[Anxiety disorders in private practice psychiatric out-patients: prevalence, comorbidity and burden (DELTA study)].

Few data are currently available on the prevalence and associated characteristics of anxiety disorders in psychiatric out-patients in France, in particular in the private health-care. However, this represents one of the principal systems of care for patients suffering from anxiety disorders, with a possible direct access and several types of treatments available (pharmacotherapy but also different kinds of psychotherapy). The aim of our study was to describe the prevalence of anxiety disorders in a large sample of patients consulting in the private sector, and in addition to study the comorbidity, the severity of the disorders, their consequences on quality of life and health care consumption.

[Electrocardiographic features of the athlete: what are the limits?].

The athlete's heart syndrome concerns only high level trained subjects. The classical electrocardiographic features of this syndrome are hypokinetic arrhythmia as bradycardia, low level of atrioventricular and of right bundle branch block and electrocardiographic T wave alterations. Sometimes, marked ventricular repolarisation alterations can suggest the presence of heart disease.

[Factor analysis of french translation of the Barratt impulsivity scale (BIS-10)].

Though the concept of impulsiveness is controversial, there are many attempts being made to measure this dimension. In this context, only psychometric measures are widely considered valid and are routinely in use. Barratt developed the first scale that specifically measured impulsiveness.

[The use of therapeutic isolation and confinement in psychiatry. A prospective study].

Despite recent developments in psychopharmacology and a better understanding of agitation patterns in psychiatric patients, the use of seclusion and restraint procedures remains a matter of daily practice. Little or no time is spent on its teaching in a formal way. There is almost no literature on these issues, and it has grown only since legal procedures initiated by patients, which forced practitioners to spend some time analysing these methods.

[Self-assessment questionnaire of alcoholic craving (ECCA Questionnaire: Behavior and Cognition in Relation to Alcohol: French translation and validation of the Obsessive-Compulsive Drinking Scale].

Clinical, neurobiological and neuropsychological hypotheses suggest that the dimension of alcohol craving includes the concept of both obsessive thoughts about alcohol use and compulsive behaviors toward drinking. Anton et al. (1995) developed a 14 items self-rating scale, the Obsessive Compulsive Drinking Scale (OCDS) which includes items for assessing three dimensions: global, and the obsessive and the compulsive subdimensions.

[Alternating addictions: apropos of 3 cases].

The concept of addiction is now of interest in psychiatry, but is a great subject of controversies. It is now recognized that as different disorders as alcoholism, drug addiction, bulimia, kleptomania, trichotillomania, pathological gambling are to be considered as addictive states. Other pathological behaviours could be included in the addictive spectrum (i.

[Treatment of moderate arterial hypertension with physical exercise].

Objective: To compare the anti-hypertensive effect of physical exercise programs with that of usual therapeutic regimens.

Methods: Blood pressure measurements at rest and during exercise were compared in two groups of patients with moderately high blood pressure treated either medically or with physical exercise. Outcome was evaluated at 5 years.

[Social adjustment and depression: value of the SAS-SR (Social Adjustment Scale Self-Report)].

The Social Adjustment Scale Self-Report (SAS-SR) is a simple and inexpensive method, which allows the routine assessment of the patient's social adjustment, especially in the case of depression. Compared with other scales based on an interview with the patient, the SAS-SR is more sensitive to change in the patient's clinical status. The SAS-SR is a useful method as part of the detection of even mild depressions, regular aftercare evaluation of out-patients or as an outcome measure in longitudinal studies.

[Effect of antidepressant treatment on sense of dyscontrol: preliminary studies].

Cumulative data in the field of phenomenology, neurobiology and psychopharmacology indicate "discontrol" as a dimension probably linked to serotonin central activity and frequently observed in major depression and other related disorders. A new questionnaire for evaluating this dimension is proposed: Behavioral Discontrol Scale (BDS). The BDS was constructed in 1990 and validated through multiple clinical studies: the first validation study included 166 patients (subdivided in 4 subgroups, anxious, depressed, alcohol abusers and bulimics fulfilling DSM III-R criteria) and 35 controls.

[Exercise training and rehabilitation techniques in patients with coronary disease].

Exercise rehabilitation is widely prescribed for patients with coronary artery disease and requires the same rigorous approach as physical training in athletes. Training techniques have been carefully described, but the precise physiological justification remains to be elucidated. In order to target the physiological mechanisms which rehabilitation training is designed to improve, it is necessary to have a coherent strategy and apply the techniques with a clear idea of the objective to be attained.

[Panic disorder in patients consulting a cardiologist].

The relationship of anxiety with cardiovascular function and symptoms has been of long historic interest, culminating in the recent emphasis given to the modulation of cardiovascular response in panic patients. Cognitive approaches postulate an interaction of physiological and psychological factors in the maintenance of panic disorder. Pharmacological approaches postulate a dysfunction of central alpha-adrenoceptors in panic and also in some cardio-vascular diseases.

[Treatment of depression: methods and stages].

According to recent epidemiological studies, the lifetime prevalence of major depression ranges between 10 and 20%. However, informations concerning the course of depressive illness remain limited. It appears that only about one-quarter, or even less, of all depressives are affected once in their lifetime.

Cost of anxiety disorders: impact of comorbidity.

The aim of this study was to assess the relative impact of co-mobidity and of symptom severity on the costs of caring for patients with generalized anxiety disorders (GAD). One thousand and forty-two patients with GAD according to DSM III-R were observed by psychiatrists using a cross-sectional methodology. Demographic, clinical, therapeutic as well as health care utilization data were collected at a single point in time.

[Panic disorder and alcoholism: effects of comorbidity].

Both epidemiological and clinical studies have demonstrated a high prevalence of panic disorder among alcoholic patients. In contrast, little attention has been given to studying alcohol abuse and/or dependence in patients suffering from panic disorder. One hundred and fifty-five consecutive referrals for treatment for panic disorder were interviewed using a modified version of the Schedule for Affective Disorders and Schizophrenia--Lifetime Version, modified for the study of anxiety disorders.

Panic disorder in cardiac outpatients.

Objective: Continuing the long history of interest in the relation of anxiety disorders to cardiovascular function and symptoms, this study investigated the level of anxiety and prevalence of panic disorder in cardiac patients and the possible associations between specific abnormal ECG results and a diagnosis of panic disorder.

Method: Consecutive patients referred for ambulatory ECG recordings were assessed with the seven anxiety items of the Hospital Anxiety and Depression Scale. Then, 50 patients with scores higher than 8 (the anxious group) were interviewed with the Schedule for Affective Disorders and Schizophrenia--Lifetime Version Modified for the Study of Anxiety Disorders (SADS-LA).

[Cardiovascular pathology and panic disorder].

The relationship between anxiety and cardiovascular function and symptoms has long been of interest, culminating in the recent emphasis on the modulation of cardiovascular response in patients with panic disorder. The relationship between panic disorder and mitral valve prolapse remains controversial. Panic disorder appears to be significantly associated with increased incidence of cardiovascular morbidity.

[Behavior dyscontrol scale: validation and initial results].

The numerous recent trials devoted to disruptive behavior disorders indicate the renewed interest of clinicians for these so-called dimensions and call for revision of the instruments with which they are evaluated. The present paper provides a brief review of the currently used scales for rating impulsivity. A new scale for evaluating the behavioural dyscontrol is proposed.

[Panic disorder and alcoholism].

Relationships between alcoholism and anxiety disorder are well known by clinicians. Studies have recently shown that the prevalence of alcohol abuse or dependence is very high in patients with panic disorder with or without agoraphobia (Thyer et al., 1986; Bibb and Chambless, 1986).

Advantages of electrocardiographic monitoring in top level athletes.

We used continuous electrocardiographic monitoring according to Holter's method for a tentative evaluation of the prognostic value of the main electrocardiographic peculiarities of the "athlete's heart". Five hundred and eighty-seven Holter recordings were performed in 164 top athletes divided into three groups: dynamic, static and mixed. Selection criteria were either clinical or electrical (resting-ECG).