How Do Young Adult Drinkers React to Varied Alcohol Warning Formats and Contents? An Exploratory Study in France

Research on alcohol warnings has increased in the last decade, providing key evidence to governments on warning format and contents. The bulk of this research, however, has been conducted in Anglosphere countries, whereas fewer studies have focused on other countries which have high per capita alcohol consumption, and where the high social acceptability of drinking is liable to affect how people accept and react to prevention measures. Since France has one of the highest per capita alcohol consumption rates in the world according to the World Health Organization (WHO), we therefore explore how young adults in France react to warnings on alcoholic beverage advertisements. We conducted 25 in-depth interviews, in 2017, with 18–25-year-old drinkers in France. Respondents were asked open-ended questions on the perceived impact of various warning contents (i.e., on health risk, social-cost risk, and on short- vs. long-term risk) and formats (text only vs. larger text combined with colored pictograms). Warnings that targeted youth-relevant risks (i.e., road accidents or sexual assault) were considered to be the most meaningful and credible, although warnings communicating longer term risks (i.e., brain, cancer) were also thought to be influential. Less familiar risks, such as marketing manipulation and calorie intake, elicited the most negative reactions. Larger text-and-pictogram warnings were considered to be the most effective format in capturing attention and increasing awareness. Regardless of format and content, however, these warnings were not perceived as effective for decreasing alcohol consumption

The French version of the HSCL-25 has now been validated for use in primary care

Background The Hopkins Symptom Checklist in 25 items (HSCL-25) helps to assess anxiety and depression in Primary Care. Anxiety and depression show considerable overlap in primary care. This self-administrated questionnaire is valid, reliable and ergonomic in the original US version. We have translated it into French. The aim of this study was to estimate the test characteristics of the HSCL-25, in its French version (F-HSCL-25), by comparing it to the Present State Examination-9 French version (F-PSE-9) and by determining its internal validity and dimensions. Method Outpatients from three French General Practice settings (rural, semi-rural and urban) were recruited: approximately 20,000 outpatients among 17 GPs. Two groups were formed: F-HSCL-25 ≥1.75 and F-HSCL-25 1.75 was considered to indicate a clinically relevant level of symptoms of depression and anxiety. In order to obtain two balanced groups, a different method of randomization was chosen for each group. The F-PSE-9 was randomly administered to 1 in 2 patients in the F-HSCL-25 ≥1.75 group, and to 1 in 16 in the (much larger) F-HSCL-25 <1.75 group. The diagnostic performance was assessed and the test results obtained from both groups were compared with their F-PSE-9 results. Results Of the 1126 patients who completed the F-HCL-25, 886 joined the F-HSCL-25 <1.75 group and 240 the F-HSCL-25 ≥1.75 group. The overall prevalence of depression, using the F-HSCL-25, was 21% in these medical practices. The diagnostic performance of the F-HSCL-25 versus the F-PSE-9, the external criteria were as follows: Positive Predictive Value (PPV) 69.8%, Negative Predictive Value (NPV) 87%; Sensitivity 59.1%, and Specificity 91.4%. The Principal Component Analysis showed that F-HSCL-25 is a one-dimensional tool (anxiety and depression dimensions combined) with a Cronbach Alpha of 0.93. Conclusion The F-HSCL-25 is an appropriate diagnostic tool for anxiety and depression in primary care in France due to its high specificity and high NPV. The HSCL-25 scale has a high eigenvalue. This pilot study will be extended throughout Europe; however, preliminary evidence suggests that the HSCL-25 is a reliable and suitable diagnostic tool for primary care

Effect of early intervention for early-stage psychotic disorders on suicidal behaviours – a systematic review protocol

BackgroundThe early stages of psychotic disorders correspond to the early phases of the disease and include the prodromal phase and first-episode psychosis; they constitute a period at high risk of suicidal behaviour. A long duration of untreated psychosis (DUP) is among the risk factors of suicidal behaviour identified in this early period. Many studies have shown the effectiveness of early interventions on the overall prognosis of psychotic disorders in the early stages, and early intervention strategies have been developed and tested worldwide. Several authors reported an improvement in suicidal behaviours; however, all these data have not been systematically analysed yet. The main objective of this systematic review was to collect evidence on the effect on suicidal behaviour of early interventions for patients in the early stages of psychotic disorders.MethodsWe will carry out a systematic review of the literature according to the PRISMA criteria by searching articles in five databases (PubMed, Cochrane, PsycINFO, Scopus, EMBASE), without restriction on the publication date. The selection criteria are: articles (any type; e.g. prospective, retrospective, controlled or uncontrolled, and literature reviews) on early interventions for psychotic disorders in the early stages with data on suicide attempts, death by suicide, suicidal ideation; articles written in English or French. Exclusion criteria are: articles on suicidal behaviours in patients with psychotic disorders in the early stages, but without early intervention, and articles on early-stage psychotic disorders without data on suicidal behaviours.DiscussionIf this review confirms the effectiveness on suicidal behaviours of early interventions for young patients with psychotic disorders, the development/implementation of such intervention programmes should be better promoted.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021237833

Parkinson's disease and iatrogenic impulsive-compulsive behaviors: A case/non-case study to build a complete model of individual vulnerability

Background and aims: Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases. First-line medications consist of drugs that act by counteracting dopamine deficiency in the basal ganglia. Unfortunately, iatrogenic impulsive-compulsive behaviors (ICBs) can occur in up to 20% of PD patients over the course of their illness. ICBs must be considered multifactorial disorders that reflect the interactions of the medication with an individual’s vulnerability and the underlying neurobiology of PD. We aimed to explore the predictive genetic, psychopathological and neurological factors involved in the development of ICBs in PD patients by building a complete model of individual vulnerability. Methods: The PARKADD study was a case/non-case study. A total of 225 patients were enrolled (“ICB” group, N 5 75; “no ICB” group, N 5 150), and 163 agreed to provide saliva samples for genetic analysis. Sociodemographic, neurological and psychiatric characteristics were assessed, and genotyping for the characterization of polymorphisms related to dopaminergic and opioid systems was performed. Results: Factors associated with “ICBs” were younger age of PD onset, personal history of ICB prior to PD onset and higher scores on the urgency and sensation seeking facets of impulsivity. No gene variant was significantly associated, but the association with the opioid receptor mu 1 (OPRM1) rs1799971 polymorphism was close to significance. Discussion and conclusions: The influence of gene-environment interactions probably exists, and additional studies are needed to decipher the possible role of the opioid system in the development of ICBs in PD patients

Nine forward–backward translations of the Hopkins symptom checklist-25 with cultural checks

Introduction: The Hopkins Symptom Checklist-25 (HSCL-25) is an effective, reliable, and ergonomic tool that can be used for depression diagnosis and monitoring in daily practice. To allow its broad use by family practice physicians (FPs), it was translated from English into nine European languages (Greek, Polish, Bulgarian, Croatian, Catalan, Galician, Spanish, Italian, and French) and the translation homogeneity was confirmed. This study describes this process. Methods: First, two translators (an academic translator and an FP researcher) were recruited for the forward translation (FT). A panel of English-speaking FPs that included at least 15 experts (researchers, teachers, and practitioners) was organized in each country to finalize the FT using a Delphi procedure. Results: One or two Delphi procedure rounds were sufficient for each translation. Then, a different translator, who did not know the original version of the HSCL-25, performed a backward translation in English. An expert panel of linguists compared the two English versions. Differences were listed and a multicultural consensus group determined whether they were due to linguistic problems or to cultural differences. All versions underwent cultural check. Conclusion: All nine translations were finalized without altering the original meaning

Maternité et conduites addictives (enjeux et intérêts de l'addictologie de liaison en périnatalité)

Il n'existe pas de données actuellement en France sur la prévalence des conduites addictives en dehors des consommations de substances licites (alcool, tabac) chez les femmes enceintes, et ce malgré l'importance de ces conduites chez les femmes en âge de procréer, en particulier pour le cannabis et les troubles du comportement alimentaire. Une étude menée à la maternité du CHU de Nantes auprès de 300 femmes nous a en effet permis d établir la prévalence relativement élevée des conduites addictives chez les femmes enceintes. Or si la problématique des conduites addictives pendant la grossesse commence à être reconnue comme un problème de santé publique préoccupant, la prévention comme le repérage restent encore peu répandus sur l ensemble du territoire français. Les enjeux du repérage et de la prise en charge des conduites addictives chez les femmes enceintes sont pourtant multiples puisqu elles ont un impact non seulement sur le déroulement et l issue de la grossesse, sur le développement fœtal, en terme de conséquences néonatales, mais aussi sur le développement psychocomportemental de l enfant à long terme. De plus, les processus psychopathologiques en jeu dans les addictions, en particulier la problématique de séparation-individuation, font écho aux enjeux psychopathologiques propres au processus de maternalité et peuvent être à l origine de dysfonctionnements des interactions mère-enfant. Mais il s agit aussi d une population de femmes jeunes, dont la motivation au changement est facilitée par la grossesse et la préoccupation maternelle pour l enfant, et pour qui cette période de la vie peut être une opportunité particulièrement importante pour s engager dans des soins. L'intervention des équipes de liaison en addictologie dans les maternités est donc à développer, d une part pour former les équipes des maternités au repérage de l ensemble des conduites addictives chez les femmes enceintes, en particulier de l alcool et du cannabis, mais aussi des troubles des conduites alimentaires, et d autre part pour faciliter l accès de ces femmes à des soins spécifiques qui doivent pouvoir leur être systématiquement proposés. Dans tous les cas la prise en charge de ces grossesses à haut risque devra être multidisciplinaire, réunissant la sage-femme, le gynécologue-obstétricien, le médecin généraliste, le pédiatre, la puéricultrice, l'assistante sociale, l'addictologue et parfois le pédopsychiatre. Elle s'organisera au mieux dans le cadre d un réseau, pour permettre un étayage et un accompagnement attentif et offrir à la mère et à son bébé un cadre de soins contenant et sécurisant.NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Etude de la personnalité de joueurs pathologiques en demande de soins au service d'addictologie de Nantes

Le jeu pathologique est défini selon le DSM IV comme une pratique inadaptée, persistante et répétée des jeux de hasard et d'argent. Les hypothèses étiopathogéniques sont multiples. Selon la littérature, sa prévalence est de 1 à 3 % en population générale et de nombreuses comorbidités sont décrites, en particulier des troubles de la personnalité, mais il existe peu d études françaises. Ainsi nous avons réalisé une étude transversale dans le service d addictologie de Nantes chez 24 patients consultants pour un problème de jeu. Une évaluation globale des conduites addictives (Addiction Severity Index) et de la personnalité (SCID II, MMPI-2 ; ERS ; BIS-10) a été effectuée. Nos résultats étaient congruents avec la littérature internationale et retrouvaient une fréquence élevée de certains troubles et traits de personnalité et des dimensions d impulsivité élevées. Nous avons discuté ces résultats en les comparant à ceux de la littérature internationale.NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Prospective Study on Factors Associated with Referral of Patients with Opioid Maintenance Therapy from Specialized Addictive Disorders Centers to Primary Care

International audienceBackground: One of the most important issues for opiate maintenance therapy efficacy is the involvement of primary care physicians (PCPs) in opiate use disorder treatment, especially after referral from specialized units. This study aimed to analyze the progress of subjects in a specialized center and after referral to PCPs. Methods: This study was an observational prospective study. Recruitment took place in a specialized addictive disorder center in western France. All patients were evaluated (sociodemographical data, severity of substance use disorders through the TMSP scale, the quality of life through the TEAQV scale) by physicians during the 5-year-follow up of the study. Analysis focused on four main times during follow-up: entry/last visit into specialized care and into primary care. Results: 113 patients were included in this study; 93% were receiving methadone and 7% buprenorphine. Ninety (90) were referred to primary care. In primary care follow-up, the probability of the lowest severity score for substance use disorders remained stable over time. Conclusions: In daily practice, a center specialized in addictive disorders referred OMT management to PCPs for a majority of patients, and benefits regarding substance use disorders severity and quality of life remained stable after referral. Our results need to be confirmed

Stakeholder Framing of Advertising Legislation: An Analysis of Media and Parliamentary Representations of the Loi Évin in the United Kingdom.

OBJECTIVE: The Loi Évin legislation restricts alcohol advertising in France and is more comprehensive than the self-regulation-based U.K. approach. Through contributions to news media and parliamentary processes, stakeholders can play an important role in framing the debate around public policy. This project therefore aimed to analyze how the Loi Évin has been represented since its inception in U.K. media and Parliament by the advertising and alcohol industries, politicians, and nongovernmental organizations. METHOD: Qualitative analysis of media and parliamentary documents using the hermeneutic method, analyzing contexts in which the Loi Évin was mentioned by stakeholders in the media and in Parliament. Print and trade media articles referencing the Loi Évin were retrieved from the ProQuest media archive [from 1985 to 2016]. U.K. parliamentary representations referencing the Loi Évin were obtained from the parliamentary database for publications and the Hansard parliamentary record. A total of 109 documents referencing the Loi Évin were identified, of which 71 met the inclusion criteria and were included for analysis. RESULTS: The alcohol and advertising industries have framed the Loi Évin as incompatible with European Union principles, irrational and ineffective, with arguments changing over time in response to landmark events and rulings. Supporters of Loi Évin-style legislation failed to counter industry framing of advertising as not contributing to increased consumption. CONCLUSIONS: The portrayal of the Loi Évin by industry in the United Kingdom is an important example of policy framing and provides evidence of the synergy between advertising and alcohol industry representatives in combatting legislation that could harm profits