105 results on '"Antoine Yrondi"'
Search Results
2. Adherence to clinical practice guidelines for using electroconvulsive therapy in elderly depressive patients
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Antoine Yrondi, Olivier Blanc, Loic Anguill, Christophe Arbus, Ludivine Boudieu, Marie-Camille Patoz, Adeline Arnould, Thomas Charpeaud, Jean-Baptiste Genty, Racan Abidine, Maximilien Redon, Romain Rey, Bruno Aouizerate, Djamila Bennabi, Wissam El-Hage, Bruno Etain, Jérôme Holtzmann, Marion Leboyer, Fanny Molière, Raphaelle Marie Richieri, Florian Stéphan, Guillaume Vaiva, Anne Sauvaget, Emmanuel Poulet, Emmanuel Haffen, Philippe Courtet, Philippe Fossati, Pierre-Michel Llorca, and Ludovic Samalin
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ECT ,Mood disorder ,Major depressive disorder ,Bipolar disorder ,Geriatric patients ,Psychiatry ,RC435-571 - Abstract
Abstract Objectives Electroconvulsive therapy (ECT) is one of the most effective treatments in mood disorders, mainly in major depressive episode (MDE) in the context of either unipolar (MDD) or bipolar disorder (BD). However, ECT remains a neglected and underused treatment. Older people are at high risk patients for the development of adverse drug reactions. In this context, we sought to determine the duration of MDEs and the number of lines of treatment before the initiation of ECT in patients aged 65 years or over according to the presence or absence of first-line indications for using ECT from international guidelines. Methods In this multicenter, retrospective study including patients aged 65 years or over with MDEs in MDD or BD who have been treated with ECT for MDEs, data on the duration of MDEs and the number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. Results We identified 335 patients. The mean duration of MDEs before ECT was about 9 months. It was significantly shorter in BD than in MDD- about 7 and 10 months, respectively. The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. The presence of first-line indications for using ECT from guidelines did not reduce the duration of MDEs before ECT, except where there was a previous response to ECT. The first-line indications reduced the number of lines of treatment before starting ECT. Conclusion Even if ECT seems to be a key treatment in the elderly population due to its efficacity and safety for MDEs, the delay before this treatment is still too long.
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- 2024
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3. Psychosis with use of amphetamine drugs, methylphenidate and atomoxetine in adolescent and adults
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François Montastruc, Vanessa Rousseau, Agnes Sommet, Alexis Revet, Genevieve Durrieu, Jacques Hamard, Philippe Garcia, and Antoine Yrondi
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Psychiatry ,RC435-571 - Abstract
Background Use of psychostimulants and relative drugs has increased worldwide in treatment of attention-deficit hyperactivity disorder (ADHD) in adolescents and adults. Recent studies suggest a potential association between use of psychostimulants and psychotic symptoms. The risk may not be the same between different psychostimulants.Objective To assess whether amphetamine or atomoxetine use is associated with a higher risk of reporting symptoms of psychosis than methylphenidate use in adolescents and adults, particularly in patients with ADHD.Methods Using VigiBase, the WHO’s pharmacovigilance database, disproportionality of psychotic symptoms reporting was assessed among adverse drug reactions related to methylphenidate, atomoxetine and amphetamines, from January 2004 to December 2018, in patients aged 13–25 years. The association between psychotic symptoms and psychostimulants was estimated through the calculation of reporting OR (ROR).Findings Among 13 863 reports with at least one drug of interest, we found 221 cases of psychosis with methylphenidate use, 115 with atomoxetine use and 169 with a prescription of an amphetamine drug. Compared with methylphenidate use, amphetamine use was associated with an increased risk of reporting psychotic symptoms (ROR 1.61 (95% CI 1.26 to 2.06)]. When we restricted the analysis to ADHD indication, we found a close estimate (ROR 1.94 (95% CI 1.43 to 2.64)). No association was found for atomoxetine.Conclusion Our study suggests that amphetamine use is associated with a higher reporting of psychotic symptoms, compared with methylphenidate use.Clinical implications The prescription of psychostimulants should consider this potential adverse effect when assessing the benefit–risk balance.
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- 2024
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4. Predictors of prospective suicide attempts in a group at risk of personality disorder following self-poisoning
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Lionel Cailhol, Mariève Marcoux, Anjali Mathur, Antoine Yrondi, and Philippe Birmes
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personality disorder ,alexythimia ,suicidal behavior (SB) ,suicide ,suicidal ideation (SI) ,self-poisoning nonlethal suicide attempt ,Psychiatry ,RC435-571 - Abstract
BackgroundPatients with personality disorder (PD) are at risk for suicidal behavior and are frequently admitted for this reason to emergency departments. In this context, researchers have tried to identify predictors of their suicidal acts, however, the studies have been mostly retrospective, and uncertainty remains. To prospectively explore factors associated with suicide attempts (SA) in individuals screened for PD from the ecological context of emergencies.MethodsPatients were recruited from two emergency departments after a self-poisoning episode (n = 310). PDQ-4+ (risk of PD), TAS-20 (alexithymia), SIS (suicidal intent), H (hopelessness), BDI-13 (depression), AUDIT (alcohol consumption), and MINI (comorbidity) questionnaires were completed. SA over the subsequent two years were identified by mailed questionnaires and hospitals’ active files. Logistic regression analyses were performed.ResultsHaving a previous suicidal attempt was linked to a 2.7 times higher chance of recurrence after 6 months, whereas the TAS-20 showed a 1.1 times higher risk at 18 months (OR = 1.1) and the BDI at 24 months (OR = 1.2). Each one-unit increment in TAS-20 and BDI-13 scores increased the risk of SA by 9.8 and 20.4% at 18 and 24 months, respectively.ConclusionSome clinical features, such as alcohol dependence, suicide intent, and hopelessness, may not be reliable predictors of SA among PD patients. However, in the short term, previous SA and, in the long term, depression and alexithymia may be the most robust clinical predictors to consider in our sample of patients with self-poisoning SA.Clinical trial registration: [ClinicalTrials.gov], NCT00641498 24/03/2008 [#2006-A00450-51].
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- 2023
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5. Mobile health in the specific management of first-episode psychosis: a systematic literature review
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Claire Maechling, Antoine Yrondi, and Amandine Cambon
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early psychosis ,first-episode psychosis ,early intervention ,mobile health ,mobile applications ,digital intervention ,Psychiatry ,RC435-571 - Abstract
PurposeThe purpose of this systematic literature review is to assess the therapeutic efficacy of mobile health methods in the management of patients with first-episode psychosis (FEP).MethodThe participants are patients with FEP. The interventions are smartphone applications. The studies assess the preliminary efficacy of various types of application.ResultsOne study found that monitoring symptoms minimized relapses, visits to A&E and hospital admissions, while one study showed a decrease in positive psychotic symptoms. One study found an improvement in anxiety symptoms and two studies noted an improvement in psychotic symptoms. One study demonstrated its efficacy in helping participants return to studying and employment and one study reported improved motivation.ConclusionThe studies suggest that mobile applications have potential value in the management of young patients with FEP through the use of various assessment and intervention tools. This systematic review has several limitations due to the lack of randomized controlled studies available in the literature.
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- 2023
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6. What are the neural correlates of dissociative amnesia? A systematic review of the functional neuroimaging literature
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Simon Taïb, Antoine Yrondi, Béatrice Lemesle, Patrice Péran, and Jérémie Pariente
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cognitive disorder ,memory loss ,hysteria ,dissociative disorder ,stress ,trauma ,Psychiatry ,RC435-571 - Abstract
AimDissociative amnesia is an emblematic psychiatric condition in which patients experience massive memory loss ranging from focal to global amnesia. This condition remains poorly understood and this review aims to investigate the neuroanatomical feature of this disease.MethodsWe conducted a systematic review of the scientific literature available on PubMed, up to December 1, 2022, using a combination of keywords referring to dissociative amnesia. We included every scientific report involving patients undergoing a functional imaging procedure.ResultsTwenty-two studies met our inclusion criteria (gathering 49 patients). Only one was a controlled study with a large sample. The other 21 were case reports and case series. In resting state, neuroimaging studies mostly showed a hypo-activated right inferolateral prefrontal cortex, associated with limbic hypoactivity and lesser activation of the hippocampal and para-hippocampal structures. The patients also presented abnormal patterns of cerebral activation when performing memory tasks. When testing recognition of memories from the amnestic period, patients showed increased activation across temporal areas (hippocampal and para-hippocampal gyri) and the limbic network. When trying to recollect memories from an amnestic period compared to a non-amnestic period, patients failed to activate these structures efficiently. Most of these patterns tended to return to normal when symptoms resolved.ConclusionThis review identified a paucity of controlled studies in the field of dissociative amnesia neuroimaging, which restricts the extrapolation of results. Patients with dissociative amnesia present a broad prefronto-temporo-limbic network dysfunction. Some of the brain areas implicated in this network might represent potential targets for innovative treatments.
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- 2023
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7. Impact of 3D-printed models in meetings with parents of children undergoing interventional cardiac catheterisation
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Clément Karsenty, Khaled Hadeed, Camelia Djeddai, Julie Lateyron, Aitor Guitarte, Remi Vincent, Nathalie DeBarros, Nicolas Combes, Jerome Briot, Yves Dulac, Antoine Yrondi, and Philippe Acar
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3D-printed model ,catheterisation ,anxiety ,patient information ,complex congenital heart disease ,Pediatrics ,RJ1-570 - Abstract
BackgroundPaediatric interventional catheterisation has consistently improved in recent decades, with often highly successful outcomes. However, progress is still required in terms of the information delivered to parents and how parental anxiety is managed.AimTo investigate the impact of cardiac printed models on improving parental understanding and alleviating anxiety before interventional catheterisation.MethodsThe parents of children undergoing interventional cardiac catheterisation were prospectively enrolled in the study. A questionnaire highlighting knowledge and understanding of the condition and cardiac catheterisation per se was scored on a scale of 1–30. The State-Trait Anxiety Inventory (STAI), which generates current anxiety scores, was also used before and after the pre-catheterisation meeting. The “printing group” received an explanation of catheterisation using the device and a three-dimensional (3D) model, while the “control group” received an explanation using only the device and a manual drawing.ResultsIn total, 76 parents of 50 children were randomly assigned to a “control group” (n = 38) or “printing group” (n = 38). The groups were comparable at baseline. The level of understanding and knowledge improved after the “control group” and “printing group” meetings (+5.5±0.8 and +10.2±0.8; p
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- 2023
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8. Evolution of Cognitive Impairments in Treatment-Resistant Depression: Results from the Longitudinal French Centers of Expertise for Treatment-Resistant Depression (FACE-DR) Cohort
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Alexis Vancappel, Yecodji Dansou, Ophelia Godin, Emmanuel Haffen, Antoine Yrondi, Florian Stephan, Raphaelle Marie Richieri, Fanny Molière, Jérôme Holtzmann, Mathilde Horn, Etienne Allauze, Jean Baptiste Genty, Alex Bouvard, Jean-Michel Dorey, Vincent Hennion, Vincent Camus, Guillaume Fond, Barbara Peran, Michel Walter, Loic Anguill, Charlotte Scotto D’apolina, Estelle Vilà, Benjamin Fredembach, Jean Petrucci, Romain Rey, Anne Sophie Nguon, Bruno Etain, Mathilde Carminati, Philippe Courtet, Guillaume Vaiva, Pierre Michel Llorca, Marion Leboyer, Bruno Aouizerate, Djamila Bennabi, and Wissam El Hage
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treatment-resistant depression ,cognitive impairments ,neuropsychology ,memory ,executive function ,processing speed ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Previous studies set out profound cognitive impairments in subjects with treatment-resistant depression (TRD). However, little is known about the course of such alterations depending on levels of improvement in those patients followed longitudinally. The main objective of this study was to describe the course of cognitive impairments in responder versus non-responder TRD patients at one-year follow-up. The second aim was to evaluate the predictive aspect of cognitive impairments to treatment resistance in patients suffering from TRD. We included 131 patients from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centers. They undertook comprehensive sociodemographic, clinical, global functioning, and neuropsychological testing (TMT, Baddeley task, verbal fluencies, WAIS-4 subtests, D2 and RLRI-16) at baseline (V0) and one-year follow-up (V1). Most patients (n = 83; 63.36%) did not respond (47 women, 49.47 ± 12.64 years old), while one-third of patients responded (n = 48, 30 women, 54.06 ± 12.03 years old). We compared the cognitive performances of participants to average theoretical performances in the general population. In addition, we compared the cognitive performances of patients between V1 and V0 and responder versus non-responder patients at V1. We observed cognitive impairments during the episode and after a therapeutic response. Overall, each of them tended to show an increase in their cognitive scores. Improvement was more prominent in responders at V1 compared to their non-responder counterparts. They experienced a more marked improvement in code, digit span, arithmetic, similarities, and D2 tasks. Patients suffering from TRD have significant cognitive impairments that persist but alleviate after therapeutic response. Cognitive remediation should be proposed after therapeutic response to improve efficiency and increase the daily functioning.
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- 2023
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9. Efficacy of traumatic memory reactivation with or without propranolol in PTSD with high dissociative experiences
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Pascal Roullet, Simon Taïb, Claire Thalamas, Guillaume Vaiva, Wissam El Hage, Antoine Yrondi, and Philippe Birmes
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ptsd ,dissociation ,propranolol ,memory reactivation ,mde ,traumatic memory ,depression ,high dissociative experiences ,Psychiatry ,RC435-571 - Abstract
Background: Post-traumatic stress disorder (PTSD) with dissociative symptoms is now a full-fledged subtype of this disorder. The dissociative subtype is associated with a greater number of psychiatric comorbidities. To date, the impact of dissociation on the efficacy of PTSD treatment remains unclear. Objective: The aim of this study was to compare the efficacy of a traumatic memory reactivation procedure with the administration of propranolol or a placebo once a week for six consecutive weeks in reducing PTSD and MDE symptoms between PTSD subjects with or without high dissociative symptoms. Method: For that, we conducted a randomized clinical trial in 66 adults diagnosed with longstanding PTSD and measured the SCID PTSD module, the PTSD Checklist (PCL-S), Beck’s Depression Inventory-II (BDI-II), and the Dissociative Experiences Scale (DES). Results: Patients with and without high dissociative experience had significant improvement in their PCL-S scores over the 6 treatment sessions, and PCL-S scores continued to decline in all patients during the post-treatment period. However, there was no correlation between the presence/absence of high dissociative experiences and no specific effect of propranolol treatment. We found exactly the same results for MDE symptoms. Interestingly, patients with high dissociative experiences before treatment exhibited very significant improvement in their DES scores after the 6 treatment sessions, and patients maintained this improvement 3 months post-treatment. Conclusions: The traumatic memory reactivation procedure is an effective way to treat dissociative symptoms in patients with PTSD, and improvement of these dissociative symptoms was associated with a decrease in both PTSD and depression severity.
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- 2022
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10. Prevalence and prediction of PTSD and depression in mothers of children surviving a motor vehicle crash
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Antoine Yrondi, Hélène Colineaux, Isabelle Claudet, Jérome Sales de Gauzy, Samantha Huo, Simon Taib, Eric Bui, and Philippe Birmes
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motor vehicle crash ,peritraumatic ,cortisol ,mothers ,ptsd ,Psychiatry ,RC435-571 - Abstract
Introduction: Few studies have examined the psychopathological consequences for parents of children who were survivors of a motor vehicle crash (MVC). This study assessed the impact of dissociation and peritraumatic distress on the severity of PTSD and post-traumatic major depressive episode (MDE) symptoms in mothers during the first years after the MVC and the role that cortisol response might play in this association. Methods: 125 mothers were included. Peritraumatic distress and dissociation were assessed. Morning salivary cortisol was tested at the baseline. Participants were assessed for a probable diagnosis of PTSD and MDE at 5 weeks, 6 months and 12 months. Results: At 5 weeks, 12 (13.6%) mothers exhibited probable PTSD. During the first year, the PCL score was higher when the (i) Peritraumatic Distress Inventory (PDI) score increased and (ii) the Peritraumatic Dissociation Experience Questionnaire (PDEQ) score increased. Cortisol levels were lower when the PDI score increased. Conclusion: This is the first study to assess the mothers of MVC survivors for one year following the trauma. We confirm that peritraumatic responses are useful for predicting the severity of PTSD symptoms. These results could encourage the implementation of follow-up programmes not only for survivors but also for their mothers. HIGHLIGHTS Mothers of children involved in motor vehicle accident are at risk for developing PTSD. Peritraumatic responses (distress and dissociation) are associated to the severity of PTSD symptoms. Low salivary cortisol levels were associated with high peritraumatic distress.
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- 2022
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11. Association between the expression of lncRNA BASP-AS1 and volume of right hippocampal tail moderated by episode duration in major depressive disorder: a CAN-BIND 1 report
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Antoine Yrondi, Laura M. Fiori, Nikita Nogovitsyn, Stefanie Hassel, Jean François Théroux, Zahia Aouabed, Benicio N. Frey, Raymond W. Lam, Roumen Milev, Daniel J. Müller, Jane A. Foster, Claudio Soares, Susan Rotzinger, Stephen C. Strother, Glenda M. MacQueen, Stephen R. Arnott, Andrew D. Davis, Mojdeh Zamyadi, Jacqueline Harris, Sidney H. Kennedy, and Gustavo Turecki
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Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract The pathophysiology of major depressive disorder (MDD) encompasses an array of changes at molecular and neurobiological levels. As chronic stress promotes neurotoxicity there are alterations in the expression of genes and gene-regulatory molecules. The hippocampus is particularly sensitive to the effects of stress and its posterior volumes can deliver clinically valuable information about the outcomes of antidepressant treatment. In the present work, we analyzed individuals with MDD (N = 201) and healthy controls (HC = 104), as part of the CAN-BIND-1 study. We used magnetic resonance imaging (MRI) to measure hippocampal volumes, evaluated gene expression with RNA sequencing, and assessed DNA methylation with the (Infinium MethylationEpic Beadchip), in order to investigate the association between hippocampal volume and both RNA expression and DNA methylation. We identified 60 RNAs which were differentially expressed between groups. Of these, 21 displayed differential methylation, and seven displayed a correlation between methylation and expression. We found a negative association between expression of Brain Abundant Membrane Attached Signal Protein 1 antisense 1 RNA (BASP1-AS1) and right hippocampal tail volume in the MDD group (β = −0.218, p = 0.021). There was a moderating effect of the duration of the current episode on the association between the expression of BASP1-AS1 and right hippocampal tail volume in the MDD group (β = −0.48, 95% C.I. [−0.80, −0.16]. t = −2.95 p = 0.004). In conclusion, we found that overexpression of BASP1-AS1 was correlated with DNA methylation, and was negatively associated with right tail hippocampal volume in MDD.
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- 2021
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12. Teaching emergency situations during a psychiatry residency programme using a blended learning approach: a pilot study
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Juliette Salles, Philippe Birmes, Laurent Schmitt, Bruno Bastiani, Maria Soto, Stéphanie Lafont-Rapnouil, Anjali Mathur, Emmanuelle Bougon, Christophe Arbus, and Antoine Yrondi
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Special aspects of education ,LC8-6691 ,Medicine - Abstract
Abstract Background Emergency psychiatry is an essential component in the training of psychiatry residents who are required to make patient-centred orientation decisions. This training calls for specific knowledge as well as skills and attitudes requiring experience. Kolb introduced a theory on experiential learning which suggested that effective learners should have four types of abilities: concrete experience, reflective observation, abstract conceptualisation and active experimentation. We aimed to evaluate a resident training programme that we designed for use in an emergency psychiatry setting based on the experimental learning theory. Methods We designed a four-step training programme for all first-year psychiatry residents: (i) theoretical teaching of psychiatric emergency knowledge, (ii) concrete experience of ability teaching involving an initial simulation session based on three scenarios corresponding to clinical situations frequently encountered in emergency psychiatry (suicidal crisis, hypomania and depressive episodes), (iii) reflective observation and abstract conceptualisation teaching based on videos and clinical interview commentary by a senior psychiatrist for the same three scenarios, (iv) active experimentation teaching during a second simulation session based on the same three frequently encountered clinical situations but with different scenarios. Training-related knowledge acquisition was assessed after the second simulation session based on a multiple-choice quiz (MCQ), short-answer questions and a script concordance test (SCT). The satisfaction questionnaire was assessed after the resident had completed his/her initial session in order to evaluate the relevance of teaching in clinical practice. The descriptive analyses were described using the mean (+/- standard deviation). The comparative analyses were conducted with the Wilcoxon or Student’s t tests depending on data distribution. Results The residents’ mean MCQ and short-answer question scores and SCT were 7.25/10 (SD = 1.2) 8.33/10 (SD = 1.4), 77.5/100 (SD = 15.8), respectively. The satisfaction questionnaire revealed that 67 % of residents found the teaching consistent. Conclusion We designed a blended learning programme that associated, classical theoretical learning to acquire the basic concepts, a learning with simulation training to experiment the clinical situations and a video support to improve learning of interview skills and memory recall. The residents indicate that this training was adequate to prepare them to be on duty. However, despite this encouraging point, this program needs further studies to attest of its efficiency.
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- 2021
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13. Occurrence of Side Effects in Treatment-Resistant Depression: Role of Clinical, Socio-Demographic and Environmental Characteristics
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Anna Levy, Wissam El-Hage, Djamila Bennabi, Etienne Allauze, Alexandra Bouvard, Vincent Camus, Philippe Courtet, Jean-Michel Dorey, Bruno Etain, Guillaume Fond, Jean-Baptiste Genty, Jérôme Holtzmann, Mathilde Horn, Marion Leboyer, Pierre-Michel Llorca, Manon Meyrel, Fanny Molière, Anne-Sophie Nguon, Jean Petrucci, Romain Rey, Raphaelle Richieri, Florian Stephan, Guillaume Vaiva, Michel Walter, Emmanuel Haffen, Bruno Aouizerate, and Antoine Yrondi
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expert centres ,treatment-resistant depression ,antidepressants ,side effects ,clinical severity ,childhood trauma ,Psychiatry ,RC435-571 - Abstract
Introduction: Treatment-resistant depression (TRD) is a disabling psychiatric condition characterized by the failure of two antidepressants (ADs). Since the occurrence of side effects (SEs) appears to be one of the main determinants of early discontinuation of pharmacological treatments contributing to a pseudo-resistance, the purpose of this study was to determine the parameters associated with the occurrence of SEs under ADs in a cohort of patients with TRD.Methods: An observational, cross-sectional, multicentre study was carried out using data from the French network of Expert Centers for TRD. For the 108 patients enrolled in the study, the statistical analyses focused on the overall occurrence and on the profile of the SEs (9 categories, 32 items).Results: SEs were influenced by age and sex and were positively associated with the intensity of anxious, depressive and suicidal symptoms, a history of childhood trauma (sexual abuse, emotional abuse and neglect), and negatively associated with self-esteem, and assessment of overall functioning.Conclusion: Using variables accessible in common practice, these results fall within the dynamic of a more tailored approach to medicine that could allow, through integrated pharmacological management, the continuation of antidepressant treatments, and therefore limit the risk of therapeutic failure.
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- 2021
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14. Changes in Cannabis Consumption During the Global COVID-19 Lockdown: The International COVISTRESS Study
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Juliette Salles, Antoine Yrondi, Fouad Marhar, Nicolas Andant, Raimundo Avilés Dorlhiac, Binh Quach, Jiao Jiao, Samuel Antunes, Ukadike Chris Ugbolue, Julien Guegan, Karine Rouffiac, Bruno Pereira, The COVISTRESS Network, Maélys Clinchamps, Stéphanie Mestres, Cécile Miele, Valentin Navel, Lénise Parreira, Yves Boirie Jean-Baptiste Bouillon-Minois, Martine Duclos Maria Livia Fantini, Jeannot Schmidt, Stéphanie Tubert-Jeannin, Mickael Berthon, Pierre Chausse, Michael Dambrun, Sylvie Droit-Volet, Serge Guimond, Laurie Mondillon, Armelle Nugier, Pascal Huguet, Samuel Dewavrin, Geraldine Naughton, Amanda Benson, Claus Lamm, Karen Gbaglo, Vicky Drapeau, Benjamin Bustos, Gu Yaodong, Haifeng Zhang, Peter Dieckmann, Julien Baker, Yanping Duan, Gemma Gao, Wendy Y J Huang, Ka Lai Kelly Lau, Chun-Qing Zhang, Perluigi Cocco, Rosamaria Lecca, Monica Puligheddu, Michela Figorilli, Morteza Charkhabi, Reza Bagheri, Daniela Pfabigan, David Neto, Pedro Almeida, Maria João Gouveia, Pedro Quinteiro, Constanta Urzeala, Benoit Dubuis, Juliette Lemaignen, Andy Liu, Foued Saadaoui, Keri Kulik, and Kuan-chou Chen
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cannabis (marijuana) ,COVID-19 ,addiction ,lockdown ,tobacco ,Psychiatry ,RC435-571 - Abstract
Introduction: COVID-19 lockdown measures have been sources of both potential stress and possible psychological and addiction complications. A lack of activity and isolation during lockdown are among the factors thought to be behind the growth in the use of psychoactive substances and worsening addictive behaviors. Previous studies on the pandemic have attested to an increase in alcohol consumption during lockdowns. Likewise, data suggest there has also been a rise in the use of cannabis, although it is unclear how this is affected by external factors. Our study used quantitative data collected from an international population to evaluate changes in cannabis consumption during the lockdown period between March and October, 2020. We also compared users and non-users of the drug in relation to: (1) socio-demographic differences, (2) emotional experiences, and (3) the information available and the degree of approval of lockdown measures.Methods: An online self-report questionnaire concerning the lockdown was widely disseminated around the globe. Data was collected on sociodemographics and how the rules imposed had influenced the use of cannabis and concerns about health, the economic impact of the measures and the approach taken by government(s).Results: One hundred eighty two respondents consumed cannabis before the lockdown vs. 199 thereafter. The mean cannabis consumption fell from 13 joints per week pre-lockdown to 9.75 after it (p < 0.001). Forty-nine respondents stopped using cannabis at all and 66 admitted to starting to do so. The cannabis users were: less satisfied with government measures; less worried about their health; more concerned about the impact of COVID-19 on the economy and their career; and more frightened of becoming infected in public areas. The risk factors for cannabis use were: age (OR = 0.96); concern for physical health (OR = 0.98); tobacco (OR = 1.1) and alcohol consumption during lockdown (OR = 1.1); the pre-lockdown anger level (OR = 1.01); and feelings of boredom during the restrictions (OR = 1.1).Conclusion: In a specific sub-population, the COVID-19 lockdown brought about either an end to the consumption of cannabis or new use of the drug. The main risk factors for cannabis use were: a lower age, co-addictions and high levels of emotions.
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- 2021
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15. Case Report: Use of Subcutaneous Midazolam During an Episode of Catatonia
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Valentin Raymond, Etienne Véry, Adeline Jullien, Fréderic Eyvrard, Loic Anguill, and Antoine Yrondi
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catatonia ,benzodiazepine ,subcutaenous administration ,negativism ,withdrawal ,Psychiatry ,RC435-571 - Abstract
Midazolam is a benzodiazepine (BZD) mainly used in anesthetic induction due to its pharmacokinetic features. Its place in the therapeutic management of catatonia remains to be determined. Here we present the case of a 65-year-old man who presented with a first episode of catatonia with opposition to any form of oral treatment, where a single dose of 1 mg of subcutaneous (SC) Midazolam permitted clinical improvement allowing oral treatment to be given. The patient's history notably included a renal transplant linked to Polycystic Kidney Disease (PKD) and no history of psychiatric illness nor of any use of psychotropic drugs. As the patient refused to drink or eat and ceased answering basic questions, a psychiatric assessment was required. A diagnosis of Catatonic disorder due to a general medical condition [DSM 5–293.89/ ICD10 [F06.1]] was made. A Bush-Francis Catatonia Rating Scale (BFCRS) analysis returned a score of 15 out of 62, with stupor, mutism, negativism, staring, withdrawal, rigidity, and stereotypy. As the negativism prevented the patient from taking any form of oral treatment, after a brief discussion with the unit's physician, it was decided to administer 1 mg of SC Midazolam. One hour later, the patient was more responsive and compliant, and agreed to drink, eat, and take medication. Thus, the catatonic signs of mutism, negativism, staring, and withdrawal were resolved, but waxy flexibility and catalepsy appeared, leading to a new BFCRS score of 10 out of 62. Oral treatment with 2.5 mg Lorazepam, 4 times a day, was then initiated. Midazolam could be a safer choice compared with the other options available, such as other SC BZD, considering the complex safety profile of this patient with renal insufficiency. This situation represents the first report of using SC Midazolam as an injectable treatment for catatonia. More studies are needed to assess the clinical pertinence of SC Midazolam in the treatment of catatonia.
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- 2021
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16. Relationship between childhood physical abuse and clinical severity of treatment-resistant depression in a geriatric population.
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Antoine Yrondi, Christophe Arbus, Djamila Bennabi, Thierry D'Amato, Frank Bellivier, Thierry Bougerol, Vincent Camus, Philippe Courtet, Olivier Doumy, Jean-Baptiste Genty, Jérôme Holtzmann, Mathilde Horn, Christophe Lancon, Marion Leboyer, Pierre-Michel Llorca, Julia Maruani, Rémi Moirand, Fanny Molière, Jean Petrucci, Raphaelle Richieri, Ludovic Samalin, Florian Stephan, Guillaume Vaiva, Michel Walter, FondaMental Advanced Centres of Expertise in Resistant Depression (FACE-DR) Collaborators, Emmanuel Haffen, Bruno Aouizerate, and Wissam El-Hage
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Medicine ,Science - Abstract
IntroductionWe assessed the correlation between childhood maltreatment (CM) and severity of depression in an elderly unipolar Treatment-Resistant Depression (TRD) sample.MethodsPatients were enrolled from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centres.ResultsOur sample included 96 patients (33% of the overall cohort) aged 60 years or above, with a mean age of 67.2 (SD = 5.7). The majority of the patients were female (62.5%). The Montgomery and Asberg Depression Rating Scale (MADRS) and Quick Inventory Depression Scale-Self Report (QIDS-SR) mean scores were high, 28.2 (SD = 7.49) [MADRS score range: 0-60; moderate severity≥20, high severity≥35] and 16.5 (SD = 4.94) [IDS-SR score range: 0-27; moderate severity≥11, high severity≥16], respectively. Mean self-esteem scores were 22.47 (SD = 6.26) [range 0-30]. In an age- and sex-adjusted model, we found a positive correlation between childhood trauma (CTQ scores) and depressive symptom severity [MADRS (β = 0.274; p = 0.07) and QIDS-SR (β = 0.302; p = 0.005) scores]. We detected a statistically significant correlation between physical abuse and depressive symptom severity [MADRS (β = 0.304; p = 0.03) and QIDS-SR (β = 0.362; p = 0.005) scores]. We did not observe any significant correlation between other types of trauma and depressive symptom severity. We showed that self-esteem (Rosenberg scale) mediated the effect of physical abuse (PA) on the intensity of depressive symptoms [MADRS: b = 0.318, 95% BCa C.I. [0.07, 0.62]; QIDS-SR: b = 0.177, 95% BCa C.I. [0.04, 0.37]]. Preacher & Kelly's Kappa Squared values of 19.1% (k2 = 0.191) and 16% (k2 = 0.16), respectively for the two scales, indicate a moderate effect.ConclusionTo our knowledge, this is the first study conducted in a geriatric TRD population documenting an association between childhood trauma (mainly relating to PA) and the intensity of depressive symptoms.
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- 2021
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17. Post-traumatic Stress Disorder With Flashbacks of an Old Childhood Memory Triggered by Right Temporal Lobe Epilepsy Surgery in Adulthood
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Antoine Yrondi, Luc Valton, Viviane Bouilleret, Nozar Aghakhani, Jonathan Curot, and Philippe Jean Birmes
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PTSD (post traumatic stress disorder) ,epilepsy ,surgery ,hospital ,childhood trauma ,CTQ ,Psychiatry ,RC435-571 - Abstract
BackgroundA plethora of data show that the hippocampus and the amygdala are involved in post-traumatic stress disorder (PTSD). Neural dysfunctions leading to PTSD (e.g. how the amygdala and the hippocampus are altered) are only partially known. The unusual case of a patient presenting with refractory epilepsy and developing PTSD immediately after surgery is described. Such symptoms in epileptic patients may help to explore PTSD mechanisms.Case reportA 41-year-old male suffering from partial refractory temporal lobe epilepsy was operated in May 2017. A right amygdala, hippocampus, and temporal pole selective resection was performed. He experienced intense PTSD symptoms 1 month after surgery. He complained about repetitive intrusive memories of abuse. The PTSD checklist score was equal to 62/80. He reported a history of childhood abuse: physical and emotional abuse as well as emotional negligence, assessed with the Childhood Trauma Questionnaire. No other medical history was recorded. He never complained about PTSD or any other psychiatric symptoms before surgery.Conclusionthis case indicates that PTSD may occur after temporal lobe epilepsy surgery and may specifically stem, as in this context, from the excision of part of the medial temporal lobe structures. Although rarely reported, PTSD may be undiagnosed when not selectively detected via multi-disciplinary neurological and psychiatric management, in the preoperative period and the immediate and delayed postoperative period.
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- 2020
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18. Posttraumatic Stress Disorder Symptoms in Lymphoma Patients: A Prospective Study
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Claire Camille, Chloé Dimeglio, Antoine Yrondi, Gisèle Compaci, Emmanuelle Delmas, Mélanie Gauché, Guy Laurent, and Philippe Birmes
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cancer ,lymphoma ,peritraumatic distress ,peritraumatic dissociation ,posttraumatic stress disorder ,stressor ,Psychiatry ,RC435-571 - Abstract
The cancer experience may be marked by repeat stressors and/or traumas. The aim of our study was to assess traumatic events in a group of patients diagnosed with lymphoma and to determine which of these contribute to the development of Post-Traumatic Stress Disorder/PTSD. Two weeks after receiving a diagnosis of lymphoma, patients were referred for an assessment of peritraumatic distress (using the Peritraumatic Distress Inventory/PDI) and peritraumatic dissociation (using the Peritraumatic Dissociative Experiences Questionnaire/PDEQ). Three months after the diagnosis, we recorded the following parameters: the patients' worst experiences, the presence of PTSD symptoms, using the PTSD CheckList/PCL, as it related to the diagnosis, and symptoms of anxiety using the Hospital Anxiety and Depression/HAD scale and of depression using the Beck Depression Inventory/BDI-II. The study recruited 129 patients, with a mean age of 46 years (SD = 17.3); 70 (54%) men, 87 (67.5%) with Non-Hodgkin's lymphoma, and 42 with Hodgkin's lymphoma. Two weeks after the diagnosis, 49% of patients reported peritraumatic distress, and 20% peritraumatic dissociation, during or immediately after being informed of the lymphoma diagnosis. Three months after the diagnosis, the severity of PTSD symptoms was evaluated. At this stage none of the patients suffered PTSD, but 29 (23%) individuals exhibited partial PTSD: 13.4% correlated it to receiving the lymphoma diagnosis, 8% to telling family members, and 1.6% to adverse effects. Peritraumatic distress and dissociation as a result of receiving a lymphoma diagnosis, as well as anxiety and a mucositis within the first 3 months post-diagnosis, were factors that were significantly associated with PTSD symptoms, accounting for 35.8% in PTSD symptom load. Our study reveals that clinicians should assess the impact of a number of stressors, which are risk factors for PTSD symptoms, starting from the time point of the initial lymphoma diagnosis.
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- 2020
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19. The Prevalence of Hepatitis E in a Patient Cohort Presenting With Addictive Injection Behavior
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Antoine Yrondi, Juliette Salles, Jean Marie Péron, Marie Sporer, Simon Taib, Adeline Gallini, Chloé Noilhan, Chloé Dimeglio, Flora Entajan, Marie Crequy, Jacques Izopet, and Laurent Schmitt
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addiction ,hepatitis E ,injection ,intravenous ,seroprevalence ,Psychiatry ,RC435-571 - Abstract
Introduction: Hepatitis E is the most common cause of acute viral hepatitis worldwide. Seroprevalence is approximately 15% in developed countries, and 22% in France. hepatitis E virus (HEV) can be transmitted via transfusions and therefore possibly intravenous (IV) drug use. Hepatitis E serology is routinely tested in patients who seek medical advice for addictive injection behavior at the addiction treatment, support and prevention unit of Toulouse University Hospital. We assume that hepatitis E is more prevalent in patients presenting with addictive injection behavior than in the general French population.Methods: Hepatitis E serological assays [immunoglobulin M (IgM) and IgG] were carried out for all patients presenting with addictive injection behavior during an initial evaluation. The controls were taken from a cohort of 3,353 blood donors living in southern France and who donated blood during the first 2 weeks of October 2011.Results: We included 52 patients presenting with addictive injection behavior and 103 healthy controls matched for age, sex, and area of residence. We found no difference between patients and controls for the prevalence of hepatitis E: patients vs. healthy controls: positive IgGs: 42.31%, 95% confidence interval (CI) (28.73–56.80%) vs. 43.43%, 95% CI (33.50–53.77%) (p = 0.89) and positive IgMs: 3.85%, 95% CI (0.47–13.22%) vs. 4.85%, 95% CI (0.16–10.97%) (p = 0.57).Conclusion: There was no difference in HEV seroprevalence between IV drug users and the general population, suggesting that the IV route of HEV infection is not significant in this population.
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- 2019
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20. Exploring venlafaxine pharmacokinetic variability with a phenotyping approach, a multicentric french-swiss study (MARVEL study)
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Célia Lloret-Linares, Youssef Daali, Sylvie Chevret, Isabelle Nieto, Fanny Molière, Philippe Courtet, Florence Galtier, Raphaëlle-Marie Richieri, Sophie Morange, Pierre-Michel Llorca, Wissam El-Hage, Thomas Desmidt, Frédéric Haesebaert, Philippe Vignaud, Jerôme Holtzmann, Jean-Luc Cracowski, Marion Leboyer, Antoine Yrondi, Fabienne Calvas, Liova Yon, Philippe Le Corvoisier, Olivier Doumy, Kyle Heron, Damien Montange, Siamak Davani, Julien Déglon, Marie Besson, Jules Desmeules, Emmanuel Haffen, and Frank Bellivier
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Therapeutics. Pharmacology ,RM1-950 ,Toxicology. Poisons ,RA1190-1270 - Abstract
Abstract Background It is well known that the standard doses of a given drug may not have equivalent effects in all patients. To date, the management of depression remains mainly empirical and often poorly evaluated. The development of a personalized medicine in psychiatry may reduce treatment failure, intolerance or resistance, and hence the burden and costs of mood depressive disorders. The Geneva Cocktail Phenotypic approach presents several advantages including the “in vivo” measure of different cytochromes and transporter P-gp activities, their simultaneous determination in a single test, avoiding the influence of variability over time on phenotyping results, the administration of low dose substrates, a limited sampling strategy with an analytical method developed on DBS analysis. The goal of this project is to explore the relationship between the activity of drug-metabolizing enzymes (DME), assessed by a phenotypic approach, and the concentrations of Venlafaxine (VLX) + O-demethyl-venlafaxine (ODV), the efficacy and tolerance of VLX. Methods/design This study is a multicentre prospective non-randomized open trial. Eligible patients present a major depressive episode, MADRS over or equal to 20, treatment with VLX regardless of the dose during at least 4 weeks. The Phenotype Visit includes VLX and ODV concentration measurement. Following the oral absorption of low doses of omeprazole, midazolam, dextromethorphan, and fexofenadine, drug metabolizing enzymes activity is assessed by specific metabolite/probe concentration ratios from a sample taken 2 h after cocktail administration for CYP2C19, CYP3A4, CYP2D6; and by the determination of the limited area under the curve from the capillary blood samples taken 2–3 and 6 h after cocktail administration for CYP2C19 and P-gp. Two follow-up visits will take place between 25 and 40 days and 50–70 days after inclusion. They include assessment of efficacy, tolerance and observance. Eleven french centres are involved in recruitment, expected to be completed within approximately 2 years with 205 patients. Metabolic ratios are determined in Geneva, Switzerland. Discussion By showing an association between drug metabolism and VLX concentrations, efficacy and tolerance, there is a hope that testing drug metabolism pathways with a phenotypical approach would help physicians in selecting and dosing antidepressants. The MARVEL study will provide an important contribution to increasing the knowledge of VLX variability and in optimizing the use of methods of personalized therapy in psychiatric settings. Trial registration ClinicalTrials.gov NCT02590185 (10/27/2015). This study is currently recruiting participants.
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- 2017
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21. Clinical Pharmacy in Psychiatry: Towards Promoting Clinical Expertise in Psychopharmacology
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Hervé Javelot, Clara Gitahy Falcao Faria, Frederik Vandenberghe, Sophie Dizet, Bastien Langrée, Mathilde Le Maout, Céline Straczek, Adeline Egron, Alexis Erb, Guillaume Sujol, Antoine Yrondi, Sébastien Weibel, Philippe D. Vincent, Guillaume Meyer, and Coraline Hingray
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clinical pharmacy ,mental health ,psychiatry ,expertise ,psychopharmacology ,Pharmacy and materia medica ,RS1-441 - Abstract
Although clinical pharmacy is a discipline that emerged in the 1960s, the question of precisely how pharmacists can play a role in therapeutic optimization remains unanswered. In the field of mental health, psychiatric pharmacists are increasingly involved in medication reconciliation and therapeutic patient education (or psychoeducation) to improve medication management and enhance medication adherence, respectively. However, psychiatric pharmacists must now assume a growing role in team-based models of care and engage in shared expertise in psychopharmacology in order to truly invest in therapeutic optimization of psychotropics. The increased skills in psychopharmacology and expertise in psychotherapeutic drug monitoring can contribute to future strengthening of the partnership between psychiatrists and psychiatric pharmacists. We propose a narrative review of the literature in order to show the relevance of a clinical pharmacist specializing in psychiatry. With this in mind, herein we will address: (i) briefly, the areas considered the basis of the deployment of clinical pharmacy in mental health, with medication reconciliation, therapeutic education of the patient, as well as the growing involvement of clinical pharmacists in the multidisciplinary reflection on pharmacotherapeutic decisions; (ii) in more depth, we present data concerning the use of therapeutic drug monitoring and shared expertise in psychopharmacology between psychiatric pharmacists and psychiatrists. These last two points are currently in full development in France through the deployment of Resource and Expertise Centers in PsychoPharmacology (CREPP in French).
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- 2021
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22. Significant Decrease in Hippocampus and Amygdala Mean Diffusivity in Treatment-Resistant Depression Patients Who Respond to Electroconvulsive Therapy
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Antoine Yrondi, Federico Nemmi, Sophie Billoux, Aurélie Giron, Marie Sporer, Simon Taib, Juliette Salles, Damien Pierre, Claire Thalamas, Laurent Schmitt, Patrice Péran, and Christophe Arbus
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depressive disorder ,electroconvulsive therapy ,MRI ,DTI ,mean diffusivity ,Psychiatry ,RC435-571 - Abstract
Introduction: The hippocampus plays a key role in depressive disorder, and the amygdala is involved in depressive disorder through the key role that it plays in emotional regulation. Electroconvulsive therapy (ECT) may alter the microstructure of these two regions. Since mean diffusivity (MD), is known to be an indirect marker of microstructural integrity and can be derived from diffusion tensor imaging (DTI) scans, we aim to test the hypothesis that treatment-resistant depression (TRD) patients undergoing bilateral (BL) ECT exhibit a decrease of MD in their hippocampus and amygdala.Methods: Patients, between 50 and 70 years of age, diagnosed with TRD were recruited from the University Hospital of Toulouse and assessed clinically (Hamilton Depression Rating Scale, HAM-D) and by DTI scans at three time points: baseline, V2 (during treatment), and V3 within 1 week of completing ECT.Results: We included 15 patients, who were all responders. The left and right hippocampi and the left amygdala showed a significant decrease in MD at V3, compared to baseline [respectively: β = −2.78, t = −1.97, p = 0.04; β = −2.56, t = −2, p = 0.04; β = −2.5, t = −2.3, p = 0.04, false discovery rate (FDR) corrected]. MD did not decrease in the right amygdala. Only the left amygdala was significantly associated with a reduction in HAM-D (ρ = 0.55, p = 0.049, FDR corrected).Conclusion: MD is an indirect microstructural integrity marker, which decreases in the hippocampus and the left amygdala, during BL ECT in TRD populations. This could be interpreted as a normalization of microstructural integrity in these structures.
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- 2019
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23. Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures
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Abel Guillen, Jonathan Curot, Philippe Jean Birmes, Marie Denuelle, Valérie Garès, Simon Taib, Luc Valton, and Antoine Yrondi
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PNES ,epilepsy ,suicidal behavior ,suicide ,trauma ,PTSD ,Psychiatry ,RC435-571 - Abstract
Introduction: Patients with psychogenic nonepileptic seizures (PNESs) have often been exposed to traumatic events, which is a risk factor for suicidal behavior. This would suggest that the severity of suicidal ideation is greater in PNES than in patients suffering only from epileptic seizures (ESs). However, these psychiatric symptoms may be underestimated in the ES population. The specific features or similarities between the psychiatric clinical profiles of these two groups should be elaborated to improve therapeutic management. Our study is the first to compare suicidal ideation, suicide risk, posttraumatic stress disorder (PTSD), and depression disorder simultaneously in both groups, in a tertiary care epilepsy center.Material and methods: We prospectively enrolled patients hospitalized for video-electroencephalography (EEG) monitoring to assess repeated seizures before an ES or a PNES diagnosis was made. During the psychiatric consultation that accompanied the video EEG, we rated the severity of suicidal ideation and depressive symptoms, suicidal risk, traumatic exposure history, and PTSD symptoms.Results: Eighteen subjects were enrolled and diagnosed with PNES, and 42, with ES. The PNES group reported more exposures to traumatic events and more intense PTSD symptoms (median: 17 vs. 27; p = 0.001). The severity of suicidal ideation did not differ significantly between the two groups.Conclusion: It is the severity of PTSD symptoms in PNES patients that differentiates them from ES patients, although exposure to traumatic events is also frequent in ES patients. We demonstrated that suicidal ideation and suicide risk are equally high in the ES and PNES groups. Therefore, both groups require extreme vigilance in terms of suicidal risk.
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- 2019
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24. Treatment-Resistant Depression in a Real-World Setting: First Interim Analysis of Characteristics, Healthcare Resource Use, and Utility Values of the FondaMental Cohort
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Antoine Yrondi, Djamila Bennabi, Emmanuel Haffen, Delphine Quelard, Ludovic Samalin, Julia Maruani, Etienne Allauze, Damien Pierre, Thierry Bougerol, Vincent Camus, Thierry D’Amato, Olivier Doumy, Jérôme Holtzmann, Christophe Lançon, Fanny Moliere, Rémi Moirand, Isabel Nieto, Raphaëlle Marie Richieri, Mathilde Horn, Laurent Schmitt, Florian Stephan, Jean-Baptiste Genty, Guillaume Vaiva, Michel Walter, Philippe Courtet, Marion Leboyer, Pierre-Michel Llorca, Sophie Marguet, Nathalie Dennis, Dominique Schaetz, Wissam El-Hage, and Bruno Aouizerate
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treatment-resistant depression ,real-world ,utility ,healthcare resource use ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Background: Major depressive disorder (MDD) is among the most common psychiatric disorders. One-third of patients are usually unresponsive to several lines of treatment. This study aimed to describe the FondaMental French cohort of patients with treatment-resistant depression (TRD) and to estimate utility and healthcare resource use outcomes. Methods: Patients with TRD were evaluated prospectively over four years (baseline, 6, 12, 18, 24, 36 and 48 months) in a real-world clinical setting. Interim analyses focused on the first two consecutive years. Four MDD-related states (major depressive episode (MDE), response, remission, recovery) were defined based on the MADRS (Montgomery–Åsberg depression rating scale) and other clinical events. Health status was assessed with the EuroQol 5 Dimensions 5 Level (EQ-5D-5L) questionnaire. Utility values were estimated as preference measures that the patients assigned to their overall health status. Results: This study was based on 252 patients with TRD. The mean utility value by health state was 0.41, 0.63, 0.80, and 0.90, for MDE, response, remission, and recovery, respectively. At baseline, 59% of patients had an MADRS score of at least 28. Their baseline average utility value was lower compared to the other patients (0.43 versus 0.58, p < 0.001). This significant difference persisted at the following visits. The rate of patients in MDEs having at least one hospitalisation for depression or other reasons than depression was generally higher than that in the other health states. Conclusion: This study documented patterns in healthcare resource consumption, quality of life, and other characteristics in patients with TRD, both globally and by health state and depression severity.
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- 2020
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25. Assessment of Translocator Protein Density, as Marker of Neuroinflammation, in Major Depressive Disorder: A Pilot, Multicenter, Comparative, Controlled, Brain PET Study (INFLADEP Study)
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Antoine Yrondi, Bruno Aouizerate, Wissam El-Hage, Fanny Moliere, Claire Thalamas, Nicolas Delcourt, Marie Sporer, Simon Taib, Laurent Schmitt, Nicolas Arlicot, Deborah Meligne, Agnes Sommet, Anne S. Salabert, Sebastien Guillaume, Philippe Courtet, Florence Galtier, Denis Mariano-Goulart, Nicolas Menjot De Champfleur, Emmanuelle Le Bars, Thomas Desmidt, Mathieu Lemaire, Vincent Camus, Maria J. Santiago-Ribeiro, Jean P. Cottier, Philippe Fernandez, Marie Meyer, Vincent Dousset, Olivier Doumy, Didier Delhaye, Lucile Capuron, Marion Leboyer, Emmanuel Haffen, Patrice Péran, Pierre Payoux, and Christophe Arbus
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depressive disorder ,depression ,neuroinflammation ,inflammation ,TSPO ,DPA-714 ,Psychiatry ,RC435-571 - Abstract
Background: Major depressive disorder (MDD) is a serious public health problem with high lifetime prevalence (4.4–20%) in the general population. The monoamine hypothesis is the most widespread etiological theory of MDD. Also, recent scientific data has emphasized the importance of immuno-inflammatory pathways in the pathophysiology of MDD. The lack of data on the magnitude of brain neuroinflammation in MDD is the main limitation of this inflammatory hypothesis. Our team has previously demonstrated the relevance of [18F] DPA-714 as a neuroinflammation biomarker in humans. We formulated the following hypotheses for the current study: (i) Neuroinflammation in MDD can be measured by [18F] DPA-714; (ii) its levels are associated with clinical severity; (iii) it is accompanied by anatomical and functional alterations within the frontal-subcortical circuits; (iv) it is a marker of treatment resistance.Methods: Depressed patients will be recruited throughout 4 centers (Bordeaux, Montpellier, Tours, and Toulouse) of the French network from 13 expert centers for resistant depression. The patient population will be divided into 3 groups: (i) experimental group—patients with current MDD (n = 20), (ii) remitted depressed group—patients in remission but still being treated (n = 20); and, (iii) control group without any history of MDD (n = 20). The primary objective will be to compare PET data (i.e., distribution pattern of neuroinflammation) between the currently depressed group and the control group. Secondary objectives will be to: (i) compare neuroinflammation across groups (currently depressed group vs. remitted depressed group vs. control group); (ii) correlate neuroinflammation with clinical severity across groups; (iii) correlate neuroinflammation with MRI parameters for structural and functional integrity across groups; (iv) correlate neuroinflammation and peripheral markers of inflammation across groups.Discussion: This study will assess the effects of antidepressants on neuroinflammation as well as its role in the treatment response. It will contribute to clarify the putative relationships between neuroinflammation quantified by brain neuroimaging techniques and peripheral markers of inflammation. Lastly, it is expected to open innovative and promising therapeutic perspectives based on anti-inflammatory strategies for the management of treatment-resistant forms of MDD commonly seen in clinical practice.Clinical trial registration (reference: NCT03314155): https://www.clinicaltrials.gov/ct2/show/NCT03314155?term=neuroinflammation&cond=depression&cntry=FR&rank=1
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- 2018
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26. Significant Need for a French Network of Expert Centers Enabling a Better Characterization and Management of Treatment-Resistant Depression (Fondation FondaMental)
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Antoine Yrondi, Djamila Bennabi, Emmanuel Haffen, Marion Garnier, Frank Bellivier, Thierry Bourgerol, Vincent Camus, Thierry D’Amato, Olivier Doumy, Frédéric Haesebaert, Jérôme Holtzmann, Christophe Lançon, Philippe Vignaud, Fanny Moliere, Isabel Nieto, Raphaëlle Marie Richieri, Philippe Domenech, Corentin Rabu, Luc Mallet, Liova Yon, Laurent Schmitt, Florian Stephan, Guillaume Vaiva, Michel Walter, Pierre-Michel Llorca, Philippe Courtet, Marion Leboyer, Wissam El-Hage, and Bruno Aouizerate
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treatment-resistant depression ,depressive disorder ,assessment ,network ,innovative strategies ,Psychiatry ,RC435-571 - Abstract
BackgroundMajor depression is characterized by (i) a high lifetime prevalence of 16–17% in the general population; (ii) a high frequency of treatment resistance in around 20–30% of cases; (iii) a recurrent or chronic course; (iv) a negative impact on the general functioning and quality of life; and (v) a high level of comorbidity with various psychiatric and non-psychiatric disorders, high occurrence of completed suicide, significant burden along with the personal, societal, and economic costs. In this context, there is an important need for the development of a network of expert centers for treatment-resistant depression (TRD), as performed under the leadership of the Fondation FondaMental.MethodsThe principal mission of this national network is to establish a genuine prevention, screening, and diagnosis policy for TRD to offer a systematic, comprehensive, longitudinal, and multidimensional evaluation of cases. A shared electronic medical file is used referring to a common exhaustive and standardized set of assessment tools exploring psychiatric, non-psychiatric, metabolic, biological, and cognitive dimensions of TRD. This is paralleled by a medico-economic evaluation to examine the global economic burden of the disease and related health-care resource utilization. In addition, an integrated biobank has been built by the collection of serum and DNA samples for the measurement of several biomarkers that could further be associated with the treatment resistance in the recruited depressed patients. A French observational long-term follow-up cohort study is currently in progress enabling the extensive assessment of resistant depressed patients. In those unresponsive cases, each expert center proposes relevant therapeutic options that are classically aligned to the international guidelines referring to recognized scientific societies.DiscussionThis approach is expected to improve the overall clinical assessments and to provide evidence-based information to those clinicians most closely involved in the management of TRD thereby facilitating treatment decisions and choice in everyday clinical practice. This could contribute to significantly improve the poor prognosis, the relapsing course, daily functioning and heavy burden of TRD. Moreover, the newly created French network of expert centers for TRD will be particularly helpful for a better characterization of sociodemographic, clinical, neuropsychological, and biological markers of treatment resistance required for the further development of personalized therapeutic strategies in TRD.
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- 2017
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27. Reporting of harms in clinical trials of esketamine in depression: a systematic review
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Tanguy Taillefer de Laportalière, Adeline Jullien, Antoine Yrondi, Philippe Cestac, and François Montastruc
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Psychiatry and Mental health ,Applied Psychology - Abstract
While previous systematic reviews of trials evaluating conventional antidepressants highlighted inadequacies and inconsistencies in adverse event (AE) reporting, no evaluation is available on esketamine in resistant depression. The objective of this review was to assess quality of reporting AEs in all published clinical trials studying esketamine. It also aimed to compare the proportions of AEs reported in journal articles to those recorded in the ClinicalTrial.gov Registers. Clinical trials evaluating the efficacy and safety of esketamine in depression were searched using Medline and ClinicalTrials.gov. The quality of reporting harms was assessed using a 21-item checklist from the CONSORT Extension of Harms (1 point by item). The total quality score was graded into four categories: high (17–21), moderate (12–16), low (7–11) and very low (0–6). Ten clinical trials were included in the analysis. Nine trials were classified as ‘low quality’ with regard to safety, one trial was classified as ‘moderate quality’. Compared to AEs recorded in ClinicalTrials.gov, we found that 41.5% of serious AEs and 39% of non-serious AEs were not reported in the published articles. Among them, the majority were psychiatric events but also cardiovascular events and 94% concerned patients from esketamine groups. Quality of AEs reporting in published clinical trials of esketamine was poor and harms were reported less frequently in journal publications than in ClinicalTrial.gov Registers. The study suggests that an assessment of the benefits/risks balance of esketamine based on the results reported in trial publications is flawed due to the poor accuracy and completeness of harm data.
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- 2023
28. Psychopharmacological properties and therapeutic profile of the antidepressant venlafaxine
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Basile Coutens, Antoine Yrondi, Claire Rampon, and Bruno P. Guiard
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Pharmacology ,Depressive Disorder, Major ,Serotonin ,Venlafaxine Hydrochloride ,Animals ,Humans ,Cyclohexanols ,Antidepressive Agents ,Selective Serotonin Reuptake Inhibitors - Abstract
Major depression (MD) is one of the most common psychiatric disorders worldwide. Currently, the first-line treatment for MD targets the serotonin system but these drugs, notably the selective serotonin reuptake inhibitors, usually need 4 to 6 weeks before the benefit is felt and a significant proportion of patients shows an unsatisfactory response. Numerous treatments have been developed to circumvent these issues as venlafaxine, a mixed serotonin-norepinephrine reuptake inhibitor that binds and blocks both the SERT and NET transporters. Despite this pharmacological profile, it is difficult to have a valuable insight into its ability to produce more robust efficacy than single-acting agents. In this review, we provide an in-depth characterization of the pharmacological properties of venlafaxine from in vitro data to preclinical and clinical efficacy in depressed patients and animal models of depression to propose an indirect comparison with the most common antidepressants. Preclinical studies show that the antidepressant effect of venlafaxine is often associated with an enhancement of serotonergic neurotransmission at low doses. High doses of venlafaxine, which elicit a concomitant increase in 5-HT and NE tone, is associated with changes in different forms of plasticity in discrete brain areas. In particular, the hippocampus appears to play a crucial role in venlafaxine-mediated antidepressant effects notably by regulating processes such as adult hippocampal neurogenesis or the excitatory/inhibitory balance. Overall, depending on the dose used, venlafaxine shows a high efficacy on depressive-like symptoms in relevant animal models but to the same extent as common antidepressants. However, these data are counterbalanced by a lower tolerance. In conclusion, venlafaxine appears to be one of the most effective treatments for treatment of major depression. Still, direct comparative studies are warranted to provide definitive conclusions about its superiority.
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- 2022
29. Clinical features and outcomes of COVID-19 patients hospitalized for psychiatric disorders: a French multi-centered prospective observational study
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Claire Jansen, Pierre Thomas, Djamila Bennabi, Dominique Drapier, Thomas Schwitzer, Delphine Capdevielle, Noe Teboul, Pascal Delamillieure, Emmanuelle Corruble, Christophe Schmitt, Daniela Dobre, Olivier C. Martin, Pierre Abdel Ahad, Antoine Pelissolo, Clément Vansteene, Benjamin Rolland, Marion Leboyer, Raymund Schwan, Fabienne Ligier, Wanda Yekhlef, Antoine Yrondi, Raphaël Gaillard, William Lecoeur, Radoine Haoui, Mathilde Roser, Vincent Laprevote, Catherine Massoubre, Sonia Dollfus, Fabien Joubert, Philip Gorwood, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Centre Psychothérapique de Nancy [Laxou] (CPN), Faculté de Médecine [Nancy], Université de Lorraine (UL), Adaptation, mesure et évaluation en santé. Approches interdisciplinaires (APEMAC), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL), GHU Paris Psychiatrie et Neurosciences, Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Département de psychiatrie adulte, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital La Colombière, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Imagerie et Stratégies Thérapeutiques de la Schizophrénie (ISTS), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier le Vinatier [Bron], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique des maladies mentales et de l'encéphale (CMME - Service de psychiatrie), Hôpital Sainte-Anne-Université Paris Cité (UPCité), Service Psychiatrie et psychologie médicale [CHU Toulouse], Pôle Psychiatrie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Toulouse Neuro Imaging Center (ToNIC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Centre Hospitalier Gérard Marchant, Lille Neurosciences & Cognition - U 1172 (LilNCog), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre de Psychiatrie et Neurosciences (U894), Centre Psychothérapique de Nancy (CPN), Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, HAL UR1, Admin, Centre de recherche en neurosciences de Lyon (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service Universitaire d’Addictologie de Lyon [CH Le Vinatier, Bron] (Pôle MOPHA - SUAL), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Etablissement Public de Santé Alsace Nord, Partenaires INRAE, Hôpital Sainte-Anne-Université de Paris (UP), Etablissement public de santé de Ville-Evrard (EPS), Service Psychiatrie et psychologie médicale [CHU Purpan], CHU Toulouse [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Lille Neurosciences & Cognition - U 1172 (LilNCog (ex-JPARC)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)
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medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Population ,[SDV.NEU.PC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior ,Confusional state ,Logistic regression ,Lower risk ,03 medical and health sciences ,0302 clinical medicine ,Organic mental disorders ,Intensive care ,medicine ,Psychiatry ,Prospective cohort study ,education ,Applied Psychology ,Univariate analysis ,education.field_of_study ,[SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior ,business.industry ,Medical record ,COVID-19 ,Odds ratio ,medicine.disease ,Mental health ,Confidence interval ,030227 psychiatry ,3. Good health ,[SDV] Life Sciences [q-bio] ,Psychiatry and Mental health ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Original Article ,Observational study ,business ,030217 neurology & neurosurgery - Abstract
Background: At the beginning of COVID-19 pandemic, specific COVID/PSY wards were created in France to provide care for inpatients with COVID-19 and psychiatric disorders. In this multi-center prospective study, we set out to assess the clinical features and risk factors of somatic aggravation in patients hospitalized in COVID/PSY wards. Methods: Data were collected between 28 February and 30 May, 2020. We collected demographic data, psychiatric diagnoses, medical data and COVID-19-related clinical data. Somatic aggravation was estimated by the number of patients transferred to intensive care or medicine units, the number of deaths and the number of patients presenting a confusional state. A multivariate logistic model was used to assess the risk factors of confusional state and transfer to intensive care or medicine units. The risk of death was analysed by the univariate predictors of this outcome. Outcomes: 350 patients were included in the study. The number of inclusions peaked one week after that of the general population and declined more slowly. Overall, 24 (7%) were transferred to medicine units, 7 (2%) died and 51 (15%) patients presented a confusional state. Severe respiratory symptoms predicted the transfer to a medicine unit (OR 17.1; CI 4.9-59.3). Older age, an organic mental disorder, a confusional state, and severe respiratory symptoms predicted mortality in univariate analysis. Age > 55 (OR 4.9; CI 2.1-11.4), an affective disorder (OR 4.1; CI 1.6-10.9), and severe respiratory symptoms (OR 4.6; CI 2.2-9.7) predicted a higher risk, while smoking (OR 0.3; CI 0.1-0.9) predicted a lower risk of a confusional state. Interpretation: COVID-19 patients with severe psychiatric disorders have multiple somatic comorbidities and a high risk of confusion. COVID/PSY wards may play a role in reducing the mortality of COVID-19 in patients with psychiatric disorders. Funding Statement: There was no funding source for this study. Declaration of Interests: There are no conflicts of interest to be declared. Ethics Approval Statement: This observational study was conducted according to the principles of the Declaration of Helsinki. In accordance with French bioethics laws, it was classified as a non- interventional study, since it concerned anonymized clinical data that are routinely compiled in medical records. Compliance with French regulations on personal data collection was supervised by the personal data referent of the Centre Psychotherapique de Nancy. Patients, and their legal guardian when appropriate, were informed in writing, in agreement with national regulations for observational studies.
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- 2023
30. Comparative effects of 15 antidepressants on the risk of withdrawal syndrome: A real-world study using the WHO pharmacovigilance database
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Régis Bouquié, François Montastruc, Antoine Yrondi, Philippe Garcia, Alexis Revet, Jacques Hamard, and Jean-Baptiste Quilichini
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Adult ,Adolescent ,Venlafaxine ,World Health Organization ,computer.software_genre ,Lower risk ,Pharmacovigilance ,Young Adult ,chemistry.chemical_compound ,medicine ,Humans ,Duloxetine ,Agomelatine ,Database ,business.industry ,Antidepressive Agents ,Discontinuation ,Desvenlafaxine ,Psychiatry and Mental health ,Clinical Psychology ,chemistry ,Antidepressant ,Female ,Vortioxetine ,business ,computer ,Selective Serotonin Reuptake Inhibitors ,medicine.drug - Abstract
Background While case reports and clinical trials reported withdrawal syndrome after reduction and/or discontinuation of antidepressant drugs, no large study has been conducted to compare the risk between the different antidepressants. Methods Using data recorded from January 1st, 1988, and December 31st, 2020 in VigiBase®, the World Health Organization's Global Individual Case Safety Reports database, we performed disproportionality analysis to investigate the risk of reporting withdrawal syndrome in patients treated by short half-life antidepressants compared with patients treated by long half-life antidepressants. In addition, we aimed to better inform clinical practice by comparing 15 antidepressants for the risk of reporting withdrawal syndrome. Results Among the 338,498 reports with antidepressants of interest, we found 15,507 cases of withdrawal syndrome. Short half-lives antidepressants were associated with an increased risk of reporting a withdrawal syndrome compared to long half-life antidepressants (ROR 5.38; 95% CI 5.16–5.61). The risk was higher for 18–44 years old (ROR 6.88; 95% CI 6.17–7.62), women (ROR 1.38; 95% CI 1.33–1.43) and patients treated with Paroxetine, Desvenlafaxine, Venlafaxine and Duloxetine. Limitations The limitations of this study stem from the case-reporting process. Conclusions This large observational study in a real-world setting suggests that the use of short half-life antidepressants increases the risk of reporting withdrawal syndrome compared to long half-life antidepressants. Among the most common antidepressants, paroxetine and serotonin-noradrenaline reuptake inhibitors are associated with a greater risk of reporting withdrawal syndrome, while agomelatine and vortioxetine present a lower risk. Additional studies are needed to corroborate our results.
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- 2022
31. Long-term benzodiazepine prescription in treatment-resistant depression: A national FACE-TRD prospective study
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Guillaume Fond, Mélanie Faugere, Laurent Boyer, Pauline Peri, Florian Stephan, Fanny Moliere, Loic Anguill, Djamila Bennabi, Emmanuel Haffen, Alexandra Bouvard, Michel Walter, Ludovic Samalin, Pierre Michel Llorca, Jean Baptiste Genty, Marion Leboyer, Jérôme Holtzmann, Anne Sophie Nguon, Romain Rey, Mathilde Horn, Guillaume Vaiva, Vincent Hennion, Bruno Etain, Wissam El-Hage, Vincent Camus, Philippe Courtet, Bruno Aouizerate, Antoine Yrondi, Christophe Lancon, and Raphaelle Richieri
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Pharmacology ,Biological Psychiatry - Published
- 2023
32. Psychotropics and COVID-19: An analysis of safety and prophylaxis
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Bastien Langrée, Eric Fakra, C. Straczek, C. Gitahy Falcao Faria, Marion Leboyer, S. Dizet, P.-M. Llorca, Raphaël Gaillard, Dominique Drapier, Hervé Javelot, M. Masson, Sébastien Weibel, Luisa Weiner, G Meyer, Philippe Fossati, Emmanuel Haffen, Antoine Yrondi, C. Hingray, Laboratoire de pharmacologie et de toxicologie neurocardiovasculaire (LPTNC), Université de Strasbourg (UNISTRA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Strasbourg, Universidade Federal do Rio de Janeiro (UFRJ), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], CHU Pontchaillou [Rennes]-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-Institut des Neurosciences Cliniques de Rennes (INCR), Centre Hospitalier Guillaume Régnier [Rennes], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Les Hôpitaux Universitaires de Strasbourg (HUS), Centre Hospitalier Chalon-sur-Saône William Morey, GHU Paris Psychiatrie et Neurosciences, Conseil national des universités (CNU), CHU Clermont-Ferrand, Université Clermont Auvergne (UCA), Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Université Bourgogne Franche-Comté [COMUE] (UBFC), Toulouse Neuro Imaging Center (ToNIC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Jonchère, Laurent, Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)
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medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Context (language use) ,03 medical and health sciences ,0302 clinical medicine ,Arts and Humanities (miscellaneous) ,Pandemic ,medicine ,Humans ,Bipolar disorder ,Psychiatry ,Pandemics ,Depression (differential diagnoses) ,Review of the Literature ,Psychotropic Drugs ,Prophylaxis ,SARS-CoV-2 ,business.industry ,Psychotropics ,COVID-19 ,Guideline ,[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences ,medicine.disease ,Mental health ,COVID-19 Drug Treatment ,030227 psychiatry ,3. Good health ,[SDV] Life Sciences [q-bio] ,[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences ,Psychotropes ,Psychiatry and Mental health ,Sécurité clinique ,Schizophrenia ,Prophylaxie ,Safety ,business ,030217 neurology & neurosurgery ,Anxiety disorder - Abstract
International audience; The use of psychotropics during the COVID-19 pandemic has raised two questions, in order of importance: first, what changes should be made to pharmacological treatments prescribed to mental health patients? Secondly, are there any positive side effects of these substances against SARS-CoV-2? Our aim was to analyze usage safety of psychotropics during COVID-19; therefore, herein, we have studied: (i) the risk of symptomatic complications of COVID-19 associated with the use of these drugs, notably central nervous system activity depression, QTc interval enlargement and infectious and thromboembolic complications; (ii) the risk of mistaking the iatrogenic impact of psychotropics with COVID-19 symptoms, causing diagnostic error. Moreover, we provided a summary of the different information available today for these risks, categorized by mental health disorder, for the following: schizophrenia, bipolar disorder, anxiety disorder, ADHD, sleep disorders and suicidal risk. The matter of psychoactive substance use during the pandemic is also analyzed in this paper, and guideline websites and publications for psychotropic treatments in the context of COVID-19 are referenced during the text, so that changes on those guidelines and eventual interaction between psychotropics and COVID-19 treatment medication can be reported and studied. Finally, we also provide a literature review of the latest known antiviral properties of psychotropics against SARS-CoV-2 as complementary information.
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- 2021
33. Association between the expression of lncRNA BASP-AS1 and volume of right hippocampal tail moderated by episode duration in major depressive disorder: a CAN-BIND 1 report
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Gustavo Turecki, Claudio N. Soares, Andrew D. Davis, Stephen R. Arnott, Jacqueline K. Harris, Nikita Nogovitsyn, Sidney H. Kennedy, Laura M. Fiori, Glenda MacQueen, Benicio N. Frey, Roumen Milev, Jane A. Foster, Stefanie Hassel, Antoine Yrondi, Susan Rotzinger, Stephen C. Strother, Daniel J. Müller, Jean-François Théroux, Zahia Aouabed, Raymond W. Lam, and Mojdeh Zamyadi
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medicine.medical_specialty ,Hippocampus ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Hippocampal formation ,Cellular and Molecular Neuroscience ,Internal medicine ,Gene expression ,medicine ,Humans ,Chronic stress ,Biological Psychiatry ,Depressive Disorder, Major ,business.industry ,RNA ,Methylation ,DNA Methylation ,medicine.disease ,Magnetic Resonance Imaging ,Psychiatry and Mental health ,Endocrinology ,DNA methylation ,Major depressive disorder ,RNA, Long Noncoding ,business ,RC321-571 - Abstract
The pathophysiology of major depressive disorder (MDD) encompasses an array of changes at molecular and neurobiological levels. As chronic stress promotes neurotoxicity there are alterations in the expression of genes and gene-regulatory molecules. The hippocampus is particularly sensitive to the effects of stress and its posterior volumes can deliver clinically valuable information about the outcomes of antidepressant treatment. In the present work, we analyzed individuals with MDD (N = 201) and healthy controls (HC = 104), as part of the CAN-BIND-1 study. We used magnetic resonance imaging (MRI) to measure hippocampal volumes, evaluated gene expression with RNA sequencing, and assessed DNA methylation with the (Infinium MethylationEpic Beadchip), in order to investigate the association between hippocampal volume and both RNA expression and DNA methylation. We identified 60 RNAs which were differentially expressed between groups. Of these, 21 displayed differential methylation, and seven displayed a correlation between methylation and expression. We found a negative association between expression of Brain Abundant Membrane Attached Signal Protein 1 antisense 1 RNA (BASP1-AS1) and right hippocampal tail volume in the MDD group (β = −0.218, p = 0.021). There was a moderating effect of the duration of the current episode on the association between the expression of BASP1-AS1 and right hippocampal tail volume in the MDD group (β = −0.48, 95% C.I. [−0.80, −0.16]. t = −2.95 p = 0.004). In conclusion, we found that overexpression of BASP1-AS1 was correlated with DNA methylation, and was negatively associated with right tail hippocampal volume in MDD.
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- 2021
34. Marqueurs biochimiques de la dépression : actualité et perspectives
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Nicolas Delcourt, Sophie Guillotin, and Antoine Yrondi
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Medical Laboratory Technology ,Biochemistry (medical) ,Analytical Chemistry - Abstract
Resume Le trouble depressif est une pathologie transgenerationnelle frequemment diagnostiquee, entrainant un retentissement important pour le patient et son entourage. Cependant, le diagnostic clinique reste complexe du fait de la diversite des formes cliniques et des mecanismes physiopathologiques encore imparfaitement connus. De plus, certaines formes de depression sont resistantes aux traitements conventionnels. Il devient ainsi primordial d’identifier des biomarqueurs diagnostiques, de reponse au traitement et pronostiques pour repondre a ces problematiques. Il n’existe a ce jour aucun biomarqueur valide en clinique, cependant plusieurs marqueurs ont emerge dans la litterature que l’on peut regrouper dans cinq grandes familles biologiques : le profil lipidique, les facteurs d’inflammation et neuroendocriniens, tres etudies en raison de la variation de leurs taux plasmatiques chez les patients depressifs, les facteurs de croissance qui pourraient permettre de predire la reponse au traitement, et certains metabolites qui pourraient etre des biomarqueurs innovants, que cela soit ceux issus du metabolisme des neurotransmetteurs impliques dans la pathologie ou ceux issus de la reponse au stress oxydatif. Malgre la multitude de biomarqueurs actuellement mis en avant, les resultats sont contradictoires entre les differentes analyses. La mise en place d’une biosignature de cette pathologie pourrait etre une solution a cette problematique.
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- 2021
35. La tachypsychie
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Antoine Yrondi, Pierre Alexis Geoffroy, Ali Amad, Sébastien Weibel, Luisa Weiner, and Gilles Bertschy
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Psychiatry and Mental health ,Arts and Humanities (miscellaneous) ,Applied Psychology - Published
- 2021
36. Accounting for childhood trauma in patients with major depressive disorder
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Antoine Yrondi
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Psychiatry and Mental health ,Depressive Disorder, Major ,Bipolar Disorder ,Adverse Childhood Experiences ,Adult Survivors of Child Abuse ,Humans ,Biological Psychiatry - Published
- 2022
37. Traumatic memory reactivation with or without propranolol for PTSD and comorbid MD symptoms: a randomised clinical trial
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Pascal Roullet, Pierre Lamy, Laetitia Dupuch, Etienne Véry, Claire Thalamas, Antoine Yrondi, Philippe Birmes, Guillaume Vaiva, Laurence Jasse, Wissam El Hage, and Axel Bourcier
- Subjects
Adult ,medicine.medical_specialty ,Adrenergic beta-Antagonists ,Propranolol ,Traumatic memories ,Placebo ,behavioral disciplines and activities ,Placebo group ,Article ,law.invention ,Stress Disorders, Post-Traumatic ,03 medical and health sciences ,Medical research ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,mental disorders ,medicine ,Humans ,Depression (differential diagnoses) ,Pharmacology ,Depressive Disorder, Major ,Post-traumatic stress disorder ,business.industry ,030227 psychiatry ,Clinical trial ,Psychiatry and Mental health ,Memory consolidation ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Post-traumatic stress disorder (PTSD) is difficult to treat but one promising strategy is to block memory reconsolidation of the traumatic event. This study aimed to evaluate the efficacy of traumatic memory reactivation under the influence of propranolol, a noradrenergic beta-receptor blocker, in reducing PTSD symptoms as well as comorbid major depression (MD) symptoms. We conducted a double blind, placebo-controlled, randomised clinical trial in 66 adults diagnosed with longstanding PTSD. Propranolol or a placebo was administered 90 min before a brief memory reactivation session, once a week for 6 consecutive weeks. Measures included the SCID PTSD module, the PTSD Check List (PCL-S) and the Beck Depression Inventory-II (BDI-II). PTSD symptoms decreased both in the pre-reactivation propranolol group (39.28%) and the pre-reactivation placebo group (34.48 %). During the 6 treatment sessions, PCL-S and BDI-II scores decreased to similar extent in both groups and there were no treatment differences. During the 3-month follow-up period, there were no treatment effects for the mean PCL-S and BDI-II scores. However, in patients with severe PTSD symptoms (PCL-S ≥ 65) before treatment, PCL-S and BDI-II scores continued to decline 3 months after the end of treatment in the propranolol group while they increased in the placebo group. Repeated traumatic memory reactivation seemed to be effective for PTSD and comorbid MD symptoms. However, the efficacy of propranolol was not greater than that of placebo 1 week post treatment. Furthermore, in this traumatic memory reactivation, PTSD symptom severity at baseline might have influenced the post-treatment effect of propranolol.
- Published
- 2021
38. Psychiatric Disorders and Hydroxychloroquine for Coronavirus Disease 2019 (COVID-19): A VigiBase Study
- Author
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Alexis Revet, Antoine Yrondi, François Montastruc, Yannick Degboé, Philippe Garcia, and Vanessa Rousseau
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hallucinations ,Databases, Pharmaceutical ,Suicide, Attempted ,Context (language use) ,Antibodies, Monoclonal, Humanized ,Toxicology ,Antiviral Agents ,030226 pharmacology & pharmacy ,Lopinavir ,Psychoses, Substance-Induced ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tocilizumab ,Pharmacovigilance ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Original Research Article ,Adverse effect ,Psychiatry ,Aged ,Cause of death ,Aged, 80 and over ,Pharmacology ,Alanine ,Ritonavir ,business.industry ,Mental Disorders ,Hydroxychloroquine ,Odds ratio ,Middle Aged ,Adenosine Monophosphate ,COVID-19 Drug Treatment ,Drug Combinations ,Suicide ,chemistry ,Female ,business ,Self-Injurious Behavior ,medicine.drug - Abstract
Introduction In the stressful context of the coronavirus disease 2019 (COVID-19) pandemic, some reports have raised concerns regarding psychiatric disorders with the use of hydroxychloroquine. In this study, we reviewed all psychiatric adverse effects with hydroxychloroquine in COVID-19 patients, as well as in other indications, reported in VigiBase, the World Health Organization’s (WHO) global database of individual case safety reports. Methods First, we analyzed all psychiatric adverse effects, including suicide, of hydroxychloroquine in COVID-19 patients reported to 16 June 2020. We also performed disproportionality analysis to investigate the risk of reporting psychiatric disorders with hydroxychloroquine compared with remdesivir, tocilizumab, or lopinavir/ritonavir prescribed in COVID-19 patients. We used reporting odds ratios (RORs) and their 95% confidence intervals (CIs) to calculate disproportionality. Second, we sought to examine the psychiatric safety profile of hydroxychloroquine in other indications (before 2020). Results Among the 1754 reports with hydroxychloroquine in COVID-19 patients, we found 56 psychiatric adverse effects. Half of these adverse effects were serious, including four completed suicides, three cases of intentional self-injury, and 12 cases of psychotic disorders with hallucinations. Compared with remdesivir, tocilizumab, or lopinavir/ritonavir, the use of hydroxychloroquine was associated with an increased risk of reporting psychiatric disorders (ROR 6.27, 95% CI 2.74–14.35). Before 2020, suicide was the main cause of death among all adverse drug reactions reported with hydroxychloroquine, followed by cardiac adverse effects (cardiomyopathy) and respiratory failure. Conclusions This pharmacovigilance analysis suggests that COVID-19 patients exposed to hydroxychloroquine experienced serious psychiatric disorders, and, among these patients, some committed suicide. Further real-world studies are needed to quantify the psychiatric risk associated with hydroxychloroquine during the COVID-19 pandemic.
- Published
- 2020
39. Neural Substrates of Psychotic Depression: Findings From the Global ECT-MRI Research Collaboration
- Author
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Patrice Péran, Narcís Cardoner, Paul Hamilton, Akihiro Takamiya, Marta Cano, Mardien L. Oudega, Guido van Wingen, Pia Nordanskog, Anders Jorgensen, Willem B Bruin, Eric van Exel, Martin Balslev Jørgensen, Mathieu Vandenbulcke, Taishiro Kishimoto, Carles Soriano Mas, Annemiek Dols, Didi Rhebergen, Christopher C. Abbott, Olga Therese Ousdal, Pascal Sienaert, Ute Kessler, Louise Emsell, Robin Kämpe, Leif Oltedal, Filip Bouckaert, Olaf B. Paulson, Antoine Yrondi, Hauke Bartsch, Graduate School, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Compulsivity, Impulsivity & Attention, Adult Psychiatry, Neurology, Psychiatry, Amsterdam Neuroscience - Neurodegeneration, APH - Aging & Later Life, APH - Mental Health, and Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep
- Subjects
Male ,medicine.medical_specialty ,Psychosis ,psychosis ,depression ,magnetic resonance imaging ,gray matter volume ,medial prefrontal cortex ,Neural substrate ,medicine.medical_treatment ,Gray matter volume ,Posterior parietal cortex ,Psychotic depression ,Audiology ,behavioral disciplines and activities ,Psykiatri ,Electroconvulsive therapy ,Magnetic resonance imaging ,mental disorders ,Medicine ,Humans ,Prefrontal cortex ,Electroconvulsive Therapy ,Aged ,Factorial model ,Psychiatry ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Depression ,Middle Aged ,medicine.disease ,Brain Cortical Thickness ,Medial prefrontal cortex ,Psychiatry and Mental health ,Female ,business - Abstract
Psychotic major depression (PMD) is hypothesized to be a distinct clinical entity from nonpsychotic major depression (NPMD). However, neurobiological evidence supporting this notion is scarce. The aim of this study is to identify gray matter volume (GMV) differences between PMD and NPMD and their longitudinal change following electroconvulsive therapy (ECT). Structural magnetic resonance imaging (MRI) data from 8 independent sites in the Global ECT-MRI Research Collaboration (GEMRIC) database (n = 108; 56 PMD and 52 NPMD; mean age 71.7 in PMD and 70.2 in NPMD) were analyzed. All participants underwent MRI before and after ECT. First, cross-sectional whole-brain voxel-wise GMV comparisons between PMD and NPMD were conducted at both time points. Second, in a flexible factorial model, a main effect of time and a group-by-time interaction were examined to identify longitudinal effects of ECT on GMV and longitudinal differential effects of ECT between PMD and NPMD, respectively. Compared with NPMD, PMD showed lower GMV in the prefrontal, temporal and parietal cortex before ECT; PMD showed lower GMV in the medial prefrontal cortex (MPFC) after ECT. Although there was a significant main effect of time on GMV in several brain regions in both PMD and NPMD, there was no significant group-by-time interaction. Lower GMV in the MPFC was consistently identified in PMD, suggesting this may be a trait-like neural substrate of PMD. Longitudinal effect of ECT on GMV may not explain superior ECT response in PMD, and further investigation is needed. Funding Agencies|Keio University Medical Science Fund [99-095-0007]; AMED [JP20dm0307102h0003]; Research Foundation Flanders (FWO) grantFWO [G0C0319N]; KU Leuven Fund [C24/18/095]; Sequoia Fund for Research on Ageing and Mental Health; National Institute of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [MH125126, MH111826]; Carlos III Health InstituteInstituto de Salud Carlos III [CD20/00189]; Lundbeck FoundationLundbeckfonden; Western Norway Regional Health Authority [911986, 912238]
- Published
- 2022
40. Adherence to treatment guidelines in clinical practice for using electroconvulsive therapy in major depressive episode
- Author
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Thierry Bougerol, Jean-Baptiste Genty, C. Lançon, Emmanuel Haffen, Isabel Nieto, M. Leboyer, Frank Bellivier, Frédéric Haesebaert, Thierry d'Amato, Michel Walter, Samuel Bulteau, Raphaëlle Richieri, Thomas Charpeaud, J Attal, Anne Sauvaget, Bruno Aouizerate, Laurent Schmitt, Antoine Yrondi, Florian Stephan, W El-Hage, Pierre-Michel Llorca, Djamila Bennabi, Olivier Blanc, Jérôme Holtzmann, E Poulet, P. Courtet, Ludovic Samalin, Fondation FondaMental [Créteil], French Society for Biological Psychiatry and Neuropsychopharmacology, Partenaires INRAE, CHU Clermont-Ferrand, CHU Toulouse [Toulouse], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Henri Mondor AP-HP/UPEC, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier le Vinatier [Bron], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Grenoble, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Charles Perrens, Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut Mondor de recherche biomédicale (IMRB), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Bipolar Disorder ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,Electroconvulsive therapy ,mental disorders ,medicine ,Humans ,Bipolar disorder ,Electroconvulsive Therapy ,Major depressive episode ,Retrospective Studies ,Depressive Disorder, Major ,[SDV.GEN]Life Sciences [q-bio]/Genetics ,business.industry ,Retrospective cohort study ,medicine.disease ,3. Good health ,030227 psychiatry ,Neuropsychopharmacology ,Clinical Practice ,[SDV.GEN.GA]Life Sciences [q-bio]/Genetics/Animal genetics ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Major depressive disorder ,Biological psychiatry ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
International audience; Background: ECT is the most effective treatment of major depressive episode (MDE) but remains a neglected treatment. The French Society for Biological Psychiatry and Neuropsychopharmacology aimed to determine whether prescribing practice of ECT followed guidelines recommendations. Methods: This multicenter, retrospective study included adult patients with major depressive disorder (MDD) or bipolar disorder (BD), who have been treated with ECT for MDE. Duration of MDE and number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. Results: Seven hundred and forty-five individuals were included. The mean duration of MDE before ECT was 10.1 months and the mean number of lines of treatment before ECT was 3.4. It was significantly longer for MDD single episode than recurrent MDD and BD. The presence of first-line indications for using ECT was significantly associated to shorter duration of MDE (9.1 vs 13.1 months, p
- Published
- 2020
41. Association Between Side Effects and Blood microRNA Expression Levels and Their Targeted Pathways in Patients With Major Depressive Disorder Treated by a Selective Serotonin Reuptake Inhibitor, Escitalopram: A CAN-BIND-1 Report
- Author
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Raymond W. Lam, Glenda MacQueen, Laura M. Fiori, Roumen Milev, Benicio N. Frey, Sidney H. Kennedy, Jane A. Foster, Antoine Yrondi, Gustavo Turecki, and Daniel J. Müller
- Subjects
Adult ,Male ,AcademicSubjects/MED00415 ,Adolescent ,Side effect ,Nausea ,Serotonin reuptake inhibitor ,Gene Expression ,Citalopram ,Pharmacology ,Regular Research Articles ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,microRNA ,Humans ,Medicine ,Escitalopram ,Pharmacology (medical) ,miRNA ,030304 developmental biology ,Depressive Disorder, Major ,0303 health sciences ,Messenger RNA ,antidepressant ,major depressive disorder ,AcademicSubjects/SCI01870 ,business.industry ,Middle Aged ,medicine.disease ,3. Good health ,side effects ,MicroRNAs ,Psychiatry and Mental health ,Antidepressant ,Major depressive disorder ,Female ,medicine.symptom ,business ,Selective Serotonin Reuptake Inhibitors ,030217 neurology & neurosurgery ,medicine.drug - Abstract
IntroductionAntidepressant drugs are effective therapies for major depressive disorder; however, they are frequently associated with side effects. Although there is some evidence for a relationship between genetic variation and side effects, little is known regarding the role of dynamic molecular factors as moderators of side effects. The aim of this study was to assess microRNA (miRNA) changes associated with side effects during escitalopram treatment and their downstream effects on target gene expression.MethodsA total 160 patients with major depressive disorder from the CAN-BIND-1 cohort were included. Side effects were assessed with the Toronto Side Effect Scale after 2 weeks of treatment with escitalopram. We assessed the relationship between side effects and changes in peripheral expression of miRNAs between baseline and week 2. For miRNA whose expression changed, we used target prediction algorithms to identify putative messenger RNA (mRNA) targets and assessed their expression.ResultsNausea was experienced by 42.5% of patients. We identified 45 miRNAs whose expression changed on initiation of escitalopram treatment, of which 10 displayed a negative association with intensity of nausea (miR15b-5p, miR17-5p, miR20a-5p, miR20b-5p, miR103a-3p, miR103b, miR106a-5p, miR182-5p, miR185-5p, and miR660-5p). Additionally, we found negative associations between 4 microRNAs (miR20a-5p, miR106a-5p, miR185-5p, miR660-5p) and mRNA targets. The expression of the miR185-5p target, CAMK2δ was significantly decreased [log 2 mean = −0.048 (0.233)] between weeks 0 and 2 (P = .01)].ConclusionsWe identified an overexpression of miR185-5p during escitalopram treatment of major depressive disorder, which was negatively associated with intensity of nausea, and identified a potential mRNA target that may mediate this effect.
- Published
- 2019
42. Quand, quoi et comment prescrire en cas de troubles de l’humeur ou d’anxiété ?
- Author
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Antoine Yrondi
- Subjects
Neurology ,Neurology (clinical) - Published
- 2022
43. Teaching emergency situations during a psychiatry residency programme using a blended learning approach: a pilot study
- Author
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Emmanuelle Bougon, Laurent Schmitt, Bruno Bastiani, Philippe Birmes, Juliette Salles, Stéphanie Lafont-Rapnouil, Antoine Yrondi, Maria Soto, Christophe Arbus, Anjali Mathur, CHU Toulouse [Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Toulouse Neuro Imaging Center (ToNIC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Hôpital Purpan [Toulouse], Institut Toulousain de Simulation en Santé [Toulouse] (ITSIMS), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), and Malbec, Odile
- Subjects
Male ,medicine.medical_specialty ,020205 medical informatics ,[SDV]Life Sciences [q-bio] ,education ,Pilot Projects ,02 engineering and technology ,Experiential learning ,Session (web analytics) ,Education ,03 medical and health sciences ,0302 clinical medicine ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Humans ,Learning ,030212 general & internal medicine ,Psychiatry ,Medical education ,LC8-6691 ,Recall ,Teaching ,4. Education ,Internship and Residency ,Problem-Based Learning ,General Medicine ,Special aspects of education ,Knowledge acquisition ,Test (assessment) ,[SDV] Life Sciences [q-bio] ,Blended learning ,Technical Advance ,Problem-based learning ,Medicine ,Female ,Emergency psychiatry ,Clinical Competence ,Psychology - Abstract
Background Emergency psychiatry is an essential component in the training of psychiatry residents who are required to make patient-centred orientation decisions. This training calls for specific knowledge as well as skills and attitudes requiring experience. Kolb introduced a theory on experiential learning which suggested that effective learners should have four types of abilities: concrete experience, reflective observation, abstract conceptualisation and active experimentation. We aimed to evaluate a resident training programme that we designed for use in an emergency psychiatry setting based on the experimental learning theory. Methods We designed a four-step training programme for all first-year psychiatry residents: (i) theoretical teaching of psychiatric emergency knowledge, (ii) concrete experience of ability teaching involving an initial simulation session based on three scenarios corresponding to clinical situations frequently encountered in emergency psychiatry (suicidal crisis, hypomania and depressive episodes), (iii) reflective observation and abstract conceptualisation teaching based on videos and clinical interview commentary by a senior psychiatrist for the same three scenarios, (iv) active experimentation teaching during a second simulation session based on the same three frequently encountered clinical situations but with different scenarios. Training-related knowledge acquisition was assessed after the second simulation session based on a multiple-choice quiz (MCQ), short-answer questions and a script concordance test (SCT). The satisfaction questionnaire was assessed after the resident had completed his/her initial session in order to evaluate the relevance of teaching in clinical practice. The descriptive analyses were described using the mean (+/- standard deviation). The comparative analyses were conducted with the Wilcoxon or Student’s t tests depending on data distribution. Results The residents’ mean MCQ and short-answer question scores and SCT were 7.25/10 (SD = 1.2) 8.33/10 (SD = 1.4), 77.5/100 (SD = 15.8), respectively. The satisfaction questionnaire revealed that 67 % of residents found the teaching consistent. Conclusion We designed a blended learning programme that associated, classical theoretical learning to acquire the basic concepts, a learning with simulation training to experiment the clinical situations and a video support to improve learning of interview skills and memory recall. The residents indicate that this training was adequate to prepare them to be on duty. However, despite this encouraging point, this program needs further studies to attest of its efficiency.
- Published
- 2021
44. Clinical Pharmacy in Psychiatry: Towards Promoting Clinical Expertise in Psychopharmacology
- Author
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Mathilde Le Maout, Philippe D. Vincent, Céline Straczek, Coraline Hingray, Guillaume Sujol, Bastien Langrée, Sébastien Weibel, Clara Gitahy Falcao Faria, Antoine Yrondi, G Meyer, S. Dizet, Hervé Javelot, Adeline Egron, Frederik Vandenberghe, and Alexis Erb
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,education ,Review ,Pharmacy and materia medica ,Multidisciplinary approach ,clinical pharmacy ,medicine ,Psychoeducation ,Relevance (law) ,Pharmacology (medical) ,General Pharmacology, Toxicology and Pharmaceutics ,Psychiatry ,health care economics and organizations ,psychopharmacology ,medicine.diagnostic_test ,Mental health ,psychiatry ,Clinical pharmacy ,RS1-441 ,Therapeutic drug monitoring ,General partnership ,expertise ,Psychopharmacology ,Psychology ,mental health - Abstract
Although clinical pharmacy is a discipline that emerged in the 1960s, the question of precisely how pharmacists can play a role in therapeutic optimization remains unanswered. In the field of mental health, psychiatric pharmacists are increasingly involved in medication reconciliation and therapeutic patient education (or psychoeducation) to improve medication management and enhance medication adherence, respectively. However, psychiatric pharmacists must now assume a growing role in team-based models of care and engage in shared expertise in psychopharmacology in order to truly invest in therapeutic optimization of psychotropics. The increased skills in psychopharmacology and expertise in psychotherapeutic drug monitoring can contribute to future strengthening of the partnership between psychiatrists and psychiatric pharmacists. We propose a narrative review of the literature in order to show the relevance of a clinical pharmacist specializing in psychiatry. With this in mind, herein we will address: (i) briefly, the areas considered the basis of the deployment of clinical pharmacy in mental health, with medication reconciliation, therapeutic education of the patient, as well as the growing involvement of clinical pharmacists in the multidisciplinary reflection on pharmacotherapeutic decisions; (ii) in more depth, we present data concerning the use of therapeutic drug monitoring and shared expertise in psychopharmacology between psychiatric pharmacists and psychiatrists. These last two points are currently in full development in France through the deployment of Resource and Expertise Centers in PsychoPharmacology (CREPP in French).
- Published
- 2021
45. Case Report: Use of Subcutaneous Midazolam During an Episode of Catatonia
- Author
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Loic Anguill, Fréderic Eyvrard, Etienne Véry, Adeline Jullien, Antoine Yrondi, and Valentin Raymond
- Subjects
Catatonia ,medicine.drug_class ,lcsh:RC435-571 ,Case Report ,negativism ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Psychiatry ,medicine ,Waxy flexibility ,subcutaenous administration ,First episode ,Psychiatry ,Benzodiazepine ,business.industry ,withdrawal ,Psychiatric assessment ,Stupor ,Lorazepam ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Anesthesia ,Midazolam ,medicine.symptom ,catatonia ,benzodiazepine ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Midazolam is a benzodiazepine (BZD) mainly used in anesthetic induction due to its pharmacokinetic features. Its place in the therapeutic management of catatonia remains to be determined. Here we present the case of a 65-year-old man who presented with a first episode of catatonia with opposition to any form of oral treatment, where a single dose of 1 mg of subcutaneous (SC) Midazolam permitted clinical improvement allowing oral treatment to be given. The patient's history notably included a renal transplant linked to Polycystic Kidney Disease (PKD) and no history of psychiatric illness nor of any use of psychotropic drugs. As the patient refused to drink or eat and ceased answering basic questions, a psychiatric assessment was required. A diagnosis of Catatonic disorder due to a general medical condition [DSM 5–293.89/ ICD10 [F06.1]] was made. A Bush-Francis Catatonia Rating Scale (BFCRS) analysis returned a score of 15 out of 62, with stupor, mutism, negativism, staring, withdrawal, rigidity, and stereotypy. As the negativism prevented the patient from taking any form of oral treatment, after a brief discussion with the unit's physician, it was decided to administer 1 mg of SC Midazolam. One hour later, the patient was more responsive and compliant, and agreed to drink, eat, and take medication. Thus, the catatonic signs of mutism, negativism, staring, and withdrawal were resolved, but waxy flexibility and catalepsy appeared, leading to a new BFCRS score of 10 out of 62. Oral treatment with 2.5 mg Lorazepam, 4 times a day, was then initiated. Midazolam could be a safer choice compared with the other options available, such as other SC BZD, considering the complex safety profile of this patient with renal insufficiency. This situation represents the first report of using SC Midazolam as an injectable treatment for catatonia. More studies are needed to assess the clinical pertinence of SC Midazolam in the treatment of catatonia.
- Published
- 2021
46. Traumatic Hystero-Neurasthenia in Professor Charcot's Leçons du Mardi
- Author
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Laurent Schmitt, Laetitia Dupuch, Simon Taib, Philippe Birmes, Etienne Véry, and Antoine Yrondi
- Subjects
medicine.medical_specialty ,Hysteria ,History, 19th Century ,Psychological Trauma ,Irritability ,medicine.disease ,Stress Disorders, Post-Traumatic ,Psychiatry and Mental health ,Posttraumatic stress ,Intrusion ,Mood ,Emotional distress ,Neurasthenia ,medicine ,Etiology ,Humans ,Male hysteria ,medicine.symptom ,Psychiatry ,Psychology - Abstract
At the end of the 19th century, several authors became interested in the physical and psychological symptoms resulting from traumatic life events. Oppenheim presented 42 detailed clinical observations. He suggested the term "traumatic neurosis." Charcot, who was interested in male hysteria, published over 20 cases of traumatic hysteria between 1878 and 1893. The symptoms were considered to have a dynamic or functional origin. The role of horror and terror during the trauma was emphasized. However, Charcot opposed the idea of traumatic neuroses as specific syndromes as he considered them to be only an etiological form of hystero-neurasthenia. In The Tuesday Lessons (Les Leçons du Mardi), he presents several observations. They are surprising when compared with the current criteria for posttraumatic stress disorder (PTSD). Although he had rejected this new entity, a hundred years before the appearance of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, Charcot described most of the symptoms mentioned for a diagnosis of PTSD such as intrusion (reliving the trauma, nightmares, and severe emotional distress), avoidance, negative changes in thinking and mood (negative thoughts, lack of interest, etc.), arousal, and reactivity (trouble sleeping, trouble concentrating, being easily startled or frightened, irritability, etc.).
- Published
- 2019
47. Le secret dans la relation de soins individuelle ou partagée
- Author
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Laurent Schmitt, Antoine Yrondi, and Juliette Salles
- Subjects
Therapeutic relationship ,Alliance ,Nursing ,Secrecy ,General Medicine ,Pshychiatric Mental Health ,Psychology ,Institutional level ,Transparency (behavior) - Abstract
Secrecy in the care relationship raises questions. For caregivers in psychiatry, it is an ethical requirement. However, the transparency of the information collected or recommendations upheld by quality departments rock the foundations of the therapeutic relationship. On which aspects is the therapeutic alliance based? How should secrecy be evoked in the team today? Beyond the dual caregiver-patient relationship, mechanisms to ensure the respect of secrecy relies on the institutional level.
- Published
- 2019
48. L’examen clinique psychiatrique standardisé pour l’étudiant, c’est possible !
- Author
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Clélia Quiles, Pierre A. Geoffroy, Antoine Yrondi, Farid Benzerouk, David Bensamoun, Hugo Peyre, Jean-Arthur Micoulaud-Franchi, Thomas Fovet, and Ali Amad
- Subjects
03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Arts and Humanities (miscellaneous) ,030212 general & internal medicine ,Applied Psychology ,030227 psychiatry - Abstract
L’approche systematique et l’examen clinique des patients constituent des piliers centraux pour l’enseignement de la medecine. Cependant, tres peu d’etudiants en medecine apprennent a examiner un patient souffrant de troubles psychiatriques au cours de leur parcours. Nous proposons dans cet article la reflexion didactique qui a permis le developpement d’un guide pour un examen clinique psychiatrique standardise a destination des etudiants en medecine. Ce guide a ete construit a partir de la trame d’un examen medical classique (antecedents, histoire de la maladie, biographie, etc.). Il incorpore egalement les differents domaines et etapes du Mental Status Examination (MSE) ainsi que des questions issues de plusieurs outils standardises. Le document propose se veut simple et facile a utiliser (systeme de cases a cocher) afin de faciliter les premiers entretiens des etudiants en medecine et des jeunes internes. La maitrise de l’examen clinique est une etape essentielle dans le processus d’apprentissage de la medecine qui permettra ensuite d’integrer, avec l’experience, la souplesse et l’adaptabilite necessaire a tout entretien psychiatrique.[resume d’auteur]
- Published
- 2018
49. Règles de bon usage des benzodiazépines
- Author
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François Montastruc, Alexis Revet, and Antoine Yrondi
- Subjects
Drug ,medicine.medical_specialty ,Benzodiazepine ,business.industry ,medicine.drug_class ,media_common.quotation_subject ,Treatment duration ,General Medicine ,Marketing authorization ,030226 pharmacology & pharmacy ,Discontinuation ,03 medical and health sciences ,0302 clinical medicine ,Drug tolerance ,Medicine ,030212 general & internal medicine ,business ,Intensive care medicine ,Adverse effect ,Active metabolite ,media_common - Abstract
Due to pharmacologic tolerance and dependence, benzodiazepines and z-drugs have to be used over short duration of treatment. Three pharmacokinetic characteristics should be taken into account by the prescriber: the galenic form, the plasma half-life, and the presence of an active metabolite. The patient and the prescriber should talk about possible adverse events and treatment discontinuation before treatment initiation. Treatment duration should be as short as possible et should not be longer than recommended by the marketing authorization. Several benzodiazepine drugs should not be prescribed at the same time, because there is no advantage in terms of effectiveness and adverse events may occur.
- Published
- 2018
50. Childhood Trauma increases suicidal behaviour in a treatment-resistant depression population: a FACE-DR report
- Author
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Antoine Yrondi, Guillaume Vaiva, Michel Walter, Thierry D Amato, Frank Bellivier, Djamila Bennabi, Thierry Bougerol, Vincent Camus, Olivier Doumy, Jean-Baptiste Genty, Emmanuel Haffen, Jérôme Holtzmann, Mathilde Horn, Christophe Lançon, Marion Leboyer, Pierre-Michel Llorca, Julia Maruani, Rémi Moirand, Fanny Molière, Jean Petrucci, Raphaelle Richieri, Ludovic Samalin, Laurent Schmitt, Florian Stephan, Philippe Courtet, Wissam El-Hage, Bruno Aouizerate, B. Aouizerate, D. Bennabi, M. Leboyer, E. Haffen, P.M. Llorca, V. Barteau, S. Bensalem, H. Laouamri, Karmene Souryis, L. Mallet, L. Yon, J. Petrucci, J.B. Genty, A. Yrondi, D. Pierre, L. Schmitt, M. Sarrail, I. Ryff, E. Beuchet, G. Tio, C. Cappe, E. Clerc, M. Garnier, R.M. Honciuc, E. Allauze, O. Blanc, F. Bellivier, N. Allaili, I. Nieto, J. Meheust, Y. Sunthavy, J. Maruani, T. Bougerol, M. Polosan, P. Courvoisier, J. Holtzmann, B. Fredembach, S. Foubert-Andreani, V. Camus, W. El Hage, T. D’Amato, F. Haesebaert, C. Dubien, M. Lefebvre, A. Meznad, J. Brunelin, R. Moirand, O. Doumy, C. Lancon, R. Richieri, P. Peri, M. Faugere, C. Faget-Agius, P. Courtet, J.P. Boulenger, F. Moliere, F. Stephan, M. Walter, C. Mesmeur, G. Vaiva, M. Horn, Fondation FondaMental [Créteil], Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Toulouse Neuro Imaging Center (ToNIC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hopital de Bohars - CHRU Brest (CHU - BREST ), Soins Primaires, Santé Publique, Registre des cancers de Bretagne Occidentale (SPURBO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Centre de recherche en neurosciences de Lyon (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier le Vinatier [Bron], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Laboratoire de Neurosciences Intégratives et Cliniques - UFC (EA 481) (NEURO), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CHU Grenoble, Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Perrens, Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Henri Mondor, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), CHU Clermont-Ferrand, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Soins Primaires, Santé Publique, Registre des cancers de Bretagne Occidentale (EA7479 SPURBO), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Laboratoire de Neurosciences Intégratives et Cliniques - UFC (UR 481) (NEURO), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier Charles Perrens [Bordeaux], CHU Henri Mondor [Créteil], CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), and Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
- Subjects
Depressive disorders ,MESH: Depression ,MESH: Violence ,Population ,Poison control ,Violence ,Suicide prevention ,Childhood trauma ,MESH: Depressive Disorder, Treatment-Resistant ,Suicidal Ideation ,Depressive Disorder, Treatment-Resistant ,03 medical and health sciences ,0302 clinical medicine ,MESH: Risk Factors ,Risk Factors ,Rating scale ,Surveys and Questionnaires ,Humans ,Medicine ,MESH: Surveys and Questionnaires ,Risk factor ,education ,Suicidal ideation ,Childhood neglect ,Biological Psychiatry ,education.field_of_study ,MESH: Humans ,MESH: Suicidal Ideation ,Depression ,business.industry ,Childhood abuse ,CTQ tree ,3. Good health ,030227 psychiatry ,Suicide ,Psychiatry and Mental health ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Treatment-resistant depression ,medicine.symptom ,Columbia Suicide Severity Rating Scale ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
International audience; Objective: In addition to heredity, exposure to early-life adversity is an important predisposing risk factor of suicidal behaviour. Although the association between Childhood Trauma (CT) and suicide risk is well documented, interactions between CT and suicidal behaviour in Treatment-Resistant Depression (TRD) populations have received little coverage. This study aimed to evaluate i) association between CT and suicidal behaviour in a TRD population, and ii) the role of personality traits and impulsiveness as potential factors of mediation in these associations.Methods: Patients were recruited from a cohort of the French network of TRD expert centers. Depressive symptom severity, CT, suicidal behaviour, personality traits, and impulsiveness were assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS), the Childhood Trauma Questionnaire (CTQ), the Columbia Suicide Severity Rating Scale (CSSRS), the Structured Clinical Interview for DSM-IV, the Big Five Inventory, and the Barratt Impulsivness Scale (BIS) respectively.Results: Among the 256 patients with a baseline CTQ, in relation to suicide risk for the current depressive episode, we found an association with the total CTQ scores mediated by the intensity of the current episode in a model adjusted for age and sex (total effect: β = 0.171; p = 0.011, direct effect: β = 0.135; p = 0.043; indirect effect: β = 0.036; p = 0.048). Focusing on CT subtypes, we detected an association between suicide risk and physical neglect in a model adjusted for age and sex (β = 0.301; p = 0.002), without any mediation by the intensity of the current episode. There was no mediation effect from personality traits nor impulsiveness. With regards to CSSRS to assess suicidal ideation, we did not find any association with the total CTQ score and CT subtype scores.Conclusion: We report a strong association between suicidal behaviour and CT (in particular childhood physical neglect) in a TRD population.
- Published
- 2021
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