Dépression et anxiété chez les patients atteints d’hémopathies malignes : prévalence et facteurs associés

BackgroundAnxiety and depression in cancer patients are associated with impaired well-being and overall quality of life.ObjectivesTo study the prevalence of depression and anxiety in patients with hematological cancer, and to assess the relationship between various demographic, behavioral and clinical factors and anxiety and depression among hematological cancer patients.MethodsThis cross-sectional study recruited 159 diagnosed hematological cancer patients and 182 participants without cancer (control group) in the University hospital center Ibn Rochd of Casablanca, Morocco. Study participants fulfilled the Hospital anxiety and depression scale (HADS) and demographic and cancer characteristics.ResultsThe mean age of hematological cancer patients was 43.9 years (SD = 13.8 years), while the mean age of the control group was 45.3 years (SD = 15.4 years). Using a cut-off score of 8 on HADS, anxiety and depression were found in 78.6% of hematological cancer patients against only 35.1% in control group. Logistic regression analysis revealed that anxiety and depression were associated with age under 40 years.ConclusionHematological cancer patients are in high risk to develop depression and anxiety. An age less than 40 years can be a predicting factor related with depression and anxiety in hematological cancer patients.     

Vie affective,désir d’enfant et parentalité chez les personnes avec schizophrénie

While many people with schizophrenia consider intimate relationships and parenting as central parts of their lives deeply affecting well-being and recovery, others report multiple challenges in these domains (e.g. stigma, social isolation, low self-esteem, emotional dysregulation, sexual dysfunctions, separation/divorce and domestic violence, low treatment adherence, perinatal complications, parenting difficulties, alteration of the quality of early parent-infant interactions, interruptions to the parenting role and custody loss). However, these domains are often overlooked in routine clinical practice and in psychiatric rehabilitation. It is therefore crucial to discuss these topics more systematically (e.g., desire to become involved in a relationship or to become a parent, representation of self as a prospective partner, parent or future parent, sexual dysfunctions, family planning) to improve patients’ outcome, well-being, and quality of life. In addition to the existing service provision, this paper presents discussions of individual and group-based psychiatric rehabilitation interventions (e.g., informed decision-making and shared-risk taking, group cognitive behavior therapy, metacognitively oriented psychoeducation) that were developed to improve outcomes for patients, infants, and relatives.     

L’anxiété envers la santé : définition et intérêt clinique d’un concept novateur et heuristique

Worrying about health and diseases is a mostly circumstantial, moderate and transient concern. But, health worries can heat up to become excessive, persistent and pathological, despite some attempts to cope with it (reassurance seeking, bodily checking, avoidance of illness situations). Between ordinary health concerns and hypochondriasis, clinical slight differences should be identified. Although they are not described in international classifications, they cause psychological distress and/or health-related risk-taking. Still little known and used in France, the concept of health anxiety emphasizes this clinical diversity. This literature review aims to specify this concept in describing the nature of cognitive and behavioral factors that initiate, reinforce and perpetuate anxiogenic process, but also emphasizes the clinical relevance of the concept of health anxiety.     

Effets de l’approche de réduction du stress Mindfulness Based Stress Reduction (MBSR) sur la santé psychique (stress,anxiété, dépression) et le mode de coping chez des patients diabétiques : une étude pilote contrôlée et randomisée

The Mindfulness Based Stress Reduction (MBSR) therapeutic approach, based on a form of mindfulness, is part of the third wave of behavioral and cognitive therapies and has resulted in numerous research studies. Research in France on this psychotherapeutic approach is mainly focused on treating chronic diseases, pain and stress in the workplace. This study aims to test the impact of this therapeutic approach on psychic health (stress, anxiety, depression and coping modes) among a type 1 diabetic population with the goal of increasing their capacity to combat stress. The following hypotheses were made: treatment based on the MBSR approach should contribute to a reduction in the mean scores of stress, anxiety and depression. On the contrary, we assume that treatment based on MBSR should lead patients to resort to more effective adjustment strategies and to reduce the use of aversive strategies such as blame. In this protocol, the patient's level of stress (PSS), anxiety and depression (HAD), and use of coping strategies (Brief cop) are evaluated at three different moments. A pretest was done for the two groups (groups A and B) and a second evaluation was carried out after group A benefited from a mindfulness training that group B had not yet received. The technique of the waiting list was chosen for the second evaluation since the measure was taken after group B benefited from the same mindfulness training as group A. Seventeen subjects agreed to participate in this study (10 subjects in group A and seven subjects in group B). The inclusion criteria were: the subjects had to accept the framework of the research for a determined period, had to have a pathology of type 1 diabetes for at least 10 years, and not suffer from major psychological troubles. They were also required to give their fully informed consent concerning the objectives of the study and to adhere to the principle of the treatment. The patients with multiple physical pathologies in addition to type 1 diabetes, as well as the patients who had already followed a psychotherapeutic treatment whose aim was similar to that of this study, were excluded. In addition, after the MBSR training, the patients were asked to do exercises at home, and those who did not comply with this request were also excluded from the study. The results show a positive effect of MBSR on some of the indicators (perceived stress, anxiety and copy modes). A significant statistical decrease in the score for perceived stress on the PSS scale was observed before and after mindfulness training. Likewise, a significant drop in the scores for anxiety on the HAD scale was observed. Moreover, the participants show an increased use of coping strategies such as active coping, planning, positive reinterpretation, expression of feelings, and acceptance. In the same vein, the results show a significant decrease in the use of blame and denial. This study suggests orientations concerning the potential efficacy of the MBSR approach on patients’ psychic health by activating their potential and resources to confront and combat their disease. MBSR proves to be a pertinent tool for managing stress in a diabetic population and for increasing patients’ autonomy in the combat against this disease. In view of the stakes involved in this disease, this study should be replicated in order to verify the interest of this approach.     

Effets de la ventilation en pression positive continue sur la dépression,l’anxiété et la qualité de vie au cours du syndrome des apnées-hypopnées obstructives du sommeil

IntroductionThe obstructive sleep apnea hypopnea syndrome (OSAHS) is a chronic stressor that may alter the emotional state and quality of life (QOL) of patients suffering from it. In this work, we proposed to estimate the prevalence of depression and anxiety, to assess the QOL in a Tunisian population of apneic patients, and to assess their evolution under continuous positive airway pressure (CPAP).MethodsWe conducted a prospective study, involving 33 apneic patients followed for SAHOS with moderate or severe class disease in the pneumology department at Hedi Chaker university hospital in Sfax, Tunisia. They received CPAP treatment for three months. We used an epidemiological record. Two scales, the Hospital Anxiety and Depression Scale (HADS) and the 36-item Short-Form Health Survey (SF-36), were completed before and after treatment to evaluate the effect of three months of treatment with CPAP.ResultsThe prevalence of depression in the study's patients, according to the HADS, was 45.5% and that of anxiety was 21.2%. After 3 months of CPAP, the prevalence of depression and anxiety had become 18.2% and 6.1%, respectively. QOL was impaired in 81.8% of cases before treatment, according to the SF-36. This figure had decreased to 69.7% after 3 months of treatment with CPAP. Apart from the third dimension (physical pain), all other dimensions were significantly improved after 3 months of CPAP treatment. The treatment with CPAP induced a significant improvement in the average scores of depression (P < 0.001), anxiety (P = 0.002) and QOL (P < 0.001).ConclusionsThese results attest to the importance of the frequency of anxio-depressive disorders as well as an altered QOL in patients with OSAHS. CPAP treatment was shown to be effective in improving these parameters, but this efficacy was partial. Specialized care may be needed in cases of residual anxio-depressive symptoms.     

Stress post-traumatique et liens d’attachement chez l’enfant atteint du cancer : revue de littérature

Introduction

Many studies show that the announcement of a chronic disease such as childhood cancer is often seen as a test for the child and his entourage. The child, unarmed meet this sudden threat of death, will have to face immediate changes, but later too, after the remission. The objective of this study is to see if there is development of post-traumatic stress disorder and post-traumatic stress symptoms in children suffering from cancer since the diagnosis is made, and whether modifications of the attachment links to relatives, especially the mother, will operate.

Soutien social,dépression et estime de soi chez les personnes âgées : les résultats d’une analyse en cluster

ObjectiveThis study investigated the relation in later life between social support and different mental health variables: depression and self-esteem. Social support was considered according to Cutrona and Russell's approach, which includes six dimensions: attachment, social integration, reassurance of worth, reliable alliance, guidance, and opportunity for nurturance. Several authors attributed to social support a major protective role in mental health. In fact, different links between social support and mental health variables were found in adulthood. More and more studies deal with social support in later life. In particular, the protective role of social support in stressful live events and its relation to mental health or illness have been examined. The objective of this study was to clarify the links between social support, depression and self-esteem in later life, with an alternative statistical method.MethodA cluster analysis was performed in order to group together older persons on the basis of their social support level. Ninety-three French older people living in their home were recruited, with a mean age of 70.72 (SD: 7.06). The social support was assessed with Caron’ social support scale (The Social Provision Scale) which measures the six functions of social relationships. Depression and self-esteem were evaluated respectively with the Center for Epidemiologic Studies Depression Scale (CES-D) and the Rosenberg Self-Esteem Scale. Cluster analysis was chosen because it allows to bound natural groupings within data and to determine homogeneous groups inside the sample of the study. Then, ANOVA were performed in order to compare these groups as for their depression and self-esteem scores.ResultsFirst, results revealed three social support profiles or groups: High social support level, Moderate social support level and Low social support level. Group with high social support level presents high level for all dimensions of social support: attachment, social integration, reassurance of worth, reliable alliance, guidance, and opportunity for nurturance. In addition, groups with moderate and low levels of social support are characterized respectively by moderate and low levels for all dimensions of social support. Second, different relationships of these profiles with depression and self-esteem were found. The older persons with high level of social support present a low depression level associated high self-esteem. Moreover, participants with moderate or low social support profile present high depression and low self-esteem levels.ConclusionThe relationship between social support and mental health was brought to light. The clinical implications and possible interventions are discussed. In particular, different methodological and conceptual approaches of social support interventions are evoked, such as interventions, which include family, friends or peers.     

Traits de personnalité, insertion socio-professionnelle et employabilité chez les jeunes en mesure d’insertion

Inactive young adults (neither employed nor in training) are at risk of long lasting precariousness and bad health.

Image du corps,dépression et anxiété des patients atteints d’un cancer du rectum avec stomie temporaire : une étude exploratoire longitudinale

Objectives

In 2012, rectal cancer represented 30 % of colorectal cancers. In the case of cancer, three treatments are available, alone or associated: radiotherapy, chemotherapy and surgery. The main treatment for rectal cancer is surgery and more particularly rectal resection. The most important complication of this surgery is fistula. To reduce the risk, surgeons put a temporary stoma who can have repercussions like psychological difficulties, alteration of body image for example. The aims of this research were to explore the evolution of body satisfaction, anxiety and depression in the surgical treatment and study the associations between these variables.

Anxiété et dépression associées à la prise en charge de la COVID-19 chez les personnels de santé au Cameroun

ObjectiveThe COVID-19 pandemic has had a significant impact worldwide, at different levels. The literature consulted indicates that healthcare workers, who are the first to respond, are generally the ones who pay the highest price. The present study assesses the extent of anxious and depressive symptoms among these actors responding to COVID-19, in the context of Cameroon.MethodThe Hospital Anxiety and Depression Scale (HADS) was used to assess anxious and depressive symptoms. Data collection involved the use of a web questionnaire for this purpose through the Google Forms virtual platform. The questionnaire link was sent to professional groups spread throughout Cameroon's ten regions. A total of 331 health professionals were interviewed over the period from April 5 to 19, 2020.ResultThe results show a high rate of anxiety (41.8%) and depression (42.8%). There is a higher susceptibility to depression in young people (30-39 years). Fear of contamination and fear of death are modulators of depression and anxiety. The anxiety-depression comorbidity in the sample is 14.73%. The prevalence rates of major depressive disorder and adjustment disorder in the sample were 8.2% and 3.3%, respectively. The data presented confirm the trends recorded in the literature regarding the impact of fatal epidemics on the mental health of healthcare workers.DiscussionThe results indicate, as is the case with most of the work consulted in the literature, that the Covid 19 pandemic is significantly affecting the mental health of healthcare workers. This underlines the urgency of setting up a specialized aid and/or support system, in the context of the current pandemic, such as that of similar health crises. Such a device does not exist in Cameroon, where the mental health response remains weak.ConclusionThese results suggest that the healthcare staff involved in the response to COVID-19 in Cameroon are significantly affected in their mental health. This underlines the need for specialized psychological help for nursing staff.     

Effets de l’huile des fruits de Dacryodes edulis sur les symptômes de l’anxiété et les performances cognitives chez la souris,après administration prolongée

ObjectiveTo study the effects of prolonged administration of Dacryodes edulis (G. Don) H.J. Lam (HDE) fruit oil on the symptoms of anxiety and cognitive performance in mice.MethodsAnxiolytic activity and effects of HDE (5 and 10 ml/kg) on cognitive performance were evaluated in male mice after oral administration for 45 days. Anxiolytic effects were investigated in open field test, elevated plus Maze and hole board test. The Morris Water Maze test was used to evaluate cognitive performance in mice. Efficacy of HDE (5 and 10 ml/kg) was compared with that of fluoxetine (2 mg/kg p.o).ResultsHDE decreases the total distance traveled, significantly increases the number of adjustments and the number of entries in the central area of open field. In the elevated cross labyrinth test, HDE increases the number of entries and the time spent in the open arms. HDE significantly increases the number of head insertion into the holes. In the Morris Water Maze test, HDE reduces latency before finding the platform and increases the time spent in the target quadrant.ConclusionThe results confirm anxiolytic effects and improved cognitive performance after prolonged oral administration of HDE in rodents.     

La puissance des répétitions des phrases des pensées positives (RPPP) : un outil efficace de traitement contre les troubles psychologiques (dépression,anxiété et stress). Une étude pilote contrôlée et randomisée

IntroductionMental and psychological troubles are common symptoms in students. Depression, anxiety and stress in mental and psychological troubles (MPSYT) takes a predominantly verbal form, as if talking to oneself about possible negative outcomes. We suggested that verbal depression, verbal anxiety and verbal stress may be a strategy to avoid more distressing emotional representations, such as negative thinking or images. Verbal depression, anxiety and stress lead to temporary reductions in MPSYT, it can maintain negative thought intrusions in the longer term. This suggests that verbal thinking style plays a causal role in maintaining intrusions, perhaps serving to trigger subsequent depressive and anxious episodes and psychological distress.ObjectiveThe current study examined alternative approaches to reducing depression, anxiety and stress by allocating volunteers to conditions in which they either practiced replacing the usual form of depression, anxiety and stress with repeating phrases of Positive Thoughts (RPPT) represented verbally. This research aims to attract the attention of carers on the positive cognitions as an effective treatment against various psychological disorders among students. The objective of this study was the first to evaluate the short-term effects of the method of Repeating Phrases of Positive Thoughts (RPPT).MethodThe total sample consisted of 44 students (11 men and 33 women) from the University of Caen, aged 18 to 23 years. It is composed of two groups: experimental group (21 persons aged 18 to 23 years) and control group (23 participants aged 18 to 23 years). The method of RPPT involved generating positive thoughts related or not related to MPSYT. Participants received training in the designated method and then practiced it for one week, before attending for reassessment.ResultsExperimental group benefited from training, with decreases in depression, anxiety and stress, and significant differences between experimental and control groups. The results show a significant improvement in psychological disturbances throughout the experimental group (p < 0.05) and a significant reduction in stress following the RPPT protocol (p < 0.01), less anxiety (p < 0.001) and also less depression (p < 0.05). The short-term effect RPPT (repeating phrases positive thoughts) is significant. Female gender and a low score of psychological disorders have emerged as two independent variables predictive of a good response to treatment (Repeating Phrases of Positive Thoughts: RPPT). The replacement of depression anxiety or stress with different forms of positive cognitions and ideation, even when unrelated to the content of depression itself, anxiety itself or stress itself, seems to have similar beneficial effects, suggesting that any form of positive cognitions and ideation can be used to effectively counter psychological troubles. Treatment and remission of depression are implemented by repetition of positive thoughts. They allow to significantly reduce depressive symptoms, anxious and stress, with a maintained effect and significant short term and thus can improve the mental health of subjects.ConclusionThe positive cognitions can improve the treatment of depression, anxiety and stress among students, their psychological well-being and quality of life. The RPTs are proposed here as a fast treatment against MPSYT. This effective tool can be offered in therapy and has great ease of implementation. These results must be confirmed by clinical and comparative studies. The results show improved stress control capabilities, improved mood and anxiety. So RPPT of intervention has proved beneficial for students. More subjects repeat phrases with a very positive sense, more depression, anxiety and stress decreases. Unlike medicinal treatments, there is no consumption limit or adverse side effects. Considering the possible positive effects on prognosis, detection, diagnosis levels and assessment of change in psychotherapy, more studies should be addressed in this regard.     

Eugène Dally (1833–1887) et les liens historiques entre la Société Médico-Psychologique et la Société d’Anthropologie de Paris

The Société Médico-Psychologique (SMP) was founded in 1852, while the Société d’Anthropologie, with the later addition “de Paris” (SAP), was founded in 1859 under the auspices of Broca. Several of its members, including some of the more eminent ones, came from the SMP. These two societies remain very active to this day.ObjectivesThe objectives of these two societies and the issues, which concerned the scientific world, are researched in the work and philosophical options of Dr. Dally (1833–1887), who was an active member and president of the two societies.Materials and methodsThe work of Eugène Dally has been compiled in the collections of the Annales Médico-Psychologiques and in the Bulletins et mémoires de la Société d’Anthropologie de Paris.ResultsEugène Dally followed in the footsteps of his father Nicolas Dally as both physiotherapist – propagating in France the benefits of gymnastics – and polygraph. A disciple of Littré and an intransigent defender of the positivist doctrine, he was also a convinced anticlerical and he defended his ideas within these two societies which he joined the same year, at the age of 27 years. His career in the SAP was brilliant (he held its chair in ethnology) in the footsteps of Broca, of whom he was a fervent disciple. After his translation of Man's Place in Nature by Th Huxley, which allowed him to defend Darwin's ideas, he introduced the concept of transformism to France and shifted Broca's anti-evolutionist stance. He defended the close links between Man and the higher apes more consequently than Huxley, anticipating the modern works of the primatologists (Frans de Waal). At the SAP he was also a critical adversary of the extrapolations made from dubious anomalies discovered upon examining the brains of criminals with the aim of considering them ill and thus explaining their acts. His arrival in the SMP coincided with the opening, which had been agreed (in sign of goodwill to the new conservative power) to non-medical members from the fields of philosophy, law, history and even religion. His work and his interventions were those of a polemicist battling in the clan of physiologists and materialists against the spiritualists and metaphysicians. Hence he took clear-cut, violently anticlerical positions when the issue of the soul was put on the agenda. The deadlock in the debates on such subjects most likely explains the gradual abandoning of multidisciplinarity within the SMP membership. During discussions in 1863, which brought together all the leading lights of the SMP on the issue of criminal responsibility, Dally equally supported an unequivocal position, setting hardened criminals alongside the ill. Thus he defended – in a conscious manner – a theoretical position which considered social defence only.ConclusionsEugène Dally is the most committed representative of a generation of anticlerical doctors obstinately pursuing the Voltairien combat. His positivist, scientific convictions most likely met with the approval of several members of the SMP who found in him their spokesman. He can be considered to be a forerunner of the movement for social defence and his position on the close ties between Man and the higher apes has more recently proved its relevance.     

Protocole d’évaluation interdisciplinaire du regard,des fonctions perceptives et praxiques chez l’enfant

This article provides a protocol for an interdisciplinary assessment of perception and praxis for children. Understanding the term “dyspraxia” was a key point to our approach, with the purpose of providing better help for the children we work with. Most of these children have cerebral palsy with relatively preserved intellectual capacities. First of all, we have elabored a theoretical model based on recent scientific data. This has served as a guideline in selecting standardized tests and developing the protocol. Which brought out in this way, multiple fields of perceptual functions and praxis. We will also discuss the testing of “vision” (central and peripheral vision, oculomotricity, eye-hand coordination, visual scanning and exploration strategies) which is essential in measuring perceptual and praxis functions. Then, a reflection on the assessment of visualspatial, visual-perceptual and visual-constructive processing is proposed. Finally, we will discuss ideomotor and ideatory aspects of the praxis functions as well as the relevance of assessing bucco-linguo-facial praxis functions in this context. The benefit of this protocol is the fact that it combines diverse scientific data and interdisciplinary clinical experience (neuropsychologist, occupational therapist, speech therapist and physiotherapist) to make a precise diagnosis for to target and efficient intervention.     

Expressions cliniques et projectives de la distorsion et de la répression de l’affect chez les femmes victimes d’inceste

ObjectivesThe originality of our work lies in the fate of affects in adult women who have been repeatedly sexually abused by their fathers during their childhood and/or adolescence. We are particularly interested in the effects of their emotional life trauma.MethodsA qualitative methodology was chosen, combining clinical research interviews and a projective Rorschach test for three women followed in a victim support association. After they had given their consent, we made sure they were followed by a therapist because the research could reactivate dramatic memories and cause them to feel unwell.ResultsFrom the Rorschach, we can identify the lack of connection between affect and representation in our patients. For two patients, the affect is volatile, which can be of a pleasant nature and then quickly switch to displeasure or generate anxiety. In the third patient, it is repressed. This repression prevents the expression of affects, which would fail to be taken care of by the psyche because of their disorganizing character.DiscussionWomen who have lived through a traumatic experience such as incest, seem to have their emotional life affected. At the end of this research, the term distortion is discussed, referring on the one hand to deformation and on the other hand to imposed movement. It thus cumulates the idea of constraint by the other and discontinuity (touching on the mode of quality). We can put forward the hypothesis that the affect would be distorted, due to an early impossibility of the environment to give meaning to the experiences of the young child. The latter was caught early in the desire of the incestuous parent, leading him to submit to the expectations of the aggressor and to forget himself. In addition to distortion, another way may be possible, that of repression where the affect is repressed, the subject withdrawing from his psychic and emotional life in order to no longer feel. Emotional distortion and repression seem to be associated with the self clivage as the subject cuts himself off from a part of himself by refusing to recognize parts of his emotional life (repression), or to identify affects as if he had lost his ability to discriminate (the good/bad). Can’t this be seen as an effect of identification with the aggressor?ConclusionRecognizing the fates of affect (distortion and repression) in women who have suffered from incest encourages us to question the classic therapeutic accompaniment modalities based on free association. Initially, this call for associativity could resemble a threat to which the subject would respond either by withdrawing or withdrawing (affective anaesthesia), or by a feeling of dilution of limits. In order to arrange the therapeutic framework, the clinician, relying on transference and counter-transference, could offer words to qualify the incest emotional experience abused by incest. Indeed, the latter could redouble the difficulty in identifying and recognizing what is good, bad, pleasant, or on the contrary unpleasant in relation to primary experiences, which have hindered the reflexive function.