[Surftherapy, an innovative mediation in an addiction treatment program]. / La surfthérapie, une médiation innovante dans un parcours de soins en addictologie.

Imagine a dream where ocean waves become allies for the caregiver. This vision took shape in a project begun in 2020 at the Clinique de l'Odet, the addictology department of the public mental health establishment in South Finistère: surf therapy as a tool for addictology care, the ocean as an ecological framework for rehabilitation. In this exceptional adventure, the dream of a care team to support patients' recovery through surfing has become a reality, where every wave is a step towards freedom; every take-off a victory on the road to recovery.

Improving decision-making and cognitive impulse control in bulimia nervosa by rTMS: An ancillary randomized controlled study.

OBJECTIVE: Impaired decision-making and inhibitory control may be involved in the pathophysiology of psychiatric disorders like bulimia nervosa (BN). Their improvement after neuromodulation may underpin clinical improvement. We assessed the effects of rTMS on these cognitive functions in a sample of women with BN. METHODS: Thirty-nine participants (22 in a sham group and 17 in an rTMS group) were assessed before and after 10 high frequency rTMS sessions over the left dorsolateral prefrontal cortex (DLPFC). RESULTS: The between-group analyses revealed no differences in the final neuropsychological performances. The within-group analyses showed that inhibitory control improved in both the go/no-go task (p = .03) and the BIS cognitive impulsivity subscale (p = .01) in the rTMS group only. Switches toward good choices on the Iowa gambling task significantly improved in the rTMS group only (p = .002), and understanding of the task contingencies increased between the two assessments, also in the rTMS group only (p = .03). DISCUSSION: This preliminary evidence suggests that modulation of left DLPFC might improve two putative cognitive biomarkers of BN.

A Lack of Clinical Effect of High-frequency rTMS to Dorsolateral Prefrontal Cortex on Bulimic Symptoms: A Randomised, Double-blind Trial.

Studies suggest that stimulation of the left dorsolateral prefrontal cortex (DLPFC) reduces food craving in bulimic patients, but evidence supporting repetitive transcranial magnetic stimulation (rTMS) as a therapeutic tool is lacking. We investigated the safety and therapeutic efficacy of an adjunct high-frequency rTMS programme targeting the left DLPFC. Forty-seven women with bulimia nervosa were randomised to a real or sham stimulation group. The real group underwent 10 rTMS sessions, each consisting of 20 trains of 5 seconds with 55-second intervals between trains, at a frequency of 10 Hz. The main outcome was the number of binge episodes in the 15 days following the end of stimulation. Overall, no significant improvement in bingeing and purging symptoms was noted after the programme. rTMS was well tolerated. This suggests that 10 sessions of high-frequency rTMS to the left DLPFC provide no greater benefit than placebo. Future studies should consider methodological issues as well as alternative targets. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Is there any impact of cognitive remediation on an ecological test in schizophrenia?

INTRODUCTION: Cognitive deficits are commonly reported in schizophrenia and have a significant impact on the daily life of patients and on their social and work inclusion. Cognitive remediation therapies (CRT) may enhance the capabilities of schizophrenia patients. Although social and work integration is the ultimate goal of CRT, previous studies have failed to carry out a detailed assessment of the effects on everyday life. METHODS: Fifty-nine schizophrenia patients were randomised into two groups (remediation or usual treatment) to test the effects of a new remediation programme, which included both rehearsal and strategy learning, on cognitive functions. An ecological test was used to evaluate its transfer to daily living skills. RESULTS: Cognitive improvements are revealed in CRT patients, mainly in memory and executive functions. Patients showing some deficiencies to perform the ecological test had better scores after the CRT. Moreover, they significantly improve their social activity scores. CONCLUSIONS: CRT would facilitate mental load monitoring by enhancing or reallocating cognitive resources, facilitating the patient's organisation and autonomy. The rehearsal learning approach improves the ability to carry out automatic operations that are less demanding in terms of cognitive resources, thereby increasing the resources available for acquisition and efficient use of strategies provided during the strategy learning approach.

Explicit and implicit emotional processing modifications in pharmacoresistant left temporal lobe epilepsy and anxiodepressive disorders.

We examined whether anxiodepressive patients with left temporal lobe epilepsy could be differentiated from those with depression but without epilepsy on tasks that investigate attentional bias toward and explicit judgment of emotional stimuli. Eight depressive patients, eight anxiodepressive patients with epilepsy, and eight controls participated in the present study. Anxiodepressive with epilepsy and depressive patients had comparable depression scores and the same cognitive profile. Two distinct emotional tasks were used: the decision lexical task and the number comparison task. Three emotional connotations were presented: neutral, positive, and negative. The pattern of results showed an attentional bias toward negative words and pictures in depressive patients and only toward negative words in anxiodepressive patients with epilepsy. Moreover, depressive patients explicitly judged negative stimuli with lower intensity and anxiodepressive patients judged neutral stimuli with higher intensity. The present study specifies the emotional functioning in depression with or without left temporal lobe epilepsy.

Ghrelin and obestatin circadian levels differentiate bingeing-purging from restrictive anorexia nervosa.

CONTEXT: Anorexia nervosa (AN) patients present with restrictive food behavior (AN-R). Some of them develop episodes of bulimia (AN-BP) without any clear pathophysiological explanation to date. Their clinical differentiation is important but not easily performed. Orexigenic/anorexigenic peptides measurements could provide some clues for that matter. OBJECTIVE: The objective of the study was to determine whether the circadian profile of total and acylated ghrelin, obestatin, and peptide YY (PYY) levels is different in AN-R subjects when compared with AN-BP patients. DESIGN AND SETTINGS: This was a cross-sectional study in an endocrinological unit. PATIENTS AND CONTROL SUBJECTS: Four groups of age-matched young women: 22 AN-R, 10 AN-BP, 16 normal-weight bulimia nervosa (BN), and nine controls. MAIN OUTCOME MEASURES: Twelve-point circadian profiles of plasma total and acylated ghrelin, obestatin, and PYY were measured. RESULTS: Total and acylated ghrelin and obestatin circadian levels were increased in AN-R when compared with controls but decreased in both AN-BP and BN groups (P < 0.001). PYY was decreased in all groups with eating disorders. Acylated to total ghrelin ratio was decreased in AN-BP and BN (P < 0.001), whereas obestatin to acylated ghrelin and PYY to acylated ghrelin ratios were increased in both groups with bingeing-purging behavior (P < 0.0001). CONCLUSIONS: Patients with AN-associated bingeing-purging behavior present a very different profile of appetite regulatory peptides when compared with the pure restrictive type. The assessment of ghrelin (and eventually obestatin) could be of particular interest for differential diagnosis. Very low ghrelin levels and increased anorexigenic to orexigenic peptide ratios suggest either a lack of adaptation to a starvation state or a higher facility to cope with undernutrition.