Agnès Bonnet

Anhédonie et dépression dans le contexte de l’infection par le VIH avec les multithérapies antirétrovirales (ANRS-EN12-VESPA)

INTRODUCTION Anhedonia is defined as the loss of the capacity to feel pleasure and there is no consensus with its relationship with depressive symptomatology. Furthermore, no study has investigated the problematic of anhedonia in the context of HIV-infection, which concern a lot of patients with depressive symptoms. Depressive symptomatology presents a major challenge in the management of HIV-infection due to its central role in clinical progression. OBJECTIVE This study aims to disentangle relationship between determinants of anhedonia, depression and anxiety in order to optimise mental management of HIV infection. METHOD In 2003, a face-to-face survey (ANRS-EN12-VESPA) was conducted among patients selected in a random stratified sample of 102 French hospital departments delivering HIV care. Eligible respondents were HIV-infected outpatients, aged 18 or older living in France and diagnosed for at least six months. Among solicited patients, 2932 agreed to participate (response rate: 59%) and data about anhedonia, anxiety and depression are available for 1427 patients. The face-to-face gathered information on sociodemographic characteristics, such as education level, gender, partner, children, financial situation or housing and also psychosocial and sociobehavioural characteristics, such as drug use. Self-reported side effects of treatment were also available. ASSESSMENT TOOLS Anxiety and depression were assessed using the hospital anxiety and depression (HAD) scale. Physical anhedonia was assessed using the French version of the Chapman scale. Three regression models were used to identify factors associated with anhedonia, anxiety and depression among demographic, psychosocial and clinical characteristics. RESULTS Factors independently associated with anhedonia were older age (>50), lower education level, unemployment and men HIV contaminated by heterosexual relation or injecting drug use. Women, with lower education level, unemployment, without steady partner, with a detectable viral load and who reported side effect of HAART presented more frequently anxiety. Unemployment, uncomfortable housing, no social support from friends, self-reported side effect and lipodystrophy were independently associated with depression. CONCLUSION Our results underline the multiplicity of factors associated with mental disorders related to depression. These results can be explained by the fact that the anxiety and anhedonia are two cardinal symptoms of depression. Determinants of anhedonia and anxiety reported in this study may provide the key to a more exact delineation of depressive disorders in the context of HIV infection in order to optimize long-term psychological follow up of concerned patients.

Emotional Dispositions and Substance Use: Mediating Effect of Alexithymia

Substance consumption behaviors can range from use to abuse, the latter including addictive behaviors. Relationships between emotionality, alexithymia and substance-consumption behaviors among young adults were investigated through an explanatory model wherein alexithymia fulfills a mediating function by acting as an emotion-adjustment process. 256 students (62.1% women) with a mean age of 20.7 yr. (SD = 1.6), enrolled at two universities in southern France took part in the study. They filled out a substance-use questionnaire, the Émotionnalité positive et négative à 31 (EPN–31) emotionality scale, and the 20-item Toronto Alexithymia scale (TAS–20). Mediation analyses validated the hypothesis that emotional dimensions of alexithymia act as mediators between emotionality (negative emotionality and emotional arousal) and substance use. As a mediating factor, alexithymia may be regarded as a type of operational process that regulates emotions. These results could have important implications for clinical and therapeutic applications focusing on emotion-regulation strategies and substance use.

P01-232 Depressive symptoms and emotion in adolescence: A developmental-functionalist view

Adolescent depressive symptoms are recognized as having number of consequences on academic and social achievement (Glied & Pine, 2002). Many studies highlighted the specific implication of emotion regulation deficits to explain depression or affective disorders (Garnefski & Kraaij, 2006). Despite these findings, little studies focused on the relations between emotional deficits (such as low emotional awareness) and subjective emotional intensity in adolescent depressive symptoms. The aim of this study was to examine the relationships between emotion awareness as defined by Lane & Schwartz (1987), subjective emotional intensity, and depressive symptoms. We hypothesized that lack of emotional awareness associated to strong emotional intensity may explain depressive symptoms among adolescents. 448 adolescents (age: 15.54 years 0.66) were administered the following self report questionnaires: • The Level of Emotional Awareness Scale (Lane & al. 1990). • The Differential Emotion Scale (Izard & al. 1991). • The Centre for Epidemiological Study Depression scale (Radloff, 1977). Statistical analysis shows significant negative correlations between emotional awareness and depression(r=-.23, p=.004), and positive correlations between subjective emotional intensity and depression r=.44, p

État émotionnel subjectif et prise de risques : Rôle de l'anxiété et de la fatigue psychologique

Resume La prise de risques en plongee sous-marine peut correspondre a une conduite pathologique ou resulter d’un processus de decision inadapte. La presence de facteurs comme la fatigue psychologique et le stress percu en tant que phenomenes emotionnels connus pour moduler ou biaiser le processus cognitif sont compris comme pouvant favoriser la prise de risques. L’objectif de cette recherche est d’identifier les facteurs influencant la prise de risques, et de determiner des facteurs la favorisant. La methodologie quantitative prend appui sur un echantillon de 94 plongeurs (H/F), caracterises par la presence, ou l’absence, de fatigue psychologique et de stress percu, personnel et professionnel. Nous evaluons la prise de risques par l’Echelle visuelle analogique du risque (EVAR) et l’anxiete etat-trait (STAI I/II). Les resultats soulignent un effet de la fatigue psychologique sur le facteur « Invincibilite » de la prise de risques ainsi que sur les scores d’anxiete-etat. Par ailleurs, la fatigue psychologique constitue un facteur favorisant de la prise de risques. Elle est ainsi consideree comme induisant un biais cognitif dans l’evaluation emotionnelle subjective, et pouvant induire une prise de decision non congruente a l’etat emotionnel, dans la realisation du comportement de prise de risques.