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

Young individuals identifying as lesbian, gay, bisexual, or pansexual (LGBP) are particularly vulnerable to suicidal ideation (SI). This study examines the relationships between sexual orientation, gender, coming out, and suicidal ideation among young French LGBP adults. The sample included 459 participants aged 18 to 35, 50.1% (n=230) of them identifying as LGBP. Data were collected through an online survey using the French version of the Suicidal Ideation Attributes Scale (SIDAS-FR). Findings revealed significantly higher levels of suicidal ideation among LGBP individuals compared to heterosexual people, with bisexual individuals reporting the highest levels. Women of sexual minorities, particularly those who are bisexual and pansexual, were identified as the most vulnerable subgroup for SI. Men of sexual minorities also reported increased SI compared to heterosexual men. Coming out emerged as a protective factor, with participants who had disclosed their sexual orientation to both parents reporting a lower level of SI. The study highlights the need for targeted interventions to support LGBP individuals, focusing on reducing stigma, promoting family acceptance, and strengthening community-based mental health resources.

Aims: Cannabis is widely used for various reasons, including its effects on sexuality. It has significant short- and long-term health consequences. However, its impact on sexual health remains uncertain. This study assesses sexual function in Tunisian cannabis users compared to non-users.

Methods: We conducted a cross-sectional, descriptive, and analytical case-control study at the Tunisian Association for the Fight Against Sexually Transmitted Diseases and AIDS. We used the Cannabis Abuse Screening Test (CAST) and the International Index of Erectile Function (IIEF-15) to evaluate cannabis dependence and male sexual function.

Results: The study included 30 male cannabis users matched with 30 control subjects from the general population. The median total CAST score was 24, indicating a severe level of dependence. All users reported trying cannabis at least once before sexual activity. The average IIEF-15 score among users was 63.07±4.32, and daily cannabis users had a significantly lower IIEF-15 total score (P=0.01). Compared to the control group, the mean total IIEF-15 score (P=0.001), as well as the mean scores in the domains of erection (P=0.001), orgasm (P=0.001), desire (P=0.006), and satisfaction (P=0.001), were significantly higher in the group of cannabis users.

Conclusion: This study highlights the controversial effects of cannabis on sexuality. However, the cross-sectional design limits the ability to establish a causal relationship between cannabis use and sexual dysfunction. Therefore, further research, particularly longitudinal studies, is needed along with increased awareness among healthcare professionals to ensure careful assessment of sexual function and to optimize patient management.

Introduction: Apathy, commonly observed in neurocognitive disorders, is characterized by a reduction in goal-directed behavior with a reduction of initiatives interests and emotions. This article presents the case of Mrs. B., a 70-year-old patient with mild neurocognitive disorder and apathy, who underwent an intervention combining transcranial direct current stimulation (tDCS) and cognitive training delivered through a web application.

Observations: After four weeks, clinical scales and self-report questionnaires revealed: reduced intensity in emotional blunting, increased interest, and decreased fatigue, although apathy remained stable according to the apathy diagnostic criteria. These changes were corroborated by vocal analyses, which showed improved prosody, increased speech rate, and fewer pauses. Changes in prosodic and temporal markers appeared to align with the behavioral improvements reported by the patient.

Discussion: These findings highlight the potential of prosodic and temporal speech markers to assess and monitor apathy. This innovative approach may enhance clinical evaluations and support the development of more tailored interventions.

Objective: The authors sought to assess differences in children and adolescents' characteristics according to the type of hospital they were admitted to.

Methods: This retrospective study was conducted with the French national insurance database (SNDS). Patients aged less than 18 and discharged from psychiatric hospitals in 2022 were included. Characteristics of stays were described according to the types of facilities: public, private not-for-profit, or private for-profit hospitals.

Results: In 2022, 20,598 patients were hospitalized in psychiatric facilities in France, totaling 46,222 stays. There were 76.92% of the stays in public, 13.39% in non-profit facilities, and 9.70% in for-profit facilities. In public and non-profit facilities, patients were more frequently male, younger, and had shorter lengths of stay compared to those in for-profit facilities.

Conclusions: Public facilities take care of the majority of patients. Characteristics of patients and stays differ according to the type of facility. There is a significant common population between public and private sectors.

Introduction: Body Dysmorphic Disorder (BDD) is a condition characterized by a distorted perception of one's own body image. Individuals with BDD exhibit excessive concern about their appearance, often fixating on perceived flaws that are either imaginary or minor. The prevalence of body image-related eating disorders has been increasing among university students, particularly in health-related fields, where students frequently experience pressure to maintain an ideal body shape and weight.

Methods: This cross-sectional qualitative study was conducted with Nutrition students at a community university in Caçador, Santa Catarina, Brazil. Body image perception was assessed using the Silhouette Matching Task (SMT) by means of an online questionnaire via Google Forms. Data analysis was performed using Student's t-test and Pearson's correlation, with statistical significance set at P<0.05.

Results: A total of 46 students participated, of whom 76.08% (n=35) were female. The mean BMI was 23.33kg/m², with a predominance of eutrophic individuals (74.28%). In contrast, the mean BMI for males was 28.42kg/m², with overweight being the predominant nutritional status. Regarding body image perception, 77.14% of females and 63.64% of males reported dissatisfaction with excess weight. The study found that males had a significantly higher weight (P=0.00003; r=0.578). Additionally, body dissatisfaction was more prevalent among females (P=0.00531; r=0.357) and increased with BMI (P=0.0015; r=0.455).

Conclusion: The findings indicate a high prevalence of body dissatisfaction among students, even among those with a nutritionally adequate status, particularly females. These results highlight the strong sociocultural pressure surrounding body image which significantly impacts this population.

Background: Studies have shown that psychiatrists have a higher suicide rate compared to the general population and other medical specialists.

Aim: To evaluate the prevalence, methods, and factors associated with suicide attempts (SA) among Moroccan psychiatrists.

Method: A cross-sectional online survey was carried out in August 2023 using an anonymous questionnaire created online on Google Forms.

Results: In all, 142 Moroccan psychiatrists practicing in the private and public sectors were included. Among these, 7.7% had a history of lifetime suicide attempts. Factors associated with TS among Moroccan psychiatrists are the personal history of depressive and anxiety disorders, the high scores of perceived stress, the psychoactive substances use; including tobacco, alcohol, and anxiolytics, as well as the family history of psychiatric disorders and the family history of suicide.

Conclusion: Suicide attempts among Moroccan psychiatrists are a serious mental health problem that has a negative impact on the psychiatrist himself, his entourage, and the quality of care provided to patients.

Introduction: Tele-expertise is a care tool that has developed significantly in certain medical disciplines such as dermatology, ophthalmology and cardiology in France in recent years. At Brest University Hospital, we have been able to set up tele-expertise in psychiatry since April 2023, via a secure platform (Omnidoc), on assistance with prescribing or de-prescribing psychotropic drugs. The aim of this study is to evaluate its contribution after 18 months of use.

Methods: A total of 166 tele-expertise requests were received and analyzed between April 2023 and September 2024. For each tele-expertise, we collected: the response time, the number of opinions given, the breakdown of requests by requesting physician's specialty, the number of different requesting physicians, the number of requests per requesting physician, the number of post-opinion consultations, the psychiatric diagnosis evoked and the number of requests for assistance with deprescribing. A satisfaction questionnaire was sent to each requesting physician who had requested at least one opinion during the period studied.

Results: A total of 152 tele-expertise requests were included in the final analysis. The average response time was 4hours over the study period, with a median response time of 1hour. Ninety-five percent of requesting physicians were satisfied with the quality of exchanges with the psychiatrist. Ninety-three percent of requesting physicians also felt that the tele-expertise had improved patient management. Fifty nine percent of requesting physicians prescribed psychotropic drugs differently since they had sought advice. Fifty eight percent felt they had learned how to better prescribe or deprescribe psychotropic drugs. Ninety-four percent thought they would use tele-expertise again and/or recommend it to a colleague. Finally, requests for help in deprescribing psychotropic drugs concerned only 6 of the 152 requests (3.9%).

Conclusion: The introduction of tele-expertise in psychiatry, focusing on medication via a secure platform, has been much appreciated by GPs in particular. It could improve patient care and encourage city-hospital collaboration.