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Biomedical subjects

O Canceil

Publications and source records attributed to O Canceil.

8 recordsLinked to original sources
PubMedDate not supplied

[First clinical episode of bipolar disorders: a study within a population of bipolar I and bipolar II French patients].

Clinical symptoms of bipolar disorders onset act as a prognostic risk-factor. Discrepancies of data are related with geographical or cultural conditions. Within a patient population of bipolar (ICD 10) in and out patients of a psychiatric department, manic or hypomanic disorders initiate the space disease in 33% of the cases theses features are similar within the western psychiatric population. In a maghrebian population this proportion reaches 50%. A percentage of 65% of bipolar 1 patients was found within our sample. Sex ratio is 1 for bipolar 1, when, for bipolar 2 disorders sex-ratio was superior to 1, in favor of females. Mean age of the first episode of the disease was younger for patients with a familial history of the disease.

Adolescent↗
PubMedDate not supplied

[Antipsychotic drugs and cardiovascular safety: current studies of prolonged QT interval and risk of ventricular arrhythmia].

Cardiovascular mortality is higher among schizophrenic patients than in the general population, and it is possible that most unexplained sudden deaths among these patients are due to ventricular arrhythmias for which antipsychotic drugs are either the cause or a predisposing factor. Most antipsychotic agents show electrophysiological effects resembling those of class 1a antiarrhythmic agents, and may be responsible for prolonging the QT interval, potentially going on to cause torsades de pointes. Some of the antipsychotic agents carry a high risk of arrhythmias, related to their effects on the QT interval. These include thioridazine, pimozide, sultopride, droperidol, and to a lesser extent haloperidol and chlorpromazine. In the case of the new atypical antipsychotic agents, it is possible to rank the risks of different drugs, with sertindole (now withdrawn from sale) having the highest risk, and ziprasidone somewhat lower, followed by risperidone and finally by quetiapine, clozapine and olanzapine which have negligible effects on the QT interval. A number of risk factors have been demonstrated, particularly: hypokalaemia and hypomagnesaemia, bradycardia, congenital long QT syndrome, and any underlying cardiac pathology. Lastly, the risk associated with any given antipsychotic agent is increased if it is combined either with any other drug known to prolong the QT interval and provoke torsades de pointes, or with any drug capable of inhibiting the hepatic metabolism of the antipsychotic agent. A list of such drugs is provided, together with advice on the action to be taken when prescribing an antipsychotic agent to a patient with a long QT interval.

Antipsychotic Agents↗
PubMedDate not supplied

[Prodromal symptoms of schizophrenia].

The concept of prodromal symptoms of schizophrenia has frequently been subject to debate. Authors widely admit the existence of early specific and non-specific signs preceding the first psychotic episode; however, they have yet to clearly demonstrate their ability to predict and specify the outbreak of a psychosis. These prodromal symptoms consist of behavioral abnormalities, pseudo-neurotic signs, subtle cognitive and affective changes. All these symptoms vary from patient to patient. In general, it is widely believed that future patients go through a variety of abnormal, subjective experiences that progressively develop during their pre-puberty and puberty periods. However, the limit of this assessment is that an individual could present the same prodromal symptoms without necessarily developing a psychotic illness, as a result of toxic intake, a situational crisis, etc. Furthermore, while the prodrome is a retrospective concept, its value and specificity can only be prospective, given that patients' descriptions of pre-morbid changes may be corrupted by inefficient memory reconstruction. DSM III-R included prodromal symptoms; individual presenting such symptoms would potentially present psychopathological vulnerability to psychosis regardless of associated genetic risk. Several investigations have shed doubts on their measurement's reliability; therefore, this classification is no longer present in the latest version (DSM IV). Moreover, recent neurodevelopemental hypothesis on schizophrenia have paved the way for possible early intervention, especially because early treatments could well improve illness prognosis. This viewpoint is reinforced by the improved tolerance of new anti-psychotic treatment. In this report, we review the key Articles published over the last 15 Years on this matter. We distinguish two schools of thought: on one hand, the German school referring to the validity of particular neuro-psychological symptoms: attention, perception, proprioperception which can be assessed with many evaluation tools: PAS, TDI, BSABS, SPI-A. The German school points to the fact that patients experimenting such changes could potentially be aware of their state. On the other hand, the Anglo-Saxon school refers to the detection of an "at risk" population. The Anglo-Saxons no longer refer to "prodromal symptoms" but rather to a "prodromal period" that extends to about one Year. This period would begin with the patient's first behavioral changes and extend until the first psychotic episode. Both schools agree that, at this stage, neither the recognition nor the description of the period preceding psychosis allows to effectively predict it. As a result, some Authors continue to refer to psychological changes forming a risk factor for the development of subsequent psychosis, rather than clear predictors of inevitable illness. As for relapses, prodromal signs and symptoms found in schizophrenic patients are both specific and non-specific. In most cases, patients experiment perceptions and behavioral changes before psychosis exacerbation. It is not uncommon for a substantial increase in prodromal symptoms to be followed by degradation in psychotic symptoms. On the other hand, many such increases in psychotic symptoms were not preceded by increases in possible prodromal symptoms; hence their importance in identifying the timing of an intervention, but many relapses will occur regardless of the detection of said symptoms.

Diagnosis, Differential↗