Bulteau Samuel

Centre Hospitalier Universitaire de Nantes | CHU Nantes

Over the past three decades, non-invasive brain stimulation (NIBS) techniques have gained worldwide attention and demonstrated therapeutic potential in various medical fields, particularly psychiatry. The emergence of these novel techniques has led to an increased need for robust training programs to provide practitioners, whether clinicians or sci...

Background: Major depressive disorder is one of the leading causes of disability worldwide. Recently, the WHO has highlighted the negative impact of recent crises (COVID-19 pandemic, war in Ukraine, economic crisis). Although most international guidelines recommend psychological and psychosocial interventions as a first-line treatment for mild to...

Virtual reality (VR) is an attractive technology for cognitive assessment, as it provides a more embodied experience compared with typical test situations, such as those using paper and pencil. In addition, VR can immerse individuals in complex situations similar to real-life ones, thereby improving the ecological validity (i.e., face validity) of...

Intranasal esketamine is used in France for treatment-resistant depression. Dissociative symptoms are common side effects during treatment sessions. We report a case of delayed spontaneous dissociative symptoms following esketamine administration. A 20-year-old female with treatment-resistant depression received esketamine treatment. Dissociative s...

Background: Posttraumatic stress disorder (PTSD) is a severe and frequent affection that is highly comorbid to major depressive disorder. Comorbid PTSD and depression are usually treatment-resistant, with a high risk of functional impairment and suicide. Esketamine nasal spray is a recent validated treatment for treatment-resistant depression (TRD)...

Adverse drug reactions (ADRs) are a major public health issue, especially when it comes to the elderly. Potentially inappropriate prescribing (PIP) are one of the causes of ADRs in older people. A PIP can be defined as a prescription for which the benefit/risk ratio is unfavourable compared to other therapeutic alternatives. Psychotropic drugs are...

BACKGROUND Major depressive disorder is one of the leading causes of disability, worldwide. Recently, WHO underlined the negative impact of recent crises (COVID-19 pandemic, war in Ukraine, economic crisis). Although most international guidelines recommend psychological and psychosocial interventions as first-line treatment for mild to moderate dep...

Nitrous oxide (N2O) has recently emerged as a potential fast-acting antidepressant but the cerebral mechanisms involved in this effect remain speculative. We hypothesized that the antidepressant response to an Equimolar Mixture of Oxygen and Nitrous Oxide (EMONO) would be associated with changes in cerebral connectivity and brain tissue pulsations...

Objective: Electroconvulsive therapy (ECT) is an effective treatment for patients experiencing a major depressive episode, especially older ones. Identification of specific responses within early ECT sessions remains an issue of debate, however. Hence, this pilot study prospectively examined the outcome in terms of depressive signs, symptom by sym...

Transgender and gender-diverse (TGD) individuals experience higher rates of mood and anxiety disorders than the general public. Transcranial direct current stimulation (tDCS) is an effective and well-tolerated treatment for major depressive disorder, in cisgender patients. With the very recent exception of electroconvulsive therapy (ECT), neuromodu...

Background: In 2008, the U.S. FDA approved rTMS as a treatment against medication-resistant depression. However, real-world rTMS outcomes remain understudied. This study investigates how rTMS for depression is delivered in routine clinical practice in France, and measures its effectiveness as well as its moderators. Methods: Five centers provide...

The COVID-19 pandemic imposed two lockdowns of eight and six weeks in France. While access to care was reduced during lockdown periods, these stressful situations with the pandemic and lockdown periods may have a negative impact on mental health, especially in vulnerable subgroups. Monitoring of psychotropic drugs consumption in France is a compreh...

Nitrous oxide (N2O) has recently emerged as a potential fast-acting antidepressant but the cerebral mechanisms involved in this effect remain speculative. We hypothesized that the antidepressant response to an Equimolar Mixture of Oxygen and Nitrous Oxide (EMONO) would be associated with changes in cerebral connectivity and brain tissue pulsations...

Major depressive disorder is a leading global cause of disability. There is a growing interest for memory in mood disorders since it might constitute an original tool for prevention, diagnosis, and treatment. MDD is associated with impaired autobiographical memory characterized by a tendency to overgeneral memory, rather than vivid episodic self‐de...

La réalisation pratique d’un traitement par stimulation magnétique transcrânienne (rTMS) est aujourd’hui peu intégrée dans les habitudes de soin en France. De fait, si les connaissances théoriques et scientifiques sont maintenant répandues, les considérations pratiques peuvent demeurer obscures pour les psychiatres qui ne pratiquent pas eux-mêmes l...

At a time when innovations in psychiatry are booming, particularly in the field of medical devices, we thought it necessary, as members of French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), to reconsider one of the oldest medical devices in psychiatry: the ECT apparatus. First, we recall the regulatory aspects of ECT. Nat...

Introduction: The perinatal period is an at-risk period for the emergence or decompensation of psychiatric disorders. Transcranial electrical stimulation (tES) is an effective and safe treatment for many psychiatric disorders. Given the reluctance to use pharmacological treatments during pregnancy or breastfeeding, tES may be an interesting treatme...

Psychological flexibility is a key process in mental health, both in a psychopathological approach and from a quality of life and well-being perspective. The notion seems to suffer from a conceptual vagueness with multiple definitions, stemming from different conceptual propositions, with a frequent opposition between a “neuropsychological” approac...

Introduction Le trouble dépressif majeur est le plus prévalent de tous les troubles psychiatriques et peut affecter la référence à soi. La plupart des stratégies thérapeutiques de la dépression visent à modifier le processus de référence à soi pour rectifier le biais cognitif négatif du patient. L'efficacité de ces traitements est souvent mesurée a...

Background Recently intermittent theta burst stimulation (iTBS) proved to be non-inferior to conventional repetitive transcranial magnetic stimulation (10 Hz rTMS) in unipolar depression after failure of one antidepressant trial, but to date no randomized control trial assessed the ability of iTBS to improve depression level and quality of life in...

Aim: Deep brain stimulation (DBS) has proven to be an effective therapy of some treatment-resistant psychiatric disorders and movement disorders. Comorbid depressive symptoms are common and difficult to manage. Treatment with electroconvulsive therapy (ECT) may be required. There are few published cases describing the safety and efficacy of ECT fo...

Background Electroconvulsive therapy (ECT) is the most effective non-pharmacological treatment for treatment-resistant depression (TRD) but can expose to transient cognitive impairments. Understanding factors underlying these cognitive side effects is important. This study investigated the impact of anticholinergic treatments on cognitive performan...

Background: Transcranial Direct Current Stimulation (tDCS) and Virtual Reality Exposure Therapy (VRET) are individually increasingly used in psychiatric research. Objective/hypothesis: Our study aimed to investigate the feasibility of combining tDCS and wireless 360° full immersive active and embodied VRET to reduce height-induced anxiety. Meth...

Recent evidence suggests an association between benzodiazepines (BZDs) use and lower brain amyloid load, a hallmark of AD pathophysiology. Other AD-related markers include hippocampal atrophy, but the effect of BZDs on hippocampal volume remains unclear. We aimed at 1) replicating findings on BZDs use and brain amyloid load and 2) investigating ass...

Objectives: Depression as well as a treatment by antidepressant are factors that may interfere with sexuality. Due to this complex relationship between depression, antidepressant and sexuality, it is difficult to incontestably establish the exclusive accountability of a treatment or of a psychiatric disorder on sexual dysfunctions. The main purpos...

Résumé Les traitements de la dépression comprennent un mode de vie adapté, l’activité physique, les psychothérapies, les médicaments antidépresseurs et thymorégulateurs, la neuromodulation, les chronothérapies et les cures thermales. Les traitements médicamenteux utilisés dans le traitement de l’EDC sont les traitements antidépresseurs et les thymo...

Introduction Le trouble dépressif majeur est le plus prévalent de tous les troubles psychiatriques et peut affecter la référence à soi. La plupart des stratégies thérapeutiques de la dépression visent à modifier le processus de référence à soi pour rectifier le biais cognitif négatif du patient. L’efficacité de ces traitements est souvent mesurée a...

BACKGROUND In neuropsychology, fully-immersive virtual reality has been spotlighted as a promising tool. It is considered that not only overcome existing limitation of neuropsychological tests, but also appropriate for treating executive functions within daily living tasks due to its high ecological validity. While fully-immersive virtual reality o...

Background Although clozapine is the most effective antipsychotic drug for treatment-resistant schizophrenia, it leads to a poor or partial response in 40 to 70% of patients. Augmentation of clozapine with electroconvulsive therapy (ECT) is a highly effective and relatively safe treatment for these clozapine-resistant patients. However, parameters...

Objective: The aim of the study was to identify clinical variables associated with changes in specific domains of self-reported depression during treatment by antidepressant and/or repetitive Transcranial Magnetic Stimulation (rTMS) in patients with Major Depressive Disorder (MDD). Methods: Data from a trial involving 170 patients with MDD receivin...

Background: Nearly 3% of the general population is treated by antipsychotic. The aim of this study was to assess the conformity of monitoring with the minimal screening recommended by guidelines to prevent Metabolic Syndrome. Research design and method: A cohort study was conducted using SNIIRAM data (2013 to 2017). The analysis included patients w...

Some studies have suggested that postural balance improved after a single session of transcranial direct current stimulation (tDCS), whereas others have found minimal, if any, effects on postural performance. To address the issue of replication in tDCS studies, we re-tested the anodal tDCS effects of left dorsolateral prefrontal cortex while perfor...

Objectives: Relapses and recurrence remain the greatest risks posed by patients with severe mood disorders after discontinuation of electroconvulsive therapy (ECT). To date, despite a wide range of literature on ECT, little is known about the rate of recurrence of depression after maintenance ECT (mECT) discontinuation specifically. This study sou...

Résumé La pandémie du COVID-19 a des conséquences majeures sur l’organisation des soins. En France et dans le monde, les centres pratiquant l’électroconvulsivothérapie (ECT) ont vu leur activité diminuer, voire s’arrêter, pour de diverses raisons. Dans ce contexte, le maintien ou la reprise de cette activité thérapeutique essentielle pour de nombre...

Background: Depression is a debilitating and costly disease for our society, especially in the case of treatment-resistant depression (TRD). Repetitive transcranial magnetic stimulation (rTMS) is an effective adjuvant therapy in treatment-resistant unipolar and non-psychotic depression. It can be applied according to two therapeutic strategies aft...

RÉSUMÉ Objectifs: La pandémie de la maladie à coronavirus (COVID-19) a provoqué une crise sanitaire majeure et mis en quarantaine la moitié de la population planétaire. En France, elle a provoqué une réorganisation en urgence de l’offre de soins mobilisant les soignants dans un climat d’incertitude. L'objectif du présent article est de faire le poi...

Résumé La pandémie récente de COVID-19 a entraîné des changements organisationnels majeurs dans les lieux de soins et notamment en hospitalisation en psychiatrie. Pour évaluer l’évolution de l’activité des différents centres pratiquant l’ECT, une enquête nationale en ligne a été réalisée. 65 réponses de toute la France ont été analysées. Plus de 90...

Background: ECT is the most effective treatment of major depressive episode (MDE) but remains a neglected treatment. The French Society for Biological Psychiatry and Neuropsychopharmacology aimed to determine whether prescribing practice of ECT followed guidelines recommendations. Methods: This multicenter, retrospective study included adult pat...

Introduction Depression is among the most widespread psychiatric disorders in France. Psychiatric disorders are associated with considerable social costs, amounting to €22.6 billion for treatment and psychotropic medication in 2011. Treatment as usual (TAU), mainly consisting of pharmacotherapy and psychotherapy, is effective for only a third of pa...

Introduction Depression is among the most widespread psychiatric disorders in France. Psychiatric disorders are associated with considerable social costs, amounting to €22.6 billion for treatment and psychotropic medication in 2011. Treatment as usual (TAU), mainly consisting of pharmacotherapy and psychotherapy, is effective for only a third of pa...

Les ECT sont un traitement de référence pour les troubles de l’humeur avec des taux d’efficacité encore inégalés pour les dépression sévères ou résistantes. Les recommandations officielles de l’ANAES concernant l’ECT ont maintenant plus de 20 ans (1997), et peu d’études ont tenté depuis de décrire ses modalités d’utilisation dans notre pays. Or le...

Introduction Le burnout peut être défini comme un syndrome psychologique associant un épuisement émotionnel, une dépersonnalisation et une baisse de l’accomplissement personnel [1]. Le burnout affecte en particulier les professionnels d’aide à la personne, comme les sapeurs-pompiers. Les conséquences du burnout sont nombreuses, allant de la baisse...

Introduction La dépression est un trouble psychiatrique répandu, qui entraîne des coûts sociaux considérables. Le traitement usuel (TU), associant généralement antidépresseurs et psychothérapie, n’est efficace que pour un tiers des patients. La stimulation transcrânienne à courant continu (tDCS) est un traitement non invasif, peu coûteux, et bien t...

La prévalence des états dépressifs caractérisés chez les sujets âgés de plus de 65 ans est estimée environ à 30 % en institution et 10 % à domicile. Sur le plan cognitif, les états dépressifs sont marqués principalement par une détérioration des capacités attentionnelles, de la vitesse de traitement de l’information et des fonctions exécutives. Ces...

Objective: The current study aimed to examine whether specific features of psychomotor retardation (PMR) and cognitive functioning established different profiles in unipolar (UD) and bipolar depression (BD). Methods: Two groups of age-matched patients with UD (n=54) and BD (n=20) completed the Montgomery-Asberg Depression Rating Scale (MADRS/60)...

The safety and efficacy of neuronavigated intermittent theta burst stimulation (iTBS) in patients with bipolar depression has not yet been investigated. We hypothesized the superiority of active iTBS over sham. Twenty-six patients were randomly allocated to receive either active (n=12) or sham (n=14) iTBS. Response and remission rates according to...

Introduction The proven effectiveness of neuromodulation and stimulation techniques for the management of psychiatric disorders has brought strongly needed innovation in psychiatry, given the high prevalence and high costs of treatment resistance. Although evidence-based guidelines in neuromodulation have been implemented to improve the clinical ef...

Major depression (MD) is a debilitating condition associated with huge personal, social, and economic costs, as well as excessive mortality and disability. A large proportion of subjects doesn’t reach adequate clinical improvements with psychosocial and pharmacologic interventions and are exposed to side effects. In recent years, novel neuromodulat...

Introduction Transcranial Direct Current Stimulation (tDCS), a medical device, has Grade B evidence-based efficacy for treatment-naive depressive patients, or with treatment, and no resistance. Its ease of use, its good tolerance and its cost of acquisition, lower than transcranial magnetic stimulation and electroconvulsive therapy, make it a good...

Résumé La stimulation magnétique transcrânienne répétée (rTMS) est un outil thérapeutique d’utilisation encore récente en psychiatrie. Cet article a pour objectif d’actualiser l’état des connaissances sur la rTMS dans le traitement des troubles de l’humeur. La rTMS possède une efficacité certaine (niveau de preuve de grade 1) dans le traitement ini...

Background: Nitrous oxide (N2O) is used worldwide for analgesia and anesthesia. It is also used for recreational purposes by some people. N2O can have major side effects (myeloneuropathy, delusions, emphysema) when used to excess. In France, N2O is available as an equimolar mixture of oxygen and nitrous oxide (EMONO). Its substance use disorder pot...

Background: Many studies were conducted to assess the benefit/risk of equimolar mixture of oxygen and nitrous oxide (EMONO), but evaluating the appetite associated to its use is now getting very little attention in the literature. The purpose of this study was to investigate the effects present, felt, and sought during care by the child related wit...

Objectives: Due to its ease of use, tolerance, and cost of acquisition, transcranial direct current stimulation (tDCS) could constitute a credible therapeutic option for non-resistant depression in primary care, when combined with drug management. This indication has yet to receive official recognition in France. The objective of this study is to e...

Les traitements des épisodes dépressifs caractérisés (EDC) sont essentiellement médicamenteux et psychothérapiques. Une rémission clinique est atteinte dans seulement 30 % des cas après une première ligne de traitement antidépresseur bien conduite [1]. La majorité des patients dépressifs (63 %) auraient une faible observance médicamenteuse, due à u...

Objective Therapeutic observance is one of the cornerstones of bipolar disease prognosis. Nostalgia of previous manic phase has been described as a cause of treatment retrieval in bipolar disorder. But to date no systematic study has examined manic episode remembering stories. Our aim was to describe manic experience from the patient’s point of vie...

Introduction: Co-occurring pain impairs depression’s prognosis. Selective serotonin reuptake inhibitors or serotonin and norepinephrine reuptake inhibitors are first-line pharmacotherapies for depression and inhibit many cytochrome 2D6 enzymes. Codeine is a first-line treatment for pain and needs to be metabolized into morphine by cytochrome 2D6 to...

The proven effectiveness of neuromodulation and stimulation techniques for the management of psychiatric disorders has brought strongly needed innovation in psychiatry, given the high prevalence and high costs of treatment resistance. Although evidence-based guidelines in neuromodulation have been implemented to improve the clinical efficacy, safet...

Background Craving is a core symptom of addictive disorders, such as pathological gambling for example. Over the last decade, several studies have assessed the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the addiction field, which triggers the dorsolateral prefrontal cortex (DLPFC) to decrease craving. The STIMJEU study inves...

Introduction L’isotrétinoïne est le médicament de choix des acnés sévères. Cependant, le lien entre ce médicament et la survenue de complications psychiatriques est controversé. Il est difficile à évaluer car l’acné en elle-même a un impact sur la qualité de vie et peut parfois induire une anxiété, une dépression ou des idées suicidaires. L’objecti...

The administration of dopaminergic medication to treat the symptoms of Parkinson’s disease (PD) is associated with addictive behaviors and impulse control disorders. Little is known, however, on how PD patients differ from other patients seeking treatments for behavioral addictions. The aim of this study was to compare the characteristics of behavi...

Aim: Poppers have become legal in France since June 2013. Is their liberalisation associated with an increase of severe side effects observed? Methods: To identify elevated methaemoglobinaemia related to poppers abuse, we reviewed all methaemoglobin concentrations measured in Nantes university hospital, during 12 months. Results: Methaemoglobi...

Catatonia can lead to severe complications and may be lethal but is often underdiagnosed. The clinical presentation can be similar to coma. In these situations, electroconvulsive therapy (ECT) can be used as first-line treatment to enable extubation, recovery of autonomy, and rapid discharge from intensive care. We report 4 cases of patients hospit...