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BACKGROUND: Recent changes in psychiatric care and teaching that limit patient contact for medical students can be overcome in part by simulation-based education. Understanding the learning processes of medical students involved in psychiatric simulation-based programmes could usefully inform efforts to improve this teaching. This study explored the learning processes of medical students the first time they role-play in psychiatry.METHODS: We used constructivist grounded theory to analyse semi-structured interviews of 13 purposively sampled medical students and the six psychiatrists who trained them. To improve the triangulation process, the results of this analysis were compared with those of the analyses of the role-play video and the debriefing audio-tapes.RESULTS: Five organising themes emerged: improving the students' immediate perception of patients with mental disorders; cultivating clinical reasoning; managing affect; enhancing skills and attitudes and fostering involvement in learning psychiatry.CONCLUSION: Results suggest that psychiatric role-playing can improve students' progressive understanding of psychiatry through the development of intuition and by allaying affects. Emotional elaboration and student involvement appear to be key features.

The aberrant expression of miRNAs is often correlated to tumor development. MiR-7-5p is a recently discovered downregulated miRNA in thyroid papillary carcinoma (PTC). The goal of this project was to characterize its functional role in thyroid tumorigenesis and to identify the targeted modulated pathways. MiR-7-5p overexpression following transfection in TPC1 and HT-ori3 cells decreased proliferation of the two thyroid cell lines. Analysis of global transcriptome modifications showed that miR-7-5p inhibits thyroid cell proliferation by modulating the MAPK and PI3K signaling pathways which are both necessary for normal thyroid proliferation and play central roles in PTC tumorigenesis. Several effectors of these pathways are indeed targets of miR-7-5p, among which EGFR and IRS2, two upstream activators. We confirmed the upregulation of IRS2 and EGFR in human PTC and showed the existence of a negative correlation between the decreased expression of miR-7-5p and the increased expression of IRS2 or EGFR. Our results thus support a tumor-suppressor activity of miR-7-5p. The decreased expression of miR-7-5p during PTC tumorigenesis might give the cells a proliferative advantage and delivery of miR-7-5p may represent an innovative approach for therapy., SCOPUS: ar.j, info:eu-repo/semantics/published

Der stationäre Suizid wird definiert als Suizid während des voll- oder teilstationären Aufenthaltes, der sich entweder in den Räumlichkeiten selbst (Kliniksuizid) oder während Ausgängen und Beurlaubungen in oder außerhalb des Krankenhausgeländes abspielt. In dieser Arbeit erfolgt eine epidemiologisch-deskriptive Darstellung der insgesamt in den letzten 10 Jahren während des Aufenthaltes vollzogenen 18 stationären Suizide an einer psychiatrischen Abteilung im Krankenhaus mit Vollversorgungsauftrag.

To assess the structural performance of psychiatric hospitals in Germany during the COVID(coronavirus disease)-19 pandemic, a nationwide survey was launched in March 2020, in which the corona-related changes in care structures during the first wave of the pandemic were collated.Data on the care situation were collected by means of a survey in 38 out of 388 contacted psychiatric and psychotherapy hospitals in Germany over the course of 1 month. The changes and adaptations of the care structures, the type of therapy measures applied and care options for people with mental disorders and a COVID-19 infection as well as the legal basis underlying the care for patients unable to consent were documented.On average, the inpatient treatment capacity of psychiatric hospitals in Germany decreased by approximately 40% compared with prepandemic periods. Day clinic and outpatient services were also only available in a limited form or were even discontinued completely. Specialized wards for patients with COVID-19 infections were available in most of the surveyed clinics (84%).Psychiatric hospitals were already able to respond quickly and adequately to the crisis situation in the first wave of the pandemic, e.g. by setting up COVID wards; however, the reduction in treatment capacity to 60% has significantly worsened the care situation for people with mental illnesses. Therefore, further efforts should urgently be made to adapt mental health care to the requirements of the pandemic in the long term.ZIEL: Um die strukturelle Leistungsfähigkeit psychiatrischer Kliniken in Deutschland während der COVID(„coronavirus disease“)-19-Pandemie beurteilen zu können, wurde im März 2020 eine Umfrage durchgeführt, in der die Corona-bedingten Veränderungen der Versorgungstrukturen während der ersten Welle der Pandemie erfasst wurden.Zur Erfassung der Versorgungssituation wurden mittels Umfrage Daten in 38 von 388 angeschrieben Kliniken für Psychiatrie und Psychotherapie in Deutschland im Verlauf eines Monats erhoben. Dokumentiert wurden die Veränderungen und Anpassungen der Versorgungsstrukturen, die Art der angewendeten Therapiemaßnahmen und Versorgungsmöglichkeiten für Menschen mit psychischen Störungen und einer COVID-19-Infektion sowie die der Versorgung zugrunde liegende Rechtsgrundlage bei nichteinwilligungsfähigen Patient*innen.Im Durchschnitt verringerte sich die stationäre Behandlungskapazität psychiatrischer Kliniken in Deutschland etwa um 40 % im Vergleich zu Zeiten vor der Pandemie. Auch die tagesklinischen und ambulanten Angebote der Kliniken waren nur noch in eingeschränkter Form vorgehalten oder wurden sogar komplett eingestellt. In den meisten befragten Einrichtungen (84 %) standen Spezialbereiche für COVID-19-infizierte Patient*innen zur Verfügung.Psychiatrische Kliniken waren bereits in der ersten Welle der Pandemie in der Lage, schnell und adäquat auf die Krisensituation z. B. durch Einrichtung von COVID-Stationen zu reagieren. Durch die Reduzierung der Behandlungskapazitäten auf 60 % hat sich jedoch die Versorgungssituation für Menschen mit psychischen Erkrankungen deutlich verschlechtert. Deshalb sollten dringend weitere Anstrengungen unternommen werden, um die Versorgung im Bereich der psychischen Gesundheit langfristig an die Anforderungen der Pandemie anzupassen.

ZusammenfassungEmpathisch sein heißt, fühlen und verstehen können, was andere fühlen. Vermuten zu können, was das Gegenüber fühlt, denkt und wünscht, beruht auf der Fähigkeit, eigene Gefühle und Gedanken als getrennt von jenen anderer wahrnehmen und regulieren zu können. Definierte Therapieerfolge mit adäquatem Aufwand erreichen zu können, verlangt ein Fokussieren auf Wesentliches und Wichtiges. Die Empathie ist im Bereich der Psychotherapie jener Faktor, für den für sich genommen die höchste Effektstärke nachgewiesen werden konnte. Empathietraining ermöglicht eine bessere soziale Performance. Im Falle von Defiziten in sozialer Kompetenz ist störungsunabhängig ein besonders hoher Leidensdruck nachweisbar.

De nombreux médecins et psychiatres français ont supposé que les épices, la sexualité et les dangers de la masculinité “primitive” étaient intrinsèquement liés dans le Maghreb colonial. Ils rapportaient régulièrement que la nourriture maghrébine était insupportablement épicée et, par conséquent, la cuisine locale était souvent jugée inappropriée aux palais européens. Les médecins et psychiatres soupçonnaient souvent que le piquant de leur nourriture affectait et augmentait la sexualité des hommes nord-africains, ou que ceux-ci croyaient au moins que les épices provoquaient une augmentation de la libido, ce que les auteurs coloniaux redoutaient comme, pour eux, la sexualité des hommes colonisés semblait immodérée, menaçante et dangereuse avant même l’effet supplémentaire des épices. Dans sa thèse de médecine, par exemple, Gabriel Perrin décrit comment des hommes algériens âgés utilisaient la nourriture épicée comme une forme d’aphrodisiaque, ne voulant pas accepter que pour eux, “l’heure de la frigidité” fût venue (Perrin, 1895 : 47). Many French doctors and psychiatrists in the colonial Maghreb supposed that spices, sexuality and the dangers of “primitive” masculinity were intrinsically linked. They regularly described Maghrebi food as unbearably spicy and, consequently, local cuisine was often deemed inappropriate for European palates. These doctors and psychiatrists often suspected that the spiciness of their food affected the sexuality of North African men, causing an increase in libido, which was something that colonial authors feared as, to them, the sexuality of colonised men seemed immoderate, threatening and dangerous even before the added effect of spices. In his medical dissertation, for example, Gabriel Perrin described how older Algerian men used spicy food as a form of aphrodisiac, unwilling to accept that for them the “time of frigidity” had come (Perrin, 1895: 47).

Die Wernicke-Encephalopathie (WE) ist eine neurologische Komplikation eines klinisch manifesten Thiaminmangels. Thiaminmangelerscheinungen stellen eine relevante Ursache für akutes und subakutes Delir dar und haben verheerende Langzeitfolgen. In der vorliegenden Kasuistik berichten wir über Thiaminsubstitution im Falle eines 49-jährigen Patienten, welcher im Rahmen einer Alkoholabhängigkeitserkrankung zum körperlichen Entzug und psychischer Stabilisierung am Universitätsklinikum Tulln stationär aufgenommen wurde. Weiters besprochen werden Standards in der Wernicke-Prophylaxe, Diskrepanzen in Guidelines und Tipps für die Praxis.

Si le PAP m’était conté… 2019 a vu s’inscrire dans les annales de l’histoire du Québec les cent ans de l’Hôpital en santé mentale Albert-Prévost, pionnier des soins psychiatriques. Un siècle et une Institution marqués par plusieurs périodes de révolution (tranquille ou non), dont l’expression la plus concrète peut être vue dans les nombreux changements de nom de l’établissement, de sanatorium à hôpital en santé mentale, reflétant un contexte social, politique et surtout administratif fluctuant. Bien que le mandat principal d’Albert-Prévost, celui de soigner les plus vulnérables, demeure encore relativement immuable, il a dû s’adapter à la stable instabilité dans lequel ont évolué et se sont construits le Québec et son système de santé au cours des cent dernières années. Différents acteurs et penseurs s’y sont succédé, d’opinions et d’orientations variées (et parfois conflictuelles), mais unis dans leur désir de protéger l’identité d’Albert-Prévost et d’assurer sa pérennité. Ainsi, malgré les contraintes et pressions extérieures, l’Institution a tenu et continue à tenir moult rôles dans le système de santé québécois : outre le traitement et la réadaptation de patients, il a également contribué à la formation de nombreux psychiatres et professionnels de la santé qui rayonnent maintenant dans tout le Québec.Ce récit se veut une façon de revenir aux origines de cette Institution, ses balbutiements, échecs et réussites, dont la collection forme l’histoire d’un pionnier de la psychiatrie moderne du Québec.De 1919 à aujourd’hui, l’évolution se poursuit., Objectives In the context of the 100th anniversary celebrations of the Hôpital en santé mentale Albert-Prévost, the present article retraces the history of this pioneering institution in the provision of psychiatric care in the province of Québec.Methods Multiple psychiatrists and health-care professionals who once worked or are still working at Albert-Prévost were interviewed to record their recollection of how psychiatric care was delivered as knowledge about mental illness progressed and how different defining historical events concerning the administration of this institution unfolded. Private and public archives as well as articles documenting the history of this institution were consulted in order to contextualize the participants’ experiences.Results A brief exploration of the historical and political context that led to the creation of the Sanatorium Albert-Prévost is provided. The key administrative, political and sociological issues are described at each critical period as well as the interplay between the growing knowledge base about the causes and treatments of psychiatric problems and different models of provision of care as different generations of clinicians search for an optimal practice and organisation of care. It’s triple mission of care, teaching and research is described.Conclusion The Hôpital en santé mentale Albert-Prévost has contributed in a significant manner in the shaping of mental health care provision in Québec and several physicians and other health care professionals who have worked there, throughout the past century, have been key contributors to the social, educational, cultural and political advances in this province.

Obgleich alternative Settings, wie etwa videogestutzte Therapien, keine Neuheit darstellen, fuhrte der COVID-19-Ausbruch zu einer explosiven Zunahme dieses Therapieformats und es ist davon auszugehen, dass dieses „neue“ Format der Therapie-Community zumindest anteilig erhalten bleibt. Auch in der Autismustherapie werden aktuell uberdurchschnittlich viele Therapiesitzungen im Videoformat abgehalten. Neben den Herausforderungen dieses Umdenkprozesses und der zu bewerkstelligenden Anpassungsleistung aller Beteiligten offenbaren sich – nicht nur angesichts neu gesammelter Erfahrungen – die Implikation und Erfolgschancen dieses Formats deutlich, das im hiesigen Kontext als Erganzung zu verstehen ist. Dieser Beitrag mochte in die videogestutzte Autismustherapie einfuhren, mogliche therapeutische Interventionen skizzieren und sich mit dem Forschungsstand hinsichtlich der Wirksamkeit dieser Therapieform befassen.

Background: Previous studies among the general population indicated an association between mental illnesses and different forms of financial difficulties, such as indebtedness. Objective: Investigation of the financial burden and associated factors among inpatients and day clinic patients in psychiatric care. Material and methods: A total of 488 patients in psychiatric care in the catchment area of the Psychiatric University Hospital Charité at St. Hedwig Hospital participated in a cross-sectional patient survey carried out with a structured interview regarding financial burden, sociodemographic and clinical variables. Results: Of the participants 269 (55.1%) showed outstanding debts, loans or unpaid bills. Among the participants who were willing to give information about the amount of debts, the majority (47.0%) had debts between 1000 € and 9999 € and 36.3% between 10,000 € and 99,999 €. In the binary regression models, younger age and substance use disorders were factors significantly associated with outstanding debts. Of the participants 22.3% had outstanding debts >10,000 € and were depending on social welfare, so that indebtedness could be assumed. Conclusion: Financial burdens and outstanding debts among patients in psychiatric care should be inquired about and considered more intensively in practice. Suitable models of support need to be developed and evaluated., Hintergrund Bisherige Studien der Allgemeinbevölkerung weisen auf eine Assoziation zwischen psychischen Erkrankungen und verschiedenen Formen finanzieller Schwierigkeiten wie Verschuldung hin. Ziel der Arbeit: Untersuchung der finanziellen Belastungen und assoziierter Faktoren bei Patient*Innen in (teil-)stationärer psychiatrischer Behandlung. Material und Methoden: Insgesamt 488 Teilnehmer*Innen einer querschnittlichen Patientenbefragung mittels eines strukturierten Interviews zu soziodemografischen sowie klinischen Variablen in (teil-)stationärer psychiatrischer Behandlung in der psychiatrischen Universitätsklinik der Charité im St. Hedwig, zuständig für einen spezifischen Versorgungsbereich in Berlin, gaben Auskunft zu finanziellen Belastungen. Ergebnisse: Insgesamt 269 (55,1 %) Teilnehmer*Innen wiesen Schulden, Kredite oder offene Rechnungen auf. Unter den Teilnehmer*Innen, die Auskunft zur Kredit- oder Schuldenhöhe machten (n = 215), wies der größte Teil (47,0 %) Schulden oder Kredite in der Höhe zwischen 1000 und 9999 € auf, gefolgt von 36,3 % mit Schulden/Krediten zwischen 10.000 und 99.999 €. In den Regressionsmodellen hinsichtlich des Vorliegens von Schulden erwiesen sich ein jüngeres Alter und das Vorliegen einer Substanzabhängigkeit als signifikant assoziierte Faktoren. 22,3 % der Befragten wiesen Schulden in Höhe >10.000 € auf und lebten von Sozialleistung, sodass eine Überschuldung angenommen werden könnte. Diskussion: Finanzielle Belastungen und bestehende Schulden sollten im psychiatrischen Bereich stärker in der Praxis erfragt und beachtet werden. Geeignete Unterstützungsformen sollten entwickelt und evaluiert werden.

AIM: Early intervention programs for first-episode psychosis have led to the awareness that the period before onset of a first episode is important in light of early intervention. This has induced a focus on the so-called 'at risk mental state' (ARMS). Individuals with ARMS are at increased risk for later psychotic disorder, but also for other psychiatric disorders as well as poor psychosocial functioning. Thus, adequate detection and treatment of ARMS is essential.METHODS: Since 2018, screening for and treatment of ARMS is recommended standard care in the Netherlands. Implementation is still ongoing. We initiated a naturalistic long-term cohort study of ARMS individuals, the onset and transition of and recovery from adverse development (OnTheROAD) study, with the aim to monitor course and outcome of symptoms and psychosocial functioning over time, as well as patterns of comorbidity and associations with factors of risk and resilience. To this end, participants complete a broad battery of instruments at baseline and yearly follow-up assessments up to 3 years. Outcome is defined in terms of symptom severity level, functioning and quality of life. In particular, we aim to investigate the impact of negative symptoms as part of the ARMS concept. Results from this study can aid in refining the existing ARMS criteria, understanding the developmental course of ARMS and investigating the hypothesized pluripotentiality in outcome of ARMS. New knowledge may inform the further development of specialized early interventions.RESULTS AND CONCLUSIONS: In this article, we describe the rationale, outline and set-up of OnTheROAD.

BACKGROUND: The present multicenter study aimed at defining the clinical profile of patients with major depressive disorder (MDD) and comorbid migraine. METHODS: Demographic and clinical information for 1410 MDD patients with vs without concurrent migraine were compared by descriptive statistics, analyses of covariance, and binary logistic regression analyses. RESULTS: The point prevalence rate for comorbid migraine was 13.5% for female and 6.2% for male patients. MDD + migraine patients were significantly younger, heavier, more likely female, of non-Caucasian origin, outpatient, and suffering from asthma. The presence of MDD + migraine resulted in a significantly higher functional disability. First-line antidepressant treatment strategy revealed a trend towards agomelatine. Second-generation antipsychotics were significantly less often administered for augmentation treatment in migraineurs. Overall, MDD + migraine patients tended to respond worse to their pharmacotherapy. CONCLUSION: Treatment guidelines for comorbid depression and migraine are warranted to ensure optimal efficacy and avoid possible pitfalls in psychopharmacotherapy, including serotonin syndrome., SCOPUS: ar.j, DecretOANoAutActif, info:eu-repo/semantics/published

ZusammenfassungIm Rahmen der aktuellen coronavirus disease 2019(COVID-19)-Pandemie müssen sich viele Bereiche der Medizin umstrukturieren. Dies betrifft auch die Versorgung von Patienten mit psychischen Erkrankungen. Die Therapie psychischer Erkrankungen umfasst psychotherapeutische und psychopharmakologische Interventionen. Letztere können mit einer Vielzahl an unerwünschten Arzneimittelwirkungen (UAW) assoziiert sein, stellen aber in der aktuellen Situation mit Kontakt- und Ausgangsbeschränkungen die präferierte Therapieoption dar. Da der direkte Patientenkontakt zugunsten des Telefonats oder der Videokonferenz reduziert ist, müssen angepasste diagnostische und therapeutische Optionen gefunden werden, um eine ausreichende Patientensicherheit zu gewährleisten. Bedeutend sind hierbei die ausführliche Aufklärung der Patienten sowie eine aktive Abfrage von Symptomen zur rechtzeitigen Erkennung von UAW. Unter der Behandlung mit Psychopharmaka sind UAW zu befürchten, die besonders ungünstig sind, wenn sie im Rahmen einer akuten Infektion auftreten oder ein erhöhtes Infektionsrisiko begünstigen. Hierzu gehören Atemdepression, Agranulozytose, Intoxikation durch Hemmung des Arzneistoffmetabolismus und venöse Thromboembolien, die jeweils mit potenziell lebensbedrohlichen Folgen einhergehen. Gleichzeitig sollte auf eine ausreichende Wirksamkeit der Medikation geachtet werden, da die gegenwärtige Krise zu einer Exazerbation vorbestehender psychischer Erkrankungen führen bzw. deren Erstmanifestation begünstigen kann.

As all french psychiatric clinics after 1945, the Pasteur Hospital in Poitiers sought to renew itself in depth to breaking with its archaic system inherited from the asylum. The war and its many traumas played a major role in the evolution of psychiatric care, and particularly in the development of social therapies. The creation of the Cité hospitalière de la Milétrie, in 1956, was the occasion for many therapeutic innovations and successful care experiments. Some of these were pioneering in France, such as the home-based aftercare for alcoholics set up in 1954, or the first steps towards a child psychiatry service at the Milétrie hospital. A rare document also made its appearance during a testimony: the monthly Milétrie-Presse, a magazine published from 1962 to 1967 by a therapeutic workshop of the psychiatric hospital, which the remaining documents are still in the hands of a few retired nurses., Comme tous les hôpitaux psychiatriques français après 1945, l’hôpital Pasteur de Poitiers cherche à se renouveler en profondeur afin rompre définitivement avec son système archaïque hérité de l’asile. La guerre et son lot de traumatismes ont joué un rôle majeur dans l’évolution des soins psychiatriques, et en particulier dans le développement de thérapies sociales. La création de la Cité hospitalière de la Milétrie, en 1956, est l’occasion de nombreuses innovations thérapeutiques et expériences de soin réussies. Certaines se sont avérées pionnières sur le territoire national, tel que le suivi à domicile des alcooliques en postcure mis en place dès 1954 à Pasteur, ou encore l’ébauche, à la Milétrie, du service de psychiatrie infantile. Un document rare a également fait son apparition au cours d’un témoignage : la revue mensuelle Milétrie-Presse, éditée de 1962 à 1967 par un atelier thérapeutique de la Milétrie et dont les seuls exemplaires conservés sont aux mains de quelques infirmiers retraités.

The care of patients, especially in the field of agitation or psychiatry, requires close coordination between different actors. Interdisciplinarity makes it possible to analyse and harmonise the links between various disciplines with the common aim of solving complex problems. This interdisciplinarity must now become a fundamental in the teaching of health sciences and a prerequisite for the functioning of hospital services, in particular in the formalisation of acute care pathways.

Background: Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that suicidal behaviours have been associated with maladaptive strategies of emotion regulation. Methods: This study examined the relative contributions of emotional dysregulation to suicide attempt history in a clinical sample of borderline adolescents. Data were analyzed from 85 participants of the Collaborative European Research Network on Borderline Personality Disorder. Participants completed measures of BPD traits and symptoms, suicide behaviours, emotional dysregulation, attachment styles and lifetime depressive disorders. Results: In an SEM model, lifetime depressive disorders and insecure attachment styles have a significant direct effect on lifetime suicide attempt, but only lifetime depressive disorders have an indirect effect through emotion dysregulation. The results suggest that emotional dysregulation has a mediating role in suicide attempts among BPD adolescents. Conclusions: These findings call for the development of interventions targeting the role of emotion dysregulation in effectively predicting and preventing suicidality in borderline adolescents., SCOPUS: ar.j, info:eu-repo/semantics/published

Objectives: Fatigue has been suggested as a marker of biological aging. It seems plausible that this symptom might be associated with changes in brain health. The objective of this study was to examine the associations between persistent fatigue and neuroimaging correlates in a non-disease-specific population of community-dwelling older adults. Methods: We performed a cross-sectional analysis using data from The Multidomain Alzheimer Preventive Trial (MAPT). We included 458 subjects. Persistent fatigue was defined as meeting exhaustion criterion of Fried frailty phenotype in two consecutive clinical visits six months apart between study baseline and one year. Brain imaging correlates, assessed by magnetic resonance imaging (MRI), were the outcomes. The associations between persistent fatigue and brain correlates were explored using mixed model linear regressions with random effect at the center level. Results: The mean age of the participants was 74.8 ± 4 years old, and 63% of the subjects were women. Forty-seven participants (10%) exhibited a persistent fatigue profile. People with persistent fatigue were older compared to subjects without persistent fatigue (76.2 years ± 4.3 vs.74.7 ± 3.9 p = 0.009). Persistent fatigue was associated with higher white matter hyperintensity volume in the fully adjusted analysis. We did not find any cross-sectional association between persistent fatigue and sub-cortical volumes and global and regional cortical thickness. Conclusion: Persistent fatigue was cross-sectionnally associated with higher white matter hyperintensity volume in older adults. Further longitudinal studies, using an assessment tool specifically designed and validated for measuring fatigue, are needed to confirm our findings., SCOPUS: ar.j, info:eu-repo/semantics/published

Background: Motor deficits in autism have a double aspect: on one side, they are neglected by standard diagnostic procedures, on the other they are very frequent (70%) and promising as early indicator of the syndrome. Their characterization is extremely relevant, as they could impact on social abilities based on the understanding of others’ actions. Method: Fifty-two typically developing children (TD) and 13 children with autism spectrum disorder (ASD) took part to the study. Children were evaluated in pantomime execution, and in two tasks based on pantomime observation: recognition of pantomime meaning, and error recognition, with observed pantomimes that could contain spatial, temporal or body-part-as-tool errors. Results: TD children performance in tasks based on observation appeared strongly associated to individual motor skills. In general, ASD children exhibited a poorer performance than TD in all tasks. Most interestingly, in both pantomime execution and error recognition they showed a parallel and selective prevalence of spatial errors, whose scores resulted to be correlated with the autistic symptoms severity. Conclusions: In TD children, the capacity to decode the actions done by others relies on the observer motor repertoire. In children with autism, the parallelism between deficits in pantomime execution and recognition suggests that during action observation the motor resonance is impoverished due to an impaired motor repertoire, thus impeding a proper social contact with others., SCOPUS: ar.j, info:eu-repo/semantics/published

As massive amounts of information are becoming available to people, understanding the mechanisms underlying information-seeking is more pertinent today than ever. In this study, we investigate the underlying motivations to seek out information in healthy and addicted individuals. We developed a novel decision-making task and a novel computational model which allows dissociating the relative contribution of two motivating factors to seek out information: a desire for novelty and a general desire for knowledge. To investigate whether/how the motivations to seek out information vary between healthy and addicted individuals, in addition to healthy controls we included a sample of individuals with gambling disorder—a form of addiction without the confound of substance consumption and characterized by compulsive gambling. Our results indicate that healthy subjects and problem gamblers adopt distinct information-seeking “modes”. Healthy information-seeking behavior was mostly motivated by a desire for novelty. Problem gamblers, on the contrary, displayed reduced novelty-seeking and an increased desire for accumulating knowledge compared to healthy controls. Our findings not only shed new light on the motivations driving healthy and addicted individuals to seek out information, but they also have important implications for the treatment and diagnosis of behavioral addiction., SCOPUS: ar.j, info:eu-repo/semantics/published

Les patients psychiatriques sont à risque d’hypovitaminose D et de mortalité liée au Covid-19. En plus des bénéfices sur la santé mentale, la supplémentation en vitamine D peut être potentiellement efficace pour prévenir les formes graves d’infections au Covid-19. Un dosage de vitamine D n’est pas nécessaire et n’est pas remboursé en France dans cette indication. Une supplémentation mensuelle de 50 000 UI pourrait être suffisante dans la plupart des cas. Le double de la dose est recommandé pour les patients obèses. Le risque de lithiase rénale n’est pas augmenté à ces doses, même en cas de supplémentation chez un patient sans carence en vitamine D. La crise du Covid-19 est une opportunité pour diffuser la supplémentation en vitamine D chez les patients psychiatriques, elle a en effet fait ses preuves sur d’autres pathologies respiratoires comme les infections bénignes de voies aériennes supérieures et la grippe.

Despite plenty of effective antidepressant (AD) treatments, the outcome of major depressive disorder (MDD) is often unsatisfactory, probably due to improvable exploitation of available therapies. This European, cross-sectional, naturalistic multicenter study investigated the frequency of additional psychotherapy in terms of a manual-driven psychotherapy (MDP) in 1410 adult in- and outpatients with MDD, who were primarily treated with AD psychopharmacotherapy. Socio-demographic and clinical patterns were compared between patients receiving both treatments and those lacking concomitant MDP. In a total of 1279 MDD patients (90.7%) with known status of additional MDP, those undergoing a psychopharmacotherapy-MDP combination (31.2%) were younger, higher educated, more often employed and less severely ill with lower odds for suicidality as compared to patients receiving exclusively psychopharmacotherapy (68.8%). They experienced an earlier mean age of MDD onset, melancholic features, comorbid asthma and migraine and received lower daily doses of their first-line ADs. While agomelatine was more often established in these patients, MDD patients without MDP received selective serotonin reuptake inhibitors more frequently. These two patient groups did not differ in terms of response, non-response and treatment resistant depression (TRD). Accordingly, the employment of additional MDP could not be related to better treatment outcomes in MDD. The fact that MDP was applied in a minority of patients with rather beneficial socio-demographic and clinical characteristics might reflect inferior accessibility of these psychotherapeutic techniques for socially and economically disadvantaged populations., SCOPUS: ar.j, info:eu-repo/semantics/published

The COVID-19 pandemic impacted the accessibility of psychotherapy for particularly vulnerable patients during the period of confinement in the French-speaking part of Switzerland. We had to adapt our usual therapeutic programs. We illustrate this approach in an outpatient program of dialectical behavioral therapy for patients with borderline personality disorder. Each week the individual therapies took place by videoconference or phone. The skills training group was held individually by videoconference or phone and was supported by an online skills training program. Patients filled out their diary cards online. Intersession contact with the therapist remained available as usual and we could organize team consultation. The aim of this study is to describe how a sample of our patients experienced the period of confinement.We compared the experiences of seven patients suffering from borderline personality disorder during two periods: eight weeks prior to confinement, and during the eight weeks of confinement. We analyzed their daily diary cards (The seven patients were predominantly female (85.7 %) and had an average age of 35.1 (11.5) years. Measurements prior to the start of the pandemic indicated on average severe depression (Beck Depression Inventory, m = 30.9 [10.0]) and marked hopelessness (Beck Hopelessness Scale, m = 15.0 [5.0]). Analysis of the daily diary cards indicated that the confinement period significantly predicted a decrease in feelings of shame or guilt, fear and tension. At the same time, however, there was an increase in distress. Weekly monitoring of problem behaviors showed a decrease in binge-eating behaviors and a trend towards a decrease in alcohol consumption during confinement.Despite the small number of patients included, two types of repeated measurements indicated convergent results, with some improvements during confinement: a decrease of the feelings of fear, shame or guilt, and tension, and a decrease of the frequency of binge-eating behaviors. The decreased pace of daily social and professional life may explain these improvements. The diminution of the above-mentioned feelings as triggers for addictive and compulsive behaviors may also account for the improvements regarding binge-eating. However, they also experienced an increased distress that may reflect the loneliness experienced during this period. The pre-pandemic development of computerized tools that were already familiar to patients greatly facilitated the necessary adaptations to maintain an intensive therapeutic setting during the confinement. This may partly explain why these patients were able to adjust the challenges of this period.

International audience; Hepatitis C is a transmissible hepatic and extra-hepatic disease caused by the hepatitis C virus (HCV). HCV develops into a chronic infection among approximately 70% of the contaminated subjects. Chronic HCV infection is estimated to affect between 0.5% and 1 % of the general population in France, which causes an important burden of disease, in particular due to the occurrence of cirrhosis and liver cancer. New antiviral drugs now allow to cure more than 95% of patients in just a few weeks of treatment with very limited safety issues. This therapeutic revolution has led the World Health Organization and many national governments to aim for an elimination of HCV, which has been defined as a 90%-reduction of the incidence rate, and a 65%-reduction in the number of HCV-related deaths on the basis of the 2015 figures. In this respect, the French Ministry of Health has recently decided to extend the ability to prescribe the new antiviral drugs to any physician. However, the elimination campaign of HCV will also need to correctly identify, screen, and treat the main target populations. If people who inject drugs (PWIDs) certainly constitute the most important population concerned by the challenge of HCV elimination, more hidden reservoirs in which HCV transmission can insidiously evolve should be identified and specifically targeted as well. Inpatient psychiatric populations might constitute one of these hidden reservoirs. International data suggest that chronic HCV infection affects approximately 5% of psychiatric inpatients in Europe. This very high prevalence estimate can in part be due to the very frequent psychiatric disorders found among the current or former PWIDs. However, a part of the seropositive patients does not report a history of drug use, and other factors could contribute to the increased risk of contamination in this population including atypical routes of transmission related to institutional promiscuity. Exploring the general profile and risk-behaviors of the psychiatric inpatients found infected by the HCV is thus warranted for future studies. Screening and treating HCV in the specific population of psychiatric patients is part of the general public health objective of eliminating HCV at a national level. Moreover, it also directly fits into the individualized psychiatric care. Many recent data suggest that HCV also has a neural tropism, in particular within glial cells, such as astrocytes or oligodendrocytes. As such, HCV foments inflammatory processes in the brain and contributes to cognitive impairments and psychiatric symptoms such as anxiety or depression. At the individual level, treating HCV infection can improve the psychiatric state and increase patients' outcomes in terms of well-being and quality of life. For all these reasons, the field of psychiatry needs local and national actions for informing and training professionals about HCV screening and treating modalities. Patient and family associations also need to be involved in this general effort of micro-elimination. A key role should be assigned to the general practitioners embedded within inpatient psychiatric units. They are the best fitted professionals to screen, treat, and empower patients, to inform and train other caregivers of the psychiatric field, and to act as a relay with hepatology teams if required. Hospital pharmacists are other important stakeholders. In a national context in which the funding of psychiatric care, including medications, is based on predefined funding envelops, innovative initiatives will have to be set up by local or national health authorities, in partnership with pharmacists, to allow for the treatment of psychiatric inpatients. In conclusion, the world of psychiatry is a possible hidden reservoir of HCV and, as such, a part of the challenge for eliminating the virus. Patients, families, and caregivers will have to be correctly sensitized and trained to play their role in the process. Specific investigations will be required to better understand why such an increased prevalence of HCV is observed in this population. Specific adaptations of the cascade of care within psychiatric settings, including access to treatment, will need to be designed, implemented, and evaluated for reaching micro-elimination of HCV in psychiatry.

Nutritional interventions have beneficial effects on certain psychiatric disorder symptomatology and common physical health comorbidities. However, studies evaluating nutritional literacy in mental health professionals (MHP) are scarce. This study aimed to assess the across 52 countries. Surveys were distributed via colleagues and professional societies. Data were collected regarding self-reported general nutrition knowledge, nutrition education, learning opportunities, and the tendency to recommend food supplements or prescribe specific diets in clinical practice. In total, 1056 subjects participated in the study: 354 psychiatrists, 511 psychologists, 44 psychotherapists, and 147 MHPs in-training. All participants believed the diet quality of individuals with mental disorders was poorer compared to the general population (p < 0.001). The majority of the psychiatrists (74.2%) and psychologists (66.3%) reported having no training in nutrition. Nevertheless, many of them used nutrition approaches, with 58.6% recommending supplements and 43.8% recommending specific diet strategies to their patients. Only 0.8% of participants rated their education regarding nutrition as ‘very good.’ Almost all (92.9%) stated they would like to expand their knowledge regarding ‘Nutritional Psychiatry.’ There is an urgent need to integrate nutrition education into MHP training, ideally in collaboration with nutrition experts to achieve best practice care., publishedVersion

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

While the transcription factor NEUROD2 has recently been associated with epilepsy, its precise role during nervous system development remains unclear. Using a multi-scale approach, we set out to understand how Neurod2 deletion affects the development of the cerebral cortex in mice. In Neurod2 KO embryos, cortical projection neurons over-migrated, thereby altering the final size and position of layers. In juvenile and adults, spine density and turnover were dysregulated in apical but not basal compartments in layer 5 neurons. Patch-clamp recordings in layer 5 neurons of juvenile mice revealed increased intrinsic excitability. Bulk RNA sequencing showed dysregulated expression of many genes associated with neuronal excitability and synaptic function, whose human orthologs were strongly associated with autism spectrum disorders (ASD). At the behavior level, Neurod2 KO mice displayed social interaction deficits, stereotypies, hyperactivity, and occasionally spontaneous seizures. Mice heterozygous for Neurod2 had similar defects, indicating that Neurod2 is haploinsufficient. Finally, specific deletion of Neurod2 in forebrain excitatory neurons recapitulated cellular and behavioral phenotypes found in constitutive KO mice, revealing the region-specific contribution of dysfunctional Neurod2 in symptoms. Informed by these neurobehavioral features in mouse mutants, we identified eleven patients from eight families with a neurodevelopmental disorder including intellectual disability and ASD associated with NEUROD2 pathogenic mutations. Our findings demonstrate crucial roles for Neurod2 in neocortical development, whose alterations can cause neurodevelopmental disorders including intellectual disability and ASD., SCOPUS: ar.j, info:eu-repo/semantics/published

Objective The primary aim of this study was to investigate whether there are clinical differences between patients who are referred or not referred for psychiatric consultation and liaison service. The secondary aim was to compare the perspectives of doctors, nurses and patients. Methods This naturalistic, prospective and comparative study (N = 294) utilised a control sample of non-referrals (n = 177, consenting 81) and referrals (n = 177, consenting 49). The normality of the data was examined with the Shapiro-Wilk test; bivariate group comparisons were made using Mann-Whitney, Wilcoxon tests and bivariate regression analyses. Statistically adjusted group comparisons were performed with multivariate median regressions. Results The sample presented limited representativeness. Referred patients were predominantly women, mostly living alone and not working. Compared to the non-referred patients, their disease episode and length of hospital stay were significantly longer, self-efficacy and quality of life lower and psychological stress was higher. For referred patients, there were no differences between the estimations of mental burden and the need for care among doctors, nurses and patients. Self-efficacy and appraisal of one's own burden were the best predictors of the extent of mental symptoms. Discussion Patients in an admission ward for internal medicine referred to a psychiatric consultation-liaison service displayed a more adverse psychosocial profile and were more psychologically burdened than non-referred patients, but they are also relevantly subsyndromal burdened. Identifying and supporting burdened patients is an endeavour that requires collaborative care, especially in the transition to specialised mental health and to primary care., publishedVersion

Treatment-resistant depression (TRD) occurs in ~30% of patients with major depressive disorder (MDD) but the genetics of TRD was previously poorly investigated. Whole exome sequencing and genome-wide genotyping were available in 1209 MDD patients after quality control. Antidepressant response was compared to non-response to one treatment and non-response to two or more treatments (TRD). Differences in the risk of carrying damaging variants were tested. A score expressing the burden of variants in genes and pathways was calculated weighting each variant for its functional (Eigen) score and frequency. Gene-based and pathway-based scores were used to develop predictive models of TRD and non-response using gradient boosting in 70% of the sample (training) which were tested in the remaining 30% (testing), evaluating also the addition of clinical predictors. Independent replication was tested in STAR*D and GENDEP using exome array-based data. TRD and non-responders did not show higher risk to carry damaging variants compared to responders. Genes/pathways associated with TRD included those modulating cell survival and proliferation, neurodegeneration, and immune response. Genetic models showed significant prediction of TRD vs. response and they were improved by the addition of clinical predictors, but they were not significantly better than clinical predictors alone. Replication results were driven by clinical factors, except for a model developed in subjects treated with serotonergic antidepressants, which showed a clear improvement in prediction at the extremes of the genetic score distribution in STAR*D. These results suggested relevant biological mechanisms implicated in TRD and a new methodological approach to the prediction of TRD., SCOPUS: ar.j, info:eu-repo/semantics/published

The residency years comprise the last period of a physician’s formal training. It is at this stage that trainees consolidate the clinical skills required for independent practice and achieve a level of ethical development essential to their work as physicians, a process known as professional identity formation (PIF). Ethics education is thought to contribute to ethical development and to that end the Royal College of Physicians and Surgeons of Canada (RCPSC) requires that formal ethics education be integrated within all postgraduate specialty training programs. However, a formal ethics curriculum can operate in parallel with informal and hidden ethics curricula, the latter being more subtle, pervasive, and influential in shaping learner attitudes and behavior. This paper reports on a study of the formal, informal, and hidden ethics curricula at two postgraduate psychiatry programs in Canada. Based on the analysis of data sources, we relate the divergences between the formal, informal, and hidden ethics curricula to two aspects of professional identity formation (PIF) during psychiatry residency training. The first is the idea of group membership. Adherence to the hidden curriculum in certain circumstances determines whether residents become part of an in-group or demonstrate a sense of belonging to that group. The second aspect of PIF we explore is the ambiguous role of the resident as a student and a practitioner. In ethically challenging situations, adherence to the messages of the hidden curriculum is influenced by and influences whether residents act as students, practitioners, or both. This paper describes the hidden curriculum in action and in interaction with PIF. Our analysis offers a complementary, empirical perspective to the theoretical literature concerning PIF in medical education. This literature tends to position sound ethical decision-making as the end result of PIF. Our analysis points out that the mechanism works in both directions: how residents respond to hidden curriculum in ethics can be a driver of professional identity formation., Les années de résidence comprennent la dernière période de formation officielle d’un médecin. C’est à ce stade que les stagiaires consolident les compétences cliniques requises pour une pratique indépendante et atteignent un niveau de développement éthique essentiel à leur travail de médecin, un processus appelé formation d’identité professionnelle (FIP). On pense que l’éducation à l’éthique contribue au développement de l’éthique et à cette fin, le Collège royal des médecins et chirurgiens du Canada (CRMCC) exige que l’éducation formelle en éthique soit intégrée dans tous les programmes de formation spécialisée postdoctorale. Cependant, un programme d’éthique formel peut fonctionner en parallèle avec des programmes d’éthique informels et cachés, ces derniers étant plus subtils, omniprésents et influents pour façonner les attitudes et le comportement des apprenants. Cet article fait état d’une étude des programmes d’éthique formels, informels et cachés de deux programmes de psychiatrie postdoctorale au Canada. Sur la base de l’analyse des sources de données, nous relions les divergences entre les programmes d’éthique formels, informels et cachés à deux aspects de la formation de l’identité professionnelle (FIP) pendant la formation en résidence en psychiatrie. Le premier est l’idée d’appartenance à un groupe. L’adhésion au programme caché dans certaines circonstances détermine si les résidents font partie d’un groupe ou manifestent un sentiment d’appartenance à ce groupe. Le deuxième aspect du FIP que nous explorons est le rôle ambigu du résident en tant qu’étudiant et praticien. Dans des situations éthiquement difficiles, l’adhésion aux messages du programme caché est influencée et influence le fait que les résidents agissent en tant qu’étudiants, praticiens ou les deux. Cet article décrit le curriculum caché en action et en interaction avec le FIP. Notre analyse offre une perspective empirique complémentaire à la littérature théorique concernant le FIP dans l’enseignement médical. Cette littérature tend à faire de la prise de décisions éthiques saines le résultat final du FIP. Notre analyse souligne que le mécanisme fonctionne dans les deux sens: la façon dont les résidents réagissent au curriculum caché en éthique peut être un moteur de la formation de l’identité professionnelle.

Après avoir été l’une des substances pharmacologiques les plus étudiées des années 1950-1970, le LSD, puissant psychédélique ayant de nombreuses indications thérapeutiques, est abandonné par la communauté scientifique internationale au début des années 1970. Si des facteurs externes à la médecine ont eu un impact sur le déclin de ce médicament, il est également nécessaire de s’interroger sur les causes internes de ce rejet. Pour ce faire, une littérature anglo-saxonne émerge ces dernières années dans le champ des psychedelic studies, que nous enrichissons ici par une étude mettant en lumière les spécificités des sources françaises sur le sujet. Cet article souhaite montrer comment la méthode de la psychothérapie dite « psychédélique », inventée par une partie des chercheurs/euses travaillant avec le LSD, ainsi que la remise en cause de la probité de ces mêmes thérapeutes jugés trop « enthousiastes », ont été des facteurs essentiels du discrédit de ce médicament. Though it had been one of the most studied pharmacological substances in the years 1950-1970, LSD, a potent psychedelic with numerous therapeutic indications, came to be neglected by the international scientific community in the early 1970s. Whereas factors that are external to medicine have had an impact on the decline of this drug, it is also necessary to ponder on the internal causes of such rejection. To do so, some Anglo-Saxon literature has been emerging in recent years in the field of psychedelic studies to be here enriched through a study highlighting the specificities of French sources on the subject. This paper is meant to show how the method of so-called “psychedelic” psychotherapy designed by some of the researchers using LSD, together with the questioning of their probity, as these therapists were deemed to be “overenthusiastic”, have both then been key factors in bringing this drug into disrepute. Después de haber sido una de las sustancias farmacológicas más estudiadas en las décadas de 1950 y 1970, el LSD, un potente psicodélico con muchas indicaciones terapéuticas, fue abandonado por la comunidad científica internacional a principios de la década de 1970. Si bien existieron factores externos a la medicina que tuvieron un impacto en el declive de este medicamento, es necesario considerar también las causas internas de este rechazo. Para ello, en los últimos años ha surgido una literatura anglófona en el campo de los psychedelic studies que enriquecemos aquí con un estudio que destaca las especificidades de las fuentes francesas sobre el tema. Este artículo tiene como objetivo mostrar cómo el método de la psicoterapia llamada “psicodélica”, inventado por algunos de los investigadores e investigadoras que trabajan con LSD, así como el cuestionamiento de la probidad de esos mismos terapeutas considerados demasiado “entusiastas”, fueron factores esenciales en el descrédito de este medicamento.

Background: Short-term and working memory (STM and WM) deficits have been demonstrated in individuals with autism spectrum disorder (ASD) and may emerge through atypical functional activity and connectivity of the frontoparietal network, which exerts top-down control necessary for successful STM and WM processes. Little is known regarding the spectral properties of the frontoparietal network during STM or WM processes in ASD, although certain neural frequencies have been linked to specific neural mechanisms. Methods: We analysed magnetoencephalographic data from 39 control adults (26 males; 27.15 ± 5.91 years old) and 40 adults with ASD (26 males; 27.17 ± 6.27 years old) during a 1-back condition (STM) of an n-back task, and from a subset of this sample during a 2-back condition (WM). We performed seed-based connectivity analyses using regions of the frontoparietal network. Interregional synchrony in theta, alpha, and beta bands was assessed with the phase difference derivative and compared between groups during periods of maintenance and recognition. Results: During maintenance of newly presented vs. repeated stimuli, the two groups did not differ significantly in theta, alpha, or beta phase synchrony for either condition. Adults with ASD showed alpha-band synchrony in a network containing the right dorsolateral prefrontal cortex, bilateral inferior parietal lobules (IPL), and precuneus in both 1- and 2-back tasks, whereas controls demonstrated alpha-band synchrony in a sparser set of regions, including the left insula and IPL, in only the 1-back task. During recognition of repeated vs. newly presented stimuli, adults with ASD exhibited decreased theta-band connectivity compared to controls in a network with hubs in the right inferior frontal gyrus and left IPL in the 1-back condition. Whilst there were no group differences in connectivity in the 2-back condition, adults with ASD showed no frontoparietal network recruitment during recognition, whilst controls activated networks in the theta and beta bands. Conclusions: Our findings suggest that since adults with ASD performed well on the n-back task, their appropriate, but effortful recruitment of alpha-band mechanisms in the frontoparietal network to maintain items in STM and WM may compensate for atypical modulation of this network in the theta band to recognise previously presented items in STM., SCOPUS: ar.j, info:eu-repo/semantics/published

Two themes have puzzled the research on developmental and learning disorders for decades. First, some of the risk and protective factors behind developmental challenges are suggested to be shared and some are suggested to be specific for a given condition. Second, language-based learning difficulties like dyslexia are suggested to result from or correlate with non-linguistic aspects of information processing as well. In the current study, we investigated how adults with developmental dyslexia or ADHD as well as healthy controls cluster across various dimensions designed to tap the prominent non-linguistic theories of dyslexia. Participants were 18–55-year-old adults with dyslexia (n = 36), ADHD (n = 22), and controls (n = 35). Non-linguistic theories investigated with experimental designs included temporal processing impairment, abnormal cerebellar functioning, procedural learning difficulties, as well as visual processing and attention deficits. Latent profile analysis (LPA) was used to investigate the emerging groups and patterns of results across these experimental designs. LPA suggested three groups: (1) a large group with average performance in the experimental designs, (2) participants predominantly from the clinical groups but with enhanced conditioning learning, and (3) participants predominantly from the dyslexia group with temporal processing as well as visual processing and attention deficits. Despite the presence of these distinct patterns, participants did not cluster very well based on their original status, nor did the LPA groups differ in their dyslexia or ADHD-related neuropsychological profiles. Remarkably, the LPA groups did differ in their intelligence. These results highlight the continuous and overlapping nature of the observed difficulties and support the multiple deficit model of developmental disorders, which suggests shared risk factors for developmental challenges. It also appears that some of the risk factors suggested by the prominent non-linguistic theories of dyslexia relate to the general level of functioning in tests of intelligence., SCOPUS: ar.j, info:eu-repo/semantics/published

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Alcohol Use Disorder (AUD) has a disconcertingly high relapse rate (70–80% within a year following withdrawal). Preventing relapse or minimizing its extent is hence a challenging goal for long-term successful management of AUD. New perspectives that rely on diverse neuromodulation tools have been developed in this regard as care supports. This paper focuses on electroencephalogram-neurofeedback (EEG-NF), which is a tool that has experienced renewed interest in both clinical and research areas. We review the literature on EEG-based neurofeedback studies investigating the efficacy in AUD and including at least 10 neurofeedback training sessions. As neurofeedback is a form of biofeedback in which a measure of brain activity is provided as feedback in real-time to a subject, the high degree of temporal resolution of the EEG interface supports optimal learning. By offering a wide range of brain oscillation targets (alpha, beta, theta, delta, gamma, and SMR) the EEG-NF procedure increases the scope of possible investigations through a multitude of experimental protocols that can be considered to reinforce or inhibit specific forms of EEG activity associated with AUD-related cognitive impairments. The present review provides an overview of the EEG-NF protocols that have been used in AUD and it highlights the current paucity of robust evidence. Within this framework, this review presents the arguments in favor of the application of EEG-NF as an add-on tool in the management of alcohol disorders to enhance the cognitive abilities required to maintain abstinence more specifically, with a focus on inhibition and attentional skills., SCOPUS: re.j, info:eu-repo/semantics/published

Background: Globally, people who inject drugs are highly vulnerable to HIV transmission. Methadone maintenance treatment (MMT) programs are one of the most cost-effective mechanisms to substitute opioid use and improve the quality of life of patients. Since the coverage of MMT is still limited and even for those patients who are treated, improving their knowledge on HIV and maintaining healthy behaviors are key to maximizing the outcomes of HIV harm reduction programs. This study examined the knowledge on HIV, perceived risk and HIV testing among drug users accessing methadone maintenance services in three Vietnamese mountainous areas. Methods: A cross-sectional study of 300 people enrolling for MMT services in three provinces in Vietnam was conducted. The factors associated with the knowledge, attitudes, and practices of respondents about HIV/AIDS were exploited using multivariable logistic model. Results: Of the 300-people surveyed, 99% knew of HIV and 60.6% were identified as having good knowledge. While 75.2% identified that injecting drugs was a risk factor for HIV, 52.2% thought they were not at risk of HIV mainly as they did not share needles. 92.6% had undergone HIV testing with 17.4% being positive, a number which was significantly lower than Vietnam's national average for people who inject drugs. Age, ethnicity and education were associated with knowledge of HIV while ART treatment was linked to self-assessed HIV status. Conclusions: This study sheds new light on the knowledge attitudes and practices of people who inject drugs, particularly males in mountainous areas of Vietnam regarding HIV prevention. Overall, knowledge was good with most conducting safe practices towards transmission. Enhanced education and targeting of minority groups could help in increasing the numbers receiving MMT and HIV services., SCOPUS: ar.j, info:eu-repo/semantics/published

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