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

{"title":"The Integrative Temporal Identity Model (TIM-E) for complex psychotrauma: A randomized comparative pilot study.","authors":"Erwan Dieu, Alix Lavandier, Samantha Aljoboory","doi":"10.1016/j.encep.2026.08.013","DOIUrl":"https://doi.org/10.1016/j.encep.2026.08.013","url":null,"abstract":"<p><strong>Background: </strong>Complex post-traumatic stress disorder (CPTSD) is distinguished from PTSD by enduring disturbances in emotion regulation, self-concept, and relationships (disturbances in self-organization, DSO). Validated PTSD treatments (trauma-focused CBT, EMDR) can reduce core symptoms, but the persistence of DSO, adherence difficulties, and partial non-response in certain polytraumatized patients justify the exploration of integrative, phased, and process-based approaches. In this perspective, the TIM-E model proposes a mechanistic target: restoring temporal continuity of the self (past/present/future) to reduce traumatic presentification (the subjective and involuntary experience of the trauma occurring in the present) and reopen capacities for future-oriented projection and action.</p><p><strong>Methods: </strong>Fifteen adults presenting with complex psychotrauma (exposure to at least two distinct traumatic events, marked functional impairment) were randomized into three groups (n=5/group): (1) TIM-E/ORACLE (a phased integrative program combining individual sessions including EMDR and temporality work, a virtual reality (VR) component centered on temporal avatars, and skills-oriented group sessions), (2) standard individual EMDR (comparable dose), and (3) a waitlist control (usual non-psychotherapeutic care). Symptoms were assessed pre- and post-intervention using the PCL-5 (PTSD) and the SIDES-SR (complex symptomatology). This study is presented as a pilot/exploratory trial. Within-group non-parametric tests and between-group comparisons with effect sizes were reported.</p><p><strong>Results: </strong>TIM-E showed a significant reduction in PCL-5 (P=0.005) and SIDES-SR (P=0.0001) scores, with a high proportion of sub-clinical PCL-5 scores. EMDR significantly reduced the SIDES-SR (P=0.002) and showed a trend on the PCL-5 (P≈0.08). The control group showed no significant improvement. Post-treatment between-group differences emerged on the PCL-5 (F(2,12)=6.15, P=0.014, η_p²=0.51) and particularly on the SIDES-SR (F(2,12)=15.4, P=0.0005, η_p²≈0.72), in favor of TIM-E, notably for complex dimensions.</p><p><strong>Discussion: </strong>Despite significant limitations (small sample size, lack of blinding and active control), these results suggest that a temporality- and identity-focused integrative program could improve not only PTSD symptoms but also the DSO of CPTSD. Larger randomized controlled trials, including clinician-administered diagnostic measures and mechanistic mediators (future projection, identity continuity), are warranted.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208223","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":"Factorial validation of the PC-PTSD-5 in the adult Quebec population.","authors":"Jacques D Marleau, Mélissa Généreux","doi":"10.1016/j.encep.2026.08.014","DOIUrl":"https://doi.org/10.1016/j.encep.2026.08.014","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to evaluate the factor structure and psychometric properties of the PC-PTSD-5 scale applied to the COVID-19 crisis among Quebec adults. The assessment of factor structure has rarely been conducted in the general population.</p><p><strong>Methodology: </strong>Two online surveys were conducted in February and May-June 2021 among adults living in Quebec. Exploratory and confirmatory factor analyses, together with item response theory analyses, were conducted to evaluate the unidimensionality of the PC-PTSD-5.</p><p><strong>Results: </strong>The factor analysis results supported the presence of a unidimensional structure. Configural and scalar invariance were also supported across gender, age, and language most spoken at home. In addition, the item response theory analyses provided further evidence of the scale's psychometric robustness at the item level. The convergent and divergent validity results also supported the criterion-related validity of the measure.</p><p><strong>Discussion and conclusion: </strong>The results confirm the existence of a unidimensional structure for the PC-PTSD-5 scale items related to the COVID-19 crisis. Therefore, using the total score of the five items is appropriate. Given its excellent psychometric properties and brevity, its use is recommended among the adult population of Quebec.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208239","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":"French psychiatric caregivers' perceptions of psychedelics: A national survey.","authors":"Anne Buot, Jean-Del Burdairon, Luc Mallet, Raphaël Gaillard, Benjamin Rolland, Lucie Berkovitch","doi":"10.1016/j.encep.2026.06.015","DOIUrl":"https://doi.org/10.1016/j.encep.2026.06.015","url":null,"abstract":"<p><strong>Objectives: </strong>The use of psychedelic substances such as LSD, psilocybin, and dimethyltryptamine is currently being re-evaluated for their therapeutic potential in psychiatry. While international clinical research had started in the 2010s, France only initiated its first psychedelic trials in 2024. This study aimed to explore the knowledge, perceptions, and attitudes of French mental health professionals regarding the use of psychedelics in clinical and recreational settings.</p><p><strong>Materials and methods: </strong>An anonymous online survey was conducted between December 2023 and January 2024 among psychiatry caregivers in France. The questionnaire included 19 items across five sections: demographic information, knowledge of psychedelics, perception of their therapeutic and recreational use, and personal experimentation with psychoactive substances. Data was analyzed using linear and ordinal regressions, controlling for age, gender, profession and experience with ketamine.</p><p><strong>Results: </strong>A total of 298 respondents participated, primarily from public hospitals. Most were psychiatrists (41.4%) or psychologists (20.4%). About 88% had heard of medical studies on psychedelics, with high awareness of psilocybin and ketamine use in treatment-resistant depression. However, awareness of other therapeutic indications was limited. Fifty-three percent rated the therapeutic benefit-risk ratio of psychedelics as favorable, whereas 61% rated recreational use as dangerous. Favorable perception of therapeutic use was associated with male gender, personal experience with psychedelics, and clinical practice with ketamine. However, in a subgroup of clinicians (psychiatrists, residents, nurses) only clinical practice with ketamine remained significantly associated with favorable opinions. Personal experimentation was the only predictor of more positive attitudes toward recreational use.</p><p><strong>Discussion: </strong>The results indicated a moderate but cautious openness among French psychiatry caregivers towards therapeutic psychedelics, less enthusiastic than in other international surveys. Their opinions were strongly influenced by personal and clinical experience. A notable finding was the clear separation caregivers made between therapeutic and recreational contexts.</p><p><strong>Conclusions: </strong>French psychiatry caregivers are aware of the growing interest in psychedelics and express moderate support for their medical use. Clinical practice with ketamine appears to play a pivotal role in shaping favorable attitudes. As France embarks on clinical trials with psychedelics, caregiver perspectives are likely to evolve, warranting further surveys in the coming years.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208253","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":"Autistic burnout: Early insights from a systematic review on characteristics, precipitating factors, and protective mechanisms.","authors":"Priscille Bory, Marine Fiorentino, Laura Bérenguier, Anne Denis","doi":"10.1016/j.encep.2026.08.011","DOIUrl":"https://doi.org/10.1016/j.encep.2026.08.011","url":null,"abstract":"<p><strong>Objectives: </strong>Despite sustained advocacy by autistic individuals over the years, autism research has largely overlooked autistic burnout, a critical but understudied phenomenon. Recently, scientific research has begun to address this gap. This systematic review of literature aims to consolidate scientific knowledge about autistic burnout. The objectives of this study are to provide a comprehensive overview of the known characteristics of autistic burnout, its precipitating factors and strategies for recovery and to clarify how it differs from depression.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines we searched PubMed, PsychINFO, and Web of Science in January 2025 to identify articles that fit our study goals. Some inclusion and exclusion criteria were determined for this review. We appraised the quality of studies with a Critical Appraisal Skills Programme (CASP) checklist. A qualitative analysis was conducted based on the final selected articles.</p><p><strong>Results: </strong>Thirteen articles met inclusion criteria, revealing key characteristics of autistic burnout. Autistic burnout is characterized by a range of symptoms including mental and physical exhaustion, and impairment in cognitive capacities, particularly executive functions. Furthermore, significant impacts on mental health were reported with self-injury and suicidal ideation. Current research conceptualized autistic burnout as a chronic condition with emerging evidence distinguishing it from depression. Key factors precipitating autistic burnout included masking, social interaction and exposure to stressors. Recovery strategies for autistic individuals often emphasized increased self-awareness of personal need and seeking support within an autistic community. However, some studies suggested that not all individuals fully recover from autistic burnout or might benefit from targeted therapeutic interventions.</p><p><strong>Conclusion: </strong>This review highlights the lack of knowledge among professionals about autistic burnout and emphasizes the detrimental impact this can have on patient care. Autistic burnout being a new study subject, further research is necessary to deepen conceptual clarity and explore the nuanced dimensions of this phenomenon. Future work should strive to improve representativity in their study.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208096","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":"Sexual craving as a core process in dysregulated sexual behaviors: Psychometric validation of the Short Scale of Sexual Craving (3SC).","authors":"Cécile Miele, Valérie Moulin, Bruno Pereira, Julien Cabé, Servane Barrault","doi":"10.1016/j.encep.2026.06.006","DOIUrl":"https://doi.org/10.1016/j.encep.2026.06.006","url":null,"abstract":"<p><strong>Background: </strong>Dysregulated sexual behaviors (DSB) constitute a clinically heterogeneous field in which behavioral content provides limited information about underlying psychological processes. Sexual craving, defined as an unwanted, intrusive, and difficult-to-regulate urge toward sexual behavior, may represent a measurable process-based dimension relevant across heterogeneous DSB presentations. No validated brief measure of sexual craving exists for DSB beyond pornography use.</p><p><strong>Methods: </strong>Seventy-six adults reporting DSB, including normophilic and paraphilic presentations, were recruited through clinical and community channels in France. Participants completed the Short Scale of Sexual Craving (3Sc), a three-item measure assessing frequency, intensity, and perceived loss of control, and the Sexual Addiction Screening Test (SAST), used as a criterion comparator. Psychometric analyses examined acceptability, internal consistency, structural validity, and criterion validity, with sensitivity analyses comparing samples with and without participants reporting child sexual exploitation material (CSEM) use.</p><p><strong>Results: </strong>Acceptability was satisfactory. Internal consistency was acceptable given the scale's brevity and multidimensional design. Structural analysis showed theoretically coherent clustering of 3Sc items with SAST content. Craving frequency and intensity discriminated between SAST-positive and SAST-negative participants across both normophilic and paraphilic presentations. Perceived loss of control was less discriminant among participants reporting CSEM use, likely reflecting context-specific inhibition and reporting biases.</p><p><strong>Conclusions: </strong>The 3Sc demonstrates preliminary psychometric support as a brief, process-centered, and non-moralistic screening tool for sexual craving across heterogeneous DSB. These findings support a reorientation of DSB assessment, from classifying behavioral content toward identifying how sexual urges are regulated, and provide an empirical operator for examining addiction-informed hypotheses without presupposing their validity.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041793","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":"French validation of the short version of the ASA questionnaire: An exploration of the socio-technical imaginaries and cosmology of Socially Interactive Agent evaluation.","authors":"Vincent P Martin, Charlotte Menard, Jean-Arthur Micoulaud-Franchi, Jacopo Bodini, Adélaïde de Lastic, Rocio Berenguer, Stéphane Mouchabac, Fabien Boucaud, Catherine Pelachaud, Florian Pécune, Gemma Serrano","doi":"10.1016/j.encep.2026.07.005","DOIUrl":"https://doi.org/10.1016/j.encep.2026.07.005","url":null,"abstract":"<p><strong>Context: </strong>Socially Interactive Agents (SIAs) in mental health are of great promise for psychiatry, but currently lack validated instruments to evaluate both technological acceptance and clinical alliance. In the Human-Computer Interface (HCI) community, SIAs are broadly evaluated using the Artificial Social Agent Questionnaire (ASAQ), to evaluate how users perceive and interact with SIAs. Despite its importance in the SIA community, this questionnaire is unknown in psychiatry and has never been validated in French. Furthermore, doubts remain about the constructs measured by it.</p><p><strong>Objectives: </strong>Our objective is threefold: (i) validate the short version of ASAQ in French (24 items); (ii) analyse through Exploratory Graphical Analysis (EGA) the underlying dimensions of the short ASAQ; (iii) discuss an interdisciplinary conceptual analysis of the socio-technical imaginaries and cosmology (the way to inhabit the world) promoted by the SIA community.</p><p><strong>Method: </strong>After a rigorous translation process, we recruited 203 French-speaking participants to evaluate 14 videos of SIA/human interactions using the ASAQ. We validated the short ASAQ using both usual psychometric methods and EGA.</p><p><strong>Results: </strong>The French version of the short ASAQ had satisfactory psychometrics properties. The EGA revealed three underlying dimensions, expertly named 'instrumental' (items related to technological acceptance of the SIAs), 'affective' (items related to affective aspects of the interaction with SIAs) and 'relational' (items related to relational aspects of the interaction with SIAs).</p><p><strong>Discussion: </strong>The interdisciplinary conceptual analysis identified the tension between instrumental and the relational dimensions - mediated by the affective one - as part of a naturalistic cosmology that traditionally contrasts nature and culture.</p><p><strong>Conclusion: </strong>This study contributes to bridging the gap between the evaluation frameworks of HCI and the clinical frameworks of psychiatry, toward a more integrated understanding of digital relationality. Recognizing and interrogating the underlying socio-technical imaginaries and cosmology beyond the ASAQ is essential for any future adaptation of the ASAQ within mental health contexts.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041841","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":"Artificial intelligence in psychiatry: Conditions for a successful clinical innovation.","authors":"Stephane Mouchabac, Alexis Bourla, Olivier Bonnot, John Torous","doi":"10.1016/j.encep.2026.07.001","DOIUrl":"https://doi.org/10.1016/j.encep.2026.07.001","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031920","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":"Acceptability of artificial intelligence in psychiatry: A script-based and network analysis study among French psychiatrists.","authors":"Stéphane Mouchabac, Vincent P Martin, Yannis Constantinidès, Pierre-Alexis Geoffroy, Ludovic Samalin, John Torous, Alexis Bourla, Olivier Bonnot","doi":"10.1016/j.encep.2026.07.002","DOIUrl":"https://doi.org/10.1016/j.encep.2026.07.002","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is increasingly integrated into psychiatric practice, raising not only technical but also epistemological and ethical questions. Beyond performance, the acceptability of AI remains a critical condition for its implementation, particularly in a field deeply rooted in subjectivity and clinical judgment.</p><p><strong>Objectives: </strong>To assess the acceptability of AI-based tools in psychiatry using a scenario-based approach, and to explore the structural relationships between its key dimensions (utility, usability, reliability, risk, and professional alignment) through network analysis.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using the Script Method, presenting three clinical vignettes reflecting successive stages of care: diagnostic support, AI-assisted therapeutic guidance, and digital monitoring via wearable devices. A total of 1533 participants were recruited, of whom 727 were included in the final analysis. Acceptability was assessed using Likert-scale items derived from UTAUT models and a pragmatic/social acceptability framework. Psychometric validation included internal consistency analyses and Unique Variable Analysis. Network analysis and Exploratory Graphical Analysis were performed to identify structural patterns of acceptability.</p><p><strong>Results: </strong>Acceptability emerged as a multidimensional construct structured around four communities: (1) reliability and ease of use, (2) usefulness and professional acceptability, (3) risks related to professional culture, and (4) practical risks and implementation. The most central node was related to the preservation of the clinician's role in decision-making, highlighting the centrality of professional identity. Risk perception was globally low, with ceiling effects on several items. Digital literacy and theoretical orientation significantly influenced acceptability, with structural differences observed in network connectivity. Gender differences were particularly marked in the digital monitoring scenario.</p><p><strong>Conclusions: </strong>The acceptability of AI in psychiatry depends less on technical performance than on its alignment with professional values and clinical reasoning. AI is more readily accepted as a support to clinical judgment than as an autonomous system. These findings suggest that the successful integration of AI will require the development of epistemically compatible systems that preserve clinician autonomy and the therapeutic relationship.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031908","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":"Cross-cultural adaptation and validation of the CCQ-Brief in Moroccan Arabic: A psychometric study.","authors":"Brahim El Kinany, Meryem El Mghari, Salma Alaoui Balghiti, Noussissy Sandokane Hounnoukon, Assia Boukniter, Ajebli Mohammed, Amal Ouraghene, Ferdaouss Qassimi, Amine Bout, Chadya Aarab, Samira El Fakir, Rachid Aalouane","doi":"10.1016/j.encep.2026.06.012","DOIUrl":"https://doi.org/10.1016/j.encep.2026.06.012","url":null,"abstract":"<p><strong>Introduction: </strong>Craving is a fundamental clinical dimension of cocaine use disorders and plays a major role in the maintenance of dependence and the occurrence of relapse. Despite its clinical relevance, no validated instrument was available in Moroccan Arabic specifically designed to assess cocaine craving. This study aimed to adapt and validate the Cocaine Craving Questionnaire - Brief (CCQ-Brief) in Moroccan Arabic.</p><p><strong>Methods: </strong>The scale was translated using the round-trip translation procedure, followed by expert review and preliminary testing. Psychometric properties were reviewed in a cross-sectional study including patients with cocaine use disorder. Acceptability, internal consistency, convergent validity, inter-rater reliability, and test-retest reliability were assessed. Convergent validity was examined using the craving intensity subscale of the Voris Cocaine Craving Scale (VCCS).</p><p><strong>Results: </strong>Sixty participants were included. The scale showed high acceptability, with no missing data and a short response time. Internal consistency was high (Cronbach's α=0.87). A strong correlation with the VCCS-Craving intensity (r=0.968) confirmed convergent validity. Reproducibility indices were excellent, with an inter-rater ICC of 0.98 and a test-retest ICC of 0.95. Limited floor and ceiling effects were observed for some items.</p><p><strong>Conclusion: </strong>The Moroccan Arabic version of the CCQ-Brief shows good psychometric properties, making it a reliable, simple, and culturally appropriate tool for assessing cocaine craving in clinical practice and academic research.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031950","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":"[Tailoring care to the mind: The emerging role of artificial intelligence in precision psychiatry. Part II: Validating, regulating and integrating artificial intelligence into care].","authors":"Sandy Bergonzo, Stéphane Mouchabac, Yann Auxéméry, Andrii Kulakovskyi, Engin Altunlu, Marion Leboyer, Olivier Bonnot, Alexis Bourla, Nikolaos Koutsouleris, Solène Frileux","doi":"10.1016/j.encep.2026.08.007","DOIUrl":"https://doi.org/10.1016/j.encep.2026.08.007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Precision psychiatry seeks to tailor care to the clinical, biological, cognitive, behavioral, and contextual characteristics of each patient. Artificial intelligence may help achieve this goal by combining multimodal data, identifying complex patterns, following individual trajectories, and refining prognostic or therapeutic stratification. Yet strong statistical performance does not automatically translate into meaningful clinical benefit. This second part of Tailoring Care to the Mind: The Emerging Role of Artificial Intelligence in Precision Psychiatry explores the conditions required for an algorithm to become a reliable, acceptable, equitable, and responsible clinical innovation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We conducted a narrative and conceptual review organized around three main questions. First, how should predictive models be evaluated from a clinical perspective? Second, under what conditions can they be integrated into routine psychiatric care? Third, what ethical, regulatory, and relational issues arise when these tools are used in practice? Particular attention was given to discrimination, calibration, decision usefulness, external validation, bias, acceptability, interpretability, responsibility, and human oversight.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Statistical performance alone is not enough to establish the clinical value of a model. A useful system must not only distinguish between patients with different outcomes, but also provide risk estimates that match what is actually observed in practice. It should demonstrate added value compared with clinical judgment, existing scores, or standard care, while taking into account the consequences of false-positive and false-negative predictions. External validation is essential because a model that performs well in one population or center may be less reliable elsewhere. Performance must also be examined across clinically relevant subgroups to identify unequal or potentially discriminatory effects. Once deployed, models require ongoing monitoring, as changes in populations, data collection, or clinical practice may lead to model drift and loss of calibration. Their integration into care also depends on practical factors: the information provided must be understandable, timely, useful, and compatible with clinical workflows. Acceptability among clinicians and patients is shaped by perceived usefulness, reliability, transparency, preservation of professional roles, maintenance of human contact, and confidence in the protection of sensitive psychiatric data. Ethical legitimacy further requires clear rules for data access, secondary use, accountability, and the possibility of questioning or overriding an algorithmic recommendation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Artificial intelligence should be seen neither as a replacement for the psychiatrist nor as a neutral technical device. It becomes a third component within the clinical relationship","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009458","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}