Introduction Bipolar Disorder (BD) is a common psychiatric disease. It has been demonstrated a long time ago that bipolar patients are more painful than the healthy subjects. Substance use disorder is a frequent comorbidity in BD, but also in painful patients. The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain. Objectives The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain Methods We included all bipolar patients from the FACE-BD cohort which is a prospective cohort of French outpatients with BD enrolled at the 12 advanced Centers of Expertise in Bipolar Disorder (CEBD). Pain has been evaluated by the “pain item” of the EQ-5D scale and we divided subjects in four categories: “no pain”, “slight pain”, “moderate pain”, “severe or extreme pain”. A multivariate analysis was performed to identify differences between each pain’s groups according to the kind of substance use disorder, psychiatric comorbidities and clinicals data. Results The cohort enrolled 1897 bipolar patients, 970 had no pain (51.1%), 507 had slight pain (26.7%), 298 had moderate pain (15.7%) and 122 had severe or extreme pain (6.4%). We found significant differences according to age, comorbidities and clinicals data with older, more anxious, and more severe patients more represented in the more painful groups. Painful bipolar patients had also more frequently lifetime substance use disorders (alcohol, opioid, sedative, marijuana) and we were able to characterize different profiles in bipolar patients. Conclusions Bipolar patients with a painful expression had more risks to have a lifetime substance use disorder, an anxiety disorder, and a higher score on MADRS. Interestingly, subjects seemed to prefer substances with anxiolytic or antalgic effects during the acute intoxication as alcohol, marijuana, opioid and sedatives. Disclosure of Interest None Declared

Des anomalies du rythme circadien sont décrites dans les troubles de l’humeur, qu’il s’agisse de la dépression, du trouble bipolaire ou du trouble affectif saisonnier. Les altérations des rythmes du sommeil et des cycles de pics hormonaux sont les troubles les plus souvent cités. La conception de la dépression comme témoin d’une altération des relations entre le pacemaker interne (principalement organisé par le noyau suprachiasmatique) et les rythmes sociaux exogènes (générés par la lumière essentiellement) est enrichissante, bien que imparfaitement maîtrisée. C’est dans cette idée que les gènes « d’horloges » ou gènes Clock qui régulent ce rythme interne, ont été étudiés dans la dépression et montrent une association, pour certaines études avec le risque de rechute, les troubles du sommeil et la réponse aux antidépresseurs. Les variables physiologiques de la dépression en rapport directe avec des rythmes biologiques sont revues dans cet article. La plupart des approches thérapeutiques dans la dépression ont un impact sur les rythmes biologiques. Certaines d’entre elles agissent exclusivement sur cette dimension. C’est le cas de la privation de sommeil médicalisée (bouleversant les rythmes) ou de la luxthérapie (qui resynchronise les rythmes par une exposition matinale à une lumière intense). Certaines psychothérapies se focalisent sur les rythmes sociaux. Ainsi dans le trouble bipolaire, le respect d’une régularité de ces rythmes sociaux permet en effet de réduire le risque de rechute thymique. Enfin, les antidépresseurs améliorent les rythmes biologiques à terme (après le délai de 15 jours avant l’amélioration clinique), et certaines molécules en développement se basent spécifiquement sur ce mécanisme d’action pour amélioration la dépression (propriétés agonistes mélatoninergiques).

L’ensemble des donnees montre que les sujets bipolaires sont beaucoup plus a risque de dependance a des substances que d’abus. On peut retenir le chiffre de 40 % de sujets dependants parmi les bipolaires. Les donnees montrent egalement qu’il existe une forte proportion de comorbidite addictive « independante » du trouble bipolaire, c’est-a-dire survenant en dehors des episodes thymiques. Comorbidite addictive des troubles bipolaires

The presence of a Gene-Environment interaction means that when both factors are detected, the risk is increased compared to the sum (or the multiplication) of each of them.A first way to use such interaction is to fix a known environmental factor (for example when all patients are being exposed to alcohol) and see how some genes may be involved on related- or endo-phenotypes.The survival status of a male alcohol-dependent sample (n=126), recruited 9 years before, was for example analysed. We found that the C allele of the 5-HT1b gene, and tobacco dependence, were found in excess in the non-surviving patients, but that no endo-phenotypes are being directly involved.With this same GxE approach, we also found that a haplotype of the DAT gene was involved in the risk of withdrawal seizures (Le Strat et al., in press) when all patients stopped, at least once in their lifetime, drinking alcohol.A second strategy is to analyse some environmental factors potentially involved (such as early aggression) and compare these risk factors in patients with or without genetically related vulnerability (such as high initial tolerance to alcohol or familial history of dependence) to explain alcohol abuse or dependence. We will present a new study (S.A.G.E.) based on 3.000 young adults assessed for these factors.Gene-Environment interactions approach could help to select more accurately specific candidate genes, identify more homogenous subgroups of patients, and ultimately, may lead to more focused, i.e. more efficient, prevention strategies.

In many primates, infants possess distinctive coloration that changes as a function of age. This colour is thought to serve the purpose of eliciting caretaking behaviour from the mother as well as other conspecifics. The present study investigated the responses of adult female rhesus macaques (Macaca mulatta) to pictures of infant faces in relation to infant age and facial coloration. Study animals were shown digitized images of neonates and 5–6-month-old infants displaying either unaltered facial colour, pink neonatal colour, or novel (green) facial colour. While infant and neonate faces of all colours elicited the attention of adult females, pink neonatal facial coloration did not appear to be especially attractive to subjects in contrast with the findings from an earlier study [Higley, J.D., Hopkins, W.D., Hirsch, R.M. Marra, L.M. Suomi S.J., 1987. Preferences of female rhesus monkeys (Macaca mulatta) for infantile coloration. Dev. Psychobiol. 20, 7–18]. The results suggest that infant facial colour is not particularly important in mediating infant attractiveness to rhesus macaque females as previously suggested or that other infantile facial characteristics might be more important than colour in eliciting caretaking behaviours amongst females.