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Notredame CE, Wathelet M, Morgiève M, Grandgenèvre P, Debien C, Mannoni C, Pauwels N, Ducrocq F, Leaune E, Binder P, Berrouiguet S, Walter M, Courtet P, Vaiva G, Thomas P. The 3114: A new professional helpline to swing the French suicide prevention in a new paradigm. Eur Psychiatry 2022:1-11. [PMID: 36203338 DOI: 10.1192/j.eurpsy.2022.2318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- C-E Notredame
- CHU Lille, Psychiatry Department, F-59000Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
| | - M Wathelet
- CHU Lille, Psychiatry Department, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, F-59350St-André, France
- Centre National de Ressources et Résilience pour les psychotraumatismes (Cn2r), F-75000 Paris and F-59000Lille, France
| | - M Morgiève
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- CERMES3, CNRS, INSERM, University of Paris, F-75006, Paris, France
| | - P Grandgenèvre
- CHU Lille, Psychiatry Department, F-59000Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
| | - C Debien
- CHU Lille, Psychiatry Department, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
| | - C Mannoni
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, F-59350St-André, France
| | - N Pauwels
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, F-59350St-André, France
| | - F Ducrocq
- CHU Lille, Psychiatry Department, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
| | - E Leaune
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, F-69500Bron, France
| | - P Binder
- Department of general medicine, Medicine and pharmacy University of Poitiers, F-86000Poitiers, France
| | - S Berrouiguet
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- LaTIM, INSERM, UMR1101, F-29200Brest, France
- CHU Brest, Psychiatry Department, F-29609Brest, France
| | - M Walter
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- EA 7479 SPURBO, West Brittany University, F-29238Brest, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, F-34000Montpellier, France
| | - P Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, F-34000Montpellier, France
- IGF, University of Montpellier, CNRS, INSERM, F-34000Montpellier, France
| | - G Vaiva
- CHU Lille, Psychiatry Department, F-59000Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- Centre National de Ressources et Résilience pour les psychotraumatismes (Cn2r), F-75000 Paris and F-59000Lille, France
| | - P Thomas
- CHU Lille, Psychiatry Department, F-59000Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, F-59000Lille, France
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Fanet H, Ducrocq F, Tournissac M, Oummadi A, Lo A, Bourrassa P, De Smedt-Peyrusse V, Azzougen B, Capuron L, Layé S, Moussa F, Trifilieff P, Calon F, Vancassel S. Tetrahydrobiopterin administration facilitates amphetamine-induced dopamine release and motivation in mice. Behav Brain Res 2020; 379:112348. [PMID: 31711897 DOI: 10.1016/j.bbr.2019.112348] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/04/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
Dopamine (DA) is a critical neurotransmitter involved in motivational processes. Tetrahydrobiopterin (BH4) is an essential cofactor for tyrosine hydroxylase, the rate-limiting enzyme in DA synthesis. Decreases in BH4 levels are observed in several DA-related neuropsychiatric diseases involving impairment in motivation. Yet, whether BH4 could be used to treat motivational deficits has not been comprehensively investigated. To investigate the effects of exogenous BH4 administration on the dopaminergic system and related behaviors, we acutely injected mice with BH4 (50 mg/kg). Passage of BH4 through the blood brain barrier and accumulation in brain was measured using the in situ brain perfusion technique. DA release was then recorded using in-vivo micro-dialysis and motivation was evaluated through operant conditioning paradigms in basal condition and after an amphetamine (AMPH) injection. First, we showed that BH4 crosses the blood-brain barrier and that an acute peripheral injection of BH4 is sufficient to increase the concentrations of biopterins in the brain, without affecting BH4- and DA-related protein expression. Second, we report that this increase in BH4 enhanced AMPH-stimulated DA release in the nucleus accumbens. Finally, we found that BH4-induced DA release led to improved performance of a motivational task. Altogether, these findings suggest that BH4, through its action on the dopaminergic tone, could be used as a motivational enhancer.
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Affiliation(s)
- H Fanet
- INRA, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France; Université de Bordeaux, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France; Faculty of Pharmacy, Université Laval, Quebec City, QC, Canada; Neurosciences Axis, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada; OptiNutriBrain International Associated Laboratory (NurtriNeuro France-INAF Canada), Quebec City, Canada
| | - F Ducrocq
- INRA, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France; Université de Bordeaux, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France
| | - M Tournissac
- Faculty of Pharmacy, Université Laval, Quebec City, QC, Canada; Neurosciences Axis, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada; OptiNutriBrain International Associated Laboratory (NurtriNeuro France-INAF Canada), Quebec City, Canada
| | - A Oummadi
- INRA, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France; Université de Bordeaux, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France
| | - A Lo
- LETIAM, Lip(Sys)2' EA7357, IUT d'Orsay, Université Paris Sud 11, Plateau de Moulon, Orsay, France; Biochemistry and Neuropediatrics Department, Groupe Hospitalier Trousseau Laroche-Guyon, 26 Avenue du Dr Arnold Netter, Paris, France
| | - P Bourrassa
- Faculty of Pharmacy, Université Laval, Quebec City, QC, Canada; Neurosciences Axis, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada; OptiNutriBrain International Associated Laboratory (NurtriNeuro France-INAF Canada), Quebec City, Canada
| | | | - B Azzougen
- INRA, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France; Université de Bordeaux, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France
| | - L Capuron
- INRA, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France
| | - S Layé
- INRA, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France; OptiNutriBrain International Associated Laboratory (NurtriNeuro France-INAF Canada), Quebec City, Canada
| | - F Moussa
- LETIAM, Lip(Sys)2' EA7357, IUT d'Orsay, Université Paris Sud 11, Plateau de Moulon, Orsay, France; Biochemistry and Neuropediatrics Department, Groupe Hospitalier Trousseau Laroche-Guyon, 26 Avenue du Dr Arnold Netter, Paris, France
| | - P Trifilieff
- INRA, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France
| | - F Calon
- Faculty of Pharmacy, Université Laval, Quebec City, QC, Canada; Neurosciences Axis, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada; OptiNutriBrain International Associated Laboratory (NurtriNeuro France-INAF Canada), Quebec City, Canada
| | - S Vancassel
- INRA, Nutrition and Integrated Neurobiology, UMR 1286, Bordeaux, France; OptiNutriBrain International Associated Laboratory (NurtriNeuro France-INAF Canada), Quebec City, Canada.
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Brunet A, Ayrolles A, Gambotti L, Maatoug R, Estellat C, Descamps M, Girault N, Kalalou K, Abgrall G, Ducrocq F, Vaiva G, Jaafari N, Krebs MO, Castaigne E, Hanafy I, Benoit M, Mouchabac S, Cabié MC, Guillin O, Hodeib F, Durand-Zaleski I, Millet B. Paris MEM: a study protocol for an effectiveness and efficiency trial on the treatment of traumatic stress in France after the 2015-16 terrorist attacks. BMC Psychiatry 2019; 19:351. [PMID: 31703570 PMCID: PMC6842179 DOI: 10.1186/s12888-019-2283-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 09/11/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The Paris and Nice terrorist attacks affected a thousand of trauma victims and first-line responders. Because there were concerns that this might represent the first of several attacks, there was a need to quickly enhance the local capacities to treat a large number of individuals suffering from trauma-related disorders. Since Reconsolidation Therapy (RT) is brief, relatively easy to learn, well tolerated and effective, it appeared as the ideal first-line treatment to teach to clinicians in this context. METHODS This study protocol is a two-arm non-randomized, multicenter controlled trial, comparing RT to treatment as usual for the treatment of trauma-related disorders. RT consists of actively recalling one's traumatic event under the influence of the ß-blocker propranolol, once a week, for 10-25 min with a therapist, over 6 consecutive weeks. This protocol evaluates the feasibility, effectiveness, and cost-utility of implementing RT as part of a large multi-center (N = 400) pragmatic trial with a one-year follow-up. DISCUSSION Paris MEM is the largest trial to date assessing the efficiency of RT in the aftermath of a large-scale man-made disaster. RT could possibly reinforce the therapeutic arsenal for the treatment of patients suffering from trauma-related disorders, not only for communities in western countries but also worldwide for terror- or disaster-stricken communities. TRIAL REGISTRATION Clinical Trials (ClinicalTrials.gov). June 3, 2016. NCT02789982.
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Affiliation(s)
- A. Brunet
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Department of Psychiatry, McGill University, Montréal, Canada
| | - A. Ayrolles
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - L. Gambotti
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - R. Maatoug
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - C. Estellat
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - M. Descamps
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Department of Psychiatry, McGill University, Montréal, Canada
| | - N. Girault
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - K. Kalalou
- Unité de recherche clinique, EPS de Ville Evrard, G03, 5 rue du Dr Delafontaine, 93200 Saint-Denis, France
| | - G. Abgrall
- Assistance Publique - Hôpitaux de Paris -, Hôtel-Dieu, 75004 Paris, France
| | - F. Ducrocq
- France CHRU de Lille, Pôle de Psychiatrie Médecine Légale et Santé en milieu Pénitentiaire, SCA-Lab CNRS UMR 9193, 59037 cedex Lille, France
| | - G. Vaiva
- France CHRU de Lille, Pôle de Psychiatrie Médecine Légale et Santé en milieu Pénitentiaire, SCA-Lab CNRS UMR 9193, 59037 cedex Lille, France
| | - N. Jaafari
- CIC INSERM U802, CHU de Poitiers, Unité de recherche clinique intersectorielle en psychiatrie du Centre Hospitalier Henri Laborit, 86022 Poitiers, France
| | - M. O. Krebs
- Centre Hospitalier Sainte Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Université Paris Descartes, Paris, France
| | - E. Castaigne
- Service de Psychiatrie, CHU de Bicêtre, HUPS, APHP 78, rue du général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - I. Hanafy
- CH Marne La Vallée, Service de Médecine Légale, 77420 Marne-La-Vallée, France
| | - M. Benoit
- Clinical Neuroscience Department Hospital Pasteur 1, France University of Côte d’Azur, 30 avenue de la voie, 06002 NICE cedex 1 Romaine, France
| | - S. Mouchabac
- Département de psychiatrie et de psychologie médicale de l’adulte, Hôpital universitaire Saint-Antoine, Université Pierre et Marie Curie, Paris VI - AP-HP, 184 rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - M. C. Cabié
- Pôle Paris 11 Les Hôpitaux de Saint Maurice, 12-14 rue Val d’Osne, 94410 St Maurice, France
| | - O. Guillin
- Service Hospitalo-universitaire, CH du Rouvray, 4 rue Paul Eluard, 76300 Sotteville-lès-Rouen, France
- unité Inserm U1079 Faculté de médecine et de pharmacie, 76000 Rouen, France
| | - F. Hodeib
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - I. Durand-Zaleski
- ECEVE, UMR 1123 URCEco Ile de France Hôtel Dieu, 1 place du Parvis de Notre Dame, 75004 Paris, France
| | - B. Millet
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
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Plancke L, Ducrocq F, Clément G, Chaud P, Haeghebaert S, Amariei A, Chan-Chee C, Goldstein P, Vaiva G. Les sources d’information sur les tentatives de suicide dans le Nord - Pas-de-Calais. Apports et limites. Rev Epidemiol Sante Publique 2014; 62:351-60. [DOI: 10.1016/j.respe.2014.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 09/12/2014] [Accepted: 09/26/2014] [Indexed: 10/24/2022] Open
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Maître E, Debien C, Nicaise P, Wyngaerden F, Le Galudec M, Genest P, Ducrocq F, Delamillieure P, Lavoisy B, Walter M, Dubois V, Vaiva G. [Advanced directives in psychiatry: A review of the qualitative literature, a state-of-the-art and viewpoints]. Encephale 2013; 39:244-51. [PMID: 23537636 DOI: 10.1016/j.encep.2012.10.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [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: 04/25/2012] [Accepted: 10/22/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Advance Directives are written documents, which are used for people to notify their preference for a future situation when they are unable to give their consent. In psychiatry, psychiatric advance directives (PADs) can be used for patients with chronic psychotic disorders such as schizophrenia, or a bipolar disorder. PADs give the patient an opportunity to state wishes in advance about his/her treatment when he/she is in an acute state of illness. PADs were initially developed as a way for patients to defend themselves against the power of the psychiatrists, but are likely to become a useful tool in psychiatric care. PADs may contain information about medication, non pharmaceutical devices, and the name of a proxy decision maker. The main objective is to reduce the number of compulsory hospitalisations. OBJECTIVE This article is a qualitative review which carries out a state-of-the-art on the use of PADs for people with chronic psychotic disorders and defines suggestions to include this intervention in the French psychiatric context. METHOD We used the keywords psychiatric advance directives, crisis card, Ulysse directives, joint crisis plan (JCP) in the MEDLINE database to propose a qualitative review. We selected original clinical studies about the use of PADs for people with psychotic disorders. RESULTS We included 36 articles. The qualitative analysis identified seven main themes: different types of PADs, effectiveness of PADs, practical use of PADs, patient's views, clinician's views, economical aspects, and legal aspects. The content of the PADs is consistent with psychiatric standard care in nearly all cases, regarding medical instructions, pre-emergency interventions, non-hospital alternatives and non-medical personal care. Patients use their PADs to describe prodromal symptoms of relapse and to suggest a treatment and a hospitalisation in advance. PADs are not used to refuse all treatments. Patients show a strong interest in creating a directive and a high level of satisfaction when using it. They feel they have more control over their mental health problem and are more respected and valued as a person. Thirty-six to fifty-three percent of clinicians had positive opinions regarding PADs. They valued the increase of the patient's autonomy and the prevention of relapse, but were concerned about difficulties for accessing the documents, and about the lack of training of the medical teams. Clinicians also feared the pressure of relatives or partners on treatment decisions. The qualitative analysis revealed the specific benefit of the JCP, a particular type of PADs negotiated with the medical team, on the reduction of the general number of admissions. We can identify practical problems such as the lack of accessibility to PADs in emergency situations, and the clinician's reluctance to use PADs. The only economical evaluation showed a non-significant decrease in total costs. DISCUSSION PADs are used in a few countries, although their benefits in terms of patient's perceptions and compulsory admissions are promising. The JCP proposes a specific clinical approach based on therapeutic alliance. Its creation also involves the clinician, family members and a neutral mediator in a negotiated process. The JCP is likely to be the most efficient PAD model in reducing compulsory admissions. The use of the JCP appears to be relevant in the context of the new French legislation, establishing outpatient commitment orders and could be an effective way to improve the relationships with patients.
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Affiliation(s)
- E Maître
- Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, service de psychiatrie adulte, université Lille Nord de France, hôpital Michel-Fontan, CHRU de Lille, rue André-Verhaeghe, 59037 Lille cedex, France
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Berna G, Vaiva G, Ducrocq F, Duhem S, Nandrino JL. Categorical and dimensional study of the predictive factors of the development of a psychotrauma in victims of car accidents. J Anxiety Disord 2012; 26:239-45. [PMID: 22177942 DOI: 10.1016/j.janxdis.2011.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [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] [Received: 02/05/2011] [Revised: 08/22/2011] [Accepted: 11/20/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to evaluate the predictive factors of the emergence of complete PTSD and subsyndromal PTSD (defined as individuals exposed to a traumatic event with at least one psychopathological impact, such as hyperarousal, avoidance or persistent re-experiencing) following a motor vehicle accident (MVA). METHODS We recruited 155 adult MVA patients, physically injured and admitted to trauma service, over two years. In the week following the accident, patients were asked to complete questionnaires assessing their social situation (sex, age, marital and employment status, prior MVA or trauma), comorbidity (MINI), distress (PDI) and dissociation (PDEQ) experienced during and immediately after the trauma. An evaluation using the CAPS was conducted six months after the trauma to assess a possible PTSD. RESULTS At six months, 25.8% of the participants developed subsyndromal symptoms and 7.74% developed complete PTSD. The three symptoms that best discriminated the groups were dysphoric emotion, perceived life threat and dissociation. Logistic regression results showed that the strongest predictor of PTSD was the perceived life threat. In addition, a dimensional approach to the results revealed significant correlations between (1) peritraumatic distress and persistent re-experiencing or hyperarousal and (2) dissociation score and avoidance strategy. The presence of a prior traumatic event reinforces avoidance strategies. CONCLUSIONS Our results stress that peritraumatic factors (especially the perception of a life threat) are good predictors of PTSD development. A dimensional perspective allows better identification of psychological complications following an MVA.
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Affiliation(s)
- G Berna
- Univ Lille Nord de France, F-59000 Lille, France
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Vaiva G, Jehel L, Cottencin O, Ducrocq F, Duchet C, Omnes C, Genest P, Rouillon F, Roelandt JL. Prévalence des troubles psychotraumatiques en France métropolitaine. Encephale 2008; 34:577-83. [DOI: 10.1016/j.encep.2007.11.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Accepted: 11/19/2007] [Indexed: 11/26/2022]
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Jehel L, Charles E, Ducrocq F, Vaiva G, Hervé C. Particularités de l’état de stress post-traumatique de la personne âgée. Encephale 2006; 32 Pt 4:S1125-9. [PMID: 17356482 DOI: 10.1016/s0013-7006(06)76299-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- L Jehel
- Unité de Psychiatrie et Psychotraumatologie, Hôpital Universitaire Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
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Cottencin O, Vaiva G, Huron C, Devos P, Ducrocq F, Jouvent R, Goudemand M, Thomas P. Directed forgetting in PTSD: a comparative study versus normal controls. J Psychiatr Res 2006; 40:70-80. [PMID: 15907941 DOI: 10.1016/j.jpsychires.2005.04.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2004] [Revised: 03/16/2005] [Accepted: 04/05/2005] [Indexed: 11/30/2022]
Abstract
The most characteristic feature of Post-Traumatic Stress Disorder (PTSD) is the reexperiencing syndrome. The patient's memory seems to be fixed on the traumatic event, which may be due to disturbance of the autobiographic memory. To retrieve memories, others have to be inhibited. These inhibition mechanisms have been studied using the Directed Forgetting Paradigm, which measures the capacity to forget recently processed information and to retain the relevant information. Our hypothesis is that during PTSD, the memory is saturated with traumatic memories, so that the patients are no longer able to use the inhibitory processes. Therefore, during a Directed Forgetting Task (DFT) in which words "to remember" and words "to forget" are given, PTSD patients cannot inhibit the words "to forget", and so recall more words than the controls. We studied 30 patients with PTSD and compared them with 30 healthy controls, using DFT. The results show that the patients remembered significantly fewer words overall, and fewer of the words "to remember" than the controls, both for immediate and final recall. Our results are in favor of a reduction in directed forgetting in patients suffering from PTSD, resulting in difficulty in inhibiting irrelevant information from the overall information. There seems to be a deficit in the inhibitory processes in the memory in PTSD.
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Affiliation(s)
- O Cottencin
- Department of Psychiatry, FONTAN Hospital, University of Lille II, School of Medicine, Rue Verhaeghe, 59037 Lille Cedex, France.
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Damsa C, Pirrotta R, Adam E, Hyams H, Lazignac C, Ducrocq F. Approche thérapeutique des troubles dissociatifs. Annales Médico-psychologiques, revue psychiatrique 2005. [DOI: 10.1016/j.amp.2005.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Of all the psychological complications that an individual is likely to present with when confronted with an exceptional event, the Post-Traumatic Stress Disorder is characterized by being progressive, frequent, invalidating, strongly associated with comorbidity, and having the tendency to become chronic if it is not detected clinically. By definition, it is threatening and produces an intense fear reaction. The traumatic event is a situation of extreme stress, not only capable of altering the physical and psychological homeostasis of the individual, but is also recognized as determinant in the aetiopathology of complications. The intensity of this distress can be identified clinically and physiologically, and is currently considered as an important risk factor for the development of PTSD later on, together with other pre-, peri- and post-traumatic factors. In fact, the most studied field is the therapeutic approach, in particular drug treatment, of the fully-constituted disorder, although this actually represents tertiary prevention. Even though primary prevention seems to concern Medicine very little, any prospect of performing secondary prevention should begin by rapid identification of the risk or vulnerability factors and should allow a population at risk from developing complications to be defined. Its potential therapeutic impact brings together psychotherapeutic and drug treatment, since it is only this combination that seems able to allow the most favourable clinical outcome to be achieved for an individual, who is confronted by an out-of-the-ordinary event. The aims of secondary prevention strategies are, for example, to reduce the incidence of acute PTSD in patients seen following the event. The benefits for the individual and for the society can easily be measured in terms of the consequences on his/her social, professional and family life, or in terms of cost. The usefulness of this prevention can also be measured by the possible ways that other conditions, comorbid to PTSD, are controlled, such as anxiety disorders, depression and substance abuse, for example. Secondary prevention strategies may also be aimed at determining the therapeutic impact, by preventing or moderating the appearance of an acute stress, or even by contributing in avoiding the onset of chronic PTSD. Psychopharmacology of the immediate and post-immediate disorders, however, remains a field which has been studied very little. Reduction or control of the high, prolonged level of hyperarousal phenomena or hypersensitization of the hypothalamo-pituitary axis, would contribute to the comfort of the individual, and would participate in the prevention of PTSD. Based on current knowledge of the neurobiology of trauma, we look into the existing and potential pharmacological possibilities. Even though benzodiazepines tend to have an important role, knowledge of other drugs and therapeutic groups is rapidly increasing. In this review, we will see that the efficacy of anti-adrenergic drugs and certain other anxiolytics is now well-documented, this opening the door to their use in the future. Other drug groups offer interesting, well-proven approaches, such as serotoninergic drugs, CRF or NPY antagonists, NMDA antagonists, anticonvulsants or other GABAergic agents. In view of this disorder, which represents a true public health problem, we consider that it is now possible to widen the horizons of our drug therapy, in combination with any necessary psychotherapeutic treatment, to reach the heart of the traumatic event, that often upsets the victims, both by the psychological suffering it induces, and the loss of his/her social, family and professional references and support structures.
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Affiliation(s)
- F Ducrocq
- Psychiatre, praticien hospitalier, Cellule d'Urgence Médico-Psychologique, SAMU Régional de Lille, Clinique Universitaire de Psychiatrie, CHRU de Lille, 59037 Lille cedex
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Ducrocq F. [Not Available]. Penelope 2001:45-9. [PMID: 11632682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Ducrocq F, Vaiva G, Cottencin O, Molenda S, Bailly D. [Post-traumatic stress, post-traumatic depression and major depressive episode: literature]. Encephale 2001; 27:159-68. [PMID: 11407268] [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] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Although they are likely to add their effects, physical and psychic traumata (or traumas) can provoke in different ways the appearance of depressive symptoms sometimes common. Post-traumatic depression, reactional depression, major depressive disorder and post-traumatic stress disorder represent different clinical and nosographic disorders in despite of their occasionally common symptomatic core. Historically, it is interesting to note during the XXth century the true semantic change of the terms of trauma from the somatic field to the psychic sphere. Physical traumatism is often represented by a material shock for the subject and by its organic consequences. It is defined as an event that leaves its mark which itself inflicts and handicaps the vital trajectory of the subject. It primarily comprises brain and rachis injuries, whose evolution is frequently characterized by the occurrence/appearance of a depressive disorder, whose genesis rests on psychological but also neurobiologic and physical arguments. Thus major depressive disorders are often present in the course of various physical traumatisms mainly related to nervous system. In accordance with several studies, the prevalence of major depressive disorders ranges from 25% to 50%. These mood disorders occur in the year which follows the accidental event. Their average time of revelation is estimated at four months and their average duration lies between three and six months. Lastly, although these depressive illnesses present clinical symptoms comparable with those observed in other contexts, some nuances can be raised. Nonetheless, they confine sometimes with true clinical forms depending on the intensity, the form, the circumstances or the consequences of the trauma. Psychic traumatism doesn't have the same profile and rests for much dedicated with the reexperiencing. Thus for some authors, depression illness represents a disorder that occurs after a traumatic event whereas others see a differential diagnosis which exludes or which represents a comorbidity with post-traumatic stress disorder. The review of the literature allows us to emphasize the complexity of the links as well as the clinical and epidemiologic differences between stress disorder and major depressive disorder. From the clinical point of view, the major features of PTSD are articulated around a triad of symptoms. They include the reexperiencing symptoms of the traumatic event such as intrusive memories and recurrent nightmares, the protective reactions such as avoidance of the stimuli associated with the trauma and emotional numbing, and the arousal symptoms such as the startled response and hypervigilance. The complexity of this syndrom is due to the frequent combination of these symptoms with other nonspecific ones. As far as the mood is concerned (the mood symptoms are concerned), the regrouping of some of these symptoms allows the clinician to sometimes releave a depressive symptomatology without being able to assess the DSM diagnosis of major depressive disorder. Epidemiologic studies dealing with the risk of installation of a PTSD after a traumatic event reveal differences in the prevalence depending on the nature of the traumatic events: ranging from 1% in general population to 80% following some situations of extreme and durable psychic suffering. Between both poles, one finds a prevalence ranging between 20 and 50% following other events such as serious accidents, natural disasters or criminal assaults. The clinical features of depressive episodes comorbid or associated with PTSD have some characteristics making it possible to individualize various clinical forms as a function of traumatic event type: asthenic, characterial or with somatic symptoms. According to the majority of authors, the co-occurrence of post-traumatic stress disorder and major depressive disorder is high although differential diagnosis is sometimes difficult. However, conceptual differences remain and two conceptions are distinguished. For some authors, like Bleich and Shalev, there would not be true chronological evolution from PTSD to MDD. Moreover the presence of symptoms considered as pertaining to the mood register within the criteria of PTSD would be clearly predictive of the occurrence and the severity of the diagnosis but not of the chronicity. For others, there would be a continuity between post-traumatic stress disorder and major depressive disorder. It is the case in many studies of veterans but also for civilian traumatic events. It is also the case for the American national study of comorbidity in which Kessler concludes that for 78% of the subjects who present a comorbidity PTSD/MDD (comorbidity raised for 48% of the 5,877 subjects included), the mood disorder is secondary to PTSD. (ABSTRACT TRUNCATED)
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Affiliation(s)
- F Ducrocq
- Centre d'Accueil et de Crise, Clinique Fontan, CHRU de Lille, 59037 Lille
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Vaiva G, Ducrocq F, Cottencin O, Goudemand M, Thomas P. Immediate fright reaction: an essential criterion in the development of posttraumatic stress disorder (PTSD). Can J Psychiatry 2000; 45:939. [PMID: 11190369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Ducrocq F. [Depression and sexual disorders]. Encephale 1999; 25:515-6. [PMID: 10598317] [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] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Nowadays, we talk more and more often about sexual disorders, and depression in one of the possible etiologies of them. Depression could lead to sexual disorders or induce them indirectly. Paradoxically, depression treatments, such as tricyclic antidepressant or SSRI could induce this kind of disorder. Tianeptine, the only molecule representative of this pharmacological class, has proved its good acceptability on the libido, as shown by the results of a meta-analysis. The respect of the sexual function is essential to obtain a good observance of the antidepressant treatment.
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Kochman F, Ducrocq F, Parquet PJ. [Cyclic oro-alimentary disorders]. Rev Prat 1997; 47:1913-6. [PMID: 9453191] [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] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Eating behaviours have been changing in our society for at least twenty years. Thus, they represent a good indicator of the functioning of a society or a person. Beyond these recent sociocultural variations, recent clinical and research data, particularly in chronobiology, showed clearly the influence of hormonal or seasonal changes in our eating behaviours. Actually, we observed that an important proportion of these cyclic turmoils can fit into other phenomena and cyclic pathologies: premenstrual syndrome, seasonal affective disorders, bipolar disorders, binge eating.
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Affiliation(s)
- F Kochman
- Service de psychiatrie de l'enfant et de l'adolescent, Centre hospitalier régional, Clinique Fontan, Lille
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Kochman F, Benzion I, Ducrocq F, Parquet PJ. From Research to Practice with Internet …. Eur Psychiatry 1997. [DOI: 10.1016/s0924-9338(97)80456-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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