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Biomedical subjects

P Pichot

Publications and source records attributed to P Pichot.

At least 19 recordsLinked to original sources
PubMed2002

[The Pinel myth].

Explore the source record for details and available documents.

Deinstitutionalization↗
PubMed1996

[Panic: attack and disorder. History of the word and concepts].

The history of the word panic, of the concepts of Panic attack and of Panic Disorder is a complex one. The adjective word panic, derived from the Greek, stressed initially the intensity of a feeling of unjustified, individual or collective, fear, similar to the reaction provoked, according to the mythology, by the intervention of the God Pan. In their present meanings, the concepts belong to the group of anxiety states, the Panic attack being a symptom characterized by a paroxysmal anxiety which may appear in various psychopathological states, whereas the Panic Disorder is a nosological category whose diagnostic criterium is the appearance, with a definite frequency, of Panic attacks. The disorder is frequently associated to agoraphobia considered, when it exists, as a complication. It is necessary to describe, in addition to the terms and concepts related to panic, the history of the terms angoisse and anxiété (and of the equivalent ones in English and German, since many studies dealing with the subject have been written in those languages) and the history of agoraphobia. The history of the word panic and of the psychiatric concepts to which it is applied today are partially different as are the current meanings of the adjective and the substantive (and today of the verb to panic) from their technical meanings. In the technical vocabulary the substantive word refers on the one side to an abnormal group behaviour whose mechanisms, when it appears in an army by also elsewhere, are studied by social psychopathology. On the other side it has been used until recently, but only in psychiatric texts written in English, for describing acute individual states of high anxiety, eventually associated with other symptoms, and considered as pertaining-in contrast to the Panic attack in its present meaning-to various psychiatric illnesses (melancholic panic, homosexual panic). A description of states similar in their aspects, including the association to agoraphobia, to the present Panic attack, may be found in the literature of the XIXth century. Essential in this respect is the description of anxiety neurosis which Freud isolated in 1895 from neurasthenia and defined by the coexistence of a state of moderate and permanent anxiety and of anxiety attacks, whose manifestations were identical to those of the present Panic attack. Under the influence of Klein's researches which, from 1962 on, demonstrated the differential reactivity to drug therapy of its two component parts, anxiety neurosis was divided in two distinct entities. The term Panic attack-for reasons given in detail by the paper-was proposed for the acute anxiety attack, whereas the state of moderate and permanent anxiety, considered as a completely independent disorder, received the name of Generalized Anxiety Disorder. The concept, with its corresponding nomenclature, was adopted initially in the United States by the RDC (1975), then by the DSM-III (1980). It is accepted today and has been the source of a large number of investigations about its semiological, nosological, epidemiological, etio-pathogenic and therapeutic aspects which fall outside of the scope of this paper.

Agoraphobia↗
PubMed1994

[Neurasthenia, yesterday and today].

Neurasthenia was described and explained in very mechanistic terms, at the end of the 19th century, by G.M. Beard to account for physical and mental exhaustion and for varied somatic troubles imputed to failure of too much solicited nervous resources. This concept was then universally adopted and gave rise to diverse interpretations, among which was the Freud's one. Later, in Occident, came a deterioration, the diagnostic of neurasthenia giving way to those of anxious or affective disorders. In the same time, at least for ideological and cultural reasons, the concept remained lively in Russia and in Asia. During the last decade the western psychiatry has been led to accept that there are clinical situations focussed on fatigue and fatigability, even if it coined for them new terminologies (post-infectious fatigue, chronic fatigue syndrome, etc.) and while DSMs keep on ignoring neurasthenia, the ICD 10 gives it an important place.

Asia↗
PubMed1992

[The history of German psychiatry from the viewpoint of French psychiatrists].

The reception of German psychiatry by the French psychiatrists has been influenced by material elements, such as the knowledge of the German language and/or the disposability of translations, but even more by factors of a general nature. The main reason has been the perception by the French psychiatrists of the progressive loss of influence of their own school, initially the leading one in the world, in favour of the German, a change which began with Griesinger and became evident at the time of Kraepelin. Around 1850, as demonstrated by many papers written by leading French psychiatrists, the interest both for the theoretical aspects of German psychiatry and for its care system was great. The judgements were extremely positive, although French authors tended to contrast the philosophical outlook of the Germans with their own concrete clinical approach. The war of 1870-71 produced no radical change. But the growing influence of German psychiatry induced negative reactions whose main target was the work of Kraepelin, and especially his synthesis of Dementia praecox which was in direct opposition with the then dominant concepts of Magnan. The French opinion was divided between defenders and adversaries of Kraepelin's ideas. In the years immediately preceding World War I the attacks increased. The alleged contrast between the descriptive clinical (and according to a German author like Jaspers literary and superficial) French psychiatry and the scientific theoretical (and for the most aggressive French authors valueless) German one was a recurrent theme. The nationalistic tone reached on the French side its apex during the war years, some faint traces remaining several years after 1920. But on the whole the influence of the concepts proposed by German speaking authors, not only Kraepelin, but also Bleuler, Kretschmer, Freud among others was then on the increase. After 1945, contrasting with the years after World War I, no hostility against German psychiatry can be detected, as testified by the choice of the main speakers by the French organizers of the First World Congress of Psychiatry in 1950. The creation in 1984 of the Association of European Psychiatrists, an initiative taken jointly by the French and German psychiatrists, can be considered as the symbolic conclusion of the relations between the two national schools.

Cross-Cultural Comparison↗
PubMed1992

[Current developments in psychiatry: current interest of works by A. Quételet and J. Guislain].

The influence of Adolphe Quételet and Joseph Guislain, born respectively in 1796 and 1797 in Gent, on the most recent developments of Psychiatry has a paradoxical character. Quételet was a mathematician and astronomer, but his interest in statistics led him to organize the standardized collection on data on an international basis and to initiate the measurement of social and pathological behaviours, two trends which dominate present day epidemiological, nosological and clinical research in Psychiatry. Although Guislain is rightly honoured as the organizer of a human system of treatment for the mentally ill in Belgium, his theoretical ideas about the nature of mental disorders, he considered as reactions to a basic disturbance, whose aspects were determined by the physical and psychological peculiarities of the individual, have been practically forgotten. But they provide an alternative to the now prevalent tendency towards a strictly categorical nosology, whose shortcomings are more and more apparent in empirical biological and clinico-epidemiological research.

Belgium↗
PubMed1992

[Noise, sleep and behavior].

The negative effects of noise on sleep and behaviour have been related to three mechanisms: a physiological arousal (above a certain threshold of noise), an aversive reaction and an interference with non auditive neurophysiological and mental processes. The perturbation of verbal communication and the effects of sleep are the directly observable consequences. The negative effects of noise above a certain threshold on sleep have been demonstrated both in experimental conditions and in real life. They concern length, EEG pattern, and subjective quality and produce an increase of irritability and tiredness. There is no habituation. In all populations studied, strong discomfort is expressed by 50% of the subjects living in an area with an Ldn of 75 dB in the case of air traffic noise, the same results being obtained with ground traffic for a 5-15 dB higher level. Objective expressions of discomfort: use of aural protections, closing the windows, staying indoor, changing residence, increase linearly with the intensity of noise. Noise influences the incidence of stress-related disorders: hypertension, related cardio-vascular diseases, psychosomatic and psychological disorders. It has been shown by the use of different techniques (epidemiological studies based on the frequency of medical contacts, on the diagnoses made by general practitioners, on the use of specific drugs, and on the examination of the whole population) that the prevalence increases in relation with the level of noise in the vicinity of airports.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior↗
PubMed1990

[Epidemiology of depression].

According to epidemiological data, 5-6% of the general population are suffering from some kind of depressive disorders. Only a small proportion of them are seen by psychiatrist; others are seen by general practitioners, and many more do not seek medical advice. In a study carried out in France on 400 non-selected patients consulting general practitioners 8% of the patients have a depressive disorder and further 9% anxiety disorders.

Adult↗
PubMed1989

The historical roots of behavior therapy.

This paper reviews lines of thought that are historically relevant to the emergence of behavior therapy. First consideration is given to animal magnetism, and the reaction against it. Then the influence of German psychiatry is surveyed, followed by various views of disorders of the nervous system. These in different ways affected the Freudian mode of thinking and also Pavlovian theory, and more indirectly experimental psychology.

Animals↗
PubMed1989

Efficacy of tianeptine in anxious-depressed patients: results of a controlled multicenter trial versus amitriptyline.

265 adult outpatients with dysthymic disorder (DSM-III) associated with clinically manifest anxiety (according to FDA criteria) were included in a multicenter, randomized double-blind study. The trial consisted of three phases: placebo pretreatment phase and inclusion in the trial, treatment phase, placebo posttreatment phase. Patients were treated in monotherapy for 42 days with a mean dosage of 3 tablets per day corresponding to 37.5 mg/day of tianeptine or 75 mg/day of amitriptyline respectively. The following assessment instruments were used: the Montgomery and Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HARS), and the Check-List for the Evaluation of Somatic Symptoms of J.D. Guelfi and C.B. Pull (CHESS 82). Analysis of MADRS total scores showed an important and rapid improvement in tianeptine and amitriptyline groups, reaching statistical significance as soon as D7. At the end of the 6-week treatment period the tianeptine group reached a decrease of 64% in the initial MADRS total score versus 69% in the amitriptyline group. 78% of patients treated with tianeptine and 83% of patients treated with amitriptyline were considered as treatment responders. There was no difference in drop-out rates between the two groups. HARS scores showed a decrease in psychic as well as somatic anxiety in both groups. The action of tianeptine on anxious-depressive symptomatology was confirmed by the concomitant improvement of global clinical rating and patients' self-rating (HSCL). Statistical comparison of all clinical rating-scale scores in patients having completed the trial failed to show any significant group differences.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Fluvoxamine and imipramine: results of a long-term controlled trial.

Following a multicentre double-blind controlled trial comparing the effects of fluvoxamine and imipramine in depressed inpatients (M.D.E.) 39 patients continued on longer term treatment with maintenance of double-blind conditions (17 on fluvoxamine, 22 on imipramine). The results regarding the reasons for premature interruption of treatment show a slight advantage in favour of fluvoxamine. There were several significant differences in favour of fluvoxamine at the 20th week. The most common side-effects were hot flushes with imipramine and dizziness with fluvoxamine. Overall, despite the small number of patients, the results show a greater clinical tolerance to fluvoxamine than to imipramine.

Antidepressive Agents↗