Biomedical subjects
Publications and source records attributed to M Ansseau.
The study of neurohypophyseal function in various neuropsychiatric diseases is interesting because: (1) The main neurohypophyseal peptides vasopressin (AVP) and oxytocin (OT) share by themselves modulatory influence on behavior. (2) Hypothalamo-posterior pituitary axis is directly influenced by modifications of central neurotransmitter metabolism involved in behavior control.
Among other confounding factors, the influence of the intake of estrogen-containing oral contraceptives on the dexamethasone suppression test (DST) results has never been specifically studied. Therefore, we performed 1 mg DSTs in 14 healthy women taking oral contraceptives and 14 age-matched women taking no oral contraceptives. Mean 0800h basal total cortisol was significantly higher among the women taking contraceptives than in the control group, whereas mean free cortisol did not significantly differ. At 1600h following DST, no significant difference existed between the two groups. Two subjects taking contraceptives and one control subject were considered DST nonsuppressors. These results confirm the powerful influence of oral contraceptives on basal total cortisol levels but suggest a lack of significant influence on DST results.
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Disturbances in dopaminergic neurotransmission seem to play an important role in biochemical mechanisms involved in depressive disorders. The study of the growth hormone (GH) response to apomorphine, a dopaminergic agonist, provides an indirect index of dopaminergic neurotransmission at the postsynaptic level. In the present study, we assessed the role of the dopaminergic system in some psychopathological dimensions in depression: personality dimensions, suicidal behavior, psychomotor disturbances and dichotomy unipolar/bipolar. Our studies included major depressed inpatients matched for gender, age and, in the case of women, menopausal status. Our results show that dopaminergic disturbances are related to social introversion and anxiety according to dopaminergic hypothesis of schizophrenic disorders and dopaminergic hyperactivity hypothesis of anxiety disorders. A blunted GH response to apomorphine could be considered as a biological marker of suicidal behavior. Moreover motor retardation appeared to be in relationship with dopaminergic disturbances. Finally, the dopaminergic system did not appear to play a significant role in the dichotomy unipolar/bipolar. The results show the interest of the apomorphine test in the assessment of the relationship between biochemical disturbances and clinical correlates.
While post-traumatic stress disorder has drawn increasing interest over the last years, very few studies have been focused to burned patients. In its first part, this article provides a brief reminder of the symptomatology of post-traumatic stress disorder, of its various pathogenic theories as well as its various treatment approaches. The second part of the article reviews more specifically the literature about post-traumatic stress disorder in burned patients, emphasizing the need of a rapid and effective psychological therapy.
According to recent European epidemiological studies, the lifetime prevalence of major depression ranges between 16 and 20%. Information concerning the natural course of depressive illness remain limited. Longitudinal studies of depressed patients are impeded by the inconsistencies of the labelling of change points in the course of illness (remission, recovery, relapse, recurrence...) and of criteria used to define each of them. Recently, definitions of these terms have been proposed but still need to be clinically validated. Internationally accepted definitions are particularly necessary in order to assess the efficacy of antidepressants at 3 levels: during the acute treatment of an episode, for maintenance treatment (recovery from the complete length of an episode) and for prophylactic treatment (reduction of the risk of future episodes).
BACKGROUND: The authors set forth to test the usefulness of trazodone as an alternative anxiolytic in benzodiazepine-dependent patients. METHOD: Ten benzodiazepine-dependent patients according to DSM-III-R were hospitalized during a 2-4 week period and treated with trazodone (100 mg t.i.d.) while their benzodiazepine intake was progressively tapered; they left the hospital on a regimen of only a 300-mg daily dose of trazodone and were followed as outpatients at monthly intervals. The dose of trazodone was individually adapted according to condition. RESULTS: Very limited withdrawal phenomena occurred during the benzodiazepine taper period; during the 1-year follow-up, all patients remained off benzodiazepines and showed no evidence of abuse of trazodone. The dose of trazodone was significantly reduced to 185 mg (p = .003); the ratings of anxiety and depressive symptoms also significantly improved during follow-up: from 12.3 to 5.4 on the Hamilton Rating Scale for Anxiety (p = .002) and from 11.6 to 4.8 on the Hamilton Rating Scale for Depression (p = .002). CONCLUSION: These findings suggest the usefulness of trazodone as an alternative anxiolytic in patients at risk for benzodiazepine abuse.
Several lines of evidence suggest that dopamine might be involved in anxiety states. In this study, we assessed the growth hormone (GH) response to apomorphine (a dopaminergic agonist) 0.5 mg SC in nine drug-free inpatients meeting Research Diagnostic Criteria (RDC) for panic disorder who were age-matched and gender-matched with nine major depressive, and nine minor depressive inpatients. The three groups differed significantly in their mean GH peak response: 5.29 +/- 2.75 ng/ml in major depressives, 26.27 +/- 12.71 ng/ml in minor depressives, and 37.28 +/- 10.58 ng/ml in panics, with a significantly higher response in panic than in either minor or major depressive patients. These results support dopaminergic overactivity in panic disorder as compared with major and minor depression.
Several cerebrospinal fluid (CSF) studies have provided support for a possible role for the dopaminergic system as a biological correlate of suicidal behavior. Indeed, low CSF levels of the dopamine metabolite homovanillic acid (HVA) have been described in depressed patients with a history of suicide attempts. In this study, we assessed the dopamine receptor sensitivity in relationship to suicidal behavior by measuring growth hormone (GH) response to apomorphine 0.5 mg subcutaneously (sc) in 15 DSM-III-R (APA 1987) major depressive inpatients with a history of suicide attempts, compared to age-matched and gender-matched major depressive inpatients without a history of suicide. Patients with a history of suicidal behavior exhibited a significantly lower GH response to apomorphine than patients who never attempted suicide (t = 3.60, df = 1.28, p = 0.0012). Therefore, these results suggest that a blunted GH response to apomorphine could represent a biological marker of suicidal behavior.
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Apomorphine challenge tests (0.5 mg SC) were performed in 14 normal male volunteers and in 9 male schizophrenic inpatients, drug-free for at least 2 wk. In the normal volunteers, apomorphine induced an increase of serum growth hormone (GH) (maximum at 40 min), of vasopressin-neurophysin (hNpI) (maximum at 20 min), and oxytocin-neurophysin (hNpII) (maximum at 20 min). The release of neurophysins was independent of digestive side effects. In the schizophrenics, the GH level and release pattern were similar to those in the controls. The basal level of hNpI was reduced (t0: 0.42 +/- 0.1 ng/ml in the schizophrenics and 0.66 +/- 0.05 ng/ml in the controls, p < 0.02). In contrast, the basal level of hNpII was increased (3.34 +/- 0.04 ng/ml in the schizophrenics to 0.92 +/- 0.21 ng/ml in the controls, p = 0.001). The response to apomorphine was blunted, with no significant release of hNpI or of hNpII. Although the hNpII data are consistent with an increased dopaminergic tone, the psychopathological meaning of the increased basal oxytocinergic and decreased vasopressinergic functions remains to be defined.
We report a non-significantly higher growth hormone (GH) response to intravenous clonidine administration (150 micrograms) in 10 male patients with panic disorder who had never received antidepressant therapy than in 10 matched controls. These results are consistent with data suggesting a normal or increased adrenergic receptor sensitivity in panic disorder patients.
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