Fabrice BernaCHRU de Strasbourg, Université de Strasbourg, Inserm U1329
Fabrice Berna
Prof. of Psychiatry (MD, PhD)
About
201
Publications
41,002
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Introduction
My main research and interests topics
-Deprescription of psychotropics, in particular antipsychotics in schizophrenia
-Deep phenotyping in schizophrenia
-Complementary and alternative medicines
-Interactions between autobiographical memory and self in psychiatric disorders, in particular schizophrenia.
Additional affiliations
September 2017 - present
September 2018 - September 2018
August 2010 - August 2011
Education
November 2006 - August 2010
University of Strasbourg, University Hospital of Strasbourg, INSERM U666, France
Field of study
September 1996 - October 2006
University of Nancy, France
Field of study
- Medicine
Publications
Publications (201)
Objectives
Metacognitive training (MCT) for psychosis is a group intervention that combines cognitive‐behavioural therapy and psychoeducation. It has proven efficacy in reducing psychotic symptoms and correcting cognitive biases implicated in the development and maintenance of psychotic symptoms. However, other outcomes, such as patient satisfactio...
Introduction
Neurological disorders (ND) have a high incidence in sub-Saharan Africa (SSA). In this region, systemic challenges of conventional medicine (CM) and cultural beliefs have contributed to a large utilization of traditional medicine (TM). Yet, data on TM and those who use it in the treatment of ND in SSA are scarce. Here, we systematicall...
Sub-optimal response in schizophrenia is frequent, warranting augmentation strategies over treatment-as-usual (TAU). We assessed nutraceuticals/phytoceutical augmentation strategies via network meta-analysis. Randomized controlled trials in schizophrenia/schizoaffective disorder were identified via the following databases: PubMed, MEDLINE, EMBASE,...
Depuis la crise du Covid-19, les autorités sanitaires françaises sont préoccupées par les dérives thérapeutiques, notamment liées aux pratiques de soins non conventionnelles (PSNC). En Suisse, les récents rapports de la Mission interministérielle de vigilance et de lutte contre les dérives sectaires (MIVILUDES) sur la « hausse des signalements liés...
Dans la partie 1 de notre étude, nous avions clarifié les définitions de « dérives sectaires » ainsi que les réponses politiques et juridiques à ces dérives en France et en Suisse. Cette seconde partie se concentre sur la méthodologie d’évaluation des dérives sectaires dans le domaine de la santé et sur l’analyse des données disponibles pour observ...
Contexte : Le recours aux pratiques de soins non conventionnelles concerne une large proportion de la population en France, en particulier les patients ayant des maladies chroniques. Certaines sont utilisées par des professionnels de santé et sont intégrées aux soins conventionnels, par exemple dans des services hospitaliers de médecine intégrative...
Autism spectrum disorder (ASD) is characterized by an alteration of the sense of self, particularly self-continuity. While former studies focused on the recollection and narrative of single past events, the present study aimed to explore autistic individuals’ narrative identity by assessing for the first time their life story, described as the most...
Background: Healthcare workers’ mental health has been impacted by the COVID-19 pandemic, emphasizing the
need for mental health interventions in this population. Online cognitive behavioral therapy (CBT) is efficient to
reduce stress and may reach numerous professionals. We developed “MyHealthToo”, an online CBT program to
help reduce stress among...
Rationale
Withdrawal syndrome (WDS) has been described after discontinuation of antipsychotics. WDS could be the consequence of an over-activation of the dopaminergic pathway. Antipsychotics with a higher affinity for dopamine D2 receptors could be associated with a higher risk of WDS. This study aims to address this statement and evaluate the risk...
Background: Sub-optimal response in schizophrenia is frequent, warranting augmentation strategies over treatment-as-usual (TAU).
Methods: We assessed nutraceuticals/phytoceutical augmentation strategies via network meta-analysis. Randomized controlled trials in schizophrenia/schizoaffective disorder were identified via the following databases: PubM...
Schizophrenia is characterized by the most salient medication adherence problems among severe mental disorders, but limited prospective data are available to predict and improve adherence in this population. This investigation aims to identify predictors of medication adherence over a 1-year period in a large national cohort using clustering analys...
The principle of similitude put forward by Hahnemann has challenging practical consequences in the selection of the right homeopathic medicine for a patient. According to this principle, only the medicines that best fit the totality of the symptoms of a given patient are supposed to really cure: this greatly depends on the homeopath's clinical anal...
Background
Schizophrenia has high socioeconomic impact among severe psychiatric disorders.
Aims
To explore clinician-reported and patient-reported inequities between patients under the poverty threshold vs. the others.
Method
916 patients consecutively recruited in 10 national centers received a comprehensive standardized evaluation of illness se...
Question
This umbrella review and guidelines aimed to provide evidence to support the rational choice of selected adjunctive therapies for schizophrenia.
Study selection and analysis
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and World Federation of Societies of Biological Psychiatry (WFSBP)-grading r...
Introduction
Among treatment-resistant depression (TRD), we identified anergic-anhedonic clinical presentations (TRAD) as putatively responsive to pro-dopaminergic strategies. Based on the literature, non-selective monoamine oxidase inhibitors (MAOI) and dopamine D2 receptor agonists (D2RAG) were sequentially introduced, frequently under the covera...
Background: The media and several French official organizations report an explosion in the use of complementary and alternative medicines (CAM) in France, possibly boosted by the Covid-19 pandemic. In addition, the French Miviludes (Mission of Vigilance and Fight Against Sectarian Aberrations) routinely asserts in its yearly reports a dramatic upti...
Background: The media and several French official organizations report an “explosion” in the use of complementary and alternative medicines (CAM) in France, possibly “boosted” by the Covid-19 pandemic. In addition, the French Miviludes (Mission of Vigilance and Fight Against Sectarian Aberrations) routinely asserts in its yearly reports “a dramatic...
Severe mental illness (SMI) patients often have complex health needs, which makes it difficult to access and coordinate their care. This study aimed to develop a computerized adaptive testing (CAT) tool, PREMIUM CAT-ACC, to measure SMI patients' experience with access and care coordination. This multicenter and cross-sectional study included 496 ad...
Background
The care environment significantly influences the experiences of patients with severe mental illness and the quality of their care. While a welcoming and stimulating environment enhances patient satisfaction and health outcomes, psychiatric facilities often prioritize staff workflow over patient needs. Addressing these challenges is cruc...
BACKGROUND
The care environment significantly influences the experiences of patients with severe mental illness and the quality of their care. While a welcoming and stimulating environment enhances patient satisfaction and health outcomes, psychiatric facilities often prioritize staff workflow over patient needs. Addressing these challenges is cruc...
Background: Police personnel are among the first responders exposed to terrorist attacks, raising in number in the late decades. Due to their profession, they are also exposed to repetitive violence, increasing their vulnerability to PTSD and depression.
Objective: Our study aims at comparing the prevalence of PTSD and depression, and the risk fact...
Different types of resistance to passive movement, i.e. hypertonia, were described in schizophrenia spectrum disorders (SSD) long before the introduction of antipsychotics. While these have been rediscovered in antipsychotic-naïve patients and their non-affected relatives, the existence of intrinsic hypertonia vs drug-induced parkinsonism (DIP) in...
Schizophrenia is characterized by the most salient medication adherence problems among severe mental disorders, but limited prospective data are available to predict and improve adherence in this population. This investigation aims to identify predictors of medication adherence over a one-year period in a large national cohort using clustering anal...
Caffeine is the most consumed psychoactive substance worldwide. Previous studies suggested higher caffeine consumption in subjects with schizophrenia spectrum disorders (SSD) as well as associations with symptoms, medication and medication side-effects. In a large and well-characterized sample of SSD subjects we explored the association between caf...
Schizophrenia is associated with early neurodevelopmental disorders, including most frequently learning disorders (LD), among them dyslexia and dyspraxia. Despite the demonstrated links between schizophrenia and LD, specific clinical patterns of the schizophrenia with a history of LD subgroup remain unknown. The aim of the present study was to inve...
Autobiographical memory (AM) impairments influence both sense of identity and social functioning of patients with schizophrenia. However, cognitive remediation methods addressing these difficulties do not sufficiently consider the heterogeneity of this disorder and frequently face methodological limitations. The aim of the present study was to eval...
Abnormal movements are intrinsic to some forms of endogenous psychoses. Spontaneous dyskinesias are observed in drug-naïve first-episode patients and at-risk subjects. However, recent descriptions of spontaneous dyskinesias may actually represent the rediscovery of a more complex phenomenon, ‘parakinesia’ which was described and documented in exten...
Catatonia has been defined by ICD-11 as a nosologically unspecific syndrome. Previous neuropsychiatric conceptions of catatonia such as Wernicke-Kleist-Leonhard's (WKL) one, have isolated chronic catatonic entities, such as progressive periodic catatonia (PPC) and chronic system catatonias (CSC). This study aimed at comparing the clinical and neuro...
Background
Tobacco use is common in subjects with schizophrenia (SZ) and has sometimes been associated with better functioning in short-term studies. Only few studies embrace an extensive examination of tobacco influence on clinical, cognitive and therapeutic characteristics in stabilized SZ outpatients. The objective of the present study was to as...
In the first half of the 20th century, well before the antipsychotic era, paratonia, Gegenhalten and psychomotor hypertonia were described as new forms of hypertonia intrinsic to particular psychoses and catatonic disorders. A series of astute clinical observations and experiments supported their independence from rigidity seen in Parkinson's disea...
Background
Transcranial magnetic stimulation (TMS) is useful for mapping the motor-evoked potential (MEP) and cortical silence period (CSP). Robotic positioning fasten the process of mapping and contrasting different conditions.
New method
We explore the feasibility of contrasting different TMS effects using parametric statistical maps of induced e...
Résumé
Le terme de Gegenhalten a été créé par Karl Kleist pour définir une forme d’hypertonie qui reste souvent confondue avec le négativisme. Malheureusement, de nombreux référentiels de psychiatrie continuent à faire l’amalgame entre ces deux concepts. L’intérêt grandissant porté aux anomalies motrices dans les psychoses endogènes nous invite à r...
Résumé
La psychiatrie actuelle reconnaît les « dyskinésies spontanées » comme des manifestations possibles de la schizophrénie. Nous pensons qu’il ne s’agit que d’un nouveau nom donné à des mouvements anormaux intrinsèques aux psychoses endogènes décrits depuis plus d’un siècle sous le nom de « parakinésies ». Celles-ci ont été décrites, filmées et...
The World Health Organization (WHO) recommends adults complete 150-300 min per week of moderate physical activity or 75-150 min of vigorous physical activity or an equivalent combination of both, to optimize health. To explore the factors associated with adequate MVPA in stabilized outpatients with schizophrenia. 425 stabilized outpatients were rec...
Background
Previous research has reported that patients with schizophrenia would regard false memories with higher confidence, and this meta-memory deficit was suggested as a neurocognitive marker of schizophrenia. However, how schizophrenia patients determine their memory decision confidence has received scant consideration. This study, therefore,...
Current classification systems use the terms “catatonia” and “psychomotor phenomena” as mere a-theoretical descriptors, forgetting about their theoretical embedment. This was the source of misunderstandings among clinicians and researchers of the European collaboration on movement and sensorimotor/psychomotor functioning in schizophrenia and other...
Objectif
Le « seasonal pattern assessment questionnaire » (SPAQ) est le questionnaire le plus utilisé pour évaluer les effets saisonnier de l’humeur et du comportement, et est souvent utilisé comme outil de dépistage de dépression saisonnière syndromale et sous-syndromale. L’objectif de cette étude est de valider la version française du questionnai...
Background
Metabolic syndrome (MetS) is a highly prevalent and harmful medical disorder often comorbid with psychosis where it can contribute to cardiovascular complications. As immune dysfunction is a key shared component of both MetS and schizophrenia (SZ), this study investigated the relationship between immune alterations and MetS in patients w...
Objectives
High rates of non-right-handedness (NRH) including mixed-handedness have been reported in neurodevelopmental disorders. In schizophrenia (SZ), atypical handedness has been inconsistently related to impaired features. We aimed to determine whether SZ subjects with NRH and mixed-handedness had poorer clinical and cognitive outcomes compare...
On December 11, 2018, five people were killed and 11 injured during a terrorist attack on Strasbourg's Christmas market. As the attacker was on the run during the night, part of the population was locked down for several hours. Our study aimed at assessing factors associated with the development of PTSD and health services use among the victims. Fo...
The aim of our study was to compare the performance of three different instruments measuring clinical and cognitive dimensions of insight.
Data on 182 outpatients with schizophrenia and one-year follow-up assessments was drawn from the FACE-SZ cohort. Awareness of clinical state (« clinical insight ») was measured using both a clinician-rated measu...
Autobiographical memory disorders are well described in schizophrenia. Current research on patients’ memory impairments aims to: 1) better understand the cognitive processes responsible for those difficulties, and 2) develop new methods to palliate autobiographical memory disorders in schizophrenia. The present review describes how the use of weara...
The aim of our study was to compare the performance of three different instruments measuring clinical and cognitive dimensions of insight.
Data on 182 outpatients with schizophrenia and one-year follow-up assessments was drawn from the FACE-SZ cohort. Awareness of clinical state (« clinical insight ») was measured using both a clinician-rated meas...
The Seasonal Pattern Assessment Questionnaire (SPAQ), by Rosenthal et al. (1984), is by far the most used questionnaire to evaluate seasonal effects on mood and behavior. It includes a general seasonality score (GSS), composed of 6 items, from which cutoffs have been established to screen for seasonal affective disorder (SAD). However, it has never...
Treatment resistant schizophrenia (TRS) affects around 30% of patients with schizophrenia resulting in poor functioning, relapses and reduced quality of life. Convergent findings show that inflammation could contribute to resistance. We thus search for immune signatures of patients with TRS/UTRS in a sample of community-dwelling outpatients with sc...
Introduction: The literature has provided contradictory results regarding the status of episodic memory in autism spectrum disorder (ASD). This might be explained by methodological differences across studies. In the present one, the well-recommended Autobiographical Interview was used in which important aspects of episodic memory were assessed, nam...
Bipolar disorder (BD) is a disabling disorder with functional impact on everyday life. Recent studies suggest that autobiographical memory impairment may contribute to the maintenance of psychopathology, leading to enduring altered self-construct. Moreover, past personal experiences also support the ability to project oneself into the future to pre...
We conducted a longitudinal online study to examine attenuated psychotic symptoms (APS) over time in a sample of locked-down individuals. We used (i) questionnaires and (ii) the automatic analysis of the emotional content of narratives. Participants ( N = 162) were recruited to complete an online survey 4 times between March and June 2020 (T1, T2,...
Patients with schizophrenia show severe autobiographical memory impairment, thought to reflect retrieval deficits caused by executive dysfunction. However, prior research has focused exclusively on strategic (voluntary) retrieval, and ignored involuntary retrieval resulting from automatic and associative processes, involving minimal cognitive contr...
Schizophrenia is associated with memory disorders that affect patients in their daily life. Patients complain about difficulty to remember knowledge that has been recently learnt together with its context (episodic memory, EM) but also more complex events that have been personally experienced (autobiographical memory, AM). While deficits at both en...
Background
There is growing concern about measuring patient experience with mental health care. There are currently numerous patient-reported experience measures (PREMs) available for mental health care, but there is little guidance for selecting the most suitable instruments. The objective of this systematic review was to provide an overview of th...
The structural characteristics of self-concept refer to the way in which the elements of self-knowledge are organized and can be experienced by individuals in the form of self-concept clarity. It is intimately linked to autobiographical memory. Therefore, we sought to compare self-concept clarity and autobiographical memory between adults with ASD...
Introduction
Delivering bad news is a stressful moment for both patient and clinician. As poor bad-news consultation quality may lead to misunderstandings, lack of treatment adherence, acute or even post-traumatic stress in patients, training interventions to improve communication skills and stress-management are necessary. Mindfulness is a recogni...
Background
The acknowledgment of the mental health toll of the COVID-19 epidemic in healthcare workers has increased considerably as the disease evolved into a pandemic status. Indeed, high prevalence rates of depression, sleep disorders, and post-traumatic stress disorder (PTSD) have been reported in Chinese healthcare workers during the epidemic...
Involuntary autobiographical memories are mental representations of personally experienced past events that come to mind spontaneously, with no preceding attempt to recall them. They have been showed to be more frequent and more emotional in the psychosis continuum. Although schizophrenia is strongly associated with thought disorders, including cog...
Background:
The determinants of quality of life (QoL) in schizophrenia are largely debated, mainly due to methodological discrepancies and divergence about the concepts concerned. As most studies have investigated bi- or tri-variate models, a multivariate model accounting for simultaneous potential mediations is necessary to have a comprehensive v...
Background:
Music therapy is based on the use of musical elements by a trained and qualified therapist. Clinical researches have suggested that children with Autism Spectrum Disorders (ASD) may benefit from MT. In this regard, this study examines if MT is more effective than simply listening to music for children with ASD.
Method:
A 8-month RCT...
Acyl coenzyme A binding protein (ACBP), also known as diazepam binding inhibitor (DBI) is a multifunctional protein with an intracellular action (as ACBP), as well as with an extracellular role (as DBI). The plasma levels of soluble ACBP/DBI are elevated in human obesity and reduced in anorexia nervosa. Accumulating evidence indicates that genetic...
Background: The acknowledgement of the mental health toll of the COVID-19 epidemic in healthcare workers has increased considerably as the disease evolved into a pandemic status. Indeed, high prevalence rates of depression, sleep disorders and post-traumatic stress disorder (PTSD) have been reported in Chinese healthcare workers during the epidemic...
Autobiographical memory (AM) impairment in schizophrenia affects the richness of detail in personal memories and is one of the major predictors of patients’ social functioning. Despite the empirical evidence attributing these difficulties to a defective encoding process, cognitive remediation interventions targeting AM in schizophrenia often focus...
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...
While the ICD-DSM paradigm has been a major advance in clinical psychiatry, its usefulness for biological psychiatry is debated. By defining consensus-based disorders rather than empirically driven phenotypes, consensus classifications were not an implementation of the biomedical paradigm. In the field of endogenous psychoses, the Wernicke-Kleist-L...
The prevalence of auditory hallucinations in schizophrenia, and theories suggesting a link between autobiographical memory and hallucination, raise the possibility of a dominant role of auditory imagery in autobiographical remembering in patients with schizophrenia, whereas visual imagery is dominant in autobiographical memory of healthy adults. Th...