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Biomedical subjects

Emmanuelle Corruble

Publications and source records attributed to Emmanuelle Corruble.

At least 19 recordsLinked to original sources
PubMed2006

Quality of life and psychological status in patients with primary Sjögren's syndrome and sicca symptoms without autoimmune features.

OBJECTIVE: To compare pain, fatigue, and sicca symptoms; quality of life; and psychological status between patients with primary Sjögren's syndrome (SS) and those with sicca symptoms but no autoimmune features (sicca asthenia polyalgia syndrome [SAPS]), and to determine whether a psychological pattern can be detected in patients with SAPS, which could suggest psychological distress as the cause. METHODS: This cross-sectional, prospective study included 111 patients with primary SS according to the American-European Consensus Group criteria and 65 SAPS patients with no focus on lip biopsy and no anti-SSA/SSB antibodies. Pain, fatigue, and sicca symptoms were assessed using visual analog scales; quality of life was assessed using the Short Form 36 (SF-36); and psychological distress by the Symptom Checklist-90-Revised (SCL-90-R) questionnaire. RESULTS: No difference was observed between primary SS and SAPS patients for pain, fatigue, sicca symptoms, quality of life, and psychological status. Fatigue and pain, but not dryness, were correlated with both quality of life and psychological distress in both groups. For primary SS patients, physical and mental composite scores on the SF-36 correlated well with global severity index (GSI) scores of the SCL-90-R (r = -0.29, P = 0.006 and r = -0.61, P < 0.0001, respectively). CONCLUSION: Patients with primary SS and SAPS do not differ in quality of life or psychological status. Although both diseases probably have a different origin, they may require the same psychological support or psychiatric care. The strong correlation between the composite physical and mental scores of the SF-36 and the GSI scores of the SCL-90-R in primary SS patients emphasizes the importance of the psychological dimension in results of the SF-36.

Cross-Sectional Studies↗
PubMed2005

Reports on defense styles in depression.

INTRODUCTION: 'State effect' of depression on personality makes its assessment during depression difficult. Many clinicians do not only refer to the patient, but use additional information sources, especially reports from close informants. Our hypothesis was that an informant could assess the defensive functioning of the depressed patient. The objective of this study was to investigate the validity of the informants' assessment of defense styles in depressed patients. METHODS: Sixty-three inpatients with DSM-IV major depression as primary diagnosis were included. They were administered the Defense Style Questionnaire (DSQ) at admission (D0) and 28 days after treatment (D28) according to their current state. At the same time, informants rated an adapted version of the DSQ (INF-DSQ), according to the patient's current (D0 and D28) and premorbid defensive functioning (D0). Otherwise, severity of depression was assessed using the 17-item Hamilton Depression Rating Scale at D0 and D28. RESULTS: Agreement between patient's and informant's DSQ scores was moderate, both at D0 and D28, even if comparison of mean defense scores does not show significant difference. Mature defense scores significantly increased between D0 and D28, whereas immature defense scores significantly decreased, with both the DSQ and INF-DSQ. During the episode, informants are able to discriminate premorbid from current D0 defenses, but not from current D28 defenses. CONCLUSION: Even if this study has strong limitations, our results argue for the interest of close informants to assess premorbid personality. Before it could be validated, the INF-DSQ should be further studied in other subgroups of patients, especially its ability to give accurate descriptions of patient's premorbid defenses during an acute episode.

Adaptation, Psychological↗
PubMed2004

Defense styles in depressed suicide attempters.

Defense styles may discriminate between depressed patients with or without recent suicide attempts. The aim of the present study was to identify which defense mechanisms are associated with recent suicide attempts in depression. The Defense Style Questionnaire (DSQ) was rated at admission by 156 depressed inpatients with (n = 60) or without (n = 96) recent suicide attempt. Depression intensity was correlated negatively with mature style, humor and sublimation and positively with projection. Although it was not significantly different in terms of sociodemographic and depression variables, recent suicide attempters had higher scores on immature style, especially acting out, passive agression, autistic fantasy and projection. Prospective assessment of defense styles and suicide attempts should be carried out to determine whether these differences are a cause of imminent suicide attempts in depression. If so, the DSQ may be used in clinical practice to help discriminate depressed patients with high risk of imminent suicide attempt.

Adult↗
PubMed2004

Should major depression with 'high normal' thyroid-stimulating hormone be treated preferentially with tricyclics?

In a prospective and naturalistic setting, two samples representing 209 depressed inpatients were assessed for thyroid functioning at admission before antidepressant treatment, and for depression before and after 1 month of antidepressant treatment. We hypothesized that serum thyroid-stimulating hormone (TSH) elevation > or = upper 25th percentile of the normal reference range is associated with poorer response to antidepressant therapy and differences between tricyclic antidepressants (TCA) and other antidepressants. Screening for mild thyroid failure defined as serum TSH concentrations > or = upper 25th percentile of the normal range may provide clues to the clinician. Such patients have a more severe form of depression and a slower or impaired response to antidepressant therapy. It is also possible that they would benefit preferentially from TCA rather than other antidepressants.

Adolescent↗
PubMed2003

Defense styles, impulsivity and suicide attempts in major depression.

BACKGROUND: The aim of our study was to identify if defense mechanisms are associated with impulsivity and lifetime suicide attempts in depressed patients. SAMPLING AND METHODS: The Defense Style Questionnaire, the Impulsivity Rating Scale and the Impulse Control Scale were used in 77 depressed inpatients. RESULTS: Impulsivity was correlated positively with immature and neurotic styles and negatively with mature style. Some but not all defense mechanisms were relevant in this respect. The number of lifetime suicide attempts was positively correlated not only with impulsivity, but also with immature style and to a lesser extent with neurotic style. Several defense mechanisms were involved in these correlations: undoing, projection, passive aggression, acting out, splitting and somatization. CONCLUSIONS: Like impulsivity, defense styles may be relevant to discriminate recurrent suicide attempters in depression. Prospective assessment of defense styles and suicide attempts in depression is needed.

Adolescent↗
PubMed2003

Understanding impulsivity in severe depression? A psychometrical contribution.

BACKGROUND: Depression, especially severe depression, is strongly associated with suicidality. Impulsivity is one of the main dimensions of suicidality. The objective of this study was to assess the structure of impulsivity in severe depression and its relationships to suicide attempts. METHODS: 127 depressed in-patients were assessed at admission and after 4 weeks of treatment for depression and impulsivity with the Impulsivity Rating Scale (IRS) and the Impulse Control Scale (ICS) or the Baratt Impulsivity Scale (BIS). RESULTS: Three dimensions of impulsivity were evidenced in these severely depressed patients, i.e., behavioral loss of control, nonplanning and cognitive. These three dimensions are state dependent. Recent suicide attempts in severe depression are related to loss of control and cognitive impulsivity but not to nonplanning. IRS ad ICS may assess primarily behavioral impulsivity, i.e., loss of control and nonplanning, whereas BIS may assess primarily cognitive impulsivity. CONCLUSIONS: In the future, these three dimensions should be correlated to biological and genetic markers of impulsivity [serotonergic (5-HT) system] and prospective studies should assess the predictive value of the three dimensions of impulsivity in the occurrence of suicide attempts in depressed patients.

Adult↗
PubMed2003

The MDP75: a new approach in the determination of the minimal clinically meaningful difference in a scale or a questionnaire.

BACKGROUND AND OBJECTIVE: The MDP75 (Minimal Difference Perceived 75% of the time) is the difference in the global score from a scale or a questionnaire which, 75% of the time, leads to the higher score being spontaneously attributed by patients or clinicians to the most severe situation. This may be considered as a "minimal clinically perceptible difference" because the proportion of "consistent" choices only exceeds the proportion that could be observed "by chance" by 50%. METHODS: The MDP75 can be estimated through a comparison of two groups of items (group A and group B) randomly selected from the instrument, using a sample of subjects. A logistic regression is then used that relates the choice of A or B to the difference: score(A) - score(B). RESULTS: Data were collected on a depression scale, the HDRS. Three clinicians classified 300 pairs of situations. The MDP75 obtained was 2.7, with a 95% confidence interval of [1.9, 4.1]. CONCLUSION: It can be noted that this value is consistent with expert opinion (3 or 4). Nevertheless, in view of the small number of clinicians involved in the data collection phase, further studies are required to confirm this result.

Depressive Disorder↗
PubMed2002

Early and delayed personality changes associated with depression recovery? A one-year follow-up study.

Many studies have shown the state effect of depression on personality. However, the chronology of personality changes associated with depression recovery remains unstudied. The objective of this study is to assess early (first month) and delayed personality changes associated with depression recovery. Fifty-seven depressed inpatients were assessed with the Temperament and Character Inventory (TCI) at admission, 1 month, and 1 year post-treatment. Patients were divided into poor and favorable outcome. No significant personality change was observed in patients with poor depression outcome. Conversely, a favorable outcome of depression was associated with early and delayed personality changes. Early changes were: decrease in Harm avoidance (HA(1):Worry and pessimism), increase in Cooperativeness and Self-directedness (SD(1):Responsibility, SD(4):Self-acceptance, SD(2):Purposefulness and SD(3):Resourcefulness). Delayed changes were changes in character: increase in Self-Directedness (SD(1):Responsibility, SD(4):Self-acceptance, SD(5): Congruent second nature), decrease in Self-transcendence (ST(2):Transpersonal identification). This study shows the different status of personality changes associated with depression recovery, and it contributes to a better knowledge of the state effect and of subtle clinical changes in patients who are recovering from depression. It may also have implications for the prediction of depression outcome.

Adolescent↗
PubMed2002

Efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder: a 3-month double-blind study.

BACKGROUND: The prevalence of generalized anxiety disorder (GAD) represents an important public health issue. Hydroxyzine, an antagonist of histamine receptors, showed both efficacy and safety in previous short-term double-blind studies over placebo in this pathology. The aim of the current study was to confirm those positive results over a 3-month period in adult outpatients. METHOD: This multicenter, parallel (hydroxyzine [50 mg/day]; bromazepam [6 mg/day]), randomized, double-blind, placebo-controlled trial included 2 weeks of single-blind run-in placebo, 12 weeks of double-blind randomized treatment, and 4 weeks of single-blind run-out placebo. Three hundred thirty-four of 369 selected outpatients with a diagnosis of GAD according to DSM-IV criteria and a Hamilton Rating Scale for Anxiety (HAM-A) total score >/= 20 were randomized before entering the double-blind period. The primary outcome criterion was the change in the HAM-A score from baseline to 12 weeks of double-blind treatment with hydroxyzine compared with placebo. RESULTS: In the intent-to-treat analysis, the mean +/- SD change in HAM-A scores from baseline to endpoint was -12.16 +/- 7.74 for hydroxyzine and -9.64 +/- 7.74 for placebo (p =.019). Results at endpoint for percentage of responders (p =.003) and remission rates (p =.028), Clinical Global Impressions-Severity scale score (p =.001), maintenance of efficacy (p =.022), and Hospital Anxiety and Depression scale score on day 84 (p =.008) also confirmed the efficacy of hydroxyzine over placebo. The study showed no statistically significant difference between hydroxyzine and bromazepam. Except for drowsiness, which was more frequent with bromazepam, safety results were comparable in the 3 groups. CONCLUSION: Hydroxyzine showed both efficacy and safety in the treatment of GAD and appears to be an effective alternative treatment to benzodiazepine prescription.

Adult↗
PubMed1999

Serum thyroid-stimulating-hormone concentration as an index of severity of major depression.

Alterations in thyroid axis are common in depression and subclinical hypothyroidism may predispose to recurrent depressive episodes and resistance to antidepressants. The same normal reference ranges are used in both depressive and non-psychiatric patients to detect hypothyroidism. We hypothesized that in depressive patients, serum TSH (thyrotropin) elevation within the normal reference range (>/= upper 25th percentile) may be related to patients' characteristics reflecting the severity of the depressive illness. We analysed, in a cross-sectional study, the relationship between serum TSH and serum-free thyroxine (T4) concentrations and different demographic and psychiatric characteristics in 94 depressive in-patients with DSM-III-R criteria for major depression. The frequency of subclinical hypothyroidism (normal serum T4, higher than normal serum TSH) was 5.3 %. In univariate analyses patients who had serum TSH concentrations >/= upper 25th percentile of the normal range were more likely to have recurrent depression, longer disease duration, higher number of episodes of major depression, higher number of previous suicide attempts and higher body mass index than those patients who had serum TSH concentrations < upper 25th percentile of the normal range (age-adjusted p<0.05). Stepwise logistic regression analysis showed that serum TSH >/= upper 25th percentile of the normal range was positively associated with recurrent depression (p=0.0001), presence of somatic disease condition (p=0.04), marital status (p=0.06) and number of suicide attempt (p=0.1). On the other hand, significantly higher serum TSH concentrations were observed in patients with recurrent depression, melancholia and associated somatic disease conditions. Correspondence analysis showed that serum TSH in the higher 25th percentile of the normal reference range projected together with the presence of melancholia, psychiatric and somatic disease conditions, severe major depressive episodes, recurrence of depressive episodes, prescription of at least two antidepressants or non-response to two antidepressants, and previous suicide attempts. Our study suggests that serum TSH concentration in the upper 25th percentile of the normal reference range may be associated with characteristics of severe major depression. Further prospective studies are needed to establish whether serum TSH concentration in the upper 25th percentile of the normal reference range is a contributory causal factor or a consequence of the severity of major depression.

Journal Article↗