L'Encephale[JOURNAL]
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200 papers
Factor structure and psychometric properties of the French Versions of the Big Five Inventory-2 Short (BFI-2-S) and Extra-Short (BFI-2-XS) informant-report forms.
Lignier B, Petot JM, De Oliveira P … +6 more , Nicolas M, Canada B, Courtois R, John OP, Plaisant O, Soto CJ
Encephale · 2026 Feb · PMID 41760462 · Publisher ↗
OBJECTIVES: A growing body of research has recently highlighted that informant-report is a unique and too often neglected source of personality information. Several personality questionnaires have a form that can be fill...
OBJECTIVES: A growing body of research has recently highlighted that informant-report is a unique and too often neglected source of personality information. Several personality questionnaires have a form that can be filled out by informants, including the second version of the Big Five inventory (BFI-2), which uses 60 items to assess five major personality dimensions or domains and 15 facets. However, researchers sometimes need shorter questionnaires. The objective of this study was to verify the psychometric properties of the two short forms of the BFI-2 informant-report. METHODS: We asked 1445 students of psychology and sports science and technology to describe a person they know well, and we obtained the complete description of 1380 people. We used exploratory structural equation models to analyze the factor structure of the two sets of items making up the 30-item BFI-2-S, which provides the assessment of the "Big Five" domains and 15 facets (6 items per domain, 2 items per facet), and the 15-item BFI-2-XS which only provides the assessment of the Big Five. We assessed the psychometric properties of the scales measuring the big five domains using conventional indices, and the psychometric properties of the BFI-2-S facets based on the significance and magnitude of the observed and residual correlations between the two items of which they are composed. RESULTS: The analyses showed excellent fits to the data of the five-factor models. For both questionnaires, almost all items had a high loading on the expected factor, and the cross-loadings overall were small. The correlations between the factors were also small, which indicated discriminant validity. The correlations of the short form scales with the full BFI-2 scales were very large, including the facet scales of the BFI-2-S, indicating excellent concurrent validity. Multigroup analyses suggested differential functioning of certain items, but the magnitude of this bias was small to negligible and insufficient to explain differences according to the gender and age of the people described. DISCUSSION: The two short forms of the informant-report BFI-2 presented the expected factorial structure and had satisfactory psychometric properties. When the informants were students, they provided reliable and valid descriptions of older people, engaged in family, professional and social life and who often were not available to participate in personality studies. However, it is unknown whether this conclusion can generalize to less educated informants. CONCLUSION: The 30-item BFI-2-S and the 15-item BFI-2-XS informant-report forms provide a valid substitute for the full BFI-2 when external circumstances limit the time available for data collection, provided that it is possible to call on reliable informants.
Coprescription of antipsychotics and benzodiazepines at hospital discharge.
Demourgues M, Richaud A, Thiec J … +5 more , Debruyne AL, Guillemin S, Tournier M, Salvo F, Queuille E
Encephale · 2026 Feb · PMID 41708357 · Publisher ↗
INTRODUCTION: Antipsychotics and benzodiazepines (BZD) are known to increase the risk of sedation, dizziness, cognitive impairment and even confusion when used in combination because of their psycholeptic properties. Ant...
INTRODUCTION: Antipsychotics and benzodiazepines (BZD) are known to increase the risk of sedation, dizziness, cognitive impairment and even confusion when used in combination because of their psycholeptic properties. Antipsychotics and BZD coprescription should therefore be minor at discharge from a psychiatric hospital, especially for conventional sedative antipsychotics (CS-AP), such as cyamemazine, levomepromazine, or loxapine which are often used as adjunctive treatments like BZD. OBJECTIVES: The primary objective was to investigate the prevalence of prescription of CS-AP, long-term antipsychotics (LT-AP), and BZD among patients discharged from hospitalization in psychiatry. The secondary objective was to assess factors associated with CS-AP and BZD coprescription. MATERIAL AND METHODS: A retrospective study was conducted by collecting all discharge prescriptions from patients discharged from a psychiatric hospital in 2022 and 2023. To assess prevalence, antipsychotic and BZD use was registered when at least one medication from these classes was prescribed at discharge. Multivariate logistic regression analysis was used to assess factors associated with CS-AP and BZD coprescription. Sensitivity analyses were performed to corroborate our results. RESULTS: In total, 5,733 psychiatric stays were associated with prescribed medications at discharge, corresponding to 4,131 different patients. Mean age was 39.8 (±18.7) years. Women represented 56.3% of the studied population. The prevalence of psychotropic drugs on discharge prescriptions was 38.7% for CS-AP, 69.1% for LT-AP, and 48.3% for BZD. The most prescribed drugs, respectively for CS-AP, LT-AP, and BZD, were cyamemazine (24.3% of prescriptions), aripiprazole (16.2%), and diazepam (24.7%). Prevalence of CS-AP+BZD and CS-AP+LT-AP+BZD coprescriptions was respectively 14.8% and 10.1%. After adjustment for age, sex, mode of admission, length of stay class, and prescription of at least one LT-AP at discharge, the CS-AP+BZD coprescription at discharge was associated with two factors: length of hospital stay≤14 days and an initial admission to a psychiatric emergency department (aOR: 1.35, 95% CI [1.14; 1.59], and aOR: 1.23, 95% CI [1.05; 1.45], respectively). Sensitivity analyses showed a similar trend, although results were not always statistically significant. DISCUSSION: Our results highlight the importance of an effective hospital-to-community care transition to optimize psycholeptic treatments and minimize the risk of adverse drug reactions in outpatient settings. Cyamemazine was the most prescribed CS-AP at discharge, probably due to its anxiolytic properties. This trend raises concerns regarding its appropriateness when combined with other anxiolytic treatments, such as BZD. The association between CS-AP+BZD coprescription and length of stay<14 days shows that the short hospitalization may hinder proper adaptation of pharmacological treatments. The association between CS-AP+BZD coprescription and initial admission to a psychiatric emergency department may reflect insufficient re-evaluation of the coprescribed drugs probably introduced during acute crisis management. However, our study has several limitations, including reliance on our classification of CS-AP and BZD, and lack of data on key confounders such as diagnoses, seriousness of the acute episode, prior treatments, and post-discharge care. CONCLUSION: Prevalence of CS-AP with BZD is high at discharge from a psychiatric hospital, especially in patients with short hospital stays (≤14 days).
Alexithymia in patients with posttraumatic stress disorder: A meta-analysis.
Couette M, Cagnone V, Turc G … +3 more , Johnson S, Mouchabac S, Ferreri F
Encephale · 2026 Jun · PMID 41708356 · Publisher ↗
OBJECTIVES: Posttraumatic stress disorder (PTSD) is a psychiatric condition resulting from one or more traumatic events, characterized by behavioural and emotional disturbances. Alexithymia, the difficulty in identifying...
OBJECTIVES: Posttraumatic stress disorder (PTSD) is a psychiatric condition resulting from one or more traumatic events, characterized by behavioural and emotional disturbances. Alexithymia, the difficulty in identifying and describing internal emotions, is a significant comorbidity that can exacerbate PTSD symptoms but is often understated. This study aimed to estimate the prevalence of alexithymia in PTSD patients and explore associated factors and potential moderators. METHODS: We conducted a systematic review of the literature, querying three databases for studies on alexithymia in adults with PTSD. Meta-analyses were performed to assess the prevalence of alexithymia and explore its moderators. RESULTS: Thirty-six studies met the inclusion criteria. The pooled prevalence of alexithymia in PTSD patients was 53% (95% CI: 42-65%). The mean TAS score indicated a possible threshold for alexithymia (56.12, 95% CI: 50.77-61.48), with a significant difference in alexithymia scores between PTSD patients and trauma-exposed controls (SMD: 0.78, 95% CI: 0.22-1.34). PTSD severity was positively correlated with alexithymia, and alexithymia was significantly associated with dissociative symptoms. CONCLUSIONS: Alexithymia is a frequent and impactful comorbidity in PTSD, complicating its clinical picture and therapeutic management. The introspective difficulties associated with alexithymia hinder the effectiveness of traditional therapies, and its influence on body-related symptoms suggests that integrating Mind-Body approaches may improve treatment outcomes. Given the significant overlap between alexithymia, dissociation, and trauma exposure, a more tailored, nuanced treatment is needed to enhance emotional regulation and self-awareness in PTSD patients.
[The romande fidelity scale for early intervention in psychosis].
Alameda L, Conchon C, Sprüngli-Toffel É … +19 more , Curtis L, Meyer N, Edan A, Navarro AL, Devillé C, Armando M, Mebdouhi N, Gorgellino M, Favre G, Abrahamyan Empson L, Golay P, Vieira S, Cruz N, Solida A, Koller C, Greiser-Evain A, Khachouf TO, Cleusix M, Conus P
Encephale · 2026 Jun · PMID 41708355 · Publisher ↗
INTRODUCTION: The Early Intervention in Psychosis (EIP) model has become the "gold standard" for the treatment of young patients with emerging psychotic disorders. In Switzerland, however, the model remains insufficientl...
INTRODUCTION: The Early Intervention in Psychosis (EIP) model has become the "gold standard" for the treatment of young patients with emerging psychotic disorders. In Switzerland, however, the model remains insufficiently developed, and access to care varies substantially across regions. To establish a common language and a shared definition of EIP, a working group from the French-speaking Swiss cantons (Romand) developed the Romand Fidelity Scale for Early Intervention in Psychosis (EFRIPP) between 2023 and 2024. The EFRIPP was designed to: (i) define the essential criteria for establishing an EIP service adapted to the Romand context for centers wishing to implement this practice; (ii) prevent divergence from elements with proven scientific effectiveness; and (iii) create a harmonized tool for training new mental health professionals and supporting a concrete understanding of the EIP model. METHOD: A multidisciplinary group from the public psychiatric services of the Swiss cantons of Vaud, Neuchâtel, Geneva, Valais, Fribourg, and Jura met four times a year between 2023 and 2024 to develop the EFRIPP. The authors of this article are members of this group. The EFRIPP draws on several existing fidelity scales (UK, Denmark, Australia, Quebec) but are primarily based on the Quebec scale, given the cultural and linguistic proximity between Switzerland and Quebec. RESULTS: The EFRIPP is organized around a set of core EIP criteria, divided into three sections assessing: (i) the structure and organization of the EIP center; (ii) clinical modalities and processes; and (iii) support for practitioners. Overall, the EFRIPP includes 44 criteria: 30 rated continuously (1-5) and 14 rated dichotomously (0=absent; 1=present). À weighted scoring system yields a total score, categorized as "insufficient adherence" (0-100), "minimal adherence" (101-120), "acceptable adherence" (121-140), "good adherence" (141-160), or "excellent adherence" (161-176). CONCLUSION: We hope that this tool will help harmonize of EIP practices in French-speaking Switzerland and support their implementation across the cantons, so that young patients developing a psychotic disorder have access to the best possible care, regardless of where they live.
Habilitative and rehabilitative educational interventions as protective factors against cognitive decline in adults with Down syndrome: A retrospective study.
Recupero M, Zagaria T, Elia F … +7 more , Grasso M, Caraci F, Barone C, Greco D, Ferri R, Serretti A, Buono S
Encephale · 2026 Feb · PMID 41708354 · Publisher ↗
BACKGROUND AND OBJECTIVES: Adults with Down syndrome (DS) face a markedly elevated risk of Alzheimer's disease (AD), yet modifiable environmental factors that modulate cognitive decline remain under-explored. We aimed to...
BACKGROUND AND OBJECTIVES: Adults with Down syndrome (DS) face a markedly elevated risk of Alzheimer's disease (AD), yet modifiable environmental factors that modulate cognitive decline remain under-explored. We aimed to determine whether formal education and lifelong habilitative/rehabilitative educational interventions (HREI) preserve neuropsychological functioning in DS. METHODS: We retrospectively reviewed records of 50 adults with DS (median=41 years). Global cognition and seven Test for Severe Impairment (TSI) domains were compared between individuals with dementia (n=25) and matched controls without dementia (n=25). Participants were further stratified by schooling (0-5 vs. 8-13years) and HREI exposure/duration. RESULTS: The dementia group performed significantly worse in praxis, language comprehension, immediate memory, general knowledge, conceptualisation and total TSI score (P<0.01). Within this group,≥8years of schooling and HREI exposure were each associated with higher global cognition and superior performance across up to five domains; no benefit was evident when interventions ceased after age 18. Schooling and HREI did not differentiate participants without dementia. CONCLUSION: Formal education and sustained HREI appear to confer cognitive reserve in DS, attenuating AD-related decline. These findings support policies that guarantee educational inclusion and lifelong, structured cognitive-motor enrichment for individuals with DS. Prospective larger-scale studies are warranted to delineate optimal dosage and timing of enrichment programmes in DS.
Psychological sequalae of patients experiencing aborted sudden cardiac death and their relatives.
Banos A, Bouteiller XP, Beneyto M … +5 more , Duchateau J, Rousseau C, Tixier R, André C, Sacher F
Encephale · 2026 Jan · PMID 41571537 · Publisher ↗
AIM: Sudden cardiac death occurs mainly outside of the hospital, placing witnesses in a pivotal role to intervene and enhance the survival. We aim to investigate its potential psychological repercussions on both the pati...
AIM: Sudden cardiac death occurs mainly outside of the hospital, placing witnesses in a pivotal role to intervene and enhance the survival. We aim to investigate its potential psychological repercussions on both the patient and the witness. OUTCOMES: Incidence of acute stress disorder and/or post-traumatic stress disorder among patients and their relatives at 3 and 6 months following sudden cardiac death. METHODS: All patients admitted for resuscitated sudden cardiac death at our institution between 2019 to 2021 were screened. Within 15 days following resuscitated sudden cardiac death, both the patients and one of their relatives underwent face-to-face interviews with dedicated questionnaires. At 3-6 months post-event, participants were contacted by phone to complete the questionnaires. RESULTS: Twenty-two patients (6 females, 51±11yo) and 23 relatives (13 females, 49±15yo) were included. The reason for sudden cardiac death was ischemic (n=9/22) or dilated cardiomyopathies (n=5/22), idiopathic ventricular fibrillation (n=4/22) or others (4/22). Relatives exhibited a higher magnitude of acute stress compared to patients (26±25 vs 48±20, P<0.001). Five persons were lost to follow-up (2 patients and 3 relatives). Nevertheless, 4/20 (20%) patients and 3/20 (15%) relatives were diagnosed with post-traumatic stress disorder. CONCLUSIONS: Post-traumatic stress disorder in patients/relatives is frequent after resuscitated sudden cardiac death (20 to 15%). It is crucial to maintain close vigilance since patients remain susceptible to the future onset of post-traumatic stress disorder, even when they manifest milder symptoms of acute stress. Offering early interventions for relatives may serve as a preventive measure.
Experience of patients suffering from insomnia with a focus on their perceptions and therapeutic journey.
Royant-Parola S, Poirot I, Geoffroy PA
Encephale · 2026 Jun · PMID 41571536 · Publisher ↗
OBJECTIVES: This survey explores the experience of French patients suffering from insomnia disorder, focusing on their perception of the disorder and their therapeutic journey to identify gaps in their care pathway. The...
OBJECTIVES: This survey explores the experience of French patients suffering from insomnia disorder, focusing on their perception of the disorder and their therapeutic journey to identify gaps in their care pathway. The main objectives included assessing the impact of insomnia disorder on daily life, well-being, and awareness of treatment options. METHODS: The survey was performed at the end of 2022 and included 150 French patients aged 35 to 65years suffering from chronic insomnia disorder according to the DSM-5 criteria. Participants were recruited from a national online panel managed by IPSOS via an electronic pre-screening questionnaire (community/non-hospital setting). A 20-item questionnaire was used to assess perception of sleep, the impact of insomnia symptoms, and views on the therapeutic options proposed to them. RESULTS: Seventy-one percent of respondents with clinical insomnia associated "good quality sleep" with uninterrupted sleep and feeling refreshed in the morning. Mental stress and having an overactive brain were perceived as the main factors contributing to insomnia for 73% and 38% of clinical insomnia patients, respectively. Insomnia disorder significantly impacted patients' daily functioning, with many reporting difficulties in work performance (61%), poor concentration (73%), and anxiety (39%). A large portion of respondents also expressed concerns over forgetfulness (53%) and diminished social and emotional well-being (up to 67%). Although multiple diagnostic and therapeutic guidelines exist for insomnia treatment, only 19% of participants received educational support, and 79% had never been referred for cognitive behavioral therapy for insomnia (CBT-I), considered to be the first-line treatment. Most patients (79%) would like to have access to more educational content about insomnia. CONCLUSION: This survey highlights the substantial impact of insomnia disorder on patients' lives, extending beyond sleep quality to affect overall well-being and work performance. It points toward important gaps in current treatment practices, especially non-pharmacological approaches. Improving clinicians' awareness of evidence-based approaches and resources is key to improved insomnia disorder care and patient outcomes.
Effects of a psychoeducation program for relatives of patients with first-episode psychosis who have received psychoeducation: An observational study.
Bouchez M, Andreou Y, Martin J … +4 more , Vachet V, Franck N, Endomba FT, Chauvet-Gelinier JC
Encephale · 2026 Jun · PMID 41571535 · Publisher ↗
OBJECTIVES: The aim of this study was to examine the relationship between psychoeducation for relatives (PER) following a first-episode psychosis (FEP), as well as the impact of this PER on the mental health of these rel...
OBJECTIVES: The aim of this study was to examine the relationship between psychoeducation for relatives (PER) following a first-episode psychosis (FEP), as well as the impact of this PER on the mental health of these relatives. METHODS: We conducted an observational study of patients who experienced a FEP and underwent psychoeducation (PE) about it (FEP - PE). We divided the sample into two groups according to the achievement of PER. The assessment of post-FEP outcome was based on subsequent diagnosis of schizophrenia, bipolar disorder, schizoaffective disorder, or major depressive episode, as well as subsequent hospitalization in a mental health unit. Mental health of relatives was assessed using the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory Form Y (STAI-Y1 and 2), and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). RESULTS: We enrolled 51 patients, 28 of whom had at least one relative who had benefited from PER. We found no significant association between PER and outcome after FEP. We found a positive and significant effect of PER on relatives' anxiety. The effect on depressive symptoms and well-being was positive but not significant. CONCLUSIONS: This study found promising results regarding the psychological impact of PE for relatives of patients with an FEP but no significant impact on the evolution of the FEP. This work suggests the extension of PE to improve the mental health of relatives and further studies regarding the effect on the evolution of FEP.
Postpartum catatonic syndrome with complete remission in less than 24hours: A case report.
Dao V, Todorov L, Cordina A … +3 more , Faurent M, Haroche A, Pham-Scottez A
Encephale · 2026 Jun · PMID 41571534 · Publisher ↗
Abstract loading — click title to view on PubMed.
Violence and aggressiveness in borderline disorder: A systematic review.
Gaudin M, Garrivet J, Kazour F … +1 more , Gohier B
Encephale · 2026 Apr · PMID 41571533 · Publisher ↗
INTRODUCTION: Borderline Personality Disorder (BPD) affects 1 to 3% of the general population and up to 20% of psychiatric inpatients. It is characterized by emotional dysregulation, impaired interpersonal relationships,...
INTRODUCTION: Borderline Personality Disorder (BPD) affects 1 to 3% of the general population and up to 20% of psychiatric inpatients. It is characterized by emotional dysregulation, impaired interpersonal relationships, and impulsive behaviors. This systematic review aims to identify psychopathological mechanisms, comorbidities, and gender differences associated with violence in BPD. METHODS: This review followed PRISMA guidelines and included studies published in English or French with no time restriction. Literature searches were conducted in PubMed and Ovid using the search equation: ((violence [MeSH Terms]) or (aggression [MeSH Terms])) and (borderline personality disorder [MeSH Terms]) and (psychiatry). Of 502 initial publications, 28 were included in the final analysis. RESULTS: Aggressiveness in BPD was found to be associated with emotional dysregulation and impulsivity, influencing violent behaviors (β=0.25 to 0.52). Comorbidities such as bipolar disorder, substance use, or co-occurring personality disorders exacerbated aggression (OR=2.1 to 3.2). Suicidal and self-harming behaviors affected 78% of adolescents and 73% of adults with BPD. Women accounted for 75% of BPD diagnoses and presented more self-directed aggression (suicide, self-harm), whereas men more frequently exhibited outwardly directed aggression. Finally, childhood trauma and dysfunctional family environments were seen as major predictors of aggressive and suicidal behaviors in adulthood (OR=3.9 to 5.8). CONCLUSION: Findings highlighted the central role of emotional dysregulation, impulsivity, and early trauma in BPD-related aggression. Clinical implications include the need for targeted therapies (e.g., DBT, MBT), early screening for trauma, and gender-sensitive approaches. This review underscores the interaction between biological, psychological, and social factors in BPD-associated violence and calls for personalized interventions and the integration of longitudinal research designs.
French psychiatrists' perspectives on proposed medical aid in dying legislation.
Olie E, Courtet P
Encephale · 2026 Jan · PMID 41565559 · Publisher ↗
INTRODUCTION: France is poised to legalize Medical Aid in Dying (MAiD). Such a law may have potential implications for mental healthcare. METHODS: We conducted an anonymous survey of 168 French psychiatrists between June...
INTRODUCTION: France is poised to legalize Medical Aid in Dying (MAiD). Such a law may have potential implications for mental healthcare. METHODS: We conducted an anonymous survey of 168 French psychiatrists between June and July 2024 to assess familiarity with the proposed law, willingness to participate in MAiD, and perceived ethical implications. RESULTS: Eighteen percent of psychiatrists were unaware of the draft law, while only 9% had precise knowledge. Thirty-seven percent expressed a willingness to participate in MAiD for their patients. Concerns emerged around differentiating rational end-of-life requests from suicidal ideation driven by potentially treatable mental disorders such as depression. DISCUSSION: The absence of psychiatric assessment in the proposed legislation raises ethical and clinical dilemmas, particularly given the high prevalence of underdiagnosed depression in severe medical conditions. Psychiatrists find themselves balancing suicide-prevention mandates with respect for patient autonomy.
General practitioners' choices when starting treatment for major depression: Update of Dusmenil et al. survey (2012) in view of new mental health devices.
Arderiu S, Prébois S, Lapeyre-Mestre M
Encephale · 2026 Jan · PMID 41565558 · Publisher ↗
INTRODUCTION AND OBJECTIVES: A 2011 study on general practitioners' (GP) management of major depressive disorders (MDD) revealed limited treatment options, predominantly pharmacotherapy. Since then, France has implemente...
INTRODUCTION AND OBJECTIVES: A 2011 study on general practitioners' (GP) management of major depressive disorders (MDD) revealed limited treatment options, predominantly pharmacotherapy. Since then, France has implemented mental health initiatives, including "Mon Soutien Psy", covering up to 12 psychologist sessions by health insurance (8 during our study). The program "Dispositif de Soins Partagés en Psychiatrie" (DSPP) is a specific scheme implemented in the Occitanie region (South of France) with the aim of improving collaboration between psychiatrists and GPs at a local level. The aim of this study was to investigate MDD care management in primary care according to the implementation of these new schemes. METHODS: We reused the 2011 case vignette survey, adding items related to new schemes. The survey was done by means of electronic-questionnaires sent to GPs by the regional Union of Health professionals in three different French administrative areas (Bouches-du-Rhône and Ille-et-Vilaine, with "Mon Soutien Psy", and Haute-Garonne for the DSPP). RESULTS: In total, 158 GPs completed the survey - 69.0% from Haute-Garonne - for a total response rate of 3.4%. Compared with the 2011 survey, there was a significant increase in the number of GPs managing patients in collaboration with a specialist (6.3 versus 3.3%; P<0.05) and assessing the situation before prescribing an antidepressant (44.2 versus 10.7%; P<0.00001). GPs were mostly from Haute-Garonne (DSPP area). Attitudes towards psychotherapies had improved since 2011, though some misconceptions persisted. Barriers were no longer the reimbursement or the patient's reluctance to undergo psychotherapy but rather the overly long wait to get an appointment. Overall, MDD management in primary care aligned more closely with the guidelines. CONCLUSION: Results indicate positive trends: GPs show greater adherence to MDD management guidelines and a willingness to consult specialists while handling cases independently. Nonetheless, further improvements are necessary with larger studies needed for validation. Recent mental health programs likely contributed to these advancements.
Clinical and sociodemographic characteristics of patients with heart failure and schizophrenia or psychotic disorder in France.
Dalfin W, Bannay A, Baillot S … +2 more , Laprévote V, Dobre D
Encephale · 2026 Jan · PMID 41565557 · Publisher ↗
OBJECTIVES: To assess the clinical and socio-demographic characteristics of patients hospitalized for heart failure (HF) with schizophrenia or psychotic disorder comorbidity. METHOD: We conducted an observational study f...
OBJECTIVES: To assess the clinical and socio-demographic characteristics of patients hospitalized for heart failure (HF) with schizophrenia or psychotic disorder comorbidity. METHOD: We conducted an observational study from the national French PMSI database. We included patients hospitalized with a principal diagnosis of HF between 2019 and 2023, with and without a secondary diagnosis of schizophrenia or psychotic disorder. In total, we included 693,398 HF patients, 7368 with and 686,030 without schizophrenia or psychotic disorder. RESULTS: Men with HF and schizophrenia or psychotic disorder were on average eight years younger (69.9 vs. 77.8 years), and women were four years younger (79.4 vs. 83.6 years) than men and women without this comorbidity. Overall, HF patients with schizophrenia or psychotic disorder were more often women (57.9 vs. 49.9%) and had a higher prevalence of obesity (29.9 vs. 22.6%), chronic obstructive pulmonary disease (19.6 vs. 14.2%), and stroke (12.6 vs. 10%). The length of stay was longer in patients with schizophrenia (11.7 vs. 10.2 days). Men with HF and schizophrenia or psychotic disorder were on average ten years younger than women with this pathology (69.9 vs. 79.4 years) and had a higher prevalence of myocardial infarction (13.7 vs. 8.3%). CONCLUSION: Patients with HF and schizophrenia or psychotic disorder are younger than HF patients without this comorbidity. Despite the younger age, patients with schizophrenia or psychotic disorder have a higher burden of comorbidities and a longer length of stay. Patients with schizophrenia or psychotic disorder, especially men, need close follow-up to prevent the early occurrence of HF.
Evolving electroconvulsive therapy practices at a French psychiatric hospital: A retrospective study.
Zrelli M, Souabni K, De Maricourt P … +8 more , Amagat M, Gaillard R, Smadja S, Vinckier F, Tomberli F, Mazeraud A, Domenech P, Chalah MA
Encephale · 2026 Jun · PMID 41423391 · Publisher ↗
INTRODUCTION: Electroconvulsive therapy (ECT) is an effective and widely used treatment for managing severe and/or resistant psychiatric disorders. Historically, the bitemporal setup (BT) and the age-based dosing method...
INTRODUCTION: Electroconvulsive therapy (ECT) is an effective and widely used treatment for managing severe and/or resistant psychiatric disorders. Historically, the bitemporal setup (BT) and the age-based dosing method (ABM) have been the most common approaches. However, more recent practices, including the titration method (TM), right unilateral (RUL) electrode placement, and pulse width reduction, appear to have comparable efficacy and better tolerability. The primary objective of this study was to evaluate clinical outcomes before and after the implementation of these new practices at Sainte-Anne Hospital (GHU psychiatrie & neurosciences), the largest psychiatric hospital in Paris, France. METHOD: This retrospective study included adult patients who underwent an acute course of ECT between December 2022 and May 2024. Clinical and sociodemographic data, stimulation parameters (electrodes placement, ABM vs. TM, charge difference between first and last session), and seizure characteristics (seizure duration and postictal suppression during first and last session) were collected from medical records. Data were compared and analyzed before and after the implementation of the new practices and according to the dosing method (ABM vs. TM). For treatments with TM the administered charge determined by the TM was also compared with the theoretical charge determined by ABM. As not all data followed a normal distribution, comparisons of quantitative data were made using the Mann-Whitney or Kruskal-Wallis test. Categorical data were compared using Chi test. RESULTS: Data from 75 patients were included, of whom 72 completed the course of ECT and were included in the analysis of efficacy and tolerability. Compared with the previous practices, the new practices resulted in a significant reduction in charge increase between the first and the last session (P<0.01) and a trend toward less frequently perceived memory disturbances (-21%, P<0.10), with no significant differences in sociodemographic data or seizure characteristics (P>0.05). There was a trend towards more full responders with the new practices (+15%), albeit the difference was statistically non-significant. Compared with ABM, TM resulted in a significant reduction in charge difference (P<0.001) and a trend toward less perceived memory disturbances (-23%, P<0.10) with no significant differences in other variables (P>0.05). In patients who received ECT with the TM, the administered charge was significantly lower than the theoretical charge (P<0.01). CONCLUSION: The new ECT practices improve tolerability, especially regarding memory, while maintaining clinical efficacy by using reduced electrical charges. These findings highlight the importance of personalizing ECT protocols to optimize tolerability without compromising efficacy.
The French version of the Exercise in Mental Illness Questionnaire (EMIQ-Fr): Translation, cross-cultural validation and psychometric properties.
Tecco JM, Romain AJ, Stanton R … +5 more , Philippot A, Khazaal Y, Dan B, Petzold MB, Vancampfort D
Encephale · 2026 Jun · PMID 41423390 · Publisher ↗
OBJECTIVE: Exercise offers trans-diagnostically numerous mental health benefits. Mental health professionals play a crucial role in prescribing exercise to their patients. However, there is limited research on exercise p...
OBJECTIVE: Exercise offers trans-diagnostically numerous mental health benefits. Mental health professionals play a crucial role in prescribing exercise to their patients. However, there is limited research on exercise prescription behavior among French-speaking mental health professionals. This study aimed to translate the Exercise in Mental Illness Questionnaire (EMIQ-HP) into French, validate it cross-culturally and evaluate the psychometric properties of the translated version. METHODS: We followed guidelines for the cross-cultural adaptation of self-rating questionnaires to translate the EMIQ-HP and tested its 7-day test-retest reliability in a sample of 46 French-speaking Belgian mental health professionals. Reliability was assessed using intra-class correlations (ICC) and Cohen's kappa (κ). RESULTS: The items and scales of the French version of the questionnaire (EMIQ-Fr) demonstrated ICCs ranging from 0.41 to 0.77 and κ values from 0.42 to 0.71, with all items exhibiting either moderate (≥0.41) to substantial (≥0.61) 7-day test-retest reliability. ICCs for subscales ranged from 0.44 to 0.84 with scales exhibiting either moderate (≥0.41) to almost perfect (≥0.81) 7-day test-retest reliability. CONCLUSIONS: The EMIQ-Fr is the first standardized French language questionnaire designed to assess mental health professionals' views on exercise in mental disorders. Its application in future research could enhance our understanding and support of patients with mental disorders in achieving or maintaining health-beneficial levels of exercise.
[Involuntary care: From dangerousness to risk assessment].
Oswald P, Pham T
Encephale · 2025 Dec · PMID 41421873 · Publisher ↗
OBJECTIVE: To explore the limitations of psychiatric dangerousness assessments in Belgium, France, the UK, and the Netherlands, and to assess whether systematic and structured risk assessment, supported by enhanced foren...
OBJECTIVE: To explore the limitations of psychiatric dangerousness assessments in Belgium, France, the UK, and the Netherlands, and to assess whether systematic and structured risk assessment, supported by enhanced forensic psychiatry skills and interdisciplinarity, could improve involuntary care decisions. METHODS: Comparative analysis of legislative frameworks (Belgian law of 26 June 1990, amended in 2024; French Public Health Code; Mental Health Act 1983; Compulsory Mental Health Care Act 2020; Wet verplichte geestelijke gezondheidszorg 2020) and assessment practices based on literature and statistical data. RESULTS: Compulsory measures have been strongly increasing in Belgium, France, the UK, and the Netherlands for over a decade. Subjective dangerousness assessments, based on vague legal criteria not recently revised, show significant variability in Belgium and France where structured tools are absent, unlike the UK and the Netherlands which are developing initiatives around risk assessment, notably with the HCR-20 V3 to structure decisions. These tools demonstrate validated predictive accuracy but would require essential training for implementation. CONCLUSIONS: Implementing structured tools, combined with interdisciplinary and forensic psychiatry training inspired by the Nixon line, could reduce subjective biases, stigma, and trauma pending studies confirming their effectiveness.
Abnormal Child Behavior in primary school students: A Bayesian network analysis.
Till AC, Henry TR, Scutari M … +1 more , Briganti G
Encephale · 2026 Jun · PMID 41421872 · Publisher ↗
The Conners Teacher Rating Scale revised: short (CTRS-R: S) is a widely used psychometric instrument to screen for Attention Deficit and Hyperactivity Disorder (ADHD) as well as a broader construct of abnormal child beha...
The Conners Teacher Rating Scale revised: short (CTRS-R: S) is a widely used psychometric instrument to screen for Attention Deficit and Hyperactivity Disorder (ADHD) as well as a broader construct of abnormal child behavior. In this study, we aimed to examine the network structure of abnormal child behavior using the CTRS-R: S in a sample of 525 French-speaking primary school students from Belgium. We employed Bayesian network analysis to estimate both the 28-item network and the network with the 8 items with the highest strength centrality, using the PC algorithm and bootstrapping to estimate the figures. Our study uncovered associations between inattention symptoms and learning disorders, shedding new light on the complexity of abnormal child behavior. We also identified different network structures, revealing a fresh perspective on the underlying mechanisms of these conditions. Our findings, though preliminary, are consistent with previous research and add to the burgeoning literature on Bayesian network analysis in abnormal child behavior research. Overall, our study underscores the complexity of the construct of abnormal child behavior and the importance of considering multiple factors in screening and diagnosis, emphasizing the need for a comprehensive approach to understanding and treating these disorders.
[High-security prisons: How far is it possible to care people in prison?].
Fovet T, Eck M, Carton B … +7 more , Fédèle M, Lacambre M, Moncany AH, Paulet C, Senon JL, Thomas P, Giravalli P
Encephale · 2025 Dec · PMID 41421871 · Publisher ↗
In March 2025 the French Minister of Justice announced that, beginning at the end of July 2025, the prisons of Vendin-le-Vieil and Condé-sur-Sarthe would host approximately 200 individuals convicted of drug trafficking w...
In March 2025 the French Minister of Justice announced that, beginning at the end of July 2025, the prisons of Vendin-le-Vieil and Condé-sur-Sarthe would host approximately 200 individuals convicted of drug trafficking within newly established units specifically designed to address organized crime. Incarceration conditions in these high-security facilities will be extremely strict, with the explicit goal of severing incarcerated people's contact with the outside world. The detrimental effects of solitary confinement on incarcerated people's health are well-documented, and numerous international conventions and treaties stipulate that such measures should be used only in exceptional circumstances, as a last resort, and for the shortest time possible. This article examines the role of healthcare professionals within these high-security units. To what extent can the principle of equivalence of care - according to which incarcerated individuals must receive healthcare equivalent to that provided to the general population - be upheld in this context? We address the issue of the ethical responsibility of healthcare professionals working in facilities where conditions of incarceration are known to have deleterious effects on the health of incarcerated individuals.
Interoceptive patterns and alexithymia in adolescents with anorexia nervosa.
Lahaye H, Heniquez A, Tual C … +2 more , Garny de la Riviere S, Benarous X
Encephale · 2026 Jun · PMID 41421870 · Publisher ↗
INTRODUCTION: Alexithymia is a central concept in understanding the psychological vulnerability to eating disorders. Associations between alexithymia and distinct components of interoception have previously been reported...
INTRODUCTION: Alexithymia is a central concept in understanding the psychological vulnerability to eating disorders. Associations between alexithymia and distinct components of interoception have previously been reported in healthy individuals and those with mental health problems. From a therapeutic perspective, it is important to determine whether such associations exist for adolescents with anorexia nervosa and which domains of interoception (i.e., accuracy [IAc], awareness [IAw], and sensibility [ISe]) are concerned. METHOD: A cross-sectional study was conducted on twenty 12-17-year-old hospitalized adolescent girls with restrictive anorexia nervosa (M=14years±1.59, mean BMI of 15.59). The heartbeat detection task (HBDT) assessed IAc and IAw. The Porges Body Perception Questionnaire (PBPQ) was used for ISe, the Children-Toronto Alexithymia Scale (CTAS) for alexithymia, alongside the Child Depressive Inventory (CDI) for depression, the ECAP for anxiety, and the Difficulties in Emotion Regulation Scale-Youth scale (DERS-Y) for emotional dysregulation. RESULTS: The error rate at the HBDT was negatively correlated with the CTAS sub score "Externally-oriented thinking" but no other CTAS sub scores or other clinical dimensions. The association between IAw and the CTAS sub-score "Externally-oriented thinking" failed to remain significant after Bonferroni correction. The PBPQ total score was positively correlated with the CDI total score and the ECAP fear sub score. CONCLUSION: Among adolescents hospitalized for anorexia nervosa, the more accurate the detection of heart rate, the more frequently operative thinking was reported, while a high level of ISe was associated with anxiety and depression-related symptoms. The mechanisms underlying the relation between the discrimination of body perception and emotional processing may vary across psychiatric disorders.
The fabric of mood in mania co-occurring with substance use.
Fares C
Encephale · 2025 Dec · PMID 41421869 · Publisher ↗
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