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

Context: Sexual sensation seeking and sexual compulsivity are two characteristics associated with sexual risk taking and can be studied in different contexts, one of these being that of forensics. Among the different tools used to assess these characteristics, the Sexual Sensation Seeking Scale (SSSS) and the Sexual Compulsivity Scale (SCS) are particularly concise and specific.

Method: This study proposes a French translation of those scales, the fSSSS and the fSCS, validated among a sample of 536 participants from France. Assessments of factor structure, internal consistency and reliability showed good psychometric properties. Convergent and divergent validities were assessed using various forensic-related measures and demonstrated the relevance of both scales in this context.

Introduction: Social functioning is an individual's ability to interact effectively and appropriately with his or her social environment. In psychiatry, acting on social functioning is necessary to reduce the intensity of symptoms and promote patient life in the community. This study proposes a cross-cultural validation of the Social Functioning Questionnaire (SFQ) in Moroccan dialectal Arabic.

Methods: This work consists of creating a translated version according to a rigorous methodology, including direct and reverse translation, as well as evaluation by linguistic experts. A sample of 160 participants was then selected to evaluate the psychometric properties of the SFQ in a statistical study.

Results: The validation study showed high acceptability and reliability, with a Cronbach's alpha coefficient of 0.803. The results also showed good reproducibility, with perfect inter-observer stability between the test and the retests.

Conclusion: This version of the SFQ is reliable and valid for measuring social functioning in our Moroccan population.

Objectives: Psychiatric patients are frequently exposed to factors that increase their risk of developing chronic liver diseases. These factors include the presence of metabolic syndrome, high rates of current or past alcohol and illicit substance use, and the direct liver toxicity of certain psychiatric medications. Despite this, systematic screening for chronic liver diseases in this population is not routine. Transient elastography (FibroScan®), a non-invasive method to assess liver stiffness, could facilitate early detection of advanced hepatic fibrosis. This study aimed to assess the acceptability of non-invasive liver fibrosis evaluation using FibroScan® among psychiatric inpatients and to evaluate the prevalence of alcohol and illicit drug use, viral hepatitis, significant liver fibrosis, and linkage to somatic care.

Methods: This prospective, interventional cohort study was conducted in a tertiary psychiatric hospital from March 2023 to January 2024. Liver stiffness measurement (LSM) by transient elastography (FibroScan®) screening for the detection of significant liver fibrosis was proposed to all hospitalized patients after providing informed consent. Patients responded to a structured interview that included the AUDIT-C questionnaire to assess alcohol use disorders, along with items on illicit drug use and other liver disease risk factors like metabolic syndrome or viral hepatitis. Significant fibrosis was defined as liver stiffness measurement (LSM) ≥10kPa. Demographic, clinical, biological and virological data was collected from patients' medical files.

Results: A total of 180 patients were included in the study, with 122 (67.8%) consenting to FibroScan® screening. The cohort's mean age was 44.4±15.5 years, with 61% male. The seroprevalence of HCV antibodies was 2.5%, with a higher prevalence among men (6.5%). Chronic HBV infection prevalence was 0.81%. Metabolic syndrome was present in 28.7% of patients. Alcohol use disorders were identified in 45.9% of patients, with men showing higher AUDIT-C scores than women (P=0.04). Drug use was reported by 37.7% of patients, with recent use in 20%. Significant fibrosis was detected in 0.8% of patients and linkage to care was provided in this case.

Conclusions: Transient elastography is an acceptable method for screening hepatic fibrosis in psychiatric settings. It represents an excellent option to assess other associated comorbidities in this underserved population and improve linkage to somatic care.

Objective: Seclusion is a measure used as a last resort in psychiatry to manage high-risk situations of hetero- or self-agression. However, few studies have investigated factors that could be associated with seclusion. The aim of this study was to assess the clinical and socio-demographic characteristics of patients who were prescribed seclusion.

Patients and methods: An observational, retrospective study was carried out between January 2019 and December 2020, including patients with psychosis who had been hospitalized. Clinical and socio-demographic characteristics, as well as psychopathological scores were compared between patients who required seclusion and those who did not. A binomial logistic regression including gender, age, symptom severity, knowledge of the French language and judicial history was performed.

Results: We included 127 patients (41 of whom were prescribed seclusion). Patients requiring seclusion had more severe symptoms, as indicated by the Positive And Negative Syndrome Scale total scores (98.8±21.95 vs 85.9±25.64; P=0.02), the positive symptoms subscale (28.4±8.89 vs 24±7.63; P=0.02), and the general psychopathology symptoms subscale (48.3±12.03 vs 41.9±12.21; P=0.02). These patients had poor knowledge of French (21% vs 4.7%; P<0.01) and a statistical trend was found in relation to judicial history (24% vs 11%; P=0.07). The differences in symptomatology (P=0.03) and language knowledge (P=0.04) were maintained in the multivariate analysis.

Discussion and conclusion: Our study found that the implementation of a seclusion was associated with the severity of symptoms and with a lack of knowledge of the French language. Particular attention should therefore be paid to these specific patients in order to use de-escalation techniques and provide comprehensible explanations to patients who do not speak French.

Objectives: This project aimed to explore the impact of psychological distress (anxiety, depression and post-traumatic stress) and resilience on quality of life and psychological health at work (well-being or distress at work) of nursing home and healthcare staff members in the Moselle department in Northeastern France.

Methods: In the spring of 2021 230 professionals replied to an online questionnaire. The theoretical model was tested through path analyses.

Results: Results showed that higher resilience scores were associated with lower post-traumatic stress, anxiety, and depression scores. Anxiety and depression were negatively correlated with quality of life, while higher quality of life scores were linked to greater well-being at work. Resilience was found to have a significant impact on the psychological state of professionals, with differences observed between well-being and distress at work.

Discussion: In conclusion, our study revealed that resilience plays a significant role in influencing the psychological state of professionals, ultimately impacting their psychological health at work. Therefore, interventions aimed at addressing anxiety, depression, and traumatic symptoms could potentially enhance resilience and mitigate work-related psychological disorders among frontline healthcare professionals.

Objective: To examine the role of smoking status on motivation to reduce alcohol consumption in patients admitted to the emergency department (ED) with alcohol use disorder (AUD).

Methods: A standardized questionnaire was administered to patients admitted to the ED of the Hôpital Européen Georges-Pompidou (Paris, France), whatever the cause of admission, as part of an AUD screening, brief intervention, and referral to treatment (SBIRT) program. The questionnaire collected demographic, cognitive impairment assessment variables including school curriculum difficulties and medical characteristics, smoking status, cannabis use and the Fast Alcohol Consumption Evaluation (FACE) for AUD risk assessment. Patients aged 18-90years with a FACE score≥4 for women and≥5 for men were selected. An analogue scale from 0 to 10 was used to assess motivation, estimation of the right time, and self-confidence to reduce or stop alcohol consumption.

Results: Of the 3903 patients included between 2021 and 2023, 803 (21%) presented with TUA, with 72% excessive drinkers and 28% with a probable alcohol dependence. The study population was predominantly male (n=418, 52%). Current smokers accounted for 43% of patients (n=343), and only 8% (n=27) wished to obtain the contact details of the national quitline Tabac-Info-Service, a percentage twice as high as that observed among smokers at low or no risk of AUD. The average age was 48.7years (SD: 21.6), and smokers had a lower average age than the average for all participants (41years, SD: 17.4). On the other hand, former smokers were older on average (58.3years, SD: 20.6). In all, 36% (n=209) of patients with excessive alcohol consumption were smokers while 59% (n=134) of those with probable alcohol dependence were smokers. In terms of school curriculum, 13% (n=108) had experienced learning difficulties (50% of whom were smokers), 42% (n=339) had repeated a year (44% of whom were smokers), and 18% (n=146) had been suspended or excluded from school (53% of whom were smokers). In terms of neurological history, 35% (n=278) had suffered from memory loss and 19% (n=156) from fainting (42%, 53% of whom were smokers respectively). Less than 10% reported epilepsy episodes (8.7%: n=70) or neurodevelopmental disorders (6.4%: n=51). Among them, 54% and 61% respectively were smokers. Past-month cannabis use concerned 14% of patients (n=112), 85% of whom declared they smoked. In the descriptive analyses, more smokers than non-smokers felt that their admission to ED motivated them to reduce or stop their alcohol consumption, considered that it was the right time to do so, and declared a higher level of self-confidence in achieving this objective. In bivariate analyses, motivation and the right time to reduce or stop drinking were significantly associated with being a smoker, but these results were not found in the multivariate analysis.

Conclusion: Thes

Clozapine remains the gold-standard for resistant schizophrenia. However, it is associated with serious adverse events and a low patient adherence that could be enhanced by therapeutic education. Identifying patients' needs is a prerequisite for building educational tools. The aims of the study were to build an adapted information tool after evaluating patients' knowledge and expectations regarding their clozapine treatment, and to estimate patients' satisfaction with this tool. Patients' knowledge and expectations were evaluated by means of a short oral and semi-structured interview, based on an 11-item questionnaire developed by pharmacists and psychiatrists. Patients with schizophrenia or a schizo-affective disorder were included from four different care structures of the university psychiatry department. Finally, an education tool was built based on patients' answers and tested among them. Between February 2020 and September 2021, 51 patients (17 women) around 36 years of age were interviewed. 45% were aware of a clozapine indication. Half of the patients did not know how to react in case of forgetting a dose. Although the rhythm of blood tests was understood by most patients (84%), only 29% estimated they had a general knowledge about them. Many patients (73%) could cite no more than two adverse effects. Regarding interactions, 69% had a partial knowledge and 31% none at all. Patients preferred to receive information in the form of a brochure. The subsequent brochure was tested on 15 patients who were satisfied with it. The survey revealed a general lack of knowledge among patients about their clozapine treatment. The tool built based on patients' answers has been adapted and liked by patients.

Insomnia disorder is a major health concern, particularly among patients with mood disorders. This study validates the translated version of the Insomnia Severity Index (ISI) in a French population with psychiatric disorders, particularly mood disorders. The ISI was completed by 260 patients with sleep complaints comorbid with psychiatric disorders, including 209 patients with mood disorders. The majority of participants were women (n=168), and the most diagnosed condition in the population was unipolar mood disorder (n=170). Internal and external validity analyses validated the scale's reliability and its validity in relation to sleep quality and a diagnosis of insomnia made by a sleep psychiatrist. These results support the use of the French translation of the ISI in a French population with psychiatric disorders.

Objectives: The present study investigates the prevalence of antinuclear autoantibodies among Moroccan patients with schizophrenia compared to healthy controls and examines the potential associations between the presence of antinuclear autoantibodies and selected sociodemographic and clinical characteristics of patients with schizophrenia.

Methods: A cross-sectional assessment was conducted between May 2020 and December 2022. The study involved a total of 157 patients who were diagnosed with schizophrenia and admitted to the Ar-Razi Psychiatric Hospital of Ibn Sina University Hospital Center of Rabat, Morocco. A total of 115 healthy controls (blood donors) were recruited from the transfusion center of Kenitra, Morocco. Antinuclear autoantibodies screening was performed by an indirect immunofluorescence assay (IFA) using HEp-2 cells/liver (Monkey), and 16 specificities of nuclear antigens (ENA) were tested using immunodot assay on an automated platform.

Results: The prevalence of antinuclear autoantibodies was significantly higher in patients as compared to healthy control (35 vs. 12.7% with P<0.05) suggesting strongly underlying autoimmune processes in the studied patients. Among the 55 samples tested positive for antinuclear autoantibodies in patients, a total of 29 samples had a positive immunodot result against the following antigens: Jo1, SSA, SSB, Ro 52, AMA-M2, PM-Scl, Sm and Sm/RNP. Logistic regression analysis identified tobacco consumption as the only significant predictor of positive antinuclear autoantibodies (B=2.179, P=0.018).

Conclusion: This preliminary study provides original data on the prevalence of antinuclear autoantibodies in Moroccan patients with schizophrenia and reveals a strong association between tobacco consumption and antinuclear autoantibodies positivity. The present findings replicate the previously reported association between autoimmune processes and schizophrenia in other geographical areas and warrant extension to other circulating autoantibodies towards a full profiling of autoimmunity in Moroccan patients with schizophrenia.