[Add-on value of plasma assays during prescription of antipsychotics]. / Intérêt des dosages plasmatiques lors de la prescription des antipsychotiques.

The plasma dosage of antipsychotics is justified in many clinical situations, such as the existence of surprising side effects depending on the dose of administered antipsychotic or, in the event of a lack of therapeutic efficacy. This method allows the clinician to get out of the pure empiricism, trial and error, of his/her supposed beliefs concerning patient compliance and, above all, to base his/her decisions on objective elements in the psychopharmacological field. However, it is clear that this inexpensive and easily accessible technology is not used very often. In the event of a result of the plasma dosage higher or lower than the normal values, it will first be necessary to exclude a phenomenon of drug interactions. Then, the calculation of the metabolic ratio will make it possible to suspect the existence of a particular genetic polymorphism of metabolism (poor metabolizer? ultra-rapid metabolizer?) of the concerned cytochrome, which can then be confirmed by genotyping oriented towards this cytochrome.

Le dosage plasmatique des antipsychotiques est justifié dans de nombreuses situations cliniques, comme l'existence d'effets secondaires surprenants en fonction de la dose d'antipsychotique administrée, ou encore, en cas de manque d'efficacité thérapeutique. Cette méthode permet au clinicien de sortir de l'empirisme pur, essai-erreur, de ses supposées croyances concernant l'observance du patient et, surtout, de baser ses décisions sur les éléments objectifs dans le domaine psychopharmacologique. Pourtant, force est de constater que cette technologie peu coûteuse et facilement accessible n'est que trop peu souvent utilisée. En cas de résultat du dosage plasmatique supérieur ou inférieur à la norme, il conviendra, tout d'abord, d'exclure un phénomène d'interactions médicamenteuses. Ensuite, le calcul du ratio métabolique permettra de soupçonner éventuellement l'existence d'un polymorphisme génétique de métabolisation particulier (métaboliseur lent ? métaboliseur ultra-rapide ?) du cytochrome concerné, qui pourra alors être confirmé par un génotypage orienté vers ce cytochrome.

[Suicide prevention]. / La prévention du suicide.

Suicide is a public health problem that affects people throughout their lives: from childhood to adolescence, and from adulthood to old age. Numerous risk factors for suicide have been identified, not only at the level of the individual, but also at the level of the family, the community and society as a whole. These factors include the existence of a mental health problem, in particular depression and substance abuse. At the clinical level, it is important to try to spot the signs of impending suicide and organize an appropriate care strategy. But there are also protective factors against suicide at individual, societal and cultural levels. There are many strategies for preventing suicide. These approaches range from raising awareness of the problem of suicide among the general population and destigmatizing mental illnesses, to more targeted measures for people at risk of suicide: actively treating depression, training healthcare professionals to identify individuals at risk, developing telephone helplines, setting up peer-help programs and developing post-hospitalisation follow-up programs.

Le suicide est un problème de santé publique qui touche les personnes tout au long de leur vie : de l'enfance à l'adolescence, et de l'âge adulte aux personnes âgées. De nombreux facteurs de risque de suicide ont été identifiés non seulement au niveau de l'individu, mais également au niveau de la famille, de la communauté et de la société. Parmi ceux-ci, citons l'existence d'une pathologie mentale, en particulier la dépression et les abus de substances. Au niveau clinique, il importe d'essayer de repérer les signes de suicide imminent et de mettre en place une stratégie adéquate. Mais il existe également des facteurs de protection contre le suicide au niveau individuel, sociétal, ou culturel. Nombreuses sont les stratégies de prévention du suicide. Cela va de la sensibilisation de la population générale à la problématique du suicide et la déstigmatisation des pathologies mentales, à des mesures plus ciblées pour le public à risque de suicide : traiter activement la dépression, former les professionnels de la santé à identifier les individus à risque, développer des lignes téléphoniques d'urgence, mettre en place des programmes de «pair-aidance¼ et développer des programmes de suivi post-hospitalisation.

[Prevention of psychiatric illness]. / La prévention des maladies psychiatriques.

Prevention and early intervention in the field of mental health are recognized as key elements in minimizing the impact of any potentially serious mental health condition. However, early intervention in the field of young people's health is an objective that is underdeveloped. There are several possible avenues of prevention: selective preventive interventions for individuals whose risk of developing a mental disorder is significantly higher than the rest of the population, interventions for individuals who are no longer asymptomatic, secondary prevention strategies aimed at mitigating the onset of negative prognostic factors, and tertiary prevention strategies aimed at remedying resistance to treatment and psychosocial dysfunction. Epigenetics will undoubtedly be a promising area for the prevention of mental disorders in the future. Epigenetic processes, which can be modified by preventive measures such as physical activity, could lead to resilience to mental disorders. Finally, lifestyle factors (physical exercise, diet, smoking, lack of sleep) could also play a role in the emergence or prevention of mental illness.

La prévention et l'intervention précoce dans le domaine de la santé mentale sont reconnues comme des éléments-clés pour minimiser l'impact de tout état de santé mental potentiellement grave. Cependant, l'intervention précoce dans le domaine de la santé des jeunes est un objectif qui n'est qu'insuffisamment développé. Plusieurs axes de prévention peuvent se rencontrer : les interventions de prévention sélective chez des individus dont le risque de développer un trouble mental est significativement plus élevé que le reste de la population, les interventions indiquées chez des individus qui ne sont plus asymptomatiques, les stratégies de prévention secondaire visant à atténuer l'apparition de facteurs pronostiques négatifs, les stratégies de prévention tertiaire visant à remédier à la résistance au traitement et au dysfonctionnement psychosocial. L'épigénétique constituera, sans aucun doute, à l'avenir, un domaine prometteur pour la prévention des troubles mentaux. Les processus épigénétiques, modifiables par des mesures préventives comme l'activité physique, pourraient conduire à la résilience des troubles mentaux. Enfin, des facteurs liés au mode de vie (exercice physique, alimentation, tabac, manque de sommeil) pourraient également jouer un rôle dans l'émergence ou la prévention des maladies mentales.

Bioderived 4D Printable Terpene Photopolymers from Limonene and ß-Myrcene.

Green manufacturing and reducing our cultural dependency on petrochemicals have been topics of growing interest in the past decade, particularly for three-dimensional (3D) printable photopolymers where often toxic solvents and reagents have been required. Here, a simple solvent-free, free-radical polymerization is utilized to homo- and copolymerize limonene and ß-myrcene monomers to produce oligomeric photopolymers (Mn < 11 kDa) displaying Newtonian, low viscosities (∼10 Pa × s) suitable for thiol-ene photo-cross-linking, yielding photoset materials in a digital light processing (DLP)-type 3D printer. The resulting photosets display tunable thermomechanical properties (poly(limonene) displays elastic moduli exceeding 1 GPa) compared with previous works focusing on monomeric terpenes as well as four-dimensional (4D) shape memory behavior. The utility of such photopolymers for biomedical applications is briefly considered on the premise of the hydrophilic nature (measured by contact angle) as well as their cytocompatibility upon seeding films with macrophages. These terpene-derived, green 4D photopolymers are shown to have promising physical behaviors suitable for an array of manufacturing and 3D printing applications.

Inflammatory Markers May Inform the Effects of Electroconvulsive Therapy on Cognition in Patients with Depression.

INTRODUCTION: The neurobiological mechanisms underlying the acute cognitive effects of electroconvulsive therapy (ECT) remain poorly understood. Prior research has shown that proinflammatory cytokines such as IL-6, TNF-α, IL1-ß, and IL-10 may interfere with cognitive functioning. Interestingly, immunomodulation is one of the proposed modes of action of ECT. This study investigates whether changes of peripheral levels of IL-6, TNF-α, IL1-ß, and IL-10 are related to changes in cognitive functioning following ECT. METHODS: In the week before and 1 week after an acute course of ECT, 62 patients suffering from depression underwent a neuropsychological evaluation to assess their processing speed using the Symbol Digit Substitution Test (SDST), verbal episodic memory using the Hopkins Verbal Learning Test-Revised (HVLT-R), and their retrospective autobiographic memory using the Autobiographical Memory Interview (AMI) with the peripheral inflammatory markers being measured at the same 2 time points. RESULTS: Patients improved drastically following ECT, while their main performance on both the HVLT-R and AMI declined and their SDST scores remained stable. The levels of IL-6 and IL1-ß had both decreased, where the decrease in IL-6 was related to the decrease in HVLT-R scores. Higher baseline IL-10 levels were associated with a more limited decrease of the HVLT-R scores. CONCLUSION: Our findings tentatively suggest that the effects of ECT on verbal episodic memory may be related to the treatment's immunomodulatory properties, most notably due to decreased IL-6 levels. Moreover, baseline IL-10 appears to be a potential biomarker to predict the effects of ECT on verbal episodic memory. Whilst compelling, the results of this study should be interpreted with caution as, due to its exploratory nature, no correction for multiple comparisons was made. Further, a replication in larger cohorts is warranted.

Inflammation, Hippocampal Volume, and Therapeutic Outcome following Electroconvulsive Therapy in Depressive Patients: A Pilot Study.

INTRODUCTION: Electroconvulsive therapy (ECT) influences the concentration of peripheral inflammatory markers, such as interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). In which way this immune effect contributes to the impact of ECT on the central nervous system in depression remains unknown. OBJECTIVE: The aim of this study was to examine whether the hippocampal volumetric increase in depressed patients treated with ECT is related to changes in peripheral IL-6 and TNF-α levels. METHODS: IL-6 and TNF-α plasma levels were measured in 62 patients 1 week before and after an acute course of ECT. Hippocampal volumes were analyzed in a magnetic resonance imaging (MRI) subsample of 13 patients at the same time points. RESULTS: A significant decrease in IL-6 levels was observed in the total sample and a significant increase in hippocampal volume in the MRI subsample. The reduction of peripheral IL-6 correlated with an increase in total hippocampal volume. A more limited decrease of TNF-α correlated with a more limited increase of both the total and left hippocampus volumes. CONCLUSION: This pilot study is the first to highlight the link between peripheral immune changes and hippocampal volume increase following ECT. Further research is required to conclude whether ECT indeed exerts its central effect on the brain via changes of peripheral inflammatory markers.

Imbalance between abstract and concrete repetitive thinking modes in schizophrenia.

OBJECTIVE: Repetitive thoughts can be divided in two modes: abstract/analytic (decontextualized and dysfunctional) and concrete/experiential (problem-focused and adaptive). They constitute a transdiagnostic process involved in many psychopathological states but have received little attention in schizophrenia, as earlier studies only indexed increased ruminations (related to dysfunctional repetitive thoughts) without jointly exploring both modes. This study explored the two repetitive thinking modes, beyond ruminations, to determine their imbalance in schizophrenia. METHODS: Thirty stabilized patients with schizophrenia and 30 matched controls completed the Repetitive Response Scale and the Mini Cambridge-Exeter Repetitive Thought Scale, both measuring repetitive thinking modes. Complementary measures related to schizophrenic symptomatology, depression and anxiety were also conducted. RESULTS: Compared to controls, patients with schizophrenia presented an imbalance between repetitive thinking modes, with increased abstract/analytic and reduced concrete/experiential thoughts, even after controlling for comorbidities. Schizophrenia is associated with stronger dysfunctional repetitive thoughts (i.e. abstract thinking) and impaired ability to efficiently use repetitive thinking for current problem-solving (i.e. concrete thinking). CONCLUSION: This imbalance confirms the double-faced nature of repetitive thinking modes, whose influence on schizophrenia's symptomatology should be further investigated. The present results also claim for evaluating these processes in clinical settings and for rehabilitating the balance between opposite repetitive thinking modes.

A comparative study between cognitive impairments of adults with schizophrenia and children with psychotic spectrum disorders: a literature review.

BACKGROUND: Cognitive impairments have been extensively reported for patients suffering from schizophrenia but a lot of questions persist about these troubles. Several domains of cognitive functions are impaired which result in daily life difficulties. Many arguments tend to show that children suffering from psychotic spectrum disorders present cognitive impairments also but things are not clearly defined. The aim of this review is to compare the cognitive impairments of children suffering from psychotic symptoms and adults suffering from schizophrenia in order to improve the understanding of the two clinical affections. A better understanding of the disease is necessary to improve the health care which currently give poor results. SUBJECTS AND METHODS: Besides the Diagnostic and Statistical Manual (DSM-5) and the French reference books, the present research has been conducted using PubMed, Medline, PsycINFO, PsycARTICLES and ScienceDirect. Literature about cognitive impairments of adults with schizophrenia and children with psychotic spectrum disorders is assessed and results are compared. RESULTS: Both children and adults suffer from cognitive impairments: language, memories, executive and motor functions and IQ are impaired. An important heterogeneity in the troubles has been observed and a poor knowledge in terms of onset time, evolution, intensity, impact on everyday life and therapeutic interest has been reported. CONCLUSION: Adults with schizophrenia and children suffering from psychotic spectrum disorders have similar cognitive impairments in many domains of cognition. The similarities in term of cognitive impairments highlighted in the present work should support new studies in order to adapt to children the current cognitive therapies which are mostly provided to adults. As the cognitive impairments are heterogeneous, each patient should receive a tailored neurocognitive exam which takes into account its abilities and weaknesses.

Enhanced high harmonic generation driven by high-intensity laser in argon gas-filled hollow core waveguide.

We show that a significant enhancement of the photon flux produced by high harmonic generation can be obtained through guided configuration at high laser intensity largely above the saturation intensity. We identify two regimes. At low pressure, we observe an intense second plateau in the high harmonic spectrum in argon. At relatively high pressure, complex interplay between strongly time-dependent ionization processes and propagation effects leads to important spectral broadening without loss of spectral brightness. We show that the relevant parameter for this physical process is the product of laser peak power by gas pressure. We compare source performances with high harmonic generation using a gas jet in loose focusing geometry and conclude that the source developed is a good candidate for injection devices such as seeded soft x-ray lasers or free electron lasers in the soft x-ray range.

Treatment-Resistant Depression in Real-World Clinical Practice: A Systematic Literature Review of Data from 2012 to 2022.

OBJECTIVE: Real-world evidence in treatment-resistant depression (TRD; commonly defined as non-response to ≥ 2 consecutive treatments at adequate dosage and duration) is lacking. A systematic literature review was conducted to understand disease burden and treatment outcomes for patients with TRD, studied in a real-world setting over the last decade. DATA SOURCES: A literature search was conducted in May 2022 in MEDLINE, Embase, The Cochrane Libraries and PsycINFO, comprising studies published from 2012 to 2022. Bibliographies of all relevant identified systematic reviews and relevant conference proceedings from 2020 to 2022 were manually hand-searched. STUDY SELECTION: Real-world studies, including cohort, cross-sectional, case-control, chart review and registry studies, published in English and reporting outcomes in adults with TRD, were included. DATA EXTRACTION: Extracted data included study and baseline disease characteristics, treatment type, treatment response, clinical outcomes and health-related quality of life. RESULTS: Twenty studies were included. Criteria for TRD varied, but patients typically experienced long-lasting depression (range 1.4 to 16.5 years). Across studies, mean disease severity scores demonstrated moderate to severe depression, reflecting a high burden of disease at baseline. Remission rates were typically low but generally increased with longer follow-up durations. However, the heterogeneity of interventions, follow-up durations (range 2 weeks to 9.4 years) and assessment tools precluded their quantitative synthesis. Studies were frequently limited by low sample size (range 14 to 411 patients) and health-related quality of life was infrequently assessed. CONCLUSIONS: There is a lack of clinical consensus regarding the definition, assessment and monitoring of TRD in real-world practice. Nevertheless, TRD carries a high burden of illness and there is an unmet need for faster and more effective treatments. To better understand the personal burden of affected patients, future studies would benefit from standardisation of severity assessment and measures of treatment effectiveness, as well as greater consideration of health-related quality of life.

Many people continue to experience depression even after trying two or more medications. This is called treatment-resistant depression (TRD). Most of the information we have on TRD comes from clinical trials, which take place under tightly-controlled conditions. It is important to understand the effects of TRD and TRD treatments on people in their day-to-day lives. Researchers studying people's day-to-day lives call this researching in a "real-world setting". We searched for studies carried out in real-world settings in the last 10 years. We found 20 relevant studies. As these studies were in real-world settings, there were many differences between them, including differences in how TRD was diagnosed, the treatments used, how long people were monitored and how results were measured. This made it difficult to compare how successful different treatments were. Most studies included a small number of people and monitored them for a relatively short time. We found people with TRD had usually lived with it for many years and their symptoms were moderate or severe. Only two studies asked people how TRD affected their lives. These two studies found health-related quality of life and work productivity was low. Most studies found lots of people still had symptoms of depression after treatment. However, symptoms typically improved more when studies monitored people for a longer time. To improve our knowledge of TRD, future studies should monitor more people for longer and use the same ways of measuring results. They should also ask how TRD affects people's daily lives.

Optimization and phase matching of fiber-laser-driven high-order harmonic generation at high repetition rate.

High-repetition-rate sources are very attractive for high-order harmonic generation (HHG). However, due to their pulse characteristics (low energy, long duration), those systems require a tight focusing geometry to achieve the necessary intensity to generate harmonics. In this Letter, we investigate theoretically and experimentally the optimization of HHG in this geometry, to maximize the extreme UV (XUV) photon flux and improve the conversion efficiency. We analyze the influence of atomic gas media (Ar, Kr, or Xe), gas pressure, and interaction geometries (a gas jet and a finite and a semi-infinite gas cell). Numerical simulations allow us to define optimal conditions for HHG in this tight focusing regime and to observe the signature of on-axis phase matching. These conditions are implemented experimentally using a high-repetition-rate Yb-doped fiber laser system. We achieve optimization of emission with a recorded XUV photon flux of 4.5×10(12) photons/s generated in Xe at 100 kHz repetition rate.

Fighting stigma of mental illness in midsize European countries.

PURPOSE: Stigma is the most powerful obstacle to the development of mental health care. Numerous activities aiming to reduce the stigma of mental illness and the consequent negative discrimination of the mentally ill and their families have been conducted in Europe. Descriptions of many of these activities are not easily available, either because there are no publications that describe them, or because descriptions exist only in local languages. This supplement aims to help in overcoming this imbalance by providing a description of anti-stigma activities in 14 countries in Europe regardless of the language in which they were published and regardless whether they were previously published. METHODS: The review was undertaken by experts who were invited to describe anti-stigma activities in the countries in which they reside. It was suggested that they use all the available evidence and that they consult others in their country to obtain a description of anti-stigma activities that is as complete as possible. RESULTS: The anti-stigma activities undertaken in the countries involved are presented in a tabular form. The texts contributed by the authors focus on their perception of the stigma of mental illness and of activities undertaken to combat it in their country. CONCLUSIONS: Although much has been done against the stigmatization and discrimination of the mentally ill, fighting stigma remains an essential task for mental health programs and for society. The descriptions summarized in this volume might serve as an inspiration for anti-stigma work and as an indication of potential collaborators in anti-stigma programs.

Deficit in negative emotional information processing in schizophrenia: does it occur in all patients?

The nature of the impairment in the processing of emotional information in schizophrenia is still being debated. Some authors reported that schizophrenia patients would show deficits in the treatment processing of negative emotional information without a negative bias, as observed in controls, when in a combined emotional situation including positive/negative information. Eighteen subjects with paranoid schizophrenia in remission with a low level of negative symptoms and 18 control subjects were exposed to 108 pairs of pictures (International Affective Picture System) depicting different emotions (N = negative, P = positive, n = neutral) from six different combinations: N/N, P/P, n/n, P/N, P/n, and N/n. The subjects responded by clicking on a right or left button in response to a negative or positive feeling toward the stimuli (forced choice task). They were also asked to classify each of the individual pictures as positive, negative, or neutral (emotion-recognition task). In this well-defined group of paranoid schizophrenia patients in remission, we observed the persistence of a negative bias when an ambiguous situation is displayed (P/N) with the absence of an impairment in negative emotional information recognition and the presence of a positive bias in the recognition of neutral stimuli, reflecting a tendency to keep arousal-provoking perceptual cues from entering into subjective awareness.

Do general practitioners and psychiatrists agree about defining cure from depression? The DEsCRIBE™ survey.

BACKGROUND: This study aimed to document the outcome dimensions that physicians see as important in defining cure from depression. The study also aimed to analyse physicians' attitudes about depression and to find out whether they affect their prescribing practices and/or the outcome dimensions that they view as important in defining cure. METHODS: A 51-item questionnaire based on six validated scales was used to rate the importance of several depression outcome dimensions. Physicians' attitudes about depression were also assessed using the Depression Attitude Scale. Overall, 369 Belgian physicians (264 general practitioners [GPs]; 105 psychiatrists) participated in the DEsCRIBE™ survey. RESULTS: GPs and psychiatrists strongly agreed that functioning and depressive symptomatology were most important in defining cure; anxious and somatic symptomatology was least important. GPs and psychiatrists differed in their attitudes about depression (p <0.001). Logistic regression revealed that the attitudes of GPs - but not psychiatrists - were significantly associated with their rates of antidepressant prescription (p < 0.001) and that certain attitudes predicted which outcome dimensions were seen as important in defining cure. CONCLUSIONS: Belgian GPs and psychiatrists strongly agreed on which criteria were important in defining cure from depression but differed in their attitudes about depression. The outcome dimensions that were considered important in defining cure were influenced by physicians' attitudes - this was more pronounced in GPs than in psychiatrists.

Management of marked liver enzyme increase during olanzapine treatment: a case report and review of the literature.

OBJECTIVES: Atypical antipsychotics commonly cause isolated asymptomatic increase in the aminotransferase levels. Furthermore, the strategy in the choice of antipsychotic agent must take into account hepatic tolerance because of the non-negligible incidence of liver disorders among the psychiatric population. The aim of this article is to better understand the strategy to adopt during an increase of liver enzymes in a psychotic patient under atypical neuroleptic treatment. METHOD: A clinical case is presented of a female patient treated for psychotic decompensation with increase of liver enzymes (Olanzapine). Her treatment was changed several times over a period of 7 years and laboratory investigations were conducted simultaneously. RESULTS: It seems that the increase of liver enzymes is slightly more frequent with Clozapine and Olanzapine than Risperidone, Perazine and Haloperiol. CONCLUSION: The different mechanisms of hepatotoxicity are unknown at present but it seems that the hypersensibility mechanism is likely to be dose dependent. During an increase of enzymes, it is important to combine a control of hepatic enzymes with a reduction of neuroleptic dosage. Discontinuation should be considered if a continued increase of enzymes above certain values is shown or if a clinical symptom appears. We note also that some risk factors were found, including geriatric or pedopsychiatric age, obesity, and association with active ingredients or addictive substances responsible for hepatic disorders.

Shape Memory Poly(ß-hydroxythioether) Foams for Oil Remediation in Aquatic Environments.

Shape memory poly(ß-hydroxythioether) foams were produced using organobase catalyzed reactions between epoxide and thiol monomers, allowing for the rapid formation of porous media within approximately 5 min, confirmed using both rheology and physical foam blowing. The porous materials possess ultralow densities (0.022 g × cm-3) and gel fractions of approximately 93%. Thermomechanical characterizations of the materials revealed glass transition temperatures tunable from approximately 50 to 100 °C, elastic moduli of approximately 2 kPa, and complete strain recovery upon heating of the sample above its glass transition temperature. The foams were characterized for their ability to take up oil from an aqueous multilayered ideal environment, revealing more than 2000% mass of oil (relative to the foam mass) could be collected. Importantly, while post-fabrication functionalization was possible with isocyanate chemistry followed by addition of hexadecanethiol or 3,3-bis(hexadecylthio)propan-1-ol, the oil collection efficiency of the system was not significantly enhanced, indicating that these materials, as porous media, possess unique attributes that make them appealing for environmental remediation without the need for costly modifications or manipulations.

Improvement of psychomotor retardation after electroconvulsive therapy is related to decreased IL-6 levels.

BACKGROUND: Prior studies suggest that IL-6 may be involved in the pathophysiology of psychomotor symptoms in depression. Electroconvulsive therapy (ECT), as yet the most effective biological treatment of severe depression, is known to improve psychomotor functioning, while recent studies have shown a decrease in the elevated IL-6 levels of depressed patients following ECT. OBJECTIVES: This study investigates whether the improvement in psychomotor functions in patients with depression after ECT is related to changes in IL-6 levels. METHODS: Peripheral IL-6 was quantified and the severity of psychomotor agitation and retardation determined using the CORE assessment of psychomotor symptoms in 62 patients with a (unipolar or bipolar) depressive episode within one week before and within one week after their course of ECT. RESULTS: IL-6 levels had decreased significantly following ECT and both psychomotor retardation and agitation had improved. The decrease in IL-6 levels was related to the improvement of psychomotor retardation, with post-hoc analysis revealing that higher baseline IL-6 levels positively correlated with higher psychomotor retardation scores. CONCLUSION: With this study, we provide the first evidence that the improvement of psychomotor retardation after ECT for depression is related to the immunomodulatory properties of the treatment, most specifically the decrease in IL-6 levels.

Movement, mood and cognition: Preliminary insights into the therapeutic effects of electroconvulsive therapy for depression through a resting-state connectivity analysis.

BACKGROUND: Electroconvulsive therapy (ECT) is a highly effective treatment for depression but how it achieves its clinical effects remains unclear. METHODS: We set out to study the brain's response to ECT from a large-scale brain-network perspective. Using a voxelwise analysis, we looked at resting-state functional connectivity before and after a course of ECT at the whole-brain and the between- and within-network levels in 17 patients with a depressive episode. Using a group-independent component analysis approach, we focused on four networks known to be affected in depression: the salience network (SN), the default mode network (DMN), the cognitive executive network (CEN), and a subcortical network (SCN). Our clinical measures included mood, cognition, and psychomotor symptoms. RESULTS: We found ECT to have increased the connectivity of the left CEN with the left angular gyrus and left middle frontal gyrus as well as its within-network connectivity. Both the right CEN and the SCN showed increased connectivity with the precuneus and the anterior DMN with the left amygdala. Finally, improvement of psychomotor retardation was positively correlated with an increase of within-posterior DMN connectivity. LIMITATIONS: The limitations of our study include its small sample size and the lack of a control dataset to confirm our findings. CONCLUSION: Our voxelwise data demonstrate that ECT induces a significant increase of connectivity across the whole brain and at the within-network level. Furthermore, we provide the first evidence on the association between an increase of within-posterior DMN connectivity and an improvement of psychomotor retardation, a core symptom of depression.

Distinct effects of protracted withdrawal on affect, craving, selective attention and executive functions among alcohol-dependent patients.

AIMS: The present study examined the effects of protracted alcohol withdrawal on affectivity, craving, selective attention and executive functions (EFs) in alcohol-dependent patients. METHODS: Selective attention (The D2 Cancellation Test), flexibility (Trail Making Test), inhibition (Stroop Task), decision making (Iowa Gambling Task), craving (Obsessive-Compulsive Drinking Scale) and state affectivity (Positive and Negative Affectivity Schedule) were assessed in alcohol-dependent patients (DSM-IV, n = 35) matched to non-alcohol-dependent participants (n = 22) at the onset (T1: day 1 or 2) and at the end (T2: days 14-18) of protracted withdrawal during rehab. RESULTS: Alcohol-dependent patients' abilities to focus their attention on relevant information, to switch from one pattern to another, to inhibit irrelevant information and to make advantageous choices were lower than those of control participants during both times of a withdrawal cure. No effect of time emerged from analyses for selective attention and EF deficits. Conversely, significant differences between T1 and T2 were observed for craving and affect scores indicating a weakening of alcohol craving and negative affect as well as an improvement of positive affect among patients from onset to the end of cure. CONCLUSION: Control functions of the Supervisory Attentional System (Norman and Shallice, 1986) were impaired and did not improve during a 3-week withdrawal cure, whereas alcohol craving and negative state affectivity significantly improved in parallel during this period. Implications for understanding the clinical processes of withdrawal are discussed.

Inter-individual variability of social perception and social knowledge impairments among patients with schizophrenia.

Deficits in social perception and knowledge and their negative impact on social functioning, have been repeatedly reported among patients with schizophrenia. However, earlier studies have focused on an overall assessment of social perception and social knowledge, without exploring their sub-components nor the interindividual variation of the deficit. This study aims to refine the exploration of this deficit and to assess its interindividual variation. Twenty-nine patients with schizophrenia and 24 healthy controls, matched for age and gender, completed a validated and integrated social perception and knowledge task (i.e. the PerSo test). Patients with schizophrenia had reduced performance in all PerSo subtests, namely contextual fluency, interpretation and social convention. However, these deficits were not correlated with the severity of clinical symptoms, and individual profiles analyses showed a marked heterogeneity among patients on their abilities. Our study confirms the existence of deficits in social perception and knowledge and underlines their considerable heterogeneity. Therefore, it is necessary to test and rehabilitate individually social perception and knowledge.