Farmers exhibit a significantly increased risk of suicide despite an overall lower mortality rate. General practitioners are identified by these patients as their primary source of healthcare. XXX is a rural area characterized by small livestock farms, both recognized as risk factors.To explore the experiences of general practitioners in XXX regarding suicidal behaviors among farmers.A phenomenological qualitative study was conducted with nine general practitioners practicing in XXX. Data were collected through individual semi-structured interviews using an interview guide.Farmers are described as reluctant to seek care and rarely consult for psychological issues. The trajectories analyzed reveal multiple contributing factors: psychiatric (depression, alcoholism, impulsivity), psychosocial (isolation, administrative burden, economic insecurity), and family-related (inheritance conflicts, pressure to take over the farm). Suicidal acts are portrayed as violent and impulsive. Faced with these risks, physicians systematically screen for suicidal ideation but encounter barriers such as stigma surrounding mental health care and lack of resources. They report feelings of profound helplessness and perceive suicides as personal failures.Suicide prevention is already difficult in the general population. The complexity of this care lies in the fact that patients are distant from care and uncomfortable admitting that they have a mental health problem. We must reach these populations in difficulty. We must develop local resources and be familiar with them in order to easily refer patients.These findings highlight the complexity of suicidal behaviors in this population and the challenges of their management. The study underscores the need for a multidisciplinary and locally adapted approach to better guide farmers toward appropriate care.

Psychological issues are common in general practice consultations. Psychotherapy is the first-line treatment for mild to moderate anxiety–depressive disorders. Access to psychotherapy remains limited, and additional barriers affect socio-economically disadvantaged patients (system saturation, stigma, compartmentalized care pathways, reduced mobility). The “Mon soutien psy” program, implemented in April 2022 (revised in June 2024), aims to facilitate such access. Its utility in the follow-up of socio-economically disadvantaged patients has not yet been evaluated.To gather general practitioners’ evaluations of the “Mon soutien psy” program in the management of socio-economically disadvantaged patients in the Paris region in 2024.A qualitative grounded theory study was conducted among self-employed and salaried general practitioners working in disadvantaged districts of Paris and its suburbs. Data were collected through semi-structured individual interviews continued until data saturation was reached. A constant comparative analysis was performed. Consent was obtained for participation in the study and for audio recording.Fourteen general practitioners were interviewed (6 in private practice, 8 salaried). According to the general practitioners, the program is useful in the management of socio-economically disadvantaged patients, providing an alternative to follow-up with private psychologists or with other pre-existing structures (e.g., community mental health centers). Several barriers to access for disadvantaged patients were reported: a limited number of participating practitioners, difficulties accessing information, upfront payment requirements, language barriers, and digital illiteracy.Some of the limitations mentioned in this study had already been identified in the literature, including difficulties in obtaining appointments and the fact that the program reaches only a limited segment of the patient population. The issue of access related to language barriers is not specific to this program; it is a common challenge in medical practice and constitutes an obstacle to care. This highlights the relevance of transcultural psychotherapy and ethnopsychiatry services.Although the program is generally well received by physicians, they nonetheless call for improvements to strengthen its role in the management of socio-economically disadvantaged patients: broader inclusion criteria and measures to encourage psychologists to participate.

Many studies have found a high prevalence of depression in medical students, but there are few data on the use of care.Our goals were to assess the prevalence of service use and adequate treatment in medical students suffering from depression, to explore the prevalence and reasons for foregoing care, and to compare data from 2021 and 2024.In 2024, a national online survey of French medical school students and residents of all specialities was conducted. The Composite International Diagnostic Interview Short-Form questionnaire assessed 12-month Major Depressive Disorder (MDD); 12-month service use and pharmacotherapy were evaluated. We also studied the prevalence and reasons for foregoing care, as well as the type of psychotherapy.7640 medical students were included, 30% suffering from MDD. Only half of the medical students with MDD received adequate treatment. Among those reporting psychotropic medications, 1 in 5 used their hospital service's pharmacy and 1 in 10 self-prescribed anxiolytics. Use of services increased between 2021 and 2024 (30% to 50%), with more access to psychotherapy and a stable level of pharmacological treatments in 2024. Among students who consulted a “psy”, 1 in 5 declared they didn’t have sufficient sessions. Delivered psychotherapies were mainly cognitive behavioural therapy (32%) and psychoanalysis (10%). The main reason for not seeking psychotherapeutic help was the financial burden (23%).The study had strengths: the large number of students (>5000) and the increased number of questions regarding the use of care and the reason for not using care. However, this study also had limitations. First, the response rate was low (<10%) and lower than the 2021 survey. Second, we didn’t have information about the duration of psychotherapy or pharmacotherapy, with a risk of overestimating the prevalence of adequate treatment.To our knowledge, this is the largest and most complete study on care use in medical students. It highlighted the improvement of treatment for MDD in this population, but also the need for complementary actions because only half of the students with MDD received adequate treatment.

Psychological distress among medical students is a major public health concern with demonstrated consequences for care quality, medical errors, and professional sustainability. National data show high rates of anxiety and depression among XXX medical students. Local studies in XXX revealed high levels of burnout risk and anxiety among general practice residents. The prevalence of major depressive episodes (MDE) and residents’ preferences for improvement strategies remain insufficiently explored.The primary objective was to estimate the prevalence and severity of MDE among general practice residents at XXX University. The secondary objective was to identify residents’ priorities and expectations regarding preventive, screening, and support interventions to address psychological distress during residency.A descriptive cross-sectional monocentric study was conducted in 2023 among general practice residents at XXX University. An anonymous online questionnaire included sociodemographic variables, general psychological indicators, and the Composite International Diagnostic Interview–Short Form (CIDI-SF) to assess MDE during the preceding 12 months. Opinions regarding potential interventions were collected using five-point Likert scales. Descriptive statistics and chi-square tests (p < 0.05) were applied.Among 123 respondents, 52% reported significant psychological difficulties during residency. A total of 22.8% met CIDI-SF criteria for MDE, predominantly moderate (53.6%) or severe (42.9%), and 17.9% presented subsyndromic depressive states. Residents expressed broad support for multiple improvement strategies: – Strengthened resident training on stress management, coping with medical errors, end-of-life care, and psychosocial risks (80–90% approval). – Enhanced pedagogical, managerial, and psychosocial risk-awareness training for supervisors in ambulatory and hospital settings (70–85%). – Strict enforcement of working-time regulations and expansion of ambulatory training positions (>90%). – Implementation of a departmental well-being unit and identification of a quality-of-life referent (≈80%). – Clear, repeated dissemination of information regarding available mental-health structures (≈90%). – Strong preference for an independent psychological support service, outside the academic validation structure (82.9%).The high prevalence of depressive symptoms underscores substantial psychological vulnerability. Residents’ proposals emphasize structural reforms, institutional responsibility, and the need for psychologically safe and independent access to care.General practice residents experience considerable psychological distress. Their recommendations highlight actionable priorities for improving prevention, screening, and support systems, thereby contributing to safer training environments.

Hypnotherapy is increasingly used in general medicine in XX to manage psychological conditions such as anxiety. Several studies support its effectiveness in reducing anxiety symptoms. However, evidence regarding the efficacy of hypnotherapy as a stand-alone intervention remains limited, as hypnosis is often combined with other psychological approaches such as cognitive-behavioural therapy.Description of the hypnosis methods reported in studies discussing hypnotherapy alone for the treatment for anxiety disorders (techniques used, session procedure, duration of therapy, individual or group sessions, use of self-hypnosis).We conducted a narrative review using systematic review methods, focusing on treating anxiety with hypnosis. Searches were performed in PubMed, PsycINFO, and Cochrane databases and Google scholar. The search strategy was based on mesh terms. The search equation was : ("Hypnosis"[Mesh]) AND ("Anxiety Disorders"[Mesh]) ; ("Hypnosis"[Mesh]) AND ("general anxiety disorder" [Supplementary Concept]) ; ("Hypnosis"[Mesh]) AND ("Phobic Disorders"[Mesh]) ; ("Hypnosis"[Mesh]) AND ("Panic Disorder"[Mesh]) ; ("Hypnosis"[Mesh]) AND ("Agoraphobia"[Mesh]) ; ("Hypnosis"[Mesh]) AND ("Phobia, Social"[Mesh]). The inclusion criteria were: original articles in English or French, articles addressing hypnotherapy in the treatment of anxiety disorders in patients over 18 years of age. PRISMA Flowchart was used. SANRA tool were applied.Among the 18 included articles, only one was a randomized clinical trial. While a few well-described methods were identified for panic or phobic disorders, the remaining studies revealed substantial heterogeneity in methodology, with procedures for anxiety disorders often poorly documented. Protocol standardization is lacking concerning group modality, session number, and the use of self-hypnosis.These findings are consistent with those observed in other clinical indication, such as insomnia. This review may help researchers identify and refine existing hypnosis methods in this field. It also highlights the need to publish precise, standardized hypnotherapy protocols prior to assessing their effectiveness.This narrative review highlights the methodological obstacles to clinical trial implementation, primarily related to the absence of standardized protocols and the lack of a recognized gold standard hypnotherapy method. We proposed IDEAL framework, which recommends research steps to evaluate one specific non-pharmacological therapy. This approach may support future clinical trials aiming to assess the effectiveness of a standardized hypnosis method.

Pharmacological options to alleviate insomnia — benzodiazepines, “Z drugs”, and others — can all have significant undesirable effects, such as addiction or interaction with other medications, raising concerns for long-term use. Given the worrying side effects and risks, it is recommended to prescribe them as a second-line treatment, and physicians and patients often turn to non-pharmacological or over-the-counter drugs such as herbal medicines.The objective of this study was to evaluate the efficacy of a supplement comprising eschscholtzia and valerian extracts in alleviating insomnia associated with anxiety.This was a double-blind, randomized, placebo-controlled study conducted in adults (n=84) with an Insomnia Severity Index (ISI) score ≥ 15 and a Hamilton Anxiety Rating Scale (HAM-A) score > 8 and < 25 at inclusion. Participants received three tablets per day of either the supplement (containing 120mg of eschscholzia plus 50mg of valerian per tablet) or a placebo from day (D) 7 to D35, with follow-up until D57. Sleep habits were assessed daily using an actimeter and an electronic sleep diary, ISI and HAM-A scores being determined on D7, 36 and 57.On D36, reductions in ISI scores were significantly greater in the supplemented group versus the placebo group (6.21 ± 4.91 [95%CI -7.82; -4.60] vs 3.89 ± 4.45 [95%CI -5.21; -2.57], p=0.030), as were reductions in HAM‑A scores (6.24 ± 6.45 [95%CI -8.36; -4.12] vs 3.57 ± 5 [95%CI -5.28; -1.85], p=0.049). No between-group difference was statistically significant on D57. No severe adverse events or supplement-related adverse events were reported. Most of the patients had no difficulty in stopping the allocated supplementation (86.8% with supplement vs 100% with placebo, p > 0.05) and the majority reported no withdrawal symptoms (97.4% vs 95.5%, p > 0.05).Exploratory analyses indicated changes in intestinal microbiota composition with the supplement, suggesting possible involvement of the gut-brain axis in its beneficial effects on sleep.The tested supplement improved sleep quality, reduced associated anxiety and was well tolerated, supporting its consideration as a therapeutic option for relieving insomnia. Supplement discontinuation was easy; this plant-based product could therefore be used as an interesting alternative to conventional pharmaceutical treatments.

Depressive disorders are highly prevalent in primary care. Gender, understood as a social and cultural construct shaping norms, behaviors, and expectations, influences both the expression of depressive symptoms and how they are interpreted by clinicians. Yet little is known about how gender representations influence diagnostic reasoning and management in general practice. Understanding these mechanisms is crucial to reducing inequities in care. This study explored how general practitioners (GPs) perceive and integrate gender in their approach to depressive disorders.To explore the influence of GPs’ gender-related representations on the identification, interpretation, and management of depressive disorders in primary care in the XXX.A qualitative study using semi-structured interviews was conducted with GPs recruited from diverse practice settings. The interview guide explored perceptions of depressive symptoms in relation to the gender of patients and the physicians’ own professional positioning. Interviews were transcribed verbatim and analyzed using a general inductive approach to allow themes to emerge from the data.Gender representations deeply shaped the clinical process at every stage. For women, GPs associated depressive symptoms with multidimensional social pressures — family responsibilities, professional demands, body image norms — and with higher exposure to sexual violence. For men, the social expectation of emotional restraint and strength led to reduced expression of distress and to compensatory behaviors such as alcohol use, social withdrawal, or irritability, often masking underlying depression. These contrasting patterns led to differentiated care pathways: while men were often underdiagnosed despite a perceived higher suicide risk, GPs reported a tendency to medicalize and hospitalize women more frequently. Although participants expressed a desire for neutrality, they acknowledged the persisting influence of implicit gender biases and described adaptive strategies with variable success.Findings show how gendered expectations influence clinical interpretation and contribute to inequities in the diagnosis and treatment of depressive disorders. Addressing these biases is essential to improve diagnostic accuracy and aligning care with actual patient needs.This study highlights a pattern of overmedicalization among women and underdiagnosis among men. Increasing awareness of gender bias is essential to ensure equitable care and reduce preventable disparities, particularly regarding suicide risk.