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Biomedical subjects

M Ferreri

Publications and source records attributed to M Ferreri.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Oropharyngeal form of the Lasthenie de Ferjol syndrome. Apropos of a case].

The Lasthenie de Ferjol Syndrome associates an iron-deficient anemia by blood auto-spoliation with mental disorders. In this paper, the authors present an oropharyngeal form of this disease. Based on this case review (and those reported in the literature), they remind us this syndrome's mains characteristics, underlying how exceptional and particular this clinical report is. At least they point out how to diagnose, manage, and treat patients with this strange illness.

Adult↗
PubMed1987

[Construction and preliminary validation of an anxiety scale, the FARD (Ferreri anxiety rating diagram)].

The complexity of the anxious disease does not facilitate the clinical approach. That the reason why the authors have developed a rating scale based on a descriptive symptomatology to find out a diagnosis, to rate the severity of illness and to facilitate the pharmaceutical prescription. To develop a skill needed by general practitioners as well as specialists, Prof. M. Ferreri worked with pools of medical doctors to isolate the more frequent items in the anxious symptomatology. So they pointed out a first group of 14 items. A first statistical approach was to compare the new scale with the well-known Hamilton anxiety scale by the way of a sample of 81 ratings. After a first factor analysis, a sub-group of 12 items were definitely retained. These items were split in 4 factors which permitted to present the factorial results in diagram [Acta psychiat. belg., 87, 704-713 (1987)].

Adult↗
PubMed1982

[Anxiety states and bromazepam (author's transl)].

In the study reported here 73 ambulatory patients with neurotic or reactional anxiety state were treated with bromazepam (Lexomil) 6 to 12 mg/24 hours in 3 divided doses with a double dose at night. Treatment lasted from 28 days (8 patients) to 60 days or more (42 patients). Results were excellent or good in 43 cases, with rapid improvement in the psychic component of anxiety. Twelve of the 15 patient s who took bromazepam 4 hours before going to bed plus a hypnotic at night showed improvement in the quality of sleep. During weaning of ambulatory alcoholic subjects by gradual withdrawal of alcoholic beverages, bromazepam proved useful in reducing the anxiety load. The drug was generally well tolerated.

Adult↗
PubMedDate not supplied

[Ultrasensitive TSH and thyroliberin test in patients hospitalized for depression].

In this prospective study of 35 patients hospitalized for depression, TSH levels were measured before and after stimulation by TRH. The type of depression was determined and its intensity was evaluated by means of the HARD scale. Subjects with systemic disease or receiving treatments known as being likely to influence TSH levels had been excluded. In none of these 35 patients was the TSH level below the lower limit of normal values, nor was there any blunting of response to TRH. These results suggest that depression is not a cause of TSH fall and that a low TSH level with normal hormonaemia must call for scintiscanning, even in depressed subjects.

Adult↗
PubMedDate not supplied

Psychiatric comorbidity is related to headache induced by chronic substance use in migraineurs.

Headache centers have to deal with patients suffering from headache induced by chronic substance use which is a well-recognized complication of migraine treatment. The objective of this study was to compare psychiatric comorbidity between migraineurs with and without chronic substance use: 34 migrainous inpatients with chronic substance use were compared with 34 sex-matched noncomplicated migraineurs in a case-control study. The results showed a significantly higher prevalence of major depressive disorder, panic disorder, and social phobia in the patients with a history of chronic substance use. Consistently, anxious and depressive dimensions were significantly higher in these patients. Therefore, psychiatric morbidity may be linked to chronic substance use in migraineurs. This stresses the importance of psychiatric assessment and the need for appropriate treatment in such patients.

Adult↗
PubMedDate not supplied

[Distinction between anxiety state/trait in general practice: a descriptive study].

State-anxiety has been defined as a transitory emotional response involving unpleasant feelings of tension and apprehensive thoughts. Trait-anxiety, on the other hand, has been defined as a personality trait referring to individual differences in the likelihood that a person would experience state anxiety in a stressful situation. The aim of the present study was to assess trait and state-anxiety in a population of patients consulting physicians for anxious complaints. Thus, patients who stopped the benzodiazepine (BZD) treatment after three months and those who continued it for six months were compared. Included patients were evaluated at inclusion (D0), after three months (M3) and after six months (M6). The investigator filled the Covi anxiety scale, the Raskin depression scale and a CGI; patients were asked to fill the Spielberger state/trait-anxiety questionnaire. 1,112 patients have been included, 48% considered their anxiety as chronic, 50% said the evolution was progressive, 87% considered it resulting of a trigger factor, 69% received a benzodiazepine (BZD) treatment. At D0: Covi anxiety score was 5.3 +/- 2.3 points, STAI I (state-anxiety) score was 57.4 +/- 12.2 points and STAI II (trait-anxiety) score was 52.7 +/- 10.2 points. At M3, all scores decreased, and 85% were considered as ameliorated, but differences were significant (p = 0.0001) at M6. When comparing at D0 patients who stopped BZD treatment at M3 and those who continued it, some differences appeared. In fact subjects who stopped the treatment had lower score at the STAI II, presented significantly less flushes (p = 0.01), less tremor (p = 0.04) and less feverishness (p = 0.05). Their score at Covi tended to be lower (p = 0.11). The severity of the disease, evaluated with the CGI, was also lower for the patients who stopped the BZD treatment. The trait-anxiety appeared as a good predictor of the efficacy of the BZD treatment. In fact, the trait-anxiety refers to a tendency to be anxious and higher anxiety necessitates longer treatment. The treatment response was less important in the patients who continued the treatment at M3, indicating the presence of residual anxiety in these patients.

Adolescent↗
PubMedDate not supplied

[Sulpiride: study of 669 patient presenting with pain of psychological origin].

Among somatoform disorders, pain disorder (DSM IV) appears to be relatively common in general practice and to cause social, psychological, and functional impairment. A previous study conducted by Lemoine (1997) has shown that sulpiride is more effective than placebo in reducing intensity and frequency of pain in this disorder. The aim of our study was to assess safety and efficacy of sulpiride in a large sample of patients under natural conditions of use, in general practice. In a multicenter, open clinical trial, 669 patients (mean age: 47 years +/- 12; male: 245, female: 424) fulfilling the DSM IV criteria for pain disorder (of gastrointestinal localization), were included by 321 general practitioners (GP) and treated for 6 weeks with sulpiride 150 mg/d. Investigators' evaluations were planned at D14 and D42. Furthermore a diary was given to each patient for self evaluation and intercurrent events reporting. The pain was of psychological type in 93% of cases and caused social or working disabilities in 78% of patients. At inclusion the mean score of the Hamilton Anxiety Rating Scale was 18 +/- 8, and the mean score of the depression scale HARD (Humeur, Angoisse, Ralentissement, Danger) was 14.8 +/- 6.4. During the study 7.9% of the patients had at least one adverse event, and 3% of patients were withdrawn for adverse event. Safety assessed with a specific variable (grouping together adverse events' reporting and results of CGI item 3) was good for 88% of patients. The principal criterion of efficacy was the clinician's evaluation of the intensity and frequency of abdominal pain on a four-point scale from 0 (asymptomatic) to 3 (important/continuous) from D0 to D End a decrease in pain intensity (91% of patients) and in pain frequency (89%) was observed as well as in frequency and intensity of related gastroenterological symptoms such as disturbances of bowel movements (79% and 78%), bloated symptoms (88% and 83%), nausea/vomiting (90% and 90%). A similar improvement (p < 0.001) was observed from D0 to End point on the self evaluation parameters (Visual Analogic Scales), assessing pain (mean score D0-D End: 17.1 +/- 15.9), quality of sleep (mean score D0-D End: 27.1 +/- 17.8), activity (mean score D0-D End: 24.4 +/- 18.8), and appetite (mean score D0-D End: 22.6 +/- 16.6). In conclusion these results confirm the usefulness of sulpiride in the treatment of pain disorders a symptomatology known to cause difficulties to GP's in their practice.

Abdominal Pain↗
PubMedDate not supplied

[What information do patients with schizophrenia have about their illness and treatment?].

Improved compliance with antipsychotic medication is a major issue in schizophrenic management. For this purpose educational programs have been used, but up to now, little or no information has been gathered or published in France concerning schizophrenic patients' opinion on information they have about their disease and their treatment. Thus we conducted a survey in concert with 78 psychiatrists from the French psychiatric health service. From this cross sectional survey we assessed 336 outpatients (male: 72%; mean age: 36 +/- 10.4 years) with schizophrenia according to the DSM IV (paranoid sub type: 57%, disorganized: 12%, catatonic: 1%, undifferentiated: 12%, residual: 18%). The mean duration of the illness was 11.6 years (sd: 8.5) and the mean duration of the follow up with the same psychiatrist was 5.4 years (sd: 5.1). Patients completed a questionnaire which assessed their level of information on mental illness and treatment. The diagnosis of schizophrenia has been told to their patients by 39% of the psychiatrists, and treatment has been explained to the patients by 96% of the practitioners. Results indicate less than half of the patients (45%) felt ill, only 46% thought they knew their illness well or very well (nevertheless only 31% of them named spontaneously the diagnosis of schizophrenia or psychosis), and 61% considered that they had been given sufficient information. Most of the patients (79%) were persuaded that their treatment was useful, and 75% of patient were completely satisfied with their treatment. Surprisingly 92% reported taking their medication regularly. Most patients think that a high level of information about their illness (74%) and treatment (79%) help them to cope better with their schizophrenia. Analysis performed according to patients characteristics indicated that paranoid patients felt more ill (p = 0.035) than others, thought to know less about their illness (p = 0.0065), and were less satisfied with their treatment (p = 0.04) and their level of information (p = 0.03). Patients with a duration of their illness longer than 10 years were more convinced of the utility of their treatment (p = 0.02) and had debated more on the choice of their treatment with their psychiatrist (p = 0.047). Patients older than 35 years were more satisfied with their information (p = 0.002). More patients with atypical antipsychotics accepted to take their treatment on a regular basis (p = 0.035) compared to patients under classical neuroleptics. This survey underlines that mental health consumers' opinions can be obtained even in the field of schizophrenia, and argues in favour of further such investigations. It also highlights the need for educational programs on schizophrenia and antipsychotic medications.

Adaptation, Psychological↗
PubMedDate not supplied

[Catatonia de novo, report on a case: immediate vital prognosis and psychiatric prognosis in longer term].

We report on the case of a 20 year old woman with no previous psychiatric history, who displayed a first episode of catatonia with acute onset. Symptoms started plainly with sudden general impairment, intense asthenia, headache, abdominal pain and confusion. After 48 hours, the patient was first admitted to an emergency unit and transferred to an internal medicine ward afterwards. She kept confused. Her behaviour was bizarre with permanent swinging of pelvis, mannerism, answers off the point and increasingly poor. The general clinical examination was normal, except for the presence of a regular tachycardia (120 bpm). The paraclinical investigations also showed normal: biology, EEG, CT Scan, lumbar puncture. Confusion persisted. The patient remained stuporous, with fixed gazing and listening-like attitudes. She managed to eat and move with the help of nurses but remained bedridden. The neurological examination showed hypokinaesia, extended hypotonia, sweating, urinary incontinence, bilateral sharp reflexes with no Babinski's sign and an inexhaustible nasoorbicular reflex. The patient was mute and contrary, actively closed her eyes, but responded occasionally to simple instructions. For short moments, she suddenly engaged in inappropriate behaviors (wandering around) while connecting back to her environment answering the telephone and talking to her parents. The patient's temperature rose twice in the first days but with no specific etiology found. During the first 8 days of hospitalization, an antipsychotic treatment was administered: haloperidol 10 mg per os daily and cyamemazine 37.5 mg i.m. daily. Despite these medications, the patient worsened and was transferred to our psychiatric unit in order to manage this catatonic picture with rapid onset for which no organic etiology was found. On admission, the patient was stuporous, immobile, unresponsive to any instruction, with catalepsy, maintenance of postures, severe negativism and refusal to eat. A first treatment by benzodiazepine (clorazepate 20 mg i.v.) did not lead to any improvement. The organic investigations were completed with cerebral MRI and the ruling out of a Wilson's disease. Convulsive therapy was then decided. It proved dramatically effective from the first attempt; 4 shocks were carried out before the patient's relatives ask for her discharge from hospital. The patient revealed she had experienced low delirium during her catatonic state. The clinical picture that followed showed retardation with anxiety. She was scared with fear both for the other patients and the nursing team. She kept distant and expressed few affects. The treatment at the time of discharge was olanzapine 10 mg per os. She was discharged with a diagnosis of catatonia but with no specific psychiatric etiological diagnosis associated. She discontinued her follow-up a few weeks later. After one year, we had no information about her. Catatonia has now become rare but remains a problem for clinicians. We reviewed data concerning short term vital prognosis and psychiatric long term prognosis in catatonia. Lethal catatonia is associated with acute onset, both marked psychomotor and neurovegetative symptoms. In the light of literature, there is no proband clinical criterion during the episode that is of relevant diagnostic value to ascertain the psychiatric etiology.

Acute Disease↗
PubMedDate not supplied

[Residual symptoms after a treated major depressive disorder: in practice ambulatory observatory carried out of city].

INTRODUCTION: The main therapeutic objective for depression is remission (absence of clinical signs of the disorder and low scores on assessment scales), yet partial remission rates remain high (insufficient criteria for diagnosing the disorder while clinically and psychometrically assessable symptoms continue to linger. The presence of residual symptoms is associated with a higher relapse rate of depression, occurring up to 5 times earlier, an increased suicide rate, significant use of healthcare services and a marked social impairment. The most frequently reported symptoms are specific to depression, i.e. anxiety and irritability, depressed mood, feelings of guilt and loss of interest in activities, asthenia and difficulty falling asleep at night. Residual symptoms constitute a valid and reliable clinical marker of prognosis (especially for relapse and chronicity) and must be treated with specific therapeutic strategies. Studies on depression with residual symptoms are few and mainly focus on populations of hospitalized patients or those with a severe form of depression. Since little work has been done with regard to patients monitored on an outpatient basis, we felt it was appropriate to select a population of depressed patients from private psychiatric practice. Our main objective was to analyze the frequency of residual symptoms after 8 to 12 weeks of antidepressant treatment and to study the clinical and socio-demographic characteristics of these subjects. DESIGN: 1 790 patients who had presented with one major depressive episode per DSM IV criteria and who had been receiving antidepressant treatment for 8 to 12 weeks were included and evaluated. 463 private psychiatrists practicing in metropolitan France were randomly selected and stratified by region and sex ratio (30% female and 70% male) to obtain a sample as representative as possible of the French psychiatrist population. The following were measured and assessed: anthropometric and socio-demographic characteristics, the history of depression, a description of the last major depressive episode, a description of its management, current clinical variables, the Hamilton Depression Rating Scale (HDRS) score, the physician's assessment of residual symptoms, and a description of the patient's management on the day of the appointment. RESULTS: Following acute treatment, evaluation of depressive symptoms on the Hamilton scale showed that 549 (32%) of subjects had a score below 8; 792 patients (46.7%) had a score between 8 and 18; and 354 (20%) had a score above 18. Patients in the first group (HDRS<8) who were considered to be in remission started treatment early (chi2=18.28, DOF=4, p<0.01) for a first episode (51.3%) with a low number of initial symptoms (chi2=27.03, DOF=6, p<0.01). The evaluators found persistent depressogenic factors (chi2=15.9, DOF=2, p<0.01) and significant psychiatric co-morbidity (chi2=18.28, DOF=4, p<0.01) in subjects in partial remission (HDRS between 8 and 18). The non-responders (HDRS>18) presented a history of more depressive episodes (chi2=17.04, DOF=4, p<0.01) and a delay of more than 30 days before treatment was initiated (chi2=18.2, DOF=4, p<0.01). With regard to the nature of residual symptoms, at least 50% of subjects in partial remission were very symptomatic for depressive mood (65.4%), psychic anxiety (56.6%), and loss of interest and time away from work (49.4%). Indicators of severe depression (early morning insomnia, psychomotor retardation, agitation, hypochondriasis, weight loss and lack of awareness of the disorder) were reported less frequently, and usually not at all. Conclusion - These results illustrate three important points. First, a significant percentage (46.7%) of patients who responded to treatment subsequent to the acute period presented with residual symptoms. Second, these symptoms are included in the areas of depressed mood - psychic anxiety . Third, a delay in initiating treatment seems to have an effect on response. These results confirm the need to develop strategies to screen for these residual forms for these residual forms of depression, as well as specific methods to treat them.

Ambulatory Care↗
PubMedDate not supplied

[Residual symptoms after a treated major depressive disorder: a survey among private psychiatrists].

UNLABELLED: Recent studies suggest that depression with residual symptoms is a frequent progressive form of this disease. It is associated with a poor prognosis that translates into an earlier and higher relapse rate, and has a significant medical and social impact. Several literature reviews emphasize that residual symptoms are under-evaluated and that their treatment should follow an incisive strategy with the goal of complete eradication of symptoms. Specific patterns have not been detected either, and the evaluation of residual symptoms remains subject to numerous biases due to the lack of a validated definition. The purpose of this study was to analyze the opinions and attitudes of psychiatrists about residual symptoms following major depressive episodes treated with antidepressants as part of their daily private practice. DESIGN: 867 psychiatrists were selected from across France to form a representative sample of the medical specialization. They were questioned with a closed-choice questionnaire on the scope of the residual depressive symptoms concept (definition, professional consensus), determining factors in their onset (factors associated with the patient, with the initial episode, with management) and their practical and therapeutic attitude towards these symptoms. RESULTS: The estimated prevalence of residual symptoms in their depressed patients was 25%. Fifty-seven percent of the physicians queried felt the concept was appropriate, but 70.3% thought that it did not have a strong professional consensus. The definitions deemed most appropriate were those involving the persistence of clinical signs (asthenia or minor cognitive impairment), whereas the use of psychometric criteria was mentioned less often. There is a clear absence of consensus concerning the diagnostic delay of residual symptoms, as 30% diagnosed them after 6 months. Responses about factors that may be predictive or affect the onset of residual symptoms (associated with the patient, the nature of the initial episode and the management) did not reflect a unified position, nor did they necessarily correspond to the data in the literature. However, while the therapeutic attitude seemed adequate (verifying treatment compliance, clinical re-evaluation, therapeutic re-adjustment), 64% of the physicians considered residual symptoms to be a therapeutic challenge. CONCLUSION: Through the wide disparity of responses, this observational study demonstrates the absence of consensus with regard to the concept of residual symptoms. While it does appear that practitioners often adopt an approach that is pragmatic yet still close to that recommended by the ANAES [Agence National d'Accréditation et d'Evaluation en Santé, French National Health Accreditation and Evaluation Agency], such an approach does not seem to be optimized for the specific treatment of these symptoms. This clinical concept remains little studied, and lacking a specific definition, appears to be under-evaluated and under-treated by conventional treatment strategies. Further research on residual symptoms is necessary in order to establish true and valid definitions that will.

Adult↗
PubMedDate not supplied

[Neurotic inhibition and transnosographic approach. Apropos of a multicenter study of carpipramine].

We have performed a national multicentric atrial in psychiatry, collecting 546 patients with neurotic inhibition. The efficacy of carpipramine was evaluated in this disease. A transnosographic and epidemiologic analysis of this syndrome was realized on this group of out patients. The statistical study by a factorial analysis of correspondences shows the epidemiological and symptomatic characteristics of inhibition. The endpoints were DSM-III criteria of chronic anxiety, adaptation disorders and functional sexual disorders on the first axis and different types of personality on the second axis.

Adolescent↗
PubMedDate not supplied

[A new scale of quantitative and qualitative evaluation of anxiety: the Ferrerri Anxiety Rating Diagram (FARD)].

This new instrument to evaluate anxiety, the F.A.R.D. (Ferreri anxiety rating diagram - 1987) has been conceived to appreciate the repercussions of anxiety on the activity of the subject. It realizes a special image of anxiety. It has been studied, by both psychiatrists and general practitioners in 320 patients included on generalised anxiety disorders criteria (following DMS III). The validation has been realised in a study of prazepam for 81 patients. The F.A.R.D. is based upon 12 items. The factor analysis has retained 4 factors explaining 66% of the whole variance. These 4 factors composed by 3 items each are: relational, somatic, vigilance, cognitive. This new instrument, the F.A.R.D.: evaluates the intensity of anxiety, precision, the shape of anxiety, specifies sub-groups of anxiety, allows a following of evolution, appreciates the pharmaco-clinical profile of the anxiolytic drug prescribed.

Adult↗
PubMedDate not supplied

[Validation of HARD (Hamilton depression rating scale) a diagram of the evaluation of depression by MADRS (Montgomery-Asberg depression rating scale) Multicentric study of mianserin].

A national multicentric trial has included 402 depressed patients (DSM III Criteria) and has validated diagram HARD by MADRS. A constant and similar decrease in the total of the two rating scales has been shown at several times of assessment, Day 0, 10, 20, 60, and 90. High coefficents of correlation are found between HARD and MADRS. The sensitivity to change under treatment (mianserin 60 mg) is equal for the two rating scales.

Adult↗