Sébastien Guillaume

• Doctor of Medicine
• Professor (Full) at Université de Montpellier

Background Obsessive-compulsive disorder (OCD) and eating disorders (ED) share common features, including the presence of obsessions and compulsions, and they often co-occur. Additionally, there is a significant comorbidity between ED and childhood traumatic experiences (CTE), as well as between CTE and OCD. Various biological and environmental fac...

Background and Hypothesis Schizophrenia (SCZ) and anorexia nervosa (AN) are 2 severe and highly heterogeneous disorders showing substantial familial co-aggregation. Genetic factors play a significant role in both disorders, but the shared genetic etiology between them is yet to be investigated. Study Design Using summary statistics from recent lar...

Le craving est reconnu comme un facteur clé dans le pronostic des addictions et des troubles alimentaires selon la littérature récente et la cinquième édition du Manuel diagnostique et statistique des troubles mentaux. Malgré de nombreuses recherches, les théories ne parviennent pas à présenter les différents aspects du craving et à les relier entr...

Eating disorders (EDs) are increasingly subsumed into substance use disorders (SUDs). It has recently been suggested that a dysregulated interaction between three systems (interoceptive, emotional, and reflexive) is implicated in SUDs. No study has looked at these processes together in the context of EDs. Using self-questionnaires, we showed that i...

Background: Patients with major mood disorders are at high risk of suicidal behavior compared to the general population. Suicide is a public health concern, accounting for around 1.2% of deaths worldwide. Understanding its underlying mechanisms may help identify predictive biomarkers and design novel targeted treatments. Immune dysfunctions, in par...

Background: Eating disorders (EDs) are liable to alter the disease course of bipolar disorder (BD). We explored the crossed clinical features between EDs and BD, particularly as a function of BD type (BD1 vs. BD2). Methods: 2929 outpatients attending FondaMental Advanced Centers of Expertise were assessed for BD and lifetime EDs with a semi-stru...

Background The aim of this study was to assess barriers and facilitators in the pathways toward specialist care for eating disorders (EDs). Methods Eleven ED services located in seven European countries recruited patients with an ED. Clinicians administered an adapted version of the World Health Organization “Encounter Form,” a standardized tool t...

Objectives: Up to 70% individuals with bipolar disorder (BD) are lifetime tobacco smokers, a major modifiable risk factor for morbidity. However, quitting smoking is rarely proposed to individuals with BD, mainly because of fear of unfavorable metabolic or psychiatric changes. Evaluating the physical and mental impact of tobacco cessation is primo...

Purpose: Qualitative food avoidance is a significant issue in patients with anorexia nervosa (AN) and restoring diet diversity is an important part of the treatment process. We aimed to identify clinical factors which drive food avoidance and predict its maintenance in patients with AN. Methods: In this multicentre longitudinal study, 130 female...

This study of a cohort of 1-year treatment-compliant survivors of a suicide attempt examined for the first time whether a high CYP2D6-CYP2C19 metabolic capacity (pharmacogenes related to psychopathology, suicide, and attempt severity) and/or polypharmacy treatments predicted repeat suicide attempts, adjusting for sociodemographic and clinical facto...

Background In 2020–2021, many European countries put in place temporary lockdown measures due to the increase in COVID-19 cases, although such measures have negative psychological effects. As pre-existing mental disorders are a risk factor of negative psychological consequences during pandemics, it is important to identify specific predictors of ps...

One of the biggest ambitions in the field of anorexia nervosa (AN) research is to find a reliable and effective pharmacological treatment. The fact that currently no pharmacological treatment is safe and effective in this disease is worrying and also challenging. On the basis of the progress in our understanding of AN neurobiology, we propose that...

Purpose Anorexia nervosa (AN) is a serious mental illness. It is frequently accompanied by a history of childhood maltreatment (CM) that may constitute a specific ecophenotype in patients with eating disorders necessitating special assessment and management. This retrospective study tested whether in patients with AN, CM-related chronic stress may...

Marked heterogeneity in suicide attempters has been observed, with earlier onset being linked to stronger heritability, more childhood maltreatment. Nitric oxide signalling system might be implicated in this relationship through its role in the stress response/adaptation. This study examined how NOS genetic variants and childhood maltreatment were...

Resting energy expenditure (REE; i.e., the calorie amount required for 24 h during a non-active period) is an important parameter in nutritional rehabilitation of patients with anorexia nervosa (AN). This study determined whether age, body mass index, AN duration/subtype/specific symptoms/clinical severity, cognitive function alterations, and psych...

Impairments in decision-making have been suggested as a predisposing factor to obesity development. Individuals with excess weight display riskier decisions than normal weight people. Furthermore, adolescence is a period of life in which risky behavior may increase. We aimed to investigate decision making applying the Outcome-Representation-Learnin...

Objective This study aimed to estimate the 5-year mortality among people admitted into a transdisciplinary unit providing combined psychiatric and somatic rehabilitation treatment. Methods In this retrospective study, we analyzed the clinical records of all individuals admitted into the transdisciplinary unit from 01/01/2011 to 12/31/2017 after a...

Purpose The aim of the study was to assess the relationship between weight suppression at lowest weight (WS-LW) and eating disorder (ED) clinical severity, and to test WS-LW role as a mediator of childhood maltreatment (CM) impact on ED. Methods For this retrospective cohort study, adult participants were selected at the Daycare Unit for multidisc...

Background Suicidal ideation (SI) is an important risk factor of death by suicide. Recent data suggest that suicidal depression (i.e., moderate to severe depression with SI) could be a specific depression subtype with worse clinical outcomes than nonsuicidal depression (i.e., without SI). Methods Among 898 French adult inpatients (67% women, mean...

Background The comorbidity between anorexia nervosa (AN) and bipolar disorders (BD) among subjects with AN is a matter of some debate, regarding its existence, its impact on the clinical manifestations of AN and the nature of the relationship between these disorders. Our aims were: (1) to evaluate the prevalence of BD among patients with severe AN;...

Objectives: The twofold aim of this study was: (i) to determine the effects of undernutrition on the myokines in patients with restrictive anorexia nervosa (AN) and (ii) to examine the potential link between myokines and bone parameters. Methods: Forty-two young women with restrictive AN and 42 age-matched controls CON) (mean age 18.5 ± 4.2 years a...

Background & Aims Patients with Anorexia Nervosa (AN) present many nutritional deficiencies (macro- and often also micro-nutrients), possibly explained by their inadequate food intake. Previous studies reported that selenium (Se) deficiency is common in the general population. As Se can be easily added as a supplement, the goal of this study was to...

Objective: Psychological pain is a transdiagnostic factor in mental health and a key clinical dimension to understand suicide in patients with mood disorders. However, less is known about the clinical characteristics that predict high psychological pain. The aim of this study was to fill this gap in a sample of patients with mood disorders. Method...

Objective Eating disorders (ED) are associated with an in increased risk of suicidal behaviours. Laxative abuse might alter the gut–brain axis signaling, that might be implicated in the pathophysiology of suicide. This study aims to determine the association between laxative misuse and suicide attempt (SA) and suicidal ideation (SI) in patients wit...

Background: The ability to move joints beyond the normal range of motion is called Joint Hypermobility (JHM). JHM has been associated with a plethora of physical problems and is a frequent sign of hereditary disorders of connective tissue. Neuropsychiatric conditions such as eating disorders (ED) have also been related to JHM. However, little is kn...

Since the beginning of the COVID-19 pandemic, evidence shows the negative psychological impact of lockdown measures in the general population. It is also important to identify predictors of psychological distress in vulnerable people, particularly patients with history of depressive episodes (the most prevalent psychiatric disorder), in order to ad...

This study investigated the potential role of quantitative ultrasound (QUS) to assess low bone mass in anorexia nervosa patients (AN). Bone parameters from QUS and DXA were positively correlated and significantly reduced in AN compared with controls, suggesting that QUS is a pertinent technique to assess low bone mass in these patients.PurposeThe a...

Purpose: Ehlers-Danlos syndromes (EDS) are a group of heritable conditions on which abnormal collagen synthesis lead to features such as joint hypermobility, skin abnormalities, and tissue fragility. Gastrointestinal (GI) symptoms are common among those affected. These may negatively impact eating behaviors leading to weight/nutritional problems. W...

The available interventions for people who are at risk of suicide have limited efficacy. Recently, research on new mental health treatments has started to consider psychedelic compounds, particularly psilocybin, a molecule with a few thousand years of history of use in human societies. The possible effects of psilocybin on suicidal ideation and beh...

Background Growing evidences suggest that depression with suicidal ideation (SI) could be a specific phenotype with its own characteristics. Moreover, opioid system deregulation might be implicated in suicidal behaviour (SB). The aim of this study was to determine whether the A118G polymorphism (rs1799971) in ORPM1 (the gene encoding opioid recepto...

Joint hypermobility is a common trait in the general population but also a hallmark of the hereditary disorders of connective tissue such as Ehlers-Danlos syndromes. These altered collagen conditions have been associated with multisystemic complications such as gastrointestinal problems, temporomandibular dysfunction, fragility of oral mucosa, test...

Contact • More than half of Anorexia Nervosa patients were deficient in selenium • Low selenium is associated with worse reward system functioning, as measured with delayed discounting task • Low selenium is associated with worse clinical symptoms and body shape impairments measured by EDQ and BSQ • Low selenium predicted worse quality of life • Se...

Joint hypermobility is a common trait in the general population but also a hallmark of the hereditary disorders of connective tissue such as Ehlers-Danlos syndromes. These altered collagen conditions have been associated with multisystemic complications such as gastrointestinal problems, temporomandibular dysfunction, fragility of oral mucosa, and...

Purpose: Anorexia nervosa (AN) is a serious mental illness that is frequently accompanied with a history of childhood maltreatment (CM) which may constitute a specific ecophenotype of the eating disorder necessitating special assessment and management. Chronic stress inflicted by CM in patients with AN may manifest through increased low grade infla...

Background Genetics and biology may influence the age at onset of anorexia nervosa (AN). The aims of this study were to determine whether common genetic variation contributes to AN age at onset and to investigate the genetic associations between age at onset of AN and age at menarche. Methods A secondary analysis of the Psychiatric Genomics Consor...

Research about stigmatization in eating disorders (EDs) has highlighted stereotypes, prejudices, and discrimination against people with EDs, as well as their harmful effects on them, including self-stigma and a difficult recovery process. Whereas a recent review focused on the consequences of ED stigma, our work aimed to provide a broader synthesis...

Objective: The emergence of new drugs for managing suicidal ideation (e.g. ketamine) raises the question of whether suicidal depression (i.e. moderate to severe depression with concomitant suicidal ideation) is a specific depression phenotype. Therefore, this study characterized patients with suicidal depression (baseline clinical characteristics,...

Résumé Introduction Il existe pour les patients atteints d‘anorexie mentale peu d’interventions de psychoéducation. L’objectif de cette étude est d’évaluer la faisabilité et l’acceptabilité d’un programme de psychoéducation. Les objectifs secondaires exploratoires concernent l’évaluation de l’efficacité du programme sur la symptomatologie. Méthod...

Background: Growing evidences indicate that sex hormones have an effect on cognitive functions, and that Bulimia Nervosa (BN) is associated with cognitive impairment. The aim of this study was to determine the effect of hormonal contraception (HC) use on four cognitive functions that are impaired in patients with BN. Methods: This retrospective exp...

Background Most obese women with low-trauma fractures present normal areal bone mineral density (aBMD), suggesting that other bone parameters are more determinant for fracture risk in these patients. Objectives (i) Determine the effects of obesity in young women on areal bone mineral density (aBMD), bone geometry, strength, and volumetric BMD dete...

At the time of writing (December 2020), coronavirus disease 2019 (COVID-19) has already caused more than one million deaths worldwide, and therefore, it is imperative to find effective treatments. The “cytokine storm” induced by Severe Acute Respiratory Syndrome-Coronavirus type 2 (SARS-CoV-2) is a good target to prevent disease worsening, as indic...

Bipolar disorder (BD) diagnosis currently relies on assessment of clinical symptoms, mainly retrospective and subject to memory bias. BD is often misdiagnosed as Major Depressive Disorder (MDD) resulting in ineffective treatment and worsened clinical outcome. The primary purpose of this study was to identify blood biomarkers that discriminate MDD f...

Objectives: The comorbidity of alcohol use disorder (AUD) and bipolar disorder (BD) has been repeatedly associated with poorer clinical outcomes than BD without AUD. We aimed to extend these findings by focusing on the characteristics associated with the sequence of onset of BD and AUD. Methods: 3,027 outpatients from the Fondamental Advanced Ce...

Background: This study evaluated factors linked with perceived stress related to the COVID-19 pandemic and lockdown and addictive behaviors prior to and during lockdown in a sample of students who indicated engaging in alcohol consumption behaviors before lockdown. Methods: Cross-sectional study. French students from four universities participated...

The COVID-19 pandemic has profoundly disrupted household food purchasing and preparation, including elements identified as important drivers of household food waste. The two main aims of this study were (1) to examine changes in food waste behaviors since the start of the COVID-19 pandemic in the U.S. and Italy; and (2) to investigate potential pre...

Although the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) has been shown to be a reliable and valid tool for assessing appearance pressures and appearance ideal internalization among French college students, to date its psychometric properties among French clinical populations have not been examined. The aim of this study wa...

Objective To investigate the neuropsychological features of depressed patients reporting high level of psychological pain. Methods Sixty-two inpatients were included and divided into two groups according to the level of psychological pain assessed by a Likert scale. Cognitive abilities were assessed using the Trail Making Test, the Stroop test, an...

Objective To compare clinical traits of suicidal vulnerability among in-patients with suicidal behavior disorder (SBD) with and without borderline personality disorder (BPD). Method we recruited adult patients with SBD, consecutively and voluntarily hospitalized in a specialized unit for affective disorders and suicidal behavior between July and O...

The number of psychiatric patients requesting Euthanasia or Assisted Suicide (EAS) continues to increase. The aims of this systematic review were to: 1) describe the available data related to psychiatric patients having received or requesting EAS (pEAS) for each country in which is allowed; 2) and describe the ethically salient points that arise. P...

Background Suicide prevention after a recent suicide attempt remains a major issue for clinicians. Indeed, these patients are at risk of new attempts and also less prone to interact with mental health services. As psychoeducation-based interventions are strongly recommended for patients with severe or chronic disorders and poor adherence, we develo...

Background: The current study aimed to test whether food addiction (FA) might mediate the relationship between the presence of a history of childhood maltreatment and eating disorder (ED) symptom severity. Methods: Participants were 231 patients with ED presenting between May 2017 and January 2020 to a daycare treatment facility for assessment a...

The contribution of an addictive process to anorexia nervosa (AN) is an area of growing interest. Yet, little is known about how the food addiction concept (FA) may be of interest in understanding AN. This study investigates prevalence of FA diagnostic and its association with markers of severity in individuals with AN. We conducted a retrospective...

The prescription of antidepressant drugs is one of the most frequently used strategies to prevent suicide and suicidal behavior. However, some patients develop suicidal ideation at antidepressant treatment onset, a phenomenon known as treatment-emergent suicidal ideation (TESI). Few studies have explored TESI pharmacogenomics. As the Hypothalamic-P...

Background and aims. Since mid-March 2020, over 3 billion people have been confined as a result of the COVID-19 pandemic. Problematic eating behaviors are likely to be impacted by the pandemic through multiple pathways. This study examined the relationships between stress related to lockdown measures and binge eating and dietary restriction in a po...

In the painting “Lucretia,” Artemisia Gentileschi, one of the major painters of the 17th century, depicts Lucretia’s suicide. This artwork empathic vision offers the spectator the apprehension of a unique phenomenon where psychological pain is transformed into self-aggression. To understand why the body becomes an object to attack, it is important...

The management of eating disorders (EDs) is still difficult and few treatments are effective. Recently, several studies have described the important contribution of non-invasive brain stimulation (repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and electroconvulsive therapy) and invasive brain stimulation (dee...

Background: Impairments in decision-making have been suggested as a predisposing factor to obesity development. Individuals with excess weight display higher risk-taking in their decisions than normal weight people. Adolescence is a period of life in which risk-taking behavior may increase. However, no study to date has analyzed underlying impairme...

Genome-wide association studies have discovered hundreds of loci associated with complex brain disorders, but it remains unclear in which cell types these loci are active. Here we integrate genome-wide association study results with single-cell transcriptomic data from the entire mouse nervous system to systematically identify cell types underlying...

Introduction: A better understanding of the specific contribution of risk factors to suicidal behavior could arise from analyzing suicidal ideation (SI) in clinical samples, and comparing single versus multiple suicide attempters through contemporary methods allowing complex and dynamical analyses of multiple and simultaneously interacting suicide...

It has been reported that decision making is impaired in suicide attempters. Decision making is a complex process and little is known about its different components. Yet, this information would help to understand the functioning of suicidal minds. In this study, the Prospect Valence-Learning (PVL) computational model was applied to the Iowa Gamblin...

Background : Studies comparing objective and subjective cognition in major depressive disorder (MDD) are scarce, and available data concern different cognitive functions but not decision-making specifically. This cross-sectional study aimed to explore objective (O-DMI) and subjective decision-making impairment (S-DMI) as well as the discrepancy bet...

Introduction Several studies demonstrated that the hypothalamic-pituitary-adrenal (HPA) axis is dysregulated in suicide attempters. Prospective studies found that people with an abnormal response at the dexamethasone suppression test (DST) are more likely to commit suicide. However, whether DST may predict suicide attempts remains less clear. A pos...

Patients with anorexia nervosa (AN) present more frequently a personal history of traumatizing life events than they manifest a comorbid, clinically characterized, post-traumatic stress disorder (PTSD). The psychological impact of traumatic events on patients with AN may also manifest through a post-traumatic embitterment disorder (PTED). In PTED,...

Background Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association amon...

Eating disorders and substance use disorders frequently co‐occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa and problem alcohol use (genetic correlation [rg], twin‐based = 0.23‐0.53). We estimated the genetic correlation...

Objective The threefold aim was to (1) compare areal bone mineral density (aBMD), bone turnover markers, and periostin levels in young women with either anorexia nervosa (AN) or obesity (OB) and controls (CON); (2) model the profiles according to age; and (3) determine the parameters associated with aBMD. Subjects and methods One hundred and fifty...

There is an emergence of new therapeutics specifics to suicidal depressed patients (i.e. Esketamine). Nevertheless, there are few studies characterizing those patients. The aim of this study was triple: – characterize those patients in comparison to non-suicidal depressed patients (clinical characteristics and response to treatment); – study the co...

L’usage et les troubles liés à l’usage de substances (TUS) sont la règle dans le trouble bipolaire (TB). Ils péjorent le pronostic du TB en aggravant les décompensations thymiques, en diminuant la réponse au traitement usuel et, surtout, en augmentant la mortalité toutes causes. L’épidémiologie descriptive des comorbidités addictives du TB est déso...

Une fille sur quatre et un garçon sur huit sont victimes de violence sexuelle avant l’âge de 18 ans et qu’environ un enfant sur 20 est victime de violence physique chaque année. Ces abus peuvent avoir des conséquences dramatiques. Les abus subis pendant l’enfance agissent probablement comme un facteur de stress induisant une cascade de réactions ne...

Les patients souffrant de trouble bipolaire (TB) ont un risque augmenté de souffrir également d’un trouble lié à l’usage d’alcool (AUD), qui péjore le pronostic du TB en augmentant notamment les symptômes dépressifs et le risque suicidaire. La physiopathologie de cette comorbidité reste mal connue, même si TB et AUD partagent certains facteurs de r...

Les antécédents de traumas précoces sont un important facteur de risque de troubles de trouble des conduite alimentaires (TCA). Ils sont presque quatre fois plus fréquents en population souffrant de TCA qu’en population générale. Ils sont indépendants des comorbidités psychiatriques fréquemment retrouvé dans les TCA. Ces traumas souvent associés à...

Les troubles des conduites alimentaires, anorexie mentale, boulimie, hyperphagie boulimique et autres troubles sont des affections difficiles à caractériser et évaluer, car ils affectent de nombreux secteurs de la vie du sujet. L’évaluation nécessite d’aborder les dimensions psychiatriques, nutritionnelles et somatiques des troubles et leurs conséq...

Objective: It is not yet clear what role previous history of anorexia nervosa (AN) plays in the clinical course of bulimia nervosa (BN). We aimed to investigate, using a comprehensive assessment, involving clinical characteristics, daily functioning, cognitive functions, and nutritional and physical markers in BN patients with a history of AN, and...

Childhood abuse is frequent among individuals with eating disorders and is associated with complex clinical presentations. However, to date, the differences in the presentations of eating disorders between these groups are poorly understood. The present study employed a Bayesian network approach to model the interactive network structure of eating...

Clinical and cognitive factors associated with clinical insight regarding both baseline level and its time-related changes, in outpatients treated for anorexia nervosa. The 193 participants were recruited at 13 French centers specializing in eating disorders (FFAB network) and assessed for insight (SAI-ED), body mass index (BMI), eating disorder se...

Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa (BN) and problem alcohol use (genetic correlation [rg], twin-based=0.23-0.53). We estimated the genetic correlati...

Characterized primarily by a low body-mass index, anorexia nervosa is a complex and serious illness¹, affecting 0.9–4% of women and 0.3% of men2–4, with twin-based heritability estimates of 50–60%⁵. Mortality rates are higher than those in other psychiatric disorders⁶, and outcomes are unacceptably poor⁷. Here we combine data from the Anorexia Nerv...

In MRI scans of patients with anorexia nervosa (AN), reductions in brain volume are often apparent. However, it is unknown whether such brain abnormalities are influenced by genetic determinants that partially overlap with those underlying AN. Here, we used a battery of methods (LD score regression, genetic risk scores, sign test, SNP effect concor...

Literature emphasizes the relationship between attention deficit-hyperactivity disorder (ADHD) and suicidal behavior (SB). However, the link between ADHD and the severity of SB is yet to be determined. We investigated the association between a probable diagnosis of ADHD and the severity of SB in 539 hospitalized suicide attempters, and determined t...

Objective To evaluate the potentially protective effects of oral contraceptives (OC) on bone loss in a large population of young women with anorexia nervosa (AN). Design Cross-sectional study. Setting University hospital. Patient(s) Three hundred and five patients with AN (99 of them using OC) and 121 age-matched controls. Intervention(s) None....

Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication...