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  1. Article: Medical and recreational cannabis: A cross-sectional survey assessing a sample of physicians' attitudes, knowledge and experience in a university hospital in Lebanon.

    Akiki, G / Richa, S / Kazour, F

    L'Encephale

    2022  Volume 49, Issue 2, Page(s) 130–137

    Abstract: Context: A law legalizing the farming of medical cannabis for the international market was passed in Lebanese parliament in April 2020. Thus, this makes Lebanon the first Arab country to legalize medical cannabis, a law which can hold potential public ... ...

    Abstract Context: A law legalizing the farming of medical cannabis for the international market was passed in Lebanese parliament in April 2020. Thus, this makes Lebanon the first Arab country to legalize medical cannabis, a law which can hold potential public health consequences. The advocates of legalization of medical cannabis in society and in the media influence the public opinion. A community of Lebanese physicians was the first to be asked about this subject.
    Objective: This study aims to assess a sample of physicians' opinions, knowledge and experiences with medical and non-medical cannabis.
    Method: All physicians of every speciality working at the Hôtel Dieu de France-Beirut hospital (450) received by email a 33-question-online survey in French between November 2020 and December 2020. The survey was designed based on similar studies published outside of Lebanon.
    Results: Eighty-five Lebanese physicians responded to the survey and 80% of them supported the decriminalization of medical cannabis in Lebanon. But only 16% reported knowing the indications of medical cannabis, and only 24% stated that they have adequate knowledge of its secondary effects. Eighty-eight percent of them felt that they might be more comfortable discussing the option of medical cannabis if they had formal education on the subject.
    Conclusion: Even though the majority of the sample who participated in this study seemed to approve the use of medical cannabis, they lacked the knowledge and confidence to do it. Therefore, this study highlights the need of physician training in the subject of medical cannabis. Future well-conducted university studies will produce evidence-based-guidelines for medical cannabis indications and side effects.
    MeSH term(s) Humans ; Cannabis/adverse effects ; Cross-Sectional Studies ; Lebanon ; Medical Marijuana/adverse effects ; Hospitals, University ; Physicians ; Surveys and Questionnaires ; Health Knowledge, Attitudes, Practice
    Chemical Substances Medical Marijuana
    Language English
    Publishing date 2022-01-10
    Publishing country France
    Document type Journal Article
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2021.10.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Prévalence de l’utilisation et de la dépendance aux benzodiazépines au Liban.

    Ghayad, T / Dagher, R / Rached, G / Richa, S

    L'Encephale

    2022  Volume 49, Issue 2, Page(s) 197–198

    Title translation Prevalence of benzodiazepine use and dependence in Lebanon.
    MeSH term(s) Humans ; Benzodiazepines/adverse effects ; Prevalence ; Lebanon/epidemiology ; Substance-Related Disorders/epidemiology
    Chemical Substances Benzodiazepines (12794-10-4)
    Language French
    Publishing date 2022-08-17
    Publishing country France
    Document type Letter
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2022.05.006
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  3. Article: A Physiotherapeutic Approach to a Rare Case of Windswept Deformity in a Male Adolescent.

    Sawalkar, Rutuja G / Patil, Deepali S / Gandhi, Richa S

    Cureus

    2024  Volume 16, Issue 1, Page(s) e53350

    Abstract: Primary hyperparathyroidism (PHPT) can lead to a rare condition in children and adolescents known as windswept deformity. This deformity involves one knee exhibiting an abnormal outward angulation (valgus deformity), while the other knee shows an ... ...

    Abstract Primary hyperparathyroidism (PHPT) can lead to a rare condition in children and adolescents known as windswept deformity. This deformity involves one knee exhibiting an abnormal outward angulation (valgus deformity), while the other knee shows an abnormal inward angulation (varus deformity). This asymmetrical syndrome, resembling the effect of strong winds, gives the impression that the knees are being swept in opposite directions. Various factors, such as structural bone or joint defects, accidents, or underlying disorders, can contribute to the development of windswept deformity. PHPT, a common endocrine condition characterized by elevated levels of parathyroid hormone and blood calcium, is unusual in the pediatric and adolescent populations. It can result in complications like osteoporosis and bone abnormalities, with genu valgus (outward knee angulation) being an exceptionally rare symptom. This case discusses a 19-year-old male who underwent corrective surgery for genu valgus and presented with windswept deformity due to teenage hyperparathyroidism. The case study outlines the physiotherapeutic rehabilitation strategy, emphasizing treatments such as cryotherapy, patellar mobilization, and gait training. Tailored physical therapy rehabilitation plays a crucial role in the postoperative care of patients undergoing corrective osteotomies. The results indicated a significant improvement in muscle strength, an expansion of the range of motion (ROM), and a noticeable enhancement in the individual's functional autonomy following adherence to the postoperative physiotherapy (PT) plan.
    Language English
    Publishing date 2024-01-31
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.53350
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Les enjeux éthiques de la réhabilitation psychosociale.

    Richa, Sami / Choueifati, Doris / Chemali, Nathalie / Amado, Isabelle

    L'Encephale

    2024  

    Abstract: Psychosocial rehabilitation (PSR) is a therapeutic approach which aims to improve the overall functioning of people with severe mental disorders. We detail the principles of bioethics applied to care and seek to demonstrate how PSR meets the requirements ...

    Title translation Ethical stakes of psychosocial rehabilitation.
    Abstract Psychosocial rehabilitation (PSR) is a therapeutic approach which aims to improve the overall functioning of people with severe mental disorders. We detail the principles of bioethics applied to care and seek to demonstrate how PSR meets the requirements of a humanistic psychiatry. The four fundamental principles of the ethics of care - autonomy, beneficence, non-maleficence and justice - are found in the practice of PSR. The practice and implementation of PSR is strongly encouraged in universal codes of ethics.
    Language French
    Publishing date 2024-02-28
    Publishing country France
    Document type English Abstract ; Journal Article
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2023.09.003
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  5. Article: Les enjeux ethiques en psychiatrie.

    Richa, S

    L'Encephale

    2014  Volume 40, Issue 4, Page(s) 287–288

    Title translation Ethical stakes in psychiatry.
    MeSH term(s) Ethics, Medical ; France ; Humans ; Informed Consent/ethics ; Physician-Patient Relations/ethics ; Psychiatry/ethics
    Language French
    Publishing date 2014-09
    Publishing country France
    Document type Editorial
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2014.02.003
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  6. Article: The prevalence of screened trichotillomania in medical students of Saint-Joseph University.

    Mikhael, E / Mekhael, M / Rached, G / Richa, S

    L'Encephale

    2021  Volume 48, Issue 1, Page(s) 31–37

    Abstract: Objectives: Our study aims to determine the prevalence of trichotillomania among medical students. Furthermore, we aim to determine the perception of trichotillomania in this population.: Methods: Our study is a cross-sectional study that aims to ... ...

    Abstract Objectives: Our study aims to determine the prevalence of trichotillomania among medical students. Furthermore, we aim to determine the perception of trichotillomania in this population.
    Methods: Our study is a cross-sectional study that aims to determine the prevalence and the perception of trichotillomania among medical students in, compared to a control population. The control population were non-medical students in the same university. The participants filled a questionnaire online, followed by a psychiatric assessment if needed to confirm the diagnosis. The questionnaire contained three parts that consist of demographic data, diagnostic criteria and two perception questions respectfully. All the individuals that had a positive questionnaire refused to undergo a psychiatric assessment. Consequently, our study is limited to the screening of trichotillomania.
    Results: In total, 489 answers were recorded. The prevalence of trichotillomania in the general population was estimated at 2.2% (N=11). A total of 215 medical students and 274 controls filled the form. The prevalence of trichotillomania in medical students was 0.9% (N=2), whereas in the control population, the prevalence was estimated at 3.3% (N=9). The difference was statistically insignificant (P=0.123). Among medical students, all the positive questionnaires were females. In the control population, seven of them were females and two of them were males. In total, the sex ratio would be 4.5 females for one male when both populations are combined. All the individuals that had a positive questionnaire either refused to undergo a psychiatric assessment or did not answer call-backs. Regarding the perception of trichotillomania, almost three quarters of the responders think that it is due to anxiety. There was a statistical difference between the medical students and the control population regarding the answer to the proposition "It is a psychiatric disease". Medical students (76.7%) tend to believe that more than the others do (48.9%) with a p-value less than 0.00001. In addition, the same difference is found when comparing medicals students that took psychiatric courses (86.2%) to those that did not (59.7%) with a p-value at 0.0001. Almost all students think trichotillomania is treatable.
    Conclusion: The prevalence of trichotillomania among medical students is 0.9%. Medical students are not more or less affected by trichotillomania than other students. A screening tool must be considered for this disease, considering the lack. Medical students with psychiatric knowledge know more about trichotillomania than others. For this reason, awareness campaigns regarding this disease must be done to increase general knowledge.
    Language English
    Publishing date 2021-04-15
    Publishing country France
    Document type Journal Article
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2021.01.005
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  7. Article: Les traitements de substitution aux opiaces : un parcours de respect de la dignité de la personne humaine.

    Richa, S / Dirani, E / Lucet, C / Laqueille, X

    L'Encephale

    2021  Volume 48, Issue 3, Page(s) 351–353

    Abstract: The Opioid substitution treatment (OST) has been highly argumentative in ways that raise important ethical issues. The stigma in treating opioid addiction continues to be a major barrier to effective management plan. It prevents individuals from seeking ... ...

    Title translation Opioids substitution therapy: A respect for the dignity of the human person.
    Abstract The Opioid substitution treatment (OST) has been highly argumentative in ways that raise important ethical issues. The stigma in treating opioid addiction continues to be a major barrier to effective management plan. It prevents individuals from seeking treatment and is associated with poor mental and physical health. OST are considered to improve outcomes in opioid dependency. They are legitimate therapeutic options because they comply with the four principles of bioethics: autonomy, no maleficence, beneficence and justice. OST plan should conceived in a way that outcomes only giving a medication to the patient. It has many ethical aspects that should be valued: fairness, respect and solidarity. However, OST may be misused or diverted, resulting in negative treatment outcomes, here comes the important role of the multidisciplinary treatment plan to contain and prevent from misuse. We will be discussing in this paper the ethical aspect of the OST and the values that should be promoted, in order to cherish and enhance the dignity of the human being, by replacing a deadly disease with a chronic one giving the patient a chance to lead a normal life.
    MeSH term(s) Analgesics, Opioid/therapeutic use ; Humans ; Opiate Substitution Treatment/methods ; Opioid-Related Disorders/drug therapy ; Respect ; Social Justice
    Chemical Substances Analgesics, Opioid
    Language French
    Publishing date 2021-09-25
    Publishing country France
    Document type Journal Article
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2021.03.006
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  8. Article: A comprehensive review on the role of testosterone on the neurobehavioral systems implicated in the reinforcement sensitivity theory of personality.

    El Ahdab, J / Khachan, M-J / Richa, S / Raad, G

    L'Encephale

    2022  Volume 49, Issue 2, Page(s) 174–184

    Abstract: Objectives: The Reinforcement Sensitivity Theory (RST) is a neuropsychological theory of personality emphasizing approach and avoidance as the two core behavioral aspects. Approach is represented by the behavioral approach system (BAS). Avoidance is ... ...

    Abstract Objectives: The Reinforcement Sensitivity Theory (RST) is a neuropsychological theory of personality emphasizing approach and avoidance as the two core behavioral aspects. Approach is represented by the behavioral approach system (BAS). Avoidance is represented by the behavioral inhibition system (BIS) and the fight-flight-freeze system (FFFS). Although the influence of testosterone on human behavior has been demonstrated, few studies have investigated the relation between testosterone and the RST. The aim of this narrative review was to decipher the possible role of testosterone on the biological systems involved in the RST in humans.
    Methods: Google scholar, PubMed, PsycARTICLES, PsycINFO, Scopus and Cochrane library databases were interrogated using keywords such as testosterone, BIS, BAS, FFFS, personality, reinforcement sensitivity theory.
    Results: Seven original articles, published between 2009 and 2022, assessing the relation between testosterone and the systems implicated in the RST, were included. The results of these studies suggested the presence of a possible positive relation between testosterone and the BAS. However, the impact of testosterone on the BIS and/or FFFS seems to be less clear.
    Discussion: The consistency in the results supporting the presence of a positive relation between testosterone and the BAS might lead to the consideration of testosterone as a potential correlate in the clinical assessment of several psychopathologies. The inconsistency in the conclusions regarding the impact of testosterone on the BIS and/or the FFFS might be attributed to the different questionnaires used as measurement tools. Additional research remains needed.
    MeSH term(s) Humans ; Testosterone/pharmacology ; Reinforcement, Psychology ; Personality ; Personality Disorders ; Inhibition, Psychological
    Chemical Substances Testosterone (3XMK78S47O)
    Language English
    Publishing date 2022-11-18
    Publishing country France
    Document type Review ; Journal Article
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2022.08.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Effectiveness of a two-stage strategy using the 16-item Prodromal Questionnaire (PQ16/fPQ16) and the Comprehensive Assessment of At Risk Mental States (CAARMS) in the early detection of Ultra High Risk (UHR) patients in Lebanon: a cross-sectional pilot study.

    Mourad, M / Atallah, E P / Raad, G / Haddad, R / Richa, S

    L'Encephale

    2023  Volume 50, Issue 1, Page(s) 40–47

    Abstract: Objectives: This study aims to identify the prevalence of Ultra High Risk (UHR) adults in a sample of patients in Lebanon and to compare screening and diagnostic tools.: Methods: This is a cross-sectional pilot study which targeted patients aged 17- ... ...

    Abstract Objectives: This study aims to identify the prevalence of Ultra High Risk (UHR) adults in a sample of patients in Lebanon and to compare screening and diagnostic tools.
    Methods: This is a cross-sectional pilot study which targeted patients aged 17-30 years willingly seeking psychiatric care in a university hospital in Beirut, Lebanon. Participants were invited to fill either the English or the French version of the Prodromal Questionnaire (respectively, PQ16 or fPQ16). The abbreviated version of the "Comprehensive Assessment of At-Risk Mental States" (CAARMS) was then administered to all participants. The latter were subsequently sorted into one of the three UHR groups - vulnerability group, attenuated psychosis (APS), intermittent psychosis (BLIPS) - or were diagnosed as suffering from a psychotic disorder.
    Results: Thirty-one patients participated in this study. The prevalence of positive screening on the PQ16/fPQ16 and positive diagnosis of UHR on the CAARMS were respectively of 61.29% and 45%. The APS group was the most prevalent (71.42%). A positive psychosis screening on PQ16/fPQ16 was statistically related to a UHR diagnosis on CAARMS (p-value: 0.011 on Chi
    Conclusion: This two-stage strategy for identifying UHR patients can be adopted in a tertiary health care center.
    MeSH term(s) Adult ; Humans ; Pilot Projects ; Cross-Sectional Studies ; Lebanon/epidemiology ; Psychiatric Status Rating Scales ; Prodromal Symptoms ; Psychotic Disorders/diagnosis ; Psychotic Disorders/epidemiology ; Psychotic Disorders/psychology ; Risk Factors
    Language English
    Publishing date 2023-01-28
    Publishing country France
    Document type Journal Article
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2022.11.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: The new Code of Ethics of the World Psychiatric Association: A fresh look at the ethical issues of the psychiatric profession.

    Richa, S / Diab, N / Richa, N / Choueifati, D / Choucair-Alam, N / Scheuer, M

    L'Encephale

    2023  Volume 49, Issue 3, Page(s) 325–327

    Abstract: This article develops the WPA's new Code of Ethics that was developed in 2020. It succeeds the Declaration of Hawaii of 1977 and the Declaration of Madrid of 1996. The Code is divided into four sections that cover the practice of psychiatry in clinical ... ...

    Abstract This article develops the WPA's new Code of Ethics that was developed in 2020. It succeeds the Declaration of Hawaii of 1977 and the Declaration of Madrid of 1996. The Code is divided into four sections that cover the practice of psychiatry in clinical practice, education, research and publication as well as public mental health. We will discuss the new ethical issues that this Code raises in parallel with the development of psychiatry and psychiatrists' role in society in recent years.
    MeSH term(s) Humans ; Codes of Ethics ; Ethics, Medical ; Psychiatry
    Language English
    Publishing date 2023-02-10
    Publishing country France
    Document type Journal Article
    ZDB-ID 214431-1
    ISSN 0013-7006
    ISSN 0013-7006
    DOI 10.1016/j.encep.2022.12.001
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