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Dopamine D(2) receptor antagonists modulate gene transcription in the striatum. However, the molecular mechanism underlying this effect remains elusive. Here we used the expression of Nur77, a transcription factor of the orphan nuclear receptor family, as readout to explore the role of dopamine, glutamate, and adenosine receptors in the effect of a dopamine D(2) antagonist in the striatum. First, we investigated D(2) antagonist-induced Nur77 mRNA in D(2L) receptor knockout mice. Surprisingly, deletion of the D(2L) receptor isoform did not reduce eticlopride-induced upregulation of Nur77 mRNA levels in the striatum. Next, we tested if an ibotenic acid-induced cortical lesion could block the effect of eticlopride on Nur77 expression. Cortical lesions strongly reduced eticlopride-induced striatal upregulation of Nur77 mRNA. Then, we investigated if glutamatergic neurotransmission could modulate eticlopride-induced Nur77 expression. A combination of a metabotropic glutamate type 5 (mGlu5) and adenosine A(2A) receptor antagonists abolished eticlopride-induced upregulation of Nur77 mRNA levels in the striatum. Direct modulation of Nur77 expression by striatal glutamate and adenosine receptors was confirmed using corticostriatal organotypic cultures. Taken together, these results indicate that blockade of postsynaptic D(2) receptors is not sufficient to trigger striatal transcriptional activity and that interaction with corticostriatal presynaptic D(2) receptors and subsequent activation of postsynaptic glutamate and adenosine receptors in the striatum is required. Thus, these results uncover an unappreciated role of presynaptic D(2) heteroreceptors and support a prominent role of glutamate in the effect of D(2) antagonists.

Background: Cultural context substantially affects the experience and clinical expression of psychiatric diseases, while cultural factors limit both access to and effectiveness of care, especially for migrant families requiring specific types of services. We conducted a scoping review on psychiatric services adapted to cultural diversity, to compare these models of care to the French Transcultural Psychotherapy model.Methods: Systematic electronic search of databases (PubMed and PsycINFO), manual search of archives of journals dealing with transcultural psychiatry, and consultations with international experts, to identify all papers describing clinical models devoted to psychiatric care for migrants, published between January 1990 and October 2018. Narrative synthesis of the included articles.Results: The study included 29 papers. The specificities of psychiatric services for migrant families are linked to the host country's migration patterns and citizenship model. In English-speaking countries, specialized services for ethnic minorities offer ethnic matching of the therapist and patient. In Canada, indirect transcultural consultation services have existed since the late 1990s. Australia emphasizes the networking of consultation services and professional training in cultural competence, while the Nordic countries (Sweden, Finland, Norway, and Denmark) focus management on trauma. In France, psychotherapy services, with flexible numbers of therapists involved according to the situation, have existed since 1990.Discussion: Most initiatives place emphasis on training and supervision, in an indirect approach not specifically focused on the patient, or offer cultural matching of patient and therapist. The French transcultural approach, on the contrary, makes the family's culture and its cultural diversity an integral part of the therapy process.

Transcultural psychotherapy is an original therapeutic technique designed to respond to difficulties encountered in psychiatric treatment for migrants. Today, this psychotherapy is formalized and it is in use at numerous sites in France and internationally. An increasing number of professionals are seeking training in this method. We sought to explore the experiences of these trainees, at their entry in the group and during their training. This qualitative study used focus groups to interview trainees participating in a transcultural psychotherapy training group. The thematic analysis generated two domains of experience: the emotional and personal experience within the transcultural group, including the private feelings of the trainee-participants, their initial difficulties, and the changes in these feelings; and their perception of this specific type of care, that is, their perspectives on transcultural psychotherapy and its most original aspects. Based on the narratives of trainees in this program, we conclude that becoming a transcultural psychotherapist involves a process not only of cultural decentering but also of professional decentering. This decentering cannot be learned theoretically: it must be experienced, for a long enough time to become imbued with it and to allow oneself to modify one's practices. After sufficient time in the group, the trainees succeed in extricating themselves, little by little, from their ethnocentric vision of psychotherapy, and come to tolerate and then integrate new ways of doing and thinking. [ABSTRACT FROM AUTHOR]