Publications by authors named "Frederic Denis"

33 Publications

A qualitative study on experiences of persons with schizophrenia in oral-health-related quality of life.

Braz Oral Res 2021 22;35:e050. Epub 2021 Mar 22.

University Hospital of Besançon, Besançon, France.

Our study aimed to explore the views and experiences in oral health and oral-health-related quality of life (OHRQoL) of persons with schizophrenia (PWS) in order to expand the understanding of the factors that either limit or facilitate their healthcare pathway, which can ultimately optimize their oral health and/or OHRQoL. A qualitative study was conducted in France in the Côte d'Or department (530 000 in habitants) centered on PWS's perceived meanings regarding oral health or OHRQoL, and semi-structured individual interviews were used. A conventional content analysis approach was chosen in order to highlight unrevealed themes. A sample of 20 PWS (12 males; 8 females) with a median age was 45.8 (± 9.5) were recruited to assess views and experiences regarding OHRQoL, which were focused on three dimensions: an individual dimension related to experience of "oral symptoms", a second dimension related to experience of "stress and its management", and a third related to "Autonomy dimension in oral health". We showed that PWS clearly expressed their mental representations of oral health and OHRQoL. This study supports that PWS were able to define their needs and had the ability to discuss their oral health and OHRQoL. These finding could be used to support specific interventions for this population to better manage the negative impact of antipsychotics and help them to consult dentists on a regular basis.
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http://dx.doi.org/10.1590/1807-3107bor-2021.vol35.0050DOI Listing
March 2021

[Rethinking partnerships between primary schools and child psychiatry public health services in times of COVID-19].

Sante Publique 2020 September December;32(5):531-535

Introduction: On a global scale, bringing together schools and public child psychiatry services is favored to promote the development of early interventions that could improve health trajectories, from prevention to treatment, for children exposed to psychological and psychiatric difficulties. In a public health perspective, contextualizing these practices is essential in order to ensure their sustainability and efficiency. This article sheds light on the stakes of these partnerships and their advantages in responding to the health, social, and economic mark that has been left behind by the crisis accompanying the brutal onset of the Covid-19 epidemic.

Aims: Improving the health care management for children with mental health problems or problems of a psychological nature implies taking into account their environment beyond the therapeutic framework. Interventional research, currently underway, is taking place in several sites in France: primary schools, Medical-psychological centers (CMP), and Local Committees on Mental Health (CLSM). The goal is to provide an inventory and an analysis of the partnership and interventional structures that are most efficient, based on the needs and available resources at each site. This research envisages a diversification and a contextualization of the offer of care, with great concern for equity and therapeutic efficacy, starting from school.

Results: More than simple results, our aim is to make suggestions as to how to better accompany the end of confinement and the months to come. The development of partnerships in regions that are strongly marked by social and economic inequalities is a priority in terms of public health and the direction of local policies. These partnerships would contribute to a global strategy of evaluating the needs and the personalized accompaniment of children. Formalizing the intervention with the interface being the school sector will support the school staff in overcoming the health crisis that is affecting their institution. The steady rise of CLSMs will enhance local coordination and collaboration to help the most psychologically vulnerable children and aid their parents, given their situation, to support the development of their children.

Conclusion: Restoring human and material resources to existing structures, notably in the sector of child psychiatry so that it can accomplish its public service mission seems to be a priority today. Establishing school-CMP-CLSM partnerships can contribute to providing local policy direction in the interest of elaborating individual and collective strategies that can ensure needs-adapted care that is accessible to as many children as possible.
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http://dx.doi.org/10.3917/spub.205.0531DOI Listing
March 2021

The oral health of individuals with schizophrenia: A major public health problem.

Spec Care Dentist 2021 05 29;41(3):327-328. Epub 2021 Jan 29.

Department of Odontology, Tours University Hospital, Tours, France.

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http://dx.doi.org/10.1111/scd.12576DOI Listing
May 2021

Did the Brain and Oral Microbiota Talk to Each Other? A Review of the Literature.

J Clin Med 2020 Nov 28;9(12). Epub 2020 Nov 28.

Department of Odontology, Tours University Hospital, 37261 Tours, France.

This systematic review aims to investigate the role of the oral microbiome in the pathophysiology of mental health disorders and to appraise the methodological quality of research of the oral-brain axis which is a growing interest area. The PRISMA guideline was adopted, to carry out an electronic search through the MEDLINE database, to identify studies that have explored the role of the oral microbiome in the pathophysiology of mental health disorders published from 2000 up to June 2020. The search resulted in 140 records; after exclusions, a total of 22 papers were included in the present review. In accordance with the role of the oral microbiome in the pathophysiology of mental disorders, four mental disorders were identified: Alzheimer's disease, dementia, and cognitive disorders; autism spectrum disorder; Down's syndrome and mental retardation; and Bipolar disorders. Studies argue for correlations between oral microbiota and Alzheimer's disease, autism spectrum disorders, Down's syndrome, and bipolar disorders. This field is still under-studied, and studies are needed to clarify the biological links and interconnections between the oral microbiota and the pathophysiology of all mental health disorders. Researchers should focus their efforts to develop research on the oral-brain axis in the future.
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http://dx.doi.org/10.3390/jcm9123876DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760025PMC
November 2020

Online and Recovery-Oriented Support Groups Facilitated by Peer Support Workers in Times of COVID-19: Protocol for a Feasibility Pre-Post Study.

JMIR Res Protoc 2020 Dec 18;9(12):e22500. Epub 2020 Dec 18.

Kowloon Hospital, Hong Kong, China.

Background: In times of pandemics, social distancing, isolation, and quarantine have precipitated depression, anxiety, and substance misuse. Scientific literature suggests that patients living with mental health problems or illnesses (MHPIs) who interact with peer support workers (PSWs) experience not only the empathy and connectedness that comes from similar life experiences but also feel hope in the possibility of recovery. So far, it is the effect of mental health teams or programs with PSWs that has been evaluated.

Objective: This paper presents the protocol for a web-based intervention facilitated by PSWs. The five principal research questions are whether this intervention will have an impact in terms of (Q1) personal-civic recovery and (Q2) clinical recovery, (Q3) how these recovery potentials can be impacted by the COVID-19 pandemic, (Q4) how the lived experience of persons in recovery can be mobilized to cope with such a situation, and (Q5) how sex and gender considerations can be taken into account for the pairing of PSWs with service users beyond considerations based solely on psychiatric diagnoses or specific MHPIs. This will help us assess the impact of PSWs in this setting.

Methods: PSWs will lead a typical informal peer support group within the larger context of online peer support groups, focusing on personal-civic recovery. They will be scripted with a fixed, predetermined duration (a series of 10 weekly 90-minute online workshops). There will be 2 experimental subgroups-patients diagnosed with (1) psychotic disorders (n=10) and (2) anxiety or mood disorders (n=10)-compared to a control group (n=10). Random assignment to the intervention and control arms will be conducted using a 2:1 ratio. Several instruments will be used to assess clinical recovery (eg, the Recovery Assessment Scale, the Citizenship Measure questionnaire). The COVID-19 Stress Scales will be used to assess effects in terms of clinical recovery and stress- or anxiety-related responses to COVID-19. Changes will be compared between groups from baseline to endpoint in the intervention and control groups using the Student paired sample t test.

Results: This pilot study was funded in March 2020. The protocol was approved on June 16, 2020, by the Research Ethics Committees of the Montreal Mental Health University Institute. Recruitment took place during the months of July and August, and results are expected in December 2020.

Conclusions: Study results will provide reliable evidence on the effectiveness of a web-based intervention provided by PSWs. The investigators, alongside key decision makers and patient partners, will ensure knowledge translation throughout, and our massive open online course (MOOC), The Fundamentals of Recovery, will be updated with the evidence and new knowledge generated by this feasibility study.

Trial Registration: ClinicalTrials.gov NCT04445324; https://clinicaltrials.gov/ct2/show/NCT04445324.

International Registered Report Identifier (irrid): PRR1-10.2196/22500.
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http://dx.doi.org/10.2196/22500DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752185PMC
December 2020

Consommation de soins dentaires préventifs en région Centre-Val de Loire : une étude rétrospective.

Sante Publique 2020 Jun;Vol. 32(1):87-95

Context: The demography of dentist-surgeons in the Centre-Val de Loire region is far inferior to the national average and characterized by many territorial inequalities of health. The aim of this study is to provide details concerning the dental hygienic care-seeking consumption habits in this region based on one dental care treatment, dental scaling, which allows for the mechanical elimination of dental plaque in order to prevent periodontal diseases.

Method: This retrospective study is based on data from several databases of the National Health Insurance Cross-Schemes Information System (Sniiram) for the year 2016, analyzed by the Statistical Institute of Liberal Health Professionals.

Results: It can be observed that less scaling treatments have been sought out in this region in comparison with metropolitan France and certain territories which also face difficulties in terms of care treatment offers and scaling treatment inferior to the regional average. Although the care offer is unequally distributed, it seems to have little influence on the number of treatment acts consumed per patient and notably scaling treatments. Inversely, indicators of wealth or poverty do have an impact on treatment consumption HBJD001.

Conclusion: This study suggests that the consumption of scaling treatment is independent from the dental care offers, but linked to the social gradient of the population. It points to the deficit in the consumption of this treatment in comparison to metropolitan France. The potential role of the HBJD001 treatment as a marker of the trajectory of preventive health care as well as the necessity of the adjustment of the zones determined by the ARS are put forward.
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http://dx.doi.org/10.3917/spub.201.0087DOI Listing
June 2020

[Dentistry demographics of Center Val de Loire region: Opportunities and prospects].

Sante Publique 2019 September October;31(5):711-714

The Center Val de Loire region is particularly affected by the shortage of health professionals. The demographics of dentists are not immune to this situation and the retirement of a practitioner has become a real public health issue. For this purpose, bridges were created between the faculties of odontology of Nantes, Clermont-Ferrand and the Faculty of Medicine of Tours, to welcome short cycle students in Center Val de Loire region, to create a link with the liberal practitioners and to allow the students to confront the health issues of this territory.
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http://dx.doi.org/10.3917/spub.195.0711DOI Listing
June 2020

Oral health treatment habits of people with schizophrenia in France: A retrospective cohort study.

PLoS One 2020 9;15(3):e0229946. Epub 2020 Mar 9.

Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France.

Objective: To identify the differences between persons with schizophrenia (PWS) and general population in France in terms of oral health treatment (tooth scaling, dental treatment and tooth extraction) and the factors associated with these differences.

Methods: This retrospective cohort study included PWS identified from a representative sample of 1/97th of the French population (general sample of beneficiaries). PWS were identified from 2014 data by an algorithm that included: F2 diagnostic codes in the register of long-term diseases in 2014 AND {(at least three deliveries of antipsychotics in 2014) OR (F20 diagnostic codes as a main or associated diagnosis in hospital discharge abstracts in 2012 or 2013 (hospital data for medicine, surgery and obstetrics)}. Follow-up dental care was explored for all people over a period of 3 years (2014 to 2017).

Results: In 2014, 580,219 persons older than 15 years were identified from the 96 metropolitan departments in France; 2,213 were PWS (0.4%). Fewer PWS were found along a diagonal line from north-east to south-west France, and the highest numbers were located in urban departments. PWS were more often male (58.6% vs 48.7%, p<0.001). They were less likely to have had tooth scaling but more likely to have undergone a dental extraction. In one third of departments, more than 50% of PWS had at least one tooth scaling over a three-year period; the rate of dental extraction in these departments ranged from 6 to 23%. Then, a quarter of the departments in which 40 to 100% of PWS had had at least one dental extraction (2/8) presented a rate of tooth scaling ranging from 0 to 28% over the study period.

Conclusions: Compared with the general population, PWS were less likely to have had tooth scaling and dental treatment but more likely to have undergone dental extraction.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0229946PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062238PMC
June 2020

Anticholinergic Drugs and Oral Health-related Quality of Life in Patients with Schizophrenia: A Pilot Study.

Transl Neurosci 2020 11;11:10-16. Epub 2020 Feb 11.

University Hospital of Tours ,Odontology Department, 37170 Chambray-lès-Tours, France.

Objective: The aim of this study was to explore, in a sample population of people with schizophrenia (PWS), the role of the anticholinergic burden on the perception of oral health-related quality of life (OHrQoL) in France.

Methods: A pilot study was performed between March 2014 and January 2016. PWS were recruited from a population in Côte d'Or department in France. Dental status was investigated using the Decayed, Missing, or Filled Teeth (DMFT) index, the Xerostomia Index (XI), and the Global Oral Health Assessment Index (GOHAI) for OHrQoL. The anticholinergic impregnation score was recorded using the anticholinergic impregnation scale (AIS).

Results: A sample of 62 people was selected. The DMFT score was 16.5± 8.7, the XI score was 22.9±7.8, the GOHAI score was 43.0±8.8, and the AIS score was 3.1±2.8. In total, 169 drugs were prescribed to the people of our sample, and 114 different anticholinergic drugs were observed. The most frequently used anticholinergic drugs (51.40%), in the study had a low antimuscarinic potency (1 point according to AIS scale). The multiple linear regression model showed that the OHrQoL scores were significantly lower when the DMFT scores, XI score, and anticholinergic scores were high.

Conclusions: This pilot study highlighted the potential role of the anticholinergic burden on the OHrQoL of PWS. A study with a validated specific scale for the OHrQoL and a standard anticholinergic burden scale should be conducted to clarify the role of anticholinergic drugs on the OHrQoL for PWS.
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http://dx.doi.org/10.1515/tnsci-2020-0003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029653PMC
February 2020

A collaboration between service users and professionals for the development and evaluation of a new program for cardiovascular risk management in persons with a diagnosis of severe mental illness: French multicenter qualitative and feasibility studies.

Int J Ment Health Syst 2019 27;13:74. Epub 2019 Dec 27.

EPSM Lille-Métropole, WHO Collaborating Centre for Research and Training in Mental Health, 211 Rue Salengro, 59260 Hellemmes, France.

Background: Persons with a diagnosis of severe mental illness have a life expectancy that is 20 years lower than the general population, and they are disproportionately affected by cardiovascular disorders. Improving the management of cardiovascular risk is one of the main challenges for the public health system. In the care pathway of persons with a diagnosis of severe mental illness, a better understanding of limiting and facilitating factors is required. The objective was to include persons with a diagnosis of severe mental illness, carers, and primary and mental health professionals in the creation and evaluation (feasibility) of a health promotion program designed to improve cardiovascular risk management through empowerment.

Methods: This study combines a mixed methodology with qualitative and quantitative components. A multicenter prospective qualitative study was conducted in seven mental health units in France and was coordinated by a steering committee composed of persons with a diagnosis of severe mental illness, carers, and primary and mental health professionals.

Results: This health promotion program must enable persons with a diagnosis of severe mental illness to assert their right to self-determination and to exercise greater control over their lives, beyond their diagnosis and care. Following a preliminary feasibility study, the effectiveness of this new tool will be evaluated using a randomized controlled trial in a second study.

Conclusions: The findings can be used by health organizations as a starting point for developing new and improved services for persons with a diagnosis of severe mental illness. Clinical Trials Gov NCT03689296. Date registered September 28, 2018.
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http://dx.doi.org/10.1186/s13033-019-0331-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933686PMC
December 2019

[A caregiver-person with schizophrenia partnership to improve oral health education]

Sante Publique 2019 May June;Vol. 31(3):405-415

Introduction: Poor oral health in persons with schizophrenia is a major public health issue affecting 600,000 people in France. The aim of this article was to present the different stages in the development of a specific oral health educational program for persons with schizophrenia. It takes into account experimental knowledge of these persons and presents the results of the feasibility study.

Patients And Method: The focus group method was applied to a group of health professionals and users to highlight an exploratory corpus in order to develop an oral health educational program. An expert group including persons with schizophrenia among others validated the fields and tools of this program. A feasibility study was then conducted in a control group of 7 persons with schizophrenia.

Results: Altogether, 26 persons participated in this feasibility study. The main fields investigated by the expert group aimed to promote personal responsibility for one’s health, to improve access to the healthcare system and to promote the global management of health. The feasibility study showed the ability of this program to change persons with schizophrenia representations and knowledge of this health problem. Most educational tools were considered relevant.

Conclusion: An oral health educational program was built as part of a caregiver-persons with schizophrenia partnership and showed its feasibility. A multicentric randomized trial is currently ongoing to assess the efficacy of this program with a high level of proof.
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http://dx.doi.org/10.3917/spub.193.0405DOI Listing
October 2019

Coping Strategies for Oral Health Problems by People with Schizophrenia.

Transl Neurosci 2019 7;10:187-194. Epub 2019 Aug 7.

Clinical research unit, La Chartreuse psychiatric center, Dijon, France.

Background: Persons with schizophrenia are particularity susceptible to poor oral health. Symptoms of schizophrenia often affect oral health behaviors and lifestyle. The aim was to explore coping strategies used by people with schizophrenia in oral health in order to understand and to best involve them in the management of their own oral health in daily life.

Materials And Methods: This is systematic review reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. We included cross-sectional and longitudinal quantitative and qualitative studies that 1) examined coping strategies regarding oral health in persons with schizophrenia or 2) examined coping strategies were used in dental care. We included studies conducted with at least one PWS aged 18 years old more and without restriction on sex, socioeconomic status, or language.

Results: The 8 studies included suggest that coping strategies depends on complex translation processes that can be either personal (e.g., psychological symptomatology, neuropsychological functioning to adversely affect hope, self-esteem, self-stigma, self-determination, sense of coherence, and resilience) and/or environmental factors (e.g., peer support and efficacy of rehabilitations programs). We further identified that the main factor influencing coping strategies was dental stress situation.

Conclusions: This review suggests that coping strategies play a crucial role in the recovery process for oral health of PWS. Translation processes in oral health should be more explored in the future to clarify the capacity of PWS to cope with essential self-care in oral health on daily life.
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http://dx.doi.org/10.1515/tnsci-2019-0033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689214PMC
August 2019

Oral health in schizophrenia patients: A French Multicenter Cross-Sectional Study.

Presse Med 2019 Feb 8;48(2):e89-e99. Epub 2019 Mar 8.

University Hospital of Dijon, Department of Psychiatry and Addictology, 21079 Dijon, France.

Objective: The aim of this study was to assess the oral health status of a sample of patients with schizophrenia (PWS) in Côte d'Or region (France) and to determine the factors associated with dental status.

Material And Methods: A multicenter cross-sectional descriptive study was performed. PWS were selected using a random stratified method. Dental status was investigated using the Decayed, Missing, or Filled Teeth (DMFT) index, based on 32 teeth. The Simplified Oral Hygiene Index (OHI-S), the Xerostomia Index (XI) and the Global Oral Health Assessment Index (GOHAI) for Oral Health-related Quality of Life (OHrQoL) were recorded.

Results: Among the 302 persons identified, 109 were included (acceptance rate was 49.1%). Of these, 61.5% were men. The mean age was 46.8 years±12.0 years. The majority (78%) had completed a secondary education (SE). The mean duration of mental illness (DMI) was 17.9±9.4 years, and 55.5% were taking drugs. The mean DMFT was 16.6±8.1. There was a significant relationship between age, SE, oral health variables, medical conditions and OHrQoL.

Conclusions: PWS describe a poor OHrQoL. The dental and hygiene index scores are poor. We observed a lack of brushing and of dental visit for these persons and a gap in oral health between PWS and general population.
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http://dx.doi.org/10.1016/j.lpm.2018.06.018DOI Listing
February 2019

A Therapeutic Educational Program in Oral Health for Persons with Schizophrenia: A Qualitative Feasibility Study.

Int J Dent 2018 24;2018:6403063. Epub 2018 Sep 24.

Clinical Research Unit, La Chartreuse Psychiatric Centre, 21033 Dijon, France.

Objective: The aim of this study was to test the feasibility of a therapeutic educational program in oral health (TEPOH) for persons with schizophrenia (PWS).

Design: In a qualitative study, we explored the representation of oral health before and after a TEPOH. : PWS are at greater risk of decayed and missing teeth and periodontal diseases. In a previous publication, we described the different steps in building a TEPOH by taking into account the experiences of PWS concerning oral health quality of life. This TEPOH aimed at promoting a global health approach. : Voluntary PWS and their caregivers were recruited during face-to-face interviews at "Les Boisseaux" (a psychiatric outpatient centre) in Auxerre (France) and were included in the study between November and December 2016. : We explored the experiences of participants and their perceptions of oral health before and after the TEPOH with focus group meetings.

Results: Four females and three males participated in the study, and the mean age was 29.4 ± 5. Before the TEPOH, the PWS produced 28 ideas about oral health perception and 37 after the TEPOH. After the TEPOH, elements relating to the determinants of oral health (smoking and poor diet) emerged.

Conclusions: These results show an evolution in oral health representation, and after some adjustments to the TEPOH, the second step will be to test this program in a large sample to generate a high level of evidence of the impact of TEPOH in the long term.
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http://dx.doi.org/10.1155/2018/6403063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174768PMC
September 2018

The Schizophrenia Oral Health Profile: Development and Feasibility.

Transl Neurosci 2018 22;9:123-131. Epub 2018 Sep 22.

EA 481 Integrative and Clinical Neurosciences, University Hospital of Besançon, F-25000 Besançon, France.

Background: The aim of this study was to present the different stages of development of the Schizophrenia Oral Health Profile (SOHP) questionnaire, aimed at assessing oral disorders and their impacts on functioning and psychosocial wellbeing for patients with schizophrenia (PWS) and to give the results of a feasibility study conducted in France.

Materials And Methods: The first step of this qualitative study was semi-structured interviews were conducted with 20 PWS and 6 health professionals (HP). A focus group integrating 4 PWS and 4 HP was also organised to identify the items of the SOHP. The data were analysed using a thematic analysis. Second, a feasibility study was conducted in a sample of 30 PWS who answered the SOHP questionnaire. The acceptability and understanding of the SOHP were evaluated, using a specific questionnaire.

Results: The semi-structured interviews and focus groups included 34 individuals in total. Items' selection was done with several stages and led to a SOHP scale with 53 final items related to oral disorders and their impacts on functioning and psychosocial well-being. These items were classified in 13 preselected dimensions including one additional module related to the side effects of medications (11 items). The feasibility study showed good acceptability and understanding of the items of the SOHP scale.

Conclusions: The psychometric validation of the SOHP scale, involving a large sample of PWS, is currently in progress. The SOHP is important to evaluate PWS oral health needs and to offer appropriate strategies to improve oral health of this persons.

Trial Registration: Clinical Trials Gov NCT02730832. Date registered: 21 March, 2016.
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http://dx.doi.org/10.1515/tnsci-2018-0019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153450PMC
September 2018

The Schizophrenia Coping Oral Health Profile. Development and Feasibility.

Transl Neurosci 2018 20;9:78-87. Epub 2018 Jun 20.

Clinical Research Unit, La Chartreuse Psychiatric Centre, 21033 Dijon, France.

Background: The aim of this work was to present the creation of appropriate tools to evaluate the coping strategies in Oral-Health-related Quality of Life (OHrQOL) implemented by persons with schizophrenia (PWS), the Schizophrenia Coping Oral Health Profile (SCOOHP), and the results of a feasibility study.

Methods: A qualitative investigation was conducted between June 2016 and May 2017.The first step included 26 semi-structured individual interviews, 20 with PWS and 6 with health professionals (HPs), and 2 focus groups (PWS and HPs) to explore the experiences of the participants and how they felt about coping strategies in OHrQOL. The second step was a feasibility study involving a statistical analysis to test the acceptability and internal consistency (Cronbach's α) of the SCOOHP.

Results: The analysis of these interviews allowed for us to obtain 277 items from 3545 verbatim transcriptions related to various dimensions of OHrQOL. We presented the items selected in coping concepts in this study. After selecting items in several stages, we drew up the SCOOHP scale with 23 items (15 items for positive coping and 8 items for negative coping). The feasibility study showed good acceptability, good understanding of the items and good consistency reliability (α = 0.59).

Conclusions: This is the first study that has enabled us to draw up a specific tool to assess coping strategies in OHrQOL of PWS. A multicentre study involving a larger sample of PWS is underway in order to perform the psychometric validation of the SCOOHP.

Trial Registration: Clinical Trials Gov NCT02730832. Date registered: 21 March 2016.
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http://dx.doi.org/10.1515/tnsci-2018-0014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024692PMC
June 2018

[A global approach to therapeutic education for patients with schizophrenia].

Soins Psychiatr 2017 Nov - Dec;38(313):41-44

Centre hospitalier La Chartreuse, 1, boulevard Chanoine-Kir, BP23314, 21033 Dijon cedex, France; Unité de recherche clinique du centre hospitalier La Chartreuse, 1, boulevard Chanoine-Kir BP 23314, 21033 Dijon cedex, France.

Thanks to the wealth of multiple competencies, it is now possible to undertake a global approach with the patient with schizophrenia based on therapeutic education. An 'à la carte' evolutive programme can respond to the issues inherent to this disorder, on condition that the caregivers have developed a common culture and values. An example of a programme implemented in La Chartreuse hospital in Dijon.
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http://dx.doi.org/10.1016/j.spsy.2017.09.009DOI Listing
May 2019

A Rasch Analysis between Schizophrenic Patients and the General Population.

Transl Neurosci 2017 28;8:139-146. Epub 2017 Oct 28.

UMR 1246 INSERM - SPHERE "methodS in Patient-centered outcomes and HEalth ResEarch", Nantes, France.

Background: The aim of this study was to test the General Oral Health Assessment Index Questionnaire (GOHAI) items for differential item functioning (DIF) according to demographic characteristics (gender, age) and mental health status (schizophrenic disorders versus general population) using Rasch analysis.

Methods: This is a cross-sectional study using aggregated baseline data from a validation study of the GOHAI in the French general population (GP) and similar validation study in persons with schizophrenia (PWS). DIF was tested using the Partial Credit Model. DIF were estimated in different groups of patients.

Results: The cohort comprised 363 persons: 65% were female, 83% were 25-45 years old and 30% were PWS.Five of the 12 items exhibited DIF. DIF effects were observed with schizophrenia for 3 items, with age for 3 items and with gender for 1 item. The variable "age" gave a significant explanation of the latent variable: the latent variable decreased with age (-0.40±0.08-p<0.001 for each increase of the age of 10 years). This decrease represented an effect size of 0.27 which can be qualified of a small to medium effect. The status of the individuals (GP versus PWS) and the gender did not significantly explain differences in the values of the latent variable.

Conclusion: The GOHAI scores may not be comparable across sub-groups defined by health status, age and gender without accounting for DIF. In the future, other studies should explore this way with other Oral Health related Quality of Life assessment tools and populations with mental illness.
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http://dx.doi.org/10.1515/tnsci-2017-0020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662753PMC
October 2017

Psychometric characteristics of the "General Oral Health Assessment Index (GOHAI) » in a French representative sample of patients with schizophrenia.

BMC Oral Health 2017 Apr 11;17(1):75. Epub 2017 Apr 11.

EA 481 Integrative Neurosciences and Clinical, University Hospital of Besançon, F-25000, Besançon, France.

Background: The "General Oral Health Assessment Index" (GOHAI) was widely used in clinical or epidemiological studies worldwide, as it was available for use in different languages. Therefore, the aim of this study was to evaluate the psychometric characteristics of the GOHAI in a representative sample of patients with schizophrenia.

Methods: A total of 90 schizophrenic patients (in-patients and out-patients) were recruited from the participants of the "buccodor study" (NCT02167724) between March and September 2015. They were selected using a random stratified sampling method according to their age, sex, or residential area (urban/rural area). GOHAI validity (construct, predictive, concurrent and known group validity) and internal consistency (reliability) were tested. Test-retest reliability was evaluated in 32 subjects.

Results: The mean age was 47.34 (SD = 12.17). Internal consistency indicated excellent agreement, with a Cronbach's α value of 0.82 and average inter-item correlation of 0.65. Intraclass correlation coefficients for test-retest reliability with 95% confidence intervals were not significantly different (p > 0.05). Construct validity was supported by three factor that accounted for 60.94% of the variance observed. Predictive validity was corroborated as statistically significant differences were observed between a high GOHAI score, which was associated with self-perceived satisfaction with oral health, lower age and high frequency of toothbrushing. Concurrent validity was corroborated as statistically significant relationships were observed between the GOHAI scores and most objective measures of dental status. For known group validity, they was no significant difference of the mean GOHAI score between out or in-patients (p > 0.05).

Conclusion: Acceptable psychometric characteristics of the GOHAI could help caregivers to develop ways to improve the Oral Health related Quality Of Life of schizophrenic patients.

Trial Registration: Clinical Trials Gov NCT02167724 . Date registered 17 June, 2014.
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http://dx.doi.org/10.1186/s12903-017-0368-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387256PMC
April 2017

Study protocol: a cluster randomized controlled trial to assess the effectiveness of a therapeutic educational program in oral health for persons with schizophrenia.

Int J Ment Health Syst 2016 5;10:65. Epub 2016 Oct 5.

USMR-Réseau d'aide Méthodologiste, University Hospital of Dijon, 21079 Dijon Cedex, France.

Background: Schizophrenia is a severe mental disorder that affects 1 % of the world's population, including 600,000 people in France. Persons with schizophrenia (PWS) have excess mortality (their life expectancy is reduced by 20 %) and excess morbidity. In addition, such persons may have a large number of missing or decayed teeth. Dental caries and periodontal measurement indexes are often twice as high as the level found in the general population. Poor oral health can also affect quality of life and oral health is inseparable from general health. The management of oral health problems needs a multidisciplinary approach. According to the World Health Organization, the aim of therapeutic education (TE) is to help patients take care of themselves and to improve empowerment and recovery. In this educational approach, it is important to take into account the patient's personal experience. Though rarely investigated, the personal experience of PWS in oral health quality of life (OHRQoL) must be used to build a therapeutic educational programme in oral health (TEPOH) in a multidisciplinary approach, and the effectiveness of this program must be evaluated.

Methods/design: We report the protocol of a randomized controlled cluster study. This study will be conducted in twelve hospitals in France. We hypothesized that a decrease of 20 % in the proportion of patients with CPI ≥ 3 would establish the effectiveness of TEPOH. Therefore, 12 hospitals will be randomly allocated to either TEPOH or no TEPOH. Altogether, they will have to recruit 230 PWS, who will be randomly allocated with a ratio of 1:1 to one of two conditions: control without intervention versus the group benefitting from TEPOH.

Discussion: If successful, the study will generate methodologically sound results that provide knowledge on the effectiveness of a TEP in oral health for PWS. The results can be used to promote OHRQoL in a global health approach and develop appropriate strategies to encourage and facilitate financial support for healthcare, the multidisciplinary treatment of dental disorders, and the development of training in oral and mental health for caregivers. Clinical Trials Gov NCT02512367. Date registered 19 July, 2015.
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http://dx.doi.org/10.1186/s13033-016-0096-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053217PMC
October 2016

Cross-cultural equivalence in translation of the oral health impact profile: how to interpret the final score?

Community Dent Oral Epidemiol 2016 Jun 16;44(3):199-200; discussion 200. Epub 2016 Feb 16.

EA 481 Integrative Neurosciences and Clinical, University Hospital of Besançon, Besançon, France.

The oral health impact profile (OHIP) is one of the most widely known oral health-related quality of life instruments. In Community Dentistry and Oral Epidemiology, MacEntee and Brondani report the results of a systematic review to identify acceptable methods for translating psychometric instruments for cross-cultural equivalence of the OHIP scale. But in no study has unidimensionality, one aspect of the validity of the internal structure of the scale, been verified, whereas it is a major psychometric step. In the absence of the study of unidimensionality, it is difficult to interpret the final score. The methodology of transcultural validation of the OHIP could be improved, and the study of the unidimensionality is a psychometrically necessary step for the interpretation of the finale score.
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http://dx.doi.org/10.1111/cdoe.12218DOI Listing
June 2016

Occlusal plane elevation to prevent lip self-mutilation: A case report.

Presse Med 2015 Nov 23;44(11):1198-201. Epub 2015 Oct 23.

University Hospital of Dijon, Department of Psychiatry and Addictology, 21079 Dijon, France.

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http://dx.doi.org/10.1016/j.lpm.2015.09.005DOI Listing
November 2015

Feasibility and acceptability of patient partnership to improve access to primary care for the physical health of patients with severe mental illnesses: an interactive guide.

Int J Equity Health 2015 Sep 14;14:78. Epub 2015 Sep 14.

School of Medicine, The University of Queensland, Brisbane, Australia.

Introduction: Even in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses.

Methods: A participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition.

Results: Patient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants during the small group learning sessions, a training technique designed for healthcare professionals that was adapted for this project for, and with patient partners.

Conclusion: This research has shown the feasibility and acceptability of patient partnership and patient-oriented research approaches to the R&D process of a new medical tool and intervention for patients with serious mental illness, and its acceptability for addressing inequity of this disadvantaged population in terms of access to primary care providers.
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http://dx.doi.org/10.1186/s12939-015-0200-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4568580PMC
September 2015

Effects of N-acetylcysteine, oral glutathione (GSH) and a novel sublingual form of GSH on oxidative stress markers: A comparative crossover study.

Redox Biol 2015 Dec 29;6:198-205. Epub 2015 Jul 29.

Laboratoires Le Stum, 4 impasse de Kerhoas, 56260 Larmor Plage, France. Electronic address:

Glutathione (GSH) is critical to fight against oxidative stress. Its very low bioavailability limits the interest of a supplementation. The purpose of this study was to compare the bioavailability, the effect on oxidative stress markers and the safety of a new sublingual form of GSH with two commonly used dietary supplements, N-acetylcysteine (NAC) and oral GSH. The study was a three-week randomized crossover trial. 20 Volunteers with metabolic syndrome were enrolled. GSH levels and several oxidative stress markers were determined at different times during each 21-days period. Compared to oral GSH group, an increase of total and reduced GSH levels in plasma and a higher GSH/GSSG ratio (p=0.003) was observed in sublingual GSH group. After 3 weeks of administration, there was a significant increase of vitamin E level in plasma only in sublingual GSH group (0.83 µmol/g; p=0.04). Our results demonstrate the superiority of a new sublingual form of GSH over the oral GSH form and NAC in terms of GSH supplementation.
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http://dx.doi.org/10.1016/j.redox.2015.07.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536296PMC
December 2015

[The oral health of patients in psychiatric institutions and related comorbidities].

Authors:
Frédéric Denis

Soins Psychiatr 2014 Jan-Feb(290):40-4

The oral health of inpatients who are treated for mental illness is very degraded compared with general population. We observe a significant caries index, disorders of salivary secretion and periodontal disease. The comorbidities associated such as smoking, metabolic disorders and the lack of oral hygiene explain partially this situation. A bad oral state can have grave consequences on overall health.A good oral health is an integral part of somatic care of patients hospitalized in psychiatry.
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April 2014

Anxiolytic-like effect of a salmon phospholipopeptidic complex composed of polyunsaturated fatty acids and bioactive peptides.

Mar Drugs 2013 Oct 30;11(11):4294-317. Epub 2013 Oct 30.

Laboratory of Biomolecular Engineering, University of Lorraine, École Nationale Supérieure d'Agronomie et des Industries Alimentaires (ENSAIA), National School on Agronomy and Food Industry 2, Avenue de la Forêt de Haye TSA 40602 54518, Vandoeuvre Cedex, France.

A phospholipopeptidic complex obtained by the enzymatic hydrolysis of salmon heads in green conditions; exert anxiolytic-like effects in a time and dose-dependent manner, with no affection of locomotor activity. This study focused on the physico-chemical properties of the lipidic and peptidic fractions from this natural product. The characterization of mineral composition, amino acid and fatty acids was carried out. Stability of nanoemulsions allowed us to realize a behavioral study conducted with four different tests on 80 mice. This work highlighted the dose dependent effects of the natural complex and its various fractions over a period of 14 days compared to a conventional anxiolytic. The intracellular redox status of neural cells was evaluated in order to determine the free radicals scavenging potential of these products in the central nervous system (CNS), after mice sacrifice. The complex peptidic fraction showed a strong scavenging property and similar results were found for the complex as well as its lipidic fraction. For the first time, the results of this study showed the anxiolytic-like and neuroprotective properties of a phospholipopeptidic complex extracted from salmon head. The applications on anxiety disorders might be relevant, depending on the doses, the fraction used and the chronicity of the supplementation.
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http://dx.doi.org/10.3390/md11114294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853729PMC
October 2013

Formulation, characterization and pharmacokinetic studies of coenzyme Q₁₀ PUFA's nanoemulsions.

Eur J Pharm Sci 2012 Sep 23;47(2):305-12. Epub 2012 Jun 23.

Université de Lorraine, Laboratoire d'Ingénierie des Biomolécules, ENSAIA, 2 av. de Forêt de Haye, 54500 Vandœuvre-lès-Nancy, France.

Coenzyme Q(10) (CoQ(10)) is an insoluble antioxidant molecule with great biological value but exhibit poor bioavailability. To improve the bioavailability of CoQ(10), we have proposed to formulate a nanoemulsion consisting of salmon oil, salmon lecithin, CoQ(10) and water. A commercial oily mixture, based on soybean oil and CoQ(10), was used for comparison, as well as a second oily mixture, composed of salmon lecithin, salmon oil and CoQ(10). Salmon oil and salmon lecithin were used as sources of polyunsaturated fatty acids (PUFA). The maximum solubility of CoQ(10) in salmon oil was 81.30 ± 0.08 mg/mL at 37 °C. Mean droplets size of the control and CoQ(10) nanoemulsions was 164 and 167 nm, respectively. The nanoemulsion was stable during 30 days at 25 °C. Bioavailability was evaluated as the area under the curve of CoQ(10) plasma concentration in male Wistar rats following oral administration of the three formulations of CoQ(10). The nanoemulsion increases at twice the bioavailability of CoQ(10) than conventional oily formulations regardless the nature of used fatty acids (soybean and salmon oils). Prepared nanoemulsion represents a vectorization of both LC-PUFAs and CoQ(10). That could be an interesting way to increase the absorption of these two bioactive molecules with natural low availability.
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http://dx.doi.org/10.1016/j.ejps.2012.06.008DOI Listing
September 2012

Alignment and assembly of adsorbed collagen molecules induced by anisotropic chemical nanopatterns.

Small 2005 Oct;1(10):984-91

Unité de Chimie des Interfaces, Université Catholique de Louvain, Croix du Sud 2/18, 1348 Louvain-la-Neuve, Belgium.

Collagen, a protein widely used to control cell-material interactions, is known to self-assemble in solution. Supramolecular structures also form on material surfaces following collagen adsorption. Herein, we report the use of anisotropic, flat, surface chemical nanopatterns, which consist of alkyl-terminated tracks drawn in an oligo(ethylene glycol)-terminated matrix, to direct collagen adsorption. As revealed by atomic force microscopy, the spontaneous collagen adsorption performed on such patterned substrates results in the accumulation of collagen on the hydrophobic tracks. Moreover, the width of the tracks (30-90 nm), which is much smaller than the length of the collagen molecule (approximately 300 nm), is the origin of preferential alignment of the molecules and of their assembly into continuous bundles of adsorbed collagen. This chemical guidance effect due to self-confinement of proteins upon adsorption may bring novel and valuable applications, specifically in biomaterials science and cell growth control.
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http://dx.doi.org/10.1002/smll.200500116DOI Listing
October 2005