Rouffach

Researchers are studying the predictive value of specific neuroendocrine tests TRH-TSH and DST in how patients with major depression respond to repetitive transcranial magnetic stimulation-theta burst stimulation rTMS-TBS. This pilot study involves adults aged 18 to 65 who have major depression and have not adequately responded to two previous antidepressant treatments. The goal is to see if these tests can predict a decrease of at least 50% in depression scores after treatment. The study involves 20 sessions of rTMS-TBS delivered once daily on weekdays. This treatment uses bursts of magnetic stimulation at high frequency for about five minutes per session. Patients will be evaluated for their depression symptoms at baseline, after ten sessions, and after the full 20 sessions using the 17-item Hamilton Depression Scale. Neuroendocrine tests are performed at the start and, if abnormal initially, again at the end of the treatment. Participants will be hospitalized patients monitored by investigators who assess their depression levels while blinded to the neuroendocrine test results. Assessments occur at inclusion, mid-treatment, and end of treatment to determine response. The main outcome is the change in depression scores after six weeks. Safety and other neuroendocrine changes will also be observed. The study is conducted over about six weeks with careful clinical and laboratory monitoring throughout.

People with mental disorders tend to smoke more than the general population, which contributes to a significant reduction in their life expectancy by 10 to 20 years, mainly due to heart and lung diseases such as bronchial cancers. Despite this, smoking cessation efforts tailored for psychiatric patients are limited, as smoking is often overlooked or accepted in mental health care settings. This study aims to assess a smoking cessation program called Tabapsy designed with input from mental health users, professionals, and general practitioners, focusing on adult patients receiving outpatient psychiatric care. The Tabapsy intervention includes a campaign promoting smoking cessation within psychiatric medical psychological centers CMPs and a series of supportive activities. These activities involve an initial information meeting to boost motivation, an assessment workshop to evaluate nicotine dependence and create personalized quitting plans, five thematic workshops covering nicotine replacement, emotional management, weight control, physical activity, and manual tasks, and peer support groups for shared experiences. A dedicated facilitator will lead these sessions, supported by an online resource website. The study compares the intervention against usual care in a national cluster-randomized trial involving psychiatric sectors. Participants who smoke regularly and consent will complete questionnaires via a web app at the start, 3 months, and 6 months, with additional surveys for those in the intervention group. The questionnaires cover smoking habits, dependence, motivation, cessation aid use, mental and physical well-being, and knowledge about tobacco. The main outcome is smoking cessation lasting at least 7 days at 3 months. Secondary outcomes include cost-effectiveness, implementation, quit attempts, and satisfaction. A total of 6,250 participants will be enrolled over 12 months across 22 sectors.