Psychometric qualities of the French version of the Heinrichs quality of life rating scale.

The quality of life concept has been increasingly used as a major tool for patient care and clinical investigations. The Heinrichs quality of life scale (QLS) is the quality of life assessment method widely used in schizophrenic patients. The QLS was translated into its French version by J.

[Re-evaluating neuroleptics: their antipsychotic properties?].

ANTIPSYCHOTIC PROPERTIES: Compared with traditional neuroleptics, antipsychotics affect receptors other than dopaminergic receptors, particularly serotonin receptors. Clinically, antipsychotics have little or no extrapyramidal effects and do not induce late dyskinesia. They are effective for productive symptoms.

Efficacy of tianeptine in major depressive disorders with or without melancholia.

The efficacy of tianeptine in the treatment of major depressive episodes was assessed in three double-blind placebo-controlled studies. In a first double-blind study comparing tianeptine (37.5 mg/day) with placebo, 126 patients with Major Depression or a Depressed Bipolar Disorder were treated for 42 days; 60% of these patients fulfilled DSM-III-R criteria for melancholia.

Comorbidity of personality disorders and unipolar major depression: a review.

The association of major depressive disorders with personality disorders is relevant in terms of clinical, therapeutic and prognostic aspects. However, the prevalence of this association remains unclear. This may be due to methodological considerations.

[Comorbidity in a sample of hospitalized depressed patients].

In a retrospective study of 133 in-patients with a major depressive disorder, we first described the associated psychiatric (axis I and axis II) or somatic diseases (axis III). Then, we described the patients and therapeutical practices related to comorbidity. The results of this study showed that comorbidity concerned 89% of the patients.

[Drugs diverted from reaching drug addicts].

To divert from use of psychotropic drugs can take from of a classic toxicomania, sometimes isolated, frequently in association with other toxics: alcohol, opioids. Drugs frequently concerned are anxiolytics: benzodiazepines with a short half-life. Use during more than four months, dependent personality, are risk-factors.

Time course of prefrontal lobe dysfunction in severely depressed in-patients: a longitudinal neuropsychological study.

The Stroop Colour-Word Test (SCWT) and the Verbal Fluency Test (VFT), two tests that have been suggested to be particularly sensitive to prefrontal dysfunction, were administered to 23 severely depressed in-patients. Both tests were impaired in patients at inclusion, but only verbal fluency normalized with successful treatment of depression. VFT impairment is consistent with the hypothesis of a left prefrontal cortex dysfunction in depression.

[Delusions of negation: 4 case reports].

After explaining Cotard's syndrome and its different developments from 1880 to 1992 by recelling the relations of nihilistic delusions with melancholia and pointing out the topicality of the research (more particularly in the last ten years), we'll give an account of four clinical cases: two cases involving two women aged 69 and 82, undergoing a plain melancholic episode; a case of post-melancholia paraphrenia, and a case of systemized nihilistic delusions during a post-partum melancholia. In the four cases, recovery was achieved thanks to electroconvulsive therapy. The third stage of this work considers the phenomenological and descriptive, as well as physiological and psychoanalytical assumptions adopted by the authors.

[New exigencies for new antidepressive agents].

Preclinical trials are mainly concerned with toxicologic and behavioral studies in animals. Clinical trials, in man, require answers to several key-questions: confirmation of the superiority of the compound versus placebo, short, middle, and long-term studies for evaluation of efficacy and safety, international clinical criteria defining the experimental population, research of drug interactions, studies within specific types of population, especially ageing subjects. Heterogeneity of information, for the new antidepressive compounds, is explained by several factors: prescription to out- or in-patients, by general practitioners or specialists.

[New anxiolytic drugs: methodological issues].

Compared to benzodiazepinic anxiolytics, new anxiolytic drugs are supposed to have a comparable efficacy, but a better profile of safety (abuse liability, rebound effects, cognitive impairment, sedative effects for example). Methodological issues concerning the development of new anxiolytic drugs are numerous: The diagnostic definition and classification of "Anxiety Disorders" (DSM, ICD) remain discussed and regularly revised. Anxiety disorders, while being heterogeneous, often occur in combination with each other or with depression and anxiety appears to be an ubiquitous component of most psychiatric disorders.

[Tianeptine in episodes of major depression with melancholia and signs of endogenicity].

The effectiveness and good acceptability of tianeptine have been demonstrated in episodes of major depression without melancholia or signs of psychosis which are the valided indications of the tianeptine. In a way of research program, a multicenter study was conducted in 30 patients with D.S.

[Limitations of efficacy of chemotherapies in schizophrenia].

The concept of treatment-resistant schizophrenia cannot be defined as this of resistant depression: schizophrenia is a long-term illness; its evolution is almost always influenced by neuroleptics--but complete recovery is rare. French psychiatry tends to use clinical-empirical criteria, while english speaking studies prefer quantitative criteria, by extended use of clinical and psycho-social scales. The definition of resistant schizophrenia by Kane et al.

[Clinical classification of neuroleptics. Critical study and current prospects].

Clinical classifications of neuroleptics constitute a particularity of European clinical psychopharmacology. However, the importance of evaluation scales in American psychiatry may also lead to an "implicit" clinical classification, since these drugs do not have the same effects upon the same patient. The main European classifications are described and some of actual clinic of neuroleptics are criticised, in particular the concepts of sedative, antipsychotic, antidelusional or antihallucinatory action.

[Discontinuation of neuroleptic treatment in patients with schizophrenia].

Neuroleptic maintenance treatment in schizophrenia is a conflicting issue. There is no reliable criteria to identify patients for which neuroleptic withdrawal can be experienced. However, treatment discontinuation, whose risks can be limited, must be attempted for reasons such as the patient's wellbeing, longterm side-effects prevention and patient-doctor relationship management.

[The hospitalization of a mother and her infant in an adult psychiatric department].

In this article, the authors tell of experiences of hospitalizing mothers together with their newborn children in the psychiatric ward for adults in a general hospital in the Paris region since October 1980. They studied 52 cases, 42 of which were related to post-natal depression. This study develops hypotheses leading up to its implementation, describes how it is set up, and specifies the goals of hospitalizing the two together: not automatically separating a child from its mother who develops a psychiatric condition at such a vulnerable age, observing how mother and child interact, evaluating the mother's nurturing skills and how the baby functions, taking therapeutic action for the mother and for the mother-child relationship, and allowing preventive action, a general prevention of mental illness.

Aberrant T cell-mediated immunity in untreated schizophrenic patients: deficient interleukin-2 production.

The authors examined the immune status at the cellular and humoral levels of 16 untreated schizophrenic patients. No abnormality in the distribution of T cell subsets (CD4+, CD8+) was detected. The proliferative response to the T cell mitogen phytohemagglutinin was normal.

[Sweet bulimia, salty bulimia. Emotional profiles and weight status].

In this study we precise eating and non specific symptomatology of 56 patients with DSM III bulimia syndrome. Results confirm our first hypotheses, particularly the distinction between sweety and salty bulimia and the heterogeneity of patients with this syndrome. We specially studied two types of clinical dimensions: emotional components and weight status.

Psychiatrists and Alzheimer's disease.

Psychiatric symptoms in Alzheimer's disease are not specific: anxiety, agitation, depression, memory disorders, mental confusion. Of these disorders, depression is the most accessible of these to pharmacological treatment; agitation, however, raises the institutional problem. Throughout the inexorable evolution of the disease, the psychiatrist has to pay attention to the global situation: medical, social and legal.

[Adherence to neuroleptic treatment of schizophrenic patients].

Non adherence is a topical problem: about 50% of psychiatric patients do not take their medication as prescribed. Literature's overview is revealing a lack of definition of treatment adherence and the unsatisfactoriness of methods to measure it. Reasons for reluctance to take drugs include complex treatment regimen, drug presentation, duration of treatment and side-effects, most notably akathisia and akinesia.