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Biomedical subjects

A J Coudert

Publications and source records attributed to A J Coudert.

At least 19 recordsLinked to original sources
PubMed1993

[Prevalence of anxiety and depressive symptoms in patients with type 1 and 2 diabetes].

The authors studied data on psychiatric disorders in 34 insulin-dependent and 27 non-insulin dependent diabetic patients by comparison with 25 patients suffering from hypertension. Analysis was performed following clinical diagnosis (according to DSM III-R criteria), Hamilton Anxiety Inventory, Hopkins Symptom Check List 58 and Beck Anxiety Inventory. In all groups the two major psychiatric clinical diagnoses were anxiety disorders (respectively, 53, 59 and 60%, NS) and depressive disorders (respectively 21, 22 and 20%, NS). These disorders were more common in women. The influence of degenerative complications was studied. Insulin-dependent diabetics with objective nephropathy had significantly higher anxiety scores. In non-insulin-dependent diabetic patients, microangiopathy, diabetic foot and poor control (HbA1c > or = 10%) were also associated with depressive disorders. We conclude that diabetics present with high prevalences of anxiety and depressive disorders and we suggest specific therapeutic approaches.

Adolescent↗
PubMed1992

[When to continue or stop Clozapine therapy?].

The decision whether or not to stop clozapine therapy in schizophrenic patients depends on a lot of factors involving the benefit/risk ratio. Thus, authors successively analyse various data: the clinical status of the patient is the first one. The evaluation has to take into account short and long-term efficacies; the problem of the minimal duration of clozapine therapy required before concluding to ineffectiveness is still open: from 4 to 12 months; the question of efficacy of the drug according to the type of symptoms is also quite difficult. Efficacy on positive symptoms among schizophrenic patients seems most prominent; negative symptoms also improve but the reasons why are quite difficult to evaluate. It is sometimes difficult to indicate if the improvement in negative symptoms is independent of the improvement in positive symptoms; the patient's request and his feeling (including tolerability) are another decisional factor; because of the lack of dystonia and other extrapyramidal side effects, some patients are more compliant under clozapine therapy; the side effect (hematologic, cardiovascular, hepatic and central nervous systems) lead to discontinuation of clozapine treatment when severe. The most frequent ones are: sedation, EEG alteration, seizures, increase of liver enzymes, hypotension/collapse, hypersalivation, fever (> 38), ECG alteration, tachycardia, gastro-intestinal adverse effects, weight gain, and leucopenia. In the event of a white blood cell count (WBC) below 3,500/mm3, the patient should be evaluated immediately with respect to the WBC and the differential count (DC). Should the results confirm a WBC below 3,500/mm3 and/or reveal an absolute neutrophil granulocyte count of 2,000 to 1,500/mm3, the leucocytes and the granulocytes must be checked at least twice a week.(ABSTRACT TRUNCATED AT 250 WORDS)

Agranulocytosis↗
PubMed1992

[A new therapeutic approach tp drug-resistant schizophrenia: clozapine. Long-term prospective study in 16 patients].

Clozapine, a dibenzodiazepine derivative, has potent antipsychotic activity; but bone marrow suppression resulting in agranulocytosis has been associated with clozapine treatment and has restricted the administration of this drug to treatment-resistant schizophrenic patients. This report describes preliminary results of an open prospective study of the effects of clozapine on symptomatology and social function in 16 treatment-resistant schizophrenic patients. Authors prospectively followed up for 18 months 16 DSM III-R schizophrenic patients who had failed to respond to various neuroleptics (n: 7.2 +/- 2.8); when clozapine treatment was initiated, the mean duration of the illness was 14.2 (+/- 6.7) years. Total BPRS, BPRS "positive" and "negative" symptoms scores were used for evaluation. Social integration and side effects were also studied. 14 of 16 patients are still receiving clozapine; 1 out of 14 patients has a more than 60% decrease in total BPRS, 11 out of 14 have 30 to 60% decrease in total BPRS and 2 out of 14 have less than 30% decrease in total BPRS. Improvements in both total and positive symptoms BPRS scores were observed within the first month of treatment (p < 0.001); improvement in negative symptoms was noted within the third month (p < 0.02). At the end of the follow up period, 43% of patients showed marked improvement in family life and 21% found a job during the study. Beyond noteworthy improvement of clinical symptoms in these patients who presented with severe schizophrenia, clozapine also significantly reduced the use of concomitant medication. Side effects are studied but none required treatment disruption; neurological side effects were less reported than with usual neuroleptics. It is concluded that clozapine offers particular benefits for some treatment-resistant schizophrenic patients; however the increased comparative risk requires a restricted use of clozapine to selected patients.

Adult↗
PubMed1992

[Drug therapies in anxiety disorders of children].

Although childhood anxiety disorders are currently generating new interest, they continue to pose problems in everyday clinical practice. Drug treatment is far from being the only therapeutic approach but does undeniably have a place which should be clearly defined. The main drugs, dosages, indications, and adverse effects of antidepressants, benzodiazepines, antihistamines and neuroleptics which may be used in children with anxiety disorders are discussed.

Adolescent↗
PubMed1991

[Considerations on respective roles of anxiety and depressive disorders in children].

Anxiety and depression are often clinically associated in children, but are very different in term of effect and symptoms. Family studies favor the hypothesis of a common diathesis for these disorders. Parental history of major depressive and/or anxiety disorders increase the risk of mood and anxiety disorders in children. At the present time, biological studies have not determined any biochemical conclusion for these disorders. It should be noted that although imipramine is efficient in both depressive disorder and separation anxiety, this does not implicate a common physiopathologic basis.

Anxiety Disorders↗
PubMed1990

[Anxiety disorders in children: do any risk factors exist?].

Anxiety disorders in children are currently undergoing reclassification. On the basis of a review of the literature, the authors have attempted to point out the main evidence suggesting that a number of risk factors are associated with childhood anxiety disorders. Age and sex seem to influence the risk of anxiety disorder. The child's personality is of central importance: studies of the concept of "temperament" carried out in recent years have underscored that inhibition and introversion in early childhood are associated with an increased risk for anxiety disorders in later childhood. A low socioeconomic setting also seems to be a risk factor whose incidence varies across types of anxiety disorder. Familial risk factors have a very strong effect: children of parents with current or past anxiety disorders with or without mood disorders are at increased risk for anxiety disorders; this risk varies according to the type of disorder in the parents (for instance, the respective roles of panic attacks and avoidance behaviors remain unclear). Lastly, comorbidity is also an important factor: most children with anxiety disorders also have one or several other anomalies, usually anxiety or mood disorders.

Adolescent↗
PubMed1989

[Is an obsessive-compulsive disorder in children an anxiety disorder?].

Concerning the update reconsideration of anxiety disorders of children, should childhood obsessive-compulsive disorder be assimilated as an anxiety disorder? Authors attempted to answer to this question by taking into account various levels of consideration which lead them to position childhood obsessive-compulsive disorder in the vicinity of anxiety disorders.

Adolescent↗
PubMed1989

[Acute paroxysmal anxiety in children].

Authors study acute anxiety disorders in children. They distinguish two clinical forms, depending on the knowledge of outer triggering factor: anxious paroxysm and panic attack.

Acute Disease↗
PubMed1982

[Extensive multicentric study of 1354 cases of depressed subjects treated with amineptin].

Psychiatrists and general practitioners are already well acquainted with amineptine. It nevertheless appeared interesting to expand previous clinical trials concerning use in hospitalized patients and outpatients. The results of this extensive study involving 1354 cases coming from 13 french regions confirm and specify the therapeutic indications in the various types of depression as well as its status within the antidepressant group. The low occurrence of side effects and the remarkable acceptability were also confirmed by this larger-scale study performed by 162 experimenters, all of whom were psychiatrists. The two most remarkable points arising from this study were the homogeneity of results for each region, as well as their consistency with previous findings during the clinical trial phase. Overall results in depressive disorders were: 76% positive (of which 52% very good and good results), particularly concerning melancholia (201 cases) and neurotic or reactive depressions (815 cases). Extensive evaluation of results indicated that amineptine was a fast acting desinhibiting antidepressant.

Adjustment Disorders↗
PubMed1981

[Death caused by anorexia nervosa (author's transl)].

The authors examine the clinical history of two women whose first symptoms of anorexia nervosa appeared at the ages of 20 and 30 years respectively. Their illness remained stationary for many years then suddenly became fatal after a series of severe metabolic disturbances. These occurred after a period of 26 years in the first case, and 11 years in the second. This illustrates the concept that the prognosis of anorexia nervosa is not as good when the first symptoms appear at an advanced age, and also that a vital prognosis can be established in certain cases according to percentages that are variable but no negligible. A survey of what has been written to date seems to confirm this.

Adult↗