Patients' adherence to smartphone apps in the management of bipolar disorder: a systematic review

Background: Despite an increasing number of available mental health apps in the bipolar disorder field, these tools remain scarcely implemented in everyday practice and are quickly discontinued by patients after downloading. The aim of this study is to explore adherence characteristics of bipolar disorder patients to dedicated smartphone interventions in research studies. Methods: A systematic review following PRISMA guidelines was conducted. Three databases (EMBASE, PsychInfo and MEDLINE) were searched using the following keywords: 'bipolar disorder' or 'mood disorder' or 'bipolar' combined with 'digital' or 'mobile' or 'phone' or 'smartphone' or 'mHealth' or 'ehealth' or 'mobile health' or 'app' or 'mobile-health'. Results: Thirteen articles remained in the review after exclusion criteria were applied. Of the 118 eligible studies, 39 did not provide adherence characteristics. Among the selected papers, study length, sample size and definition of measures of adherence were strongly heterogeneous. Activity rates ranged from 58 to 91.6%. Conclusion: The adherence of bipolar patients to apps is understudied. Standardised measures of adherence should be defined and systematically evaluated in future studies dedicated to these tools

COVID-19 pandemic lockdown and problematic eating behaviors in a student population

Background and aims: Since mid-March 2020, over 3 billion people have been confined as a result of the COVID-19 pandemic. Problematic eating behaviors are likely to be impacted by the pandemic through multiple pathways. This study examined the relationships between stress related to lockdown measures and binge eating and dietary restriction in a population of French students during the first week of confinement. Methods: A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days. Results: Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder. Discussion and conclusion: The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable

Recent Contributions of Air- and Biomarkers to the Control of Secondhand Smoke (SHS): A Review

Since the publication of the US Surgeon General Reports in 1996 and 2006 and the report of the California Environmental Protection Agency in 1999, many reports have appeared on the contribution of air and biomarkers to different facets of the secondhand smoke (SHS) issue, which are the targets of this review. These recent studies have allowed earlier epidemiological surveys to be biologically validated, and their plausibility demonstrated, quantified the levels of exposure to SHS before the bans in various environments, showed the deficiencies of mechanical control methods and of partial bans and the frequently correct implementation of the efficient total bans. More stringent regulation remains necessary in the public domain (workplaces, hospitality venues, transport sector, etc.) in many countries. Personal voluntary protection efforts against SHS are also needed in the private domain (homes, private cars). The effects of SHS on the cardiovascular, respiratory and neuropsychic systems, on pregnancy and fertility, on cancers and on SHS genotoxicity are confirmed through experimental human studies and through the relationship between markers and prevalence of disease or of markers of disease risk

Glycine Inhibitory Dysfunction Turns Touch into Pain through PKCgamma Interneurons

Dynamic mechanical allodynia is a widespread and intractable symptom of neuropathic pain for which there is a lack of effective therapy. During tactile allodynia, activation of the sensory fibers which normally detect touch elicits pain. Here we provide a new behavioral investigation into the dynamic component of tactile allodynia that developed in rats after segmental removal of glycine inhibition. Using in vivo electrophysiological recordings, we show that in this condition innocuous mechanical stimuli could activate superficial dorsal horn nociceptive specific neurons. These neurons do not normally respond to touch. We anatomically show that the activation was mediated through a local circuit involving neurons expressing the gamma isoform of protein kinase C (PKCγ). Selective inhibition of PKCγ as well as selective blockade of glutamate NMDA receptors in the superficial dorsal horn prevented both activation of the circuit and allodynia. Thus, our data demonstrates that a normally inactive circuit in the dorsal horn can be recruited to convert touch into pain. It also provides evidence that glycine inhibitory dysfunction gates tactile input to nociceptive specific neurons through PKCγ-dependent activation of a local, excitatory, NMDA receptor-dependent, circuit. As a consequence of these findings, we suggest that pharmacological inhibition of PKCγ might provide a new tool for alleviating allodynia in the clinical setting

Approche épidémiologique et évaluative des comportements addictifs

Within the framework of addictive behaviours, a descriptive step is often the introduction necessary for any comprehensive step. Thus, epidemiology is a tool which turns out in particular when it is a question of considered i) the existence of addictifs behavior in a specific population and to measure the relevance of the notion of "harmful use" in nosography, ii) the relevance of use of one pathology as a model of study of addictifs mechanisms. So, we estimated at first the existence of addictif behaviours in a specific population "the pregnant women". It seems that self-reports are easily useful and provide a strong adhesion of the participants. The biological markers of alcohol consumption are not helpful contrary to biological markers of tobacco exposure which revealed a higher presence of environmental tobacco smoke. This survey also reveals that half of women in Auvergne consume at least one drink of alcohol during their pregnancy and that the major consequence of this consumption : the Fœtal Alcohol Syndrome (FAS) has been found to be present in at least 1.8 of 1000 live births. So this epidemiological study allowed measure of indicators of sanitary interest for a social and preventive Medicine and targeted programs for public health. Secondly, we estimated the addictif profile of another specific population "Parkinson's disease (PD) patients" in comparison to general population. The secondary objective is to better define tools at disposal. We noticed that the hypersexuality or the pathological gambling do not seem to be overrepresented behaviours in PD patients whereas dopamine dysregulation syndrome (DDS) is frequent. In prospect of this research, it seemed that reliable tools of evaluation particularly on hypersexuality remain to be developed. Furthemore to this epidemiological research, PD patients can represent a model to better understand the functioning of addictive behaviours.Dans le cadre des comportements addictifs, une démarche descriptive est souvent le préambule nécessaire à toute démarche compréhensive. L'épidémiologie est donc un outil qui s'avère précieux notamment quand il s'agit d'estimer i) l'existence de comportements addictifs dans une population spécifique et de mesurer la pertinence nosographique de la notion "d'usage nocif", ii) la pertinence d'utilisation d'une pathologie comme modèle d'étude des mécanismes addictifs. Ainsi, nous avons dans un premier temps estimé l'existence de comportements addictifs dans une population spécifiques "les femmes enceintes". Il apparaît que les outils de type "questionnaire" sont facilement utilisables avec une forte adhérence des participantes. Les marqueurs biologiques pour l'alcool n'étaient ici pas satisfaisants contraitement à celui du tabagisme qui a dévoilé la présence importante du tabagisme passif. Cette enquête révèle également que la moitié des parturientes en Auvergne consomment au moins une fois de l'alcool au cours de leur grossesse et que la conséquence la plus grave de cette consommation, à savoir le Syndrome d'Alcoolisation Fœtale, touche au moins 1,8 naissance sur mille. Ainsi cette étude épidémiologique a permis la mesure des indicateurs d'intérêt sanitaire pour une médecine sociale et préventive et des actions ciblées de santé publique. Dans un second temps, nous avons évalué le profil addictif d'une autre population spécifique "les patients atteints par la maladie de Parkinson" en comparaison à une population indemne de la maladie. nous avons constaté que l'hypersexualité ou le jeu pathologique ne semblent pas être des comportements surreprésentés chez les patients Parkinsoniens tandis que la prise addictive de leur traitement dopaminergique est fréquente. En perspective de cette recherche épidémiologique, il est apparu que les patients Parkinsoniens peuvent représenter un modèle pour une meilleure compréhension du fonctionnement des comportements addictifs

SUICIDE ET EVALUATION. REVUE DES OUTILS DISPONIBLES EN FRANÇAIS : APPROCHE NON DIMENSIONNELLE ET AUTO-QUESTIONNAIRES

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Organization of diencephalic projections from the spinal trigeminal nucleus oralis: An anterograde tracing study in the rat

International audienceThe organization of the efferent projections from the spinal trigeminal nucleus oralis (Sp5O) to the dienceph-alon was studied in the rat using the anterograde tracer Phaseolus vulgaris leucoagglutinin. The present study confirms the existence of trigemino-thalamic pathways originating from the Sp5O and details their distribution. The main diencephalic targets of the Sp5O are the ventral posterome-dial thalamic nucleus (VPM), the posterior thalamic nuclei (Po) and the ventral part of the zona incerta (ZIv), contralat-erally, and the parvicellular part of the ventral posterior tha-lamic nucleus (VPpc), bilaterally. The distribution of these projections varies according to the dorso-ventral location of the injection sites: the dorsal part of the Sp5O projects to the medial part of the VPM and the Po, and to the caudal part of the ZIv, as well as to the VPpc. The ventral part of the Sp5O projects to the lateral part of the VPM and the Po and to the rostral part of the ZIv. These results suggest that the tri-gemino-diencephalic pathways originating from the Sp5O are involved in the processing of gustatory and somatosensory information

Alcohol Consumption for People Admitted in French Emergency Departments: A Protocol for a Multi-Center Cluster Trial

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