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Biomedical subjects

A Lesage

Publications and source records attributed to A Lesage.

At least 73 records · Page 4Linked to original sources
PubMed1988

Molecular pharmacology of niaprazine.

1. The pharmacological profile of niaprazine was investigated using in vitro ligand binding techniques. 2. Niaprazine exhibits a low affinity for the vesicular monoamine transporter and for D2, alpha 2, beta, H1 and muscarinic cholinergic receptors. Niaprazine, particularly the (+)stereoisomer, has a higher affinity for alpha 1 (Ki = 77 nM) and 5-HT2 (Ki = 25 nM) binding sites, but is poorly recognized by 5-HT1A and 5-HT1B binding sites (Ki sigma mciroM). In contrast, p-fluoro-phenylpiperazine, a major metabolite of niaprazine, exhibits a higher affinity for the 5-HT1 subclasses than for the 5HT2 class. 3. These results suggest that the pharmacological properties of niaprazine reflect both its non-reserpinic catecholamine depletor effect and its action on alpha 1 and 5-HT2 receptors. A role of p-fluoro-phenylpiperazine via 5-HT1 sites cannot be excluded.

Adrenal Medulla↗
PubMed1988

The problems of people in long-term psychiatric day care. An introduction to the Camberwell High Contact Survey.

The aims of the Camberwell High Contract Survey (CHCS) were to develop and test a systematic needs assessment procedure and use it to evaluate the services provided to long-term users of day centres and sheltered residential accommodation (excluding hospital wards). This paper describes the background to the study, the sample of 145 attenders and their characteristics, their clinical and social problems and the care provided for them.

Adolescent↗
PubMed1988

Needs for care among the long-term mentally ill: a report from the Camberwell High Contact Survey.

We report the results of a survey of the needs for items of care of 145 long-term users of psychiatric day-hospitals and day-centres in Camberwell. The overall ratio of met to unmet need was almost exactly 5:1. Need was shown to vary according to chronicity, degree of participation, and placement in day-hospital or day-centre. Specific areas of functioning and specific types of care were identified in which there was significant overprovision or underprovision. The utility of our measures, and their ability to identify clinically significant unmet need, are discussed.

Activities of Daily Living↗
PubMed1987

[Two models of services in psychiatric rehabilitation in Great-Britain.].

Social Psychiatry concepts represent the theoretical basis of British psychiatric rehabilitation. Psychiatric disabilities are explained in terms of three dimensions: psychiatric impairment, social disadvantages and personal reaction to impairment and disadvantages. Psychiatric rehabilitation consists in reducing or at least containing disabilities using medical and social treatments to affect these 3 dimensions. British Psychiatric services have pionereed deinstitutionaliza-tion and community care. However, the development of integrated community services has been slow and uneven across the country. Two British rehabilitation settings are described. Netherne Hospital, a mental hospital with local area respon-sabilities for rehabilitation. Camberwell, where admissions to mental hospital has ceased and where District Services Center coordinate the rehabilitation activities.

English Abstract↗
PubMed1986

Private exposure and covert sensitization in the treatment of exhibitionism.

The present report describes the treatment of a long standing exhibitionism case by covert sensitization and private exposure in front of his wife within an A-BC-B-BC-C single case experimental design. The therapeutic phase of the treatment lasted 10 weeks. Results show that the combination of covert sensitization and private exposure seems to be an interesting technique for married exhibitionists and their wives. Covert sensitization was used to eliminate deviant fantasies and private exposure seemed to have rendered exhibitionism socially acceptable. The various measures of subjective responses indicated that there were no exhibitionist activities during baseline and treatment nor during the year's follow-up, and the patient has been asymptomatic for more than 2 years, as confirmed by a recent follow-up visit. Controlled studies with larger groups of patients are now needed to prove the efficacy of this active, nonaversive and economical treatment for exhibitionists and their wives.

Adult↗
PubMed1984

Effect of a reversible and selective MAO-A inhibitor (cimoxatone) on diurnal variation in plasma prolactin level in man.

Prolactin (PRL) secretion is stimulated by serotonin (5-HT) and inhibited by dopamine (DA). 5-HT is generally recognized as a substrate for type A monoamine oxidase (MAO), whereas DA is considered as a substrate for either A or B, or both forms of MAO, depending on the species and tissues used. The effect of cimoxatone, a reversible, selective MAO-A inhibitor, on diurnal variation in plasma PRL level was investigated in healthy adults after a single 40 mg oral dose, as an indirect approach to investigating whether DA is preferentially a substrate for Type A or B MAO in man. The circadian rhythm in PRL, stress conditions and diet were taken into account in the present study, which was placebo-controlled. There was a slight but significant reduction in circulating PRL in the six subjects, which persisted for at least 9 h after cimoxatone. However, the duration of the decrease in plasma PRL was shorter than the inhibition of MAO-A. The results are not inconsistent with the presence of both forms of MAO in the human hypothalamus and with DA as a substrate for both forms in this region, if it is assumed that the hypothalamic concentrations of the drug during the period 0-9 hours was sufficiently high to inhibit DA deamination by both forms of MAO.

Adult↗
PubMed1984

[Toward a redefinition of community psychiatry in Quebec].

Community Psychiatry is in troubled waters in Quebec. Overwhelmed by their caseloads, community clinics do not see the end of the tunnel with their new long-term mentally-ill patients. The painful reality of the new asylum in the community raises questions about Community Psychiatry despite its remarkable progress. The authors analyze the state of the art about schizophrenia, which is mainly related to chronic mental patients and point out the discrepancy between the original ideals of Community Psychiatry and the clinical reality. They develop the four following propositions to redefine Community Psychiatry in the actual context: recognize the need for the asylum as a process; tolerate the paradox of the multidisciplinary work; narrow the target population and the type of therapy offered; and secure continuity with the community.

Chronic Disease↗
PubMed1983

[Antidepressive action, pharmacokinetic characteristics and biochemical properties of cimoxatone, a new reversible MAO-A inhibitor].

Cimoxatone is a new monoamine oxidase inhibitor (MAOI) in comparison to the existing non-selective and irreversible MAOIs used in the therapy of depression. A clinical study has been carried out in 10 depressed patients. Cimoxatone was given from 0.32 to 0.78 mg/kg/day for 28 days. The drug was shown to be effective against depression and well tolerated at the given doses. The inhibition of monoamine oxidase and its reversibility were assessed by urinary excretion of 3-methoxy-4-hydroxy- phenylethyleneglycol sulphate. The treatment had no effect on the plasma prolactin levels. The plasma concentrations of cimoxatone reached a plateau after 3 to 4 days of therapy. The study confirmed earlier findings in healthy volunteers that the principal metabolite is also active as a type A MAOI. The plasma elimination of cimoxatone and its metabolite is almost complete 4 days after the last dosing.

Adult↗
PubMedDate not supplied

[French validation of the Verona Service Satisfaction Scale-VSSS-54F].

INTRODUCTION: The Verona Service Satisfaction Scale-French version (13) was translated and adapted from the Italian version of Verona Service Satisfaction Scale (27). The VSSS makes it possible to evaluate the satisfaction of people with serious mental illness with respect to the services. The original VSSS-54 contained 7 dimensions: 1) Overall satisfaction, 2) Professionals' skills and behaviour, 3) Information, 4) Access to services, 5) Services efficacy, 6) Relatives' involvement and 7) Types of interventions. According to factorial analyses carried out by Ruggeri et al., the dimensions Information and Access to services were aggregated. However, no factorial analysis was carried out in order to verify the six dimension-structure of the VSSS. From an international perspective, the study entitled "The European Psychiatric Services: Inputs linked to Outcome Domains and Needs (EPSILON)" achieved the standardisation of different questionnaires in several languages (2). A new version of the VSSS entitled "Verona Service Satisfaction Scale-European version" (VSSS-EU) was developed and is now available in the following languages: Italian, Danish, German, English and Spanish. In order to compare in different countries the satisfaction of people with serious mental illness with respect to services, we undertook from 1998 to ascertain the psychometrical properties of the French version of the VSSS. (13). Confirmatory Factorial Analysis (CFA) was carried out on the six dimension-structure of the VSSS-54F: 1) Overall satisfaction, 2) Professionals' skills and behaviour, 3) Information and Access to services, 4) Services efficacy, 5) Relatives involvement and 6) Types of interventions. For each dimension, consistency analysis (Cronbach's alpha) was computed in order to bring forth additional psychometrical properties of the VSSS-54F. METHOD PARTICIPANTS: 150 clients involved in an intensive case management program and supported by 30 mental health workers, filled out the VSSS-54F questionnaire. These clients were comprised of 110 women and 40 men, their ages ranging from 22 to 90 years (M = 51.7, SD = 14.7). Among them, 65 (43.3%) had a diagnosis of schizophrenia or another form of psychosis, 56 (37.3%) had an affective disorder, 17 (11.3%) had anxious disorders and 7 (7.7%) other. DATA ANALYSES: Using the EQS Software (3), Confirmatory Factor Analyses (CFA) were carried out in this study. Thus, 'the evaluation of the models' fit with the empirical data was carried out by taking into account various statistical indices. In addition to the Chi square/df ratio, the indices of adjustment such as the "NonNormed Fit Index" (NNFI), the Comparative Fit Index (CFI), robust CFI (calculated starting from the Satorra-Bentler Chi Square) as well as the RMSEA (Root Mean Standard Error of Approximation) were used to measure the fit of the models. Moreover, the estimation method "Maximum Likelihood-Robust" was carried out in order to evaluate the models. RESULTS: The original model with 6 dimensions (M1) does not present satisfactory fit indices. Indeed, the Chi Square/df ratio is above 2, the NNFI, CFI and CFI robust indices are lower than. 90 and the RMSEA is higher than. 08. Most items from Types of intervention dimension presented saturation lower than.30, and consequently indicate that these items are not correlated significantly with their dimension. We notice also some correlations between error terms of the three items of Overall Satisfaction scale and other items of the VSSS questionnaire. Considering these last results and the direction taken in VSSS-EU by breaking down by profession items of Professionals' skills and behaviour scale, we obtained a new model (M2). The five dimensions of this model are as follow: 1) Psychiatrists/Psychologists' skills and behaviour (7 items), 2) Nursing staff/social workers' skills and behaviour (7 items), 3) Information and access to services (3 items), 4) Services efficacy (5 items), 5) Relatives' involvement (3 items). When we test this model, the fit indices are satisfactory: the Chi Square/df is 1.36, the NNFI, CFI and robust CFI indices are near or higher than 0.90, respectively 0.88, 0.89 and 0.94. Finally, the RMSEA index is 0.08. In addition, the correlations between five dimensions are significant and vary from 0.58 to 0.87 (p < 0.05). The internal consistency coefficients for each new scale are all satisfactory, and vary from .83 to .91, except for the Information and access to services scales. But this latter finding shall be evaluated knowing that acceptable alpha can be close to .60 when scales count less than four items (16). CONCLUSION: This study confirms with some adjustments the factorial structure of the VSSS. The results indicate five dimensions (25 items): Psychiatrists/Psychologists' skills and behaviour, Nursing staff/social workers' skills and behaviour, Information and access to services, Services efficacy, Relatives' involvement. Even if the Type of interventions dimension was not retained in the model, we suggest preserving it for eventual clinical evaluation based on each item. We also suggest, for future studies, the adaptation of the VSSS-54F to the European version, VSSS-EU. Indeed, the results of our study sustain the European version because the VSSS-EU is more focused since it separates the skills and behaviour of psychiatrists, psychologists, nurses and social workers (e.g. items 3a and 3b or items 22a and 22b). The next step in the validation process would be to measure Inter-rater and test-retest reliability as well as concurrent, convergent and discriminant validity of the VSSS-EU. Furthermore, a multicultural comparison of the VSSS-EU would be required if the instrument is used for interesting comparisons of survey.

Adult↗
PubMedDate not supplied

[Research in psychiatry].

The department of psychiatry of the Université de Montréal has now organized a well structured research network in the area of child, adult and forensic psychiatry. The authors summarize the scientific approach according to research in these different sectors and believe that, although research in psychiatry now tends to promote diagnostic and treatment methods based more and more on neuro-sciences, it does not neglect the contribution of psychosocial and clinical aspects without which the human dimensions of mental illness and the objective of improvement of care to patients would be rapidly forgotten on behalf of disembodied research projects completely deprived of the relation with patients.

Adult↗