Depressive mixed state: Evidence for a new form of depressive state in type I and II bipolar patients

Katia M’Bailara1, Donatienne Van den Bulke2, Nicolas Demazeau2, Jacques Demotes-Mainard3, Chantal Henry11EA4139 Laboratoire de psychologie, Université Victor Segalen, Bordeaux Cedex, France; 2Centre Hospitalier Charles Perrens, Bordeaux Cedex, France; 3INSERM-DRCT, ECRIN, Paris, FranceBackground: A high proportion of unipolar and bipolar type II patients can present a depressive mixed state (DMX). This state is defined by an association of a major depressive episode with at least two specific hypomanic symptoms. This state seems underdiagnosed and this could have treatment implications. The aims of our study were: (i) to investigate the frequency of DMX in type I and II bipolar patients hospitalized for a severe or resistant depressive episode and (ii) to assess the therapeutic response in naturalistic conditions.Methods: Forty-two consecutive bipolar patients referred by psychiatrists for a severe or resistant depressive episode were assessed using the French version of the Mini International Neuropsychiatric Interview 5.0 (MINI 5.0), which assesses the suicide risk and provides DSM-IV diagnosis. The intensity of mood episodes was evaluated using the MADRS and Bech-Rafaelsen Mania Scale. One group of patients included patients presenting only depressive symptoms (ie, pure major depressive episode (MDE)), and the second group included patients with a major depressive episode and at least two specific hypomanic symptoms (DMX).Results: Twenty-one patients (50%) had a pure MDE and 21 patients (50%) had a DMX. The treatment leading to recovery was very different in the two groups. Antidepressants were effective (77%) in MDE patients, whereas antipsychotics were effective (81%) in DMX. 38% of patients with a MDE also received a mood stabilizer versus 86% in the group of DMX. Five MDE patients (24%) and one DMX patient required electroconvulsive therapy. The suicidal ideations did not differ between the two groups (p = 0.7).Conclusions: Some mood episodes in bipolar patients (type I and II) are characterised by depressive and hypomanic symptoms but do not meet criteria for mixed episode as defined by DSM-IV. These episodes are often diagnosed as depressive states, but are worsened by antidepressants and often considered as resistant depression. They rapidly respond to antimanic treatment. New categories of mood disorders should take into account this particular mixed state.Keywords: bipolar depression, mixed state, depressive mixed state, resistant depressio

Implementation of Psychosocial Intervention StomieCare for Patients with Rectal Cancer Treated by Rectal Excision and Temporary Stoma: A Pilot Study of Feasibility, Acceptability and Efficacy

L’objectif de cette étude est d’évaluer la faisabilité, l’acceptabilité et l’efficacité d’une intervention psychosociale en individuel (appelée StomieCare) auprès de patients atteints d’un cancer du rectum et traités par chirurgie avec stomie temporaire. Cette intervention, en trois séances individuelles, comprend des discussions thématiques autour de problèmes communs relatifs à la maladie et/ou la stomie comme l’impact du cancer et de ces traitements sur la qualité de vie, l’estime de soi, d’apport d’informations et d’apprentissage de techniques (résolution de problème et restructuration cognitive). Trente-sept patients atteints d’un cancer du rectum et traités par chirurgie avec stomie temporaire ont été recrutés et randomisés soit dans le groupe contrôle (prise en charge traditionnelle, n = 20) soit dans le groupe intervention (prise en charge traditionnelle et StomieCare, n = 17). Une semaine avant l’opération (T1) et trois mois après le rétablissement de continuité (T2), tous les patients ont rempli la HADS pour évaluer l’anxiété et la dépression, la BIS pour l’image du corps, l’ESS pour la honte liée à l’image du corps et la FACT-C pour la qualité de vie. Des analyses statistiques intergroupes et intragroupes ont été réalisées. Les critères de faisabilité et d’acceptabilité sont satisfaisants. A T2, les scores de dépression du groupe contrôle sont significativement plus élevés que ceux du groupe intervention. A T2, et uniquement pour le groupe contrôle, il y a une altération significative des scores de qualité de vie, dépression et image du corps. Aucune différence significative n’est observée pour le groupe intervention. L’anxiété diminue entre T1 et T2 de manière significative uniquement pour le groupe contrôle. Pour conclure, StomieCare semble être une intervention faisable et acceptable à visée préventive de la symptomatologie dépressive.Objective: This study aims to evaluate the feasibility, acceptability, and efficacy of StomieCare for rectal cancer patients undergoing surgery with a temporary stoma. StomieCare (three individual sessions) comprises thematic discussions, information and education, and teaching problem-solving and cognitive restructuring. Methods: Thirty-seven rectal cancer participants treated by surgery and temporary stoma were recruited and randomized to control (routine care approach, n = 20) and intervention (routine care and StomieCare, n = 17) groups. Outcomes were psychological distress (anxiety and depression, HADS), body image (BIS, ESS), and quality of life (FACT-C), at one week before surgery (T1) and 3 months after stoma closure (T2). Interand intragroup statistical analyses were performed. Results: This study demonstrated that StomieCare is feasible and acceptable. At T2, depression scores were higher for controls than for the intervention group. The mean scores for quality of life, depression, and body image decreased in the control group but remained stable in the intervention group. Anxiety scores significantly decreased between T1 and T2 only for the control group. Conclusion: StomieCare is a feasible and acceptable intervention for the prevention of depressive symptomatology

Is wine an emotional object? Measurements of the subjective and automatic components of emotions in a wine-tasting situation

Wine is often described with emotional terms, such as surprising, disappointing, or pleasant. However, very little has been done to understand the role of emotions in wine tasting and characterise this link between emotions and wine. Many studies have looked at the extrinsic factors that can improve the emotional experience of tasters when discovering a wine, but few have been carried out on the emotional impact of the organoleptic characteristics of wines. The present study aims to determine if the automatic component of emotion has a measurable output (motor and physiological) when tasting wine. If so, does wine tasting induce a concomitant activation of the different components of emotion, such as subjective feelings or physiological and motor responses? Sixty-five connoisseurs tasted seven different red Bordeaux wines with different sensory properties and quality levels pre-defined by wine experts. Emotions were measured using subjective (subjective feelings measurement using self-declarative questionnaires) and automatic (physiological measurements such as skin conductance and heart rate, or motor measurements through facial expressions) methods. The results showed that there was a measurable physiological and motor emotional output in wine tasting. The results also highlighted that changes in the autonomic nervous system in a wine-tasting situation are structured around the dimensions of pleasantness and arousal. Motor measurements taken through facial expressions showed a marginally significant difference between wines providing pleasant and unpleasant emotions for the activation intensity of action units. The relationships established between these components, as well as their concomitant activation, allow us to define wine as an emotional object

Proceedings of the 13th annual conference of INEBRIA

CITATION: Watson, R., et al. 2016. Proceedings of the 13th annual conference of INEBRIA. Addiction Science & Clinical Practice, 11:13, doi:10.1186/s13722-016-0062-9.The original publication is available at https://ascpjournal.biomedcentral.comENGLISH SUMMARY : Meeting abstracts.https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-016-0062-9Publisher's versio

Emotional reactivity, functioning, and C-reactive protein alterations in remitted bipolar patients: Clinical relevance of a dimensional approach

International audienc

Psychiatry Res

BACKGROUND: Reducing risk attributable to traffic accidents is a public health challenge. Research into risk factors in the area is now moving towards identification of the psychological factors involved, particularly emotional states. The aim of this study was to evaluate the link between emotional reactivity and responsibility in road traffic accidents. We hypothesized that the more one's emotional reactivity is disturbed, the greater the likelihood of being responsible for a traffic accident. METHODS: This case-control study was based on a sample of 955 drivers injured in a motor vehicle crash. Responsibility levels were determined with a standardized method adapted from the quantitative Robertson and Drummer crash responsibility instrument. Emotional reactivity was assessed with the MATHYS. RESULTS: Hierarchical cluster analysis discriminated four distinctive driver's emotional reactivity profiles: basic emotional reactivity (54%), mild emotional hyper-reactivity (29%), emotional hyper-reactivity (11%) and emotional hypo-reactivity (6%). Drivers who demonstrated emotional hypo-reactivity had a 2.3-fold greater risk of being responsible for a traffic accident than those with basic emotional reactivity. CONCLUSION: Drivers' responsibility in traffic accidents depends on their emotional status. The latter can change the ability of drivers, modifying their behavior and thus increasing their propensity to exhibit risk behavior and to cause traffic accidents

Neuropsychological functioning, age, and medication adherence in bipolar disorder

International audienc

Selection procedure.

<p>Selection procedure of the final sample of bipolar outpatients (N = 353) from the FondaMental Advanced Centers of Expertise in Bipolar Disorders (FACE-BD) cohort.</p

Socio-demographic and clinical description of the sample by age groups.

<p>Socio-demographic and clinical description of the sample by age groups.</p