L'Encephale[JOURNAL]
Sun
200 papers
Perceptions of the Paris Fire Brigade regarding psychiatric emergencies.
Felix B, Briche F, Gourevitch R … +4 more , Petitclerc M, Katz J, Abgrall G, Ambar Akkaoui M
Encephale · 2026 Apr · PMID 41963173 · Publisher ↗
OBJECTIVE: This study explored the perceptions of Paris firefighters regarding psychiatric emergency interventions in a context of increasing collaboration with the psychiatric mobile emergency medical service in Paris (...
OBJECTIVE: This study explored the perceptions of Paris firefighters regarding psychiatric emergency interventions in a context of increasing collaboration with the psychiatric mobile emergency medical service in Paris (SAMU-psy). METHODS: An online questionnaire was distributed to Parisian firefighters working in central Paris from May to June 2025. Responses were analyzed descriptively. RESULTS: In total, 924 firefighters responded. They reported near-daily exposure to psychiatric situations, often perceived as complex. The most frequently encountered cases involved behavioral disturbances related to substance use (82.6%) and suicidal ideation (54.6%). Firefighters described feelings of mistrust (84.1%) but also empathy (53.3%) during these interventions. Nearly 42% reported lacking specific knowledge, and 44.5% expressed a desire for further training. Reported challenges included communication with patients, especially when care was refused, coordination with other emergency services, and emotional exhaustion. Overall, 15.8% of firefighters had previously participated in a joint intervention with the SAMU-psy. These collaborations were generally considered helpful for de-escalation or decision-making support. CONCLUSION: This study highlights the tensions, needs, and perceptions firefighters experience in psychiatric emergency situations in Paris. It emphasizes the relevance of enhanced training, more systematic access to specialized psychiatric support, and improved inter-institutional coordination to strengthen prehospital psychiatric emergency care.
[Organic causes of first episode psychosis: Review of the literature].
Tesnières C, Meunier S, Dollfus S
Encephale · 2026 Apr · PMID 41963172 · Publisher ↗
INTRODUCTION: The first episode of psychosis (FEP) could be the first presentation of a patient's psychotic symptoms. This disorder may be a sign of an entry into a psychiatric illness but may also be indicative of an or...
INTRODUCTION: The first episode of psychosis (FEP) could be the first presentation of a patient's psychotic symptoms. This disorder may be a sign of an entry into a psychiatric illness but may also be indicative of an organic pathology. Indeed, the literature reports an organic origin in 5.6% of FEP. However, no international or national consensus exists, leading to a strong disparity of practices and numerous diagnostic errors. OBJECTIVE: The aim of the thesis was to identify organic disorders that can cause a FEP in patients aged 15 to 30 years. A systematic review of the literature combined with a selective review specific to each cause allowed the inclusion 569 articles. RESULTS: Ninety aetiologies or groups of aetiologies were identified, including neurological, autoimmune, genetic, endocrine, gynaecological, gastroenterological, inflammatory and/or infectious causes. Authors' recommendations and indicators have been identified for several pathologies. Systematic reviews, meta-analyses and cost/benefit studies should be conducted for each etiology identified to establish objective recommendations. CONCLUSION: This article proposes a paraclinical assessment to carry out for a FEP in patients aged 15 to 30 years and suggests the prescription of additional paraclinical examinations in the presence of certain indicators.
Clinical approaches to hypersomnolence complaints in psychiatry: A narrative review.
Geoffroy PA, Christodoulou N, Micoulaud Franchi JA … +1 more , Maruani J
Encephale · 2026 Jun · PMID 41963171 · Publisher ↗
BACKGROUND: Hypersomnolence complaints are common in psychiatric disorders and carry substantial functional burden, yet they remain under-recognized and frequently under-investigated. Clinically, hypersomnolence spans th...
BACKGROUND: Hypersomnolence complaints are common in psychiatric disorders and carry substantial functional burden, yet they remain under-recognized and frequently under-investigated. Clinically, hypersomnolence spans three partially overlapping dimensions: excessive daytime sleepiness, excessive total sleep time/need for sleep, and sleep (wake) inertia. OBJECTIVE: To provide a pragmatic, clinician-oriented framework for evaluating and managing hypersomnolence complaints in psychiatry, integrating sleep medicine concepts with psychiatric comorbidity and real-world care pathways. METHODS: Narrative synthesis of epidemiological, clinical, and translational evidence with emphasis on: (i) precise phenotypic clarification of the complaint; (ii) systematic etiological work-up (sleep debt and circadian misalignment, depressive episodes, ADHD, anxiety/trauma-related disorders, iatrogenic factors, OSA, RLS, parasomnias, narcolepsy/idiopathic hypersomnia); and (iii) stepwise management strategies. RESULTS: Hypersomnolence affects 40-50% of patients in major depressive episodes and is frequently linked to circadian factors, insomnia comorbidity, obstructive sleep apnea, and medication effects. Objective long sleep time is common among depressed patients with hypersomnolence. Similar observations are made for ADHD, anxiety and trauma-related disorders and psychotics disorders. A three-step care algorithm is proposed: (1) universal behavioral/circadian measures; (2) targeted treatment of the underlying cause (e.g., antidepressant optimization, chronotherapeutics, CBT-I, CPAP/MAD for OSA, specific management for RLS/parasomnias, and specialist evaluation for narcolepsy/idiopathic hypersomnia); (3) management of residual symptoms (e.g., light therapy; carefully selected wake-promoting agents when indicated). CONCLUSIONS: A fine-grained clinical characterization coupled with systematic etiological screening improves diagnosis and treatment of hypersomnolence in psychiatry. Integrating sleep-specific tools (actigraphy, sleep diaries, MSLT/PSG when appropriate) with psychiatric assessment supports personalized, mechanism-informed care and may reduce morbidity, accident risk, and healthcare utilization.
[Towards sustainable psychiatry - Eco-prescription in action].
Brunn M, Berna F, Bounoure F … +2 more , Taillemite S, Fond G
Encephale · 2026 Apr · PMID 41963170 · Publisher ↗
While environmental concerns are becoming increasingly important in the field of health, drug prescription remains a blind spot in the ecological transition. In psychiatry, antidepressants are often prescribed for long p...
While environmental concerns are becoming increasingly important in the field of health, drug prescription remains a blind spot in the ecological transition. In psychiatry, antidepressants are often prescribed for long periods, sometimes outside of approved indications, and their carbon impact is rarely taken into account. This article proposes the concept of eco-prescribing, defined as the choice of treatments with a lower environmental footprint and equivalent clinical efficacy. Using data from the Ecovamed® database, we compare the carbon footprint of several antidepressants at equivalent doses and show that their impact varies by a factor of two. We discuss the practical implications of these results for psychiatrists, emphasizing that eco-prescribing does not replace clinical reasoning, but complements it. Finally, we broaden the discussion to other levers of sustainable care: remote psychotherapy, psychonutrition, physical activity, and supervised use of honest placebos. Far from being marginal, environmental criteria could become a simple benchmark to guide therapeutic choices in psychiatry concerned with sustainability.
Physical activity, athletic performance, and recovery: The role of sleep.
Geoffroy PA
Encephale · 2026 Jun · PMID 41963169 · Publisher ↗
BACKGROUND: Physical activity is widely recognized for its benefits on physical and mental health. However, interactions between sleep, athletic performance, and recovery remain complex and incompletely understood. This...
BACKGROUND: Physical activity is widely recognized for its benefits on physical and mental health. However, interactions between sleep, athletic performance, and recovery remain complex and incompletely understood. This narrative review synthesizes recent evidence on the relationships between physical activity, mental health, sleep, and performance, and outlines potential therapeutic perspectives. METHODS: We reviewed recent meta-analyses, randomized controlled trials, observational studies, and expert consensus statements addressing physical activity, sleep, mental health, athletic performance, recovery, napping, and circadian factors in both general and athletic populations. RESULTS: Physical activity shows a clear inverse dose-response relationship with depression risk, with even moderate levels conferring significant mental health benefits. Regular physical activity (≥150min/week of moderate-to-vigorous activity) significantly reduces insomnia symptoms, improves sleep efficiency, and is associated with reduced anxiety and depressive symptoms. Sleep is a key determinant of athletic performance, yet 50-78% of athletes report sleep complaints, often related to training schedules, competitions, intense light exposure, and travel-induced jet lag. Sleep deprivation impairs performance, particularly in sports requiring fine motor skills and sustained cognitive functioning and contributes to overtraining and prolonged performance decrements. Adequate sleep duration and sleep extension are associated with improved recovery and sport-specific performance. Napping may support recovery and vigilance, but its benefits depend on duration and timing, with a risk of sleep inertia following long naps (>30min). CONCLUSION: Sleep represents a pillar of mental health, athletic performance, and recovery. Integrating sleep-aware training schedules, circadian principles, and individualized physical activity programs may optimize both health, performance and recovery outcomes.
[L'Adieu au visage (Farewell to the face): A reinterpretation of "Psychiatry is Literature"].
Deneufgermain D
Encephale · 2026 Apr · PMID 41956838 · Publisher ↗
Discussing L'Adieu au visage (Farewell to the Face) in a workshop titled "Psychiatry is Literature" presupposes an analysis of the crucial issues contained in this proposition from Jean Delay. If the psychiatrist's act c...
Discussing L'Adieu au visage (Farewell to the Face) in a workshop titled "Psychiatry is Literature" presupposes an analysis of the crucial issues contained in this proposition from Jean Delay. If the psychiatrist's act consists of creating literature within reality, how does this translate today? What skills or prerequisites are necessary? And what if L'Adieu au visage were to open up a new perspective on our identity as psychiatrists, our natural affinities with literature, and the fundamentals of our art.
Adolescence and ADHD: Practical proposals regarding the transition of care.
Cabelguen C, Hadjadj Aoul S, Kammerer E … +5 more , Brustolin D, Shadili G, Vesproumis P, Romo L, Purper-Ouakil D
Encephale · 2026 Apr · PMID 41956837 · Publisher ↗
OBJECTIVES: This paper aimed to provide an overview of assessment and care strategies for adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) during the transition from childhood to adulthood, so as to assis...
OBJECTIVES: This paper aimed to provide an overview of assessment and care strategies for adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) during the transition from childhood to adulthood, so as to assist healthcare professionals in structuring transition programs within a comprehensive care pathway. MATERIALS AND METHODS: These practical proposals emerge from the 'Adolescent Transition' working group of the National Coordination for Adult ADHD which includes psychiatrists, addiction specialists, child psychiatrists, a pediatrician, a psychologist, and a users' association representative. The proposals are based on the results of a survey conducted within the Coordination, the MILESTONE study, current literature, and practitioner experiences. RESULTS: Appropriate reception after the transition of care and support arrangements are essential to optimize the effectiveness of the framework and prevent the risk of disengagement. This involves placing the young person at the center of care, actively engaging them in decision-making while integrating family and support networks. Clinical assessment addresses ADHD-related complications and co-occurrent disorders (e.g., mood, anxiety, personality, neurodevelopmental disorders), adaptive strategies, self-esteem, social skills, executive functions, emotional regulation, treatment adherence, and awareness of the disorder. Psychoeducation, cognitive-behavioral therapy, emotional regulation strategies, and cognitive remediation are advised, alongside functional adaptations such as school accommodations and student support programs. Integration of ADHD care pathways across pediatrics, psychiatry, addiction services, prison healthcare, and university services supports continuity of care, structured handovers, and access to multidisciplinary resources. DISCUSSION: The complexity of adolescence and emerging adulthood in individuals with ADHD necessitates an integrated approach that considers developmental, emotional, cognitive, and social dimensions. Early identification, continuity of care, and individualized interventions are key to improving long-term outcomes. Coordinating services across health, education, and social sectors strengthens the support system and reduces the risk of treatment discontinuity. Targeted training for adult care providers and structured transition pathways are critical to ensure the effective care. CONCLUSIONS: Comprehensive assessment and tailored interventions for adolescents and young adults with ADHD, combined with family involvement and structured care pathways are essential to facilitate a successful transition to adulthood. Existing or upcoming transition programs should be evaluated so that the most effective approaches can be replicated.
A naturalistic study on anaesthesia awareness during electroconvulsive therapy.
Rouvière C, Dumont R, Bulteau S … +2 more , Sauvaget A, Laurin A
Encephale · 2026 Apr · PMID 41956836 · Publisher ↗
INTRODUCTION: Electroconvulsive therapy (ECT) is a major non-pharmacological treatment performed under general anaesthesia for severe and/or treatment-resistant psychiatric disorders. While the effectiveness of ECT has b...
INTRODUCTION: Electroconvulsive therapy (ECT) is a major non-pharmacological treatment performed under general anaesthesia for severe and/or treatment-resistant psychiatric disorders. While the effectiveness of ECT has been well-demonstrated, the safety of the procedure remains a key clinical concern. Among the possible complications of general anaesthesia, anaesthesia awareness with recall (AAWR) is feared and can lead to serious psychological consequences. There is very little data on AAWR during ECT procedures. In this context, the main objective of our study was to assess the rate of AAWR during ECT procedures. METHOD: We conducted a retrospective observational study of the medical records for patients treated with ECT between 2020 and 2024 at the Nantes University Hospital Centre, France. RESULTS: Of the 4994 ECT sessions analysed, six AAWR events (1.2‰) were recorded. AAWR occurred during the consolidation phase in four patients, characterized by a feeling of paralysis during induction or awakening, and resulted in the discontinuation of ECT for two patients. Considering these findings, we propose an algorithm for detecting and managing AAWR during ECT treatment. CONCLUSION: ECT does not appear to present an increased risk of AAWR. Nonetheless it is important to systematically check for AAWR, make a report in the medical record, and provide effective therapies that exist for psychological trauma.
[Impact of physical activity and meditation on the clinical improvement of military personnel suffering from post-traumatic stress disorder: Focus on the role of attachment style and professional reintegration].
Eymond D, Miquel A, Duffaud A … +1 more , Trousselard M
Encephale · 2026 Apr · PMID 41951515 · Publisher ↗
INTRODUCTION: Military personnel are frequently exposed to traumatic situations that can lead to chronic post-traumatic stress disorder (PTSD). PTSD complicates their reintegration due to the high risk of retraumatizatio...
INTRODUCTION: Military personnel are frequently exposed to traumatic situations that can lead to chronic post-traumatic stress disorder (PTSD). PTSD complicates their reintegration due to the high risk of retraumatization. To support the reintegration of injured servicemen and women, the army has developed the Omega program which includes courses at the Centre des Blessés de l'Armée de Terre (CReBAT). These courses combine physical activity and reintegration workshops to which mindfulness meditation exercises have been integrated, notably through diving. The voluntary involvement of participants in this program relies on good adherence to the various workshops for post-course follow-up, which implies attachment abilities. OBJECTIVE: The aim of this study was to compare the effects of mindfulness diving (MD) with those of a multisport program (MS), mainly carried out in groups, on the clinical improvement of PTSD symptoms in military personnel with PTSD. The primary objective was to measure the impact of these two physical activities on specific PTSD symptoms. The secondary objective was to explore the role of attachment style on clinical impact and professional reintegration at one year after the course. METHOD: A controlled clinical trial was conducted with 60 military personnel suffering from PTSD, divided into two groups: CReBAT-MD and CReBAT-MS. Participants were included as they enrolled in the Omega program. Symptom severity (PCL5) was assessed at the beginning, at the end and at one to two months after the courses. Reintegration at one year was examined. Attachment style was also assessed at the start of the course to characterize all participants in two categories according to their Internal Operating Model (IOM): positive self-IOM or negative self-IOM. RESULTS: The results showed a slight improvement in PTSD symptoms in both groups (CReBAT-MD and CReBAT-MS) with no significant difference between them. Regarding reintegration at one year, no significant differences were found between the groups. However, positive effects were observed at one-two months after the course for the MS group, notably a reduction in intrusions (P<0.05) and avoidance symptoms (P<0.05). No difference was observed between subjects with positive and negative self-IOM in terms of overall clinical course, except for a trend towards improvement in negative cognitions and effects (P=0.08) for the negative self-IOM group. Nor was there any difference in terms of reintegration. CONCLUSION: The lack of marked clinical improvement may be explained by the chronic nature of PTSD in military personnel and certain methodological limitations of the study. However, in addition to physical activity, social support and group interactions could play a role in the improvement process. Individuals with a negative IOM of self appeared to benefit more from MS internships, suggesting that group physical activity could enhance self-image and social skills. Further research is needed to better understand the role of physical activity in the management of PTSD, particularly regarding its impact on social cognition and long-term reintegration.
Extracting common processes across psychotherapies through AI.
Vancappel A, Serres B, Bouyer C … +13 more , Saur R, Fourel E, Tapia G, Kosinski T, Carré A, Bortolon C, Marteau-Chasserieau F, Courtois R, Romo L, El-Hage W, Baeyens C, Morvan Y, Besche-Richard C
Encephale · 2026 Apr · PMID 41951514 · Publisher ↗
INTRODUCTION: Psychological treatments are effective in addressing mental disorders. However, they often remain confined within two primary limitations: diagnostic categories and theoretical frameworks. This study aimed...
INTRODUCTION: Psychological treatments are effective in addressing mental disorders. However, they often remain confined within two primary limitations: diagnostic categories and theoretical frameworks. This study aimed to investigate how artificial intelligence could help transcend these boundaries. METHOD: We recruited 125 psychotherapists. For each psychotherapeutic approach, we asked them to describe: (1) the proposed processes underlying psychopathology; (2) the techniques employed in treatment; and (3) potential factors contributing to resistance. RESULTS: By applying topic modeling techniques on the psychotherapists' discourse, we identified 30 topics related to psychopathological or psychotherapeutic processes (e.g., emotional regulation). Notably, none of these topics were exclusively associated with a single psychotherapeutic approach, suggesting that psychotherapies share common underlying processes. CONCLUSION: Artificial Intelligence techniques can help to identify shared processes across various psychotherapeutic approaches. This proof of concept suggests that further research utilizing these methods is warranted.
Oral language acquisition difficulties in patients with early-onset schizophrenia or bipolar disorder.
Khoury E, Lauferon C, Cohen A … +3 more , Delorme R, Hamadouche D, Ellul P
Encephale · 2026 Apr · PMID 41935922 · Publisher ↗
Schizophrenia and bipolar disorder are psychiatric conditions increasingly recognized as involving an underlying neurodevelopmental dimension, particularly in early-onset forms. Among neurodevelopmental disorders, langua...
Schizophrenia and bipolar disorder are psychiatric conditions increasingly recognized as involving an underlying neurodevelopmental dimension, particularly in early-onset forms. Among neurodevelopmental disorders, language disorders occupy a central place; yet, their specific association with schizophrenia and bipolar disorder remains insufficiently explored. This retrospective case-control study compared the prevalence of oral language acquisition difficulties among 92 hospitalized patients diagnosed with early-onset schizophrenia (n=52) or early-onset bipolar disorder (n=40). Clinical and developmental information was extracted from medical records, with particular attention to diagnoses of oral language disorder (characterized using standardized speech-language assessments) and Wechsler Verbal Comprehension Index scores. A non-significant trend towards a higher prevalence of oral language disorder was found in the early-onset schizophrenia group (38.5%) compared with early-onset bipolar disorder (22.5%). However, when only diagnoses established before the onset of psychiatric symptoms were considered, the difference became significant (32.7% vs. 10.0%; P=0.02), suggesting that language disorders may be more severe in early-onset schizophrenia and therefore more readily identifiable earlier in development. The early-onset schizophrenia group also exhibited significantly lower Verbal Comprehension Index scores and more childhood school difficulties. These findings support the hypothesis of a greater neurodevelopmental burden in early-onset schizophrenia, particularly regarding language development, and underscore the importance of early detection of oral language disorders to improve support and functional outcomes.
[The hearing with the "custody and liberty judge": How is it perceived by incarcerated people involuntary hospitalized?].
Watteau M, Eck M, Horn M … +3 more , Amad A, Wathelet M, Fovet T
Encephale · 2026 Mar · PMID 41839712 · Publisher ↗
BACKGROUND: In France, the judicial control of involuntary hospitalization by the "custody and liberty judge" (Juge des libertés et de la detention, JLD) is systematic. However, the way it is perceived by incarcerated in...
BACKGROUND: In France, the judicial control of involuntary hospitalization by the "custody and liberty judge" (Juge des libertés et de la detention, JLD) is systematic. However, the way it is perceived by incarcerated individuals' involuntary hospitalization in specially adapted hospital units (Unités hospitalières spécialement aménagées, UHSA) remains unknown. This study aimed to: (i) explore how incarcerated patients hospitalized in UHSA under involuntary psychiatric care experience and understand the JLD hearing; and (ii) compare these aspects based on the hearing format (videoconference vs. in-person). METHODS: We conducted a questionnaire-based survey at the Lille-Seclin UHSA during two periods: from January 14th, 2021 to May 2nd, 2021 (videoconference hearings) and from October 7th, 2021 to March 31st, 2022 (in-person hearings) among involuntarily hospitalized adult male patients. RESULTS: A total of 56 out of 68 eligible patients agreed to complete the questionnaire (response rate: 82%). Our results showed that people imprisoned and involuntary hospitalised were fairly satisfied with their hearing before the JLD and that they felt they understood the issues involved. Around 60% of respondents felt that they had been listened to by the JLD and that their rights had been respected during the hearing. However, 40% perceived that the hearing concerned their criminal status (whereas both systems are independent). No statistically significant differences were found between the "Videoconference" and "In-person" groups. CONCLUSION: Our findings suggest that incarcerated patients hospitalized under involuntary psychiatric care in UHSA are generally satisfied with the JLD hearing, regardless of whether it takes place via videoconference or in person. However, the hearing appears to blur the distinction between psychiatric care and the judicial process, an issue that healthcare professionals should address with particular attention.
Management of trauma-related nightmares in PTSD: Can doxazosin serve as a pragmatic alternative to prazosin?
Sipahimalani G, Roseau JB, Feingold D … +7 more , Remadi M, Lhermitte C, Houssany-Pissot S, Defontaine D, Gignoux-Froment F, Annette S, Saguin E
Encephale · 2026 Mar · PMID 41839711 · Publisher ↗
OBJECTIVES: Trauma-related nightmares (TRNs), core features of post-traumatic stress disorder (PTSD), partially or fully replicate the traumatic event and are often associated with nocturnal awakenings and significant em...
OBJECTIVES: Trauma-related nightmares (TRNs), core features of post-traumatic stress disorder (PTSD), partially or fully replicate the traumatic event and are often associated with nocturnal awakenings and significant emotional distress. In light of the imminent withdrawal of prazosin in France, this review explores the potential of doxazosin as a pharmacological alternative while emphasizing the central role of psychotherapeutic interventions in TRNs management. METHODS: Following a brief overview of TRNs and existing therapeutic strategies, both pharmacological and non-pharmacological, this review examines the available evidence on doxazosin, a selective α-adrenergic receptor antagonist, and proposes a practical initiation protocol for clinicians. RESULTS: Although limited and heterogeneous, the literature suggests that doxazosin may reduce the frequency and intensity of TRNs and improve sleep continuity, particularly in patients with marked adrenergic hyperactivation or those who previously responded to prazosin. Tolerance is generally good and extended-release formulations enable convenient nocturnal dosing. However, randomized controlled trials have produced mixed results due to small sample sizes, population heterogeneity, and comorbidities such as alcohol-related disorders. Across studies, psychotherapeutic interventions remain the most evidence-based and durable treatment for TRNs, and pharmacological options are best considered as adjuncts within an integrated care pathway. CONCLUSIONS: Doxazosin may represent a pragmatic pharmacological option for managing TRNs in PTSD, especially in the context of prazosin withdrawal. Its use should complement, rather than replace, first-line psychotherapeutic approaches and be integrated into a comprehensive, coordinated, and individualized treatment plan with careful monitoring of adverse effects. Larger, well-designed randomized controlled trials are needed to determine optimal dosing, treatment duration, and predictors of response.
To improve the diagnosis of autism spectrum disorder without intellectual impairment: A qualitative study among adults with the diagnosis and psychiatrists.
Cambier G, van der Hoeven J, Chaix G … +1 more , Dondé C
Encephale · 2026 Mar · PMID 41839710 · Publisher ↗
INTRODUCTION: Despite the evidence and expert opinion that many adults with autism spectrum disorder (ASD) face barriers to formal diagnosis, qualitative studies examining adult patients' experience and requirements for...
INTRODUCTION: Despite the evidence and expert opinion that many adults with autism spectrum disorder (ASD) face barriers to formal diagnosis, qualitative studies examining adult patients' experience and requirements for better access to the diagnosis are still lacking. AIMS: To qualitatively explore the pre-diagnosis experiences of adults with ASD, the impact of receiving a diagnosis, and the need for improved access to diagnosis both for adults with ASD and for adult psychiatrists. METHODS: Sixteen semi-structured interviews were conducted (11 adults diagnosed with ASD and 5 psychiatrists). A mixed deductive-inductive thematic analysis was employed. RESULTS: Several factors contributing to delayed diagnosis were identified including difficulties accessing healthcare, limited awareness of ASD among some clinicians, the use of camouflaging behaviors by participants, and family adaptation to their symptoms. Receiving a diagnosis was often described as a relief, allowing participants to understand past social difficulties and seek better acknowledgment and accommodation from their environment. The analysis highlighted the need to reduce wait times and service costs, as well as to enhance clinicians' knowledge of ASD to improve accessibility and satisfaction with diagnosis. Participants also noted the complex interplay between media portrayals of ASD and public understanding of the disorder. CONCLUSIONS: Increased education for mental health professionals and broader public awareness campaigns are necessary to facilitate timely access to appropriate diagnosis and support services.
Experience of the diagnostic journey for ADHD in adulthood: A quantitative and qualitative study.
Verwaerde O, Galera C, Bouvard M … +1 more , Briot K
Encephale · 2026 Mar · PMID 41833504 · Publisher ↗
INTRODUCTION: Attention deficit disorder with or without hyperactivity (ADHD) affects between 2% and 3% of the world's adult population. In France, there is a noticeable lack of understanding of adult ADHD, which is stil...
INTRODUCTION: Attention deficit disorder with or without hyperactivity (ADHD) affects between 2% and 3% of the world's adult population. In France, there is a noticeable lack of understanding of adult ADHD, which is still too often considered a childhood disorder and is sometimes the cause of a delayed diagnosis for these patients. METHOD: To assess the diagnostic experience of people diagnosed with ADHD during adulthood, we carried out a quantitative study with a self-questionnaire proposed to 201 patients aged 17 or over, as well as a qualitative study with 8 patient interviews. RESULTS: In our sample of respondents, 47% felt that they had had a difficult to very difficult diagnostic journey. Throughout the diagnostic process, patients diagnosed with ADHD in adulthood were confronted with various factors influencing their experience, some of which cannot be modified (age, gender, personal experiences, characteristics of the disorder, etc.), and some of which may have had an impact on the direction this process took. For the rest, the patient's surroundings and the encountered care providers played a major role in the patient's experience of the people around him/her and their beliefs, the patient him/herself, or the physicians met, and their responses and attitudes towards the patient. These factors were all evaluated in this study. Interview analysis of these patients' experiences reflected the serious consequences of misdiagnosis. Even though ADHD has been recognized and defined for many years, the persistence of controversy, beliefs and even misinformation, with disagreements sometimes even within the medical profession, have impacted the patient's journey. However, the diagnosis of ADHD, albeit later in life, is generally well accepted by patients who express relief from the guilt associated with their past experiences. This diagnosis also helps reduce the consumption of medical treatments, because of an adapted care, and represents a key for these patients to understand their own identity. CONCLUSION: The diagnostic journey for adult ADHD sufferers is long and difficult. Efforts to raise awareness of adult ADHD, both among medical staff and the general public, as well as the introduction of tools to help facilitate this diagnostic journey still need to be developed.
Onset of anxiety and mood disorders in French heavy cannabis users: The impact of parental separation/divorce.
Guillem E, Verneuil L, Baylé FJ
Encephale · 2026 Mar · PMID 41833503 · Publisher ↗
OBJECTIVES: Between 2004 and 2014 the cannabis clinic at Lariboisière Hospital in Paris received cannabis users seeking treatment. The objective was to identify what distinguishes (1) cannabis users with lifetime anxiety...
OBJECTIVES: Between 2004 and 2014 the cannabis clinic at Lariboisière Hospital in Paris received cannabis users seeking treatment. The objective was to identify what distinguishes (1) cannabis users with lifetime anxiety and/or mood disorders from users without such disorders, and (2) users according to the age of onset of cannabis use, the first anxiety disorder, and the first mood disorder. METHODS: Three hundred and forty-two heavy cannabis users were assessed for sociodemographic characteristics and addictive and psychiatric comorbidity (DSM-IV). RESULTS: Logistic regression analysis was carried out to distinguish cannabis users with comorbidity (n=234) from users without (n=71): women were more numerous (aOR=7.02; P<10), the number of criteria for past cannabis dependence was higher (aOR=1.43; P<10), and the users were older (OR=1.06; P=2×10). Latent class analysis identified three classes: C1 (50%) (age of onset of cannabis use preceded age of onset of anxiety and mood disorders); C2 (27.3%) (age of onset of mood and anxiety disorders preceded age of onset of cannabis use); C3 (22.7%) (age of onset of anxiety disorders preceded age of onset of cannabis use and onset of mood disorders). CONCLUSIONS: These three classes differ significantly in terms of lifetime anxiety disorder, lifetime social anxiety disorder, and parental separation/divorce rates: C1 (63.3%, 27.4%, 34.2%), C2 (82.8%, 50%, 41.7%), C3 (100%, 69.8%, 54.9%). Taking into account parental separation/divorce, and by extension adverse childhood experiences, is essential when studying the impact of the age of onset of cannabis use on the occurrence of anxiety and mood disorders.
Use of service and treatment adequacy in health students with depression.
Frajerman A, Chaumette B, Krebs MO … +1 more , Morvan Y
Encephale · 2026 Mar · PMID 41807141 · Publisher ↗
INTRODUCTION: Our study aimed to measure the prevalence of service use and adequate treatment in health students and to compare medical, dental and pharmacy specialties. METHODS: In 2021, we conducted a survey at Univers...
INTRODUCTION: Our study aimed to measure the prevalence of service use and adequate treatment in health students and to compare medical, dental and pharmacy specialties. METHODS: In 2021, we conducted a survey at Université Paris Cité for dental and pharmacy students. Data for medical students came from a national study conducted during the same period, using the same procedure. We used the Composite International Diagnostic Interview Short-Form (CIDI-SF) questionnaire to evaluate the presence of Major Depressive Disorder (MDD) in the last year. We asked the subjects if they had consulted health professionals or used pharmacotherapy for psychological problems in the previous year. RESULTS: Our sample comprised 1595 students, with very few dental students (N=76), few pharmacy students (N=187) and a vast majority of medical students. Among all students, 30% suffered from MDD, 31% used any pharmacological treatment, 16% anxiolytics, 9.5% hypnotics and 9% antidepressants. Among students with MDD, 33% received adequate treatment, including 30% recommended psychotherapy and 20% recommended pharmacological treatments. Pharmacy and preclinical students (medical students in year 2 or 3) consulted less often a psychiatrist and received less adequate treatment, recommended psychotherapy and recommended pharmacological treatments than the other students. DISCUSSION: In our study, we found a high prevalence of psychotropic use among health students but only 33% of students with MDD received adequate treatment. CONCLUSION: This underlines the need for better detection of psychiatric disorders in health students and improved treatment for them. Specific attention is needed for pharmacy students.
Mental health in physiotherapy students: A nationwide study.
Jacquot M, Lallement T, Colle R … +3 more , Jollant F, Corruble E, Frajerman A
Encephale · 2026 Mar · PMID 41807140 · Publisher ↗
INTRODUCTION: The prevalence of psychiatric disorders in young adults increased with the COVID-19 pandemic. The prevalence of mental disorders among physiotherapy students increased. Our study aimed to present the result...
INTRODUCTION: The prevalence of psychiatric disorders in young adults increased with the COVID-19 pandemic. The prevalence of mental disorders among physiotherapy students increased. Our study aimed to present the results on the mental health status of physiotherapy students in France since the COVID-19 pandemic. METHODS: An online cross-sectional survey was performed between October 1st 2023 and November 5th 2023. Anonymous questionnaires were sent to physiotherapy students via academic emails by all physiotherapy schools in France. We assessed the prevalence of depressive symptoms, generalised anxiety symptoms, burnout, eating disorder symptoms, 12-month major depressive disorder and 12-month suicidal ideation, humiliation, sexual harassment, and sexual assaults. Multivariate logistic regression was performed to identify factors associated with major depressive disorder and suicidal ideation. RESULTS: Among the 12,568 physiotherapy students, 1280 responded (response rate: 10.2%) and were included. The prevalences of depressive symptoms, anxiety symptoms, eating disorder symptoms, 12-month major depressive disorder, and 12-month suicidal ideation were 25%, 23%, 21%, 11% and 11%, respectively. Humiliation, sexual harassment and sexual aggression were reported by 19%, 1.8% and 0.7%, respectively. In multivariable analyses, curriculum year and sexual violence were associated with higher rates of major depressive episodes and suicidal ideation. CONCLUSION: This survey is the first to be carried out on French physiotherapy students at a distance from the peak of the COVID-19 pandemic. It revealed a high prevalence of various mental issues. The results of this survey highlighted the urgent need for action to improve the mental health of physiotherapy students in France.
Before patients with psychosis are placed in seclusion, organic causes must be ruled out.
Gama-Marques J, Finsterer J
Encephale · 2026 Mar · PMID 41807139 · Publisher ↗
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Effectiveness of hypnosis in adults with posttraumatic stress disorder (PTSD).
Thellier-Francois J, Binda D, Nicolier M … +5 more , Haffen E, Maillot MC, Pretalli JB, Martin E, Bennabi D
Encephale · 2026 Mar · PMID 41807138 · Publisher ↗
INTRODUCTION AND OBJECTIVES: Posttraumatic stress disorder is a common diagnosis in the French population. Current treatments are based on first-line trauma psychotherapies (CBT, exposure therapy, EMDR, and narrative the...
INTRODUCTION AND OBJECTIVES: Posttraumatic stress disorder is a common diagnosis in the French population. Current treatments are based on first-line trauma psychotherapies (CBT, exposure therapy, EMDR, and narrative therapy), accompanied by medication, particularly antidepressants. The role of hypnosis in the treatment of posttraumatic stress has been little studied and not yet defined in the literature, despite partially common dissociative processes between hypnosis and posttraumatic stress symptoms. METHOD: In our PRISMA systematic review, randomized or uncontrolled clinical trials were included from five databases (PubMed, Web of Science, Google Scholar, PsycInfo, PubPsy). RESULTS: The 12 articles selected are heterogeneous in terms of population characteristics and study design. The excessive heterogeneity of the studies required the following individual description of the results and hypnosis protocols for each study. DISCUSSION: A majority of the articles reported complete or partial effectiveness of hypnosis on posttraumatic symptoms and their progression, as well as an improvement in associated depressive and anxiety symptoms. The heterogeneity of methods raised questions about the criteria for assessing psychological trauma and its impact, hypnosis protocols, and the place of hypnosis among internationally recognized trauma therapies.
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