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Fond G, Boulangeat C, Messiaen M, Duba A, Boucekine M, Auquier P, Lançon C, Boyer L. Anxiety and depression in young physicians: Prevalence and associated factors. The MESSIAEN national study. Encephale 2021; 48:26-30. [PMID: 33892920 DOI: 10.1016/j.encep.2021.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/11/2021] [Accepted: 02/01/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Physicians are at risk of anxiety and depression. OBJECTIVES To determine the prevalence of anxiety and depression in a national sample of young physicians and their associated factors. METHODS The study is a cross-sectional observational epidemiological national study. An online anonymous questionnaire was administered to the young physicians of all French medical faculties. Anxiety and depression were assessed with the Hamilton Anxiety & Depression scale subscores for anxiety and depression. Psychotropic drug consumption, psychotherapy follow-up and other variables were self-declared. RESULTS Of the 2003 study participants, 32.3% reported a current anxiety disorder and 8.7% a current major depressive disorder according to their HAD scores and less than one on five of them was followed-up in psychotherapy or treated by antidepressant. Moral harassment, a bad quality of initial formation regarding dealing with disease and alcohol consumption were all associated with respectively anxiety disorder and major depression in multivariate analyses. Medical vocation was specifically associated with decreased major depression while being woman and increased coffee consumption were specifically associated with increased anxiety disorders. CONCLUSION Almost one third of medical students reported anxiety disorder or major depression and less than one on five received the recommended treatment (psychotherapy or antidepressant). The prevention and treatment of psychiatric disorders should be improved in this population. Moral harassment exposure, alcohol and coffee consumptions, bad quality of initial formation regarding dealing with disease have been identified as modifiable factors associated with poor mental health. Despite the absence of causal associations, these results yield some clues to guide future mental health prevention strategies in this population.
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Affiliation(s)
- G Fond
- Secteur Timone, EA 3279: CEReSS - Centre d'étude et de recherche sur les services de Santé et la qualité de vie, faculté de médecine, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13005 Marseille, France.
| | - C Boulangeat
- Secteur Timone, EA 3279: CEReSS - Centre d'étude et de recherche sur les services de Santé et la qualité de vie, faculté de médecine, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - M Messiaen
- Secteur Timone, EA 3279: CEReSS - Centre d'étude et de recherche sur les services de Santé et la qualité de vie, faculté de médecine, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - A Duba
- Secteur Timone, EA 3279: CEReSS - Centre d'étude et de recherche sur les services de Santé et la qualité de vie, faculté de médecine, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - M Boucekine
- Secteur Timone, EA 3279: CEReSS - Centre d'étude et de recherche sur les services de Santé et la qualité de vie, faculté de médecine, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - P Auquier
- Secteur Timone, EA 3279: CEReSS - Centre d'étude et de recherche sur les services de Santé et la qualité de vie, faculté de médecine, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - C Lançon
- Secteur Timone, EA 3279: CEReSS - Centre d'étude et de recherche sur les services de Santé et la qualité de vie, faculté de médecine, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - L Boyer
- Secteur Timone, EA 3279: CEReSS - Centre d'étude et de recherche sur les services de Santé et la qualité de vie, faculté de médecine, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13005 Marseille, France
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Fond G, Da Fonseca D, Korchia T, Sunhary De Verville P, Lancon C, Boyer L. How to treat inflammatory schizophrenia? Encephale 2020; 46:411-413. [DOI: 10.1016/j.encep.2020.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/19/2020] [Indexed: 11/18/2022]
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Fond GB, Lagier JC, Honore S, Lancon C, Korchia T, Verville PLSD, Llorca PM, Auquier P, Guedj E, Boyer L. Microbiota-Orientated Treatments for Major Depression and Schizophrenia. Nutrients 2020; 12:nu12041024. [PMID: 32276499 PMCID: PMC7230529 DOI: 10.3390/nu12041024] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/31/2020] [Accepted: 04/02/2020] [Indexed: 12/13/2022] Open
Abstract
Background and significance. There is a need to develop new hypothesis-driven treatment for both both major depression (MD) and schizophrenia in which the risk of depression is 5 times higher than the general population. Major depression has been also associated with poor illness outcomes including pain, metabolic disturbances, and less adherence. Conventional antidepressants are partly effective, and 44% of the subjects remain unremitted under treatment. Improving MD treatment efficacy is thus needed to improve the SZ prognosis. Microbiota-orientated treatments are currently one of the most promising tracks. Method. This work is a systematic review synthetizing data of arguments to develop microbiota-orientated treatments (including fecal microbiota transplantation (FMT)) in major depression and schizophrenia. Results. The effectiveness of probiotic administration in MD constitutes a strong evidence for developing microbiota-orientated treatments. Probiotics have yielded medium-to-large significant effects on depressive symptoms, but it is still unclear if the effect is maintained following probiotic discontinuation. Several factors may limit MD improvement when using probiotics, including the small number of bacterial strains administered in probiotic complementary agents, as well as the presence of a disturbed gut microbiota that probably limits the probiotics’ impact. FMT is a safe technique enabling to improve microbiota in several gut disorders. The benefit/risk ratio of FMT has been discussed and has been recently improved by capsule administration. Conclusion. Cleaning up the gut microbiota by transplanting a totally new human gut microbiota in one shot, which is referred to as FMT, is likely to strongly improve the efficacy of microbiota-orientated treatments in MD and schizophrenia and maintain the effect over time. This hypothesis should be tested in future clinical trials.
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Affiliation(s)
- Guillaume B. Fond
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France; (S.H.); (C.L.); (T.K.); (P.-L.S.D.V.); (P.A.); (L.B.)
- Correspondence:
| | - Jean-Christophe Lagier
- Aix Marseille University, Institut de Recherche pour le Développement, Microbes Evolution Phylogeny and Infection, Assistance Publique Hôpitaux de Marseille, Institut Hospitalo Universitaire Méditerranée Infection, 13005 Marseille, France;
| | - Stéphane Honore
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France; (S.H.); (C.L.); (T.K.); (P.-L.S.D.V.); (P.A.); (L.B.)
| | - Christophe Lancon
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France; (S.H.); (C.L.); (T.K.); (P.-L.S.D.V.); (P.A.); (L.B.)
| | - Théo Korchia
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France; (S.H.); (C.L.); (T.K.); (P.-L.S.D.V.); (P.A.); (L.B.)
| | - Pierre-Louis Sunhary De Verville
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France; (S.H.); (C.L.); (T.K.); (P.-L.S.D.V.); (P.A.); (L.B.)
| | | | - Pascal Auquier
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France; (S.H.); (C.L.); (T.K.); (P.-L.S.D.V.); (P.A.); (L.B.)
| | - Eric Guedj
- Aix-Marseille Université, CNRS, Ecole Centrale de Marseille, UMR 7249, Institut Fresnel, Département de médecine nucléaire, CERIMED, Aix-Marseille Université, F-13005 Marseille, France;
| | - Laurent Boyer
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France; (S.H.); (C.L.); (T.K.); (P.-L.S.D.V.); (P.A.); (L.B.)
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