Réduire ou arrêter les antipsychotiques dans la schizophrénie, une pure folie ? (notice n° 1577035)
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| fixed length control field | 04608cam a2200553 4500500 |
| 005 - DATE AND TIME OF LATEST TRANSACTION | |
| control field | 20251214042809.0 |
| 041 ## - LANGUAGE CODE | |
| Language code of text/sound track or separate title | fre |
| 042 ## - AUTHENTICATION CODE | |
| Authentication code | dc |
| 100 10 - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Berna, Fabrice |
| Relator term | author |
| 245 00 - TITLE STATEMENT | |
| Title | Réduire ou arrêter les antipsychotiques dans la schizophrénie, une pure folie ? |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Date of publication, distribution, etc. | 2023.<br/> |
| 500 ## - GENERAL NOTE | |
| General note | 21 |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | La demande d’arrêt du traitement antipsychotique est très fréquente chez les patients diagnostiqués avec une schizophrénie. Le psychiatre est souvent embarrassé d’y répondre, au risque que les patients arrêtent d’eux-mêmes leur traitement. Pourtant, malgré l’efficacité incontestable des antipsychotiques dans le traitement des symptômes positifs et lors des phases aiguës de psychoses, le rapport bénéfice/risque de leur maintien au long cours chez tous les patients fait aujourd’hui débat. Dans cet article, nous proposons d’examiner un certain nombre de biais cognitifs chez nous psychiatres qui peuvent nous amener à tort à ne pas oser tenter une réduction voire un arrêt chez des patients qui seraient éligibles à cette stratégie. |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Patients diagnosed with schizophrenia frequently ask if they can stop taking antipsychotics. Psychiatrists often struggle to find the correct response, aware that if they refuse the patient may stop the treatment anyway. Despite the undeniable efficacy of antipsychotics in the treatment of positive psychotic symptoms and acute phases of psychosis, the benefit-risk ratio of their long-term use in all patients is currently under debate. In this article, we examine some cognitive biases among psychiatrists that may lead us to mistakenly shy away from attempting antipsychotics deprescription in patients who would be eligible for this strategy. We argue that the evaluation of the risk of relapse following antipsychotics discontinuation is potentially biased by several methodological flaws in randomized controlled trials. After experiencing patients relapsing after they stop medication, psychiatrists are likely to jump to the false conclusion that discontinuation should be avoided. We argue that a careful dose reduction can be safe and even beneficial for some patients, even after multiple episodes. This might be the case for those in full remission, with good insight and who present a cycloid psychosis phenotype (a purely relapsing remitting phenotype of psychosis characterized by a good long-term prognosis). |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | La solicitud de interrupción del tratamiento antipsicótico es muy frecuente entre pacientes diagnosticados de esquizofrenia. A menudo, el psiquiatra se siente molesto al responder a estas peticiones, ante el riesgo de que el paciente interrumpa el tratamiento por su cuenta. Sin embargo, a pesar de la innegable eficacia de los antipsicóticos en el tratamiento de los síntomas positivos y en las fases agudas de psicosis, la relación beneficio/riesgo de mantenerlos a largo plazo entre todos los pacientes es cuestionada en la actualidad. En este artículo, proponemos analizar un cierto número de sesgos cognitivos entre noqsotros los psiquiatras que pueden llevarnos, erróneamente, a no atrevernos a intentar una reducción o incluso una discontinuación en unos pacientes que serían elegibles para esta estrategia. |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | abandon du traitement |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | antipsychotique |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | attitude face au traitement |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | bénéfice/risque |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | biais cognitif |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | observance |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | psychiatre |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | psychose |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | rechute |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | schizophrénie |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | traitement au long cours |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | antipsychotic |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | attitude toward treatment |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | benefit-risk |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | cognitive bias |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | compliance |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | long-term treatment |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | psychiatrist |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | psychosis |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | relapse |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | schizophrenia |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | Treatment discontinuation |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Schorr, Benoit |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Dormegny-Jeanjean, Ludovic C. |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Clauss-Kobayashi, Julie |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Bregeon, Efflam |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Causin, Jean-Baptiste |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | de Crespin de Billy, Clément |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Mainberger, Olivier |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Javelot, Hervé |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Foucher, Jack R. |
| Relator term | author |
| 786 0# - DATA SOURCE ENTRY | |
| Note | L'information psychiatrique | Volume 99 | 4 | 2023-04-25 | p. 219-227 | 0020-0204 |
| 856 41 - ELECTRONIC LOCATION AND ACCESS | |
| Uniform Resource Identifier | <a href="https://stm.cairn.info/revue-l-information-psychiatrique-2023-4-page-219?lang=fr&redirect-ssocas=7080">https://stm.cairn.info/revue-l-information-psychiatrique-2023-4-page-219?lang=fr&redirect-ssocas=7080</a> |
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