OBJECTIVES (1) To translate and validate the Epilepsy Anxiety Survey Instrument (EASI) in French ... more OBJECTIVES (1) To translate and validate the Epilepsy Anxiety Survey Instrument (EASI) in French people with epilepsy (PWE); (2) to further investigate the screening properties of each dimension of the EASI in terms of Diagnostic and Statistical Manual of Mental Disorders (DSM) anxiety disorders and of epilepsy-specific anxiety disorders, namely, anticipatory anxiety of seizures (AAS) and epileptic social phobia. METHODS Following back-translation, the French EASI was tested in PWE > 18 years using the Mini-International Neuropsychiatric Interview (MINI) as gold standard for DSM anxiety disorders. We added 3 original questions to explore epilepsy-specific anxiety symptoms. The Generalized Anxiety Disorders-7 (GAD-7), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and Adverse Events Profile were performed for external validity. Receiver operator characteristics (ROC) were analyzed. RESULTS One hundred and forty nine native French speakers with epilepsy were included. Concerning DSM disorders, around 25% had GAD, 18% Agoraphobia, and <10% Social Phobia or Panic Disorder. Concerning possible epilepsy-specific anxiety disorder, 35% had AAS and 38% had epileptic social phobia. Bi-dimensional structure of the EASI was confirmed. Internal and external validity was satisfactory. ROC analysis showed AUC of 0.83 for detection of GAD and AUC 0.79 for other DSM anxiety disorders. ROC analysis of the 8-item French brEASI showed good performance for detection of GAD (AUC 0.83) and other DSM anxiety disorders (AUC 0.76) but not for epilepsy-specific anxiety symptoms (AUC 0.63). Conversely, dimension 2 of the French EASI (=10 items) allowed good detection of epilepsy-specific anxiety symptoms (AUC 0.78); cutoff > 4, sensitivity 82.4, specificity 66.7. CONCLUSION Epilepsy-specific anxiety symptoms were prevalent, in around 60%. The French version of the EASI showed robust performance. The French 8-item brEASI allows screening for all DSM anxiety disorders with superior performance than the GAD-7, but is less suited to screening for epilepsy-specific anxiety. We propose the "Epilepsy-Specific Anxiety" (ESA) 10-item screening instrument, based on dimension 2 of the EASI, as a complementary clinical and research tool.
Objective: The inability to filter sensory input correctly may impair higher cognitive function i... more Objective: The inability to filter sensory input correctly may impair higher cognitive function in ADHD. However, this relationship remains largely elusive. The objectives of the present study is to investigate the relationship between sensory input processing and cognitive function in adult patients with ADHD. Method: This study investigated the relationship between deficit in sensory gating capacity (P50 amplitude changes in a double-click conditioning-testing paradigm and perceptual abnormalities related to sensory gating deficit with the Sensory Gating Inventory [SGI]) and attentional and executive function (P300 amplitude in an oddball paradigm and attentional and executive performances with a neuropsychological test) in 24 adult patients with ADHD. Results: The lower the sensory gating capacity of the brain and the higher the distractibility related to sensory gating inability that the patients reported, the lower the P300 amplitude. Conclusion: The capacity of the brain to ga...
During the past ten years, research on schizophrenia has witnessed a clear emphasis on studies ba... more During the past ten years, research on schizophrenia has witnessed a clear emphasis on studies based on negative symptoms. This interest can be explained in terms of diagnosis, specific treatment, functional prognosis and outcome issues. However, main current approaches consider negative symptoms from an operationalist view, which implies objective and atheoretical descriptions of clinical criteria, observed from a third person perspective. And the understanding of negative symptoms in schizophrenia, still a crucial issue of mental health, remains only partial. From a different perspective, psychopathology - and notably psychiatric phenomenology -, can provide a conceptual and clinical framework, taking into account subjective experience (first person perspective), based on a global understanding of the clinical situation lived by patients with schizophrenia. In the present review, we give a brief survey on the historical aspects of the description of negative symptoms. Then, we introduce the clinical contributions raised by clinical phenomenology. We principally develop Minkowski's notion of loss of vital contact, and Blankenburg's notion of loss of natural evidence. Then we highlight the current debates which are discussed and explored in contemporary psychopathology. In conclusion, we discuss the possible articulation between objective and subjective approaches, in order to better understand pauci-symptomatic forms of schizophrenia.
Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurop... more Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurophysiology. In this short review, we present the ERP’s theorical framework, the different recording methods, and the signification of these ERP’s; P50 with gating, P300, N400, P600 and contingent negative variation. We emphasize the ERP’s chronometry, the reaction times, and late positive components. At last, we propose cognitive neurophysiological profile based on the variables obtained in the various ERP’s.
Mild traumatic brain injury (MTBI) constitutes a public health problem with major socioeconomic c... more Mild traumatic brain injury (MTBI) constitutes a public health problem with major socioeconomic consequences (Maas, Stocchetti, & Bullock, 2008). The notion of post-concussion syndrome (PCS) following MTBI is now a well-described (Borg et al., 2004) and extensively discussed concept (Rees, 2003; Wood, 2007). However, current standard imaging (mainly MRI) techniques rarely reveal abnormalities, and the consequences of diffuse axonal damage are difficult to document. For these reasons, PCS is often considered to be either psychogenic in origin (Whittaker, Kemp, & House, 2007)ora fallacious pretext for financial compensation. However, it is clear that new MR imaging methods such as MRI diffusion anisotropy (Belanger, Vanderploeg, Curtiss, & Warden, 2007; Maller et al., 2010) and magnetic resonance spectroscopy (MRS; Garnett et al., 2000; Govindaraju et al., 2004) can reveal structural and metabolic white matter abnormalities in connection with post-concussion symptoms, including depression (Maller et al., 2010). A significant proportion (5-7%) of patients with MTBI present a later cognitive decline (Hammond et al., 2004). Recent studies conducted on 2525 U.S. soldiers exposed to blasts and who suffered MTBI clearly reveal the neurological correlates of PCS and indicate that PCS is closely associated with loss of consciousness during the trauma (Hoge et al., 2008). The link between cognitive deficits related to PCS and impairment of brain connectivity, particularly in frontal regions, has been recently demonstrated (Sponheim et al., 2011).Apart from a few music-related pathologies (congenital amusia, musicogenic epileptic seizures), few studies have reported abnorCeline malities of listening to or producing music in neurological and psychiatric pathologies (Vion-Dury & Besson, 2010). However, throughout human history, billions of human beings have created and listened to sound patterns and sequences that do not carry any denotative meaning (Sacks, 2008). In this respect, Andrade and Bhattacharya (2003) proposed that the brain is tuned to music. Although many studies emphasize the value of music therapy in patients with various neurological and psychiatric diseases, the scientific literature exploring changes in the quality of music listening is sparse. Sacks presented many clinical examples related to this issue (Sacks, 2008), but only a few examples of any given pathology are available to the best of our knowledge.The current study stems from a clinical observation: during individual interviews prior to neurophysiological assessment of PCS following an MTBI, several patients reported an experience of time disruption, with alterations of their capacity to evaluate durations and the feeling of being disoriented in time. This led us to question them about changes in their music listening habits because music can be regarded as an "art of time" (Emery, 2000); thus, its appreciation requires precise processing of temporal structures at different time scales (Accaoui, 2001). Following the question "Has your way of listening to music changed since your brain trauma?", patients remained silent for several seconds. Then, they reported being aware that their music listening habits had changed. However, they were unable to accurately describe this modification. This recurrent clinical observation gave rise to this study, the aim of which was to assess musicrelated changes in patients suffering from MTBI, by combining both objective and subjective data experienced in the "firstperson," according to the neurophenomenological approach (Vion-Dury, 2007; Vion-Dury et al., 2011) and by analyzing if these music-related changes are correlated to any abnormality in imaging, neuropsychological, or neurophysiologic evaluation.MethodSubjectsThis study took place during a global assessment of the PCS diagnosis in MTBI patients, as organized by the Groupe d'Etudes des Professionnels Alpes-Mediterranee sur les Traumatismes Crâniens (GREPAM-TC), from October 2008 to June 2009 (Soriat-Barriere, Tcherniack, & Vion-Dury, 2011). …
Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurop... more Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurophysiology. In this short review, we present the ERP’s theorical framework, the different recording methods, and the signification of these ERP’s; P50 with gating, P300, N400, P600 and contingent negative variation. We emphasize the ERP’s chronometry, the reaction times, and late positive components. At last, we propose cognitive neurophysiological profile based on the variables obtained in the various ERP’s.
The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe h... more The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe here two cases who were initially misdiagnosed. The first case concerned a 61 year-old woman, who was initially diagnosed as an isolated dissociative fugue and was actually suffering from severe major depressive episode. The second case concerned a 55 year-old man, who was suffering from type I bipolar disorder and polyvascular disease, and was initially diagnosed as dissociative fugue in a mooddestabilization context, while it was finally a stroke. Yet dissociative disorders as affective disorder comorbidity are relatively unknown. We made a review on this topic. Dissociative disorders are often studied through psycho-trauma issues. Litterature is rare on affective illness comorbid with dissociative disorders, but highlight the link between bipolar and dissociative disorders. The later comorbidity often refers to an early onset subtype with also comorbid panic and depersonalization-derealization disorder. Besides, unipolar patients suffering from dissociative symptoms have more often cyclothymic affective temperament. Despite the limits of such studies dissociative symptoms-BD association seems to correspond to a clinical reality and further works on this topic may be warranted.
OBJECTIVES (1) To translate and validate the Epilepsy Anxiety Survey Instrument (EASI) in French ... more OBJECTIVES (1) To translate and validate the Epilepsy Anxiety Survey Instrument (EASI) in French people with epilepsy (PWE); (2) to further investigate the screening properties of each dimension of the EASI in terms of Diagnostic and Statistical Manual of Mental Disorders (DSM) anxiety disorders and of epilepsy-specific anxiety disorders, namely, anticipatory anxiety of seizures (AAS) and epileptic social phobia. METHODS Following back-translation, the French EASI was tested in PWE > 18 years using the Mini-International Neuropsychiatric Interview (MINI) as gold standard for DSM anxiety disorders. We added 3 original questions to explore epilepsy-specific anxiety symptoms. The Generalized Anxiety Disorders-7 (GAD-7), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and Adverse Events Profile were performed for external validity. Receiver operator characteristics (ROC) were analyzed. RESULTS One hundred and forty nine native French speakers with epilepsy were included. Concerning DSM disorders, around 25% had GAD, 18% Agoraphobia, and <10% Social Phobia or Panic Disorder. Concerning possible epilepsy-specific anxiety disorder, 35% had AAS and 38% had epileptic social phobia. Bi-dimensional structure of the EASI was confirmed. Internal and external validity was satisfactory. ROC analysis showed AUC of 0.83 for detection of GAD and AUC 0.79 for other DSM anxiety disorders. ROC analysis of the 8-item French brEASI showed good performance for detection of GAD (AUC 0.83) and other DSM anxiety disorders (AUC 0.76) but not for epilepsy-specific anxiety symptoms (AUC 0.63). Conversely, dimension 2 of the French EASI (=10 items) allowed good detection of epilepsy-specific anxiety symptoms (AUC 0.78); cutoff > 4, sensitivity 82.4, specificity 66.7. CONCLUSION Epilepsy-specific anxiety symptoms were prevalent, in around 60%. The French version of the EASI showed robust performance. The French 8-item brEASI allows screening for all DSM anxiety disorders with superior performance than the GAD-7, but is less suited to screening for epilepsy-specific anxiety. We propose the "Epilepsy-Specific Anxiety" (ESA) 10-item screening instrument, based on dimension 2 of the EASI, as a complementary clinical and research tool.
Objective: The inability to filter sensory input correctly may impair higher cognitive function i... more Objective: The inability to filter sensory input correctly may impair higher cognitive function in ADHD. However, this relationship remains largely elusive. The objectives of the present study is to investigate the relationship between sensory input processing and cognitive function in adult patients with ADHD. Method: This study investigated the relationship between deficit in sensory gating capacity (P50 amplitude changes in a double-click conditioning-testing paradigm and perceptual abnormalities related to sensory gating deficit with the Sensory Gating Inventory [SGI]) and attentional and executive function (P300 amplitude in an oddball paradigm and attentional and executive performances with a neuropsychological test) in 24 adult patients with ADHD. Results: The lower the sensory gating capacity of the brain and the higher the distractibility related to sensory gating inability that the patients reported, the lower the P300 amplitude. Conclusion: The capacity of the brain to ga...
During the past ten years, research on schizophrenia has witnessed a clear emphasis on studies ba... more During the past ten years, research on schizophrenia has witnessed a clear emphasis on studies based on negative symptoms. This interest can be explained in terms of diagnosis, specific treatment, functional prognosis and outcome issues. However, main current approaches consider negative symptoms from an operationalist view, which implies objective and atheoretical descriptions of clinical criteria, observed from a third person perspective. And the understanding of negative symptoms in schizophrenia, still a crucial issue of mental health, remains only partial. From a different perspective, psychopathology - and notably psychiatric phenomenology -, can provide a conceptual and clinical framework, taking into account subjective experience (first person perspective), based on a global understanding of the clinical situation lived by patients with schizophrenia. In the present review, we give a brief survey on the historical aspects of the description of negative symptoms. Then, we introduce the clinical contributions raised by clinical phenomenology. We principally develop Minkowski's notion of loss of vital contact, and Blankenburg's notion of loss of natural evidence. Then we highlight the current debates which are discussed and explored in contemporary psychopathology. In conclusion, we discuss the possible articulation between objective and subjective approaches, in order to better understand pauci-symptomatic forms of schizophrenia.
Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurop... more Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurophysiology. In this short review, we present the ERP’s theorical framework, the different recording methods, and the signification of these ERP’s; P50 with gating, P300, N400, P600 and contingent negative variation. We emphasize the ERP’s chronometry, the reaction times, and late positive components. At last, we propose cognitive neurophysiological profile based on the variables obtained in the various ERP’s.
Mild traumatic brain injury (MTBI) constitutes a public health problem with major socioeconomic c... more Mild traumatic brain injury (MTBI) constitutes a public health problem with major socioeconomic consequences (Maas, Stocchetti, & Bullock, 2008). The notion of post-concussion syndrome (PCS) following MTBI is now a well-described (Borg et al., 2004) and extensively discussed concept (Rees, 2003; Wood, 2007). However, current standard imaging (mainly MRI) techniques rarely reveal abnormalities, and the consequences of diffuse axonal damage are difficult to document. For these reasons, PCS is often considered to be either psychogenic in origin (Whittaker, Kemp, & House, 2007)ora fallacious pretext for financial compensation. However, it is clear that new MR imaging methods such as MRI diffusion anisotropy (Belanger, Vanderploeg, Curtiss, & Warden, 2007; Maller et al., 2010) and magnetic resonance spectroscopy (MRS; Garnett et al., 2000; Govindaraju et al., 2004) can reveal structural and metabolic white matter abnormalities in connection with post-concussion symptoms, including depression (Maller et al., 2010). A significant proportion (5-7%) of patients with MTBI present a later cognitive decline (Hammond et al., 2004). Recent studies conducted on 2525 U.S. soldiers exposed to blasts and who suffered MTBI clearly reveal the neurological correlates of PCS and indicate that PCS is closely associated with loss of consciousness during the trauma (Hoge et al., 2008). The link between cognitive deficits related to PCS and impairment of brain connectivity, particularly in frontal regions, has been recently demonstrated (Sponheim et al., 2011).Apart from a few music-related pathologies (congenital amusia, musicogenic epileptic seizures), few studies have reported abnorCeline malities of listening to or producing music in neurological and psychiatric pathologies (Vion-Dury & Besson, 2010). However, throughout human history, billions of human beings have created and listened to sound patterns and sequences that do not carry any denotative meaning (Sacks, 2008). In this respect, Andrade and Bhattacharya (2003) proposed that the brain is tuned to music. Although many studies emphasize the value of music therapy in patients with various neurological and psychiatric diseases, the scientific literature exploring changes in the quality of music listening is sparse. Sacks presented many clinical examples related to this issue (Sacks, 2008), but only a few examples of any given pathology are available to the best of our knowledge.The current study stems from a clinical observation: during individual interviews prior to neurophysiological assessment of PCS following an MTBI, several patients reported an experience of time disruption, with alterations of their capacity to evaluate durations and the feeling of being disoriented in time. This led us to question them about changes in their music listening habits because music can be regarded as an "art of time" (Emery, 2000); thus, its appreciation requires precise processing of temporal structures at different time scales (Accaoui, 2001). Following the question "Has your way of listening to music changed since your brain trauma?", patients remained silent for several seconds. Then, they reported being aware that their music listening habits had changed. However, they were unable to accurately describe this modification. This recurrent clinical observation gave rise to this study, the aim of which was to assess musicrelated changes in patients suffering from MTBI, by combining both objective and subjective data experienced in the "firstperson," according to the neurophenomenological approach (Vion-Dury, 2007; Vion-Dury et al., 2011) and by analyzing if these music-related changes are correlated to any abnormality in imaging, neuropsychological, or neurophysiologic evaluation.MethodSubjectsThis study took place during a global assessment of the PCS diagnosis in MTBI patients, as organized by the Groupe d'Etudes des Professionnels Alpes-Mediterranee sur les Traumatismes Crâniens (GREPAM-TC), from October 2008 to June 2009 (Soriat-Barriere, Tcherniack, & Vion-Dury, 2011). …
Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurop... more Event related potentials (ERP’s) constitute a large research field in psychiatry, based on neurophysiology. In this short review, we present the ERP’s theorical framework, the different recording methods, and the signification of these ERP’s; P50 with gating, P300, N400, P600 and contingent negative variation. We emphasize the ERP’s chronometry, the reaction times, and late positive components. At last, we propose cognitive neurophysiological profile based on the variables obtained in the various ERP’s.
The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe h... more The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe here two cases who were initially misdiagnosed. The first case concerned a 61 year-old woman, who was initially diagnosed as an isolated dissociative fugue and was actually suffering from severe major depressive episode. The second case concerned a 55 year-old man, who was suffering from type I bipolar disorder and polyvascular disease, and was initially diagnosed as dissociative fugue in a mooddestabilization context, while it was finally a stroke. Yet dissociative disorders as affective disorder comorbidity are relatively unknown. We made a review on this topic. Dissociative disorders are often studied through psycho-trauma issues. Litterature is rare on affective illness comorbid with dissociative disorders, but highlight the link between bipolar and dissociative disorders. The later comorbidity often refers to an early onset subtype with also comorbid panic and depersonalization-derealization disorder. Besides, unipolar patients suffering from dissociative symptoms have more often cyclothymic affective temperament. Despite the limits of such studies dissociative symptoms-BD association seems to correspond to a clinical reality and further works on this topic may be warranted.
Uploads