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Biomedical subjects

G Darcourt

Publications and source records attributed to G Darcourt.

89 records · Page 5Linked to original sources
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[Neurocognitive subtypes of schizophrenia according to performance at verbal fluency tasks].

UNLABELLED: There is a general agreement that schizophrenia is an heterogeneous disorder and cognitive performances could be an interesting feature in order to allow a better description of specific subtypes. The aim of this study was: 1) to describe clinical and neuropsychological performances of 45 DSM IV schizophrenic patients divided in two groups according to their performances in verbal fluency task; 2) to compare each group with the performances of healthy subjects matched for sex, age and education. METHOD: The differentiation criteria was the total number of words generated during 3 formal and 3 semantic fluency tasks. Data were analysed using a disjoint clustering procedure with Euclidean distance. A two cluster solution was considered optimal. Cluster S1 includes 21 schizophrenic subjects defined as low performer (range: 40-83, mean 66.7). Cluster S2 includes 24 schizophrenic subjects (range: 87-158, mean 102.8). All schizophrenic patients were clinically evaluated with SANS, SAPS and a psychosocial aptitude rating scale (PARS). Patients and controls were assessed with the following battery: verbal fluency, Trail making test A & B, Stroop test, Brown Peterson paradigm for evaluation of working memory. RESULTS: Patients with low verbal fluency had significantly higher scores at the SANS and PARS. Furthermore, the low performers (cluster S1) were differentiated from those with better performances (cluster S2) by significantly poorer results in all neuropsychological tests. Comparison with healthy subjects indicated that cluster S1 patients also had significantly poorer results in all neuropsychological tests. Relative to their 24 controls cluster S2 patients performances was lower in all measures excepted in one subscore of the Stroop test and in the number of cluster produced. This later result could indicate that some capacities for willed intention were preserved in this group and that the alteration in verbal fluency performances were better explained by impairment of the other cognitive processes. DISCUSSION: These findings point out that: 1) use of performance in cognitive executive task such as verbal fluency is a possible criteria in order to separate different types of schizophrenic patients; 2) in the two groups of schizophrenic subjects, various processes defects underline cognitive performances indicating the presence of different neurobiological dysfunctioning.

Adult↗
PubMedDate not supplied

[Tolerability of tianeptine in 170 patients with depression treated during one year].

Tianeptine, a new antidepressant, has a tricyclic molecular structure. Its main biochemical activity consists of an increase in the reuptake of 5 HT both in men and animals, after acute and chronic administration. Tianeptine demonstrated its antidepressive clinical efficacy in several double-blind versus reference drug trials. A multicentre open trial, including depressed patients enabled us to evaluate the safety of tianeptine and to control the maintenance of the therapeutic efficacy in the course of its long-term prescription. Depressed patients included showed a major depressive episode, single (296.22) or recurrent (296.32) without melancholia or psychotic features, or a dysthymic disorder (300.40), according to DSM III criteria. A minimum MADRS score of a least 25, and the informed consent of the patients were required. The dose of tianeptine was 3 tablets per day (12.5 mg/tablet) with the possibility of increasing to 4 or decreasing to 2 tablets per day, depending on the symptomatology. Therapeutic efficacy was evaluated by item 1 and 2 of the Global Clinical Impression (CGI), the Montgomery and Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HARS) and the Hopkins Symptom Check-List (HSCL). Clinical and paraclinical safety were evaluated by CGI item 3, standardized ratings of patients' complaints (CHESS 84), interruption for side effects, evaluation of blood pressure, weight, biological parameters, EKGs. This intermediate evaluation concerns the first 170 depressed patients treated over a one-year period as well as the total group of patients included (n = 447).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Psychoanalytic and clinical prospects of obsessive disorders].

Is there a possible meeting-point between the psychoanalytical views of obsessive neurosis and the purely descriptive approach to symptoms, i.e. the biological, cognitive or behavioral explanations of symptoms? Obviously, it is impossible to dream of a general consensus since the processes concerned by the various therapeutic methods are not alike. What would be, for a behavior specialist, the value of discussing the reality of the primitive scene so dear to psychoanalysts? What would be, for a psychoanalyst, the value of discussing the comparative merits of the several conditioning methods? A confrontation is possible only in those fields that are common to all the parties. In this report two of these have been selected: the debate on the genesis of obsessive disorders (are they psychogenetic or organogenetic?) and the clinical study. Today's psychoanalysis discuss the first subject only sparingly, but Freud has given it much thought and it is surprising to find out to what extent his thought is in agreement with the current trends. As to the second subject, there is obviously a possibility for confrontation of the various views, since, regarding obsessive disorders, psychoanalysis provides a psychopathological model suitable for clinical practice and allowing the synthesis of the various manifestations to be made and the behavioral dynamics to be understood. I shall try to show how this model can be used profitably, even if one is ignorant of, or not familiar with, psychoanalytical metapsychology.

Freudian Theory↗
PubMedDate not supplied

[Biological indices in schizo-affective disorders].

Besides the well-defined nosological groups such as schizophrenia and affective disorders, the so-called schizoaffective disorders remain in an intermediate position. Biological features tend to build up links between these two disorders and support the hypothesis of a biological continuum between schizophrenia and affective disorders. Among these biological factors, neuroendocrinology, brain neurotransmission and sleep seem to be particularly relevant. This "continuum" hypothesis may also be supported by therapeutical and epidemiological data.

Amino Acids↗
PubMedDate not supplied

[Circadian rhythm of plasma norepinephrine in depressive disorders. Preliminary study].

The biological desynchronisation hypothesis of (endogenous) depressive disorders arises from the disturbances in the circadian rhythmicity of several biological functions in depressive illness and clinical improvement during various sleep deprivation processes. Furthermore, supportive evidence exists to postulate a central noradrenergic dysfunction, at least in a sub group of depressive disorders. We studied the 24 h kinetics of plasma norepinephrine in patients suffering from Affective Disorders-Major Depressive Episode according to DSM III criteria. Blood samples were drawn hourly from an indwelling venous catheter in supine subjects. Plasma NE was measured by HPLC with electrochemical detection. 5 patients (age: 35-63) were studied in base line drug free depressive state and compared with 5 control subjects (age: 44-53), then, in 4 patients, on the 8th and 21st days under antidepressant treatment. Control subjects exhibited a circadian rhythm of TP but a weak amplitude and low values during sleep, as previously described. Depressed patients did not display any rhythmicity because of a reduced amplitude and high plasma levels during sleep. Antidepressants did not restore the rhythm. Our results suggest a rhythmic instability involving a circadian lability linked to an ultradian release during sleep. This NA disinhibition could participate in the depressive desynchronisation and the potential relationships with sleep disorders must be discussed.

Adult↗
PubMedDate not supplied

[Circadian rhythms of the central temperature and blood cortisol in endogenous depression].

Beside neurochemical imbalances, there are numerous disruptions of circadian rhythms in endogenous depression. Recent studies have actually shown instability in rhythmicity and phase advance of many circadian rhythms in depression (central temperature, cortisol, urinary MHPG...). We have observed the longitudinal evolution of circadian rhythms (core temperature, plasma cortisol) of depressed patients who were treated by a two weeks phase-advance process, then with antidepressant drugs. Our results show that clinical improvement during phase-advance process is much faster than under tricyclics, with the same Hamilton scale level after two weeks of treatment. From a biological point of view, we show an ultradian instability, a phase advance (2 to 4 hours) and modifications of averages and amplitudes of circadian rhythms. These abnormalities tend to disappear during phase-advance process and antidepressant therapy. Phase response curves to the phase shift in depressed patients could be explained by a bad sensitivity of these subjects to external synchronisers linked to an internal dyschronism. These disturbances lead us to link desynchronisation and endogenous depression.

Antidepressive Agents↗
PubMedDate not supplied

[Clinical significance of the erythro-plasmatic ratio of lithium (author's transl)].

Six hundred erythrocyte-plasma lithium ratios have been gathered from 67 patients presenting affective disorders. Ratios values in relapse period are not altered regarding those in remission phase as between periods with neuroleptic associations and those without. Ratios values are not noticeably modified by personality, sex and the evolution of affective disorders. But lithium preventive action is essentially found in patients with high erythrocyte-plasma.

Antipsychotic Agents↗
PubMedDate not supplied

[Two-dimensional immuno-electrophoresis of cephalospinal fluid proteins wih a study of the IgG/albumin ratio in psychiatry (author's transl)].

The purpose of this study (about 187 adult psychiatric patients) is to investigate correlations between "organic brain syndrome" (vascular or abiotrophic) and values of CSF proteins (technique of two-dimensional immunoelectrophoresis). The authors show positive correlations between 'vascular' brain syndrome and increase of one alpha 2 globulin, between 'abiotrophic' brain syndrome and decrease in all globulins, the importance of brain damage and increase of IgG/albumin ratio.

Adult↗
PubMedDate not supplied

[Plasma tryptophan in a protein controlled diet in depressed patients].

Cerebral serotonin is synthetized from its blood precursor: tryptophan (TRP), an essential amino acid (6). TRP has been extensively studied since serotonine has been reported to be involved in the pathogenesis of depression (9). In one hand, brain serotonin content depends on regulation by plasma large neutral amino acids (LNAA): leucine, isoleucine, valine, tyrosine and phenylalanine that compete with TRP to cross over the blood brain barrier (7, 13). In the other hand TRP is largely linked with albumin. So, we have studied plasma total TRP, free TRP and the ratio TRP on LNAA as potential cerebral serotonin index. The aim of this study is to observe the blood variations of the biological parameters in fasting and postprandial conditions in 8 depressed women, aged from 57 to 78 years, on a short protein controlled diet: 4 women had TRP poor then rich diet and the others 4 rich then poor. Alimentary proteins modulated diets and each patient was his own control: the results under modulated diet were compared with those under normal diet at the same time. More over, 2 psychotic patients aged 58 and 70 years have been studied at the same time, in each group. Biological datas were compared with clinical evolution.

Aged↗
PubMedDate not supplied

[Hypothetical model of serotonin deficit in the aged subject. Development and validation of a clinical scale].

Few works exist about specific abnormalities of neurotransmission, therefore noticeable and with important clinical consequences in elderly patients. Specially serotonin, which neurotransmission is lower, seems to have a wide influence. The symptomatology of the serotonin shortage is well known in the young adult (Asberg and Van Praag). The aim of this study is to apply those hypothesis and to look for a particular clinical expression of symptoms usually related to a low level of serotonin in an older population, and this in a transnosographic way. We built up a clinical scale gathering different symptoms supposed to be related to a defect in the serotonin transmission in elderly subjects. From a first factor analysis, a dimensional scale of ten items as been settled and validated in 75 inpatients over 60 years old; each patient has also been assessed by a series of tests (MMS of Folstein, Hamilton Depression Rating Scale, Jouvent mood scale, Widlöcher Retardation Scale). Factor analysis results show an homogeneous factorial structure and highly selective items and had a three factors dispatching (a "main" factor, a "depression" factor, and "sleep" factor). Those subgroups of symptoms have a clinical meaning and fit the litterature. We also find a good specificity: the factor analysis on added items of depressive semiology (Hamilton scale) and serotonin related semiology shows the splitting of the Hamilton items, whenever the 5-HT- Scale items keep a steady factorial repartition. Those preliminary results deserve further studies; and external validation of the scale remains to be done. Nevertheless, the structure of this scale shows a beginning of internal validation and seems to be interesting in the elderly clinical evaluation.

Aged↗