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Biomedical subjects

G Loas

Publications and source records attributed to G Loas.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

[Brief psychiatric hospitalization: a possible way, a strategy to evolve?].

The process of disinstitutionalization combined with the economic reality is responsible for the great upheaval in taking care of psychiatric patients. The repercussions are worldwide, national, and local concerning the Philippe Pinel Psychiatric Hospital (Amiens, Somme) place of this work. So the psychiatrists of this institution have to do with the following datas: a reduction of the admissions between 1991 et 1998 (around 1,5%) and a provided reduction of the hospitalization capacities upper to 40% for the following two years! Then the connection with these two figures requires the development of new therapeutic strategies, with the existing means. In this peculiar context, a study has been carried on over 2 years: 49 psychiatric patients who benefited from a brief hospitalization (less than 48 hours) have been followed up. The interest proceeds from the high frequency of the type of clinical situation which concerns 12,5% of the admissions in the studied psychiatric department. In the same time, a pilot group of 49 patients has been drawn lots among all the admissions during the same time: patients who benefited from a more traditional hospitalization (about twelve days), with strictly a same psychiatric diagnosis as in the first group, using the ICD 10 classification. The emphasis was focussed on the patient's psychiatric curing process into the 2 groups; we have compared the item rehospitalizations in a psychiatric hospital (through the number of rehospitalization, the number of days of rehospitalization, and the necessity - or not - of a rehospitalization) with the object of estimating the benefit, the inefficiency, or even the negligence of proposing a brief hospitalization. We have also studied socio-environmental datas, antecedents and effective psychiatric follow-up into the two groups. Concerning the diagnosis, mental disorders related to alcohol abuse (F10) are the most frequent (49%) into the group brief hospitalization , which diverges from the usual results taking account hospitalizations in psychiatric services. Then we have found personality disorders (14,3%), schizophrenia (12%), adaptation disorders (10,2%), anxiety (8,2%) and opiated abuse (4,3%). By that very fact, the pilot group allows exactly the same diagnosis. There's no significant difference concerning number of hospitalizations or number of days of rehospitalization; there is even a tendency in favour of patients who have been hospitalized less than 2 days: an other hospitalization is not as frequent as in the pilot group, without any exacerbation of their pathology (no less sight of patients, same number of death). It's important to emphasize that this benefit isn't related to less severe pathology for the first group: there can be a comparison between psychiatric antecedents and seniority of mental troubles. By another way, socio-environmental datas (age, sex, social and family positions) are homogenous. Lastly, circumstances of the hospitalization - inclusion between the groups are similar: same origin of the patients, who have required themselves their admission (it means the knowledge of the psychiatric hospital, distinctly one or more previous hospitalizations). The contacts with the entourage of the patients have been managed in the same way with the same results, and medical follow-up after having left hospital were identical. So we come to the conclusion that in spite of the apparent slight of this strategy, there can be a comparison between this kind of aid and a more traditional hospitalization, in many clinical situations, all the more when the emphasis is laid on the patients psychiatric curing process. Consequently a brief hospitalization can be considered as a possible therapeutic strategy. Two facts command attention now: we must clearly define the type of patients who have really benefited of this brief hospitalization, with the object of being able to plan this strategy. By another way, it seems that a brief hospitalization, just like any hospitalization, is one part of our patients curing process for the two groups. Therefore, the choice of a psychiatric hospitalization becomes a debatable point, through the treatment of a psychiatric emergency.

Adult↗
PubMedDate not supplied

[Dependency scale in the MMPI and dependent personality in DSM-III].

We tested a dependency rating scale issued from MMPI (considered relevant for DSM-III dependent personality disorder) on 33 males who met this DSM-III personality disorder. There is no significant difference between our subjects and the standard values reported in the literature. Some hypothesis about this negative results are discussed.

Adult↗
PubMedDate not supplied

[Validation study of the Depressive Experience Questionnaire].

Sidney Blatt, considering as being insufficient the categorical-symptomatic approach of depression, has worked out a theory of depression and psychopathology that integrates the contributions of psychoanalysis as well as cognitive and developmental psychology. Within a broad psychoanalytic framework, Blatt's formulation focus on the quality of interpersonal relationship, the nature of object representation and early life experiences. Personality development is viewed as the consequence of the interaction of 2 basic developmental tasks: the establishment of the capacity to form stable, enduring, mutually satisfying interpersonal relationships and the achievement of a differentiated, realistic, essentially positive identity. The relationship between these 2 developmental lines involves a complex dialectical process during which progress in each line is essential for progress in the other and which contributes to the development of both a sense of identity and the capacity for interpersonal relatedness. These developmental lines permit not only to define an during individual's primary personality configuration but also enable to identify cognitive structures that are inherent in various forms of psychopathology, including depression. Disruptions at different developmental stages create vulnerability to different subsequent psychological disturbances. Blatt characterised as anaclitic or dependent the axis concerned with interpersonal relationship and as introjective or self-critical the axis concerned with development of the sense of self and identity. Depressive Experience Questionnaire was developed by Blatt et al. to determine the validity of this model of psychopathology which emphazises continuities between normal and pathological forms of depression. The instrument was developed by Blatt et al. by assembling a pool of items describing experiences frequently reported by depressed individual. Sixty-six items were selected and administered to a large nonclinical sample (500 female and 160 male undergraduates). Principal component analysis within sex performed on the answers to DEQ confirmed his assumption in identifying two principal depressive dimensions. The first factor involved items that are primarily externally directed and refer to a disturbance of interpersonal relationships (anaclitism); the second factor consists of items that are more internally directed and reflect concerns about self-identity (self-criticism). A third factor emerged, assessing the good functioning of subject and confidence in his resources and capacities (efficacy). Scales derived from these factors have high internal consistency and substantial test-retest reliability. The solutions for men and women were highly congruent. Factor structure has been replicated in several nonclinical and clinical samples, supporting considerable evidence to the construct validity of the DEQ Dependency and Self-criticism scales. An adolescent form of DEQ (DEQ-A) has successively been developed. Factor analysis revealed three factors that were highly congruent in female and male students and with the three factors of the original DEQ. The reliability, internal consistency and validity of DEQ-A indicate that the DEQ-A closely parallels the DEQ, especially in the articulation of Dependency and Self-criticism as two factors in depression. These formulations and clinical observations about the importance of differentiating a depression focused on issues of self-criticism from issues of dependency are consistent with the formulations of others theorists which, from very different theoretical perspectives, posit 2 types of depression, one in which either perceived loss or rejection in social relationships is central and the other in which perceived failure in achievement, guilt or lack of control serves as the precipitant of depression. These 2 types of experiences have been characterized as dominant other and dominant goal , as anxiously attached and compulsively self-reliant and as sociotropic and autonomous . Our work presents the results of a validation study of both forms of Blatt's questionnaire (for adults--DEQ--and for adolescents--DEQA) translated in French in a large population of normal subjects, aged 15 to 45 years. DEQ and DEQ-A were compared by inspection of items loading strongly on each factor and by correlation of the three factors of adults and adolescents. The exploratory factor analysis of DEQ and DEQA revealed three orthogonal factors, corresponding with Blatt's original dimensions. Consistency and external validity were adequate for all 3 factors of DEQ and DEQ-A. Anaclitism and self-criticism dimensions of DEQ and DEQ-A correlate positively with measures of depression (DSM-IV, Beck Depression Inventory), consistently with the results obtained by Blatt. Differently from this author, anaclitism appears to be less differentiated in males than in females, suggesting that the concept of dependence could assume different relevance for men and women.

Adult↗
PubMedDate not supplied

[Study of cognitive evoked potentials as a function of the affective value and significance of stimuli in anhedonic healthy subjects with dysfunctional attitudes].

In depression studies, it is important to consider healthy subjects with characteristics which may be predictive of depression. Such are anhedonia and some "dysfunctional" attitudes. For this reason, subjects with or without these characteristics were submitted to an experimental paradigm allowing an analysis of their electroencephalographical (CNV and P300) reactivity according to affective value and meaning of stimuli, and according to the probability of occurrence of these stimuli. Subjects were divided into two groups according to their scores on two scales: the Physical Anhedonia Scale of Chapman et al. and the Dysfunctional Attitudes Scale of Weissman and Beck. Several results enabled to differentiate the two groups. Anhedonic and depressogenic subjects were characterized mainly by a particular type of processing for failure situations and for the stimulus which were associated with those situations.

Acoustic Stimulation↗
PubMedDate not supplied

[Factorial structure and internal consistency of the French version of the twenty-item Toronto Alexithymia Scale in a group of 183 healthy probands].

The factorial structure of the French version of the twenty-item Toronto Alexithymia Scale (TAS-20) was studied in a group of 183 healthy subjects. The TAS-20 represents the latest revised version of the TAS. His psychometric characteristics are clearly superior than the others alexithymia scales. Our subjects filled out the TAS whose 14 items are common with the TAS-20. We conducted our statistical analyses on these 14 items. A principal components analysis was carried out and yielded a two-factor solution where the items rating the ability to describe feelings and the items rating the ability to identify feelings constitute one sole factor. The second factor corresponds to the externally oriented factor. The internal consistency of the scale was also measured by the Cronbach alpha coefficient and by the correlation between each item and the total score. The value of the Cronbach alpha was 0.79 and the correlation between each item and the total score ranges from 0.19 (p < 0.05) to 0.69 (p < 0.001) with a mean of 0.52. Our results confirm a previous work on a group of 263 normal students which showed a two-factor solution of the TAS-20. The French version of the TAS-20 seems to be reliable and constitutes a useful instrument to study alexithymia in psychopathology.

Adult↗
PubMedDate not supplied

[Operationalization of the "locus of control" concept: translation and first validation study of the Levenson control scale (IPC: the internal powerful others and chance scale)].

This work presents the study of validation of the French version of the Internal Powerful others and Chance Scale (IPC) of Levenson. A principal components analysis was carried out on a group of 134 healthy subjects. The Cronbach alpha coefficient and the correlation between the items and the total score of each sub-scale of the IPC were calculated. Our results were discussed in comparison with others studies.

Adolescent↗
PubMedDate not supplied

[Relationship between anhedonia, affective dependency and autonomy in health subjects].

Several authors have suggested that anbedonia, autonomy and interpersonal dependency could characterize personality of subjects prone to depression. We have studied in a group of 117 healthy subjects the Pearson correlation coefficients between two anbedonia scales (Physical Anbedonia Scale or PAS, Fawcett Clark Pleasure Capacity Scale-Physical Pleasure or FCPCS-PP) and the three sub-scales of the Interpersonal Dependency Inventory (IDI) (two rating dependency and one rating autonomy). The results have shown a significant correlation between the PAS and the autonomy sub-scale of the IDI. Anbedonia and autonomy could characterized a particular profile of personality.

Adolescent↗
PubMedDate not supplied

[Anhedonia in major depression. Comparison of 55 depressed patients with 54 healthy probands].

A study on 55 subjects who meet Spitzer's research Diagnosis Criteria of primary major depressive disorder and 54 healthy subjects has been conducted to explore anhedonia. The two groups were matched concerning the socio-demographic variables (sex, age, education level). Anhedonia was rated using the Physical Anhedonia Scale (PAS) and a physical sub-scale (FCPCS-PP) extracted from the Fawcett Clark pleasure scale. The severity of depression was rated using the Bech HDRS (Hamilton Depression Rating Scale) subscale for global severity. The results have shown that the major depressives are significantly more anhedonic than controls. The PAS mean score of depressives (m = 24.45, sd = 9.22) was significantly higher than the meaning score of normals (m = 16.9, sd = 7.13) (t = 4.7, df = 107, p = 0.0001). The FCPCS-PP mean score of depressives (m = 81, sd = 15) was significantly lower than the mean score of normals (m = 90.6, sd = 7.3) (t = 4.2, df = 107, p = 0.0001). The Pearson correlation coefficients between the anhedonia scales (PAS and FCPCS-PP) and the Bech HDRS were not statistically significant. Anhedonia in major depression seems to be independent of the depression intensity. The distribution of the PAS and the FCPCS-PP scores have been studied in the major depressive group using a test of normality (chi 2 analysis). The results have shown for each scale a normal distribution. Our results do not support the hypothesis of the existence of a severely anhedonic sub-group of major depressives.

Adult↗
PubMedDate not supplied

[Anhedonia in schizophrenia].

A study on 61 subjects who meet Spitzer's Research Diagnosis Criteria of schizophrenia and on 56 normal subjects has been conducted to explore anhedonia. Anhedonia was evaluated by two rating scales, the Physical Anhedonia Scale (PAS) and a sub-scale of physical pleasure (FCPCS-PP) extracted from the pleasure scale of Fawcett. The reliabilities of the scales were studied in the schizophrenic group by the Cronbach alpha and the Kuder Richardson (KR 20) coefficient and by the correlation between the two scales (concurrent validity). The Cronbach alpha was 0.77 for the FCPCS-PP and the KR 20 was 0.82 for the PAS. The correlation between the two scales was -0.37 (p < 0.01). The schizophrenics were significantly more anhedonic than normals with higher score on the PAS and with a lower score on the FCPCS-PP. Using the Beck Depression Inventory to rate depression in the schizophrenic group and to dichotomize these subjects into depressed schizophrenics and no depressed schizophrenics, we failed to find significantly differences concerning anhedonia scales between these two sub-groups of schizophrenics. There was no difference between in and outpatients concerning the anhedonia scales. Our results suggest that anhedonia would be a possible marker of schizophrenic disease. The distribution of the anhedonia scales in the schizophrenic group is normal or unimodal and it doesn't support the hypothesis of a qualitative sub-group of schizophrenics characterised by severe anhedonia.

Adult↗
PubMedDate not supplied

[External validity, reliability and basic score determination of the Toronto Alexithymia Scales (TAS and TAS-20) in a group of alcoholic patients].

The criterion validity of the Toronto Alexithymia Scales (TAS and TAS-20) was assessed by administering the scales to 47 alcoholic inpatients. The 47 subjects were inpatients meeting the Research Diagnostic Criteria for alcoholism. The subjects were assessed by two raters using the Beth Israël Questionnaire in the first week following their hospitalization. They filled out the TAS and one week later the TAS-20. Among the 47 alcoholics, 31 were alexithymic and 16 were non-alexithymic. The TAS and the TAS-20 scores of the alexithymics were significantly higher than that of the non alexithymics. The mean (sd) of the TAS in the alexithymics and the non alexithymics were respectively (m = 76.13, sd = 9.56; m = 64.2, sd = 13.88; t = 3.38, df = 45, p = 0.0015). The mean (sd) of the TAS-20 in the alexithymics and the non alexithymics were respectively (m = 54.1, sd = 8.81; m = 43.18, sd = 11.5; t = 3.62, df = 45, p = 0.0007). The one-week test-retest was r = 0.17, p < 0.001. On the basis of these findings, TAS and TAS-20 cutoff scores were suggested. A range of potential cutoff scores around the mean TAS or TAS-20 score were tested using four methods to assess the goodness of a diagnostic test (sensitivity, specificity, Younden's coefficient, positive predictive value). The best scores that maximizes the diagnostic validity of the TAS and TAS-20 in identifying alexithymic subjects were respectively 73 and 56. On the basis of the mean TAS and TAS-20 score for the non alexithymic group and the means that we have obtained with normal groups, scores of 64 and 44 were respectively selected as the cutoff level for the identification of non alexithymic subjects.

Adult↗
PubMedDate not supplied

[Physical anhedonia and depression: distinct concepts? Study of the construct validity of these dimensions in a group of 224 normal subjects].

The aim of the study was to precise the relationship between physical anhedonia and depression in healthy subjects. The construct validity of these two dimensions were determined using a principal components analysis. 224 normal subjects were recruited for the study. They filled out the abrigded version of the Beck Depression Inventory (BDI) and a physical pleasure scale (Fawcett Clark Pleasure Capacity Scale--FCPCS-PP). A principal components analyses following by a varimax rotation was done. The correlation matrix comprising items from both the BDI and the FCPCS-PP yielded a three-factor solution (two "pleasure" factors and one "depression factor") with no overlap of the significant factor loading for the items from each scale. The findings support the view that physical anhedonia is a construct that is distinct and separate from depression.

Adult↗
PubMedDate not supplied

[Clinical characteristics of chronic schizophrenic patients presenting with severe anhedonia].

The aim of the present study is first to test the existence of a sub-group of chronic schizophrenics characterized by a severe anhedonia and secondly to determine the characteristics of that sub-group. 150 patients meet the DSM III-R and RDC criteria for chronic schizophrenia and 151 healthy subjects constituted the control group. The subjects filled out the Physical Anhedonia Scale of Chapman (PAS), the Fawcett Clark Pleasure Capacity Scale-Physical Pleasure (FCPCS-PP) and the abridged form of the Beck Depression Inventory (BDI). The distributions of the PAS and FCPCS-PP were studied using a test of normality. In the normal group the distributions of the anhedonia scales were unimodal and in the schizophrenic group the distributions were not. The schizophrenics were dichotomized into anhedonic schizophrenics (PAS scores higher or equal to 29) and hedonic schizophrenics (PAS scores lower than 29) and these subgroups were compared on socio-clinical variables and PANSS, BPRS and BDI scores using chi 2 square tests or Mann and Whitney tests. They were 32 subjects in the anhedonic sub-group and 128 subjects in the hedonic sub-group. They were not significant differences between the sub-groups concerning the sex-ratio, educative level, age, mean duration of the illness, mean number of hospitalization and the mean dose of antipsychotics. The proportions of depressive and deficit syndromes did not differ between the two sub-groups but the proportion of "negatives" (using the composite score of the PANSS) was greater in the anhedonic sub-group. A discriminant analysis has been done on the items of the BPRS, PANSS and BDI and the results have shown that the anhedonic schizophrenics had more hallucinatory behavior, disorientation, blunted affect, social withdrawal, cognitive distorsions and less anxiety and displeasure than hedonic schizophrenics. Our results allow to identify a sub-group of chronic schizophrenia characterized by a severe anhedonia and will be confirmed by others studies using prospective methodology.

Adult↗