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Baussay A, Di Lodovico L, Poupon D, Doublet M, Ramoz N, Duriez P, Gorwood P. The capacity of cognitive tests to detect generalized anxiety disorder (GAD): A pilot study. J Psychiatr Res 2024; 174:94-100. [PMID: 38626566 DOI: 10.1016/j.jpsychires.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/18/2024]
Abstract
Cognitive impairment remains understudied in generalized anxiety disorder (GAD), despite the high prevalence and substantial burden associated with this disorder. We aimed to assess cognitive impairment in patients with GAD and evaluate the ability of cognitive tests to detect this disorder. Because of its high rate of comorbidity, we also examined how other anxiety disorders and current major depressive episodes affected our results. We tested 263 consecutive general practice outpatients. We used the GAD-7 and the Mini International Neuropsychiatric Interview (MINI) to detect anxiety and mood disorders. We assessed cognitive performance with the Stroop test, a facial emotion recognition test, and the trail-making test (TMT). Compared to patients without GAD, patients with GAD were significantly slower to complete the TMT(B-A) and faster to recognize emotions, especially negative ones such as disgust and anger. When controlling for other anxiety disorders and current major depressive episode, GAD retained a significant effect on the TMT(B-A), but not on the emotion recognition test. The TMT(B-A) could detect GAD with good accuracy (area under the curve (AUC) = 0.83, maximal Youden's index = 0.56), which was by no means comparable to the GAD-7 (AUC = 0.97, Youden's index = 0.81). While it is not efficient enough to replace the GAD-7 as a diagnostic tool, the capacity of the TMT(B-A) to detect GAD emphasizes the importance of cognitive flexibility impairment in GAD.
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Affiliation(s)
- Axel Baussay
- Université de Versailles Saint-Quentin-en-Yvelines. 2 Av. de La Source de La Bièvre, 78180, Montigny-le-Bretonneux, France
| | - Laura Di Lodovico
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 100 Rue de La Santé, F-75014, Paris, France; Université Paris Cité, INSERM, UMR1266, F-75013, Paris, France
| | - Daphnee Poupon
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 100 Rue de La Santé, F-75014, Paris, France
| | | | - Nicolas Ramoz
- Université Paris Cité, INSERM, UMR1266, F-75013, Paris, France
| | - Philibert Duriez
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 100 Rue de La Santé, F-75014, Paris, France; Université Paris Cité, INSERM, UMR1266, F-75013, Paris, France
| | - Philip Gorwood
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 100 Rue de La Santé, F-75014, Paris, France; Université Paris Cité, INSERM, UMR1266, F-75013, Paris, France.
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Mattioni J, Vansteene C, Poupon D, Gorwood P, Ramoz N. Associated and intermediate factors between genetic variants of the dopaminergic D2 receptor gene and harmful alcohol use in young adults. Addict Biol 2023; 28:e13269. [PMID: 36825486 PMCID: PMC10078472 DOI: 10.1111/adb.13269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/08/2022] [Accepted: 01/11/2023] [Indexed: 02/10/2023]
Abstract
Dopamine receptor D2 (DRD2) and ankyrin repeat and kinase domain-containing protein 1 (ANKK1) genes have received considerable attention for their involvement in alcohol use disorder (AUD), but many questions remain on their exact role. We conducted a population-based case-control and genetic association study in a large sample of young adults. Our aim was to assess the association between DRD2 and ANKK1 single nucleotide polymorphisms (SNPs) and harmful alcohol use, disentangling associated and possible intermediate factors. A total of 1841 college students from the French region Champagne-Ardennes, aged between 18 and 21 years and who reported at least one lifetime alcohol consumption, were included in this study. Allele frequencies were analysed according to harmful alcohol use (assessed through the Alcohol Use Disorder Identification Test [AUDIT] questionnaire). Different substance use disorders, including nicotine and cannabis dependences, were also assessed through questionnaires, as was a list of potential associated factors (e.g., major depressive episode, conduct disorder, attention-deficit/hyperactivity disorder [ADHD], school failure, sugar consumption, sexual trauma, parents' use of alcohol, tobacco or cannabis). We found that DRD2 rs1800498 was associated with harmful alcohol use. Many factors were detected, but a global path analysis revealed that DRD2 rs1800498 had a significant direct effect on harmful alcohol use and that early age at first alcohol consumption and depressive symptoms moderated this effect. This study suggests an interplay between harmful alcohol use, DRD2 genotypes and other risk factors that, with a full understanding, could be useful for preventive purposes.
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Affiliation(s)
- Julia Mattioni
- Université Paris Cité, INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Paris, France.,CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Clément Vansteene
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Daphnee Poupon
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Philip Gorwood
- Université Paris Cité, INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Paris, France.,CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Nicolas Ramoz
- Université Paris Cité, INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Paris, France
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Di Lodovico L, Vansteene C, Poupon D, Gorwood P, Duriez P. Food avoidance in anorexia nervosa: associated and predicting factors. Eat Weight Disord 2023; 28:24. [PMID: 36821001 PMCID: PMC9950187 DOI: 10.1007/s40519-023-01545-4] [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: 07/12/2022] [Accepted: 01/25/2023] [Indexed: 02/24/2023] Open
Abstract
PURPOSE Qualitative food avoidance is a significant issue in patients with anorexia nervosa (AN) and restoring diet diversity is an important part of the treatment process. We aimed to identify clinical factors which drive food avoidance and predict its maintenance in patients with AN. METHODS In this multicentre longitudinal study, 130 female outpatients with AN were assessed before and after 4 months of care in clinical centres specialized in AN. We assessed levels of avoidance of 16 food items, as well as body mass index (BMI), eating disorder severity, symptoms of depression and anxiety, emotional state, daily-life functioning, and body image perception. RESULTS We found that qualitative food avoidance was associated with the clinical severity of AN, anxiety and mood dimensions, and BMI- and body image-related factors. A younger age at onset predicted the maintenance of food avoidance after 4 months of treatment. Additional exploratory analyses suggested that anxiety and negative affect caused food avoidance more than the opposite. CONCLUSION Qualitative food avoidance can be an indicator of illness severity. During treatment, focusing on reducing anxiety and negative affect may be a way to indirectly reduce food avoidance and restore diet diversity. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- L Di Lodovico
- GHU Paris Psychiatry and Neurosciences, Clinic of Mental Illnesses and Brain Disorders, 75014, Paris, France.,Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, University of Paris, 75014, Paris, France
| | - C Vansteene
- GHU Paris Psychiatry and Neurosciences, Clinic of Mental Illnesses and Brain Disorders, 75014, Paris, France.,Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, University of Paris, 75014, Paris, France
| | - D Poupon
- GHU Paris Psychiatry and Neurosciences, Clinic of Mental Illnesses and Brain Disorders, 75014, Paris, France
| | - P Gorwood
- GHU Paris Psychiatry and Neurosciences, Clinic of Mental Illnesses and Brain Disorders, 75014, Paris, France.,Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, University of Paris, 75014, Paris, France
| | - P Duriez
- GHU Paris Psychiatry and Neurosciences, Clinic of Mental Illnesses and Brain Disorders, 75014, Paris, France. .,Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, University of Paris, 75014, Paris, France. .,CMME, GHU Paris Psychiatry and Neurosciences, 100 Rue de La Santé, 75674, Paris Cedex 14, France.
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Pineau G, Jean E, Romo L, Villemain F, Poupon D, Gorwood P. Skin conductance while facing emotional pictures at day 7 helps predicting antidepressant response at three months in patients with a major depressive episode. Psychiatry Res 2022; 309:114401. [PMID: 35101794 DOI: 10.1016/j.psychres.2022.114401] [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: 02/10/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
There are currently no reliable biological markers to identify antidepressant responders in patients suffering from major depressive disorder. In this longitudinal pilot study, we measured skin conductance response (SCR) to assess patients' emotional reactivity after antidepressant treatment initiation. Fifty-four adult patients with a major depressive episode were recruited and followed up for 3 months. After one day of antidepressant treatment (D1) and then at day 7 (D7), emotional stimuli were presented on a computer screen while SCR and subjective emotional response were recorded. Three months later, we used Montgomery and Åsberg Depression Rating Scale (MADRS) to screen patients for treatment response, and distinguished responders (N = 28) from non-responders (N = 15). While SCR at D1 did not differ between responders and non-responders, SCR at D7 was higher in responders for both positive, negative and neutral stimuli. Skin conductance rates at D7 had a relatively poor negative predictive value (38%) but a strong positive predictive value (95%). Further studies are needed to replicate in a larger sample, and validate, these preliminary results which suggest that electrodermal activity after treatment initiation could help predict antidepressant efficacy.
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Affiliation(s)
- G Pineau
- GHU Paris Psychiatrie et Neurosciences, CMME, Hôpital Sainte-Anne, F-75014 Paris, France; Etablissement public de santé Barthélémy-Durand, avenue du 8-Mai-1945, 91150 Etampes, France.
| | - E Jean
- Etablissement public de santé Barthélémy-Durand, avenue du 8-Mai-1945, 91150 Etampes, France; Service universitaire de psychiatrie de l'adolescent, centre hospitalier d'Argenteuil, 9 Rue du Lieutenant Colonel Prudhon, 95107 Argenteuil, France
| | - L Romo
- GHU Paris Psychiatrie et Neurosciences, CMME, Hôpital Sainte-Anne, F-75014 Paris, France
| | - F Villemain
- Etablissement public de santé Barthélémy-Durand, avenue du 8-Mai-1945, 91150 Etampes, France
| | - D Poupon
- GHU Paris Psychiatrie et Neurosciences, CMME, Hôpital Sainte-Anne, F-75014 Paris, France
| | - P Gorwood
- GHU Paris Psychiatrie et Neurosciences, CMME, Hôpital Sainte-Anne, F-75014 Paris, France; Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
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Pennequin N, Léger P, Freymond N, Coullandaye N, Poupon D, Tranchard É, Cuoq O, Pacheco Y. [Feasibility and benefits of training to screen for chronic obstructive pulmonary disease]. Rev Mal Respir 2019; 36:861-869. [PMID: 31279593 DOI: 10.1016/j.rmr.2019.05.041] [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: 02/26/2018] [Accepted: 05/09/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Though still under-diagnosed, chronic obstructive pulmonary disease (COPD) currently affects nearly 3.5 million people in France. The present study presents the results of continuing medical education sessions on COPD screening by electronic mini-spirometry. METHODS From April 2013 to December 2015, the sessions involved 73 health professionals. The study analysed three questionnaires administered before, after, and long after sessions led by experts within a professional associative network. RESULTS The sessions proved efficient in increasing the participants' theoretical knowledge. It increased the percentage of correct answers regarding the nature of COPD (90 % vs. 81%), the functions, features, and outputs of mini-spirometers, and the treatment recommendations. The sessions led to non-negligible changes in everyday medical practice regarding the acquisition of a mini-spirometer (+13 devices), the presentation of COPD to the patients (+33 practitioners), the dialogue on tobacco use (+32 practitioners), vaccination (+33 practitioners), and compliance with the treatment recommendations (+43 practitioners). CONCLUSION These results encourage both holding and following up such sessions. The specialized professional environment ensures knowledge updates and offers subsequent assistance. Further improving these sessions will increase their benefits in terms of diagnosis, treatment, and health economy.
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Affiliation(s)
- N Pennequin
- Cabinet de médecine générale, 69100 Villeurbanne, France
| | - P Léger
- Réseau de santé SPIRO, 69003 Lyon, France
| | - N Freymond
- Service de pneumologie, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France
| | | | - D Poupon
- Réseau de santé SPIRO, 69003 Lyon, France
| | - É Tranchard
- Laboratoire d'exploration fonctionnelle respiratoire, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France
| | - O Cuoq
- Cabinet de médecine générale, 69100 Villeurbanne, France
| | - Y Pacheco
- Service de pneumologie, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France.
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