Hypovitaminosis D is associated with depression and anxiety in schizophrenia: results from the national FACE-SZ cohort. Running title: hypovitaminosis D, depression and anxiety in schizophrenia

International audienceBackground. Guidelines have been edited for the treatment of schizophrenia (SZ) and bipola

Couples mixtes au Québec

sont-ils acceptés et vivent-ils au Québec ? Cette enquête, menée auprès de couples d'immigrants haïtiens ou africains et de Québécoises, explore les relations entre une société majoritaire, la société québécoise (elle-même minoritaire au Canada) et des groupes minoritaires.Passerieux Catherine. Couples mixtes au Québec. In: Hommes et Migrations, n°1174, mars 1994. Australie, Canada, USA. Le multiculturel dans tous ses états. pp. 18-21

Characterizing an ERP correlate of intentions understanding using a sequential comic strips paradigm

Chronometric properties of theory of mind and intentions understanding more specifically are well documented. Notably, it was demonstrated using magnetoencephalography that the brain regions involved were recruited as soon as 200 ms post-stimulus. We used event-related potentials (ERPs) to characterize an electrophysiological marker of attribution of intentions. We also explored the robustness of this ERP signature under two conditions corresponding to either explicit instructions to focus on others’ intentions or implicit instructions with no reference to mental states. Two matched groups of 16 healthy volunteers each received either explicit or no instructions about intentions and performed a nonverbal attribution of intentions task based on sequential four-image comic strips depicting either intentional or physical causality. A bilateral posterior positive component, ranging from 250 to 650 ms post-stimulus, showed greater amplitude in intentional than in physical condition (the intention ERP effect). This effect occurs during the third image only, suggesting that it reflects the integration of information depicted in the third image to the contextual cues given by the first two. The intention effect was similar in the two groups of subjects. Overall, our results identify a clear ERP marker of the first hundreds of milliseconds of intentions processing probably related to a contextual integrative mechanism and suggest its robustness by showing its blindness to task demands manipulation.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Comparison of three scales (BIS, SUMD and BCIS) for measuring insight dimensions and their evolution after one-year of follow-up: Findings from the FACE-SZ Cohort

International audienceThe aim of our study was to compare the performance of three different instruments measuring clinical and cognitive dimensions of insight. Data on 182 outpatients with schizophrenia and one-year follow-up assessments was drawn from the FACE-SZ cohort. Awareness of clinical state (« clinical insight ») was measured using both a clinician-rated measure (the Scale to assess Unawareness of Mental Disorder (SUMD)), and a self-report measure (the Birchwood Insight Scale (BIS). Cognitive insight was measured using a self-report measure (the Beck Cognitive Insight Scale (BCIS)). For each scale, change in insight was examined at the follow-up. Correlations between SUMD and BIS subscales measuring same dimensions were significant. BIS-BCIS correlations were weak for all combinations except between BIS illness dimension and BCIS composite score. At the follow-up, BIS and SUMD awareness of treatment need improved whereas illness and symptom awareness increased only on the SUMD. Conversely, cognitive insight composite scores decreased. Despite relatively good overall agreement between the two clinical insight instruments, considerable variability for similar insight dimensions measured by different instruments was found. Agreement between cognitive and clinical insight is moderate. Our study strengthens the argument that insight is harder to operationalize than other symptoms and may explain why it is so seldom explicitly targeted in schizophrenia treatment

Screening for cognitive deficits with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale

International audienceOBJECTIVE::This study aimed to evaluate the validity of the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale (ECPDS) to discriminate for cognitive impairment in schizophrenia.DESIGN::This multicentre cross-sectional study used a validation design with receiver operating characteristic (ROC) curve analysis.SETTINGS::The study was undertaken in a French network of seven outward referral centres.SUBJECTS::We recruited individuals with clinically stable schizophrenia diagnosed based on the Structured Clinical Interview for assessing Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; DSM-IV-R) criteria.MAIN MEASURES::The index test for cognitive impairment was ECPDS (independent variable), a 13-item scale completed by a relative of the participant. The reference standard was a standardized test battery that evaluated seven cognitive domains. Cognitive impairment was the dependent variable and was defined as an average z-score more than 1 SD below the normative mean in two or more cognitive domains.RESULTS::Overall, 97 patients were included (67 with schizophrenia, 28 with schizoaffective disorder, and 2 with schizophreniform disorder). The mean age was 30.2 (SD 7.7) years, and there were 75 men (77.3%). There were 59 (60.8%) patients with cognitive impairment on the neuropsychological battery, and the mean ECPDS score was 27.3 (SD 7.3). The ROC curve analysis showed that the optimal ECPDS cut-off was 29.5. The area under the curve was 0.77, with 76.3% specificity and 71.1% sensitivity to discriminate against cognitive impairment.CONCLUSION::The ECPDS is a valid triage tool for detecting cognitive impairment in schizophrenia, before using an extensive neuropsychological battery, and holds promise for use in everyday clinical practice

Mediation Analyses of Insight, Quality of Life, Depression, and Suicidality

International audienceObjective: The relationship between greater insight and increased risk of suicide in patients with schizophrenia is debated. The purpose of this study was to assess whether quality of life (QoL) and depression mediated the association between insight and suicidality. Methods: Between March 2010 and December 2015, 527 community-dwelling adults with stable schizophrenia according to DSM-IVcriteria were included in a multicenter cross-sectional study, the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) Study. Structural equation modeling was used for mediation analyses among insight, QoL, depression, and suicidality, controlling for the global level of schizophrenic symptoms. Results: The model provided a good fit for the data ( (chi32 =1.4, P = .708, Tucker-Lewis index = 1, comparative fit index =1, root mean square error of approximation =0, standardized root mean square residual =0.008) and explained 27% of the variance in suicidality. Poorer QoL and greater severity of depression mediated 68.4% of the positive association between insight and suicidality (full mediation). Poorer QoL mediated 48% of the positive effect of insight on depression (partial mediation). The severity of depression mediated 91.2% of the negative relationship between QoL and suicidality (full mediation). Conclusions: Insight appears to be an indirect risk factor for suicide in patients with schizophrenia, with the link being mediated by poorer QoL and worse underlying depression, mainly by a sequential pathway but also by a less important parallel pathway

Metabolic Syndrome and Illness Severity Predict Relapse at 1-Year Follow-Up in Schizophrenia

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Prevalence of and Risk Factors for Extrapyramidal Side Effects of Antipsychotics

International audienceBackground: Extrapyramidal side effects (EPS) have been identified as a complication of antipsychotic treatment. Previous meta-analyses have investigated EPS prevalence and risk factors in randomized clinical trials with highly selected patients, but studies in real-world schizophrenia are missing. Objective: To examine the prevalence and clinical correlates associated with EPS in a nonselected national multicenter sample of stabilized patients with schizophrenia. Methods: Between 2010 and 2016, patients suffering from schizophrenia (DSM-IV-TR criteria) were recruited through the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) network and data were collected during a comprehensive 1-day-long standardized evaluation. The Simpson-Angus Scale and the Abnormal Involuntary Movement Scale were used to assess drug-induced parkinsonism (DIP) and tardive dyskinesia, respectively. Results: The overall prevalence of DIP and tardive dyskinesia was 13.2% and 8.3%, respectively, in this community-dwelling sample of 674 patients. DIP was associated with negative symptoms (Positive and Negative Syndrome Scale [PANSS] subscore) (adjusted odds ratio [aOR] = 1.102, P Conclusions: Our results indicate the high prevalence of EPS in a nonselected community-dwelling clinically stable sample of outpatients with schizophrenia. In the monitoring of antipsychotic treatment, EPS should be systematically evaluated, especially when negative symptoms and disorganization or cognitive alteration are present. Monotherapy with a second-generation antipsychotic should be preferentially initiated for patients with these side effects

Self-reported pain in patients with schizophrenia. Results from the national first-step FACE-SZ cohort

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