Sex Differences in Ethanol Intake and Sensitivity to Aversive Effects during Adolescence and Adulthood

Aims: The present experiments examined sex differences in ethanol intake and in the influence of a social context on aversive properties of ethanol in adolescent and adult Sprague-Dawley rats. Methods: Experiment 1 examined ethanol intake, with animals receiving daily 2-h access to ethanol and water for 8 days. Experiment 2 assessed the aversive effects of ethanol using a conditioned taste aversion (CTA) paradigm, with animals placed either alone or with a same-sex, same-age peer during the ethanol intoxication phase of conditioning. Results: Ethanol intake varied with both age and sex, although the sex differences emerging at each age were opposite in nature. Adolescent males consumed more ethanol relative to their body weights than adolescent females and adults of both sexes, whereas adult females generally consumed more than adult males. The CTA test revealed no sex differences in aversive effects of ethanol in adults, whereas adolescent males were less sensitive to the aversive properties of ethanol than adolescent females when intoxication occurred in the presence of a peer. Ethanol-induced CTA was evident in adults at lower doses than in adolescents. Conclusions: These results suggest that age differences in ethanol intake in males and sex differences in intake during adolescence may be associated in part with the relative insensitivity of the male adolescents to ethanol's aversive properties, especially when intoxication occurred in a social context. However, the elevated ethanol intake observed in adult females relative to their male counterparts appears to be unrelated to the aversive properties of ethanol

Psychotropic medication use pre and post-diagnosis of cluster B personality disorder: a Quebec’s health services register cohort

Background: Cluster B personality disorders (PDs) are considered some of the most severe mental health conditions. Scarce evidence exists about the real-world utilization of psychotropics for cluster B PD individuals. Objective: We aimed to uncover trends and patterns of psychotropic medication use among individuals diagnosed with cluster B PD in the year before and after their diagnosis and to identify factors associated with medication use in a large cohort of individuals newly diagnosed with cluster B PDs. Methods: We conducted a population-based observational study using Quebec's health services register. We identified Quebec residents aged ≥14 years and insured with the provincial drug plan with a first diagnosis of cluster B PD recorded between April 1, 2002, and March 31, 2019. Cluster B PD was defined with ICD-9/10 diagnostic codes. We retrieved all claims for the main psychotropic medication classes: antipsychotics, antidepressants, anxiolytics, mood stabilizers, and attention-deficit/hyperactivity disorder (ADHD) medications. We calculated the proportion of individuals exposed to these medication classes and analyzed trends over the years using robust Poisson regression models, adjusting for potential confounders. We used robust Poisson regression to identify factors associated with medication class use. Results: We identified 87,778 new cases of cluster B PD, with a mean age of 44.5 years; 57.5% were women. Most frequent psychiatric comorbidities in the five years before cluster B PD diagnosis were depression (50.9%), anxiety (49.7%), and psychotic disorders (37.5%). Most individuals (71.0%) received at least one psychotropic during the year before cluster B PD diagnosis, and 78.5% received at least one of these medications in the subsequent year. The proportion of users increased after the diagnosis for antidepressants (51.6-54.7%), antipsychotics (35.9-45.2%), mood stabilizers (14.8-17.0%), and ADHD medications (5.1-5.9%), and remained relatively stable for anxiolytics (41.4-41.7%). Trends over time showed statistically significant increased use of antipsychotics and ADHD medications, decreased use of anxiolytics and mood stabilizers, and a stable use of antidepressants. Conclusion: Psychotropic medication use is highly prevalent among cluster B PD individuals. We observed an increase in medication use in the months following the diagnosis, particularly for antipsychotics, antidepressants, and mood stabilizers

Workplace factors, burnout signs, and clinical mental health symptoms among mental health workers in Lombardy and Quebec during the first wave of COVID-19

Abstract Several research contributions have depicted the impact of the pandemic environment on healthcare and social care personnel. Even though the high prevalence of burnout depression and anxiety in healthcare settings before COVID-19 has been well documented in the research, the recent increase in psychological distress and mental health issues in healthcare and mental health workers should be attributed to the effect of the COVID-19 pandemic. The aim of the present study is to develop, evaluate, and compare a model of COVID-19 workplace stressors between two different territories, the Italian region of Lombardy and the Canadian province of Quebec. Within this model, burnout is depicted as the strongest determinant of mental health symptoms for mental health workers. In turn, the main workplace determinants of burnout are the perception of a lack of support from the organization and the fear of contracting COVID-19 at work. Findings also provide insights for designing interventions to promote and protect mental health workers in the context of the pandemic. In conclusion, it is necessary to monitor burnout and carefully analyze elements of organizational culture, in addition to offering clinical and psychological care for those in need. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE

La recherche d'un diagnostic de trouble de personnalité borderline chez les suicidants est-elle utile aux urgences ?

État de la question: La prévalence des troubles de personnalité borderline (TPB) en population de suicidant est élevée (10 à 55 %). Ces patients présentent à la fois des récidives suicidaires plus fréquentes et un pronostic psychosocial plus péjoratif. Cependant, l'utilité du diagnostic de TPB porté à l'accueil aux urgences, dans la mise en place d'un plan de traitement spécifique, n'a jamais été étudiée. Objectif: Évaluer l'association entre un diagnostic de TPB chez les patients suicidants et l'orientation mise en place depuis les urgences. Méthode: Étude cas-témoin portant sur une inclusion de dix mois, de 478 patients admis suite à un abus médicamenteux sévère aux urgences de l'hôpital général. Le recueil des données se fait à partir de fiches anonymes remplies par le clinicien. Résultats: Sur 478 patients admis aux urgences pour intoxication médicamenteuse volontaire, 99 (22,6 %) présentent un TPB selon les cliniciens. Ils se distinguent, par rapport aux autres patients suicidants, sur des caractéristiques démographiques, un plus grand recours aux soins psychiatriques, des antécédents de tentative de suicide plus fréquents et des intoxications aux neuroleptiques plus fréquentes. Aucune différence en ce qui concerne leur orientation au décours des urgences n'a été mise en évidence. Conclusion: Les patients suicidants souffrant d'un TPB présentent plus de critères de sévérité, sans que cela influence l'orientation depuis les urgences. BACKGROUND: Management of suicide attempters accounts for 10% of the psychiatric activity in the emergency room. In this population, the prevalence of borderline personality disorder (BPD) is high (10 - 55%). These patients present poorer psychosocial outcome and more frequent suicide attempts repetitions. However, the utility of the assessment of BPD in the referral to a specific treatment plan has not been yet studied. OBJECTIVE: To examine the association between the assessment of a diagnosis of BPD after a suicide attempt and the referral from the emergency room to a specific treatment plan. HYPOTHESIS: Suicide attempters with BPD, according to clinicians diagnosis, differ in terms of severity from those without more risk factors of suicide attempt repetitions and poorer psychosocial functioning, and in psychiatric referral from the emergency room. METHOD: Our case-control study took place during 10 months in the Geneva general hospital. We continuously enrolled patients admitted to the emergency room for deliberate self poisoning and separated them into two groups (BPD and control) according to the clinician's diagnosis. Data from medical records were systemically and anonymously gathered. We compared BPD patients' socio-demographic and clinical characteristics, as well as psychiatric referral, with the control group. RESULTS: Of the 478 subjects admitted to the emergency room for deliberate self-poisoning, 99 (22.6%) were diagnosed BPD by clinicians. Compared to controls, they were more frequently female (OR=3.9) and living alone (OR=3.8) and more often resorted to psychiatric care (OR=2.9), notably to emergency care (OR=3.8). Past history of suicide attempt was also more frequent (OR=1.9) as was the use of neuroleptics in the attempt (OR=2.7). No difference was detected in terms of psychiatric referral after emergency room care. CONCLUSION: Even if borderline personality disorder in suicide attempters is associated with more severity criteria, it is not associated with a referral to a specific treatment plan

A Wide Range Fast Monochromator for the SEXAFS and X-Ray Standing Waves Beamline at ESRF

A brief description of the monochromator built in-house for the SEXAFS and X-Ray Standing Wave beamline of ESRF is given. The monochromator covers the energy range 2-40 keV with two sets of diffracting crystals and has provisions for adding a third pair. The two first crystals are ciyogenically cooled and the second ones can be sagittally bent. The height of the beam at the mirror position 11.5 m- downstream is inherently almost fixed during energy scans and can be pinned to the sample slits by simply controlling the pitch of the second crystals