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

{"title":"Accepting multiple conditions in psychiatry: From comorbidity to multimorbidity.","authors":"Christophe Gauld, Emmanuel D'Incau, Pauline Espi, Pierre Fourneret, Aileen McGonigal, Jean-Arthur Micoulaud-Franchi","doi":"10.1016/j.encep.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.encep.2024.05.004","url":null,"abstract":"<p><p>The concept of multimorbidity in psychiatry refers to the coexistence of multiple health conditions without conceptualizing a central disorder referring to a patient-centered approach that views every diagnosis equally. It emphasizes a shift from focusing on an index disorder to considering interrelated symptoms crucial in psychiatry due to frequent multimorbidity patterns. In clinical practice, multimorbidity guides patient-centered care helping to address the holistic needs of patients and challenging the organization of mental health care. In research, multimorbidity reshapes study outcomes and promotes the development of patient-reported outcome questionnaires, also posing ethical challenges and advocating for the inclusion of multimorbid patients in personalized interventions. Finally, multimorbidity in psychiatry has public health implications aligning with the socioecological systems perspective. This notion aims to improve prognosis, care, and health costs while impacting global mortality and challenging the conceptualization and organization of psychiatric care.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156572","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":"Obsessive-compulsive symptoms in dementia: Systematic review with meta-analysis.","authors":"Filipe Peste Martinho, Tiago Filipe Ferreira, Daniela Magalhães, Rita Felício, Filipe Godinho","doi":"10.1016/j.encep.2024.06.001","DOIUrl":"https://doi.org/10.1016/j.encep.2024.06.001","url":null,"abstract":"<p><p>Dementia is a highly prevalent syndrome with various causes, characterized by cognitive deficit in one or more domains, with important impairment of functioning, which frequently presents with neuropsychiatric symptoms that may include obsessive-compulsive symptoms.</p><p><strong>Objectives: </strong>The main goal of this meta-analysis was to describe and determine the prevalence of obsessive-compulsive symptoms in dementia.</p><p><strong>Materials and methods: </strong>To accomplish that, MEDLINE, CENTRAL and Psycnet databases were searched from inception to March 2023. The Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data was applied. The principal summary measures were the mean of prevalence of obsessive-compulsive symptoms in patients with dementia and the number of each type of obsession or compulsion.</p><p><strong>Results: </strong>Of the 643 articles screened, 92 were accepted for full-text assessment. Of these, 30 with information on prevalence of obsessive-compulsive symptoms in dementia or any description of those were included, yielding a total of 37 cohorts (5 studies with two cohorts and 1 study with three cohorts). According to our results, obsessive-compulsive symptoms have considerable prevalence in dementia (35.3%, 23.1-47.6%), namely in frontotemporal dementia (48.4%, 29.8-67.0%); obsessive-compulsive symptoms were less frequent in other dementia diagnosis (17.6%, 9.1-26.2%). The more frequent obsessive contents are symmetry (28.6%) and somatic (20.0%); and the more frequent compulsions are checking (27.4%); hoarding is also a relevant symptom (27.8%).</p><p><strong>Discussion: </strong>There was considerable heterogeneity in the prevalence of obsessive-compulsive symptoms in frontotemporal dementia, that is, in part related with diagnostic criteria for dementia, as well as obsessive-compulsive symptom assessment. A careful distinction between compulsions and compulsive-like symptoms is fundamental. Hypervigilance for somatic symptoms and concerns about disease and mortality, as well as deficits in cognitive domains like attention and memory may explain why somatic obsessions and checking compulsions are more prevalent.</p><p><strong>Conclusions: </strong>The present results indicate that obsessive-compulsive symptoms may be prevalent in the clinical course of many patients with dementia, especially frontotemporal dementia. Better instruments are needed to describe obsessive-compulsive phenomena in a reliable and comparable way, particularly in a population such as dementia patients, whose subjectivity is difficult to access.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146776","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":"Psychological first aid in operation for military healthcare providers : a study on pre-deployment training.","authors":"Frédérique Gignoux-Froment, Emeric Saguin, Cécile Gorin, Marianne Daudin, Sophie Annette, Julia Salomé, Mathieu Boutonnet, Luc Aigle, Pierre-Éric Schwartzbrod, Stéphane Travers, Bertrand Lahutte, Marie-Dominique Colas","doi":"10.1016/j.encep.2024.05.005","DOIUrl":"https://doi.org/10.1016/j.encep.2024.05.005","url":null,"abstract":"<p><strong>Introduction: </strong>During operational missions, while the management of physical injuries in the field remains the priority, the identification of operational incapacity of psychological origin is necessary as it is equally crucial for the safety of the individual, the group and the mission. The French Military Health Service has developed a Psychological First Aid Training in Operation (PFATO) course based on relational simulations, for military service members. The aim is to identify the early signs of psychological distress in a comrade and to adopt an adapted and protective attitude. PFATO training is also offered to healthcare providers.</p><p><strong>Methods: </strong>We conducted a descriptive cross-sectional study using a self-administered online questionnaire which was sent after deployment to all physicians or nurses trained in PFATO between July 2019 and July 2021 (n=80). The main objective of our work was to evaluate the relevance of this awareness training among physicians and nurses and to identify specific complementary expectations in operational psychiatry for this population.</p><p><strong>Results: </strong>We obtained a response rate of 55%. Significantly, 21.62% of participants used PFATO during their last deployment and another 20% observed a team member using PFATO. The circumstances of use as reported by participants included acute stress related to combat, conflict with hierarchy or comrades, and suicidal crisis. Among those who used PFATO, the training helped 87.5% of them to identify signs of psychological distress and 100% of them to assist combatants . All respondents stressed the added value of practical simulations during PFATO education. Moreover, this study also makes it possible to identify adaptations needed to optimize this module for healthcare providers.</p><p><strong>Conclusion: </strong>The results suggest the value for healthcare provider of training in first-response psychological care using relational simulation based on the model of raising awareness about PFATO.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146777","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 the legalization of recreational cannabis on the risk of psychosis: A systematic review of the literature].","authors":"Zélie Billion, Matthieu Hein","doi":"10.1016/j.encep.2024.05.003","DOIUrl":"https://doi.org/10.1016/j.encep.2024.05.003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Cannabis is the most consumed illicit substance in Europe. Although its sale and use remain generally prohibited, European public policies have evolved in recent years by legalizing cannabis for medical use and considering its legalization for recreational use. However, in the literature there are arguments in favor of a particular relationship between cannabis consumption and the development of psychotic symptoms. Thus, since cannabis consumption tends to increase with legalization, the aim of this review was to investigate the impact of the legalization of cannabis for recreational use on the risk of psychosis in regions of the world already concerned.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A systematic review of the literature was carried out in April 2024 in the PubMed-Medline database according to PRISMA criteria. The sequence of keywords used was as follows: (\"Cannabis\" [Mesh] or cannabis) AND ((\"Psychotic Disorders\" [Mesh] or Psychotic Disorders) or (\"Schizophrenia Spectrum and Other Psychotic Disorders\" [Mesh]) or (\"Schizophrenia\" [Mesh] or Schizophrenia)) AND legal use. The inclusion criteria applied for the selection of articles in this systematic review were: (1) any article investigating the potential impact of the legalization of cannabis for recreational use on the risk of psychosis (any type of psychosis diagnosed according to ICD-9, ICD-10, DSM-4 or DSM-5) by the intermediary of epidemiological (incidence or prevalence) and/or clinical (ambulatory consultations, emergency visits or hospitalizations) criteria, (2) any type of study (cross-sectional, longitudinal, prospective, retrospective, interventional and experimental) with a methodology including a temporal and/or geographic comparison of the risk of psychosis associated with the legalization of cannabis for recreational use with the exception of literature reviews and clinical cases descriptions, (3) absence of limitation for the age of the populations studied and for the date of publication, and (4) articles written in English or French. After evaluation by the two authors of the 160 articles identified, seven studies investigating the impact of the legalization of cannabis for recreational use on the risk of psychosis were included in this systematic literature review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four of the studies showed no increase in the use of health services for psychosis following the legalization of cannabis for recreational use whereas three other studies highlighted a negative impact of the legalization of cannabis for recreational use on the risk of psychosis. All of these studies were carried out in North America and were characterized by a low level of scientific evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Given the complexity of assessing the impact of the legalization of cannabis for recreational use on the risk of psychosis, additional investigations through studies of better scientific quality are essential. However, based on ","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146774","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":"Retrospective study of hepatitis C screening and seroprevalence in the GHU Paris.","authors":"Alexandra Pham-Scottez, Valérie Dauriac-Le Masson, Oumeyma Ben Dahman, Armel Toquin, Amine Benmostefa, Nabil Hallouche","doi":"10.1016/j.encep.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.encep.2024.05.002","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence of hepatitis C virus (HCV) has been estimated to be approximately ten times higher in patients with psychiatric disorders, but European data are rare and only two French studies have recently been published on the subject. Our objective was to determine the HCV screening rate and the prevalence of HCV in adult patients hospitalised in the largest French psychiatric hospital.</p><p><strong>Methods: </strong>We conducted a retrospective study of all adult patients hospitalised at GHU Paris, from 2019 to 2022, including age, gender, HCV screening, HCV serological status, and the existence of an ICD-10 diagnosis of psychoactive substance use disorder. Descriptive statistics used means±standard deviations and percentages. Bivariable comparisons used Student's t test and Chi-square test.</p><p><strong>Results: </strong>The overall HCV screening rate was 55.4% and increased over the four years from 37.1% in 2019 to 69.4% in 2022. Patients screened were significantly younger people and with a substance use disorder than unscreened patients. The prevalence of HCV over this 4-year period was 2.8% and remained stable. The HCV-positive patients were significantly more male, older and more likely to have substance use disorders than the HCV-negative patients.</p><p><strong>Conclusions: </strong>We found a prevalence rate of HCV ten times higher than the prevalence in the general population, in line with findings in many other European countries. The eradication of HCV will not be possible without the elimination of this \"forgotten reservoir\" of the virus. Efforts must be made in psychiatric hospitals to test all patients in order to treat patients suffering from hepatitis C with direct-acting antivirals.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146778","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":"Should the French approval of baclofen for alcohol dependence be extended to abstinence maintenance?","authors":"Benjamin Rolland, Laurent Karila, Nicolas Franchitto, Camille Barrault, Mickael Naassila","doi":"10.1016/j.encep.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.encep.2024.05.001","url":null,"abstract":"<p><p>Ever since 2018 France has been the only country to approve the gamma aminobutyric acid type B (GABA-B) receptor agonist baclofen for alcohol dependence. This authorization follows a ten-year period of intensive off-label use during which baclofen was used in doses of up to 300 and even 400mg per day to support the gradual reduction of alcohol consumption in patients suffering from alcohol dependence. However, in international clinical trials, baclofen has mainly been studied to support the maintenance of abstinence. The French use of baclofen was therefore somewhat atypical as it paved the way for drug-supported approaches to reducing alcohol consumption, even before nalmefene was marketed. In line with this specific use of baclofen, approval was granted only for alcohol reduction support. However, a recent Cochrane systematic review and meta-analysis by Agabio et al. found significant efficacy only for abstinence maintenance, while no significant effect was found on alcohol reduction outcomes and no dose-response relationship was identified in the analyses. The safety of baclofen was judged to be good. Based on these substantial new results, the Société française d'alcoologie (SFA) now considers that baclofen should also be approved for the maintenance of abstinence. The extension of approval should not lead to the removal of the initial indication or the possibility of using high doses, as some patients have found this therapeutic regimen particularly useful for them. France, which has been a open skies national laboratory on the use of baclofen in alcohol dependence for over ten years, should let this original therapeutic option available to patients. However, it should update the regulatory framework defining the main conditions of access to treatment for patients based on the latest and highest scientific evidence.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146779","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":"Comments on \"Anorexia nervosa: An addiction? Application of the addiction model to eating\".","authors":"Jônatas de Oliveira","doi":"10.1016/j.encep.2024.05.006","DOIUrl":"https://doi.org/10.1016/j.encep.2024.05.006","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146775","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":"Pharmacological and nutraceutical treatments for borderline personality disorder","authors":"","doi":"10.1016/j.encep.2024.04.001","DOIUrl":"10.1016/j.encep.2024.04.001","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914499","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":"Financement de la psychiatrie en France, la question des médicaments onéreux : exemple de l’Esketamine dans l’épisode dépressif caractérisé résistant","authors":"","doi":"10.1016/j.encep.2023.09.007","DOIUrl":"10.1016/j.encep.2023.09.007","url":null,"abstract":"<div><p>In France, the funding of mental health institutions relies on an annual budget allocation. Esketamine, a non-competitive NMDA glutamate receptor antagonist, has been approved for adults with treatment-resistant major depressive disorder since 2019. However, due to its high cost (€200 per 28 mg device, excluding tax), the aim of this work was to evaluate whether the income received by an institution for the management of a patient treated with Esketamine could cover the purchase of devices, based on real clinical data. Within our institution, seven patients underwent treatment with Esketamine during the study period resulting in a total usage of 714 devices, amounting to a purchase cost of €142,800. Over the course of the follow-up period, the institution received €149,054 in revenue for the treatment of these patients. Our analysis reveals that the expense associated with Esketamine constitutes 95.8 % of the income generated from caring for these patients. This not only raises questions about the pricing of this drug but also highlights the lack of a funding system for costly psychiatric drugs. This concern extends to somatic treatments associated with psychiatric care.</p></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138471228","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":"Concordance and validity between versions of the ADHD Conners scale for Parents","authors":"","doi":"10.1016/j.encep.2023.07.006","DOIUrl":"10.1016/j.encep.2023.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The Conners Scale for Parents (CRS-P) is one of the reference tools for the diagnostic assessment of Attention Deficit and Hyperactivity Disorders (ADHD). It is commonly used in both research and clinical practice. The latest edition of the Conners Parents Scale Long Version (CRS-P3L) has undergone extensive modifications but has never been compared with the 2nd edition (CRS-P2L). We aim to study the concordance between the last two editions of the CRS-P, their internal consistency, and their validity against the criteria of the ADHD-RS.</p></div><div><h3>Methods</h3><p>The study population was a cohort of 30 children diagnosed with ADHD<span> participating in a clinical trial. The parents of these children completed both editions of the CRS (P2L and P3L), as well as a DSM-IV ADHD Diagnostic Criteria Rating Scale (ADHD-RS). A linear regression model with the calculation of Lin's concordance coefficient (LCC) was used to study the concordance between the scales. Internal validity was estimated with Cronbach's alpha and inter-criteria validity with Spearman's correlation coefficient.</span></p></div><div><h3>Results</h3><p>The internal consistency found was “correct” to “good” for both editions (Cronbach alpha 0.85 and 0.77), their correlation with the ADHD-RS was medium to low (Spearman's coefficient 0.25 and 0.09). Concordance between the overall score and the sub-scores of the two editions of the same Conners scale (CRS-P2L and CRS-P3L) was fair to medium (LCC 0.29 to 0.69).</p></div><div><h3>Conclusions</h3><p>The third edition of the long version of the CRS-P showed very poor concordance with the previous edition. The diagnostic profile of the children seems to have evolved with the new edition, which appears to affect the interpretation of the tests.</p></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10289832","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}