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1.
Article in English | MEDLINE | ID: mdl-38702455

ABSTRACT

Defining homogeneous subgroups of bipolar disorder (BD) is a major goal in personalized psychiatry and research. According to the neurodevelopmental theory, age at onset may be a key variable. As potential trait markers of neurodevelopment, cognitive and functional impairment should be greater in the early form of the disease, particularly type 1 BD (BD I). The age at onset was assessed in a multicenter, observational sample of 4190 outpatients with BD. We used a battery of neuropsychological tests to assess six domains of cognition. Functioning was measured using the Functioning Assessment Short Test (FAST). We studied the potential moderation of the type of BD on the associations between the age at onset and cognitive and functioning in a subsample of 2072 euthymic participants, controlling for potential clinical and socio-demographic covariates. Multivariable analyses showed cognition to not be impaired in individuals with early (21-30 years) and very early-life (before 14 years) onset of BD. Functioning was equivalent between individuals with early and midlife-onset of BD II and NOS but better for individuals with early onset of BD I. In contrast, functioning was not worse in individuals with very early-onset BD I but worse in those with very early-onset BD II and NOS. Early-life onset BDs were not characterized by poorer cognition and functioning. Our results do not support the neurodevelopmental view that a worse cognitive prognosis characterizes early-life onset BD. This study suggests that functional remediation may be prioritized for individuals with midlife-onset BD I and very early life onset BD 2 and NOS.

2.
Acta Psychiatr Scand ; 149(3): 207-218, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38268142

ABSTRACT

INTRODUCTION: Metabolic syndrome (MetS) is a cluster of components including abdominal obesity, hyperglycemia, hypertension, and dyslipidemia. MetS is highly prevalent in individuals with bipolar disorders (BD) with an estimated global rate of 32.6%. Longitudinal data on incident MetS in BD are scarce and based on small sample size. The objectives of this study were to estimate the incidence of MetS in a large longitudinal cohort of 1521 individuals with BD and to identify clinical and biological predictors of incident MetS. METHODS: Participants were recruited from the FondaMental Advanced Center of Expertise for Bipolar Disorder (FACE-BD) cohort and followed-up for 3 years. MetS was defined according to the International Diabetes Federation criteria. Individuals without MetS at baseline but with MetS during follow-up were considered as having incident MetS. A logistic regression model was performed to estimate the adjusted odds ratio and its corresponding 95% confidence interval (CI) for an association between each factor and incident MetS during follow-up. We applied inverse probability-of-censoring weighting method to minimize selection bias due to loss during follow-up. RESULTS: Among individuals without MetS at baseline (n = 1521), 19.3% developed MetS during follow-up. Multivariable analyses showed that incident MetS during follow-up was significantly associated with male sex (OR = 2.2, 95% CI = 1.7-3.0, p < 0.0001), older age (OR = 2.14, 95% CI = 1.40-3.25, p = 0.0004), presence of a mood recurrence during follow-up (OR = 1.91, 95% CI = 1.22-3.00, p = 0.0049), prolonged exposure to second-generation antipsychotics (OR = 1.56, 95% CI = 0.99, 2.45, p = 0.0534), smoking status at baseline (OR = 1.30, 95% CI = 1.00-1.68), lifetime alcohol use disorders (OR = 1.33, 95% CI = 0.98-1.79), and baseline sleep disturbances (OR = 1.04, 95% CI = 1.00-1.08), independently of the associations observed for baseline MetS components. CONCLUSION: We observed a high incidence of MetS during a 3 years follow-up (19.3%) in individuals with BD. Identification of predictive factors should help the development of early interventions to prevent or treat early MetS.


Subject(s)
Alcoholism , Bipolar Disorder , Metabolic Syndrome , Humans , Male , Metabolic Syndrome/epidemiology , Longitudinal Studies , Bipolar Disorder/epidemiology , Risk Factors , Incidence
3.
Eur Neuropsychopharmacol ; 77: 67-79, 2023 12.
Article in English | MEDLINE | ID: mdl-37741163

ABSTRACT

Bipolar disorders (BD) are characterized by cognitive impairment during the euthymic phase, to which treatments can contribute. The anticholinergic properties of medications, i.e., the ability of a treatment to inhibit cholinergic receptors, are associated with cognitive impairment in elderly patients and people with schizophrenia but this association has not been well characterized in individuals with remitted BD. Moreover, the validity of only one anticholinergic burden scale designed to assess the anticholinergic load of medications has been tested in BD. In a literature review, we identified 31 existing scales. We first measured the associations between 27 out of the 31 scales and objective cognitive impairment in bivariable regressions. We then adjusted the bivariable models with covariates: the scales significantly associated with cognitive impairment in bivariable and multiple logistic regressions were defined as having good concurrent validity to assess cognitive impairment. In a sample of 2,031 individuals with euthymic BD evaluated with a neuropsychological battery, two scales had good concurrent validity to assess cognitive impairment, whereas chlorpromazine equivalents, lorazepam equivalents, the number of antipsychotics, or the number of treatments had not. Finally, similar analyses with subjective anticholinergic side-effects as outcome variables reported 14 scales with good concurrent validity to assess self-reported peripheral anticholinergic side-effects and 13 to assess self-reported central anticholinergic side-effects. Thus, we identified valid scales to monitor the anticholinergic burden in BD, which may be useful in estimating iatrogenic cognitive impairment in studies investigating cognition in BD.


Subject(s)
Bipolar Disorder , Cognitive Dysfunction , Humans , Aged , Bipolar Disorder/psychology , Self Report , Cholinergic Antagonists/adverse effects , Cognitive Dysfunction/chemically induced , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/complications , Iatrogenic Disease/epidemiology
4.
Antonie Van Leeuwenhoek ; 116(11): 1123-1137, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37650994

ABSTRACT

The use of yeasts as a feed supplement for cattle can promote animal development and performance. However, for the positive results to be consistent, strains with probiotic properties must be selected. The objective of this study was to isolate and identify yeasts present in the bovine feces and evaluate their probiotic potential together with strains previously isolated from the rumen (preliminary study). A total of 193 isolates were studied, including 139 isolates (19 species) from fecal samples from 11 different animals (Bos taurus and Bos indicus) and 54 strains previously isolated from rumen fluid (Bos taurus). The yeast population in the feces ranged from 3.51 to 4.99 log CFU/g, with Candida pararugosa being the most abundant (isolated from the feces of six samples analysed). Isolates were selected that had negative results in the safety tests (hemolytic activity, DNAse, and gelatinase) and had percentages greater than 35 and 70% for hydrophobicity and auto-aggregation, respectively. In addition, selected isolates had percentages greater than 77.7 and 74.7% for coaggregation with pathogenic strains of Escherichia coli and Clostridium perfringens, respectively. The isolates with percentage growth at 39 °C greater than 64.6% and viability greater than 96.7% were selected for survival testing under bovine gastrointestinal conditions. After the tests, the seven best isolates were selected, belonging to the species Candida pararugosa (L60, CCMA 928 and CCMA 930) and Pichia kudriavzevii (L97, L100, CCMA904, CCMA 907). The selected isolates were exopolysaccharide producers. Based on the results of the evaluated properties, the seven selected isolates were classified as potential probiotics for cattle.


Subject(s)
Probiotics , Saccharomyces cerevisiae , Cattle , Animals , Gastrointestinal Tract , Feces , Escherichia coli
7.
J Affect Disord ; 307: 149-156, 2022 06 15.
Article in English | MEDLINE | ID: mdl-35339569

ABSTRACT

BACKGROUND: The FACE-BD cohort is an observational cohort of individuals with bipolar disorders (BD) who benefited from a systematic evaluation with evidence-based treatment recommendations and who were followed-up every year for 3 years in France. The objectives were to describe the lifetime course of BD, associated psychiatric and somatic comorbidities, and cognition profile. This cohort aims to identify clinical/biological signatures of outcomes, trajectories of functioning and transition between clinical stages. This article summarizes 10 years of findings of the FACE-BD cohort. METHOD & RESULTS: We included 4422 individuals, all having a baseline assessment, among which 61.2% had at least one follow-up visit at either one, two or three years. A subsample of 1200 individuals had at least one biological sample (serum, plasma, DNA). Assessments include family history of psychiatric disorders, psychiatric diagnosis, current mood symptoms, functioning, hospitalizations, suicidal attempts, physical health, routine blood tests, treatment history, psychological dimensions, medico-economic data and a cognitive assessment. Studies from this cohort illustrate that individuals with BD display multiple coexistent psychiatric associated conditions including sleep disturbances, anxiety disorders, substance use disorders and suicide attempts as well as a high prevalence of metabolic syndrome. During follow-up, we observed a 55% reduction of the number of days of hospitalization and a significant improvement in functioning. CONCLUSIONS: The FACE-BD cohort provides a strong research infrastructure for clinical research in BD and has a unique position among international cohorts because of its comprehensive clinical assessment and sustainable funding from the French Ministry of Health.


Subject(s)
Bipolar Disorder , Anxiety Disorders/epidemiology , Bipolar Disorder/diagnosis , Bipolar Disorder/epidemiology , Bipolar Disorder/therapy , Cohort Studies , Comorbidity , Humans , Suicide, Attempted/psychology
8.
Eur Psychiatry ; 65(1): e15, 2022 01 21.
Article in English | MEDLINE | ID: mdl-35060460

ABSTRACT

BACKGROUND: Psychiatric comorbidities and suicide attempts are highly prevalent in Bipolar Disorders (BD). We examined the associations between childhood maltreatment, psychiatric comorbidities, and suicide attempts, in terms of lifetime prevalence, sequence of onset, and current symptoms. METHODS: We assessed 3,047 individuals with BD for suicide attempts, anxiety disorders, substance use disorders, and eating disorders. Participants completed a self-report for the assessment of childhood maltreatment. Associations between childhood maltreatment and characteristics of comorbidities (lifetime prevalence, current symptoms, and age at onset) were examined using logistic regressions and network analyses. RESULTS: Psychiatric comorbidities were frequent with a mean number per individual of 1.23 (SD = 1.4). Most comorbidities occurred prior to the onset of BD. Participants who reported higher levels of childhood maltreatment had more frequent and multiple comorbidities, which were also more currently active at inclusion. Childhood maltreatment did not decrease the age of onset of comorbidities, but was associated with a faster accumulation of comorbidities prior to the onset of BD. Logistic regression and network analyses showed that emotional abuse and sexual abuse might play a prominent role in the lifetime prevalence of psychiatric comorbidities and suicide attempts. CONCLUSIONS: Childhood maltreatment was associated with suicide attempts, and with frequent, multiple, and persistent psychiatric comorbidities that accumulated more rapidly prior to the onset of BD. Hence, childhood maltreatment should be systematically assessed in individuals with BD, in particular when the course of the disorder is characterized by a high comorbid profile or by a high suicidality.


Subject(s)
Bipolar Disorder , Child Abuse , Bipolar Disorder/epidemiology , Bipolar Disorder/psychology , Child , Child Abuse/psychology , Humans , Prevalence , Suicidal Ideation , Suicide, Attempted/psychology
9.
Encephale ; 48(2): 125-131, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34024498

ABSTRACT

OBJECTIVES: We assessed the prevalence of severe cardiovascular (CV) disease requiring hospitalization among patients with schizophrenia in France. METHOD: We included patients hospitalized with schizophrenia or psychotic disorder during 2015, in five French psychiatric hospitals. Patients with CV disease were defined as those with a correspondent ICD-10 code during a hospital stay in any general hospital, five years before or three years after the psychiatric hospitalization. CV disease included myocardial infarction (MI), stroke, heart failure (HF), coronary artery disease (CAD) or peripheral artery disease. Risk factors such as hypertension, obesity and diabetes were recorded. RESULTS: In total, 4424 patients with schizophrenia were included. Overall, 203 (4,6%) patients were diagnosed with CV disease, 93 (2.1%) with CAD, 86 (1.9%) with HF and 49 (1.1%) with stroke. The prevalence of hypertension, obesity and diabetes was 11.3%, 9.7% and 7.8%. The median (interquartile range) age of patients with MI and diabetes was 57 (49-70) and 56 (48-66) years. CONCLUSION: Patients with schizophrenia develop severe CV disease requiring hospitalization at an early age. These severe events are associated with a high prevalence of risk factors. Early screening and treatment of CV disease and risk factors is important to improve life expectancy and quality of life of these patients.


Subject(s)
Cardiovascular Diseases , Heart Failure , Hypertension , Myocardial Infarction , Schizophrenia , Stroke , Cardiovascular Diseases/complications , Cardiovascular Diseases/epidemiology , Heart Failure/complications , Heart Failure/epidemiology , Heart Failure/prevention & control , Humans , Hypertension/complications , Hypertension/epidemiology , Myocardial Infarction/complications , Myocardial Infarction/epidemiology , Obesity/complications , Obesity/epidemiology , Prevalence , Quality of Life , Risk Factors , Schizophrenia/complications , Schizophrenia/epidemiology
10.
Encephale ; 48(2): 132-138, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34092379

ABSTRACT

BACKGROUND: Cannabis is the most widely used illicit drug in the world. It is responsible for cognitive dysfunction of memory, speed of information processing, attention, and executive functions. Cognitive performance depends on the level of study, tolerance, and duration of abstinence from cannabis use. This study analyses cognitive function in a large population of regular cannabis consumers taking into account level of education. METHODS: A battery of neuropsychological tests using the Cambridge Neuropsychological Test Automated Battery was performed on a population of 58 cannabis users categorized into two groups according to their level of education with a threshold of 12 years of study, and 25 non-users. RESULTS: In Attention Switching Task percent correct trials, significant differences were found between the group of cannabis smokers with less than 12 years of study and the non-smoker group (P=0.022), and between the cannabis users with more than 12 years of study and the non-smoker group (P=0.008). A significantly lower performance in the Rapid Visual Information Processing (Mean latency, Probability of hit, Total hits, Total misses, Correct rejections) was found in the cannabis users with less than 12 years of study compared with the non-user group. CONCLUSION: In our population, chronic cannabis users presented divided and sustained attention and working memory disorders. Rapid Visual Information Processing performance may be influenced by education level in cannabis smokers.


Subject(s)
Cannabis , Attention , Executive Function , Humans , Memory, Short-Term , Neuropsychological Tests
11.
Encephale ; 48(3): 241-246, 2022 Jun.
Article in English | MEDLINE | ID: mdl-34092381

ABSTRACT

Mindfulness-based approaches have shown their effectiveness in caring for patients with substance use disorders (SUD). Mindfulness-based relapse prevention (MBRP) integrates practices from mindfulness-based interventions and cognitive-behavioral relapse prevention (RP) approaches. This article presents the preliminary results of a study that measures the effectiveness of an MBRP protocol for volunteer cannabis users willing to reduce or stop their consumptions. Twenty cannabis users were randomly assigned to either receive an eight-week outpatient MBRP program or treatment as usual (TAU). Cannabis use was assessed weekly through the timeline follow back (TLFB). Eighty percent of individuals received MBRP treatment and 60% of individuals received TAU completed treatment. Preliminary results did not find significant difference at the end of treatment (week 8) regarding the number of joints smoked. Despite the absence of any significant difference between the two groups, the contribution of mindfulness in the caring of SUD seems encouraging and promising. Many MBRP group participants reported qualitative changes in the way they consumed. This study will be continued in order to evaluate the effectiveness of MBRP on a larger number of subjects.


Subject(s)
Cannabis , Cognitive Behavioral Therapy , Mindfulness , Substance-Related Disorders , Cognitive Behavioral Therapy/methods , Humans , Mindfulness/methods , Recurrence , Secondary Prevention/methods , Treatment Outcome
12.
J Appl Microbiol ; 131(4): 1983-1997, 2021 Oct.
Article in English | MEDLINE | ID: mdl-33704882

ABSTRACT

AIMS: To investigate the probiotic potential of yeasts isolated from naturally fermented Brazilian table olives. METHODS AND RESULTS: Eighteen yeast strains were tested in terms of: safety; survival of gastrointestinal and digestion conditions; antimicrobial activity; cellular hydrophobicity; autoaggregation ability and adhesion to epithelial cells; coaggregation and inhibition of pathogenic bacteria adhesion. Six yeasts showed favourable results for all probiotic attributes: Saccharomyces cerevisiae CCMA 1746, Pichia guilliermondii CCMA 1753, Candida orthopsilosis CCMA 1748, Candida tropicalis CCMA 1751, Meyerozyma caribbica CCMA 1758 and Debaryomyces hansenii CCMA 1761. These yeasts demonstrated resistance to 37°C, pH 2·0 and bile salts, and survived in vitro digestion (≥106  CFU per ml). Furthermore, the yeasts exhibited a hydrophobic cell surface (42·5-92·2%), autoaggregation capacity (41·0-91·0%) and adhesion to Caco-2 (62·0-82·8%) and HT-29 (57·6-87·3%) epithelial cell lines. Also, the strains showed antimicrobial activity against Salmonella Enteritidis as well as the ability to coaggregate and reduce the adhesion of this pathogen to intestinal cells. CONCLUSIONS: Autochthonous yeasts from naturally fermented Brazilian table olives have probiotic properties, with potential for development of new probiotic food products. SIGNIFICANCE AND IMPACT OF STUDY: These data are important and contribute to the knowledge of new potential probiotic yeasts capable of surviving gastrointestinal tract conditions and inhibiting pathogenic bacteria.


Subject(s)
Olea , Probiotics , Bacterial Adhesion , Caco-2 Cells , Fermentation , Humans , Saccharomyces cerevisiae , Saccharomycetales , Yeasts
13.
J Psychiatr Res ; 134: 129-137, 2021 02.
Article in English | MEDLINE | ID: mdl-33385631

ABSTRACT

OBJECTIVE: To examine which characteristics predict the time to a first mood recurrence at three years in Bipolar Disorder type I (BD-I) and type II (BD-II). METHODS: Individuals with BD were followed up to 3 years. Turbull's extension of the Kaplan-Meier analysis for interval-censored data was used to estimate the cumulative probability of recurrence over time. Separate models were performed according to BD subtype to determine which baseline factors were predictive of recurrences and were adjusted for age, gender and educational level. RESULTS: We included 630 individuals with BD-I and 505 with BD-II. The first recurrence of any polarity occurred earlier in BD-II (p = 0.03). The first depressive recurrence occurred earlier in BD-II (p < 0.0001), whereas the first (hypo)manic recurrence occurred earlier in BD-I (p = 0.0003). In BD-I, the clinical variables that were associated to the time to a first mood recurrence were depressive symptoms, lifetime rapid cycling, global activation and the number of psychotropic medications at baseline. In BD-II, the time to a first recurrence was associated with a younger age at onset of BD and a higher number of lifetime mood episodes. The Areas Under the Curve for both models were moderate. CONCLUSION: Predictors of recurrences showed few specificities to BD-I or BD-II. The ability to predict recurrences in BD based on socio-demographic and clinical variables remained too moderate for a transfer in daily practice. This study highlights the need for further studies that would include other types of predictors, such as molecular, cognitive or neuro-imaging ones, to achieve an accurate level of prediction of recurrences in BD.


Subject(s)
Bipolar Disorder , Affect , Age of Onset , Bipolar Disorder/drug therapy , Bipolar Disorder/epidemiology , Humans , Longitudinal Studies , Recurrence
14.
J Appl Microbiol ; 130(2): 341-355, 2021 Feb.
Article in English | MEDLINE | ID: mdl-32869919

ABSTRACT

The main challenge of ensiling is conserving the feed through a fermentative process that results in high nutritional and microbiological quality while minimizing fermentative losses. This challenge is of growing interest to farmers, industry and research and involves the use of additives to improve the fermentation process and preserve the ensiled material. Most studies involved microbial additives; lactic acid bacteria (LAB) have been the focus of much research and have been widely used. Currently, LABs are used in modern and sustainable agriculture because of their considerable potential for enhancing human and animal health. Although the number of studies evaluating LABs in silages has increased, the potential use of these micro-organisms in association with silage has not been adequately studied. Fermentation processes using the same strain produce very different results depending on the unique characteristics of the substrate, so the choice of silage inoculant for different starting substrates is of extreme importance to maximize the nutritional quality of the final product. This review describes the current scenario of the bioprospecting and selection process for choosing the best LAB strain as an inoculant for ensiling. In addition, we analyse developments in the fermentation process and strategies and methods that will assist future studies on the selection of new strains of LAB as a starter culture or inoculant.


Subject(s)
Lactobacillales/isolation & purification , Nutritive Value , Silage/microbiology , Silage/standards , Animals , Bioprospecting , Fermentation , Lactobacillales/classification , Lactobacillales/metabolism
15.
J Affect Disord ; 276: 963-969, 2020 11 01.
Article in English | MEDLINE | ID: mdl-32745833

ABSTRACT

BACKGROUND: Valproate is associated with teratogenic and neurodevelopmental effects. Several agencies have restricted the conditions of its prescription in bipolar disorders (BD). We aimed to assess the evolution of valproate prescription and the clinical profile of BD women of childbearing age receiving valproate. METHODS: Based on a large national cohort, we included all BD women 16-50 years old. Sociodemographic, clinical and pharmacological data were recorded. Logistic regression analyses were used to describe variables associated with valproate prescription. RESULTS: Of the 1018 included women 16-50 years old, 26.9% were treated with valproate with a mean daily dosage of 968 mg. The prevalence of BD women using valproate was 32.6% before May 2015 and 17.3% after May 2015 (p<0.001), the date of French regulatory publication of restriction of valproate prescription. The multivariate analysis revealed that the inclusion period after May 2015 (OR=0.54, CI 95% 0.37-0.78, p=0.001), the age lower than 40 years (OR=0.65, CI 95% 0.43-0.98, p=0.040) and the number of lifetime mood episodes (OR=0.98, CI 95% 0.95-0.99, p=0.040) were the variables negatively associated with the use of valproate. LIMITATIONS: Study could be underpowered to determine a clinical profile associated with valproate prescription. CONCLUSIONS: The regulatory change in BD women of childbearing age had a significant impact on valproate prescription, even if the prescription rate remains high. Important efforts are needed to help clinicians and patients to improve quality of care in BD women of childbearing age.


Subject(s)
Bipolar Disorder , Valproic Acid , Adolescent , Adult , Affect , Bipolar Disorder/drug therapy , Bipolar Disorder/epidemiology , Female , Humans , Middle Aged , Valproic Acid/adverse effects , Young Adult
16.
Encephale ; 46(5): 382-389, 2020 Oct.
Article in French | MEDLINE | ID: mdl-32475691

ABSTRACT

OBJECTIVES: Cannabis use is widespread in France, particularly among adolescents and young adults, and can induce severe somatic, psychiatric and social consequences. Early identification and appropriate care of cannabis use disorders thus constitute a major public health issue. Standardized questionnaires based on patient self-reporting are recognized as the best option for identifying cannabis use disorders because of their reliability and simplicity. METHODS: We conducted a narrative literature review on cannabis use assessment tools on PubMed and selected cannabis-specific questionnaires, validated for adolescent and/or adult populations, from scientific articles in English or French between 1995 and 2010. RESULTS: Sixteen questionnaires were found according to the inclusion criteria. The CAGE-cannabis, the CAST, the CUDIT and its revised version the CUDIT-R, the PUM and the SDS are the only ones that have good characteristics for a short screening tool adapted to daily clinical practice, namely to be brief (fewer than 10 questions) and quick handover (less than 10minutes). Only the CAST has been validated in French, and the CUDIT-R is currently being validated. In the DSM-5, diagnoses of abuse or addiction have been grouped into a single diagnosis of cannabis use disorders with different levels of severity. It is relevant that tools used for screening take into account these new diagnostic concepts. The CUDIT-R is currently the only one to be validated based on DSM-5 diagnostic criteria. CONCLUSION: Among the many questionnaires available, few are suited for daily clinical practice in France because of their complexity, their long duration or the absence of a validated French translation. The CUDIT-R has good psychometric characteristics, is simple to use, and has been validated according to the criteria of DSM-5. These questionnaires are obviously not a substitute for a clinical diagnosis and must be followed by a specialist's evaluation. However, they remain an interesting mediation, encouraging a patient's awareness and commitment to care.


Subject(s)
Cannabis , Marijuana Abuse , Adolescent , Diagnostic and Statistical Manual of Mental Disorders , Humans , Marijuana Abuse/diagnosis , Marijuana Abuse/epidemiology , Psychometrics , Reproducibility of Results , Young Adult
17.
Encephale ; 46(2): 115-122, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32057409

ABSTRACT

Several studies have investigated visual processing impairment in schizophrenia. The literature on visual exploration has described restricted scanning in schizophrenia patients. This gaze behavior is characterized by increased fixation duration, a reduced scan path length and avoidance of salient features of the face with emotional content. The aim of this paper is to give an insight on the latest update on scan path deficit. Abnormal gaze exploration was replicated in various visual stimuli. This review describes gaze patterns with stimuli that imply minimal to high cognitive process: figures, objects, faces, and scenes. Interestingly, schizophrenia patients have shown cognitive flexibility by modulating gaze scanning when they are involved in an active assignment. We will also consider scanning abnormalities in real-life environment and discuss the potential therapeutic use of eye tracking in schizophrenia. The therapeutic application of eye tracking in schizophrenia is a young emerging field in psychiatry research. The recent remediation program is based on the reorientation of visual attention on the salient features of faces. For now, this program has shown encouraging results. Further studies are needed to explore behavior in real-world situations to complement laboratory measurements to move toward a full understanding of the mechanisms underlying atypical scanning in patients with schizophrenia.


Subject(s)
Exploratory Behavior , Schizophrenic Psychology , Visual Perception , Eye Movements , Fixation, Ocular , Humans
18.
Encephale ; 46(2): 96-101, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31522835

ABSTRACT

INTRODUCTION: Simulation is a very promising educational tool. It provides medical students with clinical experience without jeopardizing patients' health. This tool can be implemented in psychiatry training in order to develop interview and specific assessment skills which is why the Université de Lorraine relies increasingly on simulation in teaching psychiatry to its residents. However, there are few objective indicators in that field that make it possible to assess learners. This study aims to assess the relevance of a quantitative measure for objectivising the investigation efficiency by psychiatry residents of a suicidal risk during a simulated psychiatric interview. METHODS: A simulation exercise was offered to 20 psychiatric trainees from the Université de Lorraine. Their mission was to identify relevant information for assessing and guiding a standardized patient with suicidal risk during a psychiatric interview. The key judgemental criterion was the I2/Q ratio which corresponds to the squared number of relevant items collected by the interviewer divided by the number of questions. When dealing with emergency cases it is indeed important to collect as many key items in as little time as possible. This score was assessed by two examiners based on the analysis of filmed interviews. RESULTS: The mean I2/Q ratio was 1.13 (SEM±0.2) and ranged between 0.25 and 2.86. Statistical analysis showed a positive correlation between I2/Q ratio and students' clinical experience (R=0.46, P=0.04). The interclass correlation coefficient (ICC) of the I2/Q ratio between the two examiners was 0.94. CONCLUSION: I2/Q ratio may provide a consistent quantitative measure of a student's efficiency in assessing suicidal risk. Further research is now needed to evaluate its consistency in other clinical cases.


Subject(s)
Interview, Psychological , Psychiatry/education , Simulation Training , Adult , Education, Medical , Empathy , Female , Humans , Internship and Residency , Male , Risk Assessment , Students, Medical , Suicide/psychology , Video Recording
19.
J Neurovirol ; 25(6): 825-836, 2019 12.
Article in English | MEDLINE | ID: mdl-31332697

ABSTRACT

Treatment-emergent depression is a common complication in patients with chronic hepatitis C virus (HCV) infection undergoing antiviral combination therapy with IFN-α and ribavirin. It has recently been shown that changes in A-to-I RNA editing rates are associated with various pathologies such as inflammatory disorders, depression and suicide. Interestingly, IFN-α induces gene expression of the RNA editing enzyme ADAR1-1 (ADAR1a-p150) and alters overall RNA editing activity. In this study, we took advantage of the high prevalence of pharmacologically induced depression in patients treated with IFN-α and ribavirin to test the interest of RNA editing-related biomarkers in white blood cells of patients. In this 16-week longitudinal study, a small cohort of patients was clinically evaluated using standard assessment methods prior to and during antiviral therapy and blood samples were collected to analyse RNA editing modifications. A-I RNA editing activity on the phosphodiesterase 8A (PDE8A) gene, a previously identified RNA editing hotspot in the context of lupus erythematosus, was quantified by using an ultra-deep next-generation sequencing approach. We also monitored gene expression levels of the ADAR enzymes and the PDE8A gene during treatment by qPCR. As expected, psychiatric evaluation could track treatment-emergent depression, which occurred in 30% of HCV patients. We show that PDE8A RNA editing is increased in all patients following interferon treatment, but differently in 30% of patients. This effect was mimicked in a cellular model using SHSY-5Y neuroblastoma cells. By combining the data of A-I RNA editing and gene expression, we generated an algorithm that allowed discrimination between the group of patients who developed a treatment-emergent depression and those who did not. The current model of drug-induced depression identified A-I RNA editing biomarkers as useful tools for the identification of individuals at risk of developing depression in an objective, quantifiable biological blood test.


Subject(s)
Antiviral Agents/adverse effects , Biomarkers/blood , Depression/blood , Depression/chemically induced , Hepatitis C, Chronic/drug therapy , RNA Editing/drug effects , 3',5'-Cyclic-AMP Phosphodiesterases/blood , 3',5'-Cyclic-AMP Phosphodiesterases/genetics , Adenosine Deaminase/blood , Adenosine Deaminase/genetics , Adult , Aged , Female , Hepacivirus , Humans , Interferon-alpha/adverse effects , Longitudinal Studies , Male , Middle Aged , Polyethylene Glycols/adverse effects , RNA Editing/physiology , Recombinant Proteins/adverse effects , Ribavirin/adverse effects
20.
J Appl Microbiol ; 127(3): 845-855, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31211890

ABSTRACT

AIMS: The aim was to isolate, identify and characterize yeasts present in rumen fluid and to select strains showing potential as probiotics. METHODS AND RESULTS: Rumen fluid was sampled from 4 herds of dairy and beef cattle and 77 yeast isolates were identified. Initial screening was based on the capacity to maintain viability in a medium with different ruminal conditions. A second screening in fresh rumen fluid to assess the growth of inoculated yeasts and evaluate in vitro neutral detergent fibre digestibility (NDF-D), pH and acid accumulation was conducted. The yeast population ranged from 3·84 to 6·76 log10 CFU per ml. The main species of yeast found were Pichia kudriavzevii, Candida rugosa, C. pararugosa, C. ethanolica and Magnusiomyces capitatus. Strains CCMA 933 (C. rugosa) and CCMA 970 (C. pararugosa) showed greater ability to survive in ruminal fluid and stimulated the production of acids. Isolate CCMA 967 (C. ethanolica) survived and improved the NDF-D. CONCLUSION: Pichia kudriavzevii was the dominant yeast found in the cattle herds. Strains CCMA 933, CCMA 970 and CCMA 967 showed properties that could be useful as potential probiotics for cattle. SIGNIFICANCE AND IMPACT OF THE STUDY: This study was the first to select yeasts from the rumen fluid, with the potential to be used as probiotic, based on the ruminal conditions.


Subject(s)
Probiotics/isolation & purification , Rumen/microbiology , Yeasts/classification , Animal Feed , Animals , Cattle , Female , Fermentation , Rumen/metabolism , Yeasts/isolation & purification , Yeasts/physiology
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