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

{"title":"Impact socioéconomique des troubles du neurodéveloppement en France","authors":"Bertrand Schoentgen ,&nbsp;Edmée Chatin ,&nbsp;Helga Sallé ,&nbsp;Mikaël Leroy ,&nbsp;Nicolas Bonnet ,&nbsp;Bénédicte Défontaines","doi":"10.1016/j.encep.2024.11.015","DOIUrl":"10.1016/j.encep.2024.11.015","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to assess the economic impact of delays and inadequate diagnosis and treatment for neurodevelopmental disorders (NDDs) in France, affecting 2 to 3 million individuals. Neurodevelopmental disorders, including autism spectrum disorder (ASD), learning disabilities, and attention deficit hyperactivity disorder (ADHD), are often described as “invisible” disabilities, but they generate significant societal costs.</div></div><div><h3>Method</h3><div>The study was conducted with the support of Ashoka France as part of a collaboration between Goodwill-Management and the Aloïs Association. Goodwill-Management, a firm specializing in support for social economy organizations, offers <em>pro bono</em> assistance each year for social impact assessment. In 2022, it selected the project of the Aloïs Association, a center of expertise on cognitive disorders at all stages of life, based in Paris, to conduct the first medico-economic study on NDDs in France. The methodological approach comprised a thorough literature review, data collection from public organizations, and detailed economic analysis. The study sought to identify the potential cost-saving levers and highlight the economic burden of late diagnosis and variable care pathways for NDDs.</div></div><div><h3>Results</h3><div>The study revealed that the economic cost of NDDs in France is estimated at approximately 28 billion euros per year. In comparison, the estimated costs are 74 billion dollars in the United States and 37 billion dollars in Canada. A major contributor to these costs is the delay in diagnosis, coupled with the heterogeneity of care, which significantly impacts the professional lives of individuals with NDDs and their caregivers.</div></div><div><h3>Conclusion</h3><div>The findings underscore the importance of early diagnosis and standardized care pathways to reduce societal costs and improve the quality of life for affected individuals. To reduce societal costs and improve the quality of life for those affected, the proposed recommendations emphasize the importance of early diagnosis, increasing access to care methods recommended by the HAS (French National Health Authority), and promoting targeted prevention and psychoeducation interventions within companies, aimed at supporting employees suffering from these disorders as well as employee caregivers. Implementing these measures is expected to generate substantial economic savings and support the inclusion and well-being of individuals with neurodevelopmental conditions.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 5","pages":"Pages 557-562"},"PeriodicalIF":1.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434240","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 stability of the alternative model of personality disorders: Example of the situation related to Covid-19","authors":"Serge Combaluzier,&nbsp;Chloé Bourgoise","doi":"10.1016/j.encep.2024.11.016","DOIUrl":"10.1016/j.encep.2024.11.016","url":null,"abstract":"<div><h3>Aim and scope</h3><div>This article aims to explore the relationships between two key levels (Criteria A and B) in the Alternative Model of Personality Disorders (AMPD). Specifically, it examines the articulation between the level of personality functioning (LPF) and the pathological personality dimensions (PPD) to understand their respective contributions to personality disorder (PD) diagnosis.</div></div><div><h3>Method</h3><div>We analyzed data collected through the LPFS-BR and PID-5-BF instruments from two randomized samples of non-clinical participants, gathered both before (<em>n</em> <!-->=<!--> <!-->124) and after (<em>n</em> <!-->=<!--> <!-->126) the COVID-19 pandemic and subsequent lockdown. Mediation analyses were conducted to clarify how LPF and PPD interact in the assessment of PDs.</div></div><div><h3>Results</h3><div>Findings indicate notable intensity differences in LPF levels (<em>P</em> <!-->&lt;<!--> <!-->0.001, Cohen's d<!--> <!-->&gt;<!--> <!-->0.92), alongside high stability in both overall PD severity and PPD traits (<em>P</em> <!-->&gt;<!--> <!-->0.05). Regression analysis allowed us to examine the combined effects of Lockdown, Identity, and Detachment on PD severity through mediation modelling. Results suggest that Identity mediates the effects of both Lockdown and Detachment, with Detachment also having a direct impact.</div></div><div><h3>Discussion</h3><div>These results indicate that while certain aspects of the AMPD are context-sensitive, the PPD may offset these fluctuations through both direct and indirect mechanisms.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 5","pages":"Pages 526-531"},"PeriodicalIF":1.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426716","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":"Instability of the unstable, an observation of borderline personality disorder traits and impulsivity declaration during the pandemic","authors":"Sylvia Martin","doi":"10.1016/j.encep.2024.10.007","DOIUrl":"10.1016/j.encep.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Borderline personality disorder (BPD) is a complex mental health condition characterized by emotional, relational, and cognitive dysregulations. It is often misdiagnosed or underdiagnosed, contributing to stigmatization and inconsistent treatment. The COVID-19 pandemic, with its unique stressors, offered an opportunity to examine BPD traits in the general population.</div></div><div><h3>Aims</h3><div>This study compares the manifestation of BPD traits during the COVID-19 pandemic across clinical and non-clinical populations in France. It hypothesizes that the general population, despite experiencing similar stress-induced behaviors, will exhibit different levels of BPD traits.</div></div><div><h3>Methods</h3><div>We administered the Borderline Personality Questionnaire (BPQ), Impulsive Behavior Scale (UPPS), and Beck Hopelessness Scale (BHS) to a sample of 563 respondents via an online questionnaire.</div></div><div><h3>Results</h3><div>The findings reveal that while all groups exhibited elevated impulsivity and anxiety, BPD patients exhibited significantly higher levels of hopelessness, suicidal tendencies, anxiety and depression. This indicates the chronic and pervasive nature of BPD compared with stress-induced behaviors in the general population or other clinical samples.</div></div><div><h3>Discussion</h3><div>The results highlight the distinct nature of BPD traits and the necessity of refined diagnostic and treatment approaches. We specifically note that the “Emptiness” trait affects the overall severity of BPD. The analysis allows for the nuanced understanding that BPD, rather than being a unified pathological entity, is a disorder in which predominant traits can affect the overall severity.</div></div><div><h3>Conclusion</h3><div>BPD is a prevalent yet underdiagnosed disorder, with traits such as chronic emptiness remaining stable despite external stressors such as the COVID-19 pandemic. Focusing on understudied traits such as emptiness could enhance therapeutic approaches, and further research is needed to refine diagnostic methods and better understand BPD's diverse symptom profiles.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 5","pages":"Pages 498-508"},"PeriodicalIF":1.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426711","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":"Health professional's representations of parents with illnesses or disabilities","authors":"Charline Darmaillacq ,&nbsp;Aude-Clémence Truquin ,&nbsp;Sabine De Fougières ,&nbsp;Emilie Boujut ,&nbsp;Jaqueline Wendland","doi":"10.1016/j.encep.2024.11.013","DOIUrl":"10.1016/j.encep.2024.11.013","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study is to analyze professionals’ representations of parents with mental and/or physical health conditions.</div></div><div><h3>Methods</h3><div>We interviewed 51 health professionals and social workers. Using an inductive approach and NVivo software, we proceeded to a qualitative analysis. To comprehensively examine the content of professionals’ responses, each coding unit was assessed according to its theme (representation of the family, representation of the condition, actions on representations) and valence (negative, cautious, positive or neutral tone).</div></div><div><h3>Results</h3><div>Three major themes emerged from the interviews: 1 – Family representations: The child is vulnerable and negatively impacted by parents with mental and/or physical health conditions. This impact is embodied mostly by the mother, the father being seen as a subsidiary parental function or a potential intermediary. The extended family is invested as a protective factor. 2 – Condition representations: Physical impairment is more positively viewed than mental health conditions, psychosis being particularly negative; physical impairments are seen as more compatible with qualitative parenthood. 3 – Actions on representations: Becoming aware of their representations and reflecting on them allow professionals to think of the unique character of each situation and to put their representations into perspective; time and exposure to parents with health conditions leads them to revise their most negative representations.</div></div><div><h3>Conclusion</h3><div>While the results are broadly in line with the literature, this study investigates in detail the previously unexplored point of view of professionals. Revealing their representations may contribute to improving practices and care provided to families with mental and/or physical health conditions.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 5","pages":"Pages 509-518"},"PeriodicalIF":1.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374826","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":"Mindfulness-based relapse prevention for cannabis regular users: Finally outcomes of a randomized clinical trial","authors":"Jean-Marc Pélerin ,&nbsp;Thomas Gegout ,&nbsp;Thomas Schwitzer ,&nbsp;Raymund Schwan ,&nbsp;Eliane Albuisson ,&nbsp;Maud Gédor ,&nbsp;Vincent Laprévote ,&nbsp;François Bourgognon","doi":"10.1016/j.encep.2024.11.014","DOIUrl":"10.1016/j.encep.2024.11.014","url":null,"abstract":"<div><h3>Background</h3><div>Cannabis is the most widely used drug in the world, and the therapies proposed to help withdrawal are moderately effective. The MACBETH project is a pilot study in France. It evaluates the effectiveness of the mindfulness-based relapse prevention (MBRP) protocol for active cannabis users.</div></div><div><h3>Methods</h3><div>It comprises of two groups, an MBRP group and a Treatment As Usual (TAU) group, each with twenty participants. The primary endpoint reflects the frequency of cannabis use, and some secondary endpoints were evaluated (signs of withdrawal, adherence to treatment, and changes in consumption).</div></div><div><h3>Results</h3><div><span>We found no significant difference between the two groups on the primary and secondary endpoints. We found one significant difference in the MBRP group by further analysis for treatment adherence via an indirect criterion, the attendance at all sessions (</span><em>P</em>-value<!--> <!-->=<!--> <span>0.01). The number of units consumed from week 1 to week 8 significantly differed in the MBRP group (</span><em>P</em>-value<!--> <!-->&lt;<!--> <!-->0.05) but not in the TAU group. The average number of units consumed from week 8 to 12 increased by 1.5 in the MBRP group compared with 3.4 in the TAU group. The MBRP protocol appears to be at least as effective as the TAU protocol on the assessed criteria, and the results seem to be more durable, although not significant (<em>P</em>-value<!--> <!-->=<!--> <!-->0.2).</div></div><div><h3>Conclusions</h3><div>The MBRP protocol shows interesting results compared to TAU in this major public health problem. Further studies could deepen this field of research, especially by following samples over the long-term and measuring cravings. The MBRP protocol is proving to be an effective and serious alternative psychotherapy to drug therapies in the world of addiction.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 5","pages":"Pages 519-525"},"PeriodicalIF":1.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374964","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":"L’absence d’examen physique par le psychiatre n’est pas éthique","authors":"Mathilde Moizard ,&nbsp;Pierre A. Geoffroy","doi":"10.1016/j.encep.2024.12.001","DOIUrl":"10.1016/j.encep.2024.12.001","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 2","pages":"Pages 109-110"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374732","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":"First-episode psychosis among people who are incarcerated: What is hidden behind the “prison psychosis” concept?","authors":"Marion Eck ,&nbsp;Margot Mouchonnet ,&nbsp;Anaïs Vaglio ,&nbsp;Pierre Thomas ,&nbsp;Ali Amad ,&nbsp;Thomas Fovet","doi":"10.1016/j.encep.2024.11.011","DOIUrl":"10.1016/j.encep.2024.11.011","url":null,"abstract":"<div><div>“<em>Prison psychosis</em>” is a historical concept that is still used in clinical practice, but little explored in research. In this short paper, we propose to revisit this concept by studying first-episode psychosis (FEP) in the prison population. We analyzed a series of incarcerated people who were hospitalized for a FEP from November 2020 to May 2021 in a French facility. We dated the onset of the first psychotic symptoms (PSs) in relation to the date of incarceration and of hospitalization and we calculated the duration of untreated psychosis (DUP). While the characteristics of our sample were consistent with what we know about people diagnosed with psychosis in correctional settings (young men with positive symptoms and psychiatric comorbidities), we found great heterogeneity in the DUP and in the chronological sequence between incarceration and the onset of PSs. This preliminary but original work shows the diversity of first diagnosis of psychosis in prison, reflecting the multiplicity and complexity of interactions between psychosis and incarceration.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 4","pages":"Pages 463-465"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374869","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":"Prevalence of mental disorders in closed educational centers in France","authors":"Guillaume Bronsard ,&nbsp;Pierre-Antoine Leroux ,&nbsp;Issaga Diallo ,&nbsp;Jules Eleuterio ,&nbsp;Alban Le Bihan ,&nbsp;Laurent Boyer ,&nbsp;Nathalie Lavenne-Collot","doi":"10.1016/j.encep.2023.11.026","DOIUrl":"10.1016/j.encep.2023.11.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Closed educational centres (CEC) receive young offenders who most often have a conduct disorder (CD). Mental disorders other than conduct disorder are a negative factor in the effect of educational actions. Moreover, adverse life experiences are frequent vulnerability factors in this population. This article aims to document the prevalence and links between psychiatric disorders, exposure to trauma, and the psycho-behavioural characteristics of adolescents placed in CEC.</div></div><div><h3>Method</h3><div>We conducted a multicentre epidemiological study on a sample of 101 adolescents placed in nine closed educational centres in France. Psychiatric disorders were measured by the MINI-KID 2 and Conners Rating Scale questionnaires. Several questionnaires were used to collect sociodemographic data and the psychological profile of each adolescent.</div></div><div><h3>Results</h3><div>Among the adolescents, 90.2% had at least one mental disorder with a predominance of conduct disorder (80%). Comorbidity was also frequently found: among the subjects with conduct disorder, 37% had at least one other psychiatric disorder. Interestingly, the intensity of conduct disorder and the Adverse Childhood Experiences (ACE) score were significantly correlated. Furthermore, two subgroups were identified: adolescents with isolated conduct disorder (44.6%) and adolescents with other psychiatric disorders (45.7%) with or without conduct disorder. The latter subgroup showed higher vulnerability and poorer outcomes in terms of attachment patterns, feelings of abandonment, hostility and impulsivity.</div></div><div><h3>Conclusion</h3><div>This study is the first French epidemiological study of mental disorders in juvenile offenders. It suggests that the detection of psychiatric disorders in young people in CEC is an important prerequisite for the implementation of targeted interventions according to different profiles. Furthermore, collaboration between the medical-psychological and judicial fields, in the form of an operational partnership, is necessary to guarantee better support for these young people.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 1","pages":"Pages 15-21"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898366","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":"Barriers and facilitators to achieving employment in mainstream settings in adults with autism spectrum disorder without intellectual developmental disorders: A scoping review","authors":"Sylvie Holc ,&nbsp;Alexandre Yailian ,&nbsp;Eric Pernon ,&nbsp;Amaria Baghdadli","doi":"10.1016/j.encep.2024.02.012","DOIUrl":"10.1016/j.encep.2024.02.012","url":null,"abstract":"<div><div>Autistic people without Intellectual Developmental Disorders (IDD) have a significantly lower employment rate compared to the general population even though employment favors social integration and quality of life.</div></div><div><h3>Aims</h3><div>To examine the barriers and facilitators to employability in mainstream settings for autistic adults without intellectual disability.</div></div><div><h3>Methods</h3><div>Following the scoping review guidelines, we searched the Cochrane, PubMed and PsycINFO databases for references published between 01/01/2000 to 01/08/2023.</div></div><div><h3>Results</h3><div>A review of the 44 identified articles suggests the existence of multiple individual and environmental factors influencing job access and retention.</div></div><div><h3>Conclusions</h3><div>This is the first review to assess the facilitators and barriers to employment support for autistic people without intellectual disability. The results underline the need for studying strategies to promote access to employment and job retention for autistic people. Future research should explore the mediating and moderating factors leading to the improvement of employability of autistic people WIDD.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 1","pages":"Pages 67-73"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140905021","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":"Enjeux éthiques de la pratique infirmière en psychiatrie","authors":"Doris El-Choueifaty ,&nbsp;Enrique Ledesma ,&nbsp;Rima Sassine-Kazan","doi":"10.1016/j.encep.2024.11.009","DOIUrl":"10.1016/j.encep.2024.11.009","url":null,"abstract":"<div><div>Ethics issues relative to nursing practice in psychiatry raise consistent questioning, requiring a decision-making process based on ethical foundations. The questions relating to the patient's information, his informed consent to care and the deprivation of his liberty will be detailed in the context of the caregiver-patient relationship, which must be therapeutic but above all symmetrical.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 1","pages":"Pages S39-S41"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824751","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}