Search

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

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

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

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

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

Copyright of Journal of Gambling Issues is the property of Centre for Addiction & Mental Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La tachypsychie est un des symptômes fréquemment retrouvée des troubles de l'humeur. Cet article a pour but de résumer les connaissances actuelles sur le contexte historique, la sémiologie et la fréquence de ce symptôme dans le spectre des troubles de l'humeur. La tachypsychie pourrait se scinder en deux composantes : les « pensées accélérées » et les pensées dites « grouillantes ». Dans un état hypomane, la tachypsychie semble être caractérisée par des « pensées accélérées » résultant d'une production d'idées excessives se succédant les unes après les autres. Dans le contexte de la dépression, la tachypsychie semble sémiologiquement différente de celle de l'état hypomane et serait mieux caractérisées par le terme de « pensées grouillantes ». Elles sont caractérisées par un excès de pensées simultanées ayant une composante déplaisante/désagréable. Ces pensées induisent le sentiment que ces idées sont difficiles à saisir. Les « pensées grouillantes » sont aussi différentes des ruminations. Le « Racing and Crowded Thoughts Questionnaire (RCTQ) » développé par Bertschy et al. permet l'évaluation de ce type de symptômes. Par ailleurs, ces pensées sont principalement présentes dans les troubles de l'humeur, mais on peut également les retrouver dans d'autres troubles psychiatriques comme le TDAH et le trouble de la personnalité limite. Une approche dimensionnelle pourrait être envisagée pour ce type de symptôme. La prise en compte de la tachypsychie et de ces différentes composantes semble être primordiale pour une prise en charge la plus adaptée possible des patients souffrant de dépression. Crowded and racing thoughts are frequent symptoms in mood disorders. This paper aims to summarize the current knowledge about historical context, semiology and frequency of theses symptoms in the spectrum of mood disorders. In the context of depression, "racing thoughts" are phenomenologically different from hypomanic state and better described as "crowded thoughts": they are characterized by too many thoughts (occurring at the same time in the field of consciousness) which are described as unpleasant. These thoughts induce the feeling that ideas are difficult to grasp. « Crowded thoughts » are different from rumination too. The Racing and Crowded Thoughts Questionnaire (RCTQ) developed by Bertschy et al. allows the assessment of this type of symptoms. These thoughts are mostly present in mood disorders, but we can also find them in other psychiatric disorders like ADHD and borderline personality disorder. À dimensional approach could be considered for these symptoms. The consideration of these symptoms (racing thoughts and crowded thoughts) seems to be important for a more accurate and better treatment management of people with depression. [ABSTRACT FROM AUTHOR]

L'association entre les troubles de l'humeur et la nutrition, dont les mécanismes sont de mieux en mieux connus, semble être aujourd'hui bien établie. En effet, certains micronutriments ont un rôle important dans la prévention de ces pathologies. Il devrait être conseillé aux patients présentant de tels troubles soit une modification du modèle alimentaire, soit un apport de ces nutriments par les compléments alimentaires. The link between mood disorders and nutrition, the mechanisms of which are more clearly understood, now seems to be well established. Indeed, certain micronutrients play an important role in the prevention of these pathologies. Patients presenting such disorders should be advised to either modify their diet or to increase their intake of these nutrients through food supplements. [ABSTRACT FROM AUTHOR]

Les psychoses passionnelles ont été décrites par G.G. de Clérambault, l'érotomanie en constituant le paradigme. Délire de jalousie et délire érotomaniaque font partie des troubles délirants dans les classifications actuelles mais n'apparaissent plus comme des catégories à part. Un certain nombre de travaux récents tendent à considérer que le thème érotomaniaque est secondaire à un trouble thymique sévère, en particulier un trouble bipolaire. Le thème érotomaniaque, comme la jalousie d'ailleurs, a fortement inspiré la littérature comme le cinéma. "Psychoses passionnelles" have been described by G.G. de Clérambault at the beginning of the 20th century, erotomania appearing as a paradigm for that group. However, erotomania and jealousy appear as part of a category called delusional disorder. Numerous studies tend to consider erotomania as secondary to a severe mood disorder, notably bipolar. Erotomania and jealousy have inspired various novels as well as films. [ABSTRACT FROM AUTHOR]

Résumé Introduction L'association de l'épilepsie et des troubles de l'humeur constitue un problème clinique important en raison des conséquences délétères de cette comorbidité. Les tempéraments affectifs ont une valeur importante dans l'identification des groupes à risque de développement des troubles de l'humeur. Cependant, les travaux existant à ce jour sur ce sujet sont peu nombreux. Nous nous sommes proposés d'évaluer les symptômes de dépression et les différents types de tempéraments affectifs dans un groupe de patients épileptiques en comparaison avec des sujets témoins. Méthode Nous avons mené une étude comparative transversale, réalisée auprès de 52 patients épileptiques ambulatoires suivis depuis au moins six mois, dont l'âge était compris entre 16 et 60 ans, et de 53 sujets témoins. Résultats En cohérence avec les données de la littérature, nous avons trouvé des scores de tempéraments dépressif, cyclothymique, irritable et anxieux ainsi que des scores de dépression significativement plus élevés chez les sujets épileptiques en comparaison avec les sujets témoins. Le tempérament hyperthymique a eu le score le plus élevé, suivi des tempéraments anxieux, cyclothymique, et dépressif. Le tempérament irritable a eu le score moyen le plus bas. La distribution des types de tempéraments retrouvée dans notre étude est différente de celles rapportées par d'autres études. Ceci pourrait être expliqué par la différence entre les groupes ethniques. Dans le groupe de patients épileptiques, les scores de dépression étaient fortement associés aux scores des tempéraments dépressif, cyclothymique, irritable et anxieux. Ceci confirme les données antérieurement rapportées dans la littérature, selon lesquelles les patients épileptiques tendent à avoir des tempéraments affectifs qui les exposent au risque de développer des troubles de l'humeur. Conclusion L'évaluation des tempéraments affectifs chez les patients épileptiques permet de définir le sous-groupe à risque de développer des troubles de l'humeur, et améliorer l'approche diagnostique et thérapeutique à leurs égards. Abstract Purpose Epilepsy is a chronic neurological disorder that is associated with an increased risk for psychopathology. Depression is the most common comorbid psychiatric condition in epilepsy, with often atypical clinical manifestations, including symptoms of irritability and anxiety. Temperament refers to biologically based characteristic patterns of emotional reactivity and self-regulation. In early studies, specific temperamental factors have been shown to be risk factors for depression symptoms in adult epilepsy patients. Thus, determining the affective temperament profile of epilepsy patients has important clinical implications especially in identifying those patients most at risk of developing mood disorders. However, very few studies of temperament in epilepsy patients have yet been published. The purpose of this study was to measure depression symptoms and severity, and to assess temperament in adult epilepsy patients, in comparison with control subjects; and to evaluate among the group of epilepsy patients the relationships between affective temperament types, sociodemographic profiles, clinical characteristics, and symptoms of depression. Method Participants were recruited from the Neurology Outpatient Department of National Institute of Neurology in Tunis, Tunisia. The study sample comprised 53 epilepsy outpatients (males = 33, females = 20) over the age of 16 years with a confident diagnosis of epilepsy. Matched controls (based on sex and age) included 52 healthy individuals. The Hamilton Rating Scale for Depression (HRSD) and the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A) was used in their Arabic versions to measure depression and temperament respectively. The questionnaires were administered individually. Data were analyzed using SPSS software, version 18. Results Findings indicated that patients with epilepsy had higher scores on depression and temperament scales than healthy controls. With respect to temperaments, hyperthymic temperament had the highest score in patients and controls, followed by anxious, cyclothymic, and depressive temperaments. Irritable temperament had the lowest average score. No significant associations were found between sociodemographic profile, illness characteristics and temperament scores in patients with epilepsy. An extremely strong association was found between depressive, cyclothymic, irritable and anxious temperament scores and the HRSD scale among epilepsy patients. These findings confirm literature data about affective temperament profile in epilepsy patients that put them at greater risk for mood disorders. Conclusion Results underscore the importance of assessment of affective temperaments among epilepsy patients, which could play a key role in defining the sub-group at high risk for developing mood disorders and improving, consequently, diagnostic and therapeutic approaches to patients suffering from both epilepsy and depression. More extended studies may help validate the concepts of profile temperaments in epilepsy and their relation to depressive vulnerability. [ABSTRACT FROM AUTHOR]

Résumé Si l'existence de liens entre consommation éthylique et symptômes thymiques paraît évidente, la nature et les mécanismes qui sous-tendent ces interactions s'avèrent en revanche très complexes et moins bien connus. Cet article, qui s'appuie essentiellement sur des données empiriques et destinées aux cliniciens, vise à décrire de quelle manière la compréhension de ces symptômes thymiques permet de dégager des pistes de travail ou leviers pour le travail clinique avec les patients alcoolo-dépendants. Nous développons en particulier la manière dont la consommation aiguë entraîne des réactions émotionnelles, hors contexte d'abus ou de dépendance (caractère syntone par rapport au cadre social de consommation, « binge-drinking »). Les consommations chroniques, menant à l'abus ou à la dépendance, sont par la suite abordées en détaillant de quelle manière leur interaction biologique avec le circuit de récompense cérébrale modifie notablement l'humeur, en fonction d'un principe d'allostasie. Nous mettons aussi en évidence le rôle de facteurs de personnalité tels que la conscience de Soi dans la relation qui peut exister entre dépression et « craving ». Nous insistons également sur des manifestations annexes aux symptômes thymiques que sont les troubles de cognition sociale fréquents chez les patients alcooliques, menant souvent à un isolement social ainsi qu'à des relations interpersonnelles conflictuelles qui peuvent à leur tour être des facteurs d'accentuation du vécu dépressif. Abstract Although the existence of links between alcohol consumption and thymic symptoms seems obvious, the nature and mechanisms underlying these interactions are, on the other hand, very complex and less well-known. This article, which relies mainly on empirical data and is intended for clinicians, aims to describe how understanding these thymic symptoms can identify avenues of work or levers for clinical work with alcohol-dependent patients. In particular, we develop the way in which acute consumption leads to emotional reactions, outside the context of abuse or dependence (symptom with the social framework of consumption, "binge-drinking"). Chronic consumption leading to abuse or dependence is then discussed, detailing how their biological interaction with the brain reward circuit significantly changes mood, based on a principle of allostasis. We also highlight the role of personality factors such as self-consciousness in the relationship between depression and craving. Furthermore we emphasize manifestations related to thymic symptoms such as social cognition disorders common in alcoholic patients, often leading to social isolation as well as conflicting interpersonal relationships which can in turn be factors of accentuation as far as depression symptoms are concerned. [ABSTRACT FROM AUTHOR]

Objective: To examine the clinical characteristics of adolescent girls consulting in a mood disorder clinic with a history of physical or sexual abuse. Method: A retrospective review was conducted of the charts of 55 adolescent girls consulting in a mood disorder clinic. An analysis grid was used to gather data on demographics, personal antecedents, symptoms and diagnoses. Girls with a history of physical or sexual abuse were compared with girls without such a history. Univariate analyses and a logistic regression analysis were performed. Results: Adolescent girls with a history of physical or sexual abuse did not differ statistically from those without such a history in terms of depressive symptoms or type and number of diagnoses. However, proportionally more girls with a history of physical or sexual abuse presented self-harm and relational problems with their parents and peers. Conclusion: Both history of physical or sexual abuse and self-destructive behaviors are rooted in relational problems. The results show that these are related to one another among those adolescent girls. Clinically, these findings suggest that it is important for clinicians do a thorough exploration of self-destructive behaviors and family and peer relations when assessing depressed adolescent girls. [ABSTRACT FROM AUTHOR]

Résumé Le TDAH est le trouble comportemental le plus fréquent chez les enfants et les adolescents. Il est souvent associé à d’autres atteintes psychiatriques et physiques, ce qui complique et aggrave la symptomatologie. Parmi les troubles psychiatriques comorbides, les troubles de l’humeur, les troubles du comportement et l’anxiété sont les plus fréquemment retrouvés. De même, il existe un chevauchement entre le TDAH et les addictions, les TOC, les troubles du sommeil et les troubles de l’apprentissage. Les TCA et les TSA sont aussi de plus en plus reconnus comme des entités comorbides au TDAH. Enfin, des liens avec l’ESPT et les troubles de l’attachement ont été notés. Les affections médicales doivent également être considérées lors de l’évaluation du TDAH – les traumatismes crâniens, l’épilepsie et l’obésité entre autres. Les enfants TDAH avec des pathologies concomitantes sont plus sévèrement atteints et leur traitement est plus complexe. Une meilleure compréhension de la fréquence élevée de ces comorbidités est nécessaire pour optimiser le traitement et permettre d’améliorer le mauvais pronostic lié à l’association du TDAH avec d’autres pathologies. ADHD is a common disorder for children and is highly comorbid with a number of psychiatric and somatic disorders, which leads to important social consequences. Therefore, it is important to screen for the presence of other disorders when a diagnosis of ADHD is considered. Because of the associated pathologies, the clinical picture of the ADHD is more complex and represents a diagnostic challenge. Furthermore, the prognostic and the future of children with a comorbid ADHD is much more unfavorable than that of children with ADHD only. It is thus necessary to recognize the presentation of ADHD associated with various and frequently comorbid pathologies knowing that those will change according to age and the developmental stage. The objective of this article is to describe these comorbidities. We are going to discuss pathologies most often associated with ADHD and the impact of its symptomatology on psychiatric disorders, medical affections and other disorders such as learning disorder and developmental coordination disorder. Along these lines, we carried out a mini review of ADHD and comorbidities. Results showed that comorbid psychiatric disorders such as conduct disorders, mood disorders and anxiety are among the most frequently associated with ADHD in clinical practice. Disruptive disorders are the most common comorbidities found with ADHD. Among these disorders, oppositional defiant disorder must be distinguished from conduct disorders. Conduct disorders are highly comorbid with ADHD (in more than a third of the cases) and increase the severity of the clinical picture. When children show at the same time ADHD and a conduct disorder, they are at risk to have an antisocial personality disorder as well as addictive disorders in adulthood. Depressive disorders can be triggered by ADHD since these young patients have to face numerous failures and difficulties in their family, social and school lives. With respect to bipolar disorders, links exist with ADHD. Bipolar disorder and ADHD treatment is complex: both thymoregulators and medication of ADHD are necessary. Finally, anxiety disorders are concomitant in 33 % of ADHD children, an association which deteriorates the symptoms of inattention and distractibility. Furthermore, there is also some overlap between ADHD and addictive behavior, obsessive-compulsive disorder, tics, sleeping disorder and specific learning disorder. There is a high prevalence of the association between ADHD and addictive behaviors in connection with impulsiveness, lack of control, automedication and similarity in the neurobiological circuits. Children with an obsessive-compulsive disorder have ADHD in 33 % of the cases. Although treatments of ADHD and obsessive-compulsive disorder differ, they must be taken simultaneously. It seems that sleeping disorders are not co-occurring with ADHD but intrinsic. Besides, sleeping disorders during childhood can mime an ADHD and complicate the diagnosis to be established, in particular when restless legs syndrome or sleep apnea is present. The comorbidity of ADHD and specific learning disorders is high. Children with specific learning disorders have difficulties staying attentive and their academic performance is often below their full potential, just like the ADHD children. Therefore, clinicians who assess patients for ADHD have to systematically screen for the presence of specific learning disorders and vice versa. Likewise, autistic spectrum disorder and eating disorder are more and more recognized as comorbid entities. The DSM-IV made impossible the concomitance between autism spectrum disorders and ADHD. However, the DSM-5 did recognize the existence of this comorbidity. The association of those two pathologies results in more severe dysfunction for the children, but the treatment of ADHD is going to facilitate the medical care of autism spectrum disorders. ADHD is described as a risk factor for eating disorders. Besides, the co-occurrence of obesity with ADHD is connected to impulsiveness and the tendency to addictive behaviors. Relationships of ADHD with posttraumatic stress disorder and attachment disorder have also been noted. Similarities between ADHD and posttraumatic stress disorder can cause diagnostic errors. Indeed, for both disorders we find the following: agitation, irritability, hypervigilance, sleeping disorders, attention disorders and disorders in the executive functions. Therefore, during the assessment of a child with a clinical picture of ADHD, anamnesis must be completed with the search of traumatic events. On the other hand, attachment disorder can also be confused with ADHD. Difficult temperament can disrupt the process of attachment and is associated with a bigger risk of ADHD. Finally, other medical issues should be considered in the assessment of ADHD: brain injury, epilepsy and obesity for example. ADHD children with a co-occurring condition may be severely impaired and treatment is more complex. ADHD is strongly comorbid with a large number of psychiatric and physical pathologies. It is probably more a set of affections than a homogeneous clinical entity. The longitudinal studies of children with one or several comorbidities showed that the outcome of these children was unfavorable, the association of pathologies causing an important dysfunction. The explanations proposed for this strong tendency of comorbidity with ADHD are that comorbidities have the same risk factors (genetic and environmental) and/or that one of the disorder is a subcategory of another. This leads us to conclude that a better comprehension of the high rates of comorbidities with ADHD is essential to optimize treatment of this condition and prevent some of the negative outcomes associated with comorbid ADHD. [ABSTRACT FROM AUTHOR]

Résumé La kétamine, antagoniste NMDA utilisé en anesthésie, fait l’objet de recherches concernant son action antidépressive : cette revue de la littérature discute de son intérêt thérapeutique en psychiatrie. La kétamine a une action antidépressive rapide mais de durée transitoire à dose sub-anesthésique, avec des effets secondaires dissociatifs et cardiaques bénins. Il existerait une action spécifique et rapide sur les idées suicidaires. En modulant le métabolisme du glutamate, la kétamine stimulerait des systèmes neurotrophiques et entraînerait une neuroplasticité cérébrale accrue. Des actions anti-inflammatoires ou analgésiques seraient également impliquées. L’utilisation de la kétamine comme antidépresseur semble difficile à envisager de par son action brève et son profil de tolérance, mais cibler le système glutamatergique pourrait avoir une utilité en tant que traitement spécifique de la crise suicidaire. Objectives Major depressive disorder is a frequent and serious disease, which can result in suicide. Treatment resistance is frequent in this pathology and actual antidepressants need a few weeks before having a clinical efficacy. Ketamine is an NMDA antagonist used in anaesthesia for decades, and has shown since several years a fast and efficient antidepressant effect in patients with treatment-resistant depression. Methods The aim of this review is to investigate the state of the art of the scientific literature about the antidepressant effects of ketamine. Results A subanaesthetic infusion (0.2 mg/kg) of intravenous ketamine reduced depressive symptoms for both unipolar and bipolar depression in many randomized controlled trials. Clinical effects can be observed as soon as 4 hours after treatment and last for a few days, which has been confirmed in recent meta-analysis. This molecule could also potentiate the efficacy of electroconvulsive therapy and have a neuroprotective effect in such treatments however results are controversial. Ketamine also showed a fast and specific reduction of suicidal ideation. Mechanisms of action of ketamine are still poorly known. Its partial NMDA antagonist action modulates the metabolism of glutamate, and thus stimulates neurotropic systems such as BDNF or mTOR resulting in an increased brain neuroplasticity. Anti-inflammatory or analgesic effects may also explain ketamine's efficacy. This treatment can provoke dissociative effects and cardiovascular events which are reversible within a few hours. While promising, ketamine's efficacy has a limited duration in time. Conclusion Ketamine has a fast antidepressant effect in both resistant unipolar and bipolar depression. However it seems difficult to use it as an antidepressant in common practice due to its short duration of efficacy and adverse effects: studies are in progress to develop new molecules aiming the same molecular pathways. Ketamine could be a useful treatment of acute suicidal crisis in major depressive disorder and upcoming researches should help understanding its mechanisms of action as an antisuicidal medication. [ABSTRACT FROM AUTHOR]

Résumé Gilbert Ballet commence ses études de médecine à Limoges, pour les terminer dans la capitale. Premier chef de clinique de Charcot à la Salpêtrière en 1882, il cherche durant toute sa carrière à établir des ponts entre la neurologie et la psychiatrie. Médecin des hôpitaux en 1884, agrégé en 1886, il est chargé d’un cours de clinique annexe en 1893, mais n’accède que tardivement aux chaires universitaires d’Histoire de la médecine (1907), puis de Clinique des maladies mentales de l’hôpital Sainte-Anne (1909), dont il est le troisième titulaire. Il crée en 1904 le premier service de « délirants » à l’Hôtel-Dieu de Paris. Esprit éclectique, positiviste, il combat la théorie de la dégénérescence. Il a publié en neurologie, endocrinologie, psychiatrie clinique, sociale et légale, histoire de la médecine. Auteur d’ouvrages sur les aphasies (1886) et la neurasthénie (1897), de leçons cliniques (1897) et d’une psychobiographie du mystique suédois Swedenborg (1899), il a coordonné le premier traité collectif français de psychiatrie (1903) et fondé la revue L’Encéphale (1906). Il a étudié les rapports de l’hystérie avec l’aliénation et précisé le diagnostic différentiel entre les états dépressifs dits plus tard endogènes et réactionnels. Mais son nom reste essentiellement associé jusqu’à nos jours à la description de la psychose hallucinatoire chronique (1911 à 1916), qui encadre chronologiquement les travaux de Séglas et de Clérambault sur la sémiologie des hallucinations. Gilbert Ballet begins his medical studies at Limoges and ends them in Paris. First chef de clinique of Jean-Martin Charcot at the Salpêtrière hospital in 1882, he tries during his whole career to connect neurology and psychiatry, nervous and mental disorders. Hospital physician in 1884, fellow professor in 1886, he teaches at the faculty of medicine of Paris dating from 1893, but is appointed as titular professor only in 1907, in the chairs of history of medicine and then of clinic of mental disease at the Sainte-Anne hospital (1909). He creates in 1904 the first hospital department of “ délirants ” at the Hôtel-Dieu of Paris. Eclectic, positivist (like Auguste Comte), he opposes the theory of degeneracy of Valentin Magnan. He has written many works in neurology, endocrinology, clinical, social and forensic psychiatry, history of medicine. He has published books on aphasias (1886) and neurasthenia (1897, with the father of Marcel Proust), clinical lessons (1897) and a psychobiography of the Swedish philosopher and prophet Swedenborg. He also managed the first collective treatise of mental pathology in France (1903) and founded the review L’Encéphale . He has studied the relations of hysteria with alienation (after Charcot) and described the differential diagnostic between depressions (melancholia) that would be later called endogenous and reactive. But his name is essentially connected to the description of the chronic hallucinatory psychosis (1911–1916), between the works of Séglas and Clérambault on the semiology of the hallucinations. [ABSTRACT FROM AUTHOR]

Résumé La catatonie est un syndrome clinique fréquent et pourtant méconnu. Décrite précisément par le psychiatre allemand Karl Kahlbaum à la fin du xix e siècle, la catatonie a connu certains rebondissements nosologiques. Rattachée à la schizophrénie par Emil Kraepelin puis par Eugen Bleuler, il a fallu attendre le milieu du xix e siècle pour reconnaître des catatonies en lien avec d’autres étiologies, notamment des affections somatiques. Ce changement de paradigme a permis de redécouvrir ce syndrome, d’en dessiner une prise en charge et de tenter d’en comprendre l’origine. D’un point de vue diagnostique, nous verrons que quelques signes cardinaux peuvent être retenus : inhibition et rigidité, stéréotypies, agitation sans but, négativisme et ambivalence. Le traitement de la catatonie doit être double : soulager le symptôme, c’est-à-dire lever l’état catatonique, et traiter la cause. Parmi les traitements symptomatiques, certaines benzodiazépines (notamment le lorazépam) et le zolpidem sont efficaces dans la majeure partie des cas et constituent un test diagnostique. En cas d’échec, l’électroconvulsivothérapie reste le traitement de référence en seconde ligne. Concernant la cause de la catatonie, on distingue les affections psychiatriques : les troubles de l’humeur en premier lieu, la schizophrénie, mais aussi l’autisme et la catatonie périodique, et également de très nombreuses causes organiques parmi lesquelles nous soulignerons la place de l’encéphalite à anticorps anti-NMDAR (récepteur N-Méthyl-D-Aspartate du glutamate). Le traitement de la cause doit être entrepris au plus vite et parallèlement au traitement de l’état catatonique, à l’exception des neuroleptiques qui risquent d’aggraver la catatonie s’ils sont administrés trop tôt. La catatonie correspondrait au niveau cérébral à un dysfonctionnement des circuits impliqués dans le mouvement volontaire, en réaction à la peur, le plus souvent sous forme stuporeuse mais parfois sous forme furieuse. Le cortex orbitofrontal latéral, en défaut dans la catatonie, et porteur de récepteurs GABA-A, serait fortement impliqué dans cette réaction primitive qu’il a pour rôle d’inhiber par interaction avec le cortex orbitofrontal médian et l’amygdale. Catatonia is a frequent but unrecognized syndrome. Described in the late nineteenth century by the German psychiatrist Karl Kahlbaum, catatonia has experienced some nosological twists including the attachment to schizophrenia by Emil Kraepelin and Eugen Bleuler. It was not until the mid-nineteenth century that clinicians recognize catatonia related to other etiologies including somatic ones. This paradigm shift has helped to rediscover this syndrome, to find a treatment algorithm and try to understand its pathophysiology. From a diagnostic point of view, we will see that a few cardinal signs may be retained: inhibition and rigidity, stereotypies, aimless agitation, negativity and ambivalence. The treatment of catatonia must be twofold: to relieve the catatonic state, and to treat the cause. Among symptomatic treatments, some benzodiazepines (such as lorazepam) and zolpidem are generally very effective and provide a diagnostic test. If that fails, electroconvulsive therapy is the main second line treatment. Regarding the cause of catatonia, one should distinguish psychiatric disorders: mood disorders, schizophrenia, autism and periodic catatonia; and numerous organic causes among which we will highlight anti-NMDAR (N-Methyl-D-aspartate glutamate receptor) encephalitis. Treating the cause should be undertaken as quickly as possible in parallel with the treatment of the catatonic state, except for neuroleptics which may worsen catatonia if administered early. Catatonia corresponds to a dysfunction of the circuits involved in voluntary movement in response to fear, most often in the form of stupor but sometimes in a furious form. The lateral orbitofrontal cortex, in default in catatonia, and carrier of GABA-A receptors, would be heavily involved in this primitive reaction which it should inhibit by interaction with the median orbitofrontal cortex and the amygdala. [ABSTRACT FROM AUTHOR]

Résumé Depuis 1950 en France, le concept de dépression s’est déployé pour quitter le strict domaine de la psychiatrie des troubles graves de l’humeur en faveur d’un abord plus dimensionnel, qui intéresse désormais l’ensemble des problématiques médicales. À travers la trajectoire et les options défendues par Thérèse Lempérière, clinicienne de terrain et professeur de psychiatrie, nous pouvons suivre les péripéties de cette histoire. Après les premières années de quête et d’espoirs vers une meilleure compréhension étiopathogénique de ces troubles, cette chercheuse rigoureuse constate que seul un schéma multifactoriel peut éclairer l’origine de cette pathologie complexe. Au-delà de tous conflits théoriques, elle défendra alors l’intérêt d’un abord plus pragmatique, pour mieux diffuser une conception trans-nosographique et intégrative de la dépression, réellement utile pour la prise en charge de tous les patients. Since 1950 in France, the concept of depression has grown to leave the strict domain of psychiatry, based on serious mood disorders, in favor of a more dimensional understanding, which now concerns all medical issues. Through the trajectory and options defended by Thérèse Lempérière, experienced clinician and professor of psychiatry, we can follow the adventures of this story. After the first years of quest and hopes to better etiopathogenic explanation of these disorders, this rigorous researcher says that only a multifactorial pattern can illuminate the origin of this complex disease. Beyond all theoretical conflicts, she defends the interests of a more pragmatic approach. So, she broadcasts a trans-nosographic and integrative vision of depression, actually useful for the treatment of all patients. [ABSTRACT FROM AUTHOR]

TODAY, THE TERM DEPRESSION HAS LOST ITS MEANING. RECENT SCIENTIFIC DATA SUGGESTS A CHANGE IN OUR CLASSIFICATIONS OF MENTAL DISORDERS. DEPRESSION IS FREQUENTLY USED TO REFER TO « NORMAL » SADNESS, ANXIETY DISORDERS, PERSONNALITY DISOTRDERS OR ADJUSTMENT DISORDERS… MOREOVER, IN OUR SOCIETY, THIS DIAGNOSIS REMAINS BADLY ACCEPTED. IT IS REALLY TIME TO BE AWARE OF THE DETERIORATION OF THE IMAGE OF PSYCHIATRY, AND PARTICULARLY THE BAD IMAGE OF DEPRESSION AND ITS TREATMENT WITH ANTIDEPRESSANTS. THIS PAPER IS A REFLEXION INVITING GENERAL PRACTICIONERS AND PSYCHIATRISTS TO PROGRESSIVELY AVOID THE TERM DEPRESSION AND RATHER USE THE DIAGNOSIS OF UNIPOLAR MOOD DISORDER, A BROADER CONCEPT, MORE ADAPTED TO NEW SCIENTIFIC DATA, LESS STIGMATIZING, AND CLOSER TO THE EVOLUTION OF OUR SOCIETY. [ABSTRACT FROM AUTHOR]

Résumé Les épisodes de manie et de mélancolie reconnues depuis l’Antiquité ont longtemps été attribués aux troubles de la bile noire et considérés comme deux états pathologiques distincts. À partir de la fin du xviii e siècle a été formulée l’hypothèse qu’il pourrait s’agir de deux formes d’une même maladie. Cette « folie périodiques » caractérisée par des troubles thymiques a été au xx e siècle désignée dans la nosographie comme « psychose maniaco-dépressive », puis comme Troubles bipolaires. La démonstration au milieu du xx e siècle de l’efficacité des sels de Lithium, utilisés en médecine depuis le xix e siècle, dans le traitement des épisodes aigus et dans la régulation de la thymie, a conduit à l’introduction de la notion de Troubles Bipolaires de l’humeur et à la description de leurs différentes formes. Les nosographies du début du xxi e siècle dissocient les Troubles Bipolaires et ceux dits unipolaires qui n’incluent que des épisodes dépressifs. Episodes of mania and melancholy have been recognized since Antiquity. They were attributed to black bile and considered as two distinct pathological states. From the xviii th century onwards, they were thought of as two aspects of the same illness. In the xx th century, “periodic insanity” characterized by thymus disorders were named by nosography as: “manic-depressive psychosis”. Later on, it was called: “bi-polar disorder”. At the beginning of the xx th century, the demonstration of the effectiveness of lithium salts (used in medicine ever since the xix th century), in the treatment of acute episodes and in the regulation of the thymus, led to create the notion of “bipolar mood disorder” and the description of their different forms. Early xxi st Century nosography dissociates bipolar and unipolar disorders that only include depressive episodes. [ABSTRACT FROM AUTHOR]

Résumé Le trouble disruptif avec dysrégulation de l’humeur (TDDH) est la seule nouvelle entité diagnostique du DSM-5 concernant spécifiquement l’enfant et l’adolescent. Elle appartient aux troubles de l’humeur et a été créée pour rendre compte de troubles mixtes du comportement et des émotions affectant des enfants et adolescents qui auraient par le passé fait l’objet d’un diagnostic de trouble bipolaire ou d’un trouble du comportement perturbateur. Cette nouvelle entité diagnostique est la résultante d’un certain nombre de travaux et de débats dont nous retracerons les principales étapes et les enjeux en termes de diagnostic et de caractéristiques neuropsychologiques. Disruptive mood dysregulation disorder (DMDD) is a new DSM 5 diagnosis specifically addressing children and adolescents. DMDD belongs to the category of mood disorders and has been created to improve recognition of a condition characterized by both mood and behavioral symptoms and to avoid a diagnosis of bipolar disorder in children and adolescents with severe chronic irritability and temper tantrums. Its validity and possible overlap with disruptive behavior disorders such as oppositional defiant disorder or conduct disorder and neurodevelopmental disorder such as attention deficit hyperactivity disorder – especially in children with severe emotional liability or comorbidities – are still subject to debate. This review addresses the background of DMDD, diagnosis and neuropsychological correlates. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorders are overrepresented in current works. Spectrum, endophenotypes, ratings (of bipolarity) are summoned to try to understand misleading clinical cases. Method: How can we consider the foundations of this approach, actually quite distant from the classical notion of "circularity", which itself is prototypical of the diachronic evolution of the disorders? Is it a fashion trend or a change in perspective supported by clinical data?. Results: Not claiming an unequivocal answer, we question the current positioning of bipolar disorders in the psychiatric nosography, based on the hypothesis of an "Unitarian" perspective for mood disorders. Discussion: Indeed, mood disorders are often discribed through the accompanying symptomatology, especially delusional manifestations. The latter are coined "psychotic features", being de-facto bound within an unicist conception of mood disorders. Conclusion: Thus we would be facing what would be "harmony in mood fluctuations" while dysharmony would describe clinical situations formely considered in the field of psychosis. This stance questions the impact of the concept of "unity" in the evolution of clinical classifications, with the wish for harmony being quite distant from the displacement effects of the affects. [ABSTRACT FROM AUTHOR]

Résumé: Cette revue de la littérature est consacrée aux symptômes émotionnels associés au trouble déficit d’attention/hyperactivité (TDA/H). Elle retrace notamment l’évolution récente de la recherche clinique et des critères diagnostiques qui ont fait une place plus importante aux symptômes émotionnels survenant au cours des troubles du comportement. La labilité émotionnelle est une caractéristique associée au TDA/H mais n’en est pas spécifique puisqu’elle existe également dans les troubles internalisés, dans plusieurs troubles de la personnalité et dans les troubles du comportement comme le trouble oppositionnel avec provocation (TOP) et le trouble des conduites. Nous décrirons les caractéristiques de la labilité émotionnelle sévère qui caractérise certains sujets ayant un TDAH et proposerons une conduite à tenir diagnostique à partir des nouvelles catégories identifiées par le DSM-5. Malgré certaines limites liées à sa validité insuffisante, la nouvelle entité clinique « trouble disruptif avec dysrégulation émotionnelle » permet d’attirer l’attention des cliniciens et des chercheurs sur la part émotionnelle des troubles à expression comportementale, qui nécessitent probablement des démarches diagnostiques et thérapeutiques spécifiques. [Copyright &y& Elsevier]

Résumé: Objectifs: Le DSM-5 donne une définition du symptôme psychotique indépendante de tout concept de psychose. Chez les patients dépressifs, la présence d’hallucination ou d’idée délirante, quelle que soit leur forme clinique, conduit en principe à diagnostiquer une dépression psychotique et à prescrire des neuroleptiques. Les symptômes psychotiques sont subdivisés par le DSM en ű congruents Ƈ ou ű non congruents Ƈ à l’humeur. Nous discutons de la pertinence d’une catégorie de symptômes psychotiques ű atypiques Ƈ, peu évocateurs d’une psychose au sens classique du terme. Méthode: Discussion de la définition opérationnelle des symptômes psychotiques du DSM, étude d’une série de 16 patients chez qui un diagnostic de dépression psychotique a été posé. Résultats: Sur les 16 patients, deux seulement présentaient des symptômes psychotiques classiques, évocateurs d’une psychose. Chez les autres, le diagnostic reposait sur la présence de symptômes très atypiques, comme des hallucinations visuelles par exemple. Discussion: Chez la plupart de nos patients, le diagnostic de dépression psychotique reposait sur des symptômes atypiques, dont la nature psychotique est discutable. Ces patients étaient tous migrants, originaires de pays pauvres, ce qui suggère une variété d’hypothèses expliquant nos résultats. Conclusions: Une catégorie de symptômes psychotiques atypiques, en complément des types classiques (congruents et non congruents) pourrait être utile pour préciser davantage leurs contours psychopathologiques et implications thérapeutiques. Le DSM-5 a cependant pris une voie opposée, en consolidant le type non congruent à l’humeur comme incluant aussi les symptômes les plus atypiques. [ABSTRACT FROM AUTHOR]

L’huile essentielle de Lavande officinale ou de Lavande vraie est incontournable en aromathérapie, tant son spectre d’action est large et son innocuité reconnue. De nombreuses études cliniques ont en effet validé à la fois son efficacité et sa sécurité d’emploi. Dans certaines indications, elle s’est avérée très efficace. [ABSTRACT FROM AUTHOR]

Résumé: L’attribution du diagnostic de bipolarité en pédopsychiatrie a particulièrement augmenté ces dernières années, en particulier aux États-Unis pourtant les données épidémiologiques ne montrent pas d’augmentation de sa prévalence. Beaucoup d’enfants en souffrance n’ont pas reçu de diagnostique car ils avaient un trouble qui n’avait pas encore été défini. Le DSM-5 a nommé ce trouble Disruptive Mood Dysregulation Disorder (DMDD). Dans la littérature francophone, on retrouve le terme de dysrégulation émotionnelle et comportementale sévère (DES). Les critères fondamentaux du DES sont (1) une irritabilité chronique sévère et (2) des crises de rage, celles-ci comprennent des manifestations verbales et comportementales qui sont des réactions disproportionnées en termes de durée et d’intensité par rapport à la situation qui les a provoquées. Ces enfants présentent donc un tableau clinique de troubles disruptifs qui exprime en réalité une pathologie de l’humeur internalisée, marquée par une instabilité thymique associée à une dysphorie. Ces ű rages Ƈ caractérisent donc un nouveau type spécifique de trouble de l’humeur chez l’enfant. De plus, autant le DES n’est pas une prédisposition pour un trouble bipolaire, autant il l’est pour les troubles dépressifs apparaissant précocement à l’âge adulte. Ainsi, le diagnostic de DES vise à distinguer ces enfants de ceux souffrant de troubles bipolaires et à éviter d’attribuer à tort un diagnostic de troubles des conduites ce qui aurait des conséquences préjudiciables d’un point de vu sociétal et thérapeutique. En effet, les enjeux de la prise de conscience de l’existence du DES sont majeurs pour la prise en charge, notamment médicamenteuse. [ABSTRACT FROM AUTHOR]

Introduction: Contraception-induced mood changes have been identified since the 1960s. To our knowledge, there has been no reported case about self-mutilation associated to any form of contraception. We report the case of a 17-year-old adolescent girl who presented with de novo self-mutilation and depressive symptoms three and a half weeks after the administration of 150 mg of Depot-Medroxyprogesterone Acetate (DMPA). Method: Clinical case report and literature review. Possible confounding factors are reviewed. Results: The patient had no personal psychiatric history and no significant family psychiatric history. A DSM-IV diagnosis of "mood disorder due to DMPA with depressive features" was formulated. There was no evidence of abnormal personality functioning. The mental status exam and collateral information validated the severity of her condition. Discussion: DMPA is a birth control method especially useful for adolescent girls and possible secondary mood symptoms should not limit its access. However, since depressive symptoms substantially interfere with daily functioning and may have unfortunate consequences like self-mutilation and suicidal ideation, it is important to remain vigilant regarding the onset of mood symptoms following contraceptive use in adolescent girls. This vigilance should be more specific regarding adolescent girls with a history of mood disorders, anxiety disorders, selfmutilation or family diathesis of these conditions. [ABSTRACT FROM AUTHOR]

Objective: Early life experiences are associated with severe and long-lasting effects on behavioural and emotional functioning, which in turn are thought to increase the risk for unipolar depression and other disorders of affect regulation. The neurobiological and psychological mechanisms through which adverse early life experiences confer risk are poorly understood. Method: Alterations in brain structure and function in limbic and prefrontal cortical regions have been linked to early negative experiences and to mood disorders. Results: There are a number of psychological domains that may be dysfunctional in people with mood disorders, and which, if the dysfunction occurs prior to onset of mood symptoms, may signify a risk factor for depression. Cognitive dysfunction has been examined in patients with mood disorders, with some suggestion that changes in cognitive function may antedate the onset of mood symptoms, and may be exacerbated in those who experienced early negative trauma. Social cognition, including emotion comprehension, theory of mind and empathy, represent under-studied domains of psychological function that may be negatively influenced by early adverse experience. Temperament and personality factors may also leave people vulnerable to mood instability. Conclusion: This review summarizes the evidence for dysfunction in each of these domains for people with mood disorders. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder is a form of mood disorder causing a significant reduction in the quality of life and in the daily function for about 3 % to 5 % of women of fertile age. Premenstrual dysphoric disorder (PMDD) includes various symptoms regularly present during the luteal phase of menstrual cycles, with principally depressive mood, anxiety, emotional lability and decrease of interest. The serotoninergic system is in close reciprocal relation with the gonadal hormones and has been identified as the most plausible target for interventions. The selective serotonin reuptake inhibitors are increasingly used as first-line therapy for severe PMDD. The response rate reported are better than responses to treatment of depression, obsessive-compulsive disorder or panic disorder. The doses used are variable, between 20 and 60 mg/day for fluoxe´tine, 50 and 150 mg/day for sertraline and 10–30 mg/day for paroxetine. The administration may be continuous every day in the menstrual cycle or intermittent (premenstrual only) or semi-intermittent (low doses during follicular phase and higher doses during luteal phase). Several studies indicate that intermittent treatment is more efficient in these women and thus, may offer an attractive treatment option because with reduced side-effects. [Copyright &y& Elsevier]