Psychological and psychiatric aspects of face transplantation: Lessons learned from the long-term follow-up of six patients.
Identifieur interne : 000461 ( Main/Exploration ); précédent : 000460; suivant : 000462Psychological and psychiatric aspects of face transplantation: Lessons learned from the long-term follow-up of six patients.
Auteurs : Cédric Lemogne [France] ; Frank Bellivier [France] ; Eric Fakra [France] ; Liova Yon [France] ; Frédéric Limosin [France] ; Silla M. Consoli [France] ; Laurent Lantieri [France] ; Mikaël Hivelin [France]Source :
- Journal of psychosomatic research [ 1879-1360 ] ; 2019.
Descripteurs français
- KwdFr :
- MESH :
- psychologie : Transplantation de la face.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Mâle, Études de cohortes, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- MESH :
- psychology : Facial Transplantation.
- Adult, Cohort Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies.
Abstract
Since 2005, at least 38 face transplantations have been performed worldwide. Available recommendations on psychological management are based on isolated cases or small case series, either not focused on mental health or with a short follow-up. We propose herein a clinical commentary on psychological and psychiatric outcomes from the follow-up of a prospective single-center cohort of six patients over a period of 3.5 to 9 years. Seven patients received a face transplant between January 2007 and April 2011: two patients with neurofibromatosis, four with self-inflicted ballistic trauma, one with self-immolation. One patient died at 63 days of cerebral sequelae from cardiac arrest in the setting of bacterial infection. The six other patients were routinely evaluated with unstructured psychological interviews up to May 2016 and with the Short Form 36-item health survey and the Mini-International Neuropsychiatric Interview at one year and at the end of the follow-up. Clinically meaningful observations were the following: a history of mental disorders before disfigurement was associated with poor physical and mental outcomes, including poor adherence and one suicide; untreated depression was associated with poor adherence; acceptance of the new face occurred rapidly and without significant distress in all of the patients; fear of transplant rejection was present to some degree in all of the patients and did not substantially differ from other transplantation settings; media exposure may be disturbing but may also have had positive psychological effects on some of the patients. Mental health issues related to chronic rejection and re-transplantation remain to be explored.
DOI: 10.1016/j.jpsychores.2019.02.006
PubMed: 30947816
Affiliations:
- France
- Auvergne-Rhône-Alpes, Rhône-Alpes, Île-de-France
- Créteil, Paris, Saint-Étienne
- Université Paris-Descartes
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Electronic address: cedric.lemogne@aphp.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Bellivier, Frank" sort="Bellivier, Frank" uniqKey="Bellivier F" first="Frank" last="Bellivier">Frank Bellivier</name><affiliation wicri:level="3"><nlm:affiliation>Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France; Inserm, UMR-S1144, Paris, France; Fondation FondaMental, Créteil, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France; Inserm, UMR-S1144, Paris, France; Fondation FondaMental, Créteil</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Fakra, Eric" sort="Fakra, Eric" uniqKey="Fakra E" first="Eric" last="Fakra">Eric Fakra</name><affiliation wicri:level="3"><nlm:affiliation>Centre de Recherche en Neurosciences de Lyon (CRNL) Inserm U1028, CNRS UMR5292, Université Lyon 1 - Jean Monnet, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre de Recherche en Neurosciences de Lyon (CRNL) Inserm U1028, CNRS UMR5292, Université Lyon 1 - Jean Monnet, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Saint-Étienne</settlement></placeName></affiliation></author><author><name sortKey="Yon, Liova" sort="Yon, Liova" uniqKey="Yon L" first="Liova" last="Yon">Liova Yon</name><affiliation wicri:level="3"><nlm:affiliation>Fondation FondaMental, Créteil, France; AP-HP, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie et d'Addictologie, Créteil, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Fondation FondaMental, Créteil, France; AP-HP, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie et d'Addictologie, Créteil</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Limosin, Frederic" sort="Limosin, Frederic" uniqKey="Limosin F" first="Frédéric" last="Limosin">Frédéric Limosin</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Consoli, Silla M" sort="Consoli, Silla M" uniqKey="Consoli S" first="Silla M" last="Consoli">Silla M. Consoli</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Lantieri, Laurent" sort="Lantieri, Laurent" uniqKey="Lantieri L" first="Laurent" last="Lantieri">Laurent Lantieri</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Hivelin, Mikael" sort="Hivelin, Mikael" uniqKey="Hivelin M" first="Mikaël" last="Hivelin">Mikaël Hivelin</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris, France; Institut Cochin, Inserm U1016, UMR-S 1016, CNRS UMR 8104, Génomique et épigénétique des tumeurs rares, Université Paris Descartes, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris, France; Institut Cochin, Inserm U1016, UMR-S 1016, CNRS UMR 8104, Génomique et épigénétique des tumeurs rares, Université Paris Descartes, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2019">2019</date><idno type="RBID">pubmed:30947816</idno><idno type="pmid">30947816</idno><idno type="doi">10.1016/j.jpsychores.2019.02.006</idno><idno type="wicri:Area/Main/Corpus">000530</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000530</idno><idno type="wicri:Area/Main/Curation">000530</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000530</idno><idno type="wicri:Area/Main/Exploration">000530</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Psychological and psychiatric aspects of face transplantation: Lessons learned from the long-term follow-up of six patients.</title><author><name sortKey="Lemogne, Cedric" sort="Lemogne, Cedric" uniqKey="Lemogne C" first="Cédric" last="Lemogne">Cédric Lemogne</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France. Electronic address: cedric.lemogne@aphp.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Bellivier, Frank" sort="Bellivier, Frank" uniqKey="Bellivier F" first="Frank" last="Bellivier">Frank Bellivier</name><affiliation wicri:level="3"><nlm:affiliation>Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France; Inserm, UMR-S1144, Paris, France; Fondation FondaMental, Créteil, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France; Inserm, UMR-S1144, Paris, France; Fondation FondaMental, Créteil</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Fakra, Eric" sort="Fakra, Eric" uniqKey="Fakra E" first="Eric" last="Fakra">Eric Fakra</name><affiliation wicri:level="3"><nlm:affiliation>Centre de Recherche en Neurosciences de Lyon (CRNL) Inserm U1028, CNRS UMR5292, Université Lyon 1 - Jean Monnet, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre de Recherche en Neurosciences de Lyon (CRNL) Inserm U1028, CNRS UMR5292, Université Lyon 1 - Jean Monnet, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Saint-Étienne</settlement></placeName></affiliation></author><author><name sortKey="Yon, Liova" sort="Yon, Liova" uniqKey="Yon L" first="Liova" last="Yon">Liova Yon</name><affiliation wicri:level="3"><nlm:affiliation>Fondation FondaMental, Créteil, France; AP-HP, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie et d'Addictologie, Créteil, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Fondation FondaMental, Créteil, France; AP-HP, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie et d'Addictologie, Créteil</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Limosin, Frederic" sort="Limosin, Frederic" uniqKey="Limosin F" first="Frédéric" last="Limosin">Frédéric Limosin</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Consoli, Silla M" sort="Consoli, Silla M" uniqKey="Consoli S" first="Silla M" last="Consoli">Silla M. Consoli</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Lantieri, Laurent" sort="Lantieri, Laurent" uniqKey="Lantieri L" first="Laurent" last="Lantieri">Laurent Lantieri</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Hivelin, Mikael" sort="Hivelin, Mikael" uniqKey="Hivelin M" first="Mikaël" last="Hivelin">Mikaël Hivelin</name><affiliation wicri:level="4"><nlm:affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris, France; Institut Cochin, Inserm U1016, UMR-S 1016, CNRS UMR 8104, Génomique et épigénétique des tumeurs rares, Université Paris Descartes, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris, France; Institut Cochin, Inserm U1016, UMR-S 1016, CNRS UMR 8104, Génomique et épigénétique des tumeurs rares, Université Paris Descartes, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author></analytic><series><title level="j">Journal of psychosomatic research</title><idno type="eISSN">1879-1360</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Cohort Studies (MeSH)</term><term>Facial Transplantation (psychology)</term><term>Female (MeSH)</term><term>Follow-Up Studies (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Prospective Studies (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Transplantation de la face (psychologie)</term><term>Études de cohortes (MeSH)</term><term>Études de suivi (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Transplantation de la face</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Facial Transplantation</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cohort Studies</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Études de cohortes</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Since 2005, at least 38 face transplantations have been performed worldwide. Available recommendations on psychological management are based on isolated cases or small case series, either not focused on mental health or with a short follow-up. We propose herein a clinical commentary on psychological and psychiatric outcomes from the follow-up of a prospective single-center cohort of six patients over a period of 3.5 to 9 years. Seven patients received a face transplant between January 2007 and April 2011: two patients with neurofibromatosis, four with self-inflicted ballistic trauma, one with self-immolation. One patient died at 63 days of cerebral sequelae from cardiac arrest in the setting of bacterial infection. The six other patients were routinely evaluated with unstructured psychological interviews up to May 2016 and with the Short Form 36-item health survey and the Mini-International Neuropsychiatric Interview at one year and at the end of the follow-up. Clinically meaningful observations were the following: a history of mental disorders before disfigurement was associated with poor physical and mental outcomes, including poor adherence and one suicide; untreated depression was associated with poor adherence; acceptance of the new face occurred rapidly and without significant distress in all of the patients; fear of transplant rejection was present to some degree in all of the patients and did not substantially differ from other transplantation settings; media exposure may be disturbing but may also have had positive psychological effects on some of the patients. Mental health issues related to chronic rejection and re-transplantation remain to be explored.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">30947816</PMID><DateCompleted><Year>2020</Year><Month>02</Month><Day>25</Day></DateCompleted><DateRevised><Year>2020</Year><Month>02</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-1360</ISSN><JournalIssue CitedMedium="Internet"><Volume>119</Volume><PubDate><Year>2019</Year><Month>04</Month></PubDate></JournalIssue><Title>Journal of psychosomatic research</Title><ISOAbbreviation>J Psychosom Res</ISOAbbreviation></Journal><ArticleTitle>Psychological and psychiatric aspects of face transplantation: Lessons learned from the long-term follow-up of six patients.</ArticleTitle><Pagination><MedlinePgn>42-49</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0022-3999(18)30695-0</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jpsychores.2019.02.006</ELocationID><Abstract><AbstractText>Since 2005, at least 38 face transplantations have been performed worldwide. Available recommendations on psychological management are based on isolated cases or small case series, either not focused on mental health or with a short follow-up. We propose herein a clinical commentary on psychological and psychiatric outcomes from the follow-up of a prospective single-center cohort of six patients over a period of 3.5 to 9 years. Seven patients received a face transplant between January 2007 and April 2011: two patients with neurofibromatosis, four with self-inflicted ballistic trauma, one with self-immolation. One patient died at 63 days of cerebral sequelae from cardiac arrest in the setting of bacterial infection. The six other patients were routinely evaluated with unstructured psychological interviews up to May 2016 and with the Short Form 36-item health survey and the Mini-International Neuropsychiatric Interview at one year and at the end of the follow-up. Clinically meaningful observations were the following: a history of mental disorders before disfigurement was associated with poor physical and mental outcomes, including poor adherence and one suicide; untreated depression was associated with poor adherence; acceptance of the new face occurred rapidly and without significant distress in all of the patients; fear of transplant rejection was present to some degree in all of the patients and did not substantially differ from other transplantation settings; media exposure may be disturbing but may also have had positive psychological effects on some of the patients. Mental health issues related to chronic rejection and re-transplantation remain to be explored.</AbstractText><CopyrightInformation>Copyright © 2019 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lemogne</LastName><ForeName>Cédric</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France. Electronic address: cedric.lemogne@aphp.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bellivier</LastName><ForeName>Frank</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France; Inserm, UMR-S1144, Paris, France; Fondation FondaMental, Créteil, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fakra</LastName><ForeName>Eric</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Centre de Recherche en Neurosciences de Lyon (CRNL) Inserm U1028, CNRS UMR5292, Université Lyon 1 - Jean Monnet, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yon</LastName><ForeName>Liova</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Fondation FondaMental, Créteil, France; AP-HP, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie et d'Addictologie, Créteil, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Limosin</LastName><ForeName>Frédéric</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France; Inserm, U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Consoli</LastName><ForeName>Silla M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lantieri</LastName><ForeName>Laurent</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hivelin</LastName><ForeName>Mikaël</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Chirurgie Plastique, Reconstructrice et Esthétique, Paris, France; Institut Cochin, Inserm U1016, UMR-S 1016, CNRS UMR 8104, Génomique et épigénétique des tumeurs rares, Université Paris Descartes, Paris, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>02</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Psychosom Res</MedlineTA><NlmUniqueID>0376333</NlmUniqueID><ISSNLinking>0022-3999</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D054445" MajorTopicYN="N">Facial Transplantation</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>07</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2019</Year><Month>02</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>02</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>4</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>4</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>2</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30947816</ArticleId><ArticleId IdType="pii">S0022-3999(18)30695-0</ArticleId><ArticleId IdType="doi">10.1016/j.jpsychores.2019.02.006</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Rhône-Alpes</li><li>Île-de-France</li></region><settlement><li>Créteil</li><li>Paris</li><li>Saint-Étienne</li></settlement><orgName><li>Université Paris-Descartes</li></orgName></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Lemogne, Cedric" sort="Lemogne, Cedric" uniqKey="Lemogne C" first="Cédric" last="Lemogne">Cédric Lemogne</name></region><name sortKey="Bellivier, Frank" sort="Bellivier, Frank" uniqKey="Bellivier F" first="Frank" last="Bellivier">Frank Bellivier</name><name sortKey="Consoli, Silla M" sort="Consoli, Silla M" uniqKey="Consoli S" first="Silla M" last="Consoli">Silla M. Consoli</name><name sortKey="Fakra, Eric" sort="Fakra, Eric" uniqKey="Fakra E" first="Eric" last="Fakra">Eric Fakra</name><name sortKey="Hivelin, Mikael" sort="Hivelin, Mikael" uniqKey="Hivelin M" first="Mikaël" last="Hivelin">Mikaël Hivelin</name><name sortKey="Lantieri, Laurent" sort="Lantieri, Laurent" uniqKey="Lantieri L" first="Laurent" last="Lantieri">Laurent Lantieri</name><name sortKey="Limosin, Frederic" sort="Limosin, Frederic" uniqKey="Limosin F" first="Frédéric" last="Limosin">Frédéric Limosin</name><name sortKey="Yon, Liova" sort="Yon, Liova" uniqKey="Yon L" first="Liova" last="Yon">Liova Yon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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