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Pouchon A, Bertrand A, Polosan M, Dondé C. Simulation-based teaching of psychiatric interviewing to residents: A comparison of peer-to-peer and teacher role-play on confidence in clinical skills. Encephale 2024:S0013-7006(24)00017-4. [PMID: 38423858 DOI: 10.1016/j.encep.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To compare the effects of two simulation-based teaching programs of psychiatric interviewing using two role-play modalities on first-year psychiatry residents' confidence in their psychiatric clinical skills. METHODS The teaching program consisted of seven 2-hour sessions per month led by two psychiatrists and academic teachers. In the peer-to-peer role-play group, students played either the patient's or doctor's role, and case scenarios were proposed by the students; in the teacher role-play group, a teacher played the patient' role and case scenarios were written by teachers. Simulation debriefing was teacher-guided in both groups. Confidence was measured with the Confidence in Psychiatric Clinical Skills Questionnaire (CPCQ) before and after the teaching program. RESULTS Both strategies induced a significant improvement in the CPCQ total score. However, the peer-to-peer role-play program induced a significantly larger improvement in the CPCQ total score. DISCUSSION Compared to teacher role-play, peer-to-peer role-play may enable a better comprehension of the patient perspective, reduce performance anxiety during the simulated scenario, and provide a partly improvised scenario that is more transferable to real-life clinical experiences. CONCLUSION Teaching psychiatric interviewing using the peer-to-peer role-play approach enables greater improvement in confidence in clinical skills than teacher role-play.
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Affiliation(s)
- Arnaud Pouchon
- Univ. Grenoble Alpes, Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, 38000 Grenoble, France
| | - Antoine Bertrand
- Univ. Grenoble Alpes, Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, 38000 Grenoble, France
| | - Mircea Polosan
- Univ. Grenoble Alpes, Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, 38000 Grenoble, France
| | - Clément Dondé
- Univ. Grenoble Alpes, Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, 38000 Grenoble, France.
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Mallet J, Dondé C, Dubertret C, Gorwood P. Patients' awareness of recovery mediates the link between clinical and level of functional remission in schizophrenia to a larger extent in those treated with long-acting antipsychotics. Ther Adv Psychopharmacol 2024; 14:20451253241231269. [PMID: 38370363 PMCID: PMC10874148 DOI: 10.1177/20451253241231269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Background Clinical remission is a step towards functional remission for subjects with schizophrenia. While recovery is both a subjective personal journey and a clinical outcome to be targeted, data on patient self-rated outcomes are scarce. Objectives (i) To determine the extent to which the association between clinical and functional remission is mediated by the subjective experience of recovery as reported by patients versus their relatives or their psychiatrist and (ii) to assess differences according to treatment, specifically with oral antipsychotics only versus long-acting injectable antipsychotics (LAIs). Design Clinical observational study. Methods Community-dwelling participants with schizophrenia enrolled in the EGOFORS cohort (N = 198) were included. Clinical symptoms and remission were assessed using the Positive and Negative Syndrome Scale. Functional remission was assessed with the Functional Remission of General Schizophrenia Scale. Awareness of recovery was assessed with one question 'What percentage of recovery do you think you have now (from 0% - no recovery - to 100% - full recovery)?', asked of the patient, also of the patient's close relative, and the psychiatrist. We used mediation analyses, taking into account the type of pharmacological treatment. Results Remission criteria and perceived remission measures were significantly correlated, both within and between groups (r > 0.330). The patient's awareness of recovery mediated the relationship between clinical remission and level of functional remission, while the level of recovery according to psychiatrists or close relatives did not. The direct effect of clinical remission on the level of functional remission became non-significant when taking into account the mediator (patients' awareness of recovery) in the group of patients with LAI (t = 1.5, p = 0.150) but not in the group of patients with other treatments (t = 3.1, p = 0.003). Conclusion Patients with LAIs may be more efficient in reporting their level of functional remission. Higher patient awareness could be an interesting candidate to explain this. However, as the study was cross-sectional, such a proposal should be tested with a more specifically designed protocol, such as a long-term cohort.
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Affiliation(s)
- Jasmina Mallet
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (INSERM UMR1266), Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
- Psychiatry Department, CH Alpes-Isère, Saint-Egrève, France
| | - Caroline Dubertret
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (INSERM UMR1266), Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Philip Gorwood
- Université Paris Cité, GHU Paris Psychiatrie et Neurosciences, Clinique des Maladies Mentales et de l'Encéphale (Sainte-Anne Hospital), 100 rue de la Santé, Paris 75014, France
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM UMR1266, Paris, France
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Dondé C, Fivel L, Haesebaert F, Poulet E, Mondino M, Brunelin J. Mechanistic account of the left auditory cortex for tone-matching in schizophrenia: A pilot transcranial random noise stimulation (tRNS) sham-controlled study. Asian J Psychiatr 2024; 92:103879. [PMID: 38157711 DOI: 10.1016/j.ajp.2023.103879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Deficits in the ability to match tones following brief delay and their contribution to higher-order cognitive alterations have been repeatedly documented in schizophrenia. The aim was to explore if left fronto-temporal high-frequency transcranial random noise stimulation (hf-tRNS), with electrodes placed over brain regions involved in tone-matching would significantly modulate performances in participants with schizophrenia. METHODS In a randomized, double-blind sham-controlled study, 10 participants with schizophrenia were allocated to receive ten sessions of either active or sham hf-tRNS. The anode was placed over the left prefrontal cortex and the cathode over the left temporoparietal junction. A tone-matching task was administered before and after the hf-tRNS. RESULTS We calculated the changes in tone-matching performance before and after hf-tRNS session in each group. A significant between-group difference was observed for the difficult tone-matching conditions (W= 14.500, p = 0.032), with tone-matching improvement in the sham group and no improvement in the active group. DISCUSSION hf-tRNS could disrupt the test-retest learning effect in the tone-matching task in individuals with schizophrenia. It is likely that this disruption resulted from cathodal-induced inhibition of the functional coupling between auditory cortical areas that correlates with tone-matching performance in patients. CONCLUSION The findings contribute to our understanding of hf-tRNS effects on early auditory processing in schizophrenia.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000 Grenoble, France; INSERM, U1216, Grenoble institute Neurosciences, F-38000 Grenoble, France; Adult Psychiatry Department, University Hospital Grenoble Alpes, F-38000 Grenoble, France.
| | - Laure Fivel
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Fréderic Haesebaert
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Emmanuel Poulet
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Marine Mondino
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Jérôme Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France.
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Dondé C, Coulon N, Turbé H, Andre M, Boyer L, Capdevielle D, Chereau I, Dassing R, Dorey JM, Dubertret C, Leignier S, Llorca PM, Misdrahi D, Passerieux C, Pignon B, Rey R, Schorr B, Schürhoff F, Urbach M, Fond G, Mallet J. Clinical and cognitive characteristics of subjects with schizophrenia and childhood attention-deficit/hyperactivity disorder: Results from the multicentric FACE-SZ cross-sectional dataset. Schizophr Res 2024; 264:105-112. [PMID: 38128341 DOI: 10.1016/j.schres.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/28/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Childhood Attention-deficit/hyperactivity disorder (C-ADHD) is a neurodevelopmental disorder, associated with an increased risk of subsequent schizophrenia. The objective of the present study was to determine the prevalence of C-ADHD in schizophrenia and the clinical and cognitive characteristics associated with C-ADHD history in schizophrenia. METHODS 569 subjects with schizophrenia (74 % men, mean age 30.8) were included in ten expert centers at a national level and tested with a comprehensive battery of clinician-rated, patient-reported scales and cognitive tests. C-ADHD was assessed with the WURS (Wender Utah Rating Scale) self-report questionnaire. Multivariate, correlation, and principal component analyses (PCA) were conducted. RESULTS Thirty-nine subjects (N = 39, 6.9 %) were classified in the C-ADHD group. Compared to those without C-ADHD, subjects with C-ADHD were more frequently male, had lower education levels, more severe positive clinical symptoms, more subjective cognitive deficits complaints, and lower medication adherence with small to medium effect sizes. Two cognitive components emerged from the PCA, one component including perceptual reasoning and working memory, and another component including visuospatial search and graphomotor speed, cognitive inhibition/flexibility and central executive functioning. Both components were associated with lower performances in the C-ADHD group. CONCLUSIONS C-ADHD is frequent in schizophrenia and associated with more severe positive symptoms and impaired cognitive performances compared to those without C-ADHD. This suggests that the pathophysiological mechanisms contributing to these disorders may lead to the worsening of the cognitive functioning in patients with both disorders. C-ADHD is a relevant clinical marker to discriminate subgroups of schizophrenia with different profiles for a precision-psychiatry approach.
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Affiliation(s)
- Clément Dondé
- Fondation Fondamental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, France; Adult Psychiatry Department CHU Grenoble Alpes, 38000 Grenoble, France; Psychiatry Department, CH Alpes-Isère, F-38000 Saint-Egrève, France.
| | - Nathalie Coulon
- Fondation Fondamental, Créteil, France; Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Hugo Turbé
- Fondation Fondamental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Myrtille Andre
- Fondation Fondamental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Laurent Boyer
- Fondation Fondamental, Créteil, France; AP-HM, Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Delphine Capdevielle
- Fondation Fondamental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation Fondamental, Créteil, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, EA 7280 Clermont-Ferrand, France
| | - Romane Dassing
- Fondation Fondamental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Jean-Michel Dorey
- Fondation Fondamental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Caroline Dubertret
- Fondation Fondamental, Créteil, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
| | - Sylvain Leignier
- Fondation Fondamental, Créteil, France; Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Pierre-Michel Llorca
- Fondation Fondamental, Créteil, France; University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - David Misdrahi
- Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France; Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France; University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), France
| | - Christine Passerieux
- Fondation Fondamental, Créteil, France; Versailles Hospital, Department of Adult Psychiatry and Addictology, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines, 94807 Villejuif, France
| | - Baptiste Pignon
- Fondation Fondamental, Créteil, France; Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, Créteil, France
| | - Romain Rey
- Fondation Fondamental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Benoît Schorr
- Fondation Fondamental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Franck Schürhoff
- Fondation Fondamental, Créteil, France; Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, Créteil, France
| | - Mathieu Urbach
- Fondation Fondamental, Créteil, France; Versailles Hospital, Department of Adult Psychiatry and Addictology, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines, 94807 Villejuif, France
| | - Guillaume Fond
- Fondation Fondamental, Créteil, France; AP-HM, Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Jasmina Mallet
- Fondation Fondamental, Créteil, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
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Chevillotte E, Dondé C. Peer workers to address discrimination against women in psychiatry and mental health. Encephale 2024; 50:108-110. [PMID: 37400333 DOI: 10.1016/j.encep.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/27/2023] [Accepted: 05/04/2023] [Indexed: 07/05/2023]
Abstract
Compared to the general population and to males with mental health disorders, women with these disorders face more obstacles in psychiatric and mental health care settings. This strongly encourages mental health policies and psychiatric care to consider specific strategies that prevent gender bias in treatment among women with mental health issues. A growing body of research demonstrates the benefits of having peer workers-professionals with a lived experience of mental health issues who use their own experiences of mental distress to support others with comparable experiences-in mental health services. We postulate that peer support can become an important and integrated aspect of preventing and addressing discrimination against women in psychiatry and mental health care. First, women peer workers may combine their lived experiences as service users and as women to provide unique, experience- and gender-based support to women users who experience discrimination. Non-women or women peer workers who did not experience gender discrimination in psychiatric settings may nevertheless benefit from the integration of gender education in their curriculum and, in turn, bring a feminist lens to their work to achieve this mission. Second, using their experience as service users, peer workers have the credible ability to communicate and translate women patients' needs to the medical staff, and thus facilitate concrete, need-based adjustments of services. Third, peer workers' involvement as instructors in medical schools could provide early awareness of injustices experienced by women in psychiatry and mental health care. Further research is required to test the effectiveness of peer workers in addressing discrimination against women in real-world clinical settings. More broadly, from a diversity perspective, we believe that peer workers are one of the critical elements in the fight against discrimination in psychiatry and mental health.
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Affiliation(s)
- Elise Chevillotte
- Adult Psychiatry Department, CH Alpes-Isère, 38000 Saint-Egrève, France
| | - Clément Dondé
- Adult Psychiatry Department, CH Alpes-Isère, 38000 Saint-Egrève, France; University Grenoble Alpes, 38000 Grenoble, France; Adult Psychiatry Department, CHU de Grenoble-Alpes, 38000 Grenoble, France.
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6
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Dondé C, Dubertret C, Fond G, Andre M, Berna F, Boyer L, Capdevielle D, Chereau I, Coulon N, Dorey JM, Leignier S, Llorca PM, Misdrahi D, Passerieux C, Pignon B, Rey R, Schorr B, Schürhoff F, Urbach M, Polosan M, Mallet J. History of learning disorders is associated with worse cognitive and functional outcomes in schizophrenia: results from the multicentric FACE-SZ cross-sectional dataset. Eur Arch Psychiatry Clin Neurosci 2023; 273:1773-1783. [PMID: 36583738 DOI: 10.1007/s00406-022-01544-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
Schizophrenia is associated with early neurodevelopmental disorders, including most frequently learning disorders (LD), among them dyslexia and dyspraxia. Despite the demonstrated links between schizophrenia and LD, specific clinical patterns of the schizophrenia with a history of LD subgroup remain unknown. The aim of the present study was to investigate cognitive impairment, symptoms and functional outcome associated with a history of LD in a large cross-sectional, multicentric, sample of schizophrenia subjects. 492 community-dwelling subjects with schizophrenia (75.6% male, mean age 30.8 years) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. The 51 (10.4%) subjects identified with a history of LD had significantly impaired general cognitive ability (Wechsler Adult Intelligence Scale Full Scale Total IQ: Cohen's d = 0.50, p = 0.001), processing speed (d = 0.19), verbal comprehension (d = 0.29), working memory (d = 0.31), cognitive inhibition and flexibility (d = 0.26), central executive functioning (d = 0.26), phonemic verbal fluency (d = 0.22) and premorbid intellectual ability (d = 0.48), as well as with a worse functional outcome (Global Assessment of Functioning, d = 0.21), independently of age, sex, education level, symptoms, treatments, and addiction comorbidities. These results indicate that a history of LD is associated with later cognitive impairment and functional outcome in schizophrenia. This suggests that history of LD is a relevant clinical marker to discriminate subgroups of patients with schizophrenia with different profiles in a precision psychiatry framework.
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Affiliation(s)
- Clément Dondé
- Fondation Fondamental, Créteil, France.
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France.
- Psychiatry Department, CH Alpes-Isère, 38000, Saint-Egrève, France.
| | - Caroline Dubertret
- Fondation Fondamental, Créteil, France
- Institute of Psychiatry and Neuroscience of Paris, Université de Paris, INSERM UMR1266, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Guillaume Fond
- Fondation Fondamental, Créteil, France
- School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, AP-HM, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Myrtille Andre
- Fondation Fondamental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Fabrice Berna
- Fondation Fondamental, Créteil, France
- Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Strasbourg, France
| | - Laurent Boyer
- Fondation Fondamental, Créteil, France
- School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, AP-HM, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Delphine Capdevielle
- Fondation Fondamental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation Fondamental, Créteil, France
- University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, 63000, Clermont-Ferrand, France
| | - Nathalie Coulon
- Fondation Fondamental, Créteil, France
- Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - Jean-Michel Dorey
- Fondation Fondamental, Créteil, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - Sylvain Leignier
- Fondation Fondamental, Créteil, France
- Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - Pierre-Michel Llorca
- Fondation Fondamental, Créteil, France
- University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, 63000, Clermont-Ferrand, France
| | - David Misdrahi
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- Aquitaine Institute for Cognitive and Integrative Neuroscience, UMR 5287-INCIA, University of Bordeaux, CNRS, Bordeaux, France
| | - Christine Passerieux
- Fondation Fondamental, Créteil, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 Rue de Versailles, 78157, Le Chesnay, France
- DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines 94807, Villejuif, France
| | - Baptiste Pignon
- Fondation Fondamental, Créteil, France
- UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie Génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de Psychiatrie, Créteil, France Fondation FondaMental, Fondation de Cooperation Scientifique, Université Paris-Est, Créteil, France
| | - Romain Rey
- Fondation Fondamental, Créteil, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - Benoît Schorr
- Fondation Fondamental, Créteil, France
- Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Strasbourg, France
| | - Franck Schürhoff
- Fondation Fondamental, Créteil, France
- UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie Génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de Psychiatrie, Créteil, France Fondation FondaMental, Fondation de Cooperation Scientifique, Université Paris-Est, Créteil, France
| | - Mathieu Urbach
- Fondation Fondamental, Créteil, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 Rue de Versailles, 78157, Le Chesnay, France
| | - Mircea Polosan
- Fondation Fondamental, Créteil, France
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
- Psychiatry Department, CH Alpes-Isère, 38000, Saint-Egrève, France
| | - Jasmina Mallet
- Fondation Fondamental, Créteil, France
- Institute of Psychiatry and Neuroscience of Paris, Université de Paris, INSERM UMR1266, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
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7
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Bernardin F, Gauld C, Martin VP, Laprévote V, Dondé C. The 68 symptoms of the clinical high risk for psychosis: Low similarity among fourteen screening questionnaires. Psychiatry Res 2023; 330:115592. [PMID: 37948888 DOI: 10.1016/j.psychres.2023.115592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/28/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
The Clinical High Risk for psychosis (CHR) is a heterogeneous condition with multiple symptoms. CHR screening is challenging in routine care, as a wide variety of questionnaires exists. We propose to explore the extent to which these questionnaires differ or overlap in item content. We performed a systematic and quantitative analysis of item content in a set of widely-used CHR screening questionnaires. Items were extracted from questionnaires and reworded according to the Structured Interview for Psychosis-Risk Syndromes (SIPS). Then, symptoms were generated from individual items. The Jaccard Index was calculated to assess content overlap. The 14 analysed questionnaires were composed of 347 items, from which 198 symptoms were generated and, in turn, collapsed into 68 distinct symptoms. Positive symptoms were the most commonly represented. The overall overlap across questionnaires showed weak similarity (Jaccard = 0.19±0.50). CHR screening questionnaires might evaluate the same broad clinical construct, but have different scopes within that construct, and may be more or less comprehensive than one another. Clinicians and researchers should be mindful of the specific features of each instrument for optimal CHR screening.
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Affiliation(s)
- Florent Bernardin
- Centre Psychothérapique de Nancy, Pôle Transversal Médico-Technique et Clinique, Centre de, Liaison et d'Intervention Précoce, Laxou F-54520, France; Institut National de la Santé et de la Recherche Médical, INSERM U1114, Pôle de Psychiatrie, Fédération de Médecine Translationnelle de Strasbourg, Centre Hospitalier Régional Universitaire, de Strasbourg, Université de Strasbourg, Strasbourg, France.
| | - Christophe Gauld
- Department of Child Psychiatry, Université de Lyon, 59 Bd Pinel, Lyon F-69000, France; Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de, Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France
| | - Vincent P Martin
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence F-33400, France; Univ. Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Vincent Laprévote
- Centre Psychothérapique de Nancy, Pôle Transversal Médico-Technique et Clinique, Centre de, Liaison et d'Intervention Précoce, Laxou F-54520, France; Institut National de la Santé et de la Recherche Médical, INSERM U1114, Pôle de Psychiatrie, Fédération de Médecine Translationnelle de Strasbourg, Centre Hospitalier Régional Universitaire, de Strasbourg, Université de Strasbourg, Strasbourg, France; Université de Lorraine, Faculté de Médecine, Vandœuvre-lès-Nancy F-54500 France
| | - Clément Dondé
- Univ. Grenoble Alpes, Grenoble F-38000, France; INSERM, U1216, Grenoble F-38000, France; Psychiatry Department, CHU Grenoble Alpes, Grenoble F-38000, France.
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8
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Pouchon A, Vinckier F, Dondé C, Gueguen MC, Polosan M, Bastin J. Reward and punishment learning deficits among bipolar disorder subtypes. J Affect Disord 2023; 340:694-702. [PMID: 37591352 DOI: 10.1016/j.jad.2023.08.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/24/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Reward sensitivity is an essential dimension related to mood fluctuations in bipolar disorder (BD), but there is currently a debate around hypersensitivity or hyposensitivity hypotheses to reward in BD during remission, probably related to a heterogeneous population within the BD spectrum and a lack of reward bias evaluation. Here, we examine reward maximization vs. punishment avoidance learning within the BD spectrum during remission. METHODS Patients with BD-I (n = 45), BD-II (n = 34) and matched (n = 30) healthy controls (HC) were included. They performed an instrumental learning task designed to dissociate reward-based from punishment-based reinforcement learning. Computational modeling was used to identify the mechanisms underlying reinforcement learning performances. RESULTS Behavioral results showed a significant reward learning deficit across BD subtypes compared to HC, captured at the computational level by a lower sensitivity to rewards compared to punishments in both BD subtypes. Computational modeling also revealed a higher choice randomness in BD-II compared to BD-I that reflected a tendency of BD-I to perform better during punishment avoidance learning than BD-II. LIMITATIONS Our patients were not naive to antipsychotic treatment and were not euthymic (but in syndromic remission) according to the International Society for Bipolar Disorder definition. CONCLUSIONS Our results are consistent with the reward hyposensitivity theory in BD. Computational modeling suggests distinct underlying mechanisms that produce similar observable behaviors, making it a useful tool for distinguishing how symptoms interact in BD versus other disorders. In the long run, a better understanding of these processes could contribute to better prevention and management of BD.
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Affiliation(s)
- Arnaud Pouchon
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France.
| | - Fabien Vinckier
- Motivation, Brain & Behavior (MBB) lab, Institut du Cerveau (ICM), Hôpital Pitié-Salpêtrière, F-75013 Paris, France; Université Paris Cité, F-75006 Paris, France; Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, F-75014 Paris, France
| | - Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France; Department of Psychiatry, CH Alpes-Isère, 38000 Saint-Egrève, France
| | - Maëlle Cm Gueguen
- Department of Psychiatry, University Behavioral Health Care & the Brain Health Institute, Rutgers University-New Brunswick, Piscataway, USA; Laureate Institute for Brain Research, Tulsa, OK 74136 USA
| | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France
| | - Julien Bastin
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.
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9
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Rouy M, Pereira M, Saliou P, Sanchez R, El Mardi W, Sebban H, Baqué E, Dezier C, Porte P, Micaux J, de Gardelle V, Mamassian P, Moulin CJA, Dondé C, Roux P, Faivre N. Confidence in visual detection, familiarity and recollection judgments is preserved in schizophrenia spectrum disorder. Schizophrenia (Heidelb) 2023; 9:55. [PMID: 37679358 PMCID: PMC10485068 DOI: 10.1038/s41537-023-00387-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
An effective way to quantify metacognitive performance is to ask participants to estimate their confidence in the accuracy of their response during a cognitive task. A recent meta-analysis1 raised the issue that most assessments of metacognitive performance in schizophrenia spectrum disorders may be confounded with cognitive deficits, which are known to be present in this population. Therefore, it remains unclear whether the reported metacognitive deficits are metacognitive in nature or rather inherited from cognitive deficits. Arbitrating between these two possibilities requires equating task performance between experimental groups. Here, we aimed to characterize metacognitive performance among individuals with schizophrenia across three tasks (visual detection, familiarity, recollection) using a within-subject design while controlling experimentally for intra-individual task performance and statistically for between-subject task performance. In line with our hypotheses, we found no metacognitive deficit for visual detection and familiarity judgments. While we expected metacognition for recollection to be specifically impaired among individuals with schizophrenia, we found evidence in favor of an absence of a deficit in that domain also. We found no specific metacognitive deficit in schizophrenia spectrum disorder in the visual or memory domain. The clinical relevance of our findings is discussed in light of a hierarchical framework of metacognition.
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Affiliation(s)
- Martin Rouy
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France.
| | - Michael Pereira
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Pauline Saliou
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Rémi Sanchez
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Wassila El Mardi
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Hanna Sebban
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Eugénie Baqué
- Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - Childéric Dezier
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Perrine Porte
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Julia Micaux
- Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - Vincent de Gardelle
- Centre d'Économie de la Sorbonne, CNRS and Paris School of Economics, Paris, France
| | - Pascal Mamassian
- Laboratoire des Systèmes Perceptifs, Département d'Études Cognitives, École Normale Supérieure, PSL University, CNRS, Paris, France
| | - Chris J A Moulin
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
- Adult Psychiatry Department, CH Alpes-Isère, F-38000, Saint-Egrève, France
| | - Paul Roux
- Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - Nathan Faivre
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
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10
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Pouchon A, Nasserdine R, Dondé C, Bertrand A, Polosan M, Bioulac S. A systematic review of pharmacotherapy for attention-deficit/hyperactivity disorder in children and adolescents with bipolar disorders. Expert Opin Pharmacother 2023; 24:1497-1509. [PMID: 37300473 DOI: 10.1080/14656566.2023.2224920] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/09/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The data suggests that in children and adolescents, bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD) may be strongly correlated. Even though drugs for ADHD and BD are largely accepted, there is relatively little research on the management of comorbidity in children and adolescents, particularly in terms of safety. We provide a synthesis of these findings because one hasn't been made yet. AREAS COVERED As a primary outcome, we wanted to determine whether stimulant or non-stimulant treatment of children and adolescents with ADHD and comorbid BD was effective. As a secondary outcome, we wanted to determine tolerability, especially the risk of mood switch. EXPERT OPINION The findings of this systematic review suggest that methylphenidate, when used with a mood stabilizer, may be safe and not significantly increase the risk of a manic switch or psychotic symptoms when used to treat ADHD that co-occurs with a BD. In situations where stimulants are ineffective or have low tolerance, atomoxetine also seems to be a good alternative, and also in cases of co-morbid anxiety, oppositional defiant disorder, conduct disorders, ICT disorders, and substance use disorders. Additional research with a higher level of evidence is necessary to corroborate these preliminary findings.
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Affiliation(s)
- Arnaud Pouchon
- Grenoble Institut Neurosciences, University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble, France
| | - Rayan Nasserdine
- Department of Psychiatry, University Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France
| | - Clément Dondé
- Grenoble Institut Neurosciences, University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble, France
- Psychiatry Department, CH Alpes-Isère, Saint-Egrève, France
| | - Antoine Bertrand
- Grenoble Institut Neurosciences, University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble, France
| | - Mircea Polosan
- Grenoble Institut Neurosciences, University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble, France
| | - Stéphanie Bioulac
- Grenoble Institut Neurosciences, University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble, France
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11
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Blouzard E, Pouchon A, Polosan M, Bastin J, Dondé C. Effort-Cost Decision-making Among Individuals With Schizophrenia: A Systematic Review and Meta-analysis. JAMA Psychiatry 2023; 80:548-557. [PMID: 37043223 PMCID: PMC10099175 DOI: 10.1001/jamapsychiatry.2023.0553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/31/2023] [Indexed: 04/13/2023]
Abstract
Importance Motivational impairments in schizophrenia are by definition associated with poor outcome. It is postulated that the reduction of goal-directed behavior arises from abnormal trade-offs between rewards and efforts. Objective To examine whether schizophrenia is associated with impairments in effort-cost decision-making. Data Sources For this systematic review and meta-analysis, the PubMed, ScienceDirect, PsycINFO, Embase, and ClinicalTrials.gov databases were searched from inception to July 2022 for studies that investigated effort-cost decision-making in schizophrenia. Search terms included effort, cost, and schizophrenia. Study Selection Consensual criteria for inclusion were peer-reviewed studies published in English that used a computerized effort-cost decision-making behavioral paradigm and compared individuals with schizophrenia with control individuals. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was used for abstracting data. Data were extracted independently by 2 authors and then pooled using random-effects sizes and bayesian approaches. Main Outcomes and Measures The main outcomes were performance on effort-cost decision-making tasks requiring an effort-reward trade-off, measured by Hedges g effect size. Effects of moderators were tested with meta-regressions and subgroup analyses. Results Twenty studies involving 1503 participants were included: 837 individuals with schizophrenia (541 [64.6%] male; mean [SD] age, 35.89 [6.70] years) and 666 control individuals without schizophrenia (360 [54.1%] male; mean [SD] age, 34.16 [5.92] years). Participants with schizophrenia had significantly reduced willingness to expend effort for rewards compared with controls (k = 20; effect size, 0.43; 95% CI, 0.30-0.56; P < .001; I2 = 33.1%; Q test P = .08). The magnitude of the deficit was significantly greater for high-reward trials. The severity of negative symptoms was negatively associated with effort-cost decision-making (k = 8; effect size, -0.33; 95% CI, -0.50 to -0.15; P < .001), while participants with a high number of negative symptoms had a significantly larger impairment in effort-cost decision-making (k = 5; effect size, 0.47; 95% CI, 0.10-0.84; P = .01). Conclusions and Relevance In this systematic review and meta-analysis, schizophrenia was associated with deficits in effort allocation as indexed by effort-cost decision-making tasks. Understanding the cognitive and neurobiological mechanisms driving effort allocation impairments may assist in developing novel interventions.
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Affiliation(s)
- Elodie Blouzard
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
| | - Arnaud Pouchon
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
- Adult Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Mircea Polosan
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
- Adult Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Julien Bastin
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
| | - Clément Dondé
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
- Adult Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
- Adult Psychiatry Department, Centre Hospitalier Alpes-Isère, Saint-Egrève, France
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12
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Dondé C, Kantrowitz JT, Medalia A, Saperstein AM, Balla A, Sehatpour P, Martinez A, O'Connell MN, Javitt DC. Early auditory processing dysfunction in schizophrenia: Mechanisms and implications. Neurosci Biobehav Rev 2023; 148:105098. [PMID: 36796472 PMCID: PMC10106448 DOI: 10.1016/j.neubiorev.2023.105098] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
Schizophrenia is a major mental disorder that affects approximately 1% of the population worldwide. Cognitive deficits are a key feature of the disorder and a primary cause of long-term disability. Over the past decades, significant literature has accumulated demonstrating impairments in early auditory perceptual processes in schizophrenia. In this review, we first describe early auditory dysfunction in schizophrenia from both a behavioral and neurophysiological perspective and examine their interrelationship with both higher order cognitive constructs and social cognitive processes. Then, we provide insights into underlying pathological processes, especially in relationship to glutamatergic and N-methyl-D-aspartate receptor (NMDAR) dysfunction models. Finally, we discuss the utility of early auditory measures as both treatment targets for precision intervention and as translational biomarkers for etiological investigation. Altogether, this review points out the crucial role of early auditory deficits in the pathophysiology of schizophrenia, in addition to major implications for early intervention and auditory-targeted approaches.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000 Grenoble, France; INSERM, U1216, F-38000 Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, F-38000 Grenoble, France; Psychiatry Department, CH Alpes-Isère, F-38000 Saint-Egrève, France.
| | - Joshua T Kantrowitz
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States; Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Alice Medalia
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY 10032, United States
| | - Alice M Saperstein
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY 10032, United States
| | - Andrea Balla
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Pejman Sehatpour
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Antigona Martinez
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Monica N O'Connell
- Translational Neuroscience Division, Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Daniel C Javitt
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
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13
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Dondé C, Pouchon A, Polosan M. Recovery effect: Cigarette smoking acts on the neural dynamics of early auditory processing in schizophrenia. Schizophr Res 2023; 254:76-77. [PMID: 36805235 DOI: 10.1016/j.schres.2022.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 02/18/2023]
Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes Adult Psychiatry Unit, Grenoble Institut Neurosciences, 38000 Grenoble, France.
| | - Arnaud Pouchon
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes Adult Psychiatry Unit, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes Adult Psychiatry Unit, Grenoble Institut Neurosciences, 38000 Grenoble, France
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14
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Forcheron V, Sacareau E, Bourgeois J, Pouchon A, Polosan M, Gaboreau Y, Dondé C. Experience, impact and needs of informal parental caregivers around the communication of a diagnosis of schizophrenia. Int J Soc Psychiatry 2023; 69:101-110. [PMID: 34991395 DOI: 10.1177/00207640211068978] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS To qualitatively characterize the experience, impact and needs of informal family caregivers around the communication of a diagnosis of schizophrenia. METHODS In all, 13 informal family caregivers were recruited. All were parents. Semi-structured interviews were used to explore their experience of the diagnosis of schizophrenia, the impacts of the diagnosis and the needs related to the diagnosis around its communication. Interviews were recorded, transcribed, codes generated and mixed deductive-inductive thematic analysis undertaken. RESULTS Participants described receiving the diagnosis of schizophrenia for their relative as a devastating experience, although some nuanced the experience with a sense of relief of finally naming the disorder and getting access to care. Caregivers' experience and representations prior to hearing the diagnosis played an important role in the way the 'news' was internalized. The communication of the diagnosis constituted a starting point for acceptance of the reality of the illness in participants. Numerous unmet needs around the communication of the diagnosis were reported by participants, including personnalized support, specific explanations about the disorder and guidance on their role as caregiver. CONCLUSION A specific attention must be given to the communication of the diagnosis of schizophrenia to the informal family caregivers. Information giving must be early, comprehensive, personalized and embedded into tailored education and support programmes for caregivers to facilitate illness acceptance and adaptation.
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Affiliation(s)
- Véra Forcheron
- Université Grenoble Alpes, Grenoble, France.,Adult Psychiatry Department, Alpes-Isère Psychiatric Hospital, Saint-Egrève, France
| | - Elodie Sacareau
- Université Grenoble Alpes, Grenoble, France.,Adult Psychiatry Department, Alpes-Isère Psychiatric Hospital, Saint-Egrève, France
| | - Jérôme Bourgeois
- Adult Psychiatry Department, Alpes-Isère Psychiatric Hospital, Saint-Egrève, France
| | - Arnaud Pouchon
- Université Grenoble Alpes, Grenoble, France.,INSERM, U1216, Grenoble, France.,Adult Psychiatry Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Mircea Polosan
- Université Grenoble Alpes, Grenoble, France.,INSERM, U1216, Grenoble, France.,Adult Psychiatry Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Yoann Gaboreau
- Université Grenoble Alpes, Grenoble, France.,Department of General Practice, Faculty of Medicine, University of Grenoble, Grenoble, France.,Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications (TIMC-IMAG)
| | - Clément Dondé
- Université Grenoble Alpes, Grenoble, France.,Adult Psychiatry Department, Alpes-Isère Psychiatric Hospital, Saint-Egrève, France.,INSERM, U1216, Grenoble, France.,Adult Psychiatry Department, Grenoble Alpes University Hospital, Grenoble, France
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15
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Spillebout C, Pelluet A, Bioulac S, Fourneret P, Polosan M, Dondé C. Detection of clinical high risk for psychosis in child and adolescent mental health services: Validation of the first step with the French versions of the Prodromal Questionnaire (fPQ-16) and scale of Perceptual and Cognitive Aberrations (fPCA). Early Interv Psychiatry 2023. [PMID: 36638840 DOI: 10.1111/eip.13366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/07/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023]
Abstract
AIM To validate the French versions of the 16-items Prodromal Questionnaire (PQ-16) and the 9-items scale of Perceptual and Cognitive Aberrations (PCA) to facilitate screening of psychosis risk in native French-speaking young individuals referred to Child and Adolescent Mental Health Services. METHOD Participants (N = 87, age range 10-18 years) were diagnosed with a non-psychotic disorder according to the Diagnostic and Statistical Manual of Mental Disorders. The French versions of the PQ-16 and PCA were developed using a forward-backward translation procedure. Psychometric properties were tested including (i) internal validity with Pearson correlations and Cronbach's coefficients, and (ii) external validity by correlations with each other's. RESULTS (i) Correlations between fPQ-16 and fPCA total scores and individual items were mostly >.4. Cronbach's coefficients were .80 for the fPQ-16 and .61 for the fPCA. (ii) The fPQ-16 and fPCA total scores were significantly correlated with a large effect size (rs = 0.66). CONCLUSION The fPQ-16 and the fPCA are psychometrically acceptable instruments for the screening of potential psychotic symptoms in French-speaking children and young adolescents under 18 years old referred to Child and Adolescent Mental Health Services.
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Affiliation(s)
| | - Albane Pelluet
- Service de Psychopathologie de l'Enfant et du Développement, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Stéphanie Bioulac
- Laboratoire de Psychologie et Neurocognition (CNRS-UMR 5105), Service de Psychiatrie de l'enfant et l'adolescent, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Pierre Fourneret
- Service de Psychopathologie de l'Enfant et du Développement, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Mircea Polosan
- Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Université Grenoble Alpes, Grenoble, France.,Adult Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Clément Dondé
- Université Grenoble Alpes, Grenoble, France.,Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Université Grenoble Alpes, Grenoble, France.,Adult Psychiatry Department, CHU Grenoble Alpes, Grenoble, France.,Early Intervention in Psychosis, CH Alpes-Isère, Saint-Egrève, France
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16
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Dondé C, Jaffiol A, Khouri C, Pouchon A, Tamisier R, Lejoyeux M, d'Ortho MP, Polosan M, Geoffroy PA. Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis. Aust N Z J Psychiatry 2022; 56:1068-1079. [PMID: 34971518 DOI: 10.1177/00048674211068395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To provide a qualitative view and quantitative measure of sleep disturbances across and between early stages - clinical ultra high-risk and first episode - of psychotic and bipolar disorders. METHODS Electronic databases (PubMed, Cochrane, Embase, PsychINFO) were searched up to March 2021 for studies comparing sleep measures between individuals with an early stage and controls. Standard mean deviations (Cohen's d effect sizes) were calculated for all comparisons and pooled with random-effects models. Chi-square tests were used for direct between-subgroups (ultra high-risk vs first episode) comparisons of standard mean deviations. The effects of age, sex ratio, symptoms and treatment were examined in meta-regression analyses. RESULTS A database search identified 13 studies that contrasted sleep measures between individuals with an early stage (N = 537) and controls (N = 360). We observed poorer subjective sleep quality (standard mean deviation = 1.32; 95% confidence interval, [1.01, 1.62]), shorter total sleep time (standard mean deviation =-0.44; 95% confidence interval, [-0.67, -0.21]), lower sleep efficiency (standard mean deviation = -0.72; 95% confidence interval, [-1.08, -0.36]), longer sleep onset latency (standard mean deviation = 0.75; 95% confidence interval, [0.45, 1.06]) and longer duration of wake after sleep onset (standard mean deviation = 0.49; 95% confidence interval, [0.21, 0.77]) were observed in early stages compared to controls. No significant differences were observed for any of the reported electroencephalographic parameters of sleep architecture. No significant between-subgroups differences were observed. Meta-regressions revealed a significant effect of the age and the antipsychotic status on subjective measures of sleep. CONCLUSION The early stage population presents with significant impairments of subjective sleep quality continuity, duration and initiation. Systematic assessments of sleep in early intervention settings may allow early identification and treatment of sleep disturbances in this population.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Adult Psychiatry Department, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Antoine Jaffiol
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Adult Psychiatry Department, 38000 Grenoble, France
| | - Charles Khouri
- Univ. Grenoble Alpes, CHU Grenoble Alpes, HP2, Clinical Pharmacology Department, INSERM CIC1406, 38000 Grenoble, France
| | - Arnaud Pouchon
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Adult Psychiatry Department, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Renaud Tamisier
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2, Pneumology and Physiology Department, Thorax and vessels pole, 38000 Grenoble, France
| | - Michel Lejoyeux
- Université de Paris, Psychiatry and Addictology Department, AP-HP, GHU Paris Nord, DMU Neurosciences, Bichat Hospital - Claude Bernard, GHU Paris - Psychiatry & Neurosciences, Paris, France
| | - Marie-Pia d'Ortho
- Université de Paris, NeuroDiderot, Inserm U1141, Sleep Medicine and Clinical Physiology Department, AP-HP, GHU Paris Nord, DMU DREAM, Bichat Hospital, Paris, France
| | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Adult Psychiatry Department, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Pierre A Geoffroy
- Université de Paris, Psychiatry and Addictology Department, AP-HP, GHU Paris Nord, DMU Neurosciences, Bichat Hospital - Claude Bernard, GHU Paris - Psychiatry & Neurosciences, Paris, France.,Université de Paris, NeuroDiderot, Inserm U1141, Sleep Medicine and Clinical Physiology Department, AP-HP, GHU Paris Nord, DMU DREAM, Bichat Hospital, Paris, France
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17
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Pouchon A, Polosan M, Dondé C. Interventional psychiatry: Why an umbrella term is useful? Aust N Z J Psychiatry 2022; 56:1044. [PMID: 35481787 DOI: 10.1177/00048674221096616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Arnaud Pouchon
- Univ. Grenoble-Alpes, Grenoble Institut Neurosciences, Inserm U1216, CHU Grenoble-Alpes, France.,Department of Psychiatry, CHU Grenoble-Alpes, La Tronche, France
| | - Mircea Polosan
- Univ. Grenoble-Alpes, Grenoble Institut Neurosciences, Inserm U1216, CHU Grenoble-Alpes, France.,Department of Psychiatry, CHU Grenoble-Alpes, La Tronche, France
| | - Clément Dondé
- Univ. Grenoble-Alpes, Grenoble Institut Neurosciences, Inserm U1216, CHU Grenoble-Alpes, France.,Psychiatry Department, CH Alpes-Isère, Saint-Egrève, France
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18
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Lefebvre A, Pouchon A, Bioulac S, Mallet J, Polosan M, Dondé C. Management of schizophrenia in women during the perinatal period: a synthesis of international recommendations. Expert Opin Pharmacother 2022; 23:1337-1350. [PMID: 35835161 DOI: 10.1080/14656566.2022.2102421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The perinatal period in schizophrenia is associated with high risk of psychotic relapse and pregnancy/child outcomes. The extent to which antipsychotics may potentially affect the fetus or the child development is unclear and debated. Even though guidelines have been developed, there is a lack of consensual recommendations regarding the optimal strategy to manage schizophrenia during the perinatal period. AREAS COVERED This systematic review describes the current state of evidence with respect to the impact of recommended interventions for schizophrenia during the perinatal period, including childbearing age, pregnancy and post-partum. It compares recent international treatment guidelines for this specific group of women. Last, this review presents a set of major points to be discussed with patients and relatives for shared-decision making and a summary of key recommendations from the international guidelines. EXPERT OPINION Although treatment guidelines may be of significant help, discrepancies exist across them regarding the management of antipsychotics for schizophrenia women during the perinatal period. Shared decision-making and advance directives represent useful patient-centered approaches during this specific period. Further cohort-based evidence is needed to better identify maternal and fetal risks associated to antipsychotic treatment exposure.
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Affiliation(s)
| | - Arnaud Pouchon
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Stéphanie Bioulac
- Laboratoire de Psychologie et Neurocognition (CNRS-UMR 5105), Université Grenoble Alpes; Service Psychiatrie de l'enfant et l'adolescent, CHU Grenoble Alpes, France
| | - Jasmina Mallet
- Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
| | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Psychiatry Department, CH Alpes-Isère, F-38000 Saint-Egrève, France
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19
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Dondé C, Pouchon A, Pelluet A, Bougerol T, Polosan M. The Impact of Wearing a Face Mask on the Psychiatric Interview: a National Survey During the COVID-19 Pandemic. Psychiatr Q 2022; 93:435-442. [PMID: 34626317 PMCID: PMC8501330 DOI: 10.1007/s11126-021-09962-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 01/20/2023]
Abstract
The COVID-19 pandemic has forced to rapidly encourage the use of face masks during medical consultations, with significant implication for psychiatry. This study examined the opinions and attitudes of psychiatrists toward the impact of wearing a face mask on the psychiatric interview. 513 psychiatrists and trainee psychiatrists completed an electronic survey about the impact of wearing a face mask on the psychiatric interview. Less efficiency in capturing clinical signs/symptoms, emergence of false inferences in patients and altered patient-clinician interactions were commonly reported negative impacts of face mask (66-96%). The quality of the therapeutic alliance was reported as affected by the mask by 47% of the sample. Results were mixed on the use of telepsychiatry as a potential solution to mask-related inconvenience. The use of face masks has significant negative effects on the psychiatric interview. Providing specific training to clinicians could be a potential solution for masks-induced biases.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000, Grenoble, France. .,INSERM, U1216, F-38000, Grenoble, France. .,Adult Psychiatry Department, CHU Grenoble Alpes, F-38000, Grenoble, France. .,Adult Psychiatry Department, CH Alpes-Isère, F-38000, Saint-Egrève, France.
| | - Arnaud Pouchon
- Univ. Grenoble Alpes, F-38000, Grenoble, France.,INSERM, U1216, F-38000, Grenoble, France.,Adult Psychiatry Department, CHU Grenoble Alpes, F-38000, Grenoble, France
| | - Albane Pelluet
- Université, Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,Service de Psychopathologie du Développement de l'Enfant et de l'Adolescent, Femme-Mère-Enfant, HôpitalHospices Civils de Lyon, Bron, France
| | - Thierry Bougerol
- Univ. Grenoble Alpes, F-38000, Grenoble, France.,INSERM, U1216, F-38000, Grenoble, France.,Adult Psychiatry Department, CHU Grenoble Alpes, F-38000, Grenoble, France
| | - Mircea Polosan
- Univ. Grenoble Alpes, F-38000, Grenoble, France.,INSERM, U1216, F-38000, Grenoble, France.,Adult Psychiatry Department, CHU Grenoble Alpes, F-38000, Grenoble, France
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20
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Bortolon C, Dorahy MJ, Brand R, Dondé C, Slovak S, Raffard S. The effect of voice content and social context on shame: a simulation and vignette paradigm to evaluate auditory verbal hallucinations. Cogn Neuropsychiatry 2022; 27:122-138. [PMID: 34353237 DOI: 10.1080/13546805.2021.1962265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Recent theoretical models and preliminary data suggest that shame is a central emotion in the context of auditory verbal hallucinations (AVH or voice-hearing). Nevertheless, all previous studies were correlational. Thus, the present study sought to explore whether simulated AVH experiences can trigger shame using an experimental design. METHODS 346 participants from the general population were randomised to one of 6 conditions. They had to read a vignette describing a character who was either in a situation alone or with a close friend. While reading the vignettes, participants also heard either negative or neutral simulated voices or non-voice neutral sounds. Subsequently, participants completed different measures, including shame. RESULTS Our results showed that both the negative and neutral simulated voice-hearing triggered higher levels of shame, but also other negative emotions when compared to ambient sound, regardless of the social context. Participants in the simulated voice-hearing conditions reported higher levels of maladaptive coping strategies and negative beliefs about voices than in the ambient sound condition. CONCLUSIONS The simulation of neutral and negative voices trigger similar levels of subjective shame, indicating the effect is not specific to negative voices but rather associated with the experience per se. Nevertheless, it can also trigger other negative emotions.
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Affiliation(s)
- Catherine Bortolon
- LIP PC2S Lab, Department of Psychology, University Grenoble Alpes, Grenoble, France.,Centre référent de réhabilitation psychosociale et de remédiation cognitive, Centre Hospitalière Alpes Isère, Grenoble, France
| | - Martin J Dorahy
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Rachel Brand
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Clément Dondé
- Inserm U1216, Grenoble Institut des Neurosciences, CHU Grenoble-Alpes, Université Grenoble Alpes, Grenoble, France
| | | | - Stéphane Raffard
- University Department of Adult Psychiatry, La Colombière Hospital, CHU Montpellier, Montpellier, France.,Univ Paul Valéry Montpellier 3, Univ. Montpellier, Montpellier, France
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21
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Lavallé L, Dondé C, Gawęda Ł, Brunelin J, Mondino M. Impaired self-recognition in individuals with no full-blown psychotic symptoms represented across the continuum of psychosis: a meta-analysis. Psychol Med 2021; 51:2864-2874. [PMID: 32466806 DOI: 10.1017/s003329172000152x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Impairments in self-recognition (i.e. recognition of own thoughts and actions) have been repeatedly shown in individuals with schizophrenia. According to classical clinical characterizations, schizophrenia is included in a continuum encompassing a large range of genetic statuses, psychotic states and symptoms. The current meta-analysis aims to determine whether self-recognition is affected by individuals within the psychosis continuum. METHOD Three populations were considered: people with an at-risk mental state for psychosis (ARMS), hallucination-prone individuals and unaffected relatives of patients with schizophrenia. Eleven studies contrasted self-recognition between these three populations (n = 386) and healthy controls (n = 315) and four studies used correlational analysis to estimate comparable effects (n = 629). Eligible studies used experimental paradigms including source-monitoring and self-monitoring. RESULTS We observed significantly reduced self-recognition accuracy in these populations [g = -0.44 (-0.71 to -0.17), p = 0.002] compared to controls. No influence of the type of population, experimental paradigm or study design was observed. CONCLUSION The present analysis argues for self-recognition deficits in populations with no full-blown psychotic symptoms represented across the continuum of psychosis.
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Affiliation(s)
- Layla Lavallé
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon, F-69000, France
- Lyon University, F-69000, France
- Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678Bron, France
| | - Clément Dondé
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon, F-69000, France
- Lyon University, F-69000, France
- Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678Bron, France
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Jérome Brunelin
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon, F-69000, France
- Lyon University, F-69000, France
- Centre Hospitalier le Vinatier, Batiment 416, 95 Bd Pinel, 69678Bron, France
| | - Marine Mondino
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon, F-69000, France
- Lyon University, F-69000, France
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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22
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Chapron SA, Nourredine M, Dondé C, Haesebaert F, Micoulaud-Franchi JA, Geoffroy PA, Rolland B. Efficacy and safety of topiramate for reducing impulsivity: A transdiagnostic systematic review and meta-analysis of a common clinical use. Fundam Clin Pharmacol 2021; 36:4-15. [PMID: 34212434 DOI: 10.1111/fcp.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/27/2021] [Accepted: 06/24/2021] [Indexed: 11/29/2022]
Abstract
Impulsivity is an important transdiagnostic feature of many psychiatric disorders, as well as a marker of poorer outcome. Topiramate is broadly used for reducing impulsivity in various neuropsychiatric disorders, but no systematic review or meta-analysis has ever explored whether evidence supports this clinical use. We conducted a systematic review and meta-analysis of the literature, using PubMed, PsycInfo and Cochrane databases. We included all studies assessing the efficacy of topiramate in adults with high levels of impulsivity, based on either psychometric or neuropsychological measures. Seven articles were included, involving 578 participants. Important heterogeneity in designs and quality features was observed. Topiramate lowered impulsivity levels in two of the studies that used the Barratt Impulsiveness Scale (BIS) (401 participants) and in one of the studies that used neuropsychological measures (63 participants). Four other studies found no effect of topiramate on impulsivity. A larger reduction in the BIS-11 overall score, with a mean difference of 2.57 (95% confidence interval -4.12 to -1.02), was found in the topiramate group than the placebo group using a random effects model. However, one study accounted for the major part (85.5%) of it, and most included studies presented a high risk of bias. The use of a self-assessment scale induced an additional risk of self-report bias. No clear-cut evidence was found for a transdiagnostic effectiveness of topiramate in reducing impulsivity levels. However, encouraging results were found in some specific disorders.
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Affiliation(s)
- Sophie-Athéna Chapron
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France
| | - Mikail Nourredine
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France
| | - Clément Dondé
- Department of Medicine, University Grenoble Alpes, Grenoble, France.,Psychiatry Department, University Hospital Grenoble Alpes, Grenoble, France.,INSERM U1216, Brain Behavior and Neuromodulation Team, Grenoble Institute Neuroscience, La Tronche, France
| | - Frédéric Haesebaert
- Faculty of Medicine Lyon-Est, University Claude Bernard Lyon 1, Lyon, France.,Department SUR-CL3R-PEPS, Le Vinatier Hospital, Bron, France
| | - Jean-Arthur Micoulaud-Franchi
- USR CNRS 3413 SANPSY, Pellegrin University Hospital, University of Bordeaux, France.,University Sleep Clinic, Services of functional exploration of the nervous system, University Hospital of Bordeaux, Bordeaux, France
| | - Pierre Alexis Geoffroy
- Department of Psychiatry and Addictive Medicine, University Hospital Bichat-Claude Bernard, Public Hospitals of Paris, Paris, France.,INSERM U1141, NeuroDiderot, Paris University, Paris, France
| | - Benjamin Rolland
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France.,Academic Department of Addiction Medicine of Lyon (SUAL), Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.,INSERM U1028, CNRS UMR5292, PSY2R Team, Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France
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23
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Dondé C, Laprévote V, Lavallé L, Haesebaert F, Fakra E, Brunelin J. Cognitive insight in individuals with an at-risk mental state for psychosis: A meta-analysis. Early Interv Psychiatry 2021; 15:449-456. [PMID: 32452629 DOI: 10.1111/eip.12993] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/09/2020] [Accepted: 04/28/2020] [Indexed: 01/01/2023]
Abstract
AIM To compare cognitive insight abilities measured with the Beck Cognitive Insight Scale (BCIS) between individuals with an at-risk mental state (ARMS) and healthy controls. METHOD Review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS A search for articles investigating cognitive insight in ARMS in the MEDLINE and ScienceDirect databases revealed five studies including 303 ARMS and 376 controls. Regarding BCIS subscales, ARMS individuals displayed significant higher scores for self-certainty than controls with a small-to-moderate effect size (ESg = 0.45 [0.23;0.67], P < .005), whereas no significant difference was observed for self-reflectiveness (ESg = -0.56 [-0.18;1.29], P = .14). No significant differences were observed between ARMS and controls for overall cognitive insight abilities as indexed by the BCIS composite score (ESg = -0.24 [-0.43;0.91], P = .45). CONCLUSIONS Self-certainty abnormalities seem to predate the expression of full-blown psychotic episode and to be higher in ARMS than in healthy controls. By contrast, ARMS did not display abnormal self-reflectiveness and overall cognitive insight abilities.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Vincent Laprévote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France.,INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.,Faculté de Médecine, Université de Lorraine, Nancy, France
| | - Layla Lavallé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Eric Fakra
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jerome Brunelin
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
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24
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Dondé C, Pouchon A, Brunelin J, Polosan M. tDCS as a first-choice agent in individuals at high-risk for psychosis? Encephale 2021; 48:472-473. [PMID: 33994158 DOI: 10.1016/j.encep.2021.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/08/2021] [Indexed: 11/27/2022]
Affiliation(s)
- C Dondé
- Université Grenoble Alpes, 38000 Grenoble, France; INSERM, U1216, 38000 Grenoble, France; Adult Psychiatry Department, CHU de Grenoble Alpes, 38000 Grenoble, France; Adult Psychiatry Department, CH Alpes-Isère, 38000 Saint-Egrève, France.
| | - A Pouchon
- Université Grenoble Alpes, 38000 Grenoble, France; INSERM, U1216, 38000 Grenoble, France; Adult Psychiatry Department, CHU de Grenoble Alpes, 38000 Grenoble, France
| | - J Brunelin
- INSERM, U1028; CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response, PSYR2 Team, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Centre hspitalier Le Vinatier, Bron, France
| | - M Polosan
- Université Grenoble Alpes, 38000 Grenoble, France; INSERM, U1216, 38000 Grenoble, France; Adult Psychiatry Department, CHU de Grenoble Alpes, 38000 Grenoble, France
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Mondino M, Fonteneau C, Simon L, Dondé C, Haesebaert F, Poulet E, Brunelin J. Advancing clinical response characterization to frontotemporal transcranial direct current stimulation with electric field distribution in patients with schizophrenia and auditory hallucinations: a pilot study. Eur Arch Psychiatry Clin Neurosci 2021; 271:85-92. [PMID: 32533249 DOI: 10.1007/s00406-020-01149-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/29/2020] [Indexed: 12/25/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been proposed as a therapeutic option for treatment-resistant auditory verbal hallucinations (AVH) in schizophrenia. In such cases, repeated sessions of tDCS are delivered with the anode over the left prefrontal cortex and the cathode over the left temporoparietal junction. Despite promising findings, the clinical response to tDCS is highly heterogeneous among patients. Here, we explored baseline differences between responders and nonresponders to frontotemporal tDCS using electric field modeling. We hypothesized that responders would display different tDCS-induced electric field strength in the brain areas involved in AVH compared to nonresponders.Using baseline structural MRI scans of 17 patients with schizophrenia and daily AVH who received 10 sessions of active frontotemporal tDCS, we constructed individual realistic whole brain models estimating electric field strength. Electric field maps were compared between responders (n = 6) and nonresponders to tDCS (n = 11) using an independent two-sample t test. Clinical response was defined as at least a 50% decrease of AVH 1 month after the last tDCS session.Results from the electric field map comparison showed that responders to tDCS displayed higher electric field strength in the left transverse temporal gyrus at baseline compared to nonresponders (T = 2.37; p = 0.016; 32 voxels).These preliminary findings suggested that the strength of the tDCS-induced electric field reaching the left transverse temporal gyrus could play an important role in the response to frontotemporal tDCS. In addition, this work suggests the interest of using electric field modeling to individualize tDCS and increase response rate.
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Affiliation(s)
- Marine Mondino
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Clara Fonteneau
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Louis Simon
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Emmanuel Poulet
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
- Emergency Psychiatry Unit, Edouard Herriot Hospital, Lyon University Hospital, Lyon, France
| | - Jerome Brunelin
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France.
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France.
- Centre Hospitalier Le Vinatier, Bron, France.
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26
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Dondé C, Brunelin J, Micoulaud-Franchi JA, Maruani J, Lejoyeux M, Polosan M, Geoffroy PA. The Effects of Transcranial Electrical Stimulation of the Brain on Sleep: A Systematic Review. Front Psychiatry 2021; 12:646569. [PMID: 34163380 PMCID: PMC8215269 DOI: 10.3389/fpsyt.2021.646569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/19/2021] [Indexed: 01/23/2023] Open
Abstract
Transcranial Electrical Stimulation (tES) is a promising non-invasive brain modulation tool. Over the past years, there have been several attempts to modulate sleep with tES-based approaches in both the healthy and pathological brains. However, data about the impact on measurable aspects of sleep remain scattered between studies, which prevent us from drawing firm conclusions. We conducted a systematic review of studies that explored the impact of tES on neurophysiological sleep oscillations, sleep patterns measured objectively with polysomnography, and subjective psychometric assessments of sleep in both healthy and clinical samples. We searched four main electronic databases to identify studies until February 2020. Forty studies were selected including 511 healthy participants and 452 patients. tES can modify endogenous brain oscillations during sleep. Results concerning changes in sleep patterns are conflicting, whereas subjective assessments show clear improvements after tES. Possible stimulation-induced mechanisms within specific cortico-subcortical sleep structures and networks are discussed. Although these findings cannot be directly transferred to the clinical practice and sleep-enhancing devices development for healthy populations, they might help to pave the way for future researches in these areas. PROSPERO registration number 178910.
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Affiliation(s)
- Clément Dondé
- University Grenoble Alpes, Grenoble, France.,U1216 INSERM, Grenoble Institut of Neuroscience, La Tronche, France.,Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon, France.,Lyon University, Lyon, France.,Centre Hospitalier le Vinatier, Batiment 416, Bron, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Julia Maruani
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France.,Université de Paris, Paris, France.,INSERM U1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France
| | - Michel Lejoyeux
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, Paris, France
| | - Mircea Polosan
- University Grenoble Alpes, Grenoble, France.,U1216 INSERM, Grenoble Institut of Neuroscience, La Tronche, France.,Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Pierre A Geoffroy
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France
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27
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Pouchon A, Dondé C, Polosan M. Punding Behavior as a Red Flag for Dementia in a Patient With Depression: Case Report. Front Psychiatry 2021; 12:637861. [PMID: 33912083 PMCID: PMC8071987 DOI: 10.3389/fpsyt.2021.637861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/11/2021] [Indexed: 11/21/2022] Open
Abstract
Punding is defined as a stereotypic, complex, repetitive, and non-goal-oriented activity. This behavior has been observed in Parkinson's disease and chronic amphetamine users. However, in general, punding behavior is largely under-diagnosed. Here, we describe a rare case of a 53-year-old woman showing punding behavior during major depressive disorder with atypical clinical features suggestive of a frontal syndrome. Neuropsychological evaluations mainly reported deficits in executive functioning. Brain MRI and lumbar puncture were normal. Brain perfusion SPECT showed hypoperfusion predominating in the right frontal and parietooccipital lobes, and a slight hypoperfusion in subthalamic nucleus including the posterior area of right striatum. We diagnosed this case as a frontotemporal dementia. Punding behavior could be a red flag for dementia in patients with major depressive disorder.
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Affiliation(s)
- Arnaud Pouchon
- Univ. Grenoble Alpes, Inserm U1216 Grenoble Institute of Neurosciences, Psychiatry Department CHU Grenoble Alpes, Grenoble, France
| | - Clément Dondé
- Univ. Grenoble Alpes, Inserm U1216 Grenoble Institute of Neurosciences, Psychiatry Department CHU Grenoble Alpes, Grenoble, France
| | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm U1216 Grenoble Institute of Neurosciences, Psychiatry Department CHU Grenoble Alpes, Grenoble, France
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Sehatpour P, Dondé C, Adair D, Kreither J, Lopez-Calderon J, Avissar M, Bikson M, Javitt DC. Comparison of cortical network effects of high-definition and conventional tDCS during visuomotor processing. Brain Stimul 2020; 14:33-35. [PMID: 33181350 DOI: 10.1016/j.brs.2020.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/24/2020] [Accepted: 11/04/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Pejman Sehatpour
- Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, New York, NY, USA; Schizophrenia Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
| | - Clément Dondé
- Université Grenoble Alpes, Inserm U1216, Grenoble Institut des Neurosciences, CHU Grenoble-Alpes, F-38000, Grenoble, France
| | - Devin Adair
- Department of Biomedical Engineering, The City College of New York, CUNY, NY, USA
| | - Johanna Kreither
- PIA Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas, Centro de Psicología Aplicada, Facultad de Psicología, Universidad de, Talca, Chile
| | | | - Michael Avissar
- Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, New York, NY, USA
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, CUNY, NY, USA
| | - Daniel C Javitt
- Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, New York, NY, USA; Schizophrenia Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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Sehatpour P, Dondé C, Hoptman MJ, Kreither J, Adair D, Dias E, Vail B, Rohrig S, Silipo G, Lopez-Calderon J, Martinez A, Javitt DC. Network-level mechanisms underlying effects of transcranial direct current stimulation (tDCS) on visuomotor learning. Neuroimage 2020; 223:117311. [PMID: 32889116 PMCID: PMC7778833 DOI: 10.1016/j.neuroimage.2020.117311] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/15/2020] [Accepted: 08/18/2020] [Indexed: 02/02/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation approach in which low level currents are administered over the scalp to influence underlying brain function. Prevailing theories of tDCS focus on modulation of excitation-inhibition balance at the local stimulation location. However, network level effects are reported as well, and appear to depend upon differential underlying mechanisms. Here, we evaluated potential network-level effects of tDCS during the Serial Reaction Time Task (SRTT) using convergent EEG- and fMRI-based connectivity approaches. Motor learning manifested as a significant (p <.0001) shift from slow to fast responses and corresponded to a significant increase in beta-coherence (p <.0001) and fMRI connectivity (p <.01) particularly within the visual-motor pathway. Differential patterns of tDCS effect were observed within different parametric task versions, consistent with network models. Overall, these findings demonstrate objective physiological effects of tDCS at the network level that result in effective behavioral modulation when tDCS parameters are matched to network-level requirements of the underlying task.
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Affiliation(s)
- Pejman Sehatpour
- Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, New York, NY, USA; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
| | - Clément Dondé
- Université Grenoble Alpes, Inserm U1216, Grenoble Institut des Neurosciences, CHU Grenoble-Alpes, F-38000 Grenoble, France
| | - Matthew J Hoptman
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Johanna Kreither
- PIA Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas, Centro de Psicología Aplicada, Facultad de Psicología, Universidad de Talca, Chile
| | - Devin Adair
- Department of Biomedical Engineering, The City College of New York, CUNY, NY, USA
| | - Elisa Dias
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Blair Vail
- Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, New York, NY, USA
| | - Stephanie Rohrig
- Department of Psychology, Hofstra University, New Hempstead, NY, USA
| | - Gail Silipo
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | | | - Antigona Martinez
- Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, New York, NY, USA; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Daniel C Javitt
- Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, New York, NY, USA; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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30
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Dondé C, Brunelin J, Mondino M, Cellard C, Rolland B, Haesebaert F. The effects of acute nicotine administration on cognitive and early sensory processes in schizophrenia: a systematic review. Neurosci Biobehav Rev 2020; 118:121-133. [PMID: 32739422 DOI: 10.1016/j.neubiorev.2020.07.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 01/10/2020] [Revised: 06/18/2020] [Accepted: 07/25/2020] [Indexed: 12/01/2022]
Abstract
Nicotine use, which is mostly done through smoking tobacco, is among the most burdensome comorbidities of schizophrenia. However, the ways in which nicotine affects the cognitive and early sensory alterations found in this illness are still debated. After conducting a systematic literature search, 29 studies were selected. These studies involve individuals with schizophrenia who underwent cognitive and/or early sensory function assessments after acute nicotine administration and include 560 schizophrenia subjects and 346 non-schizophrenia controls. The findings highlight that a single dose of nicotine can improve a range of cognitive functions in schizophrenia subjects, such as attention, working memory, and executive functions, with attention being the most responsive domain. In addition, nicotine can modulate early detection of changes in the sensory environment at both the auditory and visual levels. Nevertheless, effects vary strongly depending on the type of neuropsychological assessment and nicotine intake conditions used in each study. The current findings suggest the need to consider a potential decrease of cognitive and early sensory performance when patients with schizophrenia quit smoking.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000 Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, F-38000 Grenoble, France.
| | - Jérôme Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | - Marine Mondino
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | | | - Benjamin Rolland
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | - Frédéric Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
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Abstract
BACKGROUND Based on the observed clinical overlap between obsessive-compulsive disorder (OCD) and schizophrenia (SCZ), both conditions may share, at least in part, common cognitive underpinnings. Among the cognitive deficits that could be involved, it has been hypothesized that patients share a failure in their abilities to monitor their own thoughts (source monitoring), leading to confusion between what they actually did or perceived and what they imagined. Although little is known regarding source-monitoring performances in patients with OCD, numerous studies in patients with SCZ have observed a relationship between delusions and/or hallucinations and deficits in both internal source- and reality-monitoring abilities. METHODS The present work compared source-monitoring performances (internal source and reality monitoring) between patients with OCD (n = 32), patients with SCZ (n = 38), and healthy controls (HC; n = 29). RESULTS We observed that patients with OCD and patients with SCZ displayed abnormal internal source-monitoring abilities compared to HC. Only patients with SCZ displayed abnormalities in reality monitoring compared to both patients with OCD and HC. CONCLUSIONS Internal source-monitoring deficits are shared by patients with OCD and SCZ and may contribute to the shared cognitive deficits that lead to obsessions and delusions. In contrast, reality-monitoring performance seems to differentiate patients with OCD from patients with SCZ.
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Affiliation(s)
- Layla Lavallé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, LyonF-69000, France.,University Lyon 1, VilleurbanneF-69000, France.,Center Hospitalier Le Vinatier, F-69500 Bron, France
| | - Rémy Bation
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, LyonF-69000, France.,University Lyon 1, VilleurbanneF-69000, France.,Center Hospitalier Le Vinatier, F-69500 Bron, France.,Psychiatry Unit, Wertheimer Hospital, CHU, LyonF-69500, France
| | - Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, LyonF-69000, France.,University Lyon 1, VilleurbanneF-69000, France.,Center Hospitalier Le Vinatier, F-69500 Bron, France
| | - Marine Mondino
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, LyonF-69000, France.,University Lyon 1, VilleurbanneF-69000, France.,Center Hospitalier Le Vinatier, F-69500 Bron, France
| | - Jérome Brunelin
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, LyonF-69000, France.,University Lyon 1, VilleurbanneF-69000, France.,Center Hospitalier Le Vinatier, F-69500 Bron, France
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Abstract
Objective: The aim of this study was to validate the French version of the 7-item
Auditory Hallucination Rating Scale (AHRS) so as to facilitate fine-grained
assessment of auditory hallucinations (AH) in native French-speaking
patients with schizophrenia (SZ) in clinical settings and studies. Method: Patients (N = 66) were diagnosed with SZ according to the
Diagnostic and Statistical Manual of Mental Disorders.
The French version of the AHRS was developed using a forward–backward
translation procedure. Psychometric properties of the French version of the
AHRS were tested including (i) construct validity with a confirmatory
one-factor analysis, (ii) internal validity with Pearson correlations and
Cronbach α coefficients, and (iii) external validity by correlations with
the Scale for Assessment of Positive Symptoms (SAPS-H1), the Positive and
Negative Syndrome Scale (PANSS-P3; concurrent), the PANSS-Negative subscale
and age of subjects (divergent), and inter-rater intraclass correlation
coefficients (ICCs). Results: (i) The confirmatory one-factor analysis found a root mean square error of
approximation (RMSEA) = 0.00, 90% confidence interval = [0.000 to 0.011],
and a comparative fit index = 0.994. (ii) Correlations between AHRS total
score and individual items were mostly ≥0.4. Cronbach α coefficient was
0.61. (iii) Correlations with PANSS-P3 and SAPS-H1 were 0.42 and 0.53,
respectively. In a subset of participants (N = 16), ICC
values were extremely high and significant for AHRS total and individual
item scores (ICCs range 0.899 to 0.996) Conclusion: The French version of the AHRS is a psychometrically acceptable instrument
for the evaluation of AH severity in French-speaking patients with SZ.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Emmanuel Poulet
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Department of Emergency Psychiatry, University Hospital Edouard Herriot, Hospices civils de Lyon, France
| | - Marine Mondino
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Jérôme Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
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Dondé C, Brunelin J, Haesebaert F. Duration, pitch and intensity features reveal different magnitudes of tone-matching deficit in schizophrenia. Schizophr Res 2020; 215:460-462. [PMID: 31615741 DOI: 10.1016/j.schres.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/29/2019] [Accepted: 10/06/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Clément Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | - Jerome Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
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34
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Dondé C, Avissar M, Weber MM, Javitt DC. A century of sensory processing dysfunction in schizophrenia. Eur Psychiatry 2020; 59:77-79. [DOI: 10.1016/j.eurpsy.2019.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 11/27/2022] Open
Abstract
Approximately 100 years ago, Bleuler famously declared that “Sensory response to external stimulus is quite normal” in schizophrenia, followed however by the cryptic statement: “Busch and Kraepelin have found in perception experiment (using the shutter and revolving drum apparatus) that schizophrenics show many more errors and particularly omissions than do the healthy … Using accurate apparatus, we were unable to substantiate these findings”.
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Dondé C, Senn M, Eche J, Kallel L, Saoud M, Brunelin J. Well-informed but not aware: The P.A.C.T.® psychoeducation program for schizophrenia improves knowledge about, but not insight into, the illness. Asian J Psychiatr 2019; 46:15-18. [PMID: 31586795 DOI: 10.1016/j.ajp.2019.09.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/26/2019] [Accepted: 09/26/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Most individuals with schizophrenia (SZ) have little to no insight regarding the presence of their illness. Psychoeducational programs are state-of-the-art interventions that consist in delivering stabilized patients with accurate knowledge about their illness and its treatment. Evidence suggests a significant relationship between levels of illness-related knowledge and insight in SZ patients. However, the effect of psychoeducation on these related outcomes needs to be explored further. METHODS In this open label study involving 30 French-speaking patients with SZ, we propose to compare levels of knowledge and insight before and after the French P.A.C.T.® psychoeducation program to investigate how this approach affects both outcomes. Knowledge levels were measured with the self-questionnaire "What do I know?". Insight levels were measured using the Scale to Assess Unawareness of Mental Disorder (SUMD). Symptoms were assessed with the Positive And Negative Syndrome Scale (PANSS). RESULTS A large significant improvement of knowledge was observed (p < 0.001; d = 0.77). By contrast, the analysis reported no significant effect of psychoeducation on insight (p = 0.86; d = 0.07). PANSS total scores were significantly decreased after treatment (p = 0.001; d = 0.66). CONCLUSIONS Although the P.A.C.T.® program is a promising tool for improving illness-related knowledge in SZ patients, its use is not sufficient to significantly improve insight levels.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | - Muriel Senn
- Centre Hospitalier de la Côte Basque, F-64109, Bayonne, France
| | - Julien Eche
- Department of Liaison Psychiatry, University Hospital Neurologique, Hospices civils de Lyon, Lyon, France
| | | | - Mohamed Saoud
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France; Department of Liaison Psychiatry, University Hospital Neurologique, Hospices civils de Lyon, Lyon, France
| | - Jérôme Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
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Dondé C, Martinez A, Sehatpour P, Patel GH, Kraut R, Kantrowitz JT, Javitt DC. Neural and functional correlates of impaired reading ability in schizophrenia. Sci Rep 2019; 9:16022. [PMID: 31690846 PMCID: PMC6831596 DOI: 10.1038/s41598-019-52669-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 10/22/2019] [Indexed: 01/14/2023] Open
Abstract
Deficits in early auditory processing (EAP) are a core component of schizophrenia (SZ) and contribute significantly to impaired overall function. Here, we evaluate the potential contributions of EAP-related impairments in reading to functional capacity and outcome, relative to effects of auditory social cognitive and general neurocognitive dysfunction. Participants included 30-SZ and 28-controls of similar age, sex, and educational achievement. EAP was assessed using an auditory working memory (tone-matching) task. Phonological processing and reading Fluency were assessed using the Comprehensive Test of Phonological Processing and Woodcock-Johnson reading batteries, respectively. Auditory-related social cognition was assessed using measures of emotion/sarcasm recognition. Functional capacity and outcome were assessed using the UCSD Performance-based Skills Assessment and Specific Level of Functioning scale, respectively. fMRI resting-state functional-connectivity (rsFC) was used to evaluate potential underlying substrates. As predicted, SZ patients showed significant and interrelated deficits in both phonological processing (d = 0.74, p = 0.009) and reading fluency (d = 1.24, p < 0.00005). By contrast, single word reading (d = 0.35, p = 0.31) was intact. In SZ, deficits in EAP and phonological reading ability significantly predicted reduced functional capacity, but not functional outcome. By contrast, deficits in reading fluency significantly predicted impairments in both functional capacity and functional outcome. Moreover, deficits in reading fluency correlated with rsFC alterations among auditory thalamus, early auditory and auditory association regions. These findings indicate significant contributions of EAP deficits and functional connectivity changes in subcortical and early auditory regions to reductions in reading fluency, and of impaired reading ability to impaired functional outcome in SZ.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France. .,University Lyon 1, Villeurbanne, F-69000, France. .,Centre Hospitalier Le Vinatier, Bron, France. .,Nathan Kline Institute, Orangeburg, NY, USA. .,Dept. of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA.
| | - Antigona Martinez
- Nathan Kline Institute, Orangeburg, NY, USA.,Dept. of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA
| | - Pejman Sehatpour
- Nathan Kline Institute, Orangeburg, NY, USA.,Dept. of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA
| | - Gaurav H Patel
- Dept. of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA
| | - Rebecca Kraut
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Joshua T Kantrowitz
- Nathan Kline Institute, Orangeburg, NY, USA.,Dept. of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA
| | - Daniel C Javitt
- Nathan Kline Institute, Orangeburg, NY, USA. .,Dept. of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA.
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Dondé C, Martínez A, Kantrowitz JT, Silipo G, Dias EC, Patel GH, Sanchez-Peña J, Corcoran CM, Medalia A, Saperstein A, Vail B, Javitt DC. Bimodal distribution of tone-matching deficits indicates discrete pathophysiological entities within the syndrome of schizophrenia. Transl Psychiatry 2019; 9:221. [PMID: 31492832 PMCID: PMC6731304 DOI: 10.1038/s41398-019-0557-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 06/03/2019] [Accepted: 06/20/2019] [Indexed: 12/11/2022] Open
Abstract
To date, no measures are available that permit differentiation of discrete, clinically distinct subtypes of schizophrenia (SZ) with potential differential underlying pathophysiologies. Over recent years, there has been increasing recognition that SZ is heterogeneously associated with deficits in early auditory processing (EAP), as demonstrated using clinically applicable tasks such as tone-matching task (TMT). Here, we pooled TMT performances across 310 SZ individuals and 219 healthy controls (HC), along with clinical, cognitive, and resting-state functional-connectivity MRI (rsFC-MRI) measures. In addition, TMT was measured in a group of 24 patients at symptomatic clinical high risk (CHR) for SZ and 24 age-matched HC (age range 7-27 years). We provide the first demonstration that the EAP deficits are bimodally distributed across SZ subjects (P < 0.0001 vs. unimodal distribution), with one group showing entirely unimpaired TMT performance (SZ-EAP+), and a second showing an extremely large TMT impairment (SZ-EAP-), relative to both controls (d = 2.1) and SZ-EAP+ patients (d = 3.4). The SZ-EAP- group predominated among samples drawn from inpatient sites, showed higher levels of cognitive symptoms (PANSS), worse social cognition and a differential deficit in neurocognition (MATRICS battery), and reduced functional capacity. rsFC-MRI analyses showed significant reduction in SZ-EAP- relative to controls between subcortical and cortical auditory regions. As opposed to SZ, CHR patients showed intact EAP function. In HC age-matched to CHR, EAP ability was shown to increase across the age range of vulnerability preceding SZ onset. These results indicate that EAP measure segregates between discrete SZ subgroups. As TMT can be readily implemented within routine clinical settings, its use may be critical to account for the heterogeneity of clinical outcomes currently observed across SZ patients, as well as for pre-clinical detection and efficacious treatment selection.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France. .,University Lyon 1, Villeurbanne, F-69000, France. .,Centre Hospitalier Le Vinatier, Bron, France. .,Nathan Kline Institute, Orangeburg, NY, USA. .,Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA.
| | - Antigona Martínez
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA ,0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Joshua T. Kantrowitz
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA ,0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Gail Silipo
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA
| | - Elisa C. Dias
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA
| | - Gaurav H. Patel
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Juan Sanchez-Peña
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Cheryl M. Corcoran
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA ,0000 0001 0670 2351grid.59734.3cDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Alice Medalia
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Alice Saperstein
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Blair Vail
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Daniel C. Javitt
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA ,0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
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Dondé C, Mondino M, Leitman DI, Javitt DC, Suaud-Chagny MF, D'Amato T, Brunelin J, Haesebaert F. Are basic auditory processes involved in source-monitoring deficits in patients with schizophrenia? Schizophr Res 2019; 210:135-142. [PMID: 31176535 DOI: 10.1016/j.schres.2019.05.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/29/2019] [Accepted: 05/26/2019] [Indexed: 10/26/2022]
Abstract
Patients with schizophrenia (SZ) display deficits in both basic non-verbal auditory processing and source-monitoring of speech. To date, the contributions of basic auditory deficits to higher-order cognitive impairments, such as source-monitoring, and to clinical symptoms have yet to be elucidated. The aim of this study was to investigate the deficits and relationships between basic auditory functions, source-monitoring performances, and clinical symptom severity in SZ. Auditory processing of 4 psychoacoustic features (pitch, intensity, amplitude, length) and 2 types of source-monitoring (internal and reality monitoring) performances were assessed in 29 SZ and 29 healthy controls. Clinical symptoms were evaluated in patients with the Positive And Negative Syndrome Scale. Compared to the controls, SZ individuals in showed significant reductions in both global basic auditory processing (p < .0005, d = 1.16) and source-monitoring (p < .0005, d = 1.24) abilities. Both deficits correlated significantly in patients and across groups (all p < .05). Pitch processing skills were negatively correlated with positive symptom severity (r = -0.4, p < .05). A step-wise regression analysis showed that pitch discrimination was a significant predictor of source-monitoring performance. These results suggest that cognitive mechanisms associated with the discrimination of basic auditory features are most compromised in patients with source-monitoring disability. Basic auditory processing may index pathophysiological processes that are critical for optimal source-monitoring in schizophrenia and that are involved in positive symptoms.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France; Nathan Kline Institute, Orangeburg, NY, USA; Dept. of Psychiatry, Columbia University Medical Center, New York, NY, US.
| | - Marine Mondino
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
| | - David I Leitman
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
| | - Daniel C Javitt
- Nathan Kline Institute, Orangeburg, NY, USA; Dept. of Psychiatry, Columbia University Medical Center, New York, NY, US
| | - Marie-Françoise Suaud-Chagny
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
| | - Thierry D'Amato
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
| | - Jérôme Brunelin
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France
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Dondé C, Sehatpour P, Kreither J, Silipo G, Javitt DC. Comparison of high-definition and conventional tDCS on visuomotor sequence learning. Encephale 2019. [DOI: 10.1016/j.encep.2019.04.048] [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] [Indexed: 11/26/2022]
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Dondé C, Silipo G, Dias EC, Javitt DC. Hierarchical deficits in auditory information processing in schizophrenia. Schizophr Res 2019; 206:135-141. [PMID: 30551982 PMCID: PMC6526044 DOI: 10.1016/j.schres.2018.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/11/2018] [Accepted: 12/04/2018] [Indexed: 01/31/2023]
Abstract
Deficits in auditory processing contribute significantly to impaired functional outcome in schizophrenia (SZ), but mediating factors remain under investigation. Here we evaluated two hierarchical components of early auditory processing: pitch-change detection (i.e. identifying if 2 tones have "same" or "different" pitch), which is preferentially associated with early auditory cortex, and serial pitch-pattern detection (i.e. identifying if 3 tones have "same" or "different" pitch, and, if "different", which one differed from the others), which depends also on auditory association regions. Deficits in pitch-change detection deficits in SZ have been widely reported and correlated with higher auditory disturbances such as Auditory Emotion Recognition (AER). Deficits in serial pitch-pattern discrimination have been less studied. Here, we investigated both pitch perception components, along with integrity of AER in SZ patients vs. controls using behavioral paradigms. We hypothesized that the deficits could be viewed as hierarchically organized in SZ, with deficits in low-level function propagating sequentially through subsequent levels of processing. Participants included 27 SZ and 40 controls. The magnitude of the deficits in SZ participants was large in both the pitch-change (d = 1.15) and serial pitch-pattern tasks (d = 1.21) with no significant differential task effect. The effect size of the AER deficits was extremely large (d = 2.82). In the SZ group, performance in both pitch tasks correlated significantly with impaired AER performance. However, a mediation analysis showed that serial pitch-pattern detection mediated the relationship between simpler pitch-change detection and AER in patients. Findings are consistent with hierarchical models of cognitive dysfunction in SZ with deficits in early information processing contributing to higher level impairments. Furthermore, findings are consistent with recent neurophysiological results suggesting similar level impairments for processing of simple vs. more complex tonal dysfunction in SZ.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France; Nathan Kline Institute, Orangeburg, NY, USA; Dept. of Psychiatry, Columbia University Medical Center, New York, NY, USA.
| | - Gail Silipo
- Nathan Kline Institute, Orangeburg, NY, USA.
| | | | - Daniel C. Javitt
- Nathan Kline Institute, Orangeburg, NY USA,Dept. of Psychiatry, Columbia University Medical Center, New York, NY USA
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Abstract
INTRODUCTION Auditory and visual dysfunctions are key pathophysiological features of schizophrenia (Sz). Therefore, remedial interventions that directly target such impairments could potentially drive gains in higher-order cognition (e.g., memory, executive functions, emotion processing), symptoms and functional outcome, in addition to improving sensory abilities in this population. Here, we reviewed available sensory-targeted cognitive training (S-TCT) programs that were investigated so far in Sz patients. Area covered: A systematic review of the literature was conducted following PRISMA guidelines. Twenty-seven relevant records were included. The superiority of S-TCT over control conditions on higher-order cognition measures was repeatedly demonstrated, but mostly lost significance at later endpoints of evaluation. Clinical symptoms and functional outcome were improved in a minority of studies. S-TCT interventions were associated with the relative normalization of several neurobiological biomarkers of neuroplasticity and sensory mechanisms. Expert commentary: S-TCT, although time-intensive, is a cost-efficient, safe and promising technique for Sz treatment. Its efficacy on higher-order cognition opens a critical window for clinical and functional improvement. The biological impact of S-TCT may allow for the identification of therapeutic biomarkers to further precision-medicine. Additional research is required to investigate the long-term effects of S-TCT, optimal training parameters and potential confounding factors associated with the illness.
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Affiliation(s)
- Clément Dondé
- a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.,b University Lyon 1 , Villeurbanne, F-69000 , France.,c Centre Hospitalier Le Vinatier, Department of Psychiatry , Bron, F-69000 , France
| | - Marine Mondino
- a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.,b University Lyon 1 , Villeurbanne, F-69000 , France.,c Centre Hospitalier Le Vinatier, Department of Psychiatry , Bron, F-69000 , France
| | - Jérôme Brunelin
- a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.,b University Lyon 1 , Villeurbanne, F-69000 , France.,c Centre Hospitalier Le Vinatier, Department of Psychiatry , Bron, F-69000 , France
| | - Frédéric Haesebaert
- a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.,b University Lyon 1 , Villeurbanne, F-69000 , France.,c Centre Hospitalier Le Vinatier, Department of Psychiatry , Bron, F-69000 , France
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Dondé C, Neufeld NH, Geoffroy PA. The Impact of Transcranial Direct Current Stimulation (tDCS) on Bipolar Depression, Mania, and Euthymia: a Systematic Review of Preliminary Data. Psychiatr Q 2018; 89:855-867. [PMID: 29785673 DOI: 10.1007/s11126-018-9584-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The neurobiological basis of bipolar disorders (BD) has received increased attention and several brain regions and brain circuits have been correlated with clinical symptoms. These brain regions and circuits may represent targets for neuromodulation techniques such as transcranial Direct Current Stimulation (tDCS). We systematically reviewed the literature to explore the risks and benefits of tDCS in BD and examined all mood states. Following the PRISMA guidelines, a systematic literature search using several databases was performed from April 2002 to June 2017. From the 135 eligible studies, we retained 19 relevant articles for the systematic review, including 170 patients with BD treated by tDCS. Data from 10 studies suggest that tDCS improves depressive symptoms in BD. One case report of add-on-tDCS reported a significant positive response on manic symptoms. In 4 studies, tDCS impacted specific neurocognitive functions in euthymic patients. There is also preliminary evidence that tDCS improves neurological soft signs and sleep quality in euthymia. Side effects were predominantly transient and low-intensity, although 6 cases of hypomanic/manic affective switches have been reported. The majority of studies have been open trials with few patients. More sufficiently powered randomized controlled trials are needed to clarify the effectiveness of tDCS. Preliminary data suggests that tDCS holds promise as a treatment for BD, especially during depressive episodes. Perhaps most promising are emerging data suggesting tDCS may impact neurocognition and sleep quality in euthymia and be useful for relapse prevention.
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Affiliation(s)
- Clément Dondé
- University Lyon 1, F-69000, Villeurbanne, France. .,Centre Hospitalier Le Vinatier, CH Le Vinatier, Batiment 416, 95 boulevard Pinel, BP 300 39, 69 678 Bron Cedex, France.
| | | | - Pierre A Geoffroy
- Inserm, U1144, F-75006, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, F-75013, Paris, France.,AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475, Paris cedex 10, France.,Fondation FondaMental, 94000, Créteil, France
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Thevenet M, Dondé C, Machabert R, Ancona L, Jost C, Georgieff N. Perspective de prise en charge d’enfants atteints de troubles du spectre autistique par psychothérapie inspirée des thérapies basées sur la mentalisation. Encephale 2018; 44:482-485. [DOI: 10.1016/j.encep.2017.10.008] [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: 06/16/2017] [Revised: 10/20/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022]
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Dondé C, Vignaud P, Poulet E, Brunelin J, Haesebaert F. Management of depression in patients with schizophrenia spectrum disorders: a critical review of international guidelines. Acta Psychiatr Scand 2018; 138:289-299. [PMID: 29974451 DOI: 10.1111/acps.12939] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Depression is a frequent but potentially treatable clinical dimension in patients with schizophrenia spectrum disorders (PWS). However, there is a lack of consensual recommendations regarding the optimal strategy to manage depression in PWS. In this study, we aimed to compare the various proposed strategies to define a core set of valid care recommendations for depression management in PWS. METHODS After a systematic search of the literature, the methodological quality of 10 international guidelines from four continents was compared using a validated guideline appraisal instrument (AGREE II). Key recommendations for the management of depression in PWS were subsequently reviewed and discussed. RESULTS The methodological quality of the guidelines was heterogeneous. Although all guidelines proposed pharmacotherapy, psychosocial interventions were a minor concern. Waiting for antipsychotic effects mostly was recommended during the acute phase of schizophrenia. During the postpsychotic phase of the illness, a switch to a second-generation antipsychotic and/or the adjunction of an antidepressant were the primary recommendations. Cognitive behavioural therapy and other medications were considered with strong variations. CONCLUSIONS Further studies are needed to strengthen the level of evidence for antidepressive approaches in PWS. The inclusion of PWS as stakeholders is also considered to be a major issue for future guideline development.
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Affiliation(s)
- C Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - P Vignaud
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - E Poulet
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France.,Department of Psychiatry Emergencies, CHU Lyon, Hôpital Edouard Herriot, Lyon, France
| | - J Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - F Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France.,University Lyon 1, Villeurbanne, France.,Centre Hospitalier Le Vinatier, Bron, France.,CERVO Brain Research Center, Québec, QC, Canada.,Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, QC, Canada
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Dondé C, D'Amato T, Rey R. Dermatoglyphics patterns abnormalities as putative markers of psychometric-risk for schizophrenia. Psychiatr Danub 2018; 30:109-111. [PMID: 29546868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Clément Dondé
- NSERM U1028, CNRS UMR 5292, ΨR2 Team, Lyon Neuroscience Research Center; Centre Hospitalier Le Vinatier, CH Le Vinatier, Batiment 416, 95 boulevard Pinel, BP 300 39; 69 678 Bron cedex, France,
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Dondé C, Moirand R, Carre A. L’activation comportementale : un outil simple et efficace dans le traitement de la dépression. Encephale 2018; 44:59-66. [DOI: 10.1016/j.encep.2017.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 01/09/2023]
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47
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Dondé C, Amad A, Nieto I, Brunoni AR, Neufeld NH, Bellivier F, Poulet E, Geoffroy PA. Transcranial direct-current stimulation (tDCS) for bipolar depression: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78:123-131. [PMID: 28552295 DOI: 10.1016/j.pnpbp.2017.05.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 05/23/2017] [Accepted: 05/24/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Bipolar disorder (BD) is a severe and recurrent brain disorder that can manifest in manic or depressive episodes. Transcranial Direct Current Stimulation (tDCS) has been proposed as a novel therapeutic modality for patients experiencing bipolar depression, for which standard treatments are often inefficient. While several studies have been conducted in this patient group, there has been no systematic review or meta-analysis that specifically examines bipolar depression. We aimed to address this gap in the literature and evaluated the efficacy and tolerability of tDCS in patients fulfilling DSM-IV-TR criteria for BD I, II, or BD not otherwise specified (NOS). METHODS We systematically searched the literature from April 2002 to November 2016 to identify relevant publications for inclusion in our systematic review and meta-analysis. Effect sizes for depression rating-scale scores were expressed as the standardized mean difference (SMD) before and after tDCS. RESULTS Thirteen of 382 identified studies met eligibility criteria for our systematic review. The meta-analysis included 46 patients from 7 studies with depression rating-scale scores pre- and post-tDCS. Parameters of tDCS procedures were heterogeneous. Depression scores decreased significantly with a medium effect size after acute-phase of treatment (SMD 0.71 [0.25-1.18], z=3.00, p=0.003) and at the furthest endpoint (SMD 1.27 [0.57-1.97], z=3.57, p=0.0004). Six cases of affective switching under tDCS treatment protocols were observed. CONCLUSIONS Depressive symptoms respond to tDCS in patients with BD. Additional studies, and particularly randomized controlled trials, are needed to clarify the effectiveness of tDCS in bipolar depression, the frequency of tDCS-emergent hypomania/mania, and which tDCS modalities are most efficient.
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Affiliation(s)
- Clément Dondé
- INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response ΨR2 Team, Centre Hospitalier Le Vinatier, F-69678, France; Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response ΨR2 Team, Centre Hospitalier Le Vinatier, F-69678, France.
| | - Ali Amad
- University Claude Bernard Lyon 1, Villeurbanne F-69000, France
| | - Isabel Nieto
- AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris, Cedex 10, France; Fondation FondaMental, Créteil 94000, France
| | - André Russowsky Brunoni
- Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of São Paulo, São Paulo, Brazil
| | | | - Frank Bellivier
- AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris, Cedex 10, France; Fondation FondaMental, Créteil 94000, France; Inserm, U1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
| | - Emmanuel Poulet
- INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response ΨR2 Team, Centre Hospitalier Le Vinatier, F-69678, France; CHU Lyon, Hôpital Edouard Herriot, Department of Psychiatry Emergencies, France; Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response ΨR2 Team, Centre Hospitalier Le Vinatier, F-69678, France
| | - Pierre-Alexis Geoffroy
- AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris, Cedex 10, France; Fondation FondaMental, Créteil 94000, France; Inserm, U1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France.
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48
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Gargot T, Dondé C, Arnaoutoglou NA, Klotins R, Marinova P, Silva R, Sönmez E. How is psychotherapy training perceived by psychiatric trainees? A cross-sectional observational study in Europe. Eur Psychiatry 2017; 45:136-138. [PMID: 28756112 DOI: 10.1016/j.eurpsy.2017.05.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/11/2017] [Accepted: 05/21/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- T Gargot
- Département de psychiatrie de l'enfant et de l'adolescent, Hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Laboratoire Institut des Systèmes Intelligents et de Robotique (ISIR), Université UPMC, CNRS, 75005 Paris, France.
| | - C Dondé
- Inserm U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, 69500 Bron, France; Université Claude-Bernard Lyon 1, 69100 Lyon, France
| | - N A Arnaoutoglou
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, Oxford, UK
| | - R Klotins
- Tavistock and Portman NHS Foundation Trust, Adult Department, 120 Belsize Lane, London NW3 5BA, UK
| | - P Marinova
- Private psychiatric practice, Sofia, Bulgaria
| | - R Silva
- Department of Psychiatry and Mental Health of the Baixo Vouga Hospital Centre, Avenida Artur Ravara, 3814-501 Aveiro, Portugal
| | - E Sönmez
- Marmara University School of Medicine, Department of Psychiatry, Istanbul, Turkey
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- EFPT Psychotherapy Working Group 2016-2017, European Federation of Psychiatric Trainees, avenue de la Couronne, 201050 Bruxelles, Belgium
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49
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Lavigne B, Lepetit A, Dondé C, Barbotin B, Lardinois M. Prise en charge des internes de psychiatrie en souffrance : résultats d’une enquête déclarative chez les représentants et les coordonnateurs locaux. Eur Psychiatry 2015. [DOI: 10.1016/j.eurpsy.2015.09.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
L’internat est une période de stress chronique élevé pour les étudiants en médecine et des travaux récents révèlent une prévalence importante des trouble psychiatriques au cours de cette période [1,2]. L’Association française fédérative des étudiants en psychiatrie (AFFEP) a mené une enquête afin de faire un état des lieux sur la prise en charge des internes de psychiatrie en souffrance psychologique au cours de leur cursus. Trois groupes ont été interrogés : les référents AFFEP, qui représentent les internes de psychiatrie dans chaque subdivision, les coordinateurs locaux et interrégionaux du DES de psychiatrie et du DESC de psychiatrie de l’enfant et de l’adolescent. Entre 2013 et 2015, 86 internes ont présenté des difficultés psychologique soit environ 4 % des internes. Cela s’est principalement traduit par des difficultés ou un absentéisme en stage, la mise en arrêt de travail, et quelques rares cas de suicides ou tentatives de suicide ont été décrits. Les premières personnes à signaler les difficultés étaient majoritairement le médecin chef de service, l’interne lui-même ou son co-interne. Une fois les difficultés signalées, des mesures professionnelles étaient mises en place dans 35 % des cas, et 15 % des internes concernés bénéficiaient de soins. La médecine du travail était peu sollicitée, tandis que le coordinateur local, les co-internes, et l’association locale représentaient les principaux intervenants. Pour tous, ce sont les coordinateurs locaux qui sont jugés les intervenants les plus légitimes dans ces situations. Les dispositifs d’évaluation de la santé des internes, en particuliers les comités médicaux, étaient peu connus des référents même s’ils sont jugés utiles par les internes et les coordinateurs locaux. Du fait de la prévalence importante des internes concernés, de l’hétérogénéité et du manque de prises en charge , il semble crucial de proposer des recommandations consensuelles avec les enseignants universitaires, favorisant le parcours professionnel et l’accès aux soins pour ces internes.
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