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Biomedical subjects

D Widlöcher

Publications and source records attributed to D Widlöcher.

At least 19 recordsLinked to original sources
PubMed1996

Attention deficits in depression: an electrophysiological marker.

EVENT-RELATED POTENTIALS were recorded in young depressed subjects and compared with results from controls. Subjects were required to respond to targets (rare high-frequency sounds) presented to a designated ear, and to ignore targets presented to the non-designated ear as well as standards (frequent low-frequency sounds) presented to either ear. The results confirm those previously obtained with elderly depressed patients, showing the same general profile of electrophysiological and behavioural differences, and in particular a substantial reduction of the N200 amplitude in response to attended targets in depressed subjects. It is suggested that the N200 component could be a marker of depression.

Adult↗
PubMed1995

[Dissociative hysteria].

Under the term of dissociative hysteria are described a set of clinical syndromes characterized by behavioral disorders and psychic activity anomalies. The nature of the symptoms seems very similar to hysterical conversion. Psychogenic amnesia, psychogenic fugues and multiple personality disorder are described. There is some evidence that the symptoms are related to psychic affective traumatisms and no physiological alteration. Two mechanisms are proposed: dissociation of personality and amnesia. Clinical course generally improves spontaneously. Various forms of psychotherapy may be used.

Amnesia↗
PubMed1994

Decrease of complexity in EEG as a symptom of depression.

Nonlinear dynamic analysis provides new methods for the processing of the electroencephalogram (EEG). We demonstrate here that the EEG dynamics of major depressive subjects is more predictable, that is less complex, than that of control subjects. Moreover, the consequence of treatment upon the EEG dynamics seems to be dependent on the appearance of the illness. Although the specificity of this dynamic signature for different stages of depression is to be confirmed, the assumption of a strong link between a healthy system and a high level of complexity in dynamics is further supported.

Adult↗
PubMed1994

Circadian pattern of motor activity in major depressed patients undergoing antidepressant therapy: relationship between actigraphic measures and clinical course.

The 24-hour motor activity pattern was evaluated in 26 inpatients with major depression at treatment onset and after 4 weeks of antidepressant therapy. Clinical state, depression, and psychomotor retardation, as well as motor activity level and circadian rhythm, were simultaneously assessed. Treatment responders and nonresponders were also considered. Diurnal hypoactivity and reduced 24-hour rhythm amplitude were found at treatment onset. Activity level increased significantly on discharge. The rest-activity cycle for each depressed patient fit a cosine function of 24-hour periodicity. Data tended to show no phase shift but a large intragroup phase variability. Preliminary findings of a negative correlation between basic activity level and clinical improvement, and a trend toward responders having a lower activity level than nonresponders, suggest that activity could be used to predict therapeutic response.

Adult↗
PubMed1994

Loss of control of pre-motor activation in anxious agitated and impulsive depressives. A clinical and ERP study.

1. Current research uses a variety of traditional validation methods in order to test the clinical expression of biological models in psychiatry. The application of these methods has resulted in a paradoxical situation which requires the definition of new objectives in biological and pharmacoclinical research: the biological specificity of new psychotropic drugs does not assume any congruence between their pharmacological and their therapeutic effects, but raises the question of the relationship between biological systems and clinical symptomatology. The dimensional description of psychopathological disorders may be more appropriate to biological studies in psychiatry. 2. A study was undertaken on a population of twenty-one in-patients fulfilling the DSM III-R criteria for major depressive episode. They were divided into two groups on the basis of contrasting clinical dimensions: anxious-agitation and impulsiveness versus retardation and affective blunting. 3. Significant clinical differences between the two groups on mood profiles were echoed by contrasts in event-related potentials during a go-nogo task: only anxious agitated and impulsive patients developed an abnormal cortical activity, as measured by contingent negative variation (CNV), in the nogo condition. 4. This paper suggests how a paradigm with control of motor action leads to specify premotor activation abnormalities in the agitated impulsive depression subtype.

Adult↗
PubMed1994

Nicotine dependence and motives for smoking in depression.

Smoking variables were assessed in female (n = 48) and male (n = 28) French hospitalized depressed smokers. Nicotine dependence, motives for smoking, and emotional situations in which depressed smokers were likely to smoke were compared with those of female (n = 36) and male (n = 60) nondepressed smokers from the general population. Depressed smokers scored higher than controls on nicotine dependence, and on stimulant and sedative smoking; they also reported that they were more likely to smoke in negative emotional situations. Sedative smoking decreased significantly between admission and discharge. Sedative smoking is a strong reason for smoking among depressed smokers regardless of degree of dependence, whereas stimulant smoking is positively correlated with degree of dependence. Nicotine dependence is also significantly correlated with anhedonia, and its relationship to depression is discussed in regard to nicotine action on hedonic systems.

Adult↗
PubMed1994

A case is not a fact.

Why do we publish clinical data? Between the scientistic illusion that assumes that cases are objective data and the disillusioned observation that psychoanalytic literature is mainly used to boost identity feelings, what role is played by such publications? New psychoanalytical knowledge results from clinical practice and not from scientific experiments or observations. A clinical vignette, even more than a full monograph, is clearly not designed to prove a theory from objective facts but to illustrate a particular clinical view. The quality of a case report relies on at least three criteria: data economy; adequacy to the proposed thesis; and convincingness or persuasion. A case is not a fact, because understanding it presupposes 'semantic holism': understanding any mental state requires taking into consideration a 'world of knowledge'. Empathy results from an unlimited work of inferences. In presenting a case, the psychoanalyst is always in a sense a 'thought-reader'. He describes what he believes he discovers.

Authorship↗
PubMed1994

[Psychological theories on the vulnerability to depression].

The problem of psychological vulnerability refers back to the dysymetric interactions between biological, life-event and personality factors. The term "personality" must be defined in terms of three factors: differential characteristics of the primary traits, "temperament" from the purely biological stand-point, and psychodynamic organization. The following discussion will deal solely with notions of temperament and psychodynamic organization. The renewed interest in the notion of temperament for the constitution of depression has been evoked in a number of recent studies, and allows an integrative approach of the biological phenomena. From the stand-point of psychodynamic organization, we should be less concerned with a strictly etiological role than with the mechanisms involved: loss of the object, in the neurotic model (depressive neurosis?) absence of the object (severe narcissistic disorders). This psychodynamic clinical approach must also take into account the triggering or unmasking effects of the depressive state itself on the underlying personality structure.

Depressive Disorder↗
PubMed1993

Ascending-descending threshold difference and internal subjective judgment in CFF measurements of depressed patients before and after clinical improvement.

The purpose of this study was to measure, using the method of limits, the ascending-descending threshold difference, delta = fa-fd, in subjects with major depression. 28 patients were given two sessions, one before treatment and the other after recovery. Mean values of delta measured in the second session were significantly smaller than those scored before treatment. The two sets of values were positively correlated. The ascending-descending threshold difference was suggested previously as likely related to the internal subjective judgment of subjects. The present results are consistent with the hypothesis of a more conservative response criterion in depressed patients before than after clinical improvement.

Adult↗
PubMed1993

[Emotional disorders in HIV infection].

Psychiatric and neurological symptoms have been the target of many studies, but the emotional and behavioral modifications in HIV infection remain quite unknown. Working on the emotional dimensions and the heterogeneity of depressive mood, we were interested in evaluating the emotional symptomatology in HIV infected patients. Fifteen HIV-positive and fifteen HIV-negative homosexual men paired by age and educational level were studied. They were seen by two trained psychologists who assessed depression, anxiety and mood dimensions with the MADRS depression scale, Covi's anxiety scale, Depressive Mood scale, Abrams and Taylor scale for Emotional Blunting and Retardation scale. HIV-positive subjects had significantly higher scores of emotional blunting: anhedonia and hypoexpressiveness. Scores of depression, anxiety, irritability and hyperexpressiveness were not significantly different between both groups. Hypoexpressiveness scores were correlated to the CDC stages of the disease. This means that the emotional deficit seems to increase with the course of the disease, and is present in the absence of depression or anxiety. The question of the origin of this emotional blunting can be raised: is it the result of an adaptative behavior and/or the action of the virus on the central nervous system? Further studies are needed to confirm these results and answer this question.

Adaptation, Psychological↗
PubMed1993

[Post-partum blues: a critical review of the literature].

The abundant literature dealing with the post partum blues has failed to describe a possible causing factor in these emotional and physical manifestations which are frequently observed in mothers during the first few days following delivery. The post partum blues has been considered as a promising model for depressive states but its function has never been clearly established. No agreement has been reached as to its physiological mechanism. Presently there is a renewed interest for the "third day blues" in relation to post-birth depression, which is known to be frequent, and to the early interactions. The authors present a review of the literature and emphasize the necessity to approach this issue from a new standpoint and with new conceptual and measurement tools. The role of post partum blues could well be, through a biological process involving the dopamine, to facilitate the establishment of early mother-infant bonds by provoking a decrease in blunted affect.

Affect↗
PubMed1992

Theoretical considerations and perspectives on the onset of action of moclobemide.

The aim of this paper is to focus on methodological problems related to clinical studies on the onset of action of antidepressants, especially moclobemide. The methodological discussion proposed focuses on: --global efficacy as a function of time; --proposals for a specific approach to the study of the onset of action; --quality of the response and onset of action; --the dimensional level and the onset of action.

Antidepressive Agents↗
PubMed1992

Clinical subtypes and age at onset in schizophrenic siblings.

This study examines the concordance of clinical subtypes and age at onset of schizophrenia in 42 sibships of multiply affected schizophrenic patients. Subtypes were defined by four major diagnostic systems (DSM-III, DSM-III-R, ICD-10, and Tsuang-Winokur criteria) and rated both for the first hospitalization and long-term diagnosis. When a sibship method was used, no concordance for subtypes was found in siblings. Age at onset, analyzed as a continuous variable with the intraclass correlation method, was found to be correlated in siblings. This finding suggest that the search for continuous traits distributed in families of schizophrenic patients might constitute an alternative to discrete category-based family studies.

Age Factors↗
PubMed1991

Over-reporting of maladjustment by depressed subjects. Findings from retesting after recovery.

The extent to which patients' reports of maladjustment is influenced by depressive symptoms was estimated in 25 acute depressed patients responding to pharmacotherapy. Their social adjustment over the same four-month period immediately prior to hospitalization was assessed on two separate occasions: firstly when they were acutely depressed, and again a mean of 20 days later when clinically recovered. Significant differences between the two reports were found in mean score of maladjustment in four out of five fields of social adjustment (work, social/leisure life, family of origin, marriage, and sex). The reduction in depressive symptoms scores (of pessimism considered separately), correlated significantly with changes in the total maladjustment score. The reduction in pessimism scores correlated with changes in the scores for both work and social/leisure fields, and also accounted for 40% of the total variance in maladjustment score. These results indicate that impaired social adjustment as assessed during the height of the depressive illness arises in part from a symptom--related overreporting bias leading patients to make a harsh appraisal of themselves.

Adult↗
PubMed1991

Depressed subjects unwittingly overreport poor social adjustment which they reappraise when recovered.

Potential biases due to acute depressive symptomatology on raters' assessments of social maladjustment derived from patients' reports were assessed in 25 patients responding to pharmacotherapy during medium-term hospitalization. Patients were questioned on two separate occasions about their social maladjustment covering the exact same period (the 4 months preceding hospitalization): the first was during the acute illness phase, and the second a mean of 20.5 days later, when symptoms remitted. In the second report, composite scores for all fields as a whole showed significantly fewer reports of social impairment than did the first. Significant differences from the first to the second evaluation concerning both subjective distress and observable behavior were found in four and three, respectively, of the five "fields" of social adjustment. Although subjective distress was most modified by remission of acute symptoms, even supposedly objective, observable disturbances were significantly affected. These results indicate that acutely depressed patients overreport social maladjustment, which they then more accurately reappraise when symptoms remit. Patients are completely unaware of both the initial bias and of the reappraisal.

Acute Disease↗