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Nobile B, Jaussent I, Kahn JP, Leboyer M, Risch N, Olié E, Courtet P. Risk factors of suicide re-attempt: A two-year prospective study. J Affect Disord 2024; 356:535-544. [PMID: 38657762 DOI: 10.1016/j.jad.2024.04.058] [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: 02/08/2024] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND History of suicide attempt (SA) is the strongest predictor of a new SA and suicide. It is primordial to identify additional risk factors of suicide re-attempt. The aim of this study was to identify risk factors of suicide re-attempt in patients with recent SA followed for 2 years. METHODS In this multicentric cohort of adult inpatients, the median of the index SA before inclusion was 10 days. Clinicians assessed a large panel of psychological dimensions using validated tools. Occurrence of a new SA or death by suicide during the follow-up was recorded. A cluster analysis was used to identify the dimensions that best characterized the population and a variable "number of personality traits" was created that included the three most representative traits: anxiety, anger, and anxious lability. Risk factors of re-attempt were assessed with adjusted Cox regression models. RESULTS Among the 379 patients included, 100 (26.4 %) re-attempted suicide and 6 (1.6 %) died by suicide. The two major risk factors of suicide re-attempt were no history of violent SA and presenting two or three personality traits among trait anxiety, anger and anxious lability. LIMITATIONS It was impossible to know if treatment change during follow-up occur before or after the re-attempt. DISCUSSION One of the most important predictors of re-attempt in suicide attempters with mood disorders, was the presence of three personality traits (anger, anxiety, and anxious lability). Clinicians should provide close monitoring to patients presenting these traits and proposed treatments specifically targeting these dimensions, especially anxiety.
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Affiliation(s)
- B Nobile
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France.
| | - I Jaussent
- Institute for Neurosciences of Montpellier INM, INSERM Montpellier, University of Montpellier, Montpellier, France
| | - J P Kahn
- Université de Lorraine, Nancy, France; Clinique Soins-Etudes de Vitry le François, Fondation Sant'e des Etudiants de France (FSEF), Paris, France
| | - M Leboyer
- FondaMental Foundation, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, 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), Créteil, France
| | - N Risch
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France
| | - Ph Courtet
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France
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Nobile B, Gourguechon-Buot E, Gorwood P, Olié E, Courtet P. Association of clinical characteristics, depression remission and suicide risk with discrepancies between self- and clinician-rated suicidal ideation: Two large naturalistic cohorts of outpatients with depression. Psychiatry Res 2024; 335:115833. [PMID: 38471242 DOI: 10.1016/j.psychres.2024.115833] [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: 12/01/2023] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
Clinician- and self-rating of suicidal ideation (SI) are often discrepant. The aim of this study was to determine: 1) Association between discrepant self- and clinician-rated SI with clinical characteristics, depression remission and SA (SA) risk; 2) which SI assessment (self or clinician) predicted depression remission and risk of SA. LUEUR and GENESE are two large, prospective, naturalistic cohorts of French adult outpatients with unipolar depression treated and followed for 6 weeks. SI presence was assessed and defined with a score to the suicidal item of the Montgomery-Åsberg Depression Rating Scale ≥3. Discordant SI was defined as SI detection by only one of the two evaluators (patient or clinician). In both cohorts, 49.3 % (GENESE) and 34 % (LUEUR) patients had discordant SI. Clinical characteristics were more severe, and risk of SA was higher in patients with current SI (concordant and discordant) than in patients without SI and in the concordant than in the discordant group. Prediction of the risk of SA and of depression non-remission was comparable by the two ratings. Patients with SI (concordant and discordant) have more severe clinical characteristics and patients with concordant SI are the most at risk of SA during the follow-up. It is crucial to assess SI and to improve how it is evaluated.
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Hôpital La Colombière, University of Montpellier, CNRS, INSERM, 39, Avenue Charles Flahault, BP 34493, Montpellier 34093 CEDEX 5, France.
| | - Elia Gourguechon-Buot
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Hôpital La Colombière, University of Montpellier, CNRS, INSERM, 39, Avenue Charles Flahault, BP 34493, Montpellier 34093 CEDEX 5, France
| | - Philip Gorwood
- Inserm UMRS1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Hôpital La Colombière, University of Montpellier, CNRS, INSERM, 39, Avenue Charles Flahault, BP 34493, Montpellier 34093 CEDEX 5, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Hôpital La Colombière, University of Montpellier, CNRS, INSERM, 39, Avenue Charles Flahault, BP 34493, Montpellier 34093 CEDEX 5, France
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Yrondi A, Javelot H, Nobile B, Boudieu L, Aouizerate B, Llorca PM, Charpeaud T, Bennabi D, Lefrere A, Samalin L. French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN) guidelines for the management of patients with partially responsive depression and treatment-resistant depression: Update 2024. Encephale 2024:S0013-7006(24)00019-8. [PMID: 38369426 DOI: 10.1016/j.encep.2023.11.029] [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: 06/19/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION The purpose of this update is to add newly approved nomenclatures and treatments as well as treatments yet to be approved in major depressive disorder, thus expanding the discussions on the integration of resistance factors into the clinical approach. METHODS Unlike the first consensus guidelines based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology (AFPBN) developed an update of these guidelines for the management of partially responsive depression (PRD) and treatment-resistant depression (TRD). The expert guidelines combine scientific evidence and expert clinicians' opinions to produce recommendations for PRD and TRD. RESULTS The recommendations addressed three areas judged as essential for updating the previous 2019 AFPBN guidelines for the management of patients with TRD: (1) the identification of risk factors associated with TRD, (2) the therapeutic management of patients with PRD and TRD, and (3) the indications, the modalities of use and the monitoring of recent glutamate receptor modulating agents (esketamine and ketamine). CONCLUSION These consensus-based guidelines make it possible to build bridges between the available empirical literature and clinical practice, with a highlight on the 'real world' of the clinical practice, supported by a pragmatic approach centred on the experience of specialised prescribers in TRD.
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Affiliation(s)
- Antoine Yrondi
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Fondation FondaMental, Créteil, France; Inserm, UPS, ToNIC, service de psychiatrie et psychologie médicale, Centre expert dépression résistante, Toulouse NeuroImaging Center, université de Toulouse, CHU de Toulouse, Toulouse, France
| | - Hervé Javelot
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; EPSAN, Centre de Ressources et d'Expertise en PsychoPharmacologie du Grand'Est (CREPP GE), Brumath, France; UR7296, laboratoire de pharmacologie, faculté de médecine de Strasbourg, Centre de recherche en biomédecine de Strasbourg (CRBS), Strasbourg, France
| | - Bénédicte Nobile
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Fondation FondaMental, Créteil, France; Department of Emergency Psychiatry and Acute Care, CHU de Montpellier, Montpellier, France; Inserm, CNRS, IGF, University of Montpellier, Montpellier, France
| | - Ludivine Boudieu
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Department of Psychiatry, CHU of Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Bruno Aouizerate
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Fondation FondaMental, Créteil, France; Centre hospitalier Charles-Perrens, université de Bordeaux, Bordeaux, France; Inrae, NutriNeuro, U1286, University of Bordeaux, Bordeaux, France
| | - Pierre-Michel Llorca
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Fondation FondaMental, Créteil, France; Department of Psychiatry, CHU of Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Thomas Charpeaud
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Clinique du Grand Pré, Durtol, France
| | - Djamila Bennabi
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Fondation FondaMental, Créteil, France; Centre d'investigation clinique, CIC-Inserm-1431, centre hospitalier universitaire de Besançon, Besançon, France
| | - Antoine Lefrere
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Fondation FondaMental, Créteil, France; UMR7289, CNRS, pôle de psychiatrie, institut de neurosciences de la Timone, Aix-Marseille université Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - Ludovic Samalin
- French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), Saint-Germain-en-Laye, France; Fondation FondaMental, Créteil, France; Department of Psychiatry, CHU of Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France.
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Nobile B, Courtet P. Daridorexant: Caution Is Needed About Suicidal Risk in Depressed Patients With Insomnia-Reply to Palagini et al. J Clin Psychiatry 2023; 84:23lr14892a. [PMID: 37428089 DOI: 10.4088/jcp.23lr14892a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, Créteil, France
- Corresponding Author: Bénédicte Nobile, PharmD, PhD, IGF, La Colombiere Hospital, 39, Ave Charles Flahault, BP 34493, 34093 Montpeiller Cedex 5, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, Créteil, France
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Porras-Segovia A, Nobile B, Olié E, Gourguechon-Buot E, Garcia EB, Gorwood P, Abascal-Peiró S, Courtet P. Factors associated with transitioning from suicidal ideation to suicide attempt in the short-term: Two large cohorts of depressed outpatients. J Affect Disord 2023; 335:155-165. [PMID: 37182605 DOI: 10.1016/j.jad.2023.05.018] [Citation(s) in RCA: 3] [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: 08/12/2022] [Revised: 04/18/2023] [Accepted: 05/06/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND This study explores factors associated with transitioning from recent suicidal ideation (SI) to suicide attempt (SA) in depressed outpatients. METHODS This is a case-control study nested in two cohorts (LUEUR and GENESE) of depressed adult outpatients recruited in France and followed up for six weeks. SI, depression, anxiety, insomnia, impulsivity, and hopelessness were assessed with validated scales. Differences between patients with SI who attempted suicide during follow up and those who did not were explored using logistic regressions. RESULTS There was a slight majority of females in both cohorts. Mean age was 47.2 years in LUEUR and 49.4 years in GENESE. Of the 3785 participants in the LUEUR cohort, 72 (2.1 %) attempted suicide within the 6-week period vs. 19 of the 2698 participants (0.7 %) in the GENESE cohort. In LUEUR, factors associated with SA within the 6-week period were lifetime history of SA (OR = 5.35, 95 % CI = 3.30-8.66), high SI at baseline (OR = 3.87, 95 % CI = 2.4-6.24), associated treatments (OR = 3.28, 95 % CI = 2.00-5.38), and less improvement over follow-up in the following symptoms: SI (OR = 3.64, 95 % CI = 1.89-7.02), depression (OR = 3.66, 95 % CI = 1.76-7.62), and anxiety (OR = 3.26, 95 % CI = 1.46-7.27). In GENESE, associated factors were lifetime history of SAs (OR = 9.93, 95 % CI = 3.83-25.80), and less improvement in SI (OR = 9.20, 95 % CI = 3.61-23.44). LIMITATIONS Heterogeneity of cohorts prevented from performing a pooled analysis with a greater sample size. CONCLUSIONS In depressed outpatients, lack of improvement was strongly associated with a short-term SA, particularly in patients with a history of previous SAs. Fast acting treatment on SI and depression may help prevent SAs.
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Affiliation(s)
- Alejandro Porras-Segovia
- Instituto de Investigación Fundación Jiménez Díaz, Madrid, Spain; Division of Psychiatry, Imperial College London, London, UK.
| | - Bénédicte Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France
| | - Elia Gourguechon-Buot
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Enrique Baca Garcia
- Instituto de Investigación Fundación Jiménez Díaz, Madrid, Spain; University Hospital Fundación Jiménez Díaz, Madrid, Spain; Departamento de Psiquiatría, Hospital Rey Juan Carlos de Móstoles, Móstoles, Spain; Universidad Católica del Maule (Talca), Chile; Departamento de Psiquiatría, Hospital Central de Villalba, Madrid, Spain; Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Madrid, Spain; Nimes University Hospital, Nimes, France; CIBERSAM, Spain; Departamento de Psiquiatría, Universidad Autónoma de Madrid, Spain
| | - Philip Gorwood
- Instituto de Investigación Fundación Jiménez Díaz, Madrid, Spain
| | - Sofía Abascal-Peiró
- University Hospital Fundación Jiménez Díaz, Madrid, Spain; Departamento de Psiquiatría, Hospital Rey Juan Carlos de Móstoles, Móstoles, Spain
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, 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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Nobile B, Belzeaux R, Aouizerate B, Dubertret C, Haffen E, Llorca PM, Roux P, Polosan M, Schwan R, Walter M, Rey R, Januel D, Leboyer M, Bellivier F, Etain B, Courtet P, Olié E. Clinical characteristics associated with discrepancies between self- and clinician-rated suicidal ideation in patients with bipolar disorder (FACE-BD cohort). Psychiatry Res 2023; 321:115055. [PMID: 36680982 DOI: 10.1016/j.psychres.2023.115055] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/27/2022] [Accepted: 01/07/2023] [Indexed: 01/11/2023]
Abstract
Suicidal ideation (SI) is a major suicide risk factor; therefore, it is crucial to identify individuals with SI. Discrepancies between the clinicians and patients' estimation of SI may lead to under-evaluating the suicide risk. Yet, studies on discrepancies between self- and clinician-rated SI are lacking, although identifying the patients' sociodemographic and clinical characteristics associated with such discrepancies might help to reduce the under-evaluation risk. Therefore, the aim of this study was to identify features associated with SI rating discrepancies in patients with bipolar disorder (BD) because of the high prevalence of suicide in this population. Among the patients recruited by the French network of FondaMental expert centers for BD, patients with SI (i.e. ≥2 for item 12 of the Quick Inventory of Depressive Symptomatology-Self Report and/or ≥3 for item 10 of the clinician-rated Montgomery and Åsberg Depression Rating Scale) were selected and divided in concordant (i.e. SI in both self- and clinician-rated questionnaires; n = 130; 25.6%), and discordant (i.e. SI in only one questionnaire; n = 377; 74.4%). Depression severity was the feature most associated with SI evaluation discrepancy, especially in patients with SI identified only with the self-rated questionnaire. Clinician may under-evaluate SI presence in patients with low depression level.
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, Créteil F-94000, France.
| | - Raoul Belzeaux
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; FondaMental Foundation, Créteil F-94000, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Bruno Aouizerate
- FondaMental Foundation, Créteil F-94000, France; Centre Hospitalier Charles Perrens, Bordeaux, France; Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux, France
| | - Caroline Dubertret
- FondaMental Foundation, Créteil F-94000, France; Université Paris Cité, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Emmanuel Haffen
- FondaMental Foundation, Créteil F-94000, France; Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, 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
| | - Paul Roux
- FondaMental Foundation, Créteil F-94000, France; Université Paris-Saclay, UVSQ, CESP UMR1018, DevPsy-DisAP, Centre Hospitalier de Versailles, Pôle de Psychiatrie et Santé Mentale, 78157 Le Chesnay, France
| | - Mircea Polosan
- FondaMental Foundation, Créteil F-94000, France; Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Raymund Schwan
- FondaMental Foundation, Créteil F-94000, France; Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - Michel Walter
- FondaMental Foundation, Créteil F-94000, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - Romain Rey
- FondaMental Foundation, Créteil F-94000, France; INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Dominique Januel
- FondaMental Foundation, Créteil F-94000, France; Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France
| | - Marion Leboyer
- FondaMental Foundation, Créteil F-94000, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, 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), Créteil, France
| | - Frank Bellivier
- FondaMental Foundation, Créteil F-94000, France; Université Paris Cité, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - Bruno Etain
- FondaMental Foundation, Créteil F-94000, France; Université Paris Cité, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
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- FondaMental Foundation, Créteil F-94000, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, Créteil F-94000, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, Créteil F-94000, France
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,Corresponding author: Bénédicte Nobile, PharmD, PhD, IGF, La Colombiere Hospital, 39, avenue Charles Flahault, BP 34493, 34093 Montpeiller cedex 5, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
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9
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Nobile B, Eiden C, Peyriere H, Courtet P. [The dangers of tramadol for suicide risk]. Rev Prat 2022; 72:931. [PMID: 36512004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Céline Eiden
- Département de pharmacologie médicale et toxicologie, hôpital Lapeyronie, CHU Montpellier, France
| | - Hélène Peyriere
- Département de pharmacologie médicale et toxicologie, hôpital Lapeyronie, CHU Montpellier, France
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Abstract
BACKGROUND The opioid tramadol is used as analgesic drug, and more recently was also proposed for the management of major depressive disorder. However, growing evidence suggests a link between opioid system dysfunction and suicidal behaviors, raising the question of tramadol use in view of the high addictive and suicidal risk. Here, we present the case of a young adult woman with multiple suicide attempts related to tramadol addiction. CASE PRESENTATION A 25-year-old woman was admitted for suicide attempt by phlebotomy in the Department of Psychiatric Emergency and Acute Care, Montpellier (France), in March 2020. The suicide attempt occurred 3 days after an abrupt tramadol withdrawal. In 2018, due to spinal disc herniation, she had a first prescription of tramadol to which she became addicted. The patient described an effect on psychological pain and suicidal ideation. However, she had to increase tramadol dose to obtain the desired effects, and for several months her intake was 2 000 mg per day. When she could not obtain tramadol any longer, suicidal ideation and psychological pain increased, leading to the suicide attempt. At the time of a worldwide opioid crisis that contributes to increasing suicidal behaviors, this case raises questions about tramadol prescription (often considered to be less addictive and with lower abuse potential) to individuals at risk of suicide.
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France. .,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France. .,FondaMental Foundation, Montpellier, France.
| | - Marine Bonnin
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Montpellier, France
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11
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Nobile B, Olié E, Dubois J, Benramdane M, Guillaume S, Courtet P. Characterization of suicidal depression: a one-year prospective study. Eur Psychiatry 2022; 65:1-40. [PMID: 35431010 PMCID: PMC9058444 DOI: 10.1192/j.eurpsy.2022.16] [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: 11/06/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/24/2022] Open
Abstract
Background Suicidal ideation (SI) is an important risk factor of death by suicide. Recent data suggest that suicidal depression (i.e., moderate to severe depression with SI) could be a specific depression subtype with worse clinical outcomes than nonsuicidal depression (i.e., without SI). Methods Among 898 French adult inpatients (67% women, mean age: 41.23 [SD: 14.33]) with unipolar depression, 71.94% had moderate to severe depression (defined using the cut-offs of validated scales: beck depression inventory, clinician-rated 30-item inventory depression symptomatology, and quick inventory of depressive symptomatology) and among them, 63.6% had SI according to the suicidal item (score ≥ 2) of the depression scale they filled in. Clinical features (anxiety, psychological pain, and hopelessness) were assessed at baseline. The occurrence of a suicide attempt (SA) or a suicide event (SE) (i.e., actual, aborted or interrupted SA, or hospitalization for SI) was recorded during the 1-year follow-up. The risk of actual SA and SE was compared between groups with adjusted Cox regression models. Results The risk of actual SA and SE during the follow-up was 2- and 1.8-fold higher, respectively, in patients with suicidal depression, independently of potential cofounders such as history of lifetime SA, age, sex, and baseline depression severity. Conclusions Suicidal depression is associated with poorer prognosis in terms of actual SA/SE, despite optimal care (i.e., care in a hospital department specialized in the management of suicidal crisis). Specific therapeutic strategies might be needed for these patients.
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
- FondaMental Foundation, Montpellier, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
- FondaMental Foundation, Montpellier, France
| | - Jonathan Dubois
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Myriam Benramdane
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
- FondaMental Foundation, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
- FondaMental Foundation, Montpellier, France
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12
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Nobile B, Olié E, Dubois J, Guillaume S, Gorwood P, Courtet P. Characteristics and treatment outcome of suicidal depression: Two large naturalistic cohorts of depressed outpatients. Aust N Z J Psychiatry 2022; 56:347-364. [PMID: 34281409 DOI: 10.1177/00048674211025697] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The emergence of new drugs for managing suicidal ideation (e.g. ketamine) raises the question of whether suicidal depression (i.e. moderate to severe depression with concomitant suicidal ideation) is a specific depression phenotype. Therefore, this study characterized patients with suicidal depression (baseline clinical characteristics, suicidal ideation and depression evolutions, suicide risk) in two large cohorts of outpatients with depression. METHODS LUEUR and GENESE are two large, prospective, naturalistic cohorts of French adult outpatients with depression (Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria), treated and followed up for 6 weeks. Depression severity was assessed with the Hospital Anxiety and Depression Scale, and suicidal ideation with the suicidal item of the Montgomery-Åsberg Depression Rating Scale. Patients with moderate or severe depression (Hospital Anxiety and Depression Scale-Depression subscale score >11) were selected and classified as without suicidal ideation (suicidal item of the Montgomery-Åsberg Depression Rating Scale <2), with moderate suicidal ideation (suicidal item of the Montgomery-Åsberg Depression Rating Scale [2; 3]) and with severe suicidal ideation (suicidal item of the Montgomery-Åsberg Depression Rating Scale ⩾4). RESULTS Baseline clinical features were more severe (e.g. higher anxiety and depression scores) in depressed patients with moderate/severe suicidal ideation. Depression remission after treatment was less frequent among patients with severe suicidal ideation. The risk of suicide attempt during the follow-up was threefold higher in patients with suicidal ideation among those 10% had persistent suicidal ideation. CONCLUSION Suicidal depression could be a specific depression phenotype with more severe clinical characteristics, less frequent depression remission, suicidal ideation persistence and higher suicide attempt risk, despite antidepressant treatment. It seems that novel therapeutic strategies could be needed.
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France.,IGF, Hôpital La Colombière, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France.,IGF, Hôpital La Colombière, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Jonathan Dubois
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France.,IGF, Hôpital La Colombière, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Sebastien Guillaume
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France.,IGF, Hôpital La Colombière, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Philip Gorwood
- Inserm UMRS1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France.,IGF, Hôpital La Colombière, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
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13
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Strumila R, Nobile B, Korsakova L, Lengvenyte A, Olie E, Lopez-Castroman J, Guillaume S, Courtet P. Psilocybin, a Naturally Occurring Indoleamine Compound, Could Be Useful to Prevent Suicidal Behaviors. Pharmaceuticals (Basel) 2021; 14:ph14121213. [PMID: 34959614 PMCID: PMC8704767 DOI: 10.3390/ph14121213] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 12/24/2022] Open
Abstract
The available interventions for people who are at risk of suicide have limited efficacy. Recently, research on new mental health treatments has started to consider psychedelic compounds, particularly psilocybin, a molecule with a few thousand years of history of use in human societies. The possible effects of psilocybin on suicidal ideation and behaviors have not been specifically studied yet; however, the current knowledge on the suicidal process and the available data on es/ketamine suggest that psylocibin could be used to modulate the thoughts and behavioral patterns in individuals who are at risk of suicidal behaviors. Here, we summarize the available evidence on the possible mechanisms underlying psilocybin positive effects on suicide risk. Major pathways related to suicidal behaviors that might be modulated by psylocibin include serotonin receptors. Specifically, psylocibin directly stimulates the serotonin 2A receptor (5HT2A), targeting the inflammatory and oxidative stress pathways and leading to a rapid increase in brain plasticity and inflammation suppression and increases in cognitive flexibility, spirituality, and empathy. We also present preliminary epidemiological data and provide a rationale for studying psilocybin in individuals with suicidal ideation or who are at risk of suicidal behaviors. This review presents a framework to understand the basis for psilocybin use in individuals who are at risk of suicidal behaviors and calls for clinical studies.
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Affiliation(s)
- Robertas Strumila
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 34000 Montpellier, France; (A.L.); (E.O.); (S.G.); (P.C.)
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34295 Montpellier, France;
- Psychiatric Clinic, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
- Correspondence: (R.S.); (B.N.)
| | - Bénédicte Nobile
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 34000 Montpellier, France; (A.L.); (E.O.); (S.G.); (P.C.)
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34295 Montpellier, France;
- Correspondence: (R.S.); (B.N.)
| | - Laura Korsakova
- Laboratory of Preclinical Drug Investigation, Institute of Cardiology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Aiste Lengvenyte
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 34000 Montpellier, France; (A.L.); (E.O.); (S.G.); (P.C.)
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34295 Montpellier, France;
| | - Emilie Olie
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 34000 Montpellier, France; (A.L.); (E.O.); (S.G.); (P.C.)
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34295 Montpellier, France;
| | - Jorge Lopez-Castroman
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34295 Montpellier, France;
- Department of Adult Psychiatry, Nimes University Hospital, 44307 Nimes, France
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28001 Madrid, Spain
| | - Sébastien Guillaume
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 34000 Montpellier, France; (A.L.); (E.O.); (S.G.); (P.C.)
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34295 Montpellier, France;
| | - Philippe Courtet
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 34000 Montpellier, France; (A.L.); (E.O.); (S.G.); (P.C.)
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34295 Montpellier, France;
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14
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Nobile B, Durand M, Olié E, Guillaume S, Molès JP, Haffen E, Courtet P. The Anti-inflammatory Effect of the Tricyclic Antidepressant Clomipramine and Its High Penetration in the Brain Might Be Useful to Prevent the Psychiatric Consequences of SARS-CoV-2 Infection. Front Pharmacol 2021; 12:615695. [PMID: 33767623 PMCID: PMC7985338 DOI: 10.3389/fphar.2021.615695] [Citation(s) in RCA: 9] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/04/2021] [Indexed: 12/12/2022] Open
Abstract
At the time of writing (December 2020), coronavirus disease 2019 (COVID-19) has already caused more than one million deaths worldwide, and therefore, it is imperative to find effective treatments. The “cytokine storm” induced by Severe Acute Respiratory Syndrome-Coronavirus type 2 (SARS-CoV-2) is a good target to prevent disease worsening, as indicated by the results obtained with tocilizumab and dexamethasone. SARS-CoV-2 can also invade the brain and cause neuro-inflammation with dramatic neurological manifestations, such as viral encephalitis. This could lead to potentially incapacitating long-term consequences, such as the development of psychiatric disorders, as previously observed with SARS-CoV. Several pathways/mechanisms could explain the link between viral infection and development of psychiatric diseases, especially neuro-inflammation induced by SARS-CoV-2. Therefore, it is important to find molecules with anti-inflammatory properties that penetrate easily into the brain. For instance, some antidepressants have anti-inflammatory action and pass easily through the blood brain barrier. Among them, clomipramine has shown very strong anti-inflammatory properties in vitro, in vivo (animal models) and human studies, especially in the brain. The aim of this review is to discuss the potential application of clomipramine to prevent post-infectious mental complications. Repositioning and testing antidepressants for COVID-19 management could help to reduce peripheral and especially central inflammation and to prevent the acute and particularly the long-term consequences of SARS-CoV-2 infection.
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Affiliation(s)
- B Nobile
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - M Durand
- Pathogenesis and Control of Chronic Infection, University of Montpellier, INSERM, EFS; CHU Montpellier, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - S Guillaume
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - J P Molès
- Pathogenesis and Control of Chronic Infection, University of Montpellier, INSERM, EFS; CHU Montpellier, Montpellier, France
| | - E Haffen
- FondaMental Foundation, Créteil, France.,Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, Université de Franche-Comté, Besancon, France
| | - P Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
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15
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Nobile B, Dubois J, Aouizerate B, Aubin V, Loftus J, Bellivier F, Belzeaux R, Dubertret C, Gard S, Haffen E, Schwan R, Llorca PM, Passerieux C, Roux P, Polosan M, Etain B, Leboyer M, Courtet P, Olié E. Characterization of depressed bipolar patients with current suicidal ideation. Aust N Z J Psychiatry 2021; 55:289-304. [PMID: 33043675 DOI: 10.1177/0004867420963744] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Bipolar disorder is one of the most frequent psychiatric disorders among suicidal patients. A large part of patients with bipolar disorder (30-50%) will attempt suicide. Suicidal ideation being a major risk factor of suicidal act, it is crucial to better characterize patients with suicidal bipolar depression (i.e. depression with current suicidal ideation). The aim of this study was to characterize suicidal bipolar depressed patients in comparison with non-suicidal depressed patients in terms of clinical characteristics, evolution of depression and suicidal ideation course over time, and risk of suicide attempt during follow-up. METHODS Among patients with bipolar disorder recruited from the network of FondaMental expert centres for bipolar disorder between 2009 and 2017, we selected patients with at least mild depression (Montgomery-Åsberg Depression Rating Scale total score >11) and without current manic symptomatology (Young Mania Rating Scale total score <7) at baseline (N = 938). Suicidal depression was defined by a baseline score ⩾2 for item 12 of the Quick Inventory of Depressive Symptomatology-Self Report (N = 271, 28.9%). Non-suicidal depression was defined by a baseline item 12 of the Quick Inventory of Depressive Symptomatology-Self Report score <2 (N = 667, 71.1%). A subsample of about 300 patients (with or without suicidal ideation at baseline) was followed up for 2 years. RESULTS Baseline clinical features (e.g. depression severity, childhood trauma, global functioning) were more severe in patients with than without suicidal depression. Suicidal patients tended to remain more suicidal throughout the follow-up than patients without suicidal ideation at baseline (3.4-fold higher risk of persistent suicidal ideation at the 2-year visit despite an improvement in depressive symptomatology). CONCLUSIONS Depressed bipolar disorder patients reporting suicidal ideation had more severe clinical features at baseline and were more prone to report persistent suicidal ideation during the follow-up, independently of thymic state. Clinicians should closely monitor this subgroup of patients.
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France and PSNREC, University of Montpellier, INSERM, CHU of Montpellier, Montpellier, France.,Fondation FondaMental, Créteil, France
| | - Jonathan Dubois
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France and PSNREC, University of Montpellier, INSERM, CHU of Montpellier, Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France.,Charles-Perrens Hospital, Department of clinical and academic Psychiatry, Bordeaux.,France/NutriNeuro, UMR INRA 1286, University of Bordeaux, Bordeaux, France
| | - Valerie Aubin
- Psychiatric Center, Hospital Princess Grace, Monaco, France
| | - Joséphine Loftus
- Fondation FondaMental, Créteil, France.,Psychiatric Center, Hospital Princess Grace, Monaco, France
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France.,AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Fernand Widal, and INSERM UMRS 1144 and Université de Paris, 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
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, service de Psychiatrie et Addictologie. Hopital Louis Mourier, Colombes, Inserm U1266, Faculté de médecine, Université de Paris, France
| | - Sebastien Gard
- Fondation FondaMental, Créteil, France.,Charles-Perrens Hospital, Department of clinical and academic Psychiatry, Bordeaux
| | - Emmanuel Haffen
- Fondation FondaMental, Créteil, France.,Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, Université de Franche-Comté, UBFC
| | - Raymund Schwan
- Fondation FondaMental, Créteil, France.,Université de Lorraine; Centre Psychothérapique de Nancy, Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Nancy, France; INSERM U1114
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France.,Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France and Université Paris-Saclay, UVSQ, Inserm, CESP, Equipe "PsyDev", 94807, Villejuif, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France.,Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France and Université Paris-Saclay, UVSQ, Inserm, CESP, Equipe "PsyDev", 94807, Villejuif, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France.,Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France and Université Paris-Saclay, UVSQ, Inserm, CESP, Equipe "PsyDev", 94807, Villejuif, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France.,AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Fernand Widal, and INSERM UMRS 1144 and Université de Paris, Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France.,AP-HP, Département Médico-universitaire de Psychiatrie et d'addictologie (DMU ADAPT), Hôpitaux Universitaires Henri Mondor, Université Paris-est-Créteil, INSERM U955, équipe de Neuro-psychiatrie translationnelle, IMRB (Institut Mondor de Recherches Biomédicales), Créteil, France
| | | | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France and PSNREC, University of Montpellier, INSERM, CHU of Montpellier, Montpellier, France.,Fondation FondaMental, Créteil, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France and PSNREC, University of Montpellier, INSERM, CHU of Montpellier, Montpellier, France.,Fondation FondaMental, Créteil, France
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Abstract
PURPOSE OF REVIEW The aim of this review was to analyze COVID-19 effect on the biological features of suicidal vulnerability and its interaction with suicide-related biological pathways. We carried out a narrative review of international publications on the interactions of COVID-19 with the biological bases of suicide. RECENT FINDINGS We hypothesize that SARS-CoV-2 interacts with multiple biological processes that underlie suicidal behavior, such as the renin-angiotensin system, nicotinic receptors, and central and systemic inflammation. Social distancing measures may also worsen subjective or objective social disconnection, thus increasing the risk of suicide. Interestingly, the drugs used to prevent suicide could be promising options to counteract brain damage caused by this coronavirus. SARS-CoV-2 interacts with multiple biological pathways involved in suicide and opens a new window for understanding the suicidal process. The development of suicide prevention treatments in the context of a pandemic may benefit from knowledge on these interactions.
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Affiliation(s)
- I Conejero
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.
| | - B Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- FondaMental Foundation, Créteil, France
| | - Ph Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- FondaMental Foundation, Créteil, France
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17
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Abstract
Suicide is a major public health problem. It becomes necessary and essential to identify persons at risk and to offer them an appropriate care. Entry in the DSM 5 of suicidal behavior (SB) as a disease to study is a first step in its recognition as an independent disease with its own physiopathology. Long time considered as a consequence or as a symptom of others psychiatric diseases, there is actually no specific treatment of SB. Nevertheless, new ways of understanding of mechanisms underlying SB are emerging and could consequently lead to find new specific therapeutics. Understanding the role played by psychological pain in SB seems to be a good approach to decipher the physiopathology of SB. Furthermore, we are witnessing the emergence of potential specific therapeutics such as ketamine that has shown promising results in treating SB.
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Affiliation(s)
- Philippe Courtet
- Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Univ Montpellier, Inserm, CHU de Montpellier, Montpellier, France. - Département d'urgence et de post-urgence psychiatrique, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France
| | - Bénédicte Nobile
- Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Univ Montpellier, Inserm, CHU de Montpellier, Montpellier, France. - Département d'urgence et de post-urgence psychiatrique, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France
| | - Émilie Olié
- Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Univ Montpellier, Inserm, CHU de Montpellier, Montpellier, France. - Département d'urgence et de post-urgence psychiatrique, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France
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18
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Ramoz N, Hoertel N, Nobile B, Voegeli G, Nasr A, Le Strat Y, Courtet P, Gorwood P. Corticotropin releasing hormone receptor CRHR1 gene is associated with tianeptine antidepressant response in a large sample of outpatients from real-life settings. Transl Psychiatry 2020; 10:378. [PMID: 33154348 PMCID: PMC7644692 DOI: 10.1038/s41398-020-01067-y] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/29/2020] [Accepted: 10/19/2020] [Indexed: 11/19/2022] Open
Abstract
Polymorphisms of genes involved in the hypothalamic-pituitary-adrenocortical (HPA) axis have been associated with response to several antidepressant treatments in patients suffering of depression. These pharmacogenetics findings have been reported from independent cohorts of patients mostly treated with selective serotonin reuptake inhibitors, tricyclic antidepressant, and mirtazapine. Tianeptine, an atypical antidepressant, recently identified as a mu opioid receptor agonist, which prevents and reverses the stress induced by glucocorticoids, has been investigated in this present pharmacogenetics study. More than 3200 Caucasian outpatients with a major depressive episode (MDE) from real-life settings were herein analyzed for clinical response to tianeptine, a treatment initiated from 79.5% of the subjects, during 6-8 weeks follow-up, assessing polymorphisms targeting four genes involved in the HPA axis (NR3C1, FKPB5, CRHR1, and AVPR1B). We found a significant association (p < 0.001) between CRHR1 gene variants rs878886 and rs16940665, or haplotype rs878886*C-rs16940665*T, and tianeptine antidepressant response and remission according to the hospital anxiety and depression scale. Analyses, including a structural equation model with simple mediation, suggest a moderate effect of sociodemographic characteristics and depressive disorder features on treatment response in individuals carrying the antidepressant responder allele rs8788861 (allele C). These findings suggest direct pharmacological consequences of CRHR1 polymorphisms in the antidepressant tianeptine response and remission, in MDE patients. This study replicates the association of the CRHR1 gene, involved in the HPA axis, with (1) a specificity attributed to treatment response, (2) a lower risk of chance finding, and in (3) an ecological situation.
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Affiliation(s)
- Nicolas Ramoz
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Vulnerability of Psychiatric and Addictive Disorders, 75014, Paris, France.
| | - Nicolas Hoertel
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Vulnerability of Psychiatric and Addictive Disorders, 75014 Paris, France ,grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (APHP), Corentin Celton Hospital, Department of Psychiatry, 92130 Issy-les-Moulineaux, France ,grid.10988.380000 0001 2173 743XUniversity of Paris, Paris, France
| | - Bénédicte Nobile
- grid.121334.60000 0001 2097 0141Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France
| | - Géraldine Voegeli
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Vulnerability of Psychiatric and Addictive Disorders, 75014 Paris, France ,grid.414435.30000 0001 2200 9055GHU Paris Psychiatrie et Neurosciences, Clinique des Maladies Mentales et de l’Encéphale (CMME), Centre Hospitalier Sainte-Anne, Paris, France
| | - Ariane Nasr
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Vulnerability of Psychiatric and Addictive Disorders, 75014 Paris, France
| | - Yann Le Strat
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Vulnerability of Psychiatric and Addictive Disorders, 75014 Paris, France ,grid.50550.350000 0001 2175 4109Service de Psychiatrie, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes, France
| | - Philippe Courtet
- grid.121334.60000 0001 2097 0141Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France
| | - Philip Gorwood
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Vulnerability of Psychiatric and Addictive Disorders, 75014 Paris, France ,grid.414435.30000 0001 2200 9055GHU Paris Psychiatrie et Neurosciences, Clinique des Maladies Mentales et de l’Encéphale (CMME), Centre Hospitalier Sainte-Anne, Paris, France
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19
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Nobile B, Durand M, Courtet P, Van de Perre P, Nagot N, Molès JP, Olié E. Could the antipsychotic chlorpromazine be a potential treatment for SARS-CoV-2? Schizophr Res 2020; 223:373-375. [PMID: 32773341 PMCID: PMC7381925 DOI: 10.1016/j.schres.2020.07.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/10/2020] [Accepted: 07/21/2020] [Indexed: 12/27/2022]
Affiliation(s)
- B Nobile
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.
| | - M Durand
- Pathogenesis and Control of Chronic Infection, INSERM, EFS, Université de Montpellier, Montpellier, France
| | - P Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France; FondaMental Foundation, France
| | - P Van de Perre
- Pathogenesis and Control of Chronic Infection, INSERM, EFS, Université de Montpellier, Montpellier, France
| | - N Nagot
- Pathogenesis and Control of Chronic Infection, INSERM, EFS, Université de Montpellier, Montpellier, France; Department of Medical Information, CHU Montpellier, France
| | - J P Molès
- Pathogenesis and Control of Chronic Infection, INSERM, EFS, Université de Montpellier, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France; FondaMental Foundation, France
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20
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Nobile B, Durand M, Olié E, Guillaume S, Molès JP, Haffen E, Courtet P. Clomipramine Could Be Useful in Preventing Neurological Complications of SARS-CoV-2 Infection. J Neuroimmune Pharmacol 2020; 15:347-348. [PMID: 32601885 PMCID: PMC7324075 DOI: 10.1007/s11481-020-09939-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/23/2020] [Indexed: 12/20/2022]
Affiliation(s)
- B Nobile
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France. .,PSNREC, INSERM, CHU de Montpellier, University Montpellier, Montpellier, France.
| | - M Durand
- Pathogenesis and control of chronic infection, INSERM, EFS; CHU Montpellier, Montpellier, University of Montpellier, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,PSNREC, INSERM, CHU de Montpellier, University Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - S Guillaume
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,PSNREC, INSERM, CHU de Montpellier, University Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - J P Molès
- Pathogenesis and control of chronic infection, INSERM, EFS; CHU Montpellier, Montpellier, University of Montpellier, Montpellier, France
| | - E Haffen
- FondaMental Foundation, Créteil, France.,Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, Université de Franche-Comté, UBFC, Besançon, France
| | - P Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,PSNREC, INSERM, CHU de Montpellier, University Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
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21
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Affiliation(s)
- Philippe Courtet
- Université Montpellier, CHRU Montpellier, Montpellier, France 34090. .,PSNREC, Université Montpellier, INSERM, CHU de Montpellier, Montpellier, France,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Bénédicte Nobile
- PSNREC, Université Montpellier, INSERM, CHU de Montpellier, Montpellier, France,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
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22
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23
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Affiliation(s)
- Bénédicte Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
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24
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Nobile B, Ramoz N, Jaussent I, Gorwood P, Olié E, Castroman JL, Guillaume S, Courtet P. Polymorphism A118G of opioid receptor mu 1 (OPRM1) is associated with emergence of suicidal ideation at antidepressant onset in a large naturalistic cohort of depressed outpatients. Sci Rep 2019; 9:2569. [PMID: 30796320 PMCID: PMC6385304 DOI: 10.1038/s41598-019-39622-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 01/18/2019] [Indexed: 12/18/2022] Open
Abstract
Antidepressants have been the object of an international controversy for about thirty years. Some patients are inclined to develop suicidal ideation (SI) at antidepressant onset; this phenomenon is known as Treatment Emergent Suicidal Ideation (TESI), and it has conducted regulatory bodies to prompt warnings on antidepressants. Since, few studies have explored the pharmacogenomics of TESI. Given the growing body of evidence connecting the opioidergic system with suicidal behavior (particularly mu opioid receptor (MOR)), we decided to examine the relationship between two genetic polymorphisms (SNPs) in the opioidergic system and TESI in a sample of 3566 adult depressed outpatients. General practitioners and psychiatrists throughout France followed participants for 6 weeks after an initial prescription of tianeptine, an antidepressant treatment with mu agonism. Suicidal ideation was assessed with the item 10 of the Montgomery-Asberg Depression Rating Scale (item dedicated to SI) at baseline, and after 2 weeks, 4 weeks and 6 weeks. We analysed rs1799971 from the OPRM1 gene and rs105660 from the OPRK1 gene. Within the sample, 112 patients reported TESI while 384 did not. We found a significant association between AA genotype of rs1799971 and TESI even after adjustment for potential cofounders (OR = 1.93, 95% CI = [1.07; 3.49]; p-value = 0.03). On the other hand there were no significant association between rs1799971 and rs105560 with worsening of suicidal ideation or lifetime suicide attempts. Nevertheless, our results suggest a possible involvement of opioidergic system in TESI.
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Affiliation(s)
- B Nobile
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, Montpellier, France.
| | - N Ramoz
- INSERM UMRS1266, Institute of Psychiatry and Neuroscience of Paris, Université Sorbonne Paris Cité, Paris, France
| | - I Jaussent
- INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France
| | - Ph Gorwood
- INSERM UMRS1266, Institute of Psychiatry and Neuroscience of Paris, Université Sorbonne Paris Cité, Paris, France
| | - E Olié
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, Montpellier, France.,INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France.,FondaMental Foundation, Montpellier, France
| | - J Lopez Castroman
- INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France.,Department of Psychiatry, CHU Nimes, Nimes, France
| | - S Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, Montpellier, France.,INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France.,FondaMental Foundation, Montpellier, France
| | - Ph Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, Montpellier, France.,INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France.,FondaMental Foundation, Montpellier, France
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25
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Nobile B, Jaussent I, Gorwood P, Lopez Castroman J, Olié E, Guillaume S, Courtet P. Tianeptine is associated with lower risk of suicidal ideation worsening during the first weeks of treatment onset compared with other antidepressants: A naturalistic study. J Psychiatr Res 2018; 96:167-170. [PMID: 29073492 DOI: 10.1016/j.jpsychires.2017.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/09/2017] [Revised: 10/11/2017] [Accepted: 10/13/2017] [Indexed: 01/15/2023]
Abstract
Worsening of suicidal ideation during the first weeks of antidepressant treatment is a poorly understood phenomenon that prompted regulatory bodies to issue specific warnings. To better understand the causes of this phenomenon, this study compared the risk of suicidal ideation worsening in patients taking different types of antidepressant medications. To this aim, 4017 depressed adult outpatients were followed by general practitioners and psychiatrists throughout France for 6 weeks after prescription of an antidepressant treatment. The main study outcomes were to monitor changes (worsening or improvement) in suicidal ideation between baseline (treatment onset) and the study end (week 6) and to determine the remission rates according to the treatment type. Depression severity was assessed with the patient-administered Hospital Anxiety and Depression Scale and suicidal ideation with the 9-item Montgomery-Asberg Depression Rating Scale and the Hopelessness Scale. Use of tianeptine, a mu-opioid receptor agonist was significantly associated with a lower risk of suicidal ideation worsening compared with other antidepressants in the first 6 weeks of treatment. Conversely, remission rates were not significantly affected by the treatment type. Our results highlight a potential interest of opioid agonists to reduce the risk of worsening of suicidal ideation at antidepressant initiation.
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Affiliation(s)
- B Nobile
- Inserm U1061, France, University of Montpellier, Montpellier, France.
| | - I Jaussent
- Inserm U1061, France, University of Montpellier, Montpellier, France
| | - Ph Gorwood
- Inserm U675-U894, Centre of Psychiatry and Neurosciences, Paris, France
| | - J Lopez Castroman
- Inserm U1061, France, University of Montpellier, Montpellier, France; Department of Psychiatry, CHU Nimes, Nimes, France
| | - E Olié
- Inserm U1061, France, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; FondaMental Foundation, France
| | - S Guillaume
- Inserm U1061, France, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; FondaMental Foundation, France
| | - Ph Courtet
- Inserm U1061, France, University of Montpellier, Montpellier, France; Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; FondaMental Foundation, France
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Espada M, Munoz R, Nobile B, Kho R, Magtibay P, Castle E, Magrina J. Insulation Failures in Robotic and Laparoscopic Instrumentation: A Prospective Evaluation. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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