Radicalisation et « image de soi »

Europe and France are traversed by new forms of mobilization, individual or collective initiatives that find their expression in an exacerbated radicalism, forged and fed by the rejection of the republican pact. With economic crisis, young people are looking for an ideal. This phenomenon of radicalization feeds in particular societal and social changes of recent decades, such as the break-up of the family structure with the devaluation of parental authority. Also, radical Islamism offers them a “kit ready to think”. We report the role of “self-image” as a product of bodily sensations and emotions in the genesis of this phenomenon. Radical Islam can provide them a kind of “identity prosthesis” that will support the gap between self-representation and self-idealism.     

COVID-19 pandemic and mental health consequences: Systematic review of the current evidence

BackgroundDuring the COVID-19 pandemic general medical complications have received the most attention, whereas only few studies address the potential direct effect on mental health of SARS-CoV-2 and the neurotropic potential. Furthermore, the indirect effects of the pandemic on general mental health are of increasing concern, particularly since the SARS-CoV-1 epidemic (2002–2003) was associated with psychiatric complications.MethodsWe systematically searched the database Pubmed including studies measuring psychiatric symptoms or morbidities associated with COVID-19 among infected patients and among none infected groups the latter divided in psychiatric patients, health care workers and non-health care workers.ResultsA total of 43 studies were included. Out of these, only two studies evaluated patients with confirmed COVID-19 infection, whereas 41 evaluated the indirect effect of the pandemic (2 on patients with preexisting psychiatric disorders, 20 on medical health care workers, and 19 on the general public). 18 of the studies were case-control studies/compared to norm, while 25 of the studies had no control groups. The two studies investigating COVID-19 patients found a high level of post-traumatic stress symptoms (PTSS) (96.2%) and significantly higher level of depressive symptoms (p = 0.016). Patients with preexisting psychiatric disorders reported worsening of psychiatric symptoms. Studies investigating health care workers found increased depression/depressive symptoms, anxiety, psychological distress and poor sleep quality. Studies of the general public revealed lower psychological well-being and higher scores of anxiety and depression compared to before COVID-19, while no difference when comparing these symptoms in the initial phase of the outbreak to four weeks later. A variety of factors were associated with higher risk of psychiatric symptoms and/or low psychological well-being including female gender, poor-self-related health and relatives with COVID-19.ConclusionResearch evaluating the direct neuropsychiatric consequences and the indirect effects on mental health is highly needed to improve treatment, mental health care planning and for preventive measures during potential subsequent pandemics.     

Réflexion sur la péréquation financière de psychiatrie en France

For 25 years work has been underway in France for the implementation of an alternative to public financing of health care. In the absence of progress, some regional health agencies are engaged in work related to the reallocation of public finances between psychiatric institutions. We propose a reflection with suggestion on the method proposed by the Provence Alpes Côte d’Azur Regional Health Agency. Without questioning the need for a reallocation of resources between psychiatric institutions, the method proposed here needs to evolve further to be applied in a legitimate and appropriate manner. There is a kind of urgency for a reallocation of resources between psychiatric institutions in France, but it implies a collective thinking and especially the definition of evaluation procedures for the selected models. These conditions are necessary to guarantee the quality of French psychiatry and equity in access to psychiatric care.     

‘Chronophilia’: Entries of Erotic Age Preference into Descriptive Psychopathology

A scientific nomenclature of erotic age preferences informed the mid- through late nineteenth century joint appearance of homosexuality and sexual abuse of minors on the medico-legal scene. Yet, even in the twenty-first century, legal, psychiatric and culture-critical dimensions of related terms are rarely cleanly distinguished. Review of primary sources shows the ongoing Western suspension of notions of ‘sick desire’, alongside and beyond the medicalisation of homosexuality, between metaphor, legal interdiction and postulated psychopathology. Virtually all early attention to erotic age preference occurred in the context of emergent attention to erotic gender preference. Age of attraction and age difference centrally animate modern homosexuality’s pre-modern past; its earliest psychiatric nomenclature and typologies (1844–69); its early aetiologies stipulating degrees of sexual differentiation (1890s); its concomitant sub-classification (1896–1914); its earliest psychophysiological tests (1950s); and, finally, its post-psychiatric, social scientific typologies (1980s). Several identifications of ‘paedophilia’ were seen throughout the 1890s but as a trope it gained cultural momentum only during, and as a seemingly intriguing corollary of, the progressive depsychiatricisation of homosexuality across the Anglo-European world (late 1950s through 1980s). Early twentieth century sources varied in having it denote (1) a distinct perversion, thus possible ‘complication’ of sexual inversion (2) a discrete corollary of psychosexual differentiation akin to gender preference (3) a distinct subtype of fetishism, thus a likely imprint of early seduction (4) a more intricate expression of erotic symbolism or psychosexual complex or (5) a taste answering to culture, a lack of it, or a libertine disregard for it.     

The Covid-19 infection: An opportunity to develop systematic vitamin D supplementation in psychiatry

Psychiatric patients are at risk of hypovitaminosis D and Covid-19-related mortality. In addition to the mental health benefits, vitamin D supplementation may be potentially effective in preventing severe forms of Covid-19 infections. Vitamin D supplementation is not necessary and is not reimbursed in France for this indication. A monthly supplementation of 50,000 IU may be sufficient in most cases. Double the dose is recommended for obese patients. The risk of renal lithiasis is not increased at these doses, even when supplemented in a patient without vitamin D deficiency. The Covid-19 crisis is an opportunity to disseminate vitamin D supplementation in psychiatric patients, as it has been shown to be effective in other respiratory diseases such as mild upper respiratory tract infections and influenza.