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Background Individuals with insomnia are a subpopulation at high-risk of suicide. However, despite the elements in favour of an implication of anhedonia in the occurrence of current suicidal ideations (SI), no study has investigated the role played by this affective symptom in the occurrence of current SI in individuals with insomnia. The aim of this study was to investigate the risk of current SI associated with lifelong anhedonia and recent change of anhedonia in individuals with insomnia. Method Demographic and polysomnographic data from 493 individuals with insomnia selected retrospectively from the clinical database of the Erasme Hospital Sleep Laboratory were analysed. Current SI were considered present if the score in item 9 of the Beck Depression Inventory (BDI-II) was ≥1 and/or if they were highlighted during the systematic psychiatric assessment conducted on admission to the Sleep Laboratory. Logistic regression analyses were used to determine the risk of current SI associated with anhedonia in individuals with insomnia. Results The prevalence of current SI was 21.5% in our sample of individuals with insomnia. After adjusting for major confounding factors, multivariate logistic regression analyses demonstrated that unlike lifelong anhedonia, only recent change of anhedonia was a risk factor for current SI in individuals with insomnia. Conclusion In this study, we demonstrated that in individuals with insomnia, recent change of anhedonia is a risk factor for current SI, which seems to justify more systematic research and adequate therapeutic management of this condition to allow better prevention in this particular subpopulation at high-risk of suicide.

Resume Objectifs Vu le peu de donnees actuellement disponibles dans la litterature, notre objectif etait d’investiguer la prevalence du syndrome d’apnees obstructives du sommeil (SAOS) chez les jeunes adultes et d’etudier le risque de SAOS associe a la depression majeure typique et atypique dans cette sous-population particuliere. Methodes Les donnees de 264 jeunes adultes âges de 18 a 30 ans ont ete collectees au depart de la base de donnees du Laboratoire de Sommeil de l’Hopital Erasme (Bruxelles, Belgique) afin de permettre nos analyses. Un index d’apnees-hypopnees obstructives du sommeil superieur ou egal a cinq par heure a ete utilise pour le diagnostic de SAOS. Nous avons utilise des analyses de regression logistique pour determiner le risque de SAOS associe a la depression majeure chez les jeunes adultes. Resultats La prevalence du SAOS dans notre population de jeunes adultes etait de 18,6 %. Apres ajustement pour les principaux facteurs confondants associes au SAOS, les analyses de regression multivariee ont indique que contrairement a la depression typique, la depression atypique etait un facteur de risque du SAOS chez les jeunes adultes. Conclusions Dans notre etude, nous avons mis en evidence que la depression atypique etait associee a un risque accru de SAOS chez les jeunes adultes, en particulier ceux adresses au laboratoire du sommeil, ce qui semble justifier une recherche plus systematique de cette pathologie chez les jeunes adultes souffrant de depression atypique afin de permettre la mise en place de strategies therapeutiques adaptees et eviter les consequences negatives associees a la survenue concomitante de ces deux pathologies.

Resume La musique a toujours fait partie de notre culture. Il existe des differences interindividuelles importantes dans la capacite a eprouver du plaisir a l’ecoute d’une musique. Une partie de la population est incapable d’en ressentir du plaisir. Ce fait est nomme « anhedonie musicale ». Plusieurs etudes mettent en avant l’existence d’une anhedonie musicale chez des sujets sains, non deprimes, en l’absence d’amusie, mais aussi en l’absence d’une perte de plaisir a la presentation d’autres stimuli. On parle d’anhedonie musicale « specifique » pour decrire une perte de plaisir qui ne concerne que les stimuli musicaux. Elle est un phenomene rare. Chez 5 % des individus, l’anhedonie musicale est congenitale. Elle peut aussi etre acquise suite a des lesions cerebrales focales de localisations diverses. La recompense musicale semble etre traitee par la connectivite existant entre les zones corticales auditives, situees au niveau du gyrus temporal superieur, et les zones du systeme de recompense, telles que le noyau accumbens, le noyau caude et le systeme limbique. Le plaisir musical semble rester intact dans une grande variete de troubles neurologiques impliquant une alteration des fonctions cognitives. Actuellement, la litterature n’a pas encore pu etablir des liens entre l’anhedonie specifique a la musique et certains troubles mentaux comme la depression ou la schizophrenie.

Resume Objectifs La theorie interpersonnelle du suicide (Interpersonal Psychological Theory of Suicide, IPTS) a ete proposee en 2005 par Joiner afin de promouvoir un modele theorique global du comportement suicidaire. Selon cet auteur, trois facteurs de risque provoqueraient le comportement suicidaire : la perception d’etre un fardeau, l’appartenance contrariee et la capacite acquise a se donner la mort. L’objet de l’article est de presenter la theorie et une synthese des travaux. Sa pertinence sur le risque suicidaire des medecins et des etudiants en medecine est ensuite abordee et une etude originale dans un groupe de 178 etudiants en medecine est presentee. Methodes Les etudiants en medecine se repartissaient de la maniere suivante selon le risque suicidaire : 95 n’ont aucun risque suicidaire (absence d’idees suicidaires, de plans suicidaires ou d’antecedents de tentative de suicide), 24 ont des idees suicidaires life-time, 28 presentent des idees suicidaires recentes, 26 des plans suicidaires actuels. Resultats et Conclusion Utilisant des questionnaires valides mesurant les trois dimensions et controlant la depression par l’echelle de Beck ainsi que le sexe et l’âge, les resultats ont montre un niveau significativement plus eleve, d’une part, d’appartenance contrariee chez les sujets avec des plans ou des idees suicidaires recentes comparativement aux autres groupes d’etudiants et, d’autre part, du sentiment d’etre un fardeau chez les sujets avec des plans suicidaires comparativement aux trois autres groupes.

No treatment has been approved and recognized as effective in borderline personality disorder (BPD). Impulsivity is a key dimension because it is a predictor of remission but also suicide. The purpose of this review is to establish an inventory on the management of impulsivity in BPD and determine the effective treatments. A systematic review on the PubMed and Ovid databases was conducted up to September 2019 to December 2019 using the PRISMA guidelines. The inclusion criteria were: studies with patients with borderline personality disorder, were published between 1989 and 2019, used English-language and evaluated impulsivity before and after treatment. 41 articles selected were included for pharmacological treatment. 24 articles were found for psychotherapeutic management and one randomized study of transcranial magnetic stimulation. Based on this review, we must focus on psychotherapy in BPD, particularly the schema therapy, dialectical behavioral therapy, psychoeducation, system training of emotional predictability and problem solving and psychotherapy using mentalisation. The use of neuroleptics and mood stabilizers appears to be more effective than antidepressants. Another approach, such as transcranial magnetic stimulation, may prove useful in the near future if this technique is studied further.

The aim of the present study was to investigate the risk of nonremission following electroconvulsive therapy (ECT), as associated with borderline personality disorder, in individuals with major depression in the context of the contradictory data available in the literature.We analyzed demographic and clinical data from 210 individuals with major depression who were treated with ECT. Study participants were recruited from the medical records database of the Psychiatry Department at Erasme Hospital. Only individuals with major depression who were in remission, as demonstrated during the systematic psychiatric interview performed at the end of ECT (ie, with a60% reduction in their 24-item Hamilton Depression Rating Scale score, combined with a score of10), were included in the "remission" group. Logistic regression analyses were used to determine the risk of nonremission following ECT.Nonremission following ECT occurred frequently (42.9%) in our sample. Moreover, after adjusting for major confounding factors, multivariate logistic regression analyses demonstrated that borderline personality disorder was a risk factor for nonremission following ECT in individuals with major depression.We demonstrated that borderline personality disorder was associated with a higher risk of nonremission following ECT in individuals with major depression. This finding seems to justify more systematic screening as well as more adequate management of this personality disorder in individuals with major depression who are treated with ECT to allow for attaining better remission rates in this subpopulation.

Given the limited data in the literature, the aim of this study was to investigate the risk of relapse within 6 months associated with borderline personality disorder (BPD) in major depressed individuals treated with electroconvulsive therapy. Demographic and clinical data from 109 major depressed individuals with partial or complete response to electroconvulsive therapy recruited from the database of the Psychiatry Department of Erasme Hospital were analysed. Cox regression analyses were used to determine the risk of relapse within 6 months associated with BPD in major depressed individuals treated with electroconvulsive therapy. Relapses within 6 months were frequent (37.6%) in our sample of major depressed individuals treated with electroconvulsive therapy. After adjusting for major confounding factors, multivariate Cox regression analyses demonstrated that BPD was a risk factor for relapse within 6 months in major depressed individuals treated with electroconvulsive therapy. In our study, we demonstrated that BPD is associated with higher risk of relapse within 6 months in major depressed individuals treated with electroconvulsive therapy, which seems to justify a more systematic screening for BPD in order to allow the implementation of more effective prevention strategies for relapse within 6 months in this particular subpopulation.

Given the limited data currently available in the literature, the aim of this study was to investigate the risk of excessive daytime sleepiness (EDS) associated with major depression in a large sample of adolescents. The clinical and polysomnographic data of 105 adolescents recruited from the database of the Erasme Hospital sleep laboratory were analysed. A score > 10 on the Epworth Sleepiness Scale was used as cut-off for the diagnosis of EDS. The status (remitted or current) and the severity (mild to moderate or severe) of major depressive episodes were determined based on the diagnostic criteria of the DSM-IV-TR during a systematic psychiatric assessment. Logistic regression analyses were performed to determine the risk of EDS associated with major depression in adolescents. The prevalence of EDS was 34.3% in our sample of adolescents. After adjusting for the main confounding factors associated with EDS, multivariate logistic regression analysis demonstrated that unlike mild to moderate major depression, remitted major depression and severe major depression were risk factors for EDS in adolescents. In our study, we have highlighted that in adolescents, the EDS could be both residual symptom and severity marker of major depression, which seems to justify a systematic psychiatric assessment in adolescents with EDS complaints in order to allow better management of this problem in this particular subpopulation.

To date, few studies have investigated the prevalence and risk factors of excessive daytime sleepiness (EDS) in major depression. Thus, the aim of the present study was to examine the prevalence and risk factors of EDS in a large sample of individuals with major depression., SCOPUS: ar.j, info:eu-repo/semantics/published

International audience; Whilst people with schizophrenia have high levels of obesity and metabolic disease, our understanding of their eating behaviors is still limited. Our aim was to evaluate the relationships between eating behavior and clinical data in schizophrenia. A cross-sectional study including 66 schizophrenia outpatients compared to 81 healthy controls was undertaken. Eating behavior was assessed using the shortened 21-item version of the Three-Factor Eating Questionnaire (TFEQ-R21). The patients had a mean of 44 +/- 11 years; a mean BMI of 30.3 +/- 8 kg/m(2) (vs. 24 +/- 3.3 kg/m(2) for controls) and a mean duration of illness of 7.2 +/- 6 years. All mean TFEQ scores were significantly higher in patients (indicating poorer eating behaviors) compared to controls after adjustment for age and sex, BMI and smoking status. Among patients, mean TFEQ scores were not significantly different between men and women samples. The ``cognitive restraint'' factor was significantly higher in schizophrenia patients with a BMI < 25 than in the group of overweight patients with a BMI > 25. Our findings suggest that disordered eating behaviors affect schizophrenia patients regardless of gender or duration of disease compared to controls. More research is needed to help clarify the relationships between eating behaviors and weight-related outcomes in schizophrenia.

This study had the aim to explore the psychometric properties of the Arabic version of the Alexithymia Questionnaire for Children (AQC) that measures the three dimensions of alexithymia (DIF, diffi...

Resume La recherche sur l’alexithymie necessite la mise au point d’instruments de mesure parmi lesquels l’echelle d’alexithymie de Toronto a 20 items (TAS-20) est consideree comme la reference. La TAS-20 comprend trois sous-echelles ou dimensions mesurant l’incapacite a identifier ses sentiments (DIF), l’incapacite a decrire ses sentiments (DDF) et la tendance a avoir des pensees tournees vers l’exterieur (EOT). L’etude de l’alexithymie chez l’enfant et l’adolescent rend necessaire d’utiliser des instruments adaptes comme l’echelle d’alexithymie chez l’enfant (QAE) qui a ete mise au point a partir d’une reformulation des items de la TAS-20. Deux etudes de validation ont montre les qualites psychometriques du QAE dans des populations d’enfants sains. L’objet de la presente etude etait de verifier les qualites psychometriques du QAE dans une population de 105 adolescents hospitalises en psychiatrie pour des troubles divers. L’analyse factorielle confirmatoire a montre l’adequation des donnees a la structure tridimensionnelle de l’echelle mais une structure bidimensionnelle sans la dimension EOT s’est averee significativement superieure. La coherence interne mesuree par le coefficient α de Cronbach avait pour valeur 0,71 ou 0,83 pour l’echelle globale (20 items) ou pour l’echelle a 12 items sans le facteur EOT. En conclusion il est recommande chez les enfants ou adolescents de ne prendre en consideration que les dimensions DDF et DIF du QAE et en utilisant la sommation de ces deux sous-echelles.

Several studies have investigated the prevalence and risk factors of depression in individuals with type 2 diabetes. However, few studies have investigated the prevalence and risk factors for type 2 diabetes in major depression.The aim of this study was to examine the prevalence and risk factors of type 2 diabetes in a large sample of individuals with major depression.Data from 703 individuals with major depression recruited from the research database of the sleep laboratory of the Erasme Hospital were analysed. Only individuals with a diagnosis of type 2 diabetes according to the diagnostic criteria of the American Diabetes Association were included in the diabetes group. Logistic regression analyses were conducted to examine clinical and demographic risk factors of type 2 diabetes in major depression.The prevalence of type 2 diabetes in major depression is 21.2%. Multivariate logistic regression analysis revealed that male sex, high blood pressure, hypertriglyceridemia, BMI ≥30kg/m², age ≥50 years, sleep duration6.5 hours, C-reactive protein ≥4.5mg/L, Beck Depression Inventory12, and apnea-hypopnea index ≥5/h were significant risk factors of type 2 diabetes in major depression.Type 2 diabetes is a common condition in major depression. In this subpopulation, most of the risk factors for type 2 diabetes are reversible, which justifies better prevention and management of this disorder to avoid its negative consequences.

Background/Aims: Post-stroke neurocognitive disorders (post-stroke NCD) have been reported with a very variable prevalence. Methods: Based on a systematic literature search, hospital-based studies published between January 1990 and September 2015 were selected when they reported the prevalence of total, mild, and major post-stroke NCD diagnosed by using specified criteria. Factors affecting prevalence were assessed using meta-regression analysis. Results: Among the 7,440 references evaluated, 16 hospital-based studies were selected, corresponding to a total of 3,087 patients. The overall prevalence of total post-stroke NCD was 53.4% (95% CI: 46.9–59.8): 36.4% for mild post-stroke NCD (95% CI: 29–43.8) and 16.5% (95% CI: 12.1–20.8) for major post-stroke NCD. The overall prevalence was mainly influenced by the threshold score used for categorization (p = 0.0001) and, in the subgroup of studies using a conservative threshold (i.e., ≤7th percentile), by the recurrent stroke rate (p = 0.0005). The prevalence of major post-stroke NCD was mainly influenced by age (p = 0.003). Conclusion: More than half of stroke survivors experience post-stroke NCD, corresponding to mild post-stroke NCD in two-thirds of cases and major post-stroke NCD in one-third of cases. Harmonization of stroke assessment and cognitive score thresholds is urgently needed to allow more accurate estimation of post-stroke NCD prevalence, especially mild post-stroke NCD.

In primary insomnia, specific dynamics of hyperarousal are evident during the night. Similarly, in major depression, many elements also favor of the presence of hyperarousal. Thus, it would be interesting to investigate if hyperarousal presents the same dynamic in major depression. Polysomnographic data from 30 healthy controls, 66 patients with major depression and prodromal insomnia, and 86 primary insomnia sufferers recruited from the sleep laboratory database were studied for whole night and thirds of the night. Insomnia sufferers and patients with depression exhibit a similar polysomnographic pattern both for whole night (increased sleep latency and WASO and reduced SWS and REM) and thirds of night (increased WASO at first and last thirds, reduced SWS in first third, and reduced in REM in first and last third). No alterations were detected during the second third of the night. Just as in primary insomnia, the hyperarousal phenomenon is found mainly in major depression with prodromal insomnia during the sleep-onset period and the first and last thirds of the night, but lesser during the second third of the night. These specific dynamics of hyperarousal may aid in the understanding of the particular relationship between insomnia and depression.

Background Several studies have investigated the prevalence and risk factors of excessive daytime sleepiness in the general population. However, few studies have investigated these in the particular subpopulation of insomnia sufferers. Thus, the aim of this study was to examine the prevalence and risk factors of excessive daytime sleepiness in a large sample of insomnia sufferers. Methods Data from 1311 insomnia sufferers with age ≥ 18 years and recruited from the research database of the sleep laboratory of the Erasme Hospital were analysed. A score > 10 on the Epworth scale was used as the cut-off score for excessive daytime sleepiness. Logistic regression analyses were conducted to examine clinical and demographic risk factors of excessive daytime sleepiness in insomnia sufferers. Results The prevalence of excessive daytime sleepiness in our sample was 45.61%. Multivariate logistic regression analysis revealed that non-use of Z-drugs, non-use of Trazodone alone or in combination, body mass index ≥ 25 & Conclusion Excessive daytime sleepiness is a common complaint for individuals with insomnia. In this subpopulation, most of the risk factors for excessive daytime sleepiness are reversible, which justifies better management of this complaint to avoid its negative consequences.

The number of alternations between Non-Rapid Eye Movement (NREM) sleep and Rapid Eye Movement (REM) sleep in humans is usually considered to consist of 4–5 cycles of about 90 minutes duration per night. Previous studies by our group showed a normal distribution on 26 healthy human subjects. The present study retrospectively analyzes the polysomnograms of 2,312 unmedicated patients who were admitted for medical and/or psychiatric reasons in the Erasme University Hospital between 2003 and 2014. The normal distribution of the Number of Cycles and Mean Cycle Duration was confirmed. Q-Q plots were very close to linearity. This distribution allows the use of these variables in parametric comparisons. The Number of Cycles per night and the Mean Cycle Duration showed predominant links with REM sleep-related variables, such as the REM Latency, REM sleep duration, the REM/NREM sleep ratio. None of these variables was associated with the diagnosis of Major Depressive Disorder, nor the intensity of Depression as measured by the Beck Depression Inventory (short version). On the other hand, the diagnosis of Major Depressive Disorder was significantly associated with the Insomnia Severity Index and correlated with the intensity of depressive symptoms (Beck Depression Inventory)., SCOPUS: ar.j, info:eu-repo/semantics/published

The aim of this study was to empirically investigate the network organisation during rapid eye movement sleep (REMS) and slow-wave sleep (SWS) using the effective connectivity measured using the Granger causality to identify new potential biomarkers for the diagnosis, classification, and potential favourable response to treatment in major depression. Polysomnographic data were analysed from 24 healthy individuals and 16 major depressed individuals recruited prospectively. To obtain the 19×19 connectivity matrix of all possible pairwise combinations of electrodes by the Granger causality method from our electroencephalographic data, we used the Toolbox MVGC multivariate Granger causality. The computation of network measures was realised by importing these connectivity matrices into the EEGNET Toolbox. Major depressed individuals (versus healthy individuals) and those with endogenous depression (versus those with neurotic depression) present alterations of small-world network organisation during REMS, whereas major depressed individuals with potential favourable response to electroconvulsive therapy (versus those with potential unfavourable response) have a less efficient small-world network organisation during SWS. Thus, alterations in network organisation during REMS could be biomarkers for the diagnosis and classification of major depressive episodes, whereas alterations of network organisation during SWS could be a biomarker to predict potential favourable response to treatment by electroconvulsive therapy., SCOPUS: ar.j, info:eu-repo/semantics/published

Given the contradictory data on REMS alterations in major depression, the aim of this study was to empirically demonstrate that based on the number of sleep ultradian cycles, it was possible to highlight different subtypes of major depression characterized by specific patterns of REMS alterations. Demographic and polysomnographic data from 211 individuals (30 healthy controls and 181 untreated major depressed individuals) recruited from the sleep laboratory database were analyzed. Major depressed individuals with sleep ultradian cycles 4 showed alterations consistent with REMS disinhibition (shortened REM latency as well as increase in REMS percentage, REMS duration and REMS/NREMS ratio). Regarding major depressed individuals with 4 sleep ultradian cycles, their REMS alterations were intermediate to those present in major depressed individuals with sleep ultradian cycles 4. Thus, in major depressed individuals, the highlighting of this heterogeneity of REMS alterations based on the number of sleep ultradian cycles seems to suggest the involvement of distinct pathophysiological mechanisms and could open new perspectives for future sleep research in psychiatry., SCOPUS: ar.j, info:eu-repo/semantics/published

The main goal of our study was to investigate the association between psychotic-like experiences, aberrant salience, and cannabis use in a nonclinical sample of Belgian students. The participants were asked to complete a self-report questionnaire on cannabis use. The Community Assessment of Psychic Experiences and the Aberrant Salience Inventory were used to assess psychotic-like experiences and aberrant salience. The final sample was of 257 students. Cannabis users showed significantly higher Aberrant Salience Inventory score and, concerning the Community Assessment of Psychic Experiences, higher total, positive, and negative dimension scores. Years of cannabis use and frequency of use showed a positive correlation with Aberrant Salience Inventory score. Our results support the evidence that cannabis use is associated with an increased rate of psychotic experiences in individuals without a clinical form of psychosis. Future studies are required to better investigate the meaning of the association between cannabis use, psychotic-like experiences, and aberrant salience.

Objectives In a clinical population, we estimated the frequency of mood disorders among 271 patients suffering from Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in comparison to a control group matched for age and gender. Method The frequency of mood disorders was measured using the Mini International Neuropsychiatric Interview (MINI), DSM-IV version. Results Mood disorders were more frequent among eating disorder (ED) patients than among controls, with a global prevalence of the order of 80% for each ED group. The majority of the mood disorders comorbid with ED were depressive disorders (MDD and dysthymia). The relative chronology of onset of these disorders was equivocal, because mood disorders in some cases preceded and in others followed the onset of the eating disorders. Limitations Our sample was characterized by patients with severe ED and high comorbidities, and thus do not represent the entire population of AN or BN. This also may have resulted in an overestimation of prevalence. Conclusion Mood disorders appear significantly more frequently in patients seeking care for ED than in controls. These results have implications for the assessment and treatment of ED patients, and for the aetio-pathogenesis of these disorders.

Anhedonia stands as a core symptom and potential trait marker of major depressive disorder (MDD). The importance of rapid eye movement sleep latency (REML) as a biological marker of depression has previously and repeatedly been studied. The aim of this paper is to analyse the relationship between anhedonia and REML in moderately to severely depressed patients. The shortened Beck Depression Inventory (BDI-13) was chosen to assess depressive symptoms and, among them, more particularly, anhedonic symptoms. Two-way ANCOVA was used for statistical analyses. A significant association between anhedonic symptoms and REML was found when the number of sleep cycles (NCy) and the severity of depression were added as covariates. Our findings suggest that REML may be a useful variable to differentiate some diagnostic subtypes of depression related to anhedonia.

The present study had two aims and used two different samples. The first aim was to determine if alexithymia and dependent personality disorder (DPD) are distinct or overlapping constructs. The second aim was to determine the specificity and the stability of the relationship between alexithymia and DPD. The first study used exploratory principal components analysis (PCA) in a sample of 477 non-clinical subjects who completed three questionnaires measuring alexithymia (Twenty item Toronto Alexithymia Scale, i.e. TAS-20), dependent personality disorder (Dependent Personality Questionnaire, i.e. DPQ) and depression (Beck Depression Inventory-II, i.e. BDI-II). The second study used a sample of 305 subjects consecutively admitted to an outpatient department of legal medicine. The subjects completed (at admission and 3 months later) the Structured Clinical Interview for DSM-IV, screen questionnaire (SCID-II-SQ), the TAS-20 and the BDI. Multiple regressions were done. For the first study, the PCA yielded a four-factor solution with no overlap of the significant factor loadings for the items from each scale and with the factors corresponding to their respective construct. For the second study, multiple regressions showed that only avoidant personality disorder was an independent predictor of the TAS-20 scores. Alexithymia is a construct that is distinct and separate from DPD and depression. Alexithymia is not a stable feature of DPD while it is a core feature of avoidant personality disorder.

International audience; BACKGROUND:Anhedonia is considered a suicide risk factor in patients with major affective disorders. Here, we wanted to quantify the association between anhedonia and current suicidal ideation according to the absence/presence of between-group differences for depressive scores and psychiatric disorders.METHODS:We performed a meta-analysis of data on studies retrieved from Medline, Web of Science, and PsycINFO from 1965 to 2016 using, among others, the terms (suicid* or depression) and anhedonia.RESULTS:We identified 15 observational case-control studies that investigated the anhedonia differences in individuals with and without current (i.e., within the past week, independently of the lifetime suicidality status) suicidal ideation (defined as thoughts of killing oneself). Overall, 657 subjects with and 6,690 subjects without current suicidal ideation could be compared. Anhedonia level was higher in the group with current suicidal ideation than in the group without, with a medium effect size (standardized mean difference = 0.57, z = 5.43, P < 0.001, 95% confidence interval, CI = 0.37-0.79). The association between anhedonia and current suicidal ideation remained significant when controlling for depression and psychiatric disorders. The anhedonia scales used in the selected studies did not allow investigating consummatory and motivational anhedonia separately.CONCLUSION:Our major finding is the robust association between anhedonia and current suicidal ideation, independently of depression. This is highly relevant for the clinicians' daily practice and might help improving suicidal risk detection and the development of new therapeutic strategies for suicide prevention.

Our aim is to verify empirically the existence of a major depressed subgroup with a similar polysomnographic pattern as primary insomnia, including at rapid eye movement sleep level., SCOPUS: ar.j, info:eu-repo/semantics/published

Background Cannabis is the most popular illicit drug in the western world and its use seems to be strongly associated with an increased risk of developing schizophrenia and other psychotic disorders. Its use can induce transient psychotic symptoms in healthy individuals and increase rate of subclinical psychotic symptoms in the general population. Subclinical psychotic experiences (also called Psychotic Like Experiences: PLEs), such as magical thinking, paranoid ideation or hallucinations, could be considered as a phenotype qualitatively similar to the symptomatology of psychotic disorders but quantitatively less severe in terms of intensity, frequency and impairment. They are fairly common in the general population and usually transitory and self-limiting but they could become abnormally persistent and evolve to a full-blown psychotic disorder, especially if combined with certain environmental risk factors, such as trauma, urbanicity, cannabis use. PLEs may be considered as an early marker of a latent psychosis vulnerability and the frequently good outcome of subclinical psychosis can be turned in negative outcomes by the association with environmental risk factors, such as cannabis use. We focus our attention on aberrant salience, a peculiar psychotic experience, frequently reported during the prodromal phase that precede the onset of full-blown psychotic illness. Aberrant salience is the unusual or incorrect assignment of salience or significance to innocuous stimuli; it has been hypothesized to be an important mechanism in the development of psychosis. Methods Undergraduate students of ULB (Universitè Libre de Bruxelles) and INSAS (Institut national supérieur des arts du spectacle) of Brussels (Belgium) were invited to participate to the study. A self-report questionnaire, investigating socio-demographic characteristics, and cannabis use was administered, evaluating lifetime and current cannabis use. Aberrant Salience Inventory (ASI) is a 29 item Yes–No questionnaire developed to evaluate aberrant salience. French version of Community Assessment of Psychic Experiences (CAPE), was used to evaluate dimensions of psychosis and PLEs. CAPE is a 42-item, self-report questionnaire, developed to measure the lifetime prevalence of PLEs in the general population. The questionnaire assesses three symptom dimensions (positive, depressive and negative symptoms). All statistical analysis was carried out with Statistical Package for Social Sciences, Version 20.0. We evaluated individual correlations between years of cannabis use and days of cannabis use in the last month with the tools scores. We also explored correlation of ASI score with different CAPE scores and different types of PLEs. Correlations were carried out by using the nonparametric Spearman correlation test. Results The final sample was of 257 participants. 46,3% of subjects reported a lifetime cannabis use and 35.0% reported a current cannabis use (last 30 days). Compared with non-users, cannabis users showed significant higher ASI scores and also higher positive and negative dimensions CAPE scores. No significant association was found between cannabis consumption and the depressive dimension of CAPE. Years of cannabis use and frequency of use in the last 30 days showed a small positive correlation with ASI score; also, weaker positive correlations with CAPE positive and negative dimensions scores were observed. Discussion To some extent, our results support the evidences that cannabis use is associated with an increased rate of psychotic experiences in individuals without clinical form of psychosis. Future prospective longitudinal studies are required to better investigate the meaning of the association between cannabis use and PLEs.

Background Oxidative stress has been intensively studied as a key biochemical system in the pathophysiology of schizophrenia. However, little is known about the implication of oxidative stress in the development of physical illnesses in schizophrenia patients, who are characterized by high cardiovascular risk and decreased life expectancy. Advanced glycation end-products (AGEs) are considered to be markers of oxidative stress and are linked to the development of atherosclerosis. Methods We investigated AGE levels determined by a noninvasive skin autofluorescence (skin AF) method (AGE-Reader™) in schizophrenia patients. Skin AF was assessed in 55 schizophrenia patients without diabetes or renal disease and 55 healthy controls matched for age, gender and smoking status. Nineteen of the 55 schizophrenia patients had a severe form of the disease (Kraepelinian schizophrenia). Results Skin AF was significantly higher in schizophrenia patients compared to controls (2.46 ± 0.52 and 1.90 ± 0.21, respectively, p

Because some evidence favors the hyperarousal model of insomnia, we sought to learn more about the dynamics of this phenomenon during sleep. Polysomnographic data from 30 normative subjects and 86 untreated primary insomnia sufferers recruited from the database of the sleep laboratory were studied for whole nights and in terms of thirds of the night. Untreated primary insomnia sufferers had an increased sleep latency and excess of WASO, together with a deficit in REM and NREM sleep during the entire night. In terms of thirds of the night, they presented a major excess of WASO during the first and last thirds of the night but an excess of lesser importance during the middle third. A deficit in SWS was found during the first third of the night, but for REM, the deficit was present during both the first and last thirds. Primary insomnia sufferers had no SWS or REM deficit during the second third of the night. We found that the hyperarousal phenomenon occurs mainly during the sleep-onset period of the first and last thirds of the night and is less important during the middle third. These results open new avenues for understanding the pathophysiology of primary insomnia.

Aims: The objective of the present study was to explore the comorbidity of borderline personality disorder (BPD) with other personality disorders in adolescents and compare these comorbidities in male and female subjects. Methods: The sample was drawn from a European research project investigating the phenomenology of BPD in adolescence (EURNET BPD). A total of 85 BPD patients (11 boys and 74 girls) with a mean age of 16.3 years were included in the study. Results: According to the results of the Structured Interview for DSM-IV Disorders of Personality, obsessive-compulsive (35.3%), antisocial (22.4%), avoidant (21.2%), dependent (11.8%) and paranoid (9.4%) personality disorders had significant co-occurrences with BPD. Although none of the gender differences was statistically significant, we observed a trend towards higher rates of antisocial personality disorders in men (45.5%) than in women (19%). Conclusion: The study results confirmed the frequency of Axis II comorbidity in adolescents with BPD and, for the first time, evidenced a differential pattern of comorbidity in males and females. This differential pattern must be taken into account when developing treatment strategies for adolescents with BPD.

Resume Le syndrome de tako-tsubo ou cardiomyopathie de stress se caracterise par un tableau clinique evoquant un syndrome coronaire aigu sans lesion coronaire retrouvee a l’angiographie. Sa physiopathologie n’est pas completement elucidee mais est clairement rapportee a un stress aigu physique ou psychique. Les patients presentant un syndrome de tako-tsubo rencontres dans notre exercice questionnent l’existence de comorbidites psychiatriques associees au tako-tsubo. Cet article se propose, a travers une revue de la litterature, de repondre a la question suivante : existe-t-il des populations plus a risque de developper un syndrome de tako-tsubo ?

Objective The aim of this study was to explore the relationship between alexithymia and borderline personality disorder (BPD) in adolescents. Methods The study investigated a sample of 59 consulting or inpatient adolescents with a well-established diagnosis of BPD (SIDP-IV) and a control sample of healthy adolescents individually matched by gender, age and socio-economic status. Alexithymia, depression and trait-anxiety were rated using the Twenty-item Toronto Alexithymia Scale (TAS-20), the Beck Depression Inventory (BDI-II) and the trait-anxiety subscale from the State-Trait Anxiety Inventory (STAI-T), respectively. A confirmatory factorial analysis (CFA) was performed to test the fit of the three-factor structure of the TAS-20 in the adolescent sample (N = 140). BPD and control groups were compared on alexithymic scores using ANCOVA analyses controlling for the potential confounding effects of depression and anxiety. Results The ratio of the chi-square to its degrees of freedom, the goodness-of-fit index, the adjusted goodness-of-fit index and Steiger's root-mean-square error of approximation had satisfactory values of 1.54; 0.87; 0.83 and 0.058, respectively. The two ANCOVA demonstrated no significant difference for TAS-20 scores. BPD subjects were more alexithymic than healthy subjects but this difference was mainly explained by the levels of depression or anxiety. Limitations Since BPD subjects have high comorbidity with depression or anxiety, longitudinal studies examining the absolute and relative stability of TAS-20 scores are necessary to determine whether alexithymia constitutes a state or a trait in BPD. Conclusions BPD adolescents are characterized by alexithymia, probably of a secondary or state-dependent nature.

Resume La cardiopathie de stress ou Tako Tsubo est une pathologie cardiaque evoquant un syndrome coronaire aigu, avec signes electrocardiographiques, augmentation des enzymes cardiaques, mais ou la coronarographie ne retrouve pas d’anomalie. Cette pathologie est secondaire a un stress aigu, physique ou psychique. La mortalite hospitaliere est faible ainsi que le risque de recidive, pour autant il n’existe pas de consensus sur le traitement et la prevention. On peut alors s’interroger sur l’existence de personnalites predisposees et donc sur la place du psychiatre dans cette prise en charge.

The aim of this study was to examine how far Goodman’s addictive disorder criteria were met by individuals with eating disorders according to subtypes. The study provided a cross‐sectional comparison among three samples of eating disorders [restricting anorexia nervosa (R‐AN), N=68; purging anorexia nervosa (P‐AN), N=42; and bulimia nervosa (BN), N=66], a sample of substance‐related disorders (SRDs, N=48) and a sample of matched controls (N=201). Diagnosis of addictive disorder was made following Goodman’s criteria.Addictive personality traits were assessed with the Addiction Potential Scale of the MinnesotaMultiphasic PersonalityInventory— 2andwiththeZuckerman’sSensationSeekingScale.ResultsshowedthatindividualswithBNmetGoodman’saddictive disordercriteriain the same proportion as drug‐addicted individuals (65% vs 60%, p=NS). They both showed higher rates than R‐AN individuals (35%; R‐AN versus BN: F=11.9, p

BACKGROUND Suicide attempt is a serious condition that is frequent in France. Picardie ranks fifth in France for suicide (418 deaths in 2005 for 1,890,000 inhabitants). Suicide attempt is one of the priorities of the regional public health program. The National Agency for Accreditation and Evaluation in Health (Anaes) has designed targeted clinical audits (TCA) on various conditions to promote this method as the basic tool for quality improvement. AIM We investigated the contribution of TCA for improving the quality of care of suicide attempt within a regional framework in Picardie. METHODS TCA were conducted in 12 state hospitals (eight Surgical Medicine and Obstetrics, three specialized in psychiatry, one local) between 2004 and 2006. The standards from the Anaes had 16 criteria in three fields: care on admission (n=10); assessment of family and social environment (n=2); management for after hospital care (n=4). A project manager and a MD certified in health care quality supported the medical (MD certified in acute care and in psychiatry) and nursing staff of the emergency wards. All the wards analyzed 30 patients' files for the first cycle, set up and implemented improvement actions and then performed the second cycle of data collection. RESULTS All wards fully satisfied the protocol with 30 patients' files per cycle and two cycles. In all wards the teams consisted of physicians (both certified for emergency or psychiatry) and others care providers (nurses, psychologists, social workers, secretary). For the first cycle, three criteria (patient assessment, somatic examination and coordination) met the 100% target for more than half of the wards while three criteria (sociofamily and environmental evaluation, management for after hospital care, monitoring of follow-up) did not conform by more than 50% in more than half of the wards. All wards implemented changes after the first cycle with a total of 29 interventions, each one specifically devoted to improving a particular criterion. Intervention included better coordination and communication, protocol design and reminders, and information tools. The second cycle showed modest and mixed changes. After the interventions only one criteria reached the 100% target in one ward; the degree of conformity decreased in nine cases (with a mean of -23%) and increased in 16 cases (+19%). Globally, three criteria improved by less than 10% while three slightly decreased. DISCUSSION G. Shaw introduced clinical audits in 1989 to boost a poorly performing system within the "clinical governance" framework, a condition quite different from the French healthcare system in 2005. Therefore, the validation of clinical audit in a different context appeared necessary. Anaes has not yet published the evaluation of this method in a peer reviewed journal. Observed changes are modest and mixed. Moreover, the true impact on care delivery appears limited and one cannot rule out that the observed improvements are in fact related to an improvement in traceability or due to Hawthorne's effect. Quality improvement methods must be evaluated and validated by scientific methods such as for new treatments with clinical research. CONCLUSION The feasibility of the method was excellent, due to the methodological and technical support, however the method did not significantly improve the quality of care.

The aim of the study was to explore the relationships between subjective or objective symptoms and mortality in schizophrenia. 310 subjects meeting the ICD-10 criteria for schizophrenia were included in the study between 1998 and 2000. At the initial assessment the following variables were respectively assessed to evaluate subjective and objective symptoms: the Frankfurt Complaints Questionnaire (FCQ) and the Positive and Negative Syndrome Scale (PANSS). In May 2008, information about the subjects were collected in order to know if they are alive or not and if they are deceased to know the date and the causes of their death. Survival analysis was conducted using the Kaplan-Meier product-limit estimator and standardized mortality ratio (SMR) was calculated. A multivariate Cox regression was done to detect predictive factors associated with mortality. Absolute mortality rates were 10.01%, 4.46% and 5.42% for overall mortality, unnatural causes and natural causes, respectively. SMR for overall mortality was 4.73. Cox regression analyses showed that elevated scores of FCQ was significant predictor of deaths from unnatural causes. High levels of subjective symptoms, as rated by the FCQ were independent predictor of mortality by unnatural causes in schizophrenic subjects. There were several limitations: The causes of death were not determined by autopsy and secondly, the duration of the study could be insufficient to detect significant associations between clinical variables and mortality.

Resume La recherche sur l’alexithymie, l’incapacite a trouver des mots pour exprimer ses emotions ou sentiments, a connu un developpement important ces dernieres decennies notamment par la mise au point d’instruments de mesure presentant une validite et une fidelite satisfaisantes. L’etude de l’alexithymie chez l’enfant et l’adolescent est peu developpee par l’absence d’instruments specifiques. L’objet de la presente etude est de presenter la version francaise et une premiere etude de validation du questionnaire d’alexithymie pour enfants (QAE) developpe recemment a partir de la version a 20 items (TAS-20) de l’echelle d’alexithymie de Toronto, instrument le plus utilise dans le monde. L’etude de validation a porte sur un groupe de 80 enfants « tout venant » issus de la population generale. Le QAE comprend 20 items repartis a priori en trois dimensions, la difficulte a identifier ses sentiments (DIF), la difficulte a decrire ses sentiments (DDF) et les pensees tournees vers l’exterieur (EOT). La validite interne a ete etudiee en testant l’adequation des donnees quant a la structure dimensionnelle de l’echelle en pratiquant une analyse factorielle confirmatoire. Par ailleurs, la consistance interne a ete mesuree par le cœfficient alpha de Cronbach et l’etude des correlations des items avec le score total. Les resultats ont montre des parametres satisfaisants d’adequation des donnees au modele mais avec un facteur, l’EOT ayant peu d’items significativement correles. Le cœfficient alpha etait de 0,64 avec des correlation items/score total significatives a l’exception de cinq items mesurant l’EOT. En conclusion la version francaise de la QAE reproduit la structure tridimensionnelle de la version originale de l’echelle avec une consistance interne insuffisante liee a une faiblesse du facteur EOT retrouvee dans les etudes utilisant la TAS-20 ou le QAE en population non americaine. Dans l’attente de nouvelles etudes, il est recommande de n’utiliser que le score total de l’echelle et pas les sous-scores.

Resume L’objet de la presente etude est de presenter la traduction et la determination de la note seuil de depistage d’un questionnaire permettant de depister les personnalites dependantes selon le DSM-IV. Le questionnaire de personnalite dependante ou QPD comprend huit items cotes de 0 a 3 avec un score total allant de 0 a 24. A partir d’un echantillon de 138 patients psychiatriques remplissant le QPD et le questionnaire de personnalite de Hyler (PDQ-4+) deux groupes ont ete constitues. Utilisant le PDQ-4+ pour faire le diagnostic de personnalite dependante, le premier groupe comprenait 25 sujets repondant aux criteres de personnalite dependante selon le DSM-IV et le second groupe de 20 sujets ne repondant a aucun des criteres de la personnalite dependante du DSM-IV. La note seuil de 13 au QPD correspondait au score de Youden (Sensibilite + Specificite – 100) le plus eleve avec une sensibilite de 84 %, une specificite de 90 % et une valeur predictive positive de 91,3 %.

Resume Utilisant l’echelle d’experience temporelle du plaisir (EETP) qui mesure, d’une part, le plaisir lie a la realisation sur le moment du plaisir, ou plaisir consommatoire et, d’autre part, le plaisir lie a l’anticipation du plaisir, ou plaisir anticipatoire, un travail recent a montre que les schizophrenes se caracterisaient, comparativement a des sujets sains, par une capacite normale a eprouver du plaisir sur le moment mais une capacite plus faible concernant le plaisir anticipatoire. Le but de la presente etude est, d’une part, de preciser les proprietes psychometriques (validite, fidelite) de la version francaise de la EETP et, d’autre part, de confirmer le deficit en plaisir anticipatoire chez les sujets schizophrenes par rapport aux sujets sains. Deux groupes de sujets ont ete recrutes : 125 etudiants et 162 sujets presentant soit une schizophrenie ( n = 43) ou une autre pathologie psychiatrique ( n = 119 : trouble de l’humeur, trouble nevrotique ou un trouble de la personnalite). L’ensemble des sujets remplissait les echelles suivantes : la sous-echelle de plaisir anticipatoire (EETP-ANT) et la sous-echelle de plaisir consommatoire (EETP-CONS), les echelles revisees d’anhedonie physique (PAS) et sociale (SAS) de Chapman, l’echelle de plaisir de Snaith et Hamilton (SHAPS) et l’inventaire de depression de Beck (BDI-II). Deux sous-echelles de la PAS etaient creees pour mesurer l’anhedonie anticipatoire (PAS-ANT) et l’anhedonie consommatoire (PAS-CONS). La validite interne de la EETP a ete etudiee par une analyse factorielle confirmatoire et par le calcul des coefficients alpha de Cronbach. Les resultats ont montre des parametres d’adequation satisfaisants a l’analyse factorielle confirmatoire dans le groupe etudiant et dans le groupe des malades. Les coefficients alpha de Cronbach etaient superieurs a 0,70 pour la EETP et la EETP-ANT. Les echelles (EETP, EETP-ANT et EETP-CONS) correlaient avec les echelles d’anhedonie et de plaisir. Les schizophrenes avaient un score significativement plus faible a la EETP-ANT, comparativement aux etudiants, mais sans difference a la EETP-CONS.

Resume L’objet de la communication est de presenter une synthese des etudes explorant la mortalite chez les sujets schizophrenes. Les meta-analyses recentes confirment l’augmentation de la mortalite chez les schizophrenes, notamment au cours des trois dernieres decennies, avec un risque trois fois superieur a celui de la population generale. Ce risque concerne a la fois la mortalite non naturelle et la mortalite naturelle. La cause principale de mortalite non naturelle est le suicide, avec un risque 12 fois superieur a celui de la population generale. La mortalite par cause naturelle concerne notamment les maladies cardiovasculaires et respiratoires. Les strategies preventives sont presentees avec, d’une part, la lutte contre les facteurs de risque de suicide et, d’autre part, la correction des habitudes de vie deleteres (tabagisme, sedentarite, obesite, diabete). L’implication des nouveaux neuroleptiques dans l’augmentation de la mortalite ces trois dernieres decennies est discutee.

Resume L’objet de la presente etude est de tester l’hypothese que les personnalites dependantes sont plus alexithymiques que les autres troubles de la personnalite. Trois cent cinq sujets des deux sexes consultants en medecine legale apres une agression ont ete inclus dans l’etude. Les sujets remplissaient trois questionnaires : l’echelle d’alexithymie de Toronto a 20 items (TAS-20), l’inventaire abrege de depression de Beck (BDI) et le questionnaire du SCID-II. Les 305 sujets se repartissaient ainsi : 108 sans personnalites pathologiques (35,4 %), 18 personnalites dependantes (5,9 %) et 179 autres personnalites pathologiques (58,7 %). La proportion de sujets alexithymiques etait de 35,41 % (n = 108). Les personnalites dependantes presentaient un score significativement plus important a la TAS-20 par rapport a celui des deux autres groupes. Par ailleurs, la proportion de sujets alexithymiques parmi les personnalites dependantes (77,8 %) etait significativement superieure a celle des autres personnalites pathologiques (40,8 %) et a celle des sujets temoins (19,4 %). L’interet clinique des resultats et les limites de l’etude sont discutes.

The high-risk approach based on the definition of schizotypy by Meehl (The American Psychologist 1962;17:827-38) and the basic symptom approach proposed by Huber (Fortschritte fur Neurologie und Psychiatrie 1957;25:491-520) share many points in common. In particular, several studies have shown that high scores on psychosis proneness or subjective experiences (SE) scales were associated with the onset of psychotic disorders in nonpsychiatric or nonpsychotic subjects. However, the relationships between the 2 concepts have never been studied experimentally. The present study was therefore designed to investigate the relationships between the scores of the SE scale and several psychosis proneness scales evaluating the negative and positive components of schizotypy in a sample of 399 university students. Data were analyzed using multiple regression and principal components analyses. The results show that SE, as assessed by the Frankfurt Complaint Questionnaire, were significantly associated with the positive component of schizotypy but not with the negative component. Subjective experiences could constitute vulnerability traits for psychosis and the Frankfurt Complaint Questionnaire could be use instead of the positive psychosis proneness scales.

Background: Several trials have suggested that negative symptoms are inversely correlated with suicidal risk in schizophrenic patients. This fourteen-year follow-up study compared the positive and negative symptoms of schizophrenic patients who died from suicide to those of subjects dying from other causes. Sampling and Methods: From 1991 to 1995, 150 patients meeting the research diagnostic criteria for chronic schizophrenia were assessed. On inclusion, they completed the Physical Anhedonia Scale as well as the Beck Depression Inventory, and the positive and negative symptoms were rated by the Positive and Negative Syndrome Scale. Results: During the 14-year follow-up, 8 patients committed suicide, while 17 died from other causes. The suicide victims had a shorter duration of illness and a higher level of education compared to those who died from other causes. The proportion of ‘negative’ subjects, according to the composite index of the Positive and Negative Syndrome Scale, was lower among the suicide victims than among the participants who died from other causes. All these differences were significant. The rate of deficit syndrome (0%) among the suicides was lower than that (23.5%) of the other subjects. The scores on the Physical Anhedonia Scale and of the social withdrawal item of the Beck Depression Inventory were higher in the suicides than in the subjects who died from other causes. Conclusions: These findings suggest that negative symptoms and notably deficit-negative symptoms could be associated with a low risk of suicide. In this study, the link between anhedonia and high risk of suicide in schizophrenic patients indicates that this symptom could be more closely related to depression than to negative symptoms.

Resume Une premiere etude a objective que les personnalites dependantes etaient plus alexithymiques que celles qui souffrent d’autres troubles de la personnalite. L’objet de l’etude actuelle, reprenant une partie des sujets de la precedente etude, est de tester a trois mois la stabilite de la relation entre personnalite dependante et alexithymie. Ont ete inclus dans l’etude 184 sujets des deux sexes consultant en medecine legale apres une agression. Les sujets remplissaient trois questionnaires trois mois apres l’inclusion dans l’etude : l’echelle d’alexithymie de Toronto a 20 items (TAS-20), l’inventaire abrege de depression de Beck (BDI) et le questionnaire du SCID-II. Les 184 sujets se repartissaient en : 72 sans personnalites pathologiques, neuf personnalites dependantes et 103 autres personnalites pathologiques. Les personnalites dependantes presentaient, d’une part, un score significativement plus important a la TAS-20 par rapport au groupe sans personnalites pathologiques et, d’autre part, un score non significativement different a cette meme echelle par rapport au groupe autres personnalites pathologiques. L’alexithymie ne semble pas specifique des personnalites dependantes.

International audience; INTRODUCTION: Patients with schizophrenia show high susceptibility to distraction but the neural mechanisms underlying sensitivity to distraction are not clearly established. We designed a paradigm to assess whether sensitivity to distraction and dorsal stream dysfunction are related in schizophrenia. METHOD: 60 patients, 37 schizotypals, and 58 healthy controls were asked to locate a target square appearing above or below fixation and to ignore a distractor that either moved abruptly (in Experiments 1 and 3) or changed in colour (in Experiment 2). The distractor condition was compared to a baseline condition with no distractor. Resistance to interference was assessed by manipulating the probability of the distractor changing more frequently (50%, 75%, 100%) on one side of fixation. RESULTS: Patients, schizotypals, and controls showed attentional capture with longer response times when the distractor changed as compared to the baseline condition. In contrast to controls, the magnitude of interference from distractors remained stable for patients and schizotypals across all probability conditions and this was confined to attentional capture by motion, not by colour. CONCLUSION: We found a similar pattern of results in patients and in schizotypals. Our attentional capture paradigm could help to identify early cognitive impairments in populations at risk to develop schizophrenia. The data are interpreted in terms of dysfunction of frontal control on dorsal stream functions in schizophrenia.

Resume Des difficultes en theorie de l’esprit (TdE), une capacite a inferer chez autrui des etats mentaux, intentions et emotions, ont ete observees de facon repetee chez les personnes presentant une personnalite schizotypique ou atteintes de schizophrenie. Une tendance a effectuer des choix de facon hâtive dans des situations de raisonnement probabiliste a egalement ete observee dans ces deux populations. Cette etude vise a examiner les performances a une tâche de TdE et a une tâche de raisonnement probabiliste chez des participants ayant un score eleve a une echelle d’anhedonie sociale (EAS), une des caracteristiques de la schizotypie, et chez des participants temoins. L’existence d’un lien entre score faible en TdE et choix sur la base de peu d’indices est egalement etudie. Conformement aux hypotheses, les resultats montrent que les participants du groupe experimental ont des scores significativement inferieurs en TdE et demandent significativement moins d’indices pour effectuer un choix en situation probabiliste. En revanche, il n’existe pas de correlation entre les performances de ces deux tâches. L’absence de correlation peut etre attribuee a une distance trop importante entre contextes experimental et ecologique pour la tâche de raisonnement probabiliste. L’interet de l’etude repose le choix de l’EAS comme critere de schizotypie en regard du type de tâche experimentale propose pour l’etude de la TdE.

Resume L’objectif de l’etude est, d’une part, d’etudier la mortalite d’une cohorte de 150 sujets presentant une schizophrenie chronique suivis pendant 14 ans et, d’autre part, de rechercher des variables predictives de la survie. Cent cinquante sujets presentant une schizophrenie chronique (research diagnostic criteria, RDC) ont ete inclus entre 1991 et 1995 et reevalues en mai 2005. A l’inclusion, la symptomatologie clinique a ete evaluee par l’echelle breve d’evaluation psychiatrique (BPRS), l’echelle d’evaluation des syndromes positifs et negatifs (PANSS) et l’inventaire abrege de depression de Beck (BDI). Differents taux de mortalite ont ete calcules dont le taux absolu a partir de la methode de Kaplan-Meier et le ratio de mortalite standardise (RSM). La valeur predictive de differentes variables a ete testee par une regression multiple selon le modele de Cox. Dans les analyses ont ete distinguees la mortalite globale et celle par suicide. Le taux de mortalite absolu est de 18,57 % avec un RSM de 4,83. Le taux de mortalite absolu par suicide est de 6,98 %. Une proportion elevee de sujets masculins, une dose importante en neuroleptiques expliquent notamment la mortalite globale des schizophrenes. Une dose elevee de neuroleptiques et une proportion elevee de sujets classes « positifs » selon l’indice composite de la PANSS sont predictives de la mortalite par suicide. Cette etude de suivi d’une cohorte de sujets ayant une schizophrenie chronique montre une surmortalite importante d’origine naturelle et non naturelle.