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Ronat L, Hanganu A. Neuropsychiatric and cognitive features of major depressive disorder in aging, based on the data from the US National Alzheimer's Coordinating Center (NACC). Encephale 2024; 50:130-136. [PMID: 37088582 DOI: 10.1016/j.encep.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/03/2023] [Accepted: 01/12/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVE The diagnosis of Major Depressive Disorder (MDD) is based on the DSM-V criteria and is established by a clinician. This allows quantifying depression based on clinical criteria. As such, MDD differs from other types of depressions that are measured by subjective scales. Here, we evaluated the MDD risk factor on other neuropsychiatric symptoms (NPS) as well as MDD association with cognitive performance in Alzheimer's disease (AD), Mild Cognitive Impairment (MCI) and Healthy Controls (HC). METHODS Data of 208 patients with AD, 291 patients with MCI and 647 HC were extracted from the National Alzheimer's Coordinating Center database. All participants included in this study were assessed by a physician for the MDD criteria, underwent an NPS evaluation using the NeuroPsychiatric Inventory, and a comprehensive cognitive assessment. Participants were classified as being with and without MDD. We performed logistic regression and MANCOVA models respectively with NPS and cognitive performance as variables of interest and MDD as fixed factors within each group. The MANCOVA was controlled for the effects of age, sex, and education. RESULTS MDD increased the risk for psychotic, affective and behavioral NPS in MCI, as well as affective and behavioral NPS in HC and AD. Also, MCI with MDD had lower performance on selective attention and mental flexibility. CONCLUSIONS MDD seems to increase the probability of a prevalence of NPS in all groups (HC, MCI and AD). Longitudinal data processing would help to understand the neuropsychiatric evolution of elderly subjects with MDD.
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Affiliation(s)
- L Ronat
- Centre de recherche de l'institut universitaire de gériatrie de Montréal, M7819, 4545 ch. Queen-Mary, H3W 1W6, Montréal, QC, Canada; Faculté de médecine, département de médecine, université de Montréal, Québec, Canada
| | - A Hanganu
- Centre de recherche de l'institut universitaire de gériatrie de Montréal, M7819, 4545 ch. Queen-Mary, H3W 1W6, Montréal, QC, Canada; Faculté des arts et des sciences, département de psychologie, université de Montréal, Québec, Canada.
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Bamouss A, Mungo A, Hein M. [Impact of the diagnostic method for borderline personality disorder on the acute response and the risk of early relapse in major depressed individuals treated with ECT: A systematic literature review]. Encephale 2024:S0013-7006(24)00011-3. [PMID: 38311474 DOI: 10.1016/j.encep.2023.11.021] [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: 04/27/2023] [Revised: 10/25/2023] [Accepted: 11/08/2023] [Indexed: 02/06/2024]
Abstract
INTRODUCTION Given the contradictory data available in the literature, the aim of this systematic review was to investigate the impact of the diagnostic method for borderline personality disorder (BPD) on the acute response and the risk of early relapse in major depressed individuals treated with electroconvulsive therapy (ECT). METHOD After a systematic literature review performed during March 2023 in the PubMed-Medline database according to the PRISMA criteria, 47 articles were identified using the keyword algorithm ("Electroconvulsive Therapy" [Mesh] or electroconvulsive therapy) and ("Borderline Personality Disorder" [Mesh] or borderline personality disorder). The inclusion criteria applied for the selection of articles in this systematic review were: (1) articles investigating the impact of BPD on the acute response and/or the risk of early relapse in major depressed individuals (> 18 years old) treated with ECT, (2) diagnosis of BPD and major depressive disorder by validated screening tests and/or systematic psychiatric interviews based on diagnostic criteria of international classification, (3) any type of study (cross-sectional, longitudinal, prospective, retrospective, interventional and experimental), (4) articles written in English or French, and (5) articles published after January 2000. After assessment of the 47 articles based on these inclusion criteria by two authors, seven studies investigating the impact of BPD diagnosed by systematic psychiatric interview or screening tests on the acute response and the risk of early relapse in major depressed individuals treated with ECT were included in this systematic review. RESULTS Unlike the three studies diagnosing BPD by screening tests, the four studies diagnosing BPD by systematic psychiatric interview demonstrated a negative impact of this personality disorder on the acute response or the risk of early relapse in major depressed individuals treated with ECT. However, all studies included in this systematic review presented a low level of scientific evidence (cross-sectional epidemiological studies and retrospective cohort studies). CONCLUSION Despite the need for studies of better scientific quality, the results of this systematic review seem to indicate that screening for BPD by systematic psychiatric interview during the pre-ECT assessment and the establishment of adequate therapeutic strategies in case of comorbid BPD could be promising options to allow better acute response and better prevention of early relapses in major depressed individuals treated with ECT.
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Affiliation(s)
- Amine Bamouss
- Service de psychiatrie et laboratoire du sommeil, hôpital universitaire de Bruxelles, université libre de Bruxelles (ULB), Bruxelles, Belgique
| | - Anaïs Mungo
- Service de psychiatrie et laboratoire du sommeil, hôpital universitaire de Bruxelles, université libre de Bruxelles (ULB), Bruxelles, Belgique
| | - Matthieu Hein
- Service de psychiatrie et laboratoire du sommeil, hôpital universitaire de Bruxelles, université libre de Bruxelles (ULB), Bruxelles, Belgique.
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Bottemanne H, Frileux S, Guesdon A, Fossati P. [Belief updating and mood congruence in depressive disorder]. Encephale 2021; 48:188-195. [PMID: 34916079 DOI: 10.1016/j.encep.2021.06.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/27/2021] [Accepted: 06/12/2021] [Indexed: 12/28/2022]
Abstract
Depressive disorder is characterized by a polymorphic symptomatology associating emotional, cognitive and behavioral disturbances. One of the most specific symptoms is negative beliefs, called congruent to mood. Despite the importance of these beliefs in the development, the maintenance, and the recurrence of depressive episodes, little is known about the processes underlying the generation of depressive beliefs. In this paper, we detail the link between belief updating mechanisms and the genesis of depressive beliefs. We show how depression alters information processing, generating cognitive immunization when processing positive information, affective updating bias related to the valence of belief and prediction error, and difficultie to disengage from negative information. We suggest that disruption of belief-updating mechanisms forms the basis of belief-mood congruence in depression.
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Affiliation(s)
- H Bottemanne
- Paris Brain Institute - Institut du Cerveau (ICM), UMR 7225/UMRS 1127, CNRS / INSERM, Sorbonne university, Paris, France; Sorbonne University, Department of Philosophy, SND Research Unit, UMR 8011, CNRS, Paris, France; Department of psychiatry, Pitié-Salpêtrière hospital, DMU Neuroscience, Sorbonne university, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France.
| | - S Frileux
- Paris Brain Institute - Institut du Cerveau (ICM), UMR 7225/UMRS 1127, CNRS / INSERM, Sorbonne university, Paris, France; Department of psychiatry, Pitié-Salpêtrière hospital, DMU Neuroscience, Sorbonne university, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - A Guesdon
- Paris Brain Institute - Institut du Cerveau (ICM), UMR 7225/UMRS 1127, CNRS / INSERM, Sorbonne university, Paris, France; Department of psychiatry, Pitié-Salpêtrière hospital, DMU Neuroscience, Sorbonne university, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - P Fossati
- Paris Brain Institute - Institut du Cerveau (ICM), UMR 7225/UMRS 1127, CNRS / INSERM, Sorbonne university, Paris, France; Department of psychiatry, Pitié-Salpêtrière hospital, DMU Neuroscience, Sorbonne university, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France
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Bou Khalil R. Targeting all psychopathological dimensions in the treatment of anorexia nervosa. Encephale 2020; 47:79-81. [PMID: 33041048 DOI: 10.1016/j.encep.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/19/2020] [Accepted: 06/06/2020] [Indexed: 10/23/2022]
Abstract
Efforts to improve the prognosis of subjects with anorexia nervosa [AN] through the development of specific therapeutic interventions have yielded unsatisfactory results. AN can be perceived as a mental disorder that is clinically composed of disturbed psychopathological dimensions found in major depressive disorder, obsessive compulsive disorder, body dysmorphic disorder, and delusional disorder somatic type. Future treatment strategies of patients with AN might target these multiple psychopathological dimensions. Considering that each of these dimensions is known to be best treated with psychopharmacologic drugs such as antidepressants, mood stabilizers and antipsychotic drugs, AN treatment guidelines may need to consider prescribing them to patients.
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Affiliation(s)
- R Bou Khalil
- Saint Joseph University, Hôtel-Dieu de France, A. Naccache boulevard - Achrafieh, (P.O. box: 166830), Beirut, Lebanon.
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Chrétien P, Caillet P, Bouazzaoui F, Kaladjian A, Younes N, Sanchez S. [Is the orientation of patients suffering from depressive disorder to the psychiatric emergencies by a general practitioner associated with the decision to hospitalize?]. Encephale 2018; 45:46-52. [PMID: 29503028 DOI: 10.1016/j.encep.2017.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Depressive disorders affect nearly 350 million people worldwide and are the world's leading cause of incapacity. Patients who are depressed preferentially approach their general practitioner (GP), who is their first point of contact, in 50-60% of cases. The aim of our study is to assess whether the orientation of patients suffering from anxiety-depressive disorder towards a GP in a general emergency is a factor associated with hospitalization when compared to patients who present themselves spontaneously for the same disorders. Our secondary objective was to identify the different profiles of patients who were hospitalized for these disorders as an emergency. MATERIALS AND METHODS We conducted a cross-sectional study for the year 2015, targeting patients who presented as general emergencies at the centre hospitalier de Troyes and who had received a psychiatric diagnosis in the context of an anxiety or depressive disorder. RESULTS Five hundred and twenty four patients were included. A univariate analysis showed that referral by the attending physician was associated with hospitalization in 57.9% vs. 42.1% cases (P=0.007), at an odds ratio at 1.98 [1.22-3.21] by multivariate analysis. Analysis by ascending hierarchical classification made it possible to identify 3 profiles for hospitalized patients: 1) patients with a known psychiatric history, a history of past or current follow-ups directed by a psychiatrist, with at least one psychotropic treatment, the presence of psychotic symptoms and a low suicidal risk compared to the rest of the study population; 2) patients without a psychiatric history, or a history of past or ongoing psychiatric follow-up and the absence of ongoing psychotropic treatment. These patients were referred by a GP (67% vs 23%, P<0.001) and their suicidal risk was higher (59% vs 26%, P<0.001); 3) patients about whom the psychiatrist had little information at the time of the emergency consultation. CONCLUSIONS The relevance of GPs in orientation towards emergencies pleads in favor of a partnership and an early exchange between treating physicians and the psychiatrists.
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Affiliation(s)
- P Chrétien
- Hôpitaux Champagne Sud, centre hospitalier Troyes, 101, avenue Anatole-France, CS 10718, 10003 Troyes cedex, France
| | - P Caillet
- CHU de Nantes, 29, chemin de la Basse Gaudinière, 44300 Nantes, France
| | - F Bouazzaoui
- CHU de Reims, 51, avenue Cognacq-Jay, 51100 Reims, France
| | - A Kaladjian
- CHU de Reims, 51, avenue Cognacq-Jay, 51100 Reims, France
| | - N Younes
- Centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France; EA 40-47, université Versailles Saint-Quentin, 78000 Versailles, France
| | - S Sanchez
- Hôpitaux Champagne Sud, centre hospitalier Troyes, 101, avenue Anatole-France, CS 10718, 10003 Troyes cedex, France.
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Abstract
Links between affective and endocrine-metabolic disorders are numerous and complex. In this review, we explore most frequent endocrine-metabolic comorbidities. On the one hand, these comorbidities imply numerous iatrogenic effects from antipsychotics (metabolic side-effects) or from lithium (endocrine side-effects). On the other hand, these comorbidities are also associated with affective disorders independently from medication. We will successively examine metabolic syndrome, glycemic disturbances, obesity and thyroid disorders among patients with affective disorders. Endocrinemetabolic comorbidities can be individually encountered, but can also be associated. Therefore, they substantially impact morbidity and mortality by increasing cardiovascular risk factors. Two distinct approaches give an account of processes involved in these comorbidities: common environmental factors (iatrogenic effects, lifestyle), and/or shared physiological vulnerabilities. In conclusion, we provide a synthesis of important results and recommendations related to endocrine-metabolic comorbidities in affective disorders : heavy influence on morbidity and mortality, undertreatment of somatic diseases, importance of endocrine and metabolic side effects from main mood stabilizers, impact from sex and age on the prevalence of comorbidities, influence from previous depressive episodes in bipolar disorders, and relevance of systematic screening for subclinical (biological) disturbances.
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Affiliation(s)
- M Cermolacce
- Pôle universitaire de psychiatrie, CHU Sainte-Marguerite, 13274 Marseille cedex 9, France; Laboratoire de Neurosciences Cognitives, UMR CNRS 6155 & Aix-Marseille Université, Fédération 3C, Marseille, France.
| | - R Belzeaux
- Pôle universitaire de psychiatrie, CHU Sainte-Marguerite, 13274 Marseille cedex 9, France
| | - M Adida
- Pôle universitaire de psychiatrie, CHU Sainte-Marguerite, 13274 Marseille cedex 9, France
| | - J-M Azorin
- Pôle universitaire de psychiatrie, CHU Sainte-Marguerite, 13274 Marseille cedex 9, France
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