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Psychiatric Comorbidities and Psychotropic Medication Use in Autism: A Matched Cohort Study with ADHD and General Population Comparator Groups in the United Kingdom / R. HOUGHTON in Autism Research, 11-12 (December 2018)
[article]
Titre : Psychiatric Comorbidities and Psychotropic Medication Use in Autism: A Matched Cohort Study with ADHD and General Population Comparator Groups in the United Kingdom Type de document : Texte imprimé et/ou numérique Auteurs : R. HOUGHTON, Auteur ; C. LIU, Auteur ; Federico BOLOGNANI, Auteur Article en page(s) : p.1690-1700 Langues : Anglais (eng) Mots-clés : United Kingdom attention deficit hyperactivity disorder autism spectrum disorder electronic medical records polypharmacy psychiatric comorbidities psychotropic medications Index. décimale : PER Périodiques Résumé : Psychiatric comorbidities and use of psychotropic medications are common among patients with autism spectrum disorder (ASD). However, most previous research used data from the United States (US) and few studies have compared medication use in ASD to control groups, making contextualization of results difficult. In the United Kingdom (UK), general practitioners play a key role in the management of ASD. We conducted a retrospective, cross-sectional study over calendar year 2015, using primary care data from the UK. We identified a prevalent cohort of ASD cases (n = 10,856) and matched control groups of (a) general population (n = 21,712) and (b) attention deficit hyperactivity disorder (ADHD; n = 7,058) on age, sex and region. We described psychiatric comorbidities, psychotropic medications, and healthcare utilization in all three cohorts. Within the ASD cohort, we used multivariable logistic regression models to explore associations between patient characteristics and the outcomes of: any psychotropic medication, polypharmacy, and number of primary care visits. We used conditional logistic regression to compare the ASD and control groups. Psychiatric comorbidities were recorded for 41.5% of ASD patients; 32.3% received psychotropic medication and 9.8% received polypharmacy. Increased age and all psychiatric comorbidities (except conduct disorder) were associated with treatment use. Males were less likely to receive a treatment than females [Odds ratio (OR) 0.74 (0.66-0.83)]. ASD patients were more likely to take psychotropic medications than the general population [OR 4.91 (4.46-5.40)], but less likely compared to ADHD patients [OR 0.40 (0.37-0.44)]. Overall, rates of medication use in the UK were lower than those previously reported in the US. Autism Research 2018, 11: 1690-1700. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We used electronic medical records from the UK, to describe the amount of psychiatric comorbidities, psychotropic medication use and healthcare resource use in ASD. Around one in three people with ASD were prescribed a psychotropic medication, which was more than the general population, but less than for those with ADHD. Increased age, psychiatric comorbidities and female gender were all independently associated with psychotropic medication use. Rates of medication use in the UK were lower than those previously reported in the US. En ligne : http://dx.doi.org/10.1002/aur.2040 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=372
in Autism Research > 11-12 (December 2018) . - p.1690-1700[article] Psychiatric Comorbidities and Psychotropic Medication Use in Autism: A Matched Cohort Study with ADHD and General Population Comparator Groups in the United Kingdom [Texte imprimé et/ou numérique] / R. HOUGHTON, Auteur ; C. LIU, Auteur ; Federico BOLOGNANI, Auteur . - p.1690-1700.
Langues : Anglais (eng)
in Autism Research > 11-12 (December 2018) . - p.1690-1700
Mots-clés : United Kingdom attention deficit hyperactivity disorder autism spectrum disorder electronic medical records polypharmacy psychiatric comorbidities psychotropic medications Index. décimale : PER Périodiques Résumé : Psychiatric comorbidities and use of psychotropic medications are common among patients with autism spectrum disorder (ASD). However, most previous research used data from the United States (US) and few studies have compared medication use in ASD to control groups, making contextualization of results difficult. In the United Kingdom (UK), general practitioners play a key role in the management of ASD. We conducted a retrospective, cross-sectional study over calendar year 2015, using primary care data from the UK. We identified a prevalent cohort of ASD cases (n = 10,856) and matched control groups of (a) general population (n = 21,712) and (b) attention deficit hyperactivity disorder (ADHD; n = 7,058) on age, sex and region. We described psychiatric comorbidities, psychotropic medications, and healthcare utilization in all three cohorts. Within the ASD cohort, we used multivariable logistic regression models to explore associations between patient characteristics and the outcomes of: any psychotropic medication, polypharmacy, and number of primary care visits. We used conditional logistic regression to compare the ASD and control groups. Psychiatric comorbidities were recorded for 41.5% of ASD patients; 32.3% received psychotropic medication and 9.8% received polypharmacy. Increased age and all psychiatric comorbidities (except conduct disorder) were associated with treatment use. Males were less likely to receive a treatment than females [Odds ratio (OR) 0.74 (0.66-0.83)]. ASD patients were more likely to take psychotropic medications than the general population [OR 4.91 (4.46-5.40)], but less likely compared to ADHD patients [OR 0.40 (0.37-0.44)]. Overall, rates of medication use in the UK were lower than those previously reported in the US. Autism Research 2018, 11: 1690-1700. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We used electronic medical records from the UK, to describe the amount of psychiatric comorbidities, psychotropic medication use and healthcare resource use in ASD. Around one in three people with ASD were prescribed a psychotropic medication, which was more than the general population, but less than for those with ADHD. Increased age, psychiatric comorbidities and female gender were all independently associated with psychotropic medication use. Rates of medication use in the UK were lower than those previously reported in the US. En ligne : http://dx.doi.org/10.1002/aur.2040 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=372 Psychiatric comorbidities and use of psychotropic medications in people with autism spectrum disorder in the United States / Richard HOUGHTON in Autism Research, 10-12 (December 2017)
[article]
Titre : Psychiatric comorbidities and use of psychotropic medications in people with autism spectrum disorder in the United States Type de document : Texte imprimé et/ou numérique Auteurs : Richard HOUGHTON, Auteur ; Rose C. ONG, Auteur ; Federico BOLOGNANI, Auteur Article en page(s) : p.2037-2047 Langues : Anglais (eng) Mots-clés : autism spectrum disorder claims database medicaid psychiatric comorbidities polypharmacy psychotropic medications Index. décimale : PER Périodiques Résumé : This study investigated psychotropic medication usage in two large, cohorts of people with autism spectrum disorder (ASD) throughout the calendar year 2014. The cohorts referred to individuals with commercial (employer-sponsored) and Medicaid insurance in the United States. We aimed to understand prescribing patterns of such medications across a wide age-range and in the presence/absence of other clinical and non-clinical characteristics, including psychiatric comorbidities. We described the prevalence and length of prescriptions by age, psychiatric comorbidity and overall. We also fitted multivariable logistic regression models to describe the relationship between treatments and subject characteristics simultaneously. Eighty percent of the identified population was male, although gender did not impact the odds of receiving medication. Medication use was strongly associated with age, increasing most rapidly before adulthood; generally plateauing thereafter. All psychiatric comorbidities studied also individually increased the chances of medication use, with epilepsy and ADHD having the highest associations in both the commercial (OR?>?7) and Medicaid (OR around 12) cohorts. Those in non-capitated insurance plans, in foster care and white individuals also had increased odds of prescriptions. Overall, slightly more Medicaid enrollees received any psychotropic treatment (commercial: 64%, Medicaid: 69%). Nonetheless in both cohorts, a large proportion of individuals received treatment even without a diagnosis of any other psychiatric comorbidity (commercial: 31%, Medicaid: 33%). In summary, this report sheds new light on the latest patterns of psychiatric comorbidity profile and psycho-pharmacological treatment patterns in ASD Autism Res 2017, 10: 2037–2047. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary this study identified a large number of children and adults in the US with autism spectrum disorder (autism) from employer-sponsored and government funded (Medicaid) health insurance data. Psychotropic medications were used by over two thirds of people, and four in ten people received two medications at the same time. The chances of receiving medication increased for individuals with other psychiatric conditions (e.g., ADHD), and also increased with age. En ligne : http://dx.doi.org/10.1002/aur.1848 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=323
in Autism Research > 10-12 (December 2017) . - p.2037-2047[article] Psychiatric comorbidities and use of psychotropic medications in people with autism spectrum disorder in the United States [Texte imprimé et/ou numérique] / Richard HOUGHTON, Auteur ; Rose C. ONG, Auteur ; Federico BOLOGNANI, Auteur . - p.2037-2047.
Langues : Anglais (eng)
in Autism Research > 10-12 (December 2017) . - p.2037-2047
Mots-clés : autism spectrum disorder claims database medicaid psychiatric comorbidities polypharmacy psychotropic medications Index. décimale : PER Périodiques Résumé : This study investigated psychotropic medication usage in two large, cohorts of people with autism spectrum disorder (ASD) throughout the calendar year 2014. The cohorts referred to individuals with commercial (employer-sponsored) and Medicaid insurance in the United States. We aimed to understand prescribing patterns of such medications across a wide age-range and in the presence/absence of other clinical and non-clinical characteristics, including psychiatric comorbidities. We described the prevalence and length of prescriptions by age, psychiatric comorbidity and overall. We also fitted multivariable logistic regression models to describe the relationship between treatments and subject characteristics simultaneously. Eighty percent of the identified population was male, although gender did not impact the odds of receiving medication. Medication use was strongly associated with age, increasing most rapidly before adulthood; generally plateauing thereafter. All psychiatric comorbidities studied also individually increased the chances of medication use, with epilepsy and ADHD having the highest associations in both the commercial (OR?>?7) and Medicaid (OR around 12) cohorts. Those in non-capitated insurance plans, in foster care and white individuals also had increased odds of prescriptions. Overall, slightly more Medicaid enrollees received any psychotropic treatment (commercial: 64%, Medicaid: 69%). Nonetheless in both cohorts, a large proportion of individuals received treatment even without a diagnosis of any other psychiatric comorbidity (commercial: 31%, Medicaid: 33%). In summary, this report sheds new light on the latest patterns of psychiatric comorbidity profile and psycho-pharmacological treatment patterns in ASD Autism Res 2017, 10: 2037–2047. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary this study identified a large number of children and adults in the US with autism spectrum disorder (autism) from employer-sponsored and government funded (Medicaid) health insurance data. Psychotropic medications were used by over two thirds of people, and four in ten people received two medications at the same time. The chances of receiving medication increased for individuals with other psychiatric conditions (e.g., ADHD), and also increased with age. En ligne : http://dx.doi.org/10.1002/aur.1848 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=323 Autistic spectrum disorder, attention deficit hyperactivity disorder, and psychiatric comorbidities: A nationwide study / Mu-Hong CHEN in Research in Autism Spectrum Disorders, 10 (February 2015)
[article]
Titre : Autistic spectrum disorder, attention deficit hyperactivity disorder, and psychiatric comorbidities: A nationwide study Type de document : Texte imprimé et/ou numérique Auteurs : Mu-Hong CHEN, Auteur ; Han-Ting WEI, Auteur ; Li-Chi CHEN, Auteur ; Tung-Ping SU, Auteur ; Ya-Mei BAI, Auteur ; Ju-Wei HSU, Auteur ; Kai-Lin HUANG, Auteur ; Wen-Han CHANG, Auteur ; Tzeng-Ji CHEN, Auteur ; Ying-Sheue CHEN, Auteur Article en page(s) : p.1-6 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder Attention deficit hyperactivity disorder Psychiatric comorbidities Index. décimale : PER Périodiques Résumé : Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both frequently comorbid with other psychiatric disorders, but the comorbid effect of ASD and ADHD relative to the comorbid risk of other psychiatric disorders is still unknown. Using the Taiwan National Health Insurance Research Database, 725 patients with ASD-alone, 5694 with ADHD-alone, 466 with ASD + ADHD, and 27,540 (1:4) age-/gender-matched controls were enrolled in our study. The risk of psychiatric comorbidities was investigated. The ADHD + ASD group had the greatest risk of developing schizophrenia (hazard ratio [HR]: 95.89; HR: 13.73; HR: 174.61), bipolar disorder (HR: 74.93; HR: 19.42; HR: 36.71), depressive disorder (HR: 17.66; HR: 12.29; HR: 9.05), anxiety disorder (HR: 49.49; HR: 50.92; HR: 14.12), disruptive behavior disorder (HR: 113.89; HR: 93.87; HR: 26.50), and tic disorder (HR: 8.95; HR: 7.46; HR: 4.87) compared to the ADHD-alone, ASD-alone, and control groups. Patients with ADHD + ASD were associated with the greatest risk of having comorbid bipolar disorder, depressive disorder, anxiety disorder, disruptive behavior disorder, and tic disorder. The diagnoses of ASD and ADHD preceded the diagnoses of other psychiatric comorbidities. A comprehensive interview scrutinizing the psychiatric comorbidities would be suggested when encountering and following patients with both ASD and ADHD in clinical practice. En ligne : http://dx.doi.org/10.1016/j.rasd.2014.10.014 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=260
in Research in Autism Spectrum Disorders > 10 (February 2015) . - p.1-6[article] Autistic spectrum disorder, attention deficit hyperactivity disorder, and psychiatric comorbidities: A nationwide study [Texte imprimé et/ou numérique] / Mu-Hong CHEN, Auteur ; Han-Ting WEI, Auteur ; Li-Chi CHEN, Auteur ; Tung-Ping SU, Auteur ; Ya-Mei BAI, Auteur ; Ju-Wei HSU, Auteur ; Kai-Lin HUANG, Auteur ; Wen-Han CHANG, Auteur ; Tzeng-Ji CHEN, Auteur ; Ying-Sheue CHEN, Auteur . - p.1-6.
Langues : Anglais (eng)
in Research in Autism Spectrum Disorders > 10 (February 2015) . - p.1-6
Mots-clés : Autism spectrum disorder Attention deficit hyperactivity disorder Psychiatric comorbidities Index. décimale : PER Périodiques Résumé : Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both frequently comorbid with other psychiatric disorders, but the comorbid effect of ASD and ADHD relative to the comorbid risk of other psychiatric disorders is still unknown. Using the Taiwan National Health Insurance Research Database, 725 patients with ASD-alone, 5694 with ADHD-alone, 466 with ASD + ADHD, and 27,540 (1:4) age-/gender-matched controls were enrolled in our study. The risk of psychiatric comorbidities was investigated. The ADHD + ASD group had the greatest risk of developing schizophrenia (hazard ratio [HR]: 95.89; HR: 13.73; HR: 174.61), bipolar disorder (HR: 74.93; HR: 19.42; HR: 36.71), depressive disorder (HR: 17.66; HR: 12.29; HR: 9.05), anxiety disorder (HR: 49.49; HR: 50.92; HR: 14.12), disruptive behavior disorder (HR: 113.89; HR: 93.87; HR: 26.50), and tic disorder (HR: 8.95; HR: 7.46; HR: 4.87) compared to the ADHD-alone, ASD-alone, and control groups. Patients with ADHD + ASD were associated with the greatest risk of having comorbid bipolar disorder, depressive disorder, anxiety disorder, disruptive behavior disorder, and tic disorder. The diagnoses of ASD and ADHD preceded the diagnoses of other psychiatric comorbidities. A comprehensive interview scrutinizing the psychiatric comorbidities would be suggested when encountering and following patients with both ASD and ADHD in clinical practice. En ligne : http://dx.doi.org/10.1016/j.rasd.2014.10.014 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=260 From man to fly - convergent evidence links FBXO25 to ADHD and comorbid psychiatric phenotypes / Benjamin HARICH in Journal of Child Psychology and Psychiatry, 61-5 (May 2020)
[article]
Titre : From man to fly - convergent evidence links FBXO25 to ADHD and comorbid psychiatric phenotypes Type de document : Texte imprimé et/ou numérique Auteurs : Benjamin HARICH, Auteur ; Marieke KLEIN, Auteur ; Charlotte W. OCKELOEN, Auteur ; Monique VAN DER VOET, Auteur ; Marlies SCHIMMEL-NABER, Auteur ; Nicole DE LEEUW, Auteur ; Annette SCHENCK, Auteur ; Barbara FRANKE, Auteur Article en page(s) : p.545-555 Langues : Anglais (eng) Mots-clés : Drosophila melanogaster Fbxo25 Tdrp Adhd psychiatric comorbidities Index. décimale : PER Périodiques Résumé : BACKGROUND: Mental disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD), have a complex etiology, and identification of underlying genetic risk factors is challenging. This study used a multistep approach to identify and validate a novel risk gene for ADHD and psychiatric comorbidity. METHODS: In a single family, severely affected by ADHD and cooccurring disorders, we applied single nucleotide polymorphism (SNP)-array analysis to detect copy-number variations (CNVs) linked to disease. Genes present in the identified CNV were subsequently tested for their association with ADHD in the largest data set currently available (n = 55,374); this gene-set and gene-based association analyses were based on common genetic variants. Significant findings were taken forward for functional validation using Drosophila melanogaster as biological model system, altering gene expression using the GAL4-UAS system and a pan-neuronal driver, and subsequently characterizing locomotor activity and sleep as functional readouts. RESULTS: We identified a copy number gain in 8p23.3, which segregated with psychiatric phenotypes in the family and was confirmed by quantitative RT-PCR. Common genetic variants in this locus were associated with ADHD, especially those in FBXO25 and TDRP. Overexpression of the FBXO25 orthologue in two Drosophila models consistently led to increased locomotor activity and reduced sleep compared with the genetic background control. CONCLUSIONS: We combine ADHD risk gene identification in an individual family with genetic association testing in a large case-control data set and functional validation in a model system, together providing an important illustration of an integrative approach suggesting that FBXO25 contributes to key features of ADHD and comorbid neuropsychiatric disorders. En ligne : http://dx.doi.org/10.1111/jcpp.13161 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422
in Journal of Child Psychology and Psychiatry > 61-5 (May 2020) . - p.545-555[article] From man to fly - convergent evidence links FBXO25 to ADHD and comorbid psychiatric phenotypes [Texte imprimé et/ou numérique] / Benjamin HARICH, Auteur ; Marieke KLEIN, Auteur ; Charlotte W. OCKELOEN, Auteur ; Monique VAN DER VOET, Auteur ; Marlies SCHIMMEL-NABER, Auteur ; Nicole DE LEEUW, Auteur ; Annette SCHENCK, Auteur ; Barbara FRANKE, Auteur . - p.545-555.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 61-5 (May 2020) . - p.545-555
Mots-clés : Drosophila melanogaster Fbxo25 Tdrp Adhd psychiatric comorbidities Index. décimale : PER Périodiques Résumé : BACKGROUND: Mental disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD), have a complex etiology, and identification of underlying genetic risk factors is challenging. This study used a multistep approach to identify and validate a novel risk gene for ADHD and psychiatric comorbidity. METHODS: In a single family, severely affected by ADHD and cooccurring disorders, we applied single nucleotide polymorphism (SNP)-array analysis to detect copy-number variations (CNVs) linked to disease. Genes present in the identified CNV were subsequently tested for their association with ADHD in the largest data set currently available (n = 55,374); this gene-set and gene-based association analyses were based on common genetic variants. Significant findings were taken forward for functional validation using Drosophila melanogaster as biological model system, altering gene expression using the GAL4-UAS system and a pan-neuronal driver, and subsequently characterizing locomotor activity and sleep as functional readouts. RESULTS: We identified a copy number gain in 8p23.3, which segregated with psychiatric phenotypes in the family and was confirmed by quantitative RT-PCR. Common genetic variants in this locus were associated with ADHD, especially those in FBXO25 and TDRP. Overexpression of the FBXO25 orthologue in two Drosophila models consistently led to increased locomotor activity and reduced sleep compared with the genetic background control. CONCLUSIONS: We combine ADHD risk gene identification in an individual family with genetic association testing in a large case-control data set and functional validation in a model system, together providing an important illustration of an integrative approach suggesting that FBXO25 contributes to key features of ADHD and comorbid neuropsychiatric disorders. En ligne : http://dx.doi.org/10.1111/jcpp.13161 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422 Characteristics Associated with Autism Spectrum Disorder Risk in Individuals with Down Syndrome / Marie M. CHANNELL in Journal of Autism and Developmental Disorders, 49-9 (September 2019)
[article]
Titre : Characteristics Associated with Autism Spectrum Disorder Risk in Individuals with Down Syndrome Type de document : Texte imprimé et/ou numérique Auteurs : Marie M. CHANNELL, Auteur ; Laura J. HAHN, Auteur ; T. C. ROSSER, Auteur ; D. HAMILTON, Auteur ; Michelle A. FRANK-CRAWFORD, Auteur ; George T. CAPONE, Auteur ; S. L. SHERMAN, Auteur Article en page(s) : p.3543-3556 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder Down syndrome Intellectual disability Maladaptive behavior Psychiatric comorbidities Index. décimale : PER Périodiques Résumé : We examined autism spectrum disorder (ASD) risk in a large national sample of 203 individuals with Down syndrome, 6-25 years old, to determine the association of ASD risk with age, sex, IQ, adaptive behaviors, and maladaptive behaviors. We used a two-pronged approach by (1) considering ASD symptomatology continuously across the sample of individuals with DS and examining associations with each characteristic, and (2) dichotomizing our sample into high and low ASD risk groups and comparing groups on each characteristic. The pattern of results was largely similar across both types of analyses. ASD symptomatology/risk was negatively associated with IQ and adaptive behaviors and positively associated with certain types of maladaptive behaviors. Clinical implications for screening and therapeutic purposes are discussed. En ligne : http://dx.doi.org/10.1007/s10803-019-04074-1 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=405
in Journal of Autism and Developmental Disorders > 49-9 (September 2019) . - p.3543-3556[article] Characteristics Associated with Autism Spectrum Disorder Risk in Individuals with Down Syndrome [Texte imprimé et/ou numérique] / Marie M. CHANNELL, Auteur ; Laura J. HAHN, Auteur ; T. C. ROSSER, Auteur ; D. HAMILTON, Auteur ; Michelle A. FRANK-CRAWFORD, Auteur ; George T. CAPONE, Auteur ; S. L. SHERMAN, Auteur . - p.3543-3556.
Langues : Anglais (eng)
in Journal of Autism and Developmental Disorders > 49-9 (September 2019) . - p.3543-3556
Mots-clés : Autism spectrum disorder Down syndrome Intellectual disability Maladaptive behavior Psychiatric comorbidities Index. décimale : PER Périodiques Résumé : We examined autism spectrum disorder (ASD) risk in a large national sample of 203 individuals with Down syndrome, 6-25 years old, to determine the association of ASD risk with age, sex, IQ, adaptive behaviors, and maladaptive behaviors. We used a two-pronged approach by (1) considering ASD symptomatology continuously across the sample of individuals with DS and examining associations with each characteristic, and (2) dichotomizing our sample into high and low ASD risk groups and comparing groups on each characteristic. The pattern of results was largely similar across both types of analyses. ASD symptomatology/risk was negatively associated with IQ and adaptive behaviors and positively associated with certain types of maladaptive behaviors. Clinical implications for screening and therapeutic purposes are discussed. En ligne : http://dx.doi.org/10.1007/s10803-019-04074-1 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=405