Mouvement des survivants de la psychiatrie

Le mouvement des survivants de la psychiatrie, aussi appelé mouvement des ex-patients, des consommateurs ou des usagers de la psychiatrie constitue un groupe revendicatif de personnes se définissant comme ayant vécu l'expérience de la folie ou de la maladie mentale ainsi que celle de la prise en charge par le système de soins en santé mentale. Ses membres opposent aux définitions médicales et psychiatriques les expériences des patients ainsi que leur propre vision du soin. Le mouvement des patients peut remonter au temps de l'aliénisme (voir histoire de la psychiatrie), alors que les patients de l'hôpital Bedlam (nom populaire attribué au Bethlem Royal Hospital à Londres) ont adressé à la chambre des Lords la Pétition des pauvres personnes distraites à la Maison de Bedlam afin de dénoncer les conditions de leur enfermement. Pendant le , un certain nombre de pamphlets sont publiés à l'encontre du système, généralement reçus avec opposition par les responsables des maisons de fous de l'époque. La Société des amis des soi-disant fous, fondée en 1845 à Londres, réagissait contre les excès du traitement moral dans les asiles et au danger dans la société victorienne d'être envoyé à l'asile pour une conduite jugée immorale. Quelques décennies plus tard, un autre ancien patient psychiatrique, Clifford W. Beers, a fondé le Comité national sur l'hygiène mentale, qui est finalement devenu l'Association nationale pour la santé mentale. Beers cherchait à améliorer le sort des personnes recevant des soins psychiatriques publics, en particulier celles qui étaient internées dans des institutions publiques. Son livre, A Mind that Found Itself (1908), décrit son expérience de la maladie mentale et le traitement qu'il a rencontré dans les hôpitaux psychiatriques. Le travail de Beers a stimulé l'intérêt du public pour des soins et des traitements plus responsables. Cependant, si M.

Influence of MCHR2 and MCHR2-AS1 Genetic Polymorphisms on Body Mass Index in Psychiatric Patients and In Population-Based Subjects with Present or Past Atypical Depression

Pierre Magistretti, Aurélie Delacrétaz

Obesity development during psychotropic treatments represents a major health issue in psychiatry. Melanin-concentrating hormone receptor 2 (MCHR2) is a central receptor involved in energy homeostasis. MCHR2 shares its promoter region with MCHR2-AS1, a long antisense non-coding RNA. The aim of this study was to determine whether tagging single nucleotide polymorphisms (tSNPs) of MCHR2 and MCHR2-AS1 are associated with the body mass index (BMI) in the psychiatric and in the general population. The influence of MCHR2 and MCHR2-AS1 tSNPs on BMI was firstly investigated in a discovery psychiatric sample (n(1) = 474). Positive results were tested for replication in two other psychiatric samples (n(2) = 164, n(3) = 178) and in two population-based samples (CoLaus, n(4) = 5409; GIANT, n(5) = 113809). In the discovery sample, TT carriers of rs7754794C>T had 1.08 kg/m(2) (p = 0.04) lower BMI as compared to C-allele carriers. This observation was replicated in an independent psychiatric sample (-2.18 kg/m(2); p = 0.009). The association of rs7754794C>T and BMI seemed stronger in subjects younger than 45 years (median of age). In the population-based sample, a moderate association was observed (-0.17 kg/m(2); p = 0.02) among younger individuals (

Public Library of Science2015

Association of PCK1 with Body Mass Index and Other Metabolic Features in Patients With Psychotropic Treatments

Pierre Magistretti, Aurélie Delacrétaz

Weight gain is a major health problem among psychiatric populations. It implicates several receptors and hormones involved in energy balance and metabolism. Phosphoenolpyruvate carboxykinase 1 is a rate-controlling enzyme involved in gluconeogenesis, glyceroneogenesis and cataplerosis and has been related to obesity and diabetes phenotypes in animals and humans. The aim of this study was to investigate the association of phosphoenolpyruvate carboxykinase 1 polymorphisms with metabolic traits in psychiatric patients treated with psychotropic drugs inducing weight gain and in general population samples. One polymorphism (rs11552145G > A) significantly associated with body mass index in the psychiatric discovery sample (n = 478) was replicated in 2 other psychiatric samples (n(1) = 168, n(2) = 188), with AA-genotype carriers having lower body mass index as compared to G-allele carriers. Stronger associations were found among women younger than 45 years carrying AA-genotype as compared to G-allele carriers (-2.25 kg/m(2), n = 151, P = 0.009) and in the discovery sample (-2.20 kg/m(2), n = 423, P = 0.0004). In the discovery sample for which metabolic parameters were available, AA-genotype showed lower waist circumference (-6.86 cm, P = 0.008) and triglycerides levels (-5.58 mg/100 mL, P < 0.002) when compared to G-allele carriers. Finally, waist-to-hip ratio was associated with rs6070157 (proxy of rs11552145, r(2) = 0.99) in a population-based sample (N = 123,865, P = 0.022). Our results suggest an association of rs11552145G > A polymorphism with metabolic-related traits, especially in psychiatric populations and in women younger than 45 years.

Lippincott, Williams & Wilkins2015

Impact of HSD11B1 polymorphisms on BMI and components of the metabolic syndrome in patients receiving psychotropic treatments

Pierre Magistretti, Murielle Bochud, Aurélie Delacrétaz

Background Metabolic syndrome (MetS) associated with psychiatric disorders and psychotropic treatments represents a major health issue. 11 beta-Hydroxysteroid dehydrogenase type 1 (11 beta-HSD1) is an enzyme that catalyzes tissue regeneration of active cortisol from cortisone. Elevated enzymatic activity of 11 beta-HSD1 may lead to the development of MetS. Methods We investigated the association between seven HSD11B1 gene (encoding 11 beta-HSD1) polymorphisms and BMI and MetS components in a psychiatric sample treated with potential weight gain-inducing psychotropic drugs (n = 478). The polymorphisms that survived Bonferroni correction were analyzed in two independent psychiatric samples (n(R1) = 168, n(R2) = 188) and in several large population-based samples (n(1) = 5338; n(2) = 123 865; n(3) > 100 000). Results HSD11B1 rs846910-A, rs375319-A, and rs4844488-G allele carriers were found to be associated with lower BMI, waist circumference, and diastolic blood pressure compared with the reference genotype (P-corrected < 0.05). These associations were exclusively detected in women (n = 257) with more than 3.1 kg/m(2), 7.5 cm, and 4.2 mmHg lower BMI, waist circumference, and diastolic blood pressure, respectively, in rs846910-A, rs375319-A, and rs4844488-G allele carriers compared with noncarriers (P-corrected < 0.05). Conversely, carriers of the rs846906-T allele had significantly higher waist circumference and triglycerides and lower high-density lipoprotein-cholesterol exclusively in men (P-corrected = 0.028). The rs846906-T allele was also associated with a higher risk of MetS at 3 months of follow-up (odds ratio: 3.31, 95% confidence interval: 1.53-7.17, P-corrected = 0.014). No association was observed between HSD11B1 polymorphisms and BMI and MetS components in the population-based samples. Conclusions Our results indicate that HSD11B1 polymorphisms may contribute toward the development of MetS in psychiatric patients treated with potential weight gain-inducing psychotropic drugs, but do not play a significant role in the general population. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.

Lippincott Williams & Wilkins2015

Impact of HSD11B1 polymorphisms on BMI and components of the metabolic syndrome in patients receiving psychotropic treatments

Pierre Magistretti, Murielle Bochud, Aurélie Delacrétaz

Lippincott Williams & Wilkins2015