Sudden Changes and Their Associations with Quality of Life during COVID-19 Lockdown: A Cross-Sectional Study in the French-Speaking Part of Switzerland.

The lockdown due to the COVID-19 pandemic has led to various sudden changes in a large number of individuals. In response, the question of how individuals from different social and economic strata cope with those changes has arisen, as well as how much they have affected their mental well-being. Choosing strategies that cope with both the pandemic and the well-being of the population has also been a challenge for different governments. While a large number of studies have investigated the mental health of people from different populations during the COVID-19 pandemic, few have explored the number and type of changes experienced during lockdown by the general population, alongside their relationships with health-related quality of life (HRQoL). To fill this research gap, an observational cross-sectional study on those associations was conducted in the French-speaking part of the Swiss general population. Data were collected from 431 participants during the first four weeks of lockdown due to COVID-19. Multivariate regressions were used to identify the sociodemographic profile of the population that experienced different types and numbers of changes during this period, the association of those changes with the HRQoL-mental and physical-and infection beliefs, and the perception of the governmental measures. We show that the more changes people experienced, the lower their mental HRQoL; however, adherence to governmental measures has helped people to cope with the imposed changes, even though the number of unexpected and unwished changes have strained their mental HRQoL. The low-income population experienced financial difficulties and changes in their food intake more frequently, while dual-citizenship or non-Swiss individuals declared conflictual situations more frequently. Sport practice had a positive association with mental HRQoL; nevertheless, a decrease in sport practice was frequently reported, which correlated with a lower mental HRQoL. Risk perception of COVID-19 increased with lower physical HRQoL score, which supports the efficiency of governmental communication regarding the pandemic. Our results support that government measures should be accompanied by effective and targeted communication about the risk of infection, in order to encourage all strata of the general population to follow such measures and adapt to the changes without unduly affecting their mental health. The usage of such tools might help to reduce the impact of policy-imposed changes on the mental HRQoL of the general population, by inducing voluntary changes in informed and engaged populations

Ethnologie de la production d’un traitement innovant en Thérapie Comportementale et Cognitive des Troubles Obsessionnels Compulsifs

Cette thèse vise à mettre en évidence le cadre social de la fabrique d’un protocole de recherche biomédicale afin d'évaluer l’efficacité d’un outil psychopédagogique novateur utilisé en thérapie cognitive et comportementale (TCC) pour les patients atteints de trouble obsessionnel compulsif (TOC) en analysant le processus de socialisation d’une psychologue clinicienne en participation observante dans une unité de recherche de neurosciences cliniques de pointe.La transmission de cette expérience et de cette position singulière prend la forme d’un récit autobiographique afin d’appréhender les différents patterns sémantiques qui ont successivement façonné l’élaboration et la réalisation d’un tel protocole de recherche. Cette description intervient au moment où la science est encore chaude, où elle est modelée par l’intervention d’une équipe de chercheurs de big-science, d’une association de patients, et de nombreux autres objets sociotechniques hétérogènes.This thesis work was aimed at the identification of the social factors surrounding a biomedical research project, from conception to execution. We took as example the evaluation of a new psychopedagogical tool to be used in cognitive and behavioural therapy for obsessive- compulsive disorder. We analysed the socialisation process of clinical psychologist immersed in a leading clinical neuroscience unit.This experience, and the resulting observations, are described in the form of an autobiographic narrative. This allows the study of the semantic and lexical patterns that shape the elaboration and implementation of such a research protocol. The description takes place when the science is still hot and the team of big-scientists is in the process of shaping it, in interaction with a patient association and various other sociotechnical objects

Crazy’App: A web survey on representations and attitudes toward mental disorders using video testimonies

International audienceIn the international context of efforts to combat the stigmatization of people with mental health problems, representations and attitudes about these illnesses have not to date been widely investigated in France. However, new technologies offer an unprecedented opportunity to collect such information on a large scale and to deploy more efficient action against stigma.OBJECTIVES: The Crazy'App survey was designed as an instrument for studying potentially stigmatizing representations and attitudes towards mental disorders. It asks respondents to react, rather than to standard diagnostic labels or case vignettes, to video testimonies by people with different mental disorders talking about their experiences.METHODS: The web survey was made available on smartphone or computer and advertised on various media and during a French exhibition about mental disorders, mental health and well-being ("Mental Désordre", Cité des sciences, Paris, 2016). It consisted of short (<2min) video testimonials by four people presenting respectively anorexia, bipolar disorder, obsessive-compulsive disorder and addiction to alcohol. Each testimony was immediately followed by series of questions to which participants were to respond using visual analog scales. The questionnaires investigated different domains, such as the causes of each of these mental disorders, the possible treatments and the respondent's personal attitudes in hypothetical situations (e.g. working with the person seen in the video). After having completed the survey, respondents were offered an opportunity to compare their own responses to those of the other respondents, and watch expert psychiatrists interviews delivering clinical and scientific knowledge and sharing their own attitudes.RESULTS: The respondents (n=2600) were young, mostly women, educated and concerned about the subject. They exhibited good knowledge of the disorders. They reported a multi-causal view of the etiologies, where psychological causes were rated higher than neurobiological causes (although less so for respondents reporting having had a mental disorder themselves), while other types of causes (environmental, spiritual, and nutritional) received much lower ratings. Respondents also expressed high potential social proximity, but this result varied according to the type of disorder, in particular, the social distance and the perception of dangerousness were greater for addiction and bipolar disorder.CONCLUSIONS: Crazy'App operationalizes emerging strategies in the efforts to combat stigma, implementing what is known as a "contact based intervention" in English-speaking countries. While it does not erase the differences in attitudes observed from one pathology to another, this type of survey-intervention based on video testimonies could help to reduce the desire for social distancing from people with mental disorders, even in a particularly sensitized and informed population. Multimedia technologies are an efficient way to offer rich, potentially interactive content better able to embody people and their actual experiences than clinical descriptions or even life narratives. However the use of videos could put the focus on the individual characteristics (physical, gestural, verbal, nonverbal…), and this should be cautiously taken into account according to the anti-stigma objectives. Connected technologies also make it possible to enhance the more classic de-stigmatization actions focused on the deconstruction of preconceived ideas, making the action more participatory, while simultaneously assessing their efficacy. By mediating contact with individuals and behaviors perceived as deviant, the aim would be to develop psycho-social skills and concrete abilities for action in the general population, to include people with mental disorders in the community

Leveraging the Web and Social Media to Promote Access to Care Among Suicidal Individuals

International audienceAfter two decades of exponential development, the Internet has become an inseparable component of suicide prevention matters. More specifically, social media has turned out to be a privileged space for suicidal individuals to express their distress and seek support. Although this tendency carries with it specific risks and challenges, it creates unprecedented opportunities to face the challenges of help seeking and access to care. In this paper, we present the empirical, technological, and theoretical evidence supporting the implementation of a digitally augmented prevention policy that would increase its reach. Congruent to the clinical observations and theories on the help-seeking process, we argue that social media can help undertake three main functions of increasing proactivity to bring suffering Web users to care. The gateway function relates to the properties of social media interactions to leverage help-seeking barriers and enable ambivalent individuals to access the mental healthcare system. The communication outreach function Aims:to broadcast pro-help-seeking messages, while drawing on the functional structure of the social media network to increase its audience. The intervention outreach function consists in using machine learning algorithms to detect social media users with the highest risk of suicidal behaviors and give them a chance to overcome their dysfunctional reluctance to access help. We propose to combine these three functions into a single coherent operational model. This would involve the joint actions of a communication and intervention team on social networks, working in close collaboration with conventional mental health professionals, emergency service, and community resources

Prendre soin des jeunes suicidaires jusque sur les réseaux sociaux : le projet Elios

International audienceIt is widely acknowledged that adolescents and young adults are particularly vulnerable to suicidal behavior. However, the “service desert”—the persistent lack of access to care services—within this population remains a major obstacle to prevention. Although it has brought with it specific risks, the ubiquity of social media offers new ways of overcoming the traditional barriers to help-seeking, owing to the specific modes of interaction and communication that it involves. The Elios project (Équipe en ligne d’intervention et d’orientation pour la prévention du suicide/Online Intervention and Referral Team for Suicide Prevention) aims to harness the digital possibilities of social media to promote access to care for suicidal young people. It consists of a team of online clinicians who will provide suicidal young people with first-line assistance by intervening directly on social media platforms thanks to innovative and integrated technological solutions. Specifically, Elios will offer online counseling, motivational support, crisis intervention, and referral to mainstream care services. The system is due to be implemented as part of a randomized controlled trial. If proved effective, it could be used for other care situations within France’s conventional health care system.Bien que la vulnérabilité particulière des adolescents et des jeunes adultes aux conduites suicidaires soit largement établie, le défaut persistant d’accès aux soins dans cette population reste un obstacle majeur à la prévention. Sans être dénués de risques propres, les réseaux sociaux, dont l’utilisation s’est largement généralisée, offrent des modalités d’interaction et de communication qui pourraient permettre de dépasser les classiques obstacles à la recherche d’aide. Le projet d’Équipe en ligne d’intervention et d’orientation pour la prévention du suicide (Elios) vise à exploiter les potentialités du numérique pour favoriser l’accès aux soins chez les jeunes suicidaires. Il consiste en une équipe de web-cliniciens qui interviendront directement sur les réseaux sociaux, en utilisant des solutions technologiques innovantes et intégrées, pour apporter aux jeunes une première réponse, soutenir leur démarche de demande d’aide, les sécuriser lorsque nécessaire et les orienter vers des services de soins conventionnels. Actuellement mis en œuvre et évalué dans le cadre d’un essai contrôlé randomisé, le dispositif pourrait être généralisé comme une offre de soins de droit commun

Les dispositifs d’aide à distance : lignes de force de la prévention du suicide en France

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The 3114: A new professional helpline to swing the French suicide prevention in a new paradigm

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