenia. METHODS: One hundred and seventy-eight patients diagnosed with schizophrenia were recruited from the day hospital of a regional psychiatric academic hospital. Lifetime suicide attempts were compared between groups of patients stratified according to their enzymatic profile. Several socio-demographics and clinical covariates were controlled for. RESULTS: Among the 178 patients, 16 and 44 were UM as determined by their CYP2D6 and CYP2C19 genotype respectively. Univariate analysis showed a significant association between suicidal attempts and CYP2D6 and CYP2C19 UM status (P=0.041 and P=0.029 respectively). These associations remained significant in multivariate analyses (adjusted for age, sex, dose exposure and antidepressant use…) for both CYP2D6 (P=0.020, OR=4.096, 95% CI [1.25-13.48]) and CYP2C19 (P=0.016, OR=2.680, 95% CI [1.21-5.95]). CONCLUSION: This study suggests that the UM phenotypes for both CYP2D6 and CYP2C19 are associated with an increased risk for suicide attempts in patients with schizophrenia.
French validation of the Stigma Resistance Scale in a sample of people with psychotic disorders.
Gomez S, Attal J, Besson M … +10 more , Boggero M, Bottai T, Gaubert B, Giordana JY, Masson D, Mora G, Milles-Simonet C, Schandrin A, Simonet B, Lecardeur L
Encephale · 2025 Aug · PMID 39547921 · Publisher ↗
OBJECTIVES: The aim of this study was to translate the Stigma Resistance Scale into French and to examine its psychometric qualities to measure stigma resistance in people with psychotic disorders. METHODS: The Stigma Re...
OBJECTIVES: The aim of this study was to translate the Stigma Resistance Scale into French and to examine its psychometric qualities to measure stigma resistance in people with psychotic disorders. METHODS: The Stigma Resistance Scale was rigorously translated into French, involving translation, back-translation, and adjustments based on focus groups. The French version of the Stigma Resistance Scale comprises 20 items divided into five subscales measuring resistance to stigma at different levels. The psychometric qualities of the French version were assessed in comparison with other scales such as the Internalized Stigma of Mental Illness, the Beck Depression Inventory, the Self-Evaluation of Negative Symptoms, and the Schizophrenia Quality of Life Questionnaire Short Form. The study involved 59 patients with psychotic disorders and was approved by a committee for the protection of individuals. Participants were recruited from seven investigating centers, and data were collected via semi-structured interviews and self-questionnaires. RESULTS: The five-factor structure developed by the original scale for a multi-diagnostic population was not found by confirmatory factor analysis on our sample. An exploratory factor analysis revealed a two-factor structure. Internal consistency, measured by Cronbach's alpha coefficient, was greater than 0.7 in favor of a strong internal consistency of the psychometric instrument. The correlation result obtained with the only instrument measuring stigma resistance (Internalized Stigma of Mental Illness subscale) demonstrated good convergent validity (r=-0.37). Similarly, scores on the Stigma Resistance Scale were strongly correlated with scores on other scales measuring negative symptomatology, depression, quality of life and insight. This demonstrates the satisfactory divergent validity of the instrument. CONCLUSION: The study aimed to validate the Stigma Resistance Scale in French, revealing a two-factor structure in patients with psychotic disorders. The two dimensions identified reflect a proactive attitude to stigma (egocentrism) and a willingness to defend the rights of people with mental disorders (allocentrism). Cultural factors may explain the differences in the factorial models between the original and French versions. The Stigma Resistance Scale is the first tool validated in the French language to provide a specific self-assessment of stigma resistance with good psychometric properties for patients suffering from psychotic disorders.
Prevalence of problematic drug use in Martinique in 2006: The NEMO study.
Rollier S, Lehoux T, Angerville B … +3 more , Vaissade L, Lacoste J, Merle S
Encephale · 2025 Aug · PMID 39516102 · Publisher ↗
OBJECTIVES: Substance use disorders are of worldwide public health interest. Local estimates of problematic drug use provide useful indicators to regional public health agencies in developing prevention and treatment pro...
OBJECTIVES: Substance use disorders are of worldwide public health interest. Local estimates of problematic drug use provide useful indicators to regional public health agencies in developing prevention and treatment programs. The purpose of the current study was to estimate the prevalence of problematic drug use in Martinique. METHODS: The capture-recapture method was applied to a multisource data collection (eight specialized drug and two law enforcement sources) to provide an estimate of drug use (opiates, cocaine hydrochloride, crack (cocaine base), stimulants and/or hallucinogens). Data collection was organized over a period of six consecutive months (September 2005 to March 2006) and concerned all persons residing in Martinique longer than three months and who had consumed at least one of the studied drugs in the month prior to the study. RESULTS: We identified 287 cases (86% male; mean age 36.1±9.6 years), 98% of whom had used crack. Comorbid use of illicit drugs other than alcohol and cannabis was 4%. Our study showed that patients with problematic drug use in Martinique is estimated to be 1.936 [95% CI: 964,2907] in a total population of 380.863 (INSEE, 1999). Prevalence rates were 5.0 per thousand among the global population and 7.7 per thousand in the adult population aged 15-64 years. CONCLUSIONS: Our study is the first to provide relevant data on the extent of problematic drug use in Martinique for health policies and decision-makers.
Stigma: Bipolar disorder versus cancer, a first-person account.
Milandelle M, Gheysen F, Verdoux H
Encephale · 2025 Jun · PMID 39510878 · Publisher ↗
The author shares her experience as patient and epidemiologist with bipolar disorder and cancer. She explains why stigma was more challenging to bear with bipolar disorder than with cancer. This account also includes the...
The author shares her experience as patient and epidemiologist with bipolar disorder and cancer. She explains why stigma was more challenging to bear with bipolar disorder than with cancer. This account also includes the perspective of two psychiatrists who provided her medical care. This paper aims to share a message of hope with patients with psychiatric diseases and offer some thoughts to help to reduce a patient's stigma.
Sleep apnea syndrome in patients with methadone or buprenorphine.
Guillet C, Endomba FT, Aravantinos D … +5 more , Hussami A, Beye F, Girod JC, Georges M, Aho Glélé LS
Encephale · 2025 Aug · PMID 39510877 · Publisher ↗
OBJECTIVES: This work aimed to assess the association between sleep apnea syndrome (SAS) and opioid substitution treatments (OST) dose/timing of administration in patients receiving methadone or buprenorphine for an opio...
OBJECTIVES: This work aimed to assess the association between sleep apnea syndrome (SAS) and opioid substitution treatments (OST) dose/timing of administration in patients receiving methadone or buprenorphine for an opioid use disorder (OUD). METHODS: We conducted a retrospective cross-sectional study by including files of adult patients treated between November 2015 and January 2023 with methadone or buprenorphine and who had a nocturnal respiratory polygraphy. We collected information on treatments and polygraphical recording data such as the apnea-hypopnea index (AHI). RESULTS: We enrolled 60 patients on methadone and 15 on buprenorphine. The sample encompassed 72% of males, and the mean age was 36±7.49years. Moderate to severe and severe SAS were significantly associated with the daily dose and the evening administration but was not predicted by the type of OST. However, the mean and median values of AIH were significantly greater with methadone. Contrary to methadone, there was no significant correlation between the buprenorphine daily dose and the AHI. The best sensitivities and specificities for the prediction of an AHI≥15 events/h and an AHI≥30 events/h were respectively obtained with methadone dose thresholds of 77.5mg/day. CONCLUSIONS: In this sample, the methadone daily dose of 77.5mg was the best cut-point to predict moderate to severe SAS, especially while taken in the evening, and we found no correlation between buprenorphine and the AHI. These results draw clinicians' attention to buprenorphine use as an alternative for patients treated with methadone and having SAS.
[On the leads of Pinel, francophone psychiatry shines over the Mediterranean].
El-Hachem C, Dirani E, Bou Khalil R
Encephale · 2025 Jun · PMID 39510876 · Publisher ↗
Abstract loading — click title to view on PubMed.
Early access to post-emergency addiction care: ASAP project.
Demina A, Meille V, Petit B … +2 more , Cannard JF, Trojak B
Encephale · 2025 Apr · PMID 39510875 · Publisher ↗
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Neuroimaging correlates of cognitive disorders secondary to electroconvulsive therapy: A systematic review.
Hassan J, Péran P, Yrondi A
Encephale · 2025 Jun · PMID 39510874 · Publisher ↗
OBJECTIVES: Electroconvulsive therapy is known as an efficient therapy, which is sometimes recommended for the management of severe and resistant depression. However, ECT is associated with cognitive adverse effects. The...
OBJECTIVES: Electroconvulsive therapy is known as an efficient therapy, which is sometimes recommended for the management of severe and resistant depression. However, ECT is associated with cognitive adverse effects. The study of the neurobiological correlates of the cognitive adverse effects of ECT has been covered in few published reviews. However, these mechanisms have been investigated in an increasing number of studies in recent years, particularly in neuroimaging. This systematic review of the literature focuses on correlates between changes in structural or functional neuroimaging and impairment of cognitive functions during the ECT treatment. METHODS: We conducted a systematic review of the literature using PRISMA methodology. Searches were performed on the Medline and Web of Science databases using the following equation: "electroconvulsive therapy AND (MRI OR fMRI OR DTI OR neuroimaging) AND depression AND cogniti*". RESULTS: This article highlights the significant heterogeneity of the results. In structural imaging, approximately 50% of the studies did not report any correlation between volumetric changes and neuropsychological changes. In studies that did highlight a correlation, the latter was mainly reported with changes in the hippocampus. From a functional perspective, we highlighted a correlation between changes in the connectivity of the hippocampal region and cognition. CONCLUSION: These results demonstrate a growing interest in understanding the neurobiological mechanisms underlying cognitive disorders secondary to ECT treatment. The ultimate aim behind this understanding is to adopt a more effective prevention strategy vis-à-vis these adverse effects.
Suicide attempts in Martinique and Reunion Island and appointments no-show.
Ndiaye C, Messiah A, Gokalsing E … +6 more , Lislet N, Gillet C, Rene E, Atwan N, Jehel L, Spodenkiewicz M
Encephale · 2025 Jun · PMID 39510873 · Publisher ↗
OBJECTIVES: Studies on suicidal behaviors in the French overseas territories remain rare. Although mental health resources are limited, some patients identified as being at risk of suicide do not attend the specialist co...
OBJECTIVES: Studies on suicidal behaviors in the French overseas territories remain rare. Although mental health resources are limited, some patients identified as being at risk of suicide do not attend the specialist consultations scheduled after identification or screening. Thus, the objective of our study was, firstly to provide a descriptive profile of patients followed up for a suicide attempt in Martinique and Reunion Island, and secondly to explore the risk factors associated with appointments no-show during follow-up. METHODS: We conducted an ancillary retrospective cross-sectional study using data from the APSOM study. Data were collected on 255 patients aged at least 16, admitted to hospital emergency departments after a suicide attempt and followed up in ambulatory care, including 137 in Martinique and 118 in Reunion Island. The characteristics of the sample were described by means [min, max] and proportions [95% confidence intervals]. Differences according to the presence of appointments no-show or not were analyzed using comparison tests of means and percentages (Chi, Fisher and Wilcoxon). Factors associated with appointments no-show were analyzed using a bootstrapped multivariate logistic regression model. RESULTS: The mean age of patients was 35 years [16-84 years]. Women were predominant with a sex ratio of 2.4:1 (71% women). Unemployment affected 37% [28%, 46%] of patients in Martinique and 49% [40%, 59%] in Reunion Island. Psychoactive substances consumption at the time of the suicidal act was observed in 36% [27%, 45%] of patients in Martinique and 34% [26%, 44%] in Reunion Island. The average number of suicide attempts was two per patient [1-20]. Finally, we found no significant association with appointments no-show except for center. Patients from Reunion Island were associated with better compliance than patients from Martinique (OR: 0.20 [0.05-0.65], P<0.012). CONCLUSION: Our study provides a description of suicide attempts admitted to hospital and followed up in ambulatory care in two French overseas territories and suggests interesting approaches for adapting prevention strategies to the socioeconomic context and cultural realities of these territories, particularly outreach interventions for the most vulnerable patients.
Serum biomarkers, lifetime substance use and conversion to bipolar disorder.
Wirowski N, Lobato AS, Bender LV … +8 more , Cardoso TA, Mondin TC, Souza LDM, Silva RAD, Oses JP, Wiener CD, Jansen K, Pedrotti Moreira F
Encephale · 2025 Aug · PMID 39510872 · Publisher ↗
INTRODUCTION: The diagnostic conversion of major depressive disorder (MDD) to bipolar disorder (BD) is a topic that is currently the subject of several studies. However, there are few studies that clarify the interaction...
INTRODUCTION: The diagnostic conversion of major depressive disorder (MDD) to bipolar disorder (BD) is a topic that is currently the subject of several studies. However, there are few studies that clarify the interaction between conversion, substance use and biomarkers. OBJECTIVES: The aim of this study was to investigate serum biomarker levels and lifetime substance use as predictors for diagnostic conversion from major depressive disorder to bipolar disorder in an outpatient sample of adults. METHODS: This was a prospective longitudinal study nested within a larger two-phase study. Male and female individuals, between the ages of 18 and 60, diagnosed with MDD by the Mini International Neuropsychiatric Interview Plus who participated in the two stages of the study were included. The instrument alcohol smoking and substance involvement screening test (ASSIST) was used to evaluate substance use. The enzyme linked immuno sorbent assay (ELISA) technique was used to measure the levels of the following biomarkers: brain derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial cell line-derived neurotrophic factor (GDNF), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α). RESULTS: The conversion rate from MDD to BD was 12.4%. The prevalence of female individuals, subjects with up to eight years of schooling, who had lifetime psychotic symptoms and reported lifetime use of cocaine was higher among individuals who converted their diagnosis to BD than among individuals who did not (P<0.05). In the crude analysis, there was no interaction between biomarkers and substance use except for NGF with cocaine. Based on the adjusted analysis model, it was observed that the interaction remains (OR: 1.476; 95% CI: 1.019-2.137). CONCLUSIONS: Individuals with late diagnosis and treatment of bipolar disorder may have a worse prognosis. Therefore, results suggesting that NGF and cocaine use are potential predictors of conversion to bipolar disorder can help in clinical practice, contributing to the identification of conversion and to more specific therapeutic interventions.
Experience of neurofeedback and methylphenidate in children with ADHD.
Bousquet E, Kerbage H, Purper-Ouakil D … +1 more , Fongaro E
Encephale · 2025 Aug · PMID 39510871 · Publisher ↗
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. ADHD is commonly treated with medication, such as methylphenidate, but some f...
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. ADHD is commonly treated with medication, such as methylphenidate, but some families and practitioners prefer psychosocial interventions as first line treatments. Many studies have investigated neurofeedback as a potential non-pharmacological treatment for ADHD yielding contradictory findings regarding its efficiency. Qualitative research on neurofeedback in ADHD is limited and can add valuable information on the acceptability and perceived efficacy among service users. This study aimed to explore the perceptions and experiences of children and adolescents with ADHD regarding the use of neurofeedback and methylphenidate. Eleven interviews with children and their parents explored their subjective experiences and perceived changes. Overall, neurofeedback was negatively experienced by those families: the intervention did not meet their expectations, and they reported minimal observed changes. The treatment with methylphenidate, however, was more manageable for families and was perceived to be more efficient despite its side effects.
An exploratory study of blind spot bias in psychiatrists: The value of mindfulness and ethical skills'.
Macé M, Magisson F, Trousselard M
Encephale · 2025 Aug · PMID 39510870 · Publisher ↗
INTRODUCTION: Psychiatry is an area of medicine that is particularly exposed to the risks of cognitive bias, notably because diagnosis is subjective. However, psychiatrists may develop psycho-cognitive skills that protec...
INTRODUCTION: Psychiatry is an area of medicine that is particularly exposed to the risks of cognitive bias, notably because diagnosis is subjective. However, psychiatrists may develop psycho-cognitive skills that protect against bias, as the reflective approach to their patients favors the activation of system 2 (logical) as opposed to system 1 (intuitive) processes. Furthermore, the collegial practices found in psychiatry, a consequence of the ethical questions psychiatrists must address, can also mitigate the impact of bias. On the other hand, clinical ethics committees have adopted structured deliberation practices that aim to improve collective decision-making and limit the cognitive biases associated with groupthink. OBJECTIVE: The primary aim was to compare blind spot bias in a group of psychiatrists and a group of 'ethicists', experts in group deliberation. The secondary objective was to study the distribution of skills influencing the balance between systems 1 and 2 (notably, ethical deliberation, feeling of efficacy, mindfulness, and values) in both groups. The general hypothesis is that psychiatrists are less prone to blind spot bias and are more competent in the skills studied. METHODS: This descriptive, cross-sectional study was conducted from April 2022 to May 2023. Thirty-two psychiatrists were recruited from several French hospitals, along with 20 'ethicists'. All participants completed the following self-administered questionnaires: the Bias Blind Spot Scale (French version), the Euro Moral Case Deliberation (Euro-MCD, ethical skills), Bandura's self-efficacy scale (self and collective efficacy), the Freiburg Mindfulness Inventory (mindfulness), and the Schwartz Value Survey (values). RESULTS: The ratio of self/other blind spot bias was lower in the 'ethicists' group than the psychiatrists' group (P<0.001). Euro-MCD scores were higher (P<0.001) and psychiatrists tended to have a better sense of collective efficacy (P=0.08). No significant difference was found between the two groups for total mindfulness or presence and acceptance sub-scores. Scores for hedonic value were higher among psychiatrists (P<0.02). CONCLUSION: The results do not confirm our hypotheses. There is less evidence of blind spot bias among our sample of 'ethicists', who are experts in group deliberation, than psychiatrists, who have experience of the patient/physician dyad. The ethical skills that are developed within the formal deliberation process seem particularly interesting in terms of reducing cognitive bias.
COVID-19 lockdown: Impact on youth mental health using gold standard interviews - Insights and lessons from the CoCo20 study protocol.
Revah A, Gindt M, Guivarch J … +6 more , Fossard O, Metelkina-Fernandez V, Nachon O, Richez A, Askenazy F, Fernandez A
Encephale · 2024 Dec · PMID 39368934 · Publisher ↗
Abstract loading — click title to view on PubMed.
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