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Frajerman A, Deflesselle E, Colle R, Corruble E, Costemale-Lacoste JF. [Burnout, anxiety, insomnia and depressive symptoms among French outpatient physicians in the second wave of COVID-19: Comparison between general practitioners and specialists]. Encephale 2024; 50:192-199. [PMID: 37121809 PMCID: PMC10076503 DOI: 10.1016/j.encep.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 01/10/2023] [Accepted: 01/31/2023] [Indexed: 04/08/2023]
Abstract
INTRODUCTION The 2019 coronavirus (COVID-19) pandemic has caused a public health crisis worldwide. Concerns have been expressed about the rapid deterioration of mental health among primary care physicians among whom burnout already had a high prevalence prior to the pandemic. However, there is little data on private doctors during the pandemic. France experienced a second wave with a second lockdown. We aimed to assess and compare physicians' burnout, anxiety and depression symptoms and insomnia between general practitioners (GP) and all other private specialists during the second Covid-19 wave. METHODS We conducted an online survey of private practitioners registered on Doctolib® (n=32,655), the interface software most used by private practitioners for booking medical appointments in France. Doctors were invited by email to complete an online survey in November 2020. Inclusions were closed on 1st December. The 2nd lockdown lasted from 30th October to 15th December 2020. We used the Copenhagen Burnout Inventory (CBI) to assess burnout syndrome. A mean score of>50 in at least one subscale defined burnout. The Hospital Anxiety and Depression Scale assessed anxiety and depression symptoms. We used two cut-offs, 8 (>7) and 11 (>10), as both are validated in the ability to find cases. The Insomnia Severity Index (ISI) measures sleep-related complaints among physicians (cut-off >7). To link variations in the psychological scales to the COVID-19 pandemic, one of the items asked explicitly whether participants considered that "the COVID-19 epidemic we are currently experiencing is a source of excess stress, psychological suffering or burnout". Approval for this study was obtained from the local institutional review board of the University of Paris-Saclay, France. The questionnaires were collected anonymously. Statistical significance was tested using the chi-square test and student's t-test to compare the prevalence between GPs and other specialities. Subsequently, logistic regression models were run for statistically significant associations. RESULTS 1992 physicians replied, a response rate of 12.8% of those who received the invitation email. Among them, 79.4% suffered from psychological distress (symptoms of anxiety or depression or burnout), of which 71.3% suffered from burnout, 26.7% from depressive symptoms, 58.9% from anxiety symptoms and 45.8% from insomnia. There was no difference in gender between GPs and specialists, but there was an age difference (P<0.001). GPs had a higher prevalence of burnout (OR=1.33 CI95 [1.09;1.63]) and took more psychotropic drugs (1.38 CI95 [1.05;1.81]). They were also more likely to perceive their stress as work-related (OR=1.50 CI95 [1.23;1.81]) or COVID-19-related (OR=1.43 CI95 [1.16;1.77]). CONCLUSION Our study is the first to assess the mental health of private practitioners in the second wave in association with COVID-19 stress. Firstly, GPs who provide primary care have a significantly higher burnout rate than other doctors. Secondly, COVID-19 stress is associated with more significant psychological distress. Thirdly, almost 80% of the private doctors surveyed suffer from psychological pain, and 71% suffer from burnout. This study has strengths and limitations. Firstly, this study assesses mental health and stress related to its COVID-19 association. Second, this is the largest population of private physicians during the COVID-19 pandemic. The low response rate is the main limit of this study. The alarming rates of psychological distress among private doctors and, in particular, GPs should lead to intervention to help doctors reduce stress, burnout and other mental disorders. This study gives a picture of the situation during the second wave and the lock-in, and we need to be cautious with the next waves.
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Affiliation(s)
- Ariel Frajerman
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie de Bicêtre, Mood Center Paris Saclay, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Paris-Saclay, 94275 Paris, France; Inserm U1266-GDR 3557, institut de psychiatrie et neurosciences de Paris, institut de Psychiatrie, Paris, France; Université Paris Cité, Paris, France.
| | - Eric Deflesselle
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Département de médecine générale, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France
| | - Romain Colle
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie de Bicêtre, Mood Center Paris Saclay, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Paris-Saclay, 94275 Paris, France
| | - Emmanuelle Corruble
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Service hospitalo-universitaire de psychiatrie de Bicêtre, Mood Center Paris Saclay, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Paris-Saclay, 94275 Paris, France
| | - Jean-François Costemale-Lacoste
- MOODS Team, Inserm, CESP, université Paris-Saclay, faculté de médecine Paris-Saclay, 94275 Le Kremlin-Bicêtre, France; Centre hospitalier le Vinatier, Bron, France; Union régionale des professionnels de santé libéraux, Auvergne Rhône-Alpes, France
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Frajerman A, Colle R, Corruble E, Costemale-Lacoste JF. Telemedicine use during the COVID-19 lockdown is associated with fewer depressive symptoms among physicians in private practice. Gen Hosp Psychiatry 2023; 84:256-257. [PMID: 37316371 PMCID: PMC10247547 DOI: 10.1016/j.genhosppsych.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Ariel Frajerman
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Medicine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France.
| | - Romain Colle
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Medicine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France
| | - Emmanuelle Corruble
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Medicine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France
| | - Jean-François Costemale-Lacoste
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Medicine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire des Pathologies Psychiatriques Résistantes, Z19, Centre hospitalier le Vinatier, 95 boulevard Pinel, F-69678 Bron Cedex, France
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Frajerman A, Colle R, Hozer F, Deflesselle E, Rotenberg S, Chappell K, Corruble E, Costemale-Lacoste JF. Psychological distress among outpatient physicians in private practice linked to COVID-19 and related mental health during the second lockdown. J Psychiatr Res 2022; 151:50-56. [PMID: 35447507 PMCID: PMC9002100 DOI: 10.1016/j.jpsychires.2022.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/26/2022] [Accepted: 04/04/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Outpatient physicians in private practice, as inpatient physicians, are on the frontline of the COVID-19 pandemic. Mental-health consequences of the pandemic on hospital staff have been published, but the psychological distress among outpatient physicians in private practice due to COVID-19 has never been specifically assessed. METHODS A French national online cross-sectional survey assessed declared psychological distress among outpatient physicians in private practice linked to COVID-19, sociodemographic and work conditions, mental health (Copenhagen Burn-out Inventory, Hospital Anxiety and Depression Scale, and the Insomnia severity Index), consequences on alcohol, tobacco, and illegal substance misuse, and sick leave during the 2nd COVID-19 wave. FINDINGS Among the 1,992 physicians who answered the survey, 1,529 (76.8%) declared psychological distress linked to COVID-19. Outpatient physicians who declared psychological distress linked to COVID-19 had higher rates of insomnia (OR = 1.4; CI95 [1.1-1.7], p = 0.003), burnout (OR = 2.7; CI95 [2.1; 3.2], p < 0.001), anxiety and depressive symptoms (OR = 2.4; CI95 [1.9-3.0], p < 0.001 and OR = 1.7; CI95 [1.3-2.3], p < 0.001) as compared to physicians who did not. They also had higher psychotropic drug use in the last twelve months, or increased alcohol or tobacco consumption due to work-related stress and were more frequently general practitioners. INTERPRETATION The feeling of being in psychological distress due to COVID-19 is highly frequent among outpatient physicians in private practice and is associated with mental health impairment. There is a need to assess specific interventions dedicated to outpatient physicians working in private practice.
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Affiliation(s)
- Ariel Frajerman
- MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France; Inserm U1266-GDR 3557, Institut de psychiatrie et neurosciences de Paris, Institut de Psychiatrie, Paris, France; Université de Paris, Paris, France.
| | - Romain Colle
- MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France
| | - Franz Hozer
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France; AP-HP Centre-Université de Paris, Hôpital Corentin-Celton, Département Médico-Universitaire de Psychiatrie et Addictologie, 92130, Issy-les-Moulineaux, France
| | - Eric Deflesselle
- MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, F-94275, France; Département de Médecine Générale, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, F-94275, France
| | - Samuel Rotenberg
- MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France
| | - Kenneth Chappell
- MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, F-94275, France
| | - Emmanuelle Corruble
- MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France
| | - Jean-François Costemale-Lacoste
- MOODS Team, INSERM U1178, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, F-94275, France
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Hoertel N, Cipel H, Blanco C, Oquendo MA, Ellul P, Leaune E, Limosin F, Peyre H, Costemale-Lacoste JF. Cerebrospinal fluid levels of monoamines among suicide attempters: A systematic review and random-effects meta-analysis. J Psychiatr Res 2021; 136:224-235. [PMID: 33618064 DOI: 10.1016/j.jpsychires.2021.01.045] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND It remains unclear whether the dopaminergic and noradrenergic systems may be implied in suicide attempt risk. In addition, although the serotonergic system has been extensively studied, no formal meta-analysis has been performed to examine its association with suicide attempt. METHODS Using PRISMA methodology, we performed a systematic literature review and random-effects meta-analyses of the differences in cerebrospinal fluid (CSF) levels of 5-HIAA, HVA and MHPG between suicide attempters and individuals who never attempted suicide. RESULTS We identified 30 studies including 937 suicide attempters and 1128 non-attempters; 29 of them measured CSF levels of 5-HIAA, 22 measured CSF levels of HVA and 14 measured CSF levels of MHPG. CSF levels of 5-HIAA and HVA were significantly lower in suicide attempters than in non-attempters [SMD = -0.43 (95% CI: -0.71 to -0.15; p < 0.01) and SMD = -0.45 (95% CI: -0.72 to -0.19; p < 0.01), respectively]. We did not find a significant association between CSF MHPG levels and suicide attempt. LIMITATIONS Our analyses relied on a limited number of studies of good quality and most studies included small sample sizes. CONCLUSION Both serotonin and dopamine systems may play a role in suicide attempt risk. Our findings suggest that a silo approach to biomarkers should be phased out in favor of the study of multiple systems in parallel and in the same populations to progress in the identification of the biological components independently associated with suicide risk, with the goal of identifying new treatment targets and improving suicide risk prediction.
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Affiliation(s)
- Nicolas Hoertel
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France; AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Département de Psychiatrie, France; INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Hélène Cipel
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Maria A Oquendo
- Perelman School of Medicine, University of Pennsylvania, USA
| | - Pierre Ellul
- Child and Adolescent Psychiatry, Robert Debré Hospital, Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Edourd Leaune
- CPS/Psymobile - CH Le Vinatier / IRPhiL - Université Lyon 3, France
| | - Frédéric Limosin
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France; AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Département de Psychiatrie, France; INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Hugo Peyre
- Child and Adolescent Psychiatry, Robert Debré Hospital, Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Jean-François Costemale-Lacoste
- GHU Paris, Psychiatrie et Neurosciences, Paris University, France; INSERM UMRS 1178, CESP, Team « MOODS », Le Kremlin-Bicêtre, France.
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Hoertel N, Rotenberg L, Schuster JP, Blanco C, Lavaud P, Hanon C, Hozer F, Teruel E, Manetti A, Costemale-Lacoste JF, Seigneurie AS, Limosin F. Generalizability of pharmacologic and psychotherapy trial results for late-life unipolar depression. Aging Ment Health 2021; 25:367-377. [PMID: 31726850 DOI: 10.1080/13607863.2019.1691146] [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] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Despite evidence of low representativeness of clinical trial results for depression in adults, the generalizability of clinical trial results for late-life depression is unknown. This study sought to quantify the representativeness of pharmacologic and psychotherapy clinical trial results for late-life unipolar depression. METHOD Data were derived from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of 34,653 adults from the United States population. To assess the generalizability of clinical trial results for late-life depression, we applied a standard set of eligibility criteria representative of pharmacologic and psychotherapy clinical trials to all individuals aged 65 years and older in NESARC with a DSM-IV diagnosis of MDE and no lifetime history of mania/hypomania (n = 273) and in a subsample of individuals seeking help for depression (n = 78). RESULTS More than four of ten respondents and about two of ten respondents would have been excluded by at least one exclusion criterion in a typical pharmacologic and psychotherapy efficacy trial, respectively. Similar results (i.e.41.1% and 25.9%, respectively) were found in the subsample of individuals seeking help for depression. Excess percentage of exclusion in typical pharmacologic studies was accounted for by the criterion "significant medical condition". We also found that populations typically included in pharmacologic and psychotherapy clinical trials for late-life unipolar depression may substantially differ. CONCLUSION Psychotherapy trial results may be representative of most patients with late-life unipolar depression in routine clinical practice. By contrast, pharmacologic clinical trials may not be readily generalizable to community samples.
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Affiliation(s)
- Nicolas Hoertel
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France.,Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France.,Centre Psychiatrie et Neurosciences, Inserm Umr 894, Paris, France.,Université de Paris, Université Paris Descartes, Paris, France
| | - Léa Rotenberg
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Jean-Pierre Schuster
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Pierre Lavaud
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Cécile Hanon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Franz Hozer
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Elisabeth Teruel
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Aude Manetti
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | | | - Anne-Sophie Seigneurie
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Frédéric Limosin
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France.,Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France.,Centre Psychiatrie et Neurosciences, Inserm Umr 894, Paris, France.,Université de Paris, Université Paris Descartes, Paris, France
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Breton M, Costemale-Lacoste JF, Li Z, Lafuente-Lafuente C, Belmin J, Mericskay M. Blood NAD levels are reduced in very old patients hospitalized for heart failure. Exp Gerontol 2020; 139:111051. [PMID: 32783906 DOI: 10.1016/j.exger.2020.111051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Age-associated decline in nicotinamide adenine dinucleotide (NAD) tissue levels has emerged as potential driving mechanism in the establishment of energy metabolism perturbations in the context of chronic diseases, notably heart failure. OBJECTIVE The aim of this study was to measure the blood NAD levels in a healthy blood donor population and in a population of elderly patients hospitalized for decompensated heart failure. METHOD Whole blood sample was collected from 151 healthy voluntary blood donors, aged 19 to 68 years, and from 19 patients aged 75 to 101 years and hospitalized for decompensated heart failure in a geriatric ward. Metabolites were extracted by the hot buffered ethanol procedure and NAD was quantified in triplicate for each sample. RESULTS The mean concentration of NAD in blood of healthy donors was 23.4 (SD 4.05) μmol/L. There was no significant correlation between NAD levels and donors' age nor sex in the healthy population when studied as a whole. However, the linear regression curves of NAD concentration plotted against age differed between males and females (p = 0.0283) with a trend in males to decline with age that was not observed in females. The mean concentration of NAD in whole blood samples of the geriatric population was 20.7 (SD 3.6) μmol/L (p = 0.007 versus the healthy blood donor population). There were no differences between males and females (p = 0.7) nor between patients with ejection fraction inferior or superior to 50% (p = 0.86) in the geriatric population. CONCLUSION This study highlighted a diminution of NAD blood levels for elderly patients hospitalized for decompensated heart failure in comparison to a healthy population, suggesting that new therapeutics to restore NAD stock and energy metabolism would be a major progress in the management of this type of geriatric patients.
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Affiliation(s)
- Marie Breton
- Université Paris-Saclay, Inserm UMRS 1180 Signalling and Cardiovascular Pathophysiology, Châtenay-Malabry, France
| | - Jean-François Costemale-Lacoste
- GHU Paris, psychiatrie et neurosciences, Université de Paris, France; Université Paris-Saclay, Inserm UMRS 1178, CESP, Team "MOODS" Le Kremlin-Bicêtre, France
| | - Zhenlin Li
- Biological Adaptation and Ageing, Institut de Biologie Paris-Seine (IBPS), CNRS UMR 8256, INSERM ERL U1164, Sorbonne Université, Paris, France
| | - Carmelo Lafuente-Lafuente
- Service de gériatrie à orientation cardiovasculaire et neuropsychogériatrique, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, Ivry-sur-Seine, France; Faculté de Médecine, Sorbonne Université, Paris, France
| | - Joël Belmin
- Service de gériatrie à orientation cardiovasculaire et neuropsychogériatrique, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, Ivry-sur-Seine, France; Faculté de Médecine, Sorbonne Université, Paris, France
| | - Mathias Mericskay
- Université Paris-Saclay, Inserm UMRS 1180 Signalling and Cardiovascular Pathophysiology, Châtenay-Malabry, France.
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Costemale-Lacoste JF, Asmar KE, Rigal A, Martin S, Kader Ait Tayeb AE, Colle R, Becquemont L, Fève B, Corruble E. Severe insomnia is associated with metabolic syndrome in women over 50 years with major depression treated in psychiatry settings: a METADAP report. J Affect Disord 2020; 264:513-518. [PMID: 32056777 DOI: 10.1016/j.jad.2019.11.084] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 07/16/2019] [Revised: 10/02/2019] [Accepted: 11/12/2019] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Major depression is associated with metabolic syndrome and cardiovascular risk. We have previously shown that severe insomnia, a core symptom of major depression episode (MDE), is associated with hypertriglyceridemia, a component of metabolic syndrome, in women but not in men with major depression. Since insomnia is related to cardiovascular morbidity in the general population and major depression also, our objective was to assess the link between insomnia and metabolic syndrome, a marker syndrome of cardiovascular risk, during MDE, in women and in men. METHODS In 624 patients with a current MDE cohort, both insomnia and metabolic syndrome were assessed in women and men. Insomnia was rated from 0 to 6 based on the HDRS corresponding items, severe insomnia being defined by a total insomnia score ≥4. RESULTS severe insomnia was associated with metabolic syndrome in women but not in men. In multivariate logistic regressions, these results in women were independent from age, educational level, major depressive disorder duration and current smoking. These results were only significant in women aged ≥50 years, a cut-off age for menopausal status but not in women under 50 years. CONCLUSION Women aged ≥50 years with a severe insomnia during MDE have an increased risk of metabolic syndrome. Severe insomnia may be a clinical marker of metabolic risk in this population. They should be particularly monitored for metabolic syndrome and may benefit from sleep recommendations and cardiovascular prevention.
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Affiliation(s)
- Jean-François Costemale-Lacoste
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « Dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
| | - Khalil El Asmar
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « Dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Adrien Rigal
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Séverine Martin
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Abd El Kader Ait Tayeb
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Romain Colle
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Laurent Becquemont
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Bruno Fève
- Sorbonne Université-Inserm, UMR S_938, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire ICAN, F-75012, Paris, France; Service d'Endocrinologie, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, F-75012, Paris, France
| | - Emmanuelle Corruble
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France.
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Hardy P, Costemale-Lacoste JF, Trichard C, Butlen-Ducuing F, Devouge I, Cerboneschi V, Jacob E, Buferne R, Benyamina A, Cantero A, Gravier V, Ghanem T, Guérin A, Meidinger A, Baleyte JM, Pelissolo A, Corruble E. Comparison of burnout, anxiety and depressive syndromes in hospital psychiatrists and other physicians: Results from the ESTEM study. Psychiatry Res 2020; 284:112662. [PMID: 31703985 DOI: 10.1016/j.psychres.2019.112662] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 07/16/2019] [Revised: 10/25/2019] [Accepted: 10/26/2019] [Indexed: 11/26/2022]
Abstract
AIMS To compare prevalence and risk factors for burnout, anxiety and depression among hospital psychiatrists and non-psychiatrists. METHOD Regional online survey of psychiatric and non-psychiatric hospital physicians was performed including: a job-stress scale, the Hospital Anxiety and Depression Scale (HADS), the Copenhagen Burnout Inventory (CBI), a stressful work relationships list and a six items scale about work-related psychosocial risk factors (PRFs). The client-related burnout scale of the CBI has been changed to an interpersonal burnout scale. Cases were defined by a score of 8+ for the HADS-A/HADS-D and 50+ for the three CBI subscales. RESULTS 285 psychiatrists and 326 non-psychiatrists participated. The prevalence of depression, personal burnout and work-related burnout did not differ between physicians. Anxiety was lower in psychiatrists and interpersonal burnout was higher in senior psychiatrists. Multivariate analysis showed two main PRFs, common to both groups of physicians: "work intensity and time" was associated with four of the five syndromes and "emotional demands" with the three burnout syndromes. Interpersonal burnout was associated with stressful relationships with leaders, but not with patients. CONCLUSION Reducing the workload, improving the management of emotions and increasing managerial skills are important approaches for prevention.
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Affiliation(s)
- Patrick Hardy
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, 94270 Le Kremlin-Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France.
| | - Jean-François Costemale-Lacoste
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, 94270 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de l'adulte et du sujet âgé, Hôpital Corentin-Celton, Hôpitaux Universitaires Paris Ouest, Assistance Publique-Hôpitaux de Paris, 92130 Issy-les-Moulineaux, France
| | - Christian Trichard
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Secteur 91G05, EPS Barthélémy Durand, 91150 Etampes, France
| | - Florence Butlen-Ducuing
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, 94270 Le Kremlin-Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France
| | - Isabelle Devouge
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Pôle 92G13, Groupe Hospitalier Paul Guiraud, 94800 Villejuif, France
| | - Valérie Cerboneschi
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Secteur 92G18, Groupe Hospitalier Paul Guiraud, 92140 Clamart, France
| | - Elisabeth Jacob
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Unité intersectorielle de réinsertion, EPS Erasme, 92160 Antony, France
| | - Richard Buferne
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; CH Fondation Vallée, 94250 Gentilly, France
| | - Amine Benyamina
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Département de psychiatrie et d'addictologie, Hôpital Paul Brousse, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94800 Villejuif, France
| | - Alain Cantero
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Pôle 94G16, Hôpitaux de Saint-Maurice, 94410 Saint-Maurice, France
| | - Véronique Gravier
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Grand Hôpital de l'Est Francilien, 77100 Meaux, France
| | - Teim Ghanem
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Pôle de psychiatrie d'adultes, GH Nord-Essonne, 91440 Bures-sur-Yvette, France
| | - Agnès Guérin
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Pôle 94G05, CH Les Murets, 94510 La Queue-en-Brie, France
| | - Antoine Meidinger
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Clinique L'abbaye (CLINEA), 91170 Viry-Châtillon, France
| | - Jean-Marc Baleyte
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Service universitaire de psychiatrie de l'enfant et de l'adolescent, CHI Créteil, 94000 Créteil, France; Faculté de médecine, UPEC, Université Paris-Est, 94000 Créteil, France; INSERM, IMRB, U955, Team 15, 94000 Créteil, France
| | - Antoine Pelissolo
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Faculté de médecine, UPEC, Université Paris-Est, 94000 Créteil, France; Assistance Publique-Hôpitaux de Paris, Pôle de Psychiatrie, Hôpitaux Universitaires Henri-Mondor, 94000 Créteil, France; INSERM, IMRB, U955, Team 15, 94000 Créteil, France
| | - Emmanuelle Corruble
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, 94270 Le Kremlin-Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France
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Morlet E, Costemale-Lacoste JF, Poulet E, McMahon K, Hoertel N, Limosin F, Alezrah C, Amado I, Amar G, Andréi O, Arbault D, Archambault G, Aurifeuille G, Barrière S, Béra-Potelle C, Blumenstock Y, Bardou H, Bareil-Guérin M, Barrau P, Barrouillet C, Baup E, Bazin N, Beaufils B, Ben Ayed J, Benoit M, Benyacoub K, Bichet T, Blanadet F, Blanc O, Blanc-Comiti J, Boussiron D, Bouysse AM, Brochard A, Brochart O, Bucheron B, Cabot M, Camus V, Chabannes JM, Charlot V, Charpeaud T, Clad-Mor C, Combes C, Comisu M, Cordier B, Costi F, Courcelles JP, Creixell M, Cuche H, Cuervo-Lombard C, Dammak A, Da Rin D, Denis JB, Denizot H, Deperthuis A, Diers E, Dirami S, Donneau D, Dreano P, Dubertret C, Duprat E, Duthoit D, Fernandez C, Fonfrede P, Freitas N, Gasnier P, Gauillard J, Getten F, Gierski F, Godart F, Gourevitch R, Grassin Delyle A, Gremion J, Gres H, Griner V, Guerin-Langlois C, Guggiari C, Guillin O, Hadaoui H, Haffen E, Hanon C, Haouzir S, Hazif-Thomas C, Heron A, Hubsch B, Jalenques I, Januel D, Kaladjian A, Karnycheff JF, Kebir O, Krebs MO, Lajugie C, Leboyer M, Legrand P, Lejoyeux M, Lemaire V, Leroy E, Levy-Chavagnat D, Leydier A, Liling C, Llorca PM, Loeffel P, Louville P, Lucas Navarro S, Mages N, Mahi M, Maillet O, Manetti A, Martelli C, Martin P, Masson M, Maurs-Ferrer I, Mauvieux J, Mazmanian S, Mechin E, Mekaoui L, Meniai M, Metton A, Mihoubi A, Miron M, Mora G, Niro Adès V, Nubukpo P, Omnes C, Papin S, Paris P, Passerieux C, Pellerin J, Perlbarg J, Perron S, Petit A, Petitjean F, Portefaix C, Pringuey D, Radtchenko A, Rahiou H, Raucher-Chéné D, Rauzy A, Reinheimer L, Renard M, René M, Rengade CE, Reynaud P, Robin D, Rodrigues C, Rollet A, Rondepierre F, Rousselot B, Rubingher S, Saba G, Salvarelli JP, Samuelian JC, Scemama-Ammar C, Schurhoff F, Schuster JP, Sechter D, Segalas B, Seguret T, Seigneurie AS, Semmak A, Slama F, Taisne S, Taleb M, Terra JL, Thefenne D, Tran E, Tourtauchaux R, Vacheron MN, Vandel P, Vanhoucke V, Venet E, Verdoux H, Viala A, Vidon G, Vitre M, Vurpas JL, Wagermez C, Walter M, Yon L, Zendjidjian X. Psychiatric and physical outcomes of long-term use of lithium in older adults with bipolar disorder and major depressive disorder: A cross-sectional multicenter study. J Affect Disord 2019; 259:210-217. [PMID: 31446382 DOI: 10.1016/j.jad.2019.08.056] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/11/2019] [Accepted: 08/18/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Although lithium is widely used in current practice to treat bipolar disorder (BD) and treatment-resistant major depressive disorder (MDD) among older adults, little is known about its efficacy and tolerability in this population, which is generally excluded from randomized clinical trials. The objective of this study was to evaluate the efficacy and tolerability of long-term use of lithium among older adults with BD and MDD. METHOD Data from the Cohort of individuals with Schizophrenia and mood disorders Aged 55 years or more (CSA) were used. Two groups of patients with BD and MDD were compared: those who were currently receiving lithium versus those who were not. The effects of lithium on psychiatric (i.e., depressive symptoms severity, perceived clinical severity, rates of psychiatric admissions in the past-year), geriatric (overall and cognitive functioning) and physical outcomes (i.e., rates of non-psychiatric medical comorbidities and general hospital admissions in the past-year) were evaluated. All analyses were adjusted for age, sex, duration of disorder, diagnosis, smoking status, alcohol use, and use of antipsychotics, antiepileptics or antidepressants. RESULTS Among the 281 older participants with BD or MDD, 15.7% were taking lithium for a mean duration of 12.5(SD = 11.6) years. Lithium use was associated with lower intensity of depressive symptoms, reduced perceived clinical global severity and lower benzodiazepine use (all p < 0.05), without being linked to greater rates of medical comorbidities, except for hypothyroidism. LIMITATIONS Data were cross-sectional and data on lifetime history of psychotropic medications was not assessed. CONCLUSION Our results suggest that long-term lithium use may be efficient and relatively well-tolerated in older adults with BD or treatment-resistant MDD.
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Affiliation(s)
- Elise Morlet
- Department of Psychiatry, Corentin Celton Hospital, 4 Parvis Corentin Celton, 92130 Issy-les-Moulineaux, France
| | - Jean-François Costemale-Lacoste
- Department of Psychiatry, Corentin Celton Hospital, 4 Parvis Corentin Celton, 92130 Issy-les-Moulineaux, France; INSERM UMRS 1178, CESP, Le Kremlin Bicêtre, France.
| | - Emmanuel Poulet
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon F-69000, France
| | - Kibby McMahon
- Department of Psychology & Neuroscience, Duke University, 2213 Elba Street, Durham, NC 27710, United States
| | - Nicolas Hoertel
- Department of Psychiatry, Corentin Celton Hospital, 4 Parvis Corentin Celton, 92130 Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Frédéric Limosin
- Department of Psychiatry, Corentin Celton Hospital, 4 Parvis Corentin Celton, 92130 Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France
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Costemale-Lacoste JF, Colle R, Martin S, Asmar KE, Loeb E, Feve B, Verstuyft C, Trabado S, Ferreri F, Haffen E, Polosan M, Becquemont L, Corruble E. Glycogen synthase kinase-3β genetic polymorphisms and insomnia in depressed patients: A prospective study. J Affect Disord 2018; 240:230-236. [PMID: 30081294 DOI: 10.1016/j.jad.2018.07.062] [Citation(s) in RCA: 8] [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: 02/24/2018] [Revised: 06/22/2018] [Accepted: 07/22/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND 80-90% of patients with Major Depressive Episode (MDE) experience insomnia and up-to 50% severe insomnia. Glycogen Synthase Kinase-3β (GSK3B) is involved both in mood regulation and circadian rhythm. Since GSK3B polymorphisms could affect protein levels or functionality, we investigated the association of GSK3B polymorphisms with insomnia in a sample of depressed patients treated with antidepressants. METHODS In this 6-month prospective real-world treatment study in psychiatric settings (METADAP), 492 Caucasian patients requiring a new antidepressant treatment were included and genotyped for five GSK3B Single Nucleotide Polymorphisms (SNPs) (rs6808874, rs6782799, rs2319398, rs13321783, rs334558). Insomnia and MDE severity were rated using the Hamilton Depression Rating Scale (HDRS). Bi- and multivariate analyses were performed to assess the association between GSK3B SNPs and insomnia (main objective). We also assessed their association with MDE severity and HDRS response/remission after antidepressant treatment. RESULTS At baseline severe insomnia was associated with the GSK3B rs334558 minor allele (C+) [OR=1.81, CI95%(1.17-2.80), p=0.008]. GSK3B rs334558 C+ had greater insomnia improvement after 6 months of antidepressant treatment (p=0.007, β=0.17, t=2.736). No association was found between GSK3B SNPs and MDE baseline severity or 6-month response/remission. CONCLUSION GSK3B rs334558 was associated with insomnia but not with MDE severity in depressed patients. Targeting GSK3B in patients with MDE and a severe insomnia could be a way to improve their symptoms with greater efficiency. And it should be further studied whether the GSK3B-insomnia association may fit into the larger picture of mood disorders.
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Affiliation(s)
- Jean-François Costemale-Lacoste
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, Le Kremlin Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France; Dispositif Territorial de Recherche et Formation (DTRF) Paris Sud
| | - Romain Colle
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, Le Kremlin Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France; Dispositif Territorial de Recherche et Formation (DTRF) Paris Sud
| | - Séverine Martin
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, Le Kremlin Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Khalil El Asmar
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, Le Kremlin Bicêtre, France
| | - Emanuel Loeb
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, Le Kremlin Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Bruno Feve
- Sorbonne Universities, Pierre and Marie Curie University Paris 6, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital; Hospitalo-Universitary Institute, ICAN; Department of Endocrinology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris France; INSERM, UMR S_938- Centre de Recherche Saint-Antoine, Paris, France
| | - Céline Verstuyft
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, Le Kremlin Bicêtre, France; Service de Génétique Moléculaire, pharmacogénétique et hormonologie, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Séverine Trabado
- Service de Génétique Moléculaire, pharmacogénétique et hormonologie, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Florian Ferreri
- UPMC Paris 6; Department of Psychiatry, Saint-Antoine Hospital, Paris, France
| | - Emmanuel Haffen
- Department of Clinical Psychiatry, University Hospital; EA 481, Laboratory of Neurosciences, University of Bourgogne Franche-Comté; CIC-1431 Inserm, University Hospital, Besançon, France
| | - Mircea Polosan
- Univ. Grenoble Alpes; Inserm U1216, Grenoble Institut de Neurosciences, CHU de Grenoble, F-38000 Grenoble, France
| | - Laurent Becquemont
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, Le Kremlin Bicêtre, France; Centre de Recherche Clinique Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, Le Kremlin Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France; Dispositif Territorial de Recherche et Formation (DTRF) Paris Sud.
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Costemale-Lacoste JF, Balaguer E, Boniface B, Ivascu EB, Bernardini C, Metton JP, Bouhlal A, Ghanem T, Corruble E, Hardy P, Hozer F. Outpatient treatment engagement after suicidal attempt: A multisite prospective study. Psychiatry Res 2017; 258:21-23. [PMID: 28982037 DOI: 10.1016/j.psychres.2017.09.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/19/2017] [Accepted: 09/24/2017] [Indexed: 10/18/2022]
Abstract
After suicidal attempt, the rate of specialized out treatment engagement (SOTE) does not exceed 30-50%. We designed a multisite prospective naturalistic study, in order to investigate predictive factors of SOTE after emergency department discharge among 107 suicidal attempters without current psychiatric ambulatory care. Both bivariate and multivariate analyses highlighted that booking an appointment with a mental health professional before discharge was significantly associated with higher SOTE rate. Psychiatric caregivers of emergency departments should be informed that this approach is a simple, fast way to improve SOTE among this population.
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Affiliation(s)
- Jean-François Costemale-Lacoste
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Psychiatry Department, Bicêtre Hospital, HUPS, Assistance Publique des Hôpitaux de Paris, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France.
| | - Elsa Balaguer
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France; Psychiatry Department, Erasme Hospital, Antony, France
| | - Bruno Boniface
- Psychiatry Department, Bicêtre Hospital, HUPS, Assistance Publique des Hôpitaux de Paris, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France
| | - Emil-Bogdan Ivascu
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France; Psychiatry Department, Barthélémy Durand Hospital, Etampes, France
| | - Caroline Bernardini
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France; Psychiatry Department, Orsay Hospital, Orsay, France
| | - Jean-Pierre Metton
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France; Psychiatry Department, Erasme Hospital, Antony, France
| | - Ahmed Bouhlal
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France; Psychiatry Department, Barthélémy Durand Hospital, Etampes, France
| | - Teim Ghanem
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France; Psychiatry Department, Orsay Hospital, Orsay, France
| | - Emmanuelle Corruble
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Psychiatry Department, Bicêtre Hospital, HUPS, Assistance Publique des Hôpitaux de Paris, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France
| | - Patrick Hardy
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Psychiatry Department, Bicêtre Hospital, HUPS, Assistance Publique des Hôpitaux de Paris, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France
| | - Franz Hozer
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Psychiatry Department, Bicêtre Hospital, HUPS, Assistance Publique des Hôpitaux de Paris, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris-Sud, France
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Corbineau S, Breton M, Mialet-Perez J, Costemale-Lacoste JF. Major depression and heart failure: Interest of monoamine oxidase inhibitors. Int J Cardiol 2017; 247:1-6. [DOI: 10.1016/j.ijcard.2017.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 06/25/2017] [Accepted: 07/04/2017] [Indexed: 12/25/2022]
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Costemale-Lacoste JF, Trabado S, Verstuyft C, El Asmar K, Butlen-Ducuing F, Colle R, Ferreri F, Polosan M, Haffen E, Balkau B, Falissard B, Feve B, Becquemont L, Corruble E. Severe insomnia is associated with hypertriglyceridemia in women with major depression treated in psychiatry settings. J Affect Disord 2017; 217:159-162. [PMID: 28411504 DOI: 10.1016/j.jad.2017.04.011] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/02/2017] [Accepted: 04/07/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Hypertriglyceridemia (HTG) is a cardiovascular risk factor. In the general population, elevated fasting triglyceridemia (TG) is associated with insomnia. Since insomnia is a core symptom of Major Depressive Episodes (MDE), we studied the association of severe insomnia with HTG in major depression. METHODS We used the baseline data of the METADAP cohort, comprising 624 patients with a current MDE in a context of Major Depressive Disorder treated in psychiatry settings, without current alcohol use disorders. Patients were screened for severe insomnia, defined by a score of four or more on the three Hamilton Depression Rating Scale (HDRS) sleep items, and for HTG characterised by TG≥200mg/dL. RESULTS Severe insomnia was observed in 335(54%) patients with a current MDE, of whom 234(70%) were women; 49(8%) patients had HTG, of whom 25(51%) were women. 69(11%) patients were treated with lipid-lowering drugs. Severe insomnia was associated with a higher frequency of HTG in the whole sample (9.9% vs 5.6%, p=0.046) and in the subgroup of women (9.0% vs 2.0%, p=0.002). Multivariate logistic regression analyses adjusted for age, education levels, BMI and total HDRS scores confirmed the association between severe insomnia and HTG in the whole sample (OR=2.02, 95%CI [1.00-4.08], p=0.05) as well as in the subgroup of women (OR=4.82, 95%CI [1.5-15.5], p=0.008). No association was shown in men. PERSPECTIVES HTG should be systematically investigated in depressed patients with severe insomnia and particularly in women. Further studies are needed to explain the association we observed between severe insomnia and HTG.
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Affiliation(s)
- Jean-François Costemale-Lacoste
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France.
| | - Séverine Trabado
- Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; INSERM 1185, Faculté de Medicine Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre 94275, France
| | - Céline Verstuyft
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre 94275, France; Centre de resources biologiques CRP Paris Sud Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Khalil El Asmar
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France
| | - Florence Butlen-Ducuing
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Romain Colle
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Florian Ferreri
- Université Pierre et Marie Curie, Paris, France; Service de Psychiatrie, Hôpital Saint-Antoine, Paris, France
| | - Mircea Polosan
- Department of Clinical Psychiatry, CIC-1431 INSERM, University Hospital of Besançon, France & EA 481 Neuroscience, University of Bourgogne Franche-Comté, Besançon, France
| | - Emmanuel Haffen
- EA 481 Laboratory of Integrative and Clinical Neuroscience, Université de Franche-Comté/SFR FED 4234, COMUE Bourgogne/Franche-Comté, France
| | - Beverley Balkau
- INSERM UMR 1178, CESP, Renal and Cardiovascular Epidemiology, UVSQ-UPS, Villejuif, France
| | - Bruno Falissard
- INSERM UMR 1178, CESP, Département de Biostatistiques, University Paris Sud, Hôpital Paul Brousse, Assistance Publique Hôpitaux de Paris, 94400 Villejuif, France
| | - Bruno Feve
- Hôpital Saint-Antoine, Service d'Endocrinologie, Assistance Publique Hôpitaux de Paris, Paris, France; Sorbonne Universités, Université Paris 6, INSERM UMR S_938, Centre de Recherche Saint-Antoine, Paris, France
| | - Laurent Becquemont
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre 94275, France; Centre de resources biologiques CRP Paris Sud Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
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Costemale-Lacoste JF, Guilloux JP, Gaillard R. The role of GSK-3 in treatment-resistant depression and links with the pharmacological effects of lithium and ketamine: A review of the literature. Encephale 2016; 42:156-64. [PMID: 26995153 DOI: 10.1016/j.encep.2016.02.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 12/04/2014] [Accepted: 03/27/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND Since the discovery of antidepressants, new treatments have emerged with fewer side effects but no greater efficacy. Glycogen synthase kinase 3 β (GSK-3β), a kinase known for its activity on glycogen synthesis, has in the last few years raised growing interest in biological psychiatry. Several efficient treatments in major depression have an inhibitory effect on this kinase, which could be targeted in new mood disorder treatments. METHODS The aim of this review is to summarize findings concerning the intracellular pharmacologic effects of GSK-3β inhibitors on mood. After a brief description of the intracellular transduction pathways implicated in both GSK-3β and mood disorders, we reviewed the results demonstrating GSK-3β involvement in the effects of lithium and ketamine. RESULTS GSK-3β can be inhibited through several mechanisms such as serine phosphorylation or binding in a proteic scaffold and others. Its inhibition is implicated in numerous cellular pathways of interest involved in neuronal growth and architecture, cell survival, neurogenesis or synaptic plasticity. This inhibition appears to be both efficient and sufficient in improving mood in animal models. In human beings, several levels of evidence show GSK-3β inhibition with antidepressant use. Crucially, strong inhibition has been shown with lithium via the proteic scaffold PP2A/β-arrestin/AKT, and with the rapid antidepressant effect of ketamine via p70S6K. CONCLUSION Our review focuses on mechanisms whereby the GSK-3β pathway has a part in the antidepressant effect of lithium and ketamine. This article highlights the importance of translational research from cell and animal models to the clinical setting in order to develop innovative therapeutic targets.
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Affiliation(s)
- J F Costemale-Lacoste
- Inserm U1178, équipe « Dépression et antidépresseurs », CESP, université Paris-Sud, 94275 Le Kremlin-Bicêtre, France; Service de psychiatrie de l'adulte, centre hospitalier universitaire Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
| | - J P Guilloux
- Inserm U1178, équipe « Dépression et antidépresseurs », CESP, université Paris-Sud, 94275 Le Kremlin-Bicêtre, France; EA3544, faculté de pharmacie, université Paris-Sud, 92296 Châtenay-Malabry, France
| | - R Gaillard
- Laboratoire de physiopathologie des maladies psychiatriques, centre de psychiatrie et neurosciences U894, université Paris Descartes, Sorbonne Paris Cité, Paris, France; Centre hospitalier Sainte-Anne, Paris, France
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