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IntroductionSuicide is very common among people with mental disorders. In addition, suicide mortality rates are stable in this group, while they are decreasing in the general population.MethodsThe vital statuses of adult inpatients admitted to French psychiatry departments in 2008–2009 were researched in death databases on 31 December 2013. Suicide probability was calculated using a Kaplan–Meier analysis, and standardized mortality ratios (SMRs) were calculated in relation to the population of the study area.ResultsAmong the 13,979 patients included in the study, (7416 men and 6563 women; mean age 43.6 ± 14.6 years), 1454 died in total, among whom 286 died by suicide an average of 4.9 years after the date of their enrolment. The cumulative probability of suicide was 0.8% at 1 year, 1.3% at 2 years and 2.5% at 6 years. The SMR value, which was 1492 for the whole group of patients and was twice as high in women (2494) as in men (1220), decreased with age (from 2078 in patients aged 18–34 years to 1278 in patients aged 75 years or more).DiscussionOur study confirms that suicide mortality is higher in inpatients admitted to French psychiatry units than in the general population and advocates specific prevention programmes for this group.

Background The mortality of people suffering from psychiatric illnesses is far higher than that of the general population, all categories of diagnosis combined; mortality statistics can be used as an index of quality of care. The aim of this study was to assess the all-cause mortality in psychiatric patients covering all diagnostic groups. Methods The living or deceased status of 4,417 patients of majority age hospitalised in a public mental health establishment between 2004 and 2007 were requested from French National Institute for Statistics and Economic Studies on 1st January 2011. The cause of death of those people who had died was obtained from French National Institute for Health and Medical Research and comparative standardized mortality ratios (SMR) were established from the population in a region of northern France of the same age in 2006. Results The study population was made up of 54 % men and 46 % women, median age 41 and 45 years old, respectively. Four hundred and seventy-three people died during the period studied. The SMR were 421 for men (95 % CI 378–470) and 330 for women (95 % CI 281–388). The highest SMRs were found in patients aged 35–54, with a 20-time higher mortality risk than the general population of the same age. Conclusion Our study confirms the considerably higher mortality in psychiatric patients than in general population, particularly in mean age and mostly due to an unnatural cause.

Background Persons with a diagnosis of severe mental illness have a life expectancy that is 20 years lower than the general population, and they are disproportionately affected by cardiovascular disorders. Improving the management of cardiovascular risk is one of the main challenges for the public health system. In the care pathway of persons with a diagnosis of severe mental illness, a better understanding of limiting and facilitating factors is required. The objective was to include persons with a diagnosis of severe mental illness, carers, and primary and mental health professionals in the creation and evaluation (feasibility) of a health promotion program designed to improve cardiovascular risk management through empowerment. Methods This study combines a mixed methodology with qualitative and quantitative components. A multicenter prospective qualitative study was conducted in seven mental health units in France and was coordinated by a steering committee composed of persons with a diagnosis of severe mental illness, carers, and primary and mental health professionals. Results This health promotion program must enable persons with a diagnosis of severe mental illness to assert their right to self-determination and to exercise greater control over their lives, beyond their diagnosis and care. Following a preliminary feasibility study, the effectiveness of this new tool will be evaluated using a randomized controlled trial in a second study. Conclusions The findings can be used by health organizations as a starting point for developing new and improved services for persons with a diagnosis of severe mental illness. Trial registration Clinical Trials Gov NCT03689296. Date registered September 28, 2018

Background Bacillus cereus can cause severe and potentially fatal bloodstream infections in immunocompromised patients, including preterm neonates. When the infection is nosocomial, investigating a potential environmental source is crucial to mitigate the transmission. This study investigated the potential environmental sources of ten cases of B. cereus bacteraemia in a neonatal intensive care unit. Methods We retrospectively analysed strains from 6 temporal groups of cases involving 10 preterm neonates with bacteraemia (December-2018 to November-2023) and 28 related environmental samples. Strain typing used Multi-locus Sequence Typing (MLST) to identify sequence types (ST), followed by core-genome analysis (cgMLST) and whole genome sequencing (WGS) for strains within the same ST. Results The 10 clinical strains belonged to 10 different STs, while environmental strains fell into 18 STs. Fourteen strains across four STs matched clinical and environmental sources and were grouped into 4 groups (G1 to G4). Two environmental strains linked to clinical cases were isolated from medical offices, and five from nurses’ locker rooms. These strains were analysed by WGS (Illumina) alongside other Bacillus species. G1 and G2 corresponded to B. cereus species whereas strains of G3 and G4 were closely related to B. pacificus and B. paranthracis , respectively. Conclusion We determined that severe B. cereus infections cases in 10 preterm neonates were not linked to each other, but rather to multiple potential environmental reservoirs within the NICU, often located farther from clinical wards than expected. These areas are not subject to same hygienic standards as medical units. Our findings highlight the need for routine monitoring of hand hygiene practices along with close surveillance and systematic biocleaning that targets not only direct patient care areas but also the broader hospital environment.

Immunization against the Yellow fever virus (YFV) with the 17D live-attenuated vaccine is the most effective way to prevent the disease. However, unexpected severe adverse events can occur. They consist in a neurological impairment - neurological disease (YEL-AND), a YF-like illness - viscerotropic disease (YEL-AVD) or anaphylaxis. In this article, we describe the epidemiology, clinical and biological features of YEL-AND and YEL-AVD cases reported to the French National Reference Center for Arboviruses (NRCA) in the past 10 years. We conducted a national, retrospective study using the database of the NRCA from June 2012 to June 2022. All patients whose biological samples were sent to the NRCA for detection of YFV by serology and/or RT-qPCR for a suspected vaccine-associated adverse event were included. We collected data by reading medical records and conducted complementary neuro-immunological analysis, followed by a search for autoimmunity against type-1-interferon when samples were available at the NRCA. There were 10 cases of YEL-AND and 2 cases of YEL-AVD reported to the NRCA in the past 10 years, which represented an overall incidence of 0.6 for 100 000 doses. A total of 6/12 cases were previously healthy patients (50%, mean age 31 years), and 4/12 cases had cardiovascular co-morbidities (42%, mean age 56 years). The majority of YEL-AND had a favourable outcome at 6 months of follow up. One YEL-AVD patient passed. In secondary analyses, we evidenced a significant blood cerebrospinal fluid (CSF) barrier dysfunction, without intrathecal synthesis of immunoglobulin and without argument for a neuron damage. We further detected a significant rate of anti-type-1alpha interferon antibodies in 3/10 tested patients (2 YEL-AND and 1 YEL-AVD). YEL-AND and YEL-AVD are rare events that can underlie defect in the innate immunity of apparently healthy or mild co-morbid subjects. Outcome was generally favourable in the YEL-AND cases of our series, but still life-threatening or even fatal in the YEL-AVD cases.