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The French version of the Exercise in Mental Illness Questionnaire (EMIQ-Fr): Translation, cross-cultural validation and psychometric properties. 法语版精神疾病运动问卷(EMIQ-Fr):翻译、跨文化验证和心理测量特性。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-20 DOI: 10.1016/j.encep.2025.09.010
Juan Martin Tecco, Ahmed Jérôme Romain, Robert Stanton, Arnaud Philippot, Yasser Khazaal, Bernard Dan, Moritz Bruno Petzold, Davy Vancampfort

Objective: Exercise offers trans-diagnostically numerous mental health benefits. Mental health professionals play a crucial role in prescribing exercise to their patients. However, there is limited research on exercise prescription behavior among French-speaking mental health professionals. This study aimed to translate the Exercise in Mental Illness Questionnaire (EMIQ-HP) into French, validate it cross-culturally and evaluate the psychometric properties of the translated version.

Methods: We followed guidelines for the cross-cultural adaptation of self-rating questionnaires to translate the EMIQ-HP and tested its 7-day test-retest reliability in a sample of 46 French-speaking Belgian mental health professionals. Reliability was assessed using intra-class correlations (ICC) and Cohen's kappa (κ).

Results: The items and scales of the French version of the questionnaire (EMIQ-Fr) demonstrated ICCs ranging from 0.41 to 0.77 and κ values from 0.42 to 0.71, with all items exhibiting either moderate (≥0.41) to substantial (≥0.61) 7-day test-retest reliability. ICCs for subscales ranged from 0.44 to 0.84 with scales exhibiting either moderate (≥0.41) to almost perfect (≥0.81) 7-day test-retest reliability.

Conclusions: The EMIQ-Fr is the first standardized French language questionnaire designed to assess mental health professionals' views on exercise in mental disorders. Its application in future research could enhance our understanding and support of patients with mental disorders in achieving or maintaining health-beneficial levels of exercise.

目的:运动对心理健康有很多好处。心理健康专家在给病人开运动处方方面起着至关重要的作用。然而,对讲法语的心理健康专业人员的运动处方行为的研究有限。本研究旨在将《精神疾病运动问卷》(EMIQ-HP)翻译成法文,并对其进行跨文化验证,并评估翻译后的心理测量学特性。方法:我们按照EMIQ-HP自评问卷的跨文化适应性指南翻译EMIQ-HP,并在46名比利时法语心理健康专业人员中测试其7天重测信度。采用类内相关性(ICC)和Cohen’s kappa (κ)评估信度。结果:法语版问卷(EMIQ-Fr)的项目和量表的ICCs范围为0.41 ~ 0.77,κ值为0.42 ~ 0.71,所有项目均表现出中度(≥0.41)至重度(≥0.61)的7天重测信度。子量表的ICCs范围为0.44至0.84,量表表现出中等(≥0.41)至几乎完美(≥0.81)的7天测试-重测信度。结论:EMIQ-Fr是第一个标准化法语问卷,旨在评估精神卫生专业人员对运动治疗精神障碍的看法。它在未来研究中的应用可以增强我们对精神障碍患者在达到或维持对健康有益的运动水平方面的理解和支持。
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引用次数: 0
Abnormal Child Behavior in primary school students: A Bayesian network analysis. 小学生异常儿童行为:贝叶斯网络分析。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-19 DOI: 10.1016/j.encep.2025.09.006
Apolline C Till, Teague R Henry, Marco Scutari, Giovanni Briganti

The Conners Teacher Rating Scale revised: short (CTRS-R: S) is a widely used psychometric instrument to screen for Attention Deficit and Hyperactivity Disorder (ADHD) as well as a broader construct of abnormal child behavior. In this study, we aimed to examine the network structure of abnormal child behavior using the CTRS-R: S in a sample of 525 French-speaking primary school students from Belgium. We employed Bayesian network analysis to estimate both the 28-item network and the network with the 8 items with the highest strength centrality, using the PC algorithm and bootstrapping to estimate the figures. Our study uncovered associations between inattention symptoms and learning disorders, shedding new light on the complexity of abnormal child behavior. We also identified different network structures, revealing a fresh perspective on the underlying mechanisms of these conditions. Our findings, though preliminary, are consistent with previous research and add to the burgeoning literature on Bayesian network analysis in abnormal child behavior research. Overall, our study underscores the complexity of the construct of abnormal child behavior and the importance of considering multiple factors in screening and diagnosis, emphasizing the need for a comprehensive approach to understanding and treating these disorders.

《康纳斯教师评定量表》是一种广泛用于筛查注意缺陷多动障碍(ADHD)的心理测量工具,也是一种更广泛的儿童异常行为结构。本研究以比利时525名法语小学生为研究对象,采用CTRS-R: S量表对儿童异常行为的网络结构进行研究。我们采用贝叶斯网络分析对28项网络和8项强度中心性最高的网络进行估计,使用PC算法和自举法对数字进行估计。我们的研究揭示了注意力不集中症状和学习障碍之间的联系,为儿童异常行为的复杂性提供了新的视角。我们还确定了不同的网络结构,揭示了这些条件的潜在机制的新视角。我们的发现虽然是初步的,但与之前的研究一致,并为新兴的贝叶斯网络分析在异常儿童行为研究中的应用增加了新的文献。总之,我们的研究强调了儿童异常行为结构的复杂性,以及在筛查和诊断中考虑多种因素的重要性,强调了需要一种全面的方法来理解和治疗这些疾病。
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引用次数: 0
[High-security prisons: How far is it possible to care people in prison?] [高度戒备的监狱:在多大程度上可能照顾监狱中的人?]]
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-19 DOI: 10.1016/j.encep.2025.09.008
Thomas Fovet, Marion Eck, Béatrice Carton, Marc Fédèle, Mathieu Lacambre, Anne-Hélène Moncany, Catherine Paulet, Jean-Louis Senon, Pierre Thomas, Pascale Giravalli

In March 2025 the French Minister of Justice announced that, beginning at the end of July 2025, the prisons of Vendin-le-Vieil and Condé-sur-Sarthe would host approximately 200 individuals convicted of drug trafficking within newly established units specifically designed to address organized crime. Incarceration conditions in these high-security facilities will be extremely strict, with the explicit goal of severing incarcerated people's contact with the outside world. The detrimental effects of solitary confinement on incarcerated people's health are well-documented, and numerous international conventions and treaties stipulate that such measures should be used only in exceptional circumstances, as a last resort, and for the shortest time possible. This article examines the role of healthcare professionals within these high-security units. To what extent can the principle of equivalence of care - according to which incarcerated individuals must receive healthcare equivalent to that provided to the general population - be upheld in this context? We address the issue of the ethical responsibility of healthcare professionals working in facilities where conditions of incarceration are known to have deleterious effects on the health of incarcerated individuals.

2025年3月,法国司法部长宣布,从2025年7月底开始,文丹-勒-维埃和萨尔特河畔孔达姆萨监狱将在专门处理有组织犯罪的新设立的单位中关押大约200名被判犯有贩毒罪的人。这些高安全性设施的监禁条件将极其严格,其明确目标是切断被监禁人员与外界的联系。单独监禁对被监禁者健康的有害影响是有据可证的,许多国际公约和条约规定,只有在特殊情况下,作为最后手段,才应使用这种措施,而且时间要尽可能短。本文探讨了医疗保健专业人员在这些高安全性单位中的作用。在这种情况下,同等照顾原则——根据该原则,被监禁的个人必须得到与一般民众同等的保健服务——在多大程度上能够得到支持?我们处理在已知监禁条件对被监禁者的健康有有害影响的设施中工作的保健专业人员的道德责任问题。
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引用次数: 0
[Involuntary care: From dangerousness to risk assessment]. [非自愿护理:从危险到风险评估]。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-19 DOI: 10.1016/j.encep.2025.09.005
Pierre Oswald, Thierry Pham

Objective: To explore the limitations of psychiatric dangerousness assessments in Belgium, France, the UK, and the Netherlands, and to assess whether systematic and structured risk assessment, supported by enhanced forensic psychiatry skills and interdisciplinarity, could improve involuntary care decisions.

Methods: Comparative analysis of legislative frameworks (Belgian law of 26 June 1990, amended in 2024; French Public Health Code; Mental Health Act 1983; Compulsory Mental Health Care Act 2020; Wet verplichte geestelijke gezondheidszorg 2020) and assessment practices based on literature and statistical data.

Results: Compulsory measures have been strongly increasing in Belgium, France, the UK, and the Netherlands for over a decade. Subjective dangerousness assessments, based on vague legal criteria not recently revised, show significant variability in Belgium and France where structured tools are absent, unlike the UK and the Netherlands which are developing initiatives around risk assessment, notably with the HCR-20 V3 to structure decisions. These tools demonstrate validated predictive accuracy but would require essential training for implementation.

Conclusions: Implementing structured tools, combined with interdisciplinary and forensic psychiatry training inspired by the Nixon line, could reduce subjective biases, stigma, and trauma pending studies confirming their effectiveness.

目的:探讨比利时、法国、英国和荷兰精神病学危险性评估的局限性,并评估在加强法医精神病学技能和跨学科合作的支持下,系统和结构化的风险评估是否可以改善非自愿护理决策。方法:比较分析立法框架(比利时1990年6月26日法律,2024年修订;法国公共卫生法;1983年精神卫生法;2020年强制性精神保健法;Wet verplichte geestelijke gezondheidszorg 2020)和基于文献和统计数据的评估实践。结果:十多年来,比利时、法国、英国和荷兰的强制性措施一直在大力增加。主观危险性评估,基于最近未修订的模糊法律标准,在比利时和法国显示出显著的差异,其中缺乏结构化工具,不像英国和荷兰正在围绕风险评估制定倡议,特别是HCR-20 V3结构决策。这些工具展示了经过验证的预测准确性,但需要进行必要的培训才能实现。结论:实施结构化工具,结合跨学科和法医精神病学培训,受尼克松路线的启发,可以减少主观偏见,耻辱和创伤,有待研究证实其有效性。
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引用次数: 0
The fabric of mood in mania co-occurring with substance use. 躁狂的情绪结构与物质使用共存。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-19 DOI: 10.1016/j.encep.2025.09.009
Chirine Fares
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引用次数: 0
Interoceptive patterns and alexithymia in adolescents with anorexia nervosa. 青少年神经性厌食症的内感受模式与述情障碍。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-19 DOI: 10.1016/j.encep.2025.09.004
Hélène Lahaye, Anna Heniquez, Caroline Tual, Sébastien Garny de la Riviere, Xavier Benarous

Introduction: Alexithymia is a central concept in understanding the psychological vulnerability to eating disorders. Associations between alexithymia and distinct components of interoception have previously been reported in healthy individuals and those with mental health problems. From a therapeutic perspective, it is important to determine whether such associations exist for adolescents with anorexia nervosa and which domains of interoception (i.e., accuracy [IAc], awareness [IAw], and sensibility [ISe]) are concerned.

Method: A cross-sectional study was conducted on twenty 12-17-year-old hospitalized adolescent girls with restrictive anorexia nervosa (M=14years±1.59, mean BMI of 15.59). The heartbeat detection task (HBDT) assessed IAc and IAw. The Porges Body Perception Questionnaire (PBPQ) was used for ISe, the Children-Toronto Alexithymia Scale (CTAS) for alexithymia, alongside the Child Depressive Inventory (CDI) for depression, the ECAP for anxiety, and the Difficulties in Emotion Regulation Scale-Youth scale (DERS-Y) for emotional dysregulation.

Results: The error rate at the HBDT was negatively correlated with the CTAS sub score "Externally-oriented thinking" but no other CTAS sub scores or other clinical dimensions. The association between IAw and the CTAS sub-score "Externally-oriented thinking" failed to remain significant after Bonferroni correction. The PBPQ total score was positively correlated with the CDI total score and the ECAP fear sub score.

Conclusion: Among adolescents hospitalized for anorexia nervosa, the more accurate the detection of heart rate, the more frequently operative thinking was reported, while a high level of ISe was associated with anxiety and depression-related symptoms. The mechanisms underlying the relation between the discrimination of body perception and emotional processing may vary across psychiatric disorders.

述情障碍是理解饮食失调心理脆弱性的核心概念。在健康个体和有精神健康问题的个体中,曾报道过述情障碍和内感受不同成分之间的关联。从治疗的角度来看,重要的是确定青少年神经性厌食症是否存在这种关联,以及内感受的哪个领域(即准确性[IAc],意识[IAw]和敏感性[ISe])有关。方法:对20例12 ~ 17岁住院的限制性神经性厌食症少女(M=14岁±1.59,平均BMI为15.59)进行横断面研究。心跳检测任务(HBDT)评估IAc和IAw。ISe使用Porges身体知觉问卷(PBPQ),述情障碍使用儿童多伦多述情量表(CTAS),抑郁使用儿童抑郁量表(CDI),焦虑使用ECAP,情绪调节困难量表-青少年量表(DERS-Y)用于情绪失调。结果:HBDT的错误率与CTAS评分“外向型思维”负相关,而与其他CTAS评分及其他临床维度无关。经Bonferroni修正后,ilaw与CTAS分项“外向型思维”的相关性未能保持显著性。PBPQ总分与CDI总分、ECAP恐惧分值呈正相关。结论:在因神经性厌食症住院的青少年中,心率检测越准确,手术思维越频繁,而高水平的ISe与焦虑和抑郁相关症状相关。在不同的精神疾病中,身体知觉的歧视与情绪加工之间的关系的潜在机制可能有所不同。
{"title":"Interoceptive patterns and alexithymia in adolescents with anorexia nervosa.","authors":"Hélène Lahaye, Anna Heniquez, Caroline Tual, Sébastien Garny de la Riviere, Xavier Benarous","doi":"10.1016/j.encep.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.encep.2025.09.004","url":null,"abstract":"<p><strong>Introduction: </strong>Alexithymia is a central concept in understanding the psychological vulnerability to eating disorders. Associations between alexithymia and distinct components of interoception have previously been reported in healthy individuals and those with mental health problems. From a therapeutic perspective, it is important to determine whether such associations exist for adolescents with anorexia nervosa and which domains of interoception (i.e., accuracy [IAc], awareness [IAw], and sensibility [ISe]) are concerned.</p><p><strong>Method: </strong>A cross-sectional study was conducted on twenty 12-17-year-old hospitalized adolescent girls with restrictive anorexia nervosa (M=14years±1.59, mean BMI of 15.59). The heartbeat detection task (HBDT) assessed IAc and IAw. The Porges Body Perception Questionnaire (PBPQ) was used for ISe, the Children-Toronto Alexithymia Scale (CTAS) for alexithymia, alongside the Child Depressive Inventory (CDI) for depression, the ECAP for anxiety, and the Difficulties in Emotion Regulation Scale-Youth scale (DERS-Y) for emotional dysregulation.</p><p><strong>Results: </strong>The error rate at the HBDT was negatively correlated with the CTAS sub score \"Externally-oriented thinking\" but no other CTAS sub scores or other clinical dimensions. The association between IAw and the CTAS sub-score \"Externally-oriented thinking\" failed to remain significant after Bonferroni correction. The PBPQ total score was positively correlated with the CDI total score and the ECAP fear sub score.</p><p><strong>Conclusion: </strong>Among adolescents hospitalized for anorexia nervosa, the more accurate the detection of heart rate, the more frequently operative thinking was reported, while a high level of ISe was associated with anxiety and depression-related symptoms. The mechanisms underlying the relation between the discrimination of body perception and emotional processing may vary across psychiatric disorders.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Suicide reattempts in adolescents and young adults after a first suicide attempt. Results from the SURAYA prospective cohort study 首次自杀未遂后再次自杀的青少年。SURAYA前瞻性队列研究的结果。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-01 Epub Date: 2025-03-14 DOI: 10.1016/j.encep.2024.12.004
Nadine Barakat , Jérôme Brunelin , Erika Abrial , Cécilia Neige , Benoît Chalancon , Jacqueline Scholl , Anthony Fourier , Julie Brossaud , Marianne Hermand , Vincent Besch , Louis Simon , Charline Magnin , Edouard Leaune , Emmanuel Poulet

Introduction

Suicide is a particularly major public health concern among young people as it is the fourth cause of death in youth aged 15–29. Despite various prevention strategies and efforts, the rate of suicide attempts among youth has increased over time and has risen even further since the COVID-19 pandemic.

Objectives

The aim of this study was to ascertain the prevalence of suicide reattempts within 3 months in a cohort of young first-time suicide attempters aged 16 to 25 years. Exploratory objectives were to investigate potential risk factors associated with reattempts in this population.

Methods

We conducted a prospective, naturalistic, single-center cohort study including 182 patients hospitalized in emergency psychiatry for a first suicide attempt. Data on 31 sociodemographic, clinical and biological factors known to be associated with suicide were collected at baseline.

Results

Out of the 182 patients included, 146 participants remained for the 3-months follow-up analysis (mean age: 19.71 ± 2.5 years, 71.9% female). Twenty of them reattempted suicide: yielding a prevalence of 13.7% (14.3% of females and 12.2% of males). Only four clinical and biological factors under study were significantly associated with suicide reattempt.

Conclusion

Our findings underscore the critical need for targeted prevention strategies for adolescents and young adults, as they represent a high-risk group for early suicide reattempts. Further research into the factors associated with recurrent suicide attempts is essential to more accurately characterize the profiles of young individuals who reattempt suicide, thereby informing the development of effective preventive interventions and avoiding negative outcomes.
导言:自杀是年轻人中一个特别重要的公共卫生问题,因为它是15-29岁青年死亡的第四大原因。尽管采取了各种预防战略和努力,但随着时间的推移,青年自杀未遂率仍在上升,自2019冠状病毒病大流行以来,自杀未遂率进一步上升。目的:本研究的目的是确定一组年龄在16至25岁之间的首次自杀企图者在3个月内再次自杀的患病率。探索性目的是调查该人群中与再尝试相关的潜在危险因素。方法:我们进行了一项前瞻性、自然主义、单中心队列研究,包括182例首次自杀未遂的急诊精神病学住院患者。在基线时收集31项已知与自杀有关的社会人口学、临床和生物学因素的数据。结果:在纳入的182例患者中,有146例参与者进行了3个月的随访分析(平均年龄:19.71±2.5岁,女性71.9%)。其中20人再次试图自杀:患病率为13.7%(女性14.3%,男性12.2%)。研究中只有四种临床和生物学因素与自杀再企图有显著关系。结论:我们的研究结果强调了针对青少年和年轻人制定有针对性的预防策略的必要性,因为他们是早期自杀再企图的高危人群。进一步研究与复发性自杀企图相关的因素对于更准确地描述再次自杀的年轻人的特征至关重要,从而为制定有效的预防干预措施和避免负面结果提供信息。
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引用次数: 0
New cross-disciplinary sleep medicine residency in France: Results after five years 法国新的跨学科睡眠医学住院医师:五年后的结果。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-01 Epub Date: 2025-04-04 DOI: 10.1016/j.encep.2025.01.006
Julie Garrivet , Alix Romier , Isabelle Arnulf , Émilie Bequignon , Georges Bettega , Plamen Bokov , Sylvie Bonin-Guillaume , Patrice Bourgin , Xavier Dufour , Yolande Esquirol , Patricia Franco , Rodrigue Garcia , Kiyoka Kinugawa , Claire Launois , Damien Leger , Benoît Lequeux , Jean-Claude Meurice , Jean-Arthur Micoulaud-Franchi , Pierre Philip , Marie Pia d’Ortho , Pierre A. Geoffroy
The new cross-disciplinary sleep medicine residency program (SMR) was created in 2017 in France and effectively implemented beginning in 2019. This first French specific sleep medicine residency program aims to train specialists in sleep medicine by complementing the knowledge from their original Specialized Studies Diplomas (SSD). The SMR lasts one year, offering comprehensive theoretical cross-disciplinary training and two practical internships of six months each. This study, based on a standardized questionnaire, aims to provide an initial assessment of this training and its impact on the professional careers of physicians who completed the SMR, five years after its implementation. The 42 participants in this study, with an average age of 30.3 years, primarily came from Paris (21.4%) and Strasbourg (16.7%), followed by Bordeaux, Dijon, Lille, and Marseille (7.1%), Besançon, Caen, and Toulouse (4.8%), and Angers, Grenoble, Lyon, Martinique, Montpellier, Nancy, Poitiers, and Reims (2.4%). Psychiatry and pulmonology were the most represented specialties among nine specialties, with the other seven being general medicine, neurology, geriatrics, otolaryngology, cardiology, occupational medicine, and public health. Regarding practical training, combined internships (paired with SSD internship) and internships outside the subdivision were popular, highlighting the importance of diversified training. The majority of participants (76.2%) had defended their medical thesis, with 66.7% of them related to sleep medicine. Additionally, 52.4% worked in a sleep center, and 81% had activities related to sleep medicine. For participants who did not have a permanent position (residents, junior doctors, chief residents, assistants), 72.5% considered a hospital career, and 45% considered an academic career. Regarding research trajectories, 69% of participants had already published at least one scientific article, and 38.1% held or were enrolled in a master's degree in research. The survey revealed a high level of satisfaction among participants (97.6%). In conclusion, the SMR is perceived as enriching and has a direct impact on the academic and professional career paths of its participants. These results highlight the significant role of this new innovating transversal training in the development of sleep medicine in France.
新的跨学科睡眠医学住院医师项目(SMR)于2017年在法国创建,并于2019年开始有效实施。这是法国第一个专门的睡眠医学住院医师项目,旨在通过补充他们原来的专业研究文凭(SSD)的知识来培训睡眠医学专家。SMR为期一年,提供全面的跨学科理论培训和两个各六个月的实践实习。本研究基于一份标准化问卷,旨在初步评估该培训及其对完成SMR的医生职业生涯的影响,SMR实施五年后。本研究的42名参与者平均年龄为30.3岁,主要来自巴黎(21.4%)和斯特拉斯堡(16.7%),其次是波尔多、第戎、里尔和马赛(7.1%),贝桑佩尔松、卡昂和图卢兹(4.8%),以及昂热、格勒诺布尔、里昂、马提尼克、蒙彼利埃、南希、普瓦捷和兰斯(2.4%)。在9个专科中,精神病学和肺病学是最具代表性的专科,其他7个专科是全科医学、神经病学、老年病学、耳鼻喉科、心脏病学、职业医学和公共卫生。在实训方面,结合实习(配合SSD实习)和分科外实习较为流行,凸显了多元化培训的重要性。大多数参与者(76.2%)为他们的医学论文辩护,其中66.7%与睡眠医学有关。此外,52.4%的人在睡眠中心工作,81%的人有与睡眠医学相关的活动。对于没有固定职位(住院医生、初级医生、总住院医生、助理)的参与者,72.5%的人考虑在医院工作,45%的人考虑在学术领域工作。在研究轨迹方面,69%的参与者已经发表了至少一篇科学论文,38.1%的参与者拥有或正在攻读研究硕士学位。调查结果显示,参与者的满意度很高(97.6%)。总之,SMR被认为是丰富的,并对其参与者的学术和职业生涯路径有直接的影响。这些结果突出了这种新的创新横向培训在法国睡眠医学发展中的重要作用。
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引用次数: 0
A conceptual and paradigm shift whose time has come 观念和模式的转变已经到来
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-01 Epub Date: 2025-11-20 DOI: 10.1016/j.encep.2025.11.001
Christine A. Courtois
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引用次数: 0
Adversité, troubles psychiatriques adolescents et trauma complexe : comorbidités ou superposition ? 逆境、青少年精神障碍和复杂创伤:共病还是重叠?]
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-12-01 Epub Date: 2025-09-26 DOI: 10.1016/j.encep.2025.06.009
Jean Belbèze , Claire Lamas , Jérôme Silva , Maurice Corcos , Marion Robin

Objective

In a context of debates on the place of complex trauma within psychiatric pathology, it is essential to accurately measure the extent of the effects of adversity across different disorders. Such studies are rare, however, because they often focus on a single diagnosis. The measurement of adversity is usually self-reported, retrospective, and usually includes a single dimension. Furthermore, at-risk family interactions and maltreatment constitute two distinct and central risk factors for both complex trauma and psychiatric disorders. Yet they are rarely studied together, nor through an overview of psychiatric disorders. This is the aim of this study, which hypothesizes that adversity is widely distributed across all the psychiatric disorders of adolescents admitted to psychiatric hospitals, and postulates that it is possible to discern distinct adversity profiles depending on the diagnosis.

Methodology

This cross-sectional analysis stems from the Family & Care study, which aims to measure various adversity factors in hospitalized adolescents aged 13 to 19 (n = 425). Data on abuse and neglect were collected by hetero-assessment using the European abuse and neglect database Child Abuse and Neglect via Minimum Data Set (CAN-via-MDS), and family interactions were measured using the At-Risk Family Interactions and Levers (ARFIL) scale, a 30-item clinical tool also rated by hetero-assessment.

Results

Among the 425 participants, the prevalence of emotional abuse was 46.1%, physical abuse 21.4%, sexual abuse 25.1% and neglect 70.5%. The psychiatric disorders measured were all associated with significant rates of childhood adversity, and different adversity profiles could be identified according to diagnosis. Trauma- and stress-related disorders accounted for only 13.4% of disorders. The latter, as well as borderline personality disorder and oppositional defiant disorder, were associated with higher scores of at-risk family interactions than the other diagnoses, highlighting the distinct influence of at-risk family dynamics independently of abuse or neglect.

Conclusion

The determinants linked to adversity cut across all the nosographic fields in child psychiatry, and support the idea that the complex trauma clinic overlaps strongly with all the usual diagnostic categories. Depending on the diagnosis, it seems possible to identify distinct adversity profiles, with borderline personality disorder appearing as one face of complex trauma among others. The Family & Care study reinforces the value of multiplying the sources of observation in clinical practice and in future research, by combining diagnostic aspects with the relational correlates of patients under psychiatric care, which represent both risk factors and essential therapeutic levers.
目的:在关于复杂创伤在精神病理学中的地位的争论背景下,准确测量逆境在不同疾病中的影响程度是至关重要的。然而,这样的研究很少见,因为它们通常只关注一种诊断。对逆境的测量通常是自我报告的,回顾性的,通常包括一个维度。此外,处于危险中的家庭互动和虐待构成了复杂创伤和精神障碍的两个不同的核心风险因素。然而,他们很少一起研究,也没有通过精神疾病的概述。这是本研究的目的,该研究假设逆境广泛分布于精神病院收治的所有青少年的精神障碍中,并假设有可能根据诊断来辨别不同的逆境概况。方法:本横断面分析源于家庭与护理研究,旨在测量13至19岁住院青少年的各种逆境因素(n=425)。虐待和忽视的数据通过异源评估收集,使用欧洲虐待和忽视数据库儿童虐待和忽视最小数据集(CAN-via-MDS),家庭相互作用使用风险家庭相互作用和杠杆(ARFIL)量表进行测量,这是一个30个项目的临床工具,也通过异源评估进行评估。结果:425名被调查者中,精神虐待的发生率为46.1%,身体虐待的发生率为21.4%,性虐待的发生率为25.1%,忽视的发生率为70.5%。测量的精神障碍都与童年逆境的显著率相关,并且根据诊断可以识别不同的逆境特征。创伤和压力相关的疾病仅占疾病的13.4%。后者,以及边缘型人格障碍和对立违抗性障碍,与其他诊断相比,与高风险家庭互动得分更高相关,突出了与虐待或忽视无关的高风险家庭动态的独特影响。结论:与逆境相关的决定因素贯穿了儿童精神病学的所有分科领域,并支持了复杂创伤临床与所有常规诊断类别强烈重叠的观点。根据诊断,似乎有可能识别出不同的逆境特征,边缘人格障碍表现为复杂创伤的一种。家庭与护理研究强调了在临床实践和未来研究中倍增观察来源的价值,通过将诊断方面与精神科护理患者的相关因素结合起来,这既代表了风险因素,也代表了必要的治疗杠杆。
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Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique
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