Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique最新文献

{"title":"Representations and knowledge of residents about ADHD in children in two regions in France.","authors":"Thiébaut-Noël Willig, Louise Brun, Anne Piollet, Marie Dajon, Marie-Claire Thiollier, Rémy Assathiany, Pierre Fourneret, Stéphane Oustric, Michel Amouyal, Magali Masse, Anne Monge, Diane Purper Ouakil","doi":"10.1016/j.encep.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.encep.2025.02.002","url":null,"abstract":"<p><strong>Introduction: </strong>In France, knowledge and awareness of childhood ADHD remain insufficient. To guide the development of training programs for medical residents, we assessed the understanding of ADHD among residents in family practice, pediatrics, and psychiatry across two major French regions in 2021.</p><p><strong>Methods: </strong>A SurveyMonkey® survey was distributed to residents in two French regions, gathering information about their training experiences on child/adolescent ADHD, as well as their knowledge and perceptions of the disorder.</p><p><strong>Results: </strong>Among the 251 residents who completed the survey (response rate: 28.5%), 53.4% reported receiving no training on ADHD during their residency. Substantial differences were observed across specialties: 75% of psychiatry residents reported receiving training, compared to only 38% of family practice residents. Even brief training sessions (e.g., one hour) significantly improved knowledge and perceptions of ADHD, with greater effectiveness observed as the duration of training increased.</p><p><strong>Conclusions: </strong>Residency training on ADHD shows potential for improving access to care as post-training knowledge and perceptions align with those of trained practitioners actively managing ADHD in the same regions. Action plans are recommended to enhance training for family practice residents, with follow-up assessments planned using the same methodology.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonpharmacological treatments of Post-Traumatic Stress Disorder (PTSD) among children and adolescents: A scoping review.","authors":"Célie Weber, Ola Bazzi, Diane Purper-Ouakil, Erica Fongaro, Hala Kerbage","doi":"10.1016/j.encep.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.encep.2025.02.006","url":null,"abstract":"<p><p>Post-traumatic stress disorder (PTSD) is a worldwide public health burden leading to severe impairment. PTSD has a particularly high occurrence among children exposed to potentially traumatic events. Our study aimed to establish the current state of the literature regarding nonpharmacological treatments studied to date to reduce post-traumatic stress symptoms (PTSS) in children and adolescents. We conducted the search on three databases: PubMed, Web of Sciences, and Embase, using the following MeSH Terms; stress disorders, post-traumatic, and psychological treatment. We refined the search by applying filters to document type, languages, and age. Initially, 4570 articles were identified, of which 60 met our inclusion criteria and were included in the review. We included studies that focused on children and adolescents with PTSD following a traumatic event that occurred at least three months prior to being assigned to non-pharmacological treatment. Exclusion criteria included case studies, meta-analyses, literature reviews, and grief-focused therapies. Additionally, trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR), already well-established as standard treatments, were excluded. Studies were also omitted if PTSD was not formally diagnosed or if the primary outcome measured was unrelated to PTSS. Most treatments relied on psychoeducation, support, coping skills, and trauma narratives using different strategies. We found large studies on combined therapies, prolonged exposure therapy, and school-based therapies-especially with collective traumatic events. For collective traumatic events, our study exposed a preponderant utilization of group therapies. Most studies reported that the therapies tested were efficient. The level of evidence for each therapy was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, revealing noteworthy findings, particularly for prolonged exposure therapy. Our study emphasizes treatments that should be further examined in larger studies, and the specificities of psychotherapeutic treatment according to the type of traumatic event, single or collective. Based on our findings, we developed a therapeutic algorithm that can serve as a guideline for managing PTSD in children and adolescents.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Towards an equipped psychiatry].","authors":"Louis Jehel, Mathieu Guidère","doi":"10.1016/j.encep.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.encep.2025.03.002","url":null,"abstract":"<p><p>The article by Moizard and Geoffroy highlights the importance of an integrated approach in psychiatry, emphasizing the need to move beyond the dichotomy between the somatic and the psychic. In their commentary, the authors advocated for precision psychiatry, which leverages the latest scientific and technological advancements. They underscored the necessity of equipping psychiatry with advanced technologies, particularly neuroimaging, artificial intelligence, and digital twins. These tools enable a more rigorous and personalized approach to mental healthcare grounded in specific biomarkers and precise modeling of psychiatric disorders.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptual competences in philosophy of psychiatry: A cross-sectional survey.","authors":"Christophe Gauld, Awais Aftab, Marc Auriacombe, Pierre Fourneret, Christophe Arbus, Jean Naudin, Élodie Giroux, Michel Cermolacce, Tudi Gozé, Jean-Arthur Micoulaud-Franchi","doi":"10.1016/j.encep.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.encep.2025.02.005","url":null,"abstract":"<p><strong>Objectives: </strong>The complexity of psychiatry requires an integrated approach that combines empirical practice, experiential insight, and theoretical reflection. This study, integrated within a broader international project, aimed to assess self-reported conceptual competences among French psychiatry students and practitioners, underlining the pedagogical necessity of integrating philosophy into psychiatry education to address both clinical and research challenges.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among French psychiatric residents, practicing psychiatrists, and retired psychiatrists recruited through professional networks and associations. Participants completed an online questionnaire on self-reported conceptual competences in psychiatry consisting of 18 items rated on a 5-point Likert scale, plus a complementary item. The questionnaire was structured into three dimensions: perceived integration of conceptual competences (7 items), perceived execution of conceptual competences (3 items), and declared knowledge of conceptual competences (8 items). A complementary item assessed the declared nature of six psychiatric conditions.</p><p><strong>Results: </strong>A total of 353 participants, primarily women (65.2%) and psychiatry practitioners (53.4%) with an average age of 33.3years, completed the questionnaire showing varied familiarity with conceptual issues in psychiatry. The mean scores across the three dimensions of conceptual competences were as follows: 3.19 for the perceived integration of conceptual competences dimension, 3.14 for the perceived execution of conceptual competences dimension, and 3.81 for the declared knowledge of conceptual competences dimension. Among participants, 90.1% endorsed the need for including philosophical training in psychiatric curricula, with 80.2% supporting skill development in this area. High agreement was observed on the need for multiple perspectives (94.3%). Confidence in conceptual understanding was moderate (41.9%), while critical evaluation confidence was lower (24.4%).</p><p><strong>Discussion: </strong>The findings support the need for incorporating conceptual competences into psychiatry education and practice. Frequent encounters with philosophical challenges in clinical settings, coupled with noted gaps in current training, highlight the critical importance of structured pedagogical approaches in psychiatry to examine these conceptual issues. Longitudinal studies will be needed to evaluate the potential impact of such educational programs on the evolution of participants' conceptual competences across the three dimensions of the questionnaire.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Psilocybin in the setting of treatment-resistant unipolar depression: A case report].","authors":"Maroussia Dumenil, Gabriel Cordova, Wissam El-Hage","doi":"10.1016/j.encep.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.encep.2025.02.007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Current antidepressants have shown certain limitations in the treatment of unipolar depression. Their long onset of action, interactions, and side effects are obstacles to achieving lasting remission of this prevalent, often chronic or recurrent, pathology. Faced with this clinical necessity, research efforts have intensified in recent years around psychedelic drugs, with a particular focus on the mental health benefits of psilocybin. To illustrate this promising approach, we present here the clinical vignette of a student living in France for whom psilocybin led to complete remission after recurrent depressive episodes and a two-year course of Escitalopram.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;Juan, a Mexican student, decided to move to France in 2015 to further his education and broaden his horizons. Since his degree in physiotherapy from Mexico did not qualify him to practice in France, he began studying Biology from 2016 to 2020. Unfortunately, during this period, Juan experienced his first episode of major unipolar depression, marked by feelings of incompetence and academic stagnation. In March 2017, he started an initial course of Escitalopram at 5mg, which provided some relief from his depressive symptoms but did not completely alleviate his anxiety and ruminative thoughts. The treatment was discontinued after three months due to a summer travel plan. By January 2018, he encountered a more intense depressive episode for which he resumed Escitalopram at an increased dose of 10mg. He continued this treatment until August 2019, although it again proved insufficient for full symptom relief. In January 2020, he faced his most challenging relapse, sometimes unable to get out of bed for weeks. This led him to resume Escitalopram, this time at 15mg, but he struggled with significant side effects, including nausea, fatigue, and numbness. Seeking alternative solutions, in the summer of 2020 Juan tried a non-conventional approach in Mexico using psilocybin, a compound found in hallucinogenic mushrooms, under the supervision of a shaman. Following the first administration in July, he noticed a rapid partial improvement in his symptoms; a second administration two weeks later resulted in a full remission of his depressive symptoms. Juan described his experience as profoundly healing, gaining an inner peace and a deep understanding of his struggles. Since 2020, he has remained in full remission without the need for antidepressants. This case highlights the potential role of psilocybin in addressing treatment-resistant depression and the importance of further research into alternative therapeutic options.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Psilocybin, a 5-HT2A serotonergic receptor agonist, affects cortical neural networks by reducing amygdala reactivity to negative emotions and altering brain connectivity. According to David Nutt's drug harm scale, psilocybin ranks among the least dangerous substances with a relative","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative models of psychopathology and psychotherapy: A PRISMA-based scoping review.","authors":"Rodolphe Saur, Eva Fourel, Solaine Dos Santos, Thierry Kosinski, Géraldine Tapia, Chrystel Besche-Richard, Arnaud Carré, Robert Courtois, Catherine Bortolon, Céline Baeyens, Fanny Marteau-Chasserieau, Lucia Romo, Yannick Morvan, Alexis Vancappel","doi":"10.1016/j.encep.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.encep.2025.03.001","url":null,"abstract":"<p><strong>Introduction: </strong>Since the 1970s there has been increasing interest in integrative approaches to psychopathology. Within this framework, numerous models have been developed. The aim of this manuscript is to inventory these models, provide a critical evaluation of them, and offer recommendations for their further development.</p><p><strong>Method: </strong>We conducted a scoping review based on PRISMA guidelines. The search strategy included keywords related to psychotherapy and/or psychopathology, one keyword related to models or conceptualizations, and one keyword associated with the integrative notion. The selected studies focused exclusively on integrative models of psychopathology and/or psychotherapy. The research was carried out using PsycInfo, PubMed, and EMBASE databases.</p><p><strong>Results: </strong>A total of 61 manuscripts were included in the systematic review. We identified a broad range of conceptual proposals, which can be categorized into three main types of models: 1) Models proposing a general framework for understanding psychopathology, 2) Models focusing on common factors in psychotherapy and 3) Models suggesting that a specific psychotherapy is inherently integrative.</p><p><strong>Conclusions: </strong>Many of these identified models face criticism for their lack of clear methodological development, limited empirical evidence, and/or restricted applicability to psychotherapeutic interventions. Future models should aim to address these limitations in order to advance the field.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience and qualitative evaluation of two soothing prototypes in psychiatry.","authors":"Noémie Chataigner, Cynthia Fleury, Valérie Gateau","doi":"10.1016/j.encep.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.encep.2025.02.008","url":null,"abstract":"<p><strong>Objectives: </strong>The need for alternatives to restraint and seclusion in psychiatry is widely recognized. To this end, a collaborative research project between patients, caregivers and designers resulted in the production of two containing prototypes (a covering armchair and a sensory totem). The aim of the research project was to understand whether these prototypes offered a calming alternative and could limit the need for restraint.</p><p><strong>Method: </strong>Semi-structured interviews were carried out as well as participant observations, and feedback forms were given to participants. Qualitative data analysis was integral and inductive, initially thematic and then oriented according to the \"type of ward\" variable.</p><p><strong>Results: </strong>The prototypes had beneficial effects on calming and empowering patients; they supported the patient-staff relationship and contributed to team reflexivity. Rather than pathologies, the prototypes responded to appeasement needs and situations of agitation or anxiety. For closed wards, the prototypes were therapeutic and supported patient autonomy in crisis situations. For open wards, they were integrated into the activities offered but needed to be accompanied by caregivers to ensure patient safety.</p><p><strong>Discussion: </strong>The results prompted discussion on three points: 1) research methods in psychiatry and the need to integrate users in research design; 2) conceptions of autonomy in psychiatric care; 3) the place of sensory rooms and soothing techniques in reducing the use of restraint and seclusion.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment strategies for clozapine-induced sialorrhea in France: A systematic review.","authors":"Amélie Rousseau-Voisin, Hervé Javelot, Franck Lach, Guillaume Meyer, Antoine Yrondi, Adeline Egron, Audrey Foclher, Sophie Dizet, Elodie Cuvelier, Bénédicte Gohier, Hugo Botemanne","doi":"10.1016/j.encep.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.encep.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>Clozapine-induced hypersialorrhoea (or hypersalivation) is a common side effect, and at present there is no therapeutic strategy with a validated indication to treat it. The corrective strategies proposed in the scientific literature have varying degrees of validity. As a result, it is important to regularly update the available data and to make proposals that are in line with the specialties available in each country.</p><p><strong>Material and methods: </strong>A systematic review of the literature respecting PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statements was carried out using the PubMed, Embase and Cochrane databases with the keywords \"Clozapine\", \"induced\", \"hypersalivation\" or \"sialorrhea\". Only articles dealing with substances marketed in France and written in French or English were selected.</p><p><strong>Results: </strong>64 articles were included in this review. The various strategies identified corresponded mainly to treatments with regulatory actions on the cholinergic, noradrenergic and dopaminergic neurotransmission systems. This selection of drug strategies available in France for clozapine-induced hypersalivation identified 17 substances.</p><p><strong>Discussion and conclusion: </strong>The level of evidence concerning treatments for clozapine-induced hypersialorrhoea remains limited. As a first option, and if clinically feasible (benefit-risk ratio), a cautious, gradual reduction in dosage is preferred. If this fails, local anticholinergic treatment may be initiated and evaluated following pharmaco-practical recommendations based on the drugs available in France and their level of evidence.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHO recommendations on psychotherapy for mental care: The need of group therapy.","authors":"Daniela Polese","doi":"10.1016/j.encep.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.encep.2025.02.003","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking depression in women: Integrating sex-specific risk factors and treatments.","authors":"Hugo Bottemanne, Lucie Joly, Caroline Sevoz-Couche, Emmanuelle Corruble","doi":"10.1016/j.encep.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.encep.2025.04.001","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}