Michel Cermolacce

• MD at Assistance Publique Hôpitaux de Marseille

Introduction : la pratique avancée pour les infirmiers en psychiatrie et santé mentale se développe depuis 2019, en France. L’acquisition des compétences cliniques en stage pour les étudiants infirmiers en pratique avancée nécessite un suivi et une évaluation. Cet article présente la démarche d’élaboration d’un carnet de suivi de stage. Objectif :...

Objectives (1) To translate and validate the Epilepsy Anxiety Survey Instrument (EASI) in French people with epilepsy (PWE); (2) to further investigate the screening properties of each dimension of the EASI in terms of Diagnostic and Statistical Manual of Mental Disorders (DSM) anxiety disorders and of epilepsy-specific anxiety disorders, namely, a...

While the diagnosis and management of psychogenic non-epileptic seizures (PNES) remain challenging, certain evidence-based guidelines exist, which can help to optimize patient care. A multidisciplinary team approach appears to have many benefits. Current recommendations exist for some aspects of diagnosis and management of PNES, including levels of...

Aim This paper describes the characteristics of the new advanced practice nursing roles in France, as well as their challenges and perspectives, and compares the French model with the recommendations of the International Council of Nurses. Background Advanced practice nursing is particularly well established in English-speaking countries. Since 20...

Background While psychotic remission in schizophrenia (SZ) has been defined by consensus and associated with a rank of clinical predictive factors, there is a lack of data of factors associated with functional remission. Objectives To identify clinical and biological factors associated with impaired functional remission in a non-selected chronic s...

Background While symptomatic remission in schizophrenia (SZ) has been defined by consensus and associated with a rank of clinical predictive factors, there is a lack of data of factors associated with functional remission. Objectives To identify clinical and biological factors associated with impaired functional remission in a non-selected chronic...

Hypovitaminosis D has been associated with, respectively, major depressive disorder, schizophrenia (SZ), and cognitive disorders in the general population, and with positive and negative symptoms and metabolic syndrome in schizophrenia. The objective was to determine the prevalence of hypovitaminosis D and associated factors in a non-selected multi...

Background: C-reactive protein (CRP) is a general marker of peripheral inflammation and has been shown to be a good marker of neuroinflammation. CRP has been found to be elevated in patients with mood disorders (especially unipolar disorders (UD) and in schizophrenia (SZ)) but also to be lowered by antidepressants. Objective: The objectives were...

The "Praecox Feeling" (PF) is a classical concept referring to a characteristic feeling of bizarreness experienced by a psychiatrist while encountering a person with schizophrenia. Although the PF used to be considered a core symptom of the schizophrenia spectrum, it fell into disuse since the spread of operationalized diagnostic methods (Diagnosti...

This article proposes what we call an “EEG-Copeia” for neurofeedback, like the “Pharmacopeia” for psychopharmacology. This paper proposes to define an “EEG-Copeia” as an organized list of scientifically validated EEG markers, characterized by a specific association with an identified cognitive process, that define a psychophysiological unit of anal...

Objective: The inability to filter sensory input correctly may impair higher cognitive function in ADHD. However, this relationship remains largely elusive. The objectives of the present study is to investigate the relationship between sensory input processing and cognitive function in adult patients with ADHD. Method: This study investigated the r...

This chapter analysis the association between non-affective psychosis and social deprivation. The psychological, behavioral, neurocognitive and phenomenological effects of social exclusion are exposed and discussed.

Résumé Ce deuxième article, d’une série de deux portant sur l’approche physiologique de la sémiologie psychiatrique, propose d’explorer la place de la physiologie et de la sémiologie clinique suivant une approche de biologie systémique. Alors que l’approche de la sémiologie psychiatrique a été intiment liée à la construction des classifications con...

Résumé Ce premier article, d’une série de deux, portant sur l’approche physiologique de la sémiologie psychiatrique, propose d’explorer la place de la physiologie et de la sémiologie clinique dans trois systèmes de classifications psychiatriques proposés actuellement en recherche : le Manuel diagnostique et statistique des troubles mentaux (DSM), l...

Résumé Objectifs Soi et non soi sont indissociables. Nous ne pouvons pas considérer le problème du soi comme s’il était une entité séparée des autres et du monde. Méthodes Mettre entre parenthèses la question de la commensurabilité des disciplines permet de faire des ponts en les comprenant dans le monde de la vie. La phénoménologie situe constit...

Neuroleptic malignant syndrome (NMS) is a potentially lethal adverse drug reaction. We report a case of NMS potentially induced by dehydration in a female patient suffering from schizoaffective disorder. We discuss possible aetiologies and triggering factors alongside the existing literature.

The “criteriological revolution” has profoundly modified the practice and teaching of psychiatric nosology. DSM-III was based upon third-person data which aimed to be context- and observer-independent. The origin of this epistemological shift lie in the late 1970's reliability concerns about diagnosis in disorders such as schizophrenia (Aboraya, 20...

The severity of depressive symptoms across two discrete mental disorders should be evaluated with the same psychometrically validated tools. In patients with schizophrenia the Calgary Depression Rating Scale (CDSS) is recommended for evaluating depressive symptoms. The aim of this study was to validate the CDSS in patients with major depressive dis...

This article analyzes whether psychiatric disorders can be considered different from non-psychiatric disorders on a nosologic or semiologic point of view. The supposed difference between psychiatric and non-psychiatric disorders relates to the fact that the individuation of psychiatric disorders seems more complex than for non-psychiatric disorders...

Background: Previous clinical trials have suggested that repetitive transcranial magnetic stimulation (rTMS) has a significant antidepressant effect in patients with treatment resistant depression (TRD). However, results remain heterogeneous with many patients without effective response. Objective: The aim of this SPECT study was to determine be...

For years, phenomenological psychiatry has proposed that distortions of the temporal structure of consciousness contribute to the abnormal experiences described before schizophrenia emerges, and may relate to basic disturbances in consciousness of the self. However, considering that temporality refers mainly to an implicit aspect of our relationshi...

Background The feeling of being one continuous individual in time is a natural evidence, which seems to be lost for patients with schizophrenia who display ‘minimal’ or ‘bodily’ self disorders. The continuity in time is a property of the ‘minimal’ self and its alteration could disrupt the sense of self. It has long been proposed that patients with...

Delusion is usually considered in DSM 5 as a false belief based on incorrect inference about external reality, but the issue of delusion raises crucial concerns, especially that of a possible (or absent) continuity between delusional and normal experiences, and the understanding of delusional experience. In the present study, we first aim to consid...

Patients with schizophrenia have difficulty in making sensory predictions, in the time domain, which have been proposed to be related to self-disorders. However experimental evidence is lacking. We examined both voluntary and automatic forms of temporal prediction in 28 patients and 24 matched controls. A visual cue predicted (temporal cue) or not...

Background: According to Karl Jaspers, psychopathology requires a comprehensive method, understood as a systematic exploration of the first-person perspective of the patient's experience. At the same time, however, schizophrenia for Jaspers is characterized by its radical incomprehensibility. In addition, Rümke's so-called "praecox feeling" parado...

Background: Depressive symptoms are frequently associated with schizophrenia symptoms. C - Reactive protein (CRP), a marker of chronic inflammation, had been found elevated in patients with schizophrenia and in patients with depressive symptoms. However, the association between CRP level and depressive symptoms has been poorly investigated in pati...

To correctly interpret the results of a randomised controlled trial (RCT), practitioners have to spot bias and other potential problems present in the trial. Internal as well as external validity of the trial are linked to the presence of such bias. The internal validity is ensured by a clear definition of the objectives of the trial. The number of...

Objectives: The first objective of this article is to summarize the history of electroconvulsive therapy (ECT) in psychiatry in order to highlight the transition from clinical level of evidence based on phenomenological descriptions to controlled trial establishing causal relationship. The second objective is to apply the criteria of causation for...

Placebo effect remains a crucial issue in current clinical trials. Most clinical trials rely on the hypothesis of equivalent placebo response rates in both placebo and specific drug arms ("additive model"). But contrary to this dominant and rarely questioned hypothesis, several aspects may influence placebo response. A few recent meta-analyses and...

To correctly interpret the results of a randomised controlled trial (RCT), practitioners have to spot bias and other potential problems present in the trial. Internal as well as external validity of the trial are linked to the presence of such bias. The internal validity is ensured by a clear definition of the objectives of the trial. The number of...

Placebo effect remains a crucial issue in current clinical trials. Most clinical trials rely on the hypothesis of equivalent placebo response rates in both placebo and specific drug arms ("additive model"). But contrary to this dominant and rarely questioned hypothesis, several aspects may influence placebo response. A few recent meta-analyses and...

Background: New determinants of quality of life in schizophrenia need to be identified. As sensory gating deficit is core impairment in schizophrenia, the present study hypothesized that sensory gating deficit is a determinant of impaired quality of life in schizophrenia. This study therefore investigated the relationship between sensory gating de...

Hallucinations refer to a wide range of subjective human experiences. As a consequence, hallucinations constitute fascinating phenomena for the dialogue between phenomenology and neuroscience. We propose a summary of the possible strategies of this dialogue encompassing neurophenomenology or front-loaded phenomenology. We question the issue of the...

Patients with schizophrenia and people with subclinical psychotic symptoms have difficulties getting a clear and stable representation of their self. The cognitive mechanisms involved in this reduced clarity of self-concept remain poorly understood. The present study examined whether an altered way of thinking or reasoning about one's past may acco...

During the past ten years, research on schizophrenia has witnessed a clear emphasis on studies based on negative symptoms. This interest can be explained in terms of diagnosis, specific treatment, functional prognosis and outcome issues. However, main current approaches consider negative symptoms from an operationalist view, which implies objective...

Although negative symptoms are recognized as a central feature of schizophrenia, their definition as well as phenomenology have long been a vexing issue. During these last years, a major progress has been made with the delineation of two underlying subdomains of negative symptoms: diminished expression and anhedonia-avolition-apathy. As current gui...

The history of negative symptoms of schizophrenia rises early days of medicine in clinical and pathophysiological differences between positive and negative and their complex joint. Forming a set of typical core of symptoms, and some feature of a syndrome belonging to a specific pathophysiological mechanism, negative symptoms of schizophrenia emerge...

Sensory and cognitive impairments and inflammatory processes are contributing factors to the pathogenesis of schizophrenia. A previous study found that an elevated CRP level (≥5mg/L) was associated with higher cognitive impairments in schizophrenia. We aimed to investigate the association between an elevated CRP level and sensory impairments define...

In schizophrenia, perceptual inundation related to sensory gating deficit can be evaluated "off-line" with the sensory gating inventory (SGI) and "on-line" during listening tests. However, no study investigated the relation between "off-line evaluation" and "on-line evaluation". The present study investigates this relationship. A sound corpus of 36...

Cet article décrit un programme de recherche en neurosémiotique. L’idée principale consiste à proposer la composante N400 du potentiel évoqué comme «arbitre empirique » entre deux paradigmes de donation de sens : le paradigme fonctionnaliste des sciences cognitives, décrivant la séquence d’accès au lexique, et un paradigme réunissant le structurali...

The aim of the present study was to investigate the effect of second-generation antipsychotics (clozapine or another second-generation antipsychotic) on perceptual abnormalities related to sensory gating deficit. Although clozapine is known to improve sensory gating assessed neurophysiologically, we hypothesized that patients with schizophrenia tre...

L’impulsivité est une composante complexe et importante de la phénoménologie des troubles de l’humeur. Les troubles impulsifs tels qu’ils sont définis dans le DSM sont fréquemment associés aux troubles de l’humeur, surtout le trouble bipolaire de type I, et ils définissent une pathologie psychiatrique plus sévère. Les approches dimensionnelles soul...

Les patients souffrant de troubles bipolaires (TB) présentent cinq fois plus de risque de maladies cardiovasculaires que des sujets sans TB. Le syndrome métabolique est un facteur qui augmente significativement le risque de développer une maladie cardiovasculaire chez ces patients. Deux autres facteurs importants, mais néanmoins moins reconnus en p...

La clinique des troubles dissociatifs est complexe et parfois déroutante. Nous décrivons ici deux cas cliniques dont le diagnostic initial était trompeur ; le premier de ces cas concernait une femme de 61 ans, présentant une fugue dissociative, associée finalement à un épisode dépressif majeur sévère. Le second cas présenté ici concerne un homme de...

La coexistence d’un trouble affectif et d’un trouble de la personnalité comorbide est l’objet d’une littérature abondante, hétérogène, aux résultats parfois très imprécis voire discordants. Certaines données font cependant consensus, telles la potentialisation des deux troubles, tant sur le nombre des comorbidités, que des difficultés thérapeutique...

Links between affective and endocrine-metabolic disorders are numerous and complex. In this review, we explore most frequent endocrine-metabolic comorbidities. On the one hand, these comorbidities imply numerous iatrogenic effects from antipsychotics (metabolic side-effects) or from lithium (endocrine side-effects). On the other hand, these comorbi...

Coexistence in an individual of an affective disorder and a personality disorder is very common and there is an abundant literature on it. Articles are numerous and heterogeneous ; the results are sometimes imprecise or discordant. Some data are, despite these reserves, shared by the scientific community. The main consensus is first on a bad progno...

Impulsivity is a complex and important phenomenon in mood disorders. Impulse control disorders, as defined in DSM, are more frequent in mood disorders especially in Bipolar Disorder type I, and are associated with a more severe course of illness. Dimensional studies demonstrate that impulsivity is a core manifestation of bipolar disorder both as st...

Links between affective and endocrine-metabolic disorders are numerous and complex. In this review, we explore most frequent endocrine-metabolic comorbidities. On the one hand, these comorbidities imply numerous iatrogenic effects from antipsychotics (metabolic side-effects) or from lithium (endocrine side-effects). On the other hand, these comorbi...

The aim of this review is to summarize the state of knowledge concerning the relationship between cardiovascular risk, sleep abnormalities, and emotional reactivity in patients with bipolar disorder (BD). A scientific literature search of international articles was performed during August and September 2014 using the PubMed electronic database. We...

The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe here two cases who were initially misdiagnosed. The first case concerned a 61 year-old woman, who was initially diagnosed as an isolated dissociative fugue and was actually suffering from severe major depressive episode. The second case concerned a 55 ye...

The concept of the minimal self refers to the consciousness of oneself as an immediate subject of experience. According to recent studies, disturbances of the minimal self may be a core feature of schizophrenia. They are emphasized in classical psychiatry literature and in phenomenological work. Impaired minimal self-experience may be defined as a...

Mild traumatic brain injury (MTBI) has a high incidence and sometimes causes post-concussion syndrome (PCS). Modifications in music listening appear to be a complaint of patients suffering from PCS. In this article, we characterize these changes and evaluate them using both objective and subjective data. After a complete neuropsychological, morphol...

Context: Using natural connected speech, the aim of the present study was to examine the semantic congruity effect (i.e. the difference between semantically incongruous and congruous words) in sentence contexts that generate high or moderate final word expectancies. Methods: We used sentences with two levels of word expectancy in the auditory mo...

The notion of mixed states is classically associated with descriptions and categories inherited from Kraepelin. However, simultaneous descriptions of depressive and manic manifestations can be traced back to ancient times. Semiology and defi nitions of these clinical associations have evolved across the times. We provide here a short insight on fou...

The nosological position of mixed states has followed the course of classifying methods in psychiatry, the steps of the invention of the clinic, progress in the organization of care, including the discoveries of psychopharmacology. The clinical observation of a mixture of symptoms emerging from usually opposite clinical conditions is classical. In...

Because of their compilation of contrasted symptoms and their variable clinical presentation, mixed episodes have been withdrawn from the DSM. However, mixed states question not only the bonds between depression and mania, but also the distinction between bipolar disorders and schizophrenia. Indeed, doubts about the dichotomy introduced by Kraepeli...

DSM-IV mixed states have become the mixed mania and mixed depression in the new DSM-5. One noticeable point is the introduction of nine cations, among which the "with mixed features" specification. These non exclusive specifications may contribute to a more precise identification of mixed clinical pictures, and therefore to offer a more efficient t...

Epidemiological studies of major depressive episodes (MDE) highlighted the frequent association of symptoms or signs of mania or hypomania with depressive syndrome. Beyond the strict definition of DSM-IV, epidemiological recognition of a subset of MDE characterized by the presence of symptoms or signs of the opposite polarity is clinically importan...

Neurocognitive dysfunction is increasingly recognized as a prominent feature of bipolar disorder. Cognitive function seems to be impaired across different states of bipolar illness. Nervertheless, research that studies neuropsychological functioning in acute phases is scarce. Acutely ill patients have shown dysfunctions in several cognitive areas....

Despite the growing number of neuroimaging studies in bipolar disorder over the past years, the brain regions involved in mood dysregulation in this disease are still poorly understood. If some neurofunctional abnormalities seem to be independent of mood state, others were preferentially associated with mania or depression, involving the amygdala a...

Mixed states are complex manifestations of bipolar disorders. Pathophysiology of mixed states remains unclear. Several models have been proposed to understand the mechanisms underlying these mood states. These models describe mixed state either as a combinaison of depression and mania, as well as a transition between mania and depression, or mixed...

Mixed states present nosologic and diagnostic challenges with a relative paucity of evidence to guide treatment. Mixed bipolar states are difficult to treat and are associated with a high neuropsychiatric morbidity, a high risk of suicide and a poor outcome. In DSM- 5, the definition of mixed episode has been removed (in DSM- IV TR: "juxtaposed ful...

Mixed states are a frequent mood state characterized by the mixture of manic and depressive symptoms. Their clinical description has been studied for centuries but has known a renewal of interest recently. Several authors intend to redefine its diagnostic criteria to develop an appropriate therapeutic strategy. Current recommendations suggest to tr...

A literature search on the pharmacological treatment of acute bipolar mixed episodes in current guidelines shows that only seven of them address the acute management of mixed episodes as a separate condition, whereas the vast majority of these guidelines include the treatment of mixed episodes in the chapter of mania. As a general rule, most guidel...

DSM-IV mixed states have become the mixed mania and mixed depression in the new DSM-5. One noticeable point is the introduction of nine cations, among which the “with mixed features” specification. These non exclusive specifications may contribute to a more precise identification of mixed clinical pictures, and therefore to offer a more efficient t...

Epidemiological studies of major depressive episodes (MDE) highlighted the frequent association of symptoms or signs of mania or hypomania with depressive syndrome. Beyond the strict definition of DSM-IV, epidemiological recognition of a subset of MDE characterized by the presence of symptoms or signs of the opposite polarity is clinically importan...

Neurocognitive dysfunction is increasingly recognized as a prominent feature of bipolar disorder. Cognitive function seems to be impaired across different states of bipolar illness. Nervertheless, research that studies neuropsychological functioning in acute phases is scarce. Acutely ill patients have shown dysfunctions in several cognitive areas....

Despite the growing number of neuroimaging studies in bipolar disorder over the past years, the brain regions involved in mood dysregulation in this disease are still poorly understood. If some neurofunctional abnormalities seem to be independent of mood state, others were preferentially associated with mania or depression, involving the amygdala a...

Mixed states are complex manifestations of bipolar disorders. Pathophysiology of mixed states remains unclear. Several models have been proposed to understand the mechanisms underlying these mood states. These models describe mixed state either as a combinaison of depression and mania, as well as a transition between mania and depression, or mixed...

Introduction Mixed states present nosologic and diagnostic challenges with a relative paucity of evidence to guide treatment. Mixed bipolar states are difficult to treat and are associated with a high neuropsychiatric morbidity, a high risk of suicide and a poor outcome. In DSM- 5, the definition of mixed episode has been removed (in DSM- IV TR: “j...

Mixed states are a frequent mood state characterized by the mixture of manic and depressive symptoms. Their clinical description has been studied for centuries but has known a renewal of interest recently. Several authors intend to redefine its diagnostic criteria to develop an appropriate therapeutic strategy. Current recommendations suggest to tr...

The notion of mixed states is classically associated with descriptions and categories inherited from Kraepelin. However, simultaneous descriptions of depressive and manic manifestations can be traced back to ancient times. Semiology and definitions of these clinical associations have evolved across the times. We provide here a short insight on four...

Most factitious disorders and somatoform disorders diagnoses are made by physicians and access to psychiatric care for these patients is often difficult. Through an opioid-dependent patient case, we will investigate the existence of a continuum between these disorders and the potential value of an addiction approach treatment. Despites being locate...

Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurophysiology. In this short review, we present the ERP’s theorical framework, the different recording methods, and the signification of these ERP’s; P50 with gating, P300, N400, P600 and contingent negative variation. We emphasize the ERP’s chronometry, th...

Conventional electroencephalogram (EEG) is an essential non-invasive technique to determine the physiological and functional brain status. EEG is worthy of interest (i) for the diagnosis of neurological diseases in psychiatric syndromes and (ii) for the monitoring of possible iatrogenic effects of some psychiatric treatments: electroconvulsive ther...