Symptomatologie dépressive à l'adolescence : rôle de la personnalité et de la conscience émotionnelle

International audienceAim of the study. The aim of the study was to analyze the relating contribution of personality dimensions referring to Cloninger’s model and emotional awareness to depressive symptoms intensity, in a community sample of adolescents. Our purpose was also to investigate the mediating role of the emotional awareness on the personality-depression relationship.Method. A sample of 372 school students completed the following questionnaires: the Tridimensional Personality Questionnaire (TPQ), the Level of Emotional Awareness Scale (LEAS), and the Center for Epidemiologic Studies Depression scale (CES-D).Results. Correlationnal and multiple hierarchical regressions analysis confirmed the existence of direct links between each personality dimensions and depression, and the partial mediating effect of emotional awareness, but only for the novelty seeking and the harm avoidance dimensions. Conclusion. Our results confirm the relationships observed in previous research between emotion awareness and depression on one hand, and between personality and depression on the other hand. They highlight the major role played by personality and emotional processing in the vulnerability to present depressive symptoms. The importance of taking in account and assess the emotional processing in the adolescent’s depression clinical support is discussed.But de l’étude. L’objectif de cette étude était d’étudier les contributions relatives de dimensions de personnalité en référence au modèle de Cloninger et de la conscience émotionnelle à l’intensité de la symptomatologie dépressive, dans un échantillon communautaire d’adolescents. Cette recherche se proposait également d’évaluer l’effet médiateur du niveau de conscience émotionnelle sur la relation entre personnalité et dépression.Patients et méthode. Un échantillon de 372 adolescents de collèges et lycées a été constitué. Les adolescents ont complété les questionnaires suivants : le Questionnaire Tridimensionnel de Personnalité (TPQ), l’Echelle de Niveau de Conscience Emotionnelle (LEAS), et l’échelle d’évaluation de la Dépression du Centre d’Etudes Epidémiologiques (CES-D)Résultats. Les analyses en corrélations et en régressions hiérarchiques confirment l’existence de relations directes entre chacune des dimensions de personnalité et la dépression ainsi que l’effet médiateur partiel du niveau de conscience émotionnelle, mais uniquement dans le cas des dimensions « recherche de nouveauté » et « évitement du danger ». Conclusion. Les résultats obtenus mettent en évidence le lien déjà observé dans des travaux antérieurs entre conscience émotionnelle et dépression d’une part, et entre personnalité et dépression d’autre part. Ils soulignent le rôle majeur joué par la personnalité et le fonctionnement émotionnel dans la vulnérabilité à présenter des symptômes dépressifs. L’importance de prendre en compte et d’évaluer le fonctionnement émotionnel dans la prise en charge de ces troubles à l’adolescence est discutée

Affectivité et alexithymie : deux dimensions explicatives des relations entre symptômes dépressifs et anxieux

International audienceObjectives : The main objective of this study was to support the existence of emotional dimensions common to anxiety and depressive symptomatology, and confirm the common elements of emotional vulnerability, characterized by negative affectivity and alexithymia operation. The second objective of this study was the identification of characteristics specific to each disorder. We made three assumptions:1) there is a significant relationship between anxiety and depressive symptoms, 2) exists on community processes between these two entities, objectified by the sub dimensions of negative affectivity and the difficulty in identifying emotions 3) certain dimensions are specific to each disorder.Method : The study participants were students from 1st to 4th year of the University of Provence. The sample consisted of 317 subjects (77% female and 23% G; mean age = 20, 61 ± 1.55), who gave written informed consent and completed questionnaires collectively. We administered to the subjects a protocol consisting of three self-assessment scales to assess emotional dimensions and anxiety and depressive symptomatology. The dimensions of affectivity were assessed by the EPN-31. It consists of 31 items grouped into three factors: positive emotions, negative emotions and feelings of surprise. The emotional functioning was assessed by the scale of the Toronto alexithymia (TAS-20). It allows an overall assessment of the level of alexithymia, as well as three dimensions as represented by specific sub scales: difficulty identifying emotions (DIE), the difficulty to differentiate emotions (DDE), and thought oriented l outside (PEO). This scale is most used in the assessment of alexithymia. The anxiety and depressive symptoms was assessed by the subscale of anxiety and depression of the SCL90-R. This scale is widely used in screening for psychiatric symptoms, and has been validated internationally.Statistical analysis: we performed descriptive analysis, correlational analysis (correlation of Bravais-Pearson) and hierarchical multiple regression with SPSS 15.Results validate our assumptions. We observe significant correlations between anxiety and depressive symptomatology and vulnerability factors (negative affectivity, emotional activation and alexithymia). The proposed model can retain common elements and specific dimensions operating respectively for anxiety and depression.Discussion : Our study reveals the existence of a "common nucleus of vulnerability characterized by negative affectivity associated with difficulty identifying emotions. Specific dimensions appear nevertheless exist, and depression is strongly explained by low positive affect (anhedonia dimension); anxiety associated specificially to emotional activation and finally thought outward, marking the size limitation the imaginary life in alexithymia, appears to operate in depression, perhaps as a mechanism of emotional repression. The involvement of alexithymia in the functioning of the affective disorder is confirmed, this helps to clarify the modalities of therapeutic care that we offer.L’objectif de cette étude était de dégager l’existence d’un « noyau commun de vulnérabilité émotionnelle » opérant dans l’anxiété et la dépression ; et de préciser les dimensions émotionnelles spécifiques à chacune. Nous avons recruté 317 sujets étudiants. Ils ont rempli un protocole permettant d’évaluer par des échelles d’autoévaluation les symptomatologies dépressive et anxieuse ( SCLR-90), l’affectivité ( EPN-31) et l’alexithymie (TAS-20). Les résultats montrent que l’affectivité négative et la difficulté à identifier les émotions représentent des facteurs commun de vulnérabilité à l’anxiété et à la dépression ; par contre, ces deux symptomatologies se distinguent par la mise en évidence d’éléments spécifiques à chacune. On observe ainsi une faible affectivité positive dans la dépression et une forte activation dans l’anxiété, résultats qui confirment des travaux antérieurs de la littérature. Une particularité réside dans le rôle joué dans la dépression par la pensée orientée vers l’extérieur, dimension opératoire de l’alexithymie. Les limites de l’étude et les ouvertures possibles sont discutées

Transcriptome profiling of sheep granulosa cells and oocytes during early follicular development obtained by Laser Capture Microdissection

<p>Abstract</p> <p>Background</p> <p>Successful achievement of early folliculogenesis is crucial for female reproductive function. The process is finely regulated by cell-cell interactions and by the coordinated expression of genes in both the oocyte and in granulosa cells. Despite many studies, little is known about the cell-specific gene expression driving early folliculogenesis. The very small size of these follicles and the mixture of types of follicles within the developing ovary make the experimental study of isolated follicular components very difficult.</p> <p>The recently developed laser capture microdissection (LCM) technique coupled with microarray experiments is a promising way to address the molecular profile of pure cell populations. However, one main challenge was to preserve the RNA quality during the isolation of single cells or groups of cells and also to obtain sufficient amounts of RNA.</p> <p>Using a new LCM method, we describe here the separate expression profiles of oocytes and follicular cells during the first stages of sheep folliculogenesis.</p> <p>Results</p> <p>We developed a new tissue fixation protocol ensuring efficient single cell capture and RNA integrity during the microdissection procedure. Enrichment in specific cell types was controlled by qRT-PCR analysis of known genes: six oocyte-specific genes (<it>SOHLH2</it>, <it>MAEL</it>, <it>MATER</it>, <it>VASA</it>, <it>GDF9</it>, <it>BMP15</it>) and three granulosa cell-specific genes (<it>KL</it>, <it>GATA4</it>, <it>AMH</it>).</p> <p>A global gene expression profile for each follicular compartment during early developmental stages was identified here for the first time, using a bovine Affymetrix chip. Most notably, the granulosa cell dataset is unique to date. The comparison of oocyte vs. follicular cell transcriptomes revealed 1050 transcripts specific to the granulosa cell and 759 specific to the oocyte.</p> <p>Functional analyses allowed the characterization of the three main cellular events involved in early folliculogenesis and confirmed the relevance and potential of LCM-derived RNA.</p> <p>Conclusions</p> <p>The ovary is a complex mixture of different cell types. Distinct cell populations need therefore to be analyzed for a better understanding of their potential interactions. LCM and microarray analysis allowed us to identify novel gene expression patterns in follicular cells at different stages and in oocyte populations.</p

Incident Tuberculosis during Antiretroviral Therapy Contributes to Suboptimal Immune Reconstitution in a Large Urban HIV Clinic in Sub-Saharan Africa

Antiretroviral therapy (ART) effectively decreases tuberculosis (TB) incidence long-term, but is associated with high TB incidence rates in the first 6 months. We sought to determine the incidence and the long-term effects of TB during ART on HIV treatment outcome, and the risk factors for incident TB during ART in a large urban HIV clinic in Uganda.Routinely collected longitudinal clinical data from all patients initiated on first-line ART was retrospectively analysed. 5,982 patients were included with a median baseline CD4+ T cell count (CD4 count) of 117 cells/mm(3) (interquartile range [IQR]; 42, 182). In the first 2 years, there were 336 (5.6%) incident TB events in 10,710 person-years (py) of follow-up (3.14 cases/100 pyar [95% CI 2.82-3.49]); incidence rates at 0-3, 3-6, 6-12 and 12-24 months were 11.25 (9.58-13.21), 6.27 (4.99-7.87), 2.47 (1.87-3.36) and 1.02 (0.80-1.31), respectively. Incident TB during ART was independently associated with baseline CD4 count of <50 cells/mm(3) (hazard ratio [HR] 1.84 [1.25-2.70], P = 0.002) and male gender (HR 1.68 [1.34-2.11], P<0.001). After two years on ART, the patients who had developed TB in the first 12 months had a significantly lower median CD4 count increase (184 cells/mm(3) [IQR; 107, 258, n = 118] vs 209 cells/mm(3) [124, 309, n = 2166], P = 0.01), a larger proportion of suboptimal immune reconstitution according to two definitions (increase in CD4 count <200 cells/mm(3): 57.4% vs 46.9%, P = 0.03, and absolute CD4 count <200 cells/mm(3): 30.4 vs 19.9%, P = 0.006), and a higher percentage of immunological failure according to the WHO criteria (13.6% vs 6.5%, P = 0.003). Incident TB during ART was independently associated with poor CD4 count recovery and fulfilling WHO immunological failure definitions.Incident TB during ART occurs most often within 3 months and in patients with CD4 counts less than 50 cells/mm(3). Incident TB during ART is associated with long-term impairment in immune recovery

An original phylogenetic approach identified mitochondrial haplogroup T1a1 as inversely associated with breast cancer risk in BRCA2 mutation carriers

Introduction: Individuals carrying pathogenic mutations in the BRCA1 and BRCA2 genes have a high lifetime risk of breast cancer. BRCA1 and BRCA2 are involved in DNA double-strand break repair, DNA alterations that can be caused by exposure to reactive oxygen species, a main source of which are mitochondria. Mitochondrial genome variations affect electron transport chain efficiency and reactive oxygen species production. Individuals with different mitochondrial haplogroups differ in their metabolism and sensitivity to oxidative stress. Variability in mitochondrial genetic background can alter reactive oxygen species production, leading to cancer risk. In the present study, we tested the hypothesis that mitochondrial haplogroups modify breast cancer risk in BRCA1/2 mutation carriers. Methods: We genotyped 22,214 (11,421 affected, 10,793 unaffected) mutation carriers belonging to the Consortium of Investigators of Modifiers of BRCA1/2 for 129 mitochondrial polymorphisms using the iCOGS array. Haplogroup inference and association detection were performed using a phylogenetic approach. ALTree was applied to explore the reference mitochondrial evolutionary tree and detect subclades enriched in affected or unaffected individuals. Results: We discovered that subclade T1a1 was depleted in affected BRCA2 mutation carriers compared with the rest of clade T (hazard ratio (HR) = 0.55; 95% confidence interval (CI), 0.34 to 0.88; P = 0.01). Compared with the most frequent haplogroup in the general population (that is, H and T clades), the T1a1 haplogroup has a HR of 0.62 (95% CI, 0.40 to 0.95; P = 0.03). We also identified three potential susceptibility loci, including G13708A/rs28359178, which has demonstrated an inverse association with familial breast cancer risk. Conclusions: This study illustrates how original approaches such as the phylogeny-based method we used can empower classical molecular epidemiological studies aimed at identifying association or risk modification effects.Peer reviewe

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks