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Background: Multiple sclerosis (MS) is a chronic, immune mediated demyelinating illness of the central nervous system. This study looks at various comorbidities associated with MS, focusing on their impact on disease progression. Understanding comorbidities in MS is important as it can impact treatment selection and overall disease management and prognosis. Aims and Objectives: Our aim is to show the prevalence of comorbidities along with MS. This research focuses on the comorbidities associated with MS and their impact on disease progression in the Arab Gulf region, with a special emphasis on Jeddah, Saudi Arabia. Material and Methods: A retrospective record review was conducted from July 2022 to July 2023. The study included 286 patients, selected based on a definitive MS diagnosis in accordance with McDonald's 2017 criteria. Data collected included demographic information, MS type, duration of diagnosis, type of disease modifying therapy (DMT) used, Expanded Disability Status Scale (EDSS) score, and type of comorbidities. Results: The majority of the patients were female (70%) with an average age of 36 years. Most patients had relapsing remitting MS, and the majority were on DMTs, with fingolimod being the most common. Nearly half of the patients had comorbidities, with mood disorders, diabetes mellitus (DM), migraine, and hypertension (HTN) being prevalent. A significant positive association was found between the EDSS scores and both DM and HTN, but there was no significant link with migraine. Conclusion: The findings indicate that individuals with MS have an increased risk of developing comorbidities such as migraine, DM, and HTN. Emphasizing a healthy lifestyle could potentially reduce the incidence of DM and HTN and their related vascular complications. The research also notes the prevalence of mood disorders among the MS population, although it remains inconclusive whether these are separate comorbid conditions or inherent symptoms of MS. [ABSTRACT FROM AUTHOR]

La symptomatologie cognitive est un enjeu majeur en santé mentale, elle reste pourtant trop peu prise en compte dans la pratique clinique. Cet article vise à fournir une vision globale de la littérature actuelle sur le fonctionnement cognitif des personnes vivant avec un trouble bipolaire. Il a également pour objectif de mettre en lumière les interventions possibles, notamment au sein des Centres Experts du réseau FondaMental. Nous avons réalisé une revue de la littérature pour explorer différents aspects liés aux troubles cognitifs dans les troubles bipolaires, tels que les troubles cognitifs traits, les variations au cours de la maladie, et l'évaluation et le traitement de ces troubles. Des troubles cognitifs au sein de différentes sphères sont présents dans les troubles bipolaires. Ils sont retrouvés dans toutes les phases et sous-types de la pathologie, avec une augmentation de l'intensité des troubles en phase aiguë. On observe cependant une hétérogénéité interindividuelle. La société internationale pour les troubles bipolaires a élaboré des recommandations, telles que la systématisation d'un bilan de dépistage permettant d'orienter vers des consultations spécialisées en neuropsychologie, ou encore des évaluations régulières facilitant la détection précoce des processus neurodégénératifs. Les Centres Experts dans les troubles bipolaires peuvent proposer ces évaluations, des actions de prévention, de la psychoéducation ou des interventions adaptées aux troubles cognitifs, telles que la remédiation cognitive. Nous présentons enfin le programme de remédiation cognitive écologique ECo, qui se base sur des exercices créés spécifiquement pour permettre le transfert des stratégies en vie quotidienne pour les personnes vivant avec un trouble de l'humeur. L'association d'évaluations régulières, de mesures préventives et curatives permettrait de prendre en charge la symptomatologie cognitive et d'accompagner les personnes vivant avec un trouble bipolaire dans leur parcours de rétablissement. Cognitive impairments represent a major issue in mental health that remains understudied in clinical practice. This article aims to provide an overview of the literature on cognitive functioning in bipolar disorders. Additionally, its purpose is to highlight potential interventions that promote recovery, particularly within the bipolar "Centers of Expertise" of the Fondation FondaMental network. We conducted a literature review to explore various aspects related to cognitive issues in bipolar disorders, such as trait-related cognitive impairments, variations throughout the course of the illness, and the assessment and treatment of these cognitive deficits. In bipolar disorders, many cognitive disorders may present themselves in different ways; the literature identifies disorders of attention, psychomotor speed, executive functions, memory, emotional and social cognition, and metacognition. These cognitive disorders are present in all phases of the disease with heterogeneity between patients. This heterogeneity does not depend on whether patients have type I or type II bipolar disorders; nor does it depend on depressive, manic, or euthymic phases, although cognitive symptomatology is more intense in the acute phases. Bipolar disorders require treatment, although some treatments can have an influence on cognition, notably antipsychotics, lithium, or more general polypharmacy. The International Society for Bipolar Disorders (ISBD) Targeting Cognition Task Force developed consensual recommendations for clinicians regarding cognitive interventions in bipolar disorders. The recommendations include an objective and subjective assessment of cognition for all patients, regardless of whether partial or complete remission is achieved. Caregivers who are not neuropsychology specialists may, after a short training period, use screening tools such as the "Screen for Cognitive Impairment in Psychiatry" (SCIP) and "Cognitive Complaints in Bipolar Disorders Rating Assessment" (COBRA), and must refer patients for a more complete evaluation if any difficulties emerge. There is also an interest in regularly assessing cognition, in connection with the possibility of neurodegeneration. Indeed, there are several theories about the development of cognitive impairments in bipolar disorders in the literature. One theory suggests that neurodevelopmental factors could influence the occurrence of these disorders. On the contrary, the "neuroprogression model" postulates that allostatic load may disrupt cognitive functioning as part of a longer term degenerative process. The FondaMental network Centers of Expertise provide educational programs as well as interventions adapted to several aspects of psychiatric diseases, notably cognitive impairment. Patients can be provided with a complete cognitive assessment, and then directed towards appropriate therapies. The centers offer, for example, cognitive remediation for bipolar patients, with the goal of personal recovery. Cognitive remediation is a psychosocial rehabilitation treatment which consists of training cognitive functions via exercises aimed at developing problem-solving strategies that can be transferred to daily life. This treatment should lead to an improvement in patients' quality of life and autonomy. Worldwide, there is a lack of recognized programs for people with mood disorders, including bipolar disorders. However, some studies report that cognitive remediation therapy leads to cognitive and functional improvement, despite heterogeneity in the results of these studies. Some authors of these studies recommend developing individualized and integrative treatments centered around the patients' personal and professional projects, and targeting different psychological processes that mediate functional improvement. An ecological cognitive remediation program, called "Eco", was recently created in France for patients with mood disorders, including bipolar disorders. This program uses paper and manipulable tools for cognitive remediation exercises that have been created specifically to support the transfer of cognitive skills into people's daily lives. It is composed of a psychoeducational module that: develops the patient's metacognitive knowledge; reduces self-stigmatization; and increases intrinsic motivation towards therapy. The program includes three cognitive training modules (on attention, memory, and executive functions), with sub-modules for specific functions, with exercises to be done in a guided session as well as occasionally at home. The order of presentation of the modules, as well as the number of sessions per sub-module, are adapted to each patient. Exercises are composed of ten levels of difficulty, and they allow patients to discover, develop, and then generalize new cognitive strategies. A final functional training module is used in conjunction with cognitive training, in order to help the transfer of the cognitive strategies developed to complex situations in daily life. The combination of frequent assessments, preventive measures, and treatments should make it possible to manage cognitive symptoms and to support people living with a bipolar disorder in their recovery journey. [ABSTRACT FROM AUTHOR]

La maladie d'Alzheimer et les maladies apparentées entraînent des troubles de l'humeur et des troubles anxieux chez les résidents institutionnalisés. La thérapie par réminiscence a démontré un intérêt dans le traitement de ces symptômes. L'étude pilote randomisée « Réminiscences et Émotions » utilise la réalité virtuelle personnalisée pour diminuer les troubles de l'humeur des résidents. Les objectifs secondaires visent à évaluer l'acceptabilité du dispositif et la qualité de vie des résidents. Monsieur G. présente des troubles cognitifs modérés ainsi que des troubles de l'humeur. Il participe à dix séances de réalité virtuelle personnalisée pendant une période de six semaines. Les variables sont mesurées en amont et à la fin du protocole. Une analyse visuelle des scores illustre les résultats. Le dispositif de réalité virtuelle est accepté et toléré par le participant. Les scores aux échelles de l'humeur (dépression, apathie) et de l'anxiété diminuent. Aucune différence n'apparaît sur l'échelle de qualité de vie. Les interventions génèrent du plaisir et de la vivacité en lien avec l'émergence de souvenirs positifs. Il existe un intérêt de la thérapie par réminiscence en réalité virtuelle pour améliorer l'humeur du participant. Les futurs résultats permettront de conclure sur la méthode et son indication thérapeutique en institution gériatrique. The World Health Organization defined dementia as a syndrome in which there is deterioration in cognitive function beyond what might be expected from the usual consequences of biological aging. Currently, 55 million people live with Alzheimer's in the world. Unfortunately, there isn't any drug treatment to cure the degenerative disease although clinical trials are promising regarding the use of monoclonal antibodies. But, Alzheimer's disease and associated diseases lead to behavioral and psychological symptoms (anxiety, apathy, depression) which can be frequent in nursing homes. In the context of pandemic, these conditions are amplified because of the sanitary restrictions. Since the beginning of the sars-cov2 pandemic, residents have felt alone, sad and more anxious. Nowadays, non-drug interventions are recommended by health organizations for the treatment of behavioral and mood disorders in the elderly with cognitive disorders. Reminiscence therapy is a non drug intervention which has been shown to be effective in the treatment of mood disorders on elderly. Many nursing homes use this non pharmacological treatment for their residents. Some studies take interest in reminiscence and virtual reality. The use of new technologies is innovative in geriatric care and it can be used as a personalized support for reminiscence therapy. The "Bien Vieillir Nice 2030" Project of Nice's University Hospital supports this research on virtual reality and mood disorders in nursing homes/long term care unit. The objective of this study (University Hospital of Nice, CoBTeK France) is to evaluate the effects of personalized virtual reality on reduction of mood disorders in nursing homes residents with minors and moderates neurocognitive disorders. The secondary objectives are to assess the acceptability of the device, the emotional valence and the resident's quality of life. A single case study is presented to illustrate reminiscences and emotions protocol. Participants are randomized into two groups: neutral versus personalized. The neutral videos consist of unknown places like random streets or public gardens while the personalized videos are known places that mattered to the residents. Places are filmed with a camera GoPro Fusion 360°. The healthcare team and families are actively involved in the research protocol. Their help is invaluable in targeting memories related to the resident's life history. A clinical psychologist specializing in gerontology is in charge of the virtual reality sessions. The therapeutic alliance is central to our study. A humanistic method of person-centered approach allows communication with the resident to offer him to participate in the sessions. The sessions always start and end in the same way in order not to cause stress in the resident. The hardware is tested before the protocol starts, for familiarization purpose. Potential side effects related to virtual reality are identified using a cybermalaise questionnaire. The sessions are held in a sitting position for the participant's safety. In this paper, Mr. G, 92 years old benefits from personalized video according to his life story. He has moderate cognitive impairment as well as mood disorders. He received ten virtual reality sessions over a period of six weeks. The exposure time varies between five to ten minutes. We use an Oculus Rift S headset and a computer in partnership with C2Care. Variables were measured before and at the end of the protocol. We performed a visual analysis of the scores. The results indicated a decrease on mood rating scales scores (Geriatric Depression Scale, Apathy Inventory, Neuropsychiatric Inventory and Hamilton Depression Rating scale). The interventions produced pleasure and alertness in connection along with the emergence of positive memories. The headset was well tolerated by the participant, but we did not observe any effect on quality of life. There is an interest in the use of reminiscence therapy using virtual reality to improve participants' mood. Future results will allow us to conclude on the method and on its indication in nursing homes after the inclusion of 30 participants. [ABSTRACT FROM AUTHOR]

Background: Thousands of children sustain mild traumatic brain injuries (mTBI) worldwide each year. Multiple physical and somatic symptoms can occur following pediatric mTBI, including new-onset mood symptoms, headaches, and pain. Objective: This scoping review examined the existing literature pertaining to mood and anxiety symptoms following pediatric mTBI, in order to summarize the current evidence and identify areas for future research. Methods: The Pubmed, EMBase, and APA PsycINFO databases were searched to identify articles that examined mood and anxiety symptoms in children and adolescents following mTBI. Results: A total of 20 published articles were included in the review. The existing research suggests that mood and anxiety symptoms are more common in children and adolescents with mTBI, when compared to orthopedically injured or healthy controls. Several factors may contribute to the development of these symptoms: injury characteristics, older age at injury, female sex, and psychosocial variables including lower socioeconomic status and family history of psychiatric disorders. Conclusion: The findings of this review highlight the need for additional research on the relationship between pediatric mTBI and subsequent mood and anxiety symptoms. We particularly recommend long-term prospective cohort studies which include appropriate control groups as well as a neuroimaging component to distinguish complicated from uncomplicated mTBI. [ABSTRACT FROM AUTHOR]

Irritability is a main reason for referral of a child to a pediatric emergency. Few psychiatric services are dedicated to care for children and adolescents in middle income countries. Thus, there is not a clear picture about the real needs of an emergency unit to optimize the service's demands. This study aims to describe a sociodemographic profile of children and adolescents in a psychiatric emergency service due to complaints of irritability. In total, 2,255 medical records were reviewed from patients referred within a year at an emergency department of a mental health service for children and adolescents. Patients with and without irritability were compared in terms of sociodemographic features, psychiatric complaints and associated somatic and psychiatric disorders. About 30% of youths attending at this service had irritability. Most were boys (67%) with an average age of 12.6 years (±3.9). Irritability was associated with a diagnosis of mood disorder, attention deficit hyperactivity disorder and oppositional defiant disorder. There are concerns about the setting in which data was collected, since it might have some time restrictions and data imprecision. Irritability was a frequent complaint taking children and adolescents to the emergency department. This symptom co-occurs with several psychiatric disorders. These findings support the trans-nosographic view of irritability, in particular its co-occurrence with neurodevelopmental disorders. [ABSTRACT FROM AUTHOR]

Non-drug interventions (NDIs) are recommended as a first-line treatment in gerontology to address the psychological and behavioral symptoms of dementia. This article illustrates the NMIs implemented, how they are carried out and how they are evaluated as part of the Bien vieillir project at Nice University Hospital., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

The aging of the population increases the rate of depressive morbidity. It constitutes a major public health problem. In France, in 2018, people aged 65 or older represented 19.6% of the population. By 2040, they will represent about 25%. According to the World Health Organization, worldwide, among adults aged 60 and over, 15% suffer from a mental health disorder. 6.6% of disabilities are attributed to psychological or neurological disorders, the most common being dementia and depression (7%). A good knowledge of the depressive syndrome of the elderly is and will be essential for health professionals., (Copyright © 2023. Publié par Elsevier Masson SAS.)