Recent studies have shown that cannabis use acts as a specific risk factor provoking the onset of psychosis in vulnerable individuals. Association of adolescent cannabis use and psychosis risk was studied after adjustment with prodromal symptoms.

To assess possible causality between cannabis use and the risk of psychosis.

To examine associations between cannabis use and the risk of psychosis in 10 years follow-up while taking into account the prodromal symptoms of psychosis in a prospective general population sample.

The sample (N=6258) composed of a prospective Northern Finland Birth Cohort 1986. Questionnaire on prodromal symptoms for psychosis (PROD-screen) and on drug use was conducted when the cohort members were 15-16 years old. The participants were asked if they had tried cannabis: never, once, 2-4 times, 5 times or more. Information on psychoses was gathered from registers until age 27 years.

In total 102 new psychoses emerged. The proportion of psychoses in the groups 'never”, 'once”, '2-4 times”, '5 times or more” were 1.5%, 2.8%, 3.6%, and 8.5%, respectively. The hazard ratio (HR) for risk of psychosis in subjects who had tried cannabis 5 times or more was 5.9 (95% CI 2.4-14.4) when compared to non-users. The association remained statistically significant when adjusted for prodromal symptoms and parental psychosis (HR 2.6, 1.0-6.6). When gender and smoking was taken into account association was no longer significant (HR 2.3, 0.9-6.0).

Adolescent cannabis use associates with increased risk of first-episode psychosis even after controlling for baseline prodromal symptoms.

Le travail de nuit, dit aussi travail posté, n’est pas dénué de conséquences fâcheuses tant sur le plan physique que sur le plan psychique, que ce soit à court terme ou à long terme. Cependant, l’importance du retentissement sur la qualité de vie de l’individu varie selon le rythme et la périodicité du travail de nuit, ainsi qu’il est conditionné par la présence de certains facteurs psychosociaux. Le travail de nuit est par ailleurs communément admis comme pourvoyeur de stress, de fatigue chronique et serait aussi responsable d’un risque accru de pathologie psychiatrique, et surtout anxiodépressive. Ceci est principalement dû à la privation de sommeil.

Comparer la qualité de vie des travailleurs de nuit par rapport aux personnes qui travaillent le jour et mettre en exergue les risques que présente le travail posté pour la santé mentale et physique.

Étude comparative descriptive et analytique transversale.

Population étudiée : médecins, urgentistes, personnel paramédical, sapeurs pompiers, protection civile, marins, agents de police.

Instruments utilisés :

• – fiche d’exploitation précisant les données sociodémographiques ;

• – hétéroquestionnaire ;

• – échelle de somnolence d’Epworth ;

• – échelle de Hamilton ;

• – échelle de dépression de Beck ;

• – questionnaire d’évaluation de la qualité de vie SF-36 ;

• – test d’inventaire du burn-out de Maslach.

En cours.

Schizophrenia is a severe mental illness, requiring antipsychotic treatment. Relapses are associated with poor prognosis and treatment adherence is a major factor in relapse. Long-acting injectable antipsychotics increase adherence, can reduce relapse and improve long-term outcomes.

The aim of this study was to assess the effectiveness of paliperidone palmitate (PP) in terms of hospital admissions.

Patients were included in the study if they had been treated with PP for at least one year. The number of days during hospital admissions before and after initiation of PP was assessed in a mirror image design.

61 patients in the study had been treated for at least 1 year. The mean age of patients was 44 years old and 61% were male (n=37). The commonest diagnosis was schizophrenia (n=51).

In the year before initiation of PP, there were 64 admissions totalling 6089 days for all the patients, with an average of 99.8 days per patient in hospital. During the first year of treatment with PP, there were 22 admissions totalling 1412 days, with an average of 23 days per patient in hospital. 69% of patients had no admissions on PP.

In this naturalistic audit looking at admission data, treatment with PP resulted in a reduction in the number of hospital days by 76.8%. More than two-thirds of patients experienced no admissions during treatment with PP. This suggests that Paliperidone Palmitate can be effective in treating Schizophrenia as well as cost-effective treatment by reducing hospital admissions.

Cognitive impairment is a core feature of schizophrenia, associated with significant social and functional impairment. Schizophrenia has also been associated with inflammation and immune changes. Recently it has been showed that IL-6, a pro-inflammatory cytokine, was associated with cognitive impairment.

The aim of this study was to assess the associations between a pro-inflammatory cytokines (IL-6) and an anti-inflammatory cytokine (IL-4) with social cognition in a sample of stable patients with schizophrenia.

Social cognition was assessed using the Face Emotion Identification Task (FEIT) and the Hinting Task in 29 stable outpatients with schizophrenia. Blood was collected and cytokines (IL-4, IL-6) assays were realized (CBA method).

IL-6 levels showed a significant inverse correlation with FEIT global score (p = 0.019, rho = -0.475) and a trend of significant inverse correlation with the Hinting Task (p = 0.079, rho = -0.332). However, IL-4 levels showed no significant association with the FEIT or the Hinting task (rho = 0.079 and 0,121; respectively).

Elevated IL-6 levels seem to play a role in social cognitive impairment in stable patients with schizophrenia. These results should be interpreted with caution due to the limited number of participants in the study.

About a third of patients with schizophrenia have persistent auditory verbal hallucinations resulting in persistent distress, functional disability, and frequent loss of behavioral control.

To estimate the prevalence of persistent auditory hallucinations in a sample of schizophrenic patients, to specify their characteristics and to identify their clinical associated factors.

This was a cross-sectional, descriptive and analytical study carried-on 144 out-patients (101 men and 43 women, mean age 38.24 ± 10.58 years) followed for schizophrenia in the psychiatry department of the university hospital of Monastir. The assessment was consisted by the collect of epidemiological, clinical and therapeutic data and the use of the Hoffman's auditory hallucinations rating scale (AHRS), and the positive and negative symptoms scale (PANSS).

The prevalence of persistent auditory hallucinations (score of the AHRS ≥ 5) was 40.3%. The total mean score on the AHRS was 10.7 ± 7.8 for all patients and 19.4 ± 7.7 for patients with persistent auditory hallucinations. The items of the AHRS with higher sub scores were the number, the influence and the reality of the voices. The clinical associated factors with persistent auditory hallucinations after multivariate analysis were the family history of physical illness, the absence of tobacco consumption, the hallucinatory onset of disorders, the notion of prior hospitalization and continuous course.

Our results support the multidimensional nature of auditory hallucinations and confirm the existence of interindividual differences in these hallucinations. Persistent auditory hallucinations were associated with poor prognosis, requiring more effective therapeutic strategies.

25 suspected cases of suicide occurred in a 20 month period. A literature review revealed some differences in this sample that merited further study.

To summarise the demographics, risk factors and service contact history of a suicide cluster and identify specific risk profiles and to compare these findings with international data.

To produce a data set that informs suicide intervention and suicide prevention.

A case notes review of patients’ charts was carried out. Other variables were chosen because of their importance in the existing suicide literature. Recommendations from the UK National Confidential Inquiry (NCI) were also used to assess the data. Clinical perception of risk was also recorded.

In grouping risk factors together 3 profiles emerged. A chaotic pattern, a masking pattern and a recovered group whose response to relapse was increased suicidality.

This cluster have similarities and differences from the risk profile for patient suicides described in the existing literature. There was a large amount of substance misuse. Risk recognition for immediate risk of suicide was just as challenging in this group as in much larger studies. Questions regarding service provision and hypotheses about cluster occurrence are also discussed.

Cognitive deficit is a significant problem in schizophrenic patients. It cannot be attenuated by any antipsychotic drugs. It has been known that changes of neuronal density is correlated with learning and memory deficits. Bacopa monnieri (Brahmi), popularly known as a cognitive enhancer, might be a novel therapeutic agent for cognitive deficit in schizophrenia by changing cerebral neuronal density.

To determine the effects of Brahmi on attenuation at cognitive deficit and on the neuronal density in the prefrontal cortex, striatum and cornu ammonis subfield 1 (CA1) and 2/3 (CA2/3) of hippocampus in sub-chronic phencyclidine (PCP) rat model of schizophrenia.

Rats were assigned to three groups; Group-1: Control, Group-2: PCP administration and Group-3: PCP + Brahmi. Rats were tested for cognitive ability by using novel object recognition test. Neuronal density from a serial Nissl stain sections of the prefrontal cortex, striatum and CA1-3 of all rats were measured by using Image ProPlus software and manual counting.

Sub-chronic PCP administration resulted in cognitive deficits in novel object recognition task. This occurred alongside significantly increased neuronal density in CA1. The cognitive deficit was recovery to normal in PCP + Brahmi group and this occurred alongside significantly decreased neuronal density in CA1.

Brahmi can be a potential cognitive enhancer against Schizophrenia. It reduces density of neuron in CA1. The reduced neuron is possibly glutamatergic neuron, which results in neuronal toxicity and cognitive deficit. Therefore, Brahmi eliminates glutamatergic excitotoxicity in CA1 and cognitive function is then recovery.

Ces résultats suggèrent la nécessité d’améliorer les conditions de travail, de prévenir l’apparition d’un épuisement professionnel et de préserver l’empathie clinique chez les soignants. Ces actions pourraient contribuer à prévenir la violence interactionnelle dans les soins par l’amélioration de la relation thérapeutique.

The potential role of antipsychotic treatment in affecting suicide rates and in explaining the increased mortality due to somatic disorders is still debated. The aim of this study was to assess mortality in individuals who were prescribed typical and atypical neuroleptics in one voivodship in Poland.

We conducted a retrospective cohort study involving 84881 patients who had drug insurance benefits in Pomeranian voivodship and who began receiving a conventional or atypical antipsychotic medication between 2008 and 2012. Data on deaths in this population have been collected from National Death Registry. Age-standardized death rates were calculated in the adult population exposed population to any dose of atypical antipsychotic medication, in popualtion of users of atypical antipsychotics only, in population of users of conventional antipsychotic drugs only and in population of clozapine users.

In individuals who were prescribed conventional antipsychotic medication age-standardized death rate was significantly higher than in ever users of atypical medicatioons and people using only atypical drugs: 69.6 per 1000, 95% confidence interval (95% CI) 67.64–71.56 compared with 53.24 per 1000, 95% CI 50.8–55.69 and 48,38 per 1000, 95% CI 44.78–51.98. Mortality rate in clozapine users was also higher than in users oaf atypical medications (65,11 per 1000, 95% CI 50.8–55.69).

These results suggest that conventional antipsychotic medications are associated with increased risk of death compared to atypical drugs. Analysis based on administrative record linkage is the major limitation of this study. No adjustment has been made for confounding factors that may modify mortality risk.

We aimed to reduce the gap between clinicians and researchers by showing how a qualitative method may reveal experiences about how professionals explained their clinical practice in crisis intervention and what their representation are of people in crisis.

In depth, semi-structured interviews were conducted, transcribed and independently reviewed by using Grounded Theory Methodology (GTM). Data were analyzed with the constant comparative method. The study was conducted in crisis experts in Psychiatric Emergency Room (PER). A purposive sample of 17 professionals in crisis intervention included in our study.

Results showed that therapeutic processes are managed in multiple interactions and regulations. Crisis intervention is an opportunity to highlight the psychic functioning. There are multiple settings of interventions oriented by the context of the institution and theorical background of professionals. The social realities slow down the possibility to elaborate the end of the intervention.

This study illuminates that clinicians and professionals in crisis intervention need guidelines to better improve their therapeutic interventions. They also need a political support to create specialized training and develop medical and psychological services to take in charge people in crisis. This research contributes to show the discrepancy between what the professional thinks to do in their interventions and what he really do.

The study focused on the level of expressed emotion of family members of schizophrenia patients prior to and during their long-term hospitalization and how that affected the course of treatment.

The retrospective study included 112 patients diagnosed with schizophrenia and their family members. The patients had been court-ordered to undergo psychiatric treatment for a crime they committed. The following scales were used to assess the level of expressed emotion: Five minute Speech Sample (FMSS), Level of Expressed Emotional Scale (LEE), Family Attitude Scale (FAS) and Perceived Criticism (PC). Socio-demographic parameters were also used in the research.

The results show that expressed emotion of family members was high before and during long-term hospitalization of 71.4% of patients who experienced clinical worsening. This is particularly true for parents (62.5%), and more frequently for mothers. Course of the illness was better in the group of patients whose family members had low expressed emotion.

Successful treatment and favourable outcome of schizophrenia depend on the quality of relationship between the patient and his family members. High level of expressed emotion is one of the risk factors for relapse in schizophrenia.

Évaluer la corrélation entre l’anhédonie et le fonctionnement social. En effet, bien que l’anhédonie soit un symptôme principal de la dépression et un facteur pronostic clé, elle reste peu étudiée.

Mille cinq cents soixante-dix patients ayant un EDM, traités par agomélatine, ont été inclus dans une étude non interventionnelle et suivis 10 à 14 semaines par 501 médecins généralistes. Les patients ont été évalués avec la MADRS, l’échelle de plaisir de Snaith-Hamilton (SHAPS), le Questionnaire de Fonctionnement Social (QFS : un auto-questionnaire qui évalue la fréquence et la satisfaction des comportements sociaux) et une échelle visuelle analogique originale (EVA) cotant le niveau de plaisir ressenti par les patients dans leur activité favorite.

Le score MADRS a diminué de façon très significative entre le début et la fin de l’étude (–16,6 ± 8,3 ; p < 0,0001), de même que le score SHAPS (–7,2 ± 4,2 ; p < 0,0001), avec une amélioration du fonctionnement social robuste mesurée au QFS (17,2 ± 11,5 ; p < 0,0001). Les facteurs prédictifs de l’amélioration du fonctionnement social étaient : l’anhédonie (RR = 7,3 ; p < 0,0001), la réponse symptomatique (RR = 5,0 ; p < 0,0001) et la récurrence (RR = 1,33 ; p < 0,0001). Un second modèle de régression logistique a montré que la persistance de l’anhédonie était le meilleur facteur prédictif de dissociation de la réponse, c’est-à-dire de la réponse symptomatique à la MADRS sans amélioration cliniquement pertinente du fonctionnement social (QFS) (RR = 7,2 ; IC 3,3–15,8 ; p < 0,0001).

Dans cette population traitée par agomélatine, les résultats montrent que l’anhédonie est un facteur prédictif majeur du rétablissement du fonctionnement social chez les patients déprimés, ce qui concorde avec des études antérieures.

Impairments in facial emotion recognition observed among people with schizophrenia has received increasing attention over the past few decades, however the nature of this deficit is unclear. Researchers have attempted to identify mechanism explaining this deficit, focusing on such cognitive functions like abstract thinking, mental flexibility, attention, verbal and spatial memory, language abilities and executive functions. Communication skills are extremely important for good social interactions and its deficits are the core feature of schizophrenia. The purpose of the present study was to explore the relationship between emotion perception and complex language processing in patients with schizophrenia.

Subjects were 27 patient with diagnosis of paranoidal schizophrenia and 31 healthy people. Measures included The Right Hemisphere Language Battery in Polish adaptation (RHLB-PL), emotion discrimination test and control face recognition test.

Patients with schizophrenia performed worse than healthy subjects on RHLB-PL and the emotion perception task but not on the face recognition test. In healthy controls language abilities correlated with emotion perception and face recognition and, by contrast, in schizophrenic patients any correlation was observed.

The present study revealed that patients with schizophrenia have deficits in the ability to discriminate facial emotion expression and also selective communication skills impairments like humor or metaphor comprehension. Results did not indicate relation between emotion perception and language impairment in patients, suggesting specific nature of facial emotion recognition deficit in schizophrenia.