Virulent bacterial infection improves aversive learning performance in Drosophila melanogaster.

Virulent infections are expected to impair learning ability, either as a direct consequence of stressed physiological state or as an adaptive response that minimizes diversion of energy from immune defense. This prediction has been well supported for mammals and bees. Here, we report an opposite result in Drosophila melanogaster. Using an odor-mechanical shock conditioning paradigm, we found that intestinal infection with bacterial pathogens Pseudomonas entomophila or Erwinia c. carotovora improved flies' learning performance after a 1h retention interval. Infection with P. entomophila (but not E. c. carotovora) also improved learning performance after 5 min retention. No effect on learning performance was detected for intestinal infections with an avirulent GacA mutant of P. entomophila or for virulent systemic (hemocoel) infection with E. c. carotovora. Assays of unconditioned responses to odorants and shock do not support a major role for changes in general responsiveness to stimuli in explaining the changes in learning performance, although differences in their specific salience for learning cannot be excluded. Our results demonstrate that the effects of pathogens on learning performance in insects are less predictable than suggested by previous studies, and support the notion that immune stress can sometimes boost cognitive abilities

Introduction d’une consultation anténatale en santé sexuelle et planning familial au DFME du CHUV en 2018 : étude de faisabilité

Introduction . Dans un contexte de santé publique où l’accès aux soins et à la prévention sont au centre de l’attention, l’importance de la santé sexuelle, du droit à l’information et à l’éducation en matière de santé sexuelle est mise en avant. Des besoins non comblés (unmet needs) en matière de contraception, plus particulièrement après la grossesse, ont été mis en lumière de manière indirecte par les travaux de l’IUMSP de Lausanne sur l’interruption de grossesse. Sur le plan international, des recherches et recommandations visant à renforcer le conseil contraceptif par des interventions en période néonatale ont été publiées. Comme l’arrivée d’un enfant est une période de grand changement, il est important de sensibiliser la future mère et le couple à la reprise de la fertilité et par conséquent au besoin de contraception en cas de désir d’espacer les naissances ou de projet de procréation accomplie. En effet, la reprise du cycle et les enjeux contraceptifs après la grossesse ont des spécificités qui sont insuffisamment connues et qu’il est utile d’aborder de manière ciblée avec les femmes et les couples. Dans le but de pallier ces lacunes, il a été décidé d’introduire une nouvelle consultation anténatale en santé sexuelle au DFME du CHUV à Lausanne. Objectifs . Ce travail de Master vise à étudier la mise en place de cette consultation anténatale au DFME dans le contexte des suivis de grossesse à la Policlinique de la Maternité. Les objectifs principaux sont de déterminer la faisabilité et l’acceptabilité de l’implantation d’une consultation anténatale de santé sexuelle-planning familial et l’objectif secondaire de cette étude est de mesurer l’intérêt de l’implantation de cette nouvelle consultation et d’en esquisser les premiers résultats. Méthode : Il s’agit d’une étude prospective, exploratoire et mixte, les données récoltées sont quantitatives et qualitatives. Les données quantitatives sont recueillies à l’aide d’une feuille de consultation remplie par la conseillère en santé sexuelle-PF lors de la consultation. Les formulaires de consultation de 27 patientes ont été inclus dans cette étude et collectés sur une durée de trois mois en 2018. Les données qualitatives sont récoltées par l’exploration du fonctionnement et des avis des différent·e·s intervenant·e·s impliqué·e·s dans l’organisation de cette consultation (CSS-PF, sages-femmes consultantes, secrétaires, médecins). Ces informations ont été obtenues sur la base des PV des colloques de la Policlinique et de l’Unité psycho-sociale, des démarches documentées par les CSS-PF ainsi que par des entretiens oraux. Résultats L’étude montre que cette nouvelle consultation est faisable d’un point de vue organisationnel et permet de mettre en évidence le long processus qui mène à l’introduction de cette offre supplémentaire. Les principaux obstacles à son implantation sont relevés, ce qui permet de mieux les appréhender et de proposer des solutions adaptées. 92 % des participantes jugent la période anténatale comme celle de meilleure réceptivité pour cet entretien. L’acceptabilité de cette consultation est très bonne, en effet 88.5 % des femmes interrogées qualifient la possibilité d’avoir cet entretien de très appréciable et le conseil en santé sexuelle est fait par les soignantes qui semblent, selon les représentations des patientes, les plus adéquates pour remplir ce mandat. Ce travail permet également de mesurer l’intérêt de cette consultation en identifiant les besoins des participantes et montre qu’elle est utile en vue du choix contraceptif dans le post-partum. Discussion et conclusion Ce travail est une étude de faisabilité et d’acceptabilité concernant l’implantation d’une consultation anténatale pour promouvoir la contraception du post-partum au DFME. Malgré la présence de biais, cette consultation reste un concept novateur qui est appuyé par des études internationales et qui répond à une demande de santé publique locale

Prepupal Building Behavior in Drosophila melanogaster and Its Evolution under Resource and Time Constraints.

Structures built by animals are a widespread and ecologically important 'extended phenotype'. While its taxonomic diversity has been well described, factors affecting short-term evolution of building behavior within a species have received little experimental attention. Here we describe how, given the opportunity, wandering Drosophila melanogaster larvae often build long tunnels in agar substrates and embed their pupae within them. These embedded larvae are characterized by a longer egg-to-pupariation developmental time than larvae that pupate on the surface. Assuming that such building behaviors are likely to be energetically costly and/or time consuming, we hypothesized that they should evolve to be less pronounced under resource or time limitation. In accord with this prediction, larvae from populations evolved for 160 generations under a regime that combines larval malnutrition with limited developmental time dug shorter tunnels than larvae from control unselected populations. However, the proportion of larvae that embedded before pupation did not differ between the malnutrition-adapted and control populations, suggesting that tunnel length and likelihood of embedding before pupation are controlled by different genetic loci. The behaviors exhibited by wandering larvae of Drosophila melanogaster prior to pupation offer a model system to study evolution of animal building behaviors because the tunneling and embedding phenotypes are simple, facultative and highly variable

Effects of substance use disorder on treatment process and outcome in a ten-session psychiatric treatment for borderline personality disorder.

Dual diagnosis is common in Borderline Personality Disorder (BPD), one of the most common being Substance Use Disorder (SUD). Previous studies have shown that general psychiatric management (GPM) was effective in reducing borderline symptoms. In the present study, we tested whether the short GPM was as effective in the BPD + SUD as in the BPD group. We analysed a group of 99 patients presenting a BPD. 51 of these patients presented a SUD. The BPD group and the BPD + SUD group received a manual-based short variant of the GPM treatment. Previous studies have shown that a 10-session version of GPM was effective in reducing borderline symptoms at the end of the treatment (Psychother Psychosom 83:176-86, 2014). We found no significant difference in the reduction of general symptoms, which diminished in both groups. The specific borderline symptoms were also reduced in both groups, but there was a slightly higher reduction of the borderline symptoms in the SUD group. The therapeutic alliance progressed positively in all groups. Moreover, the alliance increased more over time in the SUD group. The short variant of GPM seems to be effective in BPD treatment independently from the presence of SUD. Therefore, this treatment could be an effective entry-level treatment for patients with dual diagnosis as well as patients with BPD only. Further studies are needed to confirm efficacy and long-term outcome. The trial was registered at ClinicalTrial.gov (identifier NCT01896024 )

The Therapeutic Alliance Over 10 Sessions of Therapy for Borderline Personality Disorder: Agreement and Congruence Analysis and Relation to Outcome.

The authors examined whether alliance dynamics are affected by tailoring the therapeutic relationship to the individual patient in brief psychotherapy of borderline personality disorder. Sixty patients were randomized to 10-session Good Psychiatric Management (GPM-BV) or GPM combined with Motive-Oriented Therapeutic Relationship techniques (MOTR+GPM-BV). Patient- and therapist-rated alliance was assessed weekly. Self-reported symptomatic distress was assessed pre-, mid-, and posttreatment. In MOTR+GPM-BV, stronger therapist-rated alliance predicted lower symptomatic distress in the same timepoint, but not in a lag, whereas symptomatic distress predicted therapist-rated alliance in a lag. Therapist-rated alliance was lower than patient-rated alliance in GPM-BV but not in MOTR+GPM-BV. In MOTR+GPM-BV, higher agreement on strong alliance tended to predict lower symptomatic distress. Patient- and therapist-rated alliances were temporally congruent, but congruence did not predict outcome. Addressing the relationship needs of patients may partly exert its salutary effect by increasing agreement between patients' and therapists' experience of the alliance

Processes of Change in Psychotherapy for Narcissistic Personality Disorder.

The present study aims at determining the role for outcome of potential processes of change in psychotherapy for narcissistic personality disorder (NPD). They were examined on three levels: the content, the process, and the relationship. A total of 161 patients suffering with NPD were recruited in a naturalistic setting as part of the present study. They underwent a long- term clarification-oriented psychotherapy. Sessions 15, 20, and 25 were video- or audio-recorded and analyzed with an observer-rated instrument that measures the quality of the interaction processes from the patient's and therapist's perspectives. Different self-report measures were used to assess therapy outcomes. In-session improvement was observed in both patient and therapist processes across sessions. Patient improvement in the three levels of processes was systematically related with outcome. Only partial relationships were found between therapist improvement and outcome. The present study represents the first systematic insight into core changes in patients with NPD undergoing psychotherapy

Gut physiology mediates a trade-off between adaptation to malnutrition and susceptibility to food-borne pathogens.

The animal gut plays a central role in tackling two common ecological challenges, nutrient shortage and food-borne parasites, the former by efficient digestion and nutrient absorption, the latter by acting as an immune organ and a barrier. It remains unknown whether these functions can be independently optimised by evolution, or whether they interfere with each other. We report that Drosophila melanogaster populations adapted during 160 generations of experimental evolution to chronic larval malnutrition became more susceptible to intestinal infection with the opportunistic bacterial pathogen Pseudomonas entomophila. However, they do not show suppressed immune response or higher bacterial loads. Rather, their increased susceptibility to P. entomophila is largely mediated by an elevated predisposition to loss of intestinal barrier integrity upon infection. These results may reflect a trade-off between the efficiency of nutrient extraction from poor food and the protective function of the gut, in particular its tolerance to pathogen-induced damage

Subtypes of narcissistic personality disorder based on psychotherapy process: A longitudinal nonparametric analysis.

The present study aims at empirically exploring subtypes of narcissistic personality disorder (NPD), based on patient descriptors of the psychotherapeutic process. Subtype identification and characterization of NPD is central, in particular, to increase diagnostic precision, linking categorical and dimensional conceptualizations of psychopathology, and to individualize treatments. A total of N = 161 patients diagnosed with NPD undergoing clarification-oriented psychotherapy were included in the present reanalysis of a naturalistic pre-post process-outcome study. At three crucial time-points of the therapy (Sessions 15, 20, and 25), the patient's in-session quality of content, process, and relationship are assessed using intensive video- and audio analyses. Levels of psychopathology were assessed using self-reported questionnaires. Data were analyzed using longitudinal nonparametric analysis. Based on in-session processes across three time-points, a two-subtype solution was retained (optimal vs. suboptimal process qualities). Optimal process quality of time was linked with the intensity of narcissistic symptoms; suboptimal process quality was linked with a variety of general symptom loads and problematic personality traits. The two empirical subtypes were predicted by the quality of real-life functioning with an accuracy of more than 92% and were partially associated with outcome. NPD may be empirically differentiated between patients engaging in optimal psychotherapy process versus those who engage in suboptimal psychotherapy process. This differentiation has reliable clinical predictors at the outset of treatment. The present study has implications in terms of personalizing psychotherapy for patients presenting NPD, or pathological narcissism. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Psychotherapy for Personality Disorders in a Natural Setting: A Pilot Study over Two Years of Treatment.

Long-term assessment of the effects of psychotherapy for personality disorders (PDs) in a natural environment is an important task. Such research contributes to enlarge the practice-based evidence, embedded in broad collaborations between clinicians and researchers in psychotherapy for PDs. The present pilot study used rigorous assessment procedures and incorporated feedback loops of outcome information to the therapists in demonstrating the effects of psychotherapy for PD in a natural setting. The number of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for any PD was the primary outcome (along with psychological distress, depression, impulsiveness, and quality of life as secondary measures), assessed at intake, 6, 12, 18, and 24 months of psychotherapy for N = 13 patients with PD. Data were analyzed using hierarchical linear modeling. Results demonstrated a large pre-post effect (d = 2.22) for the observer-rated measure (primary outcome), and small to medium effects for the secondary outcomes; these results were corroborated by a steady decrease of symptoms over all five time points, which was significant for several outcomes. These results add a piece to the literature by demonstrating the effects of long-term psychotherapy for PDs in increasingly diverse contexts and suggest that practice-oriented research can be carried out in a collaborative and systematic manner