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Miele C, Cabé J, Cabé N, Bertsch I, Brousse G, Pereira B, Moulin V, Barrault S. Measuring craving: A systematic review and mapping of assessment instruments. What about sexual craving? Addiction 2023; 118:2277-2314. [PMID: 37493019 DOI: 10.1111/add.16287] [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: 01/30/2023] [Accepted: 05/31/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND AND AIMS Craving is central in the definition of addictive disorders because of its diagnostic and prognostic value. Its measurement is essential in clinical practice. Previous reviews provided a better overview of existing instruments; however, they do not consider emerging substances and behaviors such as sexual addictions. Our objectives were threefold: (1) to provide a systematic review of craving assessment instruments and their psychometric characteristics within a transdiagnostic approach, (2) to highlight and map their conceptual relationships and (3) to identify potential sexual craving assessment instruments. METHODS The review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. The PubMed, Embase, PsychInfo and Cochrane/Central databases were searched for publications that met the following inclusion criterion: validation studies of craving assessment instruments, regardless of target substance or behavior. The original search identified 4561 references and included 147 articles. Each selected study was a peer-reviewed publication. RESULTS This review provides a synthesis of the psychometric properties of 36 original instruments and identified 93 variations of these instruments (e.g. translations). We were able to highlight five transdiagnostic families of instruments, each corresponding to a conceptual model. Only one instrument for assessing craving in the domain of compulsive sexual behavior, focused on pornography use, has been identified: the Pornography Craving Questionnaire. CONCLUSION This review mapped all craving assessment instruments from a transdiagnostic perspective, finding 36 original instruments and 93 variations. The evolution of instruments to measure craving mirrors the evolution of the concept of craving which has progressively integrated cognitive, conditioning and sensory dimensions, and attests to the importance of the context of assessment. Development of an instrument to measure 'sexual craving' is needed and could be based on the data from our review.
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Affiliation(s)
- Cécile Miele
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Laboratoire Inter-universitaire de Psychologie Personnalité, Cognition, Changement Social (LIP/PC2S) Université de Grenoble Alpes, Grenoble, France
| | - Julien Cabé
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
| | - Nicolas Cabé
- Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
- Normandie Université, UNICAEN, INSERM, PhIND 'Physiopathology and Imaging of Neurological Disorders', Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Ingrid Bertsch
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Unité de Consultation Psychiatrique Post-Pénale (UC3P), CHRU de Tours, Tours, France
| | - Georges Brousse
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction de la Recherche Clinique et de l'Innovation, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Valérie Moulin
- Laboratoire Inter-universitaire de Psychologie Personnalité, Cognition, Changement Social (LIP/PC2S) Université de Grenoble Alpes, Grenoble, France
| | - Servane Barrault
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Centre de Soins d'Accompagnement et de Prévention en Addictologie (CSAPA 37), CHRU of Tours, Tours, France
- Laboratory of Psychopathology and Health Processes, University of Paris, Boulogne-Billancourt, France
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Chabert J, Lambert C, Cabé J, Cherpitel CJ, Rolland B, Moustafa F, Lesage P, Ragonnet D, Geneste J, Poulet E, Dematteis M, Naassila M, Chalmeton M, Llorca PM, Pereira B, De Chazeron I, Brousse G. Could reasons for admission help to screen unhealthy alcohol use in emergency departments? A multicenter French study. Front Psychiatry 2023; 14:1271076. [PMID: 38098633 PMCID: PMC10719849 DOI: 10.3389/fpsyt.2023.1271076] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Abstract
Background Many patients admitted to general emergency departments (EDs) have a pattern of drinking that could lead to future alcohol-related complications. However, it is often difficult to screen these patients in the context of emergency. The aim of this study is to analyze whether reasons for admission could help to screen patients who have an unhealthy alcohol use. Method Patients were recruited among six public hospital ED in France, between 2012 and 2014. During a one-month period in each hospital, anonymous questionnaires including sociodemographic questions, AUDIT-C and RAPS4-QF were administered to each patients visiting the ED. The reason for admission of each patient was noted at the end of their questionnaire by the ED practitioner. Results Ten thousand Four hundred twenty-one patients were included in the analysis. Patients who came to the ED for injuries and mental disorders were more likely to report unhealthy alcohol use than non-harmful use or no use. Among male patients under 65 years old admitted to the ED for a mental disorder, 24.2% drank more than four drinks (40 g ethanol) in typical day at least four time a week in the last 12 months. Among these patients, 79.7% reported daily or almost daily heavy episodic drinking (HED, 60 g ethanol), and all were positive on the RAPS4-QF. Conclusion This study highlights that unhealthy alcohol use is frequent among ED patients and particularly among those who come for injuries or mental disorders. Men under 65 years old with a mental disorder require special attention because of their increased prevalence of daily or almost daily HED.
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Affiliation(s)
- Jonathan Chabert
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Céline Lambert
- Unité de Biostatistiques, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Julien Cabé
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | | | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon, Centre Hospitalier Le Vinatier, Hospices Civils de Lyon et Université de Lyon, Lyon, France
| | - Farès Moustafa
- Université Clermont Auvergne, INRAE, UNH, Clermont-Ferrand, France
| | - Patrick Lesage
- Centre Hospitalier Métropole Savoie, Service des Urgences, Chambéry, France
| | - Delphine Ragonnet
- Service Universitaire d’Addictologie de Lyon, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Julie Geneste
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Emmanuel Poulet
- Psychiatrie des Urgences - Groupement Hospitalier Edouard Herriot, EA 4615 « SIPAD », Université Lyon 1 - CH Le Vinatier, Lyon, France
| | - Maurice Dematteis
- Service Universitaire de Pharmaco-Addictologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Mickael Naassila
- INSERM UMRS1247-GRAP, Université Picardie Jules Verne, Amiens, France
| | - Maryline Chalmeton
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Pierre-Michel Llorca
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Bruno Pereira
- Unité de Biostatistiques, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Ingrid De Chazeron
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Georges Brousse
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
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Underner M, Perriot J, Peiffer G, Brousse G, Jaafari N. [Bronchial diseases and heroin use. A systematic review]. Rev Mal Respir 2023; 40:783-809. [PMID: 37925326 DOI: 10.1016/j.rmr.2023.09.006] [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] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/11/2023] [Indexed: 11/06/2023]
Abstract
INTRODUCTION Heroin use can cause respiratory complications including asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis (BD). OBJECTIVES A general review of the literature presenting the data on the relationships between heroin consumption and bronchial complications, while underlining the difficulties of diagnosis and management. DOCUMENTARY SOURCES Medline, 1980-2022, keywords "asthma" or "bronchospasm" or "COPD" or "bronchiectasis" and "heroin" or "opiate" or "opiates", with limits pertaining to "Title/Abstract". Concerning asthma, 26 studies were included, as were 16 for COPD and 5 for BD. RESULTS Asthma and COPD are more prevalent among heroin addicts, who are less compliant than other patients with their treatment. The authors found a positive association between frequency of asthma exacerbations, admission to intensive care and heroin inhalation. Late diagnosis of COPD worsens the course of the disease; emphysema and BD are poor prognostic factors. CONCLUSION Bronchial diseases in heroin users can be identified by means of respiratory function exploration and chest CT scans. These tests should be performed frequently in view of optimizing their care, which includes their weaning themselves from addictive substances.
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Affiliation(s)
- M Underner
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - J Perriot
- Dispensaire Émile-Roux, CLAT, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - G Brousse
- Service d'addictologie, CHU de Clermont-Ferrand, université Clermont Auvergne, 63100 Clermont-Ferrand, France
| | - N Jaafari
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
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Djerada Z, Brousse G, Niel P, Llorca PM, Eschalier A, Bentue-Ferrer D, Libert F. [Therapeutic drug monitoring of olanzapine]. Therapie 2023; 78:S75-S80. [PMID: 27793422 DOI: 10.2515/therapie/2015040] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/19/2015] [Indexed: 11/20/2022]
Abstract
Olanzapine, atypical antipsychotic, is used to treat schizophrenia and bipolar disorder. Its therapeutic drug monitoring (TDM) is quite commonly done. Olanzapine is well absorbed orally (bioavailability: 85 %), with peak plasma occurring between 4 and 6hours after oral administration. It is extensively metabolized by different hepatic enzymes (including CYP1A2 and CYP2D6 isoforms) to a large number of inactive metabolites, and its half-life is between 30 and 60hours. No specific therapeutic range, or threshold concentration could not be a consensus, but the higher intra- and interindividual variability, as well as the existence of studies suggesting a correlation between circulating concentrations of olanzapine and occurrence of therapeutic relapse or toxic phenomena appear to justify the STP for this molecule. Given these data, the interest of the STP was evaluated for this molecule to: recommended with therapeutic window of 20μg/L to 80μg/L.
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Affiliation(s)
- Zoubir Djerada
- Laboratoire de pharmacologie et toxicologie, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
| | - Georges Brousse
- Service de psychiatrie de l'adulte B, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand cedex, France
| | - Philippe Niel
- Centre hospitalier Sainte-Anne-Paris, AP-HP, 75014 Paris, France
| | - Pierre-Michel Llorca
- Service de psychiatrie de l'adulte B, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand cedex, France
| | - Alain Eschalier
- Service de pharmacologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand cedex, France
| | | | - Fréderic Libert
- Service de pharmacologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand cedex, France
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Flaudias V, Samalin L, Godin O, Gard S, Brousse G, Loftus J, Aubin V, Belzeaux R, Dubertret C, Le Strat Y, Mazer N, de Prémorel A, Roux P, Polosan M, Schwitzer T, Aouizerate B, Llorca PM, Biseul I, Etain B, Moirand R, Olié E, Haffen E, Leboyer M, Courtet P, Icick R, Guillaume S. Crossed clinical features between eating disorders and types of bipolar disorder: Results from the FondaMental Advanced Centers of Expertise - Bipolar Disorder cohort. J Affect Disord 2023; 335:177-185. [PMID: 37178826 DOI: 10.1016/j.jad.2023.05.017] [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: 10/19/2022] [Revised: 04/21/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Eating disorders (EDs) are liable to alter the disease course of bipolar disorder (BD). We explored the crossed clinical features between EDs and BD, particularly as a function of BD type (BD1 vs. BD2). METHODS 2929 outpatients attending FondaMental Advanced Centers of Expertise were assessed for BD and lifetime EDs with a semi-structured interview, and their sociodemographic, dimensional and clinical data were collected according to a standardized procedure. For each ED type, bivariate analyses were used to investigate associations between these variables and the type of BD type followed by multinomial regressions with the variables associated with EDs and BDs after Bonferroni correction. RESULTS Comorbid EDs were diagnosed in 478 (16.4 %) cases, and were more prevalent in patients with BD2 than in those with BD1 (20.6 % vs. 12.4 %, p < 0.001). Regression models showed no difference according to the subtype of bipolar disorder on the characteristics of patients with anorexia nervosa (AN), bulimia nervosa (BN) or binge eating disorder (BED). After multiple adjustments, the factors differentiating BD patients with versus without ED were primarily age, gender, body mass index, more affective lability and comorbidity with anxiety disorders. BD patients with BED also scored higher regarding childhood trauma. BD patients with AN also showed higher risk of past suicide attempts than those with BED. CONCLUSIONS In a large sample of patients with BD, we found a high prevalence of lifetime EDs, especially for the BD2 type. EDs were associated with several severity indicators, but not with BD type-specific characteristics. This should prompt clinicians to carefully screen patients with BD for EDs, regardless of BD and ED types.
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Affiliation(s)
- Valentin Flaudias
- Nantes Université, Univ Angers, Laboratoire de psychologie des Pays de la Loire, LPPL, UR 4638, Nantes, France; CHU Clermont-Ferrand, Department of Psychiatry, Clermont-Ferrand, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, 63000 Clermont-Ferrand, France.
| | - Ludovic Samalin
- FondaMental Foundation, Créteil F-94000, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, 63000 Clermont-Ferrand, France
| | | | - Sébastien Gard
- FondaMental Foundation, Créteil F-94000, France; Pôle de Psychiatrie Générale et Universitaire, Center Hospitalier Charles Perrens, France NutriNeuro, INRAE UMR 1286, University of Bordeaux, Bordeaux F-33076, France
| | - Georges Brousse
- FondaMental Foundation, Créteil F-94000, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, 63000 Clermont-Ferrand, France
| | - Joséphine Loftus
- FondaMental Foundation, Créteil F-94000, France; Pôle de Psychiatrie, Center Hospitalier Princesse Grace, Monaco
| | - Valérie Aubin
- FondaMental Foundation, Créteil F-94000, France; Pôle de Psychiatrie, Center Hospitalier Princesse Grace, Monaco
| | - Raoul Belzeaux
- FondaMental Foundation, Créteil F-94000, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Caroline Dubertret
- FondaMental Foundation, Créteil F-94000, France; Université de Paris, INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
| | - Yann Le Strat
- FondaMental Foundation, Créteil F-94000, France; Université de Paris, INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
| | - Nicolas Mazer
- FondaMental Foundation, Créteil F-94000, France; Université de Paris, INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
| | - Alix de Prémorel
- FondaMental Foundation, Créteil F-94000, France; Université de Paris, INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
| | - Paul Roux
- FondaMental Foundation, Créteil F-94000, France; Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Le Chesnay, Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - Mircea Polosan
- FondaMental Foundation, Créteil F-94000, France; Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U 1216, Grenoble, France
| | - Thomas Schwitzer
- FondaMental Foundation, Créteil F-94000, France; Université de Lorraine, Inserm U 1254, Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie CPN, Laxou, France
| | - Bruno Aouizerate
- FondaMental Foundation, Créteil F-94000, France; Pôle de Psychiatrie Générale et Universitaire, Center Hospitalier Charles Perrens, France NutriNeuro, INRAE UMR 1286, University of Bordeaux, Bordeaux F-33076, France
| | - Pierre-Michel Llorca
- FondaMental Foundation, Créteil F-94000, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, 63000 Clermont-Ferrand, France
| | - Isabelle Biseul
- FondaMental Foundation, Créteil F-94000, France; AP-HP.Nord, Groupe Hospitalo-universitaire Lariboisière-Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, Paris F-75010, France
| | - Bruno Etain
- FondaMental Foundation, Créteil F-94000, France; AP-HP.Nord, Groupe Hospitalo-universitaire Lariboisière-Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, Paris F-75010, France; INSERM UMRS 1144, Université de Paris Cité, Paris F-75006, France
| | - Remi Moirand
- FondaMental Foundation, Créteil F-94000, France; INSERM U1028, CNRS UMR5292, University Lyon 1, Villeurbanne F-69000, France; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response ΨR2 Team, Centre Hospitalier Le Vinatier, F-69678, France
| | - Emilie Olié
- FondaMental Foundation, Créteil F-94000, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU, Montpellier, France; Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Emmanuel Haffen
- Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Recherche Intégratives en Neurosciences et Psychologie Cognitive, Université de Franche-Comté, Besançon, France
| | - Marion Leboyer
- FondaMental Foundation, Créteil F-94000, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Université Paris Est Créteil, INSERM U955, F-94010, France
| | - Philippe Courtet
- FondaMental Foundation, Créteil F-94000, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU, Montpellier, France
| | - Romain Icick
- FondaMental Foundation, Créteil F-94000, France; AP-HP.Nord, Groupe Hospitalo-universitaire Lariboisière-Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, Paris F-75010, France; INSERM UMRS 1144, Université de Paris Cité, Paris F-75006, France
| | - Sébastien Guillaume
- FondaMental Foundation, Créteil F-94000, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU, Montpellier, France; Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
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Naillon PL, Flaudias V, Brousse G, Laporte C, Baker JS, Brusseau V, Comptour A, Zak M, Bouillon-Minois JB, Dutheil F. Cannabis Use in Physicians: A Systematic Review and Meta-Analysis. Medicines (Basel) 2023; 10:medicines10050029. [PMID: 37233605 DOI: 10.3390/medicines10050029] [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: 03/16/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023]
Abstract
Background: Cannabis use by physicians can be detrimental for them and their patients. We conducted a systematic review and meta-analysis on the prevalence of cannabis use by medical doctors (MDs)/students. Method: PubMed, Cochrane, Embase, PsycInfo and ScienceDirect were searched for studies reporting cannabis use in MDs/students. For each frequency of use (lifetime/past year/past month/daily), we stratified a random effect meta-analysis depending on specialties, education level, continents, and periods of time, which were further compared using meta-regressions. Results: We included 54 studies with a total of 42,936 MDs/students: 20,267 MDs, 20,063 medical students, and 1976 residents. Overall, 37% had used cannabis at least once over their lifetime, 14% over the past year, 8% over the past month and 1.1 per thousand (‱) had a daily use. Medical students had a greater cannabis use than MDs over their lifetime (38% vs. 35%, p < 0.001), the past year (24% vs. 5%, p < 0.001), and the past month (10% vs. 2%, p < 0.05), without significance for daily use (0.5% vs. 0.05%, NS). Insufficient data precluded comparisons among medical specialties. MDs/students from Asian countries seemed to have the lowest cannabis use: 16% over their lifetime, 10% in the past year, 1% in the past month, and 0.4% daily. Regarding periods of time, cannabis use seems to follow a U-shape, with a high use before 1990, followed by a decrease between 1990 and 2005, and a rebound after 2005. Younger and male MDs/students had the highest cannabis use. Conclusions: If more than a third of MDs tried cannabis at least once in their lifetime, this means its daily use is low but not uncommon (1.1‱). Medical students are the biggest cannabis users. Despite being common worldwide, cannabis use is predominant in the West, with a rebound since 2005 making salient those public health interventions during the early stage of medical studies.
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Affiliation(s)
- Pierre-Louis Naillon
- Université Clermont Auvergne, CNRS, LaPSCo, CHU Clermont-Ferrand, WittyFit, F-63000 Clermont-Ferrand, France
| | - Valentin Flaudias
- Université de Nantes, Laboratoire de Psychologie des Pays de la Loire, LPPL, F-44000 Nantes, France
| | - Georges Brousse
- Université Clermont Auvergne, NPsy-Sydo, CHU Clermont-Ferrand, Addiction, F-63000 Clermont-Ferrand, France
| | - Catherine Laporte
- Université Clermont Auvergne, Clermont Auvergne INP, CNRS, Institut Pascal, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Julien S Baker
- Sport and Physical Education, Hong Kong Baptist University, Kowloon CN-99230, Hong Kong
| | - Valentin Brusseau
- Université Clermont Auvergne, CHU Clermont-Ferrand, Endocrinology Diabetology and Metabolic Diseases, F-63000 Clermont-Ferrand, France
| | - Aurélie Comptour
- INSERM, CIC 1405 CRECHE Unit, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Marek Zak
- Institute of Health Sciences, The Jan Kochanowski University of Kielce, P-25-002 Kielce, Poland
| | | | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, CHU Clermont-Ferrand, WittyFit, F-63000 Clermont-Ferrand, France
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Nobile B, Godin O, Gard S, Samalin L, Brousse G, Loftus J, Aubin V, Belzeaux R, Dubertret C, Le Strat Y, Mazer N, de Prémorel A, Roux P, Polosan M, Schwintzer T, Llorca PM, Biseul I, Etain B, Moirand R, Olié E, Haffen E, Leboyer M, Courtet P, Guillaume S, Icick R. Physical and mental health status of former smokers and non-smokers patients with bipolar disorder. Acta Psychiatr Scand 2023; 147:373-388. [PMID: 36751870 DOI: 10.1111/acps.13535] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/29/2022] [Accepted: 01/21/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVES Up to 70% individuals with bipolar disorder (BD) are lifetime tobacco smokers, a major modifiable risk factor for morbidity. However, quitting smoking is rarely proposed to individuals with BD, mainly because of fear of unfavorable metabolic or psychiatric changes. Evaluating the physical and mental impact of tobacco cessation is primordial. The aim of this study was to characterize the psychiatric and nonpsychiatric correlates of tobacco smoking status (never- vs. current vs. former smokers) in individuals with BD. METHODS 3860 individuals with ascertained BD recruited in the network of Fondamental expert centers for BD between 2009 and 2020 were categorized into current, former, and never tobacco smokers. We compared the sociodemographic and clinical characteristics assessed by standard instruments (e.g., BD type, current symptoms load, and non-psychiatric morbidity-including anthropometric and biological data) of the three groups using multinomial regression logistic models. Corrections for multiple testing were applied. RESULTS Current smokers had higher depression, anxiety, and impulsivity levels than former and never-smokers, and also higher risk of comorbid substance use disorders with a gradient from never to former to current smokers-suggesting shared liability. Current smokers were at higher risk to have a metabolic syndrome than never-smokers, although this was only evidenced in cases, who were not using antipsychotics. CONCLUSIONS Tobacco smoking was associated with high morbidity level. Strikingly, as in the general population, quitting smoking seemed associated with their return to the never-smokers' levels. Our findings strongly highlight the need to spread strategies to treat tobacco addiction in the BD population.
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
- FondaMental Foundation, Créteil, France
| | - Ophélia Godin
- FondaMental Foundation, Créteil, France
- INSERM U955, Département Hospitalo-Universitaire de Psychiatrie et d'Addictologie des Hôpitaux Universitaires H Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France
| | - Sébastien Gard
- FondaMental Foundation, Créteil, France
- Center Hospitalier Charles Perrens, France NutriNeuro, INRAE UMR 1286, University of Bordeaux, Pôle de Psychiatrie Générale et Universitaire, Bordeaux, France
| | - Ludovic Samalin
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Georges Brousse
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Joséphine Loftus
- FondaMental Foundation, Créteil, France
- Center Hospitalier Princesse Grace, Pôle de Psychiatrie, Monaco, Monaco
| | - Valérie Aubin
- FondaMental Foundation, Créteil, France
- Center Hospitalier Princesse Grace, Pôle de Psychiatrie, Monaco, Monaco
| | - Raoul Belzeaux
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France
- FondaMental Foundation, Créteil, France
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Caroline Dubertret
- FondaMental Foundation, Créteil, France
- INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Université de Paris, Colombes, France
| | - Yann Le Strat
- FondaMental Foundation, Créteil, France
- INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Université de Paris, Colombes, France
| | - Nicolas Mazer
- FondaMental Foundation, Créteil, France
- INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Université de Paris, Colombes, France
| | - Alix de Prémorel
- FondaMental Foundation, Créteil, France
- INSERM UMR1266, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Université de Paris, Colombes, France
| | - Paul Roux
- FondaMental Foundation, Créteil, France
- UVSQ, CESP UMR1018, DevPsy-DisAP, Centre Hospitalier de Versailles, Pôle de Psychiatrie et Santé Mentale, Université Paris-Saclay, Le Chesnay, France
| | - Mircea Polosan
- FondaMental Foundation, Créteil, France
- CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm, Université Grenoble Alpes, Grenoble, France
| | - Thomas Schwintzer
- FondaMental Foundation, Créteil, France
- Centre Psychothérapique de Nancy, Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Laxou, France
- INSERM U1254, IADI, Université de Lorraine, Nancy, France
- Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Pierre-Michel Llorca
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
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- FondaMental Foundation, Créteil, France
| | - Isabelle Biseul
- FondaMental Foundation, Créteil, France
- Département de Psychiatrie et de Médecine Addictologique, AP-HP.Nord, Groupe Hospitalo-universitaire Lariboisière-Fernand Widal, DMU Neurosciences, Paris, France
| | - Bruno Etain
- FondaMental Foundation, Créteil, France
- Département de Psychiatrie et de Médecine Addictologique, AP-HP.Nord, Groupe Hospitalo-universitaire Lariboisière-Fernand Widal, DMU Neurosciences, Paris, France
- INSERM UMRS 1144, Université de Paris Cité, Paris, France
| | - Remi Moirand
- FondaMental Foundation, Créteil, France
- Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
- FondaMental Foundation, Créteil, France
| | - Emmanuel Haffen
- FondaMental Foundation, Créteil, France
- Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, France
| | - Marion Leboyer
- FondaMental Foundation, Créteil, France
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Université Paris Est Créteil, INSERM U955, Paris, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
- FondaMental Foundation, Créteil, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
- FondaMental Foundation, Créteil, France
| | - Romain Icick
- FondaMental Foundation, Créteil, France
- Centre Psychothérapique de Nancy, Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Laxou, France
- INSERM U1254, IADI, Université de Lorraine, Nancy, France
- Département de Psychiatrie et de Médecine Addictologique, AP-HP.Nord, Groupe Hospitalo-universitaire Lariboisière-Fernand Widal, DMU Neurosciences, Paris, France
- INSERM UMRS 1144, Université de Paris Cité, Paris, France
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Chazal C, Roux C, Kinouani S, Schuers M, Fortin F, Pereira B, Blanc O, Piñol-Domenech N, Brousse G, Vorilhon P, Laporte C. Effectiveness of brief interventions in primary care for cannabis users aged from 12 to 25 years old: a systematic review. Fam Pract 2022; 39:1156-1168. [PMID: 35696124 DOI: 10.1093/fampra/cmac050] [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] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The aim of this systematic review was to assess the effectiveness of brief interventions realized in primary care in reducing cannabis use for adolescents and emerging adults. METHODS PubMed, CINAHL, Embase, PsycInfo, and Central (Cochrane Library) were searched until December 2020. Randomized controlled trials conducted in primary care, concerning in-person brief interventions for non-medical cannabis users aged from 12 to 25 years old were eligible for inclusion. Brief interventions had to last 30 min or less. Patients with comorbid mental health disorder or very specific populations were not included. RESULTS One thousand eighty hundred and fifty-five studies were identified through database searching; only 8 studies involving 2,199 patients were included for qualitative synthesis after double reading and data extraction. Randomized controlled trials selected were heterogeneous regarding screening tools, initial levels of cannabis use and cannabis outcomes measures. Brief interventions were all based on motivational interviewing techniques or personalized feedback. Seven studies consisted in a single session of brief intervention. Six studies involved also other substance users. No significant reduction of cannabis use after brief intervention was found for most studies, especially in the long term. A trend of decreased cannabis consequences, such as negative psychosocial repercussions, perception of cannabis use by peers, or driving under the influence of cannabis, was reported. CONCLUSION The current state of knowledge does not allow us to say that the brief intervention is effective in reducing cannabis use among adolescents in primary care. We found a mild positive effect on cannabis consequences after brief intervention. Mixed qualitative and quantitative studies are need to better evaluate the impact of brief intervention and his faisability. PROSPERO (International Prospective Register of Systematic Reviews): n° CRD42016033080.
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Affiliation(s)
- Camille Chazal
- Department of General Practice, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Charline Roux
- Department of General Practice, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Shérazade Kinouani
- Department of General Practice, University of Bordeaux, Bordeaux F-33000, France.,University Bordeaux, Inserm, Bordeaux Population Health Research Center, Team HEALTHY, UMR 1219, Bordeaux, France
| | - Matthieu Schuers
- Department of General Practice, Normandie Univ, UNIROUEN, Rouen, France.,Department of Biomedical Informatics, CHU Rouen, Rouen, France.,Sorbonne Université, LIMICS U1142, Paris, France
| | - Frédéric Fortin
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Biostatistics Unit, Direction de la Recherche Clinique, Clermont-Ferrand, France
| | - Olivier Blanc
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
| | | | - Georges Brousse
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Service of Psychiatry B, Clermont-Ferrand, France
| | | | - Catherine Laporte
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
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9
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Balayssac D, Pereira B, Julien E, Chennell P, Brousse G, Laporte C, Authier N, Vennat B. Attitude of community pharmacists toward patients with a substance-related disorder (heroin, alcohol and tobacco), estimation of harmfulness and knowledge of these substances, and continuing education: A pilot cross-sectional study. Ann Pharm Fr 2022; 80:897-905. [PMID: 35667462 DOI: 10.1016/j.pharma.2022.05.005] [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] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/11/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate attitude of community pharmacists toward patients with a substance-related disorder (heroin, alcohol and tobacco). MATERIAL AND METHODS The attitudes were assessed thanks to the Attitude to Mental Illness Questionnaire (AMIQ) for heroin, alcohol and tobacco-related disorders in three independent groups of pharmacists. Estimation of substance-related harmfulness, knowledge of substance-related disorders and activities/needs for continuing education on substance-related disorders were also recorded. RESULTS Thirty-five pharmacists were included (heroin: 11, alcohol: 10 and tobacco: 14). AMIQ scores for heroin-related disorder were negative and lower than for alcohol (P<0.01) and tobacco (P<0.001). AMIQ scores for alcohol-related disorder were lower than for tobacco (P<0.05). The estimation of heroin-related harmfulness was higher than for alcohol and tobacco (P<0.001). The estimations of knowledge of substance-related disorders were lower for opioid and alcohol than for tobacco (P<0.001). AMIQ scores and the needs for continuing education on each associated addiction showed a positive relation (P<0.01). CONCLUSION Pharmacists had a negative attitude toward heroin and alcohol-related disorders. A positive attitude toward patients with a substance-related disorder was associated with a need for continuing education. Efforts should be made to change attitudes and to promote continuing education on heroin and alcohol-related disorders.
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Affiliation(s)
- D Balayssac
- Inserm U1107, NEURO-DOL, direction de la recherche clinique et de l'innovation, CHU de Clermont-Ferrand, université Clermont-Auvergne, 63000 Clermont-Ferrand, France.
| | - B Pereira
- Direction de la recherche clinique et de l'innovation, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - E Julien
- Université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - P Chennell
- Service de pharmacie, CNRS, Sigma Clermont, ICCF, CHU de Clermont-Ferrand, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - G Brousse
- EA7280, service de psychiatrie B et d'addictologie, UFR de médicine, CHU de Clermont-Ferrand, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - C Laporte
- Département de médecine générale, EA7280, UFR de médicine, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - N Authier
- Inserm U1107, NEURO-DOL, service de pharmacologie médicale, CHU de Clermont-Ferrand, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - B Vennat
- ACCePPT, UFR de pharmacie, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
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Bourduge C, Brousse G, Morel F, Pereira B, Lambert C, Izaute M, Teissedre F. “Intervention Program Based on Self”: A Proposal for Improving the Addiction Prevention Program “Unplugged” through Self-Concept. IJERPH 2022; 19:ijerph19158994. [PMID: 35897365 PMCID: PMC9367710 DOI: 10.3390/ijerph19158994] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/27/2022]
Abstract
The “Intervention Program based on Self” (IPSELF) project was created to address the gap between the acquisition of life skills during prevention programs and their application with a session for developing one’s self-concept included in the European program “Unplugged”. The present study evaluated its effectiveness. A total of 157 middle school students (94 girls, 63 boys, MAGE= 12.89, SD = 0.45) from three schools in France participated in this study. The participants attended one of two programs (Unplugged/IPSELF). The effectiveness of the IPSELF add-on session was measured with the Self-Concept Clarity Scale, and the differences between the two programs was measured with the prototype willingness model. Adolescents in IPSELF rated the typical nonsmoker and cannabis nonsmoker more favorably, and the typical drinker less favorably. They felt more different from the typical smoker and drinker after participation in IPSELF. More alcohol experimenters were observed in Unplugged. The knowledge gained in IPSELF appeared to help adolescents more than that gained in Unplugged to change their smoking behavior. Furthermore, IPSELF had a more beneficial effect for girls, who felt that they had gained more control over their alcohol and cannabis use than boys, whereas Unplugged had a more positive effect on boys, who gained better control over their consumption. Moreover, the girls felt that they had gained more knowledge about the substances discussed in IPSELF than in Unplugged. We therefore recommend the use of IPSELF especially with female audiences.
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Affiliation(s)
- Cédrine Bourduge
- Université Clermont Auvergne, LAPSCO, CNRS, Institut Pascal, F-63000 Clermont-Ferrand, France; (M.I.); (F.T.)
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, F-63000 Clermont-Ferrand, France
- Centre Hospitalier Universitaire de Clermont-Ferrand, Service d’addictologie et Pathologies Duelles, F-63000 Clermont-Ferrand, France;
- Correspondence: (C.B.); (G.B.)
| | - Georges Brousse
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, F-63000 Clermont-Ferrand, France
- Correspondence: (C.B.); (G.B.)
| | - Florence Morel
- Centre Hospitalier Universitaire de Clermont-Ferrand, Service d’addictologie et Pathologies Duelles, F-63000 Clermont-Ferrand, France;
| | - Bruno Pereira
- CHU Clermont-Ferrand, Unité de Biostatistiques (DRCI), F-63003 Clermont-Ferrand, France; (B.P.); (C.L.)
| | - Céline Lambert
- CHU Clermont-Ferrand, Unité de Biostatistiques (DRCI), F-63003 Clermont-Ferrand, France; (B.P.); (C.L.)
| | - Marie Izaute
- Université Clermont Auvergne, LAPSCO, CNRS, Institut Pascal, F-63000 Clermont-Ferrand, France; (M.I.); (F.T.)
| | - Frédérique Teissedre
- Université Clermont Auvergne, LAPSCO, CNRS, Institut Pascal, F-63000 Clermont-Ferrand, France; (M.I.); (F.T.)
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Zerdazi EH, Curis E, Karsinti E, Icick R, Fortias M, Batel P, Cottencin O, Orizet C, Gay A, Coeuru P, Deschenau A, Lack P, Moisan D, Pelissier-Alicot AL, Plat A, Trabut JB, Kousignian I, Boumendil L, Vicaut E, Prince N, Laplanche JL, Bellivier F, Lépine JP, Marie-Claire C, Brousse G, Vorspan F, Bloch V. Occurrence and severity of cocaine-induced hallucinations: Two distinct phenotypes with shared clinical factors but specific genetic risk factors. Drug Alcohol Depend 2022; 232:109270. [PMID: 35124387 DOI: 10.1016/j.drugalcdep.2022.109270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/16/2021] [Revised: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 11/15/2022]
Abstract
UNLABELLED Cocaine-induced transient hallucinations (CIH) are a frequent complication following cocaine intake that is associated with addiction severity. METHODS Two hundred and forty-two non-psychotic and Caucasian lifetime cocaine users were included in a French multicentric study. Clinical variables and dopamine pathway genotype data were extracted and tested with CIH scores using a zero-inflated binomial model, which allows for the exploration of factors associated with occurrence and severity separately. RESULTS Cocaine dependence (poccurrence= 6.18 × 10-5, pseverity= 9.25 × 10-8), number of cocaine dependence DSM IV-Tr criteria (poccurrence= 1.22 × 10-7, pseverity= 5.09 × 10-6), and frequency of intake during the worst period of misuse (poccurrence= 8.51 × 10-04, pseverity= 0.04) were associated with greater occurrence and higher severity of CIH. The genetic associations did not yield significant results after correction for multiple tests. However, some nominal associations of SNPs mapped to the VMAT2, DBH, DRD1, and DRD2 genes were significant. In the multivariate model, the significant variables were the number of cocaine dependence criteria, lifetime alcohol dependence, and the nominally associated SNPs. CONCLUSION Our study shows that CIH occurrence and severity are two distinct phenotypes, with shared clinical risk factors; however, they likely do not share the same genetic background.
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Affiliation(s)
- El-Hadi Zerdazi
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, Hôpitaux Universitaires Henri Mondor, DMU IMPACT, Hôpital Emile ROUX, Service d'addictologie, Limeil Brévannes 94450, France.
| | - Emmanuel Curis
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; EA 7537 BioSTM, Faculté de Pharmacie, Université Paris Descartes, USPC, Paris 75006, France
| | - Emily Karsinti
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France; Université Paris Nanterre, Laboratoire Clipsyd, Nanterre 92000, France
| | - Romain Icick
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France
| | - Maeva Fortias
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France
| | - Philippe Batel
- Centre Hospitalier Camille Claudel, Service d'Addictologie de la Charente, La Couronne 16400, France
| | - Olivier Cottencin
- University of Lille, Inserm U-1172, CHU Lille, Department of Psychiatry and Addiction Medicine, Lille 59000, France
| | - Cyrille Orizet
- APHP, GHU Centre-Université de Paris, Hôpital Européen Georges Pompidou, CSAPA Monte-Cristo, Paris 75015, France
| | - Aurélia Gay
- CHU Saint-Etienne, Service d'Addictologie, Saint-Etienne 42000, France
| | | | - Alice Deschenau
- Hôpital Paul Guiraud, CSAPA Clinique Liberté, Ivry-sur-Seine 94200, France
| | - Philippe Lack
- Hôpital de la Croix Rousse, CSAPA, Lyon 69004, France
| | - Delphine Moisan
- APHP, GHU Nord-Université de Paris, Hôpital Beaujon, UTAMA, Clichy 92110, France
| | - Anne-Laure Pelissier-Alicot
- APHM, CHU La Timone, Service de Médecine légale, Aix-Marseille Université, Faculté de Médecine, Marseille 13385, France
| | - Arnaud Plat
- APHP, GHU Nord-Université de Paris, Hôpital Beaujon, UTAMA, Clichy 92110, France
| | - Jean-Baptiste Trabut
- APHP, Hôpitaux Universitaires Henri Mondor, DMU IMPACT, Hôpital Emile ROUX, Service d'addictologie, Limeil Brévannes 94450, France
| | - Isabelle Kousignian
- EA 7537 BioSTM, Faculté de Pharmacie, Université Paris Descartes, USPC, Paris 75006, France
| | - Luana Boumendil
- EA 7537 BioSTM, Faculté de Pharmacie, Université Paris Descartes, USPC, Paris 75006, France
| | - Eric Vicaut
- APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Unité de Recherche Clinique, Paris 75010, France
| | - Nathalie Prince
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France
| | - Jean-Louis Laplanche
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Lariboisière, DMU BioGeM, Département de Biochimie et Biologie Moléculaire, Paris 75010, France
| | - Frank Bellivier
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France
| | - Jean-Pierre Lépine
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France
| | - Cynthia Marie-Claire
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France
| | - Georges Brousse
- CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Service d'Addictologie et Université d'Auvergne EA 7280, UFR de Médecine, Clermont-Ferrand 63000, France
| | - Florence Vorspan
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France
| | - Vanessa Bloch
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Pharmacie Hospitalière, Paris 75010, France
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Flaudias V, Zerhouni O, Chakroun-Baggioni N, De Chazeron I, Llorca PM, Brousse G. Evaluation of a Smartphone Application on the Reduction of Attentional Bias Toward Alcohol Among Students†. Front Psychol 2022; 13:790030. [PMID: 35222189 PMCID: PMC8869174 DOI: 10.3389/fpsyg.2022.790030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/05/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Context The recent development of “serious games” has produced encouraging results in maintaining adherence to health-related interventions. In alcohol research, several studies have shown that computerized training on attentional bias decreases alcohol consumption bias among students. However, these highly controlled experimental situations, do not allow for direct large-scale dissemination. Our objective is to evaluate an attentional bias remediation program using a gamified smartphone training procedure. Methods Fifty students from Clermont-Ferrand University were invited to participate in the study. After a cognitive assessment in the laboratory, the smartphone application was installed on each Student’s smartphone. Participants were randomly assigned to either the alcohol attentional training group or the control group Each student had to complete the 2-min program at least once a day for 15 days. After 15 days, a new cognitive assessment of attention bias was conducted in the laboratory. Forty-seven students were included in the study. Results Our analyses did not show any effect of the cognitive remediation program on attentional bias reduction between the two group [F(1, 44) < 1, p = 0.87], attentional performance [F(1, 45) = 1.63, p = 0.20] or inhibitory abilities [F(1, 45) < 1, p = 0.73]. These results were confirmed by Bayesian analyses. Discussion Despite the absence of group effects, both the alcohol and control (non-alcohol) version of this program appeared to reduce attentional bias and increase inhibition capacities in the subset of participants who had attentional bias for alcohol at baseline This pilot study identifies areas for improvement in smartphone applications for future developments. Attentional bias remediation programs remain an interesting way to explore.
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Affiliation(s)
- Valentin Flaudias
- Université de Nantes, Univ Angers, Laboratoire de Psychologie des Pays de la Loire, LPPL, EA 4638, Nantes, France
- *Correspondence: Valentin Flaudias,
| | - Oulmann Zerhouni
- Laboratoire Parisien de Psychologie Sociale, Département de Psychologie, Nanterre, France
| | - Nadia Chakroun-Baggioni
- Université Clermont Auvergne, Laboratoire de Psychologie Sociale et Cognitive, Clermont-Ferrand, France
| | - Ingrid De Chazeron
- CMP-B CHU, Clermont Auvergne INP, Institut Pascal, Centre National de la Recherche Scientifique (CNRS), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Pierre-Michel Llorca
- CMP-B CHU, Clermont Auvergne INP, Institut Pascal, Centre National de la Recherche Scientifique (CNRS), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- CMP-B CHU, Clermont Auvergne INP, Institut Pascal, Centre National de la Recherche Scientifique (CNRS), Université Clermont Auvergne, Clermont-Ferrand, France
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13
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Gay A, Cabe J, De Chazeron I, Lambert C, Defour M, Bhoowabul V, Charpeaud T, Tremey A, Llorca PM, Pereira B, Brousse G. Repetitive Transcranial Magnetic Stimulation (rTMS) as a Promising Treatment for Craving in Stimulant Drugs and Behavioral Addiction: A Meta-Analysis. J Clin Med 2022; 11:jcm11030624. [PMID: 35160085 PMCID: PMC8836499 DOI: 10.3390/jcm11030624] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/22/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/05/2023] Open
Abstract
Addiction is a mental disorder with limited available treatment options. The therapeutic potential of repetitive transcranial magnetic stimulation (rTMS) on it, by targeting craving in particular, has been explored with heterogenous results. This meta-analysis uses updated evidence to assess overall rTMS efficacy on craving, differential effects between addiction types clustered into three groups (depressant (alcohol, cannabis, opiate), stimulant (nicotine, cocaine, methamphetamine), and behavioral addiction (gambling, eating disorder)), and stimulation settings. Studies on substance use, gambling, and eating disorders are included, with unrestricted stimulation settings, by searching the PubMed, Embase, PsycINFO, and Cochrane databases up to 30 April 2020. A total of 34 eligible studies (42 units of analysis) were identified. Because of highly significant heterogeneity in primary results, a sensitivity analysis was performed on a remaining sample of 26 studies (30 units of analysis). Analyses performed using random effects model revealed a small effect size favoring active rTMS over shamTMS stimulation in the reduction in craving. We found a significant difference between addiction types, with a persistent small effect only for stimulant and behavioral groups. In these groups we found no difference between the different combinations of target and frequency of stimulation, but a significant correlation between number of sessions and craving reduction. In conclusion, efficacy of rTMS on craving in stimulant and behavioral addiction was highlighted, but recommendations on optimal stimulation settings and its clinical application await further research.
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Affiliation(s)
- Aurélia Gay
- University Department of Psychiatry and Addiction, CHU St-Etienne, CEDEX 2, 42055 Saint-Étienne, France; (M.D.); (V.B.)
- TAPE Laboratory, EA7423, Jean Monnet University, 42100 Saint-Étienne, France
- Correspondence: ; Tel.: +33-04-77828850
| | - Julien Cabe
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (J.C.); (I.D.C.); (P.-M.L.); (G.B.)
| | - Ingrid De Chazeron
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (J.C.); (I.D.C.); (P.-M.L.); (G.B.)
| | - Céline Lambert
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.L.); (B.P.)
| | - Maxime Defour
- University Department of Psychiatry and Addiction, CHU St-Etienne, CEDEX 2, 42055 Saint-Étienne, France; (M.D.); (V.B.)
| | - Vikesh Bhoowabul
- University Department of Psychiatry and Addiction, CHU St-Etienne, CEDEX 2, 42055 Saint-Étienne, France; (M.D.); (V.B.)
| | - Thomas Charpeaud
- Service d’Addictologie et Pathologies Duelles, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (T.C.); (A.T.)
| | - Aurore Tremey
- Service d’Addictologie et Pathologies Duelles, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (T.C.); (A.T.)
| | - Pierre-Michel Llorca
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (J.C.); (I.D.C.); (P.-M.L.); (G.B.)
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.L.); (B.P.)
| | - Georges Brousse
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (J.C.); (I.D.C.); (P.-M.L.); (G.B.)
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14
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Bourduge C, Teissedre F, Morel F, Flaudias V, Izaute M, Brousse G. Lockdown Impact on Stress, Coping Strategies, and Substance Use in Teenagers. Front Psychiatry 2022; 12:790704. [PMID: 35126203 PMCID: PMC8813749 DOI: 10.3389/fpsyt.2021.790704] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In response to the COVID-19 pandemic, the French government took many measures, the most notable of which was a national lockdown on 17 March 2020. Its effects have been widely studied, but to our knowledge, no study has sought to determine how adolescents have adapted to cope with this situation. The present study set out to explore teenagers' stress levels, coping strategies, and substance use during this period. METHODS This paper is a cross-sectional study that rides on an existing prevention program interviewed 348 French middle school students (209 girls and 139 boys) in grade 8 (M age = 13.45; SDage = 0.54) using an online questionnaire between March 17 and May 11, 2020 (COVID-19 lockdown). The study examined the teenagers' perceived stress, coping strategies they had used, including recent use of tobacco, alcohol and cannabis, during COVID-19 lockdown. RESULTS Teenagers reported lower perceived stress during lockdown than usually, with a significant decrease for girls. Those who perceived the least social support reported the highest levels of stress. The strategies of planning, behavioral disengagement, self-distraction, positive reframing, acceptance, and religion were used more than usual, while active coping and self-blame were used less. Acceptance was the most often used strategy and a source of decreased stress during lockdown. A significant decrease in recent tobacco, alcohol and cannabis use was also observed. CONCLUSION Changes in the use of coping strategies, withdrawal from the stressful school environment, and greater exposure to parents than to peers caused adolescents to be less stressed and to decrease their substance use during the lockdown.
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Affiliation(s)
- Cédrine Bourduge
- LAPSCO, CNRS, Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'addictologie et Pathologies Duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
- CNRS, Institut Pascal, Université Clermont Auvergne, Clermont Auvergne INP, Clermont-Ferrand, France
| | | | - Florence Morel
- Service d'addictologie et Pathologies Duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Valentin Flaudias
- Service d'addictologie et Pathologies Duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
- Laboratoire de Psychologie des Pays de la Loire (LPPL-EA-4638), Université de Nantes, Univ Angers, Nantes, France
| | - Marie Izaute
- LAPSCO, CNRS, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- CNRS, Institut Pascal, Université Clermont Auvergne, Clermont Auvergne INP, Clermont-Ferrand, France
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15
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Chapoton B, Sarda E, Tinquaut F, Bègue L, Chirain A, Brousse G, Chauvin F, Flaudias V. Suggestibility, Facebook use and relationship with substance addictive behaviors. Encephale 2022; 49:261-267. [DOI: 10.1016/j.encep.2021.10.001] [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: 06/08/2021] [Revised: 10/01/2021] [Accepted: 10/11/2021] [Indexed: 11/27/2022]
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16
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Vorspan F, Brousse G, Van Den Brink W. Editorial: Dual disorders (addictive and concomitant psychiatric disorders): Mechanisms and treatment. Front Psychiatry 2022; 13:975674. [PMID: 35982937 PMCID: PMC9379300 DOI: 10.3389/fpsyt.2022.975674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Florence Vorspan
- Université de Paris Cité, UFR de Médecine, INSERM UMRS1144, Paris, France.,Assistance Publique - Hôpitaux de Paris, GHU.NORD, Hôpital Fernand Widal, Paris, France
| | - Georges Brousse
- Université Clermont Auvergne, CNRS Institut Pascal, Clermont Auvergne INP, Clermont-Ferrand, France.,Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Wim Van Den Brink
- Service D'addictologie, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
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17
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Legeai C, Savoye E, Cantrelle C, Jasseron C, Santin G, Brousse G, Duman M, Foubert F, Mahmoudi R, Deshayes A, Antoine C, Kerbaul F. Impact of COVID-19 on 2020 transplant activity and waiting lists in France ✰,✰✰. J Liver Transpl 2022; 5:100051. [PMID: 38620879 PMCID: PMC8844634 DOI: 10.1016/j.liver.2021.100051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic strongly affected organ procurement and transplantation in France, despite the intense efforts of all participants in this domain. In 2020, the identification and procurement of deceased donors fell by 12% and 21% respectively, compared with the mean of the preceding 2 years. Similarly, the number of new registrations on the national waiting list declined by 12% and the number of transplants by 24%. The 3-month cumulative incidence of death or drop out for worsening condition of patients awaiting a liver transplant was significantly greater in 2020 compared to the previous 2 years. Continuous monitoring at the national level of early post-transplant outcomes showed no deterioration for any organ in 2020. At the end of 2020, less than 1% of transplant candidates and less than 1% of graft recipients - of any organ - had died of COVID-19.
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Affiliation(s)
- C Legeai
- Organ and Tissue Procurement and Transplantation Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - E Savoye
- Organ and Tissue Procurement and Transplantation Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - C Cantrelle
- Organ and Tissue Procurement and Transplantation Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - C Jasseron
- Organ and Tissue Procurement and Transplantation Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - G Santin
- Organ and Tissue Procurement and Transplantation Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - G Brousse
- Data Quality Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - M Duman
- Data Quality Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - F Foubert
- Data Quality Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - R Mahmoudi
- Data Quality Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - A Deshayes
- Data Quality Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - C Antoine
- Organ and Tissue Procurement and Transplantation Department, Agence de la biomédecine, Saint Denis La Plaine, France
| | - F Kerbaul
- Organ and Tissue Procurement and Transplantation Department, Agence de la biomédecine, Saint Denis La Plaine, France
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18
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Benistand P, Vorilhon P, Laporte C, Bouillon-Minois JB, Brousse G, Bagheri R, Ugbolue UC, Baker JS, Flaudias V, Mulliez A, Dutheil F. Effect of the COVID-19 pandemic on the psychotropic drug consumption. Front Psychiatry 2022; 13:1020023. [PMID: 36590615 PMCID: PMC9797694 DOI: 10.3389/fpsyt.2022.1020023] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Although the COVID-19 pandemic has had a negative impact on mental health, there is no comprehensive longitudinal study of the entire population of a country without selection bias. OBJECTIVE The objective of this study was to evaluate the prescription of psychotropic drugs during the COVID-19 pandemic, using data from the French national health data system (SNDS). DESIGN SETTINGS AND PARTICIPANTS Prescriptions for psychotropic drugs (antidepressants, anxiolytics, hypnotics, and antipsychotics) from 1 January 2015 to 30 September 2021 were collected from administrative data provided by the SNDS. This database includes more than 99% of the French population, i.e., 67 million people. The data were analyzed using an interrupted time series analysis (ITSA) model. MAIN OUTCOMES AND MEASURES Consumption of psychotropic drugs was aggregated in months and expressed in number of boxes per thousand inhabitants. RESULTS During the study period, more than 1.3 billion boxes of psychotropic medications were dispensed. Comparison of psychotropic drug dispensing before and after the pandemic showed a relative increase of 0.76 (95 CI 0.57 to 0.95, p<0.001) boxes per month per thousand inhabitants, all classes of psychotropic drugs combined. Three classes saw their consumption increase in an almost similar proportion, respectively, by 0.23 (0.15 to 0.32, p<0.001) boxes for antidepressants, 0.27 (0.20 to 0.34, p<0.001) boxes for anxiolytics and 0.23 (0.17 to 0.30, p<0.001) boxes for hypnotics. The change in antipsychotic consumption was very small, with an increase of 0.04 boxes (0.02 to 0.06, p = 0.001) per month per thousand population. CONCLUSION AND RELEVANCE The COVID-19 pandemic had led to an increase in the consumption of psychotropic drugs, confirming the significant impact of the pandemic on the mental health of the general population.
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Affiliation(s)
- Paul Benistand
- Département de Médecine Générale, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Research Unit AutomédiCation aCcompagnement Pluriprofessionnel PatienT (ACCePPT), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Catherine Laporte
- Clermont Auvergne INP, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Centre National de Recherche Scientifique (CNRS), Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean-Baptiste Bouillon-Minois
- Centre National de Recherche Scientifique (CNRS), Laboratoire de Psychologie Sociale et Cognitive (LaPSCo), Physiological and Psychosocial Stress, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- Clermont Auvergne INP, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Centre National de Recherche Scientifique (CNRS), Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Ukadike Chris Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, United Kingdom
| | - Julien S Baker
- Department of Physical Education and Health, Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Valentin Flaudias
- Laboratoire de Psychologie des Pays de la Loire, Université de Nantes, Nantes, France
| | - Aurélien Mulliez
- Direction de la Recherche Clinique et Innovations Biostatistics, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Centre National de Recherche Scientifique (CNRS), Laboratoire de Psychologie Sociale et Cognitive (LaPSCo), Physiological and Psychosocial Stress, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France
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Rolland B, Dalon F, Gauthier N, Nourredine M, Bérard M, Carton L, Brousse G, Llorca PM, Jacoud F, Van Ganse E, Belhassen M. Antipsychotic prescribing practices in real-life (APPREAL study): Findings from the French National Healthcare System Database (2007-2017). Front Psychiatry 2022; 13:1021780. [PMID: 36387010 PMCID: PMC9659890 DOI: 10.3389/fpsyt.2022.1021780] [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: 08/17/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Antipsychotics are used in a large variety of psychiatric and neurological disorders; investigating their use in real life is important to understand national prescribing practices, as well as to determine the levels of patient adherence. METHODS Using a 1/97e random sample (General Sample of Beneficiaries, EGB) of the French health insurance reimbursement database, we conducted a historical cohort study on the 2007-2017 period. The aim was to describe the sociodemographic characteristics of patients, the types of antipsychotics dispensed, the types of prescribers, the mean doses and average durations of treatment, the co-dispensed medications, and the levels of adherence to treatment. To exclude punctual uses of antipsychotics, we selected only patients with a continuous dispensing of the same antipsychotic over at least 3 months. RESULTS In total, 13,799 subjects (1.66% of the EGB sample) were included (56.0% females; mean age 55.8 ± 19.4 years). Risperidone (19.3%), cyamemazine (18.7%), olanzapine (11.9%), tiapride (8.8%), and haloperidol (7.5%) were the five most prescribed antipsychotics. 44.9% of prescriptions were written by general practitioners, 34.1% by hospital practitioners, and 18.4% by private-practice psychiatrists. On average, the mean dispensed doses were relatively low, but the variation range was large. Long-acting forms were used in 5.4% of the sample, and clozapine in 1.3%. 34.2% of patients received more than one antipsychotic, and almost 15% were prescribed at least three concomitant antipsychotics. Paliperidone and clozapine were associated with the highest levels of adherence, and risperidone and haloperidol with the lowest ones. CONCLUSION An important heterogeneity of antipsychotic prescribing practices was observed in France. The rate of use of long-acting antipsychotics was low, whereas multiple antipsychotic prescriptions were frequent.
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Affiliation(s)
- Benjamin Rolland
- Centre Hospitalier Le Vinatier, Hospices Civils de Lyon, Academic Department of Addiction Medicine (SUAL), Bron, France.,Université Claude Bernard Lyon 1, Lyon, France
| | | | - Noémie Gauthier
- Saint-Cyr au Mont d'Or Hospital, Hospital Pharmacy, Saint-Cyr-au Mont-d'Or Psychiatric Hospital, Saint-Cyr-au Mont-d'Or, France
| | - Mikaïl Nourredine
- Hospices Civils de Lyon, Pharmacotoxicology Laboratory, Department of Clinical Research and Epidemiology, Lyon, France.,Faculté de Médecine Lyon Sud, Lyon 1 University, Lyon, France
| | | | - Louise Carton
- CHU Lille, Department of Pharmacology, Inserm, Lille Neuroscience and Cognition, UMR-S1172, Université de Lille, Lille, France
| | - Georges Brousse
- CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, University Clermont Auvergne, Clermont-Ferrand, France
| | - Pierre-Michel Llorca
- CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, University Clermont Auvergne, Clermont-Ferrand, France
| | | | - Eric Van Ganse
- PELyon, Lyon, France.,Respiratory Medicine, Croix Rousse University Hospital, Lyon, France.,Claude Bernard Lyon 1 University, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
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Besson A, Tarpin A, Flaudias V, Brousse G, Laporte C, Benson A, Navel V, Bouillon-Minois JB, Dutheil F. Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph182413328. [PMID: 34948936 PMCID: PMC8705497 DOI: 10.3390/ijerph182413328] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. METHODS PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. RESULTS Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. CONCLUSION Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.
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Affiliation(s)
- Anaïs Besson
- Family Medicine, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (A.B.); (A.T.)
| | - Alice Tarpin
- Family Medicine, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (A.B.); (A.T.)
| | - Valentin Flaudias
- Univ Angers, Laboratoire de psychologie des Pays de la Loire, Université de Nantes, LPPL, EA 4638, F-44000 Nantes, France;
| | - Georges Brousse
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont–Ferrand, France; (G.B.); (C.L.)
| | - Catherine Laporte
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont–Ferrand, France; (G.B.); (C.L.)
| | - Amanda Benson
- Sport Innovation Research Group, Department of Health and Biostatistics, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
| | - Valentin Navel
- CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Jean-Baptiste Bouillon-Minois
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Emergency Medicine, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Correspondence: ; Tel.: +33-6-74-36-04-23; Fax: +33-4-73-27-46-49
| | - Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, F-63000 Clermont-Ferrand, France;
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21
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Icick R, Karsinti E, Brousse G, Chrétienneau C, Trabut JB, Belforte B, Coeuru P, Moisan D, Deschenau A, Cottencin O, Gay A, Lack P, Pelissier-Alicot AL, Dupuy G, Fortias M, Etain B, Lépine JP, Laplanche JL, Bellivier F, Vorspan F, Bloch V. Childhood trauma and the severity of past suicide attempts in outpatients with cocaine use disorders. Subst Abus 2021; 43:623-632. [PMID: 34597243 DOI: 10.1080/08897077.2021.1975875] [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: 10/20/2022]
Abstract
INTRODUCTION Suicide attempts have been associated with both cocaine use disorder (CocUD) and childhood trauma. We investigated how childhood trauma is an independent risk factor for serious and recurrent suicide attempts in CocUD. Method: 298 outpatients (23% women) with CocUD underwent standardized assessments of substance dependence (Diagnostic and Statistical Manual-mental disorders, fourth edition, text revised), impulsiveness, resilience, and childhood trauma, using validated tools. Suicide attempts history was categorized as single vs. recurrent or non-serious vs. serious depending on the lifetime number of suicide attempts and the potential or actual lethality of the worst attempt reported, respectively. Bivariate and multinomial regression analyses were used to characterize which childhood trauma patterns were associated with the suicide attempts groups. Results: 58% of CocUD patients reported childhood trauma. Recurrent and serious suicide attempts clustered together and were thus combined into "severe SA." Severe suicide attempt risk increased proportionally to the number of childhood traumas (test for trend, p = 9 × 10-7). Non-severe suicide attempt risk increased with impulsiveness and decreased with resilience. In multinomial regression models, a higher number of traumas and emotional abuse were independently and only associated with severe vs. non-severe suicide attempts (effect size = 0.82, AUC = 0.7). The study was limited by its cross-sectional design. Conclusion: These preferential associations between childhood trauma and severe suicide attempts warrant specific monitoring of suicide attempts risk in CocUD, regardless of the severity of addiction profiles.
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Affiliation(s)
- Romain Icick
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Emily Karsinti
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,ED139, Laboratoire CLIPSYD, Paris Nanterre University, Nanterre, France
| | - Georges Brousse
- INSERM UMR-1107, Neuro-Dol, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Clara Chrétienneau
- INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France
| | | | - Beatriz Belforte
- APHP, Hôpital Européen Georges Pompidou, CSAPA Monte-Cristo, Paris, France
| | | | | | | | - Olivier Cottencin
- Université de Lille, CHU Lille - Psychiaty and Addiction Medicine Department, INSERM U1172 - Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY team, Lille, France
| | - Aurélia Gay
- Service d'Addictologie, CHU St Etienne, Saint Etienne, France
| | | | | | - Gaël Dupuy
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France
| | - Maeva Fortias
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Jean-Pierre Lépine
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Jean-Louis Laplanche
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Vanessa Bloch
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
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22
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Clergue-Duval V, Nicolas-Sacy L, Karsinti E, Zerdazi EH, Laplanche JL, Brousse G, Marees AT, Derks EM, Henry P, Bellivier F, Vorspan F, Bloch V. Risk and Protective Factors of Lifetime Cocaine-Associated Chest Pain. Front Psychiatry 2021; 12:704276. [PMID: 34366936 PMCID: PMC8335401 DOI: 10.3389/fpsyt.2021.704276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 05/04/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Cocaine users often present with repetitive events of cocaine-associated chest pain (CACP), clinically resembling acute coronary syndromes. The aim of the study is to describe the specific risk factors for CACP. Method: Cocaine users (n = 316) were recruited for a multicenter cross-sectional study. Lifetime CACP history, sociodemographic factors, and lifetime use of cocaine and other substances were assessed. Thirty single nucleotide polymorphisms (SNPs) of NOS3, ROCK2, EDN1, GUCY1A3, and ALDH2 genes, suggested by the literature on coronary spasms, were selected. The associations with CACP history were tested using the chi-square test, Student's t-test and logistic regression. Results: Among the 316 subjects [78.5% men, mean age 37.5 years, (standard-deviation ±8.7)], 190 (60.1%) were daily cocaine users and 103 (32.6%) reported a lifetime CACP history. Among those with a lifetime CACP history, the median was 10 events per individual. In multivariate analysis, lifetime CACP history was associated with daily cocaine use [odds-ratio (OR) 3.24; 95% confidence intervals (1.29-9.33)], rapid route of cocaine use [OR 2.33 (1.20-4.64) vs. intranasal use], and lifetime amphetamine use [daily amphetamine use: OR 2.80 (1.25-6.32) and non-daily amphetamine use: OR 2.14 (1.15-4.04) vs. never used]. Patients with lifetime opioid maintenance treatment (OMT) reported significantly less lifetime CACP history [OR 0.35 (0.16-0.76)]. None of the selected SNPs was associated with CACP history after multiple testing corrections. Conclusions: Clinical variables describing the intensity of stimulant use were positively associated with lifetime CACP history, while OMT was negatively associated with it. Specific harm reduction strategies can target these risk factors.
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Affiliation(s)
- Virgile Clergue-Duval
- APHP, Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, Groupe hospitalier universitaire APHP Nord - Université de Paris, Paris, France
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Louise Nicolas-Sacy
- APHP, Pharmacie, Site Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France
| | - Emily Karsinti
- APHP, Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, Groupe hospitalier universitaire APHP Nord - Université de Paris, Paris, France
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- Laboratoire ClipsyD, Université Paris Nanterre, Nanterre, France
| | - El-Hadi Zerdazi
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- APHP, Service d'addictologie, DMU IMPACT, GHU Mondor, Hôpital Emile ROUX, Limeil Brévannes, France
| | - Jean-Louis Laplanche
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- APHP, Département de Biochimie et Biologie Moléculaire, Site Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France
- Faculté de Pharmacie, Université de Paris, Paris, France
| | - Georges Brousse
- Service de psychiatrie-addictologie, CHU de Clermont-Ferrand, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Andries T. Marees
- Department of Economics, School of Business and Economics, VU University Amsterdam, Amsterdam, Netherlands
| | - Eske M. Derks
- Queensland Institute of Medical Research Berghofer, Translational Neurogenomics Group, Brisbane, QLD, Australia
| | - Patrick Henry
- Faculté de Médecine, Université de Paris, Paris, France
- APHP, Département de Cardiologie, Site Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France
| | - Frank Bellivier
- APHP, Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, Groupe hospitalier universitaire APHP Nord - Université de Paris, Paris, France
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Florence Vorspan
- APHP, Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, Groupe hospitalier universitaire APHP Nord - Université de Paris, Paris, France
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Vanessa Bloch
- Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
- Fédération Hospitalo-Universitaire NOR-SUD Network of Research in Substance Use Disorders, Ile-de-France, France
- APHP, Pharmacie, Site Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France
- Faculté de Pharmacie, Université de Paris, Paris, France
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23
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Icick R, Gard S, M'Bailara K, Biseul I, Samalin L, Brousse G, Flaudias V, Llorca PM, Loftus J, Cussac I, Aubin V, Schwan R, Roux P, Polosan M, Courtet P, Olié E, Henry C, Mazer N, Haffen E, Etain B, Leboyer M, Bellivier F, Belzeaux R, Godin O, Guillaume S. The course of bipolar disorder as a function of the presence and sequence of onset of comorbid alcohol use disorders in outpatients attending the Fondamental Advanced Centres of Expertise. J Affect Disord 2021; 287:196-203. [PMID: 33799038 DOI: 10.1016/j.jad.2021.03.041] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The comorbidity of alcohol use disorder (AUD) and bipolar disorder (BD) has been repeatedly associated with poorer clinical outcomes than BD without AUD. We aimed to extend these findings by focusing on the characteristics associated with the sequence of onset of BD and AUD. METHODS 3,027 outpatients from the Fondamental Advanced Centres of Expertise were ascertained for BD-1, BD-2 and AUD diagnoses, including their respective ages at onset (AAOs, N =2,804). We selected the variables associated with both the presence and sequence of onset of comorbid AUD using bivariate analyses corrected for multiple testing to enter a binary regression model with the sequence of onset of BD and AUD as the dependent variable (AUD first - which also included 88 same-year onsets, vs. BD first). RESULTS BD patients with comorbid AUD showed more severe clinical profile than those without. Compared to BD-AUD (N =269), AUD-BD (N =276) was independently associated with a higher AAO of BD (OR =1.1, p <0.001), increased prevalence of comorbid cannabis use disorder (OR =2.8, p <0.001) a higher number of (hypo)manic/mixed BD episodes per year of bipolar illness (OR =3, p <0.01). LIMITATIONS The transversal design prevents from drawing causal conclusions. CONCLUSION Increased severity of BD with AUD compared to BD alone did not differ according to the sequence of onset. A few differences, though, could be used to better monitor the trajectory of patients showing either one of these disorders.
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Affiliation(s)
- Romain Icick
- Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de psychiatrie et de Médecine Addictologique, Paris, France. Fédération Hospitalo-Universitaire 'FHU NOR-SUD'.; Université de Paris, UMR-S 1144, Paris, France.
| | - Sébastien Gard
- Fondation Fondamental, Créteil, France; Hôpital Charles Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire (3/4/7), Bordeaux, France
| | - Katia M'Bailara
- Fondation Fondamental, Créteil, France; Hôpital Charles Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire (3/4/7), Bordeaux, France
| | - Isabelle Biseul
- Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de psychiatrie et de Médecine Addictologique, Paris, France. Fédération Hospitalo-Universitaire 'FHU NOR-SUD'
| | - Ludovic Samalin
- Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Georges Brousse
- Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Valentin Flaudias
- Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Pierre-Michel Llorca
- Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Joséphine Loftus
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Iréna Cussac
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Valérie Aubin
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Raymund Schwan
- Université de Lorraine, Inserm U1114, Centre Psychothérapique de Nancy, Nancy, France
| | - Paul Roux
- Fondation Fondamental, Créteil, France; Service Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, Le Chesnay, Université Paris-Saclay, UVSQ, Inserm, CESP, Team "DevPsy", 94807, Villejuif, France
| | - Mircea Polosan
- Fondation Fondamental, Créteil, France; Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U 1216, Grenoble, France
| | - Philippe Courtet
- Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Emilie Olié
- Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Chantal Henry
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, F-75014, Paris, France
| | - Nicolas Mazer
- Fondation Fondamental, Créteil, France; AP-HP, Groupe Hospitalo-universitaire Nord, DMU ESPRIT, service de Psychiatrie et Addictologie. Hopital Louis Mourier, Colombes, Inserm U1266, Faculté de médecine, Université de Paris, France
| | - Emmanuel Haffen
- Fondation Fondamental, Créteil, France; Service de Psychiatrie de l'Adulte, Centres Experts FondaMental, Centre Investigation Clinique 1431-INSERM, EA 481 Neurosciences, Université de Franche Comté, Besançon, France
| | - Bruno Etain
- Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de psychiatrie et de Médecine Addictologique, Paris, France. Fédération Hospitalo-Universitaire 'FHU NOR-SUD'.; Université de Paris, UMR-S 1144, Paris, France
| | - Marion Leboyer
- Fondation Fondamental, Créteil, France; Université Paris Est Créteil, Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, F-94010, Créteil, France - AP-HP, HU Henri Mondor, Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Fédération Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT) F-94010, France
| | - Frank Bellivier
- Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de psychiatrie et de Médecine Addictologique, Paris, France. Fédération Hospitalo-Universitaire 'FHU NOR-SUD'.; Université de Paris, UMR-S 1144, Paris, France
| | - Raoul Belzeaux
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France, INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Ophélia Godin
- Fondation Fondamental, Créteil, France; Université Paris Est Créteil, Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, F-94010, Créteil, France - AP-HP, HU Henri Mondor, Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Fédération Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT) F-94010, France
| | - Sébastien Guillaume
- Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
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Underner M, Perriot J, Brousse G, de Chazeron I, Schmitt A, Peiffer G, Afshari R, Ebrahimighavam S, Jaafari N. [Contribution of electronic cigarettes in smoking patients with psychotic disorders. A literature review]. Encephale 2021; 47:452-460. [PMID: 33863511 DOI: 10.1016/j.encep.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/09/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This systematic literature review focused on patients suffering from schizophrenia (SZ), psychotic disorders or mental illness (MI) including SZ. It was interested in data on prevalence of electronic cigarette (EC) use, patient perceptions and expectations, as well as caregivers' attitudes towards the EC and its benefit in helping to stop or reduce smoking. METHOD The research was carried out on Medline for the period 2000-2020. Cross-sectional, case-control, prospective, randomized controlled studies and preliminary studies were included in this review. RESULTS EC is widely used by MI patients with current and lifetime use from 7.4% to 28.6%. More specifically, patients with SZ and schizoaffective disorders observe current and lifetime use from 7% to 36%, respectively. Many reasons are given by patients for its use including the possibility of using it in places where smoking is prohibited, its lower toxicity compared to cigarettes for oneself and those around, its lower cost, and the help provided to reduce consumption. CONCLUSION EC is used by smokers with MI; several studies confirm the possibility for these smokers to reduce tobacco consumption through EC and without disturbing their mental state. However, its value in helping to quit smoking remains uncertain.
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Affiliation(s)
- M Underner
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - J Perriot
- Dispensaire Émile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Brousse
- Service de psychiatrie-addictologie, CMP-B CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - I de Chazeron
- Service de psychiatrie-addictologie, CMP-B CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - A Schmitt
- Service de psychiatrie-addictologie, CMP-B CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - R Afshari
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France; Prevention of social harms and substance use disorders center, Shiraz university of medical sciences, Shiraz, Iran
| | - S Ebrahimighavam
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France; Département de psychologie de l'éducation, faculté de psychologie et de sciences de l'éducation, université Allameh Tabataba'i, Téhéran, Iran
| | - N Jaafari
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
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Rolland B, Trojak B, Nourredine M, Bachellier J, Chappuy M, Bendimerad P, Kosim M, Hjelmström P, Meroueh F, Nubukpo P, Brousse G. Determinants of interest in extended-released buprenorphine: A survey among 366 French patients treated with buprenorphine or methadone. Drug Alcohol Depend 2021; 220:108492. [PMID: 33482572 DOI: 10.1016/j.drugalcdep.2020.108492] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
AIM To explore the factors determining the interest in extended-release buprenorphine (XR-BUP) injections among patients receiving opioid agonist treatment (OAT) in France. METHODS 366 patients receiving OAT for opioid use disorder, recruited in 66 French centers, were interviewed from 12/2018 to 05/2019. A structured questionnaire assessed their interest in XR-BUP using a [1-10] Likert scale. 'More' vs. 'less' interested groups were defined using the median score of interest, and their characteristics were explored using adjusted odds ratios (aORs) and 95 % confidence interval (95 %CI). Independent variables were as follows: sociodemographic characteristics, OAT-related features (e.g., type of OAT and prescriber, dosing, or duration of treatment), OAT representations, and personal objectives of treatment. RESULTS The median interest in XR-BUP was 7 (interquartile range: 3-9) out of 10. The participants who were 'more interested' (i.e. those scoring ≥7) showed no substantial difference in sociodemographic characteristics, relative to the 'less interested' participants. However, they more frequently reported forgetting to take their OAT (OR = 1.81; CI95 % = 1.06-3.10) or reported experiencing situations where taking their OAT was impractical (aOR = 1.69; CI95 % = 1.05-2.73). Their treatment objective was more focused on stopping illicit drugs (aOR = 1.67; 95 %CI = 1.02-2.70), reducing health risks (aOR = 3.57; 95 %CI = 1.67-7.69) and craving (aOR = 2.38; 95 %CI = 1.39-4.02) or improving family (aOR = 1.81; 95 %CI = 1.03-3.13) or professional (aOR = 2.22; 95 %CI = 1.43-3.85) recovery. CONCLUSIONS In France, where the access to OAT is relatively unrestricted, the majority of participants were interested in XR-BUP formulations. Being interested was associated with treatment objectives focused on abstinence and recovery, and with experiencing constraints in taking a daily oral OAT.
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Affiliation(s)
- Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, 69500, Bron, France; Service d'Addictologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France; INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL1, Bron, France.
| | - Benoit Trojak
- Service Hospitalo-Universitaire d'Addictologie, CHU de Dijon, Dijon, France; INSERM U1093, UFR Staps, Université de Bourgogne Franche Comté, France
| | - Mikail Nourredine
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, 69500, Bron, France
| | - Jérôme Bachellier
- Service Universitaire d'Addictologie de Tours, CHU Bretonneau, Tours, France
| | - Mathieu Chappuy
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, 69500, Bron, France; Service d'Addictologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Patrick Bendimerad
- Service d'Addictologie, Groupe Hospitalier de La Rochelle-Ré-Aunis, La Rochelle, France
| | - Margaux Kosim
- Consultations de Médecine-Alcoologie PASS, Groupe Hospitalier Pitié Salpêtrière, Paris, France; Camurus SAS, Paris, France
| | | | | | - Philippe Nubukpo
- Service d'Addictologie, Centre Hospitalier Esquirol, Limoges, France; INSERM UMR 1094, Université de Limoges, Limoges, France
| | - Georges Brousse
- Service de Psychiatrie B et d'Addictologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France; Équipe d'Accueil 7280, Université Clermont Auvergne, Clermont-Ferrand, France
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Flaudias V, Zerhouni O, Pereira B, Cherpitel CJ, Boudesseul J, de Chazeron I, Romo L, Guillaume S, Samalin L, Cabe J, Bègue L, Gerbaud L, Rolland B, Llorca PM, Naassila M, Brousse G. The Early Impact of the COVID-19 Lockdown on Stress and Addictive Behaviors in an Alcohol-Consuming Student Population in France. Front Psychiatry 2021; 12:628631. [PMID: 33633612 PMCID: PMC7900161 DOI: 10.3389/fpsyt.2021.628631] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background: This study evaluated factors linked with perceived stress related to the COVID-19 pandemic and lockdown and addictive behaviors prior to and during lockdown in a sample of students who indicated engaging in alcohol consumption behaviors before lockdown. Methods: Cross-sectional study. French students from four universities participated in this study, and 2,760 students reported alcohol use. During the first week of lockdown, students reported their perceived levels of stress regarding COVID-19. Substance use and addictive behaviors were reported before and during lockdown, and media exposure, demographical, living conditions, and environmental stressors were reported during lockdown. Results: Women reported greater levels of stress (95% CI: 1.18 to 1.93, p < 0.001). Highly-stressed students also report less social support (95% CI: -1.04 to -0.39, p < 0.001) and were more likely to worry about the lockdown (95% CI: 0.27 to -0.65, p < 0.001). Alcohol-related problemswere more prevalent among the most stressed students (95% CI: 0.02 to 0.09, p = 0.004) as well as eating problems (95% CI: 0.04 to 0.36, p = 0.016) and problematic internet use (95% CI, 0.06 to 0.14, p < 0.001). Students reporting the highest levels of stress also indicated more compulsive eating during the previous seven days (95% CI, 0.21 to 1.19, p = 0.005). Conclusions: The level of stress was strongly related to four categories of variables: (i) intrinsic characteristics, (ii) addictive behaviors before lockdown, (iii) lockdown-specific conditions, and (iv) addictive behaviors during the lockdown. Several variables linked to COVID-19 were not directly linked with perceived stress, while perceived stress was found to correlate with daily life organization-related uncertainty and anticipated consequences of lockdown. Importantly, social support seems to be a protective factor on high level of stress.
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Affiliation(s)
- Valentin Flaudias
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | - Oulmann Zerhouni
- Laboratoire Parisien de Psychologie Sociale, Département de Psychologie, University Paris Nanterre, Ad Hoc Lab, Nanterre, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | | | - Jordane Boudesseul
- Facultad de Psicología, Instituto de Investigación Científica, Universidad de Lima, Lima, Peru
| | - Ingrid de Chazeron
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | - Lucia Romo
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
- CMME, GHU Paris Psychiatrie et Neurosciences, U de Paris, Paris, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier/INSERM U1061, University of Montpellier, Montpellier, France
| | - Ludovic Samalin
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | - Julien Cabe
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | | | - Laurent Gerbaud
- Service de Santé Publique, CHU de Clermont-Ferrand, Clermont-Ferrand, France
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Groupe PEPRADE, Clermont-Ferrand, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CRNL, Inserm U1028, CNRS UMR5292, Université Lyon 1, Centre Hospitalier Le Vinatier, Bron, France
| | | | - Mickael Naassila
- Université de Picardie Jules Verne, Unité INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Centre Universitaire de Recherche en Santé, Amiens, France
| | - Georges Brousse
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
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Icick R, Bloch V, Prince N, Karsinti E, Lépine JP, Laplanche JL, Mouly S, Marie-Claire C, Brousse G, Bellivier F, Vorspan F. Clustering suicidal phenotypes and genetic associations with brain-derived neurotrophic factor in patients with substance use disorders. Transl Psychiatry 2021; 11:72. [PMID: 33479229 PMCID: PMC7820499 DOI: 10.1038/s41398-021-01200-5] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 06/13/2020] [Accepted: 07/03/2020] [Indexed: 11/09/2022] Open
Abstract
Suicide attempts (SA), especially recurrent SA or serious SA, are common in substance use disorders (SUD). However, the genetic component of SA in SUD samples remains unclear. Brain-derived neurotrophic factor (BDNF) alleles and levels have been repeatedly involved in stress-related psychopathology. This investigation uses a within-cases study of BDNF and associated factors in three suicidal phenotypes ('any', 'recurrent', and 'serious') of outpatients seeking treatment for opiate and/or cocaine use disorder. Phenotypic characterization was ascertained using a semi-structured interview. After thorough quality control, 98 SNPs of BDNF and associated factors (the BDNF pathway) were extracted from whole-genome data, leaving 411 patients of Caucasian ancestry, who had reliable data regarding their SA history. Binary and multinomial regression with the three suicidal phenotypes were further performed to adjust for possible confounders, along with hierarchical clustering and compared to controls (N = 2504). Bayesian analyses were conducted to detect pleiotropy across the suicidal phenotypes. Among 154 (37%) ever suicide attempters, 104 (68%) reported at least one serious SA and 96 (57%) two SA or more. The median number of non-tobacco SUDs was three. The BDNF gene remained associated with lifetime SA in SNP-based (rs7934165, rs10835210) and gene-based tests within the clinical sample. rs10835210 clustered with serious SA. Bayesian analysis identified genetic correlation between 'any' and 'serious' SA regarding rs7934165. Despite limitations, 'serious' SA was shown to share both clinical and genetic risk factors of SA-not otherwise specified, suggesting a shared BDNF-related pathophysiology of SA in this population with multiple SUDs.
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Affiliation(s)
- Romain Icick
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Paris, France. .,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France. .,Université de Paris, Inserm UMR-S1144, Paris, France.
| | - Vanessa Bloch
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Nathalie Prince
- grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Emily Karsinti
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,ED139, Paris Nanterre University, Nanterre, France
| | - Jean-Pierre Lépine
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Jean-Louis Laplanche
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France
| | - Stéphane Mouly
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Cynthia Marie-Claire
- grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Georges Brousse
- grid.494717.80000000115480420Inserm UMR-1107, Neuro-Dol, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Frank Bellivier
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Florence Vorspan
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
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Chappuy M, Meroueh F, Trojak B, Bachellier J, Bendimerad P, Kosim M, Hjelmström P, Nubukpo P, Brousse G, Rolland B. Factors of Interest in Extended-Release Buprenorphine: Comparisons Between Incarcerated and Non-Incarcerated Patients with Opioid Use Disorder. Patient Prefer Adherence 2021; 15:1259-1267. [PMID: 34163143 PMCID: PMC8214559 DOI: 10.2147/ppa.s311674] [Citation(s) in RCA: 3] [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] [Received: 03/18/2021] [Accepted: 05/22/2021] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Extended-release buprenorphine (XR-BUP) covers a range of formulations of buprenorphine-based treatments for opioid use disorder (OUD) that release the medication over a period of one week, one month, or six months. OUD is particularly prevalent among incarcerated populations, and previous findings have shown that incarcerated subjects were not less interested in XR-BUP than non-incarcerated subjects. However, no study has ever investigated whether the factors of interest in XR-BUP were similar in incarcerated and non-incarcerated populations. PATIENTS AND METHODS We carried out post-hoc analyses using data from the "AMBRE" survey, which was conducted among 366 individuals with OUD, that were recruited in 68 French addiction settings, including six prison medical centers. The reasons for interest in XR-BUP were compared between incarcerated and non-incarcerated interviewees, using logistic regressions models, which provided raw and adjusted odds ratios (aORs) and 95% confidence intervals (95% CI). Adjustment variables were gender, age category, level of education, and type of current medication for OUD, respectively. RESULTS Data from 317 participants (ie, 221 non-incarcerated, and 96 incarcerated individuals) were included in the analyses. Adjusted comparisons found that "no longer taking a daily treatment" (aOR= 2.91; 95% CI= 1.21-6.98) and "having a more discreet medication" (aOR= 1.76; 95% CI= 1.01-3.10) were reasons that appealed more to incarcerated participants than to non-incarcerated ones. On the other hand, the potential reduction of withdrawal symptoms (aOR= 0.54; 95% CI= 0.29-0.99) or the risk of misuse (aOR= 0.56; 95% CI= 0.34-0.94) associated with XR-BUP treatment were considered more important by non-incarcerated individuals than by incarcerated ones. CONCLUSION Incarcerated interviewees were interested in XR-BUP for different reasons than those outside prison. In particular, incarcerated patients were more interested in practicability and discretion features, and less in improving recovery or reducing misuse than non-incarcerated patients.
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Affiliation(s)
- Mathieu Chappuy
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, 69500, France
- Service d’Addictologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
- CSAPA, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | | | - Benoit Trojak
- Service Hospitalo-Universitaire d’Addictologie, CHU de Dijon, Dijon, France
- INSERM U1093, UFR Staps, Université de Bourgogne Franche Comté, Dijon, France
| | - Jérôme Bachellier
- Service Universitaire d’Addictologie de Tours, CHU Bretonneau, Tours, France
| | - Patrick Bendimerad
- Service d’Addictologie, Groupe Hospitalier de La Rochelle-Ré-Aunis, La Rochelle, France
| | - Margaux Kosim
- Consultations de Médecine-Alcoologie PASS, Groupe Hospitalier Pitié Salpêtrière, Paris, France
- Camurus SAS, Paris, France
| | | | - Philippe Nubukpo
- Service d’Addictologie, Centre Hospitalier Esquirol, Limoges, France
- INSERM UMR 1094, Université de Limoges, Limoges, France
| | - Georges Brousse
- Service de Psychiatrie B et d’Addictologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
- Équipe d’Accueil 7280, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Benjamin Rolland
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, 69500, France
- Service d’Addictologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
- INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL1, Bron, France
- Correspondence: Benjamin Rolland Service Universitaire d’Addictologie, CH Le Vinatier, Pôle MOPHA, 95 Bd Pinel, Bron, 69500, FranceTel +33 437 915 555Fax +33 437 915 556 Email
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Delorme J, Pennel L, Brousse G, Daulouède JP, Delile JM, Lack P, Gérard A, Dematteis M, Kabore JL, Authier N, Chenaf C. Prevalence and Characteristics of Chronic Pain in Buprenorphine and Methadone-Maintained Patients. Front Psychiatry 2021; 12:641430. [PMID: 33981257 PMCID: PMC8107279 DOI: 10.3389/fpsyt.2021.641430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/14/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
Chronic pain and substance use disorders frequently co-occur. Indeed, chronic pain is highly prevalent, affecting 23-68% of patients receiving opioid agonist treatments (OAT) worldwide. The majority of available estimates come from American studies, but data are still lacking in Europe. We aim to provide European estimates of the prevalence of chronic pain in patients receiving OAT using French data, since France is the first European country in terms of number of patients with OAT. The secondary objectives were to characterize the features and management of chronic pain, as well identify associated risk factors. We conducted a multicenter, cross-sectional study, recruiting patients treated either with buprenorphine or methadone in 19 French addiction centers, from May to July 2016. All participants had to complete a semi-directed questionnaire that collected sociodemographic and medical data, pain characteristics, and licit or illicit drug consumption. In total, 509 patients were included. The prevalence of chronic pain was estimated at 33.2% (95% CI: 29.1-37.3). Compared to non-chronic pain patients, chronic pain patients were older (38.4 vs. 36.1 years, p = 0.006), were more unemployed (66 vs. 52%, p = 0.003), had more psychiatric comorbidities (50 vs. 39%, p = 0.02), and split their OAT for pain management more frequently (24 vs. 7%, p = 0.009). Pain intensity was moderate or severe in 75% of chronic pain patients. Among patients with chronic pain, 15.4% were not prescribed, and did not self-medicate with, any analgesic drugs, 52.1% were prescribed analgesics (non-opioid analgesics, 76.3%; codeine, tramadol, opium, 27.2%; and morphine, fentanyl, oxycodone, 11.8%), and 32.5% exclusively self-medicated with analgesics. Moreover, 20.1% of patients with chronic pain also used illicit drugs for pain relief. On multivariate analysis, variables that remained significantly associated with chronic pain were age [OR = 1.03 (95% CI: 1.00-1.05], p = 0.02], anxiety [OR = 1.52 (1.15-2.02), p = 0.003], and depression [OR = 1.25 (1.00-1.55), p = 0.05]. Chronic pain is a highly prevalent condition in patients receiving OAT, and its appropriate management remains uncertain, since insufficient relief and frequent additional self-medications with analgesics or illicit drugs were reported by these patients. Increased awareness among caregivers is urgently needed regarding a systematic and careful assessment, along with an adequate management of chronic pain in patients receiving OAT.
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Affiliation(s)
- Jessica Delorme
- Université Clermont Auvergne, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la Douleur, Service Psychiatrie-Addictologie, Clermont-Ferrand, France.,Observatoire Français des Médicaments Antalgiques (OFMA) / French monitoring centre for analgesic drugs, Université Clermont Auvergne - CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Lucie Pennel
- Service d'Addictologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Georges Brousse
- Université Clermont Auvergne, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la Douleur, Service Psychiatrie-Addictologie, Clermont-Ferrand, France
| | - Jean-Pierre Daulouède
- Centre de Soins et d'Accompagnement et de Prévention en Addictologie (CSAPA), BIZIA, Médecins du Monde, Centre Hospitalier de la côte Basque, Bayonne, France
| | - Jean-Michel Delile
- Centre de Soins et d'Accompagnement et de Prévention en Addictologie (CSAPA) "Maurice Serisé", Comité d'Etude et d'Information sur la Drogue (CEID), Bordeaux, France
| | - Philippe Lack
- Centre de Soins et d'Accompagnement et de Prévention en Addictologie (CSAPA), Centre Hospitalier de la Croix Rousse, Lyon, France
| | - Antoine Gérard
- Centre de Soins et d'Accompagnement et de Prévention en Addictologie (CSAPA), Centre Hospitalier Emile Roux, Le Puy-en-Velay, France
| | - Maurice Dematteis
- Service d'Addictologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Jean-Luc Kabore
- Université Clermont Auvergne, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la Douleur, Service Psychiatrie-Addictologie, Clermont-Ferrand, France
| | - Nicolas Authier
- Université Clermont Auvergne, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la Douleur, Service Psychiatrie-Addictologie, Clermont-Ferrand, France.,Observatoire Français des Médicaments Antalgiques (OFMA) / French monitoring centre for analgesic drugs, Université Clermont Auvergne - CHU Clermont-Ferrand, Clermont-Ferrand, France.,Institut Analgesia, Faculté de Médecine, BP38, Clermont-Ferrand, France
| | - Chouki Chenaf
- Université Clermont Auvergne, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la Douleur, Service Psychiatrie-Addictologie, Clermont-Ferrand, France.,Observatoire Français des Médicaments Antalgiques (OFMA) / French monitoring centre for analgesic drugs, Université Clermont Auvergne - CHU Clermont-Ferrand, Clermont-Ferrand, France
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Cabé J, Brousse G, Pereira B, Cabé N, Karsinti E, Zerdazi EH, Icick R, Llorca PM, Bloch V, Vorspan F, De Chazeron I. Influence of Clinical Markers of Dopaminergic Behaviors on Depressive Symptoms During Withdrawal in Cocaine Users. Front Psychiatry 2021; 12:775670. [PMID: 34880796 PMCID: PMC8645893 DOI: 10.3389/fpsyt.2021.775670] [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: 09/14/2021] [Accepted: 10/29/2021] [Indexed: 12/04/2022] Open
Abstract
Background: During cocaine withdrawal, transient depressive symptoms that do not meet the criteria for depression, but promote relapse, are frequently observed. Their temporality could evoke a role of dopamine, especially since the underlying mechanism of these depressive symptoms is not well understood. We hypothesized that variation in the dopaminergic activity profile, modeled from clinical markers, could be implicated in the development of depressive symptoms during cocaine withdrawal. Methods: We compared patients reporting depressive symptoms (RDS+) or not (RDS-) during cocaine withdrawal. We evaluated dopaminergic activity through indirect clinical markers based on the known dopaminergic behaviors. A combined criterion was constructed for hyper and hypo dopaminergic models according to the O'Brien method and illustrated by the Hedges' effect-size and forest-plot graph. A multidimensional factorial analysis was carried out to determine which parameters discriminate RDS+/RDS- patients. Results: 313 patients were included, and 77% reported depressive symptoms during cocaine withdrawal. Hyperdopaminergic variables used to discriminate the two groups had a large overall effect size (-0.669) and included psychotic symptoms (-0.524), hallucinations (-0.548), and delusions (-0.528). The overall effect of the hypodopaminergic component was considerable (-0.604) with a large effect size for the severity of dependence (-0.616), withdrawal symptoms (-0.578), and anhedonia (-0.528). The combined model including hyperdopaminergic and hypodopaminergic components had the largest effect size (-0.785). Conclusion: The dopaminergic activities profile, assessed by indirect clinical markers, seems to characterize patients with depressive symptoms very well during cocaine withdrawal. RDS+ patients reported moreover higher levels of psychotic symptoms and more severe cocaine use disorder than RDS-.
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Affiliation(s)
- Julien Cabé
- Service d'addictologie et pathologies duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.,Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- Service d'addictologie et pathologies duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.,Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction de la Recherche Clinique et des Innovations, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nicolas Cabé
- Normandie University, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Emily Karsinti
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - El-Hadi Zerdazi
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Romain Icick
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre M Llorca
- Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.,Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France.,Service de Psychiatrie B, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Vanessa Bloch
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Florence Vorspan
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Ingrid De Chazeron
- Service d'addictologie et pathologies duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.,Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France
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Balayssac D, Pereira B, Cuq P, Douris J, Ferrari L, Boutet-Robinet E, Lechevrel M, Demeilliers C, Rat P, Coudoré F, Verron E, Lacarelle B, Guitton J, Courtois A, Allorge D, Pain S, Guerbet M, Collin A, Vennat B, Brousse G, Authier N, Laporte C. Perception of pharmacy students toward opioid-related disorders and roles of community pharmacists: A French nationwide cross-sectional study. Subst Abus 2020; 42:706-715. [PMID: 33320801 DOI: 10.1080/08897077.2020.1850607] [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: 10/22/2022]
Abstract
Background: Community pharmacists are among the frontline health professionals who manage patients with an opioid-related disorder (ORD). Pharmacists frequently have a negative attitude toward these patients, which could have a negative impact on their management. However, education on ORD may improve the attitude of future healthcare professionals. This cross-sectional study aimed to assess French pharmacy students' perceptions of ORD. Methods: This online survey was performed by emails sent to French pharmacy schools (between January 14, 2019 and May 31, 2019). The primary outcome was the perception (visual analogic scale) of ORD as a disease, the roles of community pharmacies (delivery of opioid agonist therapy-OAT and harm reduction kits), and the efficacy of OAT. The secondary outcomes assessed professional experience, university experience of and education on ORD, and the individual characteristics of students. Results: Among the 1,994 students included, 76.3% perceived ORD as a disease and felt that it was normal for pharmacists to deliver OAT (78.9%) and harm reduction kits (74.6%). However, only 46.9% perceived OAT as being effective. Multivariable analyses showed that females had a more positive perception in recognizing ORD as a disease. The progression through university years increased the positive perception of ORD as a disease and the delivery of OAT and harm reduction kits by pharmacists. Education on substance-related disorders had no impact on any scores. Students who had already delivered OAT had a negative perception of their efficacy. The students who had already performed pharmacy jobs or traineeships had a negative perception of harm reduction kit delivery. Conclusion: Education on substance-related disorders had no impact on students' perceptions. It seemed that the maturity acquired through university years had a stronger impact on the students' perceptions of ORD. Efforts must be made to improve our teaching methods and reinforce the confidence of students in the roles of community pharmacists.
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Affiliation(s)
- David Balayssac
- Inserm U1107, NEURO-DOL, Université Clermont Auvergne, CHU Clermont-Ferrand, France
| | - Bruno Pereira
- Délégation à la recherche clinique et à l'innovation, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Pierre Cuq
- Faculté de Pharmacie, Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Université de Montpellier, Montpellier, France
| | - Juliette Douris
- UFR de Pharmacie, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Luc Ferrari
- Institut Jean Lamour, UMR 7198 CNRS, Université de Lorraine, Nancy, France
| | - Elisa Boutet-Robinet
- Toxalim (Research Centre in Food Toxicology), INRAE, ENVT, INP-Purpan, UPS, Université de Toulouse, Toulouse, France
| | | | - Christine Demeilliers
- Environnement et Prédiction de la Santé des Populations, Laboratoire TIMC-IMAG (UMR-CNRS 5525), Université Grenoble-Alpes, La Tronche, France
| | - Patrice Rat
- Faculté de Pharmacie de Paris, CNRS UMR-8038 CiTCoM, Université de Paris, Paris, France
| | - François Coudoré
- Lab neuropharmacologie, CESP UMR-S1178, Université Paris-Saclay, Chatenay Malabry, Laboratoire de Microbiologie Clinique et Plateforme de dosage des anti-infectieux, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Elise Verron
- UFR pharmacie, département E2M, CNRS 6230, Université de Nantes, Nantes, France
| | - Bruno Lacarelle
- SMARTc Unit, Centre de Recherche en Cancérologie de Marseille, Inserm U1068, Assistance Publique des Hôpitaux de Marseille, Laboratoire de Pharmacocinétique et Toxicologie, Université Aix Marseille, Marseille, France
| | - Jérôme Guitton
- Laboratoire de Toxicologie, ISPBL, Faculté de Pharmacie de Lyon, Université Lyon 1, Lyon, France
| | - Arnaud Courtois
- CHU de Bordeaux, Centre Antipoison et de Toxicovigilance de Nouvelle Aquitaine, Université de Bordeaux, Bordeaux, France
| | - Delphine Allorge
- CHU Lille, Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Université de Lille, Lille, France
| | - Stéphanie Pain
- Laboratoire de Neurosciences Expérimentales et Cliniques - LNEC, INSERM U-1084, CHU Poitiers, Centre d'Addictovigilance, Pharmacologie clinique et vigilances, Université de Poitiers, Poitiers, France
| | - Michel Guerbet
- UNIROUEN, UNICAEN, ABTE, Normandie University, Rouen, France
| | - Aurore Collin
- Inserm U1107, NEURO-DOL, Université Clermont Auvergne, CHU Clermont-Ferrand, France
| | - Brigitte Vennat
- ACCePPT, UFR de Pharmacie, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- EA7280, UFR de Médicine, CHU Clermont-Ferrand Service de Psychiatrie B et d'addictologie, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Nicolas Authier
- Inserm U1107, NEURO-DOL, Université Clermont Auvergne, CHU Clermont-Ferrand, France
| | - Catherine Laporte
- Département de Médecine Générale, EA7280, UFR de Médicine, Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Bertin C, Delorme J, Riquelme M, Peyrière H, Brousse G, Eschalier A, Ardid D, Chenaf C, Authier N. Risk assessment of using off-label morphine sulfate in a population-based retrospective cohort of opioid-dependent patients. Br J Clin Pharmacol 2020; 86:2338-2348. [PMID: 31389036 PMCID: PMC7688539 DOI: 10.1111/bcp.14082] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 05/02/2019] [Accepted: 07/19/2019] [Indexed: 01/09/2023] Open
Abstract
AIMS Several addictovigilance studies have described the off-label use of morphine sulfate (MS) for nonchronic pain in opioid use disorder (OUD) patients as an alternative to conventional opioid substitution treatments (OSTs). This study primarily sought to compare the incidence of unintentional opioid-related overdose in the year following the prescription initiation in off-label MS users, compared to OST-maintained patients. METHODS Sequential cohorts of OUD patients who were regularly dispensed MS, buprenorphine, or methadone, between 1 April 2012 and 31 December 2014, were retrospectively identified using the French nationwide healthcare data system. The incidence of overdoses, deaths, doctor shopping, and complications of a viral, bacterial or thrombotic nature, was compared using the Cox regression method. RESULTS Overall, 1075, 20 834 and 9778 OUD patients without chronic-pain were included in the MS, buprenorphine, and methadone cohorts, respectively. Overdose incidence was 3.8 (P < .01 [95% confidence interval (CI): 2.1-6.8]) and 2.0 (P = .02 [95%CI: 1.1-3.6]) higher in the MS cohort vs buprenorphine and methadone, respectively. Death incidence was 9.1 (P < .01 [95%CI: 3.2-25.9]) and 3.9 (P < .01 [95%CI: 1.4-10.7]) higher in the MS cohort vs buprenorphine and methadone, respectively. The incidences of other associated risks were significantly higher in the MS group vs OSTs, except for hepatitis C viral infection and thrombotic complications. CONCLUSION This first French comprehensive nationwide study reveals increasing overdose, death, bacterial infection, abuse and diversion risks when off-label MS is initiated as alternative to OST. These results question the relevance of prescribing MS as a safe opioid maintenance treatment, considering its health risk profile.
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Affiliation(s)
- Célian Bertin
- CHU Clermont‐Ferrand, Inserm 1107, Neuro‐Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la DouleurUniversité Clermont AuvergneClermont‐FerrandFrance
- Observatoire Français des Médicaments Antalgiques (OFMA)CHU Clermont‐Ferrand and Université Clermont AuvergneClermont–FerrandFrance
| | - Jessica Delorme
- CHU Clermont‐Ferrand, Inserm 1107, Neuro‐Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la DouleurUniversité Clermont AuvergneClermont‐FerrandFrance
- Observatoire Français des Médicaments Antalgiques (OFMA)CHU Clermont‐Ferrand and Université Clermont AuvergneClermont–FerrandFrance
| | - Marie Riquelme
- CHU Clermont‐Ferrand, Inserm 1107, Neuro‐Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la DouleurUniversité Clermont AuvergneClermont‐FerrandFrance
- Observatoire Français des Médicaments Antalgiques (OFMA)CHU Clermont‐Ferrand and Université Clermont AuvergneClermont–FerrandFrance
| | - Hélène Peyrière
- CHU Montpellier, Laboratoire de Pharmacie Clinique, Département de Pharmacologie Médicale et Toxicologie, Centre AddictovigilanceUniversité de MontpellierMontpellierFrance
| | - Georges Brousse
- CIRCEA, Service de Psychiatrie‐addictologieUniversité Clermont AuvergneClermont‐FerrandFrance
| | - Alain Eschalier
- CHU Clermont‐Ferrand, Inserm 1107, Neuro‐Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la DouleurUniversité Clermont AuvergneClermont‐FerrandFrance
- Observatoire Français des Médicaments Antalgiques (OFMA)CHU Clermont‐Ferrand and Université Clermont AuvergneClermont–FerrandFrance
- Faculté de MédecineInstitut AnalgesiaClermont‐FerrandFrance
| | - Denis Ardid
- CHU Clermont‐Ferrand, Inserm 1107, Neuro‐Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la DouleurUniversité Clermont AuvergneClermont‐FerrandFrance
- Observatoire Français des Médicaments Antalgiques (OFMA)CHU Clermont‐Ferrand and Université Clermont AuvergneClermont–FerrandFrance
- Faculté de MédecineInstitut AnalgesiaClermont‐FerrandFrance
| | - Chouki Chenaf
- CHU Clermont‐Ferrand, Inserm 1107, Neuro‐Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la DouleurUniversité Clermont AuvergneClermont‐FerrandFrance
- Observatoire Français des Médicaments Antalgiques (OFMA)CHU Clermont‐Ferrand and Université Clermont AuvergneClermont–FerrandFrance
| | - Nicolas Authier
- CHU Clermont‐Ferrand, Inserm 1107, Neuro‐Dol, Service de Pharmacologie médicale, Centres Addictovigilance et Pharmacovigilance, Centre Evaluation et Traitement de la DouleurUniversité Clermont AuvergneClermont‐FerrandFrance
- Observatoire Français des Médicaments Antalgiques (OFMA)CHU Clermont‐Ferrand and Université Clermont AuvergneClermont–FerrandFrance
- Faculté de MédecineInstitut AnalgesiaClermont‐FerrandFrance
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Karsinti E, Labaeye M, Piani K, Fortias M, Brousse G, Bloch V, Romo L, Vorspan F. Network analysis of psychotic manifestations among cocaine users. J Psychiatr Res 2020; 130:300-305. [PMID: 32866679 DOI: 10.1016/j.jpsychires.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/01/2020] [Revised: 07/17/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Abstract
Psychotic experiences can be described along a continuum ranging from no psychotic experience at all, to clinical psychotic disorder. Any individual in the general population may encounter psychotic experiences under certain circumstances. Transient Cocaine Induced Psychotic Symptoms (TCIPS) are a well described model of such circumstances. Therefore, our aim was to use a network analysis to get a better knowledge on the architecture of previously described risk factors and how they contributed to two different measures of psychosis (psychosis proneness and transient cocaine induced psychotic symptoms) This study is a secondary analysis conducted among 180 cocaine users in addiction care centers in Paris and Paris suburb, who were evaluated with the PDI (Peters Delusion Inventory) and the SAPS-CIP (Scale for the Assessment of Psychotic Symptoms - Cocaine Induced Psychosis). Schizophrenia diagnosis was extracted from medical record. Relevant variables significantly associated with SAPS-CIP total score or PDI at the first step were included in a network analysis to better figurate their respective associations. The network centrality measures showed that the product preferentially used (crack vs cocaine) was related to TCIPS, psychosis proneness and, to a lesser extent, schizophrenia. Secondly, in this model TCIPS is a mediator between intensive cocaine use and psychosis proneness. Thirdly, this study refines the previous knowledge on heavy cannabis use being a risk factor for TCIPS. The observed link is not direct but mediated by psychosis proneness.
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Affiliation(s)
- Emily Karsinti
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France; INSERM UMR-S 1144, 75006 Paris, Université Paris Descartes, 75006 Paris, Sorbonne Paris Cité, Université Paris Diderot, 75013, Paris, France; Laboratoire CliPsyD, EA4430, Université Paris Nanterre, 200 Avenue de la République, 92001, Cedex Nanterre, France.
| | - Marion Labaeye
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France
| | - Kristel Piani
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France
| | - Maeva Fortias
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France; INSERM UMR-S 1144, 75006 Paris, Université Paris Descartes, 75006 Paris, Sorbonne Paris Cité, Université Paris Diderot, 75013, Paris, France
| | - Georges Brousse
- EA NPsy-Sydo, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Vanessa Bloch
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France; INSERM UMR-S 1144, 75006 Paris, Université Paris Descartes, 75006 Paris, Sorbonne Paris Cité, Université Paris Diderot, 75013, Paris, France
| | - Lucia Romo
- Laboratoire CliPsyD, EA4430, Université Paris Nanterre, 200 Avenue de la République, 92001, Cedex Nanterre, France; GHU Paris Psychiatrie et Neurosciences, CMME, INSERM UMR1266, France
| | - Florence Vorspan
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France; INSERM UMR-S 1144, 75006 Paris, Université Paris Descartes, 75006 Paris, Sorbonne Paris Cité, Université Paris Diderot, 75013, Paris, France; FHU NOR-SUD, Paris, France
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Dutheil F, Charkhabi M, Ravoux H, Brousse G, Dewavrin S, Cornet T, Mondillon L, Han S, Pfabigan D, S Baker J, Mermillod M, Schmidt J, Moustafa F, Pereira B. Exploring the Link between Work Addiction Risk and Health-Related Outcomes Using Job-Demand-Control Model. Int J Environ Res Public Health 2020; 17:ijerph17207594. [PMID: 33086543 PMCID: PMC7593928 DOI: 10.3390/ijerph17207594] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 01/12/2023]
Abstract
Purpose of the study: Work addiction risk is a growing public health concern with potential deleterious health-related outcomes. Perception of work (job demands and job control) may play a major role in provoking the risk of work addiction in employees. We aimed to explore the link between work addiction risk and health-related outcomes using the framework of job-demand-control model. Methods: Data were collected from 187 out of 1580 (11.8%) French workers who agreed to participate in a cross-sectional study using the WittyFit software online platform. The self-administered questionnaires were the Job Content Questionnaire by Karasek, the Work Addiction Risk Test, the Hospital Anxiety and Depression scale and socio-demographics. Data Analysis: Statistical analyses were performed using the Stata software (version 13). Results: There were five times more workers with a high risk of work addiction among those with strong job demands than in those with low job demands (29.8% vs. 6.8%, p = 0.002). Addiction to work was not linked to job control (p = 0.77), nor with social support (p = 0.22). We demonstrated a high risk of work addiction in 2.6% of low-strain workers, in 15.0% of passive workers, in 28.9% of active workers, and in 33.3% of high-strain workers (p = 0.010). There were twice as many workers with a HAD-Depression score ≥11 compared with workers at low risk (41.5% vs. 17.7%, p = 0.009). Sleep quality was lower in workers with a high risk of work addiction compared with workers with a low risk of work addiction (44.0 ± 27.3 vs. 64.4 ± 26.8, p < 0.001). Workers with a high risk of work addiction exhibited greater stress at work (68.4 ± 23.2 vs. 47.5 ± 25.1) and lower well-being (69.7 ± 18.3 vs. 49.3 ± 23.0) compared with workers at low risk (p < 0.001). Conclusions: High job demands are strongly associated with the risk of work addiction. Work addiction risk is associated with greater depression and poor quality of sleep. Preventive strategies should benefit from identifying more vulnerable workers to work addiction risk.
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Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000 Clermont-Ferrand, France
| | - Morteza Charkhabi
- Institute of Education, National Research University Higher School of Economics, 101000 Moscow, Russia
| | - Hortense Ravoux
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000 Clermont-Ferrand, France
| | - Georges Brousse
- Psychology Department, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | | | | | - Laurie Mondillon
- Psychology Department, Physiological and Psychosocial Stress, Université Clermont Auvergne, CNRS, LaPSCo, F-63000 Clermont-Ferrand, France
| | - Sihui Han
- Culture and Social Cognitive Neuroscience Laboratory, School of Psychological and Cognitive Sciences, Peking University, Beijing 100080, China
| | - Daniela Pfabigan
- Culture and Social Cognitive Neuroscience Laboratory, School of Psychological and Cognitive Sciences, Peking University, Beijing 100080, China
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Martial Mermillod
- Psychology Department, University Grenoble Alpes, CNRS, LPNC, 38000 Grenoble, France
| | - Jeannot Schmidt
- Emergency department, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Fares Moustafa
- Emergency department, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit, University Hospital of Clermont-Ferrand, F-63000 Clermont-Ferrand, France
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35
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Flaudias V, Iceta S, Zerhouni O, Rodgers RF, Billieux J, Llorca PM, Boudesseul J, de Chazeron I, Romo L, Maurage P, Samalin L, Bègue L, Naassila M, Brousse G, Guillaume S. COVID-19 pandemic lockdown and problematic eating behaviors in a student population. J Behav Addict 2020; 9:826-835. [PMID: 32976112 PMCID: PMC8943668 DOI: 10.1556/2006.2020.00053] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/07/2020] [Accepted: 08/15/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND AIMS Since mid-March 2020, over 3 billion people have been confined as a result of the COVID-19 pandemic. Problematic eating behaviors are likely to be impacted by the pandemic through multiple pathways. This study examined the relationships between stress related to lockdown measures and binge eating and dietary restriction in a population of French students during the first week of confinement. METHODS A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days. RESULTS Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder. DISCUSSION AND CONCLUSION The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable.
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Affiliation(s)
- Valentin Flaudias
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Sylvain Iceta
- Quebec Heart and Lung Institute (IUCPQ), Québec, QC, G1V 4G5, Canada
- School of Nutrition, Laval University, Québec, QC, G1V 0A6, Canada
- Referral Center for Eating Disorder, Hospices Civils de Lyon, Lyon University, F-69677, Bron, France
| | - Oulmann Zerhouni
- Département de Psychologie, Laboratoire Parisien de Psychologie Sociale, University Paris Nanterre, Nanterre, France
| | - Rachel F Rodgers
- Department of Applied Psychology, APPEAR, Northeastern University, Boston, MA, USA
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier/INSERM U1061, University of Montpellier, Montpellier, France
| | - Joël Billieux
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier/INSERM U1061, University of Montpellier, Montpellier, France
| | - Pierre-Michel Llorca
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | | | - Ingrid de Chazeron
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Lucia Romo
- Instituto de Investigación Científica, Facultad de Psicología, Universidad de Lima, Lima, Peru
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
| | - Pierre Maurage
- CMME GHU Paris Psychiatrie et Neurosciences, Paris, France
| | - Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Laurent Bègue
- Louvain Experimental Psychopathology Research Group, Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | | | - Georges Brousse
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Sébastien Guillaume
- Université de Picardie Jules Verne, Unité INSERM UMR 1247, Groupe de Recherche sur l’Alcool & les Pharmacodépendances, Centre Universitaire de Recherche en Santé, 80025, Amiens, France
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Chappuy M, Trojak B, Nubukpo P, Bachellier J, Bendimerad P, Brousse G, Rolland B. [Prolonged-release buprenorphine formulations: Perspectives for clinical practice]. Therapie 2020:S0040-5957(20)30098-6. [PMID: 32493637 DOI: 10.1016/j.therap.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/03/2020] [Accepted: 04/06/2020] [Indexed: 12/22/2022]
Abstract
Buprenorphine and methadone are the two main opioids agonist treatments approved for opioid use disorder. Buprenorphine is a partial agonist of the mu-opioid receptors, which has been merely available through sublingual form until now. In practice, the use of buprenorphine is smoother than that of methadone, and it induces reduced risks of overdose. However, sublingual buprenorphine also exposes to risks (e.g., withdrawal, misuse) and constraints (e.g., daily intake). Three new galenic formulations of prolonged-release buprenorphine (PRB) are being commercialized and should allow some improvements in patients' comfort and safety. This narrative review aims to describe the main technical features and efficacy and safety data of these PRBs, as well as patients' and professionals' expectancies and concerns, using data of the scientific literature and the regulatory texts. PRBs consist of one subcutaneous implant and two subcutaneous injection depots. Sixmo®/Probuphine® is a six-month-long implant which needs to be surgically placed and removed and is approved for subjects previously treated with a maximum daily dose of 8mg of sublingual buprenorphine, and can be used only for two successive periods of six months before the subject needs to be switched back to sublingual form. Sublocade® is a one-month-long depot formulation that is indicated in switch from sublingual buprenorphine, and which proposes only two dose schemes, i.e., 100 and 300mg monthly. Buvidal®/Brixadi® is a one-week- or one-month-long depot formulation with multiple dosages, which can be used in initiation or in switched from sublingual formulations. While opioid users report some concerns with a risk of coercive use of long-acting forms of buprenorphine, both users and professionals deem that these new specialties could be particularly appreciated in stabilized patients bothered with the daily intake of the treatments, or specific situations at risk of treatment dropout (e.g., following hospital discharge or prison release).
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Affiliation(s)
- Mathieu Chappuy
- Service universitaire d'addictologie de Lyon (SUAL), centre hospitalier Le Vinatier, 95, boulevard Pinel, 69678 Bron, France; Service d'addictologie, groupement hospitalier centre, hospices civils de Lyon, 69003 Lyon, France; Centre de soins, d'accompagnement et de prévention en addictologie, groupement hospitalier nord, hospices civils de Lyon, 69004 Lyon, France.
| | - Benoit Trojak
- Service hospitalo-universitaire d'addictologie, CHU de Dijon, 21079 Dijon, France; Inserm U1093 cognition, action et plasticité sensorimotrice, UFR staps, université de Bourgogne Franche Comté, 21078 Dijon, France
| | - Philippe Nubukpo
- Service universitaire d'addictologie, centre hospitalier Esquirol, 87000 Limoges, France; Inserm UMR 1094 neuroépidémiologie tropicale, université de Limoges, 87000 Limoges, France
| | - Jérôme Bachellier
- Service universitaire d'addictologie de Tours, CHU Bretonneau, 37000 Tours, France
| | - Patrick Bendimerad
- Service d'addictologie, groupe hospitalier de La Rochelle-Ré-Aunis, 17000 La Rochelle, France; Service de psychiatrie, groupe hospitalier de La Rochelle-Ré-Aunis, 17000 La Rochelle, France
| | - Georges Brousse
- Service de psychiatrie B et d'addictologie, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; Équipe d'accueil 7280, unité de formation et de recherche de médecine, université Clermont Auvergne, Clermont-Ferrand, France
| | - Benjamin Rolland
- Service universitaire d'addictologie de Lyon (SUAL), centre hospitalier Le Vinatier, 95, boulevard Pinel, 69678 Bron, France; Service d'addictologie, groupement hospitalier centre, hospices civils de Lyon, 69003 Lyon, France; Inserm, Inserm U1028, CNRS UMR 5292, CRNL, UCBL1, université de Lyon, 69500 Bron, France
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Chappuy M, Trojak B, Nubukpo P, Bachellier J, Bendimerad P, Brousse G, Rolland B. Prolonged-release buprenorphine formulations: Perspectives for clinical practice. Therapie 2020; 75:397-406. [PMID: 32499082 DOI: 10.1016/j.therap.2020.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 02/03/2020] [Revised: 03/20/2020] [Accepted: 05/14/2020] [Indexed: 12/31/2022]
Abstract
Buprenorphine and methadone are the two main opioid agonist treatments approved for opioid use disorder. Buprenorphine is a partial agonist of the mu opioid receptors, which has been merely available through sublingual form until now. In practice, the use of buprenorphine is smoother than that of methadone, and it induces reduced risks of overdose. However, sublingual buprenorphine also exposes to risks (e.g., withdrawal, misuse) and constraints (e.g., daily intake). Three new galenic formulations of prolonged-release buprenorphine (PRB) are being commercialized and should allow some improvements in patients' comfort and safety. This narrative review aims to describe the main technical features and efficacy and safety data of these PRBs, as well as patients' and professionals' expectancies and concerns, using data of the scientific literature and the regulatory texts. PRBs consist of one subcutaneous implant and two subcutaneous injection depots. Sixmo®/Probuphine® is a six-month-long implant which needs to be surgically placed and removed and is approved for subjects previously treated with a maximum daily dose of 8mg of sublingual buprenorphine, and can be used only for two successive periods of six months before the subject needs to be switched back to sublingual form. Sublocade® is a one-month-long depot formulation that is indicated in switch from sublingual buprenorphine, and which proposes only two dose schemes, i.e., 100 and 300mg monthly. Buvidal®/Brixadi® is a one-week- or one-month-long depot formulation with multiple dosages, which can be used in initiation or in switched from sublingual formulations. While opioid users report some concerns with a risk of coercive use of long-acting forms of buprenorphine, both users and professionals deem that these new specialties could be particularly appreciated in stabilized patients bothered with the daily intake of the treatments, or specific situations at risk of treatment dropout (e.g., following hospital discharge or prison release).
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Affiliation(s)
- Mathieu Chappuy
- Service universitaire d'addictologie de Lyon (SUAL), centre hospitalier Le Vinatier, 69500 Bron, France; Service d'addictologie, groupement hospitalier centre, Hospices Civils de Lyon, 69003 Lyon, France; Centre de soins, d'accompagnement et de prévention en addictologie, groupement hospitalier nord, Hospices Civils de Lyon, 69004 Lyon, France.
| | - Benoit Trojak
- Service hospitalo-universitaire d'addictologie, CHU de Dijon, 21079 Dijon, France; INSERM U1093 cognition, action et plasticité sensorimotrice, UFR staps, université de Bourgogne Franche-Comté, 21078 Dijon, France
| | - Philippe Nubukpo
- Service universitaire d'addictologie, centre hospitalier Esquirol, 87000 Limoges, France; INSERM UMR 1094 neuroépidémiologie tropicale, université de Limoges, 87000 Limoges, France
| | - Jérôme Bachellier
- Service universitaire d'addictologie de Tours, CHU Bretonneau, 37000 Tours, France
| | - Patrick Bendimerad
- Service d'addictologie, groupe hospitalier de La Rochelle-Ré-Aunis, 17000 La Rochelle, France; Service de psychiatrie, groupe hospitalier de La Rochelle-Ré-Aunis, 17000 La Rochelle, France
| | - Georges Brousse
- Service de psychiatrie B et d'addictologie, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; Équipe d'accueil 7280, unité de formation et de recherche de médecine, université Clermont Auvergne, Clermont-Ferrand, France
| | - Benjamin Rolland
- Service universitaire d'addictologie de Lyon (SUAL), centre hospitalier Le Vinatier, 69500 Bron, France; Service d'addictologie, groupement hospitalier centre, Hospices Civils de Lyon, 69003 Lyon, France; Université de Lyon, UCBL1, INSERM, INSERM U1028, CNRS UMR 5292, CRNL, 69500 Bron, France
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Brousse G. Le plaisir n’est-il que dans le gène : où en sommes-nous de l’interaction gène-individu-environnement dans les addictions ? Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2015.09.043] [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: 11/27/2022] Open
Abstract
Les facteurs déterminants dans l’apparition des addictions sont généralement présentés selon la formule consacrée : interaction produit-individu-environnement. Le poids variable du facteur produit dans cette équation tiendrait à la différence de potentialité addictogène entre les différentes substances psychoactives. En ce qui concerne la vulnérabilité relative des individus on retient les facteurs psychologiques considérés comme acquis, les facteurs génétiques, et à mi-chemin entre les deux, les pathologies psychiatriques. Enfin, l’environnement constitue le creuset où l’alchimie addictive va opérer ou non. Même s’il reste très large et discutable ce modèle interactif a permis de compenser les positions unicistes. Ainsi, si on a mis, à juste titre, beaucoup d’espoir dans la vulnérabilité liée aux gènes l’intérêt de cette approche repose beaucoup plus aujourd’hui sur l’étude d’une dynamique gène environnement ou d’une interaction gène traitement que sur la découverte d’une cause unique de la maladie addictive. De la même façon, l’idée d’identifier un trouble psychologique spécifique des addictions s’éloigne progressivement. C’est la recherche sur l’interaction des différents facteurs qui enrichit aujourd’hui la connaissance en addictologie. Nous avons souhaité rendre compte des avancées en la matière. Pour ce faire nous présenteront d’abord des travaux concernant les interactions gènes traitement dans l’addiction aux opiacés (Dr F. Vorspan, Paris), puis nous discuterons de l’interaction de l’individu avec son environnement en particulier dans l’addiction à l’alcool (Dr P. Nubupko, Limoges) et enfin nous aborderons l’état des connaissances actuelles sur l’implication des facteurs psychologiques et psychiatriques dans l’étiologie de ces troubles (Pr C. Lançon, Marseille).
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Guillou Landreat M, Chereau Boudet I, Perrot B, Romo L, Codina I, Magalon D, Fatseas M, Luquiens A, Brousse G, Challet-Bouju G, Grall-Bronnec M. Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics. BMJ Open 2020; 10:e030424. [PMID: 32075821 PMCID: PMC7044887 DOI: 10.1136/bmjopen-2019-030424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Gambling characteristics are factors that could influence problem gambling development. The aim of this study was to identify a typology of gamblers to frame risky behaviour based on gambling characteristics (age of initiation/of problem gambling, type of gambling: pure chance/chance with pseudoskills/chance with elements of skill, gambling online/offline, amount wagered monthly) and to investigate clinical factors associated with these different profiles in a large representative sample of gamblers. DESIGN AND SETTING The study is a cross-sectional analysis to the baseline data of the french JEU cohort study (study protocol : Challet-Bouju et al, 2014). Recruitment (April 2009 to September 2011) involved clinicians and researchers from seven institutions that offer care for or conduct research on problem gamblers (PG). Participants were recruited in gambling places, and in care centres. Only participants who reported gambling in the previous year between 18 and 65 years old were included.Participants gave their written informed consent, it was approved by the French Research Ethics Committee. PARTICIPANTS The participants were 628 gamblers : 256 non-problem gamblers (NPG), 169 problem gamblers without treatment (PGWT) and 203 problem gamblers seeking treatment (PGST). RESULTS Six clustering models were tested, the one with three clusters displayed a lower classification error rate (7.92%) and was better suited to clinical interpretation : 'Early Onset and Short Course' (47.5%), 'Early Onset and Long Course' (35%) and 'Late Onset and Short Course' (17.5%). Gambling characteristics differed significantly between the three clusters. CONCLUSIONS We defined clusters through the analysis of gambling variables, easy to identify, by psychiatrists or by physicians in primary care. Simple screening concerning these gambling characteristics could be constructed to prevent and to help PG identification. It is important to consider gambling characteristics : policy measures targeting gambling characteristics may reduce the risk of PG or minimise harm from gambling. TRIAL REGISTRATION NUMBER NCT01207674 (ClinicalTrials.gov); Results.
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Affiliation(s)
- Morgane Guillou Landreat
- EA 7479 SPURBO, Universite de Bretagne Occidentale, Brest, France
- Addictive Disorders Department, CHRU de Brest, Brest, France
- UMR 1246 SPHERE, Université de Nantes, Nantes, France
| | | | | | - Lucia Romo
- EA 4430 CLIPSYD 'clinique psychiatrique developpement', Universite Paris-Nanterre, Nanterre, France
- Addictive Disorders, Hospital Louis-Mourier, Colombes, France
| | - Irene Codina
- Addictive disorders Unit Marmottan, GPS Perray-Vaucluse, Épinay-sur-Orge, France
| | - David Magalon
- Department of Adult Psychiatry, Hopital Sainte-Marguerite, Marseille, France
| | - Melina Fatseas
- Psychiatric Laboratory SANPSY USR 3413, University of Bordeaux, Talence, France
- Addictive Disorders, Hospital Centre Charles Perrens, Bordeaux, France
| | - Amandine Luquiens
- Psychiatry and Addictology Department, Hôpital Paul Brousse, APHP Villejuif, Villejuif cedex, France
- CESP, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- CMAP, Ecole Polytechnique, Palaiseau Cedex, France
| | - Georges Brousse
- Psychiatry and Addictology, CHU Clermont Ferrand, Clermont Ferrand, UK
| | | | - Marie Grall-Bronnec
- Addictology and Psychiatry Department, University Hospital of Nantes, Nantes, France
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Flaudias V, Zerhouni O, Chakroun-Baggioni N, Pires S, Schmitt A, De Chazeron I, Llorca PM, Brousse G. Reducing Attentional Bias in Individuals With Alcohol Use Disorders With a Tablet Application: A Randomized Controlled Trial Pilot Study. Alcohol Alcohol 2020; 55:51-55. [PMID: 31724703 DOI: 10.1093/alcalc/agz080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/07/2019] [Accepted: 09/03/2019] [Indexed: 11/12/2022] Open
Abstract
AIMS Cognitive bias modification (CBM) training has been considered a promising and effective intervention tool for reducing cognitive biases toward alcohol. However, the link between the cognitive process and actual behavior remains statistically insignificant because computerized tasks do not have sufficient ecological validity and suffer from high dropout rates. The recent development of 'serious games' has shown encouraging results in maintaining adherence to health-related interventions. We aim to evaluate a CBM program using a gamified attentional bias (AB) training procedure on a touchpad for individuals with alcohol use disorders. METHODS Forty-one patients were included in this study, 33 of whom displayed an AB and were randomly assigned into the 'CBM group' (N = 18, 16.7% women) or 'Memory group'-which involved playing a memory game-(N = 15, no woman). Eight other participants (12.5% women) with no AB comprised the 'Without AB group'. Efficacy was assessed for AB, craving, and inhibition and attentional capacities before and after the program. RESULTS We observed that the reduction of AB was higher for the 'CBM group' (Mbefore = 153.61, SD = 172.21; Mafter = 18.00, SD = 77.71; t (17) = 4.21, P = 0.001) than for the 'Memory group' (Mbefore = 73.20, SD = 66.65; Mafter =42.47, SD = 113.77; ts < 1). The analysis showed that for the 'Without AB group', there was no significant difference in AB (t (7) = -2.15, P = .07) after the program. CONCLUSIONS This study demonstrated an increased reduction of AB for patients included in the CBM program on a touchpad than for patients playing only a memory game.
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Affiliation(s)
- Valentin Flaudias
- Clermont-Ferrand, Pôle Psychiatrie B, CHU Clermont-Ferrand, 58 Rue Montalembert F-63001 Clermont-Ferrand, France.,Université Clermont Auvergne, EA NPsy-Sydo, 28 Place Henri Dunant BP 10448, F-63000 Clermont-Ferrand, France
| | - Oulmann Zerhouni
- Université Paris Nanterre, Laboratoire Parisien de Psychologie Sociale, 200 avenue de la République. F-92000 Nanterre, France
| | - Nadia Chakroun-Baggioni
- Université Clermont Auvergne, CNRS UMR 6024, LAPSCO, 34 Avenue Carnot F-63000 Clermont-Ferrand, France
| | - Sylvie Pires
- Clermont-Ferrand, Pôle Psychiatrie B, CHU Clermont-Ferrand, 58 Rue Montalembert F-63001 Clermont-Ferrand, France
| | - Audrey Schmitt
- Clermont-Ferrand, Pôle Psychiatrie B, CHU Clermont-Ferrand, 58 Rue Montalembert F-63001 Clermont-Ferrand, France
| | - Ingrid De Chazeron
- Clermont-Ferrand, Pôle Psychiatrie B, CHU Clermont-Ferrand, 58 Rue Montalembert F-63001 Clermont-Ferrand, France.,Université Clermont Auvergne, EA NPsy-Sydo, 28 Place Henri Dunant BP 10448, F-63000 Clermont-Ferrand, France
| | - Pierre Michel Llorca
- Clermont-Ferrand, Pôle Psychiatrie B, CHU Clermont-Ferrand, 58 Rue Montalembert F-63001 Clermont-Ferrand, France.,Université Clermont Auvergne, EA NPsy-Sydo, 28 Place Henri Dunant BP 10448, F-63000 Clermont-Ferrand, France
| | - Georges Brousse
- Clermont-Ferrand, Pôle Psychiatrie B, CHU Clermont-Ferrand, 58 Rue Montalembert F-63001 Clermont-Ferrand, France.,Université Clermont Auvergne, EA NPsy-Sydo, 28 Place Henri Dunant BP 10448, F-63000 Clermont-Ferrand, France
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Laporte C, Lambert C, Pereira B, Blanc O, Authier N, Balayssac D, Brousse G, Vorilhon P. Cannabis users: Screen systematically, treat individually. A descriptive study of participants in a randomized trial in primary care. PLoS One 2019; 14:e0224867. [PMID: 31790425 PMCID: PMC6886842 DOI: 10.1371/journal.pone.0224867] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/22/2019] [Indexed: 11/28/2022] Open
Abstract
Purpose The aim of the present study was to describe the profiles of a sample of young cannabis users not seeking care, for use in general practice in France. Methods In this cross-sectional study, baseline data were used from a previous clinical randomized trial, in which a brief intervention was tested. The participants were 262 cannabis users aged 15 to 25 years who smoked at least one joint per month. Assessment was undertaken both by the GP and via an anonymous self-reporting questionnaire. All statistical analyses were performed using Stata software and R. We used multiple correspondence analysis to determine the profiles of users. Results Among the 262 patients, 46.2% were daily users (more than 30 joints per month), 25.6% were regular users (from 10 to 29 joints per month), and 28.2% were recent users (fewer than 10 joints per month). The higher the frequency of use, the greater the incidence of unaccompanied use, daily use and week use (p from <0.001 to 0.01). The motivations of daily users were mostly self-treatment and habit (p <0.05). The cannabis abuse screening trial score revealed risky use for 87.5% of daily users and 34.4% for recent users. Factorial analysis identified 5 profiles according to age, risk, and motive for use. The reasons for consultation were equally distributed among users regardless of their level of use or their profile (p > 0.05). Conclusions The results provide support for the practice of asking young patients systematically about their cannabis use, allowing GPs to identify users who require medical care. GPs should consider the differences between participants according to their profile in order to determine the appropriate type of care. Trial registration Clinicaltrials.gov NCT01433692.
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Affiliation(s)
- Catherine Laporte
- Département de Médecine Générale, Equipe d’Accueil 7280, Unité de Formation et de Recherche de Médicine, Université Clermont Auvergne, Clermont-Ferrand, France
- * E-mail:
| | - Céline Lambert
- Délégation à la recherche clinique et à l’innovation, Centre Hospitalier Universitaire Clermont-Ferrand,Clermont-Ferrand, France
| | - Bruno Pereira
- Délégation à la recherche clinique et à l’innovation, Centre Hospitalier Universitaire Clermont-Ferrand,Clermont-Ferrand, France
| | - Olivier Blanc
- Equipe d’Accueil 7280, Unité de Formation et de Recherche de Médicine, Université Clermont Auvergne; Service de Psychiatrie B et d’addictologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Nicolas Authier
- Inserm, Neuro-Dol, Université Clermont Auvergne; Service de Pharmacologie Médicale, Centres Addictovigilance / Pharmacovigilance, Centre Evaluation et Traitement de la Douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - David Balayssac
- Inserm U1107, NEURO-DOL, Unité de Formation et de Recherche de Pharmacie, Université Clermont Auvergne; Laboratoire de Toxicologie, Délégation à la recherche clinique et à l’innovation, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Georges Brousse
- Equipe d’Accueil 7280, Unité de Formation et de Recherche de Médicine, Université Clermont Auvergne; Service de Psychiatrie B et d’addictologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, France
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Dematteis M, Pennel L, Brousse G. [Alcohol use disorder: evolution of the nosography]. Rev Prat 2019; 69:892-896. [PMID: 32237656] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Alcohol use disorder: evolution of the nosography. The arrival of DSM-5 has represented a nosographic break with respect to the DSMIV- TR: by leaving the old biaxial view and its hierarchical gradation between abuse and dependence; by removing the term "dependence" with its stigma and amalgams between psychic and physical dependencies; and by integrating craving, a main therapeutic target, allowing the DSM-5 to join the ICD-10 (and soon the ICD-11). Without being a revolution, the DSM-5 is a real evolution, with a modern dimensional view of addictive behaviors, according to a progressive continuum between use and use disorder (from mild to severe). This approach allows the representation of addictions to change, and to propose various therapeutic strategies adapted to the patient's objectives and inspired by the harm reduction approaches, abstinence being only one of these strategies.
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Affiliation(s)
- Maurice Dematteis
- CHU Grenoble Alpes, service universitaire de pharmacoaddictologie ; université Grenoble Alpes, UFR de médecine, Grenoble, France
| | - Lucie Pennel
- CHU Grenoble Alpes, service universitaire de pharmacoaddictologie ; université Grenoble Alpes, UFR de médecine, Grenoble, France
| | - Georges Brousse
- CHU de Clermont-Ferrand, service de psychiatrieaddictologie B ; université Clermont- Auvergne-1, UFR de médecine, EA7280, Clermont-Ferrand, France
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Underner M, Perriot J, Brousse G, de Chazeron I, Schmitt A, Peiffer G, Harika-Germaneau G, Jaafari N. Arrêt et réduction du tabac chez le patient souffrant de schizophrénie. L'Encéphale 2019; 45:345-356. [PMID: 31153585 DOI: 10.1016/j.encep.2019.04.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 02/08/2023]
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Vorspan F, Hjelmström P, Simon N, Benyamina A, Dervaux A, Brousse G, Jamain T, Kosim M, Rolland B. What place for prolonged-release buprenorphine depot-formulation Buvidal® in the treatment arsenal of opioid dependence? Insights from the French experience on buprenorphine. Expert Opin Drug Deliv 2019; 16:907-914. [PMID: 31364884 DOI: 10.1080/17425247.2019.1649252] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 12/18/2022]
Abstract
Introduction: Since the 1990s, opioid maintenance treatments (OMTs), i.e. mostly methadone and buprenorphine, have represented the therapeutic cornerstone of opioid dependence. In France, the public health strategy on opioid dependence, identified here as the 'French model', has consisted of offering a facilitated access to buprenorphine, to reach a large treatment coverage and reduce opioid-related mortality. Areas covered: Recently, a new formulation of subcutaneous buprenorphine depot (Buvidal®) has been approved in Europe for treatment of opioid dependence. The place of Buvidal® among the pre-existing arsenal of OMTs is discussed in the light of the pharmacological specificities of this new formulation, and with the particular standpoint of the French model on opioid dependence. Expert opinion: Buvidal® could constitute a promising treatment option mainly in case of: 1) OMT initiation, including in non-specialized addiction medicine care; 2) Discharge from prison or hospital; Diversion/misuse of 3) buprenorphine or 4) methadone; 5) Clinically stabilized patients wishing to avoid daily oral taking of the medication. As such, this new formulation should be highly accessible, which will require specific pathways through care as the product is intended to be administered by a healthcare professional.
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Affiliation(s)
- Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique - Hôpitaux de Paris , Paris , France.,Faculté de Médecine, Université Paris Diderot et INSERM UMRS 1144, Université Paris Descartes, Université Paris Diderot , Paris , France
| | | | - Nicolas Simon
- INSERM, IRD, SESSTIM, Hop Sainte Marguerite, Service de Pharmacologie Clinique, CAP, Aix Marseille Univ , Marseille , France
| | - Amine Benyamina
- CESP, centre d'enseignement, de recherche et de traitement des addictions, université Paris Sud , Villejuif , France
| | - Alain Dervaux
- Service de Psychiatrie et Addictologie de liaison, CHU Sud , Amiens Cedex , France.,Groupe de Recherche sur l'Alcool & les Pharmacodépendances (GRAP) INSERM U1247 , Amiens , France
| | - Georges Brousse
- EA NPsy-Sydo, université Clermont-Auvergne , Clermont-Ferrand , France
| | | | - Margaux Kosim
- Consultations de médecine-Alcoologie PASS, Groupe Hospitalier Pitié Salpêtrière , Paris , France.,Camurus SAS , Paris , France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier , Bron , France.,Université de Lyon, UCBL1, INSERM, INSERM U1028, CNRS UMR 5292, CRNL , Bron , France
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Flaudias V, Maurage P, Izaute M, de Chazeron I, Brousse G, Chakroun-Baggioni N. Craving Mediates the Relation Between Impulsivity and Alcohol Consumption Among University Students. Am J Addict 2019; 28:489-496. [PMID: 31423682 DOI: 10.1111/ajad.12944] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 07/03/2019] [Accepted: 07/25/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The relationship between impulsivity and craving in severe alcohol use disorders is well established, but the presence and characteristics of this link in University students are still to be established. The present study aims to better understand the relationship between impulsivity and craving in university students and to determine the influence of these variables on alcohol consumption characteristics. METHODS A large sample of university students (N = 1055, mean age: 20.9 years; 713 women) completed an online questionnaire to evaluate alcohol use, impulsivity, and craving. RESULTS Linear regression analysis demonstrated that the compulsive dimensions of craving (P < .001), sensation seeking (P < .001), and lack of premeditation (P < .001) constitute strong predictors of current consumption. A receiver operating characteristic (ROC) curve analysis determined the threshold level above which craving intensity can identify specific high-risk populations. A mediation analysis showed that craving has a partial mediator effect on the impact of impulsivity on alcohol consumption for this population (37,8%, P < .001). DISCUSSION AND CONCLUSIONS The sensation seeking and lack of premeditation dimensions of impulsivity, coupled with compulsive craving, are efficient predictors of excessive alcohol consumption for university students. The partial mediator effect of craving is important in terms of characterizing the relationship between impulsivity and alcohol consumption. SCIENTIFIC SIGNIFICANCE Our study centrally shows that the interaction between elevated levels of impulsivity and craving constitute a crucial risk factor for alcohol consumption in university students, and should thus constitute a target for primary prevention programs (Am J Addict 2019;00:00-00).
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Affiliation(s)
- Valentin Flaudias
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Marie Izaute
- Laboratoire de Psychologie Sociale et Cognitive, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Ingrid de Chazeron
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Nadia Chakroun-Baggioni
- Laboratoire de Psychologie Sociale et Cognitive, Université Clermont Auvergne, Clermont-Ferrand, France
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Icick R, Vorspan F, Karsinti E, Ksouda K, Lépine JP, Brousse G, Mouly S, Bellivier F, Bloch V. Gender-specific study of recurrent suicide attempts in outpatients with multiple substance use disorders. J Affect Disord 2018; 241:546-553. [PMID: 30153638 DOI: 10.1016/j.jad.2018.08.076] [Citation(s) in RCA: 9] [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] [Received: 04/09/2018] [Revised: 07/06/2018] [Accepted: 08/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND people suffering from substance use disorders (SUD) often die by suicide, so that the prevention of suicide attempts (SA) remains a top priority in this population. SA recurrence is common and is associated with suicide death, but this phenotype has been overlooked in SUD populations. Thus, we aimed at identifying the risk factors of SA recurrence in SUD, controlling for both gender and levels of exposure to addictive substances, including tobacco. METHODS we consecutively recruited 433 treatment-seeking outpatients with either opiate or cocaine use disorder and assessed their lifetime history of addictive and suicidal symptoms by standardized questionnaires. They were reliably classified as never, single or recurrent (≥ 2) suicide attempters, whose characteristics were identified by multinomial regression, stratified by gender; and compared to our previous work on serious SA in order to identify common or different risk profiles. RESULTS 86/140 (61%) suicide attempters reported recurrence. The mean number of SA was 3.1. Recurrence was independently associated with psychiatric hospitalization in both genders, with nicotine dependence in men and with sedative use disorders in women. LIMITATIONS psychiatric diagnoses were derived from the current medication regimen. CONCLUSION specific and possibly avoidable/treatable risk factors for the recurrence of SA in SUD have been identified for the first time, opening new avenues for research and prevention in this high-risk population. Apart from nicotine dependence, these risk factors were very similar to those of serious SA. Although this comparison is indirect for now, it suggests a common liability towards suicidal behavior.
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Affiliation(s)
- R Icick
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France.
| | - F Vorspan
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France
| | - E Karsinti
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; ED139, Paris Nanterre University, Nanterre F-92001, France
| | - K Ksouda
- Pharmacology Laboratory, Faculty of Medicine, Sfax, Tunisia
| | - J-P Lépine
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France
| | - G Brousse
- Psychiatry B-Department of Addiction Psychiatry, Faculty of Medicine, EA7280 and CHU Clermont-Ferrand, Clermont 1 University, Clermont-Ferrand F-63003, France
| | - S Mouly
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Internal Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France
| | - F Bellivier
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France
| | - V Bloch
- INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Hospital Pharmacy, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France
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Brousse G, Zerhouni O, Perriot J, Bègue L, Flaudias V. [Plain Packaging: The study that makes tabacologists coff]. Encephale 2018; 44:489-490. [PMID: 30446288 DOI: 10.1016/j.encep.2018.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 02/08/2023]
Affiliation(s)
- G Brousse
- EA NPsy-Sydo, université Clermont-Auvergne, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France
| | - O Zerhouni
- Département de psychologie, laboratoire parisien de psychologie sociale, université Paris Nanterre, 200, avenue de la République, 92000 Nanterre, France.
| | - J Perriot
- Department of respiratory medicine, centre Emile-Roux, IRAAT, university of Auvergne, 11, rue Vaucanson, 63100 Clermont-Ferrand, France
| | - L Bègue
- Laboratoire interuniversitaire de psychologie, personnalité, cognition, changement social, UFR SHS, université Grenoble-Alpes, 1251, avenue Centrale, BP 47, 38040 Grenoble cedex 9, France
| | - V Flaudias
- EA NPsy-Sydo, université Clermont-Auvergne, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France
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Abstract
Thirty percent of emergency department admissions are related to an alcohol misuse. Eighty percent of acute intoxications admitted in emergency departments concern patients with alcohol addiction. Care protocols validated in all of emergency departments are necessary for prevention of alcohol withdrawal syndrome. Risky uses require ultra-brief interventions, situations of abuse (light use disorders) require brief interventions and situations of dependence (moderate to severe use disorders) require motivational interviews to promote the emergence of a process of change. The key word for alcohol intervention in emergencies is: empathy. Search addictive comorbidities (tobacco and cannabis) and psychiatric comorbidities (depression and suicidal risk) must be systematic. The coordination between emergency departments and addictology departments is essential. In the emergency department, the goal is to optimise patient care path for all addictive behaviors.
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Affiliation(s)
- Georges Brousse
- Université Clermont Auvergne 1, UFR médecine, EA7280, 63001 Clermont-Ferrand, France; CHU Clermont-Ferrand, psychiatrie addictologie B, 63003 Clermont-Ferrand, France.
| | | | - Julien Cabe
- Université Clermont Auvergne 1, UFR médecine, EA7280, 63001 Clermont-Ferrand, France; CHU Clermont-Ferrand, psychiatrie addictologie B, 63003 Clermont-Ferrand, France
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Karsinti E, Piani K, Zerdazi EH, Maskos U, Faure P, Romo L, Bellivier F, Brousse G, Lépine JP, Bloch V, Vorspan F. Relevance of treated cocaine users' retrospective memory of first cocaine use. Psychiatry Res 2018; 264:210-216. [PMID: 29653350 DOI: 10.1016/j.psychres.2018.03.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 04/28/2017] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 11/20/2022]
Abstract
Little is known regarding between-subject variability in the subjective effects of first cocaine use. This study retrospectively assesses the subjective effects of first cocaine use in 160 current treatment-seeking cocaine use disorder patients. Subjective effects of first cocaine use were evaluated with an ad-hoc questionnaire used for cannabis effects. A principal component analysis (PCA) was performed, with resulting factors correlated with clinical variables (α = 0.05). Four factors emerged in the PCA, namely Anxiety (accounting for 21.5% of questionnaire variance), Disinhibition (17.3%), Tachypsychia (16%) and Calmness (13%). Male gender was associated with Disinhibition and Tachypsychia. Cocaine severity factors were associated with Disinhibition, Tachypsychia and Calmness. Opiate, sedative and poppers uses were associated with Anxiety, Tachypsychia and Calmness. The retrospective assessment of the subjective effects of first cocaine use shows significant variability. The different dimensions of subjective first effects are influenced by age, gender and previous substance use history, as well as characteristics of first cocaine use and cocaine-related outcomes.
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Affiliation(s)
- Emily Karsinti
- APHP, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, 200 rue du Fg St Denis, 75010 Paris, France; Inserm Umr-s 1144 Variabilité de réponse aux psychotropes, 4 avenue de l'Observatoire, 75006 Paris, France; EA 4430 CLIPSYD Clinique Psychanalyse Développement, Département de Sciences Psychologiques et Sciences de l'Education, Université Paris Nanterre, 200, Avenue de la République, 92001 Nanterre Cedex, France.
| | - Kristel Piani
- APHP, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, 200 rue du Fg St Denis, 75010 Paris, France
| | - El Hedi Zerdazi
- Inserm Umr-s 1144 Variabilité de réponse aux psychotropes, 4 avenue de l'Observatoire, 75006 Paris, France
| | - Uwe Maskos
- Neurobiologie intégrative des systèmes cholinergiques, CNRS UMR 3571, Département de Neuroscience, Institut Pasteur, 25, rue du Dr Roux, 75724 Paris Cedex 15, France
| | - Philippe Faure
- Neuroscience Paris-Seine - IBPS, UPMC UM CR18 - CNRS UMR 8246 - INSERM U1130, Equipe Neurophysiologie et Comportement (NPC), Boite 16, Universite P. et M. Curie, 9 quai St Bernard, 75005, Paris, France
| | - Lucia Romo
- EA 4430 CLIPSYD Clinique Psychanalyse Développement, Département de Sciences Psychologiques et Sciences de l'Education, Université Paris Nanterre, 200, Avenue de la République, 92001 Nanterre Cedex, France
| | - Frank Bellivier
- APHP, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, 200 rue du Fg St Denis, 75010 Paris, France; Faculté de Médecine, Université Paris Diderot, 16 rue Huchard, 75018 Paris, France; Inserm Umr-s 1144 Variabilité de réponse aux psychotropes, 4 avenue de l'Observatoire, 75006 Paris, France
| | - Georges Brousse
- NPsy-Sydo, Neuro-psycho-pharmacologie des systèmes dopaminergiques sous-corticaux, EA 7280, U.F.R. Médecine Université Clermont-Auvergne, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - Jean Pierre Lépine
- APHP, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, 200 rue du Fg St Denis, 75010 Paris, France; Faculté de Médecine, Université Paris Diderot, 16 rue Huchard, 75018 Paris, France; Inserm Umr-s 1144 Variabilité de réponse aux psychotropes, 4 avenue de l'Observatoire, 75006 Paris, France
| | - Vanessa Bloch
- Inserm Umr-s 1144 Variabilité de réponse aux psychotropes, 4 avenue de l'Observatoire, 75006 Paris, France
| | - Florence Vorspan
- APHP, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, 200 rue du Fg St Denis, 75010 Paris, France; Faculté de Médecine, Université Paris Diderot, 16 rue Huchard, 75018 Paris, France; Inserm Umr-s 1144 Variabilité de réponse aux psychotropes, 4 avenue de l'Observatoire, 75006 Paris, France
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Rolland B, Authier N, Brousse G, Bouhassira D, Perrot S, Dematteis M. Réponse des auteurs. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.02.006] [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: 11/30/2022]
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