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1. Decreased telomere length in a subgroup of young individuals with bipolar disorders: replication in the FACE-BD cohort and association with the shelterin component POT1

Author

Luana Spano, Cynthia Marie-Claire, Ophélia Godin, Apolline Lebras, Cindie Courtin, Jean-Louis Laplanche, Marion Leboyer, Bruno Aouizerate, Antoine Lefrere, Raoul Belzeaux, Philippe Courtet, Emilie Olié, Caroline Dubertret, Raymund Schwan, Valérie Aubin, Paul Roux, Mircea Polosan, Ludovic Samalin, Emmanuel Haffen, Fondamental Advanced Centers Of Expertise In Bipolar Disorders (Face-Bd) Collaborators, Frank Bellivier, and Bruno Etain

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Bipolar disorder (BD) has been associated with premature cellular aging with shortened telomere length (TL) as compared to the general population. We recently identified a subgroup of young individuals with prematurely shortened TL. The aims of the present study were to replicate this observation in a larger sample and analyze the expression levels of genes associated with age or TL in a subsample of these individuals. TL was measured on peripheral blood DNA using quantitative polymerase chain reaction in a sample of 542 individuals with BD and clustering analyses were performed. Gene expression level of 29 genes, associated with aging or with telomere maintenance, was analyzed in RNA samples from a subsample of 129 individuals. Clustering analyses identified a group of young individuals (mean age 29.64 years), with shorter TL. None of the tested clinical variables were significantly associated with this subgroup. Gene expression level analyses showed significant downregulation of MYC, POT1, and CD27 in the prematurely aged young individuals compared to the young individuals with longer TL. After adjustment only POT1 remained significantly differentially expressed between the two groups of young individuals. This study confirms the existence of a subgroup of young individuals with BD with shortened TL. The observed decrease of POT1 expression level suggests a newly described cellular mechanism in individuals with BD, that may contribute to telomere shortening.

Published
2024
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2. Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment in schizophrenia: results from the multicenter FACE-SZ cohort

Author

Nathan Vidal, Paul Roux, Mathieu Urbach, Cristobal Belmonte, Laurent Boyer, Delphine Capdevielle, Julie Clauss-Kobayashi, Thierry D’Amato, Romane Dassing, Caroline Dubertret, Julien Dubreucq, Guillaume Fond, Roxana-Mihaela Honciuc, Sylvain Leignier, Pierre-Michel Llorca, Jasmina Mallet, David Misdrahi, Baptiste Pignon, Romain Rey, Franck Schürhoff, Arnaud Tessier, the FACE-SZ (FondaMental Academic Centers of Expertise—Schizophrenia) Group, Christine Passerieux, Eric Brunet-Gouet, B. Aouizerate, V. Barteau, S. Bensalem, F. Berna, O. Blanc, E. Bourguignon, L. Boyer, D. CapdevielleI. Chéreau, G. Chesnoy-Servanin, T. D’Amato, A. Deloge, H. Denizot, JM. Dorey, C. Dubertret, J. Dubreucq, S. Esselin, C. Faget, C. Fluttaz, G. Fond, F. Gabayet, O. Godin, E. Haffen, RM. Honciuc, M. Jarroir, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, PM Llorca, J. Mallet, E. Metairie, D. Misdrahi, C. Passerieux, J. Petrucci, P. Peri, B. Pignon, S. Pires, C. Portalier, R. Rey, C. Roman, F. Schürhoff, K. Souryis, A. Szöke, M. Urbach, F. Vaillant, A, Vehier, P. Vidailhet, E. Vilà, G. Wahiche, H. Yazbek, and A. Zinetti-Bertschy

Subjects
neuropsychological test, schizophrenia, cholinergic antagonist, psychotropic drug, polypharmacy, Therapeutics. Pharmacology, RM1-950
Abstract

AimThe anticholinergic properties of medications are associated with poorer cognitive performance in schizophrenia. Numerous scales have been developed to assess anticholinergic burden and yet, there is no consensus indicating which anticholinergic burden scale is more relevant for patients with schizophrenia. We aimed to identify valid scales for estimating the risk of iatrogenic cognitive impairment in schizophrenia.MethodsWe identified 27 scales in a literature review. The responses to neuropsychological tests of 839 individuals with schizophrenia or schizoaffective disorder in the FACE-SZ database were collected between 2010 and 2021. We estimated the association between objective global cognitive performance and the 27 scales, the number of psychotropic drugs, and chlorpromazine and lorazepam equivalents in bivariable regressions in a cross-sectional design. We then adjusted the bivariable models with covariates: the predictors significantly associated with cognitive performance in multiple linear regressions were considered to have good concurrent validity to assess cognitive performance.ResultsEight scales, the number of psychotropic drugs, and drug equivalents were significantly associated with cognitive impairment. The number of psychotropic drugs, the most convenient predictor to compute, was associated with worse executive function (Standardized β = −0.12, p = .004) and reasoning (Standardized β = −0.08, p = .037).ConclusionAnticholinergic burden, the number of psychotropic drugs, and drug equivalents were weakly associated with cognition, thus suggesting that cognitive impairment in schizophrenia and schizoaffective disorder is explained by factors other than medication. The number of psychotropic drugs was the most parsimonious method to assess the risk of iatrogenic cognitive impairment.

Published
2024
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3. Predictors of medication adherence in a large 1-year prospective cohort of individuals with schizophrenia: insights from the multicentric FACE-SZ dataset

Author

David Misdrahi, Maud Dupuy, Yecodji Dansou, Laurent Boyer, Fabrice Berna, Delphine Capdevielle, Isabelle Chereau, Nathalie Coulon, Thierry D’Amato, Caroline Dubertret, Sylvain Leignier, Pierre Michel Llorca, Christophe Lançon, Jasmina Mallet, Christine Passerieux, Baptiste Pignon, Romain Rey, Franck Schürhoff, Joel Swendsen, Mathieu Urbach, Andrei Szöke, Ophélia Godin, Guillaume Fond, and the FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) Group

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Schizophrenia is characterized by the most salient medication adherence problems among severe mental disorders, but limited prospective data are available to predict and improve adherence in this population. This investigation aims to identify predictors of medication adherence over a 1-year period in a large national cohort using clustering analysis. Outpatients were recruited from ten Schizophrenia Expert Centers and were evaluated with a day-long standardized battery including clinician and patient-rated medication adherence measures. A two-step cluster analysis and multivariate logistic regression were conducted to identify medication adherence profiles based on the Medication Adherence rating Scale (MARS) and baseline predictors. A total of 485 participants were included in the study and medication adherence was significantly improved at the 1-year follow-up. Higher depressive scores, lower insight, history of suicide attempt, younger age and alcohol use disorder were all associated with poorer adherence at 1 year. Among the 203 patients with initially poor adherence, 86 (42%) switched to good adherence at the 1-year follow-up, whereas 117 patients (58%) remained poorly adherent. Targeting younger patients with low insight, history of suicide, alcohol use disorder and depressive disorders should be prioritized through literacy and educational therapy programs. Adherence is a construct that can vary considerably from year to year in schizophrenia, and therefore may be amenable to interventions for its improvement. However, caution is also warranted as nearly one in five patients with initially good adherence experienced worsened adherence 1 year later.

Published
2023
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4. Patients’ awareness of recovery mediates the link between clinical and level of functional remission in schizophrenia to a larger extent in those treated with long-acting antipsychotics

Author

Jasmina Mallet, Clément Dondé, Caroline Dubertret, and Philip Gorwood

Subjects
Therapeutics. Pharmacology, RM1-950, Psychiatry, RC435-571
Abstract

Background: Clinical remission is a step towards functional remission for subjects with schizophrenia. While recovery is both a subjective personal journey and a clinical outcome to be targeted, data on patient self-rated outcomes are scarce. Objectives: (i) To determine the extent to which the association between clinical and functional remission is mediated by the subjective experience of recovery as reported by patients versus their relatives or their psychiatrist and (ii) to assess differences according to treatment, specifically with oral antipsychotics only versus long-acting injectable antipsychotics (LAIs). Design: Clinical observational study. Methods: Community-dwelling participants with schizophrenia enrolled in the EGOFORS cohort ( N = 198) were included. Clinical symptoms and remission were assessed using the Positive and Negative Syndrome Scale. Functional remission was assessed with the Functional Remission of General Schizophrenia Scale. Awareness of recovery was assessed with one question ‘What percentage of recovery do you think you have now (from 0% – no recovery – to 100% – full recovery)?’, asked of the patient, also of the patient’s close relative, and the psychiatrist. We used mediation analyses, taking into account the type of pharmacological treatment. Results: Remission criteria and perceived remission measures were significantly correlated, both within and between groups ( r > 0.330). The patient’s awareness of recovery mediated the relationship between clinical remission and level of functional remission, while the level of recovery according to psychiatrists or close relatives did not. The direct effect of clinical remission on the level of functional remission became non-significant when taking into account the mediator (patients’ awareness of recovery) in the group of patients with LAI ( t = 1.5, p = 0.150) but not in the group of patients with other treatments ( t = 3.1, p = 0.003). Conclusion: Patients with LAIs may be more efficient in reporting their level of functional remission. Higher patient awareness could be an interesting candidate to explain this. However, as the study was cross-sectional, such a proposal should be tested with a more specifically designed protocol, such as a long-term cohort.

Published
2024
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5. Postpartum blues: a predictor of postpartum depression, from the IGEDEPP Cohort

Author

Alexandra Landman, Elodie Gaelle Ngameni, Marine Dubreucq, Julien Dubreucq, IGEDEPP Groups, Sarah Tebeka, and Caroline Dubertret

Subjects
associated factors, IGEDEPP, postpartum, postpartum blues, postpartum depression, pregnancy, Psychiatry, RC435-571
Abstract

Abstract Background To identify the different factors associated with postpartum blues and its association with postpartum depression, from a large French cohort. Methods We conducted an analysis of the Interaction Gene Environment in Postpartum Depression cohort, which is a prospective, multicenter cohort including 3310 women. Their personal (according to the Diagnostic and Statistical Manual, fifth edition [DSM-5]) and family psychiatric history, stressful life events during childhood, pregnancy, and delivery were collected. Likewise, the French version of the Maternity Blues Scale questionnaire was administered at the maternity department. Finally, these women were assessed at 8 weeks and 1 year postpartum by a clinician for postpartum depression according to DSM-5 criteria. Results The prevalence of postpartum blues in this population was 33%, and significant factors associated with postpartum blues were found as personal (aOR = 1.2) and family psychiatric history (aOR = 1.2), childhood trauma (aOR = 1.3), obstetrical factors, or events related to the newborn, as well as an experience of stressful life events during pregnancy (aOR = 1.5). These factors had a cumulative effect, with each additional factor increasing the risk of postpartum blues by 31%. Furthermore, adjustment for sociodemographic measures and history of major depressive episode revealed a significant association between postpartum blues and postpartum depression, mainly at early onset, within 8 weeks after delivery (aOR = 2.1; 95% CI = 1.6–2.7), but also at late onset (aOR = 1.4; 95% CI = 1.1–1.9), and mainly if the postpartum blues is severe. Conclusion These results justify raising awareness among women with postpartum blues, including reassurance and information about postpartum depression, its symptomatology, and the need for management in case of worsening or prolongation of postpartum blues.

Published
2024
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6. Subjects suffering from bipolar disorder taking lithium are less likely to report physical pain: a FACE-BD study

Author

Nathan Risch, Jonathan Dubois, Bruno Etain, Bruno Aouizerate, Frank Bellivier, Raoul Belzeaux, Caroline Dubertret, Emmanuel Haffen, Dominique Januel, Marion Leboyer, Antoine Lefrere, Ludovic Samalin, Mircea Polosan, Romain Rey, Paul Roux, Raymund Schwan, Michel Walter, FondaMental Advanced Centres of Expertise in Bipolar Disorders (FACE-BD) Collaborators, Philippe Courtet, and Emilie Olié

Subjects
bipolar disorder, lithium, lithium plasma level, mood disorders, pain, Psychiatry, RC435-571
Abstract

Abstract Background Physical pain is a common issue in people with bipolar disorder (BD). It worsens mental health and quality of life, negatively impacts treatment response, and increases the risk of suicide. Lithium, which is prescribed in BD as a mood stabilizer, has shown promising effects on pain. Methods This naturalistic study included 760 subjects with BD ( FACE-BD cohort) divided in two groups: with and without self-reported pain (evaluated with the EQ-5D-5L questionnaire). In this sample, 176 subjects were treated with lithium salts. The objectives of the study were to determine whether patients receiving lithium reported less pain, and whether this effect was associated with the recommended mood-stabilizing blood concentration of lithium. Results Subjects with lithium intake were less likely to report pain (odds ratio [OR] = 0.59, 95% confidence interval [CI], 0.35–0.95; p = 0.036) after controlling for sociodemographic variables, BD type, lifetime history of psychiatric disorders, suicide attempt, personality traits, current depression and anxiety levels, sleep quality, and psychomotor activity. Subjects taking lithium were even less likely to report pain when lithium concentration in blood was ≥0.5 mmol/l (OR = 0.45, 95% CI, 0.24–0.79; p = 0.008). Conclusions This is the first naturalistic study to show lithium’s promising effect on pain in subjects suffering from BD after controlling for many confounding variables. This analgesic effect seems independent of BD severity and comorbid conditions. Randomized controlled trials are needed to confirm the analgesic effect of lithium salts and to determine whether lithium decreases pain in other vulnerable populations.

Published
2024
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7. Association between family functioning and psychotic transition in ultra-high risk adolescents and young adults

Author

Vladimir Adrien, Justine Liewig, Thomas Diot, Florian Ferreri, Stephane Mouchabac, Caroline Dubertret, and Julie Bourgin

Subjects
psychotic transition, family functioning, environment, adolescent, FAD-60, Psychiatry, RC435-571
Abstract

BackgroundPsychotic transition (PT) is a crucial stage in schizophrenia. The Comprehensive Assessment of At-Risk Mental States (CAARMS) scale can be used to identify individuals at ultra-high risk (UHR) for psychosis and to evaluate their risk of PT. Many environmental and genetic factors have been identified as contributing to the development and decompensation of schizophrenia. This study aimed to determine if the quality of family functioning is associated with PT risk in UHR individuals aged between 11 and 25 years after 1 year of follow-up.MethodsFrom January to November 2017, 45 patients aged 12 to 25 consulting for psychiatric reasons were included. Twenty-six were classified as UHR of PT at the CAARMS. Family functioning was assessed by the Family Assessment Device—Global Functioning (FAD-GF). Thirty-seven of these patients (30% men, mean age 16 ± 2.5) were reassessed at 8–14 months of recruitment. Survival analysis was used to examine the impact of family functioning on PT risk.ResultsA total of 40% of UHR patients were classified as psychotic at reassessment. Survival analysis showed that better family functioning is a significant protective factor for PT in this population.DiscussionThis result suggests that the global family functioning has an impact at 1 year on the risk of PT in the population of adolescents and young adults who consult the hospital for psychiatric reasons. A family intervention may be effective in reducing PT risk in this population and should be considered as a potential therapeutic option.

Published
2023
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8. De Novo Variants Found in Three Distinct Schizophrenia Populations Hit a Common Core Gene Network Related to Microtubule and Actin Cytoskeleton Gene Ontology Classes

Author

Yann Loe-Mie, Christine Plançon, Caroline Dubertret, Takeo Yoshikawa, Binnaz Yalcin, Stephan C. Collins, Anne Boland, Jean-François Deleuze, Philip Gorwood, Dalila Benmessaoud, Michel Simonneau, and Aude-Marie Lepagnol-Bestel

Subjects
schizophrenia trios, cohorts, mutation, gene ontology, cytoskeleton, microtubule, Science
Abstract

Schizophrenia (SZ) is a heterogeneous and debilitating psychiatric disorder with a strong genetic component. To elucidate functional networks perturbed in schizophrenia, we analysed a large dataset of whole-genome studies that identified SNVs, CNVs, and a multi-stage schizophrenia genome-wide association study. Our analysis identified three subclusters that are interrelated and with small overlaps: GO:0007017~Microtubule-Based Process, GO:00015629~Actin Cytoskeleton, and GO:0007268~SynapticTransmission. We next analysed three distinct trio cohorts of 75 SZ Algerian, 45 SZ French, and 61 SZ Japanese patients. We performed Illumina HiSeq whole-exome sequencing and identified de novo mutations using a Bayesian approach. We validated 88 de novo mutations by Sanger sequencing: 35 in French, 21 in Algerian, and 32 in Japanese SZ patients. These 88 de novo mutations exhibited an enrichment in genes encoding proteins related to GO:0051015~actin filament binding (p = 0.0011) using David, and enrichments in GO: 0003774~transport (p = 0.019) and GO:0003729~mRNA binding (p = 0.010) using Amigo. One of these de novo variant was found in CORO1C coding sequence. We studied Coro1c haploinsufficiency in a Coro1c+/− mouse and found defects in the corpus callosum. These results could motivate future studies of the mechanisms surrounding genes encoding proteins involved in transport and the cytoskeleton, with the goal of developing therapeutic intervention strategies for a subset of SZ cases.

Published
2024
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9. Major depressive episode and postpartum depression: A network analysis comparison on the IGEDEPP cohort

Author

Sarah Tebeka, Christophe Gauld, Raoul Belzeaux, Hugo Peyre, and Caroline Dubertret

Subjects
Major depressive disorder, network analysis, postpartum depression, sadness, suicidal ideations, Psychiatry, RC435-571
Abstract

Abstract Introduction Major depression episode (MDE) and postpartum depression (PPD) have the same diagnosis criteria, but dissimilarities may be present regarding the frequency and structure of depressive symptoms. Methods We used data from the IGEDEPP Cohort (France) to examine DSM-5 depressive symptoms in two groups of women: 486 with PPD and 871 with a history of non-perinatal MDE. We compare (i) the frequency of each depressive symptom adjusted for the severity of depression, (ii) the global structure of depressive symptom networks, and (iii) the centrality of each symptom in the two networks. Results Women with PPD were significantly more likely to have appetite disturbance, psychomotor symptoms, and fatigue than those with MDE, while sadness, anhedonia, sleep disturbance, and suicidal ideation were significantly less common. There were no significant differences in the global structure of depressive symptoms of MDE and PPD. However, the most central criterion of the MDE network was “Sadness” while it was “Suicidal ideations” for the PPD network. “Sleep” and “Suicidal ideations” criteria were more central for PPD network, whereas “Culpability” was more important for MDE network than for PPD network. Conclusion We found differences in depressive symptoms expression between PPD and MDE, which justify continuing to clinically distinguish PPD from MDE.

Published
2023
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10. Covid-19 crisis impact on the next generation of physicians: a survey of 800 medical students

Author

Sandrine Passemard, Albert Faye, Caroline Dubertret, Hugo Peyre, Camille Vorms, Victor Boimare, Stéphane Auvin, Martin Flamant, Philippe Ruszniewski, and Jean-Damien Ricard

Subjects
Medical students, Volunteering, Covid-19, Special aspects of education, LC8-6691, Medicine
Abstract

Abstract Background Many initiatives have emerged worldwide to handle the surge of hospitalizations during the SARS-CoV-2 pandemic. In France, the University of Paris North called on its medical students, whose status makes them integral members of the healthcare staff, to volunteer in their capacity of medical students and/or as nurses/nursing aids in understaffed intensive care units and other Covid-19 services. We attempted to evaluate their commitment, whether the pandemic affected their certainty for the medical profession and career choices, and how they scored their sadness and anxiety levels. Methods The University of Paris North took a weekly official census of the involvement of 1205 4th–6th year medical students during the first lockdown in France. Six weeks after the lockdown began (May 4th), an e-questionnaire was sent to 2145 2nd-6th year medical students. The survey lasted 4 weeks and documented volunteering by medical students, the association between the pandemic and certainty for their profession, their choice of medical specialty and factors that influenced sadness and anxiety scores. Results 82% of 4th–6th year medical students volunteered to continue their internship or be reassigned to COVID-19 units. Of 802 2nd-6th year students who completed the e-questionnaire, 742 (93%) volunteered in Covid-19 units, of which half acted as nurses. This engagement reinforced the commitment of 92% of volunteers to become physicians. However, at the peak of the outbreak, 17% had doubts about their ability to be physicians, while 12% reconsidered their choice of future specialty. Finally, 38% of students reported a score of 7/10 or more on the sadness scale, and 43% a score of 7/10 or more for anxiety. Neither study year nor service influenced sadness or anxiety scores. However, gender influenced both, with women scoring significantly higher than men (p

Published
2021
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11. Immuno-metabolic profile of patients with psychotic disorders and metabolic syndrome. Results from the FACE-SZ cohort

Author

Marianne Foiselle, Susana Barbosa, Ophélia Godin, Ching-Lien Wu, Wahid Boukouaci, Myrtille Andre, Bruno Aouizerate, Fabrice Berna, Caroline Barau, Delphine Capdevielle, Pierre Vidailhet, Isabelle Chereau, Laetitia Davidovic, Jean-Michel Dorey, Caroline Dubertret, Julien Dubreucq, Catherine Faget, Guillaume Fond, Sylvain Leigner, Pierre-Michel Llorca, Jasmina Mallet, David Misdrahi, Emanuela Martinuzzi, Christine Passerieux, Romain Rey, Baptiste Pignon, Mathieu Urbach, Franck Schürhoff, Nicolas Glaichenhaus, Marion Leboyer, Ryad Tamouza, F. Berna, E. Haffen, M. Leboyer, P.M. Llorca, F. Schürhoff, V. Barteau, S. Bensalem, O. Godin, H. Laouamri, K. Souryis, I. Offerlin-Meyer, B. Pignon, A. Szöke, B. Aouizerate, A. Deloge, D. Misdrahi, E. Vilà, O. Blanc, I. Chéreau, H. Denizot, R.M. Honciuc, D. Lacelle, S. Pires, C. Dubertret, J. Mallet, C. Portalier, J. Dubreucq, C. Fluttaz, F. Gabayet, C. Roman, G. Chesnoy-Servanin, T. D'Amato, J.M. Dorey, R. Rey, A. Vehier, C. Lançon, C. Faget, E. Metairie, P. Peri, F. Vaillant, L. Boyer, G. Fond, P. Vidailhet, A. Zinetti-Bertschy, D. Capdevielle, H. Yazbek, S. Esselin, M. Jarroir, C. Passerieux, and M. Urbach

Subjects
Metabolic syndrome, Schizophrenia, Psychosis, Inflammation, Machine learning, Precision medicine, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Background: Metabolic syndrome (MetS) is a highly prevalent and harmful medical disorder often comorbid with psychosis where it can contribute to cardiovascular complications. As immune dysfunction is a key shared component of both MetS and schizophrenia (SZ), this study investigated the relationship between immune alterations and MetS in patients with SZ, whilst controlling the impact of confounding clinical characteristics including psychiatric symptoms and comorbidities, history of childhood maltreatment and psychotropic treatments. Method: A total of 310 patients meeting DSM-IV criteria for SZ or schizoaffective disorders (SZA), with or without MetS, were systematically assessed and included in the FondaMental Advanced Centers of Expertise for Schizophrenia (FACE-SZ) cohort. Detailed clinical characteristics of patients, including psychotic symptomatology, psychiatric comorbidities and history of childhood maltreatment were recorded and the serum levels of 18 cytokines were measured. A penalized regression method was performed to analyze associations between inflammation and MetS, whilst controlling for confounding factors. Results: Of the total sample, 25% of patients had MetS. Eight cytokines were above the lower limit of detection (LLOD) in more than 90% of the samples and retained in downstream analysis. Using a conservative Variable Inclusion Probability (VIP) of 75%, we found that elevated levels of interleukin (IL)-6, IL-7, IL-12/23 p40 and IL-16 and lower levels of tumor necrosis factor (TNF)-α were associated with MetS. As for clinical variables, age, sex, body mass index (BMI), diagnosis of SZ (not SZA), age at the first episode of psychosis (FEP), alcohol abuse, current tobacco smoking, and treatment with antidepressants and anxiolytics were all associated with MetS. Conclusion: We have identified five cytokines associated with MetS in SZ suggesting that patients with psychotic disorders and MetS are characterized by a specific “immuno-metabolic” profile. This may help to design tailored treatments for this subgroup of patients with both psychotic disorders and MetS, taking one more step towards precision medicine in psychiatry.

Published
2022
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12. Outcome prediction with a social cognitive battery: a multicenter longitudinal study

Author

Eric Brunet-Gouet, Capucine Decaix-Tisserand, Mathieu Urbach, Nadine Bazin, Bruno Aouizerate, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Caroline Dubertret, Julien Dubreucq, Guillaume Fond, Christophe Lançon, Sylvain Leignier, Jasmina Mallet, David Misdrahi, Sylvie Pires, Priscille Schneider, Franck Schurhoff, Hanan Yazbek, Anna Zinetti-Bertschy, Christine Passerieux, and Paul Roux

Subjects
Psychiatry, RC435-571
Abstract

Abstract The interest in social cognition in schizophrenia is justified by the relationship between deficits in these skills and negative functional outcomes. Although assessment batteries have already been described, there is no consensus about which measures are useful in predicting patient functioning or quality of life (QoL). We investigated a set of five measures of recognition of facial emotions, theory of mind (ToM), and empathy in a cohort of 143 patients with schizophrenia or schizoaffective disorder at inclusion and, amongst whom 79 were reassessed 1 year later. The distribution was satisfactory for the TREF (Facial Emotion Recognition Task), V-SIR (Versailles-Situational Intention Reading), and QCAE (Questionnaire of Cognitive and Affective Empathy). Internal consistency was satisfactory for the TREF, V-SIR, V-Comics (Versailles Intention Attribution Task), and QCAE. Sensitivity to change was acceptable for the TREF. The TREF and V-SIR showed a cross-sectional relationship with functioning beyond the clinical symptoms of schizophrenia but not beyond neurocognition. Moreover, the TREF and V-SIR at inclusion could not predict functioning one year later, whereas most neurocognitive and clinical dimensions at inclusion could. Finally, only affective QCAE showed a significant cross-sectional, but not longitudinal, association with QoL. In conclusion, the TREF had satisfactory psychometric properties and showed a cross-sectional, but not longitudinal, association with objective outcome measures, thus appearing to be reliable in clinical practice and research. The V-SIR also showed promising psychometric properties, despite a possible weakness to detect change. However, these measures should be interpreted within the context of the good predictive power of the neurocognitive and clinical status on the outcome.

Published
2021
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13. Determinants of Kidney Function and Accuracy of Kidney Microcysts Detection in Patients Treated With Lithium Salts for Bipolar Disorder

Author

Nahid Tabibzadeh, Anne-Laure Faucon, Emmanuelle Vidal-Petiot, Fidéline Serrano, Lisa Males, Pedro Fernandez, Antoine Khalil, François Rouzet, Coralie Tardivon, Nicolas Mazer, Caroline Dubertret, Marine Delavest, Emeline Marlinge, Bruno Etain, Frank Bellivier, François Vrtovsnik, and Martin Flamant

Subjects
nephrotoxicity, lithium, CKD-chronic kidney disease, kidney microcysts, bipolar disorder, Therapeutics. Pharmacology, RM1-950
Abstract

Objectives: Early kidney damage during lithium treatment in bipolar disorder is still hypothetical. We aimed at identifying the determinants of a decreased measured glomerular filtration rate (mGFR) and the accuracy of kidney MRI imaging in its detection.Methods: In this cross-sectional cohort study, 217 consecutive lithium-treated patients underwent mGFR and kidney MRI with half-Fourier turbo spin-echo and Single-shot with long echo time sequences.Results: Median age was 51 [27–62] years, and median lithium treatment duration was 5 [2–14] years. 52% of patients had a stage 2 CKD. In multivariable analysis, the determinants of a lower mGFR were a longer lithium treatment duration (β −0.8 [−1; −0.6] ml/min/1.73 m2 GFR decrease for each year of treatment), a higher age (β −0.4 [−0.6; −0.3] ml/min/1.73 m2 for each year of age, p < 0.001), albuminuria (β −3.97 [−6.6; −1.3], p = 0.003), hypertension (β −6.85 [−12.6; −1.1], p = 0.02) and hypothyroidism (β −7.1 [−11.7; −2.5], p = 0.003). Serum lithium concentration was not associated with mGFR. Renal MRI displayed renal microcyst(s) in 51% of patients, detected as early as 1 year after lithium treatment initiation. mGFR and lithium treatment duration were strongly correlated in patients with microcyst(s) (r = −0.64, p < 0.001), but not in patients with no microcysts (r = −0.24, p = 0.09). The presence of microcysts was associated with the detection of an mGFR

Published
2022
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14. Pharmacological treatment profiles in the FACE-BD cohort: Treatment description and complete data for bipolar subtypes

Author

Sébastien Brodeur, Hugo Terrisse, Arnaud Pouchon, Ophelia Godin, Bruno Aouizerate, Valerie Aubin, Frank Bellivier, Raoul Belzeaux, Thierry Bougerol, Philippe Courtet, Caroline Dubertret, Sebastien Gard, Emmanuel Haffen, Chantal Henry, Marion Leboyer, Emilie Olié, Paul Roux, Ludovic Samalin, Raymund Schwan, Bruno Etain, Jean-Luc Bosson, and Mircea Polosan

Subjects
Data set, Clusters, Hierarchical agglomerative clustering, Bipolar disorders, Machine learning, Computer applications to medicine. Medical informatics, R858-859.7, Science (General), Q1-390
Abstract

In the current study, we provide the list of pharmacological interventions applied during the one-year follow-up period of the Pharmacological treatment profiles in the FACE-BD cohort study. These data show the treatments used in the new clusters formed in this previous study and also in usual bipolarity subtypes. The proportion of each treatment used during the follow-up was calculated. Days on each treatment were also included in this dataset. The complete clinical and paraclinical data analyzed for clusters and bipolar subtypes were included in this dataset. Socio-demographic self-administered and clinician-administered scales, clinical evaluation during the follow-up, psychiatric and somatic comorbidities, and blood tests are shown in this material.

Published
2021
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15. Prospective cohort study of early biosignatures of response to lithium in bipolar-I-disorders: overview of the H2020-funded R-LiNK initiative

Author

Jan Scott, Diego Hidalgo-Mazzei, Rebecca Strawbridge, Allan Young, Matthieu Resche-Rigon, Bruno Etain, Ole A. Andreassen, Michael Bauer, Djamila Bennabi, Andrew M. Blamire, Fawzi Boumezbeur, Paolo Brambilla, Nadia Cattane, Annamaria Cattaneo, Marie Chupin, Klara Coello, Yann Cointepas, Francesc Colom, David A. Cousins, Caroline Dubertret, Edouard Duchesnay, Adele Ferro, Aitana Garcia-Estela, Jose Goikolea, Antoine Grigis, Emmanuel Haffen, Margrethe C. Høegh, Petter Jakobsen, Janos L. Kalman, Lars V. Kessing, Farah Klohn-Saghatolislam, Trine V. Lagerberg, Mikael Landén, Ute Lewitzka, Ashley Lutticke, Nicolas Mazer, Monica Mazzelli, Cristina Mora, Thorsten Muller, Estanislao Mur-Mila, Ketil Joachim Oedegaard, Leif Oltedal, Erik Pålsson, Dimitri Papadopoulos Orfanos, Sergi Papiol, Victor Perez-Sola, Andreas Reif, Philipp Ritter, Roberto Rossi, Thomas Schulze, Fanny Senner, Fiona E. Smith, Letizia Squarcina, Nils Eiel Steen, Pete E. Thelwall, Cristina Varo, Eduard Vieta, Maj Vinberg, Michele Wessa, Lars T. Westlye, and Frank Bellivier

Subjects
Bipolar, Precision, Personalization, Lithium, Response, Phenotype, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurophysiology and neuropsychology, QP351-495
Abstract

Abstract Background Lithium is recommended as a first line treatment for bipolar disorders. However, only 30% of patients show an optimal outcome and variability in lithium response and tolerability is poorly understood. It remains difficult for clinicians to reliably predict which patients will benefit without recourse to a lengthy treatment trial. Greater precision in the early identification of individuals who are likely to respond to lithium is a significant unmet clinical need. Structure The H2020-funded Response to Lithium Network (R-LiNK; http://www.r-link.eu.com/) will undertake a prospective cohort study of over 300 individuals with bipolar-I-disorder who have agreed to commence a trial of lithium treatment following a recommendation by their treating clinician. The study aims to examine the early prediction of lithium response, non-response and tolerability by combining systematic clinical syndrome subtyping with examination of multi-modal biomarkers (or biosignatures), including omics, neuroimaging, and actigraphy, etc. Individuals will be followed up for 24 months and an independent panel will assess and classify each participants’ response to lithium according to predefined criteria that consider evidence of relapse, recurrence, remission, changes in illness activity or treatment failure (e.g. stopping lithium; new prescriptions of other mood stabilizers) and exposure to lithium. Novel elements of this study include the recruitment of a large, multinational, clinically representative sample specifically for the purpose of studying candidate biomarkers and biosignatures; the application of lithium-7 magnetic resonance imaging to explore the distribution of lithium in the brain; development of a digital phenotype (using actigraphy and ecological momentary assessment) to monitor daily variability in symptoms; and economic modelling of the cost-effectiveness of introducing biomarker tests for the customisation of lithium treatment into clinical practice. Also, study participants with sub-optimal medication adherence will be offered brief interventions (which can be delivered via a clinician or smartphone app) to enhance treatment engagement and to minimize confounding of lithium non-response with non-adherence. Conclusions The paper outlines the rationale, design and methodology of the first study being undertaken by the newly established R-LiNK collaboration and describes how the project may help to refine the clinical response phenotype and could translate into the personalization of lithium treatment.

Published
2019
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16. Early and very early‐onset schizophrenia compared with adult‐onset schizophrenia: French FACE‐SZ database

Author

Nathalie Coulon, Ophélia Godin, Ewa Bulzacka, Caroline Dubertret, Jasmina Mallet, Guillaume Fond, Lore Brunel, Méja Andrianarisoa, George Anderson, Isabelle Chereau, Hélène Denizot, Romain Rey, Jean‐Michel Dorey, Christophe Lançon, Catherine Faget, Paul Roux, Christine Passerieux, Julien Dubreucq, Sylvain Leignier, Delphine Capdevielle, Myrtille André, Bruno Aouizerate, David Misdrahi, Fabrice Berna, Pierre Vidailhet, Marion Leboyer, and Franck Schürhoff

Subjects
adult‐onset schizophrenia, duration of untreated psychosis, early‐onset schizophrenia, symptomatology, very early‐onset schizophrenia, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Objective To compare the clinical symptomatology in patients with Early‐Onset Schizophrenia (EOS, N = 176), especially the subgroup Very Early Onset Schizophrenia (VEOS) and Adult Onset Schizophrenia (AOS, N = 551). Method In a large French multicentric sample, 727 stable schizophrenia patients, classified by age at onset of the disorder, were assessed using standardized and extensive clinical and neuropsychological batteries: AOS with onset ≥ 18 years and EOS with onset

Published
2020
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17. Confirmation of a Two-Factor Solution to the Questionnaire of Cognitive and Affective Empathy in a French Population of Patients With Schizophrenia Spectrum Disorders

Author

Eric Brunet-Gouet, Nils Myszkowski, Mickael Ehrminger, Mathieu Urbach, Bruno Aouizerate, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Caroline Dubertret, Julien Dubreucq, Guillaume Fond, Christophe Lançon, Sylvain Leignier, Jasmina Mallet, David Misdrahi, Sylvie Pires, Priscille Schneider, Franck Schurhoff, Hanan Yazbek, Anna Zinetti-Bertschy, Nadine Bazin, Christine Passerieux, Franck Zenasni, and Paul Roux

Subjects
schizophrenia spectrum, empathy, assessment method, quality of life, functioning, Psychiatry, RC435-571
Abstract

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a tool for self-assessing the cognitive and emotional components of empathy. A study showed that a two-factor model fits the data of patients with schizophrenia, whereas other reports on healthy subjects have suggested a five-factor decomposition. We aimed to replicate the model of Horan et al. in a French population with schizophrenia spectrum disorders (i.e., schizophrenia and schizoaffective disorders) participating in the EVACO Study (NCT02901015). In total, 133 patients were assessed with the QCAE, the Positive and Negative Symptom Scale (PANSS), the Personal and Social Performance Scale (PSP), and the Self rating Quality of Life Scale (S-QoL). The two-factor model demonstrated an adequate fit with the data, comparable to that reported by Horan et al. Males scored higher on the Affective subscore than females. After correction for multiple tests, psychopathology (PANSS) and functioning (PSP) did not correlate significantly with the QCAE subscores. However, quality of life (S-QoL) correlated positively with the Emotional Contagion subscore. Thus, the variability of empathetic disposition in schizophrenia may be considered through the cognitive versus affective dichotomy and properly investigated with the QCAE. The results support further investigation of the relationship between QCAE scores and subjective outcome measurements, such as quality of life, and emphasize the importance of cross-cultural comparisons.

Published
2019
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18. Impact of DRD2/ANKK1 and COMT Polymorphisms on Attention and Cognitive Functions in Schizophrenia.

Author

Irene Nkam, Nicolas Ramoz, Florence Breton, Jasmina Mallet, Philip Gorwood, and Caroline Dubertret

Subjects
Medicine, Science
Abstract

Cognitive deficits such as poor selective attention and executive functions decline have been reported in patients with schizophrenia. Many studies have emphasized the role of dopamine in regulating cognitive functions in the general population as well as in schizophrenia. However, the relationship between cognitive processes, schizophrenia and dopaminergic candidate genes is an original approach given interesting results. The purpose of the current exploratory study was to examine the interaction of dopaminergic genes (coding for dopamine receptor D2, DRD2, and for Catecholamine-O-Methyl-Transferase, COMT) with the diagnostic of schizophrenia in (i) the executive control of attention, (ii) selective attention, and (iii) executive functions.We recruited 52 patients with schizophrenia and 53 healthy controls who performed the Stroop Color-Word Test, the Attention Network Test and the Wisconsin Card Sorting test. Four single nucleotide polymorphisms (SNPs) in the DRD2 gene (rs6275, rs6277, rs2242592 and rs1800497) and two SNPs in the COMT gene (rs4680 and rs165599) have been genotyped. Patients with schizophrenia performed significantly worse than controls in all cognitive performance, taking into account demographic variables. A significant gene by disease interaction was found for the Stroop interference (p = 0.002) for rs6275 of the DRD2 gene. The COMT Val/Val genotype and schizophrenia were associated with increased number of perseverative errors (p = 0.01).In our study, the DRD2 gene is involved in attention while the COMT gene is implicated in executive functions in patients with schizophrenia.

Published
2017
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19. Prevalence of subthreshold hypomania and impact on internal validity of RCTs for major depressive disorder: results from a national epidemiological sample.

Author

Nicolas Hoertel, Yann Le Strat, Frédéric Limosin, Caroline Dubertret, and Philip Gorwood

Subjects
Medicine, Science
Abstract

BACKGROUND: Growing evidence supports the validity of distinguishing major depressive disorder (MDD) plus a lifetime history of subthreshold hypomania (D(m)) from pure MDD in psychiatric classifications. The present study sought to estimate the proportion of individuals with D(m) that would have been included in RCTs for MDD using typical eligibility criteria, and examine the potential impact of including these participants on internal validity. METHODS: Data were derived from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a national representative sample of 43,093 adults of the United States population. We examined the proportion of participants with a current diagnosis of pure MDD and D(m) that would have been eligible in clinical trials for MDD with a traditional set of eligibility criteria, and compared it with that of participants with bipolar 2 disorder if the same set of eligibility criteria was applied. We considered 4 models including different definitions of subthreshold hypomania. RESULTS: We found that more than 7 out of ten participants with pure MDD and with D(m) would have been excluded by at least one classical eligibility criterion. Prevalence rate of individuals with D(m) in RCTs for MDD with traditional eligibility criteria would have ranged from 7.98% to 22.59%. Overall exclusion rate of individuals with MDD plus at least 4 lifetime concomitant hypomanic probes significantly differ from those with pure MDD, whereas it was not significantly different in those with at least 2 lifetime concomitant hypomanic probes compared to those with bipolar 2 disorder. CONCLUSIONS: The current design of clinical trials for MDD may suffer from impaired external validity and potential impaired internal validity, due to the inclusion of a substantial proportion of individuals with subthreshold hypomania presenting with similar pattern of exclusion rates to those with bipolar 2 disorder, possibly resulting in a selection bias.

Published
2013
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20. Genome-wide association study of early-onset and late-onset postpartum depression: the IGEDEPP prospective study

Author

Sarah TEBEKA, Emilie GLOAGUEN, Jimmy MULLAERT, Qin HE, Anne BOLAND, Jean-Francois DELEUZE, Camille JAMET, Nicolas RAMOZ, and Caroline DUBERTRET

Subjects
Early-onset Postpartum Depression, Late-onset Postpartum Depression, Genome-wide association study (GWAS), Quantitative trait locus (QTL), Functional Mapping and Annotation of Genome-Wide Association Studies (FUMA), Polygenic Risk Score (PRS), Genotype-Tissue Expression (GETx), Psychiatry, RC435-571
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21. Magnesium in the treatment of alcohol withdrawal syndrome: a multicenter randomized controlled trial

Author

Guillaume Airagnes, Rémi Valter, Géraldine Ducoutumany, Clément Vansteene, Jean-Baptiste Trabut, Philip Gorwood, Caroline Dubertret, Joane Matta, Anais Charles-Nelson, and Frédéric Limosin

Subjects
General Medicine
Abstract

Objective Alcohol withdrawal syndrome (AWS) is a frequent and potentially life-threatening condition experienced in alcohol use disorder. Since hypomagnesemia is involved in AWS’s severity, we conducted a multicenter double-blind randomized placebo-controlled trial to examine the efficacy of oral magnesium supplementation as an adjuvant therapy of AWS. Material and Methods Inpatients were recruited in six different centers if they had a baseline score higher than eight on the Revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). The experimental treatment was magnesium lactate dehydrate, administrated three times per day providing a total of 426.6 mg per day and up to 15 days. The primary endpoint was the significant between-group difference of the CIWA-Ar total score change from baseline to 3 days later. The treatment group and baseline score were introduced as covariables in an analysis of covariance. Results A total of 98 inpatients were included {71.4% of men; mean age of 49.1 years [standard deviation (SD): 10.3]}. In the intention-to-treat population, the mean reduction of the CIWA-Ar score in the experimental group between baseline and 3 days later was 10.1 (SD: 5.2), whereas it was 9.2 (SD: 3.9) in the control group. The absolute difference of the adjusted mean in the experimental group compared with the control group was −0.69 (SD: 0.72), which did not correspond to a significant between-group difference (P = 0.34). Per-protocol analysis and sensitivity analyses also supported this result. Supplementary analyses found no significant difference regarding benzodiazepine consumption, magnesium blood concentration, and satisfaction to care. Conclusions The present study does not support the rationale of systematic oral magnesium supplementation in patients with AWS.

Published
2023

22. Predictors of medication adherence in a large one-year prospective cohort of individuals with schizophrenia: Insights from the Multicentric FACE-SZ Dataset

Author

david misdrahi, Maud Dupuy, Yecodji Dansou, Laurent Boyer, Fabrice Berna, Delphine Capdevieille, Isabelle Chereau, Natahlie Coulon, Thierry d'Amato, Caroline Dubertret, Sylvain Leignier, Pierre Michel Llorca, Chritophe Lançon, Jasmina MALLET, Chrisitine Passerieux, Baptiste Pignon, Romain REY, Franck Schurhoff, Joel Swendsen, Mathieu Urbach, Andrei Szoke, Ophelia Godin, and Guillaume FOND

Abstract

Schizophrenia is characterized by the most salient medication adherence problems among severe mental disorders, but limited prospective data are available to predict and improve adherence in this population. This investigation aims to identify predictors of medication adherence over a one-year period in a large national cohort using clustering analysis. Outpatients were recruited from ten Schizophrenia Expert Centers and were evaluated with a day-long standardized battery including clinician and patient-rated medication adherence measures. A two-step cluster analysis and multivariate logistic regression were conducted to identify medication adherence profiles based on the Medication Adherence rating Scale (MARS) and baseline predictors. A total of 485 participants were included in the study and medication adherence was significantly improved at the one-year follow-up. Higher depressive scores, lower insight, history of suicide attempt, younger age and alcohol use disorder were all associated with poorer adherence at one year. Among the 203 patients with initially poor adherence, 86 (42%) switched to good adherence at the one-year follow-up, whereas 117 patients (58%) remained poorly adherent. Targeting younger patients with low insight, history of suicide, alcohol use disorder and depressive disorders should be prioritized through literacy and educational therapy programs. Adherence is a construct that can vary considerably from year to year in schizophrenia, and therefore may be amenable to interventions for its improvement. However, caution is also warranted as nearly one in five patients with initially good adherence experienced worsened adherence one year later.

Published
2023

23. Predictors of functional impairment in bipolar disorder: Results from 13 cohorts from seven countries by the global bipolar cohort collaborative

Author

Katherine E. Burdick, Caitlin E. Millett, Anastasia K. Yocum, Cara M. Altimus, Ole A. Andreassen, Valerie Aubin, Raoul Belzeaux, Michael Berk, Joanna M. Biernacka, Hilary P. Blumberg, Anthony J. Cleare, Claudia Diaz‐Byrd, Caroline Dubertret, Bruno Etain, Lisa T. Eyler, Brent P. Forester, Janice M. Fullerton, Mark A. Frye, Sébastien Gard, Ophelia Godin, Emmanuel Haffen, Federica Klaus, Trine Vik Lagerberg, Marion Leboyer, Anabel Martinez‐Aran, Susan McElroy, Philip B. Mitchell, Emilie Olie, Phebe Olorunfemi, Christine Passerieux, Amy T. Peters, Daniel L. Pham, Mircea Polosan, Julia R. Potter, Martha Sajatovic, Ludovic Samalin, Raymund Schwan, Megan Shanahan, Brisa Solé, Rebecca Strawbridge, Amanda L. Stuart, Ivan Torres, Torrill Ueland, Eduard Vieta, Lana J. Williams, Anna L. Wrobel, Lakshmi N. Yatham, Allan H. Young, Andrew A. Nierenberg, Melvin G. McInnis, Centre Hospitalier Princesse Grace, Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), IMRB - 'Neuropsychiatrie translationnelle' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Henri Mondor, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Université de Lorraine (UL), Harvard Medical School [Boston] (HMS), University of Michigan [Ann Arbor], University of Michigan System, Milken Institute School of Public Health, The George Washington University (GW), Norwegian Centre for Mental Disorders Research [Oslo] (NORMENT), University of Oslo (UiO)-Haukeland University Hospital, University of Bergen (UiB)-University of Bergen (UiB)-Oslo University Hospital [Oslo], Assistance Publique - Hôpitaux de Marseille (APHM), Deakin University [Burwood], Orygen Youth Health Research Centre [Melbourne], University of Melbourne, Mayo Clinic [Rochester], Yale School of Medicine [New Haven, Connecticut] (YSM), King‘s College London, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Lariboisière-Fernand-Widal [APHP], University of California [San Diego] (UC San Diego), University of California (UC), McLean Hospital [Belmont, Ma.], University of New South Wales [Sydney] (UNSW), Centre hospitalier Charles Perrens [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Fondation FondaMental [Créteil], Université Bourgogne Franche-Comté [COMUE] (UBFC), Centro de Investigación Biomédica en Red Salud Mental [Madrid] (CIBER-SAM), University of Cincinnati College of Medicine, Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Massachusetts General Hospital [Boston], Centre Hospitalier de Versailles André Mignot (CHV), Centre Hospitalier Universitaire [Grenoble] (CHU), Case Western Reserve University [Cleveland], CHU Clermont-Ferrand, University of British Columbia (UBC), University of Oslo (UiO), IMPACT Strategic Research Centre [VIC, Australia] (Barwon Health), Guerineau, Nathalie C., CHU Henri Mondor [Créteil], and Hôpital Charles Perrens

Subjects
Bipolar Disorder, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [SDV]Life Sciences [q-bio], Cohort Studies, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, Affect, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Humans, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Prospective Studies, Longitudinal Studies, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Biological Psychiatry, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Objectives: Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD.Methods: Thirteen cohorts from 7 countries included n=5,882 individuals with BD across multiple sites. The statistical approach consisted of a systematic uniform application of analyses across sites. Each site performed a logistic regression analysis with empirically derived "higher versus lower function" as the dependent variable and selected clinical and demographic variables as predictors.Results: We found high rates of functional impairment, ranging from 41-75%. Lower community functioning was associated with depressive symptoms in 10 of 12 of the cohorts that included this variable in the analysis. Lower levels of education, a greater number of prior mood episodes, presence of a comorbid substance use disorder, and a greater total number of psychotropic medications were also associated with low functioning.Conclusions: The bipolar clinical research community is poised to work together to characterize the multi-dimensional contributors to impairment and address the barriers that impede patients' complete recovery. We must also identify the core features which enable many to thrive and live successfully with BD. A large-scale, worldwide, prospective longitudinal study focused squarely on BD and its heterogeneous presentations will serve as a platform for discovery and promote major advances toward optimizing outcomes for every individual with this illness.

Published
2022

24. Contribution of common and rare damaging variants in familial forms of bipolar disorder and phenotypic outcome

Author

Elisa Courtois, Mark Schmid, Orly Wajsbrot, Caroline Barau, Philippe Le Corvoisier, Bruno Aouizerate, Frank Bellivier, Raoul Belzeaux, Caroline Dubertret, Jean-Pierre Kahn, Marion Leboyer, Emilie Olie, Christine Passerieux, Mircea Polosan, Bruno Etain, Stéphane Jamain, and and the FondaMental Advanced Centers of Expertise in Bipolar Disorders (FACE-BD)

Subjects
lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, lcsh:RC321-571
Abstract

Genome-wide association studies on bipolar disorders (BD) have revealed an additive polygenic contribution of common single-nucleotide polymorphisms (SNPs). However, these SNPs explain only 25% of the overall genetic variance and suggest a role of rare variants in BD vulnerability. Here, we combined high-throughput genotyping data and whole-exome sequencing in cohorts of individuals with BD as well as in multiplex families with a high density of affected individuals in order to determine the contribution of both common and rare variants to BD genetic vulnerability. Using polygenic risk scores (PRS), we showed a strong contribution of common polymorphisms previously associated with BD and schizophrenia (SZ) and noticed that those specifically associated with SZ contributed more in familial forms of BD than in non-familial ones. The analysis of rare damaging variants shared by affected individuals in multiplex families with BD revealed a single interaction network enriched in neuronal and developmental biological pathways, as well as in the regulation of gene expression. We identified four genes with a higher mutation rate in individuals with BD than in the general population and showed that mutations in two of them were associated with specific clinical manifestations. In addition, we showed a significant negative correlation between PRS and the number of rare damaging variants specifically in unaffected individuals of multiplex families. Altogether, our results suggest that common and rare genetic variants both contribute to the familial aggregation of BD and this genetic architecture may explain the heterogeneity of clinical manifestations in multiplex families.

Published
2020

25. Self-Reported Pain and Emotional Reactivity in Bipolar Disorder: A Prospective FACE-BD Study

Author

Nathan Risch, Jonathan Dubois, Katia M’bailara, Irena Cussac, Bruno Etain, Raoul Belzeaux, Caroline Dubertret, Emmanuel Haffen, Raymund Schwan, Ludovic Samalin, Paul Roux, Mircea Polosan, Marion Leboyer, Philippe Courtet, Emilie Olié, on behalf of the FondaMental Advanced Centers of Expertise in Bipolar Disorders (FACE-BD) Collaborators, Guerineau, Nathalie C., Sorbonne Universités à Paris pour l'Enseignement et la Recherche - - SUPER2011 - ANR-11-IDEX-0004 - IDEX - VALID, Cohortes - Maladie Rénale Chronique - Réseau Epidémiologie et Information en Néphrologie - - CKD-REIN2010 - ANR-10-COHO-0001 - COHO - VALID, Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Fondation FondaMental [Créteil], Laboratoire de psychologie (LabPsy), Université de Bordeaux (UB), Centre hospitalier Charles Perrens [Bordeaux], Centre Hospitalier Princesse Grace, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Assistance Publique - Hôpitaux de Marseille (APHM), Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Louis Mourier - AP-HP [Colombes], Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université de Lorraine (UL), CHU Clermont-Ferrand, Université Clermont Auvergne (UCA), Centre Hospitalier de Versailles André Mignot (CHV), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Henri Mondor, IMRB - 'Neuropsychiatrie translationnelle' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), ANR-11-IDEX-0004,SUPER,Sorbonne Universités à Paris pour l'Enseignement et la Recherche(2011), ANR-10-COHO-0001,CKD-REIN,Maladie Rénale Chronique - Réseau Epidémiologie et Information en Néphrologie(2010), Hôpital Charles Perrens, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), and CHU Henri Mondor [Créteil]

Subjects
bipolar disorder, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, pain, depression, affective symptoms, [SDV]Life Sciences [q-bio], General Medicine, [SDV] Life Sciences [q-bio], Medicine, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; In patients with bipolar disorder (BD), pain prevalence is close to 30%. It is important to determine whether pain influences BD course and to identify factors associated with pain in BD in order to guide BD management. This naturalistic, prospective study used data on 880 patients with BD from the French FACE-BD cohort who were divided into two groups according to the presence or absence of pain. Multivariate models were used to test whether pain was associated with affective states and personality traits while controlling for confounders. Then, multivariate models were used to test whether pain at baseline predicted global life functioning and depressive symptomatology at one year. At baseline, 22% of patients self-reported pain. The pain was associated with depressive symptomatology, levels of emotional reactivity in a quadratic relationship, and a composite variable of personality traits (affective lability, affective intensity, hostility/anger, and impulsivity). At one year, the pain was predictive of depression and lower global life functioning. Pain worsens mental health and well-being in patients with BD. The role of emotions, depression, and personality traits in pain has to be elucidated to better understand the high prevalence of pain in BD and to promote specific therapeutic strategies for patients experiencing pain.

Published
2022

26. Violent suicide attempt history in elderly patients with bipolar disorder: The role of sex, abdominal obesity, and verbal memory: Results from the FACE-BD cohort (FondaMental Advanced center of Expertise for Bipolar Disorders)

Author

Raoul Belzeaux, Mircea Polosan, Aiste Lengvenyte, Paul Roux, Joséphine Loftus, Sébastien Gard, Christine Passerieux, Emeline Marlinge, Emmanuel Haffen, Emilie Olié, Valerie Aubin, Bruno Aouizerate, Caroline Dubertret, Raymund Schwan, Bruno Etain, Philippe Courtet, Pierre-Michel Llorca, Marion Leboyer, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Fondation FondaMental [Créteil], Vilnius University [Vilnius], Centre hospitalier Charles Perrens [Bordeaux], Hôpital Princesse Grace [Monaco], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital Louis Mourier - AP-HP [Colombes], Université Paris Cité (UPCité), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, CHU Clermont-Ferrand, Université Clermont Auvergne (UCA), Centre Hospitalier de Versailles André Mignot (CHV), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), This work was supported (in part) by the Fondation FondaMental, Créteil, France and by the Investissements d'Avenir programs managed by the ANR under references ANR-11- IDEX-0004-02 and ANR-10-COHO-10-01, Hôpital Charles Perrens, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Université de Paris (UP), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg-Université de Strasbourg (UNISTRA), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Université Paris-Saclay, Guerineau, Nathalie C., and Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)

Subjects
Male, Bipolar disorder, [SDV]Life Sciences [q-bio], Suicide, Attempted, 03 medical and health sciences, 0302 clinical medicine, Memory, medicine, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Obesity, Abdominal obesity, Aged, Retrospective Studies, California Verbal Learning Test, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Suicide attempt, business.industry, Cohort, Cognition, Middle Aged, medicine.disease, Middle age, 030227 psychiatry, Psychiatry and Mental health, Clinical Psychology, Suicide, Cross-Sectional Studies, Obesity, Abdominal, Quantitative Biology - Neurons and Cognition, FOS: Biological sciences, Female, Neurons and Cognition (q-bio.NC), [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Cognitive function, medicine.symptom, Verbal memory, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Clinical psychology
Abstract

International audience; Background: Bipolar disorder (BD) is a chronic, lifelong condition, associated with increased risk of obesity, cognitive impairment, and suicidal behaviors. Abdominal obesity and a higher risk of violent suicide attempt (SA) seem to be shared correlates with older age, BD, and male sex until middle age when menopause-related female body changes occur. This study aimed at assessing the role of abdominal obesity and cognition in the violent SA burden of individuals with BD.Methods: From the well-defined nationwide cohort FACE-BD (FondaMental Advanced center of Expertise for Bipolar Disorders), we extracted data on 619 euthymic BD patients that were 50 years or older at inclusion. Cross-sectional clinical, cognitive, and metabolic assessments were performed. SA history was based on self-report.Results: Violent SA, in contrast to non-violent and no SA, was associated with higher waist circumference, abdominal obesity and poorer California Verbal Learning Test short-delay free recall (CVLT-SDFR) (ANOVA, p < .001, p = .014, and p = .006). Waist circumference and abdominal obesity were associated with violent SA history independently of sex, BD type and anxiety disorder (Exp(B) 1.02, CI 1.00-1.05, p = .018; Exp(B) 2.16, CI 1.00-4.64, p = .009, accordingly). In an exploratory model, waist circumference and CVLT-SDFR performance mediated the association between male sex and violent SA.Limitations: Cross-sectional design and retrospective reporting.Conclusions: Violent SA history was associated with abdominal obesity and poorer verbal memory in older age BD patients. These factors were interlinked and might mediate the association between male sex and violent SA.

Published
2022

27. Redefining peripheral inflammation signature in schizophrenia based on the real-world FACE-SZ cohort

Author

Christophe Lançon, Baptiste Pignon, T Korchia, Guillaume Fond, Damien Etchecopar-Etchart, Raphaëlle Richieri, Christine Passerieux, Jasmina Mallet, David Misdrahi, Delphine Capdevielle, Mélanie Faugere, Mathieu Urbach, F. Schürhoff, N Coulon, Bruno Aouizerate, Romain Rey, Ophélia Godin, L. Boyer, Julien Dubreucq, P.L. Sunhary de Verville, Isabelle Chereau, Jean-Michel Dorey, Marion Leboyer, Julie Clauss-Kobayashi, Caroline Dubertret, Fabrice Berna, P.-M. Llorca, Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Fondation FondaMental [Créteil], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Henri Mondor, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Les Hôpitaux Universitaires de Strasbourg (HUS), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier Charles Perrens [Bordeaux], Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier le Vinatier [Bron], Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier de Versailles André Mignot (CHV), FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) Group: P M Llorca, C Lançon, L Boyer, Imagerie MOléculaire pour applications THéranostiques personnalisées (IMOTHEP), Institut FRESNEL (FRESNEL), Centre National de la Recherche Scientifique (CNRS)-École Centrale de Marseille (ECM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-École Centrale de Marseille (ECM)-Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, Quality of life, medicine.medical_specialty, Inflammation, Overweight, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, ComputingMilieux_MISCELLANEOUS, Biological Psychiatry, Pharmacology, Psychiatry, business.industry, Patient Acuity, medicine.disease, Physical activity level, 3. Good health, 030227 psychiatry, Peripheral, C-Reactive Protein, Schizophrenia, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cohort, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], medicine.symptom, business, Inflammatory biomarker, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Biomarkers
Abstract

International audience; Background: Peripheral inflammation is associated with impaired prognosis in schizophrenia (SZ). Highly sensitive C-reactive protein (hs-CRP) is the most used inflammatory biomarker in daily practice. However, no consensual cut-off has been determined to date to discriminate patients with peripheral inflammation from those without.Aims: To determine if patients with peripheral inflammation between 1 and 3 mg/L had poorer outcomes compared to those with undetectable CRP ( 1 mg/L is a reliable marker to detect peripheral inflammation in patients with schizophrenia.

Published
2021

28. Medical students and the response to COVID-19: Educational preparedness and psychological impact of their involvement in communicating with patients’ relatives

Author

Yên-Lan Nguyen, Baptiste Pignon, Sarah Tebeka, Caroline Dubertret, Olivier Huillard, Jasmina Mallet, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, Inserm U1266, 178, rue des Renouillers, 92700 Colombes, France, UFR de Médecine Paris Nord, Université de Paris, 16, rue Henri Huchard, 75018 Paris, France., and UFR de Médecine Paris Nord, Université de Paris, 16, rue Henri Huchard, 75018 Paris, France

Subjects
santé mentale, Students, Medical, 020205 medical informatics, Distance education, education, medical students, 02 engineering and technology, Computer-assisted web interviewing, health personnel, Article, Competence (law), 03 medical and health sciences, 0302 clinical medicine, Arts and Humanities (miscellaneous), Health care, étudiants en santé, pédagogie, 0202 electrical engineering, electronic engineering, information engineering, medicine, Humans, 030212 general & internal medicine, Pandemics, Response rate (survey), Medical education, business.industry, communication, COVID-19, Mental health, teaching, Psychiatry and Mental health, Preparedness, Communicable Disease Control, Anxiety, Curriculum, communication skills, medicine.symptom, Psychology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Resume Objectifs: La pandémie de COVID-19 a posé des défis sans précédent aux systèmes de santé et d'éducation du monde entier. La manière dont les étudiants en médecine pourraient et devraient participer à la réponse à cette crise reste incertaine. Pendant la première vague épidémique, les étudiants en médecine de notre hôpital ont été invités à aider à communiquer avec les proches des patients hospitalisés en unités COVID, dans le contexte de l’interdiction des visites. Les auteurs souhaitent : (i) présenter la mise en œuvre et l'évaluation rapides d'un enseignement / e-enseignement facilitant les capacités de communication avec les familles, à l'ère du COVID-19; (ii) fournir les résultats d'une évaluation précoce du sentiment de préparation de ces étudiants à ce type de mission, de leur santé mentale et leur bien-être des élèves concernés. Méthode: Le cours a été élaboré lors du premier confinement en France, à destination des étudiants volontaires pour la mission d’information aux familles (par téléphone uniquement). L’enseignement était proposé en distanciel ou en présentiel, et s’intitulait : «Comment communiquer avec les proches des patients hospitalisés COVID-19?». Les étudiants ont reçu un questionnaire en ligne anonyme deux semaines après le début de leur mission, évaluant leur sentiment de préparation pour cette mission, leur santé mentale et leur bien-être. Résultats: Soixante-six étudiants en médecine ont été formés (32% en présentiel). Le taux de réponse était de 64%. La plupart des étudiants ont informé leurs proches des soins de routine du patient (95%). Concernant l’évaluation de l’enseignement, les élèves ont été rassurés d’avoir bénéficié de ce cours (95%), l’ont jugé pertinent (86%) et ont utilisé son contenu pédagogique (81%). 33% ont été chargés de missions imprévues (seulement 36% se sont sentis préparés), dont des annonces d’aggravation clinique. La plupart d'entre eux n'ont signalé aucun impact psychologique, mais certains ont signalé des troubles anxieux ou du sommeil sans différence entre la formation en présentiel / à distance. Conclusions: Cette pandémie peut durer encore plusieurs mois. Les compétences communicationnelles sont à acquérir dans le cursus médical et plus que nécessaires dans ce contexte. Les technologies d'apprentissage à distance peuvent fournir un outil utile et accepté pour les étudiants en médecine. Nous rapportons un retour rapide sur ce que l'on peut attendre ou non des étudiants en termes de mission et de conséquences psychologiques à court terme.

Published
2021

29. Determinants of Kidney Function and Accuracy of Kidney Microcysts Detection in Patients Treated With Lithium Salts for Bipolar Disorder

Author

Nahid Tabibzadeh, Anne-Laure Faucon, Emmanuelle Vidal-Petiot, Fidéline Serrano, Lisa Males, Pedro Fernandez, Antoine Khalil, François Rouzet, Coralie Tardivon, Nicolas Mazer, Caroline Dubertret, Marine Delavest, Emeline Marlinge, Bruno Etain, Frank Bellivier, François Vrtovsnik, Martin Flamant, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Nuclear Medicine Department [Hôpital Bichat - Claude Bernard], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de Radiologie [Bichat] (DR- Bichat), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Fondation FondaMental [Créteil], Hopital Saint-Louis [AP-HP] (AP-HP), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Gestionnaire, HAL Sorbonne Université 5

Subjects
[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Pharmacology, CKD-chronic kidney disease, bipolar disorder, lithium, nephrotoxicity, kidney microcysts, Pharmacology (medical), Therapeutics. Pharmacology, RM1-950, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Original Research
Abstract

Objectives: Early kidney damage during lithium treatment in bipolar disorder is still hypothetical. We aimed at identifying the determinants of a decreased measured glomerular filtration rate (mGFR) and the accuracy of kidney MRI imaging in its detection.Methods: In this cross-sectional cohort study, 217 consecutive lithium-treated patients underwent mGFR and kidney MRI with half-Fourier turbo spin-echo and Single-shot with long echo time sequences.Results: Median age was 51 [27–62] years, and median lithium treatment duration was 5 [2–14] years. 52% of patients had a stage 2 CKD. In multivariable analysis, the determinants of a lower mGFR were a longer lithium treatment duration (β −0.8 [−1; −0.6] ml/min/1.73 m2 GFR decrease for each year of treatment), a higher age (β −0.4 [−0.6; −0.3] ml/min/1.73 m2 for each year of age, p < 0.001), albuminuria (β −3.97 [−6.6; −1.3], p = 0.003), hypertension (β −6.85 [−12.6; −1.1], p = 0.02) and hypothyroidism (β −7.1 [−11.7; −2.5], p = 0.003). Serum lithium concentration was not associated with mGFR. Renal MRI displayed renal microcyst(s) in 51% of patients, detected as early as 1 year after lithium treatment initiation. mGFR and lithium treatment duration were strongly correlated in patients with microcyst(s) (r = −0.64, p < 0.001), but not in patients with no microcysts (r = −0.24, p = 0.09). The presence of microcysts was associated with the detection of an mGFR 2 (AUC 0.893, p < 0.001, sensitivity 80%, specificity 81% for a cut-off value of five microcysts).Conclusion: Lithium treatment duration and hypothyroidism strongly impacted mGFR independently of age, especially in patients with microcysts. MRI might help detect early lithium-induced kidney damage and inform preventive strategies.

Published
2021

30. Pharmacological treatment profiles in the FACE-BD cohort: Treatment description and complete data for bipolar subtypes

Author

Bruno Aouizerate, Ludovic Samalin, Ophélia Godin, Thierry Bougerol, Raoul Belzeaux, Sébastien Brodeur, Valerie Aubin, Jean-Luc Bosson, Emilie Olié, Frank Bellivier, Bruno Etain, Sébastien Gard, Emmanuel Haffen, Arnaud Pouchon, Caroline Dubertret, Raymund Schwan, Mircea Polosan, Hugo Terrisse, Chantal Henry, Philippe Courtet, Paul Roux, Marion Leboyer, Centre Hospitalier Universitaire [Grenoble] (CHU), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-ThEMAS ), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Fondation FondaMental [Créteil], Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Princesse Grace [Monaco], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CHU Grenoble, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), CHU Bordeaux [Bordeaux], UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), Université Paris Cité (UPCité), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre Hospitalier de Versailles André Mignot (CHV), Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université Paris Cité - UFR Médecine [Santé] (UPCité UFR Médecine), and haffen, emmanuel

Subjects
Hierarchical agglomerative clustering, Complete data, medicine.medical_specialty, Science (General), Data set, Macine learning, [SDV]Life Sciences [q-bio], Computer applications to medicine. Medical informatics, R858-859.7, Pharmacological treatment, Clusters, 03 medical and health sciences, Q1-390, 0302 clinical medicine, Internal medicine, Machine learning, Bipolar disorders, Medicine, Data Article, 030304 developmental biology, 0303 health sciences, Multidisciplinary, business.industry, [SDV] Life Sciences [q-bio], Pharmacological interventions, Cohort, business, Clinical evaluation, 030217 neurology & neurosurgery, Cohort study
Abstract

International audience; In the current study, we provide the list of pharmacological interventions applied during the one-year follow-up period of the Pharmacological treatment profiles in the FACE-BD cohort study. These data show the treatments used in the new clusters formed in this previous study and also in usual bipolarity subtypes. The proportion of each treatment used during the follow-up was calculated. Days on each treatment were also included in this dataset. The complete clinical and paraclinical data analyzed for clusters and bipolar subtypes were included in this dataset. Socio-demographic self-administered and clinician-administered scales, clinical evaluation during the follow-up, psychiatric and somatic comorbidities, and blood tests are shown in this material.

Published
2021

31. Medial prefrontal disengagement during self-focus in formerly depressed patients prone to rumination

Author

Frédéric Limosin, Philippe Fossati, Philip Gorwood, Nicolas Hoertel, Romain Valabregue, Jean-Yves Rotge, Cédric Lemogne, Caroline Dubertret, Christophe Guerin-Langlois, Ayna Baladi Nejad, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Université Paris Diderot - Paris 7 (UPD7)

Subjects
Adult, Male, [SDV]Life Sciences [q-bio], media_common.quotation_subject, Prefrontal Cortex, Neuropsychological Tests, Young Adult, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Personality, Disengagement theory, Prefrontal cortex, Anterior cingulate cortex, Depression (differential diagnoses), media_common, Psychiatric Status Rating Scales, Brain Mapping, Depressive Disorder, Major, Depression, business.industry, Cognition, Middle Aged, medicine.disease, Magnetic Resonance Imaging, 030227 psychiatry, Psychiatry and Mental health, Clinical Psychology, Rumination, Cognitive, medicine.anatomical_structure, Rumination, Major depressive disorder, Female, medicine.symptom, business, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Background Medial prefrontal cortex (MPFC) activity during self-referential processing has been associated with rumination and found aberrant in depression. We investigated whether this aberrant activity reflects a trait marker that persists in remitted patients. Methods Twenty-five patients fully remitted from major depression for at least 6 months, and 29 matched healthy controls were scanned with fMRI while presented with personality trait words in two conditions: Self condition asked whether the trait described themselves; General condition asked whether the trait was generally desirable. Contrasts-of-interest were examined in a factorial model and rumination correlates were examined in 2-sample t-tests with Ruminative Response Style score as covariate. All findings were reported at a conservative p Results Self-referential processing increased anterior cortical midline activity to a similar extent in both groups. Dorsal anterior cingulate cortex (MNI(x,y,z) = -12,20,26) and dorsal MPFC (MNI(x,y,z) = -6,46,40) activity during self-referential processing was positively associated with rumination in healthy control subjects and negatively associated with rumination in remitted patients. Limitations A longitudinal design tracking the relationship between rumination and MPFC activity would have aided the interpretation of our findings as to whether high ruminators are exhibiting an adaptive process to maintain remission or whether it represents a maladaptive process considering that high ruminators have an increased vulnerability for relapse. Conclusions The association between increased anterior cortical midline activity during self-referential processing and rumination differentiated healthy controls from formerly depressed patients. Self-referential neural processing during remission from depression may depend on the cognitive tendencies to ruminate.

Published
2019

32. Bright Light Therapy in the Morning or at Mid-Day in the Treatment of Non-Seasonal Bipolar Depressive Episodes (LuBi): Study Protocol for a Dose Research Phase I / II Trial

Author

Michel Lejoyeux, Philip Gorwood, Frank Bellivier, Julia Maruani, Ali Amad, Guillaume Vaiva, Bruno Etain, Sylvie Chevret, Caroline Dubertret, Philippe Courtet, Pierre-Alexis Geoffroy, El Mountacer Billah El Abbassi, Optimisation Thérapeutique en Neuropsychopharmacologie (VariaPsy - U1144), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint Louis [APHP], Fondation FondaMental [Créteil], GHU Paris Psychiatrie et Neurosciences, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris Diderot - Paris 7 (UPD7), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hopital Louis Mourier - AP-HP [Colombes], Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), Clinique des maladies mentales et de l'encéphale (CMME - Service de psychiatrie), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Sainte-Anne, Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé (CRESS - U1153), Université Paris Diderot - Paris 7 (UPD7)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Variabilité de réponse aux Psychotropes (VariaPsy - U1144), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Louis Mourier - AP-HP [Colombes], Hôpital Sainte-Anne-Université Paris Descartes - Paris 5 (UPD5), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Centre de Psychiatrie et Neurosciences (U894), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 1 (UM1)-Université de Montpellier (UM)

Subjects
Pediatrics, medicine.medical_specialty, medicine.drug_class, [SDV]Life Sciences [q-bio], Bipolar depression, Major depressive episode, Placebo, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Bipolar disorders, medicine, Circadian rhythms, Bipolar disorder, Bright light therapy, Biological Psychiatry, Morning, business.industry, Mood stabilizer, Phototherapy, medicine.disease, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Phase i ii, Cohort, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Objective This study protocol aims to determine, using a rigorous approach in patients with bipolar disorder (BD) and non-seasonal major depressive episode (MDE), the characteristics of bright light therapy (BLT) administration (duration, escalation, morning and mid-day exposures) depending on the tolerance (hypomanic symptoms). Methods Patients with BD I or II and treated by a mood stabilizer are eligible. After 1 week of placebo, patients are randomized between either morning or mid-day exposure for 10 weeks of active BLT with glasses using a dose escalation at 7.5, 10, 15, 30 and 45 minutes/day. A further follow-up visit is planned 6 months after inclusion. Patients will be included by cohorts of 3, with at least 3 days of delay between them, and 1 week between cohorts. If none meet a dose limiting toxicity (DLT; i.e hypomanic symptoms), the initiation dose of the next cohort will be increased. If one patient meet a DLT, an additionnal cohort will start at the same dose. If 2 or 3 patients meet a DLT, from the same cohort or from two cohorts at the same dose initiation, the maximum tolerated dose is defined. This dose escalation will also take into account DLTs observed during the intra-subject escalation on previous cohorts, with a "Target Ceiling Dose" defined if 2 DLTs occured at a dose. Discussion Using an innovative and more ergonomic device in the form of glasses, this study aims to better codify the use of BLT in BD to ensure a good initiation and tolerance. Trial registrationaaClinicalTrials.gov Identifier: NCT03396744.

Published
2018

33. Outcome prediction with a social cognitive battery: a multicenter longitudinal study

Author

Mathieu Urbach, Eric Brunet-Gouet, Caroline Dubertret, Christophe Lançon, David Misdrahi, Capucine Decaix-Tisserand, A. Zinetti-Bertschy, Sylvain Leignier, Paul Roux, Franck Schürhoff, Isabelle Chereau, Lore Brunel, Priscille Schneider, Delphine Capdevielle, Bruno Aouizerate, Nadine Bazin, Julien Dubreucq, Jasmina Mallet, Hanan Yazbek, Christine Passerieux, Sylvie Pires, Guillaume Fond, Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Fondation FondaMental, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, ANR-11-IDEX-0004,SUPER,Sorbonne Universités à Paris pour l'Enseignement et la Recherche(2011), and ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010)

Subjects
Psychiatry, Longitudinal study, media_common.quotation_subject, RC435-571, Cognition, Schizoaffective disorder, Context (language use), Empathy, medicine.disease, Article, 030227 psychiatry, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Social cognition, Schizophrenia, Human behaviour, medicine, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Psychology, Neurocognitive, 030217 neurology & neurosurgery, media_common, Clinical psychology
Abstract

The interest in social cognition in schizophrenia is justified by the relationship between deficits in these skills and negative functional outcomes. Although assessment batteries have already been described, there is no consensus about which measures are useful in predicting patient functioning or quality of life (QoL). We investigated a set of five measures of recognition of facial emotions, theory of mind (ToM), and empathy in a cohort of 143 patients with schizophrenia or schizoaffective disorder at inclusion and, amongst whom 79 were reassessed 1 year later. The distribution was satisfactory for the TREF (Facial Emotion Recognition Task), V-SIR (Versailles-Situational Intention Reading), and QCAE (Questionnaire of Cognitive and Affective Empathy). Internal consistency was satisfactory for the TREF, V-SIR, V-Comics (Versailles Intention Attribution Task), and QCAE. Sensitivity to change was acceptable for the TREF. The TREF and V-SIR showed a cross-sectional relationship with functioning beyond the clinical symptoms of schizophrenia but not beyond neurocognition. Moreover, the TREF and V-SIR at inclusion could not predict functioning one year later, whereas most neurocognitive and clinical dimensions at inclusion could. Finally, only affective QCAE showed a significant cross-sectional, but not longitudinal, association with QoL. In conclusion, the TREF had satisfactory psychometric properties and showed a cross-sectional, but not longitudinal, association with objective outcome measures, thus appearing to be reliable in clinical practice and research. The V-SIR also showed promising psychometric properties, despite a possible weakness to detect change. However, these measures should be interpreted within the context of the good predictive power of the neurocognitive and clinical status on the outcome.

Published
2021

34. Five-year follow-up on a sample of gamblers: predictive factors of relapse

Author

JEU-Group, Isabelle Chéreau-Boudet, Morgane Guillou-Landreat, Marc Auriacombe, Jean-Benoit Hardouin, Marie Grall-Bronnec, Lucia Romo, Gaëlle Challet-Bouju, Caroline Dubertret, Julie Caillon, Irène Codina, Christophe Lançon, MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Centre hospitalier universitaire de Nantes (CHU Nantes), Soins Primaires, Santé Publique, Registre des cancers de Bretagne Occidentale (SPURBO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Fondation FondaMental [Créteil], Clinique, Psychanalyse, Développement (CliPsyD), Université Paris Nanterre (UPN), Laboratoire de psychologie clinique et de psychopathologie, Université Bordeaux Segalen - Bordeaux 2-JE2358, Biostatistique, Recherche Clinique et Mesures Subjectives en Santé, Université de Nantes (UN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN)-Université de Tours (UT), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, CHALLET, Gaëlle, Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR des Sciences Pharmaceutiques et Biologiques (Nantes Université - UFR Pharmacie), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), BREST - Pôle de Psychiatrie (BREST - PSY), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM)

Subjects
Male, Pediatrics, [SDV]Life Sciences [q-bio], [SDV.NEU.PC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, 030508 substance abuse, Medicine (miscellaneous), [SHS.PSY]Humanities and Social Sciences/Psychology, self-directedness, predictive model, 0302 clinical medicine, Recurrence, Risk Factors, 10. No inequality, media_common, Clinical interview, relapse, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, General Medicine, Middle Aged, Markov Chains, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, Clinical Psychology, Cohort, [SCCO.PSYC] Cognitive science/Psychology, [SCCO.PSYC]Cognitive science/Psychology, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], 0305 other medical science, Psychology, Adult, medicine.medical_specialty, media_common.quotation_subject, Sample (statistics), Gambling disorder, [SHS.PSY] Humanities and Social Sciences/Psychology, 03 medical and health sciences, recovery, Self-directedness, Markov, medicine, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Addiction treatment, Five year follow up, Abstinence, 030227 psychiatry, Behavior, Addictive, Gambling, Follow-Up Studies
Abstract

Background and AimsFew studies have been conducted on the long-term evolution of gambling disorder (GD). The aim of this study was to identify factors that could predict GD relapse.MethodsData were part of a dataset from a large 5-year cohort of gamblers who were assessed at inclusion and each year thereafter. Participants were recruited from an outpatient addiction treatment center, from various gambling places and through the press. For this specific study, inclusion criteria included (i) transitioning from GD to recovery at a follow-up time and (ii) undergoing at least one follow-up visit afterwards. Participants were evaluated using a structured clinical interview and self-report questionnaires assessing sociodemographic, gambling and clinical characteristics. “Relapse” was defined as the presence of GD (according to the DSM-5) at the N+1th visit following the absence of GD at the Nth visit. A Markov model-based approach was employed to examine predictive factors associated with relapse at a subsequent follow-up visit.ResultsThe sample consisted of 87 participants, aged 47.6 years (sd = 12.6), who were predominantly male (65%). Among the participants, 49 remained in recovery, whereas 38 relapsed. Participants who reported not having experienced at least one month of abstinence and those with a low level of self-directedness at the previous follow-up visit were more likely to relapse.ConclusionsOur findings suggest the existence of factors that are predictive of relapse in individuals with GD who had previously achieved recovery. These results can inspire the development of measures to promote long-term recovery.

Published
2021

35. Kidney function and long-term treatment with lithium salts for bipolar disorder Determinants of mGFR and accuracy of kidney microcysts detection in the diagnosis of CKD

Author

Marine Delavest, Emmanuelle Vidal-Petiot, Frank Bellivier, François Rouzet, Emeline Marlinge, François Vrtovsnik, Nahid Tabibzadeh, Pedro Fernandez, A L Faucon, Fidéline Serrano, Lisa Males, Martin Flamant, Antoine Khalil, Nicolas Mazer, Coralie Tardivon, Bruno Etain, and Caroline Dubertret

Subjects
medicine.medical_specialty, Kidney, Lithium (medication), business.industry, Lithium carbonate, Urology, Renal function, medicine.disease, chemistry.chemical_compound, medicine.anatomical_structure, chemistry, medicine, Albuminuria, Bipolar disorder, medicine.symptom, Stage (cooking), business, medicine.drug, Cohort study
Abstract

Background and objectivesKidney damage during early stages of lithium treatment in bipolar disorder is still hypothetical. We aimed at identifying the determinants of a decreased measured glomerular filtration rate (mGFR) and the accuracy of kidney MRI imaging in its detection.Design, setting, participants and measurementsCross sectional cohort study. Systematic evaluation including mGFR of 217 consecutive adult patients treated with lithium carbonate. Kidney MRI imaging in 99 patients with half-Fourier turbo spinecho and Single-shot with long echo time sequences.ResultsMedian age was 51 [27-62] years, and median lithium treatment duration was 5 [2-14] years. 52% of patients had a stage 2 CKD. In multivariable analysis, the determinants of a lower mGFR were a longer lithium treatment duration (β −0.8 [-1; - 0.6] ml/min/1.73m2GFR decrease for each year of treatment), a higher age (β −0.4 [-0.6; −0.3] ml/min/1.73m2for each year of age, p2(22%) had a higher prevalence and number of renal microcysts. Renal MRI displayed renal microcyst(s) in 51% of patients, detected as early as one year after lithium treatment initiation. mGFR and lithium treatment duration were strongly correlated in patients with microcyst(s) (r=-0.64, p2(AUC 0.893, pConclusionsBesides usual risk factors of GFR decrease, lithium treatment duration strongly impacted mGFR independently of age, especially in patients with microcysts. Hypothyroidism was also negatively associated with kidney function in these patients. MRI might help detect early lithium-induced kidney damage and inform preventive strategies.

Published
2021

36. Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

Author

Caroline Dubertret, Yann Le Strat, Jasmina Mallet, Martinez Rico, Clara, Service de psychiatrie [Hôpital Louis-Mourier, AP-HP], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)

Subjects
medicine.medical_specialty, Substance-Related Disorders, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Context (language use), Article, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Lockdown, Tobacco, medicine, Humans, Psychiatry, Pandemics, Biological Psychiatry, media_common, Pharmacology, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Public health, Addiction, Outbreak, COVID-19, Opioid use disorder, Addictions, medicine.disease, Comorbidity, 3. Good health, 030227 psychiatry, Opioids, [SDV] Life Sciences [q-bio], Scale (social sciences), SARS-CoV2, business, Alcohol, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background In the context of the COVID-19 worldwide pandemic, an up-to-date review of current challenges in addictions is necessary. While large scale disasters may have an impact on substance use and addictions, the use of some substances is also likely to modify the risk of COVID-19 infection or course. Many countries have imposed lockdowns. Whether this quarantine or the end of lockdown measures will have an impact on substance use is discussed. The aim of this review is to gather knowledge for clinicians and to guide public health policies during/after lockdown. Methods PubMed was reviewed in August 6th (2020), to determine the current evidences and observations concerning the addictions and SARS-CoV2. We used all the names of the severe acute respiratory syndrome of coronavirus 2 (SARS-CoV2 previously 2019 nCoV), the name of the coronavirus disease 2019 (COVID-19), and common substances of abuse. For the physiopathological parts, searches were conducted using key words such as “infection” or “pneumonia”. For the lockdown effects, key words such as “quarantine”, “disaster” or “outbreak” were used. Results Overall, pathophysiological data showed an increased risk of infections for individuals with Substance Use Disorders (SUD) and a possible protective role of nicotine. During lockdown, there is a substantial risk of increasing SUDs. Individuals with opioid use disorder are particularly at risk of relapse or of involuntary withdrawal. After lockdown, increase of use may be observed as far as years after. Individuals with addictions are at higher risk of multimorbidity and mortality during COVID outbreak. Conclusion This review describes useful strategies in clinical practice, including a systematic assessment of addiction comorbidity during this almost worldwide lockdown/pandemic. This review also highlights important areas for future research., Highlights • Individuals with Substance Use Disorders (SUD) show a higher risk of COVID-19. • Nicotine may prevent against COVID infection, but tobacco worsens the prognosis. • During/after lockdown, the prevalence of SUDs is likely to increase. • Individuals with opioid use disorder are at risk of relapse or involuntary withdrawal. • Individuals with addictions are at higher risk of multimorbidity or mortality.

Published
2021
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37. Relationship between neurocognition and theory of mind as a function of symptomatic profile in schizophrenia: results from the national FACE-SZ cohort

Author

Sébastien, Rambeau, Sarah, Del Goleto, Baptiste, Pignon, Mohamed, Lajnef, Jean, Petrucci, Andreï, Szöke, Guillaume, Fond, Christophe, Lançon, Jean-Michel, Dorey, Romain, Rey, Amandine, Garbisson, Delphine, Capdevielle, Sylvain, Leignier, Julien, Dubreucq, Jasmina, Mallet, Caroline, Dubertret, Mathieu, Urbach, Eric, Brunet-Gouet, Bruno, Aouizerate, David, Misdrahi, Anna, Zinetti-Bertschy, Julie, Clauss, Pierre-Michel, Llorca, Isabelle, Chereau, Marion, Leboyer, Paul, Roux, Franck, Schürhoff, Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Centre hospitalier Charles Perrens [Bordeaux], Nutrition et Neurobiologie intégrée (NutriNeuro), and Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Adult, Cohort Studies, Disorganisation symptoms, Theory of mind, Schizophrenia, Humans, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Neuropsychological Tests, Positive symptoms, Neurocognition, Problem Solving
Abstract

International audience; Introduction: Deficits in theory of mind (ToM) can vary depending on the predominant schizophrenia symptoms, and though most neurocognitive functions are involved in ToM, all may not be associated with the same symptoms. With consideration to the relationships between symptoms, neurocognition and ToM, the aim of the present study is to identify the neurocognitive functions influencing ToM capacities according to symptomatic profile. Methods: The study is based on a sample of 124 adults with schizophrenia from a French national cohort. Patients were divided into two groups according to their scores on the five Wallwork factors of the Positive and Negative Syndrome Scale using hierarchical clustering before carrying out multivariable analyses. Results: The “disorganised group” (n = 89) showed high scores on the disorganised factor, and had a ToM associated with reasoning, visual recognition and speed of processing. The “positive group” (n = 35) showed high scores on the positive and depressive factors, and had a ToM associated with working memory. Conclusions: These results suggest that neurocognitive predictors of ToM in schizophrenia are different according to the predominant clinical dimension, thus refining our knowledge of the relationship between symptoms, neurocognition and ToM, and acknowledging their status as important predictors of patients’ functional status. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Published
2021
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38. Recommendations of the schizophrenia expert center network for the screening prevention and treatment of sleep disorders based on the results from the real-world schizophrenia FACE-SZ national cohort

Author

Christine Passerieux, Raphaëlle Richieri, Romain Rey, Fabrice Berna, Isabelle Chereau, Ophélia Godin, Thierry d'Amato, P.-M. Llorca, Mathieu Urbach, Delphine Capdevielle, Caroline Dubertret, L. Boyer, Damien Etchecopar-Etchart, C. Lançon, Baptiste Pignon, Jasmina Mallet, Bruno Aouizerate, David Misdrahi, Sylvain Leignier, Marion Leboyer, Julien Dubreucq, P.L. Sunhary de Verville, Guillaume Fond, Pierre Vidailhet, F. Schürhoff, Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Fondation FondaMental, Agence Nationale de la Recherche, ANR-11-IDEX-0004,SUPER,Sorbonne Universités à Paris pour l'Enseignement et la Recherche(2011), and ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010)

Subjects
Adult, Male, Sleep Wake Disorders, medicine.medical_specialty, Psychosis, Major depressive disorder, Akathisia, Cohort Studies, Pittsburgh Sleep Quality Index, 03 medical and health sciences, 0302 clinical medicine, PSQI, Surveys and Questionnaires, medicine, Brief Psychiatric Rating Scale, Humans, Mass Screening, Major depressive episode, Psychiatry, Expert Testimony, Biological Psychiatry, Migraine, 2. Zero hunger, Pharmacology, Depressive Disorder, Major, Positive and Negative Syndrome Scale, business.industry, Sleep disorders, medicine.disease, 030227 psychiatry, 3. Good health, FACE-SZ, Barnes Akathisia Scale, Sleep Quality, Psychotic Disorders, Schizophrenia, Female, Schizophrenic Psychology, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], medicine.symptom, business
Abstract

Background: Sleep disorders associated factors are under explored in schizophrenia while the literature suggests high and heterogeneous frequency. Aims: The objective of the present study was to determine the prevalence and risk factors of sleep disorders in the real-world FACE-SZ national cohort. Method: Stabilized schizophrenic outpatients were recruited in 10 expert centers for schizophrenia. Sleep quality was explored with the Pittsburgh Sleep Quality Index (PSQI) and sleep disorders was defined by a PSQI score > 5. Psychosis severity was measured with the Positive and Negative Syndrome Scale, current major depressive episode with the Calgary Depression Scale for Schizophrenia, verbal aggressiveness with the Buss-Perry Aggression Questionnaire, adherence to treatment with the Medication Adherence Rating Scale, akathisia with the Barnes Akathisia Scale. Current somatic comorbidities and body mass index were reported. Variables with P values

Published
2021

39. Non‐alcoholic fatty liver disease in a sample of individuals with bipolar disorders: results from the FACE‐BD cohort

Author

Ophelia, Godin, Marion, Leboyer, Raoul, Belzeaux, Frank, Bellivier, Joséphine, Loftus, Philippe, Courtet, Caroline, Dubertret, Sebastien, Gard, Chantal, Henry, Pierre-Michel, Llorca, Raymund, Schwan, Christine, Passerieux, Mircea, Polosan, Ludovic, Samalin, Emilie, Olié, Bruno, Etain, A, Bing, Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)

Subjects
Male, medicine.medical_specialty, Bipolar Disorder, liver diseases, [SDV]Life Sciences [q-bio], Population, Disease, Overweight, Cohort Studies, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, Risk Factors, Internal medicine, medicine, Prevalence, Humans, education, ComputingMilieux_MISCELLANEOUS, Aged, Metabolic Syndrome, education.field_of_study, business.industry, Fatty liver, nutritional and metabolic diseases, medicine.disease, Obesity, digestive system diseases, 3. Good health, 030227 psychiatry, Psychiatry and Mental health, Alcoholism, psychiatric disorders, Cohort, fatty liver disease, Female, metabolic abnormalities, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, Metabolic syndrome, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Objective: Non-Alcoholic fatty liver disease (NAFLD) is becoming the most common liver disease in Western populations. While obesity and metabolic abnormalities are highly frequent in bipolar disorders (BD), no studies have been performed to estimate the prevalence of NALFD in individuals with BD. The aim of our study is to estimate the prevalence of NAFLD and to identify the potential associated risk factors in a large sample of BD individuals.Methods: Between 2009 and 2019, 1969 BD individuals from the FACE-BD cohort were included. Individuals with liver diseases, Hepatitis B or C, and current alcohol use disorders were excluded from the analyses. A blood sample was drawn from participants. Screening of NAFLD was determined using fatty liver index (FLI). Individuals with FLI> 60 were considered as having NAFLD.Results: The prevalence of NAFDL in this sample was estimated at 28.4%. NAFLD was observed in 40% of men and 21% of women. NAFLD was independently associated with older age, male gender, sleep disturbances, and current use of atypical antipsychotics or anxiolytics. As expected, the prevalence of NALFD was also higher in individuals with overweight and in those with metabolic syndrome.Conclusions: This study reinforces the view that individuals with BD are highly vulnerable to metabolic and cardiovascular diseases. The prevalence of NAFLD in individuals with BD was two times higher than the prevalence reported in the general population. The regular screening of the MetS in individuals with BD should be therefore complemented by the additional screening of NAFLD among these vulnerable individuals.

Published
2021

40. Immune Signatures of Treatment-Resistant Schizophrenia: A FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) Study

Author

Guillaume Fond, Philippe Le Corvoisier, F Schürhoff, A Szöke, Face-Sz Groups, I Offerlin-Meyer, Ryad Tamouza, T D′Amato, I Chéreau, J Dubreucq, E Vilà, F Gabayet, Julien Dubreucq, C Fluttaz, Wahid Boukouaci, D Misdrahi, P Vidailhet, David Misdrahi, J Mallet, B Pignon, Caroline Barau, A Vehier, C Lançon, Myrtille André, Jasmina Mallet, Baptiste Pignon, H Yazbek, Julie Clauss-Kobayashi, Christine Passerieux, J M Dorey, Caroline Dubertret, Sylvain Leignier, K Souryis, P Peri, Isabelle Chereau, F Berna, O Blanc, G Chesnoy-Servanin, S Pires, D Lacelle, A Deloge, Franck Schürhoff, Hakim Laouamri, P M Llorca, O Godin, Bruno Aouizerate, C. Portalier, Pierre-Michel Llorca, R Rey, A Zinetti-Bertschy, H Denizot, Mathieu Urbach, M Jarroir, V Barteau, C Roman, B Aouizerate, C Passerieux, S Esselin, R M Honciuc, C Dubertret, Christophe Lançon, H. Laouamri, F Vaillant, Andrei Szöke, E Metairie, Marion Leboyer, Ching-lieng Lu, M Urbach, Fabrice Berna, C Faget, Romain Rey, Ophélia Godin, E Haffen, M Leboyer, D Capdevielle, Delphine Capdevielle, Thierry D′Amato, S Bensalem, and Emilie Terro

Subjects
profile, medicine.medical_specialty, AcademicSubjects/MED00800, clozapine, Positive and Negative Syndrome Scale, immuno-inflammatory, Schizophrenia (object-oriented programming), treatment-resistant, 030227 psychiatry, schizophrenia, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Immune system, signatures, medicine, Treatment resistant schizophrenia, Psychology, Psychiatry, 030217 neurology & neurosurgery, Clozapine, Regular Articles, medicine.drug
Abstract

Treatment-resistant schizophrenia (TRS) affects around 30% of patients with schizophrenia (SZ) resulting in poor functioning, relapses, and reduced quality of life. Convergent findings show that inflammation could contribute to resistance. We thus search for immune signatures of patients with TRS/ultra TRS (UTRS) in a sample of community-dwelling outpatients with SZ. In total, 195 stabilized SZ patients (mean age = 31.2 years, 73% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. At inclusion, psychotic symptomatology was evaluated by the Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Circulating serum/plasma levels of a large panel of markers reflecting the main inflammatory pathways were evaluated. TRS was defined by current treatment by clozapine (CLZ) and UTRS by current CLZ treatment + PANSS total score ≥ 70. The frequency of TRS and UTRS patients was, respectively, 20% and 7.7% and was defined using multivariable analysis elevated by high levels of interleukin (IL)-12/IL-23p40, IL-17A, IL-10, and beta 2 microglobulin (B2M) and IL-12/IL-23p40, IL-17A, IL-6, IL-10, IFNγ, and B2M, respectively. These observations suggest that resistance and ultra resistance to CLZ treatment are underpinned by pro-inflammatory molecules mainly belonging to the T helper 17 pathway, a finding making sense given the interplay between inflammation and antipsychotic treatment responses. If confirmed, our findings may allow us to consider IL-23/IL-17 pathway as a therapeutic target for patients with resistance to antipsychotics.

Published
2021

41. Trajectories of medication adherence in patients with Bipolar Disorder along 2 years-follow-up

Author

Cyrille Perchec, Groupe Face-Bd, Philippe Courtet, Jean-Michel Azorin, Katia M'Bailara, Bruno Aouizerate, N. Corréard, Frank Bellivier, Julia-Lou Consoloni, Sébastien Gard, Marion Leboyer, Bruno Etain, Pierre-Michel Llorca, Ludovic Samalin, Paul Roux, Caroline Dubertret, Raymund Schwan, Raoul Belzeaux, Emmanuel Haffen, Valerie Aubin, Mircea Polosan, Emilie Olié, Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), ANR-10-COHO-10-01, ANR-11-IDEX-0004-02, This work was supported (in part) by the Fondation FondaMental, Cr?teil, France and by the Investissements d'Avenir programs managed by the ANR, France [grant numbers ANR-11-IDEX-0004-02, ANR-10-COHO-10-01]., This work was supported (in part) by the Fondation FondaMental, Créteil, France and by the Investissements d'Avenir programs managed by the ANR, France [grant numbers ANR-11-IDEX-0004-02 , ANR-10-COHO-10-01 ]., Assistance Publique - Hôpitaux de Marseille (APHM), Laboratoire de psychologie:Santé et qualité de vie, Université Bordeaux Segalen - Bordeaux 2, Centre Hospitalier Princesse Grace, Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010), and ANR-11-IDEX-0004,SUPER,Sorbonne Universités à Paris pour l'Enseignement et la Recherche(2011)

Subjects
medicine.medical_specialty, Bipolar Disorder, Medication adherence, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, Rating scale, Internal medicine, medicine, Humans, In patient, Bipolar disorder, Prospective Studies, Depression (differential diagnoses), business.industry, Depression, Bipolar Disorders, medicine.disease, Mental illness, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Clinical Psychology, Eating disorders, Mood, Cross-Sectional Studies, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

International audience; Background: Bipolar disorder (BD) is a chronic and severe mental illness. It requires a non-discontinued pharmacological treatment to prevent mood recurrences but nonadherence to medication is frequent. To this date, medication adherence in BD has been mostly evaluated in cross-sectional studies and often considered as a stable trait. We aimed to study medication adherence using a prospective person-oriented approach. Methods: 1627 BD patients were followed on a 2 years period and assessed every 6 months. Medication adherence was evaluated at each visit with the Medication Adherence Rating Scale (MARS). A latent class mixed model (LCMM) was used to identify trajectory classes of adherence over time. Regression analyses and linear mixed model were used to search for predictors and covariables of the trajectories. Results: Three distinct and robust trajectories of medication adherence have been identified: one that starts poorly and keeps deteriorating (4.8%), one that starts poorly but improves (9%) and one that starts well and keeps improving (86.2%). A good tolerance to psychotropic medications, low depressive symptoms, the absence of comorbid eating disorders and anticonvulsant medication were associated to a better prognosis of adherence. Along the follow-up, the lower were the depressive symptoms, the better was the medication adherence (p

Published
2020

42. Trajectories of functioning in bipolar disorders: A longitudinal study in the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort

Author

Ophelia Godin, Marion Leboyer, Yassin Mazroui, Bruno Aouizerate, Jean-Michel Azorin, Belzeaux Raoul, Frank Bellivier, Mircea Polosan, Philippe Courtet, Caroline Dubertret, Chantal Henry, Jean-Pierre Kahn, Josephine Loftus, Emilie Olié, Christine Passerieux, Dominique Costagliola, Bruno Etain, E. Haffen, P.M. Llorca, V. Barteau, S. Bensalem, M. Laaidi, H. Laouamri, K. Souryis, S. Hotier, A. Pelletier, N. Drancourt, J.P. Sanchez, E. Saliou, C. Hebbache, J. Petrucci, L. Willaume, E. Bourdin, M. Carminati, B. Etain, E. Marlinge, J. Meheust, B. Antoniol, A. Desage, S. Gard, A. Jutant, K. Mbailara, I. Minois, L. Zanouy, C. Abettan, L. Bardin, A. Cazals, B. Deffinis, D. Ducasse, M. Gachet, A. Henrion, E. Martinerie, F. Molière, B. Noisette, G. Tarquini, R. Belzeaux, N. Correard, J. L. Consoloni, F. Groppi, L. Lescalier, J. Montant, M. Rebattu, N. Viglianese, R. Cohen, M. Milazzo, O. Wajsbrot-Elgrabli, T. Bougerol, B. Fredembach, S. Garçon, P. Grignon, A. Perrin, A.M. Galliot, I. Grévin, A.S. Cannavo, N. Kayser, P. Roux, V. Aubin, I. Cussac, M.A. Dupont, I. Medecin, N. Mazer, C. Portalier, Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Laboratoire de Probabilités, Statistiques et Modélisations (LPSM (UMR_8001)), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Princesse Grace de Monaco (CHPG), Monaco, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Probabilités, Statistique et Modélisation (LPSM (UMR_8001)), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)

Subjects
Sleep Wake Disorders, 2. Zero hunger, Psychotropic Drugs, Longitudinal study, Bipolar Disorder, business.industry, General Medicine, medicine.disease, 030227 psychiatry, Cohort Studies, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cohort, Humans, Medicine, Longitudinal Studies, Bipolar disorder, business, 030217 neurology & neurosurgery, ComputingMilieux_MISCELLANEOUS, Clinical psychology
Abstract

Objective: We aimed at identifying distinct trajectories of functioning and at describing their respective clinical characteristics in a cohort of individuals with bipolar disorders. Methods: We included a sample of 2351 individuals with bipolar disorders who have been followed-up to 3 years as part as the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort. Global functioning was measured using the Functioning Assessment Short Test. We used latent class mixed models to identify distinct longitudinal trajectories of functioning over 3 years. Multivariable logistic regression models were used to identify the baseline factors that were associated with the membership to each trajectory of functioning. Results: Three distinct trajectories of functioning were identified: (1) a majority of individuals (72%) had a stable trajectory of mild functional impairment, (2) 20% of individuals had a stable trajectory of severe functional impairment and (3) 8% of individuals had a trajectory of moderate functional impairment that improved over time. The membership to a trajectory of stable severe versus stable mild functional impairment was associated with unemployment, a higher number of previous hospitalizations, childhood maltreatment, a higher level of residual depressive symptoms, higher sleep disturbances, a higher body mass index and a higher number of psychotropic medications being prescribed at baseline. The model that included these seven factors led to an area under the curve of 0.85. Conclusion: This study enabled to stratify individuals with bipolar disorders according to three distinct trajectories of functioning. The results regarding the potential determinants of the trajectory of severe functional impairment needs to be replicated in independent samples. Nevertheless, these potential determinants may represent possible therapeutic targets to improve the prognosis of those patients at risk of persistent poor functioning.

Published
2020

43. Prevalence and incidence of postpartum depression and environmental factors: The IGEDEPP cohort

Author

Sarah Tebeka, Yann Le Strat, Alix De Premorel Higgons, Alexandra Benachi, Marc Dommergues, Gilles Kayem, Jacques Lepercq, Dominique Luton, Laurent Mandelbrot, Yves Ville, Nicolas Ramoz, Sophie Tezenas du Montcel, Jimmy Mullaert, Caroline Dubertret, Emmanuelle Bertin, Cecile Bourneuf, Jeanne Colombe, Laura Couppa, Marc Dommergue, Fanny Georges, Celine Hebbache, Marie Le Bars, Julie Guiot Madhavi, Cindy Parent, Alix de Premorel, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Trousseau [APHP], Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, CHU Necker - Enfants Malades [AP-HP], UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), Université Paris Cité (UPCité), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Algorithms, models and methods for images and signals of the human brain (ARAMIS), Sorbonne Université (SU)-Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Postpartum depression, Male, medicine.medical_specialty, Life events, Cohort Studies, Depression, Postpartum, 03 medical and health sciences, 0302 clinical medicine, Psychiatric history, Postpartum, Pregnancy, Risk Factors, medicine, Prevalence, Humans, Cumulative incidence, Prospective Studies, Biological Psychiatry, Depression (differential diagnoses), Obstetrics, business.industry, Depression, Incidence (epidemiology), Incidence, Postpartum Period, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Cohort, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, business, 030217 neurology & neurosurgery, Cohort study
Abstract

Background IGEDEPP (Interaction of Gene and Environment of Depression during PostPartum) is a prospective multicenter cohort study of 3310 Caucasian women who gave birth between 2011 and 2016, with follow-up until one year postpartum. The aim of the current study is to describe the cohort and estimate the prevalence and cumulative incidence of early and late-onset postpartum depression (PPD). Methods Socio-demographic data, personal and family psychiatric history, as well as stressful life events during childhood and pregnancy were evaluated at baseline. Early and late-onset PPD were assessed at 8 weeks and 1 year postpartum respectively, using DSM-5 criteria. Results The prevalence of early-onset PPD was 8.3% (95%CI 7.3–9.3), and late PPD 12.9% (95%CI 11.5–14.2), resulting in an 8-week cumulative incidence of 8.5% (95%CI 7.4–9.6) and a one-year cumulative incidence of PPD of 18.1% (95%CI: 17.1–19.2). Nearly half of the cohort (N = 1571, 47.5%) had a history of at least one psychiatric or addictive disorder, primarily depressive disorder (35%). Almost 300 women in the cohort (9.0%) reported childhood trauma. During pregnancy, 47.7% women experienced a stressful event, 30.2% in the first 8 weeks and 43.9% between 8 weeks and one year postpartum. Nearly one in five women reported at least one stressful postpartum event at 8 weeks. Conclusion Incident depressive episodes affected nearly one in five women during the first year postpartum. Most women had stressful perinatal events. Further IGEDEPP studies will aim to disentangle the impact of childhood and pregnancy-related stressful events on postpartum mental disorders.

Published
2020

44. Changes in alcohol use and heavy episodic drinking in U.S. Women of childbearing-age and peripartum between 2001–2002 and 2012–2013

Author

Sarah Tebeka, Alix De Premorel Higgons, Yann Le Strat, Caroline Dubertret, Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)

Subjects
medicine.medical_specialty, Alcohol Drinking, [SDV]Life Sciences [q-bio], Population, Medicine (miscellaneous), Poison control, Toxicology, Suicide prevention, Occupational safety and health, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Injury prevention, Peripartum Period, Prevalence, Humans, Medicine, 030212 general & internal medicine, Child, education, Aged, education.field_of_study, Ethanol, business.industry, Public health, Human factors and ergonomics, medicine.disease, 3. Good health, Psychiatry and Mental health, Clinical Psychology, Female, business, Alcohol-Related Disorders, 030217 neurology & neurosurgery, Demography
Abstract

Background Heavy episodic drinking (HED) is a frequent pattern of alcohol use in women of childbearing age with severe consequences for both women and child, making it a major public health issue. Some states in the US have reported laws that target the use of alcohol during pregnancy. Our aim was to examine the evolution of 12-month alcohol use and 12-month HED prevalence in childbearing age, pregnant and postpartum women between 2001 and 2002 and 2012–2013. Methods Our data were drawn from the National Epidemiologic Study of Alcohol and Related Conditions (NESARC) conducted in 2001–2002 and NESARC-III conducted in 2012–2013, two independent, representative samples of U.S. population. Past-year alcohol use and HED was evaluated according face-to-face interview for all participants. Results Our sample consisted of 24,536 women of childbearing age, including 2846 pregnant and postpartum women. Prevalence of 12-month alcohol use increased from 2001 to 2002 to 2012–2013, in both childbearing-aged women (66.14% to 75.48%; aOR = 1.62, 95%CI = 1.46–1.80) and pregnant and postpartum women (57.81% to 66.19%; aOR = 1.56, 95%CI = 1.25–1.94). Prevalence of 12-month HED increased from 2001 to 2002 to 2012–2013, in both childbearing-aged women (22.57% to 36.34%; aOR = 1.97, 95%CI = 1.79–2.16) and pregnant and postpartum women (17.85% to 28.21%; aOR = 1.84, 95%CI = 1.47–2.30). Conclusions Alcohol use and HED increased in last 10 years in both childbearing age and pregnant and postpartum US women. That questions the impact of implemented laws, policies and alcohol guidelines in this population within the last 10 years.

Published
2020

45. Dramatic reduction of psychiatric emergency consultations during lockdown linked to COVID ‐19 in Paris and suburbs

Author

Liova Yon, Anne-Kristelle Trebalag, Valérie Dauriac-Le Masson, Corentin Rabu, Sarah Tebeka, Alexandra Pham-Scottez, Antoine Pelissolo, Franck Schürhoff, David Barruel, Marie Loric, Baptiste Pignon, Raphaël Gourevitch, Caroline Dubertret, François Hemery, Marion Leboyer, Hélène Cardot, Pôle de Psychiatrie [Hôpital Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital H. Mondor - A. Chenevier, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Fondation FondaMental [Créteil], Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle de Psychiatrie et d’Addictologie, Hôpitaux Universitaires Henri-Mondor, FondaMental Foundation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Albert Chenevier-Fondation de Coopération Scientifique, Centre Psychiatrique d’Orientation et d’Accueil (CPOA), Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), GHU Paris psychiatrie & neurosciences [CH Saint-Anne], CHU Henri Mondor, Martinez Rico, Clara, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)

Subjects
Male, Urban Population, [SDV]Life Sciences [q-bio], Suicide, Attempted, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Young adult, Referral and Consultation, Letter to the Editor, ComputingMilieux_MISCELLANEOUS, Psychiatry, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, General Neuroscience, General Medicine, Middle Aged, Anxiety Disorders, 3. Good health, Hospitalization, Psychiatry and Mental health, Neurology, Involuntary treatment, Anxiety, Female, Emergency psychiatry, France, medicine.symptom, Adult, Paris, 2019-20 coronavirus outbreak, medicine.medical_specialty, Adolescent, Coronavirus disease 2019 (COVID-19), Clinical Neurology, Young Adult, 03 medical and health sciences, Humans, Letters to the Editor, Aged, Emergency Services, Psychiatric, Mood Disorders, business.industry, COVID-19, medicine.disease, Suburban Population, 030227 psychiatry, Involuntary Treatment, Psychiatric, Mood, Psychotic Disorders, Mood disorders, Neurology (clinical), business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract

AimsThe COVID-19 pandemic and associated lockdown may have psychiatric consequences and increase the number of psychiatric emergency consultations. This study aimed to compare the number and characteristics of emergency psychiatric consultations during the four first weeks of the lockdown in three psychiatric emergency services from Paris and its suburbs, and to compare them to the same period in 2019.MethodsThree psychiatric centers in Paris and its suburbs took part in the study. We compared the number of total psychiatric emergency consultations during the 4 first weeks of the lockdown in France to the corresponding 4 weeks in 2019. We also compared the number of consultations during these 4-week time periods in 2020 and 2019 across different diagnostic categories.ResultsIn the 4 first weeks of the lockdown in France, 553 emergency psychiatry consultations were carried out, compared to 1224 consultations during the corresponding period of 2019, representing a 54.8 % decrease. This decrease was evident across all psychiatric disorders, including anxiety (number of consultations in 2020 representing 36.1 % of 2019), mood (41.1 %), and psychotic disorders (57.3 %). The number of suicide attempts also decreased (number of suicide attempts in 2020 representing 42.6 % of 2019). In comparison to 2019, the proportion of total consultations for anxiety disorders also decreased (16.6 % vs. 20.8 %), whilst the proportion of total consultations increased for psychotic disorders (31.1 % vs. 24.1 %).ConclusionsThe total number of psychiatric emergency consultations during lockdown dramatically decreased. The psychological consequences of lockdown may be delayed, indicating that psychiatric services should be prepared for a secondary increase in emergency presentations.

Published
2020
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46. Minimum clinically important differences for the Functioning Assessment Short Test and a battery of neuropsychological tests in bipolar disorders: results from the FACE-BD cohort

Author

Caroline Dubertret, P. Courtet, Mickael Ehrminger, Eric Brunet-Gouet, Paul Roux, Franck Bellivier, Jean-Pierre Kahn, Thierry Bougerol, Emilie Olié, Bruno Etain, Christine Passerieux, Bruno Aouizerate, M. Leboyer, Valerie Aubin, J.M. Azorin, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre Hospitalier de Versailles André Mignot (CHV), Fondation FondaMental [Créteil], Centre hospitalier Charles Perrens [Bordeaux], Centre Hospitalier Princesse Grace de Monaco (CHPG), Monaco, Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Département de Psychiatrie et de Médecine Addictologique, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier Universitaire [Grenoble] (CHU), Université Grenoble Alpes (UGA), [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Fondation Santé des Etudiants de France, Université de Lorraine (UL), Psychiatrie et Neurologie personnalisées [AP-HP Hôpital Henri-Mondor] (DHU PePsy), Hôpital Henri Mondor, Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Psychiatrie Translationnelle (Equipe 15), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil], Institute of Psychiatry, Psychology & Neuroscience, King's College London, King‘s College London, ANR-11-IDEX-0004,SUPER,Sorbonne Universités à Paris pour l'Enseignement et la Recherche(2011), ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010), HAL UVSQ, Équipe, Sorbonne Universités à Paris pour l'Enseignement et la Recherche - - SUPER2011 - ANR-11-IDEX-0004 - IDEX - VALID, Cohortes - FondaMental-Cohortes - - Psy-COH2010 - ANR-10-COHO-0010 - COHO - VALID, Hôpital Charles Perrens, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)

Subjects
Male, cognition, medicine.medical_specialty, Bipolar Disorder, Epidemiology, [SDV]Life Sciences [q-bio], Global Assessment of Functioning, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Neuropsychological Tests, working memory, memory, 03 medical and health sciences, Executive Function, 0302 clinical medicine, Physical medicine and rehabilitation, minimal clinical important differences, mental disorders, Outcome Assessment, Health Care, medicine, Reaction Time, Humans, Attention, 030212 general & internal medicine, Social Behavior, business.industry, Minimal clinically important difference, Public Health, Environmental and Occupational Health, Neuropsychology, speed processing, Cognition, Original Articles, Executive functions, executive functions, humanities, 030227 psychiatry, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, Standard error, Cross-Sectional Studies, Memory, Short-Term, social functioning, bipolar disorders, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cohort, Observational study, Female, business, Cognition Disorders
Abstract

Aims Establishing the minimum clinically important difference (MCID) in functioning and cognition is essential to the interpretation of the research and clinical work conducted in bipolar disorders (BD). The present study aimed to estimate the MCID for the Functioning Assessment Short Test (FAST) and a battery of neuropsychological tests in BD. Methods Anchor-based and distributive methods were used to estimate the MCID for the FAST and cognition using data from a large, multicentre, observational cohort of individuals with BD. The FAST and cognition were linked with the Clinical Global Impressions Scale-Severity (CGI-S) and Global Assessment of Functioning (GAF) using an equipercentile method. The magnitude of the standard error measurement (s.e.m.) provided another estimate of the MCID. Results In total, 570 participants were followed for 2 years. Cross-sectional CGI-S and GAF scores were linked to a threshold ⩽7 on the FAST for functional remission. The MCID for the FAST equalled 8- or 9-points change from baseline using the CGI-S and GAF. One s.e.m. on the FAST corresponded to 7.6-points change from baseline. Cognitive variables insufficiently correlated with anchor variables (all ρ s.e.m. for cognitive variables corresponded to a range of 0.45 to 0.93-s.d. change from baseline. Conclusions These findings support the value of the estimated MCID for the FAST and cognition and may be a useful tool to evaluate cognitive and functional remediation effects and improve patient functional outcomes in BD. The CGI-S and GAF were inappropriate anchors for cognition. Further studies may use performance-based measures of functioning instead.

Published
2020

47. Metabolic and psychiatric effects of acyl coenzyme A binding protein (ACBP)/diazepam binding inhibitor (DBI)

Author

Frank Bellivier, Christine Passerieux, Julien Dubreucq, Isabelle Martins, Antoine Lafarge, Pierre-Michel Llorca, Delphine Capdevielle, Ludovic Samalin, Caroline Dubertret, Franck Oury, Valentina Sica, Stéphanie Moriceau, Fabrice Berna, Raymond Schwan, Guido Kroemer, Face-Sz, Christophe Magnan, Sébastien Gard, José Manuel Bravo-San Pedro, Marion Leboyer, Paul Roux, Bruno Etain, Emilie Olié, Jasmina Mallet, David Misdrahi, Raoul Belzeaux, Maria Chiara Maiuri, Adrien Joseph, Jonathan Pol, Philippe Courtet, Guillaume Fond, Franck Schürhoff, D' Amato Thierry, Joséphine Loftus, Gerasimos Anagnostopoulos, Mircea Polosan, Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Institut Gustave Roussy (IGR), Université Paris-Saclay, Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Fondation FondaMental [Créteil], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Henri Mondor, Centre Hospitalier Princesse Grace de Monaco (CHPG), Monaco, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance Publique - Hôpitaux de Marseille (APHM), Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg-Université de Strasbourg (UNISTRA), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Lapeyronie [Montpellier] (CHU), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Centre de recherche en neurosciences de Lyon (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Hôpital Charles Perrens, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Psychothérapique de Nancy (CPN), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Unité de Biologie Fonctionnelle et Adaptative (BFA (UMR_8251 / U1133)), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Service de Biologie [Hôpital Européen Georges Pompidou, APHP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Karolinska University Hospital [Stockholm], Association pour la Recherche sur le Cancer, ARC ANR-18-IDEX-0001 Ligue Contre le Cancer Chancellerie des Universités de Paris Fondation pour la Recherche Médicale, FRM Agence Nationale de la Recherche, ANR: UMS3655 Institut National Du Cancer, INCa Institut Universitaire de France, IUF Fondation Leducq Association pour la Recherche sur le Cancer, ARC GDW20171100085, The authors thank Maxime Perez for establishing contacts among dispersed investigators. The authors thank the CRC Core Facilities for the technical support. G.K. is supported by the Ligue contre le Cancer (équipe labellisée), Agence National de la Recherche (ANR)—Projets blancs, ANR under the frame of E-Rare-2, the ERA-Net for Research on Rare Diseases, AMMICa US23/CNRS UMS3655, Association pour la recherche sur le cancer (ARC), Association 'Le Cancer du Sein, Parlons-en!', Cancéropôle Ile-de-France, Chancelerie des universités de Paris (Legs Poix), Fondation pour la Recherche Médicale (FRM), a donation by Elior, European Research Area Network on Cardiovascular Diseases (ERA-CVD, MINOTAUR), Gustave Roussy Odyssea, the European Union Horizon 2020 Project Oncobiome, Fondation Carrefour, High-end Foreign Expert Program in China (GDW20171100085), Institut National du Cancer (INCa), Inserm (HTE), Institut Universitaire de France, LeDucq Foundation, the LabEx Immuno-Oncology (ANR-18-IDEX-0001), the RHU Torino Lumière, the Seerave Foundation, the SIRIC Stratified Oncology Cell DNA Repair and Tumor Immune Elimination (SOCRATE), and the SIRIC Cancer Research and Personalized Medicine (CARPEM). J.M.B-S.P. is supported by a Ramon y Cajal contract funded by the Spanish Government., ANR-18-IDEX-0001,Université de Paris,Université de Paris(2018), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Joseph, A., Moriceau, S., Sica, V., Anagnostopoulos, G., Pol, J., Martins, I., Lafarge, A., Maiuri, M. C., Leboyer, M., Loftus, J., Bellivier, F., Belzeaux, R., Berna, F., Etain, B., Capdevielle, D., Courtet, P., Dubertret, C., Dubreucq, J., Thierry, D. A., Fond, G., Gard, S., Llorca, P. -M., Mallet, J., Misdrahi, D., Olie, E., Passerieux, C., Polosan, M., Roux, P., Samalin, L., Schurhoff, F., Schwan, R., Magnan, C., Oury, F., Bravo-San Pedro, J. M., Kroemer, G., Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), École Pratique des Hautes Études (EPHE), CHU Henri Mondor [Créteil], Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier Charles Perrens [Bordeaux], and Centre Psychothérapique de Nancy [Laxou] (CPN)

Subjects
Male, 0301 basic medicine, Cancer Research, medicine.medical_specialty, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Immunology, Appetite, Article, Body Mass Index, Immobilization, 03 medical and health sciences, Cellular and Molecular Neuroscience, 0302 clinical medicine, Orexigenic, medicine, Extracellular, Animals, lcsh:QH573-671, Psychiatry, Receptor, Swimming, Diazepam Binding Inhibitor, Metabolic Syndrome, 2. Zero hunger, Behavior, Animal, biology, lcsh:Cytology, Chemistry, Mental Disorders, Binding protein, Endocrine system and metabolic diseases, Feeding Behavior, Cell Biology, Darkness, Receptors, GABA-A, 3. Good health, Mice, Inbred C57BL, 030104 developmental biology, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, biology.protein, Antibody, Psychiatric disorders, Diazepam binding inhibitor, 030217 neurology & neurosurgery, Intracellular, Behavioural despair test, medicine.drug
Abstract

Acyl coenzyme A binding protein (ACBP), also known as diazepam binding inhibitor (DBI) is a multifunctional protein with an intracellular action (as ACBP), as well as with an extracellular role (as DBI). The plasma levels of soluble ACBP/DBI are elevated in human obesity and reduced in anorexia nervosa. Accumulating evidence indicates that genetic or antibody-mediated neutralization of ACBP/DBI has anorexigenic effects, thus inhibiting food intake and inducing lipo-catabolic reactions in mice. A number of anorexiants have been withdrawn from clinical development because of their side effects including an increase in depression and suicide. For this reason, we investigated the psychiatric impact of ACBP/DBI in mouse models and patient cohorts. Intravenously (i.v.) injected ACBP/DBI protein conserved its orexigenic function when the protein was mutated to abolish acyl coenzyme A binding, but lost its appetite-stimulatory effect in mice bearing a mutation in the γ2 subunit of the γ-aminobutyric acid (GABA) A receptor (GABAAR). ACBP/DBI neutralization by intraperitoneal (i.p.) injection of a specific mAb blunted excessive food intake in starved and leptin-deficient mice, but not in ghrelin-treated animals. Neither i.v. nor i.p. injected anti-ACBP/DBI antibody affected the behavior of mice in the dark–light box and open-field test. In contrast, ACBP/DBI increased immobility in the forced swim test, while anti-ACBP/DBI antibody counteracted this sign of depression. In patients diagnosed with therapy-resistant bipolar disorder or schizophrenia, ACBP/DBI similarly correlated with body mass index (BMI), not with the psychiatric diagnosis. Patients with high levels of ACBP/DBI were at risk of dyslipidemia and this effect was independent from BMI, as indicated by multivariate analysis. In summary, it appears that ACBP/DBI neutralization has no negative impact on mood and that human depression is not associated with alterations in ACBP/DBI concentrations.

Published
2020

48. Early and late postpartum depression exhibit distinct correlates: the IGEDEPP prospective cohort study

Author

Alexandra Benachi, Dominique Luton, Caroline Dubertret, Yves Ville, Laurent Mandelbrot, Sarah Tebeka, Nicolas Ramoz, Marc Dommergues, Jimmy Mullaert, Yann Le Strat, Jacques Lepercq, and Gilles Kayem

Subjects
Postpartum depression, Pregnancy, medicine.medical_specialty, business.industry, Obstetrics, medicine.disease, Mood, Cohort, medicine, History of depression, Family history, Risk factor, business, Prospective cohort study
Abstract

Objective To identify risk factors of early and late postpartum depression (PPD) among a wide range of variables including sociodemographic characteristics, childhood trauma, stressful life events during pregnancy, and history of personal and family psychiatric disorders; and to assess the contribution of each risk factor. Design Nested case-control in a prospective longitudinal cohort study. Setting Eight maternity departments in Paris metropolitan area, France. Sample 3310 women with deliveries between November 2011 and June 2016 Methods Cases were identified as women with early or late PPD. Controls were all cohort participants without either early or late PPD. Main Outcome Measures Early and late PPD are assessed respectively at 2 months and one year postpartum. Results: Stressful life events during pregnancy have a dose response relationship with both early and late PPD: each additional event increased the risk of PPD. In multivariable models, early PPD was independently associated with emotional neglect during childhood (aOR:1.6, 95%CI:1.0-2.6), stressful life event during pregnancy (aOR:1.8, 95%CI:1.4-2.4), physical concomitant chronic disease during pregnancy (aOR:1.5, 95%CI:1.0-2.1), and a history of depression (aOR:1.8, 95%CI:1.4-2.4); whereas late PPD was significantly associated with unemployment (aOR:1.8, 95%CI:1.1-2.8), emotional abuse during childhood (aOR:2.2, 95%CI:1.3-3.9), stressful life event during pregnancy (aOR:2.2, 95%CI:1.6-2.9), emergency consultation during pregnancy (aOR:1.4, 95%CI:1.0-1.8), serious postpartum complications (aOR:1.7; 95%CI:1.0-2.8) and personal and family history of mood disorder (aOR:1.5, 95%CI:1.1-2.0, and aOR:1.4, 95%CI:1.0-1.8). Conclusion: Early and late PPD presented distinct patterns of correlates, with sociodemographic, psychiatric and trauma factors. These results have important consequences in terms of prevention and specific care

Published
2020

49. Shorter and longer durations of sleep are associated with an increased twelve-month prevalence of psychiatric and substance use disorders: Findings from a nationally representative survey of US adults (NESARC-III)

Author

Yann Le Strat, Carlos Blanco, Pierre A. Geoffroy, Sarah Tebeka, Caroline Dubertret, Université de Paris (UP), and Université Paris Diderot - Paris 7 (UPD7)

Subjects
Adult, medicine.medical_specialty, Substance-Related Disorders, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Poison control, Comorbidity, Suicide prevention, Occupational safety and health, 03 medical and health sciences, 0302 clinical medicine, Prevalence of mental disorders, Injury prevention, Prevalence, Medicine, Humans, Psychiatry, Biological Psychiatry, media_common, Depressive Disorder, Major, business.industry, Addiction, Human factors and ergonomics, Sleep in non-human animals, 030227 psychiatry, 3. Good health, Diagnostic and Statistical Manual of Mental Disorders, Psychiatry and Mental health, business, Sleep, 030217 neurology & neurosurgery
Abstract

The lack of comprehensive data on the association between psychiatric and substance use disorders and habitual sleep duration represents a major health information gap. This study examines the 12-month prevalence of mental disorders stratified by duration of sleep. Data were drawn from face-to-face interviews conducted in the National Epidemiologic Survey on Alcohol and Related Conditions III, a nationally representative survey of US adults (N = 36,309). There were 1893 (5.26%) participants who reported5h of sleep/night; 2434(6.76%) 5 h/night; 7621(21.17%) 6 h/night; 9620(26.72%) 7 h/night; 11,186(31.07%) 8 h/night, and 3245(9.01%) ≥9 h/night. A U-shaped association was observed between sleep duration and all mental disorders. The prevalence of mental disorders was 55% for individuals with5 h/night and 47.81% for ≥9 h/night, versus 28.24% for the 7 h/night (aOR = 1.90 and 1.39 respectively). The greatest odds ratios were for the5 h/night group, with an increased risk above 3-fold for panic disorder (PD), post-traumatic stress disorder (PTSD), psychotic disorder, and suicide attempt; between 2 and 3 fold for major depressive disorder (MDD), bipolar disorder (BD), and generalized anxiety disorder (GAD); and between 1 and 2 fold for tobacco and drug use disorders, specific and social phobias. The ≥9 h/night group had an increased risk above 1 to 2-fold regarding tobacco and drug use disorders, MDD, BD, PD, social phobia, GAD, PTSD, psychotic disorder, and suicide attempt. U-shaped associations exist between sleep duration and mental disorders, calling for respect to recommendations for adequate sleep duration in routine clinical care as well as to actions for primary prevention in public health settings.

Published
2020

50. Daily medical education for confined students during COVID‐19 pandemic: A simple videoconference solution

Author

Frédéric Bretagnol, Damien Roux, Caroline Dubertret, David Moszkowicz, and Henri Duboc

Subjects
Histology, anatomy, Students, Medical, Coronavirus disease 2019 (COVID-19), Teaching method, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, education, computer.software_genre, Education, Distance, Betacoronavirus, 03 medical and health sciences, 0302 clinical medicine, Videoconferencing, Viewpoint, Surveys and Questionnaires, Pandemic, Medicine, Humans, Pandemics, Infection Control, 0303 health sciences, Medical education, Education, Medical, Notice, SARS-CoV-2, business.industry, Teaching, COVID-19, Continuing education, COVID‐19 pandemic, 030206 dentistry, General Medicine, anatomical learning, 030301 anatomy & morphology, General Surgery, Medical training, Coronavirus Infections, business, medical education, Surgery Department, Hospital, computer, Education, Medical, Undergraduate
Abstract

The outbreak of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 infection has recently spread globally and is now a pandemic. As a result, university hospitals have had to take unprecedented measures of containment, including asking nonessential staff to stay at home. Medical students practicing in the surgical departments find themselves idle, as nonurgent surgical activity has been canceled, until further notice. Likewise, universities are closed and medical training for students is likely to suffer if teachers do not implement urgent measures to provide continuing education. Thus, we sought to set up a daily medical education procedure for surgical students confined to their homes. We report a simple and free teaching method intended to compensate for the disappearance of daily lessons performed in the surgery department using the Google Hangouts application. This video conference method can be applied to clinical as well as anatomy lessons.

Published
2020

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