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Bendrihen N.,Institute Of Cancerologie Gustave Roussy | Bioy A.,University of Burgundy | Dauchy S.,Institute Of Cancerologie Gustave Roussy | Doucet C.,University of Rennes 2 – Upper Brittany | And 3 more authors.
Medecine Palliative | Year: 2012

Celebrating the 10th anniversary of Médicine Palliative journal, psychiatrists and psychologists from the editorial board of the review argue here their reflexion about the following question: what could be the place for "psys" working in palliative care, in the next 10 years. Two actual dangers may be at risk for the forthcoming years: one danger is being opposite to medical discourse, which may lead to an impasse; another danger is being assimilated to a pure scientifical logic, which may do miss clinical encounter. © 2012 Elsevier Masson SAS.

PubMed | Center Hospitalier Guillaume Regnier, French Institute of Health and Medical Research, University of Rennes 1, University Paris - Sud and Rennes University Hospital Center
Type: Journal Article | Journal: Acta psychiatrica Scandinavica | Year: 2016

We aimed to explore whether the prevalence of manic switch was underestimated in randomized controlled trials (RCTs) compared to observational studies (OSs).Meta-analyses and simple and systematic reviews were identified by two reviewers in a blinded, standardized manner. All relevant references were extracted to include RCTs and OSs that provided data about manic switch prevalence after antidepressant treatment for a major depressive episode. The primary outcome was manic switch prevalence in the different arms of each study. A meta-regression was conducted to quantify the impact of certain variables on manic switch prevalence.A total of 57 papers (35 RCTs and 22 OSs) were included in the main analysis. RCTs underestimated the rate of manic switch [0.53 (0.32-0.87)]. Overestimated prevalence was related to imipraminics [1.85 (1.22-2.79)]; to serotonin-norepinephrine reuptake inhibitors [1.74 (1.06-2.86)]; and to other classes of drugs [1.58 (1.08-2.31)], compared to placebo treatment. The prevalence of manic switch was lower among adults than among children [0.2 (0.07-0.59)]; and higher [20.58 (8.41-50.31)] in case of bipolar disorder.Our results highlight an underestimation of the rates of manic switch under antidepressants in RCTs compared to the rates observed in observational studies.

Gerbes A.,University of Rennes 1 | Leroy H.,Center Medical Louis Guilloux | Leferrand P.,Center Hospitalier Guillaume Regnier | Michel D.,Center Medical Louis Guilloux | And 2 more authors.
Information Psychiatrique | Year: 2015

The mental health of precarious migrants is a very frequent reason for consultation, and little is known by health professionals. A retrospective study was conducted from 2010 to 2013 in 110 patients by the Mobile Psychiatry and Insecurity Team at a specialized medical centre equipped to deal with migrants in Rennes. The average age was 29 years, 55% were homeless, 70% seeking asylum, and 76% had experienced violence. Diagnoses were: posttraumatic stress (27%), psychosocial distress (21%), anxiety-depressive syndrome (18%). 67% were lost to follow-up with a median duration of 3.5 months, mainly unaccompanied minors and people in psycho-social distress. Mental disorders that were not obvious or not recognized relieves the care management of specific individuals who are professionally trained to improve patient adherence. © 2015, John Libbey Eurotext. All rights reserved.

PubMed | Center hospitalier Guillaume Regnier, University of Rennes 1 and Rennes University Hospital Center
Type: Journal Article | Journal: Annales pharmaceutiques francaises | Year: 2015

In France, the Court can issue a medical treatment order only for criminally responsible persons. The nature of the treatment to be administered is at the discretion of the physician in charge of the sexual offenders care. Treatment management of sexual offenders relies essentially on psychotherapy, and preferentially cognitive behavioral therapy. For most severe sexual offenders, drug treatments, including hormonal treatment and selective serotonin reuptake inhibitors, are used to complement psychotherapy. This literature review aims at synthesizing practice changes in the treatment management of sexual offenders.

PubMed | Center Hospitalier Guillaume Regnier, French Institute of Health and Medical Research and University of Rennes 1
Type: | Journal: Journal of psychiatric research | Year: 2016

There is a long-standing and very active debate regarding which psychotherapeutic intervention should be used in depressive disorders. However, the effects of psychotherapies may result majorly from non-specific factors rather than from specific factors related to the type of psychotherapeutic intervention. We performed a systematic review and meta-analysis on aggregated data to understand how the effects of different psychotherapies are impacted by non-specific factors. We included randomized controlled trials that assessed the efficacy of psychotherapeutic interventions in the treatment of adult depressive disorders. The primary outcome was the change in depression score from baseline to the latest follow-up visit (i.e. response). A meta-regression was performed to predict response according to the type of intervention and non-specific factors (e.g. number of treatment sessions, length of follow-up, therapeutic allegiance of the investigator). The main analysis included 214 study arms from 84 trials. The effects of psychotherapies compared to the waiting list control condition failed to remain significant after adjusting for non-specific factors. Response increased with the number of treatment sessions (=0.03, 95% CI [0.01; 0.04]) and the length of follow-up (=0.01, 95% CI [0.00; 0.02]). Response also improved in case of presumed therapeutic allegiances among investigators (=0.29, 95% CI [0.07; 0.52]). Response to psychotherapies seems to be closely related to non-specific effects. The development of a well-designed trial that controls for non-specific factors might help disentangle the effects of psychotherapies.

Orsat M.,University of Sainte-Anne | Orsat M.,Center Hospitaller Specialise Of La Sarthe | Serre C.-H.,Center Hospitaller Specialise Of La Sarthe | Auffret E.,Center Hospitalier Guillaume Regnier | And 3 more authors.
Revue de Geriatrie | Year: 2014

Bipolar disorder is frequent and has a lifetime prevalence of 1.5% in general practice populations. It is not always easy to diagnose, thus resulting in a significant delay in treatment. Consequently, episodes of decompensation such as a manic episode can be seen in elderly patients who have never been deemed bipolar. We report a case of manic episode with psychotic features in an 88-year-old woman who was eventually diagnosed with bipolar I disorder. This case study reminds us that bipolar disorder is hard to diagnose and enables us to review its specific management in the elderly. Some of the specific features of bipolar disorder in the elderly make its clinical presentation more complex. There are no specific guidelines for the treatment of these patients, but some commonly used treatments have all shown some efficacy and ECT may be useful in the treatment of elderly patients with bipolar disorder. © La Revue de Gériatrie.

Voltzenlogel M.-C.,University of Rennes 2 – Upper Brittany | Balencon M.,Rennes University Hospital Center | Drenou A.,Rennes University Hospital Center | Drenou A.,Center Hospitalier Guillaume Regnier | And 4 more authors.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction | Year: 2014

Objective Pregnancy before 15 years old remains a troublesome issue for medical teams which are not used to working with adolescents. The aim of this work is to study the outcome of the pregnancies among very young adolescents, the psycho-social context, the medical management, the professionals involved in it and the follow-up after pregnancy. Materials and methods Retrospective analysis from four cases, in the university hospital of Rennes, during the year 2011. Results All the pregnancies were terminated, half of them on a psychological indication. Three adolescents showed evidence of major psychological distress and two of them had a history of sexual abuse. The medical care was heterogeneous, from the first meet until the follow-up after pregnancy, including the medical abortion. A multidisciplinary teamwork was found in three of the four cases. Conclusion Pregnancy before the age of 15 years old is a rare event and often ends with a medical abortion. The medical management of those vulnerable adolescents is complex and requires a multidisciplinary team approach all along the follow-up. A national evaluation of clinical practice in this area seems to be needed. © 2013 Elsevier Masson SAS. All rights reserved.

Guignard J.-H.,Center Hospitalier Guillaume Regnier | Guignard J.-H.,University of Paris Descartes | Jacquet A.-Y.,University of Paris Descartes | Lubart T.I.,University of Paris Descartes
PLoS ONE | Year: 2012

Numerous authors reported a prevalence of perfectionism in gifted populations. In addition, an unhealthy form of perfectionism that leads to anxiety disorder has been described. Using self-report measures (CAPS and R-CMAS) with 132 children, we hypothesized that intellectually gifted children express a higher level of perfectionism and anxiety. Our results pointed out a paradox: the gifted group obtained a higher self-oriented perfectionism score than the control group in 6th grade, but present the same level of anxiety. In contrast, the gifted group showed the same level of perfectionism than non-gifted 5th graders, but reported a higher anxiety level. Thus, the interplay between perfectionism and anxiety appears to be more complex than a simple linear relationship in giftedness. © 2012 Guignard et al.

Djadaoudjee L.,Center Hospitalier Guillaume Regnier
Revue de l'Infirmiere | Year: 2013

French cultural diversity is evident within French hospitals, where nurses are confronted with communication problems resultingfrom the language barrier. While communication is indeed essential, there is another important aspect of caring for a patient for behind the language barrier lies a cultural barrier which must be taken into account in order to provide high-quality care © 2013 Elsevier Masson SAS. All rights reserved.

PubMed | Center hospitalier Guillaume Regnier
Type: | Journal: Revue de l'infirmiere | Year: 2013

French cultural diversity is evident within French hospitals, where nurses are confronted with communication problems resulting from the language barrier. While communication is indeed essential, there is another important aspect of caring for a patient for behind the language barrier lies a cultural barrier which must be taken into account in order to provide high-quality care.

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