Search

Marie-Philippe Harvey,1,2 Dominique Lorrain,1,3 Marylie Martel,1,2 Kayla Bergeron-Vezina,1 Francis Houde,1,2 Mario Séguin,2,4 Guillaume Léonard1,2,5 1Research Centre on Aging, CIUSSS de l’Estrie-CHUS, 2Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3Department of Psychology, Université de Sherbrooke 4Department of Neurosurgery, Centre Hospitalier Universitaire de Sherbrooke, 5School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada Background: The prevalence of chronic pain and sleep disturbances substantially increases with age. Pharmacotherapy remains the primary treatment option for these health issues. However, side effects and drug interactions are difficult to control in elderly individuals.Aims: The objective of this study was to assess the feasibility of conducting a randomized sham-controlled trial and to collect preliminary data on the efficacy of transcranial direct current stimulation (tDCS) to reduce pain and improve sleep in older adults suffering from chronic pain.Methods: Fourteen elderly individuals (mean age 71±7 years) suffering from chronic pain and sleep complaints were randomized to receive either anodal tDCS, applied over the primary motor cortex (2mA, 20 minutes), or sham tDCS, for 5 consecutive days. Pain was measured with visual analog scales, pain logbooks and questionnaires, while sleep was assessed with actigraphy, sleep diaries and questionnaires.Results: There were no missing data for pain and sleep measures, except for actigraphy, that generated several missing data. Blinding was maintained throughout the study, for both the evaluator and participants. Active but not sham tDCS significantly reduced pain (P

International audience; Research indicates that suicide rates are high among members of law enforcement. Our objectives were: (1) to determine life events implicated in suicide mortality among French law enforcement; and (2) to describe the different life trajectories of police officers who deceased by suicide.; All suicides of police officers which occurred during 2008 (n=49) were explored using the psychological autopsy method. Key informants were: a supervisor, a colleague and a member of the family or a close friend. Each of them were interviewed by trained psychologists using standardized questionnaires exploring: sociodemographic characteristics, life events, social integration and support, health service use, mental health with the Composite International Diagnostic Interview short form (CIDI-SF), occupational stress with the Spielberger Inventory, impulsiveness with the Barratt Impulsiveness Scale and aggressiveness with the Brown-Goodwin Lifetime Aggression Scale. Information was then summarized in a timetable life trajectory of all life areas. All cases were finally appraised by at least two experts in order to identify the determinants of the suicide and to determine psychiatric diagnoses. For each period of time, a burdensomeness score was determined, from 6 (no adversity) to 1 (adversities in each sphere of life).; Of the 49 cases of suicide, two were excluded and 39 were investigated and appraised (response rate: 39/47=83%). Eighty-two percent of the suicide cases were men and the mean age at death was 35years. In more than half of the cases, police officers used their service weapon to commit suicide. All deceased police officers were suffering from mental health symptoms (primarily depression). Of them, two thirds had used healthcare for this distress. The main other cause of suicide was problems in the married life (70% of the cases). Four distinct types of life trajectories of adversities could be identified by a qualitative analysis.; It is the first time such a study was performed in France, and results are concordant with those of the literature. This study showed that all deceased police officers were suffering from mental disorders and that there was not one single profile of life trajectory: screening and support of police officers in distress need to be prioritized. Moreover, results suggested that the availability of the service weapon during off-duty periods should be reconsidered. This study helped the Home ministry to elaborate and improve strategies to prevent suicide among police officers.

The prevalence of chronic pain drastically increases with age. The objective of this study was to determine if transcranial direct current stimulation (tDCS) could be a valid treatment option to relieve chronic musculoskeletal pain in elderly individuals. Twenty-four chronic pain patients were randomized to receive either anodal tDCS over the contralateral motor cortex (2 mA, 20 minutes; n = 12) or sham tDCS (n = 12) for 5 consecutive days. Pain logbooks were used to measure pain intensity on the days before, during and after treatment sessions, and the Margolis pain drawing and scoring system was used to assess the number of painful areas. Analysis of the pain logbooks revealed that real tDCS led to a reduction in pain (p ≤ 0.04), while sham tDCS did not produce any change. Patients from the real tDCS group also reported a decrease in the number of painful areas, while the patients in the sham tDCS group reported no change. Every patient who received real tDCS reported an alleviation of pain. These results suggest that anodal tDCS applied over the motor cortex can decrease pain, and that this effect persists for several days following treatment. To our knowledge, this study is the first to investigate the analgesic effect of tDCS with a randomized, controlled trial in elderly individuals. The results can support the use of this technique in chronic pain patients aged 60 years and older. Future studies are necessary to determine whether these results can be replicated using a larger population.