[Borderline personality disorders: diagnosis and treatment].

Borderline personality disorders are complex clinical states with highly polymorphic symptoms and signs, leading to delays in their diagnosis and treatment. All international classifications emphasize certain clinical criteria such as unstable identity and interpersonal relationships, feelings of emptiness or boredom, and pathological impulsiveness. The prevalence is about 2%, with a female-male sex ratio of 2 or 3 to 1.

[Diagnosis of bipolar disorder and rationale of early treatment].

The earlier bipolarity is diagnosed and treated, the better the chances of durable recovery The bipolar spectrum consists of a large panel of clinical syndromes with heterogeneous symptoms. Clinical studies show that, on average, a period of nine years elapses between onset of the first mood symptoms and appropriate prescription of mood stabilizers. Tools such as the bipolarity index can help with earlier and more precise diagnosis of bipolarity, and with the choice of the best treatment to prevent complications of bipolar illness.

Therapeutic drug monitoring of clomipramine and amitriptyline in a depressed patient with upper digestive tract resection.

We describe a 55-year-old woman with extensive digestive resection and recurrent depressive disorder resistant to oral clomipramine tablets but not to an oral solution of amitriptyline. In the light of this case report, the potential mechanisms of drug resistance after digestive resection are discussed, including the importance of drug monitoring.

Self-referential processing and the prefrontal cortex over the course of depression: a pilot study.

Background: Depressed patients exhibit cognitive biases, including maladaptive self-focus. In a previous functional magnetic resonance imaging (fMRI) study, the dorsal medial prefrontal cortex (MPFC) activation during self-referential versus semantic processing was unique to patients, as was the left dorsolateral prefrontal cortex (DLPFC) activation. The aim of this pilot study was to examine whether this pattern was stable over the course of depression.

Evaluating major depressive episodes through the algorithmically structured systematic exploration of subject's state of mind.

Background/aims: Whereas instruments are available to diagnose depression and to rate its severity, there is a lack of instruments to assess the phenomenology of depression, i.e. a set of mental phenomena that constitute subjective experience.

In search of the depressive self: extended medial prefrontal network during self-referential processing in major depression.

Major depression is associated with an excessive self-focus, a tendency to engage oneself in self-referential processing. The medial frontal gyrus (MFG) is central to self-referential processing. This study aimed to explore the neural bases of this excessive self-focus and to disambiguate the role of the MFG in the pathophysiology of major depression.

Cognitive avoidance of intrusive memories and autobiographical memory: specificity, autonoetic consciousness, and self-perspective.

Autobiographical memory (AM) specificity is impaired in depression and post-traumatic stress disorder. Previous studies emphasised the role of cognitive avoidance of intrusive memories in this impairment. This study aimed to examine the association of cognitive avoidance of intrusive memories with specificity, autonoetic consciousness, and self-perspective.

[Adult depressive disorder: clinical aspects, nosography and psychiatrics comorbidity].

Depressed mood and anhedonia are the main symptoms of depressive disorder. With other symptoms, it is responsible for a real break with premorbid patient's way of life. Several clinicals forms, caracterised by melancholia intensity, psychotic symptoms and cognitive troubles, must be identified to adapt treatment and to prevent patients from particular risks.

[Babinski and hysteria].

Babinski made important contributions to both psychiatry and neurology. He disagreed with Charcot's theatrical interpretation of hysteria and made a subtle distinction between Suggestion and Persuasion, thereby differentiating Hysteria from Pithiatism. This paper examines Charcot's concepts and the way in which Babinski refined and honed his master's theories.

Field perspective deficit for positive memories characterizes autobiographical memory in euthymic depressed patients.

Research on autobiographical memory (AM) and the ability to retrieve specific autobiographical events in euthymic depressed patients yielded divergent results. The main goal of the present study was to further explore episodic specificity of AM among fully remitted depressed patients. Twenty euthymic depressed patients and 20 matched healthy controls were given a semi-structured interview, which assesses episodic specificity of positive and negative autobiographical memories regarding event and details' specificity, autonoetic consciousness (remember/know procedure) and visual perspective (field/observer procedure).

[Pseudo-dementia conversion and post-traumatic stress disorder].

Background: Post-traumatic stress disorder (PTSD) is often associated with other psychiatric syndromes. However, studies exploring conversion and PTSD comorbidity are scarce.

Case-report: This paper reports the case of a 45 year-old patient without medical or psychiatric history.

[Dimensional approach of emotion in psychiatry: validation of the Positive and Negative Emotionality scale (EPN-31)].

Background: This paper reports the first validation study of the EPN-31 scale (Positive and Negative Emotionality scale, 31 items) in a French psychiatric sample. This questionnaire has been adapted by Rolland from an emotion inventory developed by Diener, and is also in accordance with Watson and Clark's tripartite model of affects.

Methodological Aspects: Respondents were asked to rate the frequency with which they had experienced each affect (31 basic emotional states) during the last month.

[Episodic autobiographical memory in depression: a review].

Introduction: Autobiographical memory and personal identity (self) are linked by a reciprocal relationship. Autobiographical memory is critical for both grounding and changing the self. Individuals' current self-views, beliefs, and goals influence their recollections of the past.

Validating the bipolar spectrum in the French National EPIDEP Study: overview of the phenomenology and relative prevalence of its clinical prototypes.

Background: Few studies have been undertaken to ascertain the feasibility of using the bipolar (BP) spectrum in clinical practice. The only systematic national study is the French EPIDEP Study of consecutive inpatients and outpatients presenting with major depressive episodes (MDE). The protocol was developed in 1994 and implemented in 1995; publication of its first data began in 1998.

[Acute catatonic syndrome after neuroleptic malignant syndrome].

We report the case of a young woman who deve-loped catatonic syndrome a few days after neuroleptic mali-gnant syndrome (NMS), arising the problem of the chronology of both affections. A 20-year old woman with an history of bipolar disorder, experienced an acute manic syndrome that made hospitalization necessary. Fourteen days after loxa-pine prescription, the patient developed a NMS (DSM IV criteria) dyskinesia, dysphagia, fever and alteration of cons-ciousness.

[Stress, depression and cerebral plasticity: an update of clinical and experimental findings].

Recent studies of neuroplasticity in stress and depression have given rise to new hypotheses on the neural bases of these disorders. Based on data from imaging studies, cellular and molecular biology, and animal models, this approach could help to understand certain clinical findings, and especially cognitive impairments. Some antidepressants have effects on neuroplasticity, in addition to their symptomatic effects on depression.

Episodic autobiographical memory in depression: Specificity, autonoetic consciousness, and self-perspective.

Autobiographical memory (AM) and the self are closely linked. AM retrieval in depression is characterized by a lack of specificity, suggesting an impairment of episodic AM. Autonoetic consciousness and self-perspective, which are critical to episodic AM, have never been addressed in depression.

The Temperament and Character Inventory-Revised (TCI-R): psychometric characteristics of the French version.

Objective: To explore the psychometric characteristics of a modified version of the Cloninger's personality questionnaire, the Temperament and Character Inventory-Revised (TCI-R).

Method: A 482-subject sample, including clinical and non-clinical subjects, completed the TCI-R. We performed principal component analyses and explored the factorial structure of the questionnaire, and the internal consistency of each dimension.

Cognitive control and brain resources in major depression: an fMRI study using the n-back task.

Several neuroimaging studies have reported 'hypofrontality' in depressed patients performing a cognitive challenge compared to control subjects. Hypofrontality in depression is likely associated with an impaired behavioral performance. It is unclear whether this impaired performance is the consequence or the cause of hypofrontality.

Validating affective temperaments in their subaffective and socially positive attributes: psychometric, clinical and familial data from a French national study.

Background: One of the major objectives of the French National EPIDEP Study was to show the feasibility of systematic assessment of bipolar II (BP-II) disorder and beyond. In this report we focus on the utility of the affective temperament scales (ATS) in delineating this spectrum in its clinical as well as socially desirable expressions.

Methods: Forty-two psychiatrists working in 15 sites in four regions of France made semi-structured diagnoses based on DSM IV criteria in a sample of 452 consecutive major depressive episode (MDE) patients (from which bipolar I had been removed).