Search

Objectives: To assess olfactory functions (threshold, identification, and hedonic valence) of depressed subjects before and after an 8-week trial of escitalopram and compare the results of responders and nonresponders. Methods: Fifty-two depressed subjects were recruited. Participants received escitalopram and were evaluated at two visits: baseline (V0) and week 8 (V8). They were categorized as responders (Montgomery-Åsberg Depression Rating Scale [MADRS] score reduction of > 50%) or nonresponders to treatment. Participants were evaluated with the Mini International Neuropsychiatric Interview (MINI) at V0 and, at V0 and V8, completed psychometric and olfactory assessments, including MADRS and the State-Trait Anxiety Inventory (STAI), as well as the Sniffin’ Sticks® test (threshold and identification tasks). The hedonic valence of smell was assessed on a 10-cm linear scale after presenting two pleasant and two unpleasant odors. Forty-three participants completed the study (24 responders and 19 nonresponders). The Mann-Whitney, chi-square, and Fisher’s exact tests were used to compare olfactory, clinical, and demographic variables between groups and within the same group at V0 and V8. The Spearman coefficient was used to calculate the correlation between clinical characteristics and olfactory variables. Results: The hedonic score of pleasant odors increased significantly between V0 and V8 only for responders (V = 61.5, p = 0.018), with no significant change in nonresponders (V = 90.5, p = 0.879). Comparison of olfactory performances between groups at V0 and V8 separately did not show a significant difference between responders and nonresponders to escitalopram. Olfactory threshold and identification scores were not different between V0 and V8 for responders or nonresponders. Conclusion: Depressed subjects have olfactory anhedonia, which appears to regress following a positive antidepressant response. Hedonic valence may be an indicator of cognitive changes associated with depression; improvement of this valence may indicate a clinical response to antidepressants.

Key Clinical Message Pseudoangiomatous stromal hyperplasia (PASH) is a rare lesion of the breast stromal tissue with unknown mechanism. Hormonal stimulation of mammary myofibroblasts is the most important theory due to stromal positivity of progesterone receptor (PR) or/and estrogen receptor (ER). We report a case of PASH with stromal PR/ER negativity.

Abstract Background Clinical staging has been widely used to predict and optimize the treatment of medical disorders. Different models have been proposed to map the development, progression, and extension of psychiatric disorders over time, mainly for schizophrenia. The primary objective of this study was to classify patients with psychosis according to the McGorry staging model and compare factors between the different stages. Methods This was a cross-sectional study, collecting data from 158 patients hospitalized for schizophrenia/psychosis. The survey included the Mini International Neuropsychiatric Interview (MINI), Positive and Negative Symptom Scale (PANSS), Montgomery-Asberg Depression Rating Scale (MADRS), Yong Mania Rating Scale (YMRS), Clinical Global Impression (CGI) scale, and the McGorry staging model. Results Patients have been classified into three clinical stages: relapse of psychotic disorder (43%), multiple relapses (47.5%), and persistent and severe illness (9.5%). A higher mean duration of hospitalization, psychotic symptoms (PANSS total scale and subscales), chlorpromazine equivalent dose, and number of antipsychotic treatments were found among participants in Stage 4 as compared to the other groups. However, a significantly higher mean GAF scale was found among participants in stage 3b as compared to the other groups. Conclusion Each stage in the McGorry staging model of schizophrenia is associated with well-defined clinical presentations, which help decide the appropriate treatment. Using such models in psychiatry can improve the diagnostic process and potential therapeutic interventions for patients suffering from mental disorders.

This study investigates several methods to identify microplastics (MPs) of small size ranges (

Microplastics (MPs) (plastic particles < 5 mm in size) have become the most ubiquitous type of anthropogenic litter contaminating aquatic environments worldwide, and are capable of harming aquatic organisms and entering the food web. Microplastic research has rapidly evolved over several decades, with many studies sampling microplastic in surface waters. For sea surface sampling of MPs, different net devices have been used. But although there is an increasing number of studies using these devices to quantifying MPs in different aquatic environments, data comparison is difficult due to the lack of standardised, harmonised sampling methods and data reporting units. The Manta net device is actually the most commonly used method for sea surface sampling of MPs. The three main parts of this net are: the floating/stabilizing part, the opening mouth and the net bag, and each of them can have its own specifications. These specifications, along with the sampling methods, can be critical for the efficiency of the sampling accurate quantification of MPs in the aquatic environments. The use of different mesh sizes, inconsistency in trawling duration, speed and distance, and in the net opening dimensions, make it impossible to compare the studies between each other. This review analyzes the methodologies and characteristics of Manta nets used for MPs sampling, discussing factors that can impact the efficiency of the sampling and the quantification of MPs, and proposes recommendations in order to improve and standardize the sampling protocol.

This study aims to characterize and compare the feeding ecology of the European eels (Anguilla anguilla L.) during the continental phase (i.e. yellow and silver) along a salinity gradient (i.e. lower, middle and upper) in six northern France estuaries (i.e. brackish water). The diet and stable isotopic (i.e. δ15N and δ13C values) compositions of eels collected with a fyke net in six estuaries (Slack, Wimereux, Liane, Canche, Authie and Somme estuaries) located along the French coast of the eastern English Channel per season over a year were described by combining gut content and stable isotope analyses. Eel guts were dominated by typical BW prey, Malacostraca and Actinopterygii (54% and 40%, respectively), with the gammare Gammarus zaddachi and the green crab Carcinus maenas (38% and 14%, respectively), and smaller yellow eels of A. anguilla and juvenile European flounder, Platichthys flesus (19% and 14%, respectively) being the most frequently found in their guts. The δ13C values of a majority of eels confirmed the sea- and brackish water-specific carbon resources. Dietary and isotopic niche revealed no clear change between total length, silvering stages and seasons, but a significant difference between salinity gradients and estuaries. Eels δ13C values showed significant enrichment from upper to lower along the estuaries while the δ15N values showed an inverse effect, with the lowest values in the lower part and highest in the upper part. Higher variability in δ13C values in larger estuaries suggested that eels feed on a wide range of food sources than in smaller estuaries. While eels in the smaller estuaries fed mainly on Actinopterygii prey, eels in the larger ones had a lower trophic level (i.e. δ15N values) and fed mainly on Malacostraca prey. This spatial difference in dietary and isotopic niche is discussed in relation to biological structure of eel and environmental variables.

Abstract Background Long term displacement and exposure to challenging living conditions can influence family dynamics; gender roles; violence at home and in the community and mental well-being. This qualitative study explores these issues as perceived by Syrian refugees who have been living in Shatila, a Palestinian camp in South Beirut, Lebanon, for at least 2 years. Methods Twenty eight in-depth interviews with men and women were conducted between February and June 2018. Women were recipients of mental health services, and men were recruited from the local community. Interviews were conducted in Arabic, translated, transcribed, coded and analysed using thematic content analysis. Results Our results show patterns of harsh living conditions similar to those described earlier in the course of the Syrian refugee crisis. Lack of infrastructure, overcrowding, cramped rooms and violence were all reported. Participants also described a lack of social support, discrimination and harassment within the host community, as well as limited social support networks within their own Syrian refugee community. Family dynamics were affected by the increased responsibilities on men, women and children; with additional economic and employment demands on men, women assuming the roles of ‘mother and father’ and children having to work and contribute to the household. Participants discussed several types of violence, including parental violence against children and violence in the community. Violence against women was also reported. Reported mental health issues included depression, anxiety, sadness, frustration, hopelessness, self-neglect and a loss of sense of self and self-worth. Some participants expressed a wish to die. Conclusions This study describes experiences of changing gender roles, family dynamics, violence and mental health after long-term displacement in in Shatila camp, South Beirut as perceived by Syrian refugees. A lack of safety and security coupled with economic hardship rendered refugees even more susceptible to exploitation and harassment. Parental violence was the most commonly reported type of domestic violence.

This study aimed to determine whether dissociative symptoms and childhood trauma (CT) may help identify a specific subgroup of patients among those hospitalized for alcohol use disorder (AUD). We assessed 587 patients hospitalized for an AUD in a French addiction rehabilitation center (cross-sectional study) regarding dissociative symptoms (DES-taxon), childhood trauma (CTQ), depression (BDI), anxiety (STAI-state and STAI-trait), posttraumatic stress disorder (PTSD; PCL-5), and AUD symptoms (AUDIT). We ran a hierarchical cluster analysis and compared the clusters in terms of dissociation and CT, as well as AUD, depressive, anxiety, and PTSD symptoms. We identified three clusters of patients: (1) patients with low AUD severity and low dissociation (LALD); (2) patients with high AUD severity and low dissociation (HALD); (3) patients with high AUD severity and high dissociation (HAHD). Patients from the HAHD group had significantly higher dissociation and more severe depression, anxiety, and PTSD symptoms than those with LALD and HALD. They also reported more emotional and sexual abuse than those with LALD. Among patients with an AUD, those with high dissociation may constitute an independent subgroup that exhibits a higher prevalence for CT and higher AUD severity, as well as higher depression, anxiety, and PTSD symptoms. Patients with more severe AUD and associated psychiatric symptoms should be systematically screened for dissociation and provided with tailor-based treatments.

Despite emerging and increasing concerns related to marine micro and macroplastics, no systematic surveys have been undertaken yet in the Lebanese marine area. To understand the spatio-temporal variation of plastic litter (macro and microplastics) in the Lebanese marine environment and to determine the sources of pollution, this study investigated the characteristics of plastic pollution in sea surface waters during wet and dry seasons in 22 sites of Beirut and Tyre regions. A total of 23,023 items were identified and assessed according to the shape, color, and concentration; moreover, the risk of microplastics (MPs) contamination was explored based on a risk assessment model. The obtained results demonstrated that the average macroplastics concentration was 0.45 ± 0.6 items/m3. The average microplastics concentration was found to be 20.1 ± 21.8 and 3.78 ± 5.2 items/m3 in spring and fall respectively. During fall, MPs fragments were dominant in Beirut (97%) and Tyre (91%), and no pellets were observed. During spring, filaments were most encountered in Beirut (76.5%). The most dominant marine litter color was blue followed by black and white. The Pollution Load Index (PLI) values showed a moderate contamination of the Lebanese coast with MPs (PLI: 5.79 ± 3.93) except for several sites in Beirut that showed high values of PLI, highlighting the local influence of cities and rivers on MPs concentration. This study serves as an important baseline for understanding the characteristics of the seasonal variation of MPs along the Lebanese marine environment; it will help stakeholders and countries to take proactive and reactive actions to face plastic litter pollution in the Lebanese coastal area.

OBJECTIVES:The aim of the study was to compare olfactory functions between unipolar and bipolar patients according to the thymic states (depressed, euthymic) and determine specific olfactory variations between these different states. METHODS:We recruited 176 participants in 5 groups: depressed bipolar (DB), euthymic bipolar (EB), depressed unipolar (DU), euthymic unipolar (EU), and controls (HC). They were assessed using the Sniffin' sticks threshold and identification tests. Odors' pleasantness, intensity, familiarity and emotion were assessed. Clinical evaluation explored dimensions of depression, mania, anxiety, and anhedonia. RESULTS:Smell identification was lower in DU compared to EU patients and controls. Pleasant odors received lower hedonic rating in DU and DB patients compared to EU and EB patients respectively. Negative correlation was found in EB patients between hedonic rating and social anhedonia. In EU patients hedonic rating was negatively correlated with anxiety-state, and anhedonia. CONCLUSIONS:Odor identification of pleasant odors is altered in both depressive states. Only unipolar patients would recover a regular identification level in symptomatic remission, while bipolar subjects would keep their deficits. Hedonic rating is lower in bipolar depressed patients compared to unipolar ones, and these deficits improve after remission. Hedonic rating of pleasant odors may distinguish bipolar depression from unipolar depression during periods of decompensation and phases of remission. Olfactory assessment may be useful to screen unipolar and bipolar depression, leading to possible future sensory markers in mood disorders.

Background: Agitated and aggressive behaviours are common in the psychiatric setting and rapid tranquilisation is sometimes unavoidable. A survey of Lebanese practice has shown that an intramuscular haloperidol, promethazine and chlorpromazine combination is a preferred form of treatment but there are no randomised trials of this triple therapy. Methods: This is a pragmatic randomised trial. Setting - the psychiatric wards of the Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. Participants - any adult patient in the hospital who displays an aggressive episode for whom rapid tranquilisation is unavoidable, who has not been randomised before, for whom there are no known contraindications. Randomisation – stratified (by ward) randomisation and concealed in closed opaque envelope by independent parties. Procedure – if the clinical situation arises requiring rapid tranquilisation, medical residents overseeing the patient will open a TREC-Lebanon envelope in which will be notification of which group of treatments should be preferred [Haloperidol + Promethazine + Chlorpromazine (HPC) or Haloperidol + Promethazine (HP)], along with forms for primary, secondary and serious adverse effects. Treatment is not given blindly. Outcome - primary outcome is calm or tranquil at 20 minutes post intervention. Secondary outcomes are calm/tranquil at 40, 60 and 120 minutes post intervention, asleep, adverse effects, use of straitjacket and leaving the ward. Follow-up will be up to two weeks post randomisation. Discussion: Findings from this study will compare the HPC versus HP combination used in Lebanon’s psychiatry emergency routine practice. Trial registration: ClinicalTrials.gov NCT03639558. Registration date, August 21, 2018.

Background: Changes in olfactory recognition memory may constitute sensory markers in depression. Significant differences may exist between unipolar and bipolar depression. Our study compares olfactory memory between control, unipolar, and bipolar patients in depressed and euthymic states in order to identify potential markers of depression. Methods: 176 participants were recruited in 5 groups: depressed bipolar (DB), euthymic bipolar (EB), depressed unipolar (DU), euthymic unipolar (EU), and controls (HC). The participants had a standardized clinical and olfactory assessment (olfactory memory, evaluation of pleasantness, intensity, familiarity, and emotional aspect of smells). Results: DU, DB, and EU patients had a deficit in olfactory memory compared to HC. DB patients had lower capacity to recognize new odors. DB and DU patients had more limited detection of unfamiliar odors than HC. DB patients rated odors as less pleasant compared to the other groups. All groups had lower hedonic ratings than HC. DB patients had lower emotional ratings than EU patients. Conclusions: Olfactory memory is impaired in depressive states, thus constituting a state marker of depression. Impairments in olfactory memory persist after remission of bipolar depression, thus constituting a possible trait marker of bipolarity. Hedonic rating differentiates unipolar from bipolar depression. This is the first study that identifies a sensory marker differentiating between unipolar and bipolar depression.