Item and domain network structures of the Resilience Scale for Adults in 675 university students.

AIMS: The Resilience Scale for Adults (RSA) is a questionnaire that measures protective factors of mental health. The aim of this paper is to perform a network analysis of the RSA in a dataset composed of 675 French-speaking Belgian university students, to identify potential targets for intervention to improve protective factors in individuals. METHODS: We estimated a network structure for the 33-item questionnaire and for the six domains of resilience: perception of self, planned future, social competence, structured style, family cohesion and social competence. Node predictability (shared variance with surrounding nodes in the network) was used to assess the connectivity of items. An exploratory graph analysis (EGA) was performed to detect communities in the network: the number of communities detected being different than the original number of factors proposed in the scale, we estimated a new network with the resulting structure and verified the validity of the new construct which was proposed. We provide the anonymised dataset and code in external online materials (10.17632/64db36w8kf.2) to ensure complete reproducibility of the results. RESULTS: The network composed of items from the RSA is overall positively connected with strongest connections arising among items from the same domain. The domain network reports several connections, both positive and negative. The EGA reported the existence of four communities that we propose as an additional network structure. Node predictability estimates show that connectedness varies among the items and domains of the RSA. CONCLUSIONS: Network analysis is a useful tool to explore resilience and identify targets for clinical intervention. In this study, the four domains acting as components of the additional four-domain network structure may be potential targets to improve an individual's resilience. Further studies may endeavour to replicate our findings in different samples.

[Childhood in sex offenders; A retrospective study]. / L'enfance chez les auteurs de crimes sexuels; une étude rétrospective.

BACKGROUND: This retrospective and observational study is based on the hypothesis that sex offenders have experienced trauma and/or educational dysfunction which have a responsibility in theirs crimes of sexual type. The purpose of this study is to highlight these disturbances, develop a typology of sex offenders and offer a reflection on elements which allowed their acting out. METHODS: Two groups were selected. A group of 31 patients having committed criminal offences or murders and having been determined as mentally irresponsibles of their act (" Défense Sociale " in Belgium). This group was compared to a group of 31 patients consulting a general practitioner. A survey and a personal interview were used. Most of this questions came from Thomas Achenbach's Child Behavior Checklist (this questionnaire highlight psychiatric disorders or pathological behaviors in childhood). The inclusion criteria were: male patients major in social defense; single or series rape(s) (accompanied or not by murder); incest; pedophilia; intelligence quotient greater than or equal to 80 (determined by the scale WAIS). RESULTS: The anova test results showed a statistically significant difference between the two groups (p ⟨ 0,00063). Several different profiles of rapists were established. CONCLUSION: Indeed, patient group shows more trauma such as sexual abuse (9.8 times more) and physical abuse (3.1 times more) than the control group. Three factors were identified as a condition to an achieved rape: a pathological family dynamic, impaired impulse control and an empathic deficit.

INTRODUCTION: Cette étude rétrospective et observationnelle se base sur une hypothèse de travail postulant que les délinquants sexuels auraient évolué dans une dynamique familiale pathologique comprenant des dysfonctions éducatives et/ou des éléments traumatiques. Les buts de cette étude sont de mettre en évidence les perturbations familiales qu'ils auraient subies durant l'enfance, d'élaborer une typologie actuelle de ces délinquants en défense sociale et de proposer une réflexion sur les éléments qui ont permis leur passage à l'acte. METHODES: Deux groupes ont été sélectionnés. Le groupe de patients est représenté par 31 AICS (Auteurs d'Infractions à Caractère Sexuel) choisis aléatoirement en Défense Sociale belge en 2013 et ayant répondu à un questionnaire. Ce groupe a été comparé à un autre groupe de 31 patients ayant répondu au même questionnaire anonyme dans la salle d'attente d'un médecin généraliste. Ce questionnaire a été inspiré de la Child Behavior Checklist qui est utilisée pour mettre en évidence des comportements pathologiques de l'enfant et de l'adolescent. Les questions étaient donc ciblées dans leur passé, lorsqu'ils étaient enfants et adolescents. RESULTATS: Le test anova (p ⟨ 0,00063) montre une différence significative des scores entre les deux groupes pour les questions fermées. En effet, le groupe d'AICS présente un score plus élevé dans les paramètres scorés des réponses fermées (plus d'abus sexuels, plus de toxicomanies, etc.). Pour les pédophiles, l'étude a permis de mettre en évidence plusieurs facteurs qui orientent la pulsion sexuelle préférentiellement vers l'enfant plutôt que vers l'adulte. Les violeurs de femmes adultes semblent présenter davantage de traits sadiques. Différents profils d'AICS ont pu être établis. CONCLUSION: Le passage à l'acte du viol met en évidence sur les patients de l'étude trois facteurs nécessaires à son déroulement : une dynamique familiale pathologique, des troubles du contrôle des impulsions et un déficit empathique. Les résultats de cette recherche pourraient permettre d'apporter des informations concernant les différentes étiologies motivant leur passage à l'acte afin de mieux cibler le traitement pour diminuer le risque de récidive.

[Support for insomnia : Recommendations for practice in general medicine]. / Prise en charge de l'insomnie : Recommandations pour la pratique en médecine générale.

In Belgium, poor sleep complaints are numerous and frequent in the general population. Of these complaints, one of the most important is insomnia. Acute onset and chronicity of insomnia can be explained by different models based on genetic criteria, neurophysiological, neuroendocrine, neuroimmunological and neuroimaging. Insomnia can be associated with a lot of somatic and psychiatric comorbidities. The diagnosis of insomnia is primarily a clinical diagnosis based on medical history and physical examination. Different tools can help us in our approach, such as self-questionnaires and sleep diaries while additional tests (polysomnography and actigraphy) should be reserved for research of associated sleep disorders and for unclear situations. The management of insomnia can be non-drug treatment (exercise, light therapy, acupuncture and self-treatment cognitive behavioral therapy) but also drug treatment (benzodiazepine, Z-DRUGS, melatonin, antidepressants, herbal medicines, neuroleptics and antihistaminics). Each of these approaches has advantages and disadvantages that must be considered when choosing treatment. The aim of this review is to allow general practitioners to better understand the mechanisms of insomnia and to have recommendations for the diagnosis and treatment of insomnia.

En Belgique, les plaintes de mauvais sommeil sont multiples et fréquentes dans la population générale. Parmi ces plaintes, l'une des plus importantes est l'insomnie. La survenue aiguë et le passage à la chronicité de l'insomnie peuvent être expliqués par différents modèles reposant sur des critères génétiques, neurophysiologiques, neuroendocriniens, neuroimmunologiques et de neuroimageries. L'insomnie peut être associée à de nombreuses comorbidités somatiques et psychiatriques. Le diagnostic de l'insomnie est avant tout un diagnostic clinique reposant sur l'anamnèse médicale et l 'examen physique. Différents outils peuvent nous aider dans notre démarche, tels que les auto-questionnaires et les agendas de sommeil tandis que les examens complémentaires (polysomnographie et actimétrie) sont à réserver à la recherche de pathologies du sommeil associées et pour les situations peu claires. La prise en charge de l'insomnie peut être non médicamenteuse (exercice physique, luminothérapie, acupuncture, auto-traitement et thérapie cognitivocomportementale), mais aussi médicamenteuse (benzodiazépines, Z-DRUGS, mélatonine, antidépresseurs, médicaments à base de plantes, neuroleptiques et antihistaminiques). Chacune de ses approches présente des avantages et des inconvénients dont il faudra tenir compte lors du choix du traitement. Le but de cette revue est de permettre aux médecins généralistes de mieux comprendre les mécanismes de l'insomnie et de disposer de recommandations pour le diagnostic et le traitement de l'insomnie.

[The contribution of neuroscience research to the study of empathy]. / L'apport de la recherche en neurosciences à l'étude de l'empathie.

The study of the cerebral mechanisms underlying empathy lies currently at the heart of neuroscience research. This process which can be defined as "the ability to put oneself into other's shoes in order to feel his emotions and feelings", constitutes a basic skill in any interpersonal relationship, particularly in the caregiver-patient relationship. In addition, the study of empathy impairements offers new ways to approach diverse mental disorders such as autism or psychopathy. However, it is essential to identify how the brain processes empathy in healthy subjects before studying its impairements. The purpose of this paper will then be to synthesize what the neuroscience research already identified thanks to the numerous works in neurophysiology, neuroimaging and lesion studies. We will also mention some limitations of this field of research and end the paper with its future perspectives.

Absence of systematic relationships between REMS duration episodes and spectral power Delta and Ultra-Slow bands in contiguous NREMS episodes in healthy humans.

Previous studies in animals and humans have reported correlations between the durations of rapid eye movement sleep (REMS) episodes and immediately preceding or subsequent non-REMS (NREMS) episodes. The relationship between these two types of sleep is a crucial component in understanding the regulation and neurophysiology of ultradian alternations that occur during sleep. Although the present study replicated previous studies, we also measured NREMS in terms of spectral power Delta and Ultra-Slow bands in addition to duration in examining correlations. The spectral power Delta band, also known as slow-wave activity, measures sleep quantity and is believed to reflect sleep physiology better than mere episode durations. The Ultra-Slow spectral power band was analyzed in parallel. Healthy human participants of both sexes (n = 26, age range 15-45 yr, n = 12 female) were carefully selected to participate in two consecutive series of home polysomnograms performed after 2 nights of habituation to the equipment. In the analyses, REMS episode durations (minutes) were compared with immediately preceding and immediately subsequent NREMS episodes (Delta and Ultra-Slow power) in each sleep cycle. REMS episode duration was more strongly correlated with preceding NREMS episodes than with subsequent NREMS episodes. However, in most cases, no correlations were observed in either direction. One ultradian sleep regulation hypothesis, which is based on stronger correlations between REMS and subsequent NREMS episode durations, holds that the main purpose of REMS is to reactivate NREMS during each sleep cycle. The present results do not support that hypothesis.

[Anorexia nervosa: bioelectrical impedance analysis in body composition measurement during hospitalization]. / Anorexie mentale: etude de la composition corporelle mesurée par impédancemétrie en cours d'hospitalisation.

Monitoring parameters for anorexia nervosa include clinical, biological and psychological factors. Many research groups are currently trying to identify parameters more likely to predict the severity or the evolution of the illness. Body composition has been proposed as one of those parameters. The aim of the present study is to demonstrate that measures of body composition are more accurate and efficient than the use of body composition index (BMI). We also aim to show that body composition could be used as a prognostic factor in the long-term evolution of patients with anorexia nervosa. It's a retrospective study investigating body composition and BMI in 44 patients treated in a specialized unit for eating disorder. Measures of body composition and BMI were gathered at the time of admission and again 3 months after refeeding onset. Data was correlated to the EDI-2 questionnaire scores. BMI and %FM where found to be increased (P < 0.05) between admission and after 3 months refeeding. The double objective of reaching a BMI value > or = 20 kg/m2 and a %FM value > or = 2% was achieved by 22% of patients. No significant correlation was found between EDI-2 scores and measures of BMI and %FM either on admission or after the 3 months refeeding period. In conclusion, results of our study don't allow concluding for a prognostic superiority of %FM. Nonetheless, BMI currently used as a reference for the monitoring of eating disorders patients seems to lack sensitivity where measures of body composition seem more informative regarding nutritional status. Furthermore, fat mass plays an important role in other clinical manifestations. In addition, measures of body composition should allow more individualised therapeutic support.

[Attention-deficit/hyperactivity disorder (ADHD) and child maltreatment: a review]. / Trouble déficitaire de l'attention avec hyperactivité (TDAH) et maltraitance durant l'enfance: revue de la littérature.

Attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder of childhood with a prevalence rate of 5 % among school-age children. This disorder have a strong impact on parent-child relationships. This review synthesizes recent research evidence regarding the rate of child abuse among ADHD children. At least one per 30 chidren have been maltreated in a general population. All authors are asking for better prevention of abuse by a better knowledge of which children are at greater risk of abuse. ADHD children, like children with disabilities, are most frequently maltreated. In this group of children, abuse are often associated with co-occurrence of oppositionnal defiant disorder (ODD) or behavioral difficulties. Maltreated ADHD children have an increased risk of substance use disorders (SUDs) at adolescence. Through this review, we hypothesize about the reasons of an increased risk of abuse by ADHD children. With our clinical experience, we will try to plan prevention and detection strategies about abuse in ADHD children, which have a strong impact on children's pronostic.

[Treatment by Bach flowers: magical potion or factual medicine? A review of the literature]. / Traitement par fleurs de Bach: pensée magique ou médecine factuelle? Revue de la littérature.

In 1930, Dr Edward Bach developed flower essences known as Bach flowers. Today, over 70 years later, they are becoming more and more popular and are used by many practitioners, despite a total lack of scientific support for their use. A review of the literature on the controversial use of this alternative treatment is discussed.

[Psychotropics, pregnancy, lactation and neurodevelopmental issues: a review]. / Psychotropes, grossesse, allaitement et conséquences neurodéveloppementales: une revue de la littérature.

Young women are at risk of mental problem during pregnancy and postpartum. It is particularly important that the mental health of childbearing women is stable. However, all psychotropic medications diffuse across the placenta and are excreted into breast milk. The fetus is thus at risk of teratogenicity and postnatal behavioural sequelae. Which are today the psychotropics that can take up the challenge of minimizing the risk for the foetus and at the same time limiting the impact of morbidity on the mother ? Medical literature of last ten years is reviewed. The safety issue of psychotropic's use during pregnancy and lactation is still unresolved. Little information is available concerning developmental outcome of children exposed to medication, especially about newer molecules even though recent case reports are encouraging. Larger standardized studies are still needed.

[The serial murder: a few theoretical perspectives]. / Le meurtre en série: quelques perspectives théoriques.

Despite numbers of publications and effort to try to establish the definition, the classification, the epidemiology, the clinical aspects and the psychopathology of serial killers, a universal consensus seems to say the least. Crime, though reduced in some countries, appears to impact more and more consistent worldwide, generating controversial ideas and a multitude of possible explanations. The serial killer usually presents as a caucasian man, aged between 20 and 40 years, often embedded socially and in his family, but with serious psychiatric, personal and especially family history. Usually acting alone, the serial killer plans a crime well in advance, but sometimes within the scope of impulsivity for a minority, the victim not being previously selected. In the latter case, an actual mental illness like psychosis is found. It is clear from numerous psychopathological studies conducted so far that most serial killers are defined as psychopathic sexual sadists, whose childhood was difficult, if not flouted, punctuated by physical and psychological violence situations. In addition, pervasive fantasies combined with thoughts of death, sex and violence are as much in common with the original acts of which they are the instigators. Beyond a relentless media that is constantly watering the public with stories and pictures depicting them as such, serial killers remain an enigma. We can therefore attempt to answer the various questions raised by this phenomenon, the way these people operate and how we can curb the rise, thanks to the neurobiological and neurophysiological approaches that science offers us.

[The female psychopath: a review]. / La psychopathie féminine: une revue de la littérature.

Psychopathy related research has traditionally focused on males. Today, numerous evidences testify to the existence of the disorder in women. Nevertheless the possibility to transpose this concept unchanged to women is debated, as it was initially developed in male populations. Current researches didn't notice major gender differences in the structure of the disorder. Nevertheless, one note differences in the prevalence measurement and in the mean score of psychopathy according to usual diagnostic scales. The prevalence rates are generally lower among women, and men seem to have higher mean scores on psychopathy measures. Furthermore, man and woman share most of interpersonal and affective traits as well as psychopathic behaviours, but they may rely on different tactics to achieve the same goals. Considering these differences, the increase of the female criminality speaks to the need for understanding more the construct of the disorder in women, for validating results already obtained with larger samples and for developing objective and adapted evaluating instruments to predict reliably reoffends, institutional structures and treatment response. Secondly it would be interesting to enlighten early factors that may affect, predict or moderate the expression of the disorder, in a preventive goal.

Decreased neuroautonomic complexity in men during an acute major depressive episode: analysis of heart rate dynamics.

Major depression affects multiple physiologic systems. Therefore, analysis of signals that reflect integrated function may be useful in probing dynamical changes in this syndrome. Increasing evidence supports the conceptual framework that complex variability is a marker of healthy, adaptive control mechanisms and that dynamical complexity decreases with aging and disease. We tested the hypothesis that heart rate (HR) dynamics in non-medicated, young to middle-aged males during an acute major depressive episode would exhibit lower complexity compared with healthy counterparts. We analyzed HR time series, a neuroautonomically regulated signal, during sleep, using the multiscale entropy method. Our results show that the complexity of the HR dynamics is significantly lower for depressed than for non-depressed subjects for the entire night (P<0.02) and combined sleep stages 1 and 2 (P<0.02). These findings raise the possibility of using the complexity of physiologic signals as the basis of novel dynamical biomarkers of depression.

Altered interaction between cardiac vagal influence and delta sleep EEG suggests an altered neuroplasticity in patients suffering from major depressive disorder.

OBJECTIVE: Major depressive disorder (MDD), which is associated with altered neuroplasticity and increased relative cardiac sympathic activity, enhances the risk of cardiovascular pathologies. Interaction between cardiac sympatho-vagal indexes and delta sleep power is probably altered in MDD. METHOD: Sleep characteristics and cardiac sympatho-vagal indexes of 10 depressive patients were compared to 10 control men across the first three non-rapid eye movement (NREM)-REM cycles. Interaction between normalized high frequency (HF) and delta power bands was studied using coherence analysis. RESULTS: Patients showed increased sleep latency, stage 1 and wake durations. No differences in heart rate variabilities were observed: Total power, HF and RR-interval decreased from NREM to REM sleep and wakefulness in both groups. Gain value was lower in patients while coherence and phase shift were similar between groups. Modifications in HF appear 8 min before modifications in delta. CONCLUSION: Major depressive disorder is related to an altered link between cardiac vagal influence and delta sleep, suggesting disorders in cardiovascular controls and an altered neuroplasticity.

The impact of chronic primary insomnia on the heart rate--EEG variability link.

OBJECTIVE: To determine if chronic insomnia alters the relationship between heart rate variability and delta sleep determined at the EEG. METHODS: After one night of accommodation, polysomnography was performed in 14 male patients with chronic primary insomnia matched with 14 healthy men. ECG and EEG recordings allowed the determination of High Frequency (HF) power of RR-interval and delta sleep EEG power across the first three Non Rapid Eye Movement (NREM)-REM cycles. Interaction between normalized HF RR-interval variability and normalized delta sleep EEG power was studied by coherency analysis. RESULTS: Patients showed increased total number of awakenings, longer sleep latency and wake durations and shorter sleep efficiency and REM duration than controls (p<.01). Heart rate variability across first three NREM-REM cycles and sleep stages (NREM, REM and awake) were similar between both groups. In each group, normalized HF variability of RR-interval decreased from NREM to both REM and awake. Patients showed decreased linear relationship between normalized HF RR-interval variability and delta EEG power, expressed by decreased coherence, in comparison to controls (p<.05). Gain and phase shift between these signals were similar between both groups. CONCLUSIONS: Interaction between changes in cardiac autonomic activity and delta power is altered in chronic primary insomniac patients, even in the absence of modifications in heart rate variability and cardiovascular diseases. SIGNIFICANCE: This altered interaction could reflect the first step to cardiovascular disorders.

Working conditions predict incidence of long-term spells of sick leave due to depression: results from the Belstress I prospective study.

BACKGROUND: During the last few years, a high incidence of sick leave due to depression has been reported, resulting in important economic and social impacts. Only a limited number of studies investigating the influence of psychosocial working conditions on sick leave have been prospective and have utilised a valid methodology, while none have studied sick leave due to depression. In this study, the impact of adverse psychosocial working conditions is analysed on the risk for long-term sick leave due to depression. METHODS: This study resulted from the large-scale Belstress I study on the relationship between perceived job stress and health problems. Subjects were Belgian employees selected from 11 large companies (n = 9396). Using a longitudinal design, the association between the three Karasek stress dimensions (job control, psychological demand, and social support) was explored, separately and combined according to the demand-control and demand-control-support models and the incidence of long-term sick leave for depression as diagnosed by the family physician. RESULTS: After adjusting for age, occupational categories, living situation, and baseline depression score, 'passive jobs' (OR 2.67; 95% CI 1.15 to 6.19) and 'high strain' jobs (OR 3.23; 95% CI 1.40 to 7.43) predicted sick leave due to depression at follow-up in men. Job control predicted sick leave due to depression in both men (OR 2.43; 95% CI 1.27 to 4.66) and women (OR 2.21; 95% CI 1.05 to 4.68). CONCLUSIONS: This study provides evidence that the psychosocial working environment influences long-term sick leave due to depression. Efforts to improve skill discretion and decision authority at work could help prevent depression.

[Psychopathy: from "The Mask of Sanity" to social neurosciences]. / La psychopathie: depuis "The Mask of Sanity" aux neurosciences sociales.

Although psychopathy has traditionally been cited as a disorder of personality, confusion arises as the term is used interchangeably with the terms antisocial personality disorder of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV TR) or dissocial personality disorder, both of which are largely behaviorally based. This paper aims to provide a clinical and scientific overview of the literature on the topic of psychopathy, which examines this conundrum. This article begins with a wee bit of history about Hervey Cleckley's work, The Mask of Sanity, and then presents the definitions and nosography of psychopathy, focusing on the distinction between the antisocial psychopath and the successful psychopath. The discussion will then lead on the epidemiological aspects and diagnosis, especially psychometric and measurement tools used to assess psychopathy in the individual: Hare's Psychopathy Checklist-Revised (PCL-R), as this is the most frequently used and validated measure of psychopathy. The second section of the article reviews several studies dealing with structural and functional neuroimaging in psychopaths. The final part of this overview considers the treatment and interventions that are available to psychopathic offenders and the implications for future research, especially in terms of prevention. This review demonstrates that studies and further research are still required in psychopathy, particularly using functional neuroimaging techniques, as fMRI and magnetoencephalography, that can describe the functional neuroanatomy of human emotion. Today, cognitive and social neurosciences constitute one of the most promising way to study psychopathy.

[Confirmatory factor analysis of the French version of the emotional intelligence inventory]. / Analyse confirmatoire de la version française de l'inventaire d'intelligence émotionnelle.

BACKGROUND: In the context of the increasing interest in the study and assessment of emotional abilities in psychology, we translated into French and evaluated the construct validity of the emotional intelligence inventory (EII) designed in English [Psychol Rep; 88 (2001):353-64]. This self-rating scale is modelled along the theoretical constructs of the Mayer, Caruso and Salovey's model [Intelligence; 27 (1999):267-98]; it comprises 41 items tapping the four following factors: (1) empathy; (2) utilization of feelings, (3) handling relationships and; (4) self-control. METHODS: One thousand three hundred and thirty-five students (42.7% men) with a mean age of 19.6 years and affiliated to several school and faculties participated to this Belgian interuniversity study. They were administered the French version of the EII, as well as a series of related questionnaires. Confirmatory factor analyses (CFA) were applied to these data and various fit indices examined in order to assess the factorial adjustment to the data of the four-factor a priori structure. RESULTS: CFA did not support the original 41-item four-factor structure for the scale in French, but a good statistical fit to the data could be obtained with the reduction of the scale to 20 items. The content of the resulting item set, keeping Tapia's four factors, encourages a revision of the domain covered by the subscales. CONCLUSION: Further efforts should be directed at assessing the content validity of the proposed revised scale as a reliable tool in measuring emotional intelligence by self-report.

[Three pregnancies on nasal CPAP: a case report]. / Trois grossesses sous CPAP nasale: à propos d'une observation.

We report on a sleepy woman, suffering from morbid obesity, with a diagnosis of severe sleep apnea syndrome made at the age of 30 year, treated with nocturnal ventilatory support (nasal CPAP). The patient had an history of preeclampsia during a first pregnancy. In the following years, this patient remained very compliant with nasal CPAP, was no longer sleepy and was three times pregnant, without any complication.

Ultradian cycles in mice: definitions and links with REMS and NREMS.

Sleep can be organized in two quite different ways across homeothermic species: either in one block (monophasic), or in several bouts across the 24 h (polyphasic). Yet, the main relationships between variables, as well as regulating mechanisms, are likely to be similar. Correlations and theories on sleep regulation should thus be examined on both types of sleepers. In previous studies on monophasic humans, we have shown preferential links between the number of ultradian cycles and the rapid eye movement sleep (REMS) time, rather than with its counterpart non-rapid eye movement sleep (NREMS). Here, the sleep of 26 polyphasic mice was examined, both to better describe the NREMS distribution, which is far more complex than in humans, and to replicate the analyses performed on humans. As in humans, the strongest links with the number of cycles were with REMS. Links were not significant with NREMS taken as a whole, although positive correlations were found with the NREMS immediately preceding REMS episodes and inversely significant with the residue. This convergence between monophasic and polyphasic patterns supports the central role played by REMS in sleep alternation.

The modifications of the long-range temporal correlations of the sleep EEG due to major depressive episode disappear with the status of remission.

OBJECTIVE: The aim of the present study is to investigate the scaling properties of the sleep electroencephalogram (EEG) in remitted depressed men, and to evaluate if a past history of major depressive disorder (MDD) could modify significantly and definitively, as a "scar marker," the dynamics of the sleep EEG time series. METHODOLOGY: Whole night sleep electroencephalogram signals were recorded in 24 men: 10 untreated depressed men in full to partial remission (42.43+/-5.62 years) and 14 healthy subjects (42.8+/-8.55 years). Scaling properties in these time series were investigated with detrended fluctuation analysis (DFA) (time range: 0.16-2.00 s). The scaling exponent alpha was determined in stage 2, in slow wave sleep (stages 3 and 4), and during rapid eye movement (REM) sleep. Forty-five epochs of 20 s were chosen randomly in each of these stages for each subject in both groups. RESULTS: We did not observe a significant difference and deviation of the scaling exponents between the two groups during the three sleep stages of interest. CONCLUSION: In this study, we do not observe any functional sequelae of a past history of one or more unipolar major depressive episode on the fluctuation properties of the sleep EEG. This finding is a sign of similar underlying neuronal dynamics in healthy controls and patients with a lifetime history of MDD. This study gives an additional argument to the theory that depression does not modify definitively the dynamics of the neuronal networks and is therefore against the "depressive scar hypothesis," in which permanent residual deficit is created by the acute state of the depressive disease.