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Introduction
President of the International Association of Women's mental Health 2019-2022 www.iawmh.org
Past President of the World Federation of Societies of Biological Psychiatry www.wfsbp.org
Professor of Psychiatry and Addictive disorders
Interested in genetics, psychopharmacology, schizophrenia, addictive disorders, sex offenders.
Additional affiliations
January 2013 - present
Université de Nantes
January 2012 - present
January 2009 - present
Université de Franche-Comté
Publications
Publications (322)
Purposeof the review
Chemsex mainly concerned men who have sex with men, but seems to spread in general population. Clinical characteristics and expected effects are diverse. This paper aims at reviewing existing literature on chemsex and providing treatment guidelines.
Recent findings
The use of substances for improving or extending sexual interc...
Introduction:
A significant increase in psychoactive drugs use was observed in women of childbearing age and during the perinatal period worldwide. Yet, the use of illicit drugs, alcohol and tobacco during pregnancy is a serious health risk for the mother, developing fetus and newborn.
Methods:
This review of current trends and consequences of p...
Purpose of Review
Even if the prevalence of hypersexuality in paraphiliacs or paraphilic disorders is close to the prevalence reported in the general population, it remains a risk factor for sexual offense for many authors. We will review common risk factors between hypersexuality and paraphilic disorders as well as the comorbidity between both dis...
Objectives
The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD.
Methods
An extensive literature search was conducted using the English-language-literature ind...
In this chapter, the term “sexual disorders” will include sexual addiction (or hypersexuality) and paraphilic disorders. We have reviewed recent data on the pharmacological and psychotherapeutic treatments of sexual addiction and paraphilic disorders, respectively. Sexual addiction is a severe and frequent disorder, with psychiatric, addictive, and...
Background:
The COVID-19 pandemic brought challenges to governments, healthcare systems (including, mental healthcare services), clinicians and researchers in the EU and worldwide. A range of neurological (e.g., brain fog, encephalitis, myalgia) and psychiatric (e.g., affective disorders, delirium, cognitive disturbances) complications of a novel...
Introduction
COVID-19 has enormous impacts on each individual. The goals of our study were (1) to assess the rate of internet and psychoactive substance use, clinical depression and anxiety in a French population during the lockdown (2) to study the role of clinical and socio-demographic variables (especially, gender).
Materials and methods
During...
Forensic mental health experts play a crucial role in criminal responsibility evaluations. However, the quality of these assessments has at time come under scrutiny and has been heavily criticized. A literature review revealed significant differences between countries concerning legal frameworks and procedures for conducting these assessments. The...
Despite national and international recommendations and while there is no evidence for increased efficacy of higher doses, several studies suggested that the prescribed doses in routine practice are higher than the maximal recommended doses in 20-40% of schizophrenia patients worldwide.
Methods:
the aims of the present study were: (1) to describe...
Many pregnant women, in the world, drink caffeine-containing beverages. Maternal caffeine consumption during pregnancy may have adverse effects on foetus but results are conflicting. Our goals were to estimate the prevalence of caffeine use in a cohort of French pregnant women using maternal self-reports and to evaluate the association between caff...
Introduction:
Chemsex is defined by the use of psychoactive substances to facilitate or improve sexual relations. Our objectives were to assess the prevalence of the practice of 'chemsex' in a population of French university students and to identify socio-demographic and clinical factors associated with this practice.
Material and methods:
We ha...
Even if the fatality rate has been twice higher for men than for women, the Covid-19 pandemic has affected women more than men, both as frontline workers and at home. The aim of our article was to analyze the differences observed in mental health and violence between men and women in the COVID outbreak. For this purpose, we have used all papers ava...
Objectives: Cocaine dependence has a strong heritability component. The aim of this study was to investigate the putative association between the serotonin 2B receptor gene (HTR2B), crack use disorders and impulsivity.
Methods: A French Afro-Caribbean male population of patients with crack use disorders (n = 80) was compared to healthy Afro-Caribbe...
Many facilities involved in caring people diagnosed with mental health disorders who committed crime had to adapt to COVID-19 pandemic in France. Particularly, the impact of the COVID-19 pandemic on incarcerated people was the subject of many concerns. The COVID-19 pandemic also posed major challenges in secure psychiatric hospitals and for psychia...
Chemsex is an escalating public health issue among men who have sex with men, with potentially severe somatic and psychiatric consequences. Given the limited knowledge and lack of treatment recommendations available in this area, we proposed the use of noninvasive brain stimulation in order to reduce problematic chemsex behavior. This is the first...
The use of cannabis as a drug has undergone a remarkable change of direction: considered as a symbol of countercultures in past decades, it is presently being hailed as a cure for any number of diseases and conditions. Thus, despite concerns about the safety of cannabis and cannabinoids, quite a few drugs that contain cannabinoids have recently bee...
The treatment of people diagnosed with mental disorders who committed crimes differ greatly in countries around the world because of the long histories of criminal justice and psychiatry specific to each country. As a result, it is often difficult to grasp the specificities of each system. The main objective of this paper is to provide a narrative...
Purpose of review:
We reviewed recent data on sexual addiction and its treatment. We examined the different definitions of this disorder, related to the pathophysiological mechanisms. We addressed the pharmacological treatment of sexual addiction.
Recent findings:
Hypersexual behavior can be considered an addictive disorder. Sexual addiction is...
Objectives
Patients who survive a suicide attempt present an increased risk of relapse during the three months after discharge from a hospital, referred to herein as the post-discharge period. Developing and assessing the efficacy and safety of methods that reduce the risk of relapse in the post-discharge period is critical for professionals in the...
The digital revolution has changed, and continues to change, our world and our lives. Currently, major aspects of our lives have moved online due to the coronavirus pandemic, and social distancing has necessitated virtual togetherness. In a synopsis of 10 articles we present ample evidence that the use of digital technology may influence human brai...
Objectives: The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. T...
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...
Women are gradually losing the protection they had from historic social roles. In general, girls and women seem more influenced by beliefs about weight control and self-image as well as by female friends or role models when they use alcohol or tobacco. As compared to men, women more often use psychoactive substances to cope with stress and negative...
Introduction
Crack cocaine use disorder (CCUD) is a major public health with a strong heritability component.
Objectives
This study was aimed to investigate the putative association between the dopamine transporter gene (DAT1/SLC6A3) and crack-cocaine use disorders (CCUD) as well as the possible involvement of attention-deficit hyperactivity disor...
The traditional categorical classification system and new diagnostic systems will be discussed in this issue.
.
Most studies describing epigenetic modifications have focused on DNA methylation, but fewer studies have focused on histone modifications and noncoding RNAs. Chromatin architecture and CCCTC-binding factor represent important noncoding regulatory elements that warrant further investigation in order to improve our understanding of the genomic basis...
Cognition has attracted a growing interest in psychiatry. Since the 1990s, cognition as a whole has become an important determinant in the outcome of psychosis. Despite recent progress in the genetics of cognition, the development of new pharmacological compounds in order to improve cognition has not progressed as quickly. This issue will review an...
Current mental health services across the world remain expert-centric and are based on traditional workflows, mostly using impractical and ineffective electronic record systems or even paper-based documentation. The international network for digital mental health
(IDMHN) is comprised of top-level clinicians, regulatory and ICT experts, genetic scie...
Sexual offences are committed by a very heterogeneous population, within which we can distinguish paraphilic and non-paraphilic sex offenders (SOs). In addition, paraphiliacs vary in multiple factors, such as the target, origin, recurrence and intensity of their sexual fantasies, arousal or behaviours. Compared to other types of offenders, convicte...
Tobacco and/or alcohol use during pregnancy is a major public health concern. The aim of our study was to identify risk factors associated to maternal alcohol and tobacco use assessed by maternal self-reports combined with biological measurements in meconium samples of cotinine and ethylglucuronide which reflect fetal exposure to tobacco and alcoho...
Recently, there has been a major shift in the field of psychiatry towards the exploration of complex relationships between blood-based biomarkers and the pathophysiology of psychiatric and neuropsychiatric disorders. However, issues with study reproducibility, validity and reliability have hindered progress towards the identification of clinically...
There currently exists evidence of moderate quality that cognitive training, blood pressure management, and physical activity can delay onset or slow progression of AD.1 All other preventive interventions have cither produced negative and controversial results or are still under investigation. This issue will present reviews on both established pre...
Individuals learn by comparing the outcome of chosen and un-chosen actions. A negative counterfactual value signal is generated when this comparison is unfavorable. This can happen in private as well as in social settings-where the foregone outcome results from the choice of another person. We hypothesized that despite sharing similar features such...
https://doi.org/10.1162/jocn_a_01372 -
Individuals learn by comparing the outcome of chosen and unchosen actions. A negative counterfactual value signal is generated when this comparison is unfavorable. This can happen in private as well as in social settings—where the foregone outcome results from the choice of another person. We hypothesized th...
Objectives:
These practice guidelines for the treatment of alcohol use disorders during pregnancy were developed by members of the International Task Force of the World Federation of Societies of Biological Psychiatry and the International Association for Women's Mental Health.
Methods:
We performed a systematic review of all available publicati...
Drug development in psychiatry is gradually moving from serendipity to personalized medicine. Some promising paths will be reviewed in this issue.
.
Central nervous system disorders are traditionally dichotomized between early-onset neurodevelopmental and late-onset neurodegenerative diseases. Yet, there are commonalities in the mechanisms operating in both neurodevelopmental and neurodegenerative diseases.
Neuroimaging and recent genetics discoveries have raised many questions regarding the current diagnostic criteria of psychiatric diseases and the current classifications used, which are still based on subjective clinical assessment. Despite high-quality research in brain neuroscience and evidence-based guidelines in many psychiatric diseases, some...
Guidelines for pharmacological treatment of patients with paraphilic disorders have been developed by a working group of the World Federation of Societies of Biological Psychiatry (Thibaut et al. 2010 ). With an increasing duration of experience and number of treated patients as well as aging patients, change of or withdrawal from testosterone lowe...
Aims
To give an overview of the most common paraphilias/paraphilic disorders illustrated with case vignettes
To consider the hypersexual disorder as an important clinical diagnosis
To discuss the various forms of psychotherapy
To explain the use of SSRI’s and androgen deprivation therapy illustrated with several cases.
Learning outcomes
The parti...
Inside the brain, neural regions dynamically interact at multiple spatial and temporal scales through a highly structured and adaptive neurocircuitry. Comprehensive maps of brain connectivity have led to the emerging field of connectomics. Graph theory methods are interesting tools to improve our understanding of the brain as a complex interconnect...
The authors have described the general structure and functioning of relevant European associations professionally involved in psychiatry: the Union Européenne des Médecins Spécialistes, the European Psychiatric Association and the European Federation of Psychiatric Trainees. The authors further sketched how these associations could help in establis...
In general, forensic psychiatry remains an under-researched field with scarce epidemiological and research data. Some important clinical aspects are still pending in all European countries, such as the relationships between the psychiatric diagnoses and the penal codes, the systematic use of standardized tools for diagnosis or evaluation of risk of...
Europe is the heaviest drinking and smoking region in the world. Tobacco and alcohol use are gradually increasing in women with a close prevalence of tobacco and heavy alcohol use in girls and boys. Pharmacokinetics and pharmacodynamics differences, reward process specificities and female hormones play a major role in gender differences in addictiv...
The French philosopher René Descartes (1596-1650) argued that the natures of mind and body are completely different from one another and that each could exist by itself. How can these two structures with different natures causally interact in order to give rise to a human being with voluntary bodily motions and sensations? Even today, the problem o...
Autism spectrum disorder, a complex developmental disorder, has been found to be one of the most heritable neuropsychiatric disorders. The next step will be to translate these findings into successful treatments for this disorder.
Baclofen has been proposed for few years to help treating alcohol-dependence at higher doses than those used in neurology. Baclofen pharmacokinetics has been previously well described at low oral or intravenous doses but remains poorly investigated with such high oral doses. We here describe dose regimens of baclofen in 143 alcohol-dependent-patien...
In the 12 years since the publication of the first Consensus Paper of the WFSBP on biomarkers of neurodegenerative dementias, enormous advancement has taken place in the field, and the Task Force takes now the opportunity to extend and update the original paper. New concepts of Alzheimer’s disease (AD) and the conceptual interactions between AD and...
Parkinson's disease (PD) is a progressive degenerative disorder that leads to disabling motor symptoms and a wide variety of neuropsychiatric symptoms. Apathy is the most common psychiatric disorder in the early stages of untreated PD and can be defined as a hypodopaminergic syndrome, which also includes anxiety and depression. Apathy is also consi...
Tobacco and alcohol use remain the most prevalent addictive behaviors reported and the leading risk factors for global burden of disease, injury, and death. Considering addiction as a chronically relapsing brain disorder has opened up the way for biomedical treatment approaches.
Anxiety disorders are the most prevalent psychiatric disorders. There is a high comorbidity between anxiety (especially generalized anxiety disorders or panic disorders) and depressive disorders or between anxiety disorders, which renders treatment more complex. Current guidelines do not recommend benzodiazepines as first-line treatments due to the...
Reasons for using antipsychotic polypharmacy (APP) in routine clinical practice, despite a potentially unfavorable risk-benefit ratio, are poorly understood. This research aimed to determine (1) if severe courses of schizophrenia were associated with APP and (2) if a schizophrenia-related acute event would predict a switch to APP in the short term....
In psychiatric diseases such as mood disorders or schizophrenia, the inflammatory response system is activated. Microglia has gradually emerged as a key interface between stress-related signals and neuroimnune consequences of stress, with stressors leading to elevated microglial activity.
Objective: Schizophrenia is a severe mental disorder and many patients are treated in primary care settings. Apart from the pharmacological management of disease-associated symptoms, the detection and treatment of side effects is of the utmost importance in clinical practice. The purpose of this publication is to offer relevant evidence-based recom...
Prenatal psychoactive substance exposure has significant impact on neonatal health and child development and the development of reliable biomarkers is critical. Meconium presents several advantages for detecting prenatal exposure to psychoactive substances, as it is easy to collect and provides a broad time frame of exposure (third trimester). The...
Objectives:
Schizophrenia is a severe psychiatric disease affecting about 1% of the general population. The relative contribution of genetic factors has been estimated to be up to 80%. The mode of inheritance is complex, non-Mendelian, and in most cases involving the combined action of large numbers of genes.
Methods:
This review summarises rece...
Purpose of Review
Although the neurobiology and neuropharmacology of sexual behavior have not yet been clearly elucidated, several studies characterized the brain areas, neurotransmitters, and circuits involved in sexual disorders. Emphasis has been placed on the importance of brain dopaminergic pathways. The influence of serotonin, testosterone, a...
The prevalence, age of onset, and clinical symptoms of many neuropsychiatric diseases substantially differ between males and females. Factors influencing the relationships between brain development and function and sex or gender may help us understand the differences between males and females in terms of risk or resilience factors in brain diseases...
Objectives: Despite progress in identifying molecular pathophysiological processes in schizophrenia, valid biomarkers are lacking for both the disease and treatment response.
Methods: This comprehensive review summarises recent efforts to identify molecular mechanisms on the level of protein and gene expression and epigenetics, including DNA methyl...
Klinefelter syndrome (KS) is the most common sex chromosomal disorder with an estimated prevalence of 1 in 500-1000. Increased incidences of anxiety, depression, substance abuse, psychotic and behavioral disorders, and sexual disorders have been reported in patients with KS. The aim of this case study was to report a case of a man with untreated KS...
Three electrophysiological endophenotypes are routinely studied in schizophrenia: smooth pursuit eye movement (SPEM) dysfunction, deficits in P50 auditory-evoked potential inhibition, and saccadic inhibition deficits. The current study aimed to investigate the relationship between the COMT val158met polymorphism and these three endophenotypes. One...
Major depressive disorder (MDD) is a heritable disease with a heavy personal and socio-economic burden. Antidepressants of different classes are prescribed to treat MDD, but reliable and reproducible markers of efficacy are not available for clinical use. Further complicating treatment, the diagnosis of MDD is not guided by objective criteria, resu...
In the future, precision medicine will enable every clinician to tailor treatment and even prevention strategies to an individual's unique characteristics. In order to reach this goal, we need to collect and analyze many different types of data, from many different sources, including symptoms, genomics, and brain circuitry, as well as family dynami...
Objective: Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD).
Methods: Findings in biomarker...
{\bf Objective:}$ Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). ${\bf Methods:}$ Finding...
Objectives:
Schizophrenia is a group of severe psychiatric disorders with high heritability but only low odds ratios of risk genes. Despite progress in the identification of pathophysiological processes, valid biomarkers of the disease are still lacking.
Methods:
This comprehensive review summarises recent efforts to identify genetic underpinnin...
Digital applications and new mobile technologies can change the nature of the psychiatrist-patient relationship and future clinical practice in terms of diagnosis, follow-up, and treatment, but need to be further studied. This issue explores these new approaches in psychiatry.
Most people recognize that incarceration alone will not solve sexual violence. Indeed, treating the offenders is critical in an approach to preventing sexual violence and reducing victimization. In most cases, a diagnosis of paraphilia is associated with sexual violence. This review is intended to present and summarize the first recently published...
Many studies have suggested that the striatum, located at the interface of the cortico-basal ganglia-thalamic circuit, consists of separate circuits that serve distinct functions It plays an important role in motor planning, value processing, and decision making.
Psychotherapeutic treatment, alone or in association with pharmacotherapy, has been reported as effective for the treatment of distress and to relieve sexual addiction-associated symptoms such as shame, depression, and anxiety. In this article, the authors review the current literature on psychotherapeutic treatment of sexual addiction. Different p...
Emotions are largely affected in many psychiatric diseases. A better understanding of the neural networks involved in emotion processing is an important way to be able to improve dysfunctions in emotion recognition, as well as expression, associated with major psychiatric disorders.
The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therap...
Although both the words gender and sex have the following sense (the state of being male or female), they
are typically used in slightly different ways: sex tends to refer to biological differences (chromosomal status), while gender refers to cultural or social ones. Gender identity refers to a person’s internal sense of being male or female; gende...
Mother-son incest as well as female pedophilic disorder remain underrecognized and misdiagnosed. This is the case of a female child abuser who suffered from hypersexual disorder and mental retardation and whose son was viewed as a substitute transitional sexual partner. Our clinical case shared some common features with female sex offenders previou...
The neurophysiological components that have been proposed as biomarkers or as endophenotypes for schizophrenia can be measured through electroencephalography (EEG) and magnetoencephalography (MEG), transcranial magnetic stimulation (TMS), polysomnography (PSG), registration of event-related potentials (ERPs), assessment of smooth pursuit eye moveme...
These updated guidelines are based on the first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in the years 2005 and 2006. For this 2015 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematical...
Paraphilias are deviant sexual behaviors that cause significant distress or impairment in functioning. Some paraphiliac behaviors may lead to sex offenses. The diagnosis of paraphilia must be carefully established. In order to control paraphiliac fantasies and behaviors, as well as the level of distress of the paraphiliac individual, a comprehensiv...
Près de 80 millions de personnes abusent de l’alcool ou en sont dépendants dans le monde, il s’agit donc d’une préoccupation majeure de santé publique. L’alcoolo-dépendance est une maladie complexe, très hétérogène, dans laquelle sont intriqués des facteurs de risque personnels dont des facteurs génétiques et des facteurs environnementaux. Cette gr...
Le dictionnaire Larousse définit le « genre » au plan biologique (ensemble d’êtres vivants groupant des espèces très voisines désignées par le même nom latin : par exemple pour l’Homme, homo sapiens du groupe des hominidés) mais également par la manière d’être de quelqu’un. La question du genre, féminin ou masculin, a été abordée de deux manières t...
Substance use has increased worldwide. Based on these data, we may think that substance use has also increased during pregnancy, but epidemiological data are scarce in this population. The potential consequences of tobacco, cocaine or cannabis use during pregnancy are a major public health concern. The combined use of different substances during pr...
Objective:
To define a practice guideline for biological treatment of dementias for general practitioners in primary care.
Methods:
This paper is a short and practical summary of the World Federation of Biological Psychiatry (WFSBP) guidelines for the Biological treatment of Alzheimer's disease and other dementias for treatment in primary care (...
The treatment of paraphilias remains a challenge in the mental health field. Combined pharmacologic and psychotherapeutic treatment is associated with better efficacy. The gold standard treatment of severe paraphilias in adult males is antiandrogen treatment with cognitive behavioral therapy. Selective serotonin reuptake inhibitors have been used i...