BACKGROUND: Studies have shown that psychiatrists have a higher suicide rate compared to the general population and other medical specialists. AIM: To evaluate the prevalence, methods, and factors associated with suicide...BACKGROUND: Studies have shown that psychiatrists have a higher suicide rate compared to the general population and other medical specialists. AIM: To evaluate the prevalence, methods, and factors associated with suicide attempts (SA) among Moroccan psychiatrists. METHOD: A cross-sectional online survey was carried out in August 2023 using an anonymous questionnaire created online on Google Forms. RESULTS: In all, 142 Moroccan psychiatrists practicing in the private and public sectors were included. Among these, 7.7% had a history of lifetime suicide attempts. Factors associated with TS among Moroccan psychiatrists are the personal history of depressive and anxiety disorders, the high scores of perceived stress, the psychoactive substances use; including tobacco, alcohol, and anxiolytics, as well as the family history of psychiatric disorders and the family history of suicide. CONCLUSION: Suicide attempts among Moroccan psychiatrists are a serious mental health problem that has a negative impact on the psychiatrist himself, his entourage, and the quality of care provided to patients.
INTRODUCTION: Body Dysmorphic Disorder (BDD) is a condition characterized by a distorted perception of one's own body image. Individuals with BDD exhibit excessive concern about their appearance, often fixating on percei...INTRODUCTION: Body Dysmorphic Disorder (BDD) is a condition characterized by a distorted perception of one's own body image. Individuals with BDD exhibit excessive concern about their appearance, often fixating on perceived flaws that are either imaginary or minor. The prevalence of body image-related eating disorders has been increasing among university students, particularly in health-related fields, where students frequently experience pressure to maintain an ideal body shape and weight. METHODS: This cross-sectional qualitative study was conducted with Nutrition students at a community university in Caçador, Santa Catarina, Brazil. Body image perception was assessed using the Silhouette Matching Task (SMT) by means of an online questionnaire via Google Forms. Data analysis was performed using Student's t-test and Pearson's correlation, with statistical significance set at P<0.05. RESULTS: A total of 46 students participated, of whom 76.08% (n=35) were female. The mean BMI was 23.33kg/m, with a predominance of eutrophic individuals (74.28%). In contrast, the mean BMI for males was 28.42kg/m, with overweight being the predominant nutritional status. Regarding body image perception, 77.14% of females and 63.64% of males reported dissatisfaction with excess weight. The study found that males had a significantly higher weight (P=0.00003; r=0.578). Additionally, body dissatisfaction was more prevalent among females (P=0.00531; r=0.357) and increased with BMI (P=0.0015; r=0.455). CONCLUSION: The findings indicate a high prevalence of body dissatisfaction among students, even among those with a nutritionally adequate status, particularly females. These results highlight the strong sociocultural pressure surrounding body image which significantly impacts this population.
OBJECTIVE: The authors sought to assess differences in children and adolescents' characteristics according to the type of hospital they were admitted to. METHODS: This retrospective study was conducted with the French na...OBJECTIVE: The authors sought to assess differences in children and adolescents' characteristics according to the type of hospital they were admitted to. METHODS: This retrospective study was conducted with the French national insurance database (SNDS). Patients aged less than 18 and discharged from psychiatric hospitals in 2022 were included. Characteristics of stays were described according to the types of facilities: public, private not-for-profit, or private for-profit hospitals. RESULTS: In 2022, 20,598 patients were hospitalized in psychiatric facilities in France, totaling 46,222 stays. There were 76.92% of the stays in public, 13.39% in non-profit facilities, and 9.70% in for-profit facilities. In public and non-profit facilities, patients were more frequently male, younger, and had shorter lengths of stay compared to those in for-profit facilities. CONCLUSIONS: Public facilities take care of the majority of patients. Characteristics of patients and stays differ according to the type of facility. There is a significant common population between public and private sectors.
INTRODUCTION: Tele-expertise is a care tool that has developed significantly in certain medical disciplines such as dermatology, ophthalmology and cardiology in France in recent years. At Brest University Hospital, we ha...INTRODUCTION: Tele-expertise is a care tool that has developed significantly in certain medical disciplines such as dermatology, ophthalmology and cardiology in France in recent years. At Brest University Hospital, we have been able to set up tele-expertise in psychiatry since April 2023, via a secure platform (Omnidoc), on assistance with prescribing or de-prescribing psychotropic drugs. The aim of this study is to evaluate its contribution after 18 months of use. METHODS: A total of 166 tele-expertise requests were received and analyzed between April 2023 and September 2024. For each tele-expertise, we collected: the response time, the number of opinions given, the breakdown of requests by requesting physician's specialty, the number of different requesting physicians, the number of requests per requesting physician, the number of post-opinion consultations, the psychiatric diagnosis evoked and the number of requests for assistance with deprescribing. A satisfaction questionnaire was sent to each requesting physician who had requested at least one opinion during the period studied. RESULTS: A total of 152 tele-expertise requests were included in the final analysis. The average response time was 4hours over the study period, with a median response time of 1hour. Ninety-five percent of requesting physicians were satisfied with the quality of exchanges with the psychiatrist. Ninety-three percent of requesting physicians also felt that the tele-expertise had improved patient management. Fifty nine percent of requesting physicians prescribed psychotropic drugs differently since they had sought advice. Fifty eight percent felt they had learned how to better prescribe or deprescribe psychotropic drugs. Ninety-four percent thought they would use tele-expertise again and/or recommend it to a colleague. Finally, requests for help in deprescribing psychotropic drugs concerned only 6 of the 152 requests (3.9%). CONCLUSION: The introduction of tele-expertise in psychiatry, focusing on medication via a secure platform, has been much appreciated by GPs in particular. It could improve patient care and encourage city-hospital collaboration.
Complex post-traumatic stress disorder is a recent diagnosis with manifestations that differ from those of post-traumatic stress disorder. Persistent functional impairment is a new dimension specific to complex trauma. S...Complex post-traumatic stress disorder is a recent diagnosis with manifestations that differ from those of post-traumatic stress disorder. Persistent functional impairment is a new dimension specific to complex trauma. Some aspects of this diagnostic category which was adopted by the international classification of diseases eleventh revision are still being studied, for example, its prevalence across the world in many cultural situations where the exposure to traumatic events differ. Network analysis offers a new conceptualization of psychopathology by focusing on interactions between symptoms beyond the usual latent class approach. It makes it possible to statistically validate the international classification of diseases' new diagnostic criteria by differentiating the manifestations of different pathologies such as intense stress exposure pathologies or borderline disorder that share symptoms. It also provides various insights into this disorder and allows us to observe sequences of appearance and evolution depending on age and type of event. While childhood trauma appears to be particularly associated with complex post-traumatic stress disorder, literature mainly highlights the long-term consequences of such childhood events in adulthood. The persistent functional impairment cluster is particularly important within complex trauma networks. This is one of the most important developmental consequences for survivors and reflects a reality perceived by clinicians. This extends to psychotherapy which turns out to be longer and more complex because of the insecurity of the relationship experienced by the traumatized person. Network analysis applied to complex trauma gives an understanding of the dynamics of the relationships between its multitude of symptoms. They can define intervention targets for mental health professionals. And they can enable coordinated multi-professional actions which is an important issue especially in multi-factorial situations such as child protection. This work explores the contributions of network analysis to the understanding of complex post-traumatic stress disorder. For this purpose, we outline the central concepts of complex trauma and its implications. In particular, the impact of recurring traumatic situations of an interpersonal nature on self-construction and the ability to create relationships. We exhibit the fundamental principles of the network approach and compare the contributions of older cross-sectional analyzes with those of longitudinal networks. Then, we provide an overview of the knowledge acquired through the application of network analysis to complex trauma, from childhood to adulthood. Finally, we discuss criticisms of this approach and propose reflections on the future of this statistical analysis method which is growing fast.
Cerebrovascular abnormalities may predispose, precipitate, or perpetuate depressive symptoms in old adults, supported by the hypothesis of vascular depression. These depressive episodes are sometimes accompanied by atypi...Cerebrovascular abnormalities may predispose, precipitate, or perpetuate depressive symptoms in old adults, supported by the hypothesis of vascular depression. These depressive episodes are sometimes accompanied by atypical neurological symptoms associated with localized vascular lesions in the brain. We present the case of an 84-year-old man with vascular depression who experienced visual hallucinations and dizziness, coinciding with the incidental discovery of a cerebellar stroke. Based on this clinical case, we discuss the hypothesis of perceptual and affective cerebellar functions.
BACKGROUND: The co-occurrence of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) is common in military personnel, leading to complex clinical challenges and poor prognosis. To enhance the care of P...BACKGROUND: The co-occurrence of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) is common in military personnel, leading to complex clinical challenges and poor prognosis. To enhance the care of PTSD patients, a TBI screening protocol was developed at a French Military Training Hospital (MTH). The Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID), a self-administered questionnaire, was translated into French (OSU TBI-ID Fr) to help standardize screening. This study aims to evaluate the feasibility and tolerance of the TBI screening protocol, to explore its potential to improve clinical outcomes for military personnel suffering from PTSD, and to assess TBI prevalence in our population. DESIGN: This observational, retrospective, monocentric study was conducted at the MTH psychiatric unit. PTSD military personnel and veterans were screened for TBI using three questionnaires: OSU TBI-ID Fr, the PTSD Checklist for DSM-5 (PCL5), and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Data on patient characteristics and screening results were extracted from medical records to determine TBI prevalence. Feasibility was assessed based on the proportion of eligible patients who underwent screening, with reasons for non-participation documented. Tolerance was evaluated by recording side effects. Exploratory analyses included subgroup comparisons based on TBI or Repeated subconcussive Head Impacts (RHI) and correlations between PCL5 and RPQ scores. RESULTS: Of the 233 PTSD patients treated in the psychiatry unit, 14.1% (n=33) completed the TBI screening between September 2022 and March 2023. Among the screened patients, 39.4% (n=13) had a history of TBI, and 48.5% (n=16) had been exposed to RHI. Three participants reported anxiety while completing OSU TBI-ID Fr. The average PCL5 score was 45.8, and the average RPQ score was 25.7. The main barriers to screening in the rest of the eligible population were lack of time, oversight, and interview setting (e.g., teleconsultation). DISCUSSION AND CONCLUSION: This study introduces the French version of the OSU TBI-ID as a standardized TBI screening tool for military personnel with PTSD. The high prevalence of undiagnosed TBI, often discovered through screening, highlights the importance of early detection. This study demonstrates the acceptability and tolerance of the OSU TBI-ID Fr in this population and suggests its potential to improve care by enabling earlier TBI identification. Future research should focus on refining the protocol, enhancing its applicability across settings, and optimizing integrated care pathways to improve clinical outcomes.
To permit swift care of psychiatric and suicidal crisis, a post-emergency department unit (named UPSAM) opened on 25th March 2024 at the Angers University hospital. This unit permits a brief stay in a secure environment...To permit swift care of psychiatric and suicidal crisis, a post-emergency department unit (named UPSAM) opened on 25th March 2024 at the Angers University hospital. This unit permits a brief stay in a secure environment during which psychiatric care allows a decrease in suicidal ideation and etiological diagnosis followed by a multimodal suicide prevention strategy and ambulatory care organization. For 6 months 348 patients were hospitalized from all 3 corresponding departments. The mean length of stay was 5.6 days resulting in mean bed occupancy of 87.4% discharge; only 37.9% of patients needed public psychiatric care. UPSAM permitted a decrease in waiting time before hospitalization, with a mean delay before hospitalization of 59.4hours in April and 27.4hours in September. Other models of short-stay unit have been tested and showed efficacy in decreasing emergency department waiting time. Further work is needed to better understand appropriate care regimens according to clinical and topographical situations.
OBJECTIVE: This case report explores the efficacy of intravenous Ketamine in treating active suicidal ideation in a 24-year-old female with comorbid major depressive disorder (MDD), borderline personality disorder (BPD),...OBJECTIVE: This case report explores the efficacy of intravenous Ketamine in treating active suicidal ideation in a 24-year-old female with comorbid major depressive disorder (MDD), borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and functional neurological disorder (FND). CASE DESCRIPTION: The patient, with a history of multiple suicide attempts and treatment-resistant MDD, demonstrated significant improvement following nine intravenous ketamine sessions. The Montgomery-Åsberg Depression Rating Scale score decreased from 45 to 11, accompanied by sustained reductions in impulsivity, irritability, and depressive symptoms. DISCUSSION: This report highlights ketamine's rapid action on glutamate pathways and its potential benefits in complex psychiatric profiles where traditional treatments like electroconvulsive therapy often fail. A proposed staging model for suicidal behavior management underscores the importance of early intervention with non-classical treatments in high-risk cases. CONCLUSION: Intravenous ketamine offers a promising therapeutic option for patients with severe suicidality and comorbidities, warranting further research on its long-term efficacy and safety.
OBJECTIVES: Internet and gaming addiction were emerging mental health problems, particularly among adolescents. We aimed to determine the prevalence of Internet use disorder and gaming addiction among high school student...OBJECTIVES: Internet and gaming addiction were emerging mental health problems, particularly among adolescents. We aimed to determine the prevalence of Internet use disorder and gaming addiction among high school students and its predictors in the city of Mohammedia, Casablanca. METHODS: We conducted a cross-sectional study of 427 students at a public high school in Mohammedia from May to June 2022, which was selected by convenience. Internet addiction was assessed using the Young's Internet Addiction Test-20 items, and gaming addiction was assessed using the problem video gaming scale. Statistical Analysis was done using percentages, means, χ or Fisher's exact tests, Student's t-tests, and logistic regression in final analysis. RESULTS: The mean age of participants was 16.3±1.2, with a female predominance (71%). Among the high school students, 47.8% were from the first year and 52.2% from the second. The majority (52.7%) reported using a smart mobile phone. They used the Internet to play games (68.4%), 32.8% to communicate on social media platforms, and 34.4% to gather general information. The prevalence of Internet addiction was 93.2%. Using the Internet alone was significantly associated with Internet addiction (aOR=2.21; 95% CI 1.02-4.76). The prevalence of Internet game disorder was 14.1% and failing at least one grade was a significant risk factor (aOR=4.54; 95% CI 2.38-8.68). CONCLUSION: Moroccan adolescents seem to be at great risk of Internet and gaming addictions. Targeted action of modifiable factors would be useful for prevention.
CONTEXT: Sexual sensation seeking and sexual compulsivity are two characteristics associated with sexual risk taking and can be studied in different contexts, one of these being that of forensics. Among the different too...CONTEXT: Sexual sensation seeking and sexual compulsivity are two characteristics associated with sexual risk taking and can be studied in different contexts, one of these being that of forensics. Among the different tools used to assess these characteristics, the Sexual Sensation Seeking Scale (SSSS) and the Sexual Compulsivity Scale (SCS) are particularly concise and specific. METHOD: This study proposes a French translation of those scales, the fSSSS and the fSCS, validated among a sample of 536 participants from France. Assessments of factor structure, internal consistency and reliability showed good psychometric properties. Convergent and divergent validities were assessed using various forensic-related measures and demonstrated the relevance of both scales in this context.
OBJECTIVES: Psychiatric patients are frequently exposed to factors that increase their risk of developing chronic liver diseases. These factors include the presence of metabolic syndrome, high rates of current or past al...OBJECTIVES: Psychiatric patients are frequently exposed to factors that increase their risk of developing chronic liver diseases. These factors include the presence of metabolic syndrome, high rates of current or past alcohol and illicit substance use, and the direct liver toxicity of certain psychiatric medications. Despite this, systematic screening for chronic liver diseases in this population is not routine. Transient elastography (FibroScan®), a non-invasive method to assess liver stiffness, could facilitate early detection of advanced hepatic fibrosis. This study aimed to assess the acceptability of non-invasive liver fibrosis evaluation using FibroScan® among psychiatric inpatients and to evaluate the prevalence of alcohol and illicit drug use, viral hepatitis, significant liver fibrosis, and linkage to somatic care. METHODS: This prospective, interventional cohort study was conducted in a tertiary psychiatric hospital from March 2023 to January 2024. Liver stiffness measurement (LSM) by transient elastography (FibroScan®) screening for the detection of significant liver fibrosis was proposed to all hospitalized patients after providing informed consent. Patients responded to a structured interview that included the AUDIT-C questionnaire to assess alcohol use disorders, along with items on illicit drug use and other liver disease risk factors like metabolic syndrome or viral hepatitis. Significant fibrosis was defined as liver stiffness measurement (LSM) ≥10kPa. Demographic, clinical, biological and virological data was collected from patients' medical files. RESULTS: A total of 180 patients were included in the study, with 122 (67.8%) consenting to FibroScan® screening. The cohort's mean age was 44.4±15.5 years, with 61% male. The seroprevalence of HCV antibodies was 2.5%, with a higher prevalence among men (6.5%). Chronic HBV infection prevalence was 0.81%. Metabolic syndrome was present in 28.7% of patients. Alcohol use disorders were identified in 45.9% of patients, with men showing higher AUDIT-C scores than women (P=0.04). Drug use was reported by 37.7% of patients, with recent use in 20%. Significant fibrosis was detected in 0.8% of patients and linkage to care was provided in this case. CONCLUSIONS: Transient elastography is an acceptable method for screening hepatic fibrosis in psychiatric settings. It represents an excellent option to assess other associated comorbidities in this underserved population and improve linkage to somatic care.
INTRODUCTION: Social functioning is an individual's ability to interact effectively and appropriately with his or her social environment. In psychiatry, acting on social functioning is necessary to reduce the intensity o...INTRODUCTION: Social functioning is an individual's ability to interact effectively and appropriately with his or her social environment. In psychiatry, acting on social functioning is necessary to reduce the intensity of symptoms and promote patient life in the community. This study proposes a cross-cultural validation of the Social Functioning Questionnaire (SFQ) in Moroccan dialectal Arabic. METHODS: This work consists of creating a translated version according to a rigorous methodology, including direct and reverse translation, as well as evaluation by linguistic experts. A sample of 160 participants was then selected to evaluate the psychometric properties of the SFQ in a statistical study. RESULTS: The validation study showed high acceptability and reliability, with a Cronbach's alpha coefficient of 0.803. The results also showed good reproducibility, with perfect inter-observer stability between the test and the retests. CONCLUSION: This version of the SFQ is reliable and valid for measuring social functioning in our Moroccan population.
OBJECTIVES: This project aimed to explore the impact of psychological distress (anxiety, depression and post-traumatic stress) and resilience on quality of life and psychological health at work (well-being or distress at...OBJECTIVES: This project aimed to explore the impact of psychological distress (anxiety, depression and post-traumatic stress) and resilience on quality of life and psychological health at work (well-being or distress at work) of nursing home and healthcare staff members in the Moselle department in Northeastern France. METHODS: In the spring of 2021 230 professionals replied to an online questionnaire. The theoretical model was tested through path analyses. RESULTS: Results showed that higher resilience scores were associated with lower post-traumatic stress, anxiety, and depression scores. Anxiety and depression were negatively correlated with quality of life, while higher quality of life scores were linked to greater well-being at work. Resilience was found to have a significant impact on the psychological state of professionals, with differences observed between well-being and distress at work. DISCUSSION: In conclusion, our study revealed that resilience plays a significant role in influencing the psychological state of professionals, ultimately impacting their psychological health at work. Therefore, interventions aimed at addressing anxiety, depression, and traumatic symptoms could potentially enhance resilience and mitigate work-related psychological disorders among frontline healthcare professionals.