Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique最新文献

Introduction: Electroconvulsive therapy (ECT) is an effective and widely used treatment for managing severe and/or resistant psychiatric disorders. Historically, the bitemporal setup (BT) and the age-based dosing method (ABM) have been the most common approaches. However, more recent practices, including the titration method (TM), right unilateral (RUL) electrode placement, and pulse width reduction, appear to have comparable efficacy and better tolerability. The primary objective of this study was to evaluate clinical outcomes before and after the implementation of these new practices at Sainte-Anne Hospital (GHU psychiatrie & neurosciences), the largest psychiatric hospital in Paris, France.

Method: This retrospective study included adult patients who underwent an acute course of ECT between December 2022 and May 2024. Clinical and sociodemographic data, stimulation parameters (electrodes placement, ABM vs. TM, charge difference between first and last session), and seizure characteristics (seizure duration and postictal suppression during first and last session) were collected from medical records. Data were compared and analyzed before and after the implementation of the new practices and according to the dosing method (ABM vs. TM). For treatments with TM the administered charge determined by the TM was also compared with the theoretical charge determined by ABM. As not all data followed a normal distribution, comparisons of quantitative data were made using the Mann-Whitney or Kruskal-Wallis test. Categorical data were compared using Chi² test.

Results: Data from 75 patients were included, of whom 72 completed the course of ECT and were included in the analysis of efficacy and tolerability. Compared with the previous practices, the new practices resulted in a significant reduction in charge increase between the first and the last session (P<0.01) and a trend toward less frequently perceived memory disturbances (-21%, P<0.10), with no significant differences in sociodemographic data or seizure characteristics (P>0.05). There was a trend towards more full responders with the new practices (+15%), albeit the difference was statistically non-significant. Compared with ABM, TM resulted in a significant reduction in charge difference (P<0.001) and a trend toward less perceived memory disturbances (-23%, P<0.10) with no significant differences in other variables (P>0.05). In patients who received ECT with the TM, the administered charge was significantly lower than the theoretical charge (P<0.01).

Conclusion: The new ECT practices improve tolerability, especially regarding memory, while maintaining clinical efficacy by using reduced electrical charges. These findings highlight the importance of personalizing ECT protocols to optimize tolerability without compromising efficacy.

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.