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Lockdown measures can differentially affect mental wellbeing in populations depending on individual determinants. We aim to investigate the sociodemographic and environmental determinants of wellbeing on the French population during lockdown due to the SARS-CoV-2 pandemic with an online survey. Among 11,391 participants who completed the questionnaire, various factors negatively impacted wellbeing: being a female, a student, disabled, having no access to outdoor spaces, or living in a small home. Conversely, being employed and having more social contacts had a positive impact. During lockdowns, authorities should consider the vulnerability of specific populations, especially when they live in constrained housing conditions., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) has been validated in general population samples in many countries. Interest in using this measure in clinical populations is growing, particularly for tertiary prevention and mental health promotion. This paper reports validation of the French WEMWBS in healthy and chronic remitted schizophrenia populations. The French WEMWBS was administered to 319 workers, 75 students and 121 patients. For non-patients, self-reported Trait- and State-Anxiety, Mindfulness, Positive and Negative Affect and the General Health Questionnaire were completed. For patients, the Positive and Negative Syndrome Scale, Clinical Global Impression Severity Scale, Birchwood Insight Scale, Social Adjustment Scale, and Global Assessment of Functioning scale were completed. Test-retest reliability and responsiveness to intervention was assessed at 6 months. Whatever the sample, response frequencies showed normal distributions, and internal consistency was good (Cronbach's α). Scree plots of eigenvalues suggested a single factor in the samples. The one-dimensional solution yielded suboptimal fit indices. Construct validity was confirmed. Significant improvement in scores was observed before and after intervention. Test-retest variation was non-significant. Impairment of insight and cognition in the assessed patients implies that attention must be paid before applying WEMWBS to all patients. Nevertheless, WEMWBS proved valid and reliable in a further European population, suggesting transcultural validity for both monitoring and evaluation of interventions in healthy as well as chronic remitted schizophrenia populations., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Introduction: Addressing relevant determinants for preserved person-centered rehabilitation in mental health is still a major challenge. Little research focuses on factors associated with psychiatric hospitalization in exclusive outpatient settings. Some variables have been identified, but evidence across studies is inconsistent. This study aimed to identify and confirm factors associated with hospitalization in a specific outpatient population. Methods: A retrospective monocentric case-control study with 617 adult outpatients (216 cases and 401 controls) from a French community-based care facility was conducted. Participants had an index outpatient consultation between June 2021 and February 2023. All cases, who were patients with a psychiatric hospitalization fromthe day after the index outpatient consultation and up to 1 year later, have been included. Controls have been randomly selected from the same facility and did not experience a psychiatric hospitalization in the 12 months following the index outpatient consultation. Data collection was performed from electronic medical records. Sociodemographic, psychiatric diagnosis, historical issues, lifestyle, and follow-up-related variables were collected retrospectively. Uni- and bivariate analyses were performed, followed by a multivariable logistic regression. Results: Visit to a psychiatric emergency within a year (adjusted odds ratio (aOR): 13.02, 95% confidence interval (CI): 7.32-23.97), drug treatment discontinuation within a year (aOR: 6.43, 95% CI: 3.52-12.03), history of mental healthcare without consent (aOR: 5.48, 95% CI: 3.10-10.06), medical follow-up discontinuation within a year (aOR: 3.17, 95% CI: 1.70-5.95), history of attempted suicide (aOR: 2.50, 95% CI: 1.48-4.30) and unskilled job (aOR: 0.26, 95% CI: 0.10--0.65) are the independent variables found associated with hospitalization for followed up outpatients. Conclusions: Public health policies and tools at the local and national levels should be adapted to target the identified individual determinants in order to prevent outpatients from being hospitalized. [ABSTRACT FROM AUTHOR]

La pair-aidance repose sur l'apport de personnes ayant expérimenté le rétablissement de troubles psychiques à d'autres personnes qui font face à de tels troubles. L'adhésion renvoie aux facteurs psychosociaux qui interviennent sur l'observance, c'est-à-dire le suivi d'un traitement prescrit, des conseils et des règles hygiénodiététiques. Quel impact l'intervention des pair-aidants a-t-elle sur l'observance médicamenteuse ? Cette étude répond à cette question à travers une description des pratiques professionnelles des pair-aidants dans ce domaine. Une enquête a été diffusée aux personnes exerçant la pair-aidance en santé mentale en France, quels que soient leur mode d'exercice ou leur formation. Elle a porté sur leur pratique en matière de traitements psychopharmacologiques et d'adhésion médicamenteuse, sur leur formation de pair-aidant, leurs conditions d'exercice et leurs missions, ainsi que sur leur vécu personnel en termes de prise de médicaments psychopharmacologiques et d'effets indésirables. Cent quarante-deux sujets ont participé à l'enquête, dont 47,9 % ont suivi une formation dans le passé, 28,2 % en suivent actuellement une et 23,9 % n'en ont pas suivi. Parmi ceux qui ont suivi une formation, 55,9 % ont obtenu le diplôme universitaire de pair-aidance de l'université Lyon 1 et 32,4 % la licence parcours médiateur de santé pair de l'université Paris 13. L'adhésion médicamenteuse a été abordée dans la formation de 36,8 % des participants. Parmi les 142 participants, 54,9 % estimaient avoir des connaissances sur le sujet et 81 % souhaitaient s'y former. Dans leur pratique professionnelle, 69 % des participants considéraient la question du traitement psychopharmacologique ; parmi eux, 48,2 % abordaient celle de l'adhésion médicamenteuse. Aborder les médicaments est lié au statut de la formation, c'est-à-dire que le fait d'avoir bénéficié d'une formation de pair-aidant facilite les échanges en matière d'adhésion médicamenteuse et de connaissances générales portant sur ce domaine. Le métier de pair-aidant se professionnalise depuis peu et les savoirs expérientiels sont maintenant reconnus et valorisés. Les pair-aidants sont envisagés comme des acteurs complémentaires de la prise en charge psychopharmacologique, notamment concernant l'amélioration de l'adhésion au traitement médicamenteux. Il est nécessaire de clarifier leur cadre d'intervention et leurs missions, ainsi que leur formation initiale et continue. Peer support is defined as the contribution of people who have themselves recovered from psychological disorders given to others coping with similar disorders. Adherence refers to the psychosocial factors involved in compliance, i.e., following a prescribed treatment and the associated advice on health and dietary rules. What impact does the intervention of peer helpers have on medication adherence? This study answers this question by describing the professional practices of peer helpers in this field. A survey was sent to people working as peer helpers in mental health in France, regardless of their mode of practice or training. It focused on their practice in terms of psychopharmacological treatments and medication adherence, their training as peer helpers, the conditions of their practice and their missions, as well as their personal experience in terms of taking psychopharmacological medications and any adverse side effects. One hundred and forty-two participants responded to the survey, of whom 47.9% had taken a training course in the past, 28.2% were currently taking one and 23.9% had not. Of those who had received training, 55.9% had obtained a university diploma in peer support from the University of Lyon 1, and 32.4% a bachelor's degree in peer health mediation from the University of Paris 13. Medication adherence was addressed in the training of 36.8% of the participants. Of the 142 participants, 54.9% felt they knew something about the subject, and 81% wanted to learn more. In their professional practice, 69% of the participants considered the question of psychopharmacological treatment; of these, 48.2% addressed the issue of medication adherence. Addressing medication is linked to their training status, i.e., having benefited from peer-helper training facilitates exchanges on medication adherence and general knowledge in this area. The peer-support profession has just recently become professionalized, and experiential knowledge is now recognized and valued. Peer helpers are complementary players in psychopharmacological care, particularly with regard to improving adherence to medication. We need to clarify the scope of their intervention and missions, as well as their initial and ongoing training. [ABSTRACT FROM AUTHOR]

A first Assessment and Orientation Center (CAdEO) was created in Lyon at the beginning of June 2020 in order to facilitate access to mental health care. This structure allows any person who requests it to access a psychiatric assessment within a few days. It does not implement a follow-up, but it allows the person to be quickly directed towards the structure or the professional, public or private, who will be able to provide the care he or she needs. The CAdEO relies on a multidisciplinary team, which includes psychiatrists, psychologists and nurses (including an advanced practice nurse), in order to provide a adjusted assessment and orientation. It opens from Monday to Friday. The CAdEO, which is located in the city center, works in close partnership with the general practitioners in its health territory, as well as with all the health, medico-social and social services involved in the field of mental health. Among its consultants, about 4 out of 5 people are referred to private practice or associations. One person out of five is referred to other services in the general psychiatric sector, of which the CAdEO is the entry point. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the mental well-being of French women who were and were not pregnant during the first COVID-19 pandemic lockdown. We performed a nationwide online quantitative survey including all women between 18 and 45 years of age during the second and third weeks of global lockdown (25 March–7 April 2020). The main outcome measure was mental well-being measured by the Warwick–Edinburgh Mental Well-Being Scale (WEMWBS). This study analysed 275 responses from pregnant women and compared them with those from a propensity score–matched sample of 825 non-pregnant women. In this French sample, the median WEMWBS score was 49.0 and did not differ by pregnancy status. Women living in urban areas reported better well-being, while those with sleep disorders or who spent more than an hour a day watching the news reported poorer well-being. During the first lockdown in France, women had relatively low mental well-being scores, with no significant difference between pregnant and non-pregnant women. More than ever, health-care workers need to find a way to maintain their support for women's well-being. Minor daily annoyances of pregnancy, such as insomnia, should not be trivialised because they are a potential sign of poor well-being. [ABSTRACT FROM AUTHOR]

Background: Mental health and well-being were seriously impacted by the COVID-19 lockdown especially among young people and people with psychiatric disorders. This study aimed to identify factors associated with well-being in young people with psychiatric disorders, during early phase of COVID-19 lockdown in France. Methods: A national cross-sectional online study started on the 8th day of COVID-19 lockdown in France (during March 25–30, 2020). We included young people aged from 16 to 29 who responded to the questionnaire, living and being confined in France, with past or current psychiatric treatment. The questionnaire was accessible online and explored demographics and clinical factors, well-being, stress, situation during lockdown. Well-being was measured by the Warwick-Edinburg Mental Well-Being Scale (WEMWBS). Simple and multiple linear regression analyses were carried out. Results: 439 individuals were included with 262 (59.7%) previously treated and 177 (40.3%) currently treated. WEMWBS total score were 42.48 (9.05). Feeling of useful was the most affected dimension. Well-being was positively correlated with: currently working on site, physical activity, abilities to cope with difficulties, family and social supports (p<0.05). It was negatively correlated with: elevated stress level, anxious ruminations, dissatisfaction with information, difficulties to sleep or reorganize daily life, feeling supported by medicines (p<0.05). No individual factor was correlated with well-being. The stepwise linear multivariate model had simple R2 coefficient of determination of 0.535. Conclusion: In the specific population of young people with psychiatric disorders, factors associated with well-being at early stage of lockdown were mainly psychosocial and related to brutal disorganisation of daily life. [ABSTRACT FROM AUTHOR]

Informal caregivers are overlooked, healthcare actors. They are at particular risk of distress and suffer from poor mental health. This study aimed to investigate the perceived stress and modulating factors during the first COVID-19 lockdown in Europe, regardless of the illness that care recipients suffer from. Sociodemographic data, coping resources, and perceived stress level using the Perceived Stress Scale (PSS-10) questionnaire were assessed using a web-based survey in Switzerland, France, and Belgium with 232 informal caregivers. Mediation analyses were used to identify the factors that modulate stress. Higher perceived stress among informal caregivers was associated with a younger age for the care recipient, family relationship with the care recipient, cohabitation, and female sex of the informal caregiver. These associations were partially mediated by the fear of getting ill (age, cohabitation), the conviction that lockdowns had a negative impact on health (age, kinship), and the perceived deterioration of the care recipient's health (gender). The fear of losing the ability to cope with caregiving tasks due to an illness (COVID-19 and/or other) and the negative impact of the lockdown on care recipients' health, particularly on the mental health of young care recipients, increased the stress of informal caregivers. Our results emphasize the importance of informal caregiving support to prevent heightened stress in lockdown conditions, regardless of care recipient illness or kinship. [ABSTRACT FROM AUTHOR]

Background: Compulsory admission to psychiatric hospital is rising despite serious ethical concerns. Among measures to reduce compulsory admissions, Psychiatric Advance Directives (PAD) are the most promising, with intensive PAD (i.e. facilitated and shared) being the most effective. The aim of the study is to experiment Psychiatric Advance Directives in France. Methods: A multicentre randomized controlled trial and qualitative approach conducted from January 2019 to January 2021 with intent-to-treat analysis. Setting: Seven hospitals in three French cities: Lyon, Marseille, and Paris. Research assistants meet each participant at baseline, 6 months and 12 months after inclusion for face-to-face interviews. Participants: 400 persons with a DSM-5 diagnosis of bipolar I disorder (BP1), schizophrenia (SCZ), or schizoaffective disorders (SCZaff), compulsorily admitted to hospital within the last 12 months, with capacity to consent (MacCAT-CR), over 18 years old, and able to understand French. Interventions: The experimental group (PAD) (expected n = 200) is invited to fill in a document describing their crisis plan and their wishes in case of loss of mental capacity. Participants meet a facilitator, who is a peer support worker specially trained to help them. They are invited to nominate a healthcare agent, and to share the document with them, as well as with their psychiatrist. The Usual Care (UC) group (expected n = 200) receives routine care. Main outcomes and measures: The primary outcome is the rate of compulsory admissions to hospital during the 12-month follow-up. Secondary outcomes include quality of life (S-QoL18), satisfaction (CSQ8), therapeutic alliance (4-PAS), mental health symptoms (MCSI), awareness of disorders (SUMD), severity of disease (ICG), empowerment (ES), recovery (RAS), and overall costs. Discussion: Implication of peer support workers in PAD, potential barriers of supported-decision making, methodological issues of evaluating complex interventions, evidence-based policy making, and the importance of qualitative evaluation in the context of constraint are discussed. Trial registration: ClinicalTrials.gov identifier: NCT03630822. Registered 14th August 2018. [ABSTRACT FROM AUTHOR]

An impaired ability to appreciate other people's mental states is a well-established and stable cognitive deficit in schizophrenia, which might explain some aspects of patients’ social dysfunction. Yet, despite a wealth of literature on this topic, the basic mechanisms underlying these impairments are still poorly understood, and their links with the clinical dimensions of schizophrenia remain unclear. The present study aimed to investigate the extent to which patients’ impaired ability to appreciate other people's intentions (known as mentalizing) may be accounted for by abnormal interaction between the two types of information that contribute to this ability: (i) the sensory evidence conveyed by movement kinematics; and (ii) the observer's prior expectations. We hypothesized that this is not a generalized impairment, but one confined to certain types of intentions. To test this assumption, we designed four tasks in which participants were required to infer either: (i) basic intentions (i.e. the simple goal of a motor act); (ii) superordinate intentions (i.e. the general goal of a sequence of motor acts); (iii) social basic; or (iv) social superordinate intentions (i.e. simple or general goals achieved within the context of a reciprocal interaction). In each of these tasks, both prior expectations and sensory information were manipulated. We found that patients correctly inferred non-social, basic intentions, but experienced difficulties when inferring non-social superordinate intentions and both basic and superordinate social intentions. These poor performances were associated with two abnormal patterns of interaction between prior expectations and sensory evidence. In the non-social superordinate condition, patients relied heavily on their prior expectations, while disregarding sensory evidence. This pattern of interaction predicted the severity of ‘positive’ symptoms. Social conditions prompted exactly the opposite pattern of interaction: patients exhibited weaker dependence on prior expectations while relying strongly on sensory evidence, and this predicted the severity of ‘negative’ symptoms. We suggest both these patterns can be accounted for by a disturbance in the Bayesian inferential mechanism that integrates sensory evidence (conveyed by movement kinematics) into prior beliefs (about others’ mental states and attitudes) to produce accurate inferences about other people's intentions. [ABSTRACT FROM PUBLISHER]

Several instruments have been developed by clinicians and academics to assess clinical recovery. Based on their life narratives, measurement tools have also been developed and validated through participatory research programs by persons living with mental health problems or illnesses to assess personal recovery. The main objective of this project is to explore possible correlations between clinical recovery, personal recovery, and citizenship by using patient-reported outcome measures. All study participants are currently being treated and monitored after having been diagnosed either with (a) psychotic disorders or (b) anxiety and mood disorders. They have completed questionnaires for clinical evaluation purposes (clinical recovery) will further complete the Recovery Assessment Scale and Citizenship Measure (personal-civic recovery composite index). Descriptive and statistical analyses will be performed to determine internal consistency for each of the subscales, and assess convergent-concurrent validity between clinical recovery, citizenship and personal recovery. Recovery-oriented mental health care and services are particularly recognizable by the presence of Peer Support Workers, who are persons with lived experience of recovery. Upon training, they can personify personalized mental health care and services, that is to say services that are centered on the person's recovery project and not only on their symptoms. Data from our overall research strategy will lay the ground for the evaluation of the effects of the intervention of Peer Support Workers on clinical recovery, citizenship and personal recovery. [ABSTRACT FROM AUTHOR]

Objective: Identifying specific insight and/or metacognitive measures predicting vocational outcomes would lead to a refinement of cognitive and behavioral assessment and treatment of people with severe mental illness. Methods: We conducted a systematic review of empirical research following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Studies published in PubMed and PsycINFO from January 1, 2000 to April 30, 2020 and including words referring to "vocational outcomes", "insight," and "metacognition" were screened. Results: Twenty-eight studies were included, 19 assessing insight and 9 assessing metacognition and their relationships with vocational outcomes in patients with severe mental illness. Thirteen studies (68%) identified statistically significant relationships between insight scores and vocational outcomes. Five studies (56%) identified statistically significant relationships between metacognition scores or metacognitive training and vocational outcomes. The most common tools whose measures were significantly related to vocational outcomes were the Schedule for the Assessment of Insight, the Scale to assess Unawareness of Mental Disorder and the Metacognition Assessment Scale–Abbreviated. Conclusions and Implications for Practice: Insight and metacognition appeared to be related to the vocational outcomes of people with severe mental illness. However, due to the heterogeneity of variables used to operationalize insight, metacognition, and vocational outcomes, it was not possible to determine the overall effect of insight and metacognition. Nevertheless, assessment including the measures of insight and metacognition would be relevant in vocational rehabilitation centers and in centers providing care through employment. The literature lacks predictive models of employment variables including insight and metacognition, so further studies should address this. Impact and Implications: Insight and metacognitive levels of people with severe mental illness appeared to be related to their vocational outcomes. Assessment including the measures of insight and metacognition would be relevant in vocational rehabilitation centers and in centers providing care through employment. Further studies should focus on possible predictive relationships between insight/metacognition and the ability to (return to) work of people with severe mental illness. [ABSTRACT FROM AUTHOR]