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Kapitel 1, What We Argue About When We Argue About Disease untersucht die Methodologie der gegenwärtigen Debatte über den Krankheitsbegriff. Kapitel 2, A Domino Theory of Disease, skizziert eine Theorie pathologischer Zustände als Dysfunktionen, die ein Versagen anderer Funktionen verursachen. Kapitel 3, Against the Generalised Theory of Function, verteidigt eine auf Dysfunktionen fußende Theorie gegen einen aktuellen Einwand Justin Garsons. Kapitel 4, Why Mental Disorders are not Like Software Bugs, widerlegt ein Argument Papineaus, das psychische Erkrankung und Hirnerkrankung durch eine Analogie mit Computerhardware und Software unterscheidet. Kapitel 5, Reactive Natural Kinds and Varieties of Dependence, unterscheidet verschiedene Arten der Abhängigkeit zwischen natürlichen Arten und deren Klassifikation., Ch. 1 What We Argue About When We Argue About Disease, considers some methodological oddities evident in the disease-debate – participants claim to be in the business of conceptual analysis, but fail to argue as if this were the case. I argue these strange features are best explained by the hypothesis that pathology is a real kind. On this basis, I formulate my own research question: what is the causal structure underpinning the real kind pathology in the world? This project, I contend, is distinct from, but not in conflict with, attempts at traditional conceptual analysis. In Ch. 2 A Domino Theory of Disease, I outline a theory of pathological conditions as ‘domino dysfunctions’: dysfunctions which cause failures of function in other traits. Domino dysfunctions can be distinguished on principled grounds from non-pathological, ‘trivial’ dysfunctions. In Ch. 3 Against the Generalised Theory of Function, I defend a dysfunction-based account against a recent objection mounted by Justin Garson. I show that Garson’s Generalised Selected Effects Theory implies that neurally selected disorders are both functional and dysfunctional. I argue, on this basis, that we should reject Garson’s theory outright. In Ch. 4 Why Mental Disorders are not Like Software Bugs, I refute the argument, advanced by Papineau and others, that mental disorders are metaphysically distinct from brain disorders just as software malfunctions are distinct from hardware malfunctions in a classical computer. Finally, In Ch. 5 Reactive Natural Kinds and Varieties of Dependence, I distinguish ‘simple dependence’, ‘secondary dependence’ and ‘essential dependence’ between a natural kind and its classification. On this basis, I offer a principled hypothesis as to why psychiatric kinds may be more metaphysically unstable than paradigm biomedical kinds – even if they are bona fide natural kinds constituted by brain dysfunction.

SCOPUS: ar.j, info:eu-repo/semantics/published

Objectives: Physicians and psychologists at psychiatric university hospitals are assigned teaching tasks from the first day of work without necessarily having the prerequisite training in teaching methods. This exploratory survey provides a needs-based analysis for the prospective didactic training of physicians and psychologists at psychiatric hospitals in Germany, Austria and Switzerland.Methods: An online questionnaire was distributed at medical schools via email in German-speaking countries in Europe. All physicians involved in teaching medical students at psychiatry faculties were eligible to participate in the survey. Participants were further requested to recruit eligible participants (snowball sampling). Responses were analyzed descriptively, and differences between groups were calculated using nonparametric Mann-Whitney U tests (p<.05).Results: Overall, 97 respondents (male=55, female=42; mean age= 40.6) from 19 medical schools completed the survey. The respondents consisted of 43 residents, 39 specialists, 6 chief physicians and 9 psychologists. Of the respondents, 97.6% rated didactic competence as either highly relevant or rather relevant for teaching medical students. The highest overall interest was shown for bedside teaching (mode=4; IQR: 2-4) and error culture (mode=3; IQR: 2-4). Respondents expressed the highest training needs for topics regarding presentation and communication (mode=3; IQR: 2-3). Resident physicians were significantly more interested in bedside teaching (U=362.0, p=0.004) and roleplay (U=425.0; p=0.036) than specialist physicians, who were more interested in examination didactics (U=415.0; p=0.022). Chief physicians displayed significantly deeper interest in group dynamics (U=51; p=0.023) than specialist physicians. In-person training was preferred by a majority of respondents, and 27.4% preferred online/web-based training.Conclusions: The majority of physicians and psychologists at psychiatric university hospitals considered profe, Zielsetzung: Ärzt*innen und Psycholog*innen an psychiatrischen Universitätskliniken werden vom ersten Arbeitstag an mit Lehraufgaben konfrontiert, ohne jedoch notwendigerweise die hierzu erforderliche didaktische Ausbildung erhalten zu haben. Diese Pilotstudie liefert eine bedarfsorientierte Untersuchung für die zukünftige didaktische Ausbildung an psychiatrischen Kliniken tätigen Ärzt*nnen und Psycholog*nnen in Deutschland, Österreich und der Schweiz.Methodik: Eine Onlineumfrage wurde per E-Mail an die Medizinischen Fakultäten in deutschsprachigen, europäischen Ländern verteilt. Alle an der studentischen Lehre beteiligten Ärzt*innen an psychiatrischen Kliniken waren teilnahmeberechtigt. Die Proband*innen wurden außerdem gebeten, qualifizierte Teilnehmer*innen zu rekrutieren (Schneeballverfahren). Die Rückmeldungen wurden deskriptiv ausgewertet, Gruppenunterschiede wurden mit nonparametrischen Mann-Whitney-U-Tests berechnet (p<.05)Ergebnisse: 97 Teilnehmende (männlich=55, weiblich=42; mittleres Alter=40,6 Jahre) von 19 Medizinischen Fakultäten schlossen die Umfrage ab. Diese setzten sich aus 43 Assistenzärzt*innen (AÄ), 39 Fachärzt*innen (FÄ), 6 Chefärzt*innen (CÄ) sowie 9 Psycholog*innen zusammen. 97,6% der Proband*innen empfanden didaktische Kompetenz als relevant, oder sehr relevant für die studentische Lehre. Das größte Interesse bestand an Bedside Teaching (Modus=4; IQA: 2-4) und Fehlerkultur (Modus=3; IQA: 2-4). Der größte Ausbildungsbedarf zeigte sich bei Themen um Präsentation und Kommunikation (Modus=3; IQA: 2-3). Assistenzärzt*innen waren signifikant interessierter an Bedside Teaching (U=362; p=0,004) und Rollenspielen (U=425; p=0,036) als Fachärzt*innen, welche Prüfungsdidaktik als relevanter einstuften (U=415; p=0,022). Chefärzt*innen waren signifikant mehr an Gruppendynamik (U=51; p=0,023) interessiert als Fachärzt*innen. Die Mehrheit der Teilnehmer*innen bevorzugte Präsenzangebote, 27,4% Onlineangebote. Schlussfolgerungen: Der Großteil der Ärzt*innen u

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Most auditory environments contain multiple sound waves that are mixed before reaching the ears. In such situations, listeners must disentangle individual sounds from the mixture, performing the auditory scene analysis. Analyzing complex auditory scenes relies on listeners ability to segregate acoustic events into different streams, and to selectively attend to the stream of interest. Both segregation and selective attention are known to be challenging for adults with normal hearing, and seem to be even more difficult for children. Here, we review the recent literature on the development of auditory scene analysis, presenting behavioral and neurophysiological results. In short, cognitive and neural mechanisms supporting stream segregation are functional from birth but keep developing until adolescence. Similarly, from 6 months of age, infants can orient their attention toward a target in the presence of distractors. However, selective auditory attention in the presence of interfering streams only reaches maturity in late childhood at the earliest. Methodological limitations are discussed, and a new paradigm is proposed to clarify the relationship between auditory scene analysis and speech perception in noise throughout development., SCOPUS: sh.j, info:eu-repo/semantics/published

Depuis plusieurs décennies, les Etats Africains ont dû faire face à des guerres répétées. Ces violences constituent des évènementspotentiellement traumatiques qui impactent le psychisme et le corps des victimes [1]. Celles-ci conduisent à différentes formes des blessures physiques ou psychiques qui peuvent engendrer un trouble de stress post traumatique (TSPT). Les souvenirs traumatiques réactivés prennent dès lors la forme d’une intrusion et des sensations corporelles signalant la présence de danger même dans des situations paisibles [2]. Le but de cette scoping review est de mettre en exergue la question de l’expression traumatique en Afrique subsaharienne., info:eu-repo/semantics/published

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The brain can be understood as a complex network with interconnected brain regions linked by white matter pathways on the macroscale. In this thesis, we explored the connectivity between these regions and its disruption in brain disorders. By employing a relational approach that examines interactions and relationships across different scales, modalities, and domains, we aimed to gain a more comprehensive understanding of the brain. Our findings highlight a common pattern of disconnectivity across neurological and psychiatric disorders, showing that connections central in the network architecture are particularly vulnerable to disruptions. In an in-depth examination of insomnia, depression, and anxiety disorders, we identified multimodal brain correlates associated with symptoms of these conditions. We distinguished between common and unique associations of brain structure and function with the severity of symptoms characteristic of each disorder, providing insights into both shared and specific brain circuits. Additionally, this thesis contributes to the development and application of tools for reconstructing and analyzing brain networks. We introduced the CATO toolbox, an open-source software tool for structural and functional connectivity reconstruction. We also proposed the normalized Laplacian eigenvalue spectrum as a method for comparing neuronal networks across species and assessing differences in connectome organization. Overall, the research presented contributes to our methodologies for reconstructing and analyzing brain networks and provides insights into the organization of neuronal networks and the disruptions in network organization in brain disorders.

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The clinical phenotype of the so-called late-onset depression (LOD) affecting up to 30% of older adults and yielding heterogeneous manifestations concerning symptoms, severity and course has not been fully elucidated yet. This European, cross-sectional, non-interventional, naturalistic multicenter study systematically investigated socio-demographic and clinical correlates of early-onset depression (EOD) and LOD (age of onset ≥ 50 years) in 1410 adult in- and outpatients of both sexes receiving adequate psychopharmacotherapy. In a total of 1329 patients (94.3%) with known age of disease onset, LOD was identified in 23.2% and was associated with unemployment, an ongoing relationship, single major depressive episodes, lower current suicidal risk and higher occurrence of comorbid hypertension. In contrast, EOD was related to higher rates of comorbid migraine and additional psychotherapy. Although the applied study design does not allow to draw any causal conclusions, the present results reflect broad clinical settings and emphasize easily obtainable features which might be characteristic for EOD and LOD. A thoughtful consideration of age of onset might, hence, contribute to optimized diagnostic and therapeutic processes in terms of the globally intended precision medicine, ideally enabling early and adequate treatment allocations and implementation of respective prevention programs., SCOPUS: ar.j, info:eu-repo/semantics/published

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Children and adolescents treated with antipsychotic drugs can experience severe and bothersome adverse drug reactions (ADRs), which can have a physical as well as an emotional impact on their lives. It is important to monitor these children and adolescents closely so that ADRs are identified early. The aim of this thesis was to assess the daily clinical practice of monitoring for ADRs of antipsychotic drugs in children and adolescents, including the facilitators for and barriers to monitoring. First, the need for monitoring was assessed. The frequencies of spontaneously reported ADRs in children and adolescents treated with antipsychotic drugs were determined using data from the worldwide database VigiBase. Many different ADRs were reported by young people and healthcare professionals, including weight gain, breast enlargement, and movement disorders. Second, monitoring in daily clinical practice was examined. How ADRs were monitored was studied in various ways: questionnaires were completed by Dutch child and adolescent psychiatrists, medical records of an organization for child and adolescent psychiatry were examined, and prescription data from British general practitioners were analyzed. In none of these studies monitoring was optimal. The monitoring frequencies as well as what was monitored varied between healthcare professionals. Healthcare professionals rarely reported the reason for not monitoring and guidelines were most often not completely followed. Third, the support provided during antipsychotic drug treatment was assessed. There are clinical guidelines available for healthcare professionals on how to monitor for ADRs. The clarity of presentation and the applicability of ADR-related monitoring instructions in six clinical practice guidelines for children and adolescents treated with antipsychotic drugs were assessed. These guidelines were clearly presented but differed in what and how often to monitor and were not always easily applicable in daily practi

This dissertation presents a framework for ‘being through loss’ that reframes the conditions of engagement with grief in relation to the loss of a loved other by illustrating how an experienced sense of being in the world takes and alters shape through loss. Via close readings of research on grief as psychiatric diagnosis (e.g., Simon et al 2011; Shear et al. 2013; Castelnovo et al. 2015) and autobiographical accounts of loss by Danish author and poet Naja Marie Aidt (2019) and American author and journalist Joan Didion (2005), this project makes four main contributions to contemporary debates on grief and scholarship on loss and death. First chapter opens by identifying the “ontogenetic” premise that subtends debate in Western Europe and North America, which, I argue, is predominantly focused on how to define the phenomenon of grief and accurately respond to it. I then introduce an alternative queer performative framing of grief as an organic and entangled phenomenon. Second chapter turns to a body of literature in support of the psychiatric model of grief. Challenging claims made by scholars and experts pertaining to grief as diagnosis, I illustrate the centrality of a biomedical perspective and more specifically a neuroscientific understanding of mental illness to the formation of so called “prolonged grief disorder.” I then propose that a biomedically poised psychiatric model’s reparative approach to the bereaved subject couches an anxious effort to contain life in a sovereign, humanist form, which indirectly illustrates the organic and open quality of being as phenomenon. Chapter 3 of this dissertation engages with Naja Marie Aidt’s account of the loss of her adult son Carl. Grounded in a combined analysis of Aidt’s style of expressing grief and the reception of her book in Danish media and public, I propose that available expert and vernacular models of mourning are unequipped to acknowledge the lost other as being. I trace the origins of this inability to a m

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Introduction: La consommation de drogue illicite ou licite est actuellement très répandue dans le monde et commence à se répandre à Madagascar, Cette consommation à un certain niveau peut engendrer le pronostic vitale et fonctionnel d’un sujet nécessitant son hospitalisation. Les objectifs de cette étude sont de déterminer la prévalence et la fréquence de l’usage de drogues vu dans le service de psychiatrie de Befelatanana ainsi que de décrire les rapports entre l’apparition de ces consommations et les variables étudiésMéthode: C’est une étude rétrospective sur une période de 12 mois allant du 01 janvier 2021 au 31 Décembre 2021. Les variables étudiées ont été l’âge, le genre ainsi que les paramètres cliniques, la nature du toxique utilisée, les comorbidités somatiques ou psychiatriques, les traitements reçus, le logiciel SPSS® version 25 a été utilisé pour le traitement des donnéesRésultats: Dans cette série, l’âge des patients a varié de 17 à 74 ans, avec un âge moyen de 40,87 ans (écart-type = 12,27), Une prédominance masculine a été retrouvé à 83,87%. Le secteur tertiaire a été le secteur de travail le plus représenté avec 35,48% de taux de prévalence. La durée d’hospitalisation varie de 1 à 25 jours avec une moyenne de 6,19 jours (écart-type = 5,09), La consommation d’alcool a été retrouvé à 74,19% des cas. Les thérapeutiques par vitaminothérapie, benzodiazépine et hydratation ont été les plus représentés à 32,26%.Conclusion: La prévalence des mésusages de substances psychoactives est élevée en population psychiatrique, la surveillance et le dépistage ces mésusages doivent être systématiques pour une meilleure prise en charge.

Introduction : Les sorties non autorisées interfèrent avec la prise en charge des patients en psychiatrie alors que peu d’études abordent ce sujet. Les objectifs de cette étude sont de décrire le profil épidémiologique des patients sortis sans autorisation médicale et de décrire la prévalence de ces sorties dans ce service.Méthode : Nous avons mené une étude rétrospective sur une période de 15 mois du 01er janvier 2021 au 01er mars 2022. Les variables étudiées étaient l’âge, le sexe, la durée de l’hospitalisation, le jour du congé, le diagnostic présumé et le mode de sortie. Les données ont été saisies dans Excel® et analysées par SPSS® version 25. Le test Chi2 a été utilisé pour les comparaisons en pourcentage avec un seuil de signification fixé à 0,05.Résultats : Nous avons retenu 71 patients, soit 25% de prévalence (15,49% d’échappés, 84,51% de sorties), l’âge variait de 13 à 85 ans avec une moyenne de 33,66 ans, et un sex-ratio de 1,22. La durée moyenne du séjour a été de 4 jours, avec un départ observé le lundi (25,35%) pour les sorties et mardi et jeudi (4,23%) pour les évadés. Le trouble du comportement est le plus représenté à 38,03%. L’âge et le sexe n’étaient pas significativement corrélés aux renvois non autorisés.Conclusion : Une attention particulière doit être portée aux patients hospitalisés en psychiatrie. Pour réduire cette forte prévalence, l’initiative passe des soignants aux agents de l’État pour améliorer la santé publique.

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SCOPUS: ed.j, info:eu-repo/semantics/published

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The risk of developing drug addiction is strongly influenced by the epigenetic landscape and chromatin remodeling. While histone modifications such as methylation and acetylation have been studied in the ventral tegmental area and nucleus accumbens (NAc), the role of H2A monoubiquitination remains unknown. Our investigations, initially focused on the scaffold protein melanoma-associated antigen D1 (Maged1), reveal that H2A monoubiquitination in the paraventricular thalamus (PVT) significantly contributes to cocaine-adaptive behaviors and transcriptional repression induced by cocaine. Chronic cocaine use increases H2A monoubiquitination, regulated by Maged1 and its partner USP7. Accordingly, Maged1 specific inactivation in thalamic Vglut2 neurons, or USP7 inhibition, blocks cocaine-evoked H2A monoubiquitination and cocaine locomotor sensitization. Additionally, genetic variations in MAGED1 and USP7 are linked to altered susceptibility to cocaine addiction and cocaine-associated symptoms in humans. These findings unveil an epigenetic modification in a non-canonical reward pathway of the brain and a potent marker of epigenetic risk factors for drug addiction in humans., SCOPUS: ar.j, info:eu-repo/semantics/published

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L’article débute par l’exploration d’une série de processus psychiques individuels et systémiques avec lesquels sont aux prises les victimes d’effractions traumatiques, mais aussi ceux et celles qui en sont les témoins ou tentent de les aider. À travers l’exposé de plusieurs situations cliniques, nous allons montrer comment les effets des traumatismes dits extrêmes (abus sexuels, violence de masse, génocide…) convoquent la clinique du lien pour mobiliser les processus de résilience. La perspective du « comment vivre comme après » – expression empruntée à Guy Ausloos – sert de fil rouge pour conduire un travail thérapeutique engagé, qui favorise le (re)tissage de lien, les remaillages des liens filiatifs et affiliatifs, la réhumanisation., SCOPUS: ar.j, info:eu-repo/semantics/published

Background and Objectives: The COVID-19 pandemic and its associated factors have been shown to affect anxiety levels of young people. We meta-analytically assessed the prevalence of anxiety symptoms and anxiety disorders in children and adolescents during the pandemic, and the predictors and moderating factors influencing anxiety. Methods: Multiple databases and registers were searched in this PRISMA and MOOSE-compliant systematic review and meta-analysis (PROSPERO:CRD42021266695) until 27/06/2021. We included individual studies evaluating the prevalence and characteristics of anxiety symptoms or anxiety disorders in children and adolescents (mean age ≤18 years), during the COVID-19 pandemic. Data extraction and quality assessment were carried out by independent authors. Random-effects meta-analyses of the prevalence of anxiety symptoms and anxiety disorders were conducted using Comprehensive Meta-Analysis (CMA) V3. Results: 74 articles (total participant sample=478,882) were included (mean age=13.4 years, 52.3% female). The pooled rate of children and adolescents fulfilling diagnostic criteria for anxiety disorders was 13.0% (95%CI=4.9–30.1); the pooled prevalence of anxiety symptoms was 26.5% (95%CI=20.3–33.9). Anxiety symptoms were significantly more prevalent in females than males (B = 0.103, p<.001), significantly higher during the second wave of COVID-19, following July 2020, than during the first wave, prior to June 2020, (Q= 8.136, p=.017), and during school closure (Q= 8.100, p=.014). Quality of included studies was overall moderate. Conclusions: There is a high prevalence of anxiety symptoms in children and adolescents during the COVID-19 pandemic, especially amongst females. This study identifies vulnerable groups, risk, and protective factors, which is crucial to developing clinical practice to prevent further mental health deterioration in young people., SCOPUS: re.j, info:eu-repo/semantics/published

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Hintergrund: Menschen mit einer psychischen und somatischen Erkrankung erhalten eine weniger gute somatische Versorgung im Vergleich zur Bevölkerung ohne psychische Erkrankung. Um die Versorgungsqualität zu erhöhen, wurde in einer psychiatrischen Institution in der Schweiz 2017 das Clinical Assessment und Decision Making (CADM) durch Pflegende eingeführt. Ziel: Ziel der Studie war es, zu untersuchen, wie Ärzt_innen und leitende Psycholog_innen die Durchführung des CADM durch Pflegende erleben. Dies, um daraus Empfehlungen abzuleiten, wie die Zusammenarbeit optimiert und eine nachhaltige Etablierung des CADM gefördert werden kann. Methode: Eine Embedded Single Case Study wurde angewandt, die Datenanalyse orientierte sich an den Strategien der Grounded Theory nach Charmaz. Es fanden semistrukturierte Expert_inneninterviews (n = 11) und offene unstrukturierte Beobachtungen in einer Psychiatrie in der Schweiz statt. Ergebnisse: Die Ergebnisse zeigten neun relevante Bereiche, welche die Zusammenarbeit und das CADM durch Pflegende betreffen: „Stärken“, „Schwächen“, „Risiken“, „Chancen“, „Erwartungen“, „Herausforderungen“, „Nutzen“, „Kompetenzen der CADM Pflegenden“ und „Wünsche für die Zukunft“. Schlussfolgerungen: Die Ärzt_innen und leitenden Psycholog_innen erachteten das CADM durch Pflegende als Mehrwert für das interprofessionelle Team und die Patient_innen. Unklarheiten in Bezug auf den Verantwortungsbereich, Rollendefinitionen und Einsatzmöglichkeiten erschwerten die Implementation des CADM. Background: People with a mental and physical illness receive less good somatic care compared to the general population. Patients in psychiatry receive better medical care when nurses have in-depth medical expertise. Therefore, in a psychiatric institution in Switzerland in 2017, the Clinical Assessment and Decision Making (CADM) by nurses was implemented. Aim: The aim of the study was to investigate how physicians and senior psychologists experience the implementation of CADM b

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