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

{"title":"[Adversity, adolescent psychiatric disorders and complex trauma: Comorbidities or overlap?]","authors":"Jean Belbèze, Claire Lamas, Jérôme Silva, Maurice Corcos, Marion Robin","doi":"10.1016/j.encep.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.009","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methodology: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182514","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":"The psychosocial rehabilitation washing in France.","authors":"Laurent Lecardeur, Nicolas Franck, Marie-Cécile Bralet","doi":"10.1016/j.encep.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.010","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182158","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":"[Overview of therapeutic approaches for complex psychotrauma in children and adolescents].","authors":"Julie Rolling","doi":"10.1016/j.encep.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.encep.2025.05.006","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182518","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":"[Impact of transcranial magnetic stimulation on depressive symptoms relief in patients with chronic neuropathic pain and comorbid depression: A narrative literature review].","authors":"Pierre-Edouard Durade-Replat, Marie Floccia, Anne Philippe, Thomas C M Bienvenu","doi":"10.1016/j.encep.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.encep.2025.05.008","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034458","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":"Cannabis use and male sexuality in a Tunisian sample: A case-control study.","authors":"Mariem Bouhamed, Syrine Ajmi, Rim Masmoudi, Abdelmajid Zahaf, Ines Feki, Rim Sallemi, Jawaher Masmoudi","doi":"10.1016/j.encep.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.encep.2025.08.002","url":null,"abstract":"<p><strong>Aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030839","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":"The pathologies of artificial intelligence: Lessons for and from clinical psychiatry.","authors":"Szilvia Lestyan, Delphine Maucort-Boulch, Pierre Fourneret, Hugo Bottemanne, Élise Hassler, Maxime Ducret, Christophe Gauld","doi":"10.1016/j.encep.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.006","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030817","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":"[Speech markers as objective indicators of apathy: New insights from a case study].","authors":"Eloïse Da Cunha, Amélie David, Constance Retiere, Lise Rudler, Lyne Daumas, Eric Ettore, Philippe Robert, Raphaël Zory, Auriane Gros, Valeria Manera","doi":"10.1016/j.encep.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.005","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Observations: </strong>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.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030778","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 integrative understanding of complex trauma].","authors":"Marion Robin, Michel Spodenkiewicz, Jean Belbèze, Maurice Corcos","doi":"10.1016/j.encep.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.007","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030746","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":"Comparison of youth psychiatric hospitalizations by type of facility in 2022.","authors":"Antoine Teston, Chloé Saint-Dizier, Julian Betremieux, François Jean, Emmanuel Chazard, Maxime Bubrowszky, Antoine Lamer","doi":"10.1016/j.encep.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.003","url":null,"abstract":"<p><strong>Objective: </strong>The authors sought to assess differences in children and adolescents' characteristics according to the type of hospital they were admitted to.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016574","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":"Body image dissatisfaction in brazilian nutrition students: A cross-sectional study.","authors":"Gabriele Costa Bensberg, Ana Claudia Lunelli Moro, Débora Fernandes Pinheiro","doi":"10.1016/j.encep.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.004","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>A total of 46 students participated, of whom 76.08% (n=35) were female. The mean BMI was 23.33kg/m², with a predominance of eutrophic individuals (74.28%). In contrast, the mean BMI for males was 28.42kg/m², 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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016553","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}