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Resume Savoir a qui les personnes depressives s’adressent pour obtenir de l’aide et les traitements qu’elles recoivent est essentiel pour ameliorer la proportion de traitements adequats. L’objectif de cet article est de mieux comprendre les recours aux soins et l’adequation des traitements des personnes presentant un episode depressif majeur (EDM) en fonction des differents professionnels consultes, en utilisant les donnees d’une enquete epidemiologique nationale en population generale realisee en 2005 (Barometre sante 2005, n = 16883) par l’Institut National de prevention et d’education pour la sante. 7,8 % des personnes ont presente un EDM dans l’annee. Six sur dix ont eu recours aux soins ; 1/3 d’entre elles recoivent un traitement adequat (21 % des EDM). Parmi les personnes qui ont eu recours aux soins, 2/3 ont eu recours a un professionnel soit 1/3 des EDM, la proportion restante (soit 21,4 % des EDM) ayant eu recours a des psychotropes sans avoir declare de recours a un professionnel pour raison de sante mentale. La quasi-totalite des recours le sont a un « professionnel competent (PRC) » (soit 34,6 % des EDM). Au sein des PRC, le recours le plus important concerne les medecins generalistes (MG) (61 %, soit 21,1 % des EDM), le recours aux psychiatres (PCT) etant de 38,4 % (soit 13,3 % des EDM) et celui aux « psys » non psychiatres (PNP) de 27,8 % (soit 9,6 % des EDM). Les proportions les plus faibles de traitements adequats sont observees chez les EDM qui declarent ne pas avoir eu recours a un professionnel. Chez celles ayant eu recours a un PRC, la proportion la plus faible de traitements adequats est observee pour le recours a un MG : 37,2 %. Les proportions les plus elevees s’observent pour le recours a un PCT (65,1 %) et en particulier pour le recours a un PCT et a un MG (79,7 %). Les proportions d’usage des differents types de traitements (antidepresseurs [ATD] et psychotherapie [PT]) sont tres differentes. Pour les EDM, 33,4 % ont eu recours a des ATD (parmi lesquels 58,4 % ont egalement eu recours a des anxiolytiques [AXL]). 26,9 % ont eu recours a des AXL, 7,5 % sans prise d’ATD ; 10,8 % des EDM ont eu recours a la PT, 8,1 % ayant eu recours a la PT et aux ATD.

Introduction Pour l’OMS la schizophrenie, dont la prevalence est de 1 %, est une des dix maladies qui entraine le plus d’invalidite [1] . La duree de vie des personnes avec schizophrenie est inferieure a la population generale de 15 a 20 ans [2] . Parmi les facteurs associes a la diminution de l’esperance de vie on retrouve notamment un manque d’activite physique (AP) [3] . Ces facteurs, ajoutes aux poids des symptomes negatifs de la schizophrenie, menent au cercle vicieux du deconditionnement physique. L’objectif de ce travail est d’etudier la faisabilite d’un programme d’APA fonde sur les principes de la remediation cognitive et d’en quantifier les effets sur la symptomatologie ainsi que sur la condition physique. Materiels et methodes Le programme d’APA ciblent les processus mnesiques, attentionnels et executifs en les contextualisant autour de l’exercice physique et du plaisir du jeu et dure 3 semaines (2 × 2 h/sem). Les donnees recueillies sont : AP (GLTEQ), condition physique subjective (IFIS), qualite de vie (SF-36), symptomatologie (BPRS), fonctionnement global (EGF), condition physique objectifs (dont TM6). Statistiques descriptives univariees et t de Student (groupes independants et apparies) ont ete realises. Resultats Soixante-dix patients (19 ♀, 30 ± 12,1 ans), ont ete inclus dans l’etude, 22 ont participe aux evaluations PRE- et POST-programme. A l’entree dans l’etude, les participants presentent une faible condition physique, une inactivite physique importante et une qualite de vie moindre par rapport aux normes en population generale (p Conclusion Les exercices et jeux proposes, au sein d’un partenariat interactif au sein du groupe, avec emulation, plaisir, et regulation du stress, amenent des benefices sur les dimensions de sante mesurees.

Resume La question de la consommation de substances addictives en population etudiante et des eventuels retentissements psychiques dans cette population d’adultes jeunes est une question importante en termes de sante publique. Differentes donnees epidemiologiques attestent que le cannabis est la principale substance illicite consommee. De plus, certaines donnees tendent a montrer qu’il existe une relation entre consommation de cannabis et survenue de troubles psychiques ulterieurs notamment de nature psychotique. Ces enjeux ont amene une collaboration entre deux partenaires : le Service Inter-Universitaire de Medecine Preventive et de Promotion de la Sante de Paris (SIUMPPS) et le Laboratoire de Physiopathologie de Maladies Psychiatriques (Inserm U894) afin de realiser une enquete epidemiologique sur la consommation de substances illicites en population etudiante. Des resultats preliminaires portant sur un sous-echantillon de cette etude sont presentes. Les perspectives en termes de demarche de prevention et de prise en charge qui pourraient se degager tant des donnees issues de la litterature que des premiers resultats sont discutees.

Background Schizophrenia is a multifactorial disorder and environmental risk factors for it might contribute to hypothalamo–pituitary–adrenal axis (HPA) dysregulation. While increased cortisol levels have been reported in schizophrenia, as well as in early psychosis (compared to healthy controls), a crucial unresolved issue is whether elevated cortisol levels could be related to the distress of an emerging illness, rather than being specific to psychosis. Here, we report new findings from the first French cohort of young help-seekers (ICAAR) including ultra-high risk subjects (UHR), first-episode of psychosis (FEP) and non at-risk help seekers controls (HSC), followed by a meta-analysis of all available reports on salivary basal cortisol levels in early psychosis (UHR and FEP). Methods In the ICAAR study, 169 individuals (15–30 years old) had their basal cortisol levels sampled and they were categorized (at baseline) as either UHR, FEP, or HSC using the criteria of the Comprehensive Assessment of At-Risk Mental States (CAARMS). The three groups were compared at baseline, and the UHR and HSC individuals were also included in a one-year longitudinal follow-up. UHRs who converted to psychosis at the follow up (UHR-P) were compared to non-converters (UHR-NP). We also performed a meta-analysis from case-control studies with basal salivary measures of cortisol, drawing from a systematic bibliographic search using the keywords ‘cortisol’, ‘glucocorticoid’, ‘HPA’ with ‘UHR’, ‘CHR’, ‘at-risk mental state’, ‘schizotypal ’, ‘prodromal schizophrenia’, ‘first-episode psychosis’, ‘first episode schizophrenia‘, ‘newly diagnosed schizophrenia’, ‘recent onset schizophrenia’ [in Medline, Web of Knowledge (WOS), EBSCO], followed by a systematic screening of the resulting articles. Results Basal cortisol levels were not significantly different between UHR, FEP, and HSC controls in the ICAAR cohort. Interestingly, initial cortisol levels were correlated with positive symptoms at the one year follow-up in the ICAAR cohort. The meta-analysis revealed a significant elevation of the salivary basal cortisol levels in UHR individuals compared to controls (8 studies—1060 individuals), but not between FEP and controls (6 studies—441 individuals). Indirect comparison of salivary basal cortisol levels between UHR and FEP did not yield significant differences. Finally, no differences were detected between the baseline cortisol of UHR-P and UHR-NP (4 studies—301 individuals). Conclusion The meta-analysis (including new data) indicates that basal cortisol levels were increased in UHR compared to controls, but FEP levels were not different from UHR or controls. Many confounding factors could decrease the effect size in FEP especially medication intake. Taken together with our new results (which made use of help-seeker controls, and not merely healthy controls), the findings indicate that basal cortisol levels may not be a reliable biomarker for early psychosis. Further studies are needed to clarify the precise role of the HPA axis in psychotic conversion.

International audience; In Glioblastoma Multiforme (GBM) image-derived features (“radiomics”) could help in individualizing patient management. Simple geometric features of tumors (necrosis, edema, active tumor) and first-order statistics in Magnetic Resonance Imaging (MRI) are used in clinical practice. However, these features provide limited characterization power because they do not incorporate spatial information and thus cannot differentiate patterns. The aim of this work is to develop and evaluate a methodological framework dedicated to building a prognostic model based on heterogeneity textural features of multimodal MRI sequences (T1, T1-contrast, T2 and FLAIR) in GBM. The proposed workflow consists in i) registering the available 3D multimodal MR images and segmenting the tumor volume, ii) extracting image features such as heterogeneity metrics and iii) building a prognostic model by selecting, ranking and combining optimal features through machine learning (Support Vector Machine). This framework was applied to 40 histologically proven GBM patients with the endpoint being overall survival (OS) classified as above or below the median survival (15 months). The models combining features from a maximum of two modalities were evaluated using leave-one-out cross-validation (LOOCV). A classification accuracy of 90% (sensitivity 85%, specificity 95%) was obtained by combining features from T1 pre-contrast and T1 post-contrast sequences. Our results suggest that several textural features in each MR sequence have prognostic value in GBM.

Background Hypomanic Personality Scale (HPS) is a self-report questionnaire designed to identify vulnerable individuals at high risk of bipolar disorders in non-clinical samples. Our aim was to identify the factorial structure of HPS in a French non-clinical sample and to compare this with different factor solutions described in the literature. We carried out a survey in a French population using a French version of HPS. Methods A total of 698 participants were included in the study. They completed the HPS, the Schizotypal Personality Questionnaire-Brief (SPQ-B), the Positive And Negative Affect Schedule (PANAS), and the Beck Depression Inventory (BDI-II). We tested the 1, 3 and 4-factor solutions and used a Confirmatory Factor Analysis to compare these with the factor solutions suggested by Rawling et al. and Schalet et al. Results Goodness-of-fit indices showed that Schalet et al.'s solution “fits” our data better than Rawling et al.'s factorial solutions. HPS scores correlated with the PANAS Positive score and the SPQ-B total score. We confirmed the 3-factor structure of the HPS in a large non-clinical population of young adults and found consistent correlations with BDI, affectivity and schizotypal traits.

Image-derived features (“radiomics”) are increasingly being considered for patient management in (neuro)oncology and radiotherapy. In Glioblastoma multiforme (GBM), simple features are often used by clinicians in clinical practice, such as the size of the tumor or the relative sizes of the necrosis and active tumor. First order statistics provide a limited characterization power because they do not incorporate spatial information and thus cannot differentiate patterns. In this work, we present the methodological framework for building a prognostic model based on heterogeneity textural features of multimodal MRI sequences (T1, T1-contrast, T2 and FLAIR) in GBM. The proposed workflow consists in i) registering the available 3D multimodal MR images and segmenting the tumor volume, ii) extracting image features such as heterogeneity metrics and shape indices, iii) building a prognostic model using Support Vector Machine by selecting, ranking and combining optimal features. We present preliminary results obtained for the classification of 40 patients into short (≤ 15 months) or long (> 15 months) overall survival, validated using leave-one-out cross-validation. Our results suggest that several textural features in each MR sequence have prognostic value in GBM, classification accuracy of 90% (sensitivity 85%, specificity 95%) being obtained by combining both T1 sequences. Future work will consist in i) adding more patients for validation using training and testing groups, ii) considering additional features, iii) building a fully multimodal MRI model by combining features from more than two sequences, iv) consider survival as a continuous variable and v) combine image-derived features with clinical and histopatholoigcal data to build an even more accurate model.

Increasingly, physicians have to access clinical images distributed over multiple healthcare organizations. To this end, two DICOM protocols may be used: a regular DICOM C-STORE transaction or an HTTP-based DICOM request such as WADO or STOW. A major problem of the DICOM C-STORE transaction is that it is inefficient to transfer DICOM data sets that consist of thousands of DICOM objects (such as functional MRI data set) because of the large number of negotiations involved in the transfer. We compare the performances of C-STORE transactions with the STOW HTTP-based protocol, and show that the STOW protocol can divide the transfer time by about 50 when compared to a DICOM C-STORE transaction for studies that consists of thousands of DICOM objects.

International audience; Purpose: Cognitive deficits in schizophrenia mainly affect memory, attention and executive functions. Cognitive remediation is a technique derived from neuropsychology, which aims to improve or compensate for these deficits. Working memory, verbal learning, and executive functions are crucial factors for functional outcome. Our purpose was to assess the impact of the cognitive remediation therapy (CRT) program on cognitive difficulties in patients with schizophrenia, especially on working memory, verbal memory, and cognitive flexibility. Methods: We collected data from clinical and neuropsychological assessments in 24 patients suffering from schizophrenia (Diagnostic and Statistical Manual of mental Disorders-Fourth Edition, DSM-IV) who followed a 3-month (CRT) program. Verbal and visuo-spatial working memory, verbal memory, and cognitive flexibility were assessed before and after CRT. Results: The Wilcoxon test showed significant improvements on the backward digit span, on the visual working memory span, on verbal memory and on flexibility. Cognitive improvement was substantial when baseline performance was low, independently from clinical benefit. Conclusions: CRT is effective on crucial cognitive domains and provides a huge benefit for patients having low baseline performance. Such cognitive amelioration appears highly promising for improving the outcome in cognitively impaired patients.

International audience; In Ultra High Risk (UHR) studies, intellectual functioning is commonly assessed using premorbid IQ tools as a covariate. The aim of this study was to show that the use of the Wechsler Adult Intelligence Scale (WAIS) could yield accurate neuropsychological profiling and that an alternative approach such as a multiple-case study could be a more interesting way to isolate discrete cognitive processes in the early stage of illness.The studied population consisted of 198 adolescents and young adults (16–30 y.o.) referred to our outpatient clinic. After the CAARMS' interview, we defined 3 subgroups: UHR (N = 104), First Episode (FE; N = 30), and Help-Seekers (HS; N = 64) who were neither UHR nor psychotic. Intellectual functioning was assessed by the WAIS-III (9 subtests version) and ‘heterogeneous’ intellectual profiles were defined based on the existence of a 3-point difference in scoring at subtests constitutive of the same WAIS index.While UHR did not differ from FE or HS on WAIS' scores and sub-scores, the multiple-case study indicated a higher proportion of ‘heterogeneous’ profiles in the Verbal Comprehension Index in the UHR sample than in FE and HS (p = 0.04).The disease progression could heterogeneously impact on specific domains, in patterns depending on the stage of the illness. This approach exploring intra-subject WAIS performances might be more relevant than the use of global scores in detecting the subtle cognitive alteration of emerging psychosis.

International audience; Cannabis induces a diverse range of subjective experiences including relaxation, anxiety, euphoria, sadness, cognitive difficulties and psychotic-like symptoms. In addition, although cannabis use is associated with an overall twofold increased risk of subsequent psychotic disorders, all individuals are not at equal risk of developing psychosis when exposed to cannabis. Inconsistent results have been reported regarding the influence of variants in the catechol-O-methyltransferase (COMT) gene2,3 or in other genes of interest, such as brain-derived neurotrophic factor (BDNF), cannabinoid receptor 1 (CNR1)4,5 and more convincingly, v-Akt murine thymoma viral oncogene homolog 1 (AKT1). Inter-individual variability in subjective experience is already present at initiation of cannabis use and could reflect intrinsic personal characteristics.

This paper evaluates our 3D view interpolation rendering algorithm and proposes a few performance improving techniques. We aim at developing a rendering method for free-viewpoint 3DTV, based on depth image warping from surrounding cameras. The key feature of our approach is warping texture and depth in the first stage simultaneously and postpone blending the new view to a later stage, thereby avoiding errors in the virtual depth map. We evaluate the rendering quality in two ways. Firstly, it is measured by varying the distance between the two nearest cameras. We have obtained a PSNR gain of 3 dB and 4.5 dB for the 'Breakdancers' and 'Ballet' sequences, respectively, compared to the performance of a recent algorithm. A second series of tests in measuring the rendering quality were performed using compressed video or images from surrounding cameras. The overall quality of the system is dominated by rendering quality and not by coding.

An efficient way to transmit multi-view images is to send the texture image together with a corresponding depth image. The depth image specifies the distance between each pixel and the camera. With this information, arbitrary views can be generated at the decoder. In this paper, we propose a new algorithm for the coding of depth images that provides an efficient representation of smooth regions as well as geometric features such as object contours. Our algorithm uses a segmentation procedure based on a quadtree decomposition and models the depth image content with piecewise linear functions. We achieved a bit-rate as low as 0.33 bit/pixel, without any entropy coding. The attractivity of the coding algorithm is that, by exploiting specific properties of depth images, no degradations are shown along discontinuities, which is important for perceived depth.

Introduction Hypomanic Personality Scale (HPS) is a self-report questionnaire designed to identify high risk and vulnerable subjects to bipolar disorders in non-clinical samples. Objectives To identify HPS factorial structure in a French non-clinical sample and to compare for different factors solutions described in the literature. Methods We carried out a survey within a student population with a French version of HPS. The factorial structure of HPS was tested first by a scree plot with simulation (using R “psy” library) in an Exploratory Factorial Analysis (EFA) with promax rotation. Secondly the number of factor was fixed for a Confirmatory Factorial Analysis (CFA) performed with AMOS. Results A total of 347 students (mean age 23 years, 80% of women) were included in PCA (incomplete questionnaires were not included). Scree Plot with simulation revealed a 5 factors solution which accounted for 33% of the total variance. We also tested the 3 and 4 factors solution to compare respectively with factors solution obtained by Rawling et al. (2000) and more recently by Schalet et al. (2011). Our 4 factors solution was identical to Rawling et al. (2000) but the 3 factors solution was different from Schalet et al. (2011). Goodness of fit indices showed that the 5 factors solution “fits” our data better compared to other factorial solutions. Conclusions French version of the HPS showed a factorial structure composed of 5 factors in a non-clinical student population. However, this result needs to be confirmed with a more important and representative sample.

Introduction Theory of Mind (ToM) is the ability to assign a set of mental states to yourself and others. In bipolar disorders, alteration of social relationship can be explained by the impairment of the functioning of ToM. Deficit in ToM can be a trait marker of bipolar disorder and people in general population who has high score of hypomanic personality will be more likely to develop bipolar disorders. Aims The goal of this study is to study abilities in a ToM task in general population with different level of hypomanic personality. Methods This study examines 323 participants (23.25 ±7.74 years). Measures of hypomanic personality were evaluated by the Hypomanic Personality Scale (HPS) (Eckblad & Chapman, 1986). It is a self-report scale subdivided in 3 factors: social vitality, mood vitality and excitement. ToM was explored using Yoni task (Shamay-Tsoory & Aahron-Peretz, 2007) French adaptation. This test permits to distinguish the affective and the cognitive components of ToM. Results Forward multiple regression analyses were performed to examine the effect of components of the HPS on the total score of ToM task. In women’s group, no subscales of the HPS have been included in the model. Conversely, the analyses performed on men revealed that the mood vitality subscale was a significant predictor of ToM abilities. Conclusion The ToM task’s score is linked to the hypomanic score but only in men sample and only for the Mood vitality subscale. This result supports that deficits in ToM can be a trait marker of bipolar disorder in healthy men population.

International audience; The importance of imaging biomarkers in biomedical research and drug design is well-acknowledged in the literature, calling for appropriate standards and guidelines for imaging biomarker development , validation and qualification. The objective of this work is to define explicitly, by means of an ontology, the vocabulary pertaining to imaging biomarkers.

International audience; Cognitive-Behavioural Therapy (CBT) is considered the ‘gold standard’ in the treatment of addictive disorders related to excessive technology use. However, the cognitive components of problematic internet use are not yet well-known. The aim of the present study was to explore the cognitive components, that according to problematic users, can lead to potential internet addiction. A total of 854 European adults completed an online survey using a mixed-methods design. Internet problems and attachment styles were assessed, prevalence rates estimated, correlations, chi-squared automatic interaction detection, and content analysis were performed. Self-reported addictions to social networking, internet, and gaming had a prevalence between 1.2% (gaming) to 2.7% (social networking). Self-perception of the addiction problem and preoccupied attachment style were discriminative factors for internet addiction. In an analysis of qualitative responses from self-identified compulsive internet users, a sense of not belonging and feeling of disconnection during life events were perceived as causes for internet addiction. The development depended on a cycle of mixed feelings associated with negative thoughts, compensated by a positive online identity. The severity of this behaviour pattern produced significant impairment in various areas of the participants’ functioning, suggesting a possible addiction problem. It is suggested that health professionals administering CBT should target unhealthy preoccupations and monitor mixed feelings and thoughts related to internet use to support coping with cognitive distortions.