[Questioning disruptive disorder with emotional dysregulation]. / Questionner le trouble disruptif avec dysrégulation émotionnelle.

Disruptive Emotional Dysregulation Disorder (DEDD) responds to an increase in diagnoses of clastic crises, reactive depression and bipolarity in children and adolescents. Emerging in the 1990s, EDD has become an issue for practitioners, parents and teachers alike, and has become an integral part of the landscape of paediatric and child psychiatric disorders. Its diagnostic complexity is accentuated by criteria that include persistent and disproportionate outbursts of anger, often confused with other pathologies, especially as diagnostic tools are few and far between. Professionals in the field know little about EDD, preferring to diagnose more familiar disorders.

[Chronic obstructive pulmonary disease and music therapy]. / Bronchopneumopathie chronique obstructive et musicothérapie.

Chronic obstructive pulmonary disease with disabling co-morbidities can benefit from music therapy devices that are effective on anxiety, dyspnea, depression and quality of life. This complementary support therapy is easy to implement, in hospital or at home, and allows the patient to take ownership of this self-care.

[Psychological support for long Covid patients during a rehabilitation stay]. / L'accompagnement psychologique de patients Covid long lors d'un séjour de rééducation.

Covid long affects each patient differently. This disorder can occur in people with both severe and mild forms of the disease. It is often a series of symptoms that disrupt different areas of life in a very variable way. These symptoms can change rapidly. Moreover, several symptoms are associated and fluctuate (between aggravation and recovery) during very variable periods, which leads to a mosaic diagnosis and engages the need for multidisciplinary management.

[Chronic obstructive pulmonary disease: somato-psychological dimensions]. / Bronchopneumopathie chronique obstructive : dimensions somato-psychologiques.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is a poorly understood lung disease. It is accompanied by significant psychological co-morbidities (anxiety, depression, identity and body image disorders) which are under-diagnosed and have an impact on quality of life and the frequency of  re-hospitalization. The management of COPD is multidisciplinary and its role is to prevent complications, relieve symptoms and slow the progression of the disease. Therapeutic education of the patient brings a real added value in this multidisciplinary management.

[Psychological state of Covid-19 patients after resuscitation]. / État psychologique des patients Covid-19 après réanimation.

The epidemic of Covid-19 was characterized, from its beginning, by "emergency". A state of emergency enacted by the state authorities to fight, on one hand, against the pandemic as such and, on the other hand, to manage the influx of patients admitted in intensive care. In this unprecedented context, the suffering of the people goes beyond the emergency situation and persists in forms ranging from a pseudo-banality to the complexity of an insidious evolution.

Clinical condition, Resuscitation and Medical-Psychological Care of Severe COVID-19 patients (part 2).

Respiratory rehabilitation is the penultimate step in the medical management of patients with severe COPD-19. It is an essential step before patients' returning home, and is usually carried out in specialised Follow-up and Rehabilitation Clinics. When discharged from hospital, patients with post-severe COVID-19 usually progress in their medical condition. However, they may remain frail and have a constant fear of possible deterioration leading to (re)hospitalisation and a return to baseline. Psychological support in this phase can reduce patients' anxiety and increase their motivation to carry out daily rehabilitation activities. This support provides a stable and consistent basis for patients to focus on their progress, leaving the difficulties behind. Being aware of the improvements in their physical condition allows them to maintain their motivation to continue to be physically active. Psychological support during respiratory rehabilitation aims at preparing patients to return to the normal life they had before the disease. It is usually based on brief psychotherapies that focus on strengthening the patient's abilities through behavioural changes and through reducing risk behaviours. Only after this phase is it sometimes possible to deal with complex issues and to cope with personality mechanisms and maladaptive behaviour patterns.

La réadaptation respiratoire constitue l'avant-dernier étage dans la prise en charge des patients COVID-19 sévère, une étape essentielle avant de retrouver leur vie quotidienne. L'accompagnement psychologique occupe une place importante dans cette étape. Cette réadaptation s'effectue habituellement dans une clinique de Soins de Suite et de Réadaptation (SSR) spécialisée. On peut généralement affirmer que les patients post-COVID-19 sévère sortis de danger vont progresser. Cette progression peut se décrire à travers le modèle de la spirale ascendante. Ce sont, néanmoins, des patients fragiles, pour lesquels on craint perpétuellement une dégradation rapide des paramètres physiologiques qui risque de les ramener vers une (ré)hospitalisation d'urgence et un retour vers la case de départ. L'accompagnement psychologique empêche les sensations négatives d'occuper le devant de la scène et d'aspirer le patient vers le bas. Il permet de baisser les angoisses et d'augmenter les motivations pour effectuer des activités de réadaptation quotidiennes. De cette manière, cet accompagnement a des retentissements physiologiques importants, permettant aux patients de progresser en voie de guérison, malgré certaines séquelles occasionnées par la maladie. Cet accompagnement psychologique permet, également, de préparer les patients à leur retour à la vie d'avant et d'adoucir l'impact traumatisant des souvenirs douloureux. Le patient peut les regarder de nouveau et leur redonner un sens moins troublant. Le travail psychologique vise à rassurer ces personnes qui ont perdu confiance en leur corps. On tend à favoriser des thérapies brèves qui mettent l'accent sur les renforcements des capacités, sur les changements comportementaux et le sevrage des produits, avant d'agir sur les mécanismes de coping et sur les schémas inadaptés plus profonds.

Clinical condition, resuscitation and medical-psychological care of severe COVID-19 patients (part 1).

This interview covers the clinical and psychological condition of patients afflicted with severe COVID-19 and their pulmonary rehabilitation process. For these patients, symptoms are medically urgent and life-threatening. The sequelae of this viral attack and immune response to it are significant, and often persist for months after discharge from intensive care. To understand the medical and psychological state of these patients, a description is given of the organs affected, the oxygen cycle in the body and the medical care procedures that are used to help patients with dysfunctional respiratory systems. The link between physical and psychological progress is described. Physical weakness results from pulmonary sequelae and deconditioning, and is often experienced by patients as mental fatigue similar to psychological depression. This may draw the patient into a downward spiral, with multiple health aspects deteriorating, independently of the resolution of initial problems. Conversely, a positive physical or psychological evolution may lead to the evolution of the other. Thus, reversing the negative trend for just one system component can delay, completely arrest the spiralling down, or transform it into an upward spiral, improving the patient's condition. In addition, for people undergoing severe COVID-19, the return to normal life could be destabilizing and memories that arise from their crisis state may trigger Post-Traumatic Stress Disorder (PTSD). Health and psychosocial professionals hold an important role both in post-hospital care and in secondary prevention, i.e. prevention of relapse and re-hospitalization. Physical rehabilitation work must take these psychological factors into account, in the same way that any psychological follow-up is supposed to consider physiological factors.

Cet entretien porte sur l'état clinique médicopsychologique des patients atteints de COVID-19 sévère et sur leur réadaptation respiratoire. Pour ces patients, les séquelles de l'attaque virale et de la réaction immunitaire sont importantes et apparentes dans les tests fonctionnels et les imageries médicales. Elles persistent souvent quelques mois après la sortie des soins intensifs. Le virus SARS-CoV-2 provoque des atteintes des muqueuses bronchiques et alvéolaires. Le circuit de l'oxygène dans le corps peut être découpé en trois maillons imbriqués: l'ensemble de l'appareil respiratoire, le système cardiovasculaire, les muscles et le métabolisme énergétique. Ces systèmes fonctionnent en interdépendance. Lorsqu'il y a une défaillance de l'un des éléments, les autres sont touchés, pouvant amener l'ensemble à une décompensation. La décompensation respiratoire désigne la défaillance ou l'incapacité du système à fonctionner. Les patients sont hospitalisés en réanimation et bénéficient d'une supplémentation en oxygène, d'un support ventilatoire pour compenser la fatigue des muscles respiratoires et d'un traitement médicamenteux visant à réduire les symptômes et à lutter contre les infections acquises. À la sortie de l'hospitalisation, les patients post-COVID-19 sévère se trouvent dans un état physique et psychologique fébrile. La sensation vécue par ces personnes est celle d'une fatigue physique et mentale ; autrement dit, l'incapacité de trouver des ressources suffisantes pour effectuer des activités simples. Cette fatigue est vécue comme une dépression, une sensation qui elle seule risque d'aspirer le patient dans une spirale descendante : soit d'une fatigue en une absence de motivation, puis de sédentarité en déconditionnement musculaire. Ainsi, il y a un lien étroit qui existe entre progrès physique et renforcement psychologique, les deux sont interdépendants, un déclin dans l'un risque d'entraîner l'autre, mais, à l'inverse, une évolution positive dans l'un fait évoluer l'autre. Se rendre compte de l'amélioration de l'état physique permet de nourrir sa motivation et de trouver de l'énergie permettant de continuer à être physiquement actif. Le travail de réadaptation physique doit tenir compte de ces facteurs psychologiques, de la même manière que tout suivi psychologique doit tenir compte des facteurs physiologiques. Pour les personnes subissant un COVID-19 sévère, le retour à la vie normale peut être déstabilisant et les souvenirs de leur état de crise peuvent déclencher un syndrome de stress post-traumatique (SSPT). Les professionnels de la santé et les psychologues jouent un rôle important dans les soins post-hospitaliers et dans la prévention secondaire, c'est-à-dire la prévention des rechutes et des ré-hospitalisations.

[Pulmonary rehabilitation, return home: the issues of psychic care for severe Covid-19 patients]. / Réadaptation pulmonaire, retour au domicile : les enjeux du soin psychique des patients Covid-19 sévère.

Upon discharge from the ICU, most severe post-Covid-19 patients are considered out of danger and on the mend. A large proportion of these patients are able to go home, but some continue to be frail and suffer from the side effects of the disease and the past heavy hospitalization. Others do not have the necessary support at home. Pulmonary rehabilitation is becoming a critical step in prognosis and a comfortable return home. It allows many patients to regain confidence in their body and its potential, to bridge the gap between a medically safe passive position and daily life, which should become as independent as possible, and to optimally reduce the risks of regression or relapse.

Partial Shocks on Cooperative Multiplex Networks with Varying Degrees of Noise.

In many cooperative networks, such as alliance and trade networks, abrupt and intense changes to the state of the system (which we call "shocks"), can substantially change the network. We examine how such shocks affect multiplex networks via an agent-based model, in which agents add, drop, or change ties to increase their utility. At a certain time-point, some agents are "shocked" by changing (increasing or decreasing) the cost associated with tie-formation or tie-maintenance. Our model makes several improvements to previous models, including (a) only a fraction of nodes are shocked to simulate small wars or scattered tariff increases or decreases and (b) agents can make both utility-maximizing decisions and randomly rewire ties to explore the utility landscape. Interestingly, we find that randomly rewiring ties increases the utility of agents, for reasons similar to simulated annealing in physics. Furthermore, we create a novel metric to determine how networks change after a shock and find that the size of a shock and noise significantly changes the network, but only when agents' incentives for tie-formation are sufficiently high. Together, these results suggest that adding more realism to cooperation network models can give nuanced understanding to network shocks.

Quantifying dynamical spillover in co-evolving multiplex networks.

Multiplex networks (a system of multiple networks that have different types of links but share a common set of nodes) arise naturally in a wide spectrum of fields. Theoretical studies show that in such multiplex networks, correlated edge dynamics between the layers can have a profound effect on dynamical processes. However, how to extract the correlations from real-world systems is an outstanding challenge. Here we introduce the Multiplex Markov chain to quantify correlations in edge dynamics found in longitudinal data of multiplex networks. By comparing the results obtained from the multiplex perspective to a null model which assumes layers in a network are independent, we can identify real correlations as distinct from simultaneous changes that occur due to random chance. We use this approach on two different data sets: the network of trade and alliances between nation states, and the email and co-commit networks between developers of open source software. We establish the existence of "dynamical spillover" showing the correlated formation (or deletion) of edges of different types as the system evolves. The details of the dynamics over time provide insight into potential causal pathways.