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Nohales L, Fort E, Pelloux S, Coste C, Leblanc P, De Ternay J, Wallon M, Rolland B, Fassier JB. Occupational, academic, and personal determinants of wellbeing and psychological distress in residents: results of a survey in Lyon, France. Front Psychol 2024; 15:1347513. [PMID: 38770261 PMCID: PMC11103015 DOI: 10.3389/fpsyg.2024.1347513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/11/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction The mental health of residents is a growing significant concern, particularly with respect to hospital and university training conditions. Our goal was to assess the professional, academic, and psychological determinants of the mental health status of all residents of the academy of Lyon, France. Materials and methods The Health Barometer of Lyon Subdivision Residents (BASIL) is an initiative which consists in proposing a recurrent online survey to all residents in medicine, pharmacy, and dentistry, belonging to the Lyon subdivision. The first of these surveys was conducted from May to July 2022. Participants should complete a series of validated questionnaires, including the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and the Kessler Psychological Distress Scale (K6), respectively, and ad-hoc questions assessing their global health and hospital and academic working conditions. A Directed Acyclic Graph (DAG) analysis was conducted prior to multivariable analyses, to explore the determinants associated with low wellbeing (WEMWBS <43) and high psychological distress (K6 ≥ 13). Results A total of 904 residents (response rate: 46.7%) participated in the survey. A low level of wellbeing was observed in 23% of participants, and was significantly associated to job strain (OR = 2.18; 95%CI = [1.32-3.60]), low social support (OR = 3.13; 95%CI = [2.05-4.78]) and the experience of very poor university teaching (OR = 2.51; 95%CI = [1.29-4.91]). A high level of psychological distress was identified for 13% of participants, and associated with low social support (OR = 2.41; 95%CI = [1.48-3.93]) and the experience of very poor university teaching (OR = 2.89, 95%CI = [1.16-7.21]). Conclusion Hospital working conditions, social support, and the perception of teaching quality, were three major determinants of wellbeing and psychological distress among health profession residents. Demographic determinants, personal life and lifestyle habits were also associated. This supports a multilevel action in prevention programs aiming to enhance wellbeing and reduce mental distress in this specific population and local organizational specificities.
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Affiliation(s)
- Ludivine Nohales
- Occupational Health and Medicine Department-CRPPE Hospices Civils de Lyon, Lyon, France
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
| | - Emmanuel Fort
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
| | - Sophie Pelloux
- Service de Santé Universitaire, University Claude Bernard Lyon, Lyon, France
| | - Clio Coste
- University Claude Bernard Lyon 1, Lyon, France
- Department of Radiotherapy, Léon Bérard Cancer Center, Lyon, France
| | - Pierre Leblanc
- Direction Qualité Usagers et Santé Populationnelle, Hospices Civils de Lyon, Lyon, France
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon INSERM U1290, Lyon, France
| | - Julia De Ternay
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon INSERM U1290, Lyon, France
- SUAL, Hospices Civils de Lyon, Bron, France
| | - Martine Wallon
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
- Waking Team, CRNL University Claude Bernard Lyon, Bron, France
| | - Benjamin Rolland
- SUAL Le Vinatier, Hospices Civils de Lyon, Bron, France
- Inserm U1028, CNRS UMR5292, University Claude Bernard Lyon 1, Bron, France
| | - Jean-Baptiste Fassier
- Occupational Health and Medicine Department-CRPPE Hospices Civils de Lyon, Lyon, France
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
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Touali R, Chappuy M, Berger-Vergiat A, Deletoille M, Ragonnet D, Rochet T, Poulet E, Tazarourte K, Haesebaert J, Michel P, Rolland B. Screening problematic use of substances among young subjects attending an emergency department, and subsequent treatment seeking. Encephale 2024; 50:170-177. [PMID: 37331923 DOI: 10.1016/j.encep.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Young individuals constitute a key population for the screening of problematic use of substances (PUS), but they are not likely to seek support and are hard to reach. Targeted screening programs should thus be developed in the places of care they may attend for other reasons, including emergency departments (EDs). We aimed to explore the factors associated with PUS in young people attending an ED; we measured the subsequent access to addiction care after ED screening. METHODS This was a prospective interventional single-arm study which included any individual aged between 16 and 25 years who attended the main ED of Lyon, France. Baseline data were sociodemographic characteristics, PUS status using self-report questionnaires and biological measures, level of psychological health, and history of physical/sexual abuse. Quick medical feedback was provided to the individuals presenting a PUS; they were advised to consult an addiction unit, and contacted by phone at three months to ask whether they had sought treatment. Baseline data were used to compare PUS and non-PUS groups using multivariable logistic regressions, to provide adjusted odds ratios (aORs) and 95% confidence intervals (95% CI), with age, sex, employment status, and family environment as the adjustment variables. The characteristics of PUS subjects who subsequently sought treatment were also assessed using bivariable analyses. RESULTS In total, 460 participants were included; 320 of whom (69.6%) were presenting current substance use, and 221 (48.0%) with PUS. Compared to non-PUS individuals, PUS ones were more likely to be males (aOR=2.06; 95% CI [1.39-3.07], P<0.001), to be older (per one-year increase: aOR=1.09; 95% CI [1.01-1.17], P<0.05), to have an impaired mental health status (aOR=0.87; 95% CI [0.81-0.94], P<0.001), and to have a history of sexual abuse (aOR=3.33; 95% CI [2.03-5.47], P<0.0001). Only 132 (59.7%) subjects with PUS could be reached by phone at 3 months, among whom only 15 (11.4%) reported having sought treatment. Factors associated with treatment seeking were social isolation (46.7% vs. 19.7%; P=0.019), previous consultation for psychological disorders (93.3% vs. 68.4%; P=0.044), lower mental health score (2.8±1.6 vs. 5.1±2.6; P<0.001), and post-ED hospitalization in a psychiatric unit (73.3% vs. 19.7%; P<0.0001). DISCUSSION/CONCLUSION EDs are relevant places to screen PUS in youth, but the level of seeking further treatment needs to be substantially improved. Offering systematic screening during an emergency room visit could allow for more appropriate identification and management of youth with PUS.
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Affiliation(s)
- Rdah Touali
- Service universitaire d'addictologie de Lyon (SUAL), CH Le Vinatier, pôle MOPHA, 95, boulevard Pinel, 69500 Bron, France; Research on Healthcare Performance RESHAPE, Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France.
| | - Mathieu Chappuy
- Service universitaire d'addictologie de Lyon (SUAL), CH Le Vinatier, pôle MOPHA, 95, boulevard Pinel, 69500 Bron, France; Service universitaire d'addictologie de Lyon (SUAL), groupement hospitalier centre, hospices civils de Lyon, Lyon, France; CSAPA, groupement hospitalier Nord, hospices civils de Lyon, Lyon, France; Service pharmaceutique, hospices civils de Lyon, Lyon, France
| | - Aurélie Berger-Vergiat
- Service universitaire d'addictologie de Lyon (SUAL), groupement hospitalier centre, hospices civils de Lyon, Lyon, France
| | - Marion Deletoille
- Service universitaire d'addictologie de Lyon (SUAL), groupement hospitalier centre, hospices civils de Lyon, Lyon, France
| | - Delphine Ragonnet
- Service universitaire d'addictologie de Lyon (SUAL), groupement hospitalier centre, hospices civils de Lyon, Lyon, France
| | - Thierry Rochet
- Service de Pédopsychiatrie, CH Le Vinatier, Bron, France
| | - Emmanuel Poulet
- Service de psychiatrie d'urgences, groupement hospitalier centre, hospices civils de Lyon, Lyon, France; Inserm U1028, CNRS UMR 5292, CRNL, université de Lyon, UCBL1, Bron, France
| | - Karim Tazarourte
- Research on Healthcare Performance RESHAPE, Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France; Service d'accueil des urgences, groupement hospitalier centre, hospices civils de Lyon, Lyon, France
| | - Julie Haesebaert
- Research on Healthcare Performance RESHAPE, Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France; Service recherche et épidémiologie cliniques, hospices civils de Lyon, pôle santé publique, 69003 Lyon, France
| | - Philippe Michel
- Research on Healthcare Performance RESHAPE, Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France; Service recherche et épidémiologie cliniques, hospices civils de Lyon, pôle santé publique, 69003 Lyon, France
| | - Benjamin Rolland
- Service universitaire d'addictologie de Lyon (SUAL), CH Le Vinatier, pôle MOPHA, 95, boulevard Pinel, 69500 Bron, France; Inserm U1028, CNRS UMR 5292, CRNL, université de Lyon, UCBL1, Bron, France
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Fiorito AM, Blasi G, Brunelin J, Chowdury A, Diwadkar VA, Goghari VM, Gur RC, Kwon JS, Quarto T, Rolland B, Spilka MJ, Wolf DH, Yun JY, Fakra E, Sescousse G. Blunted brain responses to neutral faces in healthy first-degree relatives of patients with schizophrenia: an image-based fMRI meta-analysis. Schizophrenia (Heidelb) 2024; 10:38. [PMID: 38503766 PMCID: PMC10951276 DOI: 10.1038/s41537-024-00452-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
Schizophrenia is characterized by the misattribution of emotional significance to neutral faces, accompanied by overactivations of the limbic system. To understand the disorder's genetic and environmental contributors, investigating healthy first-degree relatives is crucial. However, inconsistent findings exist regarding their ability to recognize neutral faces, with limited research exploring the cerebral correlates of neutral face processing in this population. Thus, we here investigated brain responses to neutral face processing in healthy first-degree relatives through an image-based meta-analysis of functional magnetic resonance imaging studies. We included unthresholded group-level T-maps from 5 studies comprising a total of 120 first-degree relatives and 150 healthy controls. In sensitivity analyses, we ran a combined image- and coordinate-based meta-analysis including 7 studies (157 first-degree relatives, 207 healthy controls) aiming at testing the robustness of the results in a larger sample of studies. Our findings revealed a pattern of decreased brain responses to neutral faces in relatives compared with healthy controls, particularly in limbic areas such as the bilateral amygdala, hippocampus, and insula. The same pattern was observed in sensitivity analyses. These results contrast with the overactivations observed in patients, potentially suggesting that this trait could serve as a protective factor in healthy relatives. However, further research is necessary to test this hypothesis.
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Affiliation(s)
- Anna M Fiorito
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France.
- Centre Hospitalier Le Vinatier, Bron, France.
| | - Giuseppe Blasi
- Group of Psychiatric Neuroscience, Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
- Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy
| | - Jérôme Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Asadur Chowdury
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Vaibhav A Diwadkar
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Vina M Goghari
- Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Tiziana Quarto
- Department of Humanities, University of Foggia, Foggia, Italy
| | - Benjamin Rolland
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France
- Centre Hospitalier Le Vinatier, Bron, France
| | | | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Eric Fakra
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Guillaume Sescousse
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France
- Centre Hospitalier Le Vinatier, Bron, France
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Leclerc L, Fakra E, Pignon B, Benyamina A, Gaillard R, Rolland B. Opinions of French psychiatrists on the regulatory status of cannabis: Results from the "PsyCan - Encéphale" national online survey. Encephale 2024:S0013-7006(23)00215-4. [PMID: 38311481 DOI: 10.1016/j.encep.2023.11.008] [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: 09/09/2023] [Revised: 09/30/2023] [Accepted: 11/02/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE To explore the opinions of French psychiatrists toward the legalization of medical or recreational use of cannabis in France. METHODS Psycan was an anonymous Internet survey conducted between September 28, 2021 and March 29, 2022, among subscribers of the Encéphale Online community, i.e., approximately 4000 French psychiatrists. Participants were asked to complete a structured questionnaire, collecting their socio-demographic features, clinical experience, opinions toward cannabis legalization, and perceived impact of cannabis derivatives for psychiatric disorders. Logistic regression models were used to identify factors associated with being for or against cannabis legalization. RESULTS In total, 413 psychiatrists answered the survey, of whom 253 (61.3%) declared being in favour of recreational cannabis, and 349 (84.4%) of medical cannabis. Being in favour of legalization of recreational cannabis was negatively associated with being female (odd ratio [OR]=0.61; 95% confidence interval [CI]=0.41-0.93), and with the frequency of meeting patients with cannabis use disorder (OR=0.60; 95%CI=0.43-0.83). Most respondents were concerned about the development of psychotic disorders. The most frequent pro-legalization arguments were improved prevention, better control of product content, and better protection of youth, respectively. Arguments against legalization were increased societal damages, increased impact on health, including mental health. CONCLUSIONS A majority of French psychiatrists were in favour of the marketing of medical cannabis, and, to a lesser extent, the legalization of recreational cannabis. For recreational cannabis, the proportion of pro-legalization psychiatrists was slightly more elevated than that found in the French general population.
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Affiliation(s)
- Léa Leclerc
- Service universitaire d'addictologie de Lyon (SUAL), hospices civils de Lyon, pavillon K, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - Eric Fakra
- Service de psychiatrie, CHU Saint-Étienne, université Jean-Monnet, Saint-Étienne, France; PSYR2, CRNL, CNRS UMR5292, Inserm U1028, UCBL1, université de Lyon, Bron, France
| | - Baptiste Pignon
- AP-HP, hôpitaux universitaires « H. Mondor », DMU IMPACT, Inserm, IMRB, Translational Neuropsychiatry, Fondation FondaMental, université Paris-Est-Créteil (UPEC), 94010 Créteil, France
| | - Amine Benyamina
- Centre d'enseignement, de recherche et de traitement des addictions, hôpital universitaire Paul-Brousse (AP-HP), université Paris- Saclay, France UR PSYCOMADD, Villejuif, France
| | - Raphaël Gaillard
- Inserm, UMR S894, Paris Cité University and Sorbonne University, Paris, France; Centre hospitalier Sainte-Anne, Paris, France; Centre de psychiatrie et neurosciences, Paris, France
| | - Benjamin Rolland
- Service universitaire d'addictologie de Lyon (SUAL), hospices civils de Lyon, pavillon K, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France; PSYR2, CRNL, CNRS UMR5292, Inserm U1028, UCBL1, université de Lyon, Bron, France
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Peyron E, Franck N, Labaume L, Rolland B. [The psychosocial rehabilitation in addiction medicine]. Encephale 2024; 50:91-98. [PMID: 37718195 DOI: 10.1016/j.encep.2023.07.001] [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: 04/06/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVES Addictive behaviors constitute complex behaviors that are usually related to social habits, such as substance use, gambling or gaming activities, or sexual or physical activity. They progressively overrun and stifle the routine habits of the concerned individuals, for example within their occupational or family spheres of life, as well as in their hobbies or in their main physiological functions, such as sleep or eating cycles. The rehabilitation approach of care integrates the objective of restoring the altered habits and functional rhythms, to optimize the clinical outcomes and improve quality of life of the concerned persons. METHODS Using a focused and narrative literature review, we aimed to explain what psychosocial rehabilitation consists in, and why this approach is particularly relevant for the addiction care, although to date it has remained insufficiently developed in the routine practice of many facilities. RESULTS The "rehab" approach, is first based on a structured and comprehensive assessment of the clinical and functional aspects of the patient, which secondarily allows to frame an individualized project of care that is closely built together with the patient. This project of care can integrate classical pharmacotherapeutic and psychotherapeutic tools, but it also emphasizes wider approaches for restoring some basic social and physiological functions of the concerned person, such as sleep, eating, social functioning, physical activity, or spiritual needs. Priorities among these different dimensions have to be defined by the concerned person. CONCLUSIONS The "rehab" approach is particularly relevant in addiction medicine. It represents a more global conception of care that conceives the recovery of social and physiological functioning as a core treatment objective for the concerned persons. The consequences for care organization are that many additional professionals should be integrated into the treatment schemes for addiction, including peer counselors, occupational therapists, physical activity coaches, or dieticians.
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Affiliation(s)
- Eric Peyron
- Service universitaire d'addictologie de Lyon (SUAL), hospices civils de Lyon, CH Le Vinatier, 95, boulevard Pinel, 69500 Lyon, France
| | - Nicolas Franck
- Centre ressource de réhabilitation psychosociale et de remédiation cognitive, pôle centre rive gauche, hôpital Le Vinatier, UMR 5229, CNRS & Claude-Bernard university Lyon 1, université de Lyon, Lyon, France
| | | | - Benjamin Rolland
- Service universitaire d'addictologie de Lyon (SUAL), hospices civils de Lyon, CH Le Vinatier, 95, boulevard Pinel, 69500 Lyon, France; PSYR2, CRNL, U1028, CNRS, UMR5292, Inserm, UCBL1, Lyon, France.
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Touali R, Chappuy M, De Ternay J, Berger-Vergiat A, Haesebaert J, Tazarourte K, Michel P, Rolland B. Patterns and determinants of cannabis use in youth visiting an urban emergency department in France. J Addict Dis 2023:1-9. [PMID: 38048209 DOI: 10.1080/10550887.2023.2279474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
BACKGROUND Cannabis use frequently starts during adolescence and young adulthood and can induce psychosocial and health consequences. Young people constitute hard-to-reach populations. Emergency departments could constitute a key care setting to identify cannabis use and its consequences among young people. OBJECTIVES To estimate the rate of cannabis use in the 16- to 25-year-old population visiting the emergency department for any reason and to assess the psychosocial factors associated with cannabis use. METHODS This was a cross-sectional study among young people who attended the emergency department, over 5-months. Data were sociodemographic characteristics, self-administered questionnaires for problematic substance use screening, and urine drug screening samples. They were classified in the cannabis use (CU) group if they had a positive urine screen or reported cannabis use in the previous month. Characteristics of individuals in the CU and non-CU groups were compared. RESULTS A total of 460 participants were included, of whom 105 were in the CU group. Cannabis users were more likely to be male (aOR = 1.85; [1.18-2.90]), to be unemployed (aOR = 1.77; [1.03-3.04]), to have a lower mental health status score (aOR = 0. 82; [0.75-0.90]), to report a history of sexual abuse (aOR = 2.99; [1.70-5.25]), and to have a positive AUDIT screen (aOR = 4.23; [2.61-6.86]). CONCLUSIONS The emergency department is a primary care setting for young people, which is conducive to screening for substance use. Cannabis users can be assessed and referred to adapt their treatment, given their lack of adherence to the traditional addictology care system.
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Affiliation(s)
- Rdah Touali
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
| | - Mathieu Chappuy
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Groupement Hospitalier Centre, Hospices Civils de Lyon, Service Universitaire d'Addictologie de Lyon (SUAL), Lyon, France
- CSAPA, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
- Service Pharmaceutique, Hospices Civils de Lyon, Lyon, France
| | - Julia De Ternay
- Groupement Hospitalier Centre, Hospices Civils de Lyon, Service Universitaire d'Addictologie de Lyon (SUAL), Lyon, France
| | - Aurélie Berger-Vergiat
- Groupement Hospitalier Centre, Hospices Civils de Lyon, Service Universitaire d'Addictologie de Lyon (SUAL), Lyon, France
| | - Julie Haesebaert
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
- Service recherche et épidémiologie cliniques, Hospices Civils de Lyon, pôle santé publique, Lyon, France
| | - Karim Tazarourte
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
- Service d'Accueil des Urgences, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Philippe Michel
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
- Service Promotion, prévention et santé populationnelle, HCL, pôle de santé publique, Lyon, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Groupement Hospitalier Centre, Hospices Civils de Lyon, Service Universitaire d'Addictologie de Lyon (SUAL), Lyon, France
- INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, Bron, France
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Petit G, Leclercq S, Quoilin C, Poncin M, Starkel P, Maurage P, Rolland B, Dricot L, De Timary P. Links between psychopathological symptoms and cortical thickness in men with severe alcohol use disorder: A Magnetic Resonance Imaging study. Neuropsychopharmacol Rep 2023; 43:513-520. [PMID: 37013368 PMCID: PMC10739149 DOI: 10.1002/npr2.12331] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Anxiety and depression are psychopathological states frequently co-occurring with severe alcohol use disorder (SAUD). These symptoms generally disappear with abstinence but may persist in some patients, increasing the relapse risk. METHODS The cerebral cortex thickness of 94 male patients with SAUD was correlated with symptoms of depression and anxiety, both measured at the end (2-3 weeks) of the detoxification treatment. Cortical measures were obtained using surface-based morphometry implemented with Freesurfer. RESULTS Depressive symptoms were associated with reduced cortical thickness in the superior temporal gyrus of the right hemisphere. Anxiety level was correlated with lower cortical thickness in the rostral middle frontal region, inferior temporal region, and supramarginal, postcentral, superior temporal, and transverse temporal regions of the left hemisphere, as well as with a large cluster in the middle temporal region of the right hemisphere. CONCLUSIONS At the end of the detoxification stage, the intensity of depressive and anxiety symptoms is inversely associated with the cortical thickness of regions involved in emotions-related processes, and the persistence of the symptoms could be explained by these brain deficits.
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Affiliation(s)
- Géraldine Petit
- Psychiatric Emergency Unit, Department of Adult PsychiatryCliniques Universitaires Saint LucBrusselsBelgium
- Institute of Neuroscience, UCLouvainBrusselsBelgium
| | - Sophie Leclercq
- Laboratory of Nutritional PsychiatryInstitute of Neuroscience, UCLouvainBrusselsBelgium
| | | | - Marie Poncin
- Institute of Neuroscience, UCLouvainBrusselsBelgium
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY)UCLouvainLouvain‐la‐NeuveBelgium
| | - Peter Starkel
- Laboratory of Hepato‐GastroenterologyUCLouvainBrusselsBelgium
- Department of Hepato‐GastroenterologyCliniques Universitaires Saint LucBrusselsBelgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY)UCLouvainLouvain‐la‐NeuveBelgium
| | - Benjamin Rolland
- CH Le Vinatier, Service Universitaire d'Addictologie de Lyon (SUAL)BronFrance
| | | | - Philippe De Timary
- Institute of Neuroscience, UCLouvainBrusselsBelgium
- Laboratory of Hepato‐GastroenterologyUCLouvainBrusselsBelgium
- Department of Adult PsychiatryCliniques Universitaires Saint LucBrusselsBelgium
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Jurek L, Montègue S, Larrieu A, Icard C, Rolland B. Compared Profile of Late-Onset Versus Childhood-Onset ADHD: A Case-Control Study Among Treatment-Seeking Adult Patients. J Atten Disord 2023; 27:1630-1637. [PMID: 37565344 DOI: 10.1177/10870547231191756] [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] [Indexed: 08/12/2023]
Abstract
OBJECTIVE To compare the characteristics of childhood-onset versus late-onset Attention Deficit Hyperactivity Disorder (ADHD) in a sample of treatment-seeking patients. METHOD Among total of 101 adult patients who were recently diagnosed for ADHD, using the Diagnostic Interview for Adult ADHD (DIVA 2.0), 56 subjects exhibited childhood-onset ADHD, versus 45 displayed late-onset ADHD. Both groups were compared according to their sociodemographic, clinical, and neuropsychological features, providing crude (OR) and adjusted odds ratios (aOR), and their 95% confidence intervals [95% CI]. RESULTS Compared to late-onset ADHD, patients with childhood-onset had a lower educational score, (OR = 0.52; 95% CI [0.35, 0.76]), a greater score of impulsivity (aOR = 1.09; 95% CI [1.03, 1.16]), an increased number of hyperactive-impulsive ADHD symptoms (aOR = 1.9; 95% CI [1.46, 2.47]), and higher rates childhood trauma (aOR = 1.07; 95% CI [1.01, 1.13]), cannabis use disorder (aOR = 1.07; 95% CI [1.01, 1.13]), and working memory impairment. No difference was observed concerning age, sex, psychiatric symptoms, quality of life, and autonomy. CONCLUSION Childhood-onset adult ADHD displayed a more severe profile, relative to late-onset ADHD.
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Affiliation(s)
- Lucie Jurek
- Centre Hospitalier Le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
| | | | | | | | - Benjamin Rolland
- Centre Hospitalier Le Vinatier, Bron, France
- Hospices Civils de Lyon, Lyon, France
- Centre de Recherche en Neurosciences de Lyon, Bron, France
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9
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Chabert J, Lambert C, Cabé J, Cherpitel CJ, Rolland B, Moustafa F, Lesage P, Ragonnet D, Geneste J, Poulet E, Dematteis M, Naassila M, Chalmeton M, Llorca PM, Pereira B, De Chazeron I, Brousse G. Could reasons for admission help to screen unhealthy alcohol use in emergency departments? A multicenter French study. Front Psychiatry 2023; 14:1271076. [PMID: 38098633 PMCID: PMC10719849 DOI: 10.3389/fpsyt.2023.1271076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Abstract
Background Many patients admitted to general emergency departments (EDs) have a pattern of drinking that could lead to future alcohol-related complications. However, it is often difficult to screen these patients in the context of emergency. The aim of this study is to analyze whether reasons for admission could help to screen patients who have an unhealthy alcohol use. Method Patients were recruited among six public hospital ED in France, between 2012 and 2014. During a one-month period in each hospital, anonymous questionnaires including sociodemographic questions, AUDIT-C and RAPS4-QF were administered to each patients visiting the ED. The reason for admission of each patient was noted at the end of their questionnaire by the ED practitioner. Results Ten thousand Four hundred twenty-one patients were included in the analysis. Patients who came to the ED for injuries and mental disorders were more likely to report unhealthy alcohol use than non-harmful use or no use. Among male patients under 65 years old admitted to the ED for a mental disorder, 24.2% drank more than four drinks (40 g ethanol) in typical day at least four time a week in the last 12 months. Among these patients, 79.7% reported daily or almost daily heavy episodic drinking (HED, 60 g ethanol), and all were positive on the RAPS4-QF. Conclusion This study highlights that unhealthy alcohol use is frequent among ED patients and particularly among those who come for injuries or mental disorders. Men under 65 years old with a mental disorder require special attention because of their increased prevalence of daily or almost daily HED.
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Affiliation(s)
- Jonathan Chabert
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Céline Lambert
- Unité de Biostatistiques, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Julien Cabé
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | | | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon, Centre Hospitalier Le Vinatier, Hospices Civils de Lyon et Université de Lyon, Lyon, France
| | - Farès Moustafa
- Université Clermont Auvergne, INRAE, UNH, Clermont-Ferrand, France
| | - Patrick Lesage
- Centre Hospitalier Métropole Savoie, Service des Urgences, Chambéry, France
| | - Delphine Ragonnet
- Service Universitaire d’Addictologie de Lyon, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Julie Geneste
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Emmanuel Poulet
- Psychiatrie des Urgences - Groupement Hospitalier Edouard Herriot, EA 4615 « SIPAD », Université Lyon 1 - CH Le Vinatier, Lyon, France
| | - Maurice Dematteis
- Service Universitaire de Pharmaco-Addictologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Mickael Naassila
- INSERM UMRS1247-GRAP, Université Picardie Jules Verne, Amiens, France
| | - Maryline Chalmeton
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Pierre-Michel Llorca
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Bruno Pereira
- Unité de Biostatistiques, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Ingrid De Chazeron
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Georges Brousse
- Service de Psychiatrie Adulte et d’Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
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10
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Chappuy M, Lack P, David B, Penavayre G, Thabourey D, Landulpho M, Plasse A, Icard C, Bailly F, Boutahra F, Pradat P, Maynard M, Jauffret-Roustide M, de Ternay J, Rolland B. Willingness to use a drug consumption room among people who use drugs in Lyon, France, a city with no open scene of drug use (the TRABOUL survey). Harm Reduct J 2023; 20:149. [PMID: 37845698 PMCID: PMC10580523 DOI: 10.1186/s12954-023-00887-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Drug consumption rooms (DCRs) have been developed in cities with open drug scenes, with the aim to reduce drug-related harm. In Lyon, France's second-largest city, there is no distinct drug use area, which raised doubts regarding the need for a DCR. METHODS We conducted a face-to-face survey of 264 people who use drugs (PWUDs), recruited in harm reduction or addiction treatment centers, in the streets or in squats. We assess their willingness to use a DCR, and we collected sociodemographic and medical features. Bivariable comparisons and analyses adjusted for sociodemographic parameters explored the association between willing to use a DCR and other variables, thus providing crude (ORs) and adjusted odds ratios (aORs) and 95% confidence intervals (95% CI). RESULTS In total, 193 (73.1%) PWUDs accepted to participate (mean age 38.5 ± 9.3 years; 80.3% men). Among them, 64.2% declared willing to use a DCR. Being treatment-seeker (aOR 0.20, 95% CI [0.08-0.51]; p < 0.001) and not living alone (aOR 0.29; 95% CI [0.10-0.86], p = 0.025) were negatively associated with willing to use a DCR. By contrast, receiving precarity social insurance (aOR 4.12; 95% CI [1.86-9.14], p < 0.001), being seropositive for hepatitis C (aOR 3.60; 95% CI [1.20-10.84], p = 0.022), being cannabis user (aOR 2.45; 95% CI [1.01-5.99], p = 0.049), and reporting previous problems with residents (aOR 5.99; 95% CI [2.16-16.58], p < 0.001) or with the police (aOR = 4.85; 95% CI [1.43-16.39], p = 0.011) were positively associated. CONCLUSIONS PWUDs, especially the most precarious ones, largely supported the opening of a DCR in Lyon, a city with no open drug scene.
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Affiliation(s)
- Mathieu Chappuy
- Service d'Hépatologie et d'Addictologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon K, 5 Place d'Arsonval, 69002, Lyon, France
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Service Pharmaceutique, Hospices Civils de Lyon, Lyon, France
| | - Philippe Lack
- Service d'Hépatologie et d'Addictologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Baptiste David
- Service d'Hépatologie et d'Addictologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | - Christophe Icard
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
| | - François Bailly
- Service d'Hépatologie et d'Addictologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | | | - Pierre Pradat
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Marianne Maynard
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Marie Jauffret-Roustide
- Centre d'Étude Des Mouvements Sociaux (Inserm U1276/CNRS UMR 8044/EHESS), Paris, France
- British Columbia Center on Substance Use (BCCSU), British Columbia University, Vancouver, Canada
- Baldy Center on Law and Social Policy, Buffalo University, Buffalo, USA
| | - Julia de Ternay
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon K, 5 Place d'Arsonval, 69002, Lyon, France
- Univ. Lyon, UCBL1, INSERM U1028, CNRS UMR5292, CRNL, PSYR2, Lyon, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon K, 5 Place d'Arsonval, 69002, Lyon, France.
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France.
- Univ. Lyon, UCBL1, INSERM U1028, CNRS UMR5292, CRNL, PSYR2, Lyon, France.
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11
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Maurage P, Rolland B, Pitel AL, D'Hondt F. Five Challenges in Implementing Cognitive Remediation for Patients with Substance Use Disorders in Clinical Settings. Neuropsychol Rev 2023:10.1007/s11065-023-09623-1. [PMID: 37843739 DOI: 10.1007/s11065-023-09623-1] [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: 02/02/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
Many patients with substance use disorders (SUDs) present cognitive deficits, which are associated with clinical outcomes. Neuropsychological remediation might help rehabilitate cognitive functions in these populations, hence improving treatment effectiveness. Nardo and colleagues (Neuropsychology Review, 32, 161-191, 2022) reviewed 32 studies applying cognitive remediation for patients with SUDs. They underlined the heterogeneity and lack of quality of studies in this research field but concluded that cognitive remediation remains a promising tool for addictive disorders. We capitalize on the insights of this review to identify the key barriers that currently hinder the practical implementation of cognitive remediation in clinical settings. We outline five issues to be addressed, namely, (1) the integration of cognitive remediation in clinical practices; (2) the selection criteria and individual factors to consider; (3) the timing to be followed; (4) the priority across trained cognitive functions; and (5) the generalization of the improvements obtained. We finally propose that cognitive remediation should not be limited to classical cognitive functions but should also be extended toward substance-related biases and social cognition, two categories of processes that are also involved in the emergence and persistence of SUDs.
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Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-La-Neuve, Belgium.
- Faculté de Psychologie, Place du Cardinal Mercier, 10, B-1348, Louvain-La-Neuve, Belgium.
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, CH Le Vinatier, Lyon, France & PSYR, CRNL, INSERM U1028, CNRS UMR5292, UCBL1, Lyon, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience & Cognition, Lille, France
- Centre National de Ressources Et de Résilience Lille-Paris (CN2R), Lille, France
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12
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Torres C, Bauer G, Aubriet S, Scholtes C, Bailly F, Maynard-Muet M, Pradat P, Pillot-Meunier F, Lespine LF, Rolland B. Profile of patients with a positive HCV viral load in a large French psychiatric hospital (2019-2021): A case-control study. J Viral Hepat 2023; 30:830-833. [PMID: 37485610 DOI: 10.1111/jvh.13875] [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: 06/08/2023] [Revised: 07/10/2023] [Accepted: 07/16/2023] [Indexed: 07/25/2023]
Abstract
Hepatitis C virus (HCV) is highly prevalent in people with mental disorders (PWMDs). However, in the international context of HCV elimination, no previous study has explored the features of seropositive PWMDs with vs. without a positive viral load (VL). We retrospectively retrieved all HCV serology results of patients hospitalized in 2019, 2020 and 2021 in the second-largest psychiatric hospital of France. Using the medical records of all patients found seropositive for HCV, the following data were collected: sex (male, female), age (in years), previous history of illicit drug use except cannabis (yes or no) and previous history of incarceration (yes or no). We conducted a case-control comparison of these variables between the PWMDs who had and did not have a positive VL, thus providing odds ratios and 95% confidence intervals (ORs [95% CI]). In a total of 13,276 inpatients, 2540 (19.1%) underwent at least one HCV serology; 55 of them (2.16%) were found positive. A VL count was performed for 48 of them, finding 15 (31.3%) individuals with active HCV. Compared with those with a negative VL, these 15 individuals were less likely to have previous documented illicit drug use (OR = 0.18; 95% CI [0.05-0.68]) and to have been previously incarcerated (OR = 0.23; 95% CI [0.06-0.99]); age and sex did not statistically differ. In the context of HCV elimination, PWMDs yet to be treated for HCV are more likely to be those with no identified risk factor for HCV, which supports a strategy of systematic screening for HCV among PWMDs.
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Affiliation(s)
- Coralie Torres
- Department of General Medicine in Psychiatry, MOPHA, Le Vinatier Hospital, Bron, France
| | - Guillaume Bauer
- Department of General Medicine in Psychiatry, MOPHA, Le Vinatier Hospital, Bron, France
| | - Sabrina Aubriet
- Department of General Medicine in Psychiatry, MOPHA, Le Vinatier Hospital, Bron, France
| | - Caroline Scholtes
- INSERM U1052-Cancer Research Center of Lyon (CRCL), Lyon, France
- Department of Virology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - François Bailly
- Department of Virology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
- Department of Hepatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Marianne Maynard-Muet
- Center for Clinical Research (CRC), Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Pierre Pradat
- Center for Clinical Research (CRC), Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | | | | | - Benjamin Rolland
- Department of General Medicine in Psychiatry, MOPHA, Le Vinatier Hospital, Bron, France
- Academic Department of Addiction Medicine, Le Vinatier Hospital, Bron, France
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13
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Argote M, Sescousse G, Brunelin J, Baudin G, Schaub MP, Rabin R, Schnell T, Ringen PA, Andreassen OA, Addington JM, Brambilla P, Delvecchio G, Bechdolf A, Wobrock T, Schneider-Axmann T, Herzig D, Mohr C, Vila-Badia R, Rodie JU, Mallet J, Ricci V, Martinotti G, Knížková K, Rodriguez M, Cookey J, Tibbo P, Scheffler F, Asmal L, Garcia-Rizo C, Amoretti S, Huber C, Thibeau H, Kline E, Fakra E, Jardri R, Nourredine M, Rolland B. Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals. EClinicalMedicine 2023; 64:102199. [PMID: 37731936 PMCID: PMC10507201 DOI: 10.1016/j.eclinm.2023.102199] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
Background The association between cannabis use and positive symptoms in schizophrenia spectrum disorders is well documented, especially via meta-analyses. Yet, findings are inconsistent regarding negative symptoms, while other dimensions such as disorganization, depression, and excitement, have not been investigated. In addition, meta-analyses use aggregated data discarding important confounding variables which is a source of bias. Methods PubMed, ScienceDirect and PsycINFO were used to search for publications from inception to September 27, 2022. We contacted the authors of relevant studies to extract raw datasets and perform an Individual Participant Data meta-analysis (IPDMA). Inclusion criteria were: psychopathology of individuals with schizophrenia spectrum disorders assessed by the Positive and Negative Syndrome Scale (PANSS); cannabis-users had to either have a diagnosis of cannabis use disorder or use cannabis at least twice a week. The main outcomes were the PANSS subscores extracted via the 3-factor (positive, negative and general) and 5-factor (positive, negative, disorganization, depression, excitement) structures. Preregistration is accessible via Prospero: ID CRD42022329172. Findings Among the 1149 identified studies, 65 were eligible and 21 datasets were shared, totaling 3677 IPD and 3053 complete cases. The adjusted multivariate analysis revealed that relative to non-use, cannabis use was associated with higher severity of positive dimension (3-factor: Adjusted Mean Difference, aMD = 0.34, 95% Confidence Interval, CI = [0.03; 0.66]; 5-factor: aMD = 0.38, 95% CI = [0.08; 0.63]), lower severity of negative dimension (3-factor: aMD = -0.49, 95% CI [-0.90; -0.09]; 5-factor: aMD = -0.50, 95% CI = [-0.91; -0.08]), higher severity of excitement dimension (aMD = 0.16, 95% CI = [0.03; 0.28]). No association was found between cannabis use and disorganization (aMD = -0.13, 95% CI = [-0.42; 0.17]) or depression (aMD = -0.14, 95% CI = [-0.34; 0.06]). Interpretation No causal relationship can be inferred from the current results. The findings could be in favor of both a detrimental and beneficial effect of cannabis on positive and negative symptoms, respectively. Longitudinal designs are needed to understand the role of cannabis is this association. The reported effect sizes are small and CIs are wide, the interpretation of findings should be taken with caution. Funding This research did not receive any specific grant or funding. Primary financial support for authors was provided by Le Vinatier Psychiatric Hospital.
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Affiliation(s)
- Mathilde Argote
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Guillaume Sescousse
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Jérôme Brunelin
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Grégoire Baudin
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100, France
| | - Michael Patrick Schaub
- Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Zurich, Switzerland
| | - Rachel Rabin
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Thomas Schnell
- Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Petter Andreas Ringen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ole Andreas Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy und Psychosomatic, Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, CCM, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Wobrock
- Centre for Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
- Department of Psychiatry and Psychotherapy, Georg-August University Göttingen, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, Ludwig Maximillian University Munich, Munich, Germany
| | - Daniela Herzig
- Clienia Littenheid AG, Psychiatrische Tagesklinik Frauenfeld, 8500, Frauenfeld, Switzerland
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
| | - Christine Mohr
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
| | - Regina Vila-Badia
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Judith Usall Rodie
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Jasmina Mallet
- Université Paris Cité, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris France, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
| | - Valerio Ricci
- Department of Neuroscience, San Luigi Gonzaga University Hospital, 10043, Orbassano, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University of Chieti-Pescara, Italy
| | - Karolína Knížková
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
- General University Hospital in Prague, Czech Republic
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic
| | - Jacob Cookey
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Philip Tibbo
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Freda Scheffler
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Psychiatric Genetics Unit, Vall d’Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Christian Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Wilhelm Klein-Str. 27, 4002 Basel, Switzerland
| | - Heather Thibeau
- Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
| | - Emily Kline
- Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
- Department of Psychiatry, Boston University School of Medicine, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
| | - Eric Fakra
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Pôle Universitaire de Psychiatrie, CHU Saint-Etienne, Saint-Etienne, France
| | - Renaud Jardri
- Lille University, Inserm U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France
- CHU Lille, Fontan Hospital, Child & Adolescent Psychiatry Department & CURE Research Platform, Lille, France
| | - Mikail Nourredine
- Université Claude Bernard Lyon 1, Lyon, France
- Service de biostatistique, Hospices Civils de Lyon, Lyon, France
- Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
- Service Universitaire d’Addictologie de Lyon (SUAL), HCL, CH Le Vinatier, Lyon, France
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14
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Bramness JG, Leonhardt M, Dom G, Batalla A, Flórez Menéndez G, Mann K, Wurst FM, Wojnar M, Drummond C, Scafato E, Gual A, Ribeiro CM, Cottencin O, Frischknecht U, Rolland B. Education and Training in Addiction Medicine and Psychology across Europe: A EUFAS Survey. Eur Addict Res 2023:1-11. [PMID: 37557089 DOI: 10.1159/000531502] [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: 08/18/2022] [Accepted: 05/31/2023] [Indexed: 08/11/2023]
Abstract
INTRODUCTION Training in addiction medicine and addiction psychology is essential to ensure the quality of treatment for patients with substance use disorders. Some earlier research has shown varying training between countries, but no comprehensive study of addiction training across Europe has been performed. The present study by the European Federation for Addiction Societies (EUFAS) aimed to fill this gap. METHODS A Delphi process was used to develop a questionnaire on specialist training in addiction treatment in 24 European countries. The final questionnaire consisted of 14 questions on either addiction medicine or addiction psychology, covering the nature and content of the training and institutional approval, the number of academic professorial positions, and the estimated number of specialists in each country. RESULTS Information was not received from all countries, but six (Belgium, Denmark, Ireland, Italy, Poland, and Romania) reported no specialized addiction medicine training, while 17 countries did. Seven countries (Belgium, France, Ireland, Italy, Russia, Switzerland, and the Netherlands) reported no specialized addiction psychology training, while 14 countries did. Training content and evaluation methods varied. Approval was given either by governments, universities, or professional societies. Eighteen countries reported having professorships in addiction medicine and 12 in addiction psychology. The number of specialists in addiction medicine or psychology varied considerably across the countries. DISCUSSION The survey revealed a large heterogeneity in training in addiction medicine and addiction psychology across Europe. Several countries lacked formal training, and where formal training was present, there was a large variation in the length of the training. Harmonization of training, as is currently the case for other medical and psychology specializations, is warranted to ensure optimal treatment for this under-served patient group.
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Affiliation(s)
- Jørgen G Bramness
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
- Institute Clinical of Medicine, UiT - the Arctic University of Norway, Tromsø, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Faculty of Health Studies, VID - Specialized University, Oslo, Norway
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Albert Batalla
- Department of Psychiatry, University Medical Center, Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Gerardo Flórez Menéndez
- Addiction Treatment Unit, Department of Psychiatry, Complejo Hospitalario Universitario de Ourense, Galician Health System, Ourense, Spain
| | - Karl Mann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | | | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Colin Drummond
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emanuele Scafato
- Osservatorio Nazionale Alcol, WHO Collaborating Centre for Health Promotion and Research on Alcohol and Alcohol-related Problems, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Antoni Gual
- GRAC, Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, RETICS, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Olivier Cottencin
- Psychiatry and Addiction Medicine Department, University Lille, Inserm U-1772 (LiNC), CHU Lille, Lille, France
| | - Ulrich Frischknecht
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
- German Institute of Addiction and Prevention Research, Catholic University of Applied Sciences NRW, Cologne, Germany
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon, CH Le Vinatier, Hospices Civils de Lyon, Bron, France
- Inserm U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Bron, France
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15
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Bolstad I, Toft H, Lien L, Moe JS, Rolland B, Bramness JG. Longitudinal determinants of insomnia among patients with alcohol use disorder. Alcohol 2023; 108:10-20. [PMID: 36356647 DOI: 10.1016/j.alcohol.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
Insomnia is common among patients with AUD and can impair quality of life and cognitive functioning, as well as cause psycho-social problems and increased risk of relapse. Nonetheless, determinants of insomnia in patients with AUD have scarcely been studied. We aimed to examine prevalence and development of self-perceived insomnia among inpatients in treatment for AUD, and to examine factors in this group known to be associated with sleep disturbance in the general population. We examined self-reported information about sleep from 94 AUD inpatients in long-term treatment (up to 9 months) using a questionnaire identifying probable insomnia. Potential predictors identified in bivariate tests were used in binomial logistic regressions to examine the effect on sleep at baseline and at 6-week follow-up. Longitudinal multilevel analyses were used to examine factors affecting development of sleep quality during the treatment stay. At baseline, 54% of the patients reported sleep problems indicating insomnia. This was reduced to 35% at 6-week follow-up. In a cross-sectional analysis of sleep at baseline, we found that being male (OR 0.18, p = 0.042) and engaging in physical activity (OR 0.09, p < 0.001) were negatively associated with insomnia, while a high level of depressive symptoms (OR 1.10, p = 0.010) was positively associated after adjustment for age, history of trauma, and severity of dependence. Multilevel analyses of data over a 6-month period showed time interactions with physical activity, such that sleep improvement was greater in patients who initially had a low level of physical activity. This longitudinal study corroborates findings of high prevalence of insomnia among AUD patients and identifies factors in this group associated with insomnia, such as sex, depression, and physical activity. Future longitudinal studies are needed to examine the causal directions between sleep, depression, and physical activity and how these might be targeted in clinical settings.
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Affiliation(s)
- Ingeborg Bolstad
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Blue Cross East, Oslo, Norway; Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.
| | - Helge Toft
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Jenny Skumsnes Moe
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Institute Clinical of Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, 69500, Bron, France; Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Lyon, France; INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL1, Bron, France
| | - Jørgen G Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Oslo, Norway; Institute Clinical of Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
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16
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Guiraud J, Addolorato G, Aubin HJ, Bachelot S, Batel P, de Bejczy A, Benyamina A, Caputo F, Couderc M, Dematteis M, Goudriaan AE, Gual A, Lecoustey S, Lesch OM, Maremmani I, Nutt DJ, Paille F, Perney P, Rehm J, Rolland B, Scherrer B, Simon N, Söderpalm B, Somaini L, Sommer WH, Spanagel R, Walter H, van den Brink W. Sodium Oxybate for Alcohol Dependence: A Network Meta-Regression Analysis Considering Population Severity at Baseline and Treatment Duration. Alcohol Alcohol 2023; 58:125-133. [PMID: 36617267 PMCID: PMC10008102 DOI: 10.1093/alcalc/agac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/17/2022] [Accepted: 12/06/2022] [Indexed: 01/09/2023] Open
Abstract
AIMS The estimated effect of sodium oxybate (SMO) in the treatment of alcohol dependence is heterogeneous. Population severity and treatment duration have been identified as potential effect modifiers. Population severity distinguishes heavy drinking patients with <14 days of abstinence before treatment initiation (high-severity population) from other patients (mild-severity population). Treatment duration reflects the planned treatment duration. This study aimed to systematically investigate the effect of these potential effect moderators on SMO efficacy in alcohol-dependent patients. METHODS Network meta-regression allows for testing potential effect modifiers. It was selected to investigate the effect of the above factors on SMO efficacy defined as continuous abstinence (abstinence rate) and the percentage of days abstinent (PDA). Randomized controlled trials for alcohol dependence with at least one SMO group conducted in high-severity and mild-severity populations were assigned to a high-severity and mild-severity group of studies, respectively. RESULTS Eight studies (1082 patients) were retained: four in the high-severity group and four in the mild-severity group. The high-severity group was associated with larger SMO effect sizes than the mild-severity group: abstinence rate risk ratio (RR) 3.16, P = 0.004; PDA +26.9%, P < 0.001. For PDA, longer treatment duration was associated with larger SMO effect size: +11.3% per extra month, P < 0.001. In the high-severity group, SMO showed benefit: abstinence rate RR 2.91, P = 0.03; PDA +16.9%, P < 0.001. In the mild-severity group, SMO showed benefit only in PDA for longer treatment duration: +23.9%, P < 0.001. CONCLUSIONS In the retained studies with alcohol-dependent patients, high-severity population and longer treatment duration were associated with larger SMO effect sizes.
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Affiliation(s)
- Julien Guiraud
- Corresponding author: Vergio, 31 rue Fernand Pelloutier, 92110 Clichy–France. E-mail: ;
| | - Giovanni Addolorato
- Internal Medicine and Alcohol Related Disease Unit, Department of Medical and Surgical Sciences, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Rome, Rome, 00168, Italy
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Catholic University of Rome, Rome, 00168, Italy
| | - Henri-Jean Aubin
- French Institute of Health and Medical Research (Inserm), Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Universite Paris-Saclay, 94807, Villejuif, France
- Addiction Research and Treatment Center, Paul Brousse Hospital, Paris-Sud University, 94804, Villejuif, France
| | | | - Philippe Batel
- Addiction Unit of Charente, Camille Claudel Hospital, 16400 La Couronne, France
| | - Andrea de Bejczy
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41328, Gothenburg, Sweden
| | - Amine Benyamina
- Addiction Research and Treatment Center, Paul Brousse Hospital, Paris-Sud University, 94804, Villejuif, France
| | - Fabio Caputo
- Department of Internal Medicine, SS. Annunziata Hospital, University of Ferrara, 44042, Cento (Ferrara), Italy
- Centre for the Study and Treatment of Alcohol-Related Diseases, Department of Translational Medicine, University of Ferrara, 44042, Cento (Ferrara), Italy
| | | | - Maurice Dematteis
- Grenoble Alpes University, Faculty of Medicine and Grenoble-Alpes University Hospital, Department of Pharmacology and Addiction Medicine, 38043 Grenoble, France
| | - Anna E Goudriaan
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 5, 1105AZ Amsterdam, The Netherlands
- Arkin, Dept. of Research and Quality of Care, Amsterdam Public Health Research Institute, 1033 NN Amsterdam, The Netherlands
| | - Antoni Gual
- Emeritus Researcher, GRAC (Addictions Research Group), IDIBAPS, 08036, Barcelona, Spain
| | | | - Otto-Michael Lesch
- University Clinic of Psychiatry and Psychotherapy, Department of Social Psychiatry, Medical University of Vienna, 1090, Vienna, Austria
| | - Icro Maremmani
- Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, 56100, Pisa, Italy
| | - David J Nutt
- Centre for Neuropsychopharmacology, Imperial College London, W12 0NN, London, United Kingdom
| | - François Paille
- Department of Addiction Treatment, University Hospital, 54500, Vandoeuvre-lès-Nancy, France
| | - Pascal Perney
- Department of Addiction Medicine, CHU Nîmes; French Institute of Health and Medical Research (Inserm), Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Universite Paris-Saclay, Villejuif, 94807, France
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, M5S2S1, Canada; Dalla Lana School of Public Health & Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T1P8, Canada; Clinical Psychology & Psychotherapy Technical University Dresden, 01187, Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation
| | - Benjamin Rolland
- SUAL, HCL, CH Le Vinatier; Univ Lyon; UCBL; INSERM U1028; CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon (CRNL), F-69678, Bron, France
| | - Bruno Scherrer
- Bruno Scherrer Conseil, 78730, Saint Arnoult en Yvelines, France
| | - Nicolas Simon
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hop Sainte Marguerite, Department of Clinical Pharmacology, CAP-TV, 13005, Marseille, France
| | - Bo Söderpalm
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41328, Gothenburg, Sweden
| | - Lorenzo Somaini
- Addiction Treatment Center, Local Health Unit, ASL Biella, 13875, Biella, Italy
| | - Wolfgang H Sommer
- Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, D-68159, Mannheim, Germany
- Bethanian Hospital for Psychiatry, Psychosomatics and Psychotherapy, 17489, Greifswald, Germany
| | - Rainer Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, D-68159, Mannheim, Germany
| | - Henriette Walter
- University Clinic of Psychiatry and Psychotherapy, Department of Social Psychiatry, Medical University of Vienna, 1090, Vienna, Austria
| | - Wim van den Brink
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 5, 1105AZ Amsterdam, The Netherlands
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17
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Mauries S, Bertrand L, Rolland B, Stern E, Tebeka S, Davido G, Frija-Masson J, D'ortho MP, Lejoyeux M, Geoffroy PA. Effect of lockdown on sleep-wake rhythm and alcohol use. Chronobiol Int 2023; 40:300-309. [PMID: 36660961 DOI: 10.1080/07420528.2023.2168199] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The global covid-19 pandemic has imposed radical changes in daily lives. This study reflects upon sociodemographic and clinical characteristics (sleep-wake rhythm, psychiatric symptoms, and alcohol use behavior) during the full lockdown, comparing individuals who increased their alcohol use (iAU), those who maintained a stable use (sAU), and those who did not consume alcohol (AnoU). Participants were recruited via e-mails and they were required to complete an online survey that included questionnaires, during the last week of the full lockdown. The iAU group, compared to the sAU group, presented more disturbed sleep (PSQI; p < .001), more severe insomnia (ISI; p < .001), shorter sleep duration (p < .001), longer sleep latency (p < .001), and less regular sleep-wake schedules (p = .005). They also reported more anxiety (HAD-A; p = .009), more depressive symptoms (HAD-D: p = .006) and more psychotraumatic symptoms (PCL-5: p = .018). Moreover, the sAU group, compared to AnoU, showed better quality of sleep (PSQI; p = .002) and less severe anxiety symptoms (HAD-A; p = .014). Maintaining a stable use was also related to a better quality of life associated with bigger homes with more frequent outdoors living spaces and higher monthly incomes. Individuals who increased their alcohol consumption during the Covid-19 lockdown exhibited more sleep and circadian rhythm disturbances, as well as more (severe) psychiatric symptoms.
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Affiliation(s)
- Sibylle Mauries
- Département de psychiatrie et d'addictologie,AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
| | - Léa Bertrand
- Département de psychiatrie et d'addictologie,AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon, CH Le Vinatier, Hospices Civils de Lyon, Bron, France.,Inserm U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Bron, France
| | - Emilie Stern
- Psychiatry Department 75g22, GHU Paris - Psychiatry & Neurosciences, Paris, France
| | - Samuel Tebeka
- Département de psychiatrie et d'addictologie,AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France.,NeuroDiderot, Inserm U1141, Université de Paris, Paris, France
| | - Guillaume Davido
- Département de psychiatrie et d'addictologie,AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France.,NeuroDiderot, Inserm U1141, Université de Paris, Paris, France
| | - Justine Frija-Masson
- NeuroDiderot, Inserm U1141, Université de Paris, Paris, France.,Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, Paris, France
| | - Marie-Pia D'ortho
- NeuroDiderot, Inserm U1141, Université de Paris, Paris, France.,Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, Paris, France
| | - Michel Lejoyeux
- Département de psychiatrie et d'addictologie,AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France.,Psychiatry Department 75g22, GHU Paris - Psychiatry & Neurosciences, Paris, France.,NeuroDiderot, Inserm U1141, Université de Paris, Paris, France
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie,AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France.,Psychiatry Department 75g22, GHU Paris - Psychiatry & Neurosciences, Paris, France.,NeuroDiderot, Inserm U1141, Université de Paris, Paris, France.,CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
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18
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Dobre D, Schwan R, Jansen C, Schwitzer T, Martin O, Ligier F, Rolland B, Ahad PA, Capdevielle D, Corruble E, Delamillieure P, Dollfus S, Drapier D, Bennabi D, Joubert F, Lecoeur W, Massoubre C, Pelissolo A, Roser M, Schmitt C, Teboul N, Vansteene C, Yekhlef W, Yrondi A, Haoui R, Gaillard R, Leboyer M, Thomas P, Gorwood P, Laprevote V. Clinical features and outcomes of COVID-19 patients hospitalized for psychiatric disorders: a French multi-centered prospective observational study. Psychol Med 2023; 53:342-350. [PMID: 33902760 PMCID: PMC8144831 DOI: 10.1017/s0033291721001537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients with psychiatric disorders are exposed to high risk of COVID-19 and increased mortality. In this study, we set out to assess the clinical features and outcomes of patients with current psychiatric disorders exposed to COVID-19. METHODS This multi-center prospective study was conducted in 22 psychiatric wards dedicated to COVID-19 inpatients between 28 February and 30 May 2020. The main outcomes were the number of patients transferred to somatic care units, the number of deaths, and the number of patients developing a confusional state. The risk factors of confusional state and transfer to somatic care units were assessed by a multivariate logistic model. The risk of death was analyzed by a univariate analysis. RESULTS In total, 350 patients were included in the study. Overall, 24 (7%) were transferred to medicine units, 7 (2%) died, and 51 (15%) patients presented a confusional state. Severe respiratory symptoms predicted the transfer to a medicine unit [odds ratio (OR) 17.1; confidence interval (CI) 4.9-59.3]. Older age, an organic mental disorder, a confusional state, and severe respiratory symptoms predicted mortality in univariate analysis. Age >55 (OR 4.9; CI 2.1-11.4), an affective disorder (OR 4.1; CI 1.6-10.9), and severe respiratory symptoms (OR 4.6; CI 2.2-9.7) predicted a higher risk, whereas smoking (OR 0.3; CI 0.1-0.9) predicted a lower risk of a confusional state. CONCLUSION COVID-19 patients with severe psychiatric disorders have multiple somatic comorbidities and have a risk of developing a confusional state. These data underline the need for extreme caution given the risks of COVID-19 in patients hospitalized for psychiatric disorders.
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Affiliation(s)
- Daniela Dobre
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, StrasbourgF-67 000, France
| | - Raymund Schwan
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, StrasbourgF-67 000, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
| | - Claire Jansen
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
| | - Thomas Schwitzer
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, StrasbourgF-67 000, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
| | | | - Fabienne Ligier
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
- EA 4360 APEMAC, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Services hospitalo-universitaires d'addictologie, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, UCBL, Centre de recherche en neurosciences de Lyon (CRNL), INSERM U1028, CNRS UMR5292, PSYR2, Bron, France
| | - Pierre Abdel Ahad
- Pôle hospitalo-universitaire de psychiatrie adultes Paris 15ème, GHU Paris psychiatrie et neurosciences, site Sainte-Anne, Paris, France
| | - Delphine Capdevielle
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
- University Department of Adult Psychiatry, CHU, Montpellier, France
| | - Emmanuelle Corruble
- Université department of Adult Psychiatry, Hôpital La Colombière, CHU de Montpellier, France
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin BicêtreF-94275, France
| | - Pascal Delamillieure
- CHU de Caen, Service de psychiatrie, Centre Esquirol, CaenF-14000, France
- Imagerie et Stratégies Thérapeutiques de la Schizophrénie (ISTS) EA 7466, Normandie Univ, GIP Cyceron, CaenF-14000, France
- UFR Santé, Normandie Univ, CaenF-14000, France
| | - Sonia Dollfus
- CHU de Caen, Service de psychiatrie, Centre Esquirol, CaenF-14000, France
- Imagerie et Stratégies Thérapeutiques de la Schizophrénie (ISTS) EA 7466, Normandie Univ, GIP Cyceron, CaenF-14000, France
- UFR Santé, Normandie Univ, CaenF-14000, France
| | - Dominique Drapier
- Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Centre Hospitalier Guillaume Régnier, RennesF-35703, France
- EA 47 12 Comportement et Noyaux Gris Centraux, Université Rennes 1, RennesF-35703, France
| | - Djamila Bennabi
- Service de psychiatrie de l'adulte, CHRU de Besançon, F-25000Besançon, France
- Centre expert dépression résistante FondaMental, F-25000Besançon, France
| | - Fabien Joubert
- Département d'Information Médicale, CH Le Vinatier, Bron, France
| | | | - Catherine Massoubre
- Service Universitaire de Psychiatrie, EA TAPE 7423, CHU de Saint-Etienne, Saint Etienne, France
| | - Antoine Pelissolo
- UPEC, Université Paris-Est, Faculté de médecine, CréteilF-94000, France
- AP-HP, DMU IMPACT, Hôpitaux universitaires Henri-Mondor, Service de Psychiatrie, CréteilF-94000, France
- INSERM U955, Laboratoire Neuro-Psychiatrie translationnelle, CréteilF-94000, France
| | - Mathilde Roser
- UPEC, Université Paris-Est, Faculté de médecine, CréteilF-94000, France
- AP-HP, DMU IMPACT, Hôpitaux universitaires Henri-Mondor, Service de Psychiatrie, CréteilF-94000, France
- INSERM U955, Laboratoire Neuro-Psychiatrie translationnelle, CréteilF-94000, France
| | - Christophe Schmitt
- Département d'Information Médicale, Centre Hospitalier de Jury, MetzF-57073, France
| | - Noé Teboul
- Département d'Information Médicale, CH Le Vinatier, Bron, France
| | - Clément Vansteene
- Clinique des Maladies Mentales et de l'Encéphale (CMME), Hôpital Sainte-Anne, 1 Rue Cabanis, 75014Paris, France
- INSERM U894, Centre de Psychiatrie et Neurosciences (CPN), Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France
| | - Wanda Yekhlef
- Département Soins Somatiques-Préventions-Santé Publique, Pôle CRISTALES, EPS de Ville-Evrard, Neuilly sur Marne, France
| | - Antoine Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU de Toulouse, Hôpital Purpan, Toulouse, France
- ToNIC Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Radoine Haoui
- Pôle de Psychiatrie Générale Rive Gauche, Centre Hospitalier Gérard Marchant, F-31057Toulouse, France
| | - Raphaël Gaillard
- Pôle hospitalo-universitaire de psychiatrie adultes Paris 15ème, GHU Paris psychiatrie et neurosciences, site Sainte-Anne, Paris, France
- Université de Paris, Paris, France
- Human Histopathology and Animal Models, Infection and Epidemiology Department, Institut Pasteur, Paris, France
| | - Marion Leboyer
- UPEC, Université Paris-Est, Faculté de médecine, CréteilF-94000, France
- AP-HP, DMU IMPACT, Hôpitaux universitaires Henri-Mondor, Service de Psychiatrie, CréteilF-94000, France
- INSERM U955, Laboratoire Neuro-Psychiatrie translationnelle, CréteilF-94000, France
| | - Pierre Thomas
- Univ. Lille, INSERM U1172, CHU Lille, Centre Lille Neuroscience & Cognition (PSY), F-59000Lille, France
- CHU Lille, Pôle de Psychiatrie, F-59000Lille, France
| | - Philip Gorwood
- Clinique des Maladies Mentales et de l'Encéphale (CMME), Hôpital Sainte-Anne, 1 Rue Cabanis, 75014Paris, France
- Institute of Psychiatry and Neuroscience of Paris, University of Paris, INSERM U1266, Paris, France
- GHU Paris Psychiatrie et Neurosciences, CMME, Hôpital Sainte-Anne, Paris, France
| | - Vincent Laprevote
- Centre Psychothérapique de Nancy, LaxouF-54520, France
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, StrasbourgF-67 000, France
- Faculté de Médecine, Université de Lorraine, F-54500Vandoeuvre-lès-Nancy, France
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19
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de Ternay J, Larrieu A, Sauvestre L, Montègue S, Guénin M, Icard C, Rolland B. Insufficient Physical Activity Is a Global Marker of Severity in Alcohol Use Disorder: Results from a Cross-Sectional Study in 382 Treatment-Seeking Patients. Nutrients 2022; 14:nu14234958. [PMID: 36500988 PMCID: PMC9739230 DOI: 10.3390/nu14234958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Improving physical activity (PA) in patients with alcohol use disorder (AUD) has recently emerged as an important component of the global treatment strategy to improve drinking outcomes and quality of life. However, this new approach should focus on AUD patients with insufficient baseline PA and requires this subgroup to be better characterized. In a population of 382 treatment-seeking AUD patients, PA was assessed using the International Physical Activity Questionnaire, and participants were divided into two groups: insufficient PA group and sufficient PA group. The severity of the AUD was assessed using the DSM-5 criteria, the Alcohol Use Disorder Identification Test, and the Severity of Alcohol Dependence Questionnaire. In logistic regression models, individuals with insufficient PA were more likely than other AUD individuals to present a higher Body Mass Index (p < 0.001), a higher number of AUD DSM-5 criteria (p < 0.05), more frequent opioid use (p < 0.05), higher scores at the Fagerström Test for Nicotine Dependence (p < 0.001), State-Trait Anxiety Inventory (p < 0.001), impulsivity scale (p < 0.05), Pittsburgh Sleep Quality Inventory (p < 0.05), and lower WHO Quality of Life (p < 0.001) scores. In AUD, an insufficient baseline PA is associated with several markers of severity, and physical exercise interventions should be part of a multimodal treatment program integrating the global impairments of patients.
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Affiliation(s)
- Julia de Ternay
- Service Universitaire d’Addictologie de Lyon (SUAL), Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- Correspondence:
| | - Agathe Larrieu
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Laura Sauvestre
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Solène Montègue
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Monique Guénin
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Christophe Icard
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Benjamin Rolland
- Service Universitaire d’Addictologie de Lyon (SUAL), Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
- Centre de Recherche en Neurosciences de Lyon (Psychiatric Disorders, PSYR2), Université Claude Bernard Lyon 1, Inserm U1028, CNRS UMR 5292, 69100 Lyon, France
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20
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Rabiéga P, Rolland B, Hallouche N, Fouad F, Lada O, Benabadji E, Pol S. 2Description des patients psychiatriques traités pour le VHC par agents antiviraux directs et impact du traitement : étude réalisée à partir des données du Système national des données de santé entre 2015-2019. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.09.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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21
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Rolland B, Lions C, Di Beo V, Carrieri P, Authier N, Barré T, Delorme J, Mathurin P, Bailly F, Protopopescu C, Marcellin F. Adherence to opioid agonist therapy predicts uptake of direct-acting antivirals in people who use drugs: results from the French national healthcare database (the ANRS FANTASIO study). Harm Reduct J 2022; 19:119. [PMID: 36303159 PMCID: PMC9615191 DOI: 10.1186/s12954-022-00702-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background Opioid agonist therapy (OAT) is associated with reduced injection, reduced HCV transmission, and more opportunities to initiate hepatitis C virus (HCV) treatment in people who use drugs (PWUD). We aimed to study the extent to which adherence to OAT was predictive of increased uptake of direct-acting antivirals (DAA) in PWUD with chronic HCV infection. Methods Using the French national healthcare system database, we targeted PWUD (i.e. with a history of OAT) who had chronic HCV infection and were eligible for DAA during 2014–2016. Adherence to OAT was computed as a time-varying variable expressing the proportion of days covered by OAT receipt, over any six-month interval before DAA receipt. We used a Cox proportional hazards model to estimate the association between adherence to OAT and the rate of DAA uptake after adjustment for age, sex, alcohol use disorder, socioeconomic status, and liver disease severity. Results Among the 22,615 persons included in the ANRS FANTASIO study, 3438 (15.2%) initiated DAA during the study period. After multivariable adjustment, adherence to OAT was associated with a higher rate of DAA initiation. However, this association was not linear, and only individuals on OAT for 20% or more of the time in the previous six-month period had a higher rate of DAA initiation (adjusted hazard ratio [95% confidence interval]: 1.28 [1.18–1.38]). Other variables associated with DAA initiation were male sex, older age, cirrhosis or liver cancer, and higher socioeconomic status. Conclusions Adherence to OAT is a major predictor of DAA initiation in PWUD living with chronic HCV infection in France. Our results also suggest that even moderate adherence to OAT can facilitate DAA uptake. Adequate HCV training for OAT prescribers together with interventions to ensure adherence to OAT will help improve DAA initiation rates and reach HCV elimination goals. Supplementary Information The online version contains supplementary material available at 10.1186/s12954-022-00702-9.
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Affiliation(s)
- Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, CH Le Vinatier, Lyon, France.,PsyR2 CRNL, UCBL1, INSERM U1028, CNRS UMR5292, Bron, France
| | - Caroline Lions
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Vincent Di Beo
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
| | - Nicolas Authier
- CHU Clermont-Ferrand, Neuro-Dol, Service de Pharmacologie Médicale, Centres Addictovigilance et Pharmacovigilance, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Jessica Delorme
- CHU Clermont-Ferrand, Neuro-Dol, Service de Pharmacologie Médicale, Centres Addictovigilance et Pharmacovigilance, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Philippe Mathurin
- Service Des Maladies de L'appareil Digestif, CHU Lille, Université de Lille, Lille, France
| | - François Bailly
- Service d'hépatologie et d'addictologie, Groupe Hospitalier Nord, Hôpital de La Croix-Rousse, Lyon, France
| | - Camelia Protopopescu
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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22
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Louvet A, Rolland B. Reply to "Alcohol-related liver disease treatment and EBM". Liver Int 2022; 42:2346. [PMID: 35727915 DOI: 10.1111/liv.15342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 02/13/2023]
Affiliation(s)
- Alexandre Louvet
- Hôpital Huriez, Service des Maladies de l'Appareil digestif, Lille, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Université de Lyon, UCBL, Villeurbanne, France
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23
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Guiraud J, Addolorato G, Antonelli M, Aubin HJ, de Bejczy A, Benyamina A, Cacciaglia R, Caputo F, Dematteis M, Ferrulli A, Goudriaan AE, Gual A, Lesch OM, Maremmani I, Mirijello A, Nutt DJ, Paille F, Perney P, Poulnais R, Raffaillac Q, Rehm J, Rolland B, Rotondo C, Scherrer B, Simon N, Skala K, Söderpalm B, Somaini L, Sommer WH, Spanagel R, Vassallo GA, Walter H, van den Brink W. Sodium oxybate for the maintenance of abstinence in alcohol-dependent patients: An international, multicenter, randomized, double-blind, placebo-controlled trial. J Psychopharmacol 2022; 36:1136-1145. [PMID: 35796481 PMCID: PMC9548946 DOI: 10.1177/02698811221104063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sodium oxybate (SMO) has been shown to be effective in the maintenance of abstinence (MoA) in alcohol-dependent patients in a series of small randomized controlled trials (RCTs). These results needed to be confirmed by a large trial investigating the treatment effect and its sustainability after medication discontinuation. AIMS To confirm the SMO effect on (sustained) MoA in detoxified alcohol-dependent patients. METHODS Large double-blind, randomized, placebo-controlled trial in detoxified adult alcohol-dependent outpatients (80% men) from 11 sites in four European countries. Patients were randomized to 6 months SMO (3.3-3.9 g/day) or placebo followed by a 6-month medication-free period. Primary outcome was the cumulative abstinence duration (CAD) during the 6-month treatment period defined as the number of days with no alcohol use. Secondary outcomes included CAD during the 12-month study period. RESULTS Of the 314 alcohol-dependent patients randomized, 154 received SMO and 160 received placebo. Based on the pre-specified fixed-effect two-way analysis of variance including the treatment-by-site interaction, SMO showed efficacy in CAD during the 6-month treatment period: mean difference +43.1 days, 95% confidence interval (17.6-68.5; p = 0.001). Since significant heterogeneity of effect across sites and unequal sample sizes among sites (n = 3-66) were identified, a site-level random meta-analysis was performed with results supporting the pre-specified analysis: mean difference +32.4 days, p = 0.014. The SMO effect was sustained during the medication-free follow-up period. SMO was well-tolerated. CONCLUSIONS Results of this large RCT in alcohol-dependent patients demonstrated a significant and clinically relevant sustained effect of SMO on CAD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04648423.
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Affiliation(s)
- Julien Guiraud
- Department of Psychiatry, Amsterdam
Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The
Netherlands,D&A Pharma, Paris, France,Julien Guiraud, D&A Pharma, 7 rue
d’Aguesseau, Paris 75008, France. Emails:
;
| | - Giovanni Addolorato
- Alcohol Use Disorder and Alcohol
Related Disease Unit, Department of Internal Medicine and Gastroenterology,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,Internal Medicine Unit,
Columbus-Gemelli Hospital, Department of Internal Medicine and Gastroenterology,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mariangela Antonelli
- Internal Medicine Unit,
Columbus-Gemelli Hospital, Department of Internal Medicine and Gastroenterology,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Henri-Jean Aubin
- French Institute of Health and Medical
Research (Inserm), Centre de Recherche en Epidémiologie et Santé des Populations
(CESP), Universite Paris-Saclay, Villejuif, France,Addiction Research and Treatment
Center, Paul Brousse Hospital, Paris-Sud University, Villejuif, France
| | - Andrea de Bejczy
- Section of Psychiatry and
Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy,
University of Gothenburg, Goteborg, Sweden
| | - Amine Benyamina
- Addiction Research and Treatment
Center, Paul Brousse Hospital, Paris-Sud University, Villejuif, France
| | | | - Fabio Caputo
- Department of Internal Medicine, SS.
Annunziata Hospital, Cento (Ferrara), University of Ferrara, Italy,Centre for the Study and Treatment of
Alcohol-Related Diseases, Department of Translational Medicine, University of
Ferrara, Ferrara, Italy
| | - Maurice Dematteis
- Department of Addiction Medicine,
Grenoble-Alpes University Hospital, and Faculty of Medicine, Grenoble Alpes
University, France
| | - Anna Ferrulli
- Department of Endocrinology,
Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy,Department of Biomedical Sciences for
Health, University of Milan, Milan, Italy
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam
University Medical Centers, University of Amsterdam, Amsterdam, The
Netherlands,Arkin, Department of Research and
Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The
Netherlands
| | - Antoni Gual
- Psychiatry Department, Neurosciences
Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Otto-Michael Lesch
- University Clinic of Psychiatry and
Psychotherapy, Department of Social Psychiatry, Medical University of Vienna,
Austria
| | - Icro Maremmani
- Santa Chiara University Hospital,
University of Pisa, Italy
| | - Antonio Mirijello
- Department of Medical Sciences, IRCCS
Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo (FG),
Italy
| | - David J Nutt
- Centre for Neuropsychopharmacology,
Imperial College London, United Kingdom
| | - François Paille
- Department of Addiction Treatment,
University Hospital, Vandoeuvre-lès-Nancy, France
| | | | | | | | - Jürgen Rehm
- Institute for Mental Health Policy
Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Dalla Lana
School of Public Health, University of Toronto, Toronto, Ontario, Canada,Clinical Psychology &
Psychotherapy Technical University Dresden, Dresden, Germany,Department of International Health
Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow
State Medical University, Moscow, Russia
| | - Benjamin Rolland
- SUAL, HCL, CH Le Vinatier; Univ Lyon;
UCBL; INSERM U1028; CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon
(CRNL), Bron, France
| | - Claudia Rotondo
- Centro di Riferimento Alcologico
della Regione Lazio (CRARL), Dipartimento di Salute Mentale, Roma, Italy
| | - Bruno Scherrer
- Bruno Scherrer Conseil, Saint Arnoult
en Yvelines, France
| | - Nicolas Simon
- Aix Marseille Univ, APHM, INSERM,
IRD, SESSTIM, Hop Sainte Marguerite, Department of Clinical Pharmacology, CAP-TV,
Marseille, France
| | - Katrin Skala
- Department of Child and Adolescent
Psychiatry, Medical University of Vienna, Austria
| | | | - Lorenzo Somaini
- Addiction Treatment Center, Local
Health Unit, ASL Biella, Italy
| | - Wolfgang H Sommer
- Medical Faculty, Institute of
Psychopharmacology, Central Institute of Mental Health, University of Heidelberg,
Mannheim, Germany,Institute of Psychopharmacology,
Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Rainer Spanagel
- Institute of Psychopharmacology,
Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | | | | | - Wim van den Brink
- Department of Psychiatry, Amsterdam
University Medical Centers, University of Amsterdam, Amsterdam, The
Netherlands
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24
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Lespine LF, Bramness JG, Pignon B, Vaiva G, Thomas P, Roelandt JL, Benradia I, Amad A, Geoffroy PA, Rolland B. Gender-related associations between psychiatric disorders and alcohol use disorder: Findings from the french "Mental health in the general population" survey. Arch Womens Ment Health 2022; 25:895-902. [PMID: 36083520 DOI: 10.1007/s00737-022-01253-5] [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: 03/28/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022]
Abstract
Women with alcohol use disorder (AUD) might be particularly vulnerable to psychiatric comorbidities. However, population surveys have yielded disparate findings. We used data from the French Mental Health in the General Population survey to investigate gender-related risks of psychiatric comorbidities associated with AUD. A cross-sectional survey based on face-to-face interviews, including the Mini International Neuropsychiatric Interview, was conducted among 38,717 subjects. Logistic regression models were used to assess risks of psychiatric comorbidities associated with AUD. After adjustment for socio-demographics and other psychiatric disorders, both women and men with AUD were at higher risk of comorbid depressive disorder (odds ratio [OR] = 2.6, 95% confidence interval [CI]: 2.0-3.4 in women, and OR = 2.0, 95% CI: 1.7-2.4 in men), bipolar I disorder (2.5; 1.4-4.4 in women vs. 2.6; 1.9-3.4 in men), and psychotic disorder (1.6; 1.01-2.5 in women vs. 1.8; 1.4-2.3 in men). Women with AUD exhibited an increased risk of comorbid panic disorder (OR = 1.6, 95% CI: 1.1-2.2) while the increased risk of post-traumatic stress disorder (PTSD) was significant in men only (OR = 2.6, 95% CI: 1.6-4.2). The increased risk of comorbid substance use disorder (SUD) was more elevated in women, compared to men (12.9; 8.1-18.1 vs. 4.8; 4.0-5.8 in men). Most of psychiatric conditions were over-represented in both women and men with AUD, relative to controls. Gender-specific findings were that women with AUD had an increased risk of comorbid SUD or panic disorder, while men had a significantly higher risk of comorbid PTSD.
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Affiliation(s)
- Louis-Ferdinand Lespine
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Centre Hospitalier Le Vinatier, 95 Bd Pinel, 69500, Bron, France.
- UCBL1, INSERM, U1028, CNRS, UMR5292, CRNL, PSYR2, Lyon, France.
| | - Jørgen G Bramness
- Institute of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
- Norwegian National Advisory Unit On Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Baptiste Pignon
- DMU IMPACT, Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor», Fondation FondaMental, Créteil, France
| | - Guillaume Vaiva
- Lille Neuroscience & Cognition (LilNCog), Université Lille, Inserm, CHU Lille, U1172, 59000, Lille, France
| | - Pierre Thomas
- Centre National de Ressources & Résilience Pour Les Psychotraumatismes (Cn2r Lille Paris), 59000, Lille, France
| | - Jean-Luc Roelandt
- Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, EPSM Lille Métropole, 211 rue Roger Salengro, 59 260, Hellemmes, France
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Imane Benradia
- Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, EPSM Lille Métropole, 211 rue Roger Salengro, 59 260, Hellemmes, France
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Ali Amad
- Centre National de Ressources & Résilience Pour Les Psychotraumatismes (Cn2r Lille Paris), 59000, Lille, France
| | - Pierre-Alexis Geoffroy
- Service de Psychiatrie Et dAddictologie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Bichat, Paris, France
- Université de Paris, Inserm, 75019, NeuroDiderot, Paris, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Centre Hospitalier Le Vinatier, 95 Bd Pinel, 69500, Bron, France
- UCBL1, INSERM, U1028, CNRS, UMR5292, CRNL, PSYR2, Lyon, France
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25
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Argote M, Sescousse G, Brunelin J, Fakra E, Nourredine M, Rolland B. Association between formal thought disorder and cannabis use: a systematic review and meta-analysis. Schizophr 2022; 8:78. [PMID: 36175509 PMCID: PMC9523063 DOI: 10.1038/s41537-022-00286-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/10/2022] [Indexed: 10/26/2022]
Abstract
AbstractFormal thought disorder (FTD) is a multidimensional syndrome mainly occurring along the psychosis continuum. Cannabis use is known to increase symptoms of psychosis, particularly positive symptoms. However, the impact of cannabis use on FTD in individuals presenting symptoms along the psychosis continuum remains unclear. To address this knowledge gap, we conducted a meta-analysis examining the association between cannabis use and FTD in those individuals. We hypothesized that cannabis would worsen FTD. We conducted a systematic search of the PubMed, ScienceDirect, PsycINFO, Web of Science, Embase and Google Scholar databases up to July 2022. The results were collated through a random-effects model using the statistical software R. Reference lists of included studies were searched for additional relevant publications. Nineteen studies were included, totalling 1840 cannabis users and 3351 non-cannabis users. The severity of FTD was found to be higher in cannabis users (SMD = 0.21, 95%CI [0.12–0.29], p = 0.00009). Subgroup analyses revealed that FTD severity was increased among cannabis users, regardless of the disorder severity: healthy individuals (SMD = 0.19, 95%CI [0.05–0.33], p = 0.02); patients with first-episode psychosis (SMD = 0.21, 95%CI [0.01–0.41], p = 0.04); patients with schizophrenia (SMD = 0.25, 95%CI [0.11–0.38], p = 0.005). Between-group differences were not significant. In line with its already known effect on positive symptoms in psychosis, cannabis use appears to be associated with increased FTD severity all along the psychosis continuum. Future research should consider potential confounding variables such as other substance use disorders and explore how FTD dimensions are impacted by cannabis use.
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26
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Carton L, Icick R, Weibel S, Dematteis M, Kammerer E, Batisse A, Rolland B. What is the potential for abuse of lisdexamfetamine in adults? A preclinical and clinical literature review and expert opinion. Expert Rev Clin Pharmacol 2022; 15:921-925. [PMID: 35959655 DOI: 10.1080/17512433.2022.2112950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : Lisdexamfetamine dimesylate (LDX) is a prodrug approved for attention deficit/hyperactivity disorder and for moderate-to-severe binge eating disorder in adults in some countries. AREA COVERED : We aimed to specify the abuse potential of LDX in adults, using a review of pharmacokinetic/pharmacodynamic (PK/PD), animal, clinical, and pharmaco-epidemiological studies, through a PubMed search since inception until May 2021 using the following keywords: "lisdexamfetamine AND ("misuse" OR "abuse" OR "diversion" OR "addiction"). EXPERT OPINION : Most of the studies highlighted a longer Tmax than dexamphetamine leading to a delayed onset of effects and a decreased Cmax. These PK parameters were often associated with a diminished feeling of euphoria, in comparison to immediate-release dexamphetamine. The potential for abuse was also limited by the prodrug property of LDX, thus reducing the risk of misuse. Nevertheless, all the data were not convergent, as some authors reported similar Cmax for LDX and dexamphetamine and reinforcing properties with a dose-dependent effect. Epidemiological studies found that abuse rates of LDX were substantially lower than those of immediate-release dexamphetamine. Overall, although LDX abuse seems possible, we did not find evidence concerning current safety signal. However, more long-term pharmaco-epidemiological studies are still needed to confirm this finding.
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Affiliation(s)
- Louise Carton
- Degenerative and Vascular Cognitive Disorders, Pharmacology Department, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, UMR-S1172, Lille, France
| | - Romain Icick
- Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, APHP.Nord, Assistance Publique - Hôpitaux de Paris (AP-HP), France Université de Paris, Inserm UMR-S1144, Paris F-75006, France
| | - Sébastien Weibel
- Pôle de Psychiatrie, Santé Mentale et Addictologie, Hôpitaux Universitaires de Strasbourg; Inserm U1114, Strasbourg France
| | - Maurice Dematteis
- CSAPA, CHU Grenoble Alpes , Univ. Grenoble Alpes, Service Universitaire de Pharmaco-Addictologie, 38043 Grenoble, France
| | | | - Anne Batisse
- Centre d'Addictovigilance, Hôpital Fernand-Widal, Paris, France
| | - Benjamin Rolland
- Service universitaire d'Addictologie de Lyon (SUAL), HCL, CH Le Vinatier, Bron, France
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Carton L, Auger F, Laloux C, Durieux N, Kyheng M, Potey C, Bergeron S, Rolland B, Deguil J, Bordet R. Effects of acute ethanol and/or diazepam exposure on immediate and delayed hippocampal metabolite levels in rats anesthetized with isoflurane. Fundam Clin Pharmacol 2022; 36:687-698. [DOI: 10.1111/fcp.12764] [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] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 01/13/2022] [Accepted: 01/31/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Louise Carton
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
| | - Florent Auger
- Lille In vivo Imaging and Functional Exploration platform Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41‐UMS 2014‐PLBS Lille France
| | - Charlotte Laloux
- Lille In vivo Imaging and Functional Exploration platform Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41‐UMS 2014‐PLBS Lille France
| | - Nicolas Durieux
- Lille In vivo Imaging and Functional Exploration platform Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41‐UMS 2014‐PLBS Lille France
| | - Maéva Kyheng
- ULR 2694‐METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales Univ. Lille, CHU Lille Lille France
- Département de Biostatistiques CHU Lille Lille France
| | - Camille Potey
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
| | - Sandrine Bergeron
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon CH Le Vinatier, Hospices Civils de Lyon Bron France
- Inserm U1028, CNRS UMR5292 Université Claude Bernard Lyon 1 Bron France
| | - Julie Deguil
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
| | - Régis Bordet
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR‐S1172, Pharmacology Department Lille France
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Louvet A, Trabut JB, Moreno C, Moirand R, Aubin HJ, Ntandja Wandji LC, Nourredine M, Ningarhari M, Ganne-Carrié N, Pageaux GP, Bailly F, Boursier J, Daeppen JB, Luquiens A, Nguyen-Khac E, Anty R, Orban T, Donnadieu-Rigole H, Mallat A, Bureau C, Pariente EA, Paupard T, Benyamina A, Perney P, Mathurin P, Rolland B. Management of alcohol-related liver disease: the French Association for the Study of the Liver and the French Alcohol Society clinical guidelines. Liver Int 2022; 42:1330-1343. [PMID: 35488390 DOI: 10.1111/liv.15221] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 12/15/2022]
Abstract
Excessive alcohol consumption is the leading cause of liver diseases in Western countries, especially in France. Alcohol-related liver disease (ARLD) is an extremely broad context and there remains much to accomplish in terms of identifying patients, improving prognosis and treatment, and standardising practices. The French Association for the Study of the Liver wished to organise guidelines together with the French Alcohol Society in order to summarise the best evidence available about several key clinical points in ARLD. These guidelines have been elaborated based on the level of evidence available in the literature and each recommendation has been analysed, discussed and voted by the panel of experts. They describe how patients with ARLD should be managed nowadays and discuss the main unsettled issues in the field.
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Affiliation(s)
- Alexandre Louvet
- Service des Maladies de l'Appareil digestif, Hôpital Huriez, CHU, Lille, France
| | - Jean-Baptiste Trabut
- Groupe Hospitalier Cochin Saint-Vincent de Paul, Unité d'Hépatologie et d'Addictologie, Paris, France
| | | | - Romain Moirand
- Inserm, UMR 991, "Foie, Métabolismes et Cancer", Rennes, France.,Université de Rennes 1, Rennes, France
| | | | | | | | - Massih Ningarhari
- Service des Maladies de l'Appareil digestif, Hôpital Huriez, CHU, Lille, France
| | | | | | - François Bailly
- Service d'Hépato-Gastroentérologie, Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | - Rodolphe Anty
- Service d'Hépato-Gastroentérologie, CHU de l'Archet 2, Nice, France
| | - Thomas Orban
- Société Scientifique de Médecine Générale, Brussels, Belgium
| | | | - Ariane Mallat
- Service d'Hépatologie, Hopital Henri-Mondor, Créteil, France
| | | | | | - Thierry Paupard
- Service d'Hépato-Gastroentérologie, Centre Hospitalier, Dunkerque, France
| | - Amine Benyamina
- Service d'Addictologie, Hôpital Paul-Brousse, Villejuif, France
| | | | - Philippe Mathurin
- Service des Maladies de l'Appareil digestif, Hôpital Huriez, CHU, Lille, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Université de Lyon, UCBL, Lyon, France
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Mourad A, Marcellin F, Rolland B, Authier N, Delorme J, Carrieri P, Protopopescu C. Prévalence de l'hépatite C chez les usagers de drogues par injection en France: modélisation mathématique de l'évolution à l’ère des antiviraux à action directe (FANTASIO). Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.03.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Louvet A, Labreuche J, Moreno C, Vanlemmens C, Moirand R, Féray C, Dumortier J, Pageaux GP, Bureau C, Chermak F, Duvoux C, Thabut D, Leroy V, Carbonell N, Rolland B, Salamé E, Anty R, Gournay J, Delwaide J, Silvain C, Lucidi V, Lassailly G, Dharancy S, Nguyen-Khac E, Samuel D, Duhamel A, Mathurin P, Berthot C, Claudet S, Doussot A, Gérardin C, Muel E, Hiriart JB, Degré D, Gustot T, Bonadona A, Bordy L, Hilleret MN, Detry O, Honoré P, Meurisse N, Boleslawski E, Deplanque D, El Amrani M, Lebuffe G, Millet G, Soret D, Truant S, Erard-Poinsot D, Radenne S, Faure S, Gelsi E, Truchi R, Rudler M, Rouleau L, Brenner A, Larrue H, Péron JM, Robic MA, Antonini T, Duclos-Vallée JC. Early liver transplantation for severe alcohol-related hepatitis not responding to medical treatment: a prospective controlled study. Lancet Gastroenterol Hepatol 2022; 7:416-425. [DOI: 10.1016/s2468-1253(21)00430-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 02/07/2023]
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de Ternay J, Leblanc P, Michel P, Benyamina A, Naassila M, Rolland B. One-month alcohol abstinence national campaigns: a scoping review of the harm reduction benefits. Harm Reduct J 2022; 19:24. [PMID: 35246148 PMCID: PMC8895623 DOI: 10.1186/s12954-022-00603-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/17/2022] [Indexed: 12/29/2022] Open
Abstract
Over the last decade, one-month alcohol abstinence campaigns (OMACs) have been implemented within the general population in an increasing number of countries. We identified the published studies reporting data on OMACs to explore the following aspects: profile of participants, rates and factors associated with the completion of the abstinence challenge, and outcomes and harm reduction benefits in participating in the challenges. We screened 322 records, including those found in the grey literature, and reviewed 6 studies and 7 Dry July Annual Reports. Compared to non-participating alcohol users, participants were more likely to be female, have a higher income, and a higher level of education. They were heavier drinkers and were more concerned by the consequences of alcohol on health and by their health in general. Participants who achieved the one-month abstinence challenge were lower drinkers and more likely to have registered on the campaign-related Internet communities. Both successful and unsuccessful participants frequently reported health benefits, including sleep improvement and weight loss. Successful participants were more likely to durably change their alcohol drinking habits. Overall, OMACs provide short- or mid-term harm reduction benefits for both successful and unsuccessful participants. Findings were limited by the paucity of studies, their observational nature, and heterogeneity in the features of the different national campaigns, which would probably gain in enhanced internationalization.
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Affiliation(s)
- Julia de Ternay
- Service d'Addictologie, Hôpital Édouard Herriot, Hospices Civils de Lyon, 5, Place d'Arsonval, Pavillon K, 69003, Lyon, France.
| | - Pierre Leblanc
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Hospices Civils de Lyon, Lyon, France
| | - Philippe Michel
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Hospices Civils de Lyon, Lyon, France
| | - Amine Benyamina
- Hôpital Paul Brousse, AHPH, Université Paris-Sud, Paris, France.,Unité Psychiatrie-Comorbidités-Addictions (PSYCOMADD), APHP, Université Paris-Sud, Paris, France
| | - Mickael Naassila
- Groupe de Recherche sur l'Alcool et les Pharmacodépendances (GRAP), INSERM U1247, Université de Picardie Jules Verne, Amiens, France
| | - Benjamin Rolland
- Service d'Addictologie, Hôpital Édouard Herriot, Hospices Civils de Lyon, 5, Place d'Arsonval, Pavillon K, 69003, Lyon, France.,Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France.,CRNL PSYR2, Inserm U1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Bron, France
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Fovet T, Wathelet M, Benbouriche M, Benradia I, Roelandt JL, Thomas P, D'Hondt F, Rolland B. Substance Use, Substance Use Disorders, and Co-Occurring Psychiatric Disorders in Recently Incarcerated Men: A Comparison with the General Population. Eur Addict Res 2022; 28:368-376. [PMID: 36007504 DOI: 10.1159/000526079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/05/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The rates of alcohol and illegal drug use and the prevalence of alcohol and illegal drug use disorders (AUDs and DUDs) are high in prison populations, particularly in men entering jail. However, these rates have never been exhaustively assessed and compared to those of the general population in France. METHODS We based our research on two surveys, conducted in the same French region, which included a total of 630 men entering jail and 5,793 men recruited from the general population. We used the Mini-International Neuropsychiatric Interview to assess alcohol and drug use, AUD, DUD, as well as co-occurring psychiatric disorders, and we examined differences in prevalence rates between the two populations. Logistic regression models were performed to (i) identify the factors associated with AUD and DUD and (ii) test whether the interaction between admission to jail and the presence of AUD, DUD, or both is linked to the presence of at least one co-occurring psychiatric disorder. RESULTS Compared to the general population sample, the prevalence of AUD (33.8% vs. 8.7%, p < 0.001) and DUD (at least one type of drug: 28.7% vs. 5.0%, p < 0.001; cannabis: 24.0% vs. 4.7%, p < 0.001; opioids: 6.8% vs. 0.4%, p < 0.001; stimulants: 5.2% vs. 0.8%, p < 0.001) was significantly higher in the jail population sample, as well as the rates of past-year use of various substances (alcohol: 62.1% vs. 56.4%, p = 0.007; at least one type of illegal drug: 50.0% vs. 14.4%, p < 0.001; cannabis: 45.6% vs. 13.9%, opioids: 9.4% vs. 0.7%; stimulants: 8.6% vs. 1.9%). Admission to jail was associated with a higher risk of AUD (aOR = 3.80, 95% CI: 2.89-5.01, p < 0.001) or DUD (aOR = 4.25, 95% CI: 3.10-5.84, p < 0.001). History of trauma was also associated with both AUD (aOR = 1.81, 95% CI: 1.53-2.14, p < 0.001) and DUD (aOR = 2.15, 95% CI: 1.74-2.65, p < 0.001), whereas history of migration was only associated with DUD (aOR = 1.38, 95% CI: 1.12-1.71, p = 0.003). AUDs and DUDs were more strongly associated with co-occurring psychiatric disorders in incarcerated men than in the general population. Among individuals with AUD, DUD, or both, co-occurring anxiety and mood disorders were particularly more frequent in jail than in the general population. DISCUSSION/CONCLUSION As in most countries, AUD and DUD are highly prevalent among men entering jail in France. Our results also suggest that incarceration constitutes an independent vulnerability factor for a dual disorder, which supports a systematic assessment and treatment of psychiatric disorders in men entering jail and diagnosed with an AUD or DUD.
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Affiliation(s)
- Thomas Fovet
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France.,Centre National de ressources et de résilience Lille-Paris (CN2R), Lille, France
| | - Marielle Wathelet
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France.,Centre National de ressources et de résilience Lille-Paris (CN2R), Lille, France.,Fédération régionale de recherche en psychiatrie et santé mentale, Lille, France
| | - Massil Benbouriche
- University Lille, ULR 4072 - PSITEC - Psychologie: Interactions Temps Émotions Cognition, Lille, France.,Centre de Recherche, Institut National de Psychiatrie Légale Philippe-Pinel, Montréal, Québec, Canada
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France.,ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France.,ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Pierre Thomas
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France.,Fédération régionale de recherche en psychiatrie et santé mentale, Lille, France
| | - Fabien D'Hondt
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France.,Centre National de ressources et de résilience Lille-Paris (CN2R), Lille, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, CH Le Vinatier, Lyon, France.,Centre de Recherche en Neurosciences de Lyon (CRNL), Équipe PsyR, INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Université Jean Monnet Saint Etienne, Lyon, France
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de Beaurepaire R, Rolland B. Baclofen in alcohol use disorder: An analysis of the data provided by the French "Temporary Recommendation for Use" 2014-2017 cohort. Front Psychiatry 2022; 13:949750. [PMID: 36311508 PMCID: PMC9597083 DOI: 10.3389/fpsyt.2022.949750] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Alcohol use disorder (AUD) is a devastating illness for which effective treatments are lacking. Studies over the last two decades have shown that baclofen, a GABA-B agonist, could be a promising treatment for AUD. However, the efficacy of baclofen is still controversial, and studies have shown that it may be associated with an excess of hospitalizations and deaths. In March 2014, the French Health Safety Agency granted a "Temporary Recommendation for Use" (TRU) regulating the prescription of baclofen in subjects with AUD. The TRU allowed physicians to prescribe high-dose baclofen (up to 300 mg/d). The doses were adjusted, and tailored to the needs of each patient. Between March 2014 and March 2017, TRU clinical data were collected for a total of 6,939 subjects. The recorded data included information on alcohol consumption, the intensity of alcohol cravings, and adverse events. The present article proposes an analysis of the data provided by the TRU. Subjects for which data were missing regarding baclofen daily dosage, alcohol consumption or craving scores were discarded from the analyses. A cohort of two groups of subjects was analyzed. The first group included all TRU subjects suitable for analyses (5,550 subjects), and the second group included subjects followed for at least 365 days (169 subjects). Comparisons were made between baseline and endpoint of the follow-up period. The results show that a majority of subjects in the whole cohort had received doses of over 80 mg/d. The mean dose of baclofen at the endpoint was >110 mg/d in the second group of subjects. Doses of >80 mg/d were not associated with an increase in adverse events after adjustment for the follow-up duration. In terms of efficacy, comparisons between baseline and endpoint show that baclofen treatment significantly decreased alcohol consumption and alcohol cravings, and significantly increased the number of subjects with null or low-risk alcohol consumption according to WHO criteria.
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Affiliation(s)
| | - Benjamin Rolland
- Academic Department of Addiction Medicine in Lyon, Centre Hospitalier Le Vinatier, Hospices Civils de Lyon, Lyon, France
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Rolland B, Dalon F, Gauthier N, Nourredine M, Bérard M, Carton L, Brousse G, Llorca PM, Jacoud F, Van Ganse E, Belhassen M. Antipsychotic prescribing practices in real-life (APPREAL study): Findings from the French National Healthcare System Database (2007-2017). Front Psychiatry 2022; 13:1021780. [PMID: 36387010 PMCID: PMC9659890 DOI: 10.3389/fpsyt.2022.1021780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Antipsychotics are used in a large variety of psychiatric and neurological disorders; investigating their use in real life is important to understand national prescribing practices, as well as to determine the levels of patient adherence. METHODS Using a 1/97e random sample (General Sample of Beneficiaries, EGB) of the French health insurance reimbursement database, we conducted a historical cohort study on the 2007-2017 period. The aim was to describe the sociodemographic characteristics of patients, the types of antipsychotics dispensed, the types of prescribers, the mean doses and average durations of treatment, the co-dispensed medications, and the levels of adherence to treatment. To exclude punctual uses of antipsychotics, we selected only patients with a continuous dispensing of the same antipsychotic over at least 3 months. RESULTS In total, 13,799 subjects (1.66% of the EGB sample) were included (56.0% females; mean age 55.8 ± 19.4 years). Risperidone (19.3%), cyamemazine (18.7%), olanzapine (11.9%), tiapride (8.8%), and haloperidol (7.5%) were the five most prescribed antipsychotics. 44.9% of prescriptions were written by general practitioners, 34.1% by hospital practitioners, and 18.4% by private-practice psychiatrists. On average, the mean dispensed doses were relatively low, but the variation range was large. Long-acting forms were used in 5.4% of the sample, and clozapine in 1.3%. 34.2% of patients received more than one antipsychotic, and almost 15% were prescribed at least three concomitant antipsychotics. Paliperidone and clozapine were associated with the highest levels of adherence, and risperidone and haloperidol with the lowest ones. CONCLUSION An important heterogeneity of antipsychotic prescribing practices was observed in France. The rate of use of long-acting antipsychotics was low, whereas multiple antipsychotic prescriptions were frequent.
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Affiliation(s)
- Benjamin Rolland
- Centre Hospitalier Le Vinatier, Hospices Civils de Lyon, Academic Department of Addiction Medicine (SUAL), Bron, France.,Université Claude Bernard Lyon 1, Lyon, France
| | | | - Noémie Gauthier
- Saint-Cyr au Mont d'Or Hospital, Hospital Pharmacy, Saint-Cyr-au Mont-d'Or Psychiatric Hospital, Saint-Cyr-au Mont-d'Or, France
| | - Mikaïl Nourredine
- Hospices Civils de Lyon, Pharmacotoxicology Laboratory, Department of Clinical Research and Epidemiology, Lyon, France.,Faculté de Médecine Lyon Sud, Lyon 1 University, Lyon, France
| | | | - Louise Carton
- CHU Lille, Department of Pharmacology, Inserm, Lille Neuroscience and Cognition, UMR-S1172, Université de Lille, Lille, France
| | - Georges Brousse
- CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, University Clermont Auvergne, Clermont-Ferrand, France
| | - Pierre-Michel Llorca
- CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, University Clermont Auvergne, Clermont-Ferrand, France
| | | | - Eric Van Ganse
- PELyon, Lyon, France.,Respiratory Medicine, Croix Rousse University Hospital, Lyon, France.,Claude Bernard Lyon 1 University, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
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Brito MA, Amad A, Rolland B, Geoffroy PA, Peyre H, Roelandt JL, Benradia I, Thomas P, Vaiva G, Schürhoff F, Pignon B. Religiosity and prevalence of suicide, psychiatric disorders and psychotic symptoms in the French general population. Eur Arch Psychiatry Clin Neurosci 2021; 271:1547-1557. [PMID: 33566159 DOI: 10.1007/s00406-021-01233-3] [Citation(s) in RCA: 5] [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: 05/22/2020] [Accepted: 01/23/2021] [Indexed: 02/07/2023]
Abstract
We aimed to examine the association between religious beliefs and observance and the prevalence of psychiatric disorders, psychotic symptoms and history of suicide attempts in the French general population. The cross-sectional survey interviewed 38,694 subjects between 1999 and 2003, using the MINI. Current religious beliefs and observance were identified by means of two questions: "are you a believer?" and "are you religiously observant?". We studied the association between religiosity and psychiatric outcomes using a multivariable logistic regression model adjusted for sociodemographic characteristics, including migrant status. Religious beliefs were positively associated with psychotic symptoms and disorders [OR = 1.37, 95% CI (1.30-1.45) and OR = 1.38, 95% CI (1.20-1.58)], unipolar depressive disorder [OR = 1.15, 95% CI (1.06-1.23)] and generalized anxiety disorder [OR = 1.13, 95% CI (1.06-1.21)], but negatively associated with bipolar disorder [OR = 0.83, 95% CI (0.69-0.98)], alcohol use disorders [OR = 0.69, 95% CI (0.62-0.77)], substance use disorders [OR = 0.60, 95% CI (0.52-0.69)] and suicide attempts [OR = 0.90, 95% CI (0.82-0.99)]. Religious observance was positively associated with psychotic symptoms and disorders [OR = 1.38, 95% CI (1.20-1.58) and OR = 1.25, 95% CI (1.07-1.45)], but negatively associated with social anxiety disorder [OR = 0.87, 95% CI (0.76-0.99)], alcohol use disorders [OR = 0.60, 95% CI (0.51-0.70)], substance use disorders [OR = 0.48, 95% CI (0.38-0.60)] and suicide attempts [OR = 0.80, 95% CI (0.70-0.90)]. Among believers, religious observance was not associated with psychotic outcomes. Religiosity appears to be a complex and bidirectional determinant of psychiatric symptoms and disorders. In this respect, religiosity should be more thoroughly assessed in epidemiological psychiatric studies, as well as in clinical practice.
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Affiliation(s)
- Maria Alice Brito
- Département Médico-Universitaires de Psychiatrie Et D'addictologie Des Hôpitaux Universitaires Henri-Mondor, Hôpital Albert Chenevier, Groupe Hospitaliers Henri-Mondor, CHU de Créteil Assistance Publique-Hôpitaux de Paris (AP-HP), DMU IMPACT, 40 rue de Mesly, 94 000, Créteil, France.,Paris University, Paris, France
| | - Ali Amad
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France.,Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, 59000, Lille, France.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, Camberwell, London, UK
| | - Benjamin Rolland
- Service Universitaire D'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron France , CRNL, Inserm U1028-CNRS UMR5292, UCBL, Université de Lyon, Lyon, France
| | - Pierre A Geoffroy
- Paris University, Paris, France.,Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat, 46 rue Henri Huchard, 75018, Paris, France.,Université de Paris, NeuroDiderot, Inserm, 75019, Paris, France.,Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
| | - Hugo Peyre
- Paris University, Paris, France.,Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Paris, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, Équipe Eceve Inserm UMR 1123, 211 rue Roger Salengro, 59 260, Hellemmes, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, Équipe Eceve Inserm UMR 1123, 211 rue Roger Salengro, 59 260, Hellemmes, France
| | - Pierre Thomas
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France.,Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, 59000, Lille, France
| | - Guillaume Vaiva
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France.,Centre National de Ressources Et Résilience Pour Les Psychotraumatismes (Cn2r), Lille Paris, France
| | - Franck Schürhoff
- Département Médico-Universitaires de Psychiatrie Et D'addictologie Des Hôpitaux Universitaires Henri-Mondor, Hôpital Albert Chenevier, Groupe Hospitaliers Henri-Mondor, CHU de Créteil Assistance Publique-Hôpitaux de Paris (AP-HP), DMU IMPACT, 40 rue de Mesly, 94 000, Créteil, France.,Laboratoire Neuro-Psychiatrie Translationnelle, Inserm, U955, Institut Mondor de Recherche Biomédicale, 94000, Créteil, France.,Fondation FondaMental, 94000, Créteil, France.,Faculté de Médecine, UPEC, Université Paris Est Créteil, 94000, Créteil, France
| | - Baptiste Pignon
- Département Médico-Universitaires de Psychiatrie Et D'addictologie Des Hôpitaux Universitaires Henri-Mondor, Hôpital Albert Chenevier, Groupe Hospitaliers Henri-Mondor, CHU de Créteil Assistance Publique-Hôpitaux de Paris (AP-HP), DMU IMPACT, 40 rue de Mesly, 94 000, Créteil, France. .,Laboratoire Neuro-Psychiatrie Translationnelle, Inserm, U955, Institut Mondor de Recherche Biomédicale, 94000, Créteil, France. .,Fondation FondaMental, 94000, Créteil, France. .,Faculté de Médecine, UPEC, Université Paris Est Créteil, 94000, Créteil, France.
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Catoire S, Nourredine M, Lefebvre S, Couraud S, Gronfier C, Rey R, Peter-Derex L, Geoffroy PA, Rolland B. Tobacco-induced sleep disturbances: A systematic review and meta-analysis. Sleep Med Rev 2021; 60:101544. [PMID: 34597890 DOI: 10.1016/j.smrv.2021.101544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/26/2022]
Abstract
Even though tobacco-induced sleep disturbances (TISDs) have been reported in previous studies, the present article is the first meta-analysis quantitatively assessing the impact of tobacco on sleep parameters. We conducted a systematic review and meta-analysis of the studies comparing objective (i.e. polysomnography and actigraphy) and/or subjective sleep parameters in chronic tobacco smokers without comorbidities versus healthy controls. Studies were retrieved using PubMed, PsycINFO, and Web of Science. Differences are expressed as standardized mean deviations (SMD) and their 95% confidence intervals (95%CI). Fourteen studies were finally included into the review, among which ten were suitable for meta-analysis. Compared to healthy controls, chronic tobacco users displayed increased N1 percentage (SMD = 0.65, 95%CI: 0.22 to 1.07), N2 percentage (SMD = 1.45, 95%CI: 0.26 to 2.63), wake time after sleep onset (SMD = 6.37, 95%CI: 2.48 to 10.26), and decreased slow-wave sleep (SMD = -2.00, 95%CI: -3.30 to -0.70). Objective TISDs preferentially occurred during the first part of the night. Regarding subjective parameters, only the Pittsburgh Sleep Quality Index (PSQI) total score could be analyzed, with no significant between-groups difference (SMD = 0.53, 95%CI: -0.18 to 1.23). Smoking status should be carefully assessed in sleep medicine, while TISDs should be regularly explored in chronic tobacco users.
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Affiliation(s)
- Sébastien Catoire
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Unité Michel Jouvet, 69Z19, Pôle Est, CH Le Vinatier, 69500, Bron, France; Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Hôpital Lyon-Sud, CHU Lyon, 69310 Pierre Bénite, France.
| | - Mikail Nourredine
- Service Hospitalo-Universitaire de pharmacotoxicologie, Service de recherche et épidémiologie clinique Hospices Civils de Lyon, 69424, Lyon, France; Faculté de Médecine Lyon-Sud, 69921, Oullins, France
| | - Stéphanie Lefebvre
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Hôpital Lyon-Sud, CHU Lyon, 69310 Pierre Bénite, France; EMR 3738 Ciblage thérapeutique en Oncologie, Faculté de médecine et de maïeutique Lyon Sud Charles - Mérieux, Université Lyon 1, France
| | - Claude Gronfier
- Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Romain Rey
- Unité Michel Jouvet, 69Z19, Pôle Est, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Laure Peter-Derex
- Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France; Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Pierre A Geoffroy
- Service de Psychiatrie et d'Addictologie, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Bichat, Paris, France; Université de Paris, NeuroDiderot, Inserm, Paris, France; GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France; Service d'Addictologie, Hôpital Édouard Herriot, CHU Lyon, 69003, Lyon, France
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Chappuy M, Nourredine M, Clerc B, Fahmi M, Misslin P, Berthier M, Laloi L, Rolland B. Gabapentinoid use in French most precarious populations: Insight from Lyon Permanent Access to Healthcare (PASS) units, 2016-1Q2021. Fundam Clin Pharmacol 2021; 36:448-452. [PMID: 34498306 DOI: 10.1111/fcp.12726] [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: 06/07/2021] [Revised: 08/11/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Gabapentinoids (i.e., gabapentin and pregabalin) are medications approved for epilepsy, chronic pain, or generalized anxiety disorder. Recently, there have been regular reports of misuse of pregabalin, and to a lesser extent, gabapentin, in particular among opioid and polydrug users. OBJECTIVES To longitudinally explore the amounts of gabapentinoids dispensed in Lyon's Permanent Access to Healthcare (PASS) units, which offer permanent and free healthcare to precarious populations with no healthcare insurance coverage. METHODS We collected the amounts of pregabalin and gabapentin dispensed in the three PASS units of Lyon and calculated the average doses dispensed monthly between 2016 and the first quarter of 2021 (1Q2021), with and without adjustment for the number of dispensing visits. RESULTS The total doses of gabapentinoid dispensed every month in Lyon's PASS units displayed a 1233% increase for pregabalin, and a 1185% increase for gabapentin, between 2016 and 1Q2021. When adjusted for the number of visits, this increase reached a factor of 8.5 for pregabalin and 8.3 for gabapentin, respectively. However, while the increase in pregabalin dispensing was constant throughout the study period, gabapentin total dispensed doses were more fluctuating over time, and the rise of dispensations was thus less straightforward. CONCLUSION Our study reveals a local but substantial increase in gabapentinoid use in populations with no social insurance. These findings should be confirmed more widely and plead for the systematic collection of anonymous patient data in free healthcare centers in France.
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Affiliation(s)
- Mathieu Chappuy
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France.,Service Universitaire d'Addictologie de Lyon (SUAL), GH Centre, Hospices Civils de Lyon, Lyon, France.,CSAPA, GH Nord, Hospices Civils de Lyon, Lyon, France
| | - Mikail Nourredine
- Service hospitalo-universitaire de pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Lyon, France.,Service de recherche et épidémiologie clinique, Hospices Civils de Lyon, Lyon, France.,Laboratoire d'évaluation et modélisation des effets thérapeutiques, UMR CNRS 5558, Lyon, France
| | | | - Morgan Fahmi
- Service Permanence d'Accès aux Soins de Santé, CH Le Vinatier, Bron, France
| | - Pauline Misslin
- Service Pharmaceutique, CH Saint Joseph - Saint Luc, Lyon, France
| | - Maude Berthier
- Service Permanence d'Accès aux Soins de Santé, GH Centre, Hospices Civils de Lyon, Lyon, France
| | - Louise Laloi
- Service Pharmaceutique, GH Centre, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France.,Service Universitaire d'Addictologie de Lyon (SUAL), GH Centre, Hospices Civils de Lyon, Lyon, France.,Service hospitalo-universitaire de pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Lyon, France.,INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL1, Bron, France
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38
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Scherrer B, Guiraud J, Addolorato G, Aubin HJ, de Bejczy A, Benyamina A, van den Brink W, Caputo F, Dematteis M, Goudriaan AE, Gual A, Kiefer F, Leggio L, Lesch OM, Maremmani I, Nutt DJ, Paille F, Perney P, Poulnais R, Raffaillac Q, Rehm J, Rolland B, Simon N, Söderpalm B, Sommer WH, Walter H, Spanagel R. Baseline severity and the prediction of placebo response in clinical trials for alcohol dependence: A meta-regression analysis to develop an enrichment strategy. Alcohol Clin Exp Res 2021; 45:1722-1734. [PMID: 34418121 PMCID: PMC9291112 DOI: 10.1111/acer.14670] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/03/2021] [Accepted: 07/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is considerable unexplained variability in alcohol abstinence rates (AR) in the placebo groups of randomized controlled trials (RCTs) for alcohol dependence (AD). This is of particular interest because placebo responses correlate negatively with treatment effect size. Recent evidence suggests that the placebo response is lower in very heavy drinkers who show no "spontaneous improvement" prior to treatment initiation (high-severity population) than in a mild-severity population and in studies with longer treatment duration. We systematically investigated the relationship between population severity, treatment duration, and the placebo response in AR to inform a strategy aimed at reducing the placebo response and thereby increasing assay sensitivity in RCTs for AD. METHODS We conducted a systematic literature review on placebo-controlled RCTs for AD.We assigned retained RCTs to high- or mild-severity groups of studies based on baseline drinking risk levels and abstinence duration before treatment initiation. We tested the effects of population severity and treatment duration on the placebo response in AR using meta-regression analysis. RESULTS Among the 19 retained RCTs (comprising 1996 placebo-treated patients), 11 trials were high-severity and 8 were mild-severity RCTs. The between-study variability in AR was lower in the high-severity than in the mild-severity studies (interquartile range: 7.4% vs. 20.9%). The AR in placebo groups was dependent on population severity (p = 0.004) and treatment duration (p = 0.017) and was lower in the high-severity studies (16.8% at 3 months) than the mild-severity studies (36.7% at 3 months). CONCLUSIONS Pharmacological RCTs for AD should select high-severity patients to decrease the magnitude and variability in the placebo effect and and improve the efficiency of drug development efforts for AD.
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Affiliation(s)
- Bruno Scherrer
- Bruno Scherrer Conseil, Saint Arnoult en Yvelines, France
| | - Julien Guiraud
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,DA Pharma, Paris, France
| | - Giovanni Addolorato
- Alcohol Use Disorder and Alcohol Related Disease Unit, Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy.,Internal Medicine Unit, Department of Internal Medicine and Gastroenterology, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Henri-Jean Aubin
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), French Institute of Health and Medical Research (Inserm), Paris, France.,Addiction Research and Treatment Center, Paul Brousse Hospital, Paris-Sud University, Villejuif, France
| | - Andrea de Bejczy
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Amine Benyamina
- Addiction Research and Treatment Center, Paul Brousse Hospital, Paris-Sud University, Villejuif, France
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Fabio Caputo
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.,Department of Translational Medicine, Center for the Study and Treatment of Alcohol-Related Diseases, University of Ferrara, Ferrara, Italy.,Department of Translational Medicine, Center for the Study and Treatment of Chronic Inflammatory Bowel Diseases (IBD) and Gastroenterological Manifestations of Rare Diseases, University of Ferrara, Ferrara, Italy.,Department of Internal Medicine, Santissima Annunziata Hospital, Cento (Ferrara), University of Ferrara, Ferrara, Italy
| | - Maurice Dematteis
- Department of Addiction Medicine, Faculty of Medicine, Grenoble Alpes University Hospital, Grenoble Alpes University, Grenoble, France
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Research and Quality of Care, Arkin, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Antoni Gual
- Psychiatry Department, Neurosciences Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Falk Kiefer
- Medical Faculty Mannheim, Central Institute of Mental Health, Institute of Psychopharmacology, University of Heidelberg, Heidelberg, Germany.,Bethania Hospital for Psychiatry, Psychosomatics, and Psychotherapy, Greifswald, Germany
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Basic Research, National Institutes of Health, Baltimore and Bethesda, Maryland, USA.,Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland, USA.,Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA.,Division of Addiction Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Neuroscience, Georgetown Medical Center, Washington, District of Columbia, USA
| | - Otto-Michael Lesch
- Department of Social Psychiatry, University for Psychiatry and Psychotherapy, Vienna, Austria
| | - Icro Maremmani
- Santa Chiara University Hospital, University of Pisa, Pisa, Italy
| | - David J Nutt
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - François Paille
- Department of Addiction Treatment, University Hospital, Vandoeuvre-lès-Nancy, France
| | - Pascal Perney
- Addiction Medicine, Hospital Grau-du-Roi, Nimes, France
| | | | | | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada.,Department of Psychiatry, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Benjamin Rolland
- UCBL, INSERM U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon (CRNL), Univ Lyon, Bron, France
| | - Nicolas Simon
- Department of Clinical Pharmacology, CAP-TV, Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hop Sainte Marguerite, Marseille, France
| | - Bo Söderpalm
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Wolfgang H Sommer
- Medical Faculty Mannheim, Central Institute of Mental Health, Institute of Psychopharmacology, University of Heidelberg, Heidelberg, Germany.,Central Institute of Mental Health, Institute of Psychopharmacology, Heidelberg University, Mannheim, Germany
| | - Henriette Walter
- Department of Social Psychiatry, University for Psychiatry and Psychotherapy, Vienna, Austria
| | - Rainer Spanagel
- Central Institute of Mental Health, Institute of Psychopharmacology, Heidelberg University, Mannheim, Germany
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Rolland B, Haesebaert F, Zante E, Benyamina A, Haesebaert J, Franck N. Correction: Global Changes and Factors of Increase in Caloric/Salty Food Intake, Screen Use, and Substance Use During the Early COVID-19 Containment Phase in the General Population in France: Survey Study. JMIR Public Health Surveill 2021; 7:e31906. [PMID: 34283724 PMCID: PMC8335607 DOI: 10.2196/31906] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon, CH Le Vinatier, Hospices Civils de Lyon, Bron, France.,Inserm U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Bron, France
| | - Frédéric Haesebaert
- Centre Ressource de Réhabilitation Psychosociale, CH Le Vinatier, Lyon, France
| | - Elodie Zante
- Centre Ressource de Réhabilitation Psychosociale, CH Le Vinatier, Lyon, France
| | - Amine Benyamina
- PSYCOMADD 4872, Université Paris-Saclay, Paris, France.,CH Le Vinatier, Pôle Centre Rive Gauche, Bron, France
| | - Julie Haesebaert
- Service de recherche et d'épidémiologie, Pôle de santé publique, Hospices Civils de Lyon, Lyon, France
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Grolleau E, Fonteille V, Lebourgeois C, Darrason M, Michel P, Ragonnet D, Freyer G, Deculty A, Gippet C, Leclercq C, Neugnot C, Malek R, Perdriolat O, Rigaud M, Torrecillas S, Barral MC, Souquet PJ, Fassier JB, Tanguy L, Rolland B, Couraud S. Tobacco use and related behaviors among staff and students in a university hospital: A large cross-sectional survey. Tob Prev Cessat 2021; 7:49. [PMID: 34268457 PMCID: PMC8265395 DOI: 10.18332/tpc/137670] [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] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/14/2021] [Accepted: 05/18/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Smoking prevalence in the overall population in France was 27% in 2017. There are few data about smoking prevalence in hospital workers. The aim of this study was to assess prevalence of current smoking in student and staff populations at Lyon University Hospital. Secondary objectives were to identify main variables associated with current smoking and willingness to quit. METHODS We designed a single center, cross-sectional survey, using printed questionnaires. During one day, all registered staff and students were surveyed. We used optical reading to extract information from questionnaires. We performed univariate and multivariate analysis adjusted on most relevant factors. RESULTS We analyzed 9712 questionnaires. The participating rates were high: 40.6% in the student cohort and 51.5% in the staff cohort. The proportion of current cigarette users was 26% in students and 25% in staff. In multivariate analysis, current smoking was significantly associated with: younger age, male sex, occupation type (e.g. logistical staff, and paramedical students), overnight work, and e-cigarette use. Among smokers, 53% reported a willingness to quit. In multivariate analysis, number of quit attempts, and feeling symptoms from tobacco were associated with willingness to quit. CONCLUSIONS Current smoking is less frequent in our cohorts of hospital staff and students than in the general French population. However, there are deep disparities in current smoking prevalence underlining a heterogeneous population. Among smokers, the majority reported a willingness to quit and some predictive factors may help to target this audience.
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Affiliation(s)
- Emmanuel Grolleau
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Véronique Fonteille
- Equipe de Liaison en Addictologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Caroline Lebourgeois
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France.,Direction de la Performance et du Contrôle de Gestion, Hospices Civils de Lyon, Lyon, France
| | - Marie Darrason
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Philippe Michel
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France.,Direction de l'Organisation, de la Qualité des Soins et des Relations avec les Usagers Hospices Civils de Lyon, Lyon, France
| | - Delphine Ragonnet
- Service d'Addictologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Gilles Freyer
- Institut de Cancérologie des Hospices Civils de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Amélie Deculty
- Centre de Coordination en Cancérologie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Carine Gippet
- Centre de Coordination en Cancérologie, Hospices Civils de Lyon, Lyon, France
| | - Céline Leclercq
- Centre de Coordination en Cancérologie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Carole Neugnot
- Centre de Coordination en Cancérologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Radoudja Malek
- Centre de Coordination en Cancérologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Odile Perdriolat
- Unité de Tabacologie, Service de Maternité, Hôpital Femme-Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Michele Rigaud
- Centre de Coordination en Cancérologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Séverine Torrecillas
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Centre de Coordination en Cancérologie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Maud-Catherine Barral
- Unité de Tabacologie, Service de Maternité, Hôpital Femme-Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Pierre-Jean Souquet
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Jean-Baptiste Fassier
- Service de Médecine et Santé au Travail, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Lénaïck Tanguy
- Institut de Cancérologie des Hospices Civils de Lyon, Hospices Civils de Lyon, Lyon, France.,Direction de la Coopération et des Stratégies, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- Equipe de Liaison en Addictologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.,Service d'Addictologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Service Universitaire d'Addictologie de Lyon, Centre Hospitalier du Vinatier, Bron, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Equipe IBISCUS, Centre d'Innovation en Cancérologie de Lyon (CICLY), Faculté de Médecine Lyon Sud, Oullins, France
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Chapron SA, Nourredine M, Dondé C, Haesebaert F, Micoulaud-Franchi JA, Geoffroy PA, Rolland B. Efficacy and safety of topiramate for reducing impulsivity: A transdiagnostic systematic review and meta-analysis of a common clinical use. Fundam Clin Pharmacol 2021; 36:4-15. [PMID: 34212434 DOI: 10.1111/fcp.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/24/2021] [Indexed: 11/29/2022]
Abstract
Impulsivity is an important transdiagnostic feature of many psychiatric disorders, as well as a marker of poorer outcome. Topiramate is broadly used for reducing impulsivity in various neuropsychiatric disorders, but no systematic review or meta-analysis has ever explored whether evidence supports this clinical use. We conducted a systematic review and meta-analysis of the literature, using PubMed, PsycInfo and Cochrane databases. We included all studies assessing the efficacy of topiramate in adults with high levels of impulsivity, based on either psychometric or neuropsychological measures. Seven articles were included, involving 578 participants. Important heterogeneity in designs and quality features was observed. Topiramate lowered impulsivity levels in two of the studies that used the Barratt Impulsiveness Scale (BIS) (401 participants) and in one of the studies that used neuropsychological measures (63 participants). Four other studies found no effect of topiramate on impulsivity. A larger reduction in the BIS-11 overall score, with a mean difference of 2.57 (95% confidence interval -4.12 to -1.02), was found in the topiramate group than the placebo group using a random effects model. However, one study accounted for the major part (85.5%) of it, and most included studies presented a high risk of bias. The use of a self-assessment scale induced an additional risk of self-report bias. No clear-cut evidence was found for a transdiagnostic effectiveness of topiramate in reducing impulsivity levels. However, encouraging results were found in some specific disorders.
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Affiliation(s)
- Sophie-Athéna Chapron
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France
| | - Mikail Nourredine
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France
| | - Clément Dondé
- Department of Medicine, University Grenoble Alpes, Grenoble, France.,Psychiatry Department, University Hospital Grenoble Alpes, Grenoble, France.,INSERM U1216, Brain Behavior and Neuromodulation Team, Grenoble Institute Neuroscience, La Tronche, France
| | - Frédéric Haesebaert
- Faculty of Medicine Lyon-Est, University Claude Bernard Lyon 1, Lyon, France.,Department SUR-CL3R-PEPS, Le Vinatier Hospital, Bron, France
| | - Jean-Arthur Micoulaud-Franchi
- USR CNRS 3413 SANPSY, Pellegrin University Hospital, University of Bordeaux, France.,University Sleep Clinic, Services of functional exploration of the nervous system, University Hospital of Bordeaux, Bordeaux, France
| | - Pierre Alexis Geoffroy
- Department of Psychiatry and Addictive Medicine, University Hospital Bichat-Claude Bernard, Public Hospitals of Paris, Paris, France.,INSERM U1141, NeuroDiderot, Paris University, Paris, France
| | - Benjamin Rolland
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France.,Academic Department of Addiction Medicine of Lyon (SUAL), Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.,INSERM U1028, CNRS UMR5292, PSY2R Team, Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France
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Nourredine M, Gering A, Fourneret P, Rolland B, Falissard B, Cucherat M, Geoffray MM, Jurek L. Association of Attention-Deficit/Hyperactivity Disorder in Childhood and Adolescence With the Risk of Subsequent Psychotic Disorder: A Systematic Review and Meta-analysis. JAMA Psychiatry 2021; 78:519-529. [PMID: 33625499 PMCID: PMC7905700 DOI: 10.1001/jamapsychiatry.2020.4799] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE Growing evidence supports an association between attention-deficit/hyperactivity disorder (ADHD) in childhood and subsequent psychotic disorders. Both disorders share physiopathological features such as attention deficits, dopaminergic imbalance, and genetic susceptibility. However, the results of epidemiologic studies have been conflicting. OBJECTIVE To provide a quantitative synthesis of studies exploring the association between ADHD and the risk of subsequent psychotic disorder. DATA SOURCES A systematic literature search of the MEDLINE, Scopus, PsycInfo, and Web of Science databases was performed from inception until the final analysis on July 7, 2020. No restriction of language was applied. STUDY SELECTION Cohort and case-control studies examining the relative risk of developing a psychotic disorder in people diagnosed with ADHD at younger than 18 years compared with control individuals without ADHD. DATA EXTRACTION AND SYNTHESIS Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed in reporting results. Two independent reviewers extracted the data and assessed the risk of bias of individual studies using the Newcastle-Ottawa Scale. Preferably adjusted odds ratios (aORs) or hazard ratios from the identified studies were extracted, and ORs were computed when they were not adjusted. A random-effects model was used to calculate the pooled relative effect using the meta package in R. MAIN OUTCOMES AND MEASURES An association between ADHD (exposure) and psychotic disorder (outcomes); both diagnoses were based on international classification. RESULTS A total of 15 studies were included in the review. Twelve studies were pooled in the meta-analysis, representing 1.85 million participants. A diagnosis of ADHD in childhood was associated with a significant increase in the risk of subsequent psychotic disorder, with a pooled relative effect of 4.74 (95% CI, 4.11-5.46; I2 = 43% [95% CI, 0%-70%]). No significant between-group differences were found for subgroup analyses according to psychotic disorder (odds ratio [OR], 5.04; 95% CI, 4.36-5.83) or schizophrenia (OR, 4.59; 95% CI, 3.83-5.50) outcomes, cohort (OR, 4.64; 95% CI, 4.04-5.34) or case-control (OR, 6.81; 95% CI, 4.21-11.03) study design, and adjusted (OR, 4.72; 95% CI, 4.11-5.46) or unadjusted (OR, 3.81; 95% CI, 1.39-10.49) estimates. Meta-regressions were not significant when sex and bias score were used as covariates. No evidence of publication bias was found. CONCLUSIONS AND RELEVANCE These findings suggest that childhood ADHD is associated with an increased risk of a subsequent psychotic disorder. Further studies are required to determine the mechanisms linking these common conditions and whether early intervention for ADHD might reduce the risk of subsequent psychotic disorder.
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Affiliation(s)
- Mikaïl Nourredine
- Service Hospitalo-Universitaire de Pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Lyon, France,Service Universitaire d’Addictologie de Lyon, Centre Hospitalier Le Vinatier, Bron, France
| | - Adrien Gering
- Centre d’Evaluation et de Diagnostic de l’Autisme et Autres Troubles du Neurodéveloppement, Centre Hospitalier Le Vinatier, Bron, France
| | - Pierre Fourneret
- Service de Psychopathologie de l’Enfant et du Développement, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- Service Universitaire d’Addictologie de Lyon, Centre Hospitalier Le Vinatier, Bron, France,Université de Lyon, Université Claude Bernard Lyon, Centre de Recherche en Neurosciences de Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1028, Centre National de la Recherche Scientifique (CNRS) Unité Mixte de Recherche (UMR) 5292, Psychiatric Disorders: Neuroscience Research And Clinical Research 2, Lyon, France
| | - Bruno Falissard
- Centre de Recherche en Epidémiologie et en Santé des Populations, INSERM U1018, Université Paris-Saclay, Paris, France
| | - Michel Cucherat
- Laboratoire de Biométrie et Biologie Evolutive, Service de Pharmacologie Clinique, UMR CNRS 5558, Lyon, France
| | - Marie-Maude Geoffray
- Centre d’Evaluation et de Diagnostic de l’Autisme et Autres Troubles du Neurodéveloppement, Centre Hospitalier Le Vinatier, Bron, France,Health Services and Performance Research EA7425, Université Lyon 1, Lyon, France
| | - Lucie Jurek
- Centre d’Evaluation et de Diagnostic de l’Autisme et Autres Troubles du Neurodéveloppement, Centre Hospitalier Le Vinatier, Bron, France,Health Services and Performance Research EA7425, Université Lyon 1, Lyon, France
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Luquiens A, Berger-Viergat A, Larrieu A, Artigaud L, Fener C, Adamson S, Laprévote V, Rolland B. Validation of the French version of the Cannabis Use Disorder Identification Test-Revised and comparison with the Cannabis Abuse Screening Test for screening cannabis use disorder in a psychiatric sample. Drug Alcohol Rev 2021; 40:1334-1339. [PMID: 33855757 DOI: 10.1111/dar.13298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 03/22/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Several questionnaires have been developed for screening cannabis use disorder in clinical populations, but very few studies have compared the screening abilities of the different instruments. Here, we aimed to confirm the psychometric properties of a French version of the Cannabis Use Disorder Identification Test-Revised (CUDIT-R), and to compare its screening abilities with those of the Cannabis Abuse Screening Test (CAST), in subjects consulting in mental health settings. METHODS Two hundred and thirteen cannabis smokers who sought treatment for any type of mental disorder, recruited in four French centres, completed the French CUDIT-R (CUDIT-R-Fr) and the full version of the CAST, and were assessed for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria of cannabis use disorder by an addiction specialist. They were retested with the CUDIT-R-Fr after approximately a week. The factorial construct validity, internal consistency and test-retest reliability of the CUDIT-R-Fr were assessed. The compared sensitivity and specificity of the CAST and CUDIT-R-Fr were explored, using the clinician assessment as the reference. RESULTS The French CUDIT-R showed a good internal consistency (Cronbach's alpha = 0.89) and an excellent test-retest reliability (ρ = 0.97). The sensitivity and specificity for screening cannabis use disorder were 0.81 and 0.77 for the CUDIT-R, and 0.92 and 0.63 for the CAST, respectively. CONCLUSIONS Based on the recommended cut-offs, the CAST appeared more sensitive, while the CUDIT-R was more specific, for screening cannabis use disorder in a population of cannabis users with heterogeneous types of mental health disorders.
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Affiliation(s)
- Amandine Luquiens
- Paris-Saclay University, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Service d'Addictologie, CHU Nîmes, Nîmes, France
| | - Aurélie Berger-Viergat
- Service d'Addictologie Universitaire, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Agathe Larrieu
- Service Universitaire d'Addictologie de Lyon, CH le Vinatier, Bron, France
| | - Laura Artigaud
- Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Psychothérapique de Nancy, Laxou, France
| | - Clémentine Fener
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France
| | - Simon Adamson
- National Addiction Center, Department of Psychological Medicine, Christchurch School of Medicine, Christchurch, New Zealand.,Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Vincent Laprévote
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France.,INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France.,Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Benjamin Rolland
- Service d'Addictologie Universitaire, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.,Service Universitaire d'Addictologie de Lyon, CH le Vinatier, Bron, France.,PSYR2 Team, INSERM U1028, CNRS UMR5292, Université de Lyon, UCBL1, CRNL, Bron, France
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Cublier M, Menecier P, von Gunten A, Lepetit A, Dorey JM, Rolland B. Misuse of opioid analgesics in elderly patients: a review. Geriatr Psychol Neuropsychiatr Vieil 2021:pnv.2021.0926. [PMID: 33832877 DOI: 10.1684/pnv.2021.0926] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Opioid analgesic (OA) addiction occurs frequently among the elderly, and results in high morbidity and mortality due to geriatric pathologies associated with pharmacokinetic modifications. However, patients with this type of addiction are under-identified and specific screening tools should be more widely used to detect the risk factors for OA addiction. Before initiating an opioid prescription, exhaustive research into associated treatments (to track drug interaction) and opioid prescriptions by other clinicians (a phenomenon known as "doctor shopping") is required. Specific specialist care, as has been developed in the United States, is still scarce in France and treatment is provided through collaboration between geriatricians and psychiatrists. Optimisation of the treatment of somatic and psychiatric comorbidities is key to effective management.
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Affiliation(s)
- Manon Cublier
- Service universitaire de psychiatrie de l'âge avancé (SUPAA), Hôpital de Cery, Prilly, Suisse, Consultations mémoire, CH Le Vinatier, Bron, France
| | - Pascal Menecier
- Unité d'addictologie et Consultation mémoire, CH les Chanaux, Mâcon, France, Institut de psychologie, Université Lyon 2, Laboratoire Diphe, Bron, France
| | - Armin von Gunten
- Service universitaire de psychiatrie de l'âge avancé (SUPAA), Hôpital de Cery, Prilly, Suisse
| | - Alexis Lepetit
- Équipe mobile maladie d'Alzheimer, CH Les Charpennes, Villeurbanne, France
| | - Jean-Michel Dorey
- Service universitaire de psychiatrie de l'âge avancé (SUPAA), Hôpital de Cery, Prilly, Suisse, Consultations mémoire, CH Le Vinatier, Bron, France
| | - Benjamin Rolland
- Service universitaire d'addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France, Université de Lyon, UCBL, Centre de recherche en neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, PSYR2, Bron, France
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Rolland B. Baclofen approval in france: A balance between two conceptions of medicine. Eur Psychiatry 2021. [PMCID: PMC9471670 DOI: 10.1192/j.eurpsy.2021.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In October 2018, France became the first country to officially approve baclofen for alcohol use disorder (AUD), even if the French Drug Agency (ANSM) officially stated that the efficacy of baclofen in AUD could be not established at this stage, in the light of the available evidence. The decision of the ANSM comprised obvious political aspects, as baclofen approval followed a decade-long practice of off-label prescription, where doses used could reach 300 mg per day or more. This situation led to a prolonged and ferocious debate between those who questioned such a widespread and unevidenced practice, and those who defended the place of an “common sense” empirical medicine. The French story of baclofen echoes other similar controversial off-label prescribing practices in the country, from the pioneer use buprenorphine for opioid use disorder in the 1990s, to the more recent off-label use of hydroxychloroquine during the COVID-19 outbreak. In each case, similar “pros” and “cons” arguments were opposed, highlighting the difficult interpenetration between evidence-based medicine on the one hand, and on-the-ground practice on the other hand.
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Rolland B. Doctor shopping for methylphenidate as a proxy for misuse and potential abuse in the 67 million inhabitants in France. Fundam Clin Pharmacol 2021; 35:749-750. [PMID: 33774849 DOI: 10.1111/fcp.12675] [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] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, CH Le Vinatier, Lyon, France.,PSYR, CRNL, INSERM U1028, CNRS UMR5292, UCBL1, Lyon, France
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Rolland B, Trojak B, Nourredine M, Bachellier J, Chappuy M, Bendimerad P, Kosim M, Hjelmström P, Meroueh F, Nubukpo P, Brousse G. Determinants of interest in extended-released buprenorphine: A survey among 366 French patients treated with buprenorphine or methadone. Drug Alcohol Depend 2021; 220:108492. [PMID: 33482572 DOI: 10.1016/j.drugalcdep.2020.108492] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
AIM To explore the factors determining the interest in extended-release buprenorphine (XR-BUP) injections among patients receiving opioid agonist treatment (OAT) in France. METHODS 366 patients receiving OAT for opioid use disorder, recruited in 66 French centers, were interviewed from 12/2018 to 05/2019. A structured questionnaire assessed their interest in XR-BUP using a [1-10] Likert scale. 'More' vs. 'less' interested groups were defined using the median score of interest, and their characteristics were explored using adjusted odds ratios (aORs) and 95 % confidence interval (95 %CI). Independent variables were as follows: sociodemographic characteristics, OAT-related features (e.g., type of OAT and prescriber, dosing, or duration of treatment), OAT representations, and personal objectives of treatment. RESULTS The median interest in XR-BUP was 7 (interquartile range: 3-9) out of 10. The participants who were 'more interested' (i.e. those scoring ≥7) showed no substantial difference in sociodemographic characteristics, relative to the 'less interested' participants. However, they more frequently reported forgetting to take their OAT (OR = 1.81; CI95 % = 1.06-3.10) or reported experiencing situations where taking their OAT was impractical (aOR = 1.69; CI95 % = 1.05-2.73). Their treatment objective was more focused on stopping illicit drugs (aOR = 1.67; 95 %CI = 1.02-2.70), reducing health risks (aOR = 3.57; 95 %CI = 1.67-7.69) and craving (aOR = 2.38; 95 %CI = 1.39-4.02) or improving family (aOR = 1.81; 95 %CI = 1.03-3.13) or professional (aOR = 2.22; 95 %CI = 1.43-3.85) recovery. CONCLUSIONS In France, where the access to OAT is relatively unrestricted, the majority of participants were interested in XR-BUP formulations. Being interested was associated with treatment objectives focused on abstinence and recovery, and with experiencing constraints in taking a daily oral OAT.
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Affiliation(s)
- Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, 69500, Bron, France; Service d'Addictologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France; INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL1, Bron, France.
| | - Benoit Trojak
- Service Hospitalo-Universitaire d'Addictologie, CHU de Dijon, Dijon, France; INSERM U1093, UFR Staps, Université de Bourgogne Franche Comté, France
| | - Mikail Nourredine
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, 69500, Bron, France
| | - Jérôme Bachellier
- Service Universitaire d'Addictologie de Tours, CHU Bretonneau, Tours, France
| | - Mathieu Chappuy
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, 69500, Bron, France; Service d'Addictologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Patrick Bendimerad
- Service d'Addictologie, Groupe Hospitalier de La Rochelle-Ré-Aunis, La Rochelle, France
| | - Margaux Kosim
- Consultations de Médecine-Alcoologie PASS, Groupe Hospitalier Pitié Salpêtrière, Paris, France; Camurus SAS, Paris, France
| | | | | | - Philippe Nubukpo
- Service d'Addictologie, Centre Hospitalier Esquirol, Limoges, France; INSERM UMR 1094, Université de Limoges, Limoges, France
| | - Georges Brousse
- Service de Psychiatrie B et d'Addictologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France; Équipe d'Accueil 7280, Université Clermont Auvergne, Clermont-Ferrand, France
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Boucher A, Ragonnet D, Lack P, Rolland B, Chappuy M. Usages de prégabaline au sein d’une file active de CSAPA : état des lieux préliminaire. Therapie 2021. [DOI: 10.1016/j.therap.2021.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Flaudias V, Zerhouni O, Pereira B, Cherpitel CJ, Boudesseul J, de Chazeron I, Romo L, Guillaume S, Samalin L, Cabe J, Bègue L, Gerbaud L, Rolland B, Llorca PM, Naassila M, Brousse G. The Early Impact of the COVID-19 Lockdown on Stress and Addictive Behaviors in an Alcohol-Consuming Student Population in France. Front Psychiatry 2021; 12:628631. [PMID: 33633612 PMCID: PMC7900161 DOI: 10.3389/fpsyt.2021.628631] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background: This study evaluated factors linked with perceived stress related to the COVID-19 pandemic and lockdown and addictive behaviors prior to and during lockdown in a sample of students who indicated engaging in alcohol consumption behaviors before lockdown. Methods: Cross-sectional study. French students from four universities participated in this study, and 2,760 students reported alcohol use. During the first week of lockdown, students reported their perceived levels of stress regarding COVID-19. Substance use and addictive behaviors were reported before and during lockdown, and media exposure, demographical, living conditions, and environmental stressors were reported during lockdown. Results: Women reported greater levels of stress (95% CI: 1.18 to 1.93, p < 0.001). Highly-stressed students also report less social support (95% CI: -1.04 to -0.39, p < 0.001) and were more likely to worry about the lockdown (95% CI: 0.27 to -0.65, p < 0.001). Alcohol-related problemswere more prevalent among the most stressed students (95% CI: 0.02 to 0.09, p = 0.004) as well as eating problems (95% CI: 0.04 to 0.36, p = 0.016) and problematic internet use (95% CI, 0.06 to 0.14, p < 0.001). Students reporting the highest levels of stress also indicated more compulsive eating during the previous seven days (95% CI, 0.21 to 1.19, p = 0.005). Conclusions: The level of stress was strongly related to four categories of variables: (i) intrinsic characteristics, (ii) addictive behaviors before lockdown, (iii) lockdown-specific conditions, and (iv) addictive behaviors during the lockdown. Several variables linked to COVID-19 were not directly linked with perceived stress, while perceived stress was found to correlate with daily life organization-related uncertainty and anticipated consequences of lockdown. Importantly, social support seems to be a protective factor on high level of stress.
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Affiliation(s)
- Valentin Flaudias
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | - Oulmann Zerhouni
- Laboratoire Parisien de Psychologie Sociale, Département de Psychologie, University Paris Nanterre, Ad Hoc Lab, Nanterre, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | | | - Jordane Boudesseul
- Facultad de Psicología, Instituto de Investigación Científica, Universidad de Lima, Lima, Peru
| | - Ingrid de Chazeron
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | - Lucia Romo
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
- CMME, GHU Paris Psychiatrie et Neurosciences, U de Paris, Paris, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier/INSERM U1061, University of Montpellier, Montpellier, France
| | - Ludovic Samalin
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | - Julien Cabe
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
| | | | - Laurent Gerbaud
- Service de Santé Publique, CHU de Clermont-Ferrand, Clermont-Ferrand, France
- Université Clermont Auvergne, CNRS-UMR 6602, Institut Pascal, Axe TGI, Groupe PEPRADE, Clermont-Ferrand, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CRNL, Inserm U1028, CNRS UMR5292, Université Lyon 1, Centre Hospitalier Le Vinatier, Bron, France
| | | | - Mickael Naassila
- Université de Picardie Jules Verne, Unité INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Centre Universitaire de Recherche en Santé, Amiens, France
| | - Georges Brousse
- CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France
- Université Clermont Ferrand, EA NPsy-Sydo, BP 10448, Clermont-Ferrand, France
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Nourredine M, Jurek L, Angerville B, Longuet Y, de Ternay J, Derveaux A, Rolland B. Use of Topiramate in the Spectrum of Addictive and Eating Disorders: A Systematic Review Comparing Treatment Schemes, Efficacy, and Safety Features. CNS Drugs 2021; 35:177-213. [PMID: 33591567 DOI: 10.1007/s40263-020-00780-y] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Topiramate has been approved by the US Food and Drug Administration for the treatment of epilepsy since the 1990s, and it has also been used off-label in the treatment of many types of addictive disorders. To date, no systematic review has embraced the entire field of addiction, both substance use and behavioral addictions, including eating disorders, to compare topiramate-based protocols and the related level of evidence in each addictive disorder. Our objective is to fill this gap. METHODS A systematic search was conducted using the MEDLINE, PsycINFO, and Cochrane databases without a date or language limit. All trials and meta-analyses assessing the efficacy of topiramate in alcohol use disorder; cocaine use disorder; methamphetamine, nicotine, cannabis, opiate, and benzodiazepine use disorders; binge eating disorder; bulimia; and pathological gambling were analyzed. The quality of the studies was rated using the Cochrane Risk-of-Bias tool for randomized trials (ROB-2), the Risk of Bias In Nonrandomized Studies (ROBINS-I), or the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, depending on the study design. Safety features were assessed based on a wider non-systematic review. RESULTS Sixty-two articles were reviewed. Treatment protocols were relatively homogenous across addictive disorders, with slow dose titration schemes and a maximum dose range of 200-400 mg per day. The most supportive evidence for topiramate efficacy was found in alcohol use disorder for drinking reduction parameters only. To a lesser extent, topiramate could be a promising therapeutic option for binge eating disorder and cocaine use disorder. Evidence was weak for other addictive disorders. No major tolerability issues were found, provided that basic safety rules were followed. Adverse drug reactions could lead to early treatment discontinuation. DISCUSSION Though off-label, addiction specialists should consider topiramate as a second-line option for drinking reduction in alcohol use disorder, as well as for binge eating disorder or cocaine use disorder.
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Affiliation(s)
- Mikail Nourredine
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Pôle MOPHA, 95 Bd Pinel, 69500, Bron, France. .,Service Hospitalo-Universitaire de Pharmaco-Toxicologie, Hospices Civils de Lyon, Lyon, France.
| | - Lucie Jurek
- Centre d'Évaluation et Diagnostic de l'Autisme, CH Le Vinatier, Bron, France.,HESPER, Health Services and Performance Research EA7425-Université Lyon 1, Lyon, France
| | - Bernard Angerville
- Service de Psychiatrie et Addictologie de liaison, CHU Sud, Amiens Cedex, France.,Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, France
| | - Yannick Longuet
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Pôle MOPHA, 95 Bd Pinel, 69500, Bron, France
| | - Julia de Ternay
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Pôle MOPHA, 95 Bd Pinel, 69500, Bron, France
| | - Alain Derveaux
- Service de Psychiatrie et Addictologie de liaison, CHU Sud, Amiens Cedex, France.,Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Pôle MOPHA, 95 Bd Pinel, 69500, Bron, France.,Université de Lyon, UCBL, Centre de Recherche en Neurosciences de Lyon (CRNL), INSERM U1028, CNRS UMR5292, PSYR2, Bron, France
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