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Biomedical subjects

F Kochman

Publications and source records attributed to F Kochman.

10 recordsLinked to original sources
PubMed2004

Phenomenological and comorbid features associated in obsessive-compulsive disorder: influence of age of onset.

BACKGROUND: To explore clinical features of symptoms and comorbidity according to the age of onset of patients suffering from obsessive-compulsive disorder (OCD). METHODS: The survey involved collecting data from both patient members of an OCD association, and a sample of 175 OCD patients seen in OCD specialty practice. All the patients (n=617) responded to a questionnaire on family and personal psychiatric OCD history, phenomenological features of OCD and comorbidity. They were classified according to OCD age at onset [group early age of onset (EO): under 15, group late age of onset (LO): older than 15]. RESULTS: A higher percentage of patients from Group LO complained of OCD triggering by factors such as professional difficulties and childbirth (P<0.05); also they more often had (P=0.05) a sudden onset of symptoms. On the other hand, clinical features, such as superstition and magic thoughts, parasite obsessions and repeating, counting, hoarding, tapping/rubbing and collecting compulsions were significantly more frequent (P<0.05) in EO; likewise, history of tics was more frequent in this group. The existence of comorbid depression (at least one episode) did not show any significant difference between groups. However, depression preceding OCD was more frequent in LO. There was no significant difference in treatment response according to age of onset OCD. CONCLUSIONS: The results showed a clear association of EO with obsessions of superstition and parasites, repetitive compulsions and motor and vocal tics, whereas a sudden onset, triggering factors and a more frequent depression preceding OCD characterized LO.

Adolescent↗
PubMed2001

[Obsessive-compulsive disorder in children induced by streptococcal infection].

FROM OBSESSIVE-COMPULSIVE DISORDER TO PANDAS: Obsessive-compulsive disorder (OCD) represents a potentially severe and handicapping disorder that affects several hundreds of thousands of children in France. OCD has, for many years, been considered as a neurosis resulting from mental conflicts. It is currently seen as a neurobiological disorder, the etiological substratum of which is more organic than mental. Recently a sub-type of OCD was isolated in children following infection by Group A b-hemolytic streptococci. This sub-type has been described as Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS). A NEW PHYSIOPATHOLOGICAL APPROACH: The putative dysimmune relationship between bacterial infection and neurotic disorder has led to the development of an original etiopathogenic model that may lead to new therapeutic strategies. The clinical case report of an adolescent presenting with trichotillomania associated with recurrent pharyngitis is a good illustration of this. PUBLISHED DATA: Data published in medical literature over the last 10 years indicates a 10% prevalence in the young suffering from OCD, i.e. 0.1 to 0.3% of the young population.

Adolescent↗
PubMed1997

[Cyclic oro-alimentary disorders].

Eating behaviours have been changing in our society for at least twenty years. Thus, they represent a good indicator of the functioning of a society or a person. Beyond these recent sociocultural variations, recent clinical and research data, particularly in chronobiology, showed clearly the influence of hormonal or seasonal changes in our eating behaviours. Actually, we observed that an important proportion of these cyclic turmoils can fit into other phenomena and cyclic pathologies: premenstrual syndrome, seasonal affective disorders, bipolar disorders, binge eating.

Bipolar Disorder↗
PubMed1997

[Eye disorders in children and adolescents].

PURPOSE: We tried to better characterize non organic ocular disorders in children and adolescents: particularly clinical, perimetric and electrophysiological features. METHODS: We performed a prospective study in 25 cases during a period of 16 months. RESULTS: Non organic ocular disorders were seen among young girls between 9 and 11 years, mostly with bilateral, symmetrical and rapid visual loss. The symptoms were variable in time and responded favorably to suggestion. The ocular examination was normal. Visual field was abnormal in 52% of cases and very often showed a spiral (or snail) picture or a tubular constriction. 7' pattern visual evoked potentials were present in 88% of cases. The acuity was 20/20 in 92% of cases after the consultation and 100% later. CONCLUSION: The ophthalmic and electrophysiologic examination confirmed our diagnosis and eliminated more severe pathology.

Adolescent↗
PubMed1993

[Anterior-medial rotatory instability of the knee joint. Follow up results of surgical treatment].

In the years 1979-1988 65 patients (62 men and 3 women) with rotary anterior-medial instability of the knee were treated surgically. The average age was 34 years. The cause of injuries (65%) were accidents during work in mines of pit-coal. 52 patients were treated surgically in the period of 7 days after the accident. The remaining 13 ones were operated on after the period of 6 weeks. In the group of patients operated on immediately the most frequently applied procedure was the suture according to O'Donoughe of the injured ligaments and shift of the goose foot according to Slocum and Larson. But when the anterior crucial ligament was broken in the shape of a "brush", its reconstruction was formally made according to Jones. For patients with chronic instability extra-articular plastic operations were performed i.e. shift of the semi-tendinous muscle and shift of the goose foot, as well as intra-articular--in case of injury of the anterior crucial ligament. The period of observation was from 4 to 12 years. Better results were obtained in patients operated on immediately: good result--62%, satisfactory--32% and bad--6%. For all patients with chronic instability the obtained results were only satisfactory.

Accidents, Occupational↗
PubMed1976

Bernstein polynomials and Milnor algebras.

Let f be an analytic germ on C(n+1). Then there is an analytic linear partial differential operator P with polynomial dependence on s, and a polynomial b(s), such that Pf(s+1) = b(s)f(s). This paper contains a simple existence proof and geometric interpretation in the case when f has an isolated critical zero at the origin, and is contained in its Jacobian ideal of first partial derivatives.

Journal Article↗
PubMedDate not supplied

[Early maladaptive processes, depression and alexithymia in suicidal hospitalized adolescents].

Alexithymia characterizes people having important difficulties in putting their feelings and moods into words. Adolescents' depression shows some peculiarities: one of them, which is often observed, is the equal difficulty of imparting one's feelings to others. This research concerns adolescents who attempted suicide. We study classical factors: depression and hopelessness. But our main objective is at first to study the relationship between attempted suicide, depression, hopelessness and alexithymia. The second objective of our study deals with the the prominent part of early schematas in this complex inter-relation. Maladaptative early schematas are no doubt involved in dysfunctional schematas found in depression and hopelessness. As a consequence, we would like to verify the following hypothesis: maladaptative early schematas are very numerous and specific among adolescents who attempted suicide. These schematas are the core of the complex inter-relation between attempted suicide, depression, hopelessness, suicide risk, suicide relapse and alexithymia. We have compared a group of normal subjects (who did not try to take their owns lives) and a group of people who did. First, we have found that the latter are more prone to alexithymia: a large majority of these subjects exceeds by far the accepted norm of the Toronto Alexithymia Scale. We have proved that the subjects who have attempted suicide also accumulate maladaptative early schematas. The qualitative analyse of these schematas leads to a possible explanation of the tendency to self destruction. Moreover there are apparently important differences between subjects who, in the past-experienced or did not experience a major depressive episode. The analysis of the relationships between the various factors of our study brings us to the conclusion that there is an unmistakable causal link between maladaptative early schematas and the interactive set (depression-hopelessness-major depressive episode-alexithymia) all these being part of attempted suicide and forming an integrant part of a whole which is the vulnerability to the suicide. Studying the various steps of early schematas seems to be quite promising as far as depression and suicide are concerned.

Adjustment Disorders↗
PubMedDate not supplied

[Bipolar obsessive-compulsive disorder: confirmation of results of the "ABC-OCD" survey in 2 populations of patient members versus non-members of an association].

Clinical data are largely focused on depressive comorbidity in OCD. However in practice, treating resistant or severe OCD sufferers revealed many cases who seem to have an authentic OCD with a hidden comorbid bipolar disorder. Most reports had evaluated the OCD comorbidity in unipolar and bipolar mood disorders (Kruger et al., 1995; Chen et Dilsaver, 1995). The only investigation in clinical population focused on the reverse issue was conducted in Pisa. Perugi et al. (1997) have showed in a consecutive series of 315 OCD outpatients, that 15.7% presented a bipolar comorbidity, mostly with BP-II disorder. Further analyses suggested that when comorbidity occurs with bipolar and unipolar depression, it has a differential impact on the clinical picture and course of OCD. The rate of bipolar comorbidity in OCD was analyzed in a recent epidemiological survey undertaken by the French Association of patients suffering from OCD (FA-OCD or AFTOC in French). In a sample of 453 OCD patients, 76% had suffered from a major depression, 11% from bipolar disorder (DSM IV mania or hypomania), 30% from hypomania (cases that obtained a score > or = 10 on the self-rated Angst Hypomania Checklist). According to the score > or = 10 on Self-rated Questionnaire for Cyclothymic Temperament, 50% were classified as cyclothymic. The self-assessment of soft-bipolar dimensions, such as hypomania and cyclothymia was previously validated in a multi-site study in major depression (Hantouche et al., 1998). Further analyses showed that comorbidity with soft bipolarity was characterized by significant interactions with high levels of impulsivity, anger attacks and suicidal behavior. In order to confirm these data, another cohort (n = 175 patients treated by psychiatrists for OCD) was formed and named "PSY-OCD". Comparative analyses between the two populations allowed showing very few demographic and clinical differences. The frequency rate of "bipolar OCD" was equivalent in both populations: BP-II disorder (DSM IV criteria) was present in 11% of FA-OCD and 16% of PSY-OCD. Furthermore using the Hypomania Checklist showed that BP-II disorder rate (score > or = 10) was higher: 32% of in both populations. Cyclothymic rate was also globally higher, but significant difference was obtained: 56% of FA-OCD versus 45% of PSY-OCD (p = 0.02). Moreover, mood switching rate under anti-OCD drugs was equivalent in both OCD populations (respectively 38% and 33%, p = ns). In case of BP comorbidity, patients had presented a greater number of concurrent major depressive episodes and suicidal attempts. When concurrent depression was considered, the rate diagnosis of soft bipolarity was 2.5 fold, and the number of suicidal attempts augmented by 7 fold (by comparison versus non-depressed OCD). Despite very early descriptions (since the beginning of the last century) of particular relationships between so-called "psychasthenia, folie de doute, folie raisonnante" and "circular and intermittent madness or cyclothymia", a few attention has been devoted to this complex pattern of comorbidity. The comparative data deriving from the collaborative survey with patients who are members of AFTOC and with a cohort of psychiatric outpatients, confirm the reality of bipolar-OCD comorbidity, which is largely under-recognized in clinical practice. More in depth analyses are now undertaken in order to investigate the characteristics of "bipolar OCD" by comparison to "non bipolar OCD".

Adolescent↗