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R Jouvent

Publications and source records attributed to R Jouvent.

At least 73 records · Page 4Linked to original sources
PubMed1992

The dimensional approach to clinical psychopharmacology: a polysemous concept.

The last decade has seen significant progress in the development and specific clinical application of selective psychotropes. The dimensional approach to clinical psychopharmacology views the behavioral targets of psychotropes as phenomena existing on a continuum and as components, in varying degrees, of most psychopathologies. The modern concept of dimension has been used in different contexts. In psychology it has a mathematical sense, whereas in biological psychiatry it is associated more with biological function. This paper reviews these two concepts and the recent models attempting to merge them into one. The heuristic value of the dimensional approach, as well as some of its pitfalls and new avenues of research, are discussed.

Adult↗
PubMed1991

Parallel Visual Information Processing Test. An experimental assessment of alexithymia.

A novel clinical and experimental situation has been created, based on the psychopathological concepts of 'pensée opératoire' and alexithymia and the contribution of recent trends in cognitive science as to the dual skills of the brain hemispheres: the Parallel Visual Information Processing Test. This test was validated in more than 100 subjects, and revealed that holistic visual attention is reduced during logical task performance; this impairment appeared to be typical of patients with poor fantasizing ability and operative behavior. Such findings are consistent with some authors' theory according to which there is a functional commissurotomy in alexithymic and psychosomatic patients.

Adolescent↗
PubMed1990

Dimensional versus nosographic approach to Alzheimer's disease: therapeutic implications.

Negative results in therapeutic trials in Alzheimer's disease (AD) usually account for the nonefficacy of the presently tested drugs. However, methodological flaws in the design of these studies, related to the commonly used nosographic approach, can also be implicated in the lack of demonstration of beneficial results. With regard to the heterogeneity of clinical manifestations of AD, the interest of the dimensional, transnosographic approach to cognitive deficits and behavioral disturbances in dementia is suggested for these trials. Both approaches can also be combined, according to the presumed biochemical action of the tested drug in the preclinical studies and the aim of the trial.

Alzheimer Disease↗
PubMed1989

Hemisphere asymmetry of alpha burst sequential organization in depression.

A new quantitative EEG index based on the sequential variability of the frequency of occurrence of alpha bursts (alpha-BVI) was utilized for investigating the respective role of the two hemispheres in depression and their relationship with two clinical dimensions of this illness: psychomotor retardation and blunted affect. The EEG (at P3 and P4 referred to Fz) was recorded during rest periods in two groups of patients selected according to their scores on various clinical scales: one consisted of 12 patients characterized by psychomotor retardation (PMR group), the other of 9 patients characterized by blunted affect (BA group). A control group of 12 normal subjects was recorded in the same conditions. All subjects were dextral. The following main results were obtained: (1) in both groups of patients the right and the left alpha-BVI were, before treatment, significantly lower than those of the controls. (2) In controls, the sequential alpha burst variability was identical on both hemispheres. (3) In patients, before treatment, the right hemisphere alpha-BVI was significantly lower than the left. (4) Electro-clinical correlations were also observed: (A) in the BA group, before treatment, (a) between the degree of blunted affect and the decrease of the right alpha-BVI, (b) between ideoverbal retardation and the decrease of the left alpha-BVI (these correlations disappeared after treatment); (B) in the PMR group, ideoverbal retardation was, on the contrary, correlated to a right alpha-BVI decrease, this correlation persisting after treatment. These results are discussed according to the role of each hemisphere in depression.

Adult↗
PubMed1989

[Essential arterial hypertension and quality of life. Comparative crossed double-blind study of labetalol and captopril].

The purpose of this multicenter randomised, double-blind and cross-over study was to compare the antihypertensive effects of labetalol (L) and captopril (C) in 42 moderate hypertensive patients (mean age: 52 years). The drugs were given during two 4-weeks periods at the end of which the systolic (SBP) and diastolic blood pressures (DBP) were measured at rest in supine and standing positions. The assessment of the quality of life was realized with 4 scales completed by the practitioner [anxiety, depression, well-being, visual analog scale (VAS)] and 4 scales of auto-assessment completed by the patient [2 VAS, well-being, sub-scale of pleasure]. At the end of the first treatment's period (D28), both drugs had decreased significantly supine SBP and DBP (p less than 0.001), standing DBP (L = p less than 0.01; C = p less than 0.05), while only L lowered supine SBP (p less than 0.01). The cross-over analysis was unable to conclude, due to the number of patients and a significant interaction which reduced its power. Thus the effect of the first treatment's period seemed to influence the efficacy of the second one. The percentages of patients with a controlled BP were respectively: after 4 weeks of treatment, L = 61 p. 100 vs C = 42 p. 100 and at the end of study (D56), L = 67 p. 100 vs C = 64 p. 100.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Evaluating the affective and cognitive effects of a drug: theoretical and methodological considerations.

Current research leads to new drugs with new properties which are clinically screened toward a sum of traditional validation methods and clinical expression of biological models. Two complementary but different theoretical procedures underlie clinical studies. Drugs can be evaluated in "categorial" or "dimensional" perspective. In the first case, their effects are studied on a nosographic entity (for example meeting DSM III criteria for dementia or depression) by global scales whatever clinical heterogeneity or biological specific properties of the drug. In the second case, drugs effects are assessed on a single clinical dimension constituting a continuous parameter from normal to pathological state. Result of these different levels of organisation cannot be compared or correlate. Irrespect of this principle led, in the past, to confusion and lack of interpretable results. A coherent approach may clarify all the process of development of new drugs.

Affect↗
PubMed1987

Mood-independent aberrancies of word responses and action of lithium on their repetition in manic depressed illness.

Following a preceding study, two samples of patients, one French (N = 20) and one American (N = 29), from two affective disorders clinics, were given free word-association tests consisting of two successive presentations of the same list of stimulus words separated by a 15 minute interval. On the one hand, commonness of word responses was not affected by changes of mood, and consequently aberrancies in associative processes may be a trait of persons with bipolar affective disorders. On the other hand, repetition of responses was directly correlated with lithium concentration in plasma, which allowed a prediction of the success of lithium therapy.

Adult↗
PubMed1987

[Depressions resistant to tricyclic antidepressive treatment and hypothyroidism].

The relationship between thyroid disorders and depression is well known. This type of endocrine disease is mainly observed in patients with depression resistant to appropriate antidepressor therapy. Three clinical forms of this association may be distinguished: hypothyroidism in a patient with depression but without a previous psychiatric history; a relapse of depression in a manico depressive patient who has developed hypothyroidism; the finding of slight thyroid dysfunction (increased TSH response after injection of TRH) in a patient with depression. The frequency of the association of hypothyroidism and resistant depression underlines the need to perform thyroid function tests in all depressed patients who do not respond normally to appropriate antidepressor therapy. The precise mechanism of the resistance of depressive symptoms to tricyclic antidepressors is unclear. Several arguments point to an effect of triiodothyronine on central noradrenergic receptors. In practice, significant hypothyroidism implies substitute therapy. Minor thyroid dysfunction (abnormal TRH test alone) may require the association of tricyclic antidepressors and thyroid hormone although the indications and precise dosages of this drug association have not been established.

Antidepressive Agents, Tricyclic↗
PubMed1986

Cognitive function in recent-onset demyelinating diseases.

To determine cognitive disturbances in recent demyelinating disease, we studied 21 patients with definite or probable multiple sclerosis (MS) of less than two years' duration and nine patients with recently isolated optic neuritis. None had any clinical or social evidence of cognitive impairment. Mild to moderate cognitive impairment. Mild to moderate cognitive impairment was present in 18 (60%) of 30 cases, affecting visual and/or verbal efficiency. These abnormalities were statistically significant when compared with the results of a control group of 29 patients. There was no correlation with a depressive status, between the presence of cognitive impairment and either the degree of handicap or the activity of the disease. The frequency of cognitive dysfunction (60%) appears to be comparable to that reported in other series in which MS evolution is over ten years. The natural history of cognitive functions in MS has to be identified. Neuropsychologic tests could be useful in the diagnosis of monosymptomatic or paucisymptomatic forms of MS (ie, visual or medullary).

Adult↗
PubMed1984

Speech pause time and the retardation rating scale for depression (ERD). Towards a reciprocal validation.

Sixteen depressed inpatients were studied before the onset of treatment and within 48 h of discharge or of a change in medication. Patients' evaluation included clinical ratings with the Hamilton Depression Rating Scale (HDRS) and the Retardation Rating Scale for Depression (ERD), and measure of Speech Pause Time (SPT). The main results are a confirmation in French-speaking patients of Szabadi et al.'s and Greden et al.'s findings and the strong correlation between SPT changes and ERD score changes. The latter point constitutes a reciprocal validation of SPT and ERD.

Adult↗
PubMed1984

[Renal clearance technic for individualizing lithium dosage in routine hospital care].

Lithium has a narrow therapeutic index and exhibits a wide pharmacokinetic variability. Individual dosage regimen adjustment is necessary to warrant the efficacy and safety of long-term treatment. We propose the "renal clearance method" for rapid determination of the lithium carbonate daily dose for chronic therapy. After the first intake of drug by a manic-depressive patient, a four-hour trial is performed. It involves two blood samplings and two urine collections, in which lithium and creatine are assayed. Comparison of observed creatinine with a value predicted according to age, morphological characteristics, sex and serum creatinine of the patients allows the interpretation of conflicting results. The estimation of lithium and creatinine clearances of each patient is performed using a computerized or manual method which unfolds a decision procedure. The daily dosage (1.5 to 6 250 mg tablets in two or three daily intakes) is deduced from the according lithium renal clearance (0.4 to over 2 l/h) by means of a nomogram established in previous studies on about 50 patients. The clearance method has been investigated in routine hospital care on a 40 patients sample. The range of satisfactory lithium serum levels during patients monitoring was 0.6-0.9 mmol/l. Accurate dosage regimen forecasting is obtained in 92% of the patients. The percentage observed in a subset of 13 patients with the C24 method, which relies on a unique blood sample 24 hours after the first dose, was much lower (54%). The renal clearance method appears as a robust and reliable technique for individual lithium dosage regimen adjustment in routine care.

Adult↗