Adult attention-deficit/hyperactivity disorder among alcohol use disorder inpatients is associated with food addiction and binge eating, but not BMI.

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is associated with binge eating (BE), food addiction (FA), and obesity/higher BMI in individuals without alcohol use disorder (AUD). ADHD is highly prevalent in patients with AUD, but it is unknown whether the presence of comorbid AUD might change the nature of the association between ADHD, BE, FA and BMI (food and alcohol may either compete for the same brain neurocircuitry or share vulnerability risk factors). Here, we filled this gap by testing the association between ADHD and FA/BE in adult patients hospitalized for AUD, with the strength of simultaneously assessing childhood and adult ADHD. We also investigated the association between ADHD and BMI, and the other factors associated with BMI (FA/BE, AUD severity). METHODS: We included 149 AUD inpatients between November 2018 and April 2019. We assessed both childhood and adulthood ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (modified Yale Food Addiction Scale 2.0), BE (Binge Eating Scale), and BMI and AUD (clinical assessment). RESULTS: In multivariable analyses adjusted for age, adult ADHD was associated with higher BE scores (p = .048), but not significant BE (9% vs. 7%; p = .70). ADHD was also associated with FA diagnosis and the number or FA symptoms, with larger effect size for adult (ORs: 9.45[95%CI: 2.82-31.74] and 1.38[1.13-1.69], respectively) than childhood ADHD (ORs: 4.45[1.37-14.46] and 1.40[1.13-1.75], respectively). In multivariable analysis, BMI was associated with both significant BE (p < .001) and FA diagnosis (p = .014), but not adult ADHD nor AUD severity. CONCLUSION: In patients hospitalized for AUD, self-reported adult ADHD was associated with FA and BE, but not BMI. Our results set the groundwork for longitudinal research on the link between ADHD, FA, BE, and BMI in AUD inpatients.

Posttraumatic Stress Disorder Is a Risk Factor for Multiple Addictions in Police Officers Hospitalized for Alcohol.

BACKGROUND: In police officers, posttraumatic stress disorder (PTSD) is associated with alcohol use disorder (AUD), but we lack data on the association between PTSD and other substance-related and addictive disorders. OBJECTIVES: We assessed whether PTSD could be a risk factor for different substance-related and addictive disorders in police officers, including alcohol, tobacco, cannabis, and gambling. METHOD: This cross-sectional study included all police officers admitted consecutively for alcohol to an inpatient ward dedicated to police officers (Le Courbat rehabilitation center, France; n= 133). Each patient completed self-administered questionnaires that assessed lifetime exposure to potentially traumatic events (Life Event Checklist for DSM-5), PTSD severity and diagnosis (PTSD Checklist for DSM-5), AUD severity (Alcohol Use Disorder Identification Test [AUDIT]), tobacco dependence (Fagerström test for Nicotine Dependence), cannabis dependence (Cannabis Abuse Screening test), and gambling disorder (Canadian Problem Gambling Index). RESULTS: Mean AUDIT score was 23.7 ± 8.0; 66.2% had an AUDIT score ≥20. Our sample comprised a high prevalence for PTSD (38.3%) and for substance-related and addictive disorders: tobacco dependence (68.4%), cannabis dependence (3.8%), and pathological gambling (3%). Patients with PTSD experienced higher lifetime exposure to traumatic experiences: physical assault, severe human suffering, sudden accidental death of another person, and other types of stressful events/experiences. In multiple linear regressions adjusted for age, sex, and marital status, PTSD was a significant predictor of the severity of AUD and tobacco use disorder, but not of the severity of cannabis use disorder nor gambling disorder. CONCLUSIONS: PTSD is common in police officers hospitalized for alcohol and associated with a higher severity of some addictive disorders (alcohol/tobacco). PTSD and its comorbid addictive disorders should be systematically screened and treated in this population.

Adulthood and childhood ADHD in patients consulting for obesity is associated with food addiction and binge eating, but not sleep apnea syndrome.

INTRODUCTION: The exact mechanisms underlying the established association between ADHD and obesity remain unclear. Food addiction and binge eating may contribute to this link. We examined for the first time the association between childhood/adult ADHD and food addiction/binge eating in patients with obesity, as well as the association between ADHD and sleep apnea syndrome. METHODS: We included 105 obese patients from the Nutrition Department of the University Hospital of Tours (France) between January and December 2014. We assessed categorical diagnoses of childhood/adulthood ADHD (semi-structured interview DIVA 2.0), food addiction (Yale Food Addiction Scale 2.0), binge eating (Binge Eating Scale), obstructive sleep apnea (clinical assessment), and BMI (clinical assessment). RESULTS: Patients with adult ADHD were at significantly higher risk of food addiction than patients without adult ADHD (28.6% vs. 9.1%; p = .016). Adult and childhood ADHD were significantly associated with self-reported food addiction, food addiction scores and binge eating scores, with a larger effect size for adult (ORs: 4.00 [1.29-12.40], 1.37 [1.14-1.65] and 1.08 [1.03-1.14], respectively) than childhood (ORs: 3.32 [1.08-10.23], 1.29 [1.08-1.55] and 1.06 [1.01-1.11], respectively) ADHD. ADHD diagnosis was not significantly correlated to obstructive sleep apnea. Mean age of onset of ADHD preceded mean age of onset of obesity. CONCLUSION: ADHD diagnosis is associated with food addiction and binge eating, with a larger effect size for adult than childhood ADHD. Our results provide a strong rationale for further longitudinal research on the link between ADHD, food addiction, binge eating and obesity, paving the way for evidence-based therapeutic interventions for these patients.

Food Addiction is Associated with Higher Neuroticism, Lower Conscientiousness, Higher Impulsivity, but Lower Extraversion in Obese Patient Candidates for Bariatric Surgery.

BACKGROUND: The "food addiction" phenotype identifies a subpopulation of individuals experiencing substance-dependence symptoms toward specific foods. In the current debate on whether the "food addiction" phenotype should be considered as an addictive disorder, assessment of the personality traits associated with this phenotype would provide arguments for or against the "food addiction" phenotype and its inclusion in the "substance-related and addictive disorder" category. OBJECTIVES: To assess the personality characteristics associated with the "food addiction" phenotype in obesity surgery candidates (i.e., big five personality dimensions, alexithymia and impulsivity). METHODS: We assessed food addiction (Yale Food Addiction Scale), personality dimensions (Big Fig Inventory), impulsivity (Barratt Impulsiveness Scale-11th version) and alexithymia (Toronto Alexithymia Scale-20 items) in 188 bariatric surgery candidates recruited between July 2013 and November 2015 in the Nutrition Department of the University Hospital of Tours. We used chi-squared tests and Student's tests or Mann-Whitney-U-tests to determine the factors associated with food addiction. RESULTS: Prevalence of current food addiction was 16.5%. Patients with (vs. without) food addiction had lower conscientiousness (p = .047), higher neuroticism and lower extraversion (ps < 0.001), but there was no difference in terms of agreeableness (p = 0.42) or openness (p = 0.16). They were more frequently single (p = .021) and reported higher alexithymia (ps < .001) and higher impulsivity sub-scores (ps<.05). Conclusions/Importance: Food addiction shares personality traits with substance-related disorders (regarding neuroticism, conscientiousness, impulsivity, alexithymia), and one distinctive trait (low extraversion). This study provides additional data that enrich the discussion on whether the "food addiction" phenotype should be included or not in the "substance-related and addictive disorder" category.

What are Probable Olfactory Markers of Alcohol Dependence?

As the olfactory system is closely connected with the brain areas responsible for the most crucial alterations in psychiatric populations, especially cognitive and emotional impairments, the study of olfactory processing may be a relevant approach to identify specific markers of alcohol dependence. The aim of this study was to propose the probable olfactory markers for alcohol dependence through a study of the olfactory parameters that involve the central olfactory pathway. We recruited the same 41 alcohol-dependent patients in an early (day 8) and late (day 67) stage of abstinence and 41 controls matched for gender, age, and smoking status. The participants underwent clinical assessments and several olfactory evaluations. The results revealed on one hand, the persistence of decreased intensity of positive emotion (happy), increased intensity of negative emotion (sad), and increased citation of surprise in patients, suggesting the presence of probable trait markers of alcohol dependence. On the other hand, we found decreased hedonic score for pleasant and neutral odorants, and decreased odor familiarity judgment only in the early stage of evaluation as probable state markers for alcohol dependence. These results may be underpinned by several neuropsychological alterations specific to this disease and their evolution after weaning. Further studies are needed to replicate these findings and to confirm the specificity and sensitivity of the olfactory tests in a larger sample of patients. The olfactory perception of all controls must be also retested in order to determine the specific state and/or trait markers of alcohol dependence.

Validation of the French Version of the DSM-5 Yale Food Addiction Scale in a Nonclinical Sample.

OBJECTIVE: The Yale Food Addiction Scale (YFAS) is the only questionnaire that assesses food addiction (FA) based on substance dependence criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, Text Revision. Following recent updating of addiction criteria, a new DSM-5 version (YFAS 2.0) has been developed. Our study tested the psychometric properties of the French YFAS 2.0 in a nonclinical population. METHOD: We assessed 330 nonclinical participants for FA (French YFAS 2.0), eating behaviour, and eating disorder (Binge Eating Scale, Emotional Overeating Questionnaire, Three-Factor Eating Questionnaire-R18, Questionnaire on Eating and Weight Patterns-Revised, Eating Disorder Diagnostic Scale). We tested the scale's factor structure (confirmatory factor analysis based on 11 diagnostic criteria), internal consistency, and construct and incremental validity. RESULTS: Prevalence of FA was 8.2%. Our results supported a 1-factor structure similar to the US version. In both its diagnostic and symptom count versions, the YFAS 2.0 had good internal consistency (Kuder-Richardson alpha was 0.83) and was associated with body mass index (BMI), binge eating, uncontrolled and emotional eating, binge eating disorder, and cognitive restraint. FA predicted BMI above and beyond binge eating frequency. Females had a higher prevalence of FA than males but not more FA symptoms. CONCLUSIONS: We validated a psychometrically sound French version of the YFAS 2.0 in a nonclinical population, in both its symptom count and diagnostic versions. Future studies should investigate psychometric properties of this questionnaire in clinical populations potentially at risk for FA (that is, patients with obesity, diabetes, hypertension, or other metabolic syndrome risk factors).

Predictors of changes in physical, psychosocial, sexual quality of life, and comfort with food after obesity surgery: a 12-month follow-up study.

PURPOSE: Although obesity surgery provides significant postoperative improvement in quality of life (QoL), it is still unclear which factors might predict improvement in QoL after surgery. We aimed to determine which factors might predict changes in physical, psychosocial, sexual QoL, and comfort with food 12 months after surgery, by putting to the test a QoL model based on Wilson and Cleary's model. METHODS: We included 126 obese patients (48.4% had gastric banding, 34.1% had sleeve gastrectomy, and 17.5% had gastric bypass). At baseline, we assessed QoL (Quality of Life, Obesity and Dietetics rating scale), BMI, depression (Beck Depression Inventory), and binge eating (Bulimic Investigatory Test, Edinburgh). At 12 months, we assessed QoL and BMI. To determine the predictors for changes in each QoL dimension after surgery, we used linear mixed models adjusted for preoperative age, BMI, time, type of surgery, preoperative binge eating severity, and preoperative depression severity. RESULTS: After 12 months, we found significant improvement in physical, psychosocial, sexual QoL, but not in comfort with food. Increased weight loss was associated with better improvement in physical and psychosocial QoL. Higher preoperative depression severity predicted poorer improvement in physical, psychosocial, and sexual QoL. Higher preoperative binge eating severity predicted poorer improvement in psychosocial, sexual QoL, and comfort with food. CONCLUSIONS: In addition to weight loss, preoperative levels of binge eating and depression should be considered as important predictors for QoL changes after bariatric surgery. Screening and treatment for preoperative depression and binge eating might improve QoL after bariatric surgery.

Adult ADHD Diagnosis, Symptoms of Impulsivity, and Emotional Dysregulation in a Clinical Sample of Outpatients Consulting for a Behavioral Addiction.

OBJECTIVE: This study aimed to investigate ADHD in adult outpatients seeking treatment for a behavioral addiction and to identify the specificity of psychopathological features if the behavioral addiction cooccurs with adult ADHD. METHOD: Sixty-five outpatients consulting for a behavioral addiction were assessed for ADHD (DIVA-5), addictive disorder (alcohol, tobacco, cannabis, gambling, gaming, food, and sex), impulsivity (UPPS-P), and emotion dysregulation (DERS-36). RESULTS: In our sample of outpatients seeking treatment for a behavioral addiction, adult ADHD was independently associated with higher compulsive sexual behavior disorder severity, "sensation seeking," "positive urgency," difficulties in "goal-directed behavior," "impulse control," and use of "emotion regulation strategies" in the context of intense emotions. A 29% of the sample was diagnosed for adult ADHD. CONCLUSION: The association of adult ADHD with specific dimensions of impulsivity and emotion dysregulation, pave the way for future clinical and research perspectives.

High preoperative depression, phobic anxiety, and binge eating scores and low medium-term weight loss in sleeve gastrectomy obese patients: a preliminary cohort study.

OBJECTIVE: Although depression, anxiety, and binge eating are prevalent in candidates for bariatric surgery, their impact on weight loss is unknown following sleeve gastrectomy. This study assesses the associations between weight loss and preoperative depression, anxiety, and binge eating scores in patients undergoing sleeve gastrectomy for morbid obesity. METHOD: This cohort study included 34 patients who underwent sleeve gastrectomy for morbid obesity between May 2006 and February 2010 in a French tertiary referral center. We assessed preoperative depression (using the Beck depression inventory and the SCL-90-R depression subscale), anxiety (using the Hamilton anxiety rating scale and the SCL-90-R anxiety subscales), and binge eating (using the bulimic investigatory test, Edinburgh). The primary outcome was the percentage of excess weight loss at 12 months (PEWL). RESULTS: The preoperative mean body mass index (BMI) was 55.3 kg/m2 ± 10.2 kg/m2 and 41.7 kg/m2 ± 8.7 kg/m2 at the 12-month follow-up visit. The mean PEWL was 46.8% ± 15.8%. After adjusting for the preoperative BMI, the PEWL was negatively associated with preoperative scores for depression (ß= -0.357; P < 0.05), phobic anxiety (ß = -0.340; P < 0.05), interpersonal sensitivity (ß = -0.328; P < 0.05), and binge eating (ß = -0.315; P = 0.05). Other forms of anxiety were not correlated with the PEWL. CONCLUSIONS: Higher preoperative depression, phobic anxiety, interpersonal sensitivity, and binge eating scores are associated with low postoperative weight loss in patients undergoing sleeve gastrectomy. Future studies should assess the preoperative prevalence of syndromal or subsyndromal atypical depression and its relationship to postoperative weight loss in bariatric surgery candidates.

Impulsivity as a Risk Factor for Addictive Disorder Severity during the COVID-19 Lockdown: Results from a Mixed Quantitative and Qualitative Study.

Interindividual differences in personality traits, especially impulsivity traits, are robust risk factors for addictive disorders. However, their impact on addictive disorders during the COVID-19 lockdown remains unknown. This study assessed patients being followed for addictive disorders before the lockdown. We aimed to determine whether impulsivity traits (i.e., negative- and positive urgency) were associated with addictive disorders severity during the lockdowns. We also explored the patients' subjective experiences, focusing on high versus low impulsivity. The quantitative study assessed 44 outpatients consulting for addictive disorders, for impulsivity, emotion regulation, anxiety/depression, and their addictive disorder characteristics, using self-administered questionnaires. In the qualitative study, six patients from the quantitative study were assessed using guided interviews. We observed that higher negative and positive urgencies were associated with addictive disorder severity. The subjective experiences of patients during the lockdowns differed according to their emotion-related impulsivity: high versus low. Low impulsive patients used online technologies more effectively to maintain follow-up, with more positive reappraisal. In contrast, highly impulsive patients reverted more frequently to self-medication with substances and/or behaviors, more social isolation, and found coping with negative emotions more challenging. Overall, the patient's ability to cope with stressful events, like the COVID-19 lockdown, depended on their emotion-related impulsivity.

Childhood Trauma and Dissociation Correlates in Alcohol Use Disorder: A Cross-Sectional Study in a Sample of 587 French Subjects Hospitalized in a Rehabilitation Center.

This study aimed to determine whether dissociative symptoms and childhood trauma (CT) may help identify a specific subgroup of patients among those hospitalized for alcohol use disorder (AUD). We assessed 587 patients hospitalized for an AUD in a French addiction rehabilitation center (cross-sectional study) regarding dissociative symptoms (DES-taxon), childhood trauma (CTQ), depression (BDI), anxiety (STAI-state and STAI-trait), posttraumatic stress disorder (PTSD; PCL-5), and AUD symptoms (AUDIT). We ran a hierarchical cluster analysis and compared the clusters in terms of dissociation and CT, as well as AUD, depressive, anxiety, and PTSD symptoms. We identified three clusters of patients: (1) patients with low AUD severity and low dissociation (LALD); (2) patients with high AUD severity and low dissociation (HALD); (3) patients with high AUD severity and high dissociation (HAHD). Patients from the HAHD group had significantly higher dissociation and more severe depression, anxiety, and PTSD symptoms than those with LALD and HALD. They also reported more emotional and sexual abuse than those with LALD. Among patients with an AUD, those with high dissociation may constitute an independent subgroup that exhibits a higher prevalence for CT and higher AUD severity, as well as higher depression, anxiety, and PTSD symptoms. Patients with more severe AUD and associated psychiatric symptoms should be systematically screened for dissociation and provided with tailor-based treatments.

Prevalence of and risk factors for lifetime suicide attempts among Caribbean people in the French West Indies.

It has been suggested that Black people show lower suicidality than White people. The few conflicting studies estimating lifetime prevalence of suicide attempts in Caribbean populations were mainly carried out in the UK and the USA. Our aim was to investigate the prevalence of lifetime suicide attempts among the French Caribbean general population still living in the West Indies. As part of an international epidemiological multicenter study under the authority of the World Health Organization French Collaborating Centre, we interviewed 887 individuals selected from the general population in the Caribbean island of Martinique, using the Mini International Neuropsychiatric Interview. Among the interviewed individuals, 4.4% (N=39) reported having attempted suicide. Younger age, lifetime diagnoses of major mood disorder, panic disorder and alcohol dependence were all associated with a lifetime history of suicide attempts. Lifetime prevalence of suicide attempts among the French Caribbean general population was almost half as much as that measured in continental France.

Inter-Individual Differences in Food Addiction and Other Forms of Addictive-Like Eating Behavior.

The "addictive-like eating behavior" phenotype encompasses different terms or concepts, including "food addiction" (FA), "eating addiction" or "compulsive eating behavior" [...].

Do Emotion Dysregulation, Alexithymia and Personality Dimensions Explain the Association Between Attention-Deficit/Hyperactivity Disorder and Binge Eating Among Bariatric Surgery Candidates?

Background: Addictive-like eating and attention-deficit/hyperactivity disorder (ADHD) are both common among persons seeking treatment for severe obesity. Given that ADHD and addictive-like eating, especially binge eating (BE) and food addiction (FA), are both strongly associated with personality dimensions and emotion dysregulation, it is possible emotional and personality characteristics contribute to the link between addictive-like eating behaviors and ADHD in people with severe obesity. This study aimed to investigate the psychological factors associated with BE and FA in bariatric surgery candidates, and to explore the mediational role of emotional factors (emotion dysregulation and alexithymia) and personality dimensions in the association between ADHD and BE. Method: Two hundred and eighty-two (n = 282) bariatric surgery candidates were recruited during the systematic preoperative psychiatric assessment (University Hospital of Tours, France). We assessed significant BE (Binge Eating Scale), probable adult ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (Yale Food Addiction Scale 2.0, YFAS 2.0), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), alexithymia (Toronto Alexithymia Scale-20) and personality dimensions (Big Five Inventory). Mediation analyses were performed using the PROCESS macro for IBM SPSS Statistics 22. Results: Prevalence of probable adult ADHD, significant BE and FA were 8.2, 19.1, and 26.6%, respectively. Participants who screened positive for addictive-like eating showed higher prevalence of probable adult ADHD, as well as higher scores on adult and childhood ADHD symptoms. They also reported lower conscientiousness, but higher emotion dysregulation, higher alexithymia, and higher neuroticism. Only BE (as opposed to FA) was also associated with lower scores on agreeableness and openness. Analysis of the association between adult ADHD and BE suggests that emotion dysregulation, conscientiousness, agreeableness, and neuroticism are total mediators and alexithymia a partial mediator. Conclusion: Our findings suggest a significant association between ADHD and addictive-like eating among bariatric surgery candidates, and also suggest a significant role of emotion dysregulation and personality dimensions in this association. For individuals with ADHD and obesity, eating may be a way to cope with negative emotions, potentially increasing the risk for addictive-like eating behavior.

Posttraumatic Stress Disorder Is Highly Comorbid With Adult ADHD in Alcohol Use Disorder Inpatients.

Objective: Increasing number of studies show an association between adult ADHD (a-ADHD) and posttraumatic stress disorder (PTSD). We explored this association in alcohol use disorder (AUD) inpatients. Method: In total, 551 inpatients cross-sectionally completed self-administered questionnaires regarding sociodemographics, lifetime trauma exposure, PTSD Checklist for DSM-5, Adult ADHD Self-Report Scale (ASRS), and Wender Utah Rating Scale (WURS). We considered self-reported a-ADHD when ASRS and WURS had significant scores. Results: Prevalence for a-ADHD was 20%. PTSD prevalence was higher in a-ADHD patients (84% vs. 40%; p < .001). They also were younger (p < .001) and women (p = .015). Adult ADHD was associated with more traumatic events, and symptoms were correlated with PTSD severity. After adjusting for age, gender and marital status, PTSD severity was associated with a-ADHD. Conclusion: Our study confirms that a-ADHD is associated with PTSD in AUD inpatients, and thus, may represent a specific subpopulation. Future studies should explore implication of this dual diagnosis on AUD and treatment outcome.

A positive association between a polymorphism in the HTR2B gene and cocaine-crack in a French Afro-Caribbean population.

OBJECTIVES: Cocaine dependence has a strong heritability component. The aim of this study was to investigate the putative association between the serotonin 2B receptor gene (HTR2B), crack use disorders and impulsivity. METHODS: A French Afro-Caribbean male population of patients with crack use disorders (n = 80) was compared to healthy Afro-Caribbean male controls (n = 60). Comorbid ADHD and impulsivity were assessed. Five single nucleotide polymorphisms (SNPs) in the HTR2B gene were selected: rs643700, rs6736017, rs1549339, rs17586428 and rs3806545. These SNPs were chosen to include most of the linkage disequilibrium blocks in the HTR2B gene. The French translation of the Barratt Impulsivity Scale BIS-11 was used to evaluate impulsivity. Comorbid ADHD was diagnosed using the Wender Utah Rating Scale-25 item for Attention Deficit-Hyperactivity Disorder. RESULTS: We have observed a positive association between the rs6736017 polymorphism and crack use disorders in a French Afro-Caribbean male population. CONCLUSIONS: In our population, the risk effect of HTR2B rs6736017 appeared to be specific to individuals with crack use disorders rather than being driven by impulsivity or ADHD alone.

Negative Affectivity and Emotion Dysregulation as Mediators between ADHD and Disordered Eating: A Systematic Review.

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with disordered eating, especially addictive-like eating behavior (i.e., binge eating, food addiction, loss of control overeating). The exact mechanisms underlying this association are unclear. ADHD and addictive-like eating behavior are both associated with negative affectivity and emotion dysregulation, which we hypothesized are mediators of this relationship. The purpose of this systematic review was to review the evidence related to this hypothesis from studies assessing the relationship between childhood or adulthood ADHD symptomatology, negative affectivity, emotion dysregulation and addictive-like eating behavior. The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. The literature search was conducted in PubMed and PsycINFO (publication date: January 2015 to August 2020; date of search: 2nd September 2020). Out of 403 potentially relevant articles, 41 were retained; 38 publications reported that ADHD and disordered eating or addictive-like eating behavior were significantly associated, including 8 articles that suggested a mediator role of negative affectivity or emotion dysregulation. Sixteen publications reported that the association between ADHD symptomatology and disordered eating or addictive-like eating behavior differed according to gender, eating behavior and ADHD symptoms (hyperactivity, impulsivity and inattention). We discuss the practical implications of these findings and directions future research.

Childhood Trauma Predicts Less Remission from PTSD among Patients with Co-Occurring Alcohol Use Disorder and PTSD.

Post-traumatic stress disorder (PTSD) is highly prevalent among patients hospitalized for an alcohol use disorder (AUD). Hospitalization can improve PTSD and AUD outcomes in some but not all patients, but we lack data on the baseline predictors of PTSD non-remission. This study aimed to determine the baseline risk factors for non-remitted PTSD in patients hospitalized for an AUD. Of 298 AUD inpatients recruited in a rehabilitation center (Le Courbat, France), we included 91 AUD inpatients with a co-occurring PTSD and a longitudinal assessment at baseline (T1) and before discharge (T2: 8 weeks later). Patients were assessed for PTSD diagnosis/severity (PCL-5=PTSD Checklist for DSM-5), different types of trauma including childhood trauma (LEC-5=Life Events Checklist for DSM-5/CTQ-SF=Childhood Trauma Questionnaire, Short-Form), and AUD diagnosis/severity (clinical interview/AUDIT=Alcohol Use Disorders Identification Test). Rate of PTSD remission between T1 and T2 was 74.1%. Non-remitted PTSD at T2 was associated with a history of childhood trauma (physical, emotional or sexual abuse, physical negligence), but not with other types of trauma experienced, nor baseline PTSD or AUD severity. Among patients hospitalized for an AUD with co-occurring PTSD, PTSD remission was more strongly related to the existence of childhood trauma than to AUD or PTSD severity at admission. These patients should be systematically screened for childhood trauma in order to tailor evidence-based interventions.

The Modified Yale Food Addiction Scale 2.0: Validation Among Non-Clinical and Clinical French-Speaking Samples and Comparison With the Full Yale Food Addiction Scale 2.0.

OBJECTIVES: The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) was designed to assess food addiction using a shorter version than the YFAS 2.0. We lack data about the psychometric properties of the mYFAS 2.0 in patients with obesity, as well as studies comparing the psychometric properties of the mYFAS 2.0 versus the full YFAS 2.0. This study aimed to validate the French-language mYFAS 2.0 in a non-clinical population (study 1, n = 250), to determine the yet unknown psychometric properties of this scale in patients with obesity (study 2, n = 345), and to compare the full YFAS 2.0 and the mYFAS 2.0 in terms of food addiction (FA) prevalence and symptoms detection in both populations. METHOD: Study 1 included 250 non-clinical individuals (non-underweight and non-obese persons screened negative for eating disorders). Study 2 included 345 bariatric surgery candidates recruited in three centers (Québec, Canada; Reims and Tours, France). The mYFAS 2.0 structure was investigated using confirmatory factorial analyses with tetrachoric correlations. Convergent validity was tested using the full YFAS 2.0, the Binge Eating Scale (both studies), the revised 18-item Three Factor Eating Questionnaire (study 1), the Beck Depression Inventory (study 2), and the body mass index (BMI; both studies). RESULTS: The mYFAS 2.0 was unidimensional, and had adequate (study 1: KR-20 = .78) and acceptable (study 2: KR-20 = .73) internal consistency. In study 1, the mYFAS 2.0 had good convergent validity with the YFAS 2.0, BMI, binge eating, cognitive restraint, uncontrolled eating and emotional eating; in study 2, the mYFAS 2.0 had good convergent validity with the YFAS 2.0, binge eating, depression, but not BMI. Participants endorsed fewer symptoms with the mYFAS 2.0 than with the YFAS 2.0; FA prevalences were similar between questionnaires in the non-clinical, but not in the clinical sample. A FA 'diagnosis' and risk of binge eating disorder were associated but did not completely overlap. CONCLUSIONS: The mYFAS 2.0 has close psychometric properties to the YFAS 2.0 in non-clinical and clinical samples. However, the use of the mYFAS 2.0 in bariatric surgery candidates might lead to a significant underestimation of FA prevalence and number of FA symptoms.

Characteristics of a French African Caribbean epidemiological psychiatric sample with a history of suicide attempt.

Research on vulnerability factors among ethnic groups, independent of primary psychiatric diagnosis, may help to identify groups at risk of suicidal behavior. French African Caribbean general psychiatric patients (N = 362) were recruited consecutively and independently of the primary psychiatric diagnosis. Demographic and clinical characteristics and lifetime history of suicide attempts were recorded. Sixty-five patients (18%) had a history of at least one suicide attempt. Presence of professional qualifications, children, poor social contacts, treatment with benzodiazepine at inclusion, and poor treatment compliance were all associated with a lifetime history of suicide attempts.