Hospitalizations for Anorexia Nervosa during the COVID-19 Pandemic in France: A Nationwide Population-Based Study

The COVID-19 pandemic has had a detrimental impact on mental health, including on food-related behaviors. However, little is known about the effect of the pandemic on anorexia nervosa (AN). We sought to assess an association between the COVID-19 pandemic and a potential increase in hospitalizations for AN in France. We compared the number of hospitalizations with a diagnosis of AN during the 21-month period following the onset of the pandemic with the 21-month period before the pandemic using Poisson regression models. We identified a significant increase in hospitalizations for girls aged 10 to 19 years (+45.9%, RR = 1.46[1.43–1.49]; p < 0.0001), and for young women aged 20 to 29 (+7.0%; RR = 1.07[1.04–1.11]; p < 0.0001). Regarding markers of severity, there was an increase in hospitalizations for AN associated with a self-harm diagnosis between the two periods. Multivariate analysis revealed that the risk of being admitted for self-harm with AN increased significantly during the pandemic period among patients aged 20–29 years (aOR = 1.39[1.06–1.81]; p < 0.05 vs. aOR = 1.15[0.87–1.53]; NS), whereas it remained high in patients aged 10 to 19 years (aOR = 2.40[1.89–3.05]; p < 0.0001 vs. aOR = 3.12[2.48–3.98]; p < 0.0001). Furthermore, our results suggest that the pandemic may have had a particular effect on the mental health of young women with AN, with both a sharp increase in hospitalizations and a high risk of self-harming behaviors

Effectiveness of an Educational Program to Enhance Self-care Skills After Acute Coronary Syndrome: A Quasi-Experimental Study

Abstract. Background: The aim of this study is to determine the effectiveness of an educational program to enhance self-care skills in patients after an acute coronary syndrome Methods: A quasi-experimental pretest-posttest design was used in the study. A rehabilitation nurse provided an educational program (PEpSCA-CARE) to the intervention group (n = 32), and the control group (n = 35) received the conventional nursing pre-discharge care. The data was collected using the Therapeutic Self-Care Scale (TSCS) in four dimensions: medications, symptoms, activities of daily living and health status management, applied before hospital discharge and one month after hospital discharge to both groups. Patients were recruited from an intensive cardiovascular care unit during 2016. Results: The results showed statistically significant differences between both groups (p < 0.001). The intervention group tended to improve their self-care skills while the control group had opposite trends, self-care skills decreased. Conclusions: According to the findings of the study, a systematized and structured educational program, is effective in developing self-care skills in patients after an acute coronary syndrome

Spécificité de la recherche en psychiatrie ; exemple d'une étude au sein du CHU de Dijon ; étude du système télomères-télomérase et de l'expression de gênes candidats dans les leucocytes de patients atteints de troubles dépressifs (recherche de marqueurs périphériques du stress somatique)

Bien qu enjeu majeur des systèmes de santé avec presque une personne sur cinq qui vivra au cours de sa vie un trouble psychique, la recherche en psychiatrie et santé mentale n a pas encore un essor comparable aux autres disciplines médicales. Ce fait semble résulter d une double problématique : -Intrinsèque ; spécialité pluridisciplinaire par excellence, la psychiatrie pose la question de la définition de la maladie mentale, du choix d un modèle théorique, et surtout épistémologique. On observe ainsi un manque d outils ou de méthodes adaptés et standardisés. -Extrinsèque ; le manque d information du grand public et la difficulté du monde politique à prendre en considération ce champ de la santé, peuvent peut-être expliquer que la psychiatrie se trouve particulièrement sous dotée et que l on observe une importante désorganisation de la recherche avec l absence de centres de référence ou d objectifs pratiques concrets. Cette problématique a été remise en exergue par la confrontation des psychothérapies à l EVIDENCE BASED MEDECINE dans un rapport fortement polémique de l INSERM en 2004. Ce sujet est abordé à travers les difficultés rencontrées lors d une étude en cours au sein du service de psychiatrie du CHU de Dijon, et les moyens mis en œuvre pour tenir compte des différents aspectsDIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF

Approche psychosomatique et psychiatrique du diabète (présentation de l'étude "diabète et profil psychologique")

DIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF

Up-regulation of leucocytes genes implicated in telomere dysfunction and cellular senescence correlates with depression and anxiety severity scores.

BACKGROUND: Major depressive disorder (MDD) is frequently associated with chronic medical illness responsible of increased disability and mortality. Inflammation and oxidative stress are considered to be the major mediators of the allostatic load, and has been shown to correlate with telomere erosion in the leucocytes of MDD patients, leading to the model of accelerated aging. However, the significance of telomere length as an exclusive biomarker of aging has been questioned on both methodological and biological grounds. Furthermore, telomeres significantly shorten only in patients with long lasting MDD. Sensitive and dynamic functional biomarkers of aging would be clinically useful to evaluate the somatic impact of MDD. METHODOLOGY: To address this issue we have measured in the blood leucocytes of MDD patients (N=17) and controls (N=16) the expression of two genes identified as robust biomarkers of human aging and telomere dysfunction: p16(INK4a) and STMN1. We have also quantified the transcripts of genes involved in the repair of oxidative DNA damage at telomeres (OGG1), telomere regulation and elongation (TERT), and in the response to biopsychological stress (FOS and DUSP1). RESULTS: The OGG1, p16(INK4a), and STMN1 gene were significantly up-regulated (25 to 100%) in the leucocytes of MDD patients. Expression of p16(INK4a) and STMN1 was directly correlated with anxiety scores in the depression group, and that of p16(INK4a), STMN and TERT with the depression and anxiety scores in the combined sample (MDD plus controls). Furthermore, we identified a unique correlative pattern of gene expression in the leucocytes of MDD subjects. CONCLUSIONS: Expression of p16(INK4) and STMN1 is a promising biomarker for future epidemiological assessment of the somatic impact of depressive and anxious symptoms, at both clinical and subclinical level in both depressive patients and general population

Characteristics of the Depressed and Control Subjects.

<p>Characteristics of the Depressed and Control Subjects.</p

Correlative pattern of gene expression (Pearson's coefficient) in the blood leucocytes of controls and MDD subjects. For each gene the |r| value of control subjects (when significant) is in normal font weight on the upper row, and the |r| of the depressed patients in bold font weight on the lower row.

<p>Correlative pattern of gene expression (Pearson's coefficient) in the blood leucocytes of controls and MDD subjects. For each gene the |r| value of control subjects (when significant) is in normal font weight on the upper row, and the |r| of the depressed patients in bold font weight on the lower row.</p

Increased Risk of Rehospitalization for Acute Diabetes Complications and Suicide Attempts in Patients With Type 1 Diabetes and Comorbid Schizophrenia

IF 13.397 (2017)International audienceOBJECTIVE The aim of this large retrospective cohort study was to estimate the supplementary morbidity and mortality risks conferred by the co-occurrence of schizophrenia among young people with type 1 diabetes.RESEARCH DESIGN AND METHODS This nationwide population-based study included individuals aged 15–35 years hospitalized in France for type 1 diabetes from 2009 to 2012 with or without schizophrenia. For assessment of the occurrence of rehospitalization for acute diabetes complications, suicide attempts, and hospital mortality, multivariate logistic regressions and survival analysis adjusted for age, sex, and Charlson Comorbidity Index scores were performed. The association between hospitalization for suicide attempts and acute diabetes complications was further explored in a survival analysis, with the exposure of acute diabetes complications as a time-dependent covariate.RESULTS Among 45,655 individuals aged 15–35 years who were hospitalized for type 1 diabetes, 341 (0.75%) had a previous or contemporary hospitalization for schizophrenia. Within 3 years of follow-up, schizophrenia was associated with increased risks of rehospitalization for hypoglycemia (adjusted odds ratio 3.21 [95% CI 1.99–5.20]), hyperglycemia (7.01 [3.53–13.90]), ketoacidosis (2.01 [1.49–2.70]), and coma (3.17 [1.90–5.27]); hospitalization for suicide attempts (12.15 [8.49–17.38]); and hospital mortality (2.83 [1.50–5.36]). Hospitalization for a suicide attempt was associated with an increased risk of hospitalization for acute diabetes complications independently from schizophrenia (hazard ratio 3.46 [95% CI 2.74–4.38]).CONCLUSIONS Patients suffering from the combination of type 1 diabetes and schizophrenia are at increased risk of hospitalization for acute diabetes complications as well as suicide and hospital mortality. These individuals may require specific care programs and close monitoring of mental, somatic, and social health

Risk of hospitalization for self-harm among adults hospitalized with SARS-CoV-2 in France: A nationwide retrospective cohort study

International audienceWhile much work has shown a link between the global SARS-CoV-2 pandemic and poor mental health, little is known about a possible association between hospitalization with SARS-CoV-2 infection and subsequent hospitalization for self-harm. Analyses performed on the French national hospital database between March 2020-March 2021 in 10,084,551 inpatients showed that hospitalization with SARS-CoV-2 infection was not associated with hospitalization for self-harm in the following year. However, hospitalization with SARS-Cov-2 was related to an increased risk of self-harm in patients with a suicidal episode at the inclusion (aHR=1.56[1.14–2.15]), suggesting an effect of SARS-CoV-2 in patients with a recent history of self-harm