bluuebunny/crossref_metadata_2025_split huggingface dataset:
The reform of psychiatric care in Greece: 1983-1989
Authors: Sarantidis D , Kladouchos V , Tripodianakis J , Giel R , Munk-Jorgensen P 
Published: April 2020

SummaryWe have attempted to evaluate quantitative changes in the mental health delivery system in Greece, dictated by a fiveyear program to reform psychiatric care. By the end of the program, a number of psychiatric units in general hospitals, as well as community mental health centres, had been created, while the number of beds in psychiatric hospitals have been significantly reduced. Mental health services have become more accessible to the population, and served more patients. However, not all the objectives of the program have been met. Only about half of the initially proposed number of beds in the psychiatric units in general hospitals have been actually developed. The catchment area, a basic pre-requisite of the program, has not been put into effect. Finally, the noticeable trend towards a restriction of the role of psychiatric hospitals did not coincide with the development of adequate new services.
Presentation of a method of evaluating clinical criteria permitting recommendation of psychoanalytic treatment
Authors: Rappard E , Lancrenon S , Chaine L , Von Benedek L 
Published: April 2020

SummaryThe method of evaluation we describe attempts to establish the criteria applied by clinicians when recommending psychoanalytical psychotherapy or psychoanalysis. A questionnaire was constructed and a study of inter-rater agreement using this research tool was carried out. The results of inter-rater agreement as well as the variations concerning each rater are discussed. Continuation of this study will provide the opportunity to examine the validity of general principles underlying the psychoanalysts’ perceptions of their patients.
Fluoxetine seems to widen the nortriptyline antidepressant-like dose range in mice submitted to the tail suspension test (TST)
Authors: de Oliveira IR , Brito PR , Peres MF , Dardennes R , da Rocha-Junior MA , Gonidec J , Rouyer T , de Castro-E-Silva E 
Published: April 2020

SummaryThis study was designed to verify whether fluoxetine (FL), a serotonin (5-HT) re-uptake inhibitor, would interfere with nortriptyline (NT), a biphasic U-shaped curvilinear dose-response relationship recently described in our laboratory. We associated 10 mg/kg NT or vehicle to 0, 5, 10, 20 and 40 mg/kg FL, in one group, and 10 mg FL or vehicle to 0, 5, 10, 20 and 40 mg/kg NT, in another group, 30 min before the tail suspension test (TST) in mice. Although we were not able to confirm a synergistic effect between FL and NT, FL-NT association seems to require higher doses of NT to block its own anti-immobility effect at high doses, thus widening NT effective antidepressant-like dose range in mice submitted to TST.
Emotional arousal as therapy: activation vs dissociation
Authors: Marks I 
Published: April 2020

SummaryHealing through emotional arousal is an ancient idea. Abreaction may yield lasting, brief, or no improvement, or alternatively sensitization. The predictors of outcome are unclear. The emotional experience of relevant exposure therapy yields more reliable improvement; forgotten traumas may surface, which ease as exposure proceeds. High arousal does not enhance the gains, but emotional engagement in exposure seems crucial for habituation to occur. Habituation is specific to the fear cues presented, marked generalization being unusual. Emotional experience irrelevant to a phobia can also improve the phobia, but the duration of such relief is unclear and different mechanisms may be involved. Fear-reduction is unreliable with non-exposure methods. Though counterproductive during exposure, dissociation and denial may have some uses. Optimal gains may come from being able to modulate activation or suppression to suit particular circumstances.
Effects of piracetam on the dexamethasone suppression test in Alzheimer's and multi-infarct dementias
Authors: Charles G , Panzer MJ , Machowski R , Lefevre A , Mirel J 
Published: April 2020

SummaryResults of the dexamethasone suppression test (DST) in demented nondepressed patients have varied considerably, and there is evidence that these depend on the type of dementia, ie, Alzheimer’s disease (AD) or multi-infarct dementia (MID). AD is characterized by decreased central acetylcholine (Ach) activity, while MID is thought to be vascular in etiology. Pirecetam normalizes cerebral blood flow, along with other positive hemorheological properties. It may also increase central Ach levels. We performed the DST twice, 1 week apart, on 96 stable, demented geriatric inpatients. In 33 (21 AD, 11 MID), piracetam was started at an oral dose of 4.8 g/d 4-6 months before the first DST. The remaining 64 (39 AD, 25 MID) were untreated. Among untreated patients, those with MID were less suppressible (P < 0.001 and P= 0.01) and had more week-to-week variability (P = 0.0006) in the DST than AD patients. This is consistent with our previous findings. However, treated patients showed no difference in either postdexamethasone cortisol levels or reproducibility of DST results. We interpret these findings to mean that piracetam, by increasing central Ach, makes AD patients less suppressible on the DST, and by maintaining more constant limbic blood flow, makes MID patients more DST stable.
Clinical observation of 11 patients under clozapine-lithium association
Authors: Bryois C , Ferrero F 
Published: April 2020

SummaryTen men and one woman aged 27 to 52 years and presenting chronic evolution of their psychotic disorders benefited from a treatment which associated lithium sulfate at a plasmatic level of 0.5 to 0.8 meq/L with clozapine (mean posology: 300 mg/day). Five patients presented chronic disorganized schizophrenia (295.14), five a schizoaffective disorder (295.70) and one patient chronic undifferentiated schizophrenia (295.94) according to DSM III-R. Nine of the eleven patients showed mood disorders in addition to their psychotic and dissociative symptomatology. The remaining two presented chronic disorganised schizophrenia with aggressive behaviour. The clozapine-lithium association led to stabilization and improvement in the condition of all patients. Nine patients are still undergoing treatment with satisfactory results. The mean duration of the clozapine-lithium treatment, which has proved to be well tolerated with regard to side-effects, is about five years.
A family study of obsessive compulsive, eating and mood disorders
Authors: Pasquale L , Sciuto G , Cocchi S , Ronchi P , Bellodi L 
Published: April 2020

SummaryWe calculated Morbidity Risks (MR%) for the major psychiatric conditions in the families of three groups of patients, affected by Eating Disorders (ED; n = 41), Obsessive Compulsive Disorder (OCD; n = 70) and Mood Disorders (MD; n = 39). Our aim was to verify the hypothesis of a common familial pattern of aggregation. Familial risk of developing OCD was significantly increased in the families of OCD probands. Homotypic cases were also augmented in ED and MD families with respect to the rates of the general population, although without statistical significance in the crosswise comparisons. These results confirm the existence of a genetic susceptibility to the development of OCD.
Akathisia-induced suicidal behaviour
Authors: Azhar MZ , Varma SL 
Published: April 2020

SummaryThree cases of akathisia-induced impulsive suicide attempts are reported. In all three cases the patients admitted that the suicidal ideas occurred suddently. The suicidal attempts may be a result of neuroleptic – induced akathisia as they disappeared as soon as the akathisia was treated.
Personality dimensions and reactivity to 35% CO2 in panic patients and healthy controls
Authors: Perna G , Arancio C , Bertani A , Gabriele A , Bellodi L 
Published: April 2020

SummaryThe authors investigated the relationship between personality dimensions and 35% CO2, reactivity. Fifty-one patients with PD and 26 healthy controls were assessed by the Tridimensional Personality Questionnaire and inhaled one-vital capacity of a gas mixture of 35% CO2, and 65%; 02. PD patients showed stronger reactivity to 35%. CO2, and higher scores on Harm Avoidance personality dimension. No significant relationship between reactivity to 35% CO2, and Harm Avoidance, Novelty Seeking and Reward Dependence personality dimensions were found in PD patients or controls. These results suggest that the reactivity to 35% CO2, might not be related to personality.
Acute intermittent porphyria and disturbances in amino-acid metabolism in a psychiatric in-patient population
Authors: Rijn-van den Meijdenberg JCC , Fekkes D , Wilson JHP , Pepplinkhuizen L , Verhoeven WMA , Jansen HML , Ederveen AB 
Published: April 2020

SummaryIn recent years an enhanced catabolism of serine, with or without the existence of porphyria, has been demonstrated in relation to a specific subtype of psychosis, according to ICD-10 criteria, the acute polymorphic psychosis with or without symptoms of schizophrenia. Since sensory perceptual distortions play a key role in the symptomatology, patients with this disorder are referred to as Acute Polymorphic Psychosis plus psychosensory phenomena (APP+). In a retrospective study, including a total of 140 chronic psychiatric patients, we investigated the prevalence of Acute Intermittent Porphyria (AIP) and APP+. No subjects with AIP were found. In two patients APP+ could be demonstrated, based on both clinical characteristics and positive biochemical markers, ie lowered plasma serine concentration and increased TSM-ratio (100 × Taurine (μmol/l)/Serine concentration * Methionine concentration). In three patients the psychotic disorder was suspected to be present. It is concluded that careful psychiatric diagnosing may reveal specific psychotic disorders with a distinct biological pathogenetic factor, ie a disturbed serine metabolism.
The use of benzodiazepines in schizophrenia: a review
Authors: Llorca PM , Wolf MA , Estorges JP 
Published: April 2020

SummaryBenzodiazepines were first used in schizophrenia because of their anxiolytic properties. At high doses, or in association with neuroleptics, diazepam and estazolam also appears to exhibit an antihallucinatory effect, whereas alprazolam preferably acts on negative symptomatology due to its antidepressant properties.
Rationale for BPRS use in routine clinical practice: quantitative assessment of psychopathology, consistent with clinical sense
Authors: Eisele R , Gex-Fabry M , Balant-Gorgia AE , Balant L , Garrone G 
Published: April 2020

SummaryThe Brief Psychiatric Rating Scale (BPRS) is expected to provide a valuable instrument for routine evaluation of the patient's status and correct interpretation of concentrations measured during therapeutic monitoring of antipsychotic drugs. Inpatient files were searched for information relative to acute episodes and BPRS items were scored every 10 days until discharge from the hospital according to a retrospective scheme. Eighty patients were included, who met DSM III criteria for schizophrenia and bipolar disorder. Clusters of symptoms that tend to appear together were identified through principal components analysis and are in keeping with factors described previously. Differences with respect to diagnosis further suggest that such clusters convey clinically relevant information. The time course of haloperidol action was also investigated: an average 51 % improvement was observed over the first 10 days, while the proportion of patients showing a 50% or larger BPRS decrease at the time of discharge reached 90%. The prominent contribution of changes in positive, florid symptoms to global improvement is also described. Finally, association of clinical improvement with a shorter period of hospitalization is shown. These results indicate that the BPRS represents a level of abstraction compatible with the way clinicians communicate and that its introduction into routine practice may allow for better description of the course of illness
Reduced suicidality with paroxetine
Authors: López-Ibor JJ 
Published: April 2020

SummaryDepression is commonly associated with suicidal thoughts and behaviour. The effect of the antidepressant, paroxetine, on suicidality in depressed patients has been assessed by retrospective analysis of the worldwide database of short-term clinical trials. Data were analysed on 2963 patients treated with paroxetine. 554 placebo patients, and 1151 patients treated with an active control. The results clearly demonstrate the beneficial effect of antidepressant therapy on suicidal ideation. Paroxetine was not associated with the emergence of suicidality, which appears to be a feature of depressive disorder unrelated to antidepressant therapy.
Adolescence et suicide : le point sur la littérature récente
Authors: Ladame F , Wagner P 
Published: April 2020

RésuméLes auteurs présentent une revue des tendances actuelles concernant divers aspects du suicide de I’adolescent telles qu’elles apparaissent aujourd’hui dans la littérature. L’accent est mis sur la relation entre psychopathologie et suicide, I’épidémiologie, la prévention et les problèmes thérapeutiques que pose le suicide.
Trouble anxieux et dépressif mixte : problèmes cliniques
Authors: Boulenger JP , Boyer P 
Published: April 2020

RésuméLe trouble anxieux et dépressif mixte (ADM) représente une nouvelle catégorie diagnostique regroupant essentiellement des patients vus dans le cadre des soins primaires. Ces patients se définissent comme des sujets présentant des symptômes d’anxiété et de dépression d’intensité limitée et comparable, s’accompagnant au moins de quelques signes neurovégétatifs. En outre, ces patients sont censés ne pas répondre aux critères diagnostiques spécifiques de troubles anxieux ou dépressifs. Cependant, les cas de dépression anxieuse ne sont pas limités aux patients entrant dans cette nouvelle catégorie « sous-syndromale ». De nombreux patients qui répondent aux critères soit de troubles dépressifs soit de troubles anxieux peuvent également présenter des symptomes, un syndrome ou répondre à un diagnostic d’anxiété ou de dépression. On ne sait pas encore si les symptômes d’anxiété et de dépression sont deux expressions différentes d’un même processus psychopathologique sous-jacent. La description récente d’un « syndrome névrotique généralisé » (Tyrer, 1990) représente une tentative de réunification de syndromes séparés dans nos classifications actuelles. Avec cette approche globale, les états d’anxiété,de dépression ou d’ADM sont associés, à un moment ou à un autre, à des traits de personnalité spécifiques et on considère qu’ils expriment différents niveaux d’hyperréactivité à diverses situations stressantes. Cette hypothèse expliquerait le rapport étroit entre ces deux catégories de symptômes, et I’efficacité dont témoignent certains agents psychopharmacologiques à la fois sur les troubles anxieux et dépressifs.
Vers un élargissement des indications des antidépresseurs
Authors: Allain H , Benéton C , Bellissant E 
Published: April 2020

RésuméLes données neurochimiques directes ou indirectes obtenues dans différentes affections du système nerveux central (SNC) constituent la base rationnelle de I'utilisation des médicaments dans des indications précises. Les antidépresseurs (AD) tricycliques agissant sur les principales amines du SNC trouvent ainsi des applications thérapeutiques variées en dehors de la dépression. L'arrivée de nouveaux AD au mécanisme d'action, soit plus cibé (la sérotonine), soit différent (IMAO) pose de nouveau cette question des indications psychiatriques et neurologiques, qui ne peut être résolue que par des essais méthodologiquement irréprochables. Une telle approche évitera d'ignorer pendant des années des effets thérapeutiques incontestables d'une molécule ancienne, tel que ce fut le cas de la clomipramine dans les troubles obsessifs-compulsifs.
La psychiatrie française et les lois. La loi du 27 juin 1990 *
Authors: Mercuela A , Caroli F , Smagghe PO , Baldacci-Epinette C 
Published: April 2020

RésuméLa loi du 27 juin 1990 relative aux droits et á la protection des personnes hospitalisées en raison de troubles mentaux et á leurs conditions d'hospitalisation a maintenant remplacé en France, I'ancienne loi de 1838 sur les « aliénés ». Elle précise les droits des malades et veut instaurer un meilleur contrôle des conditions d'hospitalisation. L'hospitalisation á la demande d'un tiers nécessite maintenant, en plus de la demande d'admission, deux certificats médicaux attestant que le consentement du malade est impossible, que son état nécessite des soins immédiats et une surveillance médicale constante. L'hospitalisation d'office exige un certificat médical circonstancie portant sur l'état actuel du malade. Elle est prononcée par le préfet du département. La levée de l’ hospitalisation d'office est décidée par deux psychiatres experts qui doivent établir que l'intéressé n'est plus dangereux. Ces nouvelles dispositions visent essentiellement à protéger le sujet sain contre I'arbitraire, plutôt que le malade contre son entourage et lui-même. La notion de consentement impossible est en particulier ambiguë et peut aboutir à exclure de l'hospitalisation des malades dont l'état va s'aggraver. La notion de dangerosité (article 348) sur les conditions d'entrée et de sortie des malades hospitalisés d'office fait appel à des prérequis contradictoires et devrait être clarifiée.
Mood disorders with delusionsversusschizophrenic disorders with delusions. Second phase of a longitudinal study of a cohort of adolescent psychiatric inpatients with delusions
Authors: Halfon O , Mouren-Simeoni MC , Radat F , Albert E , Nahama V , Dugas M 
Published: April 2020

SummaryThe prognostic significance of an index episode of affective disorder with delusions was assessed in a longitudinal study of a cohort of adolescent psychiatric inpatients (n= 43). Part I of a study has been reported in a previous article. Initial assessmentdata (anamnestic variables, clinical assessment) did not discriminate between onset of affective disorder and schizophrenia. Part II of the study provides a longitudinal perspective of the cohort's diagnostic and life adjustment: diagnoses of schizophrenia increased, schizophreniform disorders disappeared, affective disorders were stable and a schizo-affective category emerged. Patients in the schizophrenic category had severely impaired life adjustment, while the level of functioning in unipolar and bipolar patients was consistently satisfactory. Compared to the initial diagnosis, the cohort showed a tendency to develop into schizophrenia. It is too early to affirm that every adolescent with delusional symptoms at onset will later develop schizophrenia, however, this risk appears real.
Therapist-patient relationship as a predictor of the course of schizophrenic illness
Authors: Stark FM , Lewandowski L , Buchkremer G 
Published: April 2020

SummarySchizophrenic patients seem to react sensitively to expressed affect. Expressed emotion research has shown the negative impact of specific family communication styles on the course of illness. Further studies have discussed its relation to gender. This study examines the dyadic aspects of the therapist-patient relationship, the interaction between therapist's ratings and patient's psychopathology, and the predictive value concerning the course of illness. Results show a significant association with gender. Male therapists were inclined to reduce their therapeutic commitment when being confronted with patients who suffered from disturbances Of ego-function, attention, or perception. Female therapists felt rejected by patients with delusions and with formal thought disorders, but perceived themselves as competent when dealing with anergic patients. Furthermore, patients with a less favorable course of illness at the 2-year follow-up could be discriminated by the quality of the therapist-patient relationship at the end of the primary therapeutic intervention.
Antidepressant modulation of isolation and restraint stress effects on brain chemistry and morphology
Authors: McEwen BS , Angulo J , Gould E , Mendelson S , Watanabe Y 
Published: April 2020

SummaryStress elicits adaptive responses from the brain, but it can also lead to maladaptive consequences. For example, stress can precipitate mental illness, including depression. Prolonged stress also causes damage to neurons in the hippocampus. Antidepressant drugs must be evaluated, not only for their ability to potentiate adaptive responses, but also to inhibit maladaptive consequences of stress. Ongoing research in our laboratory has compared the atypical tricyclic antidepressant, tianeptine, with the typical tricyclics, desipramine and imipramine, with respect to the effects of isolation and repeated restraint stress. Tianeptine and desipramine similarly attenuated isolation stress-induced increases in locus coeruleus and midbrain tyrosine hydroxylase mRNA levels and isolation-stress induced decreases in preproenkephalin mRNA levels in striatum and nucleus accumbens. However, tianeptine and imipramine differed in their effects in the cerebral cortex and hippocampus on 5HT2, and 5HT1A receptor levels but, surprisingly, produced similar effects on levels of the serotonin transporter labelled with [3H] paroxetine. Tianeptine also prevented stress-induced reductions in the length and number of branchpoints of dendrites of CA3 pyramidal neurons in hippocampus; comparison with effects of typical tricyclics are ongoing. Tianeptine also blocked effects of corticosterone treatment to reduce branching and length of CA3 dendrites. These actions of tianeptine may be due to interactions between 5HT and excitatory amino acids in the mossy fiber terminals on CA3 pyramidal neurons. Taken together, these results indicate that tianeptine has unique properties compared to some other antidepressant drugs, but shares in common with those drugs the ability to attenuate stress effects on tyrosine hydroxylase gene expression and on the serotonin transporter. It remains to be seen whether these actions are the basis of a common antidepressant action.
Effect of the antidepressant tianeptine on the activity of the hypothalamo-pituitary-adrenal axis
Authors: Delbende C , Mocaër E , Rettori M , Kamoun A , Vaudry H 
Published: April 2020

SummaryThe effect of the antidepressant agent, tianeptine, on the hypothalamo-pituitary-adrenal (HPA) axis was studied in adult male rats under basal and stressed conditions. Chronic treatment with tianeptine (10 mg/kg; 2 weeks; twice a day) induced a significant decrease of hypothalamic CRF (–12%) and pituitary ACTH concentrations (–21%), suggesting that tianeptine reduces the activity of hypothalamic CRF neurons and pituitary corticotrophs. The possible effect of tianeptine in the neuroendocrine response to stress was thus investigated. Rats were submitted to restraint stress for 30 min; under these conditions ACTH and corticosterone levels were considerably increased. A single injection of tianeptine was found to significantly reduce stress-evoked elevations of plasma ACTH and corticosterone. Time-course experiments, consisting of administering tianeptine 1–3 h before immobilization stress, revealed that the maximum inhibitory effect of tianeptine occurs about 2 h after injection of the antidepressant. Administration of various doses of tianeptine (from 2.5 to 20 mg/kg) showed that the effect of the drug was dose-dependent; the maximum effective dose being 10 mg/kg. Taken together, these data indicate that tianeptine may exert original ‘anti-stress’ activity.