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9 results

  • Schizophrenia and diabetes: Epidemiological data

  • F. Rouillon, F. Sorbara
  • Journal:
    European Psychiatry / Volume 20 / Issue S4 / December 2005
    Published online by Cambridge University Press:
    16 April 2020, pp. S345-S348

  • The association of diabetes mellitus and mental illness, in particular, schizophrenia, has been remarked upon for over a century. Recentepidemiological studies have shown the age- and sex-matched prevalence of diabetes in patients with schizophrenia to be 1.5–2 times those in the general population. This difference is particularly noticeable in younger patients. The explanation for this finding probably resides in both environmental and biological factors. Patients with schizophrenia tend to be sedentary and have a poor diet, which are both known risk factors for diabetes. However, familial studies have indicated a heritable component to the risk of diabetes in patients with schizophrenia. A number of biological mechanisms have been proposed to explain this, including neuroendocrine changes and neurodevelopmental anomalies, but none are entirely satisfactory. In addition, it has been suggested that treatment with antipsychotic medication may potentially increase the risk of diabetes and account for some of the increased prevalence seen in patients with schizophrenia. It has been suggested that different antipsychotic drugs may differ in their ability to facilitate the emergence of poor glycaemic control in patients with schizophrenia. However, the situation is far from clear and more work is required to accurately assess the potential risk associated with different antipsychotic drugs.

  • Bipolar sensation seeking is associated with a propensity to abuse rather than to temperamental characteristics

  • C. Henry, F. Bellivier, F. Sorbara, S. Tangwongchai, J. Lacoste, M. Faure-Chaigneau, M. Leboyer
  • Journal:
    European Psychiatry / Volume 16 / Issue 5 / August 2001
    Published online by Cambridge University Press:
    16 April 2020, pp. 289-292

  • Objective. As some temperament profiles may be markers of genetic vulnerability traits, we aimed to compare sensation seeking in euthymic bipolar patients and in controls. Methods. One hundred ninety-four patients fulfilling DSM-IV diagnostic criteria for bipolar disorders (BP), 81% of whom presented type I BP, and 95 controls were included in this study. Euthymia was assessed using both the MADRS and Bech mania scales. Subjects were evaluated using the French abbreviated form of Zuckerman’s Sensation Seeking Scale (SSS), which provide a total score (TS) and four subscores: Thrill and Adventure Seeking (TAS), Experience Seeking (ES), Disinhibition (Dis), and Boredom Susceptibility (BS). Results. SSS total score differed significantly between men (17.2 ± 0.5) and women (15.3 ± 0.6) (P = 0.02) and all the subscores were negatively correlated with age. On adjustement for sex and age, we found that bipolar patients had a high Dis score (P = 0.003). However, if the same analysis was performed with a lifetime history of alcohol abuse or dependence as a covariable, no such difference was found (P = 0.436). The SSS demonstrated a high degree of test-retest reliability (ICC = 0.91). Conclusion. These results suggest that sensation seeking assessed with the SSS is not a temperament characteristic associated with bipolar disorders but is instead linked to a tendency towards alcohol abuse.

  • Serious game dans la psychoéducation aux troubles bipolaires

  • Y. Quintilla, E. Olié, N. Franck, S. Gard, P.-M. Llorca, M. Maurel-Raymondet, P. Nuss, J.-P. Orth, A.-V. Rousselet, F. Sorbara, M. Lukasiewicz, B. Mathieu, C. Vega, P. Courtet
  • Journal:
    European Psychiatry / Volume 28 / Issue S2 / November 2013
    Published online by Cambridge University Press:
    16 April 2020, pp. 25-26
    • Article
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  • Contexte

    Le trouble bipolaire est une pathologie chronique qui nécessite la mise en place de stratégies non médicamenteuses éducatives [2]. Récemment, le concept de Serious game (jeu sérieux) [1] a fait son apparition dans les programmes d’éducation thérapeutique [4]. BIPOLIFE®[3], programme d’information ludoéducatif sur le trouble bipolaire accessible sur Internet, a été développé afin de s’intégrer dans la panoplie psychoéducative. BIPOLIFE® consiste à faire évoluer son avatar au quotidien. Ce jeu est basé sur 3 cibles : les règles hygiénodiététiques, l’observance médicamenteuse, le recours au médecin/psychiatre.

    Objectif

    Mise en place d’une étude pilote évaluant l’acceptabilité de BIPOLIFE® et son effet sur la connaissance de la maladie auprès de 63 patients bipolaires sur 3 semaines. Les patients ont été évalués avec l’échelle de connaissance du trouble bipolaire et une échelle d’acceptabilité de BIPOLIFE®.

    Résultats

    BIPOLIFE® semble être mieux accepté par des jeunes (p = 0,011) et plus efficace sur des hommes (p = 0,043) ayant une moins bonne connaissance de la maladie initiale (p ≤ 0,001). La majorité des patients a rapporté en avoir tiré bénéfice sur leur vie quotidienne, leur connaissance ou leur gestion de la maladie. Les patients ont déclaré que BIPOLIFE® est à conseiller à des personnes souffrant de TB (32 %), à leur proche entourage (32 %) ou au grand public (16 %).

    Conclusion

    Notre étude montre que BIPOLIFE® est déjà un outil pertinent dans la prise en charge des patients bipolaires. Des études complémentaires sont nécessaires pour évaluer précisément sa place dans les programmes de psychoéducation.

  • Évaluation de l’intérêt d’un Serious game chez des patients souffrant de troubles bipolaires inclus dans un programme de psychoéducation

  • E. Olié, N. Franck, S. Gard, P.-M. Llorca, M. Maurel-Raymondet, P. Nuss, J.-P. Orth, A.-V. Rousselet, F. Sorbara, M. Lukasiewicz, B. Mathieu, C. Vega, P. Courtet
  • Journal:
    European Psychiatry / Volume 28 / Issue S2 / November 2013
    Published online by Cambridge University Press:
    16 April 2020, p. 26
    • Article
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  • Introduction

    La psychoéducation du trouble bipolaire favorise l’adhésion thérapeutique et le maintien de l’euthymie à 2 ans [1]. Au terme d’un tel programme, les patients peuvent avoir besoin d’aide pour perpétuer la mise en place des apprentissages concernant l’observance thérapeutique, les routines de vie quotidienne, l’évitement des toxiques et le repérage des prodromes thymiques. Le Serious Game BIPOLIFE®, jeu centré sur un avatar souffrant de trouble bipolaire évoluant dans des situations de la vie courante, s’articule aussi autour de ces cibles.

    Objectifs

    Évaluer la qualité de l’observance thérapeutique par la Medication Adherence Rating Scale (MARS) [2], les indicateurs de routine de vie et de recours aux soins psychiatriques à 1 et 4 mois de la dernière séance de psychoéducation chez les patients utilisant BIPOLIFE® vs. suivi habituel.

    Méthodologie

    Étude pilote multicentrique randomisée contrôlée à 2 bras (durée : 24 mois) incluant des sujets euthymiques (score de dépression MADRS ≤ 12 et de manie YMRS ≤ 8 depuis 3 mois), bénéficiant d’un programme de psychoéducation. Les patients du groupe « intervention » se connecteront au site BIPOLIFE®, de manière hebdomadaire, pendant un mois (durée de connexion libre). À l’inclusion (dernière séance de psychoéducation), 1 et 4 mois, seront évalués l’attitude vis-à-vis du traitement, la qualité du sommeil, l’indice de masse corporelle, le périmètre ombilical, la consommation de toxiques, le fonctionnement psychosocial et le recours aux soins psychiatriques.

    Perspectives

    Proposer BIPOLIFE® en add-on de la psychoéducation pour renforcer les compétences acquises lors du programme et le maintien de l’euthymie.

  • Substance use and the course of early psychosis: a 2-year follow-up of first-admitted subjects

  • F. Sorbara, F. Liraud, F. Assens, F. Abalan, H. Verdoux
  • Journal:
    European Psychiatry / Volume 18 / Issue 3 / May 2003
    Published online by Cambridge University Press:
    16 April 2020, pp. 133-136
  • Objective

    To examine the impact of alcohol and substance use on the early course of psychosis.

    Methods: First-admitted subjects with psychosis (n = 58) were assessed at 6-month intervals over a 2-year follow-up. Information on substance and alcohol misuse and clinical and social outcome was collected using multiple sources of information.

    Results

    After adjustment for potential confounding factors, subjects with persistent substance misuse over the follow-up were at increased risk of readmission (OR = 3.1; 95%CI = 1.0-9.4; P = 0.05), of presenting with psychotic symptoms (OR = 4.3; 95%CI = 1.0-18.1; P = 0.04), and with a non-continuous course of illness (OR = 11; 95%CI = 1-122; P = 0.05). No significant association was found between substance misuse and social outcome, or between alcohol misuse and clinical and social outcome.

    Conclusions

    Persistent substance misuse after a first admission for psychosis has a deleterious impact on clinical outcome. Early identification and treatment of substance use is essential in the care of subjects with incipient psychosis.

  • Effects of cannabis and psychosis vulnerability in daily life: an experience sampling test study

  • H. VERDOUX, C. GINDRE, F. SORBARA, M. TOURNIER, J. D. SWENDSEN
  • Journal:
    Psychological Medicine / Volume 33 / Issue 1 / January 2003
    Published online by Cambridge University Press:
    11 February 2003, pp. 23-32

  • Background. Epidemiological findings suggest that cannabis use is a risk factor for the emergence of psychosis, and that the induction of psychotic symptoms in the context of cannabis use may be associated with a pre-existing vulnerability for psychosis. This study investigated in a non-clinical population the interaction between cannabis use and psychosis vulnerability in their effects on psychotic experiences in daily life.

    Method. Subjects (N = 79) with high or low levels of cannabis use were selected among a sample of 685 undergraduate university students. Experience sampling method (ESM) was used to collect information on substance use and psychotic experiences in daily life. Vulnerability to develop psychosis was measured using a clinical interview assessing the level of psychotic symptoms. Statistical analyses were performed using multilevel linear random regression models.

    Results. The acute effects of cannabis are modified by the subject's level of vulnerability for psychosis. Subjects with high vulnerability for psychosis are more likely to report unusual perceptions as well as feelings of thought influence than subjects with low vulnerability for psychosis, and they are less likely to experience enhanced feelings of pleasure associated with cannabis. There is no evidence that use of cannabis is increased following occurrence of psychotic experiences as would be expected by the self-medication model.

    Conclusion. Cannabis use interacts with psychosis vulnerability in their effects on experience of psychosis in daily life. The public health impact of the widespread use of cannabis may be considerable.

  • La búsqueda de sensaciones bipolar se asocia con una propensión al abuso más bien que a características temperamentales

  • C. Henry, F. Bellivier, F. Sorbara, S. Tangwongchai, J. Lacoste, M. Faure-Chaigneau, M. Leboyer
  • Journal:
    European Psychiatry (Ed.Española) / Volume 8 / Issue 8 / November 2001
    Published online by Cambridge University Press:
    12 May 2020, pp. 531-535
    Print publication:
    November 2001
  • Objetivo:

    Como algunos perfiles de temperamento pueden ser marcadores de rasgos de vul-nerabilidad genética, tratamos de comparar la búsqueda de sensaciones en pacientes bipolares eutímicos y en controles.

    Métodos:

    Se incluyó en este estudio a 194 pacientes que cumplían los criterios diagnóstics del DSM-IV para trastornos bipolares (TB), 81% de los cuales presentaban TB de tipo I, y a 95 controles. La eutimia se evaluó utilizando tanto la MADRS como la escala de manía de Bech. Se evaluó a los sujetos utilizando la forma abreviada francesa de la Escala de Búsqueda de Sensaciones de Zuckerman (SSS), que proporciona una puntuación total (PT) y cuatro subpuntuaciones: Búsqueda de emociones y aventuras (BEA), Búsqueda de experiencias (BE), Desinhibición (Des) y Susceptibilidad al aburrimiento (SA).

    Resuhados:

    La puntuación total de la SSS difirió significativamente entre los hom-bres (17,2 ± 0,5) y las mujeres (15,3 ± 0,6) (P = 0,02), y todas las subpuntuaciones correlaciona’ron nega-tivamente con la edad. En el ajuste para el sexo y la edad, encontramos que los pacientes bipolares te-nían una puntuación de Des elevada (P = 0,003). Sin embargo, si el mismo análisis se realizaba con los antecedentes vitales de abuso o dependencia de alcohol como covariable, esta diferencia no se encontra-ba (P = 0,436). La SSS demostró un alto grado de fiabilidad test-retest (ICC = 0,91).

    Conclusión:

    Estos resultados indican que la búsqueda de sensaciones evaluada con la SSS no es una característica del temperamento asociada con los trastornos bipolares, pero está relacionada en cambio con una tendencia hacia el abuso de alcohol.