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

{"title":"Cognitive therapies and insight in early schizophrenia: A systematic review.","authors":"Bastien Houdebine, Natacha Rondeau, Chrystel Besche-Richard","doi":"10.1016/j.encep.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.encep.2025.05.009","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review aims to evaluate the impact of cognitive-behavioral and metacognitive therapies on cognitive and clinical insight into early schizophrenia disease.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted across several databases, including Pubmed, PsycINFO, and Cochrane Library, focusing on studies published between 2006 and May 2024. The studies selected for this review were either randomized controlled trials (RCTs), cross-sectional studies, or exploratory studies.</p><p><strong>Results: </strong>Nine studies were included (7 RCTs, one cross-sectional study, and one exploratory study), using various tools to assess cognitive and clinical insight. The findings showed mixed results: cognitive-behavioral therapy (CBT) and metacognitive therapies (MCT) demonstrated varied outcomes. Some studies reported improvements in self-reflection and self-certainty, two facets of cognitive insight, especially in young patients.</p><p><strong>Conclusions: </strong>This study highlights the complexity of the relationship between different therapies and insight improvement in early schizophrenia. This result emphasizes the need for additional studies to improve our understanding of the effects of cognitive therapies, given that the current number of studies is too limited to draw conclusions. Future research should focus on developing more personalized and effective treatment strategies to better address the individual needs of young patients.</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":"145016567","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":"[Complex trauma: A theoretical and clinical approach].","authors":"Delphine Collin-Vézina","doi":"10.1016/j.encep.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.008","url":null,"abstract":"<p><p>The concept of complex trauma (or developmental trauma) has been proposed to refer both to chronic exposure to interpersonal experiences in children and adolescents and to the constellation of possible sequelae that cause significant difficulties throughout life. The purpose of this chapter is to provide an overview of the theoretical and clinical approaches to complex trauma in order to better understand the scope of this concept. Through a review of the literature, this chapter outlines the historical evolution of this concept, its current definition, the diagnostic issues involved, and the preferred directions for its future use in research and clinical practice. This article highlights the significant shift that has taken place over time, from a concept closely linked to the traumatic experiences of individuals and the clinical challenges they face, to a collective responsibility to implement social actions that can lead to deeper structural and systemic change.</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":"145016581","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":"[Behavioral problems in child protection: Understanding and intervening from the concept of complex trauma].","authors":"Sandrine Bonneton, Aziz Essadek","doi":"10.1016/j.encep.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.encep.2025.05.004","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents supported by child protection services (CPS) represent a population exposed to repeated relational trauma that significantly increases the risk of developing complex trauma characterized by polymorphic symptomatology. The behavioral problems presented by adolescents followed by CPS may fit within this nosographic framework. They can lead to major difficulties in adapting to their environment, especially when the trajectory of polyvictimization is pronounced. Unfortunately, the failure of professionals to recognize this diagnosis remains frequent. As a result, institutional responses are often poorly adapted to the needs of the adolescents concerned, promoting an excessive psychiatrisation of their behavioral manifestations at the expense of a comprehensive and holistic approach rooted in their traumatic history.</p><p><strong>Method: </strong>This work offers a theoretical-clinical reflection on complex trauma expressed through behavioral problems among adolescents supported by CPS. It is based on the main recent clinical and scientific contributions, particularly research related to integrative and systemic approaches.</p><p><strong>Results: </strong>Theoretical and clinical data highlight both the importance and the difficulties of identifying manifestations of complex trauma among adolescents supported by CPS, especially when they present behavioral problems. The analysis emphasizes the contributions of clinical support systems and trauma-informed practices in structuring institutional responses. These practices, particularly the Attachment, Regulation of Affect, Competence (ARC) model, by promoting a developmental and relational understanding of behavioral symptoms, provide a structured framework for operationalizing the educational support of adolescents within CPS, moving beyond crisis management logic and enabling the effective use of specific care modalities when necessary.</p><p><strong>Discussion: </strong>Recognizing traumatic history, often marked by polyvictimization, appears essential to adequately meet the needs of the adolescents concerned. While integrative and systemic approaches represent promising levers for transforming professional practices within CPS, their implementation remains marginal in France. Avenues for reflection and research are discussed to promote the concrete adoption of these models by institutions, particularly in terms of training, team support, and structuring connections between institutions, with the aim of building better-coordinated educational and therapeutic interventions.</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":"145016561","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 universitarisation of regions for psychiatric care - Facilitating access to care, combating medical desertification].","authors":"Mathilde Horn","doi":"10.1016/j.encep.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.encep.2025.04.009","url":null,"abstract":"<p><p>Mental disorders are on the increase, while access to care is becoming increasingly difficult for those affected. This article presents the \"Projet de Liaison Universitaire de TerritOire du Nord\" (PLUTON), an initiative to improve access to psychiatric care in an area of the Hauts-de-France region and to combat medical desertification. Initially conceived as a response to a health crisis, PLUTON has gradually evolved to rethink the organisation of psychiatric care in a given area. The aim was to preserve the structure of sector-based care while adding a university dimension to clinical, research and teaching activities. The success of this project is the result of an innovative, collaborative approach based on the pooling of existing resources. This tried and tested methodology means that the project can be easily and effectively replicated in other areas.</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":"145016520","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":"Lifetime suicide attempts among Moroccan psychiatrists: Prevalence, methods and risk factors.","authors":"Mohammed Barrimi, Kaoutar El Mir","doi":"10.1016/j.encep.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.encep.2025.07.001","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown that psychiatrists have a higher suicide rate compared to the general population and other medical specialists.</p><p><strong>Aim: </strong>To evaluate the prevalence, methods, and factors associated with suicide attempts (SA) among Moroccan psychiatrists.</p><p><strong>Method: </strong>A cross-sectional online survey was carried out in August 2023 using an anonymous questionnaire created online on Google Forms.</p><p><strong>Results: </strong>In all, 142 Moroccan psychiatrists practicing in the private and public sectors were included. Among these, 7.7% had a history of lifetime suicide attempts. Factors associated with TS among Moroccan psychiatrists are the personal history of depressive and anxiety disorders, the high scores of perceived stress, the psychoactive substances use; including tobacco, alcohol, and anxiolytics, as well as the family history of psychiatric disorders and the family history of suicide.</p><p><strong>Conclusion: </strong>Suicide attempts among Moroccan psychiatrists are a serious mental health problem that has a negative impact on the psychiatrist himself, his entourage, and the quality of care provided to patients.</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":"145016556","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":"Physical activity and mental health: Neurobiological mechanisms and therapeutic perspectives.","authors":"Jérôme Palazzolo","doi":"10.1016/j.encep.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.encep.2025.05.002","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977770","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":"[Tele-expertise assistance in prescribing psychotropic drugs].","authors":"Florian Stéphan, Joachim Lelièvre","doi":"10.1016/j.encep.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.encep.2025.05.007","url":null,"abstract":"<p><strong>Introduction: </strong>Tele-expertise is a care tool that has developed significantly in certain medical disciplines such as dermatology, ophthalmology and cardiology in France in recent years. At Brest University Hospital, we have been able to set up tele-expertise in psychiatry since April 2023, via a secure platform (Omnidoc), on assistance with prescribing or de-prescribing psychotropic drugs. The aim of this study is to evaluate its contribution after 18 months of use.</p><p><strong>Methods: </strong>A total of 166 tele-expertise requests were received and analyzed between April 2023 and September 2024. For each tele-expertise, we collected: the response time, the number of opinions given, the breakdown of requests by requesting physician's specialty, the number of different requesting physicians, the number of requests per requesting physician, the number of post-opinion consultations, the psychiatric diagnosis evoked and the number of requests for assistance with deprescribing. A satisfaction questionnaire was sent to each requesting physician who had requested at least one opinion during the period studied.</p><p><strong>Results: </strong>A total of 152 tele-expertise requests were included in the final analysis. The average response time was 4hours over the study period, with a median response time of 1hour. Ninety-five percent of requesting physicians were satisfied with the quality of exchanges with the psychiatrist. Ninety-three percent of requesting physicians also felt that the tele-expertise had improved patient management. Fifty nine percent of requesting physicians prescribed psychotropic drugs differently since they had sought advice. Fifty eight percent felt they had learned how to better prescribe or deprescribe psychotropic drugs. Ninety-four percent thought they would use tele-expertise again and/or recommend it to a colleague. Finally, requests for help in deprescribing psychotropic drugs concerned only 6 of the 152 requests (3.9%).</p><p><strong>Conclusion: </strong>The introduction of tele-expertise in psychiatry, focusing on medication via a secure platform, has been much appreciated by GPs in particular. It could improve patient care and encourage city-hospital collaboration.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977729","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":"[Complex psychological trauma and network analysis: From childhood to adulthood].","authors":"Maud Cappelletti, Aziz Essadek, Ariane Bazan","doi":"10.1016/j.encep.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.encep.2025.05.005","url":null,"abstract":"<p><p>Complex post-traumatic stress disorder is a recent diagnosis with manifestations that differ from those of post-traumatic stress disorder. Persistent functional impairment is a new dimension specific to complex trauma. Some aspects of this diagnostic category which was adopted by the international classification of diseases eleventh revision are still being studied, for example, its prevalence across the world in many cultural situations where the exposure to traumatic events differ. Network analysis offers a new conceptualization of psychopathology by focusing on interactions between symptoms beyond the usual latent class approach. It makes it possible to statistically validate the international classification of diseases' new diagnostic criteria by differentiating the manifestations of different pathologies such as intense stress exposure pathologies or borderline disorder that share symptoms. It also provides various insights into this disorder and allows us to observe sequences of appearance and evolution depending on age and type of event. While childhood trauma appears to be particularly associated with complex post-traumatic stress disorder, literature mainly highlights the long-term consequences of such childhood events in adulthood. The persistent functional impairment cluster is particularly important within complex trauma networks. This is one of the most important developmental consequences for survivors and reflects a reality perceived by clinicians. This extends to psychotherapy which turns out to be longer and more complex because of the insecurity of the relationship experienced by the traumatized person. Network analysis applied to complex trauma gives an understanding of the dynamics of the relationships between its multitude of symptoms. They can define intervention targets for mental health professionals. And they can enable coordinated multi-professional actions which is an important issue especially in multi-factorial situations such as child protection. This work explores the contributions of network analysis to the understanding of complex post-traumatic stress disorder. For this purpose, we outline the central concepts of complex trauma and its implications. In particular, the impact of recurring traumatic situations of an interpersonal nature on self-construction and the ability to create relationships. We exhibit the fundamental principles of the network approach and compare the contributions of older cross-sectional analyzes with those of longitudinal networks. Then, we provide an overview of the knowledge acquired through the application of network analysis to complex trauma, from childhood to adulthood. Finally, we discuss criticisms of this approach and propose reflections on the future of this statistical analysis method which is growing fast.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977741","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":"A french version of the OSU TBI-ID for screening TBI in PTSD Military personnel.","authors":"Gilles Sipahimalani, Leo Borrini, Alexander Balcerac, Flavie Bompaire, Damien Ricard, Frédérique Gignoux-Froment","doi":"10.1016/j.encep.2025.05.010","DOIUrl":"https://doi.org/10.1016/j.encep.2025.05.010","url":null,"abstract":"<p><strong>Background: </strong>The co-occurrence of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) is common in military personnel, leading to complex clinical challenges and poor prognosis. To enhance the care of PTSD patients, a TBI screening protocol was developed at a French Military Training Hospital (MTH). The Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID), a self-administered questionnaire, was translated into French (OSU TBI-ID Fr) to help standardize screening. This study aims to evaluate the feasibility and tolerance of the TBI screening protocol, to explore its potential to improve clinical outcomes for military personnel suffering from PTSD, and to assess TBI prevalence in our population.</p><p><strong>Design: </strong>This observational, retrospective, monocentric study was conducted at the MTH psychiatric unit. PTSD military personnel and veterans were screened for TBI using three questionnaires: OSU TBI-ID Fr, the PTSD Checklist for DSM-5 (PCL5), and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Data on patient characteristics and screening results were extracted from medical records to determine TBI prevalence. Feasibility was assessed based on the proportion of eligible patients who underwent screening, with reasons for non-participation documented. Tolerance was evaluated by recording side effects. Exploratory analyses included subgroup comparisons based on TBI or Repeated subconcussive Head Impacts (RHI) and correlations between PCL5 and RPQ scores.</p><p><strong>Results: </strong>Of the 233 PTSD patients treated in the psychiatry unit, 14.1% (n=33) completed the TBI screening between September 2022 and March 2023. Among the screened patients, 39.4% (n=13) had a history of TBI, and 48.5% (n=16) had been exposed to RHI. Three participants reported anxiety while completing OSU TBI-ID Fr. The average PCL5 score was 45.8, and the average RPQ score was 25.7. The main barriers to screening in the rest of the eligible population were lack of time, oversight, and interview setting (e.g., teleconsultation).</p><p><strong>Discussion and conclusion: </strong>This study introduces the French version of the OSU TBI-ID as a standardized TBI screening tool for military personnel with PTSD. The high prevalence of undiagnosed TBI, often discovered through screening, highlights the importance of early detection. This study demonstrates the acceptability and tolerance of the OSU TBI-ID Fr in this population and suggests its potential to improve care by enabling earlier TBI identification. Future research should focus on refining the protocol, enhancing its applicability across settings, and optimizing integrated care pathways to improve clinical outcomes.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977701","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":"Atypical visual hallucinations in vascular depression following cerebellar stroke.","authors":"Hugo Bottemanne, Antoine Wicker, Edouard Baudouin, Julia Korngold, Severine Martin, Nourredine Haddadi, Walid Choucha, Romain Colle, Emmanuelle Corruble","doi":"10.1016/j.encep.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.encep.2025.06.001","url":null,"abstract":"<p><p>Cerebrovascular abnormalities may predispose, precipitate, or perpetuate depressive symptoms in old adults, supported by the hypothesis of vascular depression. These depressive episodes are sometimes accompanied by atypical neurological symptoms associated with localized vascular lesions in the brain. We present the case of an 84-year-old man with vascular depression who experienced visual hallucinations and dizziness, coinciding with the incidental discovery of a cerebellar stroke. Based on this clinical case, we discuss the hypothesis of perceptual and affective cerebellar functions.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977805","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}