L’objectif de cet article est de faire le point sur les cas d’abus et de dépendance relatifs à la poudre d’opium à partir des différentes données recueillies par les centres d’évaluation et ...d’information sur la pharmacodépendanceaddictovigilance. La poudre d’opium présente un potentiel d’abus/pharmacodépendance, en particulier primaire. Il apparaît donc nécessaire de surveiller la dernière spécialité à base de poudre d’opium plus fortement dosée, Izalgi®, dont la ressemblance avec Lamaline® peut induire en erreur les prescripteurs, en particulier en termes d’indications.
The aim of this publication is to review the data reported to the Centers for Evaluation and Information on Pharmacodependence-Addictovigilance concerning the abuse and dependence related to opium powder (Lamaline®, Izalgi®). Many cases of primary dependence with opium powder were reported in France. Thus, it seems important to survey these specialties, in particular Izalgi®, which contain higher dose of opium powder (25 mg Izalgi® and 10 mg Lamaline®). Unlike Lamaline®, Izalgi® is indicated only for acute pain, thus, the off-label prescription of Izalgi® should also be surveilled.
Many studies have shown associations between a history of childhood trauma and more severe or complex clinical features of bipolar disorders (BD), including suicide attempts and earlier illness ...onset. However, the psychopathological mechanisms underlying these associations are still unknown. Here, we investigated whether affective lability mediates the relationship between childhood trauma and the severe clinical features of BD.
A total of 342 participants with BD were recruited from France and Norway. Diagnosis and clinical characteristics were assessed using the Diagnostic Interview for Genetic Studies (DIGS) or the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Affective lability was measured using the short form of the Affective Lability Scale (ALS-SF). A history of childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Mediation analyses were performed using the SPSS process macro.
Using the mediation model and covariation for the lifetime number of major mood episodes, affective lability was found to statistically mediate the relationship between childhood trauma experiences and several clinical variables, including suicide attempts, mixed episodes and anxiety disorders. No significant mediation effects were found for rapid cycling or age at onset.
Our data suggest that affective lability may represent a psychological dimension that mediates the association between childhood traumatic experiences and the risk of a more severe or complex clinical expression of BD.
Suicide is one of the leading causes of death in adolescents and help-seeking behaviour for suicidal behaviour is low. School-based screenings can identify adolescents at risk for suicidal behaviour ...and might have the potential to facilitate service use and reduce suicidal behaviour. The aim of this study was to assess associations of a two-stage school-based screening with service use and suicidality in adolescents (aged 15 ± 0.9 years) from 11 European countries after one year. Students participating in the ‘Saving and Empowering Young Lives in Europe’ (SEYLE) study completed a self-report questionnaire including items on suicidal behaviour. Those screening positive for current suicidality (first screening stage) were invited to an interview with a mental health professional (second stage) who referred them for treatment, if necessary. At 12-month follow-up, students completed the same self-report questionnaire including questions on service use within the past year. Of the
N
= 12,395 SEYLE participants, 516 (4.2%) screened positive for current suicidality and were invited to the interview. Of these, 362 completed the 12-month follow-up with 136 (37.6%) self-selecting to attend the interview (screening completers). The majority of both screening completers (81.9%) and non-completers (91.6%) had not received professional treatment within one year, with completers being slightly more likely to receive it (
χ
2
(1)
= 8.948,
V
= 0.157, p ≤ 0.01). Screening completion was associated with higher service use (OR 2.695, se 1.017, p ≤ 0.01) and lower suicidality at follow-up (OR 0.505, se 0.114, p ≤ 0.01) after controlling for potential confounders. This school-based screening offered limited evidence for the improvement of service use for suicidality. Similar future programmes might improve interview attendance rate and address adolescents’ barriers to care.
Curcumin, a natural polyphenol, has many biological properties, such as anti-inflammatory, antioxidant, and anti-carcinogenic properties, yet, its sensitivity to light, oxygen, and heat, and its low ...solubility in water renders its preservation and bioavailability challenging. To increase its bioaccessibility, we fabricated nanoliposomes and chitosan-coated nanoliposomes encapsulating curcumin, and we evaluated the systems in terms of their physicochemical characteristics and release profiles in simulated gastrointestinal mediums. Chitosan-coating enhanced the stability of nanoliposomes and slowed the release of curcumin in the simulated gastrointestinal (GI) environment. This study demonstrates that nanoliposomes and chitosan-coated nanoliposomes are promising carriers for poorly soluble lipophilic compounds with low oral bioavailability, such as curcumin.
Projected least squares is an intuitive and numerically cheap technique for quantum state tomography: compute the least-squares estimator and project it onto the space of states. The main result of ...this paper equips this point estimator with rigorous, non-asymptotic convergence guarantees expressed in terms of the trace distance. The estimator's sample complexity is comparable to the strongest convergence guarantees available in the literature and-in the case of the uniform POVM-saturates fundamental lower bounds. Numerical simulations support these competitive features.
Previous studies of bipolar disorders indicate that childhood abuse and substance abuse are associated with the disorder. Whether both influence the clinical picture, or if one is mediating the ...association of the other, has not previously been investigated.
A total of 587 patients with bipolar disorders were recruited from Norway and France. A history of childhood abuse was obtained using the Childhood Trauma Questionnaire. Diagnosis and clinical variables, including substance abuse, were based on structured clinical interviews (Structured Clinical Interview for DSM-IV Axis I disorders or French version of the Diagnostic Interview for Genetic Studies).
Cannabis abuse was significantly associated with childhood abuse, specifically emotional and sexual abuse (χ 2 = 8.63, p = 0.003 and χ 2 = 7.55, p = 0.006, respectively). Cannabis abuse was significantly associated with earlier onset of the illness (z = -4.17, p < 0.001), lifetime history of at least one suicide attempt (χ 2 = 11.16, p = 0.001) and a trend for rapid cycling (χ 2 = 3.45, p = 0.06). Alcohol dependence was associated with suicide attempt (χ 2 = 10.28, p = 0.001), but not with age at onset or rapid cycling. After correcting for possible confounders and multiple testing, a trend was observed for an interaction between cannabis abuse and childhood abuse and suicide attempt (logistic regression: r 2 = 0.06, p = 0.039). Significant additive effects were also observed between cannabis abuse and childhood abuse on earlier age at onset (p < 0.001), increased rapid cycling and suicide attempt (logistic regression: r 2 = 0.03-0.04, p < 0.001). No mediation effects were observed; childhood abuse and cannabis abuse were independently associated with the disorder.
Our study is the first to demonstrate significant additive effects, but no mediation effects, between childhood abuse and cannabis abuse on increased clinical expressions of bipolar disorders.
Objective: Duration of untreated illness represents a potentially modifiable component of any diagnosis‐treatment pathway. In bipolar disorder (BD), this concept has rarely been systematically ...defined or not been applied to large clinically representative samples.
Method: In a well‐characterized sample of 501 patients with BD, we estimated the duration of untreated bipolar disorder (DUB: the interval between the first major mood episode and first treatment with a mood stabilizer). Associations between DUB and clinical onset and the temporal sequence of key clinical milestones were examined.
Results: The mean DUB was 9.6 years (SD 9.7; median 6). The median DUB for those with a hypomanic onset (14.5 years) exceeded that for depressive (13 years) and manic onset (8 years). Early onset BD cases have the longest DUB (P < 0.0001). An extended DUB was associated with more mood episodes (P < 0.0001), more suicidal behaviour (P = 0.0003) and a trend towards greater lifetime mood instability (e.g. rapid cycling, possible antidepressant‐induced mania).
Conclusion: Duration of untreated bipolar disorder (DUB) will only be significantly reduced by more aggressive case finding strategies. Reliable diagnosis (especially for BD‐II) and/or instigation of recommended treatments is currently delayed by insufficient awareness of the early, polymorphous presentations of BD, lack of systematic screening and/or failure to follow established guidelines.
Objective
Remitted bipolar disorder (BD) patients frequently present with chronic mood instability and emotional hyper‐reactivity, associated with poor psychosocial functioning and low‐grade ...inflammation. We investigated emotional hyper‐reactivity as a dimension for characterization of remitted BD patients, and clinical and biological factors for identifying those with and without emotional hyper‐reactivity.
Method
A total of 635 adult remitted BD patients, evaluated in the French Network of Bipolar Expert Centers from 2010–2015, were assessed for emotional reactivity using the Multidimensional Assessment of Thymic States. Machine learning algorithms were used on clinical and biological variables to enhance characterization of patients.
Results
After adjustment, patients with emotional hyper‐reactivity (n = 306) had significantly higher levels of systolic and diastolic blood pressure (P < 1.0 × 10−8), high‐sensitivity C‐reactive protein (P < 1.0 × 10−8), fasting glucose (P < 2.23 × 10−6), glycated hemoglobin (P = 0.0008) and suicide attempts (P = 1.4 × 10−8). Using models of combined clinical and biological factors for distinguishing BD patients with and without emotional hyper‐reactivity, the strongest predictors were: systolic and diastolic blood pressure, fasting glucose, C‐reactive protein and number of suicide attempts. This predictive model identified patients with emotional hyper‐reactivity with 84.9% accuracy.
Conclusion
The assessment of emotional hyper‐reactivity in remitted BD patients is clinically relevant, particularly for identifying those at higher risk of cardiometabolic dysfunction, chronic inflammation, and suicide.
HLA genetics in bipolar disorder Tamouza, R.; Oliveira, J.; Etain, B. ...
Acta psychiatrica Scandinavica,
November 2018, 2018-11-00, 20181101, Letnik:
138, Številka:
5
Journal Article
Recenzirano
Objective
Bipolar Disorder (BD) is characterized by deregulated adaptive immune processes. Recent genome‐wide association studies (GWAS) implicate the major histocompatibility complex (MHC) region in ...BD. The present study investigates the potential influence of variations in human leukocyte antigen (HLA) on BD risk and/or clinical presentations. This may have relevance to the dysregulated inflammatory processes commonly found in BD.
Method
DNAs from 475 BD patients and 195 healthy controls (HC) were genotyped for classical HLA class I and II loci.
Results
We found that: (i) the HLA‐A*02~B*44~DRB1*07 sub‐haplotype is less prevalent in BD, vs. HC (pc = 2.4 × 10−2); (ii) the 57.1 and the 8.1‐derived ancestral haplotypes i.e. HLA‐A*02~B*57~Cw*06~DRB1*07~DQB1*09 and HLA‐A*02~B*08~Cw*07 are associated with rapid cycling (pc = 1.9 × 10−3 and 1.05 × 10−2, respectively); (iii) the 8.1AH‐derived HLA class II‐DRB*03~HLA‐DQB1*02 sub‐haplotype is more frequent in BD patients with a history of suicidal behaviors (pc = 2.1 × 10−2); and (iv) disease onset by an hypomanic episode or by psychotic symptoms are, respectively, more frequent in BD patients bearing the 7.1 AH‐derived A*03~B*07~DRB1*15 sub‐haplotype (pc = 8.5 × 10−3) and the HLA‐A*02~B*07~DRB1*15 sub‐haplotype (pc = 4.0 × 10−2).
Conclusion
Corroborating the established link between these HLA haplotypes/sub haplotypes and common immune disorders, our findings suggest possible HLA‐mediated proinflammatory processes operating in BD.
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