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Biomedical subjects

D Widlöcher

Publications and source records attributed to D Widlöcher.

At least 19 recordsLinked to original sources
PubMed1994

Decrease of complexity in EEG as a symptom of depression.

Nonlinear dynamic analysis provides new methods for the processing of the electroencephalogram (EEG). We demonstrate here that the EEG dynamics of major depressive subjects is more predictable, that is less complex, than that of control subjects. Moreover, the consequence of treatment upon the EEG dynamics seems to be dependent on the appearance of the illness. Although the specificity of this dynamic signature for different stages of depression is to be confirmed, the assumption of a strong link between a healthy system and a high level of complexity in dynamics is further supported.

Adult↗
PubMed1994

Circadian pattern of motor activity in major depressed patients undergoing antidepressant therapy: relationship between actigraphic measures and clinical course.

The 24-hour motor activity pattern was evaluated in 26 inpatients with major depression at treatment onset and after 4 weeks of antidepressant therapy. Clinical state, depression, and psychomotor retardation, as well as motor activity level and circadian rhythm, were simultaneously assessed. Treatment responders and nonresponders were also considered. Diurnal hypoactivity and reduced 24-hour rhythm amplitude were found at treatment onset. Activity level increased significantly on discharge. The rest-activity cycle for each depressed patient fit a cosine function of 24-hour periodicity. Data tended to show no phase shift but a large intragroup phase variability. Preliminary findings of a negative correlation between basic activity level and clinical improvement, and a trend toward responders having a lower activity level than nonresponders, suggest that activity could be used to predict therapeutic response.

Adult↗
PubMed1994

Loss of control of pre-motor activation in anxious agitated and impulsive depressives. A clinical and ERP study.

1. Current research uses a variety of traditional validation methods in order to test the clinical expression of biological models in psychiatry. The application of these methods has resulted in a paradoxical situation which requires the definition of new objectives in biological and pharmacoclinical research: the biological specificity of new psychotropic drugs does not assume any congruence between their pharmacological and their therapeutic effects, but raises the question of the relationship between biological systems and clinical symptomatology. The dimensional description of psychopathological disorders may be more appropriate to biological studies in psychiatry. 2. A study was undertaken on a population of twenty-one in-patients fulfilling the DSM III-R criteria for major depressive episode. They were divided into two groups on the basis of contrasting clinical dimensions: anxious-agitation and impulsiveness versus retardation and affective blunting. 3. Significant clinical differences between the two groups on mood profiles were echoed by contrasts in event-related potentials during a go-nogo task: only anxious agitated and impulsive patients developed an abnormal cortical activity, as measured by contingent negative variation (CNV), in the nogo condition. 4. This paper suggests how a paradigm with control of motor action leads to specify premotor activation abnormalities in the agitated impulsive depression subtype.

Adult↗
PubMed1994

Nicotine dependence and motives for smoking in depression.

Smoking variables were assessed in female (n = 48) and male (n = 28) French hospitalized depressed smokers. Nicotine dependence, motives for smoking, and emotional situations in which depressed smokers were likely to smoke were compared with those of female (n = 36) and male (n = 60) nondepressed smokers from the general population. Depressed smokers scored higher than controls on nicotine dependence, and on stimulant and sedative smoking; they also reported that they were more likely to smoke in negative emotional situations. Sedative smoking decreased significantly between admission and discharge. Sedative smoking is a strong reason for smoking among depressed smokers regardless of degree of dependence, whereas stimulant smoking is positively correlated with degree of dependence. Nicotine dependence is also significantly correlated with anhedonia, and its relationship to depression is discussed in regard to nicotine action on hedonic systems.

Adult↗
PubMed1994

A case is not a fact.

Why do we publish clinical data? Between the scientistic illusion that assumes that cases are objective data and the disillusioned observation that psychoanalytic literature is mainly used to boost identity feelings, what role is played by such publications? New psychoanalytical knowledge results from clinical practice and not from scientific experiments or observations. A clinical vignette, even more than a full monograph, is clearly not designed to prove a theory from objective facts but to illustrate a particular clinical view. The quality of a case report relies on at least three criteria: data economy; adequacy to the proposed thesis; and convincingness or persuasion. A case is not a fact, because understanding it presupposes 'semantic holism': understanding any mental state requires taking into consideration a 'world of knowledge'. Empathy results from an unlimited work of inferences. In presenting a case, the psychoanalyst is always in a sense a 'thought-reader'. He describes what he believes he discovers.

Authorship↗
PubMed1994

[Psychological theories on the vulnerability to depression].

The problem of psychological vulnerability refers back to the dysymetric interactions between biological, life-event and personality factors. The term "personality" must be defined in terms of three factors: differential characteristics of the primary traits, "temperament" from the purely biological stand-point, and psychodynamic organization. The following discussion will deal solely with notions of temperament and psychodynamic organization. The renewed interest in the notion of temperament for the constitution of depression has been evoked in a number of recent studies, and allows an integrative approach of the biological phenomena. From the stand-point of psychodynamic organization, we should be less concerned with a strictly etiological role than with the mechanisms involved: loss of the object, in the neurotic model (depressive neurosis?) absence of the object (severe narcissistic disorders). This psychodynamic clinical approach must also take into account the triggering or unmasking effects of the depressive state itself on the underlying personality structure.

Depressive Disorder↗
PubMed1992

Theoretical considerations and perspectives on the onset of action of moclobemide.

The aim of this paper is to focus on methodological problems related to clinical studies on the onset of action of antidepressants, especially moclobemide. The methodological discussion proposed focuses on: --global efficacy as a function of time; --proposals for a specific approach to the study of the onset of action; --quality of the response and onset of action; --the dimensional level and the onset of action.

Antidepressive Agents↗
PubMed1992

Clinical subtypes and age at onset in schizophrenic siblings.

This study examines the concordance of clinical subtypes and age at onset of schizophrenia in 42 sibships of multiply affected schizophrenic patients. Subtypes were defined by four major diagnostic systems (DSM-III, DSM-III-R, ICD-10, and Tsuang-Winokur criteria) and rated both for the first hospitalization and long-term diagnosis. When a sibship method was used, no concordance for subtypes was found in siblings. Age at onset, analyzed as a continuous variable with the intraclass correlation method, was found to be correlated in siblings. This finding suggest that the search for continuous traits distributed in families of schizophrenic patients might constitute an alternative to discrete category-based family studies.

Age Factors↗
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

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↗
PubMed1989

Subjective bias in reports of poor work adjustment in depressed patients.

Twenty-five depressed inpatients were asked to report their adjustment at work during the 4-month period preceding their hospitalization. Two separate reports were given: the first during the acute illness phase and the second one 10-28 days later, after symptomatic remission following standardized pharmacotherapy. Thirty-two percent more patient ratings showed absence of adjustment problems on the second report compared with the first. Significant differences between the 2 reports were found in 7 of the 9 items on the Structured and Scaled Interview to Assess Maladjustment, which is designed to assess specific aspects of maladjustment at work. The changes in the scores of maladjustment correlated with the changes in the scores of depressive symptoms, and 40% of the variation in maladjustment scores was accounted for by the pessimism item of the Montgomery-Asberg Depression Rating Scale. Much of the poor work adjustment reported by the acutely depressed patients thus seems to be caused by symptom-related subjective bias.

Adult↗
PubMed1989

Decision time and movement time in depression: differential effects of practice before and after clinical improvement.

Choice reaction time involves, at least two components of response latency, decision time and movement time. Studies of choice reaction time usually provide values of these two components averaged over a given number of trials. The aim of the present study of depressed subjects was to investigate changes across practice on Decision Time (DT) and Movement Time (MT) before and after clinical improvement. 19 depressed subjects were given two sessions of 50 trials each, one before treatment (Di) and one after recovery (Df). Decision time and movement time exhibited quite different patterns. Decision time significantly decreased with clinical improvement. No significant variation across trials was found, in either session. Movement time values varied across trials but the variations observed on Di and Df were significantly different, whereas before treatment latencies recorded at the end of the session were greater than those scored at the start, the contrary was observed after clinical recovery. No significant difference was found between values of movement time scored at the start of the two sessions.

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↗