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

Poverty and inequality in real-world schizophrenia: a national study

BackgroundSchizophrenia has high socioeconomic impact among severe psychiatric disorders.AimsTo explore clinician-reported and patient-reported inequities between patients under the poverty threshold vs. the others.Method916 patients consecutively recruited in 10 national centers received a comprehensive standardized evaluation of illness severity, addictions and patient-reported outcomes.Results739 (80.7%) of the patients were classified in the poverty group. This group had poorer objective illness outcomes (lower positive, negative, cognitive, excitement/aggressive and self-neglect symptoms and lifetime history of planned suicide) in multivariate analyses. While they had similar access to treatments and psychotherapy, they had lower access to socially useful activities, couple’s life, housing and parenthood. They had also more disturbed metabolic parameters. On the contrary, the poverty group reported better self-esteem. No significant difference for depression, risky health behavior including addictions and sedentary behavior was found.InterpretationThe equity in access to care is attributed to the French social system. However, mental and physical health remain poorer in these patients, and they still experience poor access to social roles independently of illness severity and despite healthcare interventions. These patients may have paradoxically better self-esteem due to decreased contact with society and therefore lower stigma exposure (especially at work). Schizophrenia presents itself as a distinct impoverished population concerning health-related outcomes and social integration, warranting focus in public health initiatives and improved treatment, including tailored interventions, collaborative care models, accessible mental health services, housing support, vocational training and employment support, community integration, education and awareness, research and data collection, culturally competent approaches, and long-term support

Schizophrenia Bulletin Open

Treatment-resistant schizophrenia (TRS) affects around 30% of patients with schizophrenia (SZ) resulting in poor functioning, relapses, and reduced quality of life. Convergent findings show that inflammation could contribute to resistance. We thus search for immune signatures of patients with TRS/ultra TRS (UTRS) in a sample of community-dwelling outpatients with SZ. In total, 195 stabilized SZ patients (mean age = 31.2 years, 73% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. At inclusion, psychotic symptomatology was evaluated by the Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Circulating serum/plasma levels of a large panel of markers reflecting the main inflammatory pathways were evaluated. TRS was defined by current treatment by clozapine (CLZ) and UTRS by current CLZ treatment + PANSS total score ≥ 70. The frequency of TRS and UTRS patients was, respectively, 20% and 7.7% and was defined using multivariable analysis elevated by high levels of interleukin (IL)-12/IL-23p40, IL-17A, IL-10, and beta 2 microglobulin (B2M) and IL-12/IL-23p40, IL-17A, IL-6, IL-10, IFNγ, and B2M, respectively. These observations suggest that resistance and ultra resistance to CLZ treatment are underpinned by pro-inflammatory molecules mainly belonging to the T helper 17 pathway, a finding making sense given the interplay between inflammation and antipsychotic treatment responses. If confirmed, our findings may allow us to consider IL-23/IL-17 pathway as a therapeutic target for patients with resistance to antipsychotics.Sorbonne Universités à Paris pour l'Enseignement et la RechercheFondaMental-Cohorte

Gender variability in e-learning utility essentials: evidence from a multi-generational higher education cohort

The paper reports a quantitative investigation into the nuances of gender perspectives of E-Learning utility across the social categorisations of Generation X, Y, and Z in the current phenomena of accelerated usage of e-learning in the emerging multi-generational undergraduate cohorts. Using multi-generational undergraduate cohorts (N = 611), taking a mandatory online course in a Business School curricular. With multi-group partial least-squares analysis, the study shows differences exist in the utility of e-learning within gender and Generations of X, Y, and Z. These differences may not be apparent when examined at only the gender level, which has led other researchers to conclude the gender gap is narrowing. However, we establish that within gender and across generations in a developing country context, the gender divide is not narrowing at the same pace as found in other developed countries. To accelerate the implementation of e-learning in traditional (faceto-face) undergraduate programmes globally, there is the need to contextualize Course Development, Learner Support, Assessment, and User Characteristics factors along with the different genders, and across generations to improve Results Demonstrability and Student Overall Satisfaction of utility of e-learning. In developing countries, there is a need to enhance Institutional factors to strengthen the drive to e-learning

Les idées de persécutions (de la méfiance au délire)

BORDEAUX2-BU Santé (330632101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

The real-life effectiveness of psychosocial therapies on social autonomy in schizophrenia patients: Results from a nationwide cohort study in France

International audienc

Patients with schizophrenia are less prone to interpret virtual others' empathetic questioning as helpful

International audienceIndividuals with schizophrenia are impaired in their neurocognition and present cognitive biases. Theseimpairments may lead to a deficit in recognizing helping intentions of others. To investigate recognitionof help, we designed a card-guessing game (Virtual Help Recognition Paradigm) involving two successivevirtual agents asking questions to the participant at different moments of the game. These questionswere either empathetic (i.e. on the subject's feelings) or non-empathetic (i.e. on technical aspects of thegame). We assessed how much the participant felt that the virtual agent had helped him and, her attitudeand personality traits. We measured how much the participant trusted the virtual agent with amonetary allocation procedure. Twenty individuals with schizophrenia and twenty healthy controls wererecruited. The controls� ratings demonstrated that they interpreted empathetic questioning as helpingand rewarded it positively with an increased monetary allocation. Participants with schizophrenia had areduced perception of the differences between the two agents. Only the rating concerning the �interest/attention� of the agent toward these participants yielded significant differences among conditions. Hypothetically,individuals with schizophrenia take into account the fact they are the object of another'sattention, but may fail to infer a helping intention and to behave accordingly

How and why affective and reactive virtual agents will bring new insights on social cognitive disorders in schizophrenia? An illustration with a virtual card game paradigm

International audienceIn recent decades, many studies have shown that schizophrenia is associated with severe social cognitive impairments affecting key components, such as the recognition of emotions, theory of mind, attributional style, and metacognition. Most studies investigated each construct separately, precluding analysis of the interactive and immersive nature of real-life situation. Specialized batteries of tests are under investigation to assess social cognition, which is thought now as a link between neurocognitive disorders and impaired functioning. However, this link accounts for a limited part of the variance of real-life functioning. To fill this gap, advances in virtual reality and affective computing have made it possible to carry out experimental investigations of naturalistic social cognition, in controlled conditions, with good reproducibility. This approach is illustrated with the description of a new paradigm based on an original virtual card game in which subjects interpret emotional displays from a female virtual agent, and decipher her helping intentions. Independent variables concerning emotional expression in terms of valence and intensity were manipulated. We show how several useful dependant variables, ranging from classic experimental psychology data to metacognition or subjective experiences records, may be extracted from a single experiment. Methodological issues about the immersion into a simulated intersubjective situation are considered. The example of this new flexible experimental setting, with regards to the many constructs recognized in social neurosciences, constitutes a rationale for focusing on this potential intermediate link between standardized tests and real-life functioning, and also for using it as an innovative media for cognitive remediation