vendredi 27 février 2015

RECHERCHE FRANCE Les caractéristiques cliniques et neuropsychologiques des patients bipolaires euthymiques ayant une histoire de tentative de suicide grave

Clinical and neuropsychological characteristics of euthymic bipolar patients having a history of severe suicide attempt
E. Olié1,2,3M. Seyller1,3S. Beziat2J. Loftus3,4F. Bellivier3,5T. Bougerol3,6R. Belzeaux3,7J. M. Azorin3,7S. Gard3,8J. P. Kahn3,9C. Passerieux3,10M.  Leboyer3,11B. Etain3,11C. Henry3,11 and P. Courtet1,2,3
Acta Psychiatrica Scandinavica
Volume 131, Issue 2, pages 129–138, February 2015
http://onlinelibrary.wiley.com/doi/10.1111/acps.12326/abstract
 
Author Information
1 Department of Emergency Psychiatry, CHRU, Montpellier, France
2 INSERM U1061, Montpellier, France
3 Fondamental Foundation, Foundation of Scientific Cooperation, France
4 Department of Psychiatry, Princesse-Grace Hospital, Monaco, France
5 Hospital Saint-Louis - Lariboisière - Fernand Widal, AP-HP, Paris, France
6 Academic Hospital of Grenoble, Grenoble, France
7 AP HM, Psychiatric Pole, Sainte Marguerite Marseille, France
8 Charles Perrens Hospital, Bordeaux, France
9 Brabois Hospital, Academic Hospital of Nancy, Vandoeuvre Les Nancy, France
10 Academic Hospital of Versailles, Le Chesnay, France
11 Université Paris-Est, Hopital Chenevier and AP-HP, Créteil, France
* Emilie Olié, Département Urgences et Post Urgences Psychiatriques, Hôpital Lapeyronie, 371 avenue du Doyen G. Giraud, 34295 Montpellier Cedex 5, France.
E-mail: e-olie@chu-montpellier.fr


Objective
Identifying bipolar patients at high-suicide risk is a major health issue. To improve their identification, we compared dimensional and neuropsychological profile of bipolar patients with or without history of suicide attempt, taking into account suicidal severity (i.e. admission to intensive ward).
Method
A total of 343 adult euthymic bipolar out-patients recruited in the French FondaMental Advanced Centres of Expertise for Bipolar Disorder were divided into three subgroups: 214 patients without history of suicide attempt, 88 patients with past history of non-severe suicide attempt and 41 patients with past history of severe suicide attempt. General intellectual functioning, speed of information processing, verbal learning and memory, verbal fluency and executive functioning were assessed.
Results
Severe suicide attempters had lower affective intensity and lability than non-severe attempters. Severe suicide attempters outperformed non-severe attempters for verbal learning and non-attempters for Stroop word reading part after adjustment for study centre, age, gender, educational level, antipsychotics use, depression score, anxious and addictive comorbidities.
Conclusion
Neuropsychological tasks commonly used to assess bipolar patients do not seem accurate to identify suicide attempters in euthymic patients. In the future, decision-making and emotional recognition tasks should be assessed. Moreover, clinical and neuropsychological profiles should be considered together to better define suicidal risk.

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