Astrid Chevance

• MD PhD
• Assistant Professor - Public Health at French Institute of Health and Medical Research

Introduction: Major depressive disorder (MDD) is among the most common psychiatric disorders in children and adolescents. While previous meta-analyses have synthesised evidence on the efficacy and acceptability of newer-generation antidepressants in this population, specific adverse events (AEs) remain poorly characterised. This is of high clinical...

Background Researchers explore the biology of painful experiences not primarily felt in the body (‘non-physical pain’), sometimes referred to as mental, social or emotional pain. A critical challenge lies in how to operationalise this subjective experience for biological research, a crucial process for translating findings into clinical practice....

Background Trace amine-associated receptor 1 (TAAR1) agonists offer a new approach, but there is uncertainty regarding their effects, exact mechanism of action and potential role in treating psychosis. Aims To evaluate the available evidence on TAAR1 agonists in psychosis, using triangulation of the output of living systematic reviews (LSRs) of an...

Contextualizing Ricœur’s lecture “Suffering is Not Pain” alongside his other peripheral works on the matter uncovers a “practical philosophy,” that could provide new perspectives for clinicians faced with suffering. The analysis unfolds in four stages. First, it examines Ricœur’s interest in dialoguing with psychiatry to nourish his philosophical w...

In 1992, Ricœur delivered his lecture, "Suffering is Not Pain," at a psychiatry colloquium, addressing clinicians eager to explore this profound human experience, which is notably absent from the traditional psychiatric corpus. Ricœur examined the semiology of suffering through three moments: the specific relationship between oneself and the other,...

Dans la pensée de Paul Ricœur, la souffrance est principalement abordée sous son aspect existentiel et phénoménologique, comme l’illustre le texte de la conférence « La souffrance n’est pas la douleur », présentée devant un public de psychiatres. Dans ce numéro thématique, nous proposons la toute première traduction anglaise de ce texte. Les contri...

In Paul Ricœur's thought, suffering is primarily addressed from an existential and phenomenological perspective, as illustrated in the text of the lecture "Suffering is not Pain," delivered to an audience of psychiatrists. In this thematic issue, we present the very first English translation of this text. The contributions of the various authors ex...

Background: Psychotherapy is proven efficacious for the treatment of depression. However, the patient-perceived importance of its effect is not fully appreciated in the evidence base. The smallest worthwhile difference (SWD) represents the smallest beneficial effect of an intervention that patients deem worthwhile given the harms, expenses, and inc...

Introduction Mental pain is a transdiagnostic symptom, predictive of suicide and reported as a critical outcome by patients. A previous systematic review of epidemiological and clinical research has shown a lack of consensual definition of mental pain in clinical research and high heterogeneity across the different measurement instruments of mental...

Background Approximately 30% of patients experience substantial improvement in depression after 2 months without treatment, and 45% with antidepressants. The smallest worthwhile difference (SWD) refers to an intervention’s smallest beneficial effect over a comparison patients deem worthwhile given treatment burdens (harms, expenses and inconvenienc...

Objectives This descriptive study of registered trials aimed to identify large clinical trials on antidepressants for mental disorders: (1) to assess what proportion could be labelled as ‘seeding trials’ (trials for marketing purposes) and (2) to describe their methodological characteristics and outcomes. Design A search was conducted across all t...

La santé mentale étudiante semble s’être fortement dégradée depuis 2016. Il est important de ne pas s’arrêter à ce constat, mais de proposer des stratégies d’interventions ciblées et pertinentes pour cette population. Ce chapitre propose, à partir des données de l’enquête Condition De Vie menée par l’Observatoire National de la Vie Étudiante (OVE)...

Depression is one of the leading causes of morbidity worldwide and increases the risk of suicide. Students are known as a population at risk for depression. This study aimed to evaluate the prevalence of 12 months major depressive episode (MDE) and suicidal thoughts in French students and investigate associated factors. A questionnaire was sent by...

La crise sanitaire de la Covid-19 a suscité, pour la population et les décideurs publics, une attention toute particulière sur la santé mentale, notamment vis-à-vis des étudiants. Pour autant, la problématique de la santé mentale n’est pas récente et a déjà fait l’objet de plusieurs études épidémiologiques. Ainsi, la portée, le poids et le coût des...

Le développement et l’évaluation de protocoles de prévention et d’intervention en santé mentale sont nécessaires. Cependant, les personnes présentant des troubles psychiques et psychopathologiques rencontrent des difficultés de recours aux soins auprès des professionnels de santé. Ce chapitre propose d’observer l’évolution du recours et du renoncem...

La santé mentale étudiante semble s’être fortement dégradée depuis 2016. Il est important de ne pas s’arrêter à ce constat, mais de proposer des stratégies d’interventions ciblées et pertinentes pour cette population. Ce chapitre propose, à partir des données de l’enquête Condition De Vie menée par l’Observatoire National de la Vie Étudiante (OVE)...

Abstract: Measurement invariance of psychological distress does not hold for pre/post-COVID prevalence comparisons. We used network analysis and found that modeled systems differed (global structure, connectivity, and edges). Simulations revealed that while sadness was the most central node, nervousness and discouragement were better target choices...

Introduction : La pandémie de Covid-19 a motivé de nombreuses études à déterminer l’impact psychologique de cette dernière, notamment chez les étudiants. Cependant, il est possible que les construits (variables latentes) mesurés ne soient pas comparables (invariance de mesure), biaisant ainsi la comparaison de scores totaux. À la place, une approch...

Objectives In modern professional life, mental health prevention and promotion have become a major challenge for decision-makers. Devising appropriate actions requires better understanding the role played by each work-related psychosocial factor (WPSF). The objective of this study was to present a relevant tool to hierarchise WPSFs that jointly tak...

Background There is a need to develop an awareness raising tool for GPs to reach out their patients in order to increase blood donation. The main objective was to create and validate a tool to raise awareness about blood donation that meets acceptability and preference criteria and is applicable in general practice. Material and Methods This cross...

Background Non-serious adverse events (NSAEs) should be captured and reported because they can have a significant negative impact on patients and treatment adherence. However, the reporting of NSAEs in randomised controlled trials (RCTs) is limited. Objective To identify the most important NSAEs of antidepressants for patients and clinicians, to b...

Question Although mental pain is present in many mental disorders and is a predictor of suicide, it is rarely investigated in research or treated in care. A valid tool to measure it is a necessary first step towards better understanding, predicting and ultimately relieving this pain. Study selection and analysis Following the Preferred Reporting I...

The clinical guidelines that underpin the use of drugs for mental disorders are informed by evidence from randomised controlled trials (RCTs). RCTs are performed to obtain marketing authorisation from regulators. The methods used in these RCTs could be appropriate for early phases of drug development because they identify drugs with important harms...

Background Digital pills are pills combined with a sensor, which sends a signal to a patch connected to a smartphone when the pills are ingested. Health care professionals can access patient data from digital pills online via their own interface, thus allowing them to check whether a patient took the drug. Digital pills were developed for the state...

Résumé La philosophie de l’esprit (Philosophy of Mind) représente aujourd’hui l’un des champs de recherche les plus prolifiques en philosophie et connaît une hybridation progressive avec les sciences cognitives. Elle étudie des questions fondamentales pour les neurosciences et la psychiatrie, comme la nature des états mentaux et des processus cogni...

Philosophy of Mind is currently one of the most prolific fields of research in philosophy and has witnessed a progressive hybridization with cognitive science. It focuses on fundamental questions to neuroscience and psychiatry, such as the nature of mental states and cognitive processes, or the relationships between mental states and the world. Ant...

BACKGROUND Digital pills are pills combined with a sensor, which sends a signal to a patch connected to a smartphone when the pills are ingested. Health care professionals can access patient data from digital pills online via their own interface, thus allowing them to check whether a patient took the drug. Digital pills were developed for the state...

Background Many clinical trials have assessed treatments for depressive disorders and bipolar depression. However, whether, and which, assessed outcome domains really matter to patients, informal caregivers, and health-care professionals remains unclear. Methods We did an international online survey in French, German, and English. Participants wer...

Purpose The study estimates the prevalence of probable psychiatric disorder in the working population, determines the proportion of people presenting a probable psychiatric disorder among people exposed to work-related psychosocial risk factors (PSRFs), and identifies which PSRF has the strongest association with having a probable psychiatric disor...

Cet article propose le concept de « scène sociale » issu de l’anthropologie sociale durkheimienne et de la sociologie interactionniste pour rendre possibles des réflexions méthodologiques entre psychiatre et ethnographe sur leur pratique professionnelle de l’entretien avec des personnes suivies en psychiatrie. S’intéresser plus particulièrement aux...

Résumé Les effets psychologiques de l’isolement ont déjà été décrits dans la littérature (expéditions polaires, sous-marins, prison). Néanmoins l’échelle du confinement mis en œuvre à l’occasion de la pandémie à COVID-19 est inédite. Il nous faut non seulement relire les études publiées, mais aussi anticiper les problèmes psychologiques qui pourrai...

Objective: The lack of resources and coordination to face the coronavirus epidemic raises concerns for the health of patients with mental disorders in a country where we still have memories of the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims to propose guidance to ensure mental health care du...

Objectif : L’absence de préparation du système de soins psychiatriques à l’épidémie de virus SARS-CoV-2 fait redouter un scénario pessimiste pour la santé physique et mentale des patients suivis en psychiatrie. L’objectif de cet article est de proposer des éléments de guidance pour réorganiser les soins psychiatriques dans le contexte de pandémie...

Clinical sciences do not only aim to describe psychological disorders, but also aim to explain them. And we are currently witnessing revisions of theoretical, methodological, and epistemological approaches. For instance, the ongoing debate about the use of psychiatric classifications, such as the DSM and possible alternatives (Rdoc, HiTOP), illustr...

Core outcome sets (COSs) are agreed-upon standardized sets of outcomes that should be minimally measured in all trials of a given disease. To enhance the uptake of COSs in trials, their generalizability should be increased by a change in the number and diversity of stakeholders involved in their development. Also, their credibility should be improv...

Editorial for the article Bortolon & Raffard, Network analysis: are we moving towards a new conceptualization and treatment of mental disorders? 10.1016/j.encep.2019.06.001

Introduction Au cours des dernières décennies, le monde du travail a connu de profond changement. La précarisation croissante des emplois ou encore l’augmentation actuelle des pressions au travail ne sont pas sans conséquences sur l’aggravation des problèmes de santé mentale au travail. Ces troubles mentaux peuvent être la source d’une productivité...

Introduction We have recently compared all second-generation as well as selected first-generation antidepressants in terms of efficacy and acceptability in the acute treatment of major depression. Here we present a protocol for a network meta-analysis aimed at extending these results, updating the evidence base and comparing all second-generation a...

Objective To evaluate the impact of controllable design factors on the power of antidepressants trials. Methods Using clinical trial simulation (CTS), we analyzed the combined impact on the power of trials of controllable design factors (sample size, outcome metrics, and disease severity at inclusion) and uncontrollable parameters (heterogeneity o...

Background: Few studies have examined the prevalence and correlates of subsyndromal and syndromal depressive symptoms (SSSD) among older adults with schizophrenia spectrum disorder. In this report, we examined the prevalence of SSSD and their associations with sociodemographic characteristics, clinical characteristics of schizophrenia, comorbidity,...

Objectif : Déterminer la proportion des thèses des internes de médecine générale, soutenues avant l’application de la loi Jardé, qui serait effectivement concernée par cette législation, selon la règlementation en vigueur au 1er janvier 2018. Méthode : Classification des résumés des thèses d’exercice des internes de médecine générale soutenues en 2...

Objectif. Valider un outil de classification des protocoles de recherche en deux catégories : recherche impliquant la personne humaine (RIPH) ou non (non-RIPH) d’après la réglementation en vigueur depuis avril 2018, pour les thèses des internes de médecine générale (IMG). Distinguer parmi les non-RIPH celles qui relèvent de l’avis d’un comité d’éth...

Background: Little is known about differences in mental health comorbidity and quality of life in individuals with social anxiety disorder (SAD) according to the number and the types of feared situations. Methods: Using a US nationally representative sample, the National Epidemiologic Survey on Alcohol and Related Conditions, we performed latent...