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P Pichot

Publications and source records attributed to P Pichot.

At least 19 recordsLinked to original sources

[The history of German psychiatry from the viewpoint of French psychiatrists].

The reception of German psychiatry by the French psychiatrists has been influenced by material elements, such as the knowledge of the German language and/or the disposability of translations, but even more by factors of a general nature. The main reason has been the perception by the French psychiatrists of the progressive loss of influence of their own school, initially the leading one in the world, in favour of the German, a change which began with Griesinger and became evident at the time of Kraepelin. Around 1850, as demonstrated by many papers written by leading French psychiatrists, the interest both for the theoretical aspects of German psychiatry and for its care system was great. The judgements were extremely positive, although French authors tended to contrast the philosophical outlook of the Germans with their own concrete clinical approach. The war of 1870-71 produced no radical change. But the growing influence of German psychiatry induced negative reactions whose main target was the work of Kraepelin, and especially his synthesis of Dementia praecox which was in direct opposition with the then dominant concepts of Magnan. The French opinion was divided between defenders and adversaries of Kraepelin's ideas. In the years immediately preceding World War I the attacks increased. The alleged contrast between the descriptive clinical (and according to a German author like Jaspers literary and superficial) French psychiatry and the scientific theoretical (and for the most aggressive French authors valueless) German one was a recurrent theme. The nationalistic tone reached on the French side its apex during the war years, some faint traces remaining several years after 1920. But on the whole the influence of the concepts proposed by German speaking authors, not only Kraepelin, but also Bleuler, Kretschmer, Freud among others was then on the increase. After 1945, contrasting with the years after World War I, no hostility against German psychiatry can be detected, as testified by the choice of the main speakers by the French organizers of the First World Congress of Psychiatry in 1950. The creation in 1984 of the Association of European Psychiatrists, an initiative taken jointly by the French and German psychiatrists, can be considered as the symbolic conclusion of the relations between the two national schools.

Cross-Cultural Comparison

[Current developments in psychiatry: current interest of works by A. Quételet and J. Guislain].

The influence of Adolphe Quételet and Joseph Guislain, born respectively in 1796 and 1797 in Gent, on the most recent developments of Psychiatry has a paradoxical character. Quételet was a mathematician and astronomer, but his interest in statistics led him to organize the standardized collection on data on an international basis and to initiate the measurement of social and pathological behaviours, two trends which dominate present day epidemiological, nosological and clinical research in Psychiatry. Although Guislain is rightly honoured as the organizer of a human system of treatment for the mentally ill in Belgium, his theoretical ideas about the nature of mental disorders, he considered as reactions to a basic disturbance, whose aspects were determined by the physical and psychological peculiarities of the individual, have been practically forgotten. But they provide an alternative to the now prevalent tendency towards a strictly categorical nosology, whose shortcomings are more and more apparent in empirical biological and clinico-epidemiological research.

Belgium

[Noise, sleep and behavior].

The negative effects of noise on sleep and behaviour have been related to three mechanisms: a physiological arousal (above a certain threshold of noise), an aversive reaction and an interference with non auditive neurophysiological and mental processes. The perturbation of verbal communication and the effects of sleep are the directly observable consequences. The negative effects of noise above a certain threshold on sleep have been demonstrated both in experimental conditions and in real life. They concern length, EEG pattern, and subjective quality and produce an increase of irritability and tiredness. There is no habituation. In all populations studied, strong discomfort is expressed by 50% of the subjects living in an area with an Ldn of 75 dB in the case of air traffic noise, the same results being obtained with ground traffic for a 5-15 dB higher level. Objective expressions of discomfort: use of aural protections, closing the windows, staying indoor, changing residence, increase linearly with the intensity of noise. Noise influences the incidence of stress-related disorders: hypertension, related cardio-vascular diseases, psychosomatic and psychological disorders. It has been shown by the use of different techniques (epidemiological studies based on the frequency of medical contacts, on the diagnoses made by general practitioners, on the use of specific drugs, and on the examination of the whole population) that the prevalence increases in relation with the level of noise in the vicinity of airports.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior

[Epidemiology of depression].

According to epidemiological data, 5-6% of the general population are suffering from some kind of depressive disorders. Only a small proportion of them are seen by psychiatrist; others are seen by general practitioners, and many more do not seek medical advice. In a study carried out in France on 400 non-selected patients consulting general practitioners 8% of the patients have a depressive disorder and further 9% anxiety disorders.

Adult

The historical roots of behavior therapy.

This paper reviews lines of thought that are historically relevant to the emergence of behavior therapy. First consideration is given to animal magnetism, and the reaction against it. Then the influence of German psychiatry is surveyed, followed by various views of disorders of the nervous system. These in different ways affected the Freudian mode of thinking and also Pavlovian theory, and more indirectly experimental psychology.

Animals

Efficacy of tianeptine in anxious-depressed patients: results of a controlled multicenter trial versus amitriptyline.

265 adult outpatients with dysthymic disorder (DSM-III) associated with clinically manifest anxiety (according to FDA criteria) were included in a multicenter, randomized double-blind study. The trial consisted of three phases: placebo pretreatment phase and inclusion in the trial, treatment phase, placebo posttreatment phase. Patients were treated in monotherapy for 42 days with a mean dosage of 3 tablets per day corresponding to 37.5 mg/day of tianeptine or 75 mg/day of amitriptyline respectively. The following assessment instruments were used: the Montgomery and Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HARS), and the Check-List for the Evaluation of Somatic Symptoms of J.D. Guelfi and C.B. Pull (CHESS 82). Analysis of MADRS total scores showed an important and rapid improvement in tianeptine and amitriptyline groups, reaching statistical significance as soon as D7. At the end of the 6-week treatment period the tianeptine group reached a decrease of 64% in the initial MADRS total score versus 69% in the amitriptyline group. 78% of patients treated with tianeptine and 83% of patients treated with amitriptyline were considered as treatment responders. There was no difference in drop-out rates between the two groups. HARS scores showed a decrease in psychic as well as somatic anxiety in both groups. The action of tianeptine on anxious-depressive symptomatology was confirmed by the concomitant improvement of global clinical rating and patients' self-rating (HSCL). Statistical comparison of all clinical rating-scale scores in patients having completed the trial failed to show any significant group differences.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Fluvoxamine and imipramine: results of a long-term controlled trial.

Following a multicentre double-blind controlled trial comparing the effects of fluvoxamine and imipramine in depressed inpatients (M.D.E.) 39 patients continued on longer term treatment with maintenance of double-blind conditions (17 on fluvoxamine, 22 on imipramine). The results regarding the reasons for premature interruption of treatment show a slight advantage in favour of fluvoxamine. There were several significant differences in favour of fluvoxamine at the 20th week. The most common side-effects were hot flushes with imipramine and dizziness with fluvoxamine. Overall, despite the small number of patients, the results show a greater clinical tolerance to fluvoxamine than to imipramine.

Antidepressive Agents

The concept of 'bouffée délirante' with special reference to the Scandinavian concept of reactive psychosis.

The nosological concepts of 'bouffée délirante', first described by Magnan in the 1880s, and of 'psychogenic psychosis', first described by Wimmer in 1916, are still in use in their countries of origin, France and the Scandinavian countries. Both refer to psychotic episodes of good prognosis, not connected with schizophrenia, appearing in a special fragile personality. An examination of the diagnostic criteria of the two categories shows, however, that important differences exist. Contrary to what has been claimed, Wimmer's original description, although showing an encyclopedic knowledge of the international literature of the day, has not been directly influenced by Magnan. Bouffée délirante and psychogenic psychosis, whatever their differences, have survived in their respective countries of origin against the pressure of the psychiatric consensus of the rest of the world, as evidenced by the frequency of the present use of the two diagnoses. The two categories, after having been considered for a long time as idiosyncratic peculiarities of individual national schools, are now submitted internationally to empirical studies and have become the center of a renewed interest.

Adjustment Disorders

Classification of depressive states.

Classification of depressive states is at the present time an open issue. Depression is ambiguously defined, either as a syndrome, or as a disease whose manifestation can be the depressive syndrome or other pathological manifestations (depressive equivalents). No agreement exists about the basic problem of the categorial or the dimensional nature of the classification, the later having being recently supported by several authors. The paper discusses the most commonly used classifications: the primary-secondary dichotomy, the ICD 9 and the DSM-III and especially the central problem of the endogenous- non endogenous dichotomy.

Adjustment Disorders

[DSM-III: the 3d edition of the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association].

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) published by the American Psychiatric Association in 1980, and now translated in many languages, has raised a great interest in the whole world. It has probably had on psychiatric thinking as important an impact as the Treatise of Psychiatry of E. Kraepelin at the beginning of the century. The evolution of psychiatric nosology and the circumstances of the birth of DSM-III are described. In discussing the general principles and the technical aspects, the influence of several currents of thought are emphasized: recent remedicalization of psychiatry in the United States, suspicion about speculative theories, return to an a-theoretical clinical descriptive nosology, influence of quantitative differential psychology and of the models provided by computer diagnosis. The nature of the two basic principles: the necessity of attaining a proven high interjudge reliability in diagnosis, and the descriptive a-theoretical nature of the description of each category is analyzed. From those principles derive the most original features of the DSM-III: the use of stringent diagnostic criteria, of a possible quantitative nature and the adoption of a multi-axial system. Some of the most striking changes introduced are the logical consequences of the principles e.g. the deletion of the term "neurosis". Others changes such as the introduction of new diagnostic categories or changes in the limits of classical ones (especially schizophrenia and manic-depressive psychosis) reflect a reaction against previous trends of American psychiatry and a strict adherence to a pragmatic and empirical thinking. In addition, the flexibility of its structure allows for the incorporation of new empirical results. In spite of many criticisms, either against the general orientation or against specific positions, some of which are presented in the course of this article, it is concluded that the success of the DSM-III results from a trend in psychiatric thinking not confined to the United States. Its controversial nature has stimulated the reappraisal of old concepts, and it can be considered as an important contribution towards a closer integration of psychiatry to medicine.

Humans

Berner's axial syndromes and the polydiagnostic approach of the LICET system.

The LICET system is a polydiagnostic instrument permitting recording of diagnostic criteria and assignment by diagnostic algorithms as proposed in a number of different classification systems, including the Viennese Research Criteria. In the present report, French diagnostic practices are compared with the Viennese Research Criteria for endogenomorphic-schizophrenic and endogenomorphic-cyclothymic axial syndromes.

Austria