Utility of a buccal swab point-of-care test for the IFNL4 genotype in the era of direct acting antivirals for hepatitis C virus.

BACKGROUND: The CC genotype of the IFNL4 gene is known to be associated with increased Hepatitis C (HCV) cure rates with interferon-based therapy and may contribute to cure with direct acting antivirals. The Genedrive® IFNL4 is a CE marked Point of Care (PoC) molecular diagnostic test, designed for in vitro diagnostic use to provide rapid, real-time detection of IFNL4 genotype status for SNP rs12979860. METHODS: 120 Participants were consented to a substudy comparing IFNL4 genotyping results from a buccal swab analysed on the Genedrive® platform with results generated using the Affymetix UK Biobank array considered to be the gold standard. RESULTS: Buccal swabs were taken from 120 participants for PoC IFNL4 testing and a whole blood sample for genetic sequencing. Whole blood genotyping vs. buccal swab PoC testing identified 40 (33%), 65 (54%), and 15 (13%) had CC, CT and TT IFNL4 genotype respectively. The Buccal swab PoC identified 38 (32%) CC, 64 (53%) CT and 18 (15%) TT IFNL4 genotype respectively. The sensitivity and specificity of the buccal swab test to detect CC vs non-CC was 90% (95% CI 76-97%) and 98% (95% CI 91-100%) respectively. CONCLUSIONS: The buccal swab test was better at correctly identifying non-CC genotypes than CC genotypes. The high specificity of the Genedrive® assay prevents CT/TT genotypes being mistaken for CC, and could avoid patients being identified as potentially 'good responders' to interferon-based therapy.

Suicide risk and mental health in the general population of French Polynesia.

OBJECTIVE: There are no reports on the burden of suicidal ideation and suicide attempts in the general population of French Polynesia (FP). We aimed to improve suicide prevention and mental health care by assessing the prevalence of suicide risk and major mental health disorders and care among adults in FP. METHODS: We conducted the Mental Health in General Population Survey in FP during 2015 to 2017. Participants were selected using the quota method to obtain a representative sample of the general population. Suicide risk and psychiatric diagnoses were assessed using the Mini International Neuropsychiatric Interview. RESULTS: We included 968 people aged 18 years or older. The prevalence of current suicidal ideation (13.1%) and current (2.6%) and lifetime suicide attempts (18.6%), as well as mental health disorders (42.8%), was high in FP. A notable proportion of participants with these conditions did not seek medical assistance. CONCLUSION: A high prevalence of suicide risk and mental health disorders was found in the general population of FP. Suicide prevention and mental health plans are needed in FP that include better access to primary care for the diagnosis and treatment of mental health disorders. Further research is needed to clarify cultural risk and protective factors.

Suicide in French Polynesia: a retrospective analysis based on medicolegal documents and interview with family.

OBJECTIVE: To analyse the epidemiological data on suicide in French Polynesia (FP). METHODS: Data on suicides were collected from the Public Health Direction, Judicial Police Investigations Court of Justice records, the Centre d'Opérations et de Renseignements de la Gendarmerie, patient records for those hospitalized in psychiatry and from psychological autopsies. RESULTS: The dataset consisted of 316 suicide cases in FP over 25 years (1992-2016). In FP, suicide was more frequent in men (sex ratio 3.2:1), young people (mean age, 34.4 years) and individuals with previously diagnosed psychiatric disorders (100 of 316; 31.6%) The most common method of suicide was hanging (276 of 316; 87.3%). A history of previous suicide attempts was found in 25 of 56 (44.6%) of suicide cases, when documented. The most common potential triggering factors for suicide were emotional problems. The suicide rates have remained stable during 1992-2016 (mean 10.6/100 000 inhabitants per year), with periods of economic crises increasing suicide rates. CONCLUSIONS: These results provide valuable information to enable the effective targeting of suicide prevention strategies toward those at high risk. Economic crises had larger impacts in the French overseas territories than mainland France. Given the unprecedented economic impact of the Covid-19 pandemic in FP, there is an urgent need to implement suicide epidemiological surveillance and prevention programmes.

International study of the prevalence and factors associated with insomnia in the general population.

OBJECTIVES: Insomnia is a public health problem with many repercussions. It affects a significant proportion of the general population worldwide, but the estimated prevalences in different countries are difficult to compare due to the use of heterogeneous methodologies. The objectives of the study were to compare the prevalence of insomnia in the general population in different sites around the world and to identify sociodemographic and mental health associated factors, using the same tool and within a single study. METHODS: This multicenter cross-sectional study is based on the Mental Health in the General Population survey (MHPG). It included several sites in France and 12 countries around the world with a representative sampling of the general population. The prevalence of short-term insomnia disorder was estimated by the occurrence within one month of at least one symptom, at a minimum frequency of three per week, with repercussions on everyday life. RESULTS: Out of the 57,298 participants, 11.3% had a diagnosis of short-term insomnia disorder, with significant differences in prevalence between sites, ranging from 2.3% to 25.5%. Insomnia was significantly related to having mood disorders, anxiety disorders, substance use disorders and psychotic disorders. Insomnia was also more common among women, older adults, working participants and those who practice a religion. CONCLUSIONS: The prevalence of insomnia was highly variable between sites, but the predictors appeared to be the same everywhere. Insomnia seemed to be more related to the presence of mood and anxiety disorders than a site-specific effect and thus may be a good indicator of mental health.

Mental disorders on admission to jail: A study of prevalence and a comparison with a community sample in the north of France.

BACKGROUND: The aim of the present study was to estimate prevalence rates of psychiatric and substance use disorders in male and female prisoners on admission to prison in the north of France and compare the frequency of these disorders to the general population. METHODS: This cross-sectional survey on Mental Health in the Prison Population (MHPP), conducted between March 2014 and April 2017, interviewed 653 randomly selected men and women who had recently been committed to the French general population prison system in the Nord and Pas-de-Calais departments. For each subject, the Mini International Neuropsychiatric Interview (MINI), a standardized psychiatric interview, was used to screen for psychiatric and substance use disorders. The prevalence rates were then compared with data from the Mental Health in the General Population (MHGP) survey, a general population survey that used the same assessment methodology as MHPP in the Nord and Pas-de-Calais departments. A control sample was taken from the MHGP survey with a ratio of one case (MHPP) to three controls (MHGP) matching on age and sex. RESULTS: The sample was primarily composed of French men, most of them single with low educational levels at the time of imprisonment. The mean age was 31.7 (standard deviation = 9.9; min = 18; max = 67). Most of the subjects included were first-time prisoners. The prevalence of affective disorders among newly incarcerated individuals was 31.2% with higher rates for major depressive disorder (27.2%). The prevalence of anxiety disorders was 44.4% with higher rates for generalized anxiety disorder (25.2%). The prevalence of psychotic syndromes was 6.9%. The prevalence of substance use disorders was 53.5% and a suicide risk was identified in 31.4% of the prisoners interviewed. Higher prevalence rates were found in the MHPP when compared with the MHGP for all psychiatric and substance use disorders assessed except for dysthymia and current isolated psychotic syndrome. CONCLUSIONS: Our study shows very high levels of prevalence for psychiatric and substance use disorders in recently committed French prisoners.