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Biomedical subjects

J Wauthy

Publications and source records attributed to J Wauthy.

12 recordsLinked to original sources

Psychological distress of surgical patients after orthotopic heart transplantation.

Orthotopic heart transplantation (OHT) is a major surgical intervention inducing distress and anxiety. Psychological problems after OHT have been described in many studies. Little is known, however, about the relationship between the psychological state of the patient and time after surgery. The present study involved 41 consecutive OHT patients that underwent transplantation from January 1991 to December 1992, with a retrospective review of pretransplant psychiatric evaluations to define a Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., revised (DSM III-R) Axis I diagnosis. Patients completed the Beck Depression Inventory (BDI-13), Spielberger's State Trait-Anxiety Inventory (STAI-Y), and the General Health Questionnaire (GHQ-28) between 1 and 41 months after transplantation. For comparison, 29 presumably healthy volunteers were given the same questionnaires. The study confirms the occurrence of abnormal psychological scores in the OHT group as compared to the reference population. Psychological scores, however, do not appear to be related to the time they were recorded after surgery.

Adult↗

Psychological evolution and assessment in patients undergoing orthotopic heart transplantation.

BACKGROUND: Orthotopic heart transplantation (OHT) is a major surgical intervention inducing distress and anxiety. Psychiatric evaluation of organ transplant candidates is now routinely proposed. This study purposed to assess the psychological evolution in patients having received psychological and/or psychiatric assistance before and during 1-6 postoperative months. METHODS: Twenty-two consecutive transplant candidates were psychically evaluated as part of the preoperative protocol. In the waiting period, 1 and 6 months after OHT, they were asked to fill out the following questionnaires: the General Health Questionnaire, the Spielberger's State-Trait Anxiety Inventory, the Beck Depression Inventory, the Perceived Social Support Scale, the Toronto Alexithymia Scale and the Personal Reaction Inventory. RESULTS: A DSM-IV Axis I diagnosis was found in nine patients (41%); four patients (18%) presented with an Axis II diagnosis. One month after OHT, scores of depression, anxiety and general health significantly improved, while scores of social support, alexithymia and social desirability did not differ. In the sixth postoperative month, all psychological scores remained stable. CONCLUSIONS: A high prevalence of preoperative psychopathology was reported in 22 candidates who received OHT. Surgical intervention obviously improved the quality of life after cardiac transplantation. If the impact of psychological and/or psychiatric aid remains difficult to appraise, these results emphasize the positive impact of surgery on psychological status and the appropriateness of the psychosomatician's social support intervention on patients facing the transplant process.

Adaptation, Psychological↗

[SSRI antidepressants and alcoholism].

It seems that SSRI (moreover than being antidepressant) may reduce alcohol consumption by decreasing desire, craving and liking for alcohol. The 5-HT reuptake inhibitors may be helpful for the treatment of alcoholism by reducing relapse frequency and severity. Moreover, if depression or anxiety is present, it should be effective to give them immediately because of the frequent association between these pathologies and alcoholism.

Alcoholism↗

The flesinoxan 5-HT1A receptor challenge in major depression and suicidal behavior.

The prevailing neurochemical theory about biological correlates of suicidal behavior focuses on the serotonergic system. In this study, we assessed the cortisol, ACTH, GH, prolactin and temperature responses to flesinoxan, a5-HT1A agonist, in 30 DSM-III-R major depressed inpatients subgrouped into suicide attempters (n = 15) and nonattempters (n = 15). The patients were assessed after a drug-free period of at least 3 weeks. A subsample of 16 patients completed the Buss-Durkee Hostility Inventory as a measure of impulsive aggressive behavior. Mean delta cortisol responses to flesinoxan were significantly lower in the group of depressed patients with a history of suicide attempts than in the group without history of suicidal behavior: for the delta cortisol values 14.5 +/- 16.3 micrograms/l vs 101 +/- 94 micrograms/l (F = 8.9, df = 5.25, p = 0.006). There was also a very significant difference between suicide attempters and nonattempters for the temperature (delta T degrees) responses to flesinoxan: 0.20 +/- 0.24 degrees C vs. 0.60 +/- 0.24 degrees C (F = 18.1, df = 5.25, p = 0.0003). Hormonal and temperature responses to flesinoxan were not correlated with BDHI irritability or assault subscale scores. The results of the present study support the implication of the serotonergic system, particularly 5-HT1A receptors, in the control of self-directed aggressive behavior. Moreover, in depressed patients, serotonergic abnormalities do not appear to be related to aggressive behavior.

Adult↗

Relationship between alpha 2-adrenergic function and suicidal behavior in depressed patients.

The current main neurochemical theories of the biological correlates of suicidal behavior involve serotonergic and, to a lesser extent, dopaminergic systems. Few data are available about the possible implication of the noradrenergic function. In the present study, we assessed the growth hormone response to clonidine, a selective alpha 2-adrenergic agonist, in 15 DSM-III-R major depressive inpatients with a history of suicide attempts, compared with 15 age- and gender-matched major depressive inpatients without a history of suicidal behavior. Mean (+/- SD) growth hormone peak responses to clonidine were significantly lower in the group of suicide attempters than in the control group: 2.93 +/- 3.01 ng/ml vs. 8.28 +/- 8.15 ng/ml. Therefore, these results suggest that a blunted growth hormone response to clonidine could be a biological correlate of suicidal behavior.

Adult↗

Effects of gender and diagnosis on growth hormone response to clonidine for major depression: a large-scale multicenter study.

OBJECTIVE: The authors' goal was to establish, in a large multicenter sample of patients classified according to gender and menopausal status, if the growth hormone (GH) response to clonidine discriminated patients with episodes of major depression from patients with episodes of minor depression. METHOD: The GH response to intravenous clonidine administration (150 micrograms) was compared in 71 male and 140 female patients with major depressive episodes and 47 male and 53 female patients with minor depressive episodes. These patients were diagnosed according to Research Diagnostic Criteria. RESULTS: Differences in the GH response to clonidine between diagnostic groups occurred only between male patients. These results were found in the group as a whole and in each center. The GH responses to clonidine of premenopausal women differed significantly from those of postmenopausal women in each diagnostic group. CONCLUSIONS: These results confirm that gender and menopausal status are of the utmost importance in the interpretation of the clonidine GH test.

Adult↗

[Role of the dopaminergic system in depression: clinical correlates of the apomorphine test].

Disturbances in dopaminergic neurotransmission seem to play an important role in biochemical mechanisms involved in depressive disorders. The study of the growth hormone (GH) response to apomorphine, a dopaminergic agonist, provides an indirect index of dopaminergic neurotransmission at the postsynaptic level. In the present study, we assessed the role of the dopaminergic system in some psychopathological dimensions in depression: personality dimensions, suicidal behavior, psychomotor disturbances and dichotomy unipolar/bipolar. Our studies included major depressed inpatients matched for gender, age and, in the case of women, menopausal status. Our results show that dopaminergic disturbances are related to social introversion and anxiety according to dopaminergic hypothesis of schizophrenic disorders and dopaminergic hyperactivity hypothesis of anxiety disorders. A blunted GH response to apomorphine could be considered as a biological marker of suicidal behavior. Moreover motor retardation appeared to be in relationship with dopaminergic disturbances. Finally, the dopaminergic system did not appear to play a significant role in the dichotomy unipolar/bipolar. The results show the interest of the apomorphine test in the assessment of the relationship between biochemical disturbances and clinical correlates.

Adult↗

Cytotoxic and mitogenic activities in culture media conditioned by mouse B16 melanoma cells and 3T3 fibroblasts.

Cytotoxic and mitogenic soluble factors are released into media conditioned by pure or mixed populations of mouse 3T3 fibroblasts and B16 melanoma cells cultivated in vitro. These activities are demonstrated by the use of MTT cell survival test and 3HTDR incorporation. Mitogenic (M.W. greater than 10,000) and cytotoxic factors (M.W. less than 1,000) are present and are generally more active on B16 cells than on fibroblasts. Their release into conditioned media is related to the rate of pigmentation in B16 cells and to the mode of cultivation (monolayers or cell aggregates).

Animals↗

[The biological basis of suicidal behavior: neuroendocrine and psychophysiological approach to the role of catecholamines].

The current main neurochemical theories of the biological correlates of suicidal behavior principally involve the serotonergic system. Few data are available about the possible role of the catecholaminergic (noradrenergic and dopaminergic) function. In the present study, in a first part, we assessed the growth hormone (GH) response to clonidine, a selective alpha 2-adrenergic agonist, and to apomorphine, a dopaminergic agonist, in 22 DSM-III-R major depressive male inpatients with a history of suicide attempts compared to 22 age-matched major depressive inpatients without history of suicidal behavior. Hormonal responses to clonidine and apomorphine were also compared with 4.00 PM postdexamethasone cortisol levels. The two groups differed significantly in the GH peak response after apomorphine: 6.27 +/- 3.18 ng/ml in suicide attempters vs 17.40 +/- 14.87 ng/ml in nonattempters (F = 11.78, p = 0.001). There was no statistically significant difference between the two groups for GH peak responses after clonidine. Moreover, mean postdexamethasone cortisol levels did not exhibit any significant difference between suicide attempters and nonattempters. Violent and nonviolent attempters did not differ on any of the biological measures. In a second part, P300 and contingent negative variation (CNV) were recorded in 20 depressive inpatients subgrouped into suicide attempters (n = 10) and nonattempters (n = 10). The results showed a significant reduction of both P300 and CNV amplitudes in patients who attempted suicide compared to patients without history of suicide attempts. Moreover, a significant correlation was found between the Suicidal Risk scale and CNV amplitude. In conclusion, these results suggest that a dopaminergic hypoactivity as assessed by a blunted GH response to apomorphine and by a reduction of both P300 and CNV amplitudes, could be considered as a biological correlate of suicidal behavior. In contrast, noradrenergic disturbances, particularly at the level of alpha 2-adrenergic receptors, seem to play a more minor role. Moreover, DST nonsuppression cannot be considered as a biological marker of suicidal behavior.

Adolescent↗

Development of anxiety symptoms during a deep diving experiment.

Six commercial divers were investigated for anxiety responses during a 29-day, open-sea world record dive at 500 meters of depth. Three of six (50%) divers developed anxiety. The authors emphasize the importance of research on personality traits as possible predictors for the development of anxiety during deep dives of exceptional depth and duration of confinement.

Adult↗