Team 1 : Affective disorders: bio-environmental risk and resilience

Marie-Laure Ancelin, Co-Directeur de l'unité

Depression, suicidal behavior, post-traumatic stress syndrome (PTSD) and cognitive disorders are multifactorial pathologies in which stress regulation systems and notably the hypothalamic-pituitary-adrenal (HPA) axis could play a major role involving interaction between numerous genetic and environmental factors as well as modulation of the hypothalamic-pituitary-gonadal axis (HPG). Our epidemiological and clinical approach is mainly based on the ESPRIT general population cohort; 1863 persons aged 65 years and over followed-up for more than 10 years undergoing neuropsychiatric and cardiovascular examinations, MRI, with salivary and blood samples for a DNA bank. Our main research projects aim to examine: 1. the relations between metabolic dysfunction and neuropsychiatric disorders taking into account genetic vulnerability. These studies are designed to investigate hormonal determinants of psychiatric and cognitive disorders, and their structural correlates (MRI), with a view to isolating sub-groups of “hormone-sensitive” persons who may respond differently to targeted hormone treatment. 2. diurnal cortisol secretion under basal and stressful conditions in elderly persons in order to evaluate the role of stress regulation systems in neuro-psychiatric disorders, taking into account environmental risk factors (e.g. trauma) and genetic vulnerability related to serotonin metabolism and/or HPA and HPG axes. 3. the impact of chronic stress or traumatic events on physical (e.g. vascular pathologies) and mental health, notably the onset of PTSD, in elderly community (ESPRIT cohort) and clinical samples (PHOENIX cohort). Allostatic load (biological and clinical markers of stress regulation systems) is considered as a potential marker of chronic evolution of PTSD and treatment efficacy during exposure therapy (EVEREST cohort). 4. the pharmacological impact of medication (steroids, corticosteroids, anticholinergic drugs, caffeine) on cognitive decline, dementia and psychiatric disorders (depression, PTSD). 5. the role of psychiatric, cognitive and neuro-sensorial disorders as risk factors for disability onset and mortality. Clinical studies of mental health service delivery are also being conducted. The SESAME study examines psychiatric care administered by general practitioners in the Languedoc-Roussillon region with a view to improving diagnosis and treatment. This project is currently providing information on the prevalence of mental disorders in the adult regional community, with a view to furthering understanding of care pathways and unmet needs, and assessing the diagnostic accuracy and effectiveness of treatments. The study also aims to identify causes of relapse and treatment failure. Based on this information, it will be possible to formulate intervention and prevention strategies and develop programs enhancing public information and education. The STEP Project examines the heterogeneity of case management in schizophrenia and causes of recurrence, and the clinical advantages of pharmacogenetic screening.

Biologist and Epidemiologist Research Director Inserm

Biologist and Epidemiologist Senior Research Fellow Inserm

Epidemiologist Neuropsychologist Research Director Inserm Visiting Professor , Imperial College

Psychiatrist Hospital Practitioner

Psychiatrist Hospital Practitioner, Responsible for the medical team of the University Department of Adult Psychiatry, Coordinator of the Department of Adult Psychiatry, Deputy Head of the H-U Department of Psychiatry (Hôpital La Colombière).

Ophtalmologist
Ph D Student

Biochemist

Hospital Practitioner

Clinical Research Assistant University Personnel

Psychiatrist Founder & Chief Executive Officer IXICO

Psychiatrist
Professor at King's College, London

Statistician and Epidemiologist Senior Research Assistant Inserm

Biologist and Epidemiologist Research Assistant Inserm

Statistician and epidemiologist Research Assistant Inserm

Epidemiologist
Post-doctoral Research Fellow

Publications: 

(IF : Impact factor of the journal) 
Ancelin M.L. , Artero S., Portet F., Dupuy A.M., Touchon J., Ritchie K. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. British Medical Journal 2006, 332(7539), 455-459 (IF 13.66).
Ritchie K. */Carrière I.*, de Mendonça A., Portet F., Dartigues J.F., Rouaud O., Barberger-Gateau P., Ancelin M.L . The neuro-protective effects of caffeine: a prospective population study (the Three City Study). Neurology 2007, 69(6), 536-545 (IF 8.17).
Capdevielle D, Ritchie K. The long and the short of it: are shorter periods of hospitalisation beneficial? Br J Psychiatry 2008, 192(3):164-5 (IF 5.78)
Chaudieu I.*Beluche I.*, Norton J., Boulenger J.P., Ritchie K., Ancelin M.L . Abnormal reactions to environmental stress in elderly persons with anxiety disorders: evidence from a population study of diurnal cortisol changes. Journal of Affective Disorders 2008, 106(3), 307-313 (IF 3.76).
Ritchie K.*/Jaussent I.*, Stewart R., Dupuy A.M., Courtet P., Ancelin M.L., Malafosse A. Association of adverse childhood environment and 5-HTTLPR genotype with late-life depression. Journal of Clinical Psychiatry 2009, 70(9), 1281-1288 (IF 5.22).
Carrière I., Fourrier-Reglat A., Dartigues J.F., Rouaud O., Pasquier F., Ritchie K., Ancelin M.L. Drugs with anticholinergic properties, cognitive decline and dementia in an elderly general population ( The Three City Study ). Archives of Internal Medicine, 2009, 169(14 ):1317-24 ( IF 9.81).
Ryan J., Carrière I., Scali J., Dartigues J.F., Tzourio C., Poncet M., Ritchie K., Ancelin M.L. Characteristics of hormone therapy, cognitive function and dementia: the prospective Three City Study . Neurology 2009, 73(21):1729-37 (IF 8.17). 
Scali J., Ryan J., Carrière I., Dartigues J.F., Tavernier B., Ritchie K., Ancelin M.L. A prospective study of hormone therapy and depression in community-dwelling elderly women (The Three City Study). Journal of Clinical Psychiatry , 2010, 71(12):1673-9 (IF 5.22).
Ancelin M.L., Carrière I., Boulenger J.P., Malafosse A., Stewart R., CristolJ.P., Ritchie K., Chaudieu I., Dupuy A.M. Gender and genotype modulation of the association between lipid levels and depressive symptomatology in community-dwelling elderly (The ESPRIT Study). Biological Psychiatry 2010, 68(2): 125-32 (IF 8.93).
Ritchie K.*/Carrière I*., Ritchie C., Berr C., Artero S., Ancelin M.L. Can we design population prevention programs to reduce dementia incidence? Simulation of the impact of removal of specific risk factors. British Medical Journal 2010, online first, Aug 5 (IF 13.66).
Ancelin M.L., de Roquefeuil G., Scali J., Bonnel F., Adam J.F., Cheminal J.C., Cristol J.P., Dupuy A.M., Carrière I., Ritchie K. Long-term Post-Operative Cognitive Decline in the elderly: the effects of anesthesia type, apolipoprotein E genotype, and clinical antecedents. Journal of Alzheimer's Disease 2010, 22 (sp3):105-113 (IF 3.83).
Beluche I., Carrière I., Ritchie K., Ancelin M.L . A prospective study of diurnal salivary cortisol and cognitive function in community-dwelling elderly. Psychological Medicine 2010, 40(6) : 1039-49 (IF 5.01).
Norton J., de Roquefeuil G., David M., Boulenger J.P., Ritchie K. and Mann A. The mental health of doctor-shoppers: Experience from a patient-led fee-for-service primary care setting. Journal of Affective Disorders 2011 Jan 13 (IF3.76).
Chaudieu I., Norton J., Ritchie K., Birmes P., Vaiva G.,Ancelin M.L. Long-term health consequences of traumatic exposure in elderly general population. Journal of Clinical Psychiatry 2011, in press (IF 5.22). 
Ryan J., Scali J., Carrière I., Dartigues J.F., Tzourio C., Scarabin P.Y., Ritchie K., Ancelin M.L. Gender-specific associations between estrogen receptor polymorphisms and late-life depression. British Journal of Psychiatry , in revision (IF 5.78).