Hugo Bottemanne

• MD
• Psychiatrist at University of Paris-Saclay

Computational neuropsychiatry is a leading discipline in explaining psychopathology in terms of neuronal message passing, distributed processing and belief propagation in neuronal networks. Active Inference (AI) is a way of representing this dysfunctional signal processing. According to the AI approach, all neuronal processing and action selection...

For the past decade, ketamine, an N-methyl-D-aspartate receptor (NMDAr) antagonist, has been considered a promising treatment for major depressive disorder (MDD). Unlike the delayed effect of monoaminergic treatment, ketamine may produce fast-acting antidepressant effects hours after a single administration at subanesthetic dose. Along with these a...

Clinical research has shown that persistent negative beliefs maintain depression and that subanesthetic ketamine infusions induce rapid antidepressant responses. Objective: To evaluate whether ketamine alters belief updating and how such cognitive effects are associated with the clinical effects of ketamine. Design, setting, and participants: T...

Optimistically biased belief updating is essential for mental health and resilience in adversity. Here, we asked how experiencing the COVID-19 pandemic affected optimism biases in updating beliefs about the future. One hundred and twenty-three participants estimated the risks of experiencing adverse future life events in the face of belief-disconfi...

The accuracy of grey-matter predictors of depression has remained limited. In this study, brain-based predictors of major depressive disorder (MDD) were trained using machine-learning (Best Linear Unbiased Predictors [BLUP]) and deep-learning (ResNet3D) techniques applied to high-dimensional (voxel-wise) grey-matter structure extracted from T1-weig...

BACKGROUND Suicide is a leading cause of preventable death worldwide. Nurses play a critical role in suicide prevention, yet face significant obstacles. Improving the evaluation and management of patients at risk of suicide requires innovative training techniques that safely and effectively enhance nursing students’ skills, knowledge, and confidenc...

Optimistically biased belief updating is essential for mental health and resilience in adversity. Here, we asked how experiencing the COVID-19 pandemic affected optimism biases in updating beliefs about the future. One hundred and twenty-three participants estimated the risks of experiencing adverse future life events in the face of beliefdisconfir...

We tested whether experiencing the COVID-19-related lockdowns of social and economic life affected optimistically biased belief updating and investigated the putative computational mechanisms.

Optimistically biased belief updating is essential for mental health and resilience in adversity. Here, we asked how experiencing the COVID-19 pandemic affected optimism biases in updating beliefs about the future. One hundred and twenty-three participants estimated the risks of experiencing adverse future life events in the face of beliefdisconfir...

This Viewpoint describes morphologic and functional changes in the paternal brain after childbirth.

Pourquoi les femmes sont-elles deux fois plus touchées que les hommes par la dépression ? Pour répondre à cette énigme, Lucie Joly et Hugo Bottemanne nous dévoilent la manière dont les cycles biologiques, la contraception, la grossesse et la ménopause modifient le cerveau féminin et influencent la santé psychique des femmes. Mais la nature explique...

While objective clinical structured examination (OSCE) is a worldwide recognized and effective method to assess clinical skills of undergraduate medical students, the latest Ottawa conference on the assessment of competences raised vigorous debates regarding the future and innovations of OSCE. This study aimed to provide a comprehensive view of the...

Optimistically biased belief updating is essential for mental health and resilience inadversity. Here, we asked how experiencing the COVID-19 pandemic affected optimismbiases in updating beliefs about the future. One hundred and twenty-three participantsestimated the risks of experiencing adverse future life events in the face of beliefdisconfirmin...

Optimistically biased belief updating is essential for mental health and resilience in adversity. Here, we asked how experiencing the COVID-19 pandemic affected optimism biases in updating beliefs about the future. One hundred and twenty-three participants estimated the risks of experiencing adverse future life events in the face of belief-disconfi...

Après l’accouchement, certaines femmes continuent à percevoir des mouvements fœtaux (appelés « mouvements fœtaux fantômes »). Ces perceptions peuvent persister plusieurs semaines, mois ou années, et être à l’origine de symptômes anxieux chez les femmes ayant vécu une fausse couche spontanée ou une mort fœtale in-utero. La fréquence de ces perceptio...

Introduction: A number of prescribed medicines have been reported in cases of drug-induced delusion, such as dopaminergic agents or psychostimulants. But to this day, most studies are based on a limited number of cases and focus on a few drug classes, so a clear overview of this topic remains difficult. To address this issue, we provide in this art...

Perinatal psychopharmacology is an emerging specialty that is gradually developing alongside perinatal psychiatry. The management of psychiatric disorders during the perinatal period is a challenge for perinatal practitioners due to the multiple changes occurring during this crucial period. This little-known specialty still suffers from inappropria...

Obsessive-Compulsive Disorder (OCD), characterized by the combination of obsession and compulsion, is a clinical and therapeutic challenge. Many patients with OCD do not respond to first-line treatments such as serotonin selective reuptake inhibitors (SSRIs) and exposure and response prevention psychotherapy (ERP). For these resistant patients, som...

Objective: To identify factors associated with posttraumatic stress symptoms (PTSS) 3 and 6 months after the discharge of patients hospitalized for COVID-19. Methods: Patients hospitalized for COVID-19 between March 1 and July 31, 2020, were included in a longitudinal study. Clinical assessments were conducted with online auto-questionnaires. PTSS...

FOCUS ON CLINICAL SPECIFICITIES Denial of pregnancy corresponds to an evolving pregnan¬cy without the woman being aware of being pregnant. It is generally associated with an absence of gravidic signs such as amenorrhea, abdominal swelling, breast tension, morning sickness, or maternal perception of fetal move¬ments. Although this phenomenon is not...

Introduction Reliance on sole reductionism, whether explanatory, methodological or ontological, is difficult to support in clinical psychiatry. Rather, psychiatry is challenged by a plurality of approaches. There exist multiple legitimate ways of understanding human functionality and disorder, i.e., different systems of representation, different to...

What is mood? Despite its crucial place in psychiatric nosography and cognitive science, it is still difficult to delimit its conceptual ground. The distinction between emotion and mood is ambiguous: mood is often presented as an affective state that is more prolonged and less intense than emotion, or as an affective polarity distinguishing high an...

La grossesse et le postpartum provoquent chez la femme des changements physiologiques et morphologiques majeurs, modifiant en profondeur l'intéroception maternelle. Au fil de la croissance du fœtus, le cerveau maternel adapte progressivement les prédictions intéroceptives, apprenant à distinguer les signaux mécaniques fœtaux de l'activité viscérale...

La psychopharmacologie périnatale est une spécialité émergente se développant progressivement aux cotés de la psychiatrie périnatale. La prise en charge des troubles psychiatriques pendant la période périnatale est un défi pour les praticiens de la périnatalité en raison des multiples changements survenant pendant cette période cruciale. La méconna...

The perinatal period, including pregnancy and the postpartum, causes major morphological, endocrine, and thermal transitions in women. As the fetus grows, abdominal muscle fibers stretch, internal organs like the bladder or colon move, and the uterine anatomy changes. Many of these changes involve interoception, the perception of internal body sign...

During the COVID-19 pandemic, there were an increasing prevalence of perinatal psychiatric symptoms, such as perinatal anxiety, depression, and post-traumatic stress disorders. This growth could be caused by a range of direct and indirect stress factors related to the virus and changes in health, social and economic organization. In this review, we...

Perinatal beliefs contribute to the experience of pregnancy and the process of parenthood. Many of these perinatal beliefs have been perpetuated and evolved over time and throughout the world, exerting their influence on the behavior of pregnant women in interaction with medical recommendations. These beliefs generally offer explanations for gravid...

Denial of pregnancy is a public health problem due to maternal, fetal, and neonatal morbidity, affecting both physical and mental health. It generally involves an absence of the physical signals associated with pregnancy such as abdominal swelling, amenorrhea, weight gain, or even perception of fetal movements. Despite the potential consequences fo...

Résumé Le déni de grossesse, défini par la découverte de la grossesse après le premier trimestre, représente un problème de santé publique en raison de la morbidité maternelle, fœtale, et néonatale, touchant aussi bien la santé physique que mentale. Il implique généralement une absence des signaux physiques associés à la grossesse comme le gonfleme...

Résumé La période périnatale est caractérisée par de nombreuses croyances qui participent à l’expérience de la grossesse et au processus de parentalité. Un grand nombre de ces croyances périnatales se sont perpétuées et ont évolué au fil du temps et à travers le monde, exerçant leur influence sur le comportement des femmes enceintes en interaction...

What is mood? Despite its crucial place in psychiatric nosography and cognitive science, it’s still difficult to delimit its conceptual ground. The distinction between emotion and mood is ambiguous, and mood is often presented as an affective state that is more prolonged and less intense than emotion, or as an affective polarity distinguishing high...

Résumé La pandémie COVID-19 causée par le nouveau coronavirus SARS-CoV-2 a provoqué une crise mondiale sans précédent, associée à une prolifération de théories du complot parallèlement à la dissémination du virus à travers le monde. La prévalence de théories complotistes a pu affaiblir la crédibilité des mesures gouvernementales en matière de santé...

Résumé Introduction La psychiatrie est confrontée au défi d’une pluralité d’approches complémentaires issue des multiples niveaux de compréhension du vivant, que ce soit en termes de systèmes de représentations, d’outils, de méthodologies et d’objectifs. Dans le paysage clinique et scientifique actuel, les approches computationnelles et la multipl...

Résumé La question du fonctionnement de l’esprit est au cœur des sciences cognitives. Ces dernières visent à comprendre et à expliquer les processus complexes sous-tendant la perception, la prise de décision et l’apprentissage, trois domaines fondamentaux de la cognition. La théorie du cerveau bayésien, une approche computationnelle issue des princ...

The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 has provoked an unprecedented global crisis, coupled with a proliferation of conspiracy theories alongside the spread of the virus around the world. The prevalence of conspiracy theories may have undermined the credibility of government action on public health, confused citizens about...

Résumé La kétamine, un antagoniste non compétitif du récepteur NMDA, est utilisée aujourd’hui comme traitement antidépresseur d’action rapide dans les troubles dépressifs. Ce traitement provoque des effets psychodysleptiques dissociatifs associant une déréalisation et une dépersonnalisation, et déclenche des modifications synaptogéniques favorisant...

Résumé Le trouble dépressif est caractérisé par une symptomatologie polymorphe associant des perturbations émotionnelles, cognitives, et comportementales. Les croyances négatives, dites congruentes à l’humeur, sont l’un des symptômes les plus spécifiques. Malgré l’importance de ces croyances dans le développement, le maintien, et la récurrence des...

Les troubles dépressifs périnataux constituent un enjeu thérapeutique majeur en raison de leur prévalence et des difficultés de prise en charge pharmacologique et psychothérapeutique. Nous présentons ici les fondamentaux cliniques nécessaires à la prise en charge de la dépression du postpartum (DPP), et les innovations thérapeutiques disponibles en...

Background: Persistent physical symptoms are common after a coronavirus disease 2019 (COVID-19) episode, but their pathophysiological mechanisms remain poorly understood. In this study, we aimed to explore the association between anxiety and depression at 1-month after acute infection and the presence of fatigue, dyspnea, and pain complaints at 3-m...

During the perinatal period, women develop many beliefs about pregnancy and childbirth that influence their perceptions and behaviors. These beliefs often offer explanations for new sensory phenomena associated with pregnancy, and for biological, psychological, and social transitions in the perinatal period. But these beliefs can also be deleteriou...

The perinatal period, including pregnancy and postpartum, is associated with profound perceptual, cognitive, and emotional changes. The woman's body is transformed, profoundly modifying the interoception. In this paper, we develop a bayesian predictive processing account of perinatal interoception during pregnancy, and we show how these hypotheses...

Obsessive-Compulsive Disorder (OCD) is a disabling disease characterized by intrusive thoughts, with compulsions performed to lessen distress. Many patients with OCD do not respond to first-line intervention such as serotonin reuptake inhibitors (SRIs) and Exposure and Response Prevention (ERP) therapy. Previous studies have focused on the anti-OCD...

The question of how the mind works is at the heart of cognitive science. They aim to understand and explain the complex processes underlying perception, decision-making and learning, three fundamental areas of cognition. Bayesian Brain Theory, a computational approach derived from the principles of Predictive Processing (PP), offers a mechanistic a...

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), responsible for COVID-19 pandemic, caused catastrophic health and social effects, but little is known about its consequences on mental health. Other viral infections have been associated with psychiatric sequelae: infection-triggered disturbing of the immune system and the stressful inte...

Background: Cognitive complaints are frequent after COVID-19 but their clinical determinants are poorly understood. This study aimed to explore the associations of objective cognitive performances and psychological distress with cognitive complaints in COVID-19 survivors. Materials and Methods: Patients previously hospitalized for COVID-19 in a uni...

Oxytocin is a major neuroendocrine hormone regulating many neurocognitive mechanisms. It is widely studied and well known for its impact on the mother-child bond and brain systems related to attachment, social interactions, and affect in general. The biological and neurological mechanisms associated with bereavement complications and pathological g...

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...

Newly emerging infectious diseases like the coronavirus (COVID-19) create new challenges for public healthcare systems. Prior to effective treatments or vaccination, countering the spread of these infections depends on mitigating, protective behaviours. Previous work has shown that the enacting protective behaviours depends on beliefs about individ...

Ketamine, a non-competitive NMDA receptor antagonist, is used as a fast-acting antidepressant therapy in depressive disorders. This treatment provokes dissociative effects associating derealization and depersonalization, and a synaptogenic signaling cascade promoting brain plasticity. Despite several preliminary studies suggesting the usefulness of...

Background: We report the case of a patient presenting with orofacial tardive dyskinesia (TD), following administration of a first-generation antipsychotic (Loxapine). Intervention: Four weeks of repeated sessions of Mindfulness Meditation protocols have been administered, with TD hetero-quantified before and during each session via the Abnormal I...

Major Depressive Disorder is characterized by a polymorphic and complex symptomatology associating emotional, cognitive and behavioral dimensions. One of the most specific symptoms is the congruence of beliefs with mood, characterized by a negative valence. Despite the importance of this symptom in the development, the maintenance, and the recurren...

Le trouble obsessionnel-compulsif (TOC), caractérisé par l'association d'obsessions et de compulsions, constitue un défi clinique et thérapeutique. De nombreux patients souffrant de TOC ne répondent pas aux traitements de première ligne tels que les inhibiteurs de la recapture de la sérotonine (ISRS) et la psychothérapie d'exposition avec préventio...

Points essentiels La pandémie de COVID-19 a un impact majeur sur la santé mentale périnatale : la prévalence des symptômes psychiatriques périnataux, en particulier l’anxiété et la dépression périnatale, a augmenté pendant la pandémie. Cet effet pourrait être provoqué par des facteurs de stress directement liés au virus (comme la peur d’être contam...

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...

What is mood? Despite its crucial place in cognitive science and psychiatric nosography, it is still difficult to delimit its conceptual frontiers. Mood is sometimes presented as a phantom of emotion reflecting the accumulation of affective events, as a disposition to generate a particular type of emotional, sensory and cognitive response, or as an...

Ketamine, a non-competitive NMDA receptor antagonist, is used as a fast-acting antidepressant therapy in depressive disorders. This treatment provokes dissociative effects associating derealization and depersonalization, and a synaptogenic signaling cascade promoting brain plasticity. Despite several preliminary studies suggesting the usefulness of...

Background: Treatment resistant depression (TRD) is a major public health problem that has encouraged novel treatment strategies involving sub-anesthetic ketamine infusions. While ketamine induces rapid and sustained clinical improvement, its cognitive effects are less well known. Recent theories propose that persistent negative beliefs about the f...

The Covid-19 pandemic has a negative impact on perinatal mental health: the prevalence of perinatal psychiatric symptoms, in particular anxiety and depression, has significantly increased during the COVID-19 pandemic. This effect could be caused by stress factors directly related to the virus (such as fear of being infected, or the uncertainty abou...

Mood disorders are a major public health concern, associated with an increased human and financial cost. Many studies have shown an association between cerebellar lesions and mood changes. Particularly, paraneoplastic cerebellar degeneration or spinocerebellar ataxia may induce bipolar disorder which are often unresponsive to conventional thymoregu...

Background: We report the observation of a 47-year-old woman with functional neurological disorder (tetraparesis, mixed tremors and non-epileptic seizures) treated with a protocol of augmented psychotherapy in combination with repeated transcranial magnetic stimulation (rTMS). Intervention: We carried out a biofeedback psychotherapy protocol with...

Obsessive-Compulsive Disorder (OCD) is a disabling disease characterized by intrusive thoughts, with compulsions performed to lessen distress. Many patients with OCD do not respond to first-line intervention such as serotonin reuptake inhibitors (SRIs) and Exposure and Response Prevention (ERP) therapy. Previous studies have focused on the anti-OCD...

Newly emerging infectious diseases like the coronavirus (COVID-19) create new challenges for public healthcare systems. Prior to effective treatments or vaccination, countering the spread of these infections depends on mitigating, protective behaviours. Previous work has shown that the enacting protective behaviours depends on beliefs about individ...

We conducted a retrospective observational study in Necker-Enfants Malades Hospital, France (January 2018-June 2020) to evaluate a potential temporal association between admissions for suicide behaviors in children and adolescents and the national COVID-19 lockdown (MarchMay 2020). During the study period, 234 patients were admitted for suicide beh...

Résumé L’hypothèse d’une déficience monoaminergique a longtemps dominé le cadre conceptuel pour le développement de nouvelles stratégies antidépressives, mais les limites des traitements antidépresseurs conventionnels ciblant la signalisation monoaminergique ont récemment motivé la recherche de nouvelles voies d’action antidépressives. Le succès de...

The rapid antidepressant action of ketamine, a NMDA receptor antagonist, led to an increase in its clinical use in psychiatry. Its safe use and low prevalence of hemodynamic adverse effects has been highlighted by numerous studies, but most of these trials were performed on populations without concomitant drugs, or with selective serotonin reuptake...

This chapter of the book Prescrire les psychotropes (Elsevier Masson) presents a synthesis about three fast-acting antidepressants (ketamine, psilocybin, brexanolone). It details the clinical and pharmalogical strategies for these three molecules in mood disorders.

Résumé La modélisation computationnelle permet de construire des modèles mathématiques simulant les mécanismes de perception, de prise de décision et de mise à jour des croyances. Ces modèles représentent mathématiquement ces processus complexes de traitement de l’information en combinant une distribution de probabilité antérieure, une fonction de...

When confronted with novel pathogens, humans generate several beliefs about the new threat. Building on evidence from past epidemics and three decades of research in psychology suggesting that various cognitive biases influence beliefs about life hazards, we propose that such cognitive biases have contributed to the discrepancy between early warnin...

Ketamine is a promising treatment exerting a rapid antidepressant effect after a single administration. Despite its huge clinical use, the neurocognitive mechanism involved in its effectiveness remains a mystery. Preliminary work in healthy subjects suggests that ketamine may interfere with belief updating mechanism, i.e. the way we generate belief...

Emerging infectious diseases like Covid-19 cause a major threat to global health. When confronted with new pathogens, individuals generate several beliefs about the epidemic phenomenon. Many studies have shown that individual protective behaviors largely depend on these beliefs. Due to the absence of treatment and vaccine against these emerging pat...

Humans generally consider desirable information and neglect undesirable information when updating beliefs about risks of experiencing life events. Such biased belief updating though is altered in patients with major depressive disorder (MDD). A promising novel antidepressant treatment strategy involves the administration of sub-anesthetic doses of...