« Médicaments, psychothérapies, est-ce les seuls choix possibles ? »

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1 « Médicaments, psychothérapies, est-ce les seuls choix possibles ? »
Dr Philippe Henaux Journée de l’ASMA (Association scientifique de médecine d’Assurance) 22 novembre 2018 Salle Dupréel Institut de Sociologie ULB

2 « Médicaments, psychothérapies, est-ce les seuls choix possibles ? »
Dr Philippe Henaux Journée de l’ASMA (Association scientifique de médecine d’Assurance) 22 novembre 2018 Salle Dupréel Institut de Sociologie ULB

3 La Libre Belgique, 8 octobre 2002

4 « Médicaments, psychothérapies, est-ce les seuls choix possibles ? »
Dr Pierre Cole Journée de l’ASMA (Association scientifique de médecine d’Assurance) 22 novembre 2018 Salle Dupréel Institut de Sociologie ULB

5 Potential conflict of interest
Missions de consultances pour Janssens®

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11 Potential conflict of interest
Missions de consultances pour Janssens® Responsable académique du certificat universitaires en thérapie cognitivo- comportementale à l’Université libre de Bruxelles Attention !!!

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14 Le premier devoir d'une société est de reconnaître qu'il n'existe pas une seule réponse à la souffrance psychique", laquelle n'est "ni évaluable ni mesurable«  Philippe Douste-Blazy 8 février 2005

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21 Data come from National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III) 36309 adults 12-month and life time prevalences of DSM-5MDD were 10.4% and 20.6% respectively Hasin DS, Sarvet AL, Meyers JL, Saha TD, Ruan WJ, Stohl M, Grant BF. Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States. JAMA Psychiatry Apr 1;75(4):

22 Hasin DS, Sarvet AL, Meyers JL, Saha TD, Ruan WJ, Stohl M, Grant BF
Hasin DS, Sarvet AL, Meyers JL, Saha TD, Ruan WJ, Stohl M, Grant BF. Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States. JAMA Psychiatry Apr 1;75(4):

23 4.6% of respondents met 12-month criteria for DSM-IV/CIDI MDD
Data come from the World Health Organization (WHO) WMH surveys, a series of 23 community epidemiological surveys administered in 21 countries. 4.6% of respondents met 12-month criteria for DSM-IV/CIDI MDD 56.7% respondents with 12-month MDD across surveys reported that they recognised that they needed treatment 71.1% made at least one visit to some service provider for their emotional problems (including visits to religious advisors or traditional healers) Among patients who received treatment, 41.0% met criteria for minimally adequate treatment (>1 month of a medication, plus >4 visits to any type of medical doctor) or psychotherapy (>8 visits with any professional including religious or spiritual advisor, social worker or counsellor). Thornicroft G, Chatterji S, Evans-Lacko S, Gruber M, Sampson N, Aguilar-Gaxiola S, et al. . Undertreatment of people with major depressive disorder in 21 countries. Br J Psychiatry Feb;210(2):

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25 New-York Times, 7 avril 2018

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28 Zabegalov KN, Kolesnikova TO, Khatsko SL, Volgin AD, Yakovlev OA,
Et al. Understanding antidepressant discontinuation syndrome (ADS) through preclinical experimental models. Eur J Pharmacol Jun 15;829:

29 Sequenced Treatment Alternatives to Relieve Depression (STAR-D)
Sinyor M, Schaffer A, Levitt A (2010). "The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Trial: A Review". The Canadian Journal of Psychiatry. 55 (3): 126–135.

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33 5-HT2B receptor acts as a direct positive modulator of serotonin Pet1-positive neurons in an opposite way as the known 5-HT1Anegative autoreceptor.

34 Murphy JA, Sarris J, Byrne GJ
Murphy JA, Sarris J, Byrne GJ. A Review of the Conceptualisation and Risk Factors Associated with Treatment-Resistant Depression. Depress Res Treat. 2017;2017:

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42 Philip NS, Nelson BG, Frohlich F, Lim KO, Widge AS, Carpenter LL
Philip NS, Nelson BG, Frohlich F, Lim KO, Widge AS, Carpenter LL. Low-Intensity Transcranial Current Stimulation in Psychiatry. Am J Psychiatry Jul 1;174(7):

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47 Müller VI, Cieslik EC, Serbanescu I, Laird AR, Fox PT, Eickhoff SB
Müller VI, Cieslik EC, Serbanescu I, Laird AR, Fox PT, Eickhoff SB. Altered Brain Activity in Unipolar Depression Revisited: Meta-analyses of Neuroimaging Studies. JAMA Psychiatry Jan 1;74(1):47-55.

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57 Dr Pierre COLE CHU Brugmann