Publications by authors named "Sebastien Guillaume"

112 Publications

Null effect of vortioxetine augmentation with celecoxib should not be generalized to other antidepressants.

Eur Neuropsychopharmacol 2021 Nov 23;55:84-85. Epub 2021 Nov 23.

Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France; Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, Montpellier, France.

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http://dx.doi.org/10.1016/j.euroneuro.2021.11.001DOI Listing
November 2021

Null effect of vortioxetine augmentation with celecoxib should not be generalized to other antidepressants.

Eur Neuropsychopharmacol 2021 Nov 23;55:84-85. Epub 2021 Nov 23.

Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France; Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, Montpellier, France.

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http://dx.doi.org/10.1016/j.euroneuro.2021.11.001DOI Listing
November 2021

Blood cytokines differentiate bipolar disorder and major depressive disorder during a major depressive episode: Initial discovery and independent sample replication.

Brain Behav Immun Health 2021 May 10;13:100232. Epub 2021 Mar 10.

Aix Marseille Univ, CNRS, Inst Neurosci Timone, Marseille, France.

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 from BD patients when in a depressed state. We have used clinical data and serum samples from two independent naturalistic cohorts of patients with a Major Depressive Episode (MDE) who fulfilled the criteria of either BD or MDD at inclusion. The discovery and replication cohorts consisted of 462 and 133 patients respectively. Patients were clinically assessed using standard diagnostic interviews, and clinical variables including current treatments were recorded. Blood was collected and serum assessed for levels of 31 cytokines using a sensitive multiplex assay. A penalized logistic regression model combined with nonparametric bootstrap was subsequently used to identify cytokines associated with BD. Interleukin (IL)-6, IL-10, IL-15, IL-27 and C-X-C ligand chemokine (CXCL)-10 were positively associated with BD in the discovery cohort. Of the five cytokines identified as discriminant features in the discovery cohort, IL-10, IL-15 and IL-27 were also positively associated with BD in the replication cohort therefore providing an external validation to our finding. Should our results be validated in a prospective cohort, they could provide new insights into the pathophysiological mechanisms of mood disorders.
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http://dx.doi.org/10.1016/j.bbih.2021.100232DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8474674PMC
May 2021

Alpha-smooth Muscle Actin Expression in the Stroma Predicts Resistance to Trastuzumab in Patients with Early-stage HER2-positive Breast Cancer.

Clin Cancer Res 2021 Nov 31;27(22):6156-6163. Epub 2021 Aug 31.

Department of Pathology, Yale School of Medicine, New Haven, Connecticut.

Purpose: The companion diagnostic test for trastuzumab has not changed much in the last 25 years. We used high-plex digital spatial profiling to identify biomarkers besides HER2 that can help predict response to trastuzumab in HER2-positive breast cancer.

Experimental Design: Fifty-eight protein targets were measured in three different molecularly defined compartments by the NanoString GeoMx Digital Spatial Profiler (DSP) in a tissue microarray containing 151 patients with breast cancer that received adjuvant trastuzumab as part of the Hellenic Cooperative Oncology Group 10/05 clinical trial. Promising candidate biomarkers were orthogonally validated with quantitative immunofluorescence (QIF). RNA-sequencing data from the Neoadjuvant Lapatinib and/or Trastuzumab Treatment Optimisation Study (NeoALTTO) were accessed to provide independent cohort validation. Disease-free survival (DFS) was the main outcome assessed. Statistical analyses were performed using a two-sided test (α = 0.05) and multiple testing correction (Benjamini-Hochberg method, FDR < 0.1).

Results: By DSP, high expression of alpha-smooth muscle actin (α-SMA), both in the leukocyte and stromal compartments, was associated with shorter DFS in univariate analysis ( = 0.002 and = 0.023, respectively). High α-SMA expression in the stroma was validated by QIF after controlling for estrogen receptor and progesterone receptor status [HR, 3.12; 95% confidence interval (CI), 1.12-8.68; = 0.029] showing recurrence on trastuzumab in the same cohort. In the NeoALTTO cohort, elevated levels of were predictive for shorter DFS in the multivariate analysis (HR, 3.21; 95% CI, 1.14-9.05; = 0.027).

Conclusions: This work identifies α-SMA as a novel, easy-to-implement biomarker of resistance to trastuzumab that may be valuable in settings where trastuzumab is combined with other therapies.
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http://dx.doi.org/10.1158/1078-0432.CCR-21-2103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595766PMC
November 2021

Stigmatization toward People with Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder: A Scoping Review.

Nutrients 2021 Aug 18;13(8). Epub 2021 Aug 18.

Centre Troubles des Conduites Alimentaires (TCA), Service de Nutrition Clinique, Unité de Nutrition Humaine, CHU Gabriel Montpied, CRNH, Université Clermont Auvergne, 63003 Clermont-Ferrand, France.

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 of ED stigma, including its consequences, but also its content and distribution. More precisely, we focused on three EDs-namely, anorexia nervosa, bulimia nervosa, and binge eating disorder. Based on a systematic search of four major databases in psychology, the present scoping review includes 46 studies published between 2004 and 2021. We did not conduct any quality assessment of the studies included, because our aim was to provide a wide-ranging overview of these topics instead of an appraisal of evidence answering a precise research question. The review confirmed the existence of a common ED stigma: all individuals affected by EDs reviewed here were perceived as responsible for their situation, and elicited negative emotions and social distance. However, our review also depicted a specific stigma content associated with each ED. In addition, the demographic characteristics of the stigmatizing individuals had a notable influence on the extent of ED stigma: men, young adults, and low-income individuals appeared to be the most stigmatizing toward individuals with EDs. It is important to note that ED stigma had a negative effect on individuals' eating disorders, psychological wellbeing, and treatment-seeking behavior. There is an urgent need for further research on the adverse effects of ED stigma and its prevention.
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http://dx.doi.org/10.3390/nu13082834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8400545PMC
August 2021

Stigmatization toward People with Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder: A Scoping Review.

Nutrients 2021 Aug 18;13(8). Epub 2021 Aug 18.

Centre Troubles des Conduites Alimentaires (TCA), Service de Nutrition Clinique, Unité de Nutrition Humaine, CHU Gabriel Montpied, CRNH, Université Clermont Auvergne, 63003 Clermont-Ferrand, France.

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 of ED stigma, including its consequences, but also its content and distribution. More precisely, we focused on three EDs-namely, anorexia nervosa, bulimia nervosa, and binge eating disorder. Based on a systematic search of four major databases in psychology, the present scoping review includes 46 studies published between 2004 and 2021. We did not conduct any quality assessment of the studies included, because our aim was to provide a wide-ranging overview of these topics instead of an appraisal of evidence answering a precise research question. The review confirmed the existence of a common ED stigma: all individuals affected by EDs reviewed here were perceived as responsible for their situation, and elicited negative emotions and social distance. However, our review also depicted a specific stigma content associated with each ED. In addition, the demographic characteristics of the stigmatizing individuals had a notable influence on the extent of ED stigma: men, young adults, and low-income individuals appeared to be the most stigmatizing toward individuals with EDs. It is important to note that ED stigma had a negative effect on individuals' eating disorders, psychological wellbeing, and treatment-seeking behavior. There is an urgent need for further research on the adverse effects of ED stigma and its prevention.
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http://dx.doi.org/10.3390/nu13082834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8400545PMC
August 2021

Effects of Hormonal Contraception Use on Cognitive Functions in Patients With Bulimia Nervosa.

Front Psychiatry 2021 17;12:658182. Epub 2021 May 17.

Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.

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. This retrospective exploratory study included 103 women with a diagnosis of BN based on the DSM-5 criteria. Their age ranged from 15 to 45 years, and 46.6% were taking HC (oral, transdermal, or intrauterine). Cognition was assessed with the d2 test (attention), Iowa gambling task (IGT; decision making), Brixton spatial anticipation test (set shifting), and Rey-Osterrieth complex figure test (central coherence). Data were analyzed with logistic regression models to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of HC effect on the neuropsychological test scores. In the multivariate model, HC use was significantly associated with better scores for two d2 test indices: F-score [OR = 0.98, 95% CI = (0.95; 0.99)] and final total score ratio [OR = 0.87, 95% CI = (0.77; 0.99)]. HC was also associated with a better understanding of the IGT explicit rules. No difference between the two groups (HC and non-HC use) was detected for set shifting and central coherence. This exploratory study suggests that HC could have effects on the sustained attention and concentration in women with BN. More studies are needed to confirm these results.
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http://dx.doi.org/10.3389/fpsyt.2021.658182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165222PMC
May 2021

Modification of bone mineral density, bone geometry and volumetric BMD in young women with obesity.

Bone 2021 09 14;150:116005. Epub 2021 May 14.

Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, Montpellier, France; PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France.

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 determined by advanced DXA-based methods; (ii) model the profiles of bone parameters for each population with age; and (iii) determine the factors related to body composition (i.e. lean tissue mass and fat mass) potentially implicated in the "bone adaptation" in the femoral region.

Subjects And Methods: Two hundred and twenty adolescent and young women from 18 to 35 years old were enrolled in this study: 128 patients with obesity and 92 age-matched (±6 months) normal-weight controls. aBMD was determined with DXA, whereas hip geometry and strength parameters were assessed by hip structural analysis (HSA) and volumetric BMD by 3D-SHAPER® software.

Results: Compared with controls, subjects with obesity presented significantly higher aBMD at all bone sites, but the difference was greater at hip compared with lumbar spine or radius. Bone size estimates (i.e. cortical thickness), as well as strength estimates (i.e. cross-sectional area) were higher at all femoral subregions including femoral neck, intertrochanteric region and femoral shaft in young women with obesity. In whole proximal femur and all femoral compartments, vBMD was also higher in subjects with obesity, but the difference between groups was greater for cortical vBMD compared with trabecular vBMD. When hip bone parameters were modelled for each group from individual values, maximal values were reached between 20 and 26 years in both groups but, whatever the age, subjects with obesity presented higher values than controls. In both groups, lean body mass (LBM) was the parameter most positively associated with the greatest number of bone parameters studied.

Conclusion: Our study confirmed that young women with obesity presented higher aBMD, better hip geometry and greater strength compared with normal-weight controls. Additionally, cortical and trabecular compartments measured by 3D-SHAPER® were favourably and concomitantly modified. However, it remains to be demonstrated whether the evaluation of these new parameters would provide better prediction of fracture risk in this population than aBMD.
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http://dx.doi.org/10.1016/j.bone.2021.116005DOI Listing
September 2021

The course of bipolar disorder as a function of the presence and sequence of onset of comorbid alcohol use disorders in outpatients attending the Fondamental Advanced Centres of Expertise.

J Affect Disord 2021 05 19;287:196-203. Epub 2021 Mar 19.

Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France.

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 Centres of Expertise were ascertained for BD-1, BD-2 and AUD diagnoses, including their respective ages at onset (AAOs, N =2,804). We selected the variables associated with both the presence and sequence of onset of comorbid AUD using bivariate analyses corrected for multiple testing to enter a binary regression model with the sequence of onset of BD and AUD as the dependent variable (AUD first - which also included 88 same-year onsets, vs. BD first).

Results: BD patients with comorbid AUD showed more severe clinical profile than those without. Compared to BD-AUD (N =269), AUD-BD (N =276) was independently associated with a higher AAO of BD (OR =1.1, p <0.001), increased prevalence of comorbid cannabis use disorder (OR =2.8, p <0.001) a higher number of (hypo)manic/mixed BD episodes per year of bipolar illness (OR =3, p <0.01).

Limitations: The transversal design prevents from drawing causal conclusions.

Conclusion: Increased severity of BD with AUD compared to BD alone did not differ according to the sequence of onset. A few differences, though, could be used to better monitor the trajectory of patients showing either one of these disorders.
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http://dx.doi.org/10.1016/j.jad.2021.03.041DOI Listing
May 2021

The course of bipolar disorder as a function of the presence and sequence of onset of comorbid alcohol use disorders in outpatients attending the Fondamental Advanced Centres of Expertise.

J Affect Disord 2021 05 19;287:196-203. Epub 2021 Mar 19.

Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France.

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 Centres of Expertise were ascertained for BD-1, BD-2 and AUD diagnoses, including their respective ages at onset (AAOs, N =2,804). We selected the variables associated with both the presence and sequence of onset of comorbid AUD using bivariate analyses corrected for multiple testing to enter a binary regression model with the sequence of onset of BD and AUD as the dependent variable (AUD first - which also included 88 same-year onsets, vs. BD first).

Results: BD patients with comorbid AUD showed more severe clinical profile than those without. Compared to BD-AUD (N =269), AUD-BD (N =276) was independently associated with a higher AAO of BD (OR =1.1, p <0.001), increased prevalence of comorbid cannabis use disorder (OR =2.8, p <0.001) a higher number of (hypo)manic/mixed BD episodes per year of bipolar illness (OR =3, p <0.01).

Limitations: The transversal design prevents from drawing causal conclusions.

Conclusion: Increased severity of BD with AUD compared to BD alone did not differ according to the sequence of onset. A few differences, though, could be used to better monitor the trajectory of patients showing either one of these disorders.
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http://dx.doi.org/10.1016/j.jad.2021.03.041DOI Listing
May 2021

Updated results from the international phase III ALTTO trial (BIG 2-06/Alliance N063D).

Eur J Cancer 2021 05 23;148:287-296. Epub 2021 Mar 23.

Institute Jules Bordet and l' Université Libre de Bruxelles (U.L.B), Brussels, Belgium.

Aim: To present the pre-specified analyses of >5-years follow-up of the Phase III ALTTO trial.

Patients And Methods: 8381 patients with stage I-III HER2 positive breast cancer randomised to chemotherapy plus 1-year of trastuzumab (T), oral lapatinib (L; no longer evaluated), trastuzumab followed by lapatinib (T→L), and lapatinib + trastuzumab (L+T). The primary endpoint was disease-free survival (DFS). A secondary analysis examined DFS treatment effects by hormone receptor status, nodal status and chemotherapy timing; time to recurrence; overall survival (OS) and safety (overall and cardiac).

Results: At a median follow-up of 6.9 years, 705 DFS events for L+T versus T were observed. Hazard Ratio (HR) for DFS was 0.86 (95% CI, 0.74-1.00) for L+T versus T and 0.93 (95% CI, 0.81-1.08) for T→L versus T. The 6-year DFS were 85%, 84%, and 82% for L+T, T→L, and T, respectively. HR for OS was 0.86 (95% CI, 0.70-1.06) for L+T versus T and 0.88 (95% CI, 0.71-1.08) for T→L versus T. The 6-year OS were 93%, 92%, and 91% for L+T, T→L, and T, respectively. Subset analyses showed a numerically better HR for DFS in favour of L+T versus T for the hormone-receptor-negative [HR 0.80 (95% CI, 0.64-1.00; 6-yr DFS% = 84% versus 80%)] and the sequential chemotherapy [HR 0.83 (95% CI, 0.69-1.00; 6-yr DFS% = 83% versus79%)] subgroups.

Conclusion: T+L did not significantly improve DFS and OS over T alone, both with chemotherapy, and, therefore, cannot be recommended for adjuvant treatment of early-stage HER2-positive breast cancer.

Trial Registration: clinicaltrials.gov Identifier NCT00490139.
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http://dx.doi.org/10.1016/j.ejca.2021.01.053DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103014PMC
May 2021

The Early Impact of the COVID-19 Lockdown on Stress and Addictive Behaviors in an Alcohol-Consuming Student Population in France.

Front Psychiatry 2021 9;12:628631. Epub 2021 Feb 9.

CHU Clermont-Ferrand, Pôle Psychiatrie B, Clermont-Ferrand, France.

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. Cross-sectional study. French students from four universities participated in this study, and 2,760 students reported alcohol use. During the first week of lockdown, students reported their perceived levels of stress regarding COVID-19. Substance use and addictive behaviors were reported before and during lockdown, and media exposure, demographical, living conditions, and environmental stressors were reported during lockdown. Women reported greater levels of stress (95% CI: 1.18 to 1.93, < 0.001). Highly-stressed students also report less social support (95% CI: -1.04 to -0.39, < 0.001) and were more likely to worry about the lockdown (95% CI: 0.27 to -0.65, < 0.001). Alcohol-related problemswere more prevalent among the most stressed students (95% CI: 0.02 to 0.09, = 0.004) as well as eating problems (95% CI: 0.04 to 0.36, = 0.016) and problematic internet use (95% CI, 0.06 to 0.14, < 0.001). Students reporting the highest levels of stress also indicated more compulsive eating during the previous seven days (95% CI, 0.21 to 1.19, = 0.005). The level of stress was strongly related to four categories of variables: (i) intrinsic characteristics, (ii) addictive behaviors before lockdown, (iii) lockdown-specific conditions, and (iv) addictive behaviors during the lockdown. Several variables linked to COVID-19 were not directly linked with perceived stress, while perceived stress was found to correlate with daily life organization-related uncertainty and anticipated consequences of lockdown. Importantly, social support seems to be a protective factor on high level of stress.
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http://dx.doi.org/10.3389/fpsyt.2021.628631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900161PMC
February 2021

Gastrointestinal and eating problems in women with Ehlers-Danlos syndromes.

Eat Weight Disord 2021 Dec 13;26(8):2645-2656. Epub 2021 Feb 13.

Departament de Psicologia, Unitat d'Avaluació i Intervenció en Imatge Corporal, Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.

Purpose: Ehlers-Danlos syndromes (EDS) are a group of heritable conditions in which abnormal collagen synthesis leads 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. We aimed to compare GI symptoms, disordered eating, and body mass index (BMI) between EDS patients and healthy controls, and to explore the link between these variables in EDS patients.

Method: In this cross-sectional study, women with EDS and healthy controls responded to an online survey assessing GI symptoms (heartburn/regurgitations, early satiety, nausea/vomiting, bloating, abdominal pain, dysphagia), food allergies/intolerances, disordered eating, history of eating disorders (ED), and BMI. We performed intergroup comparisons as well as multivariate analyses to explore the associations between disordered eating, GI symptoms, and BMI in the EDS group.

Results: Sixty-six women with EDS and 39 healthy controls were included in the study. The EDS patients showed significantly more GI symptoms and food allergies/intolerances, increased prevalence of ED history, higher risk of current ED, and lower BMI than the controls. In the EDS group, the risk for ED was associated with GI symptoms; restricted eating was associated with GI symptoms, food allergies/intolerances, and dysphagia; uncontrolled eating was associated with GI symptoms; and BMI was associated with GI symptoms and food allergies/intolerances.

Discussion: Our results are concordant with that of previous reports highlighting the high level of GI problems and disordered eating in women with EDS. In addition, and for the first-time, the association between both is evidenced in this specific population.

Level Of Evidence Iii: Case-control analytic study.
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http://dx.doi.org/10.1007/s40519-021-01146-zDOI Listing
December 2021

Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer in the APHINITY Trial: 6 Years' Follow-Up.

J Clin Oncol 2021 05 4;39(13):1448-1457. Epub 2021 Feb 4.

Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.

Purpose: APHINITY, at 45 months median follow-up, showed that pertuzumab added to adjuvant trastuzumab and chemotherapy significantly improved invasive disease-free survival (IDFS) (hazard ratio 0.81 [95% CI, 0.66 to 1.00], = .045) for patients with early human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC), specifically those with node-positive or hormone receptor (HR)-negative disease. We now report the preplanned second interim overall survival (OS) and descriptive updated IDFS analysis with 74 months median follow-up.

Methods: After surgery and central HER2-positive confirmation, 4,805 patients with node-positive or high-risk node-negative BC were randomly assigned (1:1) to either 1-year pertuzumab or placebo added to standard adjuvant chemotherapy and 1-year trastuzumab.

Results: This interim OS analysis comparing pertuzumab versus placebo did not reach the = .0012 level required for statistical significance ( = .17, hazard ratio 0.85). Six-year OS were 95% versus 94% with 125 deaths (5.2%) versus 147 (6.1%), respectively. IDFS analysis based on 508 events (intent-to-treat population) showed a hazard ratio of 0.76 (95% CI, 0.64 to 0.91) and 6-year IDFS of 91% and 88% for pertuzumab and placebo groups, respectively. The node-positive cohort continues to derive clear IDFS benefit from pertuzumab (hazard ratio 0.72 [95% CI, 0.59 to 0.87]), 6-year IDFS being 88% and 83%, respectively. Benefit was not seen in the node-negative cohort. In a subset analysis, IDFS benefit from pertuzumab showed a hazard ratio of 0.73 (95% CI, 0.59 to 0.92) for HR-positive disease and a hazard ratio of 0.83 (95% CI, 0.63 to 1.10) for HR-negative disease. Primary cardiac events remain < 1% in both the treatment groups. No new safety signals were seen.

Conclusion: This analysis confirms the IDFS benefit from adding pertuzumab to standard adjuvant therapy for patients with node-positive HER2-positive early BC. Longer follow-up is needed to fully assess OS benefit.
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http://dx.doi.org/10.1200/JCO.20.01204DOI Listing
May 2021

Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer in the APHINITY Trial: 6 Years' Follow-Up.

J Clin Oncol 2021 05 4;39(13):1448-1457. Epub 2021 Feb 4.

Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.

Purpose: APHINITY, at 45 months median follow-up, showed that pertuzumab added to adjuvant trastuzumab and chemotherapy significantly improved invasive disease-free survival (IDFS) (hazard ratio 0.81 [95% CI, 0.66 to 1.00], = .045) for patients with early human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC), specifically those with node-positive or hormone receptor (HR)-negative disease. We now report the preplanned second interim overall survival (OS) and descriptive updated IDFS analysis with 74 months median follow-up.

Methods: After surgery and central HER2-positive confirmation, 4,805 patients with node-positive or high-risk node-negative BC were randomly assigned (1:1) to either 1-year pertuzumab or placebo added to standard adjuvant chemotherapy and 1-year trastuzumab.

Results: This interim OS analysis comparing pertuzumab versus placebo did not reach the = .0012 level required for statistical significance ( = .17, hazard ratio 0.85). Six-year OS were 95% versus 94% with 125 deaths (5.2%) versus 147 (6.1%), respectively. IDFS analysis based on 508 events (intent-to-treat population) showed a hazard ratio of 0.76 (95% CI, 0.64 to 0.91) and 6-year IDFS of 91% and 88% for pertuzumab and placebo groups, respectively. The node-positive cohort continues to derive clear IDFS benefit from pertuzumab (hazard ratio 0.72 [95% CI, 0.59 to 0.87]), 6-year IDFS being 88% and 83%, respectively. Benefit was not seen in the node-negative cohort. In a subset analysis, IDFS benefit from pertuzumab showed a hazard ratio of 0.73 (95% CI, 0.59 to 0.92) for HR-positive disease and a hazard ratio of 0.83 (95% CI, 0.63 to 1.10) for HR-negative disease. Primary cardiac events remain < 1% in both the treatment groups. No new safety signals were seen.

Conclusion: This analysis confirms the IDFS benefit from adding pertuzumab to standard adjuvant therapy for patients with node-positive HER2-positive early BC. Longer follow-up is needed to fully assess OS benefit.
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http://dx.doi.org/10.1200/JCO.20.01204DOI Listing
May 2021

The quantitative ultrasound method for assessing low bone mass in women with anorexia nervosa.

Arch Osteoporos 2021 01 14;16(1):13. Epub 2021 Jan 14.

Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, 34295, Montpellier, France.

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.

Purpose: The aim of this study was to investigate the potential role of an alternative technique, quantitative ultrasound (QUS), to assess low bone mass in patients with anorexia nervosa (AN).

Methods: Two hundred seven young women (134 patients with AN and 73 healthy controls) with ages ranging from 14.4 to 38.4 years participated in this observational cross-sectional study. Bone mass was concomitantly evaluated by DXA to determine areal bone mineral density (aBMD; g/cm) at hip, lumbar spine, and radius and by QUS to determine broadband ultrasound attenuation (BUA; dB/MHz) at the heel.

Results: BUA (66.5 ± 4.6 dB/MHz vs 61.0 ± 5.0 dB/MHz) and aBMD at the hip (0.916 ± 0.013 g/cm vs 0.806 ± 0.010 g/cm), lumbar spine (0.966 ± 0.012 g/cm vs 0.886 ± 0.010 g/cm), and radius (0.545 ± 0.005 g/cm vs 0.526 ± 0.04 g/cm) were significantly decreased (p < 0.01) in patients with AN compared with controls. When patient and control data were pooled, BUA was significantly correlated with aBMD at the hip (r = 0.60, p < 0.001), lumbar spine (r = 0.48, p < 0.001), and radius (r = 0.40, p<0.001). In patients with AN, BUA and aBMD were mainly and positively correlated with weight, lean tissue mass, body mass index (BMI), and minimal BMI life and negatively with the duration of both disease and amenorrhea. Better concordance between the two techniques was obtained when absolute BUA and aBMD values were used according to the WHO T score classification.

Conclusion: BUA measurement at the heel by QUS appears to be a pertinent nonionizing technique to assess low bone mass in patients with AN.
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http://dx.doi.org/10.1007/s11657-020-00870-wDOI Listing
January 2021

"Waste not and stay at home" evidence of decreased food waste during the COVID-19 pandemic from the U.S. and Italy.

Appetite 2021 05 9;160:105110. Epub 2021 Jan 9.

School of Psychology, Deakin University, Victoria, Australia.

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 predictors of food waste behavior, including avoidance of supermarkets, increased home cooking, and increased role of health concerns in food choices. A sample of n = 478 (79% female) individuals from the U.S., mean (SD) age = 30.51 (10.85), and n = 476 individuals from Italy, (78% female), mean (SD) age = 33.84 (12.86), completed an online survey between April 8th and April 28 2020. Just under half of respondents (49%) reported decreased food waste since the start of the pandemic. Rates were significantly higher among the U.S. sample (61.5%, n = 294) compared to the Italian sample (38%, n = 180). Controlling for the time since restrictions were introduced, age, gender, and perceived financial security, logistic regression revealed greater reduction in food waste since the beginning of the pandemic for U.S. individuals relative to participants from Italy (OR = 0.47, p < .001). In addition, increased importance of health concerns when making food choices (OR = 1.34, p < .005) as well as more frequent cooking (OR = 1.35, p < .001), and greater avoidance of supermarkets (OR = 1.15, p = .049) were associated with greater probability of less food waste. Scarcity and greater reliance on cooking may encourage individuals to reflect on food waste practices. Further research should explore how these factors may be targeted to reduce food waste beyond the pandemic.
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http://dx.doi.org/10.1016/j.appet.2021.105110DOI Listing
May 2021

Giant Slalom: Analysis of Course Setting, Steepness and Performance of Different Age Groups - A Pilot Study.

Front Sports Act Living 2020 26;2:107. Epub 2020 Aug 26.

Swiss Federal Institute of Sport Magglingen (SFISM), Magglingen, Switzerland.

Giant slalom is the core discipline of alpine skiing, and each race has its own specific course and terrain characteristics. These variations may explain differences in the speed and time per turn profiles, which are essential for performance development and injury prevention. This study aims to address the differences in course setting and steepness of the different course sections (flat-medium-steep) and compare them to the performance parameters among young (U12, U14, U16) and older (U18, U21, elite) male athletes. The study examined a total sample size of 57 male athletes; 7 from elite level, 11 from U21, 13 from U18, 6 from U16, 13 from U14, and 7 from U12. The athletes wore a portable global navigation satellite system (GNSS) sensor to extract performance parameters. The course profiles and gate positions of nine runs were measured with differential GNSS. The runs were divided into flat, medium and steep sections. From the performance parameters (speed, time per turn, etc.) and the course setting variables, the mean value per section was calculated and used for the further analysis. In total, 192 run sections from 88 runs were recorded and analyzed. Comparisons between course settings in young and older classes showed no significant differences. However, the turning angles and horizontal gate distances were smaller in flat sections. Average speed (49.77 vs. 65.33 km/h) and time per turn (1.74 vs. 1.41 s) differed significantly between young and U21/elite categories. In medium terrain sections U21 and elite athletes spent more time in the gliding phase compared to all other athletes. It seems to be a reasonable that, given similar course setting and steepness, speed increases concurrently with the technical and tactical skills of the athlete. Moreover, the finding that the elite athletes spent more time in the gliding phase could be crucial for understanding technique and performance development in young athletes.
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http://dx.doi.org/10.3389/fspor.2020.00107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739688PMC
August 2020

Psychological pain and depression: it's hard to speak when it hurts.

Int J Psychiatry Clin Pract 2021 Jun 4;25(2):180-186. Epub 2020 Dec 4.

Psychiatric Emergency and Post Emergency Department, Hospital Lapeyronie, CHU Montpellier, Montpellier, France.

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, and Verbal Fluency Test (semantic and phonemic verbal fluency). Univariate and multivariate analyses were performed to determine neuropsychological factors associated with a high level of psychological pain.

Results: The median level of psychological pain was 8/10. High level of psychological pain was associated with poor phonemic verbal fluency performance in men ( = 0.009), but not in women, even after controlling for confounding factors (age, level of depression, anxiety). Groups did not differ on the Trail Making Test, the Stroop test, or the semantic verbal fluency measure.

Conclusion: Psychological pain is a specific clinical entity that should be considered to be more significant than just a symptom of depression. High level of psychological pain appears to be associated with a deficit of phonemic verbal fluency in depressed men. This finding could help to target psychotherapeutic treatments and improve screening.Key pointsPatients with high psychological pain do not differ on the Trail Making Test, the Stroop Test or the Sematic Verbal Fluency Measure to patients with low psychological painHigh psychological pain is associated with a deficit in phonemic verbal fluency in depressed menFuture research should aim to clarify gender differences in psychological pain in participants with and without major depressive disorder, as well as explore the complex relationship between cognition and the different forms of pain (psychological, physical and psychosomatic).
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http://dx.doi.org/10.1080/13651501.2020.1836225DOI Listing
June 2021

Psychological pain and depression: it's hard to speak when it hurts.

Int J Psychiatry Clin Pract 2021 Jun 4;25(2):180-186. Epub 2020 Dec 4.

Psychiatric Emergency and Post Emergency Department, Hospital Lapeyronie, CHU Montpellier, Montpellier, France.

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, and Verbal Fluency Test (semantic and phonemic verbal fluency). Univariate and multivariate analyses were performed to determine neuropsychological factors associated with a high level of psychological pain.

Results: The median level of psychological pain was 8/10. High level of psychological pain was associated with poor phonemic verbal fluency performance in men ( = 0.009), but not in women, even after controlling for confounding factors (age, level of depression, anxiety). Groups did not differ on the Trail Making Test, the Stroop test, or the semantic verbal fluency measure.

Conclusion: Psychological pain is a specific clinical entity that should be considered to be more significant than just a symptom of depression. High level of psychological pain appears to be associated with a deficit of phonemic verbal fluency in depressed men. This finding could help to target psychotherapeutic treatments and improve screening.Key pointsPatients with high psychological pain do not differ on the Trail Making Test, the Stroop Test or the Sematic Verbal Fluency Measure to patients with low psychological painHigh psychological pain is associated with a deficit in phonemic verbal fluency in depressed menFuture research should aim to clarify gender differences in psychological pain in participants with and without major depressive disorder, as well as explore the complex relationship between cognition and the different forms of pain (psychological, physical and psychosomatic).
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http://dx.doi.org/10.1080/13651501.2020.1836225DOI Listing
June 2021

FOOD ADDICTION AS A PROXY FOR ANOREXIA NERVOSA SEVERITY: NEW DATA BASED ON THE YALE FOOD ADDICTION SCALE 2.0.

Psychiatry Res 2020 11 23;293:113472. Epub 2020 Sep 23.

Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France; Univ Lyon, CarMeN laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, F-69310 Pierre-Benite, France; Quebec Heart and Lung Institute (IUCPQ), Québec, QC G1V 4G5, Canada. School of Nutrition, Laval University, Québec, QC, G1V 0A6, Canada. Electronic address:

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 study in a sample of 73 patients with AN. We assessed FA with the Yale Food Addiction Scale 2.0, depressive and anxiety disorders, impulsivity (Beck Depression Inventory, STAI, BIS-11) and eating behavior (BITE, EDE-Q). Prevalence of FA in our sample was 47%. FA was significantly associated and positively correlated with the binge-eating/purging subtype of AN, higher levels of depression, anxiety and greater eating psychopathology. FA was not associated with level of impulsivity nor leptin and IGF-1 blood levels. The relationship between FA severity and AN severity was mediated by the severity of binge eating behaviors. Our results suggest that the presence of FA may represent a more severe variant of AN. Longitudinal studies are needed to better understand the etiologic process between FA and AN.
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http://dx.doi.org/10.1016/j.psychres.2020.113472DOI Listing
November 2020

The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study.

Nutrients 2020 Sep 28;12(10). Epub 2020 Sep 28.

PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France.

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 and management with mainly the Eating Disorder Inventory-2 (EDI-2), the Child Trauma Questionnaire (CTQ), and the Yale Food Addiction Scale (YFAS 2.0).

Results: Participants had a median age of 24 (interquartile range (IQR) 20-33) years and manifested anorexia nervosa (61.47%), bulimia nervosa (16.88%), binge-eating disorders (9.09%), and other types of ED (12.55%). They were grouped into those likely presenting FA ( = 154) and those without FA ( = 77). The group with FA reported higher scores on all five CTQ subscales, as well as the total score of the EDI-2 ( < 0.001). Using mediation analysis; significant indirect pathways between all CTQ subscales and the EDI-2 total score emerged via FA, with the largest indirect effect emerging for physical neglect (standardized effect = 0.208; 95% confidence interval (CI) 0.127-0.29) followed by emotional abuse (standardized effect = 0.183; 95% CI 0.109-0.262).

Conclusion: These results are compatible with a model in which certain types of childhood maltreatment, especially physical neglect, may induce, maintain, and/or exacerbate ED symptoms via FA which may guide future treatments.
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http://dx.doi.org/10.3390/nu12102969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601309PMC
September 2020

COVID-19 pandemic lockdown and problematic eating behaviors in a student population.

J Behav Addict 2020 Oct 24;9(3):826-835. Epub 2020 Sep 24.

13Université de Picardie Jules Verne, Unité INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Centre Universitaire de Recherche en Santé, 80025, Amiens, France.

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 population of French students during the first week of confinement.

Methods: A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days.

Results: Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder.

Discussion And Conclusion: The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable.
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http://dx.doi.org/10.1556/2006.2020.00053DOI Listing
October 2020

COVID-19 pandemic lockdown and problematic eating behaviors in a student population.

J Behav Addict 2020 Oct 24;9(3):826-835. Epub 2020 Sep 24.

13Université de Picardie Jules Verne, Unité INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Centre Universitaire de Recherche en Santé, 80025, Amiens, France.

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 population of French students during the first week of confinement.

Methods: A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days.

Results: Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder.

Discussion And Conclusion: The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable.
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http://dx.doi.org/10.1556/2006.2020.00053DOI Listing
October 2020

Brain Stimulation in Eating Disorders: State of the Art and Future Perspectives.

J Clin Med 2020 Jul 23;9(8). Epub 2020 Jul 23.

Neuropsychiatry: Epidemiological and Clinical Research, Université Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France.

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 (deep brain stimulation and vagal nerve stimulation) for ED management. This review summarizes the available evidence supporting the use of brain stimulation in ED. All published studies on brain stimulation in ED as well as ongoing trials registered at clinicaltrials.gov were examined. Articles on neuromodulation research and perspective articles were also included. This analysis indicates that brain stimulation in EDs is still in its infancy. Literature data consist mainly of case reports, cases series, open studies, and only a few randomized controlled trials. Consequently, the evidence supporting the use of brain stimulation in EDs remains weak. Finally, this review discusses future directions in this research domain (e.g., sites of modulation, how to enhance neuromodulation efficacy, personalized protocols).
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http://dx.doi.org/10.3390/jcm9082358DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465000PMC
July 2020

The impact of the COVID-19 pandemic on eating disorder risk and symptoms.

Int J Eat Disord 2020 Jul 1;53(7):1166-1170. Epub 2020 Jun 1.

Department of Psychiatric Emergency & Acute Care , Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.

The current COVID-19 pandemic has created a global context likely to increase eating disorder (ED) risk and symptoms, decrease factors that protect against EDs, and exacerbate barriers to care. Three pathways exist by which this pandemic may exacerbate ED risk. One, the disruptions to daily routines and constraints to outdoor activities may increase weight and shape concerns, and negatively impact eating, exercise, and sleeping patterns, which may in turn increase ED risk and symptoms. Relatedly, the pandemic and accompanying social restrictions may deprive individuals of social support and adaptive coping strategies, thereby potentially elevating ED risk and symptoms by removing protective factors. Two, increased exposure to ED-specific or anxiety-provoking media, as well as increased reliance on video conferencing, may increase ED risk and symptoms. Three, fears of contagion may increase ED symptoms specifically related to health concerns, or by the pursuit of restrictive diets focused on increasing immunity. In addition, elevated rates of stress and negative affect due to the pandemic and social isolation may also contribute to increasing risk. Evaluating and assessing these factors are key to better understanding the impact of the pandemic on ED risk and recovery and to inform resource dissemination and targets.
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http://dx.doi.org/10.1002/eat.23318DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300468PMC
July 2020

Decision-making in major depressive disorder: Subjective complaint, objective performance, and discrepancy between both.

J Affect Disord 2020 06 8;270:102-107. Epub 2020 Apr 8.

Département d'Urgence & Post Urgence Psychiatrique, Neuropsychiatrie: recherche épidémiologique et clinique, INSERM, Université Montpellier, CHU Montpellier, Montpellier, France.

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 between both in people with MDD. Secondly, we assessed the association between S-DMI and O-DMI. Finally, we explored sociodemographic, clinical, and psychosocial factors related to decision-making impairment status.

Method: One hundred and nine people with MDD were assessed with the Iowa Gambling Task to identify "O-DMI". The item 9 of the Beck Depression Inventory was used to compose the variable "S-DMI". Psychiatric history, medication adherence, childhood trauma, physical and psychological pain, and negative life experiences were also collected.

Results: Forty-six percent of participants have O-DMI and 65.1% S-DMI. From 49.5% showing a discrepancy between both, 68,6% have positive discrepancy and 31,4% negative (i.e. under and overestimation respectively). O-DMI and S-DMI were not associated. Binary logistic regressions showed that the number of negative life events in the past 6 months was predictor of O-DMI, while depression severity and medication adherence predicted S-DMI. Finally, medication adherence and depression severity predicted the type of discrepancy.

Limitations: The variable S-DMI was obtained through a single item.

Conclusion: These results confirm the lack of association between objective and subjective measures of cognition in MDD, and for the first-time concerning decision-making. This suggest that both assessments should be done in order to have a deeper knowledge of the cognitive functioning of each patient.
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http://dx.doi.org/10.1016/j.jad.2020.03.064DOI Listing
June 2020

Decision-making in major depressive disorder: Subjective complaint, objective performance, and discrepancy between both.

J Affect Disord 2020 06 8;270:102-107. Epub 2020 Apr 8.

Département d'Urgence & Post Urgence Psychiatrique, Neuropsychiatrie: recherche épidémiologique et clinique, INSERM, Université Montpellier, CHU Montpellier, Montpellier, France.

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 between both in people with MDD. Secondly, we assessed the association between S-DMI and O-DMI. Finally, we explored sociodemographic, clinical, and psychosocial factors related to decision-making impairment status.

Method: One hundred and nine people with MDD were assessed with the Iowa Gambling Task to identify "O-DMI". The item 9 of the Beck Depression Inventory was used to compose the variable "S-DMI". Psychiatric history, medication adherence, childhood trauma, physical and psychological pain, and negative life experiences were also collected.

Results: Forty-six percent of participants have O-DMI and 65.1% S-DMI. From 49.5% showing a discrepancy between both, 68,6% have positive discrepancy and 31,4% negative (i.e. under and overestimation respectively). O-DMI and S-DMI were not associated. Binary logistic regressions showed that the number of negative life events in the past 6 months was predictor of O-DMI, while depression severity and medication adherence predicted S-DMI. Finally, medication adherence and depression severity predicted the type of discrepancy.

Limitations: The variable S-DMI was obtained through a single item.

Conclusion: These results confirm the lack of association between objective and subjective measures of cognition in MDD, and for the first-time concerning decision-making. This suggest that both assessments should be done in order to have a deeper knowledge of the cognitive functioning of each patient.
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http://dx.doi.org/10.1016/j.jad.2020.03.064DOI Listing
June 2020

Is post-traumatic embitterment disorder a yet unknown comorbidity of anorexia nervosa?

Med Hypotheses 2020 Mar 10;140:109670. Epub 2020 Mar 10.

Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier & Inserm U1061, Université de Montpellier, Montpellier, France.

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, the traumatic event is perceived as unjust and the patient's response involves feelings of embitterment, rage, and helplessness along with repeated intrusive memories and a persistent negative change in mental well-being. Patients with AN share several psychopathological features with the clinical disturbed dimensions described in PTED. Accordingly, the comorbidity between PTED and AN needs further characterization. Moreover, specific therapeutic intervention known to improve symptoms of PTED such as cognitive-behavioral therapy based on wisdom psychology should be tested in selected patients with AN.
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http://dx.doi.org/10.1016/j.mehy.2020.109670DOI Listing
March 2020

Is post-traumatic embitterment disorder a yet unknown comorbidity of anorexia nervosa?

Med Hypotheses 2020 Mar 10;140:109670. Epub 2020 Mar 10.

Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier & Inserm U1061, Université de Montpellier, Montpellier, France.

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, the traumatic event is perceived as unjust and the patient's response involves feelings of embitterment, rage, and helplessness along with repeated intrusive memories and a persistent negative change in mental well-being. Patients with AN share several psychopathological features with the clinical disturbed dimensions described in PTED. Accordingly, the comorbidity between PTED and AN needs further characterization. Moreover, specific therapeutic intervention known to improve symptoms of PTED such as cognitive-behavioral therapy based on wisdom psychology should be tested in selected patients with AN.
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http://dx.doi.org/10.1016/j.mehy.2020.109670DOI Listing
March 2020
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