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1. Sexual dysfunctions are associated with major depression, chronic inflammation and anticholinergic consumption in the real-world schizophrenia FACE-SZ national cohort

Author

C. Passerieux, Catherine Faget, Jasmina Mallet, Mathieu Urbach, Pierre Vidailhet, F. Schürhoff, Isabelle Chereau, Caroline Dubertret, Bruno Aouizerate, C. Lançon, Pierre-Michel Llorca, Delphine Capdevielle, Marion Dumontaud, Julien Dubreucq, David Misdrahi, A. Schandrin, Guillaume Fond, Sylvain Leignier, Marion Leboyer, Andrei Szöke, Romain Rey, Ophélia Godin, Fabrice Berna, L. Boyer, and Thierry d'Amato

Subjects
Olanzapine, Adult, Male, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Comorbidity, Cholinergic Antagonists, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Anticholinergic, Humans, Sexual Dysfunctions, Psychological, Medical prescription, Antipsychotic, Biological Psychiatry, Depression (differential diagnoses), Pharmacology, Inflammation, Depressive Disorder, Major, business.industry, medicine.disease, 030227 psychiatry, 3. Good health, Schizophrenia, Case-Control Studies, Cohort, Chronic Disease, Major depressive disorder, Female, France, business, 030217 neurology & neurosurgery, medicine.drug, Antipsychotic Agents
Abstract

Background Sexual dysfunctions (SD) are frequent in schizophrenia (SZ) and associated with treatment withdrawal, however they remain under-explored and under-treated. To date, most of the studies have focused on SD as antipsychotics' side effects in therapeutic trials. Aims The objectives of the present study were to determine the SD prevalence in stabilized SZ outpatients and their clinical, pharmacological and biological correlates. Method Two hundred and thirty-seven participants (61.2% men) were consecutively included and received a thorough 2 days- clinical assessment including the self-reported Sexual Functioning Questionnaire (SFQ). SD was defined by a SFQ score ≥ 8. Results Two hundred and thirty-seven subjects were recruited in the FACE-SZ cohort, 41% of them reported sexual dysfunctions. In multivariate analyses, SD have been associated with current major depressive disorder (adjusted odd ratio aOR = 2.29[1.08–4.85], p = .03), anticholinergic prescription (aOR = 2.65, p = .02) and chronic low-grade inflammation (aOR = 2.09, p = .03) independently of age, gender, current cannabis use disorder and olanzapine prescription. No antipsychotic has been associated with increased or decreased SD rate. Conclusions SD are frequent in SZ subjects. Major depression, anticholinergic prescription and chronic low-grade peripheral inflammation may be the three targets of interest for addressing this specific issue.

Published
2019

2. Validation and refinement of the clinical staging model in a French cohort of outpatient with schizophrenia (FACE-SZ)

Author

Ophelia Godin, Guillaume Fond, Ewa Bulzacka, Frank Schürhoff, Laurent Boyer, Andre Myrtille, Meja Andrianarisoa, Bruno Aouizerate, Fabrice Berna, Delphine Capdevielle, Isabelle Chereau, Jean-Michel Dorey, Caroline Dubertret, Julien Dubreucq, Catherine Faget, Christophe Lancon, Sylvain Leignier, Jasmina Mallet, David Misdrahi, Christine Passerieux, Romain Rey, Paul Roux, Pierre Vidailhet, Dominique Costagliola, Marion Leboyer, Pierre-Michel Llorca, Méja Andrianarisoa, Olivier Blanc, Lore Brunel, Isabelle Chéreau-Boudet, Gabrielle Chesnoy-Servanin, Jean-Marie Danion, Thierry D'Amato, Arnaud Deloge, Claire Delorme, Hélène Denizot, Cécile Fluttaz, Sandrine Fonteneau, Franck Gabayet, Elisabeth Giraud-Baro, Marie-Christine Hardy-Baylé, Delphine Lacelle, Christophe Lançon, Hakim Laouamri, Tifenn Le Gloahec, Yann Le Strat, Emeline Metairie, Pauline Peri, Sylvie Pires, Céline Portalier, Céline Roman, Mathilde Sebilleau, Aurélie Schandrin, Priscille Schneider, Franck Schurhoff, Arnaud Tessier, Anne-Marie Tronche, Mathieu Urbach, Florence Vaillant, Aurélie Vehier, Estelle Vilà, Hanan Yazbek, Anna Zinetti-Bertschy, CCSD, Accord Elsevier, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Fondation FondaMental [Créteil], Sorbonne Université (SU), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), IMRB - 'Neuropsychiatrie translationnelle' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Hôpital de la Colombière, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre hospitalier Charles Perrens [Bordeaux], Nutrition et Neurobiologie intégrée (NutriNeuro), Université Bordeaux Segalen - Bordeaux 2-Institut National de la Recherche Agronomique (INRA)-Université Sciences et Technologies - Bordeaux 1 (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), CHU Clermont-Ferrand, Université d'Auvergne - Clermont-Ferrand I (UdA), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, Assistance Publique - Hôpitaux de Marseille (APHM), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier de Versailles André Mignot (CHV), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) group: Méja Andrianarisoa 16 , Bruno Aouizerate 17 , Fabrice Berna 18 , Olivier Blanc 19 , Lore Brunel 16 , Ewa Bulzacka 16 , Delphine Capdevielle 20 , Isabelle Chéreau-Boudet 19 , Gabrielle Chesnoy-Servanin 21 , Jean-Marie Danion 18 , Thierry D'Amato 21 , Arnaud Deloge 22 , Claire Delorme 23 , Hélène Denizot 19 , Jean-Michel Dorey 21 , Caroline Dubertret 24 , Julien Dubreucq 23 , Catherine Faget 25 , Cécile Fluttaz 23 , Guillaume Fond 16 , Sandrine Fonteneau 26 , Franck Gabayet 23 , Elisabeth Giraud-Baro 23 , Marie-Christine Hardy-Baylé 26 , Delphine Lacelle 19 , Christophe Lançon 25 , Hakim Laouamri 27 , Marion Leboyer 16 , Tifenn Le Gloahec 16 , Yann Le Strat 24 , Pierre-Michel Llorca 19 , Jasmina Mallet 28 , Emeline Metairie 25 , David Misdrahi 22 , Christine Passerieux 26 , Pauline Peri 25 , Sylvie Pires 19 , Céline Portalier 24 , Romain Rey 21 , Céline Roman 23 , Mathilde Sebilleau 26 , Aurélie Schandrin 20 , Priscille Schneider 18 , Franck Schurhoff 16 , Arnaud Tessier 22 , Anne-Marie Tronche 19 , Mathieu Urbach 26 , Florence Vaillant 25 , Aurélie Vehier 21 , Pierre Vidailhet 18 , Estelle Vilà 22 , Hanan Yazbek 20 , Anna Zinetti-Bertschy 18, Centre de Psychiatrie et Neurosciences (U894), Université Montpellier 1 - UFR de Médecine (UM1 Médecine), Université Montpellier 1 (UM1), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), Laboratoire de sciences cognitives et psycholinguistique (LSCP), Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris)-École normale supérieure - Paris (ENS Paris)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Perrens, Centres d'addictologies - Région Centre, Physiopathologie clinique et expérimentale de la schizophrénie, Université Louis Pasteur - Strasbourg I-IFR37-Institut National de la Santé et de la Recherche Médicale (INSERM), Vulnérabilité à la schizophrénie : des bases neurobiologiques à la thérapeutique, Centre Hospitalier le Vinatier [Bron]-IFR19-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier de Bayeux, Psychiatrie, Centre Hospitalier le Vinatier [Bron], Centre Hospitalier de Saint-Egrève (CH Ste-Egrève), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Département des maladies infectieuses, Institut de Veille Sanitaire (INVS), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Laboratoire de neuropsychologie cognitive et prise en charge des troubles de la communication schizophrénique, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Hôpital Mignot, Université Paris Diderot - Paris 7 (UPD7), Service de pédiatrie multidisciplinaire [Hôpital de la Timone Enfants - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), Neuropsychiatrie : recherche épidémiologique et clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Université Panthéon-Sorbonne - UFR Histoire (UP1 UFR09), Université Panthéon-Sorbonne (UP1), Centre de recherche en neurosciences de Lyon (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA)-Hôpital Civil de Strasbourg, Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UM3)-Université de Montpellier (UM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg-Université de Strasbourg (UNISTRA)

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [SDV.NEU.PC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, Comorbidity, Neuropsychological Tests, Medication Adherence, Machine Learning, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Cognition, Outpatients, medicine, Humans, Cognitive Dysfunction, Stage (cooking), Medical prescription, Major depressive episode, Biological Psychiatry, Pharmacology, Depressive Disorder, Major, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, [SCCO.NEUR] Cognitive science/Neuroscience, Neuropsychology, [SDV.NEU.NB] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, medicine.disease, Prognosis, 030227 psychiatry, 3. Good health, Mood, Clinical staging, Schizophrenia, Cognitive remediation therapy, Cohort, Polypharmacy, Female, Schizophrenic Psychology, France, medicine.symptom, business, [SDV.NEU.SC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, Algorithms
Abstract

International audience; Objective: Existing staging models have not been fully validated. Thus, after classifying patients with schizophrenia according to the staging model proposed by McGorry et al. (2010), we explored the validity of this staging model and its stability after one-year of follow-up.Method: Using unsupervised machine-learning algorithm, we classified 770 outpatients into 5 clinical stages, the highest being the most severe. Analyses of (co)variance were performed to compare each stage in regard to socio-demographics factors, clinical characteristics, co-morbidities, ongoing treatment and neuropsychological profiles.Results: The precision of clinical staging can be improved by sub-dividing intermediate stages (II and III). Clinical validators of class IV include the presence of concomitant major depressive episode (42.6% in stage IV versus 3.4% in stage IIa), more severe cognitive profile, lower adherence to medication and prescription of >3 psychotropic medications. Follow-up at one-year showed good stability of each stage.Conclusion: Clinical staging in schizophrenia could be improved by adding clinical elements such as mood symptoms and cognition to severity, relapses and global functioning. In terms of therapeutic strategies, attention needs to be paid on the factors associated with the more stages of schizophrenia such as treatment of comorbid depression, reduction of the number of concomitant psychotropic medications, improvement of treatment adherence, and prescription of cognitive remediation.

Published
2018
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3. Machine learning for predicting psychotic relapse at 2 years in schizophrenia in the national FACE-SZ cohort

Author

A. Schandrin, E. Bulzacka, Guillaume Fond, Pierre Vidailhet, Delphine Capdevielle, Fabrice Berna, Mohamed Boucekine, Isabelle Chereau, Franck Schürhoff, Caroline Dubertret, L. Boyer, Romain Rey, Ophélia Godin, Thierry d'Amato, Pierre-Michel Llorca, Christine Passerieux, Jasmina Mallet, Bruno Aouizerate, Julien Dubreucq, Mathieu Urbach, C. Lançon, David Misdrahi, Sylvain Leignier, Catherine Faget, Marion Leboyer, Fondation FondaMental [Créteil], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Université Montpellier 1 (UM1), Centre Hospitalier le Vinatier [Bron], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Departement de Psychiatrie, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Génétique moléculaire de la neurotransmission et des processus neurodégénératifs (LGMNPN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), and Aix Marseille Université (AMU)

Subjects
Adult, Male, Low education, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, media_common.quotation_subject, Illness duration, Anger, Machine learning, computer.software_genre, Sensitivity and Specificity, Cohort Studies, Machine Learning, 03 medical and health sciences, 0302 clinical medicine, Recurrence, medicine, Early warning signs, Humans, Diagnosis, Computer-Assisted, Biological Psychiatry, media_common, Pharmacology, Psychiatric Status Rating Scales, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, medicine.disease, Prognosis, 030227 psychiatry, 3. Good health, Aggression, Psychotic Disorders, Schizophrenia, Cohort, Acute Psychotic Episode, Female, Schizophrenic Psychology, Cognitive Assessment System, Artificial intelligence, business, computer, Follow-Up Studies
Abstract

International audience; Background Predicting psychotic relapse is one of the major challenges in the daily care of schizophrenia. Objectives To determine the predictors of psychotic relapse and follow-up withdrawal in a non-selected national sample of stabilized community-dwelling SZ subjects with a machine learning approach. Methods Participants were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and received a thorough clinical and cognitive assessment, including recording of current treatment. Relapse was defined by at least one acute psychotic episode of at least 7 days, reported by the patient, her/his relatives or by the treating psychiatrist, within the 2-year follow-up. A classification and regression tree (CART) was used to construct a predictive decision tree of relapse and follow-up withdrawal. Results Overall, 549 patients were evaluated in the expert centers at baseline and 315 (57.4%) (mean age = 32.6 years, 24% female gender) were followed-up at 2 years. On the 315 patients who received a visit at 2 years, 125(39.7%) patients had experienced psychotic relapse at least once within the 2 years of follow-up. High anger (Buss&Perry subscore), high physical aggressiveness (Buss&Perry scale subscore), high lifetime number of hospitalization in psychiatry, low education level, and high positive symptomatology at baseline (PANSS positive subscore) were found to be the best predictors of relapse at 2 years, with a percentage of correct prediction of 63.8%, sensitivity 71.0% and specificity 44.8%. High PANSS excited score, illness duration Conclusion Machine learning can help constructing predictive score. In the present sample, aggressiveness appears to be a good early warning sign of psychotic relapse and follow-up withdrawal and should be systematically assessed in SZ subjects. The other above-mentioned clinical variables may help clinicians to improve the prediction of psychotic relapse at 2 years.

Published
2018
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4. Self-reported pain in patients with schizophrenia. Results from the national first-step FACE-SZ cohort

Author

Laurent Boyer, Christine Passerieux, Pierre Vidailhet, Delphine Capdevielle, Thierry d'Amato, A. Schandrin, Lore Brunel, Isabelle Chereau, N Coulon, Bruno Aouizerate, David Misdrahi, E. Bulzacka, Catherine Faget, Sylvain Leignier, Julien Dubreucq, Guillaume Fond, Franck Schürhoff, Mathieu Urbach, M. Andrianarisoa, Caroline Dubertret, Marion Leboyer, Pierre-Michel Llorca, Christophe Lançon, Jasmina Mallet, Hélène Denizot, Romain Rey, Ophélia Godin, Fabrice Berna, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Fondation FondaMental [Créteil], Université Pierre et Marie Curie - Paris 6 (UPMC), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Hôpital Charles Perrens, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de psychiatrie, CHU Clermont-Ferrand, Psychopathologie et neurobiologie de la schizophrénie et de la vulnérabilité à la psychose, Centre Hospitalier le Vinatier [Bron]-IFR19-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service de Psychiatrie D Adultes, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Neuropsychologie Cognitive et Prise en Charge des Troubles de la Communication Schizophreniques, Institut National de la Santé et de la Recherche Médicale (INSERM), FondaMental Foundation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Albert Chenevier-Fondation de Coopération Scientifique, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut National de la Santé et de la Recherche Médicale, AP-HM, Fondation FondaMental, Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 ( UM1 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants ( SPMC ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Aix Marseille Université ( AMU ), Universite ́ Pierre et Marie Curie-Paris, F-75005, Paris, Fédération de Médecine Translationnelle de Strasbourg ( FMTS ), Université de Strasbourg ( UNISTRA ), Institut d'Electronique et de Télécommunications de Rennes ( IETR ), Université de Nantes ( UN ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National des Sciences Appliquées - Rennes ( INSA Rennes ) -CentraleSupélec-Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-IFR19-Centre Hospitalier le Vinatier [Bron], Université Grenoble Alpes - UFR Médecine ( UGA UFRM ), Université Grenoble Alpes ( UGA ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Neuropsychologie Cognitive et prise en Charge des Troubles de la Communication schizophréniques, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Albert Chenevier-Fondation de Coopération Scientifique, Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne ( NPsy-Sydo ), CHU Clermont-Ferrand-Université Clermont Auvergne ( UCA ), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre hospitalier Charles Perrens [Bordeaux], and Université Claude Bernard Lyon 1 (UCBL)

Subjects
Male, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, medicine.medical_treatment, Comorbidity, Anxiety, Childhood trauma, Cohort Studies, [ SDV.NEU.SC ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, Benzodiazepines, 0302 clinical medicine, Prevalence, ComputingMilieux_MISCELLANEOUS, Depression (differential diagnoses), media_common, Physical pain, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, Depression, Headache, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, Antidepressive Agents, 3. Good health, Adult Survivors of Child Adverse Events, Schizophrenia, [ SDV.NEU.NB ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [ SCCO.NEUR ] Cognitive science/Neuroscience, Cohort, Antidepressant, Female, medicine.symptom, Antipsychotic Agents, Adult, medicine.medical_specialty, medicine.drug_class, media_common.quotation_subject, Pain, [ SDV.NEU.PC ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, 03 medical and health sciences, Internal medicine, medicine, Humans, Antipsychotic, Biological Psychiatry, Pharmacology, Benzodiazepine, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, Addiction, medicine.disease, 030227 psychiatry, Cross-Sectional Studies, Self Report, business, 030217 neurology & neurosurgery
Abstract

Introduction Little is known about perception of physical pain in schizophrenia (SZ). Some studies have suggested that patients with SZ may have an increased pain threshold, while others have suggested that patients with SZ may suffer from undetected and untreated high physical pain levels. The objectives of this study were (i) to investigate the prevalence of self-reported physical pain in stabilized SZ subjects, and (ii) to determine whether physical pain was associated with psychiatric characteristics and somatic comorbidities (iii) to determine whether antidepressants and benzodiazepine administration were associated with lower self-reported pain. Method 468 community-dwelling stable SZ subjects (73% men, mean aged 32 years) were recruited in the Schizophrenia Expert Center national network. Patients with moderate to extreme pain, assessed with the EQ5D-5L questionnaire, were classified as belonging to the “pain group”. Results 104 (22.2%) reported moderate to extreme pain levels. In multivariate analysis, pain has been associated with headache (OR = 2.63 [1.04–6.63], p = 0.04), higher anxiety (OR = 1.61 [1.18–2.21], p = 0.003), higher current depressive symptoms (OR = 1.09 [1.01–1.17], p = 0.03), history of childhood trauma (1.03 [1.01–1.06], p = 0.01) and older age (OR = 1.04 [1.01–1.07], p = 0.03), independently of current psychotic severity, sociodemographic variables, antipsychotic, antidepressant and benzodiazepine treatments. No association with addictive behaviors or illness characteristics has been found. Conclusion The present findings suggest that community-dwelling SZ outpatients report a high rate of self-reported physical pain, associated with headache, depression and anxiety and history of childhood trauma. Physical pain should be systematically assessed and specifically treated, when needed, in patients with SZ.

Published
2018
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