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result(s) for
"El Hage, Wissam"
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Is There a Link between Oropharyngeal Microbiome and Schizophrenia? A Narrative Review
by
El Hage, Wissam
,
Dufour-Rainfray, Diane
,
Martin, Stanislas
in
Alzheimer's disease
,
Animals
,
Antipsychotic Agents - administration & dosage
2022
The study aimed to examine the impact of the oropharyngeal microbiome in the pathophysiology of schizophrenia and to clarify whether there might be a bidirectional link between the oral microbiota and the brain in a context of dysbiosis-related neuroinflammation. We selected nine articles including three systemic reviews with several articles from the same research team. Different themes emerged, which we grouped into 5 distinct parts concerning the oropharyngeal phageome, the oropharyngeal microbiome, the salivary microbiome and periodontal disease potentially associated with schizophrenia, and the impact of drugs on the microbiome and schizophrenia. We pointed out the presence of phageoma in patients suffering from schizophrenia and that periodontal disease reinforces the role of inflammation in the pathophysiology of schizophrenia. Moreover, saliva could be an interesting substrate to characterize the different stages of schizophrenia. However, the few studies we have on the subject are limited in scope, and some of them are the work of a single team. At this stage of knowledge, it is difficult to conclude on the existence of a bidirectional link between the brain and the oral microbiome. Future studies on the subject will clarify these questions that for the moment remain unresolved.
Journal Article
Early Interventions to Prevent Post-Traumatic Stress Disorder in Youth after Exposure to a Potentially Traumatic Event: A Scoping Review
2022
The worldwide occurrence of potentially traumatic events (PTEs) in the life of children is highly frequent. We aimed to identify studies on early mental health interventions implemented within three months of the child/adolescent’s exposure to a PTE, with the aim of reducing acute post-traumatic symptoms, decreasing long term PTSD, and improving the child’s adjustment after a PTE exposure. The search was performed in PubMed and EMBASE databases resulting in twenty-seven articles meeting our inclusion criteria. Most non-pharmacological interventions evaluated had in common two complementary components: psychoeducation content for both children and parents normalizing early post-traumatic responses while identifying post-traumatic symptoms; and coping strategies to deal with post-traumatic symptoms. Most of these interventions studied yielded positive results on outcomes with a decrease in post-traumatic, anxiety, and depressive symptoms. However, negative results were noted when traumatic events were still ongoing (war, political violence) as well as when there was no or little parental involvement. This study informs areas for future PTSD prevention research and raises awareness of the importance of psychoeducation and coping skills building in both youth and their parents in the aftermath of a traumatic event, to strengthen family support and prevent the occurrence of enduring post-traumatic symptoms.
Journal Article
Functional MRI-based study of emotional experience in patients with psychogenic non-epileptic seizures: Protocol for an observational case-control study–EMOCRISES study
by
Hologne, Emmanuelle
,
Banasiak, Claire
,
El–Hage, Wissam
in
Alexithymia
,
Bioengineering
,
Biology and Life Sciences
2022
Psychogenic non epileptic seizures (PNES) are a frequent, disabling and costly disorder for which there is no consensual caring. They are considered as a dissociative disorder and they share many common characteristics with post-traumatic stress disorder (PTSD). Nevertheless, their pathophysiology is still unclear. In this study, we plan to obtain new data comparing functional brain activity of participants suffering from PNES, from PTSD and healthy controls via functional brain MRI during resting state and under emotional visual stimulation. The protocol presented hereunder describes an observational study with no direct treatment implication. Nevertheless, it could lead to a better understanding of PNES and to identifying targets for specialised cares of post-traumatic or dissociative disorders, like repetitive transcranial magnetic stimulation.
This is a prospective, single-centre, interventional, non-randomized, open, controlled and exploratory clinical study. It will involve 75 adult French, right-handed women in 3 groups, either suffering from PNES or PTSD, or healthy controls. An informed consent will be signed by each participant. All of them will be given psychiatric tests to assess dissociation and alexithymia, psychopathological profile and history, and emotional recognition. Each participant will undergo a functional brain MRI. We will record anatomical images and five functional imaging sequences including emotional periodic oscillatory stimulation, standard emotional stimulation, Go / No Go task under emotional stimulation, and resting state. Analysis will include a descriptive analysis of all participants and the treatment for functional magnetic resonance imaging images of each sequence.
This study was approved the regional Protection of Persons Committee under the reference 16.10.01 and by the French National Medical Security Agency under the reference 2016-A01295-46. The protocol and results will be published in peer-reviewed academic medical journals and disseminated to research teams, databases, specialised media and concerned patients' organisations.
Journal Article
Place of the partial dopamine receptor agonist aripiprazole in the management of schizophrenia in adults: a Delphi consensus study
2022
Background
Aripiprazole is a second-generation antipsychotic, efficacious in patients with schizophrenia during acute episodes. Due to its pharmacological profile, aripiprazole may be of interest in patients with specific clinical profiles who have not been studied extensively in randomised clinical trials.
Objectives
To capture experience with aripiprazole in everyday psychiatric practice using the Delphi method in order to inform decision-making on the use of aripiprazole for the treatment of patients with schizophrenia in clinical situations where robust evidence from clinical trials is lacking.
Methods
The scope of the survey was defined as the management of schizophrenia in adults. A systematic literature review was performed to identify the different clinical situations in which aripiprazole has been studied, and to describe the level of clinical evidence. Clinical profiles to include in the Delphi survey were selected if there was a clear interest in terms of medical need but uncertainty over the efficacy of aripiprazole. For each clinical profile retained, five to seven specific statements were generated and included in a questionnaire. The final 41-item questionnaire was proposed to a panel of 406 French psychiatrists with experience in the treatment of schizophrenia. Panellists rated their level of agreement using a Likert scale. A second round of voting on eleven items was organised to clarify points for which a consensus was not obtained in the first round.
Results
Five clinical profiles were identified in the literature review (persistent negative symptoms, pregnancy, cognitive dysfunction, addictive comorbidity and clozapine resistance). Sixty-two psychiatrists participated in the first round of the Delphi survey and 33 in the second round. A consensus was obtained for 11 out of 41 items in the first round and for 9/11 items in the second round. According to the panellists’ clinical experience, aripiprazole can be used as maintenance treatment for pregnant women, is relevant to preserve cognitive function and can be considered an option in patients with a comorbid addictive disorder or with persistent negative symptoms.
Conclusion
These findings may help physicians in choosing relevant ways to use aripiprazole and highlight areas where more research is needed to widen the evidence base.
Journal Article
High Psychological Impact of Covid‐19 on French Healthcare Workers: An Observational Cohort Study of PTSD, Depression and Burn‐Out
by
Prieto, Nathalie
,
Bui, Eric
,
Birmes, Philippe
in
Adult
,
Anxiety
,
Burnout, Professional - epidemiology
2025
Introduction The Covid‐19 outbreak hit the world forcing public institutions to rethink their core functioning. Healthcare workers (HCWs) were particularly at risk for negative mental health outcomes, given their direct exposure to many pandemic‐related stressors. Our study aimed to assess the psychological outcomes of French HCWs during the Covid‐19 pandemic, including PTSD, depression and burn‐out. Methods This study presents the baseline data of a large cohort study conducted during the pandemic. Participants were 849 French HCWs (mostly single women, working as nurses) assessed for PTSD with the PCL‐5 (PTSD Checklist for DSM‐5), for depression with the PHQ‐9 (Patient Health Questionnaire), and for burn‐out and compassion satisfaction with the ProQOL (Professional Quality of Life). Other pandemic‐related variables were also collected, including characteristics related to participants' Covid‐19 experience, as well as psychological and clinical measures. Results The prevalence rates of PTSD, moderately severe depression, and high risk for burn‐out were 17.7% (n = 146), 14.0% (n = 118) and 0.9% (n = 7), respectively. Further, findings suggested that working conditions were challenging, though they still found pride in their work. Univariate analyses showed that being a woman, not being a physician, and lacking protective equipment were each associated with higher scores on several negative psychological outcomes (PTSD, depression, burn‐out and secondary traumatic stress), though not consistently across all dimensions. Notably, satisfaction scores on the ProQOL did not differ by gender and were higher among physicians. In the multivariate analyses, not being a physician was independently associated with higher levels of PTSD, depression and burn‐out symptoms. Being a woman was independently associated with increased PTSD symptom severity. Higher levels of positivity—defined as a general tendency to view life and experiences with an optimistic and constructive outlook, as measured by the Positivity Scale—were associated with lower symptom scores across all three psychological outcomes. Conclusion This study highlights the considerable psychological toll of the Covid‐19 pandemic on French HCWs, particularly among nurses and women, and underscores the protective role of individual psychological resources such as positivity. As one of the largest cohort studies conducted during the pandemic in France, it provides critical evidence to guide public health strategies, institutional policies and mental health interventions. The findings emphasise the urgent need to strengthen occupational mental health support systems and to promote resilience‐building approaches among healthcare professionals facing prolonged crisis conditions.
Journal Article
Psychometric Validation of the English and French Versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)
2016
The purpose of this study is to assess the psychometric properties of a French version of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), a self-report measure of posttraumatic stress disorder (PTSD) symptoms, and to further validate the existing English version of the measure. Undergraduate students (n = 838 English, n = 262 French) completed the PCL-5 as well as other self-report symptom measures of PTSD and depression online. Both the English and French versions PCL-5 total scores demonstrated excellent internal consistency (English: α = .95; French: α = .94), and strong convergent and divergent validity. Strong internal consistency was also observed for each of the four subscales for each version (α's > .79). Test-retest reliability for the French version of the measure was also very good (r = .89). Confirmatory factor analysis indicated that the four-factor DSM-5 model was not a good fit of the data. The seven-factor hybrid model best fit the data in each sample, but was only marginally superior to the six-factor anhedonia model. The French version of the PCL-5 demonstrated the same psychometric qualities as both the English version of the same measure and previous versions of the PCL. Thus clinicians serving French-speaking clients now have access to this highly used screening instrument. With regards to the structural validity of the PCL-5 and of the new PTSD diagnostic structure of the DSM-5, additional research is warranted. Replication of our results in clinical samples is much needed.
Journal Article
Post-traumatic stress disorder following childbirth
2021
Background
Childbirth experience could be complicated and even traumatic. This study explored the possible risk factors for post-traumatic stress disorder following childbirth (PTSD-FC) in mothers and partners.
Methods
Through a cross-sectional online survey biographical, medical, psychological, obstetrical and trauma history data were collected. The PTSD-FC, postnatal depression, social support, and perceived mother-infant bond in 916 mothers and 64 partners were measured through self-reported psychometric assessments.
Results
Our findings highlight the possible impact of several risk factors such as emergency childbirth, past traumatic experiences and distressing events during childbirth on PTSD-FC. The difficulties in mother-infant bond and the postpartum depression were highly associated with the total score of PTSD-FC symptoms for mothers. While for partners, post-partum depression was highly associated with the total score of PTSD-FC.
Conclusions
Our study demonstrated significant links between psychological, traumatic and birth-related risk factors as well as the perceived social support and the possible PTSD following childbirth in mothers and partners. Given that, a specific attention to PTSD-FC and psychological distress following childbirth should be given to mothers and their partners following childbirth.
Journal Article
Internal consistency of the Mental Health Professional Culture Inventory: A pilot study in Romanian population
by
Shyhrete, Rexhaj
,
Kelemen, Gabriela
,
Moraitou, Margarita
in
Consistency
,
Culture
,
Factor analysis
2024
The objective of this study (registered under number 2020 006) was to assess the internal consistency of the revised Mental Health Professional Culture Inventory (MHPCI) scale, which comprises 15 items, among mental health service workers in Romania.
To examine the psychometric properties of the MHPCI questionnaire within the Romanian population, we employed two main methods: The partial credit model (PCM) and Exploratory factor analysis (EFA).
A total of 94 individuals were interviewed, and among them, 71 provided complete responses to the questionnaire. All 15 items demonstrate a strong fit with the PCM, as indicated by mean-square (MSQ) outfit and MSQ infit values falling within the range of 0.5 to 1.5. But items 3 and 11 exhibit MSQ values greater than 1.5, suggesting that it may be challenging to predict individuals’ responses to these items. The KMO index stands at 0.7, surpassing the recommended threshold of 0.6, signifying an acceptable level of suitability. Nevertheless, only 59.3% of the total variance is accounted for by the first four factors, and these factors do not align with the dimensions identified in the original article.
The internal structure of the Romanian version of the MHPCI demonstrates satisfactory psychometric properties. These properties will need to be further validated through additional studies conducted in diverse socio-cultural contexts.
Journal Article
The negative association between trait mindfulness and post‐traumatic stress disorder: A 4.5‐year prospective cohort study
by
Levy, Bernard
,
Falissard, Bruno
,
Gibert, Lionel
in
aggression
,
early intervention
,
epidemiology
2021
Objective Post‐traumatic stress disorder (PTSD) is a chronic, disabling condition. Our main objective is to investigate the association between trait mindfulness and PTSD over a period of 54 months. The secondary objective is to provide an exhaustive description of PTSD trajectories after the Bataclan attack. Methods We designed a prospective cohort study of 133 subjects present in the Bataclan concert hall during the November 2015 terrorist attack in Paris, France. Data were recorded 6, 18, 30, and 54 months after the attack. The primary endpoint was evaluated using the PTSD Check List Scale. Trait mindfulness was measured by the 14‐item Freiburg Mindfulness Inventory. Results FMI scores were consistently, significantly, and negatively associated with PCL‐5 scores. Adjusted odds ratios were at 0.81 (6 months), 0.88 (18 months) 0.82 (30 months), and 0.81 (54 months). PTSD prevalence 6 months after the event was 77%; it remained at 41% after 54 months. PTSD status of subjects is fluctuating. Latent class analysis divided the cohort into 3 groups: 21% of subject who remained below PTSD threshold throughout, 30% who remained above throughout, and 49% who steadily reduced their PTSD scores over time. Conclusion In our cohort, mindfulness is negatively associated with PTSD. Mindfulness programs are designed to improve global resilience and treat anxiety and mood disorders. Further research is needed to investigate if improving trait mindfulness is possible and beneficial for patients suffering from PTSD. PTSD prevalence remains very high for direct victims of terrorism even after 54 months. We found a strong negative association between trait mindfulness and post‐traumatic stress disorder at 6, 18, 30, and 54 months. Mindfulness prevention programs for post‐traumatic stress disorder should be implemented as soon as possible after the trauma.
Journal Article
Repetitive Transcranial Magnetic Stimulation (rTMS) in Post-Traumatic Stress Disorder: Study Protocol of a Nationwide Randomized Controlled Clinical Trial of Neuro-Enhanced Psychotherapy “TraumaStim”
by
Adrien, Vladimir
,
Ferreri, Florian
,
Mouchabac, Stephane
in
Antidepressants
,
Bioengineering
,
Brain research
2023
The use of high-frequency Transcranial Magnetic Stimulation (HF-rTMS) of the right dorsolateral prefrontal cortex (DLPFC) in treating Post-traumatic Stress Disorder (PTSD) is currently regarded as a level B intervention (probable effectiveness). HF-rTMS has attracted interest as a neuromodulation therapeutic method for PTSD. Prolonged exposure and reactivation therapy are also regarded as first-line treatments for PTSD. Randomized controlled clinical studies examining the effectiveness of several HF-rTMS sessions coupled with psychotherapy have not yet been completed. In total, 102 patients with refractory PTSD will be randomly assigned (1:1) to reactivation therapy, in addition to either active HF-rTMS (20 Hz) or sham HF-rTMS, for 12 sessions in a nationwide, multicenter, double-blind controlled trial. The impact on PTSD symptoms and neurocognitive functioning will be assessed. The primary outcome is the PTSD severity score measured based on the Clinician-Administered PTSD Scale (CAPS-5) at one month. If this additional therapy is successful, it may strengthen the case for regulatory authorities to approve this additional technique of treating PTSD. Additionally, it expands the field of neurostimulation-assisted psychotherapy.
Journal Article