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Biomedical subjects

M Bourgeois

Publications and source records attributed to M Bourgeois.

At least 253 records · Page 14Linked to original sources
PubMed1977

[Tardive Dyskinesia induced by neuroleptics: a survey of 3140 patients in a psychiatric hospital].

Tardive dyskinesia constitute the most serious complications of long term treatment with neuroleptics. In this study e,140 patients (1,568 men, 1,572 women) were examined in 4 psychiatric hospitals. 258 (8.2%) patients were found to present such a syndrom. The frequency of tardive dyskinesia was higher among female patients (167 women; 10.6%) than among male patients (91; 5.8%). On the average dyskinetic women were older than men (64.9 versus 54 years old). In 59.3% of the cases, dyskinesia was limited to an oro-facial symptomatology, but in 40.6% of the cases, this was associated with a choreo-athetoïd syndrom. Most of these patients were chronic patients. On the average they had been in hospital for 20 years, and had received neuroleptic treatment for 15 years. In half of the patients, the treatment was undergone for schizophrenia and chronic delusion. Other syndroms encountered were mental retardation, dementia, affective disorders, epilepsy, alcoholism, character disorders, etc... The frequency of tardive dyskinesia that we observed is certainly a minimum since there exits a number of transient pathological forms. We discuss a few aspects of treatments of tardive dyskinesia with neuroleptics, lithium, diethylaminoethanol, choline... we insist particularly on the problem of prevention. In patients treated with neuroleptics, tardive dyskinesea might be stopped at an early stage: secondary prevention, consisting in an early detection of the first symptoms of lingual or facial dyskinesia, should lead, if possible, to the withdrawal of the treatment. Primary prevention appears to be very important: the risk of drug-induced dyskinesia appears to be higher among people above 50 of age, and neuroleptic treatment should be administered only for the most serious forms of mental illnesses.

Aged↗
PubMed1977

[Formation of new American psychiatrist and the future of psychiatry in the U. S.--A reference for France?].

A Ballad on the future of american psychiatry. Since the publication of Johann Reil's, Rhapsodies About the Application of Psychotherapy to Mental Disturbances (1803), variations upon this theme of extravagant discourse have received enthusiastic welcomes from the ever enlarging psychiatric audience for whom they are performed... Although the soloists change, the basic orchestration continues creating an uncanny sense of déjà entendu. While there as been longstanding recognition of the contributions of biological, psychological and social forces to the etiology of mental illness, actual efforts at a synthesis of their roles have been infrequent. Rather, we have experienced ideological clustering around each with the formation of schools and movements which have tended to over-value their own viewpoint at the expense of the others and to the detriment of progress in psychiatry. The authors describe a periodicity of one to two decades in which one of the schools achieves preeminence over the others, consolidates its position in medical education and with the community at large, comes under fire for failing to provide solutions to the problems of the mentally ill, and finally experiences a decline of its influence and prestige. Since World War II, both psychoanalytic and social and community psychiatry have experienced these vicissitudes, and, as the influence of the latter diminishes, voices are already raised promoting the succession of biological psychiatry of the seat of power. We believe another cycle of hopeful expectance in the quest for psychiatric omniscience and the following period of disillusionment can be avoided. The stunning advances in biological research in the past, and the prospect of even more exciting revelations to come should not lead us to devalue those techniques and institutions which have proved effective, while in pursuit of new approaches. Experience informs us that no one discipline in psychiatry can answer all the questions confronting us, and the time is ripe for a reassessment of the appropriate contributions of each subspecialty to the field as a whole. The authors propose the establishment of fellowships in biological psychiatry to promote this subspecialty, just as fellowships have been created to train child psychiatrists, administrative psychiatrists, etc. We believe such action could insure a more active role for biological psychiatry without repeating the cycle of disruption already described. The outlines of such a fellowship are sketched.

France↗
PubMed1977

[Difficult and/or dangerous mental patients: criminologic survey on 547 subjects submitted to the maximum security ward at Cadillac between 1967 and 1976].

The writers of the article submit the results of a medico-legal analysis of 547 files of mental patients, some of whom are hard cases and others are dangerous. All the patients are males. Each of them was interned by order of civil prefect in the maximum security ward of the C.H.S. de Cadillac Mental Centre. These files cover the period between 1967 and 1976. First global study was made of all the patients whose average age, on their admission to the above-mentioned medical centre, was 33 years. The results of the study can be summed up as follows: a) Nosologically, three important groups of patients are distinguishable. Together, they constitute 85% of all the cases studied. 28% of the cases are psychotics, of whom 25,8% are chronic psychotics (14,8% schizophrenics; 7,7%, paranoiacs); 40,5% of the cases are psychopaths suffering from psychic imbalance; and finally, 16,4% of the cases are morons (debiles). b) According to their delinquent behaviour the cases fall into the following categories: 1) 47% of the cases committed acts of physical aggression (17,6%, murder or attempts at murder; 20% severe aggression; 6,2%, rape or attempts at rape). 2) 42,1% of the cases committed crimes against property (38%, theft; 4%, arson). 3) 10,6% of the cases showed anti-social behaviour (6,5%, threats of murder; 3,5% alcoholism, fugues, etc.). c) The origin of the studied population was as follows: 22% of them were sent to the maximum security ward from prisons; some of them were sent here as irresponsible and some as a result of abnormal and disturbed behaviour. 78% of them were sent to the maximum security settings from psychiatric centres: of whom 8% from other security settings and 70% from ordinary psychiatric centres [50% of whom because they had run away (fugues) and 50% of whom as a result of aggressive behaviour which was, in certain case, accompanied by threats of murder]...

Adolescent↗
PubMed1977

[Obstructive thrombosis of the pulmonary trunk: a rare but dangerous late complication of the banding procedure (author's transl)].

This paper presents three cases of obstructive thrombosis of the pulmonary trunk following banding procedure. The complication was lethal for all our patients as well as for the three others reported in the literature. Considering the typical course of the complication, the relatively late onset of cyanosis or its increase in heart diseases with primary right-to-left shunt, the X-ray pictures of the thorax depicting a drastic fall of pulmonary flow, and most of all the angio-cardiographic clues for the presence of an intravasal thrombus, it appears, that the correct diagnosis could be made early enough to permit life saving surgery. The anatomical-pathological findings and the results of histological examination are reported for all three patients.

Child↗
PubMed1977

[Present aspects of bacterial endocarditis in infants and children. Observation during the years 1969-1976 (author's transl)].

21 infants and children with proven bacterial endocarditis were observed at the Unviersity Children Hospital of Düsseldorf from January 1969 to December 1976. There was high incidence of cases in the infant group and again among the 6 to 8 years old children. Some important aspects of the disease were characteristic for the infant group (N=5): No congenital cardiac abnormality was present, but a surgical cerebro-atrial connection in two cases of hydrocephalus and a prolonged artifical respiration in a third patient could have been predisposing factors. Staphylococci were the pathologic organisms in three infants. The course of the disease consistently resembled that of septicemia and the outcome was always lethal. The diagnosis of bacterial endocarditis was disclosed only by the post mortem examination. The mitral and the tricuspid valves were affected twice respectively, the pulmonary cusps only once. In the children group (N=16) fifteen patients had a congenital malformation of the heart confirmed by previous catheterization. 8 were cyanotic and 5 of them had a tetralogy of Fallot with previous aorto-pulmonary shunting procedure (Waterston). Unlike the spectrum of micro-organisms presently found in adults, the streptococcus viridans prevailed as before, it was isolated in 11 of the 13 blood cultures which yielded positive results. The disease displayed a subacute course and mortality remained with 3 deaths relatively low. In 3 other cases a valve lesion subsisted, in two instances severe enough to necessitate surgery (aortic valve prosthesis, mitral annular narrowing). No relapse was observed during the mean follow up period of 2;8 years.

Adolescent↗
PubMed1977

[Cytogenic survey of 600 mentally retarded hospitalized patients].

A collaborative study (including the patients of 4 mental hospitals) was done in an attempt to evaluate the incidence of chromosomic anomalies in a large group of mentally retarded patients. A cytogenetic study was performed in 600 mentally retarded patients selected among 3.311 psychiatric patients. Chromosomic anomalies were found in 54 (9 per cent) mentally retarded patients. There were 43 autosomic anomalies (32 had trisomy 21) and 11 sexual chromosomes anomalies. This large series is consistent with the results found in the litterature. However of interest is the fact that this anomalies were frequently associated with affective deprivation, relational distorsion, disturbed family milieu and low social economic status during childhood.

Chromosome Aberrations↗
PubMed1976

[Medicopsychosocial syndrome of polygonosomies (XXX, XXY, XYY, syndromes etc...)].

This is an attempt to describe a common syndrom of polygonosomy. Medical, psychological and social incidences of XXX, XXY, XYY, genotypes indicate that these chromosomal aberrations share identical features: phenotypic abnormalities (high stature, dermatoglyphes abnormalities), neuropsychic troubles (neurological symptoms and mental fragility) and antisocial tendancy. One can suppose that at least some polygonosomic persons have a minimal brain dysfunction (or damage), which causes more vulnerability to environnement, deprivation and stress. Relational, educational and socio-economical factors appear now to have a marked role in the etiopathogenesis of these psychiatric troubles. Some forensic and ethical problems of human genetic research are reviewed, such as the so-called "criminal chromosome", supplementary Y chromosome, a myth based upon false and premature scientific assertions.

Antisocial Personality Disorder↗
PubMed1976

[Psychiatric effects of cardiac surgery].

The authors report three cases of psychotic complications of cardiac surgery. A review is made from literature and an inventory of psychological and organic factors implicated in this pathology. These complications are still frequent (up to 50% for Braceland, and 70% for Rabiner and al.). For Blacher there is an almost universal "psychosis" in by-pass surgery and frequent "hidden psychosis" (they are ignored and denied both by the staff and the patient). They are caused by the emotional stress, intensive care unit syndrome, or personal vulnerability. The symbolism of the heart and the personality of the cardiac patient are also in cause. Neurologic accidents, hypoxy, embolisms, are now less frequent. The collaboration of a psychiatrist with the cardiologic staff is mandatory. With this collaboration not only psychiatric complications but also somatic morbidity and mortality would be reduced.

Adjustment Disorders↗