Equine assisted services impact on social skills in autism spectrum disorder: A meta-analysis.

Many studies focus on the impact of equine assisted services (EAS) on social skills in autism spectrum disorder (ASD) but existing data are not consensual and the only available meta-analysis included only three studies and did not consider the social responsiveness scale (SRS). This meta-analysis aims to measure the impact of EAS on social skills in ASD. Using Pubmed, Embase, Web of Science and the Cochrane Library, the means and standard deviations of every available SRS post-intervention scores in each participant group were collected from the five selected randomised controlled trials with 240 participants. An EAS significant beneficial impact was found for the total SRS score, social communication and social cognition. A tendency to a significant impact was found for social awareness and social motivation. No significant difference was shown for autistic mannerisms. This meta-analysis shows a significant beneficial impact of EAS for several social skills in ASD. Further randomised controlled trials are required to complement these results and expand the knowledge on the field of possibilities of this care in ASD.

["Early detection of schizophrenia, why and who to contact?"] / Détection précoce de la schizophrénie, pourquoi et à qui s'adresser ?

"Early detection Of schizophrenia, why and who to contact? Schizophrenia usually occurs in late adolescence or early adulthood but is generally preceded by a prodromal phase or by a "high risk mental state" which corresponds to the onset of the disease. Early detection of symptoms and rapid specialized intervention begin at this stage. Medical intervention at this stage aims to influence the course of the disease and to limit the transition to a first-episode psychosis (FEP). Patients with FEP will require initiation of antipsychotic treatment. A long delay before antipsychotic treatment initiation will negatively impact the short and long term outcomes: more severe symptoms, worse treatment response and less global functioning. Early detection of schizophrenia involves general practitioners who will be firstly solicited by patients and their families. Patient should then be addressed without any delay to specialized psychiatric teams."

"Détection précoce de la schizophrénie, pourquoi et à qui s'adresser ? La schizophrénie survient généralement vers la fin de l'adolescence ou au début de l'âge adulte, mais est souvent précédée d'une phase prodromique ou « état mental à risque ¼ où se manifestent les premiers symptômes de la maladie. La détection précoce des premiers symptômes et l'intervention spécialisée débutent dès cette phase de prodromes. L'intervention à ce stade a pour objectif d'infléchir la trajectoire de la maladie et de limiter le risque de faire un premier épisode psychotique. Pour les patients qui font un tel épisode, un traitement antipsychotique doit être instauré sans délai. Le retard à l'instauration du traitement antipsychotique et à l'adressage des patients en psychiatrie impacte négativement leur pronostic à court, moyen et long terme : symptômes plus graves, moins bonne réponse au traitement et moins bon fonctionnement global. L'adressage rapide passe par une détection précoce qui implique en première ligne les médecins généralistes, qui sont souvent sollicités en première intention par les patients et leur famille."

Impact cérébral structurel et fonctionnel de la Clozapine chez les patients souffrant de schizophrénie : revue systématique des études longitudinales en neuroimagerie.

OBJECTIF: L'objectif de cette revue est d'identifier les corrélats anatomo-fonctionnels cérébraux lors d'un traitement par clozapine (CLZ) ainsi que les marqueurs anatomo-fonctionnels prédictifs de la réponse à la CLZ. MÉTHODES: Nous avons réalisé une revue systématique de la littérature avec les bases de données MEDLINE et Web of Science afin d'identifier et d'examiner toutes les études longitudinales en neuroimagerie investiguant l'impact cérébral de la CLZ. RÉSULTATS: 30 études ont été incluses et analysées. La CLZ induit une diminution du volume et de la perfusion dans les noyaux gris centraux chez les patients répondeurs. Un plus grand volume de substance grise et perfusion dans ces structures avant l'instauration de la CLZ étaient associés à une meilleure réponse au traitement. La diminution de volume et de perfusion au niveau du cortex préfrontal (CPF) est observée malgré l'instauration de CLZ mais de façon moins importante chez les patients sous CLZ que chez les patients sous antipsychotiques typiques. Un plus grand volume au niveau du CPF avant l'instauration de la CLZ est associé à une meilleure réponse clinique dans la majorité des études. Enfin, la CLZ semble induire une réduction des altérations au niveau de la substance blanche. CONCLUSION: Les corrélats anatomo-fonctionnels de la CLZ différent de ceux des autres antipsychotiques avec une action spécifique de la CLZ au niveau des ganglions de la base et du CPF pouvant participer à sa supériorité en termes de réponse clinique. Plusieurs données cliniques et d'imagerie conduisent à l'hypothèse d'un meilleur pronostic associé à une instauration plus rapide de la CLZ.

Long-term modulation of cardiac activity induced by inhibitory control over emotional memories.

Efforts to exclude past experiences from conscious awareness can lead to forgetting. Memory suppression is central to affective disorders, but we still do not really know whether emotions, including their physiological causes, are also impacted by this process in normal functioning individuals. In two studies, we measured the after-effects of suppressing negative memories on cardiac response in healthy participants. Results of Study 1 revealed that efficient control of memories was associated with long-term inhibition of the cardiac deceleration that is normally induced by disgusting stimuli. Attempts to suppress sad memories, by contrast, aggravated the cardiac response, an effect that was closely related to the inability to forget this specific material. In Study 2, electroencephalography revealed a reduction in power in the theta (3-8 Hz), alpha (8-12 Hz) and low-beta (13-20 Hz) bands during the suppression of unwanted memories, compared with their voluntary recall. Interestingly, however, the reduction of power in the theta frequency band during memory control was related to a subsequent inhibition of the cardiac response. These results provide a neurophysiological basis for the influence of memory control mechanisms on the cardiac system, opening up new avenues and questions for treating intrusive memories using motivated forgetting.

Specificity and sensitivity of the Self-assessment of Negative Symptoms (SNS) in patients with schizophrenia.

OBJECTIVES: Negative symptoms can be present at any stage of schizophrenia but their evaluation remains challenging. Self-evaluations may be particularly useful in screening negative symptoms quickly and effectively. The purpose of this study was to determine the sensitivity, the specificity, and the threshold beyond which the negative symptoms are considered pathological in a comparative study between patients with schizophrenia and healthy subjects using the Self-assessment of Negative Symptoms (SNS). METHODS: One hundred and nine patients with schizophrenia and schizoaffective disorders (DSM-5) and 99 healthy controls were included and evaluated with the SNS. AUROC analyses were performed to assess the discriminant performance of the SNS scale for screening negative symptoms in the whole sample of patients but also in 2 patient sub-samples without high scores of depression or negative symptoms. RESULTS: The SNS (AUROC = 0.942 ±â€¯0.046; p < 0.001) appears to be an appropriate screening tool for distinguishing between SZ and HC with a threshold value of 7, and the sensitivity and specificity were 92.7% (95CI = [86.1-96.8]) and 85.9% (95CI = [77.4-92.1]) respectively. A threshold at 7 was also observed in the samples without patients with high level of depressive or negative symptoms. CONCLUSION: These results indicate that SNS might be a valuable tool for screening negative symptoms in clinical practice regardless the level of depressive and negative symptoms. Further studies using SNS in subjects at high risk for psychosis or with a first psychotic episode would be useful in the detection of negative symptoms.

Fronto-subcortical functional connectivity in patients with schizophrenia and bipolar disorder during a verbal fluency task.

OBJECTIVES: Impairments in language production are common of schizophrenia (SZ) and bipolar disorder (BD). Identifying distinct functional connectivity (FC) patterns in SZ and BD may provide biomarkers for their diagnoses. METHODS: Forty-nine participants (15 SZ, 14 BD and 20 healthy controls (HC)) underwent a verbal fluency task consisting of mentally generating verbs in French, alternated with periods of silence. Functional network allowed identifying activation clusters: the medio-frontal cluster (MFC), the left subcortical cluster (LSCC) and the left fronto-lateral cluster (LFLC). FC was calculated between the average blood oxygen level-dependent signal time series in each cluster. Analyses of covariance were performed to test group differences on FC among the three paired-seed regions. RESULTS: SZ presented a significant reduced FC compared to HC within two paired-seed regions between the LFLC and the LSCC and between the MFC and the LSCC while BD were not significantly different from HC. SZ compared to BD exhibited a reduced FC within one paired-seed region between the MFC and the LSCC. There was no group effect between the MFC and the LFLC. CONCLUSIONS: A specific medio-prefronto-striato-thalamic functional dysconnectivity may be implicated in the pathophysiology of schizophrenia. This reduced fronto-subcortical FC could be a functional brain biomarker of schizophrenia.