Biomedical subjects

J M Chignon

Publications and source records attributed to J M Chignon.

22 records · Page 2Linked to original sources

PubMedDate not supplied

[Panic disorder in patients consulting a cardiologist].

The relationship of anxiety with cardiovascular function and symptoms has been of long historic interest, culminating in the recent emphasis given to the modulation of cardiovascular response in panic patients. Cognitive approaches postulate an interaction of physiological and psychological factors in the maintenance of panic disorder. Pharmacological approaches postulate a dysfunction of central alpha-adrenoceptors in panic and also in some cardio-vascular diseases. Ambulatory heart rate recordings confirm the presence of major cardiovascular changes during panic attacks in several studies. We have carried out a study in an unselected population being explored in an outpatient cardiology unit with 24 hours ambulatory heart rate recordings. Hundred and ninety-seven consecutive referrals for an ambulatory heart rate examination were assessed with the seven anxiety items of the Hospital Anxiety and Depression Scale (HAD-A). Fifty patients (26 males and 24 females), with an higher score than 8, were interviewed with the SADS-La. Sixty-two per cent of them fit DSM III-R criteria for panic disorder. Among these 50 interviewed patients, 19 (11 males and 8 females) were referred for organic heart disease and 31 (15 males and 16 females) were investigated only for functional symptomatology. The proportion of panickers was similar in patients referred either for functional or organic heart disease (63.2 vs 61.3; chi 2 = .02; p = .89). Nineteen patients (11 males and 8 females) had pathological ECG ambulatory recording results and 31 patients (15 males and 16 females) were classified as Holter (-). The proportion of panickers was found similar in these two subgroups of patients (63.2 vs 61.3; chi 2 = .02; p = .89).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

[Alternating addictions: apropos of 3 cases].

The concept of addiction is now of interest in psychiatry, but is a great subject of controversies. It is now recognized that as different disorders as alcoholism, drug addiction, bulimia, kleptomania, trichotillomania, pathological gambling are to be considered as addictive states. Other pathological behaviours could be included in the addictive spectrum (i.e. suicidal behaviours, compulsive spending). The comorbidity rates of these disorder are elevated in these populations. For example, high comorbidity rates are found between kleptomania and bulimia or drug addiction and pathological gambling. Polyaddictive states are well established. For some subjects, more than one addiction is present in life-time, but not occurring in the same period. We present three patients in whom different addictive states occurred alternately. All the patients had a history of compulsive spending and kleptomania, two of them had a history of bulimia and sexual compulsion. Some clinical characteristics were common: recurrent mood disorder, depression preceeding the addictive state, no psychoactive substance disorder. In all patients, severity of depressive state decreased when addiction appeared. Depressive symptoms varied inversely to addiction severity. The hypothesis about psychopathological links between kleptomania and bulimia on one hand and mood disorders on the other hand has been known for a long time. Kleptomania as other impulsive disorders is, for some authors, understood in the meaning of a "spectrum affective disorder". For these three patients, an antidepressant effect of the behavioural addictions is suggested. In fact, the addictions appeared alternately. The possibility of common psychopathological and/or biological mechanisms for behavioural addiction is supported by these clinical observations, that could contribute to the addiction concept validity.

Adult↗

PubMedDate not supplied

[Attempted suicide and alcohol dependence: results of an epidemiologic survey].

OBJECTIVES: The relationship between alcoholism and suicidal behaviour has long been recognized. The present study examined the lifetime prevalence of suicide attempts in alcoholic patients and the impact of comorbidity, namely with depressive anxiety disorders and antisocial personnalit disorder in alcoholic patients who attempted suicide. METHODS: In a cross-sectional design including outpatients referring for alcohol dependance according to DSM III-R criteria, we used a specific standardized and structured interview allowing DSM III-R diagnoses. RESULTS: We include 507 patients (343 males of 164 females). The mean age at the intake of the study was 43.2 (SD:9.6) years without difference between males and females. 129 patients (25.4%) had attempted suicide during their lifetime. The proportion of female was found higher than males among suicide attempters (41.9 vs 29.3%; p < or = 0.001). Age of onset of alcoholism was found younger in suicide attempters than non (p < or = 0.01), either in males and females. Moreover, we found that alcoholic suicide attempters more often reported family histories of alcoholism than did nonattempters. As regard lifetime comorbidity, major depression and drugs misuse were found more frequent in alcoholics who attempted suicide (p < or = 0.001). Moreover, we found a higher prevalence for Panic Disorder and Social Phobia in male suicide attempters.

Adult↗

PubMedDate not supplied

[Self-assessment questionnaire of alcoholic craving (ECCA Questionnaire: Behavior and Cognition in Relation to Alcohol: French translation and validation of the Obsessive-Compulsive Drinking Scale].

Clinical, neurobiological and neuropsychological hypotheses suggest that the dimension of alcohol craving includes the concept of both obsessive thoughts about alcohol use and compulsive behaviors toward drinking. Anton et al. (1995) developed a 14 items self-rating scale, the Obsessive Compulsive Drinking Scale (OCDS) which includes items for assessing three dimensions: global, and the obsessive and the compulsive subdimensions. In this study, we included 156 patients, 105 men and 51 women, who met DSM IV diagnostic criteria for alcohol dependence. The mean age of our population was 39.1 +/- 11.2 years without difference between sexes. We did not found any correlation between the CAGE score and the OCDS total score or the obsessive and compulsive subscores (respectively, r = .15, r = .10 et r = .18). Moreover, we did not found any correlation between OCDS scores and mean daily alcohol consumption (r = .18, r = .16, r = .19). This could indicate that the dimension measured by the scale was somewhat independent of actual drinking. As such, it might act as an independent measure of the "state of illness" for alcohol-dependent patients. The test-retest correlation for the OCDS total score was .95 and the obsessive and compulsive subscales test-retest correlations were .93 and .89 respectively. The internal consistency of the items of the OCDS was high (alpha = .89). Principal component analysis had identified in the french version of the OCDS, three factors accounting for 63.5% of the total variance. These results indicate that the french version of the OCDS seems to validly measure a dimension of alcohol dependence. The ease of administration, reliability, and concurrent validity of the OCDS makes it particularly useful as an outcome measurement tool for various clinical therapeutic protocols in alcoholism.

Adult↗