Categorical perception of familiarity: Evidence for a hyper-familiarity in schizophrenia

a b s t r a c t Familiarity is a crucial aspect of recognition that may be perturbed in schizophrenia patients (SZP) and may lead to delusional disorders. However, there are no existing guidelines on how to assess and treat familiarity disorders in schizophrenia. Some experimental studies have investigated familiarity processing in SZP but have produced inconsistent results, which are likely a result of methodological issues. Moreover, these studies only assessed whether familiarity processing is preserved or impaired in SZP, but not the tendency of SZP to consider unfamiliar stimuli to be familiar. By using a familiarity continuum task based on the existence of the categorical perception effect, the objective of this study was to determine whether SZP present hyper-or hypo-familiarity. To this purpose, 15 SZP and 15 healthy subjects (HS) were presented with facial stimuli, which consisted of picture morphs of unfamiliar faces and faces that were personally familiar to the participants. The percentage of the familiar face contained in the morph ranged from 5 to 95%. The participants were asked to press a button when they felt familiar with the face that was presented. The main results revealed a higher percentage of familiarity responses for SZP compared with HS from the stimuli with low levels of familiarity in the morph and a lower familiarity threshold, suggesting a hyper-familiarity disorder in SZP. Moreover, the intensity of this "hyper-familiarity" was correlated with positive symptoms. This finding clearly suggests the need for a more systematic integration of an assessment of familiarity processing in schizophrenia symptoms assessments

ALGOS: the development of a randomized controlled trial testing a case management algorithm designed to reduce suicide risk among suicide attempters

<p>Abstract</p> <p>Background</p> <p>Suicide attempts (SA) constitute a serious clinical problem. People who attempt suicide are at high risk of further repetition. However, no interventions have been shown to be effective in reducing repetition in this group of patients.</p> <p>Methods/Design</p> <p>Multicentre randomized controlled trial.</p> <p>We examine the effectiveness of «ALGOS algorithm»: an intervention based in a decisional tree of contact type which aims at reducing the incidence of repeated suicide attempt during 6 months. This algorithm of case management comprises the two strategies of intervention that showed a significant reduction in the number of SA repeaters: systematic telephone contact (ineffective in first-attempters) and «Crisis card» (effective only in first-attempters). Participants who are lost from contact and those refusing healthcare, can then benefit from «short letters» or «postcards».</p> <p>Discussion</p> <p>ALGOS algorithm is easily reproducible and inexpensive intervention that will supply the guidelines for assessment and management of a population sometimes in difficulties with healthcare compliance. Furthermore, it will target some of these subgroups of patients by providing specific interventions for optimizing the benefits of case management strategy.</p> <p>Trial Registration</p> <p>The study was registered with the ClinicalTrials.gov Registry; number: NCT01123174.</p

Relationship between childhood physical abuse and clinical severity of treatment-resistant depression in a geriatric population

Introduction: We assessed the correlation between childhood maltreatment (CM) and severity of depression in an elderly unipolar Treatment-Resistant Depression (TRD) sample. Methods: Patients were enrolled from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centres. Results: Our sample included 96 patients (33% of the overall cohort) aged 60 years or above, with a mean age of 67.2 (SD = 5.7). The majority of the patients were female (62.5%). The Montgomery and Asberg Depression Rating Scale (MADRS) and Quick Inventory Depression Scale-Self Report (QIDS-SR) mean scores were high, 28.2 (SD = 7.49) [MADRS score range: 0–60; moderate severity≥20, high severity≥35] and 16.5 (SD = 4.94) [IDS-SR score range: 0–27; moderate severity≥11, high severity≥16], respectively. Mean self-esteem scores were 22.47 (SD = 6.26) [range 0–30]. In an age- and sex-adjusted model, we found a positive correlation between childhood trauma (CTQ scores) and depressive symptom severity [MADRS (β = 0.274; p = 0.07) and QIDS-SR (β = 0.302; p = 0.005) scores]. We detected a statistically significant correlation between physical abuse and depressive symptom severity [MADRS (β = 0.304; p = 0.03) and QIDS-SR (β = 0.362; p = 0.005) scores]. We did not observe any significant correlation between other types of trauma and depressive symptom severity. We showed that self-esteem (Rosenberg scale) mediated the effect of physical abuse (PA) on the intensity of depressive symptoms [MADRS: b = 0.318, 95% BCa C.I. [0.07, 0.62]; QIDS-SR: b = 0.177, 95% BCa C.I. [0.04, 0.37]]. Preacher & Kelly’s Kappa Squared values of 19.1% (k2 = 0.191) and 16% (k2 = 0.16), respectively for the two scales, indicate a moderate effect. Conclusion: To our knowledge, this is the first study conducted in a geriatric TRD population documenting an association between childhood trauma (mainly relating to PA) and the intensity of depressive symptoms

Les suicidants et leur entourage familial

Pour un décès par suicide, on estime que l’on peut compter 6 endeuillés « directs » et 20 personnes au total en rapport plus indirect avec ce deuil. Si l’on applique à l’entourage des sujets ayant fait une tentative de suicide la même arithmétique que celle décrite pour les endeuillés, on aboutit à ce qu’entre 600 000 et 3 500 000 personnes soient concernées chaque année en France par la tentative de suicide d’un proche. Des changements dans l’entourage d’un suicidant peuvent souvent être retrouvés comme facilitateurs ou déclencheurs du geste suicidaire, et d’un autre côté, une tentative de suicide va retentir sur cet entourage, du moins cette partie de l’entourage à proximité immédiate du suicidant. Cette interpellation de l’entourage du suicidant est une question centrale. Dans les faits, une très grande majorité des tentatives de suicide dirigées vers les urgences hospitalières seront réadressées vers leur contexte de vie initial, moins de 24 heures après le geste ; pour d’autres, quelques jours après une hospitalisation dans une structure d’urgence ou dans un service de médecine, la sortie interviendra vers le circuit ambulatoire. En prenant une position très pragmatique, nous conclurons sur quatre questions qui devraient alors se poser systématiquement après une tentative de suicide : (1) existe-t-il un entourage ? ; (2) cet entourage est-il « suffisamment bon » (en reprenant la formule deWinnicott) ? ; (3) cet entourage est-il « suffisamment prêt » ? ; (4) faut-il prévoir d’accompagner cet entourage

PEUT-ON AMELIORER LA PRISE EN CHARGE DES PATIENTS SCHIZOPHRENES AUX URGENCES GENERALES ?

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

L'utilisation des Directives Anticipées en psychiatrie (une revue de littérature qualitative, état des lieux et perspectives)

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Le recontact téléphonique systématique à distance d'un geste suicidaire (quel vécu pour les patients ?)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Aspects biologiques du psychotraumatisme (intérêt de la prescription de propanolol au décours immédiat du trauma sur la prévention de survenue du psychotraumatisme)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

ANGOISSE DE SEPARATION ET TENTATIVE DE SUICIDE (A PROPOS DE 60 JEUNES SUICIDANTS AGES DE 16 A 24 ANS ; RENCONTRES AU CENTRE D'ACCUEIL ET DE CRISE DU CHRU DE LILLE)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF