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Biomedical subjects

Y Lecrubier

Publications and source records attributed to Y Lecrubier.

At least 91 records · Page 5Linked to original sources
PubMed1991

Over-reporting of maladjustment by depressed subjects. Findings from retesting after recovery.

The extent to which patients' reports of maladjustment is influenced by depressive symptoms was estimated in 25 acute depressed patients responding to pharmacotherapy. Their social adjustment over the same four-month period immediately prior to hospitalization was assessed on two separate occasions: firstly when they were acutely depressed, and again a mean of 20 days later when clinically recovered. Significant differences between the two reports were found in mean score of maladjustment in four out of five fields of social adjustment (work, social/leisure life, family of origin, marriage, and sex). The reduction in depressive symptoms scores (of pessimism considered separately), correlated significantly with changes in the total maladjustment score. The reduction in pessimism scores correlated with changes in the scores for both work and social/leisure fields, and also accounted for 40% of the total variance in maladjustment score. These results indicate that impaired social adjustment as assessed during the height of the depressive illness arises in part from a symptom--related overreporting bias leading patients to make a harsh appraisal of themselves.

Adult↗
PubMed1991

Depressed subjects unwittingly overreport poor social adjustment which they reappraise when recovered.

Potential biases due to acute depressive symptomatology on raters' assessments of social maladjustment derived from patients' reports were assessed in 25 patients responding to pharmacotherapy during medium-term hospitalization. Patients were questioned on two separate occasions about their social maladjustment covering the exact same period (the 4 months preceding hospitalization): the first was during the acute illness phase, and the second a mean of 20.5 days later, when symptoms remitted. In the second report, composite scores for all fields as a whole showed significantly fewer reports of social impairment than did the first. Significant differences from the first to the second evaluation concerning both subjective distress and observable behavior were found in four and three, respectively, of the five "fields" of social adjustment. Although subjective distress was most modified by remission of acute symptoms, even supposedly objective, observable disturbances were significantly affected. These results indicate that acutely depressed patients overreport social maladjustment, which they then more accurately reappraise when symptoms remit. Patients are completely unaware of both the initial bias and of the reappraisal.

Acute Disease↗
PubMed1991

[Therapeutic effect of amoxapine. A pragmatic study].

136 psychiatrists recruited 752 depressed outpatients considered to be a good indication for chemotherapy. Psychiatrists were trained both to diagnosis and to rating scales evaluation. The main features of the depressed syndrome was considered to be anxious in 21%, hostile in 14%, retarded in 12%, agitated in 12%, retarded and anxious in 41%. The symptomatology was present for more than six months in 2/3 of the patients. Among the psychological traits including some difficulties independently from the episode the existence of an aggressivity and/or hyperemotion were the more common (greater than 50%). 60% of the patients also qualified for Generalized Anxiety Disorder. This population was treated by Amoxapine 200 mg/day. Improvement on the MADRS was of 65% after a month of treatment. Tolerance was very good for a tricyclic. Hostility and impulsivity predicted poor response while the existence of a retardation and/or of anxiety or hyperphagia predicted a good response.

Adult↗
PubMed1990

Drug treatment of panic disorder: early response to treatment as a predictor of final outcome.

One of the core problems in clinical research is the detection of early changes in target symptoms that predict future therapeutic outcome. To analyze potential predictors of outcome, data of a multicenter study on patients with panic disorder were used. A total of 1010 patients were randomly allocated either to alprazolam, imipramine or placebo treatment. Early improvement in the number of spontaneous panic attacks within the first week of treatment predicted outcome exclusively in the alprazolam group. In contrast, placebo responders and nonresponders were differentiated by early changes in anticipatory anxiety intensity. For tricyclic antidepressants such as imipramine an evaluation period of more than one week is required to allow conclusions about outcome.

Adult↗
PubMed1990

Efficacy of reversible inhibitors of monoamine oxidase-A in various forms of depression.

The design and the main therapeutic results of 3 controlled double-blind studies comparing moclobemide with tricyclics and/or placebo in depressed patients are presented. Moclobemide, a reversible inhibitor of monoamine oxidase (RIMA), preferentially inhibits MAO-A. It showed good efficacy in major depression (DSM-III), both endogenous and non-endogenous. The 3 studies included a total of 763 patients. The therapeutic results are similar to those observed with tricyclics (2/3 good responders). Tolerability was significantly better. The onset of action was evaluated in 2 studies and was faster in the patients treated with moclobemide. The fact that reversible inhibitors of MAO-A demonstrate good efficacy independently of the diagnostic category of depression is an important new finding.

Adult↗
PubMed1989

Isolation-induced social behavioral deficit: a proposed model of hyperreactivity with a behavioral inhibition.

The behavior of mice isolated for 7-9 days (isolated mice) was compared to that of mice reared in groups (grouped mice). The method consisted of counting the number of escape attempts of the mice placed under an inverted beaker. When individually observed the isolated mice attempted to escape slightly but significantly more often than the grouped mice. When a pair of mice (one isolated + one grouped) were tested together, the number of escape attempts of the isolated mice was half of that of the grouped mice: this phenomenon was named the isolation-induced social behavioral deficit. These opposed behaviors may mean the same thing: an hyperreactivity to the novelty. In a variety of new situations under the beaker (presence of a lifeless object, of a grouped mouse or of an isolated mouse), the isolated mice were more reactive than the grouped mice. In conclusion, the social behavioral deficit test may be seen as a model of hyperreactivity with a behavioral inhibition.

Animals↗
PubMed1989

Effect of yohimbine on blood pressure in patients with depression and orthostatic hypotension induced by clomipramine.

Orthostatic hypotension, one of tricyclic antidepressant treatment's side effects, is also a factor in limiting adequate antidepressant dosing. We tested in a double-blind, crossover, placebo-controlled study the effect of low doses (4 mg/t.i.d.) of yohimbine in 12 patients with depression with clomipramine-induced orthostatic hypotension. Yohimbine, a selective alpha 2-adrenoceptor antagonist, had a favorable effect in orthostatic hypotension and induced a significant increase in blood pressure. A pharmacodynamic and pharmacokinetic interaction between yohimbine and clomipramine or demethylclomipramine was discussed.

Adult↗
PubMed1986

Efficacy of clonidine in 24 patients with acute mania.

The authors treated 24 newly hospitalized patients suffering from acute mania with 450-900 micrograms/day of clonidine, an alpha 2-adrenergic agonist, for 2 weeks. A marked decrease in manic symptoms was observed after 5 and 13 days of treatment in about half of the patients. Early response seemed to predict the final result. Patients with a family history of affective disorder and patients who had had a good response to neuroleptics during a previous manic episode tended not to respond to clonidine. At the doses given, the patients' tolerance to clonidine was excellent: sedation was markedly lower than it is with neuroleptic treatment.

Adolescent↗
PubMed1984

Pharmacological classification of benzamides.

The problem of classifying benzamides is, in general, the same as classifying neuroleptics. A pharmacological classification of neuroleptics can be established on the basis of the following criteria: specificity of action on dopaminergic receptors; penetration into the CNS; dopaminergic profile in the CNS; relative binding with respect to subclasses of DA; preferential antagonism of certain effects of apomorphine; preferential affinity for dopaminergic structures; activating effects on DA systems at low doses; different clinical effects: antiemetic, psychiatric (antihallucinatory and disinhibitory), neurologic. A relationship between biochemical, behavioural and clinical effects is proposed: antihallucinatory effect: decrease of dopaminergic function; disinhibitory effect: increase of dopaminergic function. We emphasize the problem of doses used because the different effects occurred for a given drug at different doses. This hypothesis suggests that positive symptomatology of schizophrenia is related to hyperdopaminergic activity, negative symptomatology is related to hypodopaminergic activity. Classification of benzamides: metoclopramide: peripheral dopaminolytic activity antiemesis without psychiatric or neuroleptic effects with low doses. sulpiride, tiapride, DAN 2163: peripheral effects + preferential blockade of D3 and D4 receptors, central DA activation with low doses, disinhibitory effects. With high doses, decrease of specificity for subclasses of DA receptors, central DA inhibition, antihallucinatory effects but little extrapyramidal symptomatology and sedation. sultopride: central DA inhibition, antihallucinatory effects, sedative and neurological effects.

Animals↗
PubMed1983

The place of anxiety in depressive symptomatology.

1 In the same sample of 42 depressed inpatients, treated by a sequence of anxiolytic followed by antidepressant, total depression, anxiety and retardation scores are compared. 2 Results confirm that retarded patients are good responders to antidepressants. Non-retarded patients do not respond to antidepressants but respond partially to anxiolytics. 3 The respective place of retardation and anxiety in depression is discussed.

Anti-Anxiety Agents↗