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Biomedical subjects

R Jouvent

Publications and source records attributed to R Jouvent.

At least 37 records · Page 2Linked to original sources
PubMed2000

Early and late onset bipolar disorders: two different forms of manic-depressive illness?

BACKGROUND: Conflicting results in genetic studies of bipolar disorders may be due to the clinical and genetic heterogeneity of the disease. Age at onset of bipolar disorders may be a key indicator for identifying more homogeneous clinical subtypes. We tested whether early onset and late onset bipolar illness represent two different forms of bipolar illness in terms of clinical features, comorbidity and familial risk. METHODS: Among a consecutively recruited sample of 210 bipolar patients, we compared early onset (n=58) and late onset (n=39) bipolar patients; the cut-off points were age at onset before 18 years and after 40 years for the two subgroups. The subgroups were compared by independent t tests and a contingency table by raw chi-square test. Morbid risk among first-degree relatives was measured by the survival analysis method. RESULTS: The early onset group had the most severe form of bipolar disorder with more psychotic features (P=0.03), more mixed episodes (P=0.01), greater comorbidity with panic disorder (P=0.01) and poorer prophylactic lithium response (P=0.04). First degree relatives of early onset patients also had a higher risk of affective disorders (P=0.0002), and exhibit the more severe phenotype, i.e bipolar disorder. CONCLUSION: Our data suggest that early and late onset bipolar disorders differ in clinical expression and familial risk and may therefore be considered to be different subforms of manic-depressive illness.

Adolescent↗
PubMed2000

Information processing deficits in relatives of manic depressive patients.

BACKGROUND: The importance of genetic factors in the aetiology of manic-depressive illness (MDI) has been repeatedly confirmed and indicators of vulnerability to the illness in families with affective disorders are needed. Abnormal event-related potentials (ERP) may be markers of genetic vulnerability to mental illness. Long latency and low amplitude of P300 have consistently been reported in schizophrenic patients and their relatives. A few studies have also shown P300 deficits in MDI patients, but no ERP study has been performed on their relatives. METHODS: ERPs were recorded during an auditory oddball task in 19 relatives belonging to families with two or more bipolar patients and in controls with no familial or personal history of affective disorders. The relatives were selected as having no affective disorders on a lifetime basis, but eight had an anxiety disorder. RESULTS: In all relatives, a lower P300 amplitude and a longer P300 latency was found, with much longer reaction time and post-N200 duration till button-press than controls. A lack of P300 amplitude dominance in the right hemisphere was also found in relatives in comparison with controls. There also appeared to be a frontal predominance of ERP abnormalities in relatives. CONCLUSION: We report the first evidence of deficits in reaction time and in P300 amplitude and latency, and a lack of P300 right-sided dominance, in relatives of manic-depressive patients. This pattern may constitute an endophenotypic marker of manic-depressive disorder.

Adult↗
PubMed2000

African and European HIV-positive women: psychological and psychosocial differences.

The objectives were to study and compare the psychosocial and psychopathological aspects of HIV infection in African and European HIV-positive women living in France. All women included were seen in a semi-structured interview to assess personal history, history of their HIV infection, social and family relationships, preoccupation with childbearing and concerns about HIV infection and its prognosis. The comparison of psychological and psychosocial factors between HIV-positive African and European women showed certain significant differences. The demographic characteristics did not differ, except for current professional activity, with more African women being unemployed. The medical aspects of the HIV infection were similar to those described in the literature for the two populations. The most interesting findings were on the disclosure of HIV-positive status to family and friends, with significantly more European women informing friends and family, and on the desire to have children, which was much greater in African women; while they already had significantly more children, they still wanted to have even more. All these differences emphasize the need to adapt medical and psychosocial care to gender and to the ethnic and cultural background of the person.

Adaptation, Psychological↗
PubMed2000

Body image perception among men in three countries.

OBJECTIVE: The authors tested the hypothesis that men in modern Western societies would desire to have a much leaner and more muscular body than the body they actually had or perceived themselves to have. METHOD: The height, weight, and body fat of college-aged men in Austria (N=54), France (N=65), and the United States (N=81) were measured. Using the somatomorphic matrix, a computerized test devised by the authors, the men chose the body image that they felt represented 1) their own body, 2) the body they ideally would like to have, 3) the body of an average man of their age, and 4) the male body they believed was preferred by women. The men's actual fat and muscularity was compared with that of the four images chosen. RESULTS: Only slight demographic and physical differences were found among the three groups of men. Modest differences were found between the men's measured fat and the fat of the images chosen. However, measures of muscularity produced large and highly significant differences. In all three countries, men chose a ideal body that was a mean of about 28 lb (13 kg) more muscular than themselves and estimated that women preferred a male body about 30 lb (14 kg) more muscular than themselves. In a pilot study, however, the authors found that actual women preferred an ordinary male body without added muscle. CONCLUSIONS: The wide discrepancy between men's actual muscularity and their body ideals may help explain the apparent rise in disorders such as muscle dysmorphia and anabolic steroid abuse.

Austria↗
PubMed2000

Focused attention in anhedonia: a P3 study.

Attentional and information processing impairments have been evidenced in nonclinical anhedonic subjects. However, the extent of attentional deficit has not been determined. We studied focused attention, the ability to reject irrelevant or distracting messages, in anhedonic nonclinical subjects. The event-related potentials and behavioral performances of anhedonic subjects were compared with those of control subjects during the Eriksen focused attention task (C.W. Eriksen & B.A. Eriksen, 1974); the task combined one compatible and one incompatible condition, the latter causing an interference. Anhedonic subjects exhibited a smaller P300 and slower reaction times than control subjects. Varying task conditions had different effects on anhedonic subjects and controls, suggesting that anhedonic subjects may have developed a conservative response strategy. In view of previous works, these results suggest that attentional impairment is not ascribed to specific processes, but may involve a more global deficit, that is, a resource allocation deficit.

Adolescent↗
PubMed1999

Frontal reactivity and sensation seeking an ERP study in skydivers.

1. In the line of Zuckerman's studies on sensation seeking and optimal level of arousal, the authors hypothesized that high sensation seeking might be used to compensate for anhedonia due to basal arousal deficit. A population of interest was found with parachutists practicing skydiving, generally described as very high sensation seekers. 2. After clinical assessment of emotional and affective components, amplitudes of the frontal P3 of the ERP were used as indices of arousal. 3. Skydivers presented more negative symptoms (anhedonia and blunted-affect) than controls. This was observed in isolation from any depressive episode, which would suggest the presence of emotional deficit as a trait. As expected, skydivers presented more sensation seeking than controls. These two results taken together could indicate that sensation seeking is an adaptive reaction to anhedonia. 4. ERP results showed that frontal P3 amplitudes were larger in skydivers than in controls, whereas in a previous study we showed the opposite in depressed patients with a similar emotional deficit. This could indicate that the frontal P3 amplitude does not reflect the emotional deficit per se. We suggest that it rather reflects the capacity to use some behaviors which improve automatic attentional processes in order to obtain arousing stimulation that could counterbalance the emotional deficit. Depressions with emotional deficit might be due to the lack of such a capacity.

Adult↗
PubMed1999

Alexithymia and anxiety: compounded relationships? A psychometric study.

This study is a careful examination of the relationships between different components of the alexithymia construct and state versus trait anxiety. In order to study the relations between anxiety and alexithymia in a subclinical population, we administered to 125 female college students a test battery including measures of alexithymia (TAS26), state and trait anxiety (STAI) and depression (QD2A). Results indicated positive correlations between depression, anxiety (state and trait) and alexithymia scores. Partial correlations revealed a tight link between trait anxiety and alexithymia. Furthermore, in agreement with the view that alexithymia is a multidimensional construct, the various alexithymia dimensions were found to be diversely correlated with anxiety. On the basis of partial correlation analyses, a descriptive model of the relationships between depression, state anxiety, trait anxiety and alexithymia was postulated. This model was confirmed by pathways analyses.

Adolescent↗
PubMed1999

Prevalence of DSM-IV disorders in children and adolescents with asthma versus diabetes.

OBJECTIVE: To evaluate the relationships between asthma and type and incidence of psychiatric problems in a pediatric population. METHODS: A series of 93 children and adolescents with asthma presenting during a 1-year period to a pediatric pneumology and allergy service was studied. Their psychopathological problems were compared with those of 93 children with insulin-dependent diabetes mellitus (IDDM). Various questionnaires were completed by the patients: the Child Depression Inventory (CDI), the State-Trait Anxiety Inventory for Children (STAIC), and the Coopersmith Self-Esteem Inventory (SEI). Their parents were administered the Child Behavior Checklist (CBCL). The patients were examined using the revised Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-R). RESULTS: There were more symptoms in the asthma group than in the IDDM group, as indicated by total CBCL scores, internalization and externalization CBCL subscores, and the STAIC scores. Asthma was often associated with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) psychiatric disorders. We found 30 anxiety disorders, 5 affective disorders, and 6 disruptive behaviour disorders. Asthmatic children did not seem to be more depressed than the IDDM group, and their self-esteem, overall, was good. However, the asthma subgroup presenting with psychiatric disorders had poorer self-esteem and social competence. Adolescents did not seem to suffer more psychiatric disturbances than did younger patients. Girls did not suffer more psychiatric disturbances than did boys. CONCLUSION: Asthma appears to be associated both with higher overall incidence of psychiatric problems than in IDDM and with particular categories of psychiatric problems. In particular, the problems include anxiety disorders, internalizing symptoms, and disruptive behaviours.

Adolescent↗
PubMed1998

Relationships between low red blood cell count and clinical response to fluoxetine in depressed elderly patients.

Biological variables specifically linked with serotonin deficiency were assessed in geriatric depression. Sixteen depressed patients, all > or = 60 years of age and with scores on the Montgomery-Asberg Depression Rating Scale (MADRS) > or = 20, were treated with fluoxetine (20 mg/day) for 42 days. Biological variables measured on days 1 and 42 included whole blood and plasma serotonin, plasma total and free tryptophan, and platelet paroxetine and ketanserin binding. Seven of the 16 patients showed a positive clinical response (i.e. MADRS score < or = 12 at day 42). The pre-treatment red blood cell count was the variable most related to clinical response; low levels were found in almost all responders. To a lesser extent, plasma free tryptophan before treatment was also correlated to therapeutic response, with lower values being found in responders. During treatment, plasma free tryptophan was increased in responders and decreased in non-responders. The finding that elderly depressed patients with low pre-treatment red blood cell counts subsequently responded to fluoxetine treatment is consistent with the view that tryptophan, the precursor of serotonin in brain, is taken up by red blood cells.

Aged↗
PubMed1998

Dimensional assessment of onset of action of antidepressants: a comparative study of moclobemide vs. clomipramine in depressed patients with blunted affect and psychomotor retardation.

The onset of action (during the first 2 weeks of treatment) of moclobemide (450 mg/day), a reversible MAO-A inhibitor, was compared in a double-blind, multi-center trial with clomipramine (150 mg/day) on dimensional and global depressive symptoms in 124 hospitalized patients suffering from a major depressive episode according to DSM-III-R criteria and with blunted affect and retardation. An earlier efficacy was found for moclobemide with significant treatment differences in favor of moclobemide, which were detected on negative symptoms (anhedonia, blunted affect and retardation) on days 7 and 10. The overall effect on depression at the end of the 4-week trial period was similar in both groups. However, a higher termination rate due to lack of efficacy was found with moclobemide (10 vs. 3). The tolerability was significantly better for moclobemide, as shown by the lower frequency of adverse events.

Adult↗
PubMed1998

Psychiatric genetics: search for phenotypes.

Failure to obtain convincing results in psychiatric genetics can partly be attributed to the fact that progress in molecular biology and genetic epidemiology has not been followed by an equivalent development in phenotypic description. Instead of relying entirely on classical nosological approaches, we argue that identifying more homogeneous forms of diseases through a'candidate symptom approach' among affected subjects and an endophenotype approach that identifies sub-clinical traits among non-affected relatives might yield better results. Examples where these strategies have already been fruitful when applied to complex diseases are presented in this review. Focusing on vulnerability traits might stimulate the redefinition of traditional psychiatric syndromes and help to bridge the gap between clinical and experimental approaches.

Animals↗
PubMed1998

Modelling behavioral syndromes using Bayesian networks.

In this paper Bayesian networks modelling is applied to a multidimensional model of depression. The characterization of the probabilistic model exploits expert knowledge to associate latent concentrations of neurotransmitters and symptoms. An evolution perspective is also considered. Specific criteria are introduced to detect the influence of the latent variable on the observation of symptoms. The Bayesian analysis is carried out using Gibbs sampling technique which is implemented in the BUGS software. The estimation phase leads to the selection of symptoms entering into the definition of behavioral syndromes. Results on real data are discussed. The last section deals with simulation experiments. Simulation results confirm our methodological choices. Results of the paper can enlarge to the central problem of the management of latent variables in Bayesian networks modelling.

Artificial Intelligence↗
PubMed1998

Psychopathological and emotional deficits in myotonic dystrophy.

OBJECTIVE: To evaluate psychopathological disturbances in patients with myotonic dystrophy (MD) and compare patients with MD to both patients with facioscapulohumeral dystrophy (FSHD) and healthy control subjects. METHODS: A semistructured interview was used to determine DSM III-R criteria for major depressive episodes, dysthymic episodes, and generalised anxiety. The Montgomery and Asberg and the Hamilton depressive scales, the Covi and Tyrer anxiety scales, the Abrams and Taylor scale for emotional blunting, and the depressive mood scale were all used in the study. Subjects were also asked to complete questionnaires for physical and social anhedonia. RESULTS: Fifteen patients with MD, 11 patients with FSHD, and 14 healthy subjects were studied. Patients with MD were not more depressed or anxious than healthy controls. Patients with FSHD were the most depressed and most anxious. However, patients with MD had significantly lower scores for expressiveness and significantly higher scores for anhedonia than the other two groups. CONCLUSION: Patients with MD did not present significant depressive or anxious symptomatology but rather an emotional deficit. This emotional deficit may be an adaptive reaction to the threatening implications of the disease, or the effect of the CNS lesions which occur with MD, or both.

Adaptation, Psychological↗
PubMed1997

Apolipoprotein E gene polymorphism in early and late onset bipolar patients.

To explore the involvement of apolipoprotein E gene (APO E) in major depression, we studied the APO E gene polymorphism in a sample of 156 unrelated bipolar patients and 91 healthy volunteers. This population was stratified for age at onset of the affective disorder (onset before 18 years, after 45 years and between 18 and 45 years). Early onset bipolar patients with psychotic symptoms exhibited a significant increase of epsilon4 allele frequency (28.9%) compared to either other bipolar patients (13.1%, chi2 = 6.52, df = 1, P < 0.02) or controls (12.1%, chi2 = 7.01, df = 1, P < 0.01). The association between epsilon4 and early onset bipolar disorder (BPD) with psychotic symptoms suggests that APO E gene is a risk factor for a subgroup of BPD, or influences the phenotypic expression (i.e. psychotic symptoms or age at onset) of manic depressive illness.

Adult↗
PubMed1997

[Psychopathology and cognitive neurosciences: theoretical conflicts and experimental paradigms].

Clinical research may be seen in the context of the more general problem of an exchange of knowledge between psychopathology and neurosciences. While this interaction is not contested by the specialists in either field, we cannot, nonetheless, ignore the question of their various levels of congruence. More generally, we are increasingly aware of a need for enhanced formalization of the models derived from the two disciplines with a view to setting up transpositions or even cross fertilizations. The two communities, that of psychiatrists and that of neurobiologists, while they fascinate each other, have rarely been able to produce joint findings. The psychopathologist expects a positive validation of his clinical concepts from the neurobiologist, while the neurobiologist, who has frequently not resisted the etiological temptation, wants the clinician to give him pointers to enable him to refine his own experimental models. What is required, however, is that both the psychopathologist and the neurobiologist reduce their expectations and agree to move outside of their respective disciplinary autarkies. This would avoid two traps: that of the homological temptation which leads both to graft an experimental model onto clinical entities without checking the levels of congruence or non-congruence, making do with a simple behavioral similarity; the second error consists in using the complexity of the clinical picture as an unavoidable obstacle to any coming-together of the two disciplines. These two traps have not always been avoided, in particular in the context of the use of cognitive paradigms in nosographic clinical models.

Brain↗
PubMed1996

Attention deficits in depression: an electrophysiological marker.

EVENT-RELATED POTENTIALS were recorded in young depressed subjects and compared with results from controls. Subjects were required to respond to targets (rare high-frequency sounds) presented to a designated ear, and to ignore targets presented to the non-designated ear as well as standards (frequent low-frequency sounds) presented to either ear. The results confirm those previously obtained with elderly depressed patients, showing the same general profile of electrophysiological and behavioural differences, and in particular a substantial reduction of the N200 amplitude in response to attended targets in depressed subjects. It is suggested that the N200 component could be a marker of depression.

Adult↗