[Clozapine-resistant schizophrenia related to an increased metabolism and benefit of fluvoxamine: four case reports].

Objective: Although clozapine currently remains the most effective option in treatment-resistant schizophrenia, approximately 40-70% of antipsychotic-resistant patients do not respond, or respond only partially, to clozapine. Because clozapine-resistant patients have limited alternative treatment options, in this study we propose a clozapine augmentation strategy with evidence-based support for some of them.

Background: Clozapine-resistance is often of metabolic origin.

[Should personality disorders be treated?].

Personality disorders are mental diseases in their own right. Their common characteristic is their onset during adolescence or, at the latest, in early adulthood. Personality disorders are very diverse and range from neuroses to psychoses.

Lack of initiative and interest in Alzheimer's disease: a single photon emission computed tomography study.

Apathy is defined as a lack of motivation. The aim of this study was to investigate the relation between two major dimensions of apathy (lack of initiative and lack of interest) and brain perfusion. in patients with Alzheimer's disease (AD).

[Treatment of clozapine-induced granulocytopenia with lithium (two observations)].

Despite the availability of new treatments, the antipsychotic effectiveness of clozapine has not been matched yet. Unfortunately, its regulation is limited by the side effects. The most detrimental is the hematologic toxicity (neutropenia and agranulocytosis) which requires a regular biological monitoring.

[Apathy in Alzheimer's disease: results from three French studies].

Apathy is defined as a lack of motivation in behaviour, cognition and affect. The aim of this article is to evaluate, in Alzheimer's disease (AD), the frequency of apathy and its relations with depressive symptoms and neuroanatomical correlates. We present the results of 3 French studies: the evaluation of behavioural symptoms in 499 AD subjects; the evaluation of depression and apathy in 128 AD subjects; a single photon computed tomography study (SPECT) performed in 31 AD subjects.

A placebo-controlled study of sertraline in the treatment of outpatients with seasonal affective disorder.

Rationale: Seasonal affective disorder (SAD) is a relatively common cyclical depressive illness characterized by seasonal depressions during winter. The disorder is commonly responsive to light therapy, but antidepressant drug efficacy has not been definitely established. Serotonin selective re-uptake inhibitors are potentially efficacious treatments for SAD.

Evaluation of the supervisory system in elderly subjects with and without disinhibition.

Unlabelled: Disinhibition and irritability, defined as loss of behavioral and emotional control, are frequent in the elderly. The working hypothesis for this study was that these disorders are associated with a cognitive alteration of control processes that manifests as non-routine behavior because of the dysfunction of a general executive component known as the supervisory attentional system (SAS).

Methods: A total of 28 elderly subjects with mild cognitive impairment were recruited and divided into two groups using the Neuropsychiatric Inventory.

Relationship between impulsivity and platelet serotonin content in adolescents.

The relationship between impulsivity and serotonin function was explored in impulsive and non-depressed adolescents. Platelet serotonin content was chosen as a peripheral indicator of central serotonin function. Impulsivity was assessed with a questionnaire.

The safety and tolerability of zolpidem--an update.

Zolpidem belongs to a new class of hypnotic agents, chemically distinct from the pre-existing ones, and has a unique neuropharmacological profile. It induces sedative/hypnotic effects in rodents at doses much lower than those for anticonvulsant and myorelaxant activities. Clinically, zolpidem is indicated for the short term treatment of insomnia.

Clustering and switching strategies in verbal fluency tasks: comparison between schizophrenics and healthy adults.

Verbal fluency tasks are frequently used in clinical neuropsychology. Clustering (the production of words within semantic subcategories) and switching (the ability to shift between clusters) have been described as 2 components underlying fluency performance. We compared the use of clustering and switching in schizophrenic patients and healthy subjects.

Initiation and supervisory processes in schizophrenia and depression.

Clinical studies show that schizophrenic and depressive subjects have problems with daily life activities, and neuropsychological studies tend to explain these problems in terms of a dysexecutive syndrome. Verbal fluency and sentence arrangement are tasks considered to focus on two aspects of the dysexecutive syndrome known as initiation and supervision processes, respectively. In this study, we assessed performance in these two tasks in schizophrenia and depression.

Whole blood serotonin content, tryptophan concentrations, and impulsivity in anorexia nervosa.

Background: We hypothesized that anorectics with or without bulimic features would differ on impulsivity and indices of central serotoninergic function (high impulsivity being correlated with reduced serotoninergic function).

Methods: For all patients impulsivity rating scales and questionnaires detailing severity of eating disorder were assessed, and whole blood serotonin concentration (5-HT), free and total tryptophan (TT) concentrations, and large neutral amino acids (LNAA) were assayed.

Results: Nineteen patients with anorexia nervosa were included, 10 presented associated bulimic features and nine did not.

Use of a sequencing task designed to stress the supervisory system in schizophrenic subjects.

Background: We investigated whether schizophrenic subjects are impaired in non-routine behaviour because of the dysfunction of a general executive component labelled, in neuropsychological terms, the supervisory system.

Methods: A specific verbal sequencing test was designed for this purpose. Subjects had to perform sequential reasoning with verbal material.

Verbal fluency in schizophrenia: The role of semantic clustering in category instance generation.

The aim of this study was to determine whether schizophrenic patients' impairment in semantic verbal fluency tasks is due to difficulties in organizing their search or, in other words, in organizing output in terms of clusters of meaningfully related words. Consecutive association of words belonging to subcategories of the semantic task was defined as semantic clustering. A categorical verbal fluency task was first administered to 100 healthy subjects and then to 22 schizophrenic patients and 22 healthy subjects matched for sex, age and education.

[Neurocognitive subtypes of schizophrenia according to performance at verbal fluency tasks].

Unlabelled: There is a general agreement that schizophrenia is an heterogeneous disorder and cognitive performances could be an interesting feature in order to allow a better description of specific subtypes. The aim of this study was: 1) to describe clinical and neuropsychological performances of 45 DSM IV schizophrenic patients divided in two groups according to their performances in verbal fluency task; 2) to compare each group with the performances of healthy subjects matched for sex, age and education.

Method: The differentiation criteria was the total number of words generated during 3 formal and 3 semantic fluency tasks.

[Hysterical personality disorder].

The hysteric personality disorder is characterized by: 1. an intense need for affection; it is a child-like need, seeking protection and affection, making the patient subject to suggestibility and dependence, along with an erotic behaviour which is in reality associated to fear of sexuality; 2. an exaggerated and rapidly shifting expression of emotion leading to unstable, theatrical and histrionic expression of emotions giving an impression of shallowness and lack of authenticity; 3.

A single photon emission computed tomography study of cerebral regional perfusion changes induced by a learning task in subjects with mild memory impairment.

Fifteen nondemented subjects with memory complaints underwent serial single photon emission computed tomography (SPECT) studies with technetium-99m-d, l-hexamethyl-propylene amine oxime (HMPAO) as tracer. Scans were carried out under a baseline conditions and during the learning phase of the Memory Efficiency Profile (MEP), a combined visual perception and memory task developed by Rey. Results indicate a positive correlation between activation, as indexed by HMPAO uptake, and neuropsychological assessment.

[Efficacy of antidepressants and thymoregulators in the long-term evolution of depression].

Official recommendations pointed out the long term maintenance treatment of recurrent unipolar depression on the basis of a significant effect of antidepressants and mood-stabilizers versus placebo. The results of controlled studies, mainly using imipramine or lithium salts, have not been encouraging in term of long term prognosis, due to the limited success rate for maintenance phase ranging from 30 to 48%. The "Pittsburgh study" maximized the recurrence potential by defining patients selection on at least 3 previous episodes of unipolar depression, with the immediate previous episode being no more than 2.

Antidepressant effect of 5-methoxypsoralen: The melatonin synchronizer hypothesis.

5-methoxypsoralen (5-MOP) stimulates pineal melatonin secretion, and a decrease in dark phase melatonin levels has been described in major depression. As exogenous melatonin has shown synchronizer properties, authors hypothesized that giving 5-MOP would have antidepressant properties. Twenty-six inpatients meeting the criteria of major depressive disorders were enrolled in a four-week, double blind trial of 5-MOP versus amitriptyline.

[Plasma tryptophan in a protein controlled diet in depressed patients].

Cerebral serotonin is synthetized from its blood precursor: tryptophan (TRP), an essential amino acid (6). TRP has been extensively studied since serotonine has been reported to be involved in the pathogenesis of depression (9). In one hand, brain serotonin content depends on regulation by plasma large neutral amino acids (LNAA): leucine, isoleucine, valine, tyrosine and phenylalanine that compete with TRP to cross over the blood brain barrier (7, 13).

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.

[Hesnard and the psychological ideas of the post-war period].

Hesnard was interested in all psychological theories. His goal was to develop his own theory which he conceived of as a concept of mental illness as well as all psychic life that was "at once biological and psychological, called structural-ethical". To this end, he sought to retain from various theories whatever seemed to him "useable".