BACKGROUND: The interpersonal theory of suicide emphasizes the importance of a sense of belonging and hypothesizes that finding meaning in life reduces suicidal behavior. The Meaning of Life Questionnaire (MLQ) is widely...BACKGROUND: The interpersonal theory of suicide emphasizes the importance of a sense of belonging and hypothesizes that finding meaning in life reduces suicidal behavior. The Meaning of Life Questionnaire (MLQ) is widely used internationally to assess this relationship to meaning. Despite its popularity, it lacks a validated French version, limiting its application in French-speaking populations. This absence hinders research on meaning in life and suicide prevention in these populations. AIMS: This study aimed to translate and adapt the MLQ into the French language in a population of psychiatric emergency patients. METHODS: The translated questionnaire was administered to 119 participants admitted consecutively to a crisis center, and psychometric analyses were carried out according to classical test and item response theories. RESULTS: Factor analysis confirmed the two-dimensional structure: presence and search for meaning. Internal consistency was good, with Cronbach's coefficients of 0.90 and 0.82, respectively. The fit to the IRT model was also good (Person Separation Index of 1.66 and 1.52, and Reliability Index of 0.73 and 0.70, respectively). Comparisons between groups confirmed good discriminatory power, with higher scores among patients admitted for suicide attempt. CONCLUSION: The French version of the MLQ, considering its brevity, demonstrated satisfactory psychometric properties, a major asset for its potential use in clinical practice.
AIM: The aim of the present study was to assess the Odor Hedonic Profile (OHP) to evaluate its sensitivity in relation to the level of depression. METHOD: The self-rating tool (OHP) related to everyday odors and recently...AIM: The aim of the present study was to assess the Odor Hedonic Profile (OHP) to evaluate its sensitivity in relation to the level of depression. METHOD: The self-rating tool (OHP) related to everyday odors and recently validated in the general population is based on hedonic estimation without olfactory stimulation to avoid bias linked to odorant properties and experimental protocols. OHP scores in a population with a major depressive episode were compared to a non-depressed control population and a population with a moderate depressive state. RESULTS: The results showed significant differences in OHP scores depending on the group of participants (depressed, moderately depressed, and control). The results also showed that significant differences in OHP scores are related to sex. In addition, the results showed that OHP scores were correlated with levels of depression, anxiety and pleasure experienced. Finally, the group of depressed participants showed more conservative and negative aliesthesia profiles than moderately depressed and non-depressed control participants. DISCUSSION: This study shows that OHP can be used in different populations, especially in diseases with mood/emotional disturbances such as depression.
INTRODUCTION: The body satisfaction and global self-perception questionnaire could be related to questionnaires measuring well-being. The first objective of this work was to complete the validation of the body satisfacti...INTRODUCTION: The body satisfaction and global self-perception questionnaire could be related to questionnaires measuring well-being. The first objective of this work was to complete the validation of the body satisfaction and global self-perception questionnaire by searching for underlying concepts using principal component analysis. The second was to validate the questionnaire externally, by studying correlations with several other questionnaires. METHOD: In this study, we used several samples. For internal validation by factorial analysis, we used two groups: a "non-clinical" and a "clinical" group. For external validation, we studied correlations with several other questionnaires measuring positive and negative components of perceived well-being in the "non-clinical" group. RESULTS: Four factors: Body flourishing, Mental radiance, Vigor and Serenity were highlighted, and a good external validity was measured. High links with questionnaires that measure positive dimensions of well-being and low for those that measure negative dimensions appeared in the correlations between these questionnaires. CONCLUSIONS: This study made it possible to complete the validation of the body satisfaction and global self-perception questionnaire. The originality of this questionnaire is that it simultaneously measures both positive and negative components of well-being. It could thus be proposed to evaluate any type of treatment by measuring the resulting increase in well-being.
Physical activity is increasingly recognized not only for its physical benefits but also for its profound impact on brain health. We reviewed the effects of exercise on mood and cognition with a particular focus on the u...Physical activity is increasingly recognized not only for its physical benefits but also for its profound impact on brain health. We reviewed the effects of exercise on mood and cognition with a particular focus on the underlying biological mechanisms, notably brain-derived neurotrophic factor (BDNF) and neuroplasticity. Emerging evidence indicated that exercise, particularly aerobic activity, elevates BDNF levels in key brain regions such as the hippocampus, fostering neurogenesis and synaptogenesis. These processes contribute to improved emotional regulation, alleviating symptoms of depression and anxiety, while also enhancing cognitive functions such as memory and attention. Furthermore, we investigated the implications of these findings across diverse age cohorts, including children, adults, and older adults, to elucidate age-specific effects on neurobiological processes such as growth, survival, differentiation, and neurogenesis. We also propose future research directions to enhance understanding of these mechanisms, with a particular emphasis on the therapeutic potential of physical activity as a broadly accessible intervention for promoting mental health and cognitive function across the lifespan.
INTRODUCTION: The recourse to compulsory psychiatric hospitalizations is authorized in Belgium in case of the presence of strict legal criteria defined by the law on the protection of patients with mental illness. In rec...INTRODUCTION: The recourse to compulsory psychiatric hospitalizations is authorized in Belgium in case of the presence of strict legal criteria defined by the law on the protection of patients with mental illness. In recent years, the number of compulsory psychiatric hospitalizations has been constantly increasing, leading to an increasing saturation of specialized hospitalization units. To better understand this problem, the aim of this study was therefore to investigate the impact of a medical contact during the three months preceding the occurrence of a first forensic expertise on the decision to involuntarily hospitalize psychiatric patients referred to emergency departments. MATERIAL AND METHOD: Three hundred and ninety-nine patients were retrospectively extracted from the database of forensic expertise performed in emergency departments between January 2021 and December 2023. The impact of a medical contact during the three months preceding the occurrence of a first forensic expertise on the risk of compulsory psychiatric hospitalization was assessed using logistic regression analyses. RESULTS: Sixty-two percent of forensic expertise resulted in compulsory psychiatric hospitalization. In addition, a medical contact during the prior three months was associated with higher risk of compulsory psychiatric hospitalization in patients referred to emergency departments for a first forensic expertise. CONCLUSION: In this study the results seem to confirm the hypothesis of an exhaustion of therapeutic alternatives available to compulsory care in some psychiatric patients involuntarily hospitalized after a first forensic expertise. This underlines the importance of developing new care networks that are more accessible to these patients and better adapted to their needs.
Young individuals identifying as lesbian, gay, bisexual, or pansexual (LGBP) are particularly vulnerable to suicidal ideation (SI). This study examines the relationships between sexual orientation, gender, coming out, an...Young individuals identifying as lesbian, gay, bisexual, or pansexual (LGBP) are particularly vulnerable to suicidal ideation (SI). This study examines the relationships between sexual orientation, gender, coming out, and suicidal ideation among young French LGBP adults. The sample included 459 participants aged 18 to 35, 50.1% (n=230) of them identifying as LGBP. Data were collected through an online survey using the French version of the Suicidal Ideation Attributes Scale (SIDAS-FR). Findings revealed significantly higher levels of suicidal ideation among LGBP individuals compared to heterosexual people, with bisexual individuals reporting the highest levels. Women of sexual minorities, particularly those who are bisexual and pansexual, were identified as the most vulnerable subgroup for SI. Men of sexual minorities also reported increased SI compared to heterosexual men. Coming out emerged as a protective factor, with participants who had disclosed their sexual orientation to both parents reporting a lower level of SI. The study highlights the need for targeted interventions to support LGBP individuals, focusing on reducing stigma, promoting family acceptance, and strengthening community-based mental health resources.
OBJECTIVE: In a context of debates on the place of complex trauma within psychiatric pathology, it is essential to accurately measure the extent of the effects of adversity across different disorders. Such studies are ra...OBJECTIVE: In a context of debates on the place of complex trauma within psychiatric pathology, it is essential to accurately measure the extent of the effects of adversity across different disorders. Such studies are rare, however, because they often focus on a single diagnosis. The measurement of adversity is usually self-reported, retrospective, and usually includes a single dimension. Furthermore, at-risk family interactions and maltreatment constitute two distinct and central risk factors for both complex trauma and psychiatric disorders. Yet they are rarely studied together, nor through an overview of psychiatric disorders. This is the aim of this study, which hypothesizes that adversity is widely distributed across all the psychiatric disorders of adolescents admitted to psychiatric hospitals, and postulates that it is possible to discern distinct adversity profiles depending on the diagnosis. METHODOLOGY: This cross-sectional analysis stems from the Family & Care study, which aims to measure various adversity factors in hospitalized adolescents aged 13 to 19 (n=425). Data on abuse and neglect were collected by hetero-assessment using the European abuse and neglect database Child Abuse and Neglect via Minimum Data Set (CAN-via-MDS), and family interactions were measured using the At-Risk Family Interactions and Levers (ARFIL) scale, a 30-item clinical tool also rated by hetero-assessment. RESULTS: Among the 425 participants, the prevalence of emotional abuse was 46.1%, physical abuse 21.4%, sexual abuse 25.1% and neglect 70.5%. The psychiatric disorders measured were all associated with significant rates of childhood adversity, and different adversity profiles could be identified according to diagnosis. Trauma- and stress-related disorders accounted for only 13.4% of disorders. The latter, as well as borderline personality disorder and oppositional defiant disorder, were associated with higher scores of at-risk family interactions than the other diagnoses, highlighting the distinct influence of at-risk family dynamics independently of abuse or neglect. CONCLUSION: The determinants linked to adversity cut across all the nosographic fields in child psychiatry, and support the idea that the complex trauma clinic overlaps strongly with all the usual diagnostic categories. Depending on the diagnosis, it seems possible to identify distinct adversity profiles, with borderline personality disorder appearing as one face of complex trauma among others. The Family & Care study reinforces the value of multiplying the sources of observation in clinical practice and in future research, by combining diagnostic aspects with the relational correlates of patients under psychiatric care, which represent both risk factors and essential therapeutic levers.
Complex post-traumatic stress disorder (C-PTSD), caused by repeated traumatic events of interpersonal origin (such as physical or sexual violence, or war), leads to severe disorders of emotional regulation, self-percepti...Complex post-traumatic stress disorder (C-PTSD), caused by repeated traumatic events of interpersonal origin (such as physical or sexual violence, or war), leads to severe disorders of emotional regulation, self-perception and interpersonal relationships. Without early diagnosis and intervention, children and adolescents with C-PTSD are at risk of developing chronic mental disorders. Rapid therapeutic interventions are thus required in order to avoid the persistence of symptoms and at-risk behaviours altering the development and life trajectory of these young people. The aim of this article is to provide a state-of-the-art overview of existing therapeutic interventions aimed at professionals who screen, diagnose or care for children or adolescents with C-PTSD. The specific clinical and treatment profiles of these patients (e.g., stabilization, trauma treatment, promoting cognitive and psychological integration processes, self-compassion and engagement in interpersonal relations, family involvement) are detailed, in order to propose a diagnostic strategy and set out the various possibilities for comprehensive management based on adaptations of existing therapeutic protocols for these paediatric populations. Therapeutic, psychological and psychopharmacological approaches that are either validated or in development are presented, along with their current level of scientific evidence. This article highlights the importance of training French-speaking child and adolescent psychiatric professionals in these therapies, and of further developing research in this field.
Neuropathic pain results from an injury or a dysfunction of the somatosensory system. Management of this disease is complex due to a restricted therapeutic arsenal and limited efficacy of currently available treatments....Neuropathic pain results from an injury or a dysfunction of the somatosensory system. Management of this disease is complex due to a restricted therapeutic arsenal and limited efficacy of currently available treatments. Because of its chronic and disabling nature, neuropathic pain is strongly associated with depressive disorders. New neuromodulatory approaches such as repetitive transcranial magnetic stimulation (rTMS) represent an innovative therapeutic option with documented efficacy in the treatment of neuropathic pain and major depressive disorder respectively. Despite the frequent comorbidity between neuropathic pain and depressive disorder, there is no accurate data in the literature concerning the place of rTMS in the combined treatment of these two diseases. This narrative literature review was conducted to assess the impact of antalgic rTMS protocols on the improvement of depressive symptoms in patients with chronic neuropathic pain. An analysis of 20 trials showed that motor cortex rTMS protocols with optimised parameters (frequency of at least 10 Hz, at least 2000 pulses per session and at least 10 stimulation sessions) could improve depressive symptoms in patients with chronic neuropathic pain. Other cortical target protocols including dorsolateral prefrontal cortex, anterior cingulate cortex and secondary somatosensory cortex did not seem to be effective in relieving depressive symptoms in these patients. Available data indicates a strong heterogeneity and must be confirmed by large sample size randomized trials.
INTRODUCTION: Apathy, commonly observed in neurocognitive disorders, is characterized by a reduction in goal-directed behavior with a reduction of initiatives interests and emotions. This article presents the case of Mrs...INTRODUCTION: Apathy, commonly observed in neurocognitive disorders, is characterized by a reduction in goal-directed behavior with a reduction of initiatives interests and emotions. This article presents the case of Mrs. B., a 70-year-old patient with mild neurocognitive disorder and apathy, who underwent an intervention combining transcranial direct current stimulation (tDCS) and cognitive training delivered through a web application. OBSERVATIONS: After four weeks, clinical scales and self-report questionnaires revealed: reduced intensity in emotional blunting, increased interest, and decreased fatigue, although apathy remained stable according to the apathy diagnostic criteria. These changes were corroborated by vocal analyses, which showed improved prosody, increased speech rate, and fewer pauses. Changes in prosodic and temporal markers appeared to align with the behavioral improvements reported by the patient. DISCUSSION: These findings highlight the potential of prosodic and temporal speech markers to assess and monitor apathy. This innovative approach may enhance clinical evaluations and support the development of more tailored interventions.
AIMS: Cannabis is widely used for various reasons, including its effects on sexuality. It has significant short- and long-term health consequences. However, its impact on sexual health remains uncertain. This study asses...AIMS: Cannabis is widely used for various reasons, including its effects on sexuality. It has significant short- and long-term health consequences. However, its impact on sexual health remains uncertain. This study assesses sexual function in Tunisian cannabis users compared to non-users. METHODS: We conducted a cross-sectional, descriptive, and analytical case-control study at the Tunisian Association for the Fight Against Sexually Transmitted Diseases and AIDS. We used the Cannabis Abuse Screening Test (CAST) and the International Index of Erectile Function (IIEF-15) to evaluate cannabis dependence and male sexual function. RESULTS: The study included 30 male cannabis users matched with 30 control subjects from the general population. The median total CAST score was 24, indicating a severe level of dependence. All users reported trying cannabis at least once before sexual activity. The average IIEF-15 score among users was 63.07±4.32, and daily cannabis users had a significantly lower IIEF-15 total score (P=0.01). Compared to the control group, the mean total IIEF-15 score (P=0.001), as well as the mean scores in the domains of erection (P=0.001), orgasm (P=0.001), desire (P=0.006), and satisfaction (P=0.001), were significantly higher in the group of cannabis users. CONCLUSION: This study highlights the controversial effects of cannabis on sexuality. However, the cross-sectional design limits the ability to establish a causal relationship between cannabis use and sexual dysfunction. Therefore, further research, particularly longitudinal studies, is needed along with increased awareness among healthcare professionals to ensure careful assessment of sexual function and to optimize patient management.
The body of knowledge on trauma is rapidly expanding. Since 2022, the WHO has been calling for the history of adversity to be systematically taken into account when assessing the state of health of all individuals. But a...The body of knowledge on trauma is rapidly expanding. Since 2022, the WHO has been calling for the history of adversity to be systematically taken into account when assessing the state of health of all individuals. But at this stage, our understanding of the precise mechanisms of complex trauma remains incomplete. In fact, its pathophysiology lies at the crossroads of neurobiological, psychological and relational fields of study. The aim of this review is to set out the key elements of this scientific literature in order to move towards a more global and comprehensive vision, which remains a challenge. The clinical forms of complex trauma are analyzed in the light of the neurobiology of chronic and early stress, cognitive-emotional disorders, and relational and attachment imbalances. Four dimensions each play a major role in the psycho-traumatic equation: characteristics relating to adversity factors, circumstances of onset, any prior vulnerabilities, and environmental resources (particularly relational support). Borderline personality disorder appears to be one of the faces of complex trauma, and a valuable model for understanding a pathophysiology that takes place in two stages, in which previous psychobiological changes contribute to the disproportionate or unrelated appearance of symptoms in relation to current environmental factors. This pathophysiology of a profound link between early experiences, alterations in the self and affective regulation disorders in adolescence or adulthood, raises new questions about the definition and understanding of psychiatric disorders, and first and foremost personality disorders, which are at the crossroads of the shift from "simple" trauma to complex trauma. Understanding the mechanics of trauma ultimately involves a shift from a symptom-centered approach to a dual approach involving the symptom in a synchronic (instantaneous) perspective and the patient's history in a diachronic (temporal evolution) perspective. It is also a shift from the subject to his or her environment, which calls for a global and systemic vision.
The concept of complex trauma (or developmental trauma) has been proposed to refer both to chronic exposure to interpersonal experiences in children and adolescents and to the constellation of possible sequelae that caus...The concept of complex trauma (or developmental trauma) has been proposed to refer both to chronic exposure to interpersonal experiences in children and adolescents and to the constellation of possible sequelae that cause significant difficulties throughout life. The purpose of this chapter is to provide an overview of the theoretical and clinical approaches to complex trauma in order to better understand the scope of this concept. Through a review of the literature, this chapter outlines the historical evolution of this concept, its current definition, the diagnostic issues involved, and the preferred directions for its future use in research and clinical practice. This article highlights the significant shift that has taken place over time, from a concept closely linked to the traumatic experiences of individuals and the clinical challenges they face, to a collective responsibility to implement social actions that can lead to deeper structural and systemic change.
Mental disorders are on the increase, while access to care is becoming increasingly difficult for those affected. This article presents the "Projet de Liaison Universitaire de TerritOire du Nord" (PLUTON), an initiative...Mental disorders are on the increase, while access to care is becoming increasingly difficult for those affected. This article presents the "Projet de Liaison Universitaire de TerritOire du Nord" (PLUTON), an initiative to improve access to psychiatric care in an area of the Hauts-de-France region and to combat medical desertification. Initially conceived as a response to a health crisis, PLUTON has gradually evolved to rethink the organisation of psychiatric care in a given area. The aim was to preserve the structure of sector-based care while adding a university dimension to clinical, research and teaching activities. The success of this project is the result of an innovative, collaborative approach based on the pooling of existing resources. This tried and tested methodology means that the project can be easily and effectively replicated in other areas.
INTRODUCTION: Adolescents supported by child protection services (CPS) represent a population exposed to repeated relational trauma that significantly increases the risk of developing complex trauma characterized by poly...INTRODUCTION: Adolescents supported by child protection services (CPS) represent a population exposed to repeated relational trauma that significantly increases the risk of developing complex trauma characterized by polymorphic symptomatology. The behavioral problems presented by adolescents followed by CPS may fit within this nosographic framework. They can lead to major difficulties in adapting to their environment, especially when the trajectory of polyvictimization is pronounced. Unfortunately, the failure of professionals to recognize this diagnosis remains frequent. As a result, institutional responses are often poorly adapted to the needs of the adolescents concerned, promoting an excessive psychiatrisation of their behavioral manifestations at the expense of a comprehensive and holistic approach rooted in their traumatic history. METHOD: This work offers a theoretical-clinical reflection on complex trauma expressed through behavioral problems among adolescents supported by CPS. It is based on the main recent clinical and scientific contributions, particularly research related to integrative and systemic approaches. RESULTS: Theoretical and clinical data highlight both the importance and the difficulties of identifying manifestations of complex trauma among adolescents supported by CPS, especially when they present behavioral problems. The analysis emphasizes the contributions of clinical support systems and trauma-informed practices in structuring institutional responses. These practices, particularly the Attachment, Regulation of Affect, Competence (ARC) model, by promoting a developmental and relational understanding of behavioral symptoms, provide a structured framework for operationalizing the educational support of adolescents within CPS, moving beyond crisis management logic and enabling the effective use of specific care modalities when necessary. DISCUSSION: Recognizing traumatic history, often marked by polyvictimization, appears essential to adequately meet the needs of the adolescents concerned. While integrative and systemic approaches represent promising levers for transforming professional practices within CPS, their implementation remains marginal in France. Avenues for reflection and research are discussed to promote the concrete adoption of these models by institutions, particularly in terms of training, team support, and structuring connections between institutions, with the aim of building better-coordinated educational and therapeutic interventions.
OBJECTIVES: This systematic review aims to evaluate the impact of cognitive-behavioral and metacognitive therapies on cognitive and clinical insight into early schizophrenia disease. METHODS: A comprehensive literature r...OBJECTIVES: This systematic review aims to evaluate the impact of cognitive-behavioral and metacognitive therapies on cognitive and clinical insight into early schizophrenia disease. METHODS: A comprehensive literature review was conducted across several databases, including Pubmed, PsycINFO, and Cochrane Library, focusing on studies published between 2006 and May 2024. The studies selected for this review were either randomized controlled trials (RCTs), cross-sectional studies, or exploratory studies. RESULTS: Nine studies were included (7 RCTs, one cross-sectional study, and one exploratory study), using various tools to assess cognitive and clinical insight. The findings showed mixed results: cognitive-behavioral therapy (CBT) and metacognitive therapies (MCT) demonstrated varied outcomes. Some studies reported improvements in self-reflection and self-certainty, two facets of cognitive insight, especially in young patients. CONCLUSIONS: This study highlights the complexity of the relationship between different therapies and insight improvement in early schizophrenia. This result emphasizes the need for additional studies to improve our understanding of the effects of cognitive therapies, given that the current number of studies is too limited to draw conclusions. Future research should focus on developing more personalized and effective treatment strategies to better address the individual needs of young patients.