[Psychological impact of restraint during care]

Restraints in the healthcare context is a controversial and complex topic. Used for providing care, the latter could lead to psychological implication for both patients and caregivers. A thorough understanding of those psychological consequences can support the decision-making as well as considering the safety and emotional needs of the patient.

[The psychopathological dimension of female alcoholism]

In France, as in other countries, more and more women are affected by alcoholism. Progress needs to be made in the early detection and management of their physical and psychological dependence on alcohol, as well as their psychopathological comorbidities.

[The city-hospital link in the care of severely obese patients]

After the initial weekday hospital stay, a personalized, multidisciplinary care pathway is offered to each patient followed at the specialized obesity center (CSO). This article illustrates the support approach adopted by the CSO at Caen Normandy University Hospital.

[Analysis of the psychological causes of early substance use among adolescents in school and university settings]

Experimentation with psychoactive substances (PAS), such as alcohol, tobacco or cannabis, is common in adolescence, and continues to pose a public health issue that can lead to failure at school and university. Most of the work on these issues focuses on addiction-related aspects, and little on the underlying causes of addiction. This article sheds psycho-social theoretical light on the causes of first-time use of APS, and cannabis in particular. It is particularly aimed at school nurses and university preventive medicine nurses.

Psychosocial support to medical teams in SAMUR-Protection Civile during COVID-19

The COVID-19 pandemic has had an exceptional impact on the health system. The lack of information and resources during the first stage of the outbreak COVID-19 has also meant a change in the way we work and in the way we relate to our relatives, colleagues and, of course, our patients. This traumatic situation, due to its characteristics of total uncertainty, novelty, frequency, and high intensity, made it necessary to develop a new approach to our work, a new psychological approach to the pandemic situation that leads to acute stress, insecurity, unknown consequences, uncertainty about its duration and a desolate future.

During the first wave, it was necessary to respond to the new situation. In a first phase, an intervention protocol was created for front-line pre-hospital emergency professionals and a COVID-19 psychological unit was set up in a pandemic hospital in Madrid.

In a second phase, emergency actions, their conditioning and possible change due to confinement are analysed; the emotional state of front-line intervention personnel is assessed, comparing the pre- and post-first wave period, and burnout syndrome is studied in the SAMUR-Civil Protection volunteer corps.

[Psychological support for long Covid patients during a rehabilitation stay]

Covid long affects each patient differently. This disorder can occur in people with both severe and mild forms of the disease. It is often a series of symptoms that disrupt different areas of life in a very variable way. These symptoms can change rapidly. Moreover, several symptoms are associated and fluctuate (between aggravation and recovery) during very variable periods, which leads to a mosaic diagnosis and engages the need for multidisciplinary management.

Insomnia, Medicalization, and Expert Knowledge

Historians have clearly articulated the ways in which sleeplessness has long been part of the human condition. As an object of medical expertise and public health intervention, however, insomnia is a much more recent invention, having gained its status as a pathology during the 1870s. But while insomnia has attracted considerable and concerted attention from public health authorities allied with sleep medicine specialists, this phenomenon is not well explained by classical medicalization theory, in part because it is the sleepless sufferers, not the medical experts, who typically have the authority to diagnose insomnia. The dynamics of insomnia's history are better described as those of a boundary object, around which concepts and practices of biomedicine and psychology coalesce to frame contemporary notions of self-medicalization and self-experiment.

Insomnia, Medicalization, and Expert Knowledge

Historians have clearly articulated the ways in which sleeplessness has long been part of the human condition. As an object of medical expertise and public health intervention, however, insomnia is a much more recent invention, having gained its status as a pathology during the 1870s. But while insomnia has attracted considerable and concerted attention from public health authorities allied with sleep medicine specialists, this phenomenon is not well explained by classical medicalization theory, in part because it is the sleepless sufferers, not the medical experts, who typically have the authority to diagnose insomnia. The dynamics of insomnia's history are better described as those of a boundary object, around which concepts and practices of biomedicine and psychology coalesce to frame contemporary notions of self-medicalization and self-experiment.

[Depression and music therapy: the receptive composite montage with a projective focus]

Depression is a frequent mood disorder that requires a consensual therapeutic arsenal combining psychotropic drugs and psychotherapies. When depression requires hospitalization, particularly in the context of a major depressive disorder, having an integrative tool that induces a state of relaxation, positive mood and anticipation within twenty minutes is useful for patients and care teams. The Receptive Projective Composite Montage is a standardized music therapy device with evaluated effectiveness that can fulfill this role.

[Psychology in therapeutic patient education]

In an effort to improve the quality of life of people with chronic diseases, care practices have been enriched by therapeutic patient education (TPE). This aims at the acquisition of plural knowledge and skills by patients, which promotes optimal management of the disease on a daily basis and of the resulting changes, limiting their negative repercussions on their autonomy and well-being. The subject is placed at the heart of the system, in a position of decision and responsibility, and collaborates actively with the various healthcare stakeholders. TPE therefore involves taking into account the patient's psychological dimension, using psychology and fundamental concepts for its implementation.

[Importance of psychological support for patients with Covid-19 treated at the University Hospital Center (CHU) Hôpital du Mali]

INTRODUCTION

the disease linked to Covid-19 is a SARS-CoV-2 pneumonia with strong clinical expression and highly lethal which has shaken the world since November 2019, to the detriment of certain determinants of health, in particular the psychosocial aspect. In this work, we are proposed to study the importance of psychological support for patients during the Covid-19 pandemic admitted to the treatment center of the CHU Hôpital du Mali.

METHOD

this was a cross-sectional study, a prospective recruitment including 50 patients admitted to hospital from April to May 2020.

RESULTS

in the cohort, 30% of patients had a notion of recent travel. Eighty percent (80%) of patients did not follow preventive measures before testing. Sixty percent (60%) of patients were asymptomatic at the time of screening. We found that 80% of the patients had not received any psychological preparation. 78% of the patients did not believe in the existence of the disease. At discharge, 38% of patients were depressed, 10% were in denial of the disease. Regarding the quality of care, 84% of patients were satisfied with the quality. We found that patients who had not received psychological preparation were eight times more likely to have depression, compared to patients who had received it, with a correlation coefficient (r) = 0.810 and a level of significance p < 0.001. OR which excludes 1.

CONCLUSION

this study confirms the low importance given to the psychological preparation of patients with Covid-19 in our structure. However, we believe that good psychological preparation could help improve the quality of patient care.

[Sexuality in the elderly]

Negative stereotypes are often conveyed in the area of older adults' sexuality. Contrary to popular belief, sexual desire persists in elderly. Sexual activity has a positive impact on psychological well-being but it must be adapted to the elderly body because it can be hindered by somatic pathologies or medications. In this article we emphasize the rights to privacy and to sex life in the elderly.

Addressing a Care Gap in Type 1 Diabetes Management: Using the Diabetes Distress Scale in a Community Care Setting to Address Diabetes-Related Treatment Challenges

OBJECTIVES

To bridge the gap between existing clinical evidence and recommendations around screening for diabetes-related distress (DD) and the observation of a low level of adoption of these suggestions in everyday clinical practice. We focused on the use of the Diabetes Distress Scale (DDS) by adult diabetes care specialists.

METHODS

We conducted a survey of endocrinologists and diabetes educators in our clinics, examining the use of DD screening and assessment tools, including DDS-2, DDS-17 and T1-DDS-28.

RESULTS

Our results indicated that very few practitioners surveyed are currently using the DD questionnaires, and highlighted their perceptions of the primary barriers to doing so.

CONCLUSIONS

We discuss the results of our survey of colleagues' use of the DDS and provide suggestions about how to incorporate this tool, and tips about how to address the various facets of DD. We argue that integrating the assessment of DD in clinical practice, with the use of standardized and validated self-report questionnaires, is a necessary and very feasible step towards achieving further improvements in the health and quality of life of people living with type 1 diabetes.

Life stress and background anxiety are not associated with resting metabolic rate in healthy adults

This study examined associations between anxiety, stress, and resting metabolic rate (RMR). Thirty women and 23 men had RMR measured at two visits. Participants also had body composition assessed and completed several questionnaires: State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA), Anxiety Sensitivity Index (ASI)-3, and Perceived Stress Scale (PSS)-14. The state version of the STICSA was completed at both visits, while the other questionnaires were completed at visit one. RMR was expressed in kilocalories per day and relative to lean mass (RMR_relative). Participants were divided into low-, medium-, and high-anxiety groups based on STICSA trait scores, and RMR was compared among groups using one-way ANOVA. Changes between visits were evaluated using paired t tests and Wilcoxon signed-rank tests. RMR did not change from visit one to visit two (1589 to 1586 kcal/day, p = 0.86) even though STICSA state scores slightly declined (Z-statistic = -2.39, p = 0.017). RMR_relative values were 30.3 ± 3.7, 29.0 ± 1.9, and 29.9 ± 3.6 kcal/kg of lean mass among low, medium, and high trait anxiety groups, respectively (F = 0.70, p = 0.50). No RMR variable significantly correlated with PSS-14, ASI-3, or STICSA scores. This study provides evidence that trait anxiety and life stress do not impact RMR. Whether an association between these factors exists in anxiety disorders remains to be evaluated. Novelty Contrary to previous research, this study found no associations between anxiety and RMR. It is doubtful whether practitioners need to account for healthy subjects' trait anxiety and stress when analyzing RMR data.

[Neuropsychopathology of people suffering from Parkinson's disease (2/2)]

A cognitive and psychological approach is essential to take into account all the phenomena which can be observed in the everyday life of patients with Parkinson's disease. In order to provide patients and their carer(s) with clear and specific answers to help them gain a better insight into their future everyday life, the non-motor symptoms associated with the disease must be identified: cognitive, psychological and behavioural disorders.

Neuropsychopathologie de la maladie de Parkinson (1/2)

PARKINSON'S DISEASE NEUROPSYCHOPATHOLOGY (1/2).: A progressive, neurodegenerative disease of unknown aetiology, Parkinson's disease is characterised mainly by motor disorders. As the disease progresses, other disorders appear: speech, swallowing, perspiration, genitourinary, etc., as well as cognitive and psychological conditions. The consequences are significant, both on a social level and in terms of autonomy. The treatment is specialised and multi-professional.

[Caring for people suffering from Alzheimer's disease]

The provision of physical, mental and social care to people with Alzheimer's disease is a major public health challenge. With the awareness of progressive neurological disorders and their consequences, the personal and psychological dimension of each patient must lie at the heart of the care provided throughout the disease's progression. This personalisation can have positive clinical effects while helping to preserve as much as possible the dignity of the people concerned.

[Rhythms and early interactions]

Early interactions are established in accordance to their own rhythms the tempo of which is set by the parent-infant dyad. The adjustment is made by the adult partner, who must be able to ensure this mutual interactive rhythm. It is in fact these initial interactions which form the foundations of a secure attachment.

[Patient-caregiver transference in patients at the end of life]

The question of transference has been extensively covered in nursing literature. Faced with a patient approaching the end of life, caregivers, emotionally shaken, sometimes lose their therapeutic bearings. By drawing on the principles of countertransference, they can support these patients with all the necessary empathy, without becoming lost in the complexity of transference issues.

From Improving Egos to Perfecting Smiles: Orthodontics and Psychology, 1945-2000

From World War II to the end of 20^th century, the types of patients undergoing orthodontic treatment and their reasons for doing so changed significantly. In the 1950s and 1960s, Canadian parents were told that orthodontics would "cure" inferiority complexes and protect children with crooked teeth, especially girls, from a life of delinquency and missed opportunities. By the last two decades of the 20^th century, the consumer health movement and rising incomes empowered patients to decide which treatments were right for them, and an increasing number of adult patients sought orthodontic treatment to improve their appearance. Orthodontists never abandoned their claim that orthodontic treatment could improve psychological health, as while health psychologists and other researchers increasingly called this into question. But orthodontists did begin to place greater emphasis on aesthetics as a reason for treatment, and orthodontics became part of a much larger explosion in "cosmetic dentistry" procedures that came to include tooth whitening and veneers.

[Reflections on prehospitalisation deaths]

In the past, death was a family and community affair, but today it is institutional and entrusted to healthcare personnel. Thanks to a questionnaire on their feelings about prehospitalisation deaths, the experience and training needs for healthcare personnel at a mobile emergency and intensive care service were analysed. The majority of these professionals had been confronted with difficulties when faced with prehospitalisation deaths. There is little understanding of religious rites, even though this is an important point in dealing with the situation. There is a strong desire for training. The pedagogical support offered in response to the needs expressed was recognised as being useful and should be more widespread.

[Psychological commitment: adaptive functions, paradoxes, modalities and components]

The process of psychological commitment, its adaptive functions and some of the difficulties that go along with it are specific. A description of the multimodal model of commitment provides an illustration of how motivational, affective, cognitive and behavioural mechanisms can be combined. These lead to different ways of entering into the commitment, with differing consequences on how the individual functions.

[Adaptation strategies faced with chronic pain]

Chronic pain constitutes a challenge for patients. It makes them uneasy with regard to their personality, their corporality and their life balance, and leaves long-lasting effects on their experience as a patient. The development of adaptation strategies and resources to deal with chronic pain is therefore essential.

[Physiology and physiopathology of sexuality]

From desire to orgasm, sexuality, in women and men, is underpinned by a complex organic, psychological and emotional function. Sexual dysfunction encompasses diverse aetiologies, including chronic diseases and iatrogenesis resulting from medication or surgery. The effects of a chronic disease can have an impact on all phases of the sexual response.

[Ebola crisis in Guinea: psychosocial support for patients and caregivers]

The experience of the French military health service in the fight against the Ebola epidemic in Guinea, highlights the importance of what favours the emergence of an institutional life in a context of care faced with numerous constraints and extraordinary challenges. The meticulous drawing up of procedures and the juxtaposition of expertise goes hand in hand with the construction of a triangular care system (caregivers-patients-families). This relational approach ensures each player in this system is able to find their place and a balance between constraints and satisfactions, losses and successes, isolation and support. This balance seems to favour individual and group resilience.

[Non-drug therapies, working on emotions]

Cognitive behavioural therapies are indicated for people in mental pain and also recommended in the treatment of a variety of psychological disorders. The aim is to replace the inappropriate behaviour by more adapted behaviour. Positive psychology is interested not so much in mental health disorders as in well-being and happiness. A variety of therapeutic trends which the caregiver can use to help and support patients in regaining their bearings.

[Psychological care of patients with head and neck cancer]

Treatments for head and neck cancers are generally complex and debilitating. Surgery, often mutilating, profoundly affects the relationship between oneself and others and causes verbal communication, breathing and swallowing difficulties. The functional and aesthetic sequelae are a constant reminder to the patient of the disease and make them conscious of their appearance.

They're "More Children than Adults": Teens, Unmarried Pregnancy, and the Canadian Medical Profession, 1945-611

This article examines the medical aspects of young, unmarried pregnancy in the early post-WWII period. It explores the roles played by physicians and nurses, their prescriptions for prenatal care, their psychologizing of girls' problems, and the nature of girls' hospital experiences. That these patients were indeed seen as "girls" and not women, is a central point; in fact, age, and the perception of what it meant to be "teenaged," significantly shaped the perception, treatment, and experience of unmarried pregnancy in these years.

[Psychoimmunology: a questionable model?]

INTRODUCTION

The concept of "psychoimmunology" that had long been supported by clinical observation and common sense, has acquired a sound scientific basis in the last two decades. The discovery of neuro-mediators and cytokines and their receptors shared by the central nervous system and the immune system has prompted research work using reliable methodologies to study the relationship between a 'hard' scientific field, such as immunology, and a 'soft' one, such as the behavioral sciences.

CURRENT KNOWLEDGE AND KEY POINTS

The complexity of the studies on stress and immunity lies upon the choice of immunological measurements and the development of reproducible stress protocols. Models of stress in experimental animals may address acute versus chronic stress, and individual versus social stress. In humans, typical situations such as academic exams, and care given to patients with dementia, for instance, have been chosen to study large groups of subjects. The development of self-questionnaires for a reliable evaluation of stress and its consequences has led to more accurate measurements of psychosocial events. In animals, acute stress usually drives the immune response towards a Th2, grossly 'immunosuppressive,' profile. In humans, acute stress associates an endocrine response (characterized by glucocorticoid secretion and hyperprolectinemia) with an immunosuppression. Chronic stress is more likely to induce a range of effects, depending on the capacity of the subject to cope with stress, and on his/her social environment. Among the numerous mediators of the hypothalamo-pituitary cascade, Corticotropin Releasing Hormone is a key factor in the stress-immunity relationship. Several studies in humans have demonstrated the influence of stress on the susceptibility to infections (including HIV infection) and on survival in malignant diseases. In autoimmune diseases, a high prevalence of depression, as well as a particular sensitivity to stressful events, seem to modify the course of conditions such as systemic lupus erythematosus, rhumatoid arthritis or Sjögren's disease. The relationship between stress and diseases is based on the pathogenic model which involves the following chain of events: stressor, reaction to stress, neuro-endocrine changes, abnormalities of the immune response, and occurrence (or aggravation) of a disease. The evolution from health to disease could be associated, at least partially, with a 'passive' immunosuppressive mode of response, mediated by the pituitary-adrenal axis, typically the opposite of an 'active,' immunostimulant mode of response, mediated by adrenergic stimulation.

FUTURE PROSPECTS AND PROJECTS

Concept-related problems still remain to be solved: adaptation to stress ('coping'), is both genetically and socially mediated; the significance and interpretation of stress-related abnormalities and their precise involvement in the pathogenesis of diseases may be ambiguous. However, available epidemiological and pathophysiological evidence is currently sufficient to allow physicians in their everyday practice to take stress and depression into account in order to markedly improve the prognosis of many diseases related to immune responses. Prospective studies of neuropsychological intervention, using either pharmacologic or behavioral approaches, should be made to provide the necessary rational to a psychoimmunological management of patients.