Stephane Mouchabac

Hôpital Saint-Antoine (Hôpitaux Universitaires Est Parisien) · Service de Psychiatrie

Schizophrenia is a severe, chronic, and heterogeneous mental disorder that affects approximately 1% of the world population. Ongoing research aims at clustering schizophrenia heterogeneity into various “biotypes” to identify subgroups of individuals displaying homogeneous symptoms, etiopathogenesis, prognosis, and treatment response. The present st...

Moral emotions have a key role in human prosocial behaviors. Impaired moral emotion processing can lead to disrupted decision‐making and behavioral adaptation. Better knowledge about moral emotion processing in neuropsychiatric diseases is necessary to facilitate diagnosis and patient care. The aim of this study was to investigate and to compare mo...

UNSTRUCTURED It has tremendous potential for both research and clinical applications, but challenges our conception of healthcare by opposing two distinct approaches to medicine: one centered around illness, with the aim of classifying and curing disease, the other centered around patients and their personal suffering and lived experience. In the c...

Objective Post-traumatic stress disorder (PTSD) is a common mental disorder following one or more traumatic events in which patients exhibit behavioural and emotional disturbances. Recent studies report alterations in social cognition with cerebral functioning modifications. While it is now established that brain function can be modified and severe...

Background Mood disorders are commonly diagnosed and staged using clinical features that rely merely on subjective data. The concept of digital phenotyping is based on the idea that collecting real-time markers of human behavior allows us to determine the digital signature of a pathology. This strategy assumes that behaviors are quantifiable from d...

The use of digital technologies is constantly growing around the world. The wider-spread adoption of digital technologies and solutions in the daily clinical practice in psychiatry seems to be a question of when, not if. We propose a synthesis of the scientific literature on digital technologies in psychiatry and discuss the main aspects of its pos...

Background Aripiprazole is a second-generation antipsychotic, efficacious in patients with schizophrenia during acute episodes. Due to its pharmacological profile, aripiprazole may be of interest in patients with specific clinical profiles who have not been studied extensively in randomised clinical trials. Objectives To capture experience with ar...

Features of resting brain metabolism in motor functional neurological disorder are poorly characterized. This study aimed to investigate the alterations of resting brain metabolism in a cohort of patients experiencing a first episode of motor functional neurological disorder with recent symptom onset, and their association with persistent disabilit...

Introduction Rapid cycling bipolar disorder (RCBD) is defined as four or more affective episodes (depression, mania or hypomania) within 1 year. RCBD has a high point of prevalence (from 10% to 20% among clinical bipolar samples) and is associated with greater severity, longer illness duration, worse global functioning and higher suicidal risk, but...

BACKGROUND Mood disorder is commonly diagnosed and staged using clinical features that rely merely on subjective data. The concept of digital phenotyping is based on the idea that collecting real-time markers of human behavior allow one to determine the "digital signature of a pathology". This strategy assumes that behaviors are "quantifiable" from...

Introduction: Depression is highly prevalent and causes considerable suffering and disease burden despite the existence of wide-ranging treatment options. Momentary assessment is a promising tool in the management of psychiatric disorders, and particularly depression. It allows for a real-time evaluation of symptoms and an earlier detection of rel...

Dissociative disorders (DD) and conversion disorders (CD) are frequent in general and psychiatric populations. Some evidence suggest that the hypothalamic-pituitary axis (HPA) and autonomic nervous system (ANS) are dysregulated in both disorders. We carried out a systematic review of the literature to summarize the existing knowledge on the stress...

Background: Recently, artificial intelligence technologies and machine learning methods have offered attractive prospects to design and manage crisis response processes, especially in suicide crisis management. In other domains, most algorithms are based on big data to help diagnose and suggest rational treatment options in medicine. But data in ps...

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...

Psychiatric disorder management is based on the prescription of psychotropic drugs. Response to them remains often insufficient and varies from one patient to another. Pharmacogenetics explain part of this variability. Pharmacogenetic testing is likely to optimize the choice of treatment and thus improve patients’ care, even if concerns and limitat...

BACKGROUND Conflicting data emerge from literature regarding actual use of smartphone application in medicine, some authors considering it as a breakthrough while other suggesting that real-life use is disappointing. However, digital tools are everyday more present in medicine. We developed SMARTAUTISM, a smartphone application focused on empowerme...

Background Conflicting data emerge from literature regarding the actual use of smartphone apps in medicine; some considered the introduction of smartphone apps in medicine to be a breakthrough, while others suggested that, in real-life, the use of smartphone apps in medicine is disappointingly low. Yet, digital tools become more present in medicine...

The patient's decision-making abilities are often altered in psychiatric disorders. The legal framework of psychiatric advance directives (PADs) has been made to provide care to patients in these situations while respecting their free and informed consent. The implementation of artificial intelligence (AI) within Clinical Decision Support Systems (...

High stake clinical choices in psychiatry can be impacted by external irrelevant factors. A strong understanding of the cognitive and behavioural mechanisms involved in clinical reasoning and decision-making is fundamental in improving healthcare quality. Indeed, the decision in clinical practice can be influenced by errors or approximations which...

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...

BACKGROUND Recently, Artificial Intelligence technologies and learning machine methods offer attractive prospects to design and manage crisis response processes, especially in suicide crisis management. In other domains, most algorithms are based on big data to help diagnosis process and to suggest treatment rational options in medicine. But data i...

Background Recently, artificial intelligence technologies and machine learning methods have offered attractive prospects to design and manage crisis response processes, especially in suicide crisis management. In other domains, most algorithms are based on big data to help diagnose and suggest rational treatment options in medicine. But data in psy...

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...

Background Various candidate biomarkers have been proposed in schizophrenia to better characterise the several forms of the disorder. Among these candidates, peripheral (e.g. immunological, inflammatory, microbial) and brain (structural and functional) factors have been suggested and could help subtyping schizophrenia. One other potential biomarker...

Background Stigma associated with depression and antidepressants is strong among the general population but also among patients and health professionals. Objectives This cross-sectional study is aimed at: 1) evaluating the knowledge and attitude towards antidepressant by nursing student; 2) exploring the association between instruction in psychiat...

Introduction Depression is among the most widespread psychiatric disorders in France. Psychiatric disorders are associated with considerable social costs, amounting to €22.6 billion for treatment and psychotropic medication in 2011. Treatment as usual (TAU), mainly consisting of pharmacotherapy and psychotherapy, is effective for only a third of pa...

Background: Substance Use Disorder (SUD) and behavioral addictions are common and require a multidisciplinary approach. New technologies like Virtual Reality could have the potential to improve assessment and treatment of these disorders. Objective: In the present paper, we therefore present an overview of Virtual Reality (Head Mounted Devices) in...

Background: New technologies are set to profoundly change the way we understand and manage psychiatric disorders, including obsessive-compulsive disorder (OCD). Developments in imaging and biomarkers, along with medical informatics, may well allow for better assessments and interventions in the future. Recent advances in the concept of digital phen...

D’un côté, l’accès aux soins en psychiatrie est difficile : tabou, longs délais, choix du thérapeute à l’aveugle, coûts. D’un autre côté, l’explosion des sites médicaux, de forums, d’applications de e-santé, de psychothérapie par internet… Le développement de l’intelligence artificielle s’accélère aussi en psychiatrie et pourrait changer la donne…...

Background: The Paris and Nice terrorist attacks affected a thousand of trauma victims and first-line responders. Because there were concerns that this might represent the first of several attacks, there was a need to quickly enhance the local capacities to treat a large number of individuals suffering from trauma-related disorders. Since Reconsol...

Objectives: Post-traumatic stress disorder (PTSD) is a common psychiatric condition. Patients with PTSD have marked symptoms that significantly impair their social and emotional abilities, and numerous studies have explored this issue. We hypothesized that impairment of social cognition takes part in functional disability of individuals with PTSD....

ABSTRACT Background: Technical innovations such as ecological momentary assessment (EMA),machine learning (ML), computerized adaptive testing (CAT), Digital Phenotyping, Clinical Decision Support Systems (CDSS), Algorithms, and Biomarkers have caused a paradigm shift in psychiatric care. The aim of the present study was to explore how student nurse...

Background: Delay discounting (DD) refers to the decrease of a present subjective value of a future reward as the delay of its delivery increases. Major depressive disorder (MDD), besides core emotional and physical symptoms, involves difficulties in reward processing. Depressed patients often display greater temporal discounting rates than health...

Background Non-invasive brain stimulation techniques are becoming a part of psychiatrists’ therapeutic arsenal. Proof of TMS effectiveness and its indications are becoming clearer. While international recommendations exist, and many countries have already recognized the use of these techniques, the French situation is peculiar since no recommendati...

The purpose of this article is to describe complex psychiatric disorders, to recall "minimal classical'' explorations in psychiatry, to describe the concept of "complex psychiatric disorders'' and to propose a systematized method of exploration. Some organic diseases are well known for their links with psychiatric disorders (manic syndrome and hype...

innovative treatments in neurological functional disorders : rTMS , TDCS, Neurofeedback , Virtual reality

Background Recent discoveries in the fields of machine learning (ML), Ecological Momentary Assessment (EMA), computerized adaptive testing (CAT), digital phenotype, imaging, and biomarkers have brought about a new paradigm shift in medicine. Objective The aim of this study was to explore psychiatrists’ perspectives on this paradigm through the pri...

Ces deux dernières décennies ont apporté de nouvelles données dans la compréhension des troubles fonctionnels. Ce sont surtout les données d’imagerie fonctionnelle qui ont permis de générer de nouvelles hypothèses. Ces avancées, nous permettent de concevoir ces troubles dans une logique de pathologie de réseaux, que ce soit ceux en lien avec les ét...

La dissociation, pour nombre de psychiatres français, se rapporte avant tout à la désorganisation schizophrénique. Or, cela est une véritable erreur liée au départ à une erreur de traduction du terme Spaltung de Bleuler. A l’international, le concept de dissociation renvoie encore aujourd’hui à la description de Pierre Janet: une perte d’unité, d’i...

Background Major depressive disorder (MDD) is marked by core depressive emotional and physical symptoms and is also accompanied by difficulties in reward processing. A reduction of reward anticipation, along with diminishment in anticipation predicting reduced motivation for rewards has been documented in the acute phase. Cognitive neuroscience st...

BACKGROUND New technologies are set to profoundly change the way we understand and manage psychiatric disorders, including obsessive compulsive disorder (OCD). Developments in imaging and biomarkers, along with medical informatics, may well allow for better assessments and interventions in the future. Recent advances in the concept of digital pheno...

BACKGROUND New technologies are set to profoundly change the way we understand and manage psychiatric disorders, including obsessive compulsive disorder (OCD). Developments in imaging and biomarkers, along with medical informatics, may well allow for better assessments and interventions in the future. Recent advances in the concept of digital pheno...

La séparation classique entre la psychiatrie et la neurologie s'estompe en partie en raison d'une meilleure connaissance des troubles cognitivocomportementaux dans les maladies neurologiques. Certaines structures, dont les ganglions de la base, sont impliquées à la fois dans la motricité et le comportement. Les maladies de Parkinson et de Gilles de...

Frontotemporal dementia (fv-FTD) and bipolar disorders (BPD)are chronic diseases that affect behavior and can be difficult to differentiate.Changes in eating behaviors and food preference are frequentin patients with fv-FTD (60%,Raskovsky et al., 2011, Ikeda et al., 2002) and in patients with BPD (27%, Mac ElRoy et al.,2016).In this study we propos...

organologic analysis of Electric Wind instrument not in the field of medicine, but very intersesting !!!

Les effets à l’EWI: Le Pitch-Bend, le Vibrato, le Glide. The effects with an EWI: Pitch-Bend, Vibrato, Glide.

Technical proposals for working and using octave rolls with an EWI 4000 s

Technical proposals for specific effects with EWI Glide, Glissando and Pitch Bend how to work and use technical possibilities of EWI 4000 S

Technical proposals for managing breath control with an EWI

Methode de synthèse soustractive pour EWI 4000 s

Background: Recent discoveries in the field of machine learning (ML), Ecological Momentary Assessment (EMA), Computerized Adaptive Test (CAT), digital phenotype, imaging and biomarkers, have brought about a new paradigm shift in medicine. The aim of this study was to explore psychiatrists’ perspectives on this paradigm through the prism of new Clin...

BACKGROUND Recent discoveries in the fields of machine learning (ML), Ecological Momentary Assessment (EMA), computerized adaptive testing (CAT), digital phenotype, imaging, and biomarkers have brought about a new paradigm shift in medicine. OBJECTIVE The aim of this study was to explore psychiatrists’ perspectives on this paradigm through the pri...

Background: New technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping, a paradigmatic example, refers to the use of computeri...

The pathophysiology of conversion disorder is not well understood, although studies using functional brain imaging in patients with motor and sensory symptoms are progressively increasing. We conducted a systematic review of the literature with the aim of summarising the available data on the neuroanatomical features of this disorder. We also propo...

Background: New technologies may profoundly change our way of understanding psychiatric disorders including posttraumatic stress disorder (PTSD). Imaging and biomarkers, along with technological and medical informatics developments, might provide an answer regarding at-risk patient’s identification. Recent advances in the concept of ‘digital phenot...

Les mouvements anormaux dont l’étiologie n’est ni organique, ni iatrogène sont fréquemment rencontrés en clinique. Dans la littérature différents termes sont utilisés puisque l’on on parle de « trouble neurologiques fonctionnels », de « trouble de mouvements fonctionnels », «symptômes neurologiques non expliqués médicalement », « trouble de mouveme...

Objectives: The search for objective clinical signs is a constant practitioners' and researchers' concern in psychiatry. New technologies (embedded sensors, artificial intelligence) give an easier access to untapped information such as passive data (i.e. that do not require patient intervention). The concept of "digital phenotype" is emerging in p...

Background: Anhedonia is a core symptom of major depression and a key prognostic factor that is often poorly explored in clinical trials of major depressive disorder (MDD). Beyond symptomatic remission, psychosocial functioning also reveals difficulty in achieving remission in patients with MDD. The main objective of this study was to explore the...

Résumé Le trouble de conversion constituerait-il un trouble à part ? Vécu comme une réalité par le patient, l’absence de signes « objectifs » à l’examen l’a longtemps fait considérer comme une « pathologie sans substrat ». Or, si la clinique de ce trouble est bien connue, sa compréhension précise reste sujette à interprétation et les mécanismes exa...

Les troubles psychiatriques du sujet âgé ont d’importantes conséquences en termes de morbidité, de mortalité et d’altération de la qualité de vie, justifiant les enjeux majeurs que constituent leur repérage et leur prise en charge adaptée.

INTRODUCTION: Les récentes découvertes dans le champ de la génétique, de l’imagerie et des biomarqueurs, parallèlement aux évolutions technologiques et au développement de l’informatique médicale, font basculer la médecine dans un nouveau paradigme, celui de la médecine prédictive. Ces nouveaux outils permettent de penser la psychiatrie d’une maniè...

Objectives: Behavioral and psychological symptoms have a high prevalence in dementia. They include mood disorders, psychotic disorders and behavioral disorders such as aggression or screaming. Despite a number of side effects and an increased mortality, antipsychotic drugs are widely prescribed for treatment of this disorder. In France, this incre...

Le trouble de stress post-traumatique (TSPT) est un trouble qui peut apparaître après une exposition à la mort effective ou à une menace de mort, à une blessure grave, ou à des violences sexuelles. Les définitions actuelles sont plus extensives et incluent aussi les personnes indirectement concernées, mais qui ont été amenées à se représenter l’évé...

La schizophrénie est née au début du xxe siècle. Très rapidement, des auteurs comme Kraepelin ou Bleuler ont décrit des formes atténuées de ce trouble, ainsi que des symptômes isolés survenant chez des apparentés non malades de patients schizophrènes. De ces observations sont nés les concepts de schizotypie et de schizoïdie. Le sens de ces mots a q...

Résumé Le nombre de sujets atteints de dépression dans le monde est de 350 millions selon les estimations. La recherche de nouveaux traitements, notamment dans les formes de dépressions résistantes, est une nécessité compte tenu du nombre croissant de patients en situation d’échec thérapeutique et de résistance. La scopolamine, molécule anticholine...

Background Anhedonia is a core dimension of major depressive disorder (MDD). Paradoxically, the association between anhedonia and social impairment is poorly known. Objective To determine the longitudinal relationships between depressive symptoms, anhedonia, and social functioning in depressed patients treated with agomelatine. Material and metho...

The placebo effect is an excellent model for understanding the mechanisms underlying the interaction between a subjective and complex mental activity (beliefs, expectations, hopes, learning, patient-physician relationship, socio-cultural context .) with different neural and biological systems. Initially, research on the placebo effect has focused o...

Le trouble conversif constituerait-il une pathologie à part ? Vécu comme une réalité par le patient, l’absence de signes objectifs à l’examen l’a longtemps faite considérer comme une « pathologie sans substrat ». Or, si la clinique de ce trouble est bien connue, les motivations précises qui le sous-tendent restent sujettes à l’interprétation et les...

Objectif Évaluer la corrélation entre l’anhédonie et le fonctionnement social. En effet, bien que l’anhédonie soit un symptôme principal de la dépression et un facteur pronostic clé, elle reste peu étudiée. Méthodes Mille cinq cents soixante-dix patients ayant un EDM, traités par agomélatine, ont été inclus dans une étude non interventionnelle et...

Isotretinoin (Accutane) is a treatment for severe acne that is resistant to other forms of treatment, including antibiotics and topical treatments. The prescription of this drug has been controversial ever since its initial marketing in 1982. It is the only non-psychotropic drug in the Food and Drug Administration top 10 drugs found to be associate...

La maladie de Parkinson a longtemps été considérée comme un trouble moteur. Dans les années 2000, des séries de cas sont publiées où les patients, traités par agonistes dopaminergiques essentiellement vont présenter une augmentation des conduites tournées vers le plaisir (jeu pathologique, hypersexualité, comportements stéréotypés dits de « punding...

Introduction Delusions of pregnancy are not well known. The delusion of pregnancy is defined as the belief of being pregnant despite factual evidence to the contrary. The clinical picture is heterogeneous (duration, mechanisms, topics and pre-existing psychiatric disorders). Several causes have been proposed to explain the occurrence of the delusio...