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Publisher: Elsevier   (Total: 3175 journals)

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Showing 1 - 200 of 3175 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 9)
AASRI Procedia     Open Access   (Followers: 14)
Academic Pediatrics     Hybrid Journal   (Followers: 30, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 87, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 35, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 387, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 242, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 25, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
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Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 14)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 7)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 136, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 27, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 29, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 8)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 21)
Advances in Ecological Research     Full-text available via subscription   (Followers: 42, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 43, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 7)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 53, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 15)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 8)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 15, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 11, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 6, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 7)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 18, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 385, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 9, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 336, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 10, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 438, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access   (Followers: 1)
Algal Research     Partially Free   (Followers: 9, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 51, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 44, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 34, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 42, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 197, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 62, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 27, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 62, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 14)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 39, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 171, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)

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Journal Cover L'Encéphale
  [SJR: 0.313]   [H-I: 39]   [1 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0013-7006
   Published by Elsevier Homepage  [3175 journals]
  • Facteurs de satisfaction et d’épuisement des psychiatres aux
           urgences
    • Authors: E. Very; A.H. Moncany; A. Yrondi; T. Marquet; E. Bui; L. Schmitt
      Pages: 106 - 110
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): E. Very, A.H. Moncany, A. Yrondi, T. Marquet, E. Bui, L. Schmitt
      Les services d’urgences psychiatriques tiennent une place grandissante dans le réseau de soins en santé mentale. Ils correspondent à une pratique récente de la psychiatrie, dont les modalités d’exercice sont encore mal connues. Nous avons souhaité interroger les psychiatres exerçant aux urgences, avec un intérêt particulier pour leur degré de satisfaction et les modèles théoriques dont ils s’inspirent dans leur pratique quotidienne. Nous avons adressé par courrier un questionnaire à un échantillon de 508 psychiatres exerçant aux urgences en France. Les résultats portent sur 237 réponses, pour un taux de réponse de 47 %. Les psychiatres rapportent un niveau de satisfaction élevé (6,7/10). Les facteurs de satisfaction portent sur la diversité de l’exercice clinique et la position d’interface et de coordination dans le système de soins. Les facteurs d’insatisfaction sont de nature organisationnelle mais aussi liés à la pratique clinique. Les praticiens semblent utiliser des supports théoriques intégratifs, et les modèles de crise sont cités par 40 % d’entre eux. Les perspectives d’amélioration des pratiques concernent l’organisation interne des services d’urgences ainsi que l’articulation avec le système de soins en santé mentale. Background and aim Psychiatric emergency services (PES) have recently occupied a new and growing place in the landscape of mental health services. However, few data are available on the way psychiatrists practice in the PES. Our aim was to survey psychiatrists working in PES, focusing on their job satisfaction and the theoretical models they use in their everyday practice. Method We sent a survey to a sample of 508 psychiatrists working in PES in France. Results Two hundred and thirty-seven psychiatrists returned the survey, yielding a response rate of 47%. On a 0 to 10 scale, the mean level of job satisfaction was 6.7 (SD: 1.92). Participants reported that facing a variety of clinical situations and playing a key-coordinating role in the mental health system were the two most specific features of emergency psychiatry. The main sources of dissatisfaction were organizational issues and stressful clinical experiences, including violence or hostility. Sixty-three percent (n =150) of participants reported using more than two theoretical models in their practice, while the use of crisis models was reported by almost 40% of them. When assessed for suggestions to improve the PES, the majority of participants indicated that efforts should be focused on organizational factors. Conclusion While emergency psychiatry could appear as an ungrateful practice, the majority of psychiatrists who responded to our survey reported satisfaction with their work and highlighted its unique particularities. Future research and collaborations are needed to identify organizational models of PES and their better integration in mental health networks.

      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2016.10.001
       
  • Processus psychologiques de gestion du stress et régulation
           neuroendocrinienne chez les adolescents délinquants en institution
           fermée : une étude pilote
    • Authors: L. Guillod; S. Habersaat; M. Suter; T. Jeanneret; C. Bertoni; P. Stéphan; S. Urben
      Pages: 111 - 117
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): L. Guillod, S. Habersaat, M. Suter, T. Jeanneret, C. Bertoni, P. Stéphan, S. Urben
      Objectif Les conduites externalisées à l’adolescence peuvent témoigner d’une mauvaise gestion du stress, en raison notamment de dimensions psychologiques comme des stratégies de pensée inadaptées. Cette étude propose de considérer également les dimensions biologiques impliquées dans la gestion du stress en mettant en lien les stratégies de pensée avec la régulation du cortisol, et leur association avec des symptômes externalisés. Elle vise ainsi à identifier des profils biopsychologiques particuliers chez des adolescents délinquants, afin de fournir une meilleure compréhension de leur gestion du stress et d’adapter leur suivi éducatif et psychologique. Méthode Seize adolescents incarcérés ont complété le constructive thinking inventory (CTI), le child behavior checklist-youth self-report (CBCL), le youth psychopathic traits inventory (YPI), ainsi que le Dep-ado. Leur cortisol salivaire a été récolté, au moyen de Salivettes©, 4 fois/j pendant 3jours. Résultats Les résultats montrent que les adolescents incarcérés présentent des stratégies de pensée peu efficaces et rigides ainsi qu’une régulation neuroendocrinienne journalière non adaptative. Plus ils adoptent un type de pensée catégorique face au stress, plus ils présentent de traits psychopathiques et de comportements externalisés. De plus, leur niveau de cortisol au lever est plus élevé que celui de la population générale, et est associé à des traits psychopathiques, des stratégies de pensée ésotérique et superstitieuse et une consommation de substances plus importante. Conclusion Compte tenu du stress important vécu par les adolescents délinquants en institution fermée, il semble crucial de proposer une prise en charge spécifique favorisant la continuité, la non-exclusion et l’élaboration psychique. Background Adolescence is a stressful period where important biological, psychological and social changes occur. Adolescents are particularly vulnerable during this developmental period and can use various strategies to deal with daily stress, such as substance use or externalizing behaviors. In previous studies, stress in adolescents with externalizing behaviors was often linked to ineffective cognitive coping strategies (i.e., constructive thinking) and overlooking the biological aspects involved in stress management such as neuroendocrine regulation. Indeed, repeated activation of the hypothalamic-pituitary-adrenal (HPA) axis in chronic stress situations may have long-term effects on subsequent cortisol regulation and lead to psychological difficulties. It was also shown that basal cortisol levels are lower in adolescents with externalizing behaviors. This study aims to assess the links between constructive thinking and neuroendocrine regulation in adolescent offenders and their association with externalizing symptoms (e.g., aggression, delinquency, psychopathic traits, substance use). Identifying particular biopsychological patterns can help to better understand stress management in youth with externalizing behaviors and to improve clinical treatments. Method Sixteen adolescent males aged from 12 to 18 years were recruited in an institution for juvenile offenders. Exclusion criteria were insufficient reasoning abilities assessed using the Raven Matrices Test. Regarding psychological dimensions, constructive thinking was assessed through the Constructive thinking inventory (CTI), psychopathic traits through the Youth psychopathic traits inventory (YPI), externalizing behaviors through 30 items (out of 113) and 2 subscales (aggressive behavior and delinquency problems) from the Child beh...
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2016.08.012
       
  • La faible estime de soi est corrélée à l’intentionnalité suicidaire,
           indépendamment de la sévérité de la dépression
    • Authors: C. Perrot; L. Vera; P. Gorwood
      Pages: 122 - 127
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): C. Perrot, L. Vera, P. Gorwood
      Le suicide est un problème de santé publique majeur et l’estime de soi pourrait y avoir une place déterminante. Notre objectif principal est d’évaluer s’il existe un lien entre l’intentionnalité suicidaire et l’estime de soi, en se focalisant plus spécifiquement sur ses différentes dimensions (générale, familiale, professionnelle et sociale). Notre second objectif est d’étudier le rôle potentiel du syndrome dépressif dans la relation entre estime de soi et risque suicidaire. Nous avons réalisé une étude rétrospective transversale de 2008 à 2010, au sein d’un service d’accueil des patients suicidants à l’hôpital Sainte-Anne à Paris. Les critères d’inclusion étaient : âge>15 ans ; hospitalisé suite à une tentative de suicide. L’estime de soi était évaluée via l’échelle de Coopersmith (SEI) et les patients ayant un score SEI mensonge>5 étaient exclus. Notre critère de jugement principal était la corrélation entre l’estime de soi et l’intentionnalité suicidaire. Notre critère de jugement secondaire concernait le poids du facteur « intensité du syndrome dépressif » (échelle d’Hamilton) dans cette corrélation. Cent trente-deux patients ont été inclus. L’intentionnalité suicidaire était corrélée à l’estime de soi totale (r =−0,227, p =0,009), sociale (r =−0,331, p <0,001) et familiale (r =−0,260, p =0,003). Ces corrélations restaient significatives après ajustement sur la dépression (p <0,038). L’estime de soi était corrélée à l’intentionnalité suicidaire indépendamment de la dépression, dans la population ici étudiée dans le cadre d’une prise en charge au décours d’une tentative de suicide. Ces résultats apportent des pistes de réflexion pour de futures stratégies de prévention du suicide, notamment celles agissant spécifiquement sur l’estime de soi. Introduction Suicide is a major Public Health concern, and low self-esteem might represent a major risk factor. Our main objective was to assess the correlation between self-esteem and suicide intent. More specifically, we aimed to examine the relationship between the different dimensions of self-esteem (total, general, familial, professional and social) and suicide intent. We also sought the role of depression in the relationship of self-esteem to suicide intent. Method This retrospective cross-sectional study was conducted at a suicide prevention department at the CMME (Sainte-Anne Hospital, Paris, France). We included patients aged 15 and older and admitted for suicide attempt over a 3-year period from January 2008 to December 2010. Self-esteem was assessed with the Coopersmith's Self-Esteem Inventory (SEI) scale that takes into account several domains of self-esteem. Subjects scoring over 5 points on the lie scale were excluded. Our primary endpoint was the correlation between self-esteem and suicide intent. Our secondary endpoint was the same correlation adjusted for depression severity (using the Hamilton scale). Suicide intent was estimated using Beck's Suicide Intentionality Scale (SIS). We examined the Pearson's correlation coefficients between self-esteem and suicide intent. These analyses were adjusted for the severity of depressive symptoms assessed with the Hamilton Depression Rating Scale (17 items). Results Overall, 132 patients were included. Suicide intent was correlated with total self-esteem (r =−0.227, P =0.009), social self-esteem (r =−0.331, P <0.001) and familial self-esteem (r =−0.260, P =0.003). These results remained significant after ...
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2016.10.003
       
  • IDEM-dépression : caractéristiques et évaluation d’un groupe ouvert
           combinant psycho-éducation et thérapie cognitivo-comportementale
    • Authors: L. Weiner; E. Garcia-Krafes; S. Garcia; C. Berthomier; A. Morali; J.-Y. Metzger; S. Weibel; H. Javelot; G. Bertschy
      Pages: 141 - 147
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): L. Weiner, E. Garcia-Krafes, S. Garcia, C. Berthomier, A. Morali, J.-Y. Metzger, S. Weibel, H. Javelot, G. Bertschy
      Nous avons développé un groupe ouvert combinant psycho-éducation et thérapie cognitivo-comportementale (TCC), le groupe information, découverte, échange et mobilisation concernant la dépression (IDEM-dépression), composé de 17 séances thématiques et indépendantes qui abordent chacune un sujet lié à la dépression. Il s’adresse à des patients présentant un épisode dépressif de sévérité variée, s’inscrivant dans le cadre d’un trouble unipolaire ou bipolaire. Le groupe est donc accessible à un grand nombre de patients présentant un épisode dépressif majeur. Nous présentons ici les caractéristiques de ce groupe, sa faisabilité et les résultats d’une étude d’évaluation portant sur l’impact immédiat sur l’humeur, mesuré via des échelles visuelles analogiques proposées en début et en fin de séance, et sur la satisfaction globale des participants, évaluée via deux questionnaires de satisfaction. Les résultats, issus de deux centres où le programme a été implémenté, suggèrent une amélioration significative de l’humeur suite à la participation aux séances ainsi qu’une satisfaction auto-rapportée élevée. Ils indiquent aussi que le groupe IDEM-dépression peut s’adresser à un large spectre de patients dépressifs ayant des caractéristiques cliniques hétérogènes. Dans ce contexte, il constitue une offre psychothérapique à coût réduit, orientée vers une pathologie psychiatrique très prévalente. Son efficacité sur l’humeur et sa satisfaction élevée semblent liées à son contenu de type psycho-éducation et TCC, et à son format groupal, flexible et ouvert, qui favorise la décentration et l’entraide ainsi que la réduction de la stigmatisation et de l’isolement dus à la maladie. Introduction Depression is a highly prevalent mental illness that is associated with high rates of morbidity and functional impairment. At the psychiatric unit of the University Hospital of Strasbourg, France, we have developed an open group that combines psychoeducation and cognitive-behavior therapy (CBT), the information, discovery, exchange and mobilization for depression group (IDEM-depression). IDEM-depression is composed of 17 thematic, structured, and independent sessions, which address different aspects of depression (i.e., rumination, pharmacological treatments). Because of its flexible format, patients with varying degrees of depression severity (from remission up to severe depressive symptoms) and whose depression might be bipolar or unipolar, are able to participate in the group. Thus, the group is well suited to a large number of patients with major depression. In the present study we aimed at describing the IDEM-depression group and presenting results regarding patients’ overall satisfaction, assessed via two self-report questionnaires (the Client Satisfaction Questionnaire, the CSQ-8, and the IDEM ad hoc questionnaire), as well as its effect on mood following each session assessed via a visual analog scale (VAS) ranging from 0 up to 100. Method Sixty-five patients participated in 50 sessions of the IDEM-depression group in two hospitals in Alsace. 61% of the patients had bipolar disorder, and 41% of them were inpatients. Sessions took place on a weekly basis, lasted 2hours and were proposed by a CBT-trained clinical psychologist. Patients were asked to fill-out the VAS at the beginning and at the end of each session. Moreover, they were asked to fill-out the CSQ-8 and the IDEM ad hoc questionnaire when they left the group. Other than one session (“yoga and mindfulness”), all the sessions (16 out of 17) were structured on a Powerpoint© presentation. During the first hour information was given regarding the topic (i.e., rumination), and a shared CBT conceptualization of the topic was formulated by the participants and the psychologist. For most sessions, the first hour was therefore communication and information-based, whereas during the second hour participants were asked to participate in in-session behavioral experiments and/or to evaluate specific aspects of their behavior (thoughts, emotions, activity, mindful behavior) during the last few days. The therapist manual and the slides for each session are available via e-mail to the first author.
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2016.09.004
       
  • Le questionnaire d’alexithymie pour enfants (QAE) : étude sur une
           
    • Authors: M. Delhaye; F. Orts; F. Bury; G. Loas
      Pages: 148 - 151
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): M. Delhaye, F. Orts, F. Bury, G. Loas
      La recherche sur l’alexithymie nécessite la mise au point d’instruments de mesure parmi lesquels l’échelle d’alexithymie de Toronto à 20 items (TAS-20) est considérée comme la référence. La TAS-20 comprend trois sous-échelles ou dimensions mesurant l’incapacité à identifier ses sentiments (DIF), l’incapacité à décrire ses sentiments (DDF) et la tendance à avoir des pensées tournées vers l’extérieur (EOT). L’étude de l’alexithymie chez l’enfant et l’adolescent rend nécessaire d’utiliser des instruments adaptés comme l’échelle d’alexithymie chez l’enfant (QAE) qui a été mise au point à partir d’une reformulation des items de la TAS-20. Deux études de validation ont montré les qualités psychométriques du QAE dans des populations d’enfants sains. L’objet de la présente étude était de vérifier les qualités psychométriques du QAE dans une population de 105 adolescents hospitalisés en psychiatrie pour des troubles divers. L’analyse factorielle confirmatoire a montré l’adéquation des données à la structure tridimensionnelle de l’échelle mais une structure bidimensionnelle sans la dimension EOT s’est avérée significativement supérieure. La cohérence interne mesurée par le coefficient α de Cronbach avait pour valeur 0,71 ou 0,83 pour l’échelle globale (20 items) ou pour l’échelle à 12 items sans le facteur EOT. En conclusion il est recommandé chez les enfants ou adolescents de ne prendre en considération que les dimensions DDF et DIF du QAE et en utilisant la sommation de ces deux sous-échelles. Objective The 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used measure of alexithymia in non-clinical or clinical populations. The TAS-20 evaluates three dimensions of the alexithymia construct: the difficulty identifying feelings (DIF), the difficulty describing feelings (DDF) and externally oriented thinking (EOT). The TAS-20 is also used in adolescents or children, and the psychometric properties of the scale have not been systematically evaluated in these populations. Recently several studies have shown systematic age differences in the factor structure and a decrease of the quality of the measurement with age. Notably, low reliability measured by the Cronbach α coefficient has been found for the EOT factor. Taking into account the limitations of the TAS-20 in pre-adult populations the Alexithymia Questionnaire for Children (AQC), an adaptation of the TAS-20, has been proposed by a reformulation of the TAS-20 items (Rieffe et al., 2006). Two studies in healthy children found satisfactory psychometric properties with the three-factor structure demonstrating adequate parameters in the confirmatory factorial analyses (CFA). In the two studies low reliabilities of the EOT factor were reported, and recent studies in adolescents using the TAS-20 found that a two-factor model (DDF, DIF) had a better fit than the original three-factor model. Thus, the aim of the present study was firstly to verify the psychometric properties of the AQC in a sample of adolescents presenting various psychiatric disorders and secondly to test the adequacy of the bi- or tridimensional model of the scale. Method One hundred and five adolescents (27 males, 78 females) with a mean age of 15.06 years (sd=1.55, range: 12–18 years) were hospitalized in the adolescent psychiatric department of the Erasme Hospital (Bruxelles, Belgium) for various psychiatric disorders. The main diagnoses were: adjustment disorder (n =56, 53.5%), mood or anxiety disorders (n =17, 16.2%), impulse control disorder (n =11, 10.5%). The subjects completed the French version of the AQC. CFA were done testing the adequacy of the three or two-factor structure of the scale. Two indices were considered: the normed χ2 (ratio of χ2 and degrees of freedom) and the root mean square error of approximation (RMSEA). The values for acceptable fit were normed χ2 <3 and RMSEA<0.05. Cronbach α were also calculated. Results Fit indices for the three-fact...
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2016.08.010
       
  • Terrorisme et comportement humain
    • Authors: S.J. Leistedt
      Pages: 152 - 157
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): S.J. Leistedt
      Objectifs Les théories de la religion sont essentielles pour comprendre les tendances actuelles dans les activités terroristes. Le but de ce travail est de clarifier le rôle de la religion dans la facilitation de la terreur et de décrire en parallèle les développements théoriques récents qui concernent le terrorisme et le comportement humain. Méthodes Une revue exhaustive de la littérature a été effectuée en utilisant divers moteurs de recherche comme PubCentral, Scopus, Medline et Science Direct. Les mots-clés utilisés sont : terrorisme, psychologie sociale, religion, évolution et cognition. Résultats Ce travail examine, d’une perspective multidimensionnelle, la manière dont les terroristes utilisent ces caractéristiques de la religion pour atteindre leurs objectifs. Il décrit aussi la manière dont les terroristes emploient des rituels pour conditionner les émotions à des symboles sanctifiés qui suggèrent des émotions et nourrissent des motivations, favorisant ainsi la solidarité de groupe, la confiance et la coopération. Les croyances religieuses, y compris les récompenses promises dans la vie après la mort, servent en outre à faciliter la coopération en modifiant la perception des bénéfices qu’engendreront des actions coûteuses, dont les attentats-suicides. Enfin, la manière dont le cerveau des adolescents et des jeunes adultes se développe est unique et constitue une phase du développement humain idéale pour attirer des recrues et les engager dans des comportements impliquant un niveau de risque élevé. Conclusions Ce travail apporte, sur la base de cette analyse transactionnelle de la littérature, un éclairage sur les liens qui unissent religion, terrorisme et comportement humain de manière générale. Objectives Theories of religion are essential for understanding current trends in terrorist activities. The aim of this work is to clarify religion's role in facilitating terror and outline in parallel with recent theoretical developments on terrorism and human behaviour. Methods Several databases were used such as PubCentral, Scopus, Medline and Science Direct. The search terms “terrorism”, “social psychology”, “religion”, “evolution”, and “cognition” were used to identify relevant studies in the databases. Results This work examines, in a multidimensional way, how terrorists employ these features of religion to achieve their goals. In the same way, it describes how terrorists use rituals to conditionally associate emotions with sanctified symbols that are emotionally evocative and motivationally powerful, fostering group solidarity, trust, and cooperation. Religious beliefs, including promised rewards in the afterlife, further serve to facilitate cooperation by altering the perceived payoffs of costly actions, including suicide bombing. The adolescent pattern of brain development is unique, and young adulthood presents an ideal developmental stage to attract recruits and enlist them in high-risk behaviors. Conclusions This work offers insights, based on this translational analysis, concerning the links between religion, terrorism and human behavior.

      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2017.05.002
       
  • Prévenir la violence associée à la schizophrénie avec la remédiation
           cognitive
    • Authors: C. Darmedru; C. Demily; N. Franck
      Pages: 158 - 167
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): C. Darmedru, C. Demily, N. Franck
      De l’association entre schizophrénie et violence découle un important enjeu thérapeutique en psychiatrie. Il n’y a pas de lien unique, direct, exclusif et simple entre l’agressivité et la pathologie mentale sous-jacente. Les processus impliqués sont multiples et intriqués. Parmi eux, les déficits cognitifs tiennent une place importante dans la genèse et le maintien des comportements violents et agressifs. Des études récentes montrent que des interventions de réhabilitation psychosociale telles que la remédiation cognitive et l’entraînement de la cognition sociale ont un impact positif sur le contrôle et la réduction des attitudes agressives globales et du nombre d’incidents agressifs physiques et verbaux. Les cibles thérapeutiques principales sont la cognition sociale et les fonctions exécutives, à travers respectivement l’amélioration des relations interpersonnelles et la réduction des passages à l’acte impulsifs. Ces interventions sont efficaces à différents stades d’évolution de la maladie, avec des effets bénéfiques pouvant perdurer jusqu’à 12 mois après la fin de la prise en charge. Le recours à la remédiation cognitive en tant que complément des outils de soin traditionnels ouvre de nouvelles perspectives thérapeutiques. De nouvelles études restent toutefois nécessaires avant de considérer la remédiation cognitive et l’entraînement de la cognition sociale comme des modalités de soin centrales dans la lutte contre la violence des patients ayant une schizophrénie. Objectives The association between schizophrenia and violence represents an important issue in psychiatry. Often highly publicized, violent acts raise the question of their detection, prevention, management and treatment. There is no single, direct and exclusive link between aggressiveness and the underlying psychiatric disorder. On the contrary, the processes underlying this violence are multiple and interlinked. In addition to static and dynamic risk factors, cognitive deficits play an important role in the genesis and maintenance of violent and aggressive behavior. Methods Using recent data from the international literature and the main databases, we first clarify the role played by cognitive deficits in the violence of patients with schizophrenia. We then evaluate the place of psychosocial interventions such as cognitive remediation and social cognitive training in managing the violent and aggressive behavior of these patients. Results Executive functions and working memory are the most studied neurocognitive functions in the field of violence in schizophrenia. Impulsivity, lack of cognitive flexibility, lack of adaptation and inhibition of automatic motor responses, and altered anger regulation may explain this relationship. Three main components of social cognition are associated with violent behaviors in schizophrenia: (1) the recognition of facial emotions through the inoperability of systems of “emotional monitoring”, violent inhibition and recognition of informative facial zones; (2) the theory of the mind through the erroneous interpretation of the intentions of others; (3) the attributional style through the preferentially aggressive over interpretation of social situations and weak capacities of introspection. Overall, cognitive biases inhibit response in a socially acceptable manner and increase the risk of responding impulsively and aggressively to a stressful or provocative situation. In this context, we studied the place held by psychosocial interventions in the management of the violent and aggressive behaviors of these patients. Various cognitive remediation programs have shown their feasibility in people with schizophrenia and neurocognitive deficits with a history of violence as well as their effectiveness in reducing violence, mainly by reducing impulsivity. Similarly, specific programs dedicated to social cognitive training such as Social Cognition and Interaction Training (SCIT), Reasoning and Rehabilitation Mental Health Program (R&R2 MHP) and Metacognitive Training (MCT) have shown their positive impact on the control and reduction of global aggressive attitudes and on the numbers of physical and verbal aggressive incidents in schizophrenia. The improvement of social cognition would be achieved through the amendment of interpersonal relationships and social functioning. These interventions are effective at different stages of disease progression, in patients with varied profiles, on violent attitu...
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2017.05.001
       
  • Évaluation des troubles thymiques par l’étude des données passives :
           le concept de phénotype digital à l’épreuve de la culture de métier
           de psychiatre
    • Authors: A. Bourla; F. Ferreri; L. Ogorzelec; C. Guinchard; S. Mouchabac
      Pages: 168 - 175
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): A. Bourla, F. Ferreri, L. Ogorzelec, C. Guinchard, S. Mouchabac
      Objectifs La recherche de signes cliniques objectifs est une préoccupation constante des praticiens et des chercheurs en psychiatrie. Le développement récent de certaines technologies (miniaturisation des capteurs, intelligence artificielle) permet d’avoir accès à certaines données dites passives (c’est-à-dire qui ne nécessitent pas d’intervention du patient) jusqu’alors non exploitables et de nouveaux modèles basés sur une sémiologie qui serait médiée par ces nouvelles technologies commencent à se développer avec le concept de phénotype digital : le ralentissement psychomoteur se traduisant par des modifications de l’accéléromètre, la graphorrhée par une augmentation du nombre d’appels et de SMS envoyé, etc. Notre objectif principal est de mettre en évidence le phénotype digital des troubles de l’humeur à l’aide d’une revue sélective de la littérature. Méthode Nous avons conduit une revue sélective de la littérature en interrogeant la base PubMed jusqu’à février 2017 avec les termes [Computer] [Computerised] [Mobile] [Automatic] [Automated] [Machine learning] [Sensor] [Heart rate variability] [HRV] [actigraphy] [actimetry] [digital] [motion] [temperature] [Mood] [Bipolar] [Depression] [Depressive]. Huit cent quarante-neuf articles répertoriés ont été soumis à l’évaluation, 37 articles ont été inclus. Résultats Pour les troubles unipolaires, les smartphones permettent de diagnostiquer la dépression avec une excellente précision en combinant les données du GPS et du journal des appels. Les mesures actigraphiques mettant en évidence une altération diurne dans le fonctionnement basal tandis que les capteurs ECG évaluant la variation de la variabilité du rythme cardiaque (HRV) et la température corporelle semblent être des outils utiles pour diagnostiquer un épisode dépressif. En ce qui concerne les troubles bipolaires, des systèmes qui combinent plusieurs capteurs sont décrits : MONARCA, PRIORI, SIMBA et PSYCHE. Tous ces systèmes associent des données passives et des données actives sur smartphone. À partir d’une synthèse de ces données, un phénotype digital des troubles est proposé en se basant sur l’accéléromètre et le GPS, l’ECG, la température corporelle, l’utilisation du smartphone et l’étude de la voix. Ce phénotype digital vient ainsi remettre en question certains paradigmes cliniques au sein desquels les psychiatres évoluent. L’impact de ces technologies interrogeant profondément la culture de métier du psychiatre. Discussion Ces systèmes peuvent être utilisés pour informatiser les caractéristiques cliniques des différents états mentaux étudiés, parfois avec une plus grande précision qu’un clinicien ne pourrait le faire. Par ailleurs, la plupart des auteurs recommandent l’utilisation de données passives préférentiellement aux données actives notamment en cas de troubles bipolaires car les données générées automatiquement réduisent les biais et limitent le sentiment d’intrusion que les autoquestionnaires peuvent causer. L’impact de ces technologies interroge la culture de métier du psychiatre, définie comme une langue spécifique et un ensemble de valeurs communes. Nous abordons les problèmes liés à ces changements en soulignant que l’impact de ce changement de paradigme sur les psychiatres pourrait être important, leur unité semblant remise en cause par des technologies qui modifient profondément la collecte et le traitement des données cliniques. Objectives The search for objective clinical signs is a constant practitioners’ and researchers’ concern in psychiatry. New technologies (embedded sensors, artificial intelligence) give an easier access to untapped information such as passive data (i.e. that do not require patient intervention). The conce...
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2017.07.007
       
  • Troubles disruptifs intrafamiliaux : données actuelles et
           perspectives de traitement
    • Authors: E. Bousquet; N. Franc; C. Ha; D. Purper-Ouakil
      Pages: 176 - 182
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): E. Bousquet, N. Franc, C. Ha, D. Purper-Ouakil
      Par le biais de différentes formes de violence verbale, physique ou psychologique, les enfants maltraitant leurs parents visent à les contraindre à leur propre exigence jusqu’à parfois inverser la hiérarchie familiale. L’ampleur de ce phénomène est encore mal connue même s’il existe ces dernières années un regain d’intérêt autour de ce sujet. Les familles de tous milieux socioprofessionnels peuvent être concernées. Selon le degré de sévérité de ces troubles, les critères de trouble oppositionnel avec provocation (TOP) ou de trouble des conduites (TC) sont remplis. La comorbidité avec le trouble déficit attentionnel avec hyperactivité est très fréquente. Les dimensions d’impulsivité et d’opposition y sont alors plus marquées. Par ailleurs, ces enfants souffrent d’inhibition sociale et ont peu d’estime de soi. Les relations avec leurs parents manquent d’affection et la communication est pauvre. Les enfants perçoivent le mode éducatif de leurs parents comme permissif et négligeant et le méprisent. Les parents maltraités ont honte de leur situation et s’ils décident de sortir du silence, ils se heurtent parfois au manque de compréhension de certains professionnels : professionnels de santé, services sociaux… Le traitement des troubles disruptifs intrafamiliaux ne faisait pas l’objet de programmes thérapeutiques spécifiques jusqu’au développement récent d’un groupe de contrôle actif parental au CHU de Montpellier. Inspirées des techniques de résistance non violente, des stratégies sont enseignées aux parents pour accroître leur sentiment de compétence parentale et, à terme, modifier le comportement de leur enfant. Child-to-parent violence is a form of family violence that is still a well-kept secret. Abused parents can be victims of different types of abuse. Children can use both physical and psychological violence such as financial threats to take control of the home. In this situation, parents often no longer dare to contradict their children by fear of triggering uncontrollable violence. Although the phenomenon recently drew the attention of the media, there is still little knowledge about its prevalence and clinical characteristics. Most families remain isolated for a long time and, even in case of consulting in a mental health setting, disclosure of the nature of the difficulties is often delayed. This article presents the specificities of these children and their clinical characteristics. It also studies the victimized parents, the entire family, and their relation to the external environment. When observing these young offenders oppositional defiant disorder, conduct disorder and attention deficit hyperactivity disorder are frequently found. The diagnosis of “conduct disorder confined to family context” defined in the ICD 10 is the most appropriate to describe them. But it is regrettable that there has currently been no study to validate it and to determine its specificity. Compared with other young children who have “classic” disruptive disorders, children involved in violence against their parents have more difficulties with affect regulation, impulse control, and interpersonal skills. These children also frequently have low self-esteem and difficulties interacting with their peers. They may be isolated and bullied. They feel more sadness than these other young people and use violence as a way to express their emotions. Within the family both girls and boys commit violence against their parents. Girls will mostly use psychological violence but can also be involved in physical aggression. The first victim of child-to-parent violence is the mother. As mothers are often more present at home and seen by their children as weaker than the father, they are seen as an “easy target”. If the “classic” conduct disorder is most frequently encountered in low social status families, intra familial disruptive behavior can be observed in families from all socio economic status. With respect to the parent-child relationship in those families, there are some relevant specificities. First, the quality of communication is bad, parents and children are not intimate and the tension is permanent. Furthermore, children do not respect their parents’ authority. They perceive parenting style as permissive and negligent without enough support and control, and they may want to restore a coherent authority in the family. It is important to mention that potential vulnerability factors such as older age, a history of mental illness and social isolation have been described in parents of these children. Thereby, victimized parents have all the more difficulty to stand up against their children or to cleverly adapt their authority to their behavior. Other types of inappropriate education can be the origin of the child-to-parent violence. There is a direct correlation between the high frequency of punishments and violent attitude of the children towards their parents. So, the family dynamic is characterized by an inversion ...
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2017.09.002
       
  • Make L’Encéphale great again!
    • Authors: M. Masson; R. Gaillard
      First page: 1
      Abstract: Publication date: February 2018
      Source:L'Encéphale, Volume 44, Issue 1
      Author(s): M. Masson, R. Gaillard


      PubDate: 2018-02-26T09:04:23Z
      DOI: 10.1016/j.encep.2018.01.001
       
  • Quelles comorbidités psychiatriques dans la dépendance au cannabis à
           
    • Authors: G. Dorard; C. Bungener; O. Phan; Y. Edel; M. Corcos; S. Berthoz
      Pages: 2 - 8
      Abstract: Publication date: February 2018
      Source:L'Encéphale, Volume 44, Issue 1
      Author(s): G. Dorard, C. Bungener, O. Phan, Y. Edel, M. Corcos, S. Berthoz
      Les objectifs de cette étude étaient de déterminer les comorbidités psychiatriques associées à la dépendance au cannabis chez des adolescents et des jeunes adultes comparativement à des témoins, et d’étudier les liens entre les diagnostics psychiatriques et les indicateurs de consommation de substances psychoactives. Cent patients, dépendants au cannabis, consultant en addictologie, ont été comparés à 82 témoins exempts de diagnostic lié à l’usage de cannabis, recrutés en population générale. En plus de la passation du MINI, les modalités de consommation de substances psychoactives étaient recueillies lors d’un entretien clinique multi-axial. La prévalence de patients présentant au moins un diagnostic psychiatrique de l’axe I du DSM-IV (hors troubles psychotiques) était de 79 %, contre 30,5 % chez les témoins (p <0,001) ; la présence d’un diagnostic multipliant par 8,6 le risque d’appartenir au groupe de patients dépendants consultants. La différence concernait la dysthymie actuelle, le trouble panique vie entière, la dépendance et l’abus d’alcool, et l’anxiété généralisée. Chez les patients, les prévalences de diagnostics psychiatriques étaient plus élevées chez les hommes (p =0,011) et les patients les plus âgés (p =0,006). Les spécificités psychiatriques caractérisées dans cet échantillon d’adolescents et jeunes adultes consultant en addictologie confirment l’importance de porter une attention particulière à la question du double diagnostic pour le déploiement de leur prise en charge. Background The use of illicit substances, in particular cannabis, among French adolescents and young adults has become an important public health concern. A better understanding of the mechanisms involved in pathological substance use is nowadays critical. Psychiatric comorbidities have been previously reported in adult substance abusers but are less documented in adolescents, especially regarding cannabis dependence. Objectives We investigated mental health problems in adolescents and young adults, seeking treatment for their problematic cannabis use, comparatively to healthy controls, taking into account the participant's gender and age. Moreover, we explored the relationships between psychiatric diagnosis and substance use modalities. Methods In total, 100 young patients (80 males – mean age 18.2 (SD=2.9; [14 to 25] years old)) with a cannabis dependence (DSM-IV-TR criteria) seeking treatment in an addiction unit, and 82 healthy control subjects (50 males – mean age 18.3 (SD=3.4; [14 to 25] years old)) with no substance misuse diagnostic other than for alcohol, participated in the study. The MINI was administered to evaluate cannabis dependence, and DSM-IV axis I comorbid diagnosis, and a semi-structured interview was used to determine psychoactive substance use. Results Statistical analyses revealed that 79 % of the patients reported at least one other non-drug or alcohol comorbid diagnosis, versus 30.5 % in the control group (χ 2 =16.83; P <0.001). Logistic regression indicated that participants with a psychiatric diagnosis had an 8.6 times higher risk (P <0.001; OR 95 % CI=[4.38–16.81]) of being patients. Significant inter-group differences and OR were noted for several diagnoses: dysthymia over the previous 2years (χ 2 =14.06; P <0.001; OR=10.63; OR 95 % CI=[2.41–46.87]), li...
      PubDate: 2018-02-26T09:04:23Z
      DOI: 10.1016/j.encep.2016.05.013
       
  • Recherche d’association entre abus de cannabis et bipolarité : étude
           sur un échantillon de patients hospitalisés pour un trouble bipolaire
    • Authors: F. Kazour; C. Awaida; L. Souaiby; S. Richa
      Pages: 14 - 21
      Abstract: Publication date: February 2018
      Source:L'Encéphale, Volume 44, Issue 1
      Author(s): F. Kazour, C. Awaida, L. Souaiby, S. Richa
      C’est une étude transversale qui évalue l’importance de la consommation de cannabis chez les patients admis pour un trouble bipolaire à l’Hôpital psychiatrique de la Croix–Liban (HPC), ainsi que les différences cliniques entre les consommateurs et les non-consommateurs. Sur une période de 13 mois, 100 patients bipolaires ont été successivement inclus dans l’étude. Ils ont été partagés en deux groupes selon leur consommation de cannabis. Au total, 27 % de ces patients sont consommateurs de cannabis. L’âge moyen de début de consommation est de 20,3ans. L’usage de cannabis a été retrouvé avec une prévalence plus élevée chez les jeunes adultes de sexe masculin. Les consommateurs de cannabis comparés aux non-consommateurs sont plus jeunes, comportent plus d’hommes et ont débuté leurs troubles à un âge plus jeune. Les consommateurs ont également plus d’hospitalisations et un niveau économique plus élevé. Ils se présentent plus dans un tableau de manie que de dépression. Cependant, la consommation de cannabis dans le trouble bipolaire retrouvée dans notre échantillon est inférieure à celle de la littérature. Elle est toutefois associée à un âge de début du trouble bipolaire plus jeune, avec plus d’hospitalisations par an. Les consommateurs de cannabis ont des scores de dépression, de manie et des symptômes psychotiques statistiquement similaires aux non-consommateurs. Introduction Cannabis use is very frequent in bipolar disorder and has been found to increase the duration and frequency of manic symptoms while decreasing those of depression. Bipolar patients who use cannabis were shown to have poorer compliance to treatment, more symptoms that are psychotic and a worse prognosis than patients who do not. In this study, we have evaluated the importance of cannabis use among bipolar patients admitted to the Psychiatric Hospital of the Cross, Lebanon (Hôpital Psychiatrique de la Croix [HPC]) as well as the clinical differences between cannabis users and non-users. Methods Over a period of 13 months, we recruited the patients admitted to HPC for bipolar disorder according to the MINI DSM-IV criteria. These patients were screened for substance abuse/dependence and were accordingly divided into 2 groups: cannabis users and cannabis non-users. Both groups were interviewed by a medical student and asked to answer the following questionnaires: the MINI DSM-IV, the Young Mania Rating Scale (YMRS) for evaluating manic episodes, the Montgomery and Åsberg Depression Rating Scale (MADRS) for evaluating depressive episodes, the Scale for the Assessment of Positive Symptoms (SAPS) to assess psychotic symptoms associated to the bipolar disorder, and the Cannabis Abuse Screening Test (CAST) for evaluating the importance of cannabis consumption. The study's exclusion criteria were the following: diagnosis of a confusional state, schizophrenia and other psychotic disorders, dementia, age less than 18 years old or superior to 85 years old, and non-cooperation. Results Among the 100 bipolar patients included in the study, 27 (27 %) were cannabis users. Eight of these 27 patients were first admitted to HPC for substance abuse and then included in the study after a bipolar disorder was diagnosed according to the MINI DSM-IV criteria. Cannabis use was found to be more prevalent in young males with a mean age of 20.3 years old at the first contact with the substance. Compared to non-users, cannabis users were found to be younger (33.6 vs. 43.0 years old), more commonly male (77.8 % vs. 49.3 %), and were symptomatic at a younger age (24.6 vs. 30.8 years old). Cannabis users had more hospital admissions in total (6.0 vs. 3.7), and per year (0.73 vs. 0.44) as well as higher socio-economical state. There was a linear relationship between the monthly income per household and cannabis consumption with an OR increasing with the monthly income. Consumers presented more often in a manic state (59.3 %) than in a depressed state (11.1 %). The respective scores of consumers and non-consumers were: YMRS (30.3 vs. 32.1), MADRS (38 vs. 39.5), SAPS (22.7 vs. 23.2). Among cannabis users, 55.6 % and 33.3 % represent the respective percentages of cannabis abuse and dependence. The mean CAST score in these patients was 13.4.
      PubDate: 2018-02-26T09:04:23Z
      DOI: 10.1016/j.encep.2016.08.005
       
  • Troubles du comportement alimentaire restrictif du nourrisson et du jeune
           enfant : évaluation quantitative des interactions parent/nourrisson
           pendant le repas
    • Authors: A. Bion; T. Cascales; S. Dubedout; N. Bodeau; J.P. Olives; J.P. Raynaud
      Pages: 32 - 39
      Abstract: Publication date: February 2018
      Source:L'Encéphale, Volume 44, Issue 1
      Author(s): A. Bion, T. Cascales, S. Dubedout, N. Bodeau, J.P. Olives, J.P. Raynaud
      Le but de cette étude était de montrer que les troubles du comportement alimentaire (TCA) précoces sont associés avec le tempérament du nourrisson et avec les caractéristiques émotionnelles et alimentaires des parents. L’échantillon était composé de 58 dyades parent–nourrisson présentant un TCA, comparé à 60 témoins mangeurs sains. Ces dyades ont été observées au travers de l’enregistrement vidéo d’un repas de l’enfant et ont répondu à un panel de questionnaires relatifs au tempérament de l’enfant, à son développement psychoaffectif et comportemental, aux habitudes alimentaires du parent et à son état émotionnel durant la prise alimentaire de l’enfant. Les interactions durant le repas ont été évaluées avec la Feeding Scale de Chatoor. Des tests de Student et le test exact de Fisher ont été utilisés pour les variables quantitatives et qualitatives. Une approche par régression multiple a permis de vérifier la validité des résultats trouvés lors de l’analyse bivariée en ajustant les tests sur l’âge. Comparés aux témoins, les nourrissons présentaient des scores plus élevés en termes de caractéristiques symptomatiques et leurs parents des affects négatifs (21,5±8,1 vs 15,2±8,3, t =5,8 ; p =0) et d’avantage de difficultés alimentaires (14,5±5,8 vs 11,4±5,5, t =2,2, p =0,034). Ces dyades ont fait preuve d’un manque de réciprocité et d’échanges hautement conflictuels (Z-score moyen=4,7 [p =0]). Les résultats précisent donc en partie les relations établies dans la littérature internationale entre le tempérament du nourrisson atteint de TCA et les caractéristiques parentales dans un contexte de TCA précoce. Introduction Interest in the study of early feeding disorders (FD) has steadily increased during recent decades. During this period, research described the importance of the transactional relationships and the complex interplay between caregiver and child over time. On the basis of the previous studies, our study tried to explore the associations between the characteristics of the parents and the temperamental characteristics of the infants with early FD. Goals A first aim of the present study was to show if parental perception of child temperament (including ability for arousal self-regulation) and parental characteristics (emotional and eating attitudes) are associated with early FD. A second aim was to identify emotional/behavioral difficulties in children with early FD by comparing children with a normal development and children with a diagnosed FD, and to investigate whether there are any correlations between parental emotional and feeding characteristics and a child's eating and emotional-behavioral development. A final aim was to explore if feeding conflict is bound to both infant ability for arousal self-regulatation and caregiver emotional status during meals. Method Participants: 58 clinical dyads (children aged 1–36 months) and 60 in the control group participated in the study. The sample of 58 infants and young children and their parents was recruited in a pediatric hospital. They were compared to healthy children recruited in several nurseries. Procedure: all parent-child pairs in the clinical sample were observed in a 20-minute video-recording during a meal using the procedure of the Chatoor Feeding Scale. After the videotaping, parents completed a battery of self-report questionnaires assessing their child's and their own psychological symptom status. Measures: Child's malnutrition assessment was based on the Waterlow criteria. The Child Behavior Checklist (CBCL 1½–5) was used to assess a child's emotional/behavioral functioning. The Infant Behavior Questionnaire-Revised (IBQ-R), a widely used parent-report measure of infant temperament, was used to identify the structure of infant temperament. The Eating Attitude Test-40, a self-report symptom inventory, was used to identify concerns ...
      PubDate: 2018-02-26T09:04:23Z
      DOI: 10.1016/j.encep.2016.08.009
       
  • Psychometric validation of the French version of the Connor-Davidson
           Resilience Scale
    • Authors: G. Guihard; L. Deumier; B. Alliot-Licht; L. Bouton-Kelly; C. Michaut; F. Quilliot
      Pages: 40 - 45
      Abstract: Publication date: February 2018
      Source:L'Encéphale, Volume 44, Issue 1
      Author(s): G. Guihard, L. Deumier, B. Alliot-Licht, L. Bouton-Kelly, C. Michaut, F. Quilliot
      Objectives Resilience defines the ability to face adversity with positive outcomes. Different scales, including the 25-item Connor-Davidson Resilience Scale (CDRISC), have been elaborated in order to evaluate resilience among various populations. The evaluation of resilience in French populations was impossible until CDRISC was translated into French. In the present work, we aim to validate a French version of CDRISC (f-CDRISC). Methods The survey was conducted at Nantes University. Both dental and medical students were eligible. The factor structure of f-CDRISC was determined and its replicability was tested on two sub-samples by exploratory factor analysis (EFA) and parallel analysis (PA). A third student sample was used for confirmatory factorial analysis (CFA). Results We collected 1210 responses. Four items did not reach acceptance thresholds for reliability and were discarded from the f-CDRISC. EFA and PA of the remaining 21 items highlighted a replicable 3-factor structure that was further confirmed by CFA. Resilience factors included “tolerance to negative affects”, “tenacity” and “self-confidence”. All factors displayed acceptable to good internal consistency. They were characterized by positive medium to strong correlations with the overall f-CDRISC Scale. Significant positive correlations were also observed between the resilience factors. Conclusion The present work constitutes the first study devoted to a French adaptation of the CDRISC questionnaire. We present evidence showing that the f-CDRISC is a reliable tool for resilience evaluation in French speaking populations.

      PubDate: 2018-02-26T09:04:23Z
      DOI: 10.1016/j.encep.2017.06.002
       
  • L’activation comportementale : un outil simple et efficace dans le
           traitement de la dépression
    • Authors: C. Dondé; R. Moirand; A. Carre
      Pages: 59 - 66
      Abstract: Publication date: February 2018
      Source:L'Encéphale, Volume 44, Issue 1
      Author(s): C. Dondé, R. Moirand, A. Carre
      Introduction L’un des enjeux actuels dans la prise en charge de la dépression est de disposer de traitements efficaces et peu coûteux. L’activation comportementale (AC) est une technique psychothérapeutique recommandée dans le traitement de la dépression. Objectifs de l’étude (i) Détailler les bases théoriques de l’AC et ses modalités d’utilisation thérapeutique. (ii) Proposer une revue systématique de littérature concernant les essais contrôlés randomisés impliquant l’AC dans la dépression. Méthodes Les bases de données PubMed et ClinicalTrials ont été explorées avec les mots-clés suivant : (« behavioral activation » OR « behavioural activation ») AND (« therapy » OR « psychotherapy »). (i) Les articles expliquant les concepts théoriques et pratiques de l’AC ont été sélectionnés. (ii) Les essais cliniques randomisés étudiant l’impact de l’AC dans la dépression ont été sélectionnés selon les critères PRISMA. Résultats (i) Les principes de l’AC sont d’augmenter l’engagement dans des activités associées à un sentiment de plaisir et/ou de maîtrise de la tâche à accomplir, et de diminuer l’engagement dans des comportements qui maintiennent les affects négatifs ou qui en augmentent les risques. Réactualisée par la troisième vague des TCC, l’AC a été enrichi par des interventions valorisant les valeurs personnelles du patient par les comportements à accomplir. L’AC est une thérapie brève, peu coûteuse, pouvant être évaluée et optimisée à l’aide d’outils psychométriques spécifiques. (ii) L’effet bénéfique de l’AC a été démontré dans le traitement de différentes formes cliniques de dépression avec des tailles d’effets importantes : efficacité supérieure aux conditions « liste d’attente » (d =−0,87 [IC95 % : −1,10 à −0,64], p <5×10−4), « traitement usuel de la dépression » (d =−0,78 [IC95 % : −1,13 à −0,43], p <5×10−4), « psychothérapie placebo » (d =−0,34 [IC95 % : −0,64 à −0,05], p <0,05) et « médicament antidépresseur » (d =−0,42 [IC95 % : −0,83 à −0,00], p <0,05). Conclusion L’AC est un traitement simple et efficace dans la dépression, même si les données actuelles ne permettent pas de démontrer une influence significative de l’ajout d’interventions centrées sur les valeurs à l’AC classique. L’inhibition comportementale étant un symptôme transnosographique en psychiatrie, des études supplémentaires sont nécessaires pour explorer les pleines potentialités d’application de l’AC. Introduction Major depressive disorder (MDD) is a debilitating disorder, and its treatment often requires complex and costly psychological therapies. Behavioral activation (BA) is a simple, effective and affordable psych...
      PubDate: 2018-02-26T09:04:23Z
      DOI: 10.1016/j.encep.2017.02.006
       
  • Prévalence des troubles mentaux en population générale au
           Burkina Faso
    • Authors: A. Ouédraogo; J.G. Ouango; K. Karfo; P. Goumbri; D. Nanéma; B. Sawadogo
      Abstract: Publication date: Available online 16 April 2018
      Source:L'Encéphale
      Author(s): A. Ouédraogo, J.G. Ouango, K. Karfo, P. Goumbri, D. Nanéma, B. Sawadogo
      Objectifs Déterminer à l’aide du « Mini-International Neuropsychiatric Interview » (MINI), la prévalence des troubles mentaux dans la population générale au Burkina Faso ; identifier les facteurs associés à la survenue de ces troubles. Matériel et méthode Nous avons procédé par une enquête transversale descriptive et analytique sur un échantillon représentatif de la population générale âgée d’au moins 18 ans (n =2587). Résultats Le taux de prévalence des troubles mentaux était de 41,43 %. Il était significativement plus élevé chez les femmes que chez les hommes (46,24 % versus 35,01 %; p ≤0,001). L’épisode dépressif était le trouble le plus fréquent au sein de la population enquêtée. Objectives To determine, with the use of the Mini-International Neuropsychiatric Interview (MINI), the prevalence of mental disorders in the general population of Burkina Faso; To identify the factors associated with the occurrence of these disorders. Methods We conducted a cross-sectional descriptive and analytical survey of a representative sample of the general population aged 18 years and over (n =2587). The only non-inclusion criterion was absence from the place of residence during the investigation period for whatever reason. This approach allowed us to select at random 840 households with a total number of 2587 persons aged 18 years and over. The data collection tools we used were a written questionnaire, developed by ourselves, and the Mini International Neuropsychiatric Interview or MINI questionnaire. On the ethical level, the protocol of this research and its appendices have received the prior approval of the Ethics Committee for Health Research of Burkina Faso as well as support from local customary and administrative authorities. Results The surveyed population consisted of 1 479 women (57.17 %) and 1108 men (42.83 %). Of the 2 587 people surveyed, 1 072 or 41.43 % met the criteria for at least one of the mental disorders. The prevalence rate was significantly higher among women than men (46.24 % versus 35.01 %). The depressive episode was the most frequent disorder in the surveyed population (11.60 %). Gender, place of residence and marital status were the main factors significantly associated with the occurrence of mental disorders. Conclusion This first national survey revealed a high prevalence of mental disorders. Considering the importance of mental disorders in the general population, it is important to train and involve more nurses and general practitioners in the identification and management of these disorders as there are very few specialists in the field at present.

      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2018.03.002
       
  • « Mental disorders » : une traduction troublante
    • Authors: Masson
      Abstract: Publication date: April 2018
      Source:L'Encéphale, Volume 44, Issue 2
      Author(s): M. Masson


      PubDate: 2018-04-25T06:04:51Z
       
  • Facial emotion recognition in children with or without Attention
           Deficit/Hyperactivity Disorder: Impact of comorbidity
    • Authors: J. Maire; C. Galera; S. Roux; S. Bioulac; M. Bouvard; G. Michel
      Abstract: Publication date: Available online 24 March 2018
      Source:L'Encéphale
      Author(s): J. Maire, C. Galera, S. Roux, S. Bioulac, M. Bouvard, G. Michel
      Objectives This study sought to assess facial emotion recognition deficit in children with Attention Deficit/Hyperactivity Disorder (ADHD) and to test the hypothesis that it is increased by comorbid features. Method Forty children diagnosed with ADHD were compared with 40 typically developing children, all aged from 7 to 11years old, on a computerized facial emotion recognition task (based on the Pictures of Facial Affect). Data from parents’ ratings of ADHD and comorbid symptoms (on the Conners’ Revised Parent Rating Scale) were also collected. Results Children with ADHD had significantly fewer correct answer scores than typically developing controls on the emotional task while they performed similarly on the control task. Recognition of sadness was especially impaired in children with ADHD. While ADHD symptoms were slightly related to facial emotion recognition deficit, oppositional symptoms were related to a decrease in the number of correct answers on sadness and surprise recognition. Conclusion Facial emotion recognition deficit in children with ADHD might be related to an impaired emotional process during childhood. Moreover, Oppositional Defiant Disorder seems to be a risk factor for difficulties in emotion recognition especially in children with ADHD.

      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2018.01.006
       
  • Les syndromes délirants d’identification : un facteur associé à la
           violence ' Revue de littérature à partir d’études de cas
    • Authors: M. Horn; D. Pins; G. Vaiva; P. Thomas; T. Fovet; A. Amad
      Abstract: Publication date: Available online 24 March 2018
      Source:L'Encéphale
      Author(s): M. Horn, D. Pins, G. Vaiva, P. Thomas, T. Fovet, A. Amad
      Introduction Les syndromes délirants d’identification (SDI) sont caractérisés par la présence d’idées délirantes fondées sur une erreur d’identification de personnes, de lieux ou d’objets, amenant le patient à croire en l’existence de doubles. Plusieurs cas de patients présentant un syndrome délirant d’identification et ayant commis un geste de violence ont été décrits, ce qui suggère un lien entre syndrome délirant d’identification et comportement violent. Méthode Nous avons effectué une revue systématique de littérature à partir des mots clés « misidentification » et « violence » dans la base de données électronique PubMed et analysé les données issues des descriptions de cas cliniques portant sur des gestes violents commis par des patients présentant des syndromes délirants d’identification. Nous avons examiné les données issues de 15 descriptions de cas. Résultats Les gestes violents décrits dans notre revue sont principalement rattachés à un syndrome de Capgras s’inscrivant dans le cadre d’un trouble schizophrénique. Ils sont souvent graves (avec plusieurs cas d’homicides), non planifiés, commis sur la famille ou l’entourage proche du patient et associés à des idées délirantes évoluant généralement depuis plusieurs années. Conclusion Ce travail a permis de mettre en évidence des caractéristiques communes aux gestes de violence survenant dans le cadre des syndromes délirants d’identification. La littérature sur le sujet reste néanmoins très limitée, les syndromes délirants d’identification étant fréquemment considérés comme des phénomènes anecdotiques. Les conséquences médico-légales des actes de violence associés aux syndromes délirants d’identification, encouragent à la réalisation de nouvelles études. Objectives Delusional misidentification syndromes (DMS) correspond to the delusional belief of misidentification of familiar persons, places or objects and to the conviction that they have been replaced or transformed. Several cases of patients who developed violent behavior while suffering from DMS have been published. This led some authors to consider patients with DMS at risk of violence. However, only a few studies have focused on the potential relationship between violence and DMS. The aim of our study was to explore this relationship with a literature review of published cases of patients having committed violent acts associated to DMS. Methods A systematic literature search was conducted on PubMed up to January 2017 using the following term combination “misidentification” and “violence” Fifteen cases of patients with DMS who had committed violent acts were identified. The data from these descriptions were analyzed and synthetized. Results Most of the patients were men with a diagnosis of schizophrenia and Capgras syndrome. Acts of violence were severe with a relatively high number of murders or attempted murders. For half of the patients these violent acts were perpetrated with weapons. Victims were regularly the patient's family members and the assaults were usually not planned. Delusional syndromes often progressed for several years. Importantly, substance abuse, which is known to increase the risk of violence in patients with schizophrenia, was only observed in two patients.
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2017.12.010
       
  • Facteurs prédictifs de la durée d’isolement chez les patients
           hospitalisés en psychiatrie. Une étude prospective multicentrique au
           sein du DTRF Paris-Sud
    • Authors: J.-F. Costemale-Lacoste; V. Cerboneschi; C. Trichard; R. De Beaurepaire; F. Villemain; J.-P. Metton; C. Debacq; T. Ghanem; C. Martelli; E. Baup; E. Loeb; P. Hardy
      Abstract: Publication date: Available online 24 March 2018
      Source:L'Encéphale
      Author(s): J.-F. Costemale-Lacoste, V. Cerboneschi, C. Trichard, R. De Beaurepaire, F. Villemain, J.-P. Metton, C. Debacq, T. Ghanem, C. Martelli, E. Baup, E. Loeb, P. Hardy
      Introduction L’isolement est une mesure indispensable à la prise en charge de certaines situations psychiatriques aiguës, mais soulève de nombreuses questions cliniques et éthiques invitant à en limiter la fréquence d’utilisation et la durée. Connaître les facteurs associés à la durée des isolements pourrait permettre l’élaboration de mesures de réduction. Cette étude explore les facteurs prédictifs d’une longue durée d’isolement. Méthode L’étude EPIC est une étude multicentrique observationnelle prospective des mesures de contention et d’isolement de sept établissements du sud-francilien. Notre objectif était de déterminer les facteurs prédictifs d’une durée d’isolement ≥ 7jours en s’appuyant sur des analyses statistiques descriptives, bivariées et multivariées. Résultats Deux cent trente-six mesures d’isolements ont été incluses pour cette étude. Les analyses bivariées montrent que les diagnostics de trouble de l’humeur et de trouble psychotique, l’hospitalisation sous contrainte préalable et l’administration d’un traitement sédatif sont associés à un isolement ≥ 7jours. Les analyses multivariées montrent que les diagnostics de trouble de l’humeur [OR=2,7, IC95 % (1,4–4,9), p =0,002] et de trouble psychotique [OR=3,3, IC95 % (1,2–8,4), p =0,01] sont associés à un isolement ≥ 7jours. L’administration d’un traitement sédatif est également associée dans ces 2 modèles à une durée ≥ 7jours [OR humeur=8,1 et OR psychotique=2,4]. Pour les patients ayant un trouble psychotique l’hospitalisation sous contrainte préalable est également un facteur associé à une longue durée d’isolement. Conclusion Les patients présentant un trouble de l’humeur ou un trouble psychotique nécessitant un traitement sédatif lors de l’isolement pourraient être une bonne cible de mesures de réduction de la durée en isolement. Introduction In psychiatric inpatient settings seclusion is a last resort to ensure the safety of the patient, other patients, and staff from disturbed behaviors. Despite its major interest for patients, seclusion could negatively impact treatment adherence and patient/staff relationships. Indeed, some secluded patients report a feeling of guilt during the measure and do not consider seclusion to be a healthcare intervention. To be more beneficial and to reduce the feeling by patients of being forced, seclusions should be as short and rare as possible. In other words, measures to reduce seclusion are available and have been clearly identified. Such measures could be applied, in the first instance, in patients with longer duration. In this way, the aim of this study was to investigate predictive factors of a seclusion of long duration. Methods Our study was based on the dataset of the EPIC study, an observational prospective French multicenter study of seclusion and restraint. The EPIC study occurred in seven French psychiatric hospitals in the southern region of Paris. Inclusions were realized for 73days and allowed a data collection of 302 seclusion measures. Of these measures 236 were effectively a seclusion in a standardized room. Because the median duration was 7days, we defined two grou...
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2018.01.005
       
  • On cognitive debiasing and the judgment of suicide-attackers
    • Authors: R. Bou Khalil; S. Richa
      Abstract: Publication date: Available online 24 March 2018
      Source:L'Encéphale
      Author(s): R. Bou Khalil, S. Richa
      Suicide-attacks are possibly increasing in frequency all over the world. To date, these attacks are not considered as a manifestation of a particular mental illness. However, the process of radicalization of suicide-attackers has to interest the field of mental health. One plausible explanation for the radicalization of individuals is the use of biased cognitive schemes by the indoctrinator. Among these cognitive schemes could figure the causal attribution bias in which the subject cannot distinguish in front of two factors that operate simultaneously, the share of each factor in achieving a certain goal. Another cognitive bias would be the confirmation bias during which the subject would tend to adhere to ideas from his/her own thinking or the thinking of subjects who share some cultural values with him/her and refute any other ideas. Finally, the bias of polarization or splitting could also be incriminated. Through this bias, the subject would either be proud of being a member of a cultural group or ashamed when he/she feels that this group is being attacked and that he/she is unable to rescue it. Approaches to increase the awareness of individuals to the adverse effects of these biased cognitive schemes may theoretically reduce the risk of committing suicide-attacks. However, despite numerous attempts of “deradicalization” involving technological means of communication as well as social “reintegration” centers, all approaches aiming at raising awareness of cognitive biases need to be studied in a scientific manner before they become widespread.

      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2018.01.002
       
  • L’addictologie de liaison : outils et spécificités
    • Authors: Cleirec Icard; Ramos Rolland
      Abstract: Publication date: Available online 24 March 2018
      Source:L'Encéphale
      Author(s): P. Poloméni, G. Cleirec, C. Icard, A. Ramos, B. Rolland
      Les équipes de liaison sont des équipes mobiles qui apportent leur expérience et leurs pratiques directement dans des services d’autres spécialités. En France, l’addictologie de liaison est structurée par une circulaire ministérielle de l’an deux mille en Équipes de liaison et de soins en addictologie (ELSA). Les ELSA partagent un savoir-faire relationnel commun avec d’autres équipes de liaison, en particulier la psychiatrie de liaison. Elles possèdent toutefois des spécificités qui les distinguent d’autres équipes de liaison. Parce qu’elles interviennent souvent pour des situations de mésusage de substances, sans forcément présence d’un trouble d’usage constitué, les ELSA sont formées à la pratique du Repérage précoce et intervention brève (RPIB), interventions mêlant aspects relationnels et prévention secondaire, qui n’est pas classiquement utilisée dans d’autres types d’équipes de liaison. De la même façon, les techniques d’entretien motivationnel sont relativement spécifiques à l’addictologie de liaison. Par ailleurs, la liaison addictologique doit nécessiter une expertise des conséquences somatiques du mésusage de substances, afin de former et de conseiller les équipes de services d’autres spécialités au bilan physique à réaliser selon le type de substance. Enfin, certains travaux suggèrent que des consultations addictologiques externes directement intégrées au sein des services de certaines spécialités (hépatologie, urgences, cancérologie), amélioreraient la motivation des patients et leur pronostic global. Malgré des convergences fortes avec d’autres pratiques de liaison, en particulier la psychiatrie de liaison, l’addictologie de liaison constitue une pratique originale et spécifique, qui mêle des compétences relationnelles et une expertise somatique complexe, à l’interstice entre de nombreuses spécialités médicales. Since the 1970s, the concept of “consultation/liaison (CL) psychiatry” has pertained to specialized mobile teams which meet inpatients hospitalized in non-psychiatric settings to offer them on-the-spot psychiatric assessment, treatment, and, if needed, adequate referral. Since the birth of CL psychiatry, a long set of theoretical books and articles has aimed at integrating CL psychiatry into the wider scope of psychosomatic medicine. In the year 2000, a circular issued by the Health Ministry defined the organization of “CL addiction services” in France. Official CL addiction teams are named “Équipes de Liaison et de Soins en Addictologie” (ELSAs) which are separated from CL psychiatry units. Though this separation can be questioned, it actually emphasizes that the work provided by CL addiction teams has some very specific features. The daily practice of ELSAs somewhat differs from that of psychiatric CL teams. Addictive behaviors often result from progressive substance misuse. In this respect, the ELSAs’ practice frequently involves screening, brief intervention, and referral to treatment (SBIRT) interventions, which are rather specific of addiction medicine and consist more of prevention interventions than actual addiction treatment. Moreover, for patients with characterized substance use disorders substantial skills in motivational interviewing are required in ELSA consultations. Though motivational interviewing is not specific to addiction medicine, its regular use is uncommon for other liaison teams in France. Furthermore, substance misuse can induce many types of acute or delayed substance-specific medical consequences. These consequences are often poorly known and thus poorly explored by physicians of other specialties. ELSAs have therefore the role of advising their colleagues for a personalized somatic screening among patients with substance misuse. In this respect, the service undertaken by ELSAs is not only based on relational skills but also comprises a somatic expertise. This specificity differs from CL psychiatry. Moreover, several recent studies have shown that in some cases it was useful to extend liaison interventions for addiction into outpatient consultations that are directly integrated in the consultation units of certain specialties (e.g., hepatology, emergency, or oncology). Such a partnership can substantially enhance patients’ motivation and addiction outcome. This specificity is also hardly transposable in CL psychiatry. In France, addiction medicine is an inter-specialty that is not fully-integrated into psychiatry. This separation is also applied for CL services which emphasizes real differences in the daily practices and in intervention frameworks. Regardless, CL psychiatry units and ELSAs share many other features and exhibit important overlaps in terms of targeted populations and overall missions. These overlaps are important to conjointly address, with the aim to offer integrated and collaborative services, within the hospital settings of other medical speci...
      PubDate: 2018-04-25T06:04:51Z
       
  • Comment améliorer l’adhésion aux soins des adolescents suicidants
           après une prise en charge aux urgences : une revue de la littérature
    • Authors: J. Lachal; S. Grandclerc; M. Spodenkiewicz; M.R. Moro
      Abstract: Publication date: Available online 24 March 2018
      Source:L'Encéphale
      Author(s): J. Lachal, S. Grandclerc, M. Spodenkiewicz, M.R. Moro
      Objectifs Les adolescents qui consultent dans les services d’accueil et d’urgence (SAU) après une tentative de suicide sont une population particulièrement à risque de récidive. Des soins existent, mais la mauvaise observance du suivi post-urgence à l’adolescence et en particulier dans ce contexte, les rend peu efficaces. Nous proposons de résumer la littérature internationale sur les interventions au SAU favorisant l’observance des soins proposés aux adolescents admis pour tentatives de suicide. Méthode Revue exhaustive des articles répertoriés dans les bases PubMed, PsycInfo, et des archives en ligne des revues spécialisées dans la suicidologie (Crisis, Suicide and Life-Threatening Behavior) et l’adolescence (Journal of the American Academy of Child and Adolescent Psychiatry, Journal of Adolescent Health, Neuropsychiatrie de l’enfance et de l’adolescence), sur la période janvier 1990 à juin 2017. Quatorze articles inclus présentés sous une forme de revue narrative. Résultats Les interventions sont classées en trois groupes : les interventions se déroulant uniquement au sein du SAU, et les interventions sur la transition SAU–post-SAU, auxquelles il faut ajouter les interventions en amont de la prise en charge. Les interventions qui semblent les plus efficaces sont celles qui ciblent la transition, qui sont mises en place le plus rapidement à la sortie, qui incluent activement les parents, et qui travaillent sur les barrières au traitement. Conclusion L’efficacité des approches de transition à court terme ne permet pas de conclure à plus long terme. Il n’existe aujourd’hui pas de dispositif idéal pour améliorer l’adhésion aux soins des adolescents après une tentative de suicide. Les pistes doivent être approfondies et étudiées de manière quantitative mais également qualitative. Objectives Suicidal adolescents admitted in an Emergency Department (ED) present a high risk of suicidal reattempts. Poor observance of follow-up in this particular group imped the efficacity of the treatment. We propose to summarize the international literature on ED interventions promoting suicidal adolescents’ adherence to care. Method We carried out a comprehensive review of papers listed in PubMed, PsycInfo, and CINHAL databases using keywords about adolescence, suicide, and ED. We also manually consulted the main journals specialized in suicidology (Crisis and Suicide and Life-Threatening Behavior) and adolescence (Journal of the American Academy of Child and Adolescent Psychiatry, Journal of Adolescent Health, Neuropsychiatrie de l’Enfance et de l’Adolescence). We selected the relevant articles describing or evaluating one or more interventions initiated in the ED and designed to promote adolescent adherence to post-emergency care. The results are presented in a narrative review form. Results Interventions are organized in three groups: interventions that take place solely at the ED (problem-solving interventions and educational interventions directed to families) and interventions that take place during and after emergency care (we included in this group the ED-Care program, the FISP program, and the SAFETY program), to which should be added interventions that take place prior to care, in particular specific trainings for medical and paramedical teams. Small samples and barriers in measuring adherence to care make statistical compar...
      PubDate: 2018-04-25T06:04:51Z
      DOI: 10.1016/j.encep.2018.01.004
       
  • The evaluation of depression in multiple sclerosis using the newly
           proposed Multiple Sclerosis Depression Rating Scale
    • Authors: U. Palm; M.A. Chalah; A. Créange; J.-P. Lefaucheur; S.S. Ayache
      Abstract: Publication date: Available online 17 February 2018
      Source:L'Encéphale
      Author(s): U. Palm, M.A. Chalah, A. Créange, J.-P. Lefaucheur, S.S. Ayache
      Fatigue and depression are frequent symptoms in multiple sclerosis (MS). Both are overlapping and shadowing each other and may impair the quality of life. For detection of depression symptoms in MS, the Multiple Sclerosis Depression Rating Scale (MSDRS) has been proposed recently. Here, we compare the performance of MSDRS in MS patients with and without fatigue to that of established rating scales, i.e. Hospital Anxiety and Depression Scale and Beck Depression Inventory. Twenty-nine MS patients were screened for fatigue and depression symptoms. Patients with fatigue showed significantly higher depression scores compared to patients without fatigue, whereas the number of depressed patients did not differ between the two groups. MSDRS seems to have higher sensitivity to detect severe depression than established rating scales. However, one should keep in mind that such a finding might be due to an increase in false positive cases when using MSDRS. Implementing this scale in future studies might be of help to enhance the understanding of its potential utility.

      PubDate: 2018-02-26T09:04:23Z
      DOI: 10.1016/j.encep.2017.11.004
       
  • Treating borderline personality disorder with oxytocin: An enthusiastic
           note of caution. Commentary to Servan et al. The effect of oxytocin in
           borderline personality disorder
    • Abstract: Publication date: February 2018
      Source:L'Encéphale, Volume 44, Issue 1
      Author(s): M. Debbané


      PubDate: 2018-02-26T09:04:23Z
       
  • Ethical considerations in bipolar disorders
    • Authors: S. Richa; R. Chammay; A. Dargél; C. Henry; M. Masson
      Abstract: Publication date: Available online 4 February 2018
      Source:L'Encéphale
      Author(s): S. Richa, R. Chammay, A. Dargél, C. Henry, M. Masson
      The implications of biomedical ethics principles extend to both medical care and biomedical research. They are particularly relevant for psychiatry in which pathologies are often chronic and disabling. Bipolar disorders impact the ability to make judgements and to take decisions during mood episodes and remain a stigmatised condition. Early interventions, even those in the prodromal phase, pose ethical questions for both clinicians and researchers. The degree of patients’ autonomy in their clinical care must also now be considered from a biomedical ethics perspective.

      PubDate: 2018-02-16T03:48:03Z
      DOI: 10.1016/j.encep.2017.12.005
       
  • Microduplication on the microtubule-associated protein 7 domain-containing
           3 (MAP7D3) gene in a female patient with borderline personality disorder,
           major depression and a history of oppositional defiant disorder
    • Authors: E. Khoury; J.-C. Yazbek; M. Zarzour; Y. Chamoun; E. Choueiry; R. Bou Khalil; S. Richa
      Abstract: Publication date: Available online 4 February 2018
      Source:L'Encéphale
      Author(s): E. Khoury, J.-C. Yazbek, M. Zarzour, Y. Chamoun, E. Choueiry, R. Bou Khalil, S. Richa


      PubDate: 2018-02-16T03:48:03Z
      DOI: 10.1016/j.encep.2017.11.005
       
  • Exploration of mental health of health students: Dental and medical
           formations promote anhedonia
    • Authors: Guihard
      Abstract: Publication date: Available online 1 February 2018
      Source:L'Encéphale
      Author(s): G. Guihard
      Objectives Health students usually report to experience stress during their formation. This is due to their exposure to patient's disease or death, to their learning of interpersonal relationships, and to the discovery of health practitioner's responsibility. Anhedonia represents a deficit in experiencing pleasure that is promoted by stressful living conditions. We hypothesized that health formations promote anhedonia. Our objectives have consisted in measuring anhedonia and analyzing its variation and heterogeneity among health students. Methods The Temporal Experience of Pleasure Scale (TEPS) was used to assess anhedonia and its anticipatory and consummatory dimensions. TEPS corresponds to an 18-item questionnaire, the score of which is based on a 6-point Likert scale. Low score indicates a high anhedonia propensity. Score differences were analyzed by considering gender, curriculum and formation as independent variables. A cluster analysis was used to explore anhedonia heterogeneity among our sample. Results We collected 1231 responses. Our data confirm French TEPS as a reliable tool for anhedonia evaluation in dental and medical students. Statistical analyses reveal a significant effect of gender (male>female), curriculum (clinical>preclinical) and formation (dental>medical) on anhedonia propensity. Cluster analysis highlights four sub-groups of students characterized by increasing anhedonia traits and by different gender, formation and curriculum proportions. Conclusion This work describes the first analysis of anhedonia manifestation during dental and medical studies in France. The consequences of our findings for the comprehension of dental and medical students’ mental health during their formation are discussed.

      PubDate: 2018-02-16T03:48:03Z
       
  • Dépression et maladies cardiovasculaires chez les femmes diabétiques de
           type 2 : étude cas-témoins
    • Authors: M. Gourine; K. Bentadj; S. Mostefa-Kara; A. Cherrak; S. Halimi; M. Belhadj
      Abstract: Publication date: Available online 19 December 2017
      Source:L'Encéphale
      Author(s): M. Gourine, K. Bentadj, S. Mostefa-Kara, A. Cherrak, S. Halimi, M. Belhadj


      PubDate: 2017-12-26T19:14:16Z
      DOI: 10.1016/j.encep.2017.10.004
       
  • Catatonia with schizophrenia: From ECT to rTMS
    • Authors: E. Stip; M.-E. Blain-Juste; O. Farmer; M.-P. Fournier-Gosselin; P. Lespérance
      Abstract: Publication date: Available online 11 December 2017
      Source:L'Encéphale
      Author(s): E. Stip, M.-E. Blain-Juste, O. Farmer, M.-P. Fournier-Gosselin, P. Lespérance
      Background Electroconvulsive therapy is indicated in cases of catatonic schizophrenia following a failure of the challenge test with lorazepam or Zolpidem®. Some patients need maintenance treatment with ECT. Repetitive Transcranial Magnetic Stimulation (rTMS) and anodal Transcranial direct-current stimulation (tDCS) might be effective against catatonia. Objective Consider an alternative to ECT for a refractory patient. Review Twenty-one articles were identified mainly based on case reports series were found using search on Medline, Google Scholar, PsychInfo, CAIRNS. Key words were:“catatonia”, and “rTMS”, and more generally with“ECT”,“tDCS”,“Zolpidem®”. At the end there were only six case reports with rTMS and three with tDCS. We discussed the alternative to ECT and follow up rTMS strategies illustrated by these case reports. Findings Patients mean age was 35; numbers of previous ECT vary from zero to 556; the most common motor threshold (MT) is 80%, with two patients with 110%, the most common treatment placement is L DLPFC. In one of them, ECT was the only acute-state or maintenance treatment effective in this patient, who underwent 556 ECT sessions over 20 years. High-frequency rTMS was considered as a possible alternative, given the potential adverse effects of chronic maintenance ECT in a patient with comorbid epilepsy. rTMS treatment was 3–4×/week and over time extended to once every two weeks. A persistent objective improvement in catatonia was observed on the Bush-Francis Catatonia Rating Scale. Conclusion rTMS is helpful for acute and maintenance treatment for catatonic schizophrenia who both failed multiple pharmacologic interventions and had safety concerns with continuing maintenance ECT. Clinicians should consider rTMS as a potential treatment option for refractory catatonia.

      PubDate: 2017-12-12T11:01:21Z
      DOI: 10.1016/j.encep.2017.09.008
       
 
 
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