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1. Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment in schizophrenia: results from the multicenter FACE-SZ cohort

Author

Nathan Vidal, Paul Roux, Mathieu Urbach, Cristobal Belmonte, Laurent Boyer, Delphine Capdevielle, Julie Clauss-Kobayashi, Thierry D’Amato, Romane Dassing, Caroline Dubertret, Julien Dubreucq, Guillaume Fond, Roxana-Mihaela Honciuc, Sylvain Leignier, Pierre-Michel Llorca, Jasmina Mallet, David Misdrahi, Baptiste Pignon, Romain Rey, Franck Schürhoff, Arnaud Tessier, the FACE-SZ (FondaMental Academic Centers of Expertise—Schizophrenia) Group, Christine Passerieux, Eric Brunet-Gouet, B. Aouizerate, V. Barteau, S. Bensalem, F. Berna, O. Blanc, E. Bourguignon, L. Boyer, D. CapdevielleI. Chéreau, G. Chesnoy-Servanin, T. D’Amato, A. Deloge, H. Denizot, JM. Dorey, C. Dubertret, J. Dubreucq, S. Esselin, C. Faget, C. Fluttaz, G. Fond, F. Gabayet, O. Godin, E. Haffen, RM. Honciuc, M. Jarroir, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, PM Llorca, J. Mallet, E. Metairie, D. Misdrahi, C. Passerieux, J. Petrucci, P. Peri, B. Pignon, S. Pires, C. Portalier, R. Rey, C. Roman, F. Schürhoff, K. Souryis, A. Szöke, M. Urbach, F. Vaillant, A, Vehier, P. Vidailhet, E. Vilà, G. Wahiche, H. Yazbek, and A. Zinetti-Bertschy

Subjects
neuropsychological test, schizophrenia, cholinergic antagonist, psychotropic drug, polypharmacy, Therapeutics. Pharmacology, RM1-950
Abstract

AimThe anticholinergic properties of medications are associated with poorer cognitive performance in schizophrenia. Numerous scales have been developed to assess anticholinergic burden and yet, there is no consensus indicating which anticholinergic burden scale is more relevant for patients with schizophrenia. We aimed to identify valid scales for estimating the risk of iatrogenic cognitive impairment in schizophrenia.MethodsWe identified 27 scales in a literature review. The responses to neuropsychological tests of 839 individuals with schizophrenia or schizoaffective disorder in the FACE-SZ database were collected between 2010 and 2021. We estimated the association between objective global cognitive performance and the 27 scales, the number of psychotropic drugs, and chlorpromazine and lorazepam equivalents in bivariable regressions in a cross-sectional design. We then adjusted the bivariable models with covariates: the predictors significantly associated with cognitive performance in multiple linear regressions were considered to have good concurrent validity to assess cognitive performance.ResultsEight scales, the number of psychotropic drugs, and drug equivalents were significantly associated with cognitive impairment. The number of psychotropic drugs, the most convenient predictor to compute, was associated with worse executive function (Standardized β = −0.12, p = .004) and reasoning (Standardized β = −0.08, p = .037).ConclusionAnticholinergic burden, the number of psychotropic drugs, and drug equivalents were weakly associated with cognition, thus suggesting that cognitive impairment in schizophrenia and schizoaffective disorder is explained by factors other than medication. The number of psychotropic drugs was the most parsimonious method to assess the risk of iatrogenic cognitive impairment.

Published
2024
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2. Predictors of medication adherence in a large 1-year prospective cohort of individuals with schizophrenia: insights from the multicentric FACE-SZ dataset

Author

David Misdrahi, Maud Dupuy, Yecodji Dansou, Laurent Boyer, Fabrice Berna, Delphine Capdevielle, Isabelle Chereau, Nathalie Coulon, Thierry D’Amato, Caroline Dubertret, Sylvain Leignier, Pierre Michel Llorca, Christophe Lançon, Jasmina Mallet, Christine Passerieux, Baptiste Pignon, Romain Rey, Franck Schürhoff, Joel Swendsen, Mathieu Urbach, Andrei Szöke, Ophélia Godin, Guillaume Fond, and the FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) Group

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Schizophrenia is characterized by the most salient medication adherence problems among severe mental disorders, but limited prospective data are available to predict and improve adherence in this population. This investigation aims to identify predictors of medication adherence over a 1-year period in a large national cohort using clustering analysis. Outpatients were recruited from ten Schizophrenia Expert Centers and were evaluated with a day-long standardized battery including clinician and patient-rated medication adherence measures. A two-step cluster analysis and multivariate logistic regression were conducted to identify medication adherence profiles based on the Medication Adherence rating Scale (MARS) and baseline predictors. A total of 485 participants were included in the study and medication adherence was significantly improved at the 1-year follow-up. Higher depressive scores, lower insight, history of suicide attempt, younger age and alcohol use disorder were all associated with poorer adherence at 1 year. Among the 203 patients with initially poor adherence, 86 (42%) switched to good adherence at the 1-year follow-up, whereas 117 patients (58%) remained poorly adherent. Targeting younger patients with low insight, history of suicide, alcohol use disorder and depressive disorders should be prioritized through literacy and educational therapy programs. Adherence is a construct that can vary considerably from year to year in schizophrenia, and therefore may be amenable to interventions for its improvement. However, caution is also warranted as nearly one in five patients with initially good adherence experienced worsened adherence 1 year later.

Published
2023
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3. Poverty and inequality in real-world schizophrenia: a national study

Author

Guillaume B. Fond, Dong Keon Yon, Bach Tran, Jasmina Mallet, Mathieu Urbach, Sylvain Leignier, Romain Rey, David Misdrahi, Pierre-Michel Llorca, Franck Schürhoff, Fabrice Berna, and Laurent Boyer

Subjects
schizophrenia, psychotic disorders, mental health, poverty, inequality, public health, Public aspects of medicine, RA1-1270
Abstract

BackgroundSchizophrenia has high socioeconomic impact among severe psychiatric disorders.AimsTo explore clinician-reported and patient-reported inequities between patients under the poverty threshold vs. the others.Method916 patients consecutively recruited in 10 national centers received a comprehensive standardized evaluation of illness severity, addictions and patient-reported outcomes.Results739 (80.7%) of the patients were classified in the poverty group. This group had poorer objective illness outcomes (lower positive, negative, cognitive, excitement/aggressive and self-neglect symptoms and lifetime history of planned suicide) in multivariate analyses. While they had similar access to treatments and psychotherapy, they had lower access to socially useful activities, couple’s life, housing and parenthood. They had also more disturbed metabolic parameters. On the contrary, the poverty group reported better self-esteem. No significant difference for depression, risky health behavior including addictions and sedentary behavior was found.InterpretationThe equity in access to care is attributed to the French social system. However, mental and physical health remain poorer in these patients, and they still experience poor access to social roles independently of illness severity and despite healthcare interventions. These patients may have paradoxically better self-esteem due to decreased contact with society and therefore lower stigma exposure (especially at work). Schizophrenia presents itself as a distinct impoverished population concerning health-related outcomes and social integration, warranting focus in public health initiatives and improved treatment, including tailored interventions, collaborative care models, accessible mental health services, housing support, vocational training and employment support, community integration, education and awareness, research and data collection, culturally competent approaches, and long-term support.

Published
2023
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4. Outcome prediction with a social cognitive battery: a multicenter longitudinal study

Author

Eric Brunet-Gouet, Capucine Decaix-Tisserand, Mathieu Urbach, Nadine Bazin, Bruno Aouizerate, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Caroline Dubertret, Julien Dubreucq, Guillaume Fond, Christophe Lançon, Sylvain Leignier, Jasmina Mallet, David Misdrahi, Sylvie Pires, Priscille Schneider, Franck Schurhoff, Hanan Yazbek, Anna Zinetti-Bertschy, Christine Passerieux, and Paul Roux

Subjects
Psychiatry, RC435-571
Abstract

Abstract The interest in social cognition in schizophrenia is justified by the relationship between deficits in these skills and negative functional outcomes. Although assessment batteries have already been described, there is no consensus about which measures are useful in predicting patient functioning or quality of life (QoL). We investigated a set of five measures of recognition of facial emotions, theory of mind (ToM), and empathy in a cohort of 143 patients with schizophrenia or schizoaffective disorder at inclusion and, amongst whom 79 were reassessed 1 year later. The distribution was satisfactory for the TREF (Facial Emotion Recognition Task), V-SIR (Versailles-Situational Intention Reading), and QCAE (Questionnaire of Cognitive and Affective Empathy). Internal consistency was satisfactory for the TREF, V-SIR, V-Comics (Versailles Intention Attribution Task), and QCAE. Sensitivity to change was acceptable for the TREF. The TREF and V-SIR showed a cross-sectional relationship with functioning beyond the clinical symptoms of schizophrenia but not beyond neurocognition. Moreover, the TREF and V-SIR at inclusion could not predict functioning one year later, whereas most neurocognitive and clinical dimensions at inclusion could. Finally, only affective QCAE showed a significant cross-sectional, but not longitudinal, association with QoL. In conclusion, the TREF had satisfactory psychometric properties and showed a cross-sectional, but not longitudinal, association with objective outcome measures, thus appearing to be reliable in clinical practice and research. The V-SIR also showed promising psychometric properties, despite a possible weakness to detect change. However, these measures should be interpreted within the context of the good predictive power of the neurocognitive and clinical status on the outcome.

Published
2021
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5. Attitudes towards Vaccines, Intent to Vaccinate and the Relationship with COVID-19 Vaccination Rates in Individuals with Schizophrenia

Author

Stéphane Raffard, Sophie Bayard, Margot Eisenblaetter, Jérôme Attal, Christelle Andrieu, Isabelle Chereau, Guillaume Fond, Sylvain Leignier, Jasmina Mallet, Philippe Tattard, Mathieu Urbach, David Misdrahi, Yasmine Laraki, and Delphine Capdevielle

Subjects
COVID-19, attitudes, vaccination, schizophrenia, Medicine
Abstract

Schizophrenia patients are at high risk of developing severe COVID-19 outcomes but recent evidence suggests that they are under-vaccinated. This study explored the role of potential attitudinal barriers by comparing schizophrenia patients with participants from the general population regarding COVID-19 vaccination rates, general attitudes towards vaccines, and willingness to take a COVID-19 vaccine. We conducted a cross-sectional study between April 2021 and October 2021. A total of 100 people with schizophrenia and 72 nonclinical controls were recruited. In our study, individuals with schizophrenia were under-vaccinated, despite similar general attitudes towards vaccination and higher willingness to be vaccinated against COVID-19 compared to nonclinical participants. In patients, negative attitudes toward vaccines were related to higher levels of negative psychotic symptoms and higher levels of paranoid ideation. As a whole, participants with more negative attitudes towards vaccines were less likely to be vaccinated against COVID-19 and had lower levels of trust in institutions. Vaccine hesitancy does not appear to be a major barrier for COVID-19 vaccine uptake amongst people with schizophrenia. This study suggests that disparities in COVID-19 vaccination rates in schizophrenia do not seem related to attitudinal but rather structural barriers.

Published
2022
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6. Early and very early‐onset schizophrenia compared with adult‐onset schizophrenia: French FACE‐SZ database

Author

Nathalie Coulon, Ophélia Godin, Ewa Bulzacka, Caroline Dubertret, Jasmina Mallet, Guillaume Fond, Lore Brunel, Méja Andrianarisoa, George Anderson, Isabelle Chereau, Hélène Denizot, Romain Rey, Jean‐Michel Dorey, Christophe Lançon, Catherine Faget, Paul Roux, Christine Passerieux, Julien Dubreucq, Sylvain Leignier, Delphine Capdevielle, Myrtille André, Bruno Aouizerate, David Misdrahi, Fabrice Berna, Pierre Vidailhet, Marion Leboyer, and Franck Schürhoff

Subjects
adult‐onset schizophrenia, duration of untreated psychosis, early‐onset schizophrenia, symptomatology, very early‐onset schizophrenia, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Objective To compare the clinical symptomatology in patients with Early‐Onset Schizophrenia (EOS, N = 176), especially the subgroup Very Early Onset Schizophrenia (VEOS) and Adult Onset Schizophrenia (AOS, N = 551). Method In a large French multicentric sample, 727 stable schizophrenia patients, classified by age at onset of the disorder, were assessed using standardized and extensive clinical and neuropsychological batteries: AOS with onset ≥ 18 years and EOS with onset

Published
2020
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7. Confirmation of a Two-Factor Solution to the Questionnaire of Cognitive and Affective Empathy in a French Population of Patients With Schizophrenia Spectrum Disorders

Author

Eric Brunet-Gouet, Nils Myszkowski, Mickael Ehrminger, Mathieu Urbach, Bruno Aouizerate, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Caroline Dubertret, Julien Dubreucq, Guillaume Fond, Christophe Lançon, Sylvain Leignier, Jasmina Mallet, David Misdrahi, Sylvie Pires, Priscille Schneider, Franck Schurhoff, Hanan Yazbek, Anna Zinetti-Bertschy, Nadine Bazin, Christine Passerieux, Franck Zenasni, and Paul Roux

Subjects
schizophrenia spectrum, empathy, assessment method, quality of life, functioning, Psychiatry, RC435-571
Abstract

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a tool for self-assessing the cognitive and emotional components of empathy. A study showed that a two-factor model fits the data of patients with schizophrenia, whereas other reports on healthy subjects have suggested a five-factor decomposition. We aimed to replicate the model of Horan et al. in a French population with schizophrenia spectrum disorders (i.e., schizophrenia and schizoaffective disorders) participating in the EVACO Study (NCT02901015). In total, 133 patients were assessed with the QCAE, the Positive and Negative Symptom Scale (PANSS), the Personal and Social Performance Scale (PSP), and the Self rating Quality of Life Scale (S-QoL). The two-factor model demonstrated an adequate fit with the data, comparable to that reported by Horan et al. Males scored higher on the Affective subscore than females. After correction for multiple tests, psychopathology (PANSS) and functioning (PSP) did not correlate significantly with the QCAE subscores. However, quality of life (S-QoL) correlated positively with the Emotional Contagion subscore. Thus, the variability of empathetic disposition in schizophrenia may be considered through the cognitive versus affective dichotomy and properly investigated with the QCAE. The results support further investigation of the relationship between QCAE scores and subjective outcome measurements, such as quality of life, and emphasize the importance of cross-cultural comparisons.

Published
2019
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8. Gender differences in psychosocial function and self-reported health status in late-diagnosed autistic adults: results from the FACE-ASD national cohort

Author

Julien, Dubreucq, Romain, Coutelle, Mohamed, Lajnef, Ophélia, Godin, Anouck, Amestoy, Paola, Atzori, Jean-Marc, Baleyte, Olivier, Bonnot, Manuel, Bouvard, Nathalie, Coulon, David, Da Fonseca, Caroline, Demily, Richard, Delorme, Marine, Fabrowski, Marion, Givaudan, Fanny, Gollier-Briant, Fabian, Guenolé, Elise, Humeau, Sylvain, Leignier, Florian, Lejuste, Charlotte, Levy, Juliette, Rabot, Carmen M, Schröder, Marie, Valette, Marion, Leboyer, and Mario, Speranza

Subjects
Psychiatry and Mental health, Applied Psychology
Abstract

Background While adult outcome in autism spectrum disorder (ASD) is generally measured using socially valued roles, it could also be understood in terms of aspects related to health status – an approach that could inform on potential gender differences. Methods We investigated gender differences in two aspects of outcome related to health-status, i.e. general functioning and self-perceived health status, and co-occurring health conditions in a large multi-center sample of autistic adults. Three hundred and eighty-three participants were consecutively recruited from the FondaMental Advanced Centers of Expertise for ASD cohort (a French network of seven expert centers) between 2013 and 2020. Evaluation included a medical interview, standardized scales for autism diagnosis, clinical and functional outcomes, self-perceived health status and verbal ability. Psychosocial function was measured using the Global Assessment of Functioning scale. Results While autistic women in this study were more likely than men to have socially valued roles, female gender was associated with poorer physical and mental health (e.g. a 7-fold risk for having three or more co-occurring physical health conditions) and a poorer self-perceived health status. Psychosocial function was negatively associated with depression and impairment in social communication. Half of the sample had multiple co-occurring health conditions but more than 70% reported that their visit at the Expert Center was their first contact with mental health services. Conclusions To improve objective and subjective aspects of health outcome, gender differences and a wide range of co-occurring health conditions should be taken into account when designing healthcare provision for autistic adults.

Published
2022
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9. Predictors of medication adherence in a large one-year prospective cohort of individuals with schizophrenia: Insights from the Multicentric FACE-SZ Dataset

Author

david misdrahi, Maud Dupuy, Yecodji Dansou, Laurent Boyer, Fabrice Berna, Delphine Capdevieille, Isabelle Chereau, Natahlie Coulon, Thierry d'Amato, Caroline Dubertret, Sylvain Leignier, Pierre Michel Llorca, Chritophe Lançon, Jasmina MALLET, Chrisitine Passerieux, Baptiste Pignon, Romain REY, Franck Schurhoff, Joel Swendsen, Mathieu Urbach, Andrei Szoke, Ophelia Godin, and Guillaume FOND

Abstract

Schizophrenia is characterized by the most salient medication adherence problems among severe mental disorders, but limited prospective data are available to predict and improve adherence in this population. This investigation aims to identify predictors of medication adherence over a one-year period in a large national cohort using clustering analysis. Outpatients were recruited from ten Schizophrenia Expert Centers and were evaluated with a day-long standardized battery including clinician and patient-rated medication adherence measures. A two-step cluster analysis and multivariate logistic regression were conducted to identify medication adherence profiles based on the Medication Adherence rating Scale (MARS) and baseline predictors. A total of 485 participants were included in the study and medication adherence was significantly improved at the one-year follow-up. Higher depressive scores, lower insight, history of suicide attempt, younger age and alcohol use disorder were all associated with poorer adherence at one year. Among the 203 patients with initially poor adherence, 86 (42%) switched to good adherence at the one-year follow-up, whereas 117 patients (58%) remained poorly adherent. Targeting younger patients with low insight, history of suicide, alcohol use disorder and depressive disorders should be prioritized through literacy and educational therapy programs. Adherence is a construct that can vary considerably from year to year in schizophrenia, and therefore may be amenable to interventions for its improvement. However, caution is also warranted as nearly one in five patients with initially good adherence experienced worsened adherence one year later.

Published
2023
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10. Clinical and pharmacological correlates of caffeine consumption in subjects with schizophrenia – Data from the FACE-SZ cohort

Author

Andrei Szoke, Jean-Romain Richard, Guillaume Fond, David Misdrahi, Mohamed Lajnef, Bruno Aouizerate, Laurent Boyer, Fabrice Berna, Delphine Capdevielle, Myrtille André, Isabelle Chereau, Julie Clauss-Kobayashi, Nathalie Coulon, Caroline Dubertret, Sylvain Leignier, Pierre Michel Llorca, Jasmina Mallet, Christine Passerieux, Romain Rey, Benoit Schorr, Mathieu Urbach, Marion Leboyer, Baptiste Pignon, Franck Schürhoff, M. Andre, C. Andrieu-Haller, B. Aouizerate, F. Berna, O. Blanc, E. Bourguignon, D. Capdevielle, I. Chereau-Boudet, J. Clauss-Kobayashi, N. Coulon, R. Dassing, J.M. Dorey, C. Dubertret, A. Esselin, G. Fond, F. Gabayet, M. Jarroir, D. Lacelle, M. Leboyer, S. Leignier, P.M. Llorca, J. Mallet, E. Metairie, T. Michel, D. Misdrahi, C. Passerieux, J. Petrucci, B. Pignon, P. Peri, C. Portalier, R. Rey, C. Roman, B. Schorr, F. Schürhoff, A. Szoke, A. Tessier, M. Urbach, G. Wachiche, A. Zinetti-Bertschy, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Fondation FondaMental [Créteil], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier Charles Perrens [Bordeaux], Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Grenoble, Université Paris Cité (UPCité), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)

Subjects
Psychiatry and Mental health, Caffeine, Sedation, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Schizophrenia, Negative dimension, Biological Psychiatry
Abstract

International audience; Caffeine is the most consumed psychoactive substance worldwide. Previous studies suggested higher caffeine consumption in subjects with schizophrenia spectrum disorders (SSD) as well as associations with symptoms, medication and medication side-effects. In a large and well-characterized sample of SSD subjects we explored the association between caffeine consumption and clinical (psychosis related, severity, general health) as well as pharmacological (antipsychotic treatment, sedation potential) variables. Eight hundred four subjects with data on their caffeine (coffee and tea) consumption successively recruited were included in this study. After controlling for potential confounders (demographic variables, smoking) only the negative dimension of psychosis was associated with the amount of caffeine ingested. Less severe negative symptoms were associated with higher caffeine consumption. The effect size of this association was small (partial correlation coefficient = −0.12) but significant.

Published
2023
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11. History of learning disorders is associated with worse cognitive and functional outcomes in schizophrenia: results from the multicentric FACE-SZ cross-sectional dataset

Author

Clément Dondé, Caroline Dubertret, Guillaume Fond, Myrtille Andre, Fabrice Berna, Laurent Boyer, Delphine Capdevielle, Isabelle Chereau, Nathalie Coulon, Jean-Michel Dorey, Sylvain Leignier, Pierre-Michel Llorca, David Misdrahi, Christine Passerieux, Baptiste Pignon, Romain Rey, Benoît Schorr, Franck Schürhoff, Mathieu Urbach, Mircea Polosan, and Jasmina Mallet

Subjects
Psychiatry and Mental health, Pharmacology (medical), General Medicine, Biological Psychiatry
Abstract

Schizophrenia is associated with early neurodevelopmental disorders, including most frequently learning disorders (LD), among them dyslexia and dyspraxia. Despite the demonstrated links between schizophrenia and LD, specific clinical patterns of the schizophrenia with a history of LD subgroup remain unknown. The aim of the present study was to investigate cognitive impairment, symptoms and functional outcome associated with a history of LD in a large cross-sectional, multicentric, sample of schizophrenia subjects. 492 community-dwelling subjects with schizophrenia (75.6% male, mean age 30.8 years) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. The 51 (10.4%) subjects identified with a history of LD had significantly impaired general cognitive ability (Wechsler Adult Intelligence Scale Full Scale Total IQ: Cohen's d = 0.50, p = 0.001), processing speed (d = 0.19), verbal comprehension (d = 0.29), working memory (d = 0.31), cognitive inhibition and flexibility (d = 0.26), central executive functioning (d = 0.26), phonemic verbal fluency (d = 0.22) and premorbid intellectual ability (d = 0.48), as well as with a worse functional outcome (Global Assessment of Functioning, d = 0.21), independently of age, sex, education level, symptoms, treatments, and addiction comorbidities. These results indicate that a history of LD is associated with later cognitive impairment and functional outcome in schizophrenia. This suggests that history of LD is a relevant clinical marker to discriminate subgroups of patients with schizophrenia with different profiles in a precision psychiatry framework.

Published
2022

12. Outcome prediction with a social cognitive battery: a multicenter longitudinal study

Author

Mathieu Urbach, Eric Brunet-Gouet, Caroline Dubertret, Christophe Lançon, David Misdrahi, Capucine Decaix-Tisserand, A. Zinetti-Bertschy, Sylvain Leignier, Paul Roux, Franck Schürhoff, Isabelle Chereau, Lore Brunel, Priscille Schneider, Delphine Capdevielle, Bruno Aouizerate, Nadine Bazin, Julien Dubreucq, Jasmina Mallet, Hanan Yazbek, Christine Passerieux, Sylvie Pires, Guillaume Fond, Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Fondation FondaMental, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, ANR-11-IDEX-0004,SUPER,Sorbonne Universités à Paris pour l'Enseignement et la Recherche(2011), and ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010)

Subjects
Psychiatry, Longitudinal study, media_common.quotation_subject, RC435-571, Cognition, Schizoaffective disorder, Context (language use), Empathy, medicine.disease, Article, 030227 psychiatry, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Social cognition, Schizophrenia, Human behaviour, medicine, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Psychology, Neurocognitive, 030217 neurology & neurosurgery, media_common, Clinical psychology
Abstract

The interest in social cognition in schizophrenia is justified by the relationship between deficits in these skills and negative functional outcomes. Although assessment batteries have already been described, there is no consensus about which measures are useful in predicting patient functioning or quality of life (QoL). We investigated a set of five measures of recognition of facial emotions, theory of mind (ToM), and empathy in a cohort of 143 patients with schizophrenia or schizoaffective disorder at inclusion and, amongst whom 79 were reassessed 1 year later. The distribution was satisfactory for the TREF (Facial Emotion Recognition Task), V-SIR (Versailles-Situational Intention Reading), and QCAE (Questionnaire of Cognitive and Affective Empathy). Internal consistency was satisfactory for the TREF, V-SIR, V-Comics (Versailles Intention Attribution Task), and QCAE. Sensitivity to change was acceptable for the TREF. The TREF and V-SIR showed a cross-sectional relationship with functioning beyond the clinical symptoms of schizophrenia but not beyond neurocognition. Moreover, the TREF and V-SIR at inclusion could not predict functioning one year later, whereas most neurocognitive and clinical dimensions at inclusion could. Finally, only affective QCAE showed a significant cross-sectional, but not longitudinal, association with QoL. In conclusion, the TREF had satisfactory psychometric properties and showed a cross-sectional, but not longitudinal, association with objective outcome measures, thus appearing to be reliable in clinical practice and research. The V-SIR also showed promising psychometric properties, despite a possible weakness to detect change. However, these measures should be interpreted within the context of the good predictive power of the neurocognitive and clinical status on the outcome.

Published
2021
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13. Relationship between neurocognition and theory of mind as a function of symptomatic profile in schizophrenia: results from the national FACE-SZ cohort

Author

Sébastien, Rambeau, Sarah, Del Goleto, Baptiste, Pignon, Mohamed, Lajnef, Jean, Petrucci, Andreï, Szöke, Guillaume, Fond, Christophe, Lançon, Jean-Michel, Dorey, Romain, Rey, Amandine, Garbisson, Delphine, Capdevielle, Sylvain, Leignier, Julien, Dubreucq, Jasmina, Mallet, Caroline, Dubertret, Mathieu, Urbach, Eric, Brunet-Gouet, Bruno, Aouizerate, David, Misdrahi, Anna, Zinetti-Bertschy, Julie, Clauss, Pierre-Michel, Llorca, Isabelle, Chereau, Marion, Leboyer, Paul, Roux, Franck, Schürhoff, Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Centre hospitalier Charles Perrens [Bordeaux], Nutrition et Neurobiologie intégrée (NutriNeuro), and Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Adult, Cohort Studies, Disorganisation symptoms, Theory of mind, Schizophrenia, Humans, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Neuropsychological Tests, Positive symptoms, Neurocognition, Problem Solving
Abstract

International audience; Introduction: Deficits in theory of mind (ToM) can vary depending on the predominant schizophrenia symptoms, and though most neurocognitive functions are involved in ToM, all may not be associated with the same symptoms. With consideration to the relationships between symptoms, neurocognition and ToM, the aim of the present study is to identify the neurocognitive functions influencing ToM capacities according to symptomatic profile. Methods: The study is based on a sample of 124 adults with schizophrenia from a French national cohort. Patients were divided into two groups according to their scores on the five Wallwork factors of the Positive and Negative Syndrome Scale using hierarchical clustering before carrying out multivariable analyses. Results: The “disorganised group” (n = 89) showed high scores on the disorganised factor, and had a ToM associated with reasoning, visual recognition and speed of processing. The “positive group” (n = 35) showed high scores on the positive and depressive factors, and had a ToM associated with working memory. Conclusions: These results suggest that neurocognitive predictors of ToM in schizophrenia are different according to the predominant clinical dimension, thus refining our knowledge of the relationship between symptoms, neurocognition and ToM, and acknowledging their status as important predictors of patients’ functional status. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Published
2021
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14. Recommendations of the schizophrenia expert center network for the screening prevention and treatment of sleep disorders based on the results from the real-world schizophrenia FACE-SZ national cohort

Author

Christine Passerieux, Raphaëlle Richieri, Romain Rey, Fabrice Berna, Isabelle Chereau, Ophélia Godin, Thierry d'Amato, P.-M. Llorca, Mathieu Urbach, Delphine Capdevielle, Caroline Dubertret, L. Boyer, Damien Etchecopar-Etchart, C. Lançon, Baptiste Pignon, Jasmina Mallet, Bruno Aouizerate, David Misdrahi, Sylvain Leignier, Marion Leboyer, Julien Dubreucq, P.L. Sunhary de Verville, Guillaume Fond, Pierre Vidailhet, F. Schürhoff, Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Fondation FondaMental, Agence Nationale de la Recherche, ANR-11-IDEX-0004,SUPER,Sorbonne Universités à Paris pour l'Enseignement et la Recherche(2011), and ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010)

Subjects
Adult, Male, Sleep Wake Disorders, medicine.medical_specialty, Psychosis, Major depressive disorder, Akathisia, Cohort Studies, Pittsburgh Sleep Quality Index, 03 medical and health sciences, 0302 clinical medicine, PSQI, Surveys and Questionnaires, medicine, Brief Psychiatric Rating Scale, Humans, Mass Screening, Major depressive episode, Psychiatry, Expert Testimony, Biological Psychiatry, Migraine, 2. Zero hunger, Pharmacology, Depressive Disorder, Major, Positive and Negative Syndrome Scale, business.industry, Sleep disorders, medicine.disease, 030227 psychiatry, 3. Good health, FACE-SZ, Barnes Akathisia Scale, Sleep Quality, Psychotic Disorders, Schizophrenia, Female, Schizophrenic Psychology, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], medicine.symptom, business
Abstract

Background: Sleep disorders associated factors are under explored in schizophrenia while the literature suggests high and heterogeneous frequency. Aims: The objective of the present study was to determine the prevalence and risk factors of sleep disorders in the real-world FACE-SZ national cohort. Method: Stabilized schizophrenic outpatients were recruited in 10 expert centers for schizophrenia. Sleep quality was explored with the Pittsburgh Sleep Quality Index (PSQI) and sleep disorders was defined by a PSQI score > 5. Psychosis severity was measured with the Positive and Negative Syndrome Scale, current major depressive episode with the Calgary Depression Scale for Schizophrenia, verbal aggressiveness with the Buss-Perry Aggression Questionnaire, adherence to treatment with the Medication Adherence Rating Scale, akathisia with the Barnes Akathisia Scale. Current somatic comorbidities and body mass index were reported. Variables with P values

Published
2021
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15. Immune Signatures of Treatment-Resistant Schizophrenia: A FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) Study

Author

Guillaume Fond, Philippe Le Corvoisier, F Schürhoff, A Szöke, Face-Sz Groups, I Offerlin-Meyer, Ryad Tamouza, T D′Amato, I Chéreau, J Dubreucq, E Vilà, F Gabayet, Julien Dubreucq, C Fluttaz, Wahid Boukouaci, D Misdrahi, P Vidailhet, David Misdrahi, J Mallet, B Pignon, Caroline Barau, A Vehier, C Lançon, Myrtille André, Jasmina Mallet, Baptiste Pignon, H Yazbek, Julie Clauss-Kobayashi, Christine Passerieux, J M Dorey, Caroline Dubertret, Sylvain Leignier, K Souryis, P Peri, Isabelle Chereau, F Berna, O Blanc, G Chesnoy-Servanin, S Pires, D Lacelle, A Deloge, Franck Schürhoff, Hakim Laouamri, P M Llorca, O Godin, Bruno Aouizerate, C. Portalier, Pierre-Michel Llorca, R Rey, A Zinetti-Bertschy, H Denizot, Mathieu Urbach, M Jarroir, V Barteau, C Roman, B Aouizerate, C Passerieux, S Esselin, R M Honciuc, C Dubertret, Christophe Lançon, H. Laouamri, F Vaillant, Andrei Szöke, E Metairie, Marion Leboyer, Ching-lieng Lu, M Urbach, Fabrice Berna, C Faget, Romain Rey, Ophélia Godin, E Haffen, M Leboyer, D Capdevielle, Delphine Capdevielle, Thierry D′Amato, S Bensalem, and Emilie Terro

Subjects
profile, medicine.medical_specialty, AcademicSubjects/MED00800, clozapine, Positive and Negative Syndrome Scale, immuno-inflammatory, Schizophrenia (object-oriented programming), treatment-resistant, 030227 psychiatry, schizophrenia, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Immune system, signatures, medicine, Treatment resistant schizophrenia, Psychology, Psychiatry, 030217 neurology & neurosurgery, Clozapine, Regular Articles, medicine.drug
Abstract

Treatment-resistant schizophrenia (TRS) affects around 30% of patients with schizophrenia (SZ) resulting in poor functioning, relapses, and reduced quality of life. Convergent findings show that inflammation could contribute to resistance. We thus search for immune signatures of patients with TRS/ultra TRS (UTRS) in a sample of community-dwelling outpatients with SZ. In total, 195 stabilized SZ patients (mean age = 31.2 years, 73% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. At inclusion, psychotic symptomatology was evaluated by the Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Circulating serum/plasma levels of a large panel of markers reflecting the main inflammatory pathways were evaluated. TRS was defined by current treatment by clozapine (CLZ) and UTRS by current CLZ treatment + PANSS total score ≥ 70. The frequency of TRS and UTRS patients was, respectively, 20% and 7.7% and was defined using multivariable analysis elevated by high levels of interleukin (IL)-12/IL-23p40, IL-17A, IL-10, and beta 2 microglobulin (B2M) and IL-12/IL-23p40, IL-17A, IL-6, IL-10, IFNγ, and B2M, respectively. These observations suggest that resistance and ultra resistance to CLZ treatment are underpinned by pro-inflammatory molecules mainly belonging to the T helper 17 pathway, a finding making sense given the interplay between inflammation and antipsychotic treatment responses. If confirmed, our findings may allow us to consider IL-23/IL-17 pathway as a therapeutic target for patients with resistance to antipsychotics.

Published
2021
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16. Major depression, sleep, hostility and body mass index are associated with impaired quality of life in schizophrenia. Results from the FACE-SZ cohort

Author

Baptiste Pignon, Myrtille André, L. Boyer, C. Lançon, Delphine Capdevielle, Caroline Dubertret, T Korchia, David Misdrahi, P.L. Sunhary de Verville, Sylvain Leignier, Fabrice Berna, Jasmina Mallet, Mathieu Urbach, Guillaume Fond, Thierry d'Amato, Pierre-Michel Llorca, Pierre Vidailhet, Christine Passerieux, F. Schürhoff, Bruno Aouizerate, Julien Dubreucq, Isabelle Chereau, Andrei Szöke, Romain Rey, Ophélia Godin, Marion Leboyer, Fondation FondaMental [Créteil], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Les Hôpitaux Universitaires de Strasbourg (HUS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), SECOP - centre hospitalier Charles Perrens, Université de Bordeaux (UB), Nutrition et Neurobiologie intégrée (NutriNeuro), Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre de recherche en neurosciences de Lyon (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), epartment of Addictology, Ramsay- General de Santé, SSR Petit Colmoulins, Harfleur, France, University Hospital Cochin (site Tarnier), University Sorbonne Paris-Cité (Paris V), Faculty of Medicine Paris Descartes, INSERM U894, Centre Psychiatry and Neurosciences, Paris, France. Electronic address: sandrine.lamy74@gmail.com., Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, Centre Hospitalier Charles PERRENS, Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), ANR-10-COHO-10-01 Assistance Publique - Hôpitaux de Paris, AP-HP Institut National de la Santé et de la Recherche Médicale, Inserm, This work was funded by AP-HM (Assistance Publique des Hôpitaux de Marseille), Fondation FondaMental (RTRS Santé Mentale), by the Investissements d'Avenir program managed by the ANR under reference ANR-11-IDEX-0004-02 and ANR-10-COHO-10-01 , and by INSERM (Institut National de la Santé et de la Recherche Médicale)., ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Perrens, Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Psychiatrie et Neurosciences (U894), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), and Centre hospitalier Charles Perrens [Bordeaux]

Subjects
Male, Global Assessment of Functioning, Hostility, Body Mass Index, Pittsburgh Sleep Quality Index, 03 medical and health sciences, 0302 clinical medicine, Quality of life, medicine, Major depression, Humans, Psychiatry, 2. Zero hunger, Depressive Disorder, Major, Positive and Negative Syndrome Scale, business.industry, Depression, Sleep quality, Weight, medicine.disease, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Clinical Psychology, Mood, Schizophrenia, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Quality of Life, Female, medicine.symptom, business, Sleep, Body mass index, 030217 neurology & neurosurgery, Clinical psychology
Abstract

International audience; Background: Impaired Quality of life (QoL) in schizophrenia has been mostly associated with psychotic and mood symptomatology, insight and functioning so far. Aims: QoL levels remain unsatisfactory due to other factors we aim to explore. Method: We have explored sleep quality with the Pittsburgh Sleep Quality Index, hostility with the Buss&Perry questionnaire, major depression with the Positive and Negative Syndrome Scale depressive factor, functioning with the Global Assessment of Functioning scale and weight gain with body mass index in addition to other classical QoL-associated factors. Results: 559 patients (mean age=31 (SD 9) years, 74% male sex) were included in the national FACE-SZ cohort. Impaired QoL has been significantly associated with respectively major depression, impaired sleep quality, increased hostility, impaired functioning and impaired insight independently of age, sex, treatments, tobacco smoking and body mass index. Major depression was associated with impaired psychological and physical well-being, and impaired self-esteem. Impaired sleep quality has been associated with impaired psychological and physical well-being and sentimental life. Hostility has been associated with impaired psychological well-being and self-esteem, impaired friends’ relationships and impaired autonomy. Weight was associated with impaired physical well-being. Tobacco smoking was associated with higher level of friends’ relationships. Conclusions: Major depression, sleep, hostility, and weight gain have been identified as potential targets to improve QoL in schizophrenia and should be implemented in the recommendations for good practice to optimize schizophrenia care.

Published
2020
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17. Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire

Author

Nadine Bazin, David Misdrahi, Sylvain Leignier, Mathieu Urbach, Priscille Schneider, Christophe Lançon, Guillaume Fond, Bruno Aouizerate, Hanan Yazbek, Julien Dubreucq, Eric Brunet-Gouet, Delphine Capdevielle, Paul Roux, A. Zinetti-Bertschy, Verónica Juárez Ramos, Jasmina Mallet, Sylvie Pires, Caroline Dubertret, Isabelle Chereau, Mickael Ehrminger, Lore Brunel, Christine Passerieux, Franck Schürhoff, Fondation FondaMental [Créteil], Centre Hospitalier de Versailles André Mignot (CHV), Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Centre hospitalier Charles Perrens [Bordeaux], Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), IMRB - 'Biologie du système neuromusculaire' [Créteil] (U955 Inserm - UPEC), École nationale vétérinaire - Alfort (ENVA)-Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital de la Colombière, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Louis Mourier Hospital, Centre de Psychiatrie et Neurosciences (U894), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), Université Paris Cité (UPCité), Université Clermont Auvergne (UCA), CHU Strasbourg, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, IMRB - 'Neuropsychiatrie translationnelle' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Département de neurosciences (CHU Henri Mondor), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Hôpital Charles Perrens, Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Cité - UFR Médecine [Santé] (UPCité UFR Médecine), École nationale vétérinaire d'Alfort (ENVA)-Institut Mondor de Recherche Biomédicale (IMRB), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg-Université de Strasbourg (UNISTRA)

Subjects
Adult, Male, Psychometrics, Schizophrenia (object-oriented programming), Metacognition, Physical Therapy, Sports Therapy and Rehabilitation, Assessment, Help-seeking, MESH: Adult, Aged, Case-Control Studies, Factor Analysis, Statistical, Female, France, Help-Seeking Behavior, Humans, Longitudinal Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Surveys and Questionnaires, Psychometry, MESH: Male, Middle Aged, Reproducibility of Results, Schizophrenic Psychology, Rehabilitation, 030227 psychiatry, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Schizophrenia, Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Objectives: The aim of this study is to design a questionnaire, the Versailles Metacognitive Strategies Evaluation Questionnaire, for assessing the use of metacognitive and help-seeking strategies in three key-domains of impaired daily functioning in schizophrenia. To evaluate its psychometric properties (internal consistency, factor structure, convergent and divergent validity, and stability). Design: Development of a questionnaire and psychometric validation procedure in patients with schizophrenia compared with healthy controls. Stability over one year was assessed in the patient group. Setting: Schizophrenia Centers of Expertise (French FondaMental Network). Subjects: A total of 141 patients with schizophrenia, among whom 77 participated in the second evaluation; 97 healthy subjects. Main measures: The Versailles Metacognitive Strategies Evaluation Questionnaire, Positive and Negative Symptoms Scale, Personal and Social Performance Scale, Evaluation of Cognitive Processes involved in Disability in Schizophrenia Scale, Schizophrenia Quality of Life Questionnaire, and Stages of Recovery Instrument. Results: From the 36-items version, stepwise exploratory factor analysis (oblimin) produced a 25-items scale which had a 3-factors structure (hygiene concern, social relationships, and hygiene help-seeking). Cronbach’s were respectively equal to 0.91, 0.82, and 0.78. One-year stability was good (intra-class correlation coefficient = 0.7). The three factors showed good convergent validity with measures of quality of life (rho = 0.34, P ⩽ 0.001). The first two factors correlated with recovery ( N = 34, rho = 0.53, P ⩽ 0.001). On the contrary, the factors exhibited divergent validity, with no significant correlation, with symptoms and cognitive and psychosocial functioning ( P > 0.05). Factor structure in healthy controls did not match with that of patients, all items but one were found significantly different among groups. Conclusion: The Versailles Metacognitive Strategies Evaluation Questionnaire provides a simple and valid means to assess metacognitive strategies in individuals with schizophrenia.

Published
2020
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18. Early and very early‐onset schizophrenia compared with adult‐onset schizophrenia: French FACE‐SZ database

Author

Romain Rey, Ophélia Godin, Pierre Vidailhet, Jasmina Mallet, Hélène Denizot, Christophe Lançon, Myrtille André, Isabelle Chereau, E. Bulzacka, Paul Roux, Marion Leboyer, Lore Brunel, Catherine Faget, N Coulon, David Misdrahi, George M. Anderson, Sylvain Leignier, Franck Schürhoff, Guillaume Fond, Fabrice Berna, Caroline Dubertret, Jean-Michel Dorey, Delphine Capdevielle, Christine Passerieux, Bruno Aouizerate, Julien Dubreucq, M. Andrianarisoa, Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Pierre et Marie Curie - Paris 6 (UPMC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Fondation FondaMental [Créteil], Aix Marseille Université (AMU), Assistance Publique - Hôpitaux de Marseille (APHM), CRC Scotland & London, Service de psychiatrie, CHU Clermont-Ferrand, Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Pôle de psychiatrie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-CHU Marseille, Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Laboratoire de sciences cognitives et psycholinguistique (LSCP), Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre de recherche en neurosciences de Lyon (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), École normale supérieure - Paris (ENS Paris), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris)

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Databases, Factual, Untreated psychosis, 050105 experimental psychology, early‐onset schizophrenia, lcsh:RC321-571, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, very early‐onset schizophrenia, medicine, Humans, 0501 psychology and cognitive sciences, In patient, Age of Onset, Child, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Original Research, Psychiatric Status Rating Scales, Early onset schizophrenia, business.industry, 05 social sciences, Neuropsychology, medicine.disease, Prognosis, Very early onset, 3. Good health, Psychotic Disorders, Schizophrenia, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, symptomatology, dup, Female, Schizophrenic Psychology, France, business, duration of untreated psychosis, 030217 neurology & neurosurgery, adult‐onset schizophrenia
Abstract

Objective To compare the clinical symptomatology in patients with Early‐Onset Schizophrenia (EOS, N = 176), especially the subgroup Very Early Onset Schizophrenia (VEOS) and Adult Onset Schizophrenia (AOS, N = 551). Method In a large French multicentric sample, 727 stable schizophrenia patients, classified by age at onset of the disorder, were assessed using standardized and extensive clinical and neuropsychological batteries: AOS with onset ≥ 18 years and EOS with onset, To describe schizophrenia from childhood to adulthood is complex and patients with early‐onset schizophrenia (EOS) remain undiagnosed or misclassified, especially the subgroup with very early‐onset schizophrenia (VEOS). In patients with VEOS, the DUP which exceeds 8 years, almost eight times higher than in patients with AOS, objective the problem of early diagnosis and the need to develop diagnostic programs and management cares.

Published
2020
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19. Sexual dysfunctions are associated with major depression, chronic inflammation and anticholinergic consumption in the real-world schizophrenia FACE-SZ national cohort

Author

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

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

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

Published
2019

20. Inflammatory DEpression Advances in Schizophrenia (IDEAS): A precision medicine approach of the national FACE-SZ cohort

Author

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

Subjects
Adult, Male, medicine.medical_specialty, Biological correlates, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Prevalence, Humans, Precision Medicine, Depression (differential diagnoses), Adiposity, Inflammation, Depressive Disorder, Major, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, business.industry, Depression, [SCCO.NEUR]Cognitive science/Neuroscience, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, Cognition, Middle Aged, medicine.disease, Precision medicine, Antidepressive Agents, 3. Good health, 030227 psychiatry, Psychiatry and Mental health, Clinical Psychology, Treatment Outcome, Schizophrenia, Cohort, Major depressive disorder, Antidepressant, Female, Schizophrenic Psychology, business, Toxoplasma, 030217 neurology & neurosurgery
Abstract

International audience; Background Major Depressive Disorder (MDD) is a therapeutic challenge in schizophrenia (SZ). Untangling different forms of MDD appears as the best current strategy to improve remission to treatment in the so-called precision medicine approach. Aims The objectives of the present study were to determine (i) the prevalence of Inflammatory Depression (ID) in stabilized SZ outpatients (ii) if ID was associated with clinical or cognitive profiles that may help clinicians detecting ID (iii) if antidepressants were effective in ID and (iv) the biological correlates of ID that may orientate personalized treatments.. Method Participants were consecutively included and received a thorough 2 days- clinical assessment. Results 785 subjects were recruited in the FACE-SZ cohort. 289 (36.8%) were diagnosed with MDD (remitted or unremitted), of them 57 with ID (19.7%). No clinical or cognitive features were associated with ID (all p > 0.05). ID has been associated with increased abdominal perimeter (aOR = 4.48, p = 0.002) and latent Toxoplasma infection (aOR = 2.19, p = 0.04). While antidepressants were associated with decreased depressive symptoms level in ID, 44% of the subjects remained unremitted under antidepressant, with no association with CRP blood levels. Conclusions ID may not differ from other forms of depression by its clinical symptoms but by its aetiologies. ID is associated with increased perivisceral fat and latent Toxoplasma infection that are both potentially related to gut/microbiota disturbances. Specific anti-inflammatory drugs and microbiota-targeted therapeutics appear as promising strategies in the treatment of inflammatory depression in schizophrenia.

Published
2019
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21. Relationship between childhood trauma and level of insight in schizophrenia: A path-analysis in the national FACE-SZ dataset

Author

Baptiste Pignon, Mohamed Lajnef, Ophélia Godin, Marie-Maud Geoffray, Romain Rey, Jasmina Mallet, Caroline Dubertret, Paul Roux, Christine Passerieux, Laurent Marulaz, Lore Brunel, Julien Dubreucq, Sylvain Leignier, Delphine Capdevielle, Myrtille André, Bruno Aouizerate, David Misdrahi, Fabrice Berna, Pierre Vidailhet, Isabelle Chereau, Pierre-Michel Llorca, Guillaume Fond, Christophe Lançon, Marion Leboyer, Franck Schürhoff, M.D. Andrianarisoa, B. Aouizerate, F. Berna, O. Blanc, L. Brunel, E. Bulzacka, D. Capdevielle, I. Chereau-Boudet, G. Chesnoy-Servanin, Jm Danion, T. D'Amato, A. Deloge, C. Delorme, H. Denizot, J.M. Dorey, C. Dubertret, J. Dubreucq, C. Faget, C. Fluttaz, G. Fond, S. Fonteneau, F. Gabayet, E. Giraud-Baro, M.C. Hardy-Bayle, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, T. Le Gloahec, Y. Le Strat, P.M. Llorca, J. Mallet, E. Metairie, D. Misdrahi, I. Offerlin-Meyer, C. Passerieux, P. Peri, S. Pires, C. Portalier, R. Rey, C. Roman, M. Sebilleau, A. Schandrin, F. Schurhoff, A. Tessier, Am Tronche, M. Urbach, F. Vaillant, A. Vehier, P. Vidailhet, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Pôle de Psychiatrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital H. Mondor - A. Chenevier, Service de psychiatrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Université Pierre et Marie Curie - Paris 6 (UPMC), Laboratoire de sciences cognitives et psycholinguistique (LSCP), Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Clermont-Ferrand, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Fondation FondaMental [Créteil], Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I (UdA), Centre Hospitalier le Vinatier [Bron], Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT), Mécanique des Fluides, Energies et Environnement (EDF R&D MFEE), EDF R&D (EDF R&D), EDF (EDF)-EDF (EDF), Aix Marseille Université (AMU), Assistance Publique - Hôpitaux de Marseille (APHM), Pôle de psychiatrie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-CHU Marseille, Centre de Psychiatrie et Neurosciences (U894), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Astrophysique Interprétation Modélisation (AIM (UMR7158 / UMR_E_9005 / UM_112)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire [Grenoble] (CHU), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Pôle de Psychiatrie [Hôpital Henri Mondor], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital H. Mondor - A. Chenevier, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, École normale supérieure - Paris (ENS Paris)-École normale supérieure - Paris (ENS Paris)-Centre National de la Recherche Scientifique (CNRS)-École des hautes études en sciences sociales (EHESS), Université Grenoble Alpes (UGA), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Institut National des Sciences Appliquées (INSA), Assistance Publique-Hôpitaux de Marseille (AP-HM), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Astrophysique Interprétation Modélisation (AIM (UMR_7158 / UMR_E_9005 / UM_112)), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Institut National des Sciences Appliquées (INSA)-Université Fédérale Toulouse Midi-Pyrénées, Université d'Auvergne - Clermont-Ferrand I (UdA)-CHU Clermont-Ferrand, École normale supérieure - Paris (ENS Paris), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris)

Subjects
Adult, Male, Adolescent, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Psychological Trauma, Neglect, Diagnostic Self Evaluation, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Adverse Childhood Experiences, Humans, Medicine, Path analysis (statistics), Psychological abuse, Biological Psychiatry, Physical neglect, ComputingMilieux_MISCELLANEOUS, media_common, business.industry, Adult Survivors of Child Abuse, CTQ tree, Awareness, 3. Good health, 030227 psychiatry, Psychiatry and Mental health, Cross-Sectional Studies, Physical abuse, Adult Survivors of Child Adverse Events, Psychotic Disorders, Sexual abuse, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Schizophrenia, Female, business, 030217 neurology & neurosurgery, Psychopathology, Clinical psychology
Abstract

Introduction This study aimed was to investigate the relationship between different types of childhood trauma and the level of insight (i.e., awareness of having a psychiatric disorder) in subjects suffering from schizophrenia, as well as the putative role of clinical mediators. Methods 294 community-dwelling subjects with stable schizophrenia were included into FACE-SZ, a multicentre cross-sectional study. All patients were assessed by specialized multidisciplinary teams. The level of insight was assessed by the Scale to assess Unawareness of Mental Disorder (SUMD), and childhood trauma by the Childhood Trauma Questionnaire (CTQ). Path analyses from the five CTQ subscales (physical abuse and neglect, emotional abuse and neglect, and sexual abuse) and the SUMD, with current symptomatology (i.e., positive, negative, global psychopathology and depression) as mediator, was performed. Results Physical neglect (β = 0.14) and abuse (β = 0.13) were significantly associated with poor insight. Negative symptoms were a clinical mediator of the relationship between physical neglect and poor insight. Moreover, positive (β = 0.21) and negative (β = 0.30) symptoms were associated with poor insight, whereas depression (β = −0.14) was associated with higher levels of insight. Discussion For the first time, this study shows a significant relationship between childhood trauma, specifically physical neglect and abuse, and poor insight. The level of insight was linked to different clinical dimensions. Among subjects with schizophrenia, these results provide support for a role of childhood trauma in poorer management outcomes, and the need to provide treatment, including psycho-education that better targets the consequences of childhood trauma.

Published
2019
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22. Validation and refinement of the clinical staging model in a French cohort of outpatient with schizophrenia (FACE-SZ)

Author

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

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

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

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

Author

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

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

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

Published
2018
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24. Screening for cognitive deficits with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale

Author

Mathieu Urbach, Priscille Schneider, Isabelle Chereau, Hanan Yazbek, Fabrice Berna, Anne Marie Tronche, Delphine Capdevielle, Christine Passerieux, Lore Brunel, Guillaume Fond, S. Fonteneau, Catherine Faget-Agius, Claire-Cécile Perier, Sylvain Leignier, Franck Schürhoff, Raphaëlle Richieri, A. Zinetti-Bertschy, Paul Roux, Julien Dubreucq, Eric Brunet-Gouet, Fondation FondaMental [Créteil], Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHU Strasbourg, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Henri Mondor, Hôpital de la Colombière, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), CHU Henri Mondor [Créteil], and Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
Adult, Male, 030506 rehabilitation, education.educational_degree, Psychiatric rehabilitation, specificity, Physical Therapy, Sports Therapy and Rehabilitation, Neuropsychological Tests, Sensitivity and Specificity, Chronic disability, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, medicine, Humans, Cognitive Dysfunction, education, Cognitive impairment, Aged, cognitive impairment, Rehabilitation, psychiatric rehabilitation, Cognition, Middle Aged, medicine.disease, sensitivity, schizophrenia, Cross-Sectional Studies, Schizophrenia, Scale (social sciences), Female, Schizophrenic Psychology, France, 0305 other medical science, Psychology, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Clinical psychology
Abstract

Objective: This study aimed to evaluate the validity of the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale (ECPDS) to discriminate for cognitive impairment in schizophrenia. Design: This multicentre cross-sectional study used a validation design with receiver operating characteristic (ROC) curve analysis. Settings: The study was undertaken in a French network of seven outward referral centres. Subjects: We recruited individuals with clinically stable schizophrenia diagnosed based on the Structured Clinical Interview for assessing Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; DSM-IV-R) criteria. Main measures: The index test for cognitive impairment was ECPDS (independent variable), a 13-item scale completed by a relative of the participant. The reference standard was a standardized test battery that evaluated seven cognitive domains. Cognitive impairment was the dependent variable and was defined as an average z-score more than 1 SD below the normative mean in two or more cognitive domains. Results: Overall, 97 patients were included (67 with schizophrenia, 28 with schizoaffective disorder, and 2 with schizophreniform disorder). The mean age was 30.2 (SD 7.7) years, and there were 75 men (77.3%). There were 59 (60.8%) patients with cognitive impairment on the neuropsychological battery, and the mean ECPDS score was 27.3 (SD 7.3). The ROC curve analysis showed that the optimal ECPDS cut-off was 29.5. The area under the curve was 0.77, with 76.3% specificity and 71.1% sensitivity to discriminate against cognitive impairment. Conclusion: The ECPDS is a valid triage tool for detecting cognitive impairment in schizophrenia, before using an extensive neuropsychological battery, and holds promise for use in everyday clinical practice.

Published
2018
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25. Remission of depression in patients with schizophrenia and comorbid major depressive disorder: results from the FACE-SZ cohort

Author

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

Subjects
Male, medicine.medical_treatment, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Comorbidity, Cohort Studies, [ SDV.NEU.SC ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, 0302 clinical medicine, Prevalence, ComputingMilieux_MISCELLANEOUS, Depression (differential diagnoses), [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, Remission Induction, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, Antidepressive Agents, 3. Good health, Psychiatry and Mental health, Schizophrenia, [ SDV.NEU.NB ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [ SCCO.NEUR ] Cognitive science/Neuroscience, Major depressive disorder, Antidepressant, Female, France, medicine.symptom, Adult, medicine.medical_specialty, behavioral disciplines and activities, [ SDV.NEU.PC ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, Young Adult, 03 medical and health sciences, Delusion, Internal medicine, mental disorders, medicine, Humans, Antipsychotic, Avolition, Psychiatric Status Rating Scales, Depressive Disorder, Major, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, Odds ratio, medicine.disease, 030227 psychiatry, Logistic Models, Multivariate Analysis, Quality of Life, business, 030217 neurology & neurosurgery
Abstract

BackgroundMajor depressive disorder (MDD) is underdiagnosed and undertreated in schizophrenia, and has been strongly associated with impaired quality of life.AimsTo determine the prevalence and associated factors of MDD and unremitted MDD in schizophrenia, to compare treated and non-treated MDD.MethodParticipants were included in the FondaMental Expert Centers for Schizophrenia and received a thorough clinical assessment. MDD was defined by a Calgary score ≥6. Non-remitted MDD was defined by current antidepressant treatment (unchanged for >8 weeks) and current Calgary score ≥6.Results613 patients were included and 175 (28.5%) were identified with current MDD. MDD has been significantly associated with respectively paranoid delusion (odds ratio 1.8; P = 0.01), avolition (odds ratio 1.8; P = 0.02), blunted affect (odds ratio 1.7; P = 0.04) and benzodiazepine consumption (odds ratio 1.8; P = 0.02). Antidepressants were associated with lower depressive symptoms score (5.4 v. 9.5; P < 0.0001); however, 44.1% of treated patients remained in non-remittance MDD. Nonremitters were found to have more paranoid delusion (odds ratio 2.3; P = 0.009) and more current alcohol misuse disorder (odds ratio 4.8; P = 0.04). No antidepressant class or specific antipsychotic were associated with higher or lower response to antidepressant treatment. MDD was associated with Metabolic syndrome (31.4 v. 20.2%; P = 0.006) but not with increased C-reactive protein.ConclusionsAntidepressant administration is associated with lower depressive symptom level in patients with schizophrenia and MDD. Paranoid delusions and alcohol misuse disorder should be specifically explored and treated in cases of non-remission under treatment. MetS may play a role in MDD onset and/or maintenance in patients with schizophrenia.Declaration of interestNone.

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

Author

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

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

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

Published
2018
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27. Psychiatric disability as mediator of the neurocognition-functioning link in schizophrenia spectrum disorders: SEM analysis using the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale

Author

Paul Roux, Mathieu Urbach, Sandrine Fonteneau, Fabrice Berna, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Julien Dubreucq, Catherine Faget-Agius, Guillaume Fond, Sylvain Leignier, Claire-Cécile Perier, Raphaëlle Richieri, Priscille Schneider, Franck Schürhoff, Anne-Marie Tronche, Hanan Yazbek, Anna Zinetti-Bertschy, Christine Passerieux, Eric Brunet-Gouet, M. Andrianarisoa, B. Aouizerate, N. Bazin, F. Berna, O. Blanc, L. Brunel, E. Bulzacka, D. Capdevielle, I. Chereau-Boudet, G. Chesnoy-Servanin, Jm Danion, T. D'Amato, A. Deloge, C. Delorme, H. Denizot, J.M. Dorey, C. Dubertret, J. Dubreucq, C. Faget, C. Fluttaz, G. Fond, S. Fonteneau, F. Gabayet, E. Giraud-Baro, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, T. Le Gloahec, Y. Le Strat, null Llorca, J. Mallet, E. Metairie, D. Misdrahi, I. Offerlin-Meyer, C. Passerieux, P. Peri, S. Pires, C. Portalier, L. Ramet, R. Rey, C. Roman, A. Schandrin, F. Schürhoff, A. Tessier, Am Tronche, M. Urbach, F. Vaillant, A. Vehier, P. Vidailhet, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Fondation FondaMental [Créteil], Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier de Versailles André Mignot (CHV), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département de psychiatrie adulte, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital La Colombière, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Psychometrics, media_common.quotation_subject, Metacognition, Remediation, Cohort Studies, 03 medical and health sciences, Disability Evaluation, Young Adult, 0302 clinical medicine, Cognition, Visual memory, Neuropsychology, medicine, Humans, Effects of sleep deprivation on cognitive performance, Functioning, Psychiatry, Biological Psychiatry, media_common, Psychiatric Status Rating Scales, Disability, Middle Aged, 030227 psychiatry, Psychiatry and Mental health, Cross-Sectional Studies, Psychotic Disorders, Cognitive remediation therapy, Latent Class Analysis, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Schizophrenia, Female, Schizophrenic Psychology, Psychology, Neurocognitive, 030217 neurology & neurosurgery, Vigilance (psychology)
Abstract

International audience; The functional outcome in schizophrenia spectrum disorders is affected by multiple factors such as cognitive performance and clinical symptoms. Psychiatric disability may be another important determinant of functional outcome. The purpose of this study was to test whether schizophrenia symptoms and psychiatric disability mediated the association between cognition and functioning. Between April 2013 and July 2017, we included 108 community-dwelling adults with stable schizophrenia spectrum disorder in a multicenter study. Psychiatric disability was assessed with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale by relatives of patients. ECPDS focused on the broad array of motivational, neurocognitive, sociocognitive, and metacognitive impairments that result in activity restrictions. We used a battery of tests to assess seven cognition domains (processing speed, attention/vigilance, working, verbal and visual memory, reasoning and problem solving, and executive functioning) and cross-sectional structural equation modeling (SEM) for the mediation analyses. We estimated the one-year temporal stability of ECPDS scores in 45 participants. The model provided showed good fit and explained 43.9% of the variance in functioning. The effect of neurocognition on functioning was fully mediated by symptoms (proportion mediated: 36.5%) and psychiatric disability (proportion mediated: 31.3%). The ECPDS score had acceptable one-year temporal stability. The ECPDS scale has satisfactory psychometric properties, and shows significant convergence with neurocognition and functioning, suggesting a role for this tool in the routine evaluation of cognitive remediation needs. Our model validates psychiatric disability as a crucial step from cognitive impairment to restricted participation in life situations.

Published
2018
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28. Chronic low-grade peripheral inflammation is associated with ultra resistant schizophrenia. Results from the FACE-SZ cohort

Author

Marion Leboyer, Lore Brunel, Isabelle Chereau, Guillaume Fond, Bruno Aouizerate, C. Lançon, Julien Dubreucq, Catherine Faget, Delphine Capdevielle, David Misdrahi, Pierre Vidailhet, M. Andrianarisoa, Sylvain Leignier, Caroline Dubertret, Romain Rey, Mathieu Urbach, Ophélia Godin, Pierre-Michel Llorca, L. Boyer, Jasmina Mallet, Thierry d'Amato, Fabrice Berna, Christine Passerieux, Franck Schürhoff, A. Schandrin, E. Bulzacka, N Coulon, Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Fondation FondaMental [Créteil], Institut de Recherche sur les Phénomènes Hors Equilibre (IRPHE), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), Université Clermont Auvergne (UCA)-CHU Clermont-Ferrand, Institut Européen des membranes (IEM), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier le Vinatier [Bron], Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre Hospitalier de Versailles André Mignot (CHV), Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), UFR sciences de la santé Simone Veil [UVSQ], Pôle de Psychiatrie [Hôpital Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital H. Mondor - A. Chenevier, Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Global Assessment of Functioning, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Pharmacology (medical), Treatment Failure, Functioning, Antipsychotic, Biological Psychiatry, Clozapine, Metabolic Syndrome, Psychiatric Status Rating Scales, Inflammation, Positive and Negative Syndrome Scale, business.industry, General Medicine, medicine.disease, 030227 psychiatry, 3. Good health, Peripheral, Psychiatry and Mental health, C-Reactive Protein, Schizophrenia, Cohort, Female, Metabolic syndrome, business, Resistant schizophrenia, 030217 neurology & neurosurgery, medicine.drug, Antipsychotic Agents
Abstract

International audience; A high rate of patients with schizophrenia (SZ) does not sufficiently respond to antipsychotic medication, which is associated with relapses and poor outcomes. Chronic peripheral inflammation has been repeatedly associated with schizophrenia risk and particularly to poor responders to treatment as usual with cognitive impairment in SZ subjects. The objective of present study was to confirm if ultra resistance to treatment in schizophrenia (UTRS) was associated to chronic peripheral inflammation in a non-selected sample of community-dwelling outpatients with schizophrenia. Participants were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and received a thorough clinical assessment, including recording of current treatment. Current psychotic symptomatology was evaluated by the Positive and Negative Syndrome scale for Schizophrenia (PANSS). UTRS was defined by current clozapine treatment + PANSS total score >= 70. Functioning was evaluated by the Global Assessment of Functioning scale. High sensitivity CRP (hs-CRP) was measured for each participant as a proxy to define peripheral low-grade inflammation. 609 stabilized community-dwelling SZ subjects (mean age = 32.5 years, 73.6% male gender) have been included. 60 (9.9%) patients were classified in the UTRS group. In multivariate analyses, UTRS has been associated independently with chronic peripheral inflammation (OR = 2.6 [1.2-5.7], p = 0.01), illness duration (0R = 1.1 [1.0-1.2], p = 0.02) and impaired functioning (OR = 0.9 [0.9-0.9], p = 0.0002) after adjustment for age, sex, current daily tobacco smoking, metabolic syndrome and antidepressant consumption. Peripheral low-grade inflammation is associated with UTRS. Future studies should explore if anti-inflammatory strategies are effective in UTRS with chronic low-grade peripheral inflammation.

Published
2018
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29. Auteurs

Author

Amal Abdel-Baki, Isabelle Amado, Sophie Arfeuillère, Ingrid Arnaud, Maïté Arthur, Marie-Noëlle Babinet, Nadine Bazin, Tanja Bellier-Teichmann, Corinne Bismuth, Fabienne Blain-Pierre, Pascal Bloch, Alice Bogey, Julien Bonilla-Guerrero, Charles Bonsack, Béatrice Borrel, Yann Boulon, Emmanuelle Bourlier, Marie-Cécile Bralet, Armando Brana, Lindsay Brénugat-Herné, Georges Brousse, Éric Brunet, Eva Bulzacka, Florian Cady, Jérémy Callot, Aude Caria, Caroline Cellard, Sophie Cervello, Valérian Chambon, Philippe Charrier, Fabienne Chatelard, Philippe Conus, Marc Corbière, Charlotte Danset-Alexandre, Patricia Deegan, Gwenaelle Delourme, Maurice Dematteis, Caroline Demily, Jean-Marc Destaillats, Chloé Duboc, Julien Dubreucq, Aurélie Dubrulle, Marie Dupuis, Bernard Durand, Xavier Ensenlaz, Mégane Faraldo, Sarah-Lise Farhat, Émilie Favre, Jérôme Favrod, Nicolas Franck, Guillaume François, Adeline Frankhauser, Jennifer Fredericks, Laurent Frobert, Delphine Fulachier, Franck Gabayet, Baptiste Gaudelus, Corinne Gautier, Roger Gayton, Jean-Yves Giordana, Élisabeth Giraud Baro, Julien Gobbo, Guy Gozlan, Tim Greacen, Katya Gremaud, Isabelle Grivet, Cyrielle Guy, Ghina Harika Germaneau, Christophe Hochard, Yann Hodé, Alban Ismailaj, Nematollah Jaafari, Éliane Jobert, Anne-Claire Jossserand, Emmanuelle Jouet, Mariia Kaliuzhna, Yasser Khazaal, Rémy Klein, Alexandra Koubichkine, Mila Kirstie Kulsa, Stéphanie Lagasse, Pablo Lama-Lama, Thierry Lambert, Christophe Lançon, Corinne Launay, Laurent Lecardeur, Patrick Le Cardinal, Tania Lecomte, Denis Leguay, Sylvain Leignier, Jean-Pierre Lindenmayer, Céline Loubières, Thierry Lucas, Mathilde Maillebuau, Brigitte Malangin, Massimo Marsili, Brice Martin, Juliette Martin, Catherine Massoubre, Philippe Maugiron, Alice Medalia, Fanny Melis, Sophie Meunier-Cussac, Stéphane Morandi, Laurent Morin, Anne Ngakui, Alexandra Nguyen, Ali Oker, Sandrine Orens, Bernard Pachoud, Christine Passerieux, Jacques Pellet, Joanie Pellet, David Penn, Lucie Pennel, Claire-Cécile Périer, François Petitjean, Élodie Peyroux, Inès de Pierrefeu, Pedro Planas, Morgane Plane, Valentino Pomini, Malgorzata Pousthomis, Antoinette Prouteau, Clélia Quilès, Stéphane Raffard, Sandrine Rebelle, Clare Reeder, Jennifer Regnier, Charles-Édouard Rengade, Katia Revil, Jean-François Ridders, Bérangère Rigaut, Amandine Rivet, Alexandra R-Mercier, Cécile Rochet, Jean-Luc Roelandt, Céline Roussel, Paul Roux, Caroline Salas-Toquero, Marianne Schoendorff, Bérénice Staedel, Élisabeth Thibaudeau, Aurélia Todd, Floriane Todoroff, Jean-Baptiste Van der Henst, Marie Vanzetti, Hélène Verdoux, Pascal Vianin, Gilles Vidon, Dominique Willard, Til Wykes, and Nadia Younès

Published
2018
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31. Metabolic Syndrome and Illness Severity Predict Relapse at 1-Year Follow-Up in Schizophrenia: The FACE-SZ Cohort

Author

David Misdrahi, Sylvain Leignier, Fabrice Berna, Laurent Boyer, Guillaume Fond, M. Andrianarisoa, Myrtille André, Romain Rey, Ophélia Godin, Bruno Aouizerate, Julien Dubreucq, Pierre Vidailhet, F. Schürhoff, Delphine Capdevielle, Marion Leboyer, Dominique Costagliola, Christine Passerieux, Isabelle Chereau, Jean-Michel Dorey, Pierre-Michel Llorca, Caroline Dubertret, Paul Roux, Jasmina Mallet, Christophe Lançon, and Catherine Faget

Subjects
Adult, Pediatrics, medicine.medical_specialty, Psychosis, Population, Severity of Illness Index, Medication Adherence, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Recurrence, Risk Factors, Severity of illness, medicine, Humans, Longitudinal Studies, education, Metabolic Syndrome, education.field_of_study, business.industry, Case-control study, Odds ratio, medicine.disease, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Logistic Models, Schizophrenia, Case-Control Studies, Cohort, France, business, 030217 neurology & neurosurgery, Diagnosis of schizophrenia, Antipsychotic Agents
Abstract

Objective Predicting relapse is a major challenge in schizophrenia from a clinical and medico-economic point of view. During recent decades, major psychiatric disorders have been found to be extensively associated with metabolic disorders, even before the illness onset, with a prevalence estimated to be 35% in this population. However, no study to date has, to our knowledge, explored the potential impact of metabolic syndrome (MetS) on relapse. Methods From 2010 to 2016, 185 patients (mean age = 32 years) with a DSM-IV-TR diagnosis of schizophrenia were included in the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) cohort and followed up for 1 year. Multivariable logistic regression was performed to estimate the adjusted odds ratio for relapse. Results Thirty-seven percent of stabilized outpatients with schizophrenia (mean illness duration = 11 years) experienced a relapse at least once during the 1 year of follow-up. MetS strongly predicted relapse at 1 year, independently of illness severity, insight into illness, and treatment characteristics (including medication compliance). Patients with MetS at baseline had a 3 times higher risk (95% CI, 1.1-8.4) of experiencing a new episode of psychosis during the 12 months of follow-up. Conclusions Further studies should determine if reducing or preventing MetS could help to protect subjects with schizophrenia from relapse.

Published
2017

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