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Biomedical subjects

F Borgeat

Publications and source records attributed to F Borgeat.

At least 19 recordsLinked to original sources
PubMed2006

Cognitive behaviour therapy and medication in the treatment of obsessive-compulsive disorder.

OBJECTIVE: To compare cognitive behaviour therapy (CBT) with CBT plus medication; medication alone; and placebo in the treatment of adult obsessive-compulsive disorder (OCD). METHOD: Forty-eight participants (43 completers) were recruited into two protocols. In the first protocol, 21 people with OCD were randomly allocated to either a standard medication (fluvoxamine) or standard placebo condition for a 5-month period. Both these groups subsequently received CBT for a further 5 months. In the second protocol, 22 people with OCD received CBT, one group was already stabilized on an antidepressant of choice; the second group was drug naïve. RESULTS: All active treatments, but not the placebo, showed clinical improvement. There was no difference in treatment response to CBT regardless of whether participants had previously received medication or placebo. CONCLUSION: CBT has a more specific antiobsessional effect than medication but CBT plus medication shows greatest overall clinical improvement in mood.

Adult↗
PubMed2005

[Coercion in psychiatry: current knowledge and perspectives].

Coercion is still frequently used in psychiatry and tends to be considered a necessity, when a patient at risk has lost his/her ability to judge. The aim of this article is to report and discuss current scientific knowledge on this topic. The different steps associated with coercion contribute, along with the illness, to the degree of stress experienced by the patient and might compromise his/her level of adherence to the treatment offered. Clinicians need to consider three dimensions: the coercion applied, the legal status and the subjective feeling of coercion. Pressure that is symbolically negative, positive or legal is exerted on the patients, thereby raising questions about the development of alternatives to the use of coerced treatment. The introduction of the advance directives to Swiss cantonal laws could give rise to different forms of collaboration that are more acceptable to patients.

Coercion↗
PubMed2003

[Pharmacotherapy of generalized anxiety disorder: state of the art].

A large percentage of patients in primary care suffer from Generalized Anxiety Disorder (GAD). A task force of the Swiss GAD Society has reviewed the scientific literature and has developed treatment recommendations. Basic treatment, adjunctive treatment and therapy of specific problems like insomnia and comorbidities are differentiated. Newer antidepressants are recommended as basic treatment, especially venlafaxine and paroxetine, which are licensed for that indication.

Adolescent↗
PubMed2001

Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders.

The aim was to evaluate the efficacy of a manualized cognitive-behavioural program based on habit reversal for the management of chronic tic disorder (CTD) and habit disorder (HD). Forty-seven CTD and 43 HD received a 4-month treatment program. Thirty-eight (22 CTD, 16 HD) were placed on a waitlist control group, which subsequently received treatment. The treatment approach combined awareness training, relaxation (including modification of a tension-producing style of action), and habit-reversal training, with more general cognitive restructuring of anticipations linked to ticcing. Sixty-five percent of completers reported between 75 and 100% control over the tic. At 2-year follow-up, 52% rated 75-100% control. There were also significant changes post-treatment in measures of self-esteem, anxiety, depression and style of planning action. Successful tic/habit modification was associated in CTD and HD groups with successful change in style of planning action. There were no consistent differences in any outcome measures between CTD and HD groups.

Adolescent↗
PubMed2001

[A care model adapted to brief psychiatric hospitalizations].

Practice of psychiatric hospitalization has considerably changed: deinstitutionnalization, brief hospitalizations, opened units, partnership with patients and complementarity with community mental health services. These changes appear simultaneously in most of industrialized countries. They are the result of social changes, evolution of mental health care, and a sharper perception of deinsertion risks through long term hospitalizations. Values of psychiatric hospital were based on a closed and protective place, where community life prepared to life in the community; they are now founded on an opened place where care aims at resolving crisis and keeping closely in touch with the community. These modifications imply to rethink hospital psychiatric care and their connections with environment. This paper describe a model of care developed in a first admission psychiatric unit.

Community Mental Health Services↗
PubMed2000

[Smoking in psychiatry, a neglected problem].

The prevalence of smoking and the associated health risk are especially high in psychiatric patients. Smoking prevention has, however, been neglected until now in psychiatry. Nicotine withdrawal may be associated with some difficulties in psychiatric patients. Existing programs for the prevention and treatment of tobacco dependence do not take into account these special problems.

Comorbidity↗
PubMed2000

Social phobia treated as a problem in social functioning: a controlled comparison of two behavioural group approaches.

OBJECTIVE: Treatments for social phobia result typically in significant anxiety and avoidance reduction; the repercussions in terms of social functioning, however, are not clear. This controlled study compared two approaches designed to improve the social functioning of social phobics. METHOD: Sixty-eight socially phobic patients were randomly assigned to two treatments focused on improving interpersonal relationships either with or without social skills training or a waiting list; 60 completed treatment and 59 a 1-year follow-up. Treatment was administered in small groups, 14 sessions altogether. RESULTS: No clinically meaningful change was observed during the waiting period. A statistically significant and equivalent improvement obtained in both treatment conditions. CONCLUSION: Both treatments resulted in reduced anxiety, avoidance, general psychopathology and better social functioning that maintained over follow-up. Continuing improvement in remission rates was noted; fully 60% of the patients no longer fulfilled criteria for social phobia at the end of 1-year follow-up.

Adult↗
PubMed2000

On the pharmacotherapy of obsessive-compulsive disorder: is a consensus possible?

OBJECTIVE: To examine the efficacy and tolerability of clomipramine compared with the selective serotonin reuptake inhibitors (SSRIs) in the treatment of obsessive-compulsive disorder (OCD), bearing in mind the recent Expert Consensus Guidelines recommendation to use clomipramine after 2 to 3 failed SSRI trials. METHOD: The literature on the pharmacotherapy of OCD was critically examined. RESULTS: The available research evidence is not conclusive but suggests that clomipramine possesses greater anti-obsessional efficacy than do the SSRIs. In addition, when clomipramine is presented to patients in a positive way, and properly used in small initial doses with gradual increases, it seems to be tolerated as well as the SSRIs. CONCLUSION: Recently expressed opinions that clomipramine should be used to treat OCD after 2 to 3 failed SSRI trials are not supported by research evidence. Both clomipramine and the SSRIs may be used as first-line treatments for OCD.

Clomipramine↗
PubMed2000

[Integration of clinical approaches in psychiatry. The example of obsessive-compulsive disorder].

The objective of this paper is to discuss the complex challenge of psychiatry which tries to integrate knowledge and therapeutic strategies from very different fields. Obsessive compulsive disorder is chosen as an example of a pathological condition where that integration of scientific knowledge is essential and where the combined use of pharmacotherapy, psychoeducation and cognitive behavioural therapy is particularly required for optimal treatment.

Cognitive Behavioral Therapy↗
PubMed1999

Cognitive-behaviour therapy and medication in the treatment of obsessive-compulsive disorder: a controlled study.

OBJECTIVE: To evaluate the effect of combining cognitive-behaviour therapy (CBT) and medication in the treatment of obsessive-compulsive disorder (OCD). METHOD: Twenty-nine subjects diagnosed with OCD according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria were recruited through the Anxiety Clinic of Louis-H Lafontaine Hospital. They were evaluated at baseline and after treatment on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) by a psychiatrist who was blind to treatment modality. Subjects rated their degree of resistance to their rituals and the strength of their obsessional beliefs. Subjects then received 1 of 4 treatments: medication and CBT simultaneously (n = 9), CBT only (n = 6), medication while on a wait-list for CBT (n = 6), or no treatment while on a wait-list for CBT (n = 5). RESULTS: Multivariate analysis revealed that Y-BOCS scores and clinical ratings significantly improved posttreatment in all groups except the nontreatment wait-list control group. Subjects in the 2 active treatment groups receiving CBT showed reduced strength in their obsessional beliefs. The subsequent administration of CBT to those groups on the wait-list also decreased the strength of their primary obsessional beliefs and beliefs about the consequences of not performing the rituals. CONCLUSIONS: Our results suggest that either CBT or medication alone is more effective than no treatment. The combination of CBT and medication seems to potentiate treatment efficacy, and we found it more clinically beneficial to introduce CBT after a period of medication rather than to start both therapies simultaneously.

Adult↗
PubMed1998

Preference for sex of first child among women classified as androgynous and nonandrogynous.

This paper examined the relation between gender-role orientation and the preference for sex of firstborn child in 212 pregnant nulliparous women. The Bem Sex-role Inventory was used to assess gender-role orientation of participants. Analysis suggested that gender-role orientation, as measured does not effectively predict the preference for sex of firstborn child.

Adult↗
PubMed1997

Psychosocial factors related to emotional disturbances during pregnancy.

This study explored a multifactorial model for the understanding of the factors related to the intensity of prenatal emotional disturbances. Data were gathered from 213 pregnant women during the second trimester of pregnancy. Participants were assessed according to a number of psychosocial variables. Two types of prenatal emotional disturbances were examined: depressive symptoms and ambivalence and fears related to maternity. A path analysis indicated that four risk factor domains had a direct effect on depressive symptom level: locus of control; interpersonal relationships; stressors; and psychiatric history. Four risk factor domains also had a direct effect on the level of ambivalence and fears: sociodemographics; depressive symptom level; interpersonal relationships; and family history. Several factors showed an indirect effect on one or both of the disturbances. These results indicate that the study of factors related to prenatal emotional disturbances benefits from a multifactorial model assessing direct and indirect effects.

Adult↗
PubMed1997

Psychosocial predictors of depressive symptomatology level in postpartum women.

This study explored a multifactorial model for the prediction of the intensity of depressive symptoms in postpartum women. Data were gathered from 213 pregnant women during the second trimester of pregnancy and at 6 months postpartum. Participants were assessed according to a number of psychosocial variables. A path analysis indicated that four variables had a direct effect on postpartum depressive symptomatology level: lower occupational status, prenatal depression level, more distal stressors and a personal psychiatric history. Eight variables, which reflected past and present experiences, showed an indirect effect. The implications of these findings are discussed.

Adult↗
PubMed1997

Perceptual defense and vigilance to perinatal stimuli.

The presentation times (milliseconds on a computer screen followed by a masking grid) required for the correct identification of tachistoscopically presented perinatal stimuli were compared for 30 pregnant women and 25 perimenopausal women. Analysis indicated a differential facilitation or inhibition of perception in logical relation to subjects' closeness to pregnancy or menopause: pregnant women are quicker to identify stimuli related to pregnancy or babies but slower to recognize pictures of a pregnant woman with her father or mother. This supports the validity of measurements based on the theory of perceptual defense or vigilance.

Adult↗
PubMed1996

Mental representations of pregnant nulliparous women having no sex preference.

The objective was to elicit the mental representations about the sex of the future child of 89 nulliparous pregnant women who declared having no sex preference, using the Kelly's Repertory Grid. Analyses showed that 67% of these women had no explicit and clear representation about the sex of their first child. These data suggest that these pregnant women seemed really to have no sex preference.

Adult↗
PubMed1995

Muscle control in chronic tic disorders.

EMG was recorded in nine subjects suffering from chronic tic disorder. Six subjects suffered asymmetrical tics and three had symmetrical tics. EMG in tic-affected and contralateral nonaffected sites was recorded at rest, during a baseline period, and at postbiofeedback training. All subjects received 2-4 biofeedback training sessions aimed at enhancing their ability to control levels of muscle contraction in both affected and nonaffected sites. All nine subjects met the criterion of discriminating unaided between levels of 0, 25%, 50%, and 75% of their fullest contraction. Five of the six people with asymmetrical tics showed lower resting EMG on the affected side at baseline, but EMG significantly increased in tic-affected but not nonaffected muscles after exercises aimed at enhancing muscle control. Six subjects reported a clinically significant > or = 40% decrease in tic frequency. The reflexlike quality of tic muscles can modified by biofeedback training and this constitutes a useful and relatively quickly acquired aid to tic management.

Adult↗