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Biomedical subjects

M Bourgeois

Publications and source records attributed to M Bourgeois.

405 records · Page 23Linked to original sources
PubMedDate not supplied

[Clinical study of a population of patients hospitalized for eating disorders. Discussion of DSM III-R diagnostic criteria].

Patients consecutively referred for a clinical diagnosis of eating disorders to the Unit for Addictive Disorders at the University Hospital of Nantes were included in the study. The sample contained 95 patients (94 females, 1 male; mean age +/- SD: 24.1 +/- 6.5). All the patients were evaluated with the Computerized Multiple Diagnostic Instrument for Eating Disorders, which assesses diagnostic criteria for eating disorders from different international diagnostic classifications. Seven (7%) patients fulfilled the DSM III-R criteria for anorexia nervosa (AN) and 42 (44%) the DSM III-R criteria for bulimia nervosa. Two subgroups of bulimic patients were distinguished according to Body Mass Index [anorexia-bulimia (AB) if BMI was < 18 (n = 11, 12%) and normal weight bulimia (NWB) if BMI was > 18 (n = 31, 33%)]. Most patients (n = 46, 48%) did not fulfill DSM III-R criteria for AN or bulimia, and were given the residual DSM III-R diagnosis of eating disorder not otherwise specified (EDNOS). A comparison was made of the frequencies of the different weight control strategies displayed by the patients of the 4 subgroups. Vigorous exercise was more frequently used by AN patients than by patients of the 3 other subgroups. Vomiting was more frequent in bulimic patients, although this symptom was displayed by 29% of the AN patients and 24% of the EDNOS. Abuse of laxatives or diuretics was similar in the four subgroups. Use of diuretics was infrequent in the total sample of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Individual susceptibility to addiction. Contribution of animal models].

Whereas the main clinical problem in drug addiction lies in individual vulnerability to toxicomania, experimental models of drug abuse usually focus on the brain targets involved in the reinforcing properties of drugs. In this short review, we describe the two main procedures of animal drug self-administration--retention and acquisition paradigms--designed to investigate the neural substrate of drug abuse and the individual susceptibility to toxicomania. Retention procedures have been widely employed since Weeks (1962) to study the reinforcing properties of various addictive substances in experimental animals, particularly opiates and psychostimulants. If the meso-accumbens dopaminergic pathway actually seems to underlie the reinforcing properties of psychostimulants, the question remains unsolved regarding opiates and other drugs of abuse such as benzodiazepines, nicotine or alcohol. Rather than a final common pathway for the reinforcing properties of drugs, the dopaminergic system could be considered as a modulator which enables the expression of addictive properties, supported by the interaction of drugs with other brain structures. Therefore, the neural substrate of drug reinforcement appears redundant and widespread rather than convergent and anatomically circumscribed. On the other hand, acquisition procedures deal with factors that influence the individual vulnerability to drug addiction in animals. This procedure measures the ability of animals to become dependent of low doses of addictive substances. Under various conditions such as stress, food deprivation or isolated housing, it is possible to detect changes in the vulnerability to drug consumption. Moreover, it is possible to detect behavioral characteristics that predict the vulnerability of animals to the spontaneous self-administration of psychostimulants.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

[Obstetrical complications and schizophrenia. Comparative study of obstetric antecedents in schizophrenic and bipolar patients].

Information on pregnancy and birth complications was recorded for 46 patients with DSM III-R schizophrenia or bipolar disorder. The biological mothers of the patients were interviewed personally to obtain obstetric information. There were no significant differences between schizophrenic and bipolar patients in age at the assessment, distribution of sex, paternal social class, age of the mother at birth, and birth order. Biological mothers of schizophrenics had more often than mothers of bipolar patients an history of miscarriage, but this trend failed to reach statistical significance. Pregnancy complications and birth weight were not significantly different between schizophrenic and bipolar patients. Birth complications were scored according to the method described by Parnas et al. (1982). Three scores were obtained for each patient: a frequency score, a severity score, and a total score. All the scores were significantly higher in the schizophrenic than in the bipolar group (frequency score p < 0.011; severity score p < 0.015; total score p < 0.01). Surprisingly, birth complications were more severe in female than in male schizophrenics (p < 0.017). The two groups of patients could not be differentiated by specific birth complication. The schizophrenic patients with a history of birth complication and those without such an history did not differ in age at onset, age at first hospitalization, family history of schizophrenic or non-affective psychotic disorder, neuroleptic resistance, and type of schizophrenia. Because of the small number of subjects in each group a type II error cannot be excluded for these negative results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Comorbidity of bipolar and eating disorders. Epidemiologic and therapeutic aspects].

The frequent association of bulimia nervosa and affective disorders is well documented. Most studies on this topic have focused on the comorbidity of bulimia nervosa and unipolar depression. The literature on the comorbidity of eating disorders and bipolar disorder is more sparse. Nevertheless, an increased rate of bipolar disorder, especially bipolar II disorder, has been found by several epidemiological studies in patients with bulimia nervosa. This association might be more frequent in bulimic patients presenting with a severe chronic type of eating disorder. The relatives of bulimic patients also display an increased morbid risk for bipolar disorder. Although the comorbidity of bulimia and bipolar disorder does not appear coincidental, the nosological relationships between these two disorders are not perfectly clear. The possible relationships between seasonal affective disorders and bulimia nervosa have recently been suggested by some epidemiological studies, demonstrating that bulimia may display seasonal variations with winter worsening of bulimic symptoms. Eating symptoms are present in both winter depression and bulimia nervosa. The carbohydrate craving encountered in the former disorder could be compared to "binge eating" in bulimic patients. Epidemiological data suggest that winter depression is most frequently part of a bipolar II disorder. Few data are available concerning the therapeutic implications of the association of bulimia nervosa and bipolar disorder. Some case reports of concomitant remission of both disorders with anticonvulsivants or lithium salts have been published. However, there are no controlled studies. Anticonvulsivants or lithium salts might be indicated in some bulimic patients who do not present with a typical bipolar disorder, but who fulfill clinical criteria which are potentially predictive of a good response to such medications.

Anorexia Nervosa↗
PubMedDate not supplied

[Prevalence of obsessive-compulsive disorders in a large French patient population in psychiatric consultation].

Recent epidemiologic studies were conducted in general population, showing high rate prevalence of obsessive-compulsive disorder (OCD) (2-3%). Although more investigation of OCD prevalence in clinical population is still warranted. The prevalence of DSM III-R diagnosis of OCD and obsessive-compulsive syndromes (OCS) is reported in 4 364, 16-70 year old new consecutive patients, consulting in out-patient psychiatry. Point prevalence rates of 9.2% were recorded for OCD and 17% for OCS. Significantly different from non obsessional patients, it was observed in OCD and OCS patients more male representation (41% vs 37%, p = 0.007), a younger current age (36 y vs 39 y, p < 10(-4)) and age of disorder onset, higher rate of celibat (31.5% vs 28.6%) and lesser of separated or widowed (9.4% vs 16.2%, p = 0.003), more anxiety and depression comorbidity (50% vs 39%, p < 10(-4), a higher suicidal risk (17% vs 14%, p = 0.04--especially in OCS patients: 18.3%), more chronicity (mean current episode duration: 14.8 months vs 11.2 m., p < 10(-4)) and higher rate of global functioning impairment (score at GAF: 53.9 vs 57.9, p < 10(-4)). The results of the french survey confirmed the high prevalence of OCD and OCS in patients seeking psychiatric treatment. OCS (or subclinical OCD) seem to form a valid group (high rates of comorbidity and suicidal attempts) which need to be recognized and to receive adequate treatment.

Adolescent↗
PubMedDate not supplied

[Comparative study of substance dependence comorbidity in bipolar, schizophrenic and schizoaffective disorders].

Epidemiological studies such as the Epidemiological Catchment Area survey have shown that bipolar or schizophrenic patients are especially prone to display a comorbid substance use disorder. These studies have demonstrated that this comorbidity condition constitutes a major mental health problem owing to its high frequency. The aim of the present study was to assess the prevalence of a comorbid substance use disorder in a sample of psychotic patients, and to compare the pattern of street drug use in schizophrenic, schizoaffective and bipolar patients. Comorbidity of illicit substance use disorders was assessed with the Composite International Diagnostic Interview in 92 consecutive patients fulfilling the DSM III-R criteria for bipolar disorder (BP, n = 40), schizophrenia (S, n = 38) and schizoaffective disorder (SA, n = 14). The lifetime prevalence for any substance use was 25% in the total sample, and did not differ significantly between the three groups, although a higher prevalence was found in SA (BP: 20%, S: 23.7%, SA: 42.9%, NS). The current prevalence (previous six months) was 14.1%, in the total sample (BP: 17.5%, S: 7.9%, SA: 21.4%, NS). In the three diagnostic groups, the most commonly used drug was cannabis, followed by opiates and cocaine. These results do not confirm that schizophrenics might preferentially display abuse or dependence on psychostimulants, and highlight the possible role for the drug choice of the availability of the various illicit drugs in the geographical environment of the subject. Nearly half patients (47.8%) have a lifetime history of abuse or dependence on at least two different drugs. Age at onset of substance use disorder was earlier than or concomitant to that of schizophrenic and/or mood symptoms in most patients. This chronological pattern was the same in the three diagnostic groups. Clinical variables (age at onset, age at first hospitalization, number of hospitalizations) and sociodemographic variables (age, sex, educational level, marital and occupational status) did not significantly differ between patients with a lifetime history of drug abuse or dependence and those without. Patients presenting with a current abuse or dependence were younger than those without. These results confirm in a French sample of schizophrenic and/or mood disordered patients the high frequency of the comorbidity with substance use disorders.

Adult↗
PubMedDate not supplied

[Clinical aspects of obsessive-compulsive syndromes: results of phase 2 of a large French survey].

Obsessive-Compulsive Disorder (OCD) had received a new interest from fundamental research (psychopharmacology, neurobiology and brain imagery...). Although more investigation of OCD clinical aspects are needed, especially in large cohorts of patients, not seen nor investigated only in high specialized psychiatric units. A large french survey "Screening-Understanding-Treating OCD" was conducted in 1994 with the participation of 240 psychiatrists. The survey had included 4,363 new consecutive patients consulting in out-patient psychiatry. The phase 1 had shown a point prevalence rates of 9.2% for OCD (full criteria of DSM III-R) and 17% for OCS (Obsessive-Compulsive Syndromes). From 731 patients, the phrase 2 was conducted on a cohort of 646 patients with OCD or OCS and had explored in details in the clinical aspects of the OC illness (typology, symptomatic categories, comorbidity, OCD spectrum, psychiatric family history and treatment history...). The results of the french survey phase 2 had confirmed a variety of classical and current literature data, especially: the ICD 10 proposal for diagnostic sub-typology according to symptomatic predominance (obsessions, compulsions or both); the symptomatic clustering of obsessions and compulsions into three major categories, suggested by a recent study from the Boston University; the high rate of comorbidity with anxiety and depressive disorders and with disorders related to the large OCD spectrum (somatoform disorders, eating disorders, impulse-control disorders, compulsive buying...); the impact of clinical parameters (as slowness, avoidance, lack of insight) on clinical global OCD and OCS severity; the high rate of intrafamilial psychiatric morbidity (OCD, depression, anxiety disorders).

Adult↗