[Autism spectrum disorders]. / Les troubles du spectre autistique.

Autism is an early onset neurodevelopmental syndrome, encompassing heterogeneous clinical situations and with disabling consequences for cognitive, social and emotional development. The condition is today considered to be a major public health issue.

[Qualitative survey of the law of 5 July 2011 in the field of psychiatry]. / Enquête qualitative sur la loi du 5 juillet 2011 en psychiatrie.

The law of 5 July 2011 concerning the rights and protection of subjects in psychiatric care and the modalities of their management has been severely criticized and often rejected, both before and following its application in August 2011. This study was designed to describe and compare perceptions of this law by actors in the field, six months after application of the law. This qualitative study based on twenty-four interviewees from Isère and Savoie - including psychiatrists, judges, patients and families - shows that this law is not completely rejected in practice and that it provides a number of advantages: independent view of a judge, an initial observation period, rapid management for isolated patients presenting an immediately life-threatening risk, improvement of mandatory outpatient healthcare. However, the law of 5 July 2011 also raises a number of problems: hospital leave for more than twelve hours was strictly limited by the initial text; complex relationships between justice and psychiatry; insufficient funding; hearings are problematic as they are held early, in public, and sometimes outside of hospitals; excessive number of medical certificates; certain parts of the text are unclear. As is already the case for some of these issues (law of 23 September 2013), these problems should be resolved in order to ensure better law enforcement.

Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial.

BACKGROUND: Functional capacity (FC) has been identified as a key outcome to improve real-world functioning in schizophrenia. FC is influenced by cognitive impairments, negative symptoms, self-stigma and reduced physical activity (PA). Psychosocial interventions targeting FC are still under-developed. METHODS: we conducted a quasi-experimental study evaluating the effects of an exercise-enriched integrated social cognitive remediation (SCR) intervention (RemedRugby [RR]) compared with an active control group practicing Touch Rugby (TR). To our knowledge, this is the first trial to date evaluating the effectiveness of such a program provided in a real-life environment. RESULTS: Eighty-seven people with schizophrenia were included and allocated to either the RR group (n = 57) or the TR group (n = 30) according to the routine clinical practice of the recruiting center. Outcomes were evaluated at baseline and post-treatment in both groups and after 6 months of follow-up in the RR group using standardized scales for symptom severity, social functioning, self-stigma, and a large cognitive battery. After treatment we observed moderate to large improvements in social function (Personal and Social Performance Scale [PSP], p < 0.001, d = 1.255), symptom severity (Positive and Negative Syndrome Scale [PANSS] negative, p < 0.001, d = 0.827; PANSS GP, p < 0.001, d = 0.991; PANSS positive, p = 0.009, d = 0.594), verbal abstraction (p = 0.008, d = 0.554), aggression bias (p = 0.008, d = 0.627), and self-stigma (stereotype endorsement, p = 0.019, d = 0.495; discrimination experiences, p = 0.047; d = 0.389) that were specific to the RR group and were not observed in participants playing only TR. Effects were persistent over time and even larger between post-treatment and follow-up. CONCLUSIONS: Exercise-enriched integrated SCR appears promising to improve real-life functioning in schizophrenia. Future research should investigate the potential effects of this intervention on neuroplasticity and physical fitness.