Search PubMed⌕ Search

Biomedical subjects

M Petit

Publications and source records attributed to M Petit.

178 records · Page 10Linked to original sources
PubMedDate not supplied

[French translation of the Chapman Social and Physical Anhedonia Questionnaire: validation of the French translation in controls and schizophrenic patients].

Whereas Chapman's social and physical scales are the most used instruments for the assessment of anhedonia in schizophrenia, no French translation has been still validated by the authors. Therefore, the aim of this study was first to translate into French the both scales, and after back translation, to obtain the agreement of the original authors. Second, the aim was to establish values and to establish the cut-off beyond of which French subjects could be considered as anhedonic. One hundred and twenty-three subjects were included: 72 control subjects without mental disorders and 51 stable schizophrenic patients defined by the DSM III-R, ICD 9, ICD 10, RDC or Feighner criteria. According to the literature, schizophrenic patients had higher scores for both scales than control subjects (p < 0.001; Student t test). The social anhedonia scores are different due to cultural variations. The distribution of physical anhedonia scores in control subjects or in schizophrenic patients differed from normal distributions (respectively, p < 0.05; p < 0.0001; Shapiro-Wilks test). The distribution of social anhedonia scores differed from normal distributions (p < 0.01) only in schizophrenic patients but not in control subjects. By maximising the Younden indice [Sensitivity + Specificity -1], the cut-off of the physical anhedonia score was 18 (Younden indice = 0.45), and the cut-off of the social anhedonia score was 12 (Younden indice = 0.24). In using this cut-off, the French physical anhedonia scale had a good positive predictive value (evaluated by logistic regression) for schizophrenia. Therefore, a patient with a physical anhedonia score beyond 18 have a probability of 64% to be schizophrenic. In contrast, the social anhedonia scale was less discriminant for schizophrenia. Indeed, patient with a social anhedonia score beyond 12 have a probability of 52% to be schizophrenic. This French version of Chapman's anhedonia scales could be considered as an useful instrument to assess anhedonia, in particular physical anhedonia, in schizophrenic patients.

Adult↗
PubMedDate not supplied

[Comparison of 2 depression scales and their relationship with negative and akinetic symptoms in stabilized schizophrenic patients].

Since the Bleuler's early writings, studies in schizophrenia have often shown a frequent occurrence of depression in the context of schizophrenia and also its implications for the morbidity and mortality of schizophrenic patients. The wide variability in the prevalence of depression (between 7 to 70% in post-psychotic period) is due in part to the difficulty in clearly separating depressive symptoms from akinesia induced by neuroleptic or negative symptoms and to the lack of a valid assessment of depressive symptoms in schizophrenic patients. Under these conditions, a better understanding of depressive symptomatology in schizophrenia seems to be necessary to go further in this area of research with clinical and therapeutical purposes. The "Echelle de Ralentissement Dépressif" (ERD, Widlöcher, 1983) was studied in a sample of 53 schizophrenic patients to determinate whether ERD composed of three subscores (motor, ideic and subjective) could be able to evaluate the subjective depressive symptomatology and whether its measure would be independent of negative symptoms or akinesia. Pearson's correlations and correlations with variables partialled out were used to compare ERD to Montgomery and Asberg Depression Rating Scale (MADRS, 1979) and to establish their relationship with Positive And Negative Syndrome Scale (PANSS< Kay, 1987) and an Extrapyramidal Symptom Rating Scale (ESRS, Chouinard & Ross-Chouinard, 1980). Fifty three in or outpatients (35 males and 18 females, mean age +/- standard deviation = 38.26 +/- 9.82) were evaluated in a stable condition (i.e., when the psychotic symptomatology and the neuroleptic treatment have been stabilized since 4 weeks). According to DESM III-R criteria, 49 patients met the diagnosis of schizophrenia (2 schizoaffective disorders and 2 schizophreniform disorders).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Erwin Stransky and intrapsychic ataxy].

The eventful beginnings of the concept of schizophrenia are not widely known in France. Most of the relevant texts are German in origin and French readers have access to very few of them. Yet the concept of schizophrenia has largely been adopted; everything that can contribute to the understanding of its elaboration is of importance. This elaboration did not take the form of a series of brilliant ideas from Kahlbaum, Kraepelin and Bleuler but rather the synthesis by these authors of the theories of their time - theories generally unknown to the French public. One such is the theory of intrapsychical incoordination, propounded by the prolific and interesting Viennese, Erwin Stransky, well known in German-speaking countries but not in France. He was, in 1903, the first to emphasize the importance of inaffectivity in dementia praecox. He devised an explanatory model of this disease, indicating its origin as the variable alteration of the relationship between what he termed thymo and noopsyche. Stransky was the first to speak of intrapsychical ataxy, his model offers an explanation for spectacular remissions from dementia praecox and for pseudo-lucidity. Intrapsychical ataxy, according to the model, is of diagnostic value, allowing a distinction to be made between the paralogies and "wordsalads" of hysterics (only thymopsychic) and those of dementia praecox (only noopsychic).(ABSTRACT TRUNCATED AT 250 WORDS)

Affective Symptoms↗
PubMedDate not supplied

[Schedule for evaluation of the deficit syndrome in schizophrenia: Schedule for Deficit Syndrome (SDS) (Kirkpatrick et al.). Importance pertinence of the SDS. Introduction of the French version].

The negative symptoms of schizophrenia have generated a great interest leading some authors (Crow, Andreasen, Kay) to delineate schizophrenic subtypes based on their presence or absence. Carpenter et al. have recently proposed another subtype, the deficit syndrome, based on Kraepelin's clinical description. This differs from other proposed negative subtypes and refers to the presence or absence of prominent, enduring and primary negative symptoms. Primary negative symptoms have to be due to psychophrenia itself, in other words, independent of factors such as depression, anxiety, akinesia... Kirkpatrick et al. have proposed the Schedule for the Deficit Syndrome (SDS) to reliably identify this deficit syndrome. Some studies using this instrument have supported the validity of the deficit syndrome concept. Particularly, deficit patients have clinical, neuropsychological, neurological, eye-tracking and brain imaging impairments compared to nondeficit patients. We realized a french translation of SDS and used it to study a biological index (plasma homovanillic acid, pHVA) among deficit and nondeficit schizophrenic patients. Our data suggest a specific biochemical basis for the deficit syndrome, ie, significant lower mean pHVA levels with a lack of diurnal variation for deficit patients. The french version of SDS was validated by Kirkpatrick after english back translation. We present here our psychometric data regarding reliability (assessed by weighted and unweighted kappa coefficients) and cohesiveness of the construct (assessed by rank-order correlations of each negative symptoms with the other five, using Spearman's rho). These data are quite significant and in agreement with the SDS authors.

Arousal↗
PubMedDate not supplied

[Polydiagnostic approach to schizophrenia. Validation of a computerized checklist (Diagnostic and Prognostic Scales)].

With a polydiagnostic approach of schizophrenia in mind, the authors present, in french language, a computer-diagnostic instrument, essential for any research at the present time. This includes a 183-item checklist constructed from 14 diagnostic systems for schizophrenia and from Chronic Hallucinatory Psychosis (CHP), a typically french diagnostic entity, not recognized by English-speaking countries which do not individualize it from schizophrenia. This study tested the reliability in interviewing the patients simultaneously by 2 examiners with the checklist. The interrater agreement was excellent (Kappa from 0.75 to 1) for schizophrenic diagnoses under the systems CATEGO, DSM III-R, Feighner, ICD9, Langfeldt, Pull, Schneider and Taylor-Abrams. It was good (Kappa from 0.40 to 0.75) for the 6 other schizophrenic systems, Bleuler (k = 0.52; p > 0.01), Carpenter with a cut-off at 6 (k = 0.52; p < 0.05), ICD10 (k = 0.70; p < 0.01), New-Haven (k = 0.58), RDC (k = 0.59; p < 0.01), Vienne (k = 0.68; p < 0.01), and the Chronic Hallucinatory Psychosis (Pull) (k = 0.71; p < 0.01). The validity of the computer program was tested by the concordance (Cohen's Kappa) between the diagnoses established by a medical examiner and by computer, both obtained from the same collected data (the checklist). The tests show that the concordances were excellent for the 15 diagnoses for schizophrenia and CHP (Kappa form 0.75 to 1) and always above those obtained by the tests of interreliability.

Adult↗
PubMedDate not supplied

[J. Delay hypothymic disorder. Current aspects and pertinence of the concept in schizophrenic states].

In the first part, the authors re-examined the concept of "hypothymie" described by J. Delay in 1946. "Hypothymie" is characterized by a mood disorder and particularly by an absence of mood and it is a fundamental syndrome of hebephrenia. From this syndrome "hypothymie", others signs will appear such as schizophrenic symptoms (characterized by attention disorder and formal thought disorder), paranoid symptoms or catatonic ones. Several authors, like J. Delay, had emphasized the importance of the mood disorder (an absence) in this pathology. It is the case of Kretschmer, Dide and Guiraud (who evoked the "athymhormie"), Bleuler, Kraepelin and also Stransky, Griesinger and at the beginning of the XIXth century, Haslam in England and Pinel in France. In the present time, "hypothymie" is related to some current concepts, especially the deficit forms of schizophrenia described by Carpenter and the schizophrenia type II defined by Crow. In the second part, the relationships between paranoid symptoms, depression and "hypothymie" were studied. The authors stressed the fact that there is an overlap between depressive and paranoid symptoms at the acute phase. They gave an illustration including 51 patients in an acute phase and in a stabilized one. In the acute phase, there was a negative correlation between positive symptoms and depressive symptoms in particular between conceptual disorganization, suspiciousness/persecution, positive formal thought disorder and depression (r = -0.65, p < 0.01; r = -0.57, p < 0.01; r = -0.66, p < 0.01 respectively). These correlations disappeared at discharge of the hospital and did not exist in the stabilized group.(ABSTRACT TRUNCATED AT 250 WORDS)

Depressive Disorder↗
PubMedDate not supplied

[Anti-hallucinatory coping strategies in schizophrenia].

Despite the effectiveness of antipsychotic drugs in schizophrenia, many patients continue to have persistent positive symptoms like hallucinations. It has provided new interest for coping strategies used by hallucinated patients. Therefore the aim of the study was to explore the existence of such strategies in 50 schizophrenic patients defined by the presence of hallucinations. A specific questionnaire about coping strategies and a scale for the assessment of positive and negative symptoms were used. Our results showed that each patient developed at least one strategy, even rudimentary. Moreover, whenever the type of hallucinations, they developed specific coping strategies, most of the time logically used: they used them as much as they were efficace. So coping strategies should be taken into account for the clinical management of hallucinated patients. Learning of these strategies through behavioural and cognitive therapy could help patients suffering from resistant hallucinations.

Adaptation, Psychological↗
PubMedDate not supplied

[The dopamine transporter: characterization and physiopathologic implications].

The dopamine transporter (DAT) is the carrier protein that transports dopamine across the presynaptic membrane. The DAT terminates the action of dopamine (DA) in the synapse via reuptake and thus regulates DA neurotransmission. The transporter has been studied by direct binding techniques using a variety of ligands which are inhibitors of DA transport. DAT binding, both in vivo (positron emission tomography) and in vitro (post mortem) may serve as a presynaptic marker to measure altered DA innervation in several neuropsychiatric diseases such as idiopathic Parkinson's disease, Tourette's disease, schizophrenia or cocaine addiction. In Parkinson's disease, a reduction in the density of binding sites could be due either to a degeneration of the terminal dopaminergic projections or to a compensatory readjustment in the level of dopamine synaptic transmission. This dopaminergic cell specific marker could also aid in attempts to elucidate the rate at which dopaminergic cells are lost in this disease. MPTP (a neurotoxin which induces a parkinsonian-like syndrome after conversion in MPP+) uses DAT to enter the neuron and exert its toxic effect which may be prevented by pretreatment with DA uptake blockers. In cocaine abuse, DAT mediates the addictive properties of cocaine. Cocaine binding sites on the carrier may be distinct from DA binding sites allowing the development of medication sparing the DA function but impairing the cocaine effects. In schizophrenia, functional DA uptake was reported to be increased in the striatum in post mortem brains, whereas the kinetic parameters of the uptake sites were unchanged using different transporter labeling ligands. Thus, this marker does not provide any evidence for the dopaminergic hypothesis, but an impairment of the DAT itself could possibly be involved in the etiology of schizophrenia. However, the possible interaction of drugs such as L-Dopa or neuroleptic treatment with transporter binding may be taken into account in the results analysis. Finally, the DAT gene is also an important candidate gene for psychiatric diseases such as schizophrenia or cocaine abuse.

Brain↗
PubMedDate not supplied

[Identification by typological analysis of distinct groups of schizophrenic patients. Applicability of a disorganized schizophrenia subtype].

Since Crow, Andreasen et al. have described schizophrenia in terms of negative and positive symptoms, the dichotomic approach has been well established. As a matter of fact, factor analyses, especially principal components analyses, led with symptomatic specific scales, have proved their validity. But they have shown their limits too : some authors think that the dichotomic model fails to explain all of the schizophrenic psychopathology and that a third dimension including formal thought disorders, most of the time called "disorganization", should systematically be taken into account. In this study, the authors have hypothesized that a categorial approach could describe this "disorganization". Using a cluster analysis they investigated the existence of subtypes in a population including 136 schizophrenic patients assessed with the PANSS (Positive and Negative Syndrome Scale, Kayet al., 1987). The results suggested at least five subtypes: a pure positive subtype, characterized by high scores on items delusions, hallucinatory behavior, suspiciousness/persecution, and by a low score on conceptual disorganization item; a disorganized positive subtype, characterized by high scores on positive items, including conceptual disorganization item, and also high scores on unusual thought content and autistic preoccupation items; a negative subtype, characterized by high scores on negative items and low scores on positive items, including conceptual disorganization item; a mixed subtype, characterized by high scores on the most positive, negative and general psychopathological items; a residual subtype, characterized by low scores on all the positive, negative and general psychopathological items. The good validity of this analysis was showed since differences on a number of clinical characteristics were observed between the five clusters. These results demonstrated the oversimplication of the positive-negative dichotomy and the relevance of a disorganized subtype.

Adult↗
PubMedDate not supplied

[Dynamic DNA mutations, anticipation and schizophrenia].

Recently, a new form of human mutation-expansion of trinucleotide repeats-has been found to cause fragile X syndrome, Huntington's disease and other neurodegenerative diseases. These diseases are characterized by unusual patterns of inheritance, in particular, genetic anticipation in which the severity of the disorder increases and the age at onset decreases in successive generations of a pedigree. This phenomenon, formerly ascribed to observation biases, correlates with the expansion of trinucleotide repeat sequences. Two recent studies indicate that anticipation is present in familial schizophrenia. These findings support both an active search for unstable trinucleotide repeat sequences in schizophrenia and reconsideration of the genetic models used in this disorder.

Adolescent↗
PubMedDate not supplied

[Negative symptoms, depression, anxiety and alexithymia in DSM III-R schizophrenic patients].

Coined by Sifneos in 1972, alexithymia refers to a relative narrowing in emotional functioning, an inability to find appropriate words to describe their emotions, and a poverty of fantasy life. Although initially described in the context of psychosomatic illness, alexithymic characteristics may be observed in patients with a wide range of medical and psychiatric disorders: Parkinson disease, depression, anxiety, substance abuse and eating disorders. Flattening of affect and poverty of speech, major negative symptoms, referred to chronic schizophrenia: there is a lack of outward display of emotions. Accordingly, some disturbances of alexithymia's scores would be expected in schizophrenic patients. The aims of this study were: first to establish some correlations between alexithymia and some symptoms of schizophrenia, and second to estimate the intensity of alexithymia in negative versus positive and undifferentiated schizophrenic patients. Twenty-nine patients, meeting DSM III-R criteria for schizophrenia have been studied. All of them treated by neuroleptics, were in a stable clinical status for at least one month. The patients were assessed by one trained psychiatrist (IN) using six rating scales: Beth Israel Questionnaire (BIQ) for alexithymia, Positive and Negative Syndrome Scale (PANSS), Depressive Retardation Rating Scale (DRRS), Montgomery and Asberg Depression Rating Scale (MADRS), revised Physical Anhedonia Scale (PAS), and finally, Extrapyramidal Symptom Rating Scale (ESRS). In the total sample, the mean score of BIQ was 4.79 +/- 1.68 (mean +/- SD). Significant correlations were found between alexithymia and blunted affect (r = 0.376; p < 0.05), poverty of speech (r = 0.471; p < 0.01), anxiety (r = 0.370; p < 0.05), total score of DRRS (r = 0.370; p < 0.05), and motor subscore of DRRS (r = 0.429; p < 0.05). The patients with negative symptoms of schizophrenia had significantly higher total scores in alexithymia (p < 0.05), blunted affect (p < 0.0001), poverty of speech (p < 0.0001), anxiety (p < 0.05), total score of DRRS (p = 0.01) and his motor subscore (p < 0.0001) as compared to positive and undifferentiated subtypes. In our study, alexithymia seems to be correlated with negative and depressive symptoms in negative forms of schizophrenia, regardless of medication status.

Adult↗
PubMedDate not supplied

[Alexithymia in negative symptom and non-negative symptom schizophrenia].

Coined by Sifneos in 1972, alexithymia refers to a relative narrowing in emotional functioning, an inability to find appropriate words to describe their emotions and, a poverty of fantasy life. Although initially described in the context of psychosomatic illness, alexithymic characteristics may be observed in patients with a wide range of medical and psychiatric disorders: Parkinson disease, depression, anxiety, substance abuse and eating disorders. Flattening of affect and poverty of speech, major negative symptoms, referred to chronic schizophrenia: there is a lack of outward display of emotion. Accordingly, some disturbances of alexithymia's scores would be expected in schizophrenic patients. The purpose of this study was to estimate and compare the prevalence of alexithymia in deficit and non-deficit schizophrenia. The term "deficit symptoms" may be used as Carpenter, to refer specifically to those negative symptoms that are not considered secondary. The influence of patients' symptoms has also been studied on alexithymia scores: negative and positive symptoms of schizophrenia, depression, anxiety, anhedonia and effects of neuroleptics. Twenty-five patients, meeting DSM III-R criteria for schizophrenia have been studied. All of them treated by neuroleptics, were in a stable clinical status for at least one month. The patients have been categorized into deficit (n = 12) and non-deficit (n = 13) subgroups by one trained psychiatrist (SD), using the Schedule for the Deficit Syndrome. The subjects have been assessed by the same rater (IN), blind to deficit status, using six rating scales: Beth Israel Questionnaire (BIQ) and Toronto Alexithymia Scale (TAS) for alexithymia, Positive and Negative Syndrome Scale (PANSS), Montgomery and Asberg Depression Rating Scale (MADRS), revised Physical Anhedonia Scale (PAS), and finally, Extrapyramidal Symptom Rating Scale (ESRS). Using TAS, alexithymic characteristics were more prevalent in the deficit subgroup as compared to non-deficit subgroup (83% versus 30.76%; p < 0.01). Significant correlations were observed in the non-deficit subgroup between: TAS and anxiety (r = 0.743; p < 0.01), TAS and depression (r = 0.568; p < 0.05), BIQ and blunted affect (r = 0.636; p < 0.02), BIQ and poverty of speech (r = 0.629; p < 0.02). These correlations were not significant in the deficit group of patients. Alexithymia in schizophrenic patients seems to be a trait characteristic in deficit patients, and a state related to many symptoms, such as flattening of affect, poverty of speech, depression and anxiety in nondeficit patients.

Adult↗
PubMedDate not supplied

[Hormone treatment of sex offenses].

In humans, roles for androgens have been described in the regulation of sexuality, aggression, cognition, emotion and personality. Recent advance in the understanding of factors that are associated with sexual aggression have led to improved methods of treatment. A number of organic treatments which reduce the plasma testosterone levels or decrease androgen effects on target cells are available. These treatments may reduce the chance of reoffending of sexually aggressive men. The authors will review the literature on orchidectomy, oestrogens or progestogens such as medroxyprogesterone acetate (MPA) or cyproterone acetate (CPA) which are currently used in the treatment of deviant sexuality. From now, orchidectomy and treatment with either estrogens or MPA are withdrawn. The authors will also report the good clinical efficacy of a GnRH analogue (triptoreline) in eleven sex offenders. When used in conjunction with psychotherapy, they may benefit sex offenders especially in those who are motivated for treatment.

Cyproterone Acetate↗
PubMedDate not supplied

[Early familial and environmental processes in schizophrenia. Importance of premorbid personality evaluation].

According to the neurodevelopmental hypothesis, antenatal aggressions (hypoxia and seasonal viral infections) could increase the risk of schizophrenia in adulthood as shown by an excess of obstetric complications and births in winter--spring in schizophrenic patients. As schizoid and schizotypal personality disorders are genetically linked to schizophrenia, we wanted to verify whether such disorders in the premorbid period in schizophrenic patients could be markers of a more genetic and less environmental sub-type of schizophrenia. Therefore, the aim of this study was to assess schizoid and schizotypal premorbid personality disorders (PPD) in 60 schizophrenic patients, and to assess the weight of familial and environmental factors according to the diagnosis of PPD. 41.7% of patients (25/60) had a schizoid or schizotypal PPD. Compared with patients without PPD, patients with PPD had more often schizophrenia spectrum disorders in first degree relatives (33.3% vs 14.7%, NS), less often obstetric complications (20.8% vs 50.0%, p < 0.05) and were less often born in the first half-year (44.0% vs 68.6%, p = 0.05). So, we showed a non significant positive association between schizoid--schizotypal PPD and family history of schizophrenia spectrum disorders, and a significant negative association between PPD and environmental factors: obstetric complications (OC) and birth in winter-spring. So, the absence of PPD could enable us to identify a sub-group of patients in whom environmental factors play a major role. Moreover, the relations between genetic factors and PPD seem to be complicated. Nevertheless, the notion of PPD could give information about the kind of genetic factors implicated in schizophrenia.

Adolescent↗