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Biomedical subjects

D Ginestet

Publications and source records attributed to D Ginestet.

At least 19 recordsLinked to original sources
PubMed1999

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.D. Guelfi according the back-translation method. This version of the validation study included 60 schizophrenic inpatients. The scale possesses acceptable psychometric qualities. The test-retest reliability is good for nearly all items of the scale and for the categories and overall score. The internal consistency alpha-coefficients were 0.9 for the global score and varied between 0.6 and 0.9 according to the category. Factor analysis elicited four factors. Convergent validity is good. Recommendations for future use of the QLS are proposed.

Adolescent↗
PubMed1998

[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. It is more difficult to evidence their antideficiency effect. Antipsychotics can improve certain cases of resistant schizophrenia. LIMITATIONS OF NEUROLEPTICS: Clinical response to traditional neuroleptics is not really satisfactory for approximately one quarter of the patients. In addition, problems of tolerance, particularly neurological disorders, are important. ATYPICAL NEUROLEPTICS: Sulpiride can be considered as a precursor. Amisulpride is a more recent derivative. Clozapine, risperidone and olanzapine are also distributed in France. Other compounds should be available soon. UNRESOLVED QUESTIONS: The long-term effect of these new drugs, whether similar to or superior to classical compounds, remains to be determined as well as their long-term safety profile. In addition, due to high cost, first line use of these new antipsychotics requires a cost/ benefit analysis.

Antidepressive Agents↗
PubMed1997

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. Final MADRS scores showed the efficacy of tianeptine in comparison with placebo (P = 0.007). This result was confirmed by the time course of the Severity of Illness (CGI item 1) (P = 0.015). 58% of the patients responded to tianeptine versus 41% to placebo. In another study comparing tianeptine (37.5 mg/day), imipramine (150 mg/day), and placebo, 186 depressed patients were treated for 42 days. The patients had either Major Depression or Depressed Bipolar Disorder, without melancholia (DSM III-R). In the intention-to-treat analysis, final MADRS scores showed a better efficacy of tianeptine and imipramine than placebo (P = 0.012 and P = 0.034, respectively). There were 56% responders on tianeptine vs 48% on imipramine, and 32% on placebo. A third study involved 244 patients with Major Depression with or without melancholia (DSM-III-R). They were treated in a parallel group design with tianeptine (37.5 mg/day) or tianeptine (75 mg/day) or placebo for 42 days. The high rate of placebo-responders (> 65%) did not allow any conclusion about the efficacy of tianeptine. Altogether, tianeptine was shown to be an effective and safe medication for the treatment of major depressive episodes. However, a controlled study in endogenous depression would be useful to determine the position of tianeptine among the other antidepressants in this indication.

Antidepressive Agents, Tricyclic↗
PubMed1996

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. Nonetheless, it could be estimated from this review that 20% to 50% of inpatients and 50% to 85% of out-patients with a current major depressive disorder have an associated personality disorder. Cluster B personality disorders, in particular borderline (10-30%), histrionic (2-20%) and antisocial (0-10%), seem to be overrepresented, even if the narcissistic one is rare (less than 5%). The main characteristic of Cluster C personality disorders is the great variability of results across studies, except for the obsessive compulsive personality disorder, whose prevalence is consistent and rather high (0-20%). Cluster A personality disorders are an heterogeneous group, since the prevalence of schizotypal personality disorder is rather high (0-20%), the prevalence of paranoid personality disorder is low (less than 5%) and the prevalence of schizoid personality disorder is quite variable from one study to another. The prevalence of personality disorders among patients with a lifetime major depression has been insufficiently studied, although it may concern half of these patients. The prevalence of current of lifetime major depression among patients with a personality disorder has not been sufficiently studied and results are very scattered. Also, the coexistence of personality disorder and major depression is frequent, and this review emphasizes the heterogeneity of the personality styles associated with major depression. Finally, an optimization of methods and the adjunction of a dimensional point of view to the categorical approach may help to study the comorbidity of major depression and personality disorders and its consequences.

Comorbidity↗
PubMed1995

[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. Among the other psychotropics, only certain stimulant antidepressants, like amineptine, justify of a particular attention. Drugs of which indication is not psychotropic can induce abuses: more than morphine itself, drugs including opioids or relating are in great demand by drug-addicts: antalgic like dextropropoxyphene or anticough like Neocodion, this one off the prescription. Anorectics, ephedrine vasoconstrictors and beta-stimulants abuse remains frequent.

Amphetamines↗
PubMed1995

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. Moreover, the persistence of an impaired performance on SCWT in patients at discharge suggests that a selective attention deficit may persist in patients beyond a clear clinical improvement.

Adolescent↗
PubMed1994

[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. The Marketing Authorization Committee and another committee called "Commission de transparence" assess the risk-benefit ratio, the indications of the drug (acute depressive reaction, prophylaxis of recurrences...), the medical benefit. But these advances in methodological procedures are questionable. Will they allow new discoveries, or, conversely, counteract an inventive clinical practice?

Animals↗
PubMed1991

[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.M. III criteria for major depression with melancholia and signs of endogenicity as defined by the Newcastle scale. The patients were treated in a double-blind trial for 42 days. Administration of a placebo for 4 days prior to beginning the study was designed to eliminate rapid responders to placebo. The antidepressant effectiveness was evaluated on the Hamilton (HDRS), Montgomery and Asberg (MADRS) and global clinical impression (GCI) scales. The effect was satisfactory and statistically significant. Seventeen of the 30 patients (57 percent) included in this study improved with tianeptine (CGI-item 2). Results were comparable whatever the diagnosis established on DSM III criteria: bipolar depression, major depression, recurrent or isolated forms. The acceptability evaluated from patient complaints, measurement of blood pressure and laboratory tests was very satisfactory. Treatment was withdrawn in 14 patients with no subsequent withdrawal symptoms. These findings show that tianeptine can be prescribed with success for major depression episodes with melancholia (DSM III) and signs of endogenicity, although it cannot be concluded that patients should be given this treatment in first intention for this type of depression.

Adult↗
PubMed1990

[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. Over the years indication for this type of treatment was refined: keeping an infant close to it's sick mother cannot be a general rule and it should always be possible to reverse the decision. this is only used as an attempt at keeping the newborn with its mother in acute states and when support from the father or the extended family is available. Birthing and post-partum periods could be good ones for taking preventive action concerning the child. Early identification of an interactive disturbance before it comes out as a medical problem, finding new ways of acting and having a therapeutic effect.

Adolescent↗
PubMed1989

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.

Alzheimer Disease↗
PubMed1989

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. No increase in the number of T cells showing activation markers, such as human leukocyte antigens and interleukin-2 receptors, was noted. Conversely, function studies revealed a clear deficiency in interleukin-2 production by purified T cells. This lower production was probably intrinsic to the patients' T cells, since interleukin-2 production showed normal sensitivity to prostaglandin E2-mediated down-regulation by autologous monocytes.

Adolescent↗
PubMed1984

[2 cases of amineptine dependence].

We relate two cases of amineptine (Survector) overconsumption by patients cured for atypical depression with asthenia and activities deficit as the prevalent symptoms. Prescription of two tablets a day (0,200 g) was respected in one case during six months, and in the other case during two years, with therapeutic benefit on apragmatism. To no obvious reason, within few months both patients had gradually raised the doses to twenty tablets (2 g) and thirty tablets (3 g) respectively: we observed subexcitation, insomnia, sensorial hyperaesthesia, irritability, tachyphemia with dysarthria, anorexia with weight lost of more than 10 kg and amphetamine-like troubles without confusion or delusion, as a result of which both patients were treated for their addiction, in hospital. Treatment with clorazepate perfusions did not cause any physical dependence problems. However, psychological dependence was strong enough for one of the patients to go out, on the third day, against medical decision. As far as we know, in France, only one such case of addiction use at high doses and in single intakes is mentioned in the existing literature. However, our observations suggest that it might be necessary to re-assess the place of amineptine among new antidepressive molecules with psychostimulant abilities.

Adult↗