Hypovitaminosis D is associated with depression and anxiety in schizophrenia: results from the national FACE-SZ cohort. Running title: hypovitaminosis D, depression and anxiety in schizophrenia

International audienceBackground. Guidelines have been edited for the treatment of schizophrenia (SZ) and bipola

Blood Inflammatory, Hydro-Electrolytes and Acid-Base Changes in Belgian Blue Cows Developing Parietal Fibrinous Peritonitis or Generalised Peritonitis after Caesarean Section

peer reviewedThis study aimed to describe the inflammation, hydro-electrolyte and acid-base imbalances caused by generalised peritonitis (GP) and parietal fibrinous peritonitis (PFP) after caesarean section. After clinical examination, blood was sampled from 11 cows with PFP, 30 with GP and 14 healthy cows. Serum and plasma refractometry and glutaraldehyde tests were used to evaluate the inflammation level, while hydro-electrolytes and acid-base parameters were assessed using an EPOC® device. In addition to clinical signs of dehydration (>10%), blood analysis showed a high fibrinogen concentration (PFP: 8.64 ± 8.82 g/L; GP: 7.83 ± 2.45 g/L) and fast glutaraldehyde coagulation (<3 min) indicative of severe inflammation in both diseases compared to the control group (p < 0.05). Moreover, a severe decrease in electrolytes concentration (Na+: 126.93 ± 5.79 mmol/L; K+: 3.7 ± 1.3 mmol/L; Ca++: 0.89 ± 0.12 mmol/L; Cl−: 82.38 ± 6.45 mmol/L) and a significant increase in bicarbonate (30.87 ± 8.16 mmol/L), base excess (5.71 ± 7.42 mmol/l), L-lactate (8.1 ± 4.85 mmol/L) and creatinine (3.53 ± 2.30 mg/dL) were observed in cows with GP compared to the control group (p < 0.05). In contrast, few major perturbations were noticed in PFP, where only K+ (3.64 ± 0.25 mmol/L) and Ca++ (1.06 ± 0.09 mmol/L) were significantly modified (p < 0.05). In conclusion, a high dehydration and severe inflammation are induced by PFP and GP. Nevertheless, GP causes more electrolytes and acid-base disturbances than PFP

Handedness as a neurodevelopmental marker in schizophrenia: Results from the FACE-SZ cohort

Objectives: High rates of non-right-handedness (NRH) including mixed-handedness have been reported in neurodevelopmental disorders. In schizophrenia (SZ), atypical handedness has been inconsistently related to impaired features. We aimed to determine whether SZ subjects with NRH and mixed-handedness had poorer clinical and cognitive outcomes compared to their counterparts. Methods: 667 participants were tested with a battery of neuropsychological tests, and assessed for laterality using the Edinburg Handedness Inventory. Clinical symptomatology was assessed. Learning disorders and obstetrical complications were recorded. Biological parameters were explored. Results: The prevalence of NRH and mixed-handedness was high (respectively, 42.4% and 34.1%). In the multivariable analyses, NRH was associated with cannabis use disorder (p = 0.045). Mixed-handedness was associated with positive symptoms (p = 0.041), current depressive disorder (p = 0.005)), current cannabis use (p = 0.024) and less akathisia (p = 0.019). A history of learning disorder was associated with NRH. No association was found with cognition, trauma history, obstetrical complications, psychotic symptoms, peripheral inflammation. Conclusions: Non-right and mixed-handedness are very high in patients with SZ, possibly reflecting a neurodevelopmental origin. NRH is associated with learning disorders and cannabis use. Mixed-handedness is associated with positive symptoms, current depressive disorder, cannabis use and less akathisia. However, this study did not confirm greater cognitive impairment in these patients. © 2021 Informa UK Limited, trading as Taylor & Francis Group.Sorbonne Universités à Paris pour l'Enseignement et la RechercheFondaMental-Cohorte

Overlap and Mutual Distinctions between Clinical Recovery and Personal Recovery in People with Schizophrenia in a One-Year Study

Recovery is a multidimensional construct that can be defined either from a clinical perspective or from a consumer-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. We aimed to longitudinally examine the overlap and mutual distinctions between clinical and personal recovery. Of 1239 people with schizophrenia consecutively recruited from the FondaMental Advanced Centers of Expertise for SZ network, the 507 present at one-year did not differ from those lost to follow-up. Clinical recovery was defined as the combination of clinical remission and functional remission. Personal recovery was defined as being in the rebuilding or in the growth stage of the Stages of Recovery Instrument (STORI). Full recovery was defined as the combination of clinical recovery and personal recovery. First, we examined the factors at baseline associated with each aspect of recovery. Then, we conducted multivariable models on the correlates of stable clinical recovery, stable personal recovery, and stable full recovery after one year. At baseline, clinical recovery and personal recovery were characterized by distinct patterns of outcome (i.e. better objective outcomes but no difference in subjective outcomes for clinical recovery, the opposite pattern for personal recovery, and better overall outcomes for full recovery). We found that clinical recovery and personal recovery predicted each other over time (baseline personal recovery for stable clinical recovery at one year; P =. 026, OR = 4.94 [1.30-23.0]; baseline clinical recovery for stable personal recovery at one year; P =. 016, OR = 3.64 [1.31-11.2]). In short, given the interaction but also the degree of difference between clinical recovery and personal recovery, psychosocial treatment should target, beyond clinical recovery, subjective aspects such as personal recovery and depression to reach full recovery. © 2021 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.Sorbonne Universités à Paris pour l'Enseignement et la RechercheFondaMental-Cohorte

Schizophrenia Bulletin Open

Treatment-resistant schizophrenia (TRS) affects around 30% of patients with schizophrenia (SZ) resulting in poor functioning, relapses, and reduced quality of life. Convergent findings show that inflammation could contribute to resistance. We thus search for immune signatures of patients with TRS/ultra TRS (UTRS) in a sample of community-dwelling outpatients with SZ. In total, 195 stabilized SZ patients (mean age = 31.2 years, 73% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. At inclusion, psychotic symptomatology was evaluated by the Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Circulating serum/plasma levels of a large panel of markers reflecting the main inflammatory pathways were evaluated. TRS was defined by current treatment by clozapine (CLZ) and UTRS by current CLZ treatment + PANSS total score ≥ 70. The frequency of TRS and UTRS patients was, respectively, 20% and 7.7% and was defined using multivariable analysis elevated by high levels of interleukin (IL)-12/IL-23p40, IL-17A, IL-10, and beta 2 microglobulin (B2M) and IL-12/IL-23p40, IL-17A, IL-6, IL-10, IFNγ, and B2M, respectively. These observations suggest that resistance and ultra resistance to CLZ treatment are underpinned by pro-inflammatory molecules mainly belonging to the T helper 17 pathway, a finding making sense given the interplay between inflammation and antipsychotic treatment responses. If confirmed, our findings may allow us to consider IL-23/IL-17 pathway as a therapeutic target for patients with resistance to antipsychotics.Sorbonne Universités à Paris pour l'Enseignement et la RechercheFondaMental-Cohorte

Auto-stigmatisation dans les troubles psychiques sévères et persistants

Self-stigma is highly prevalent in persons with Serious Mental Illness (SMI) and is associated with poor patient’s outcomes. Our objectives were a better understanding of self-stigma and how to reduce it trough improved clinical practice. This PhD dissertation has four steps : i) first, we reviewed the potential cognitive and neurobiological mechanisms underlying stigma and self-stigma ; ii) then we reviewed the prevalence, prédictors and correlates of self-stigma in SMI ; iii) we assessed the frequency of self-stigma and stigma resistance in the French national network of centres for psychiatric rehabilitation (REHABase), described in a previous article ; iv) we adapted in French Narrative Enhancement and Cognitive Therapy (NECT) self-stigma reduction program and initiated a stepped-wedge randomised control trial assessing its effectiveness in improving social function in SMI. Self-stigma is a major public health issue, affecting people in all geographical areas, all SMI conditions and all stages of the illness including at-risk states and early disorders. Elevated self-stigma concerned roughly one third of the participants included in the REHABase cohort. It was negatively associated with personal recovery, wellbeing and satisfaction in interpersonal relationships. Elevated stigma resistance concerned more than 50% of the participants and was positively associated with satisfaction in family relationships. The present dissertation has several implications for research and clinical practice, discussed throughlyL’auto-stigmatisation est fréquente chez les personnes avec Troubles Psychiques Sévères et Persistants (TPSP), dont elle altère le devenir clinique et fonctionnel. L’objectif de ce travail était de définir plus précisément l’auto-stigmatisation dans les TPSP et de mieux identifier les moyens d’y faire face. Il comporte plusieurs étapes : i) une 1ère revue systématique de littérature pour mieux appréhender les mécanismes cognitifs et neurobiologiques potentiels sous-tendant les effets de la stigmatisation; ii) une 2nde revue systématique de littérature sur la prévalence, les prédicteurs et les conséquences de l’auto-stigmatisation dans les TPSP ; iii) l’étude de la fréquence de l’auto-stigmatisation et de la résistance à la stigmatisation et des corrélats d’une auto-stigmatisation ou d’une résistance élevée à la stigmatisation dans la cohorte nationale des centres référents de réhabilitation psychosociale (REHABase), décrite dans un 1er article ; iv) l’adaptation française du programme de thérapie cognitive et de renforcement narratif (NECT) et un essai randomisé contrôlé évaluant son efficacité sur le fonctionnement social dans les TPSP, débutant au 1er trimestre 2020. L’auto-stigmatisation est un problème majeur de santé publique, et ce quelque soit l’aire géographique et culturelle, la pathologie ou le stade évolutif considérés. Environ 1/3 des participants de la cohorte REHABase ont une auto-stigmatisation élevée, celle-ci étant associée aux stades précoces du rétablissement et à un bien être et une satisfaction dans les relations sociales altérés. La résistance à la stigmatisation concerne plus de 50% des participants et est favorisée par la satisfaction dans les relations familiales. Ce travail a plusieurs implications cliniques et pour la recherche, discutées de façon approfondi

Self-stigma in serious mental iIllness

L’auto-stigmatisation est fréquente chez les personnes avec Troubles Psychiques Sévères et Persistants (TPSP), dont elle altère le devenir clinique et fonctionnel. L’objectif de ce travail était de définir plus précisément l’auto-stigmatisation dans les TPSP et de mieux identifier les moyens d’y faire face. Il comporte plusieurs étapes : i) une 1ère revue systématique de littérature pour mieux appréhender les mécanismes cognitifs et neurobiologiques potentiels sous-tendant les effets de la stigmatisation; ii) une 2nde revue systématique de littérature sur la prévalence, les prédicteurs et les conséquences de l’auto-stigmatisation dans les TPSP ; iii) l’étude de la fréquence de l’auto-stigmatisation et de la résistance à la stigmatisation et des corrélats d’une auto-stigmatisation ou d’une résistance élevée à la stigmatisation dans la cohorte nationale des centres référents de réhabilitation psychosociale (REHABase), décrite dans un 1er article ; iv) l’adaptation française du programme de thérapie cognitive et de renforcement narratif (NECT) et un essai randomisé contrôlé évaluant son efficacité sur le fonctionnement social dans les TPSP, débutant au 1er trimestre 2020. L’auto-stigmatisation est un problème majeur de santé publique, et ce quelque soit l’aire géographique et culturelle, la pathologie ou le stade évolutif considérés. Environ 1/3 des participants de la cohorte REHABase ont une auto-stigmatisation élevée, celle-ci étant associée aux stades précoces du rétablissement et à un bien être et une satisfaction dans les relations sociales altérés. La résistance à la stigmatisation concerne plus de 50% des participants et est favorisée par la satisfaction dans les relations familiales. Ce travail a plusieurs implications cliniques et pour la recherche, discutées de façon approfondieSelf-stigma is highly prevalent in persons with Serious Mental Illness (SMI) and is associated with poor patient’s outcomes. Our objectives were a better understanding of self-stigma and how to reduce it trough improved clinical practice. This PhD dissertation has four steps : i) first, we reviewed the potential cognitive and neurobiological mechanisms underlying stigma and self-stigma ; ii) then we reviewed the prevalence, prédictors and correlates of self-stigma in SMI ; iii) we assessed the frequency of self-stigma and stigma resistance in the French national network of centres for psychiatric rehabilitation (REHABase), described in a previous article ; iv) we adapted in French Narrative Enhancement and Cognitive Therapy (NECT) self-stigma reduction program and initiated a stepped-wedge randomised control trial assessing its effectiveness in improving social function in SMI. Self-stigma is a major public health issue, affecting people in all geographical areas, all SMI conditions and all stages of the illness including at-risk states and early disorders. Elevated self-stigma concerned roughly one third of the participants included in the REHABase cohort. It was negatively associated with personal recovery, wellbeing and satisfaction in interpersonal relationships. Elevated stigma resistance concerned more than 50% of the participants and was positively associated with satisfaction in family relationships. The present dissertation has several implications for research and clinical practice, discussed throughl

Woippy « ZAC des Chiloux » (57) : découverte d’une nouvelle tombe à char hallstattienne en Lorraine

National audienc

Persecutory ideation and anomalous perceptual experiences in the context of the COVID-19 outbreak in France: what's left one month later?

International audiencePurpose: Beyond the effects of the coronavirus pandemic on the public's health, the length of lockdown and its possible psychological impacts on populations is heavily debated. However, the consequences of lockdown on psychotic symptoms have been poorly investigated.Methods: An online survey was run from April 13 to May 11, 2020; a total of 728 French subjects from the general population were included in the study. We assessed the perceived impact of the COVID-19 outbreak, length of isolation, diagnosis/symptoms/hospitalisation related to the COVID-19 (oneself and family). Paranoid ideations and hallucination-like experiences were assessed via the Paranoia Scale and the Cardiff Anomalous Perceptions Scale, respectively. Self-reported measures of negative affect, loneliness, sleep difficulties, jumping to conclusion bias, repetitive thoughts, among others, were also included.Results: Final regression model for paranoia indicated that socio-demographic variables (age, sex and education), loneliness, cognitive bias, anxiety, experiential avoidance, repetitive thoughts and hallucinations were associated with paranoia (R2 = 0.43). For hallucinations, clinical variables as well as the quality of sleep, behavioural activation, repetitive thoughts, anxiety and paranoia were associated with hallucinations in our sample (R2 = 0.27). Neither length of isolation nor the perceived impact of the COVID-19 pandemic were associated with psychotic experiences in the final models.Conclusions: No evidence was found for the impact of isolation on psychotic symptoms in the general population in France one month after the lockdown. It nevertheless confirms the preeminent role of several factors previously described in the maintenance and development of psychotic symptoms in the context of a pandemic and lockdown measures

Toward recovery-oriented perinatal healthcare: A participatory qualitative exploration of persons with lived experience and health providers’ views and experiences

Abstract Background Perinatal mental health disorders (PMHD) remain often undetected, undiagnosed, and untreated with variable access to perinatal mental health care (PMHC). To guide the design of optimal PMHC (i.e., coproduced with persons with lived experience [PLEs]), this qualitative participatory study explored the experiences, views, and expectations of PLEs, obstetric providers (OP), childcare health providers (CHPs), and mental health providers (MHPs) on PMHC and the care of perinatal depression. Methods We conducted nine focus groups and 24 individual interviews between December 2020 and May 2022 for a total number of 84 participants (24 PLEs; 30 OPs; 11 CHPs; and 19 MHPs). The PLEs group included women with serious mental illness (SMI) or autistic women who had contact with perinatal health services. We recruited PLEs through social media and a center for psychiatric rehabilitation, and health providers (HPs) through perinatal health networks. We used the inductive six-step process by Braun and Clarke for the thematic analysis. Results We found some degree of difference in the identified priorities between PLEs (e.g., personal recovery, person-centered care) and HPs (e.g., common culture, communication between providers, and risk management). Personal recovery in PMHD corresponded to the CHIME framework, that is, connectedness, hope, identity, meaning, and empowerment. Recovery-supporting relations and peer support contributed to personal recovery. Other factors included changes in the socio-cultural conception of the peripartum, challenging stigma (e.g., integrating PMH into standard perinatal healthcare), and service integration. Discussion This analysis generated novel insights into how to improve PMHC for all users including those with SMI or autism