Search PubMed⌕ Search

Biomedical subjects

C Martin

Publications and source records attributed to C Martin.

1,426 records · Page 80Linked to original sources
PubMedDate not supplied

[Anxiety disorders in general practice: frequency--treatment. A survey of the Aquitaine Sentinel Network].

OBJECTIVE: This study, conducted in Aquitaine (Southwest France), was designed to assess both frequency and treatment of anxiety disorders in general practice patients. METHOD: The assessment was cross-sectional; a random sample of 312 patients was chosen and evaluated during the last week of Mai 1993, by 55 general practitioners who usually collaborate in the Aquitaine Sentinel Network, supported by the Department of Medical Statistics and Public Health of the University of Bordeaux. Anxiety disorders were assessed by the Composite International Diagnostic Interview and level of depression was self evaluated by the Beck Depression Inventory. The physicians reported current psychological and psychopharmacological treatments, and request for treatment of every patient tested. RESULTS: Frequency of anxiety disorders is concordant with available epidemiological data in French general population. There is no sex difference for anxiety disorders in this study, in opposition to what is known in the general population (2 = 1.47, p > .05). Women are more treated than men (drugs: chi(2) = 7.31 p < .01; psychotherapies: chi(2) = 7.58 p < .04) although they don't request for more treatment (chi(2) = .59 p M .05). Benzodiazepines and psychodynamic oriented therapies are the most used treatments for any anxiety disorders; specific treatments (antidepressive drugs, behavioral therapies) of anxiety are very rarely prescribed. CONCLUSION: This study shows the difference between the current theoretical knowledge in anxiety disorders, and the management of these disorders by the general practitioner. It suggests that patient's request, in opposition to what is often found in the literature, is not a determinant factor in treatment.

Adult↗
PubMedDate not supplied

[What is the outcome of childhood anxiety in adulthood?].

Because anxiety has normal adaptative forms through development, the identification of pathology may sometimes pose difficulty. Child and adolescent anxiety disorders were defined in modern classifications. Some of them are common to children, adolescents and adults, such as generalized anxiety disorder, panic disorder, simple phobia, social phobia, obsessive compulsive disorder, post traumatic stress disorder. According to DSM IV, separation anxiety disorder is the only disorder which starts during childhood or adolescence. From the epidemiological evidence, anxiety disorders appear frequent. There is evidence of specificity in the course of simple phobia, social phobia and obsessive compulsive disorder, but less specificity in the course of other disorders. Separation anxiety disorder and generalized anxiety disorder represent risk factors for anxiety disorders, depressive disorders or other psychiatric disorders in childhood or adulthood. Data suggest that initial severity or comorbidity may play a role regarding the prognosis of anxiety disorders. Most child and adolescent anxiety disorders are no longer present in adulthood, but most adult anxiety disorders are preceded by child and adolescent anxiety disorders.

Adolescent↗
PubMedDate not supplied

[Medico-economic study of Léponex (clozapine) in the Bordeaux Charles Perrens Hospital Center].

Schizophrenia disorders afflict approximately 1% of the population during their lifetime. Conventional antipsychotic agents show therapeutic limitations because of their side-effects and inefficacy among some patients. A novel antipsychotic class, named atypical neuroleptics, among Léponex is the leader, constitutes a hope in treatment-resistant schizophrenia. However, because the drug involves a 1% to 2% risk of agranulocytosis, an haematological oversees has been established. Moreover, the acquisition cost of clozapine is high in comparison with that of standard antipsychotics. The purpose of this study was to observe the management of 72 patients suffering from resistant schizophrenia, to assess the cost of this treatment in medical and social terms, and to realize cost-effectiveness study in Charles Perrens Hospital (Bordeaux). The survey based on three questionnaires (Clinical informations, Quality of Life, Epidemiological information) was sent to psychiatrists practising in this hospital. The results confirm efficacy (overall functioning measured by CGI which is significant, p < 0.0001) and tolerance of Léponex (no side effects in 33.3% patients, no agranulocytosis, only one neutropenia and only 4.2% neurologic side effects). We found a significant reduction of the annual mean number of days of full time hospitalization (214 days versus 135 after two years, p < 0.0005) associated with the significant reduction of direct cost mainly related to shorter length of hospitalization; and 45.8% versus 8.3% adjust to life in the community (p < 0.0004). Clozapine produced a marked improvement (p < 0.0001) in Quality of Life measured by two self-rating scales (SWN and TEAQV). The estimated total two-years cost decreased from 31,108 Francs/month/patient to 22,950 Francs/month/patient, a saving of 8,158 Francs/month/patient (a decrease of 26.2%). Although the acquisition cost of clozapine is high, cost effectiveness estimates in patients with treatment resistant schizophrenia suggest that the clinical benefits (improved psychopathology, social functioning and quality of life) of this drug may confer medium to long term economic benefits, primarily by reducing the need for psychiatric hospital service.

Adult↗