La prévalence de la dépression chez les adolescents est estimée à 5 à 9 %. Elle est associée à un risque accru de suicide. La prévention semble une approche prometteuse ce qui a accéléré le développement de programmes dans ce domaine.

Évaluer l’implantation du programme de prévention cognitivo-comportemental “Pare-chocs”dans le système scolaire français et son efficacité sur les symptômes dépressifs et la prévention d’un épisode dépressif majeur à long terme chez les adolescents.

Nous avons évalué 1968 adolescents en classe de seconde à l’aide de la Center for Epidemiological Study Depression Scale (CES-D). Les adolescents présentant un score de coupure de 26 (n = 145) ou plus ont reçu une proposition de participation à un entretien clinique puis au programme Pare-Chocs s’ils étaient sélectionnés. L’intensité de la symptomatologie dépressive était suivie par la passation régulière de la CES-D en cours (1re, 5e et 11e rencontre) et en aval de la participation au programme (8 semaine et 1 et 2 ans plus tard).

Les résultats montrent une diminution des symptômes dépressifs en fin du programme ainsi que sur les évaluations ultérieures. Pare-chocs semble adaptable au système scolaire français.

Au-delà de la diminution des symptômes dépressifs chez les adolescents, cette action semble avoir un impact au niveau collectif en sensibilisant les professionnels et en améliorant la diffusion des connaissances sur le trouble dépressif et ses moyens de prise en charge, ainsi qu’en travaillant sur la dé-stigmatisation et le dépistage d’autres troubles psychiques. La dépression reste un enjeu majeur de santé publique. Sa prévention chez les adolescents semble une approche prometteuse qui permettrait d’éviter l’apparition de la maladie à l’âge adulte.

An aging world population provides challenges for diagnostics within the field of geriatric psychiatry.

The Memory Diagnostic System(MDS) is a computerized cognitive test instrument developed for the detection of amnestic mild cognitive impairment(aMCI) in Korea. In current study, its diagnostic utility for application within Korean clinical practice was evaluated.

This study was conducted to evaluate the concurrent and discriminant validity of computerized verbal and visuospatial memory tests of the MDS.

To determine the concurrent validity, we recruited normally aging individuals and conducted a correlation analysis between these participants’ MDS scores and their scores on well-known measures used to assess each component construct: the Korean Auditory Verbal Learning Test (K-AVLT) and the Korean Rey Complex Figure Test (K-CFT). We also evaluated aMCI patients in comparison to healthy controls using the MDS as a screening instrument.

Correlations between immediate recall, delayed recall, and delayed recognition scores on the computerized verbal memory test and the corresponding scores on the K-AVLT were 0.74, 0.61, and 0.50, respectively (p<0.01, n=30). The correlation between recognition scores (as measured by the computerized visuospatial memory test) and recall scores (as measured by the K-CFT) was 0.48 (immediate), 0.48 (delayed; p<0.01, n=30). The MDS was also useful for determining differential diagnoses between aMCI patients and healthy controls, suggesting the discriminant validity of the MDS.

The MDS is a useful instrument for discriminating between aMCI cases and healthy controls within clinical practice.

Executive function is a comprehensive measure encompassing attention shifting and processing speed; the effect of aging on memory appears to be mediated by executive function.

The computerized Korean version of the Trail Making Test(TMT) is a recently developed cognitive test instrument. Its diagnostic utility for application within clinical practice was evaluated in this study.

This study was conducted to evaluate the concurrent and discriminant validity of the computerized Korean version of the TMT.

The original version of the TMT was modified for the computerized version. In the computerized version of the TMT-B, letters from the Korean alphabet (the original targets) were replaced by lyrics from the Korean national anthem. To determine the concurrent validity of the new measure, we recruited normally aging individuals and conducted a correlation analysis between these participants’ scores on the computerized version of the TMT and their scores on the original version. To determine the discriminant validity of the computerized version of the TMT, we recruited subjects from an inpatient memory clinic who showed executive function decline.

The correlations between participants’ scores on the new measures and those obtained from original versions of the TMT-A and TMT-B were 0.58 and 0.64, respectively (p<0.01, n=30). The computerized version of the TMT was also useful for determining differential diagnoses between patients with executive functioning problems and healthy controls.

The computerized version of the TMT is a useful instrument for discriminating between patients with executive functioning problems and healthy controls within clinical practice.

Bipolar disorder type II(BDII) has a prevalence of about 5% of the population according to different studies(1). There is evidence that the diagnosis of bipolar disorder patients may be delayed in 8 to 10 years, and this is especially relevant in BDII, where hypomania is often overlooked (2). The HCL-32 is a widely used and reliable instrument for the detection of previous hypomanic episodes and was validated in several languages, including Spanish (3). The massive use of internet and new technologies, may help to make this tool available to a greater extend of the population and could help detect even more cases. Accordingly, we evaluated the online version of the HCL-32.

To evaluate the validity and reliability of the HCL-32 online Spanish version.

We recruited 110 consecutive outpatients with different diagnosis, who agreed to participate and signed an informed consent. They were asked to complete a paper version(Pv)of HCL-32 in addition to an online version(Ov) sent by email within two weeks. The results were analyzed using SPSS v21.

The HCL32 Pv showed a high internal consistency as well as the Ov(Cronbach's α, 0,91 and 0,90 respectively). The total score correlation between both versions was high(0,94, p<0,001) and there were no mean score significant differences. All Item-scale's correlation were significant.

The online Spanish version of the HCL-32 for the screening of hypomanic episodes has the same good psychometric properties as the paper version, which makes it suitable to be available to more people through Internet.

Yerba mate(ilex paraguariensis(IP))is a plant widely consumed in South America as a hot(mate)or cold infusion beverage(tereré). During the last years, there was an increasing interest in its health properties supported by a growing scientific evidence. These studies showed that the IP could have hepatoprotective, hypocholesterolemic, diuretic and antioxidant properties. Furthermore it showed to be a nervous system stimulant and protectant(1). Recently, there were reports about its invitro potential to inhibit the Monoaminooxidase(MAO) which can have effects on mood state(2).

Exploratory research to study possible associations between the use of IP and mood symptoms.

An observational cross-sectional study was conducted by an online survey in paraguayan population through an invitation. The survey collected data information about sociodemographics conditions, substance use(including IP), Spielberg's State-Trait Anxiety Inventory and PHQ-9 scale for depressive symptoms. A descriptive and multiple lineal regression analysis of the data was performed.

300 subjects accepted the invitation and information was obtained of about 76% of them. The sample mean age(SD) was 27(7,4), most of them females(61,6%)and with universitary studies(66,1%). The 86% of the sample consumed IP regularly and 56% daily. Only a 3,5% reported previous psychiatric history. A significant relationship was observed between the use of IP and daily alcohol(p=0,022). No relevant associations were found concerning IP use and anxiety trait-state or depressive symptoms after adjusting for the use of coffee, tea, alcohol and others sociodemographic variables.

No significant associations were found in the sample studied between the use of IP and state-trait anxiety or depressive symptoms. Although, given the frequency of its use, the association with alcohol consumption and its potential clinical applications, more and bigger studies might be necessary.

To evaluate the association between ADHD and substance-related disorder (SRD) with and without depression, anxiety, conduct disorder and oppositional defiant disorder (CD/ODD) by age 19 years in a population-based birth cohort.

Among 5718 children in a population-based birth cohort, 343 ADHD cases and 712 age-sex matched non-ADHD controls were identified in a previous study employing medical and school records. Psychiatric diagnoses were abstracted from the medical records and collapsed into the 10 categories based on DSM-IV. The association between ADHD case status and SRD was summarized by hazard ratios (HR) and corresponding 95% CI estimated from a Cox proportional hazards model. The effects of three psychiatric disorders (depression, anxiety, CD/ODD) were evaluated separately by considering each as a time-dependent covariate in a Cox regression model.

ADHD was significantly associated with an increased risk of SRD (HR=3.70, 95% CI 2.51-5.46) by age 19 years. This association was observed in both boys and girls (HR=3.69 and 3.95, respectively). Among the boys without depression, ADHD was associated with four-fold increased risk of SRD, while the association was not present among boys with depression (HR= 4.07 vs. 0.98). Likewise, the association (HR) between ADHD case status and SRD was 0.78 and 3.77, respectively, among boys with and without CD/ODD.

The adverse effect of ADHD on SRD is more apparent for those without depression and conduct problems than it is for those with such comorbidities.

De nombreuses études ont montré que la mortalité chez les patients souffrant de maladies mentales est 2 à 6 fois plus élevée qu’en population générale [1] et que l’espérance de vie est diminuée de 15 à 20 ans [2–4].

L’objectif de cette étude consiste à comparer les causes de décès et les comorbidités, à partir de certificats de décès, d’une cohorte de patients souffrant de maladies mentales ayant été hospitalisés dans un établissement public en santé mentale à celles de la population générale d’une même région sur une période déterminée [5].

Quatre cent soixante-treize certificats de décès d’une cohorte de patients souffrant de maladies mentales, hospitalisés dans un établissement public en santé mentale, dans le département du nord, ont été analysés entre 2004 et 2011. L’âge moyen de décès retrouvé est de 54,6 ans (± 15,6). L’indice comparatif de mortalité (ICM) est de 389 (356–426) pour toutes causes de décès. La surmortalité des patients est observée pour tous types de cause. Pour les causes naturelles, les décès par pathologies pulmonaires sont 3 fois plus élevées (ICM = 323[208–501]) et ceux par pathologies cardiovasculaires, 2 fois plus élevées (ICM = 213[163–277]). Le nombre de comorbidités varie entre 3 et 4 pour 50 % des certificats de décès.

Il s’agit d’une étude fiable et reproductible, utilisant une méthodologie originale. Cette étude met en évidence, chez les patients souffrant de maladies mentales, un âge prématuré de mortalité. Les causes de mortalité sont les mêmes chez les patients qu’en population générale mais avec une fréquence plus élevée. On relève autant de comorbidités sur les certificats de décès de patients qu’en population générale, mais survenant à des âges beaucoup plus précoces chez les patients. Ces résultats soulèvent la question de la qualité du suivi somatique de ces patients.

The use of psychotherapeutic strategies in people with intellectual disabilities (ID) is at different stages in various countries in Europe. The UK and Ireland use special modified psychotherapeutic programmes for people with ID but there appears not to be many resources in psychotherapy in other European countries. The presentation considers the different psychotherapeutic approaches published in the scientific literature within the last ten years.

To ascertain the use of psychotherapy in people with intellectual disabilities in Europe.

‘Psychotherapy‘, ‘intellectual‘, ‘developemental‘, and ‘disabilities’ were chosen as keywords in searching the databases. Abstracts of publications were grouped in to psychotherapy models, Cognitive Behavioural Therapy, Systemic Psychotherapy, Analytic Psychotherapy. Sub-groups included other models, for example group psychotherapy. The formats of publications were defined as case report, structured assessment, analysis of therapeutic methods

The database research revealed nearly 300 publications on psychotherapy in people with ID over a ten-year period. It supports the assertion of the use of psychotherapy in ID. Most publications reported on work undertaken in the United Kingdom. The presentation gives more detailed information about the relationship between cognitive behavioural and analytic-oriented strategies, intervention type and study characteristics.

There is currently a good evidence base on the use of psychotherapeutic methods in working with people with ID. Much of it is in the English language literature. There is potential for the development of models to be applied in ID. The use of psychotherapeutic approaches in ID needs to be encouraged across healthcare systems in Europe.

L’équipe mobile de psychiatrie de la personne âgée (EMPPA Ouest 94), du groupe hospitalier Paul-Guiraud de Villejuif, intervient auprès des personnes de 60 ans et plus, résidant une des 15 communes de l’ouest du Val-de-Marne. Elle fonctionne de manière intersectorielle, mobilisant conjointement le psychiatre, l’infirmière de l’équipe et un infirmier du CMP du lieu de domiciliation, préalablement déterminé au sein de chacun des huit CMP du territoire.

Cette étude descriptive s’étendant du 1er janvier 2012 au 31 décembre 2013, inclut 23 patients présentant un syndrome de Diogène selon les critères de Clark (comportement caractérisé par une négligence de l’hygiène corporelle et de l’habitat, associé à une accumulation d’objets divers et un isolement).

Parmi les patients, 73,9 % sont des femmes. L’âge moyen est de 75,1 ans; 82,6 % vivent seuls à domicile; 73,9 % présentent une comorbidité somatique, seuls 21,7 % ont un médecin traitant; 82,6 % n’ont pas d’antécédents psychiatriques connus. Les signalements proviennent majoritairement des services sociaux et des centres locaux d’information et de coordination (CLIC) du territoire. Aucune pathologie n’est retrouvée dans 34,8 % des cas. Les diagnostics cliniques les plus fréquemment posés sont les troubles de l’humeur (26,1 %), les troubles démentiels (17,4 %) et les troubles psychotiques (13 %). Concernant les prises en charge proposées, 39,1 % des patients sont orientés vers un suivi psychiatrique ambulatoire, 13 % vers une consultation gériatrique. Une veille sanitaire a été instaurée dans 17,4 % des cas. Trois patients ont été hospitalisés (2 en psychiatrie, 1 en gériatrie). Une protection juridique a été indiquée dans 30,4 % des cas.

Les résultats sont comparables aux données de la littérature. L’équipe mobile, au travers d’interventions à domicile, facilite l’évaluation et l’accès aux soins des patients présentant un syndrome de Diogène.

Aripiprazole is a new dopaminergic agent and has been reported to be clinically useful as an antipsychotic drug with fewer extrapyramidal signs (EPS) and metabolic disturbances. There are some case reports concerning EPS which include acute dystonia, tardive dyskinesia and parkinsonism with aripiprazole. We report on our experience in treating a patient with Bipolar disorder developed acute dystonia and tremor.

The patient was a 53-year-old male who has been diagnosed with Bipolar disorder for 22 years and hospitalized 10 times.

He was not use antipsychotics in few months but he was in remission. Aripiprazole, 5 mg daily, was initiated for maintenance treatment. The dosage was increased to 15 mg daily five days later. The patient was reported neck and arm movements approximately six days after the initiation of aripiprazole.

He consulted with neurology and internal medicine. Standart treatment strategies for EPS were used. Initially, biperiden HCL 2 mg daily was administered orally every 12 hours, the patient's movements didn’t resolved following biperiden. Biperiden was subsequently discontinued secondary to its lack of efficacy and lorazepam 1 mg daily was administered. In addition, propranolol 40 mg daily was used for preventing tremor. There was no improvement. Two weeks later, Aripiprazol was stopped and olanzapine was started. Dystonia was resolved following olanzapine, however tremor was not improved, propranolol 40 mg daily was continued.

We reported that, the possibility of developing EPS is not away even if a drug is safe, such as aripiprazole.

to find an association between substance use and risky sexual behavior and to find association between personality traits and risky sexual behavior among substance users.

The study was applied on 100 subjects classified into 2 groups: cases and control groups. Group 1(cases) 50 substance dependence patients are chosen sequentially from the addiction department of the psychiatry and addiction hospital in kasr-alainy and group 2 (controls) included 50 normal individuals, matched for age, sex and socioeconomic status. All participants are men, range from 18 to 40 years, were taking substances for at least 6 months, and all of them could read and write. Those with a comorbid axis I diagnosis were excluded from the study. Both groups were subjected to a full psychiatric sheet, sex risk subscale of risk assessment battery (RAB), and the Eysenck personality questionnaire (EPQ). Addiction severity index is applied on cases, urine sampling was done using urine drug screening strips and a laboratory test was done for HIV and hepatitis C virus detection.

no statistically significant difference between the 2 groups regards age, education, employment and social status. The most prevalent substance is Tramadol (96%) followed by Cannabis (72%) and Herion (58 %). Hepatitis C virus is detected in (16 %) of cases, non of them have HIV infection. There were statistically significant difference in extroversion and neuroticism between cases and controls. There were a statistically significant difference between cases and controls in the sex risk subscale of RAB.There was a significant correlation between psychotocism and criminality subscales of (EPQ) and the sex risk subscale of RAB.