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S Dollfus

Publications and source records attributed to S Dollfus.

At least 55 records · Page 3Linked to original sources
PubMed1992

[A critical study of conditions for prescription and evaluation criteria of neuroleptic treatment in resistant schizophrenia].

From the study of Kane et al. (1988), devoted to clozapine, a critical analysis of criteria of assessments about studies in treatment of resistant schizophrenic patients was drawn up. Therefore, among the inclusion criteria, the authors strengthen the necessity of a very long past neuroleptic treatment (beyond six months) before diagnosing a resistance, the "drug-free improvers" characterized by improvement when patients had been treated by a placebo, the necessity of a very long placebo wash-out (beyond six weeks), and the improvement by a second treatment after a first ineffective treatment. Moreover, the doses of neuroleptics opposed to clozapine are often too high leading to adverse effects and so decreasing the positive benefits. For instance, the dose of chlorpromazine is often increased to 1,800 mg/day whereas the doses required should be only 600 mg/day in equivalence to 500 mg/day of clozapine. Lastly, the scales more specific of the symptomatology of schizophrenia such as SANS-SAPS or PANSS should be used in the clinical trials whereas until now, all the studies were made by standard and global evaluations with BPRS, CPRS and AMDP.

Antipsychotic Agents↗
PubMed1991

[Biological treatments of schizophrenia].

Biological treatments of schizophrenia primarily consist of neuroleptics. These drugs can be prescribed in a relatively standardized manner (chlorpromazine equivalent), but neuroleptics will be less than effective on the type of schizophrenia with negative symptoms. Treatment can also be performed by utilizing the bipolarity of some drugs, and it is only with these drugs that resistant schizophrenia can be mobilized. Consideration is also given to other biological treatments and new prospects in chemotherapy.

Antipsychotic Agents↗
PubMed1986

[Biochemical factors of resistance to antidepressants].

This review of the literature concerning the biochemical factors of resistance to antidepressants is essentially based on the anomalies of neurotransmitters and the enzymes which regulate them. In the case of 5HIAA, because of the bimodal distribution in depressed patients, it appears to be generally accepted that when a low level of this catabolite is found in the cerebrospinal fluid, this may represent a factor of resistance to noradrenergic antidepressants, or even to all antidepressants. In contrast, a high level of this catabolite represents a factor of poor response to serotoninergic antidepressants. Low levels of urinary MHPG predict a poor response to serotoninergic antidepressants, while high levels are observed in cases of depression resistant to noradrenergic antidepressants. MAO activity, evaluated after two weeks' treatment with MAOI, is considered to be a biochemical factor of resistance when it is inhibited by less than 80%. High levels of COMT (related to the degree of anxiety and agitation) reflect a poor response to noradrenergic antidepressants. Finally, a number of strategies designed to control resistant depression (reserpine, lithium carbonate, ...) could, in certain cases, suggest the existence of a functional defect in the serotoninergic systems.

Antidepressive Agents↗
PubMedDate not supplied

[Schizophrenia and semantic priming effects].

INTRODUCTION: This article is a review of studies using the semantic priming paradigm to assess the functioning of semantic memory in schizophrenic patients. CONTEXT: Semantic priming describes the phenomenon of increasing the speed with which a string of letters (the target) is recognized as a word (lexical decision task) by presenting to the subject a semantically related word (the prime) prior to the appearance of the target word. This semantic priming is linked to both automatic and controlled processes depending on experimental conditions (stimulus onset asynchrony (SOA), percentage of related words and explicit memory instructions). Automatic process observed with short SOA, low related word percentage and instructions asking only to process the target, could be linked to the "automatic spreading activation" through the semantic network. Controlled processes involve "semantic matching" (the number of related and unrelated pairs influences the subjects decision) and "expectancy" (the prime leads the subject to generate an expectancy set of potential target to the prime). These processes can be observed whatever the SOA for the former and with long SOA for the later, but both with only high related word percentage and explicit memory instructions. LITERATURE FINDINGS: Studies evaluating semantic priming effects in schizophrenia show conflicting results: schizophrenic patients can present hyperpriming (semantic priming effect is larger in patients than in controls), hypopriming (semantic priming effect is lower in patients than in controls) or equal semantic priming effects compared to control subjects. DISCUSSION: These results could be associated to a global impairment of controlled processes in schizophrenia, essentially to a dysfunction of semantic matching process. On the other hand, efficiency of semantic automatic spreading activation process is controversial. These discrepancies could be linked to the different experimental conditions used (duration of SOA, proportion of related pairs and instructions), which influence on the degree of involvement of controlled processes and therefore prevent to really assess its functioning. In addition, manipulations of the relation between prime and target (semantic distance, type of semantic relation and strength of semantic relation) seem to influence reaction times. However, the relation between prime and target (mediated priming) frequently used could not be the most relevant relation to understand the way of spreading of activation in semantic network in patients with schizophrenia. Finally, patients with formal thought disorders present particularly high priming effects relative to controls. CONCLUSION: These abnormal semantic priming effects could reflect a dysfunction of automatic spreading activation process and consequently an exaggerated diffusion of activation in the semantic network. In the future, the inclusion of different groups schizophrenic subjects could allow us to determine whether semantic memory disorders are pathognomonic or specific of a particular group of patients with schizophrenia.

Cerebral Cortex↗
PubMedDate not supplied

[Comparative evaluation of quality of life in patients with schizophrenia treated with conventional versus atypical neuroleptics: results of a transversal study].

AIM: The World Health Organization has defined quality of life as "the perception of an individual, his/her place in life, in the context of the culture and the system of values in which he/she lives and in relation to his/her objectives, expectations, standards and concerns". The quality of life of the schizophrenic patients has been largely studied for the evaluation of their medical, social and therapeutic needs. The impact of neuroleptics, in particular atypical neuroleptics, on the subjective quality of life of these patients remains to be specified. The aim of this study was to compare the subjective quality of life of schizophrenic patients treated with classical neuroleptics (CN) or atypical neuroleptics (AN). METHODS: One hundred patients meeting DSM IV criteria for the diagnosis of schizophrenia (American Psychiatric Association, 1994) were included in the study. Sixty-four schizophrenic patients were treated with CN and thirty-six with AN. The symptomatology of the patients was assessed using the Positive And Negative Syndrome Scale, (PANSS, Kay et al., 1987) and the Schedule for the Deficit Syndrome (SDS, Kirkpatrick et al., 1989). The extra-pyramidal symptoms were assessed using the Extrapyramidal Symptom Rating Scale (Chouinard et al., 1980). The Subjective quality of life was studied using the Lehman Quality of Life Interview (QOLI, Lehman, 1988) translated and validated in France. RESULTS: The patients treated by CN did not differ from the patients treated by AN in terms of severity of the positive and negative symptoms. The patients treated with AN presented significantly less extrapyramidal side effects than the patients treated with CN. No significant difference in terms of quality of life was found between both groups of patients. CONCLUSION: The kind of neuroleptic (CN vs AC) does not seem to influence the quality of subjective life of schizophrenic patients.

Adult↗
PubMedDate not supplied

Objective and subjective extrapyramidal side effects in schizophrenia: their relationships with negative and depressive symptoms.

The aim of this study was to show that objective extrapyramidal symptoms (O-EPS) were strongly correlated to negative and depressive symptoms while subjective extrapyramidal symptoms (S-EPS) were not. Ninety-one schizophrenic patients were evaluated by the Extrapyramidal Symptoms Rating Scale (ESRS), Montgomery and Asberg Depression Rating Scale (MADRS) and Scale for the Assessment of Negative Symptoms (SANS). While significant correlations were found between O-EPS and SANS (r = 0.51; p < 0.001) and between O-EPS and MADRS (r = 0.26; p < 0.01), no significant relationship existed between S-EPS and SANS (r = 0.19) or MADRS (r = 0.19). Similar results regarding the relationships between EPS and SANS were found in stabilized and acute subgroups and in deficit and nondeficit subgroups. A stepwise multiple regression showed that 41% of the variance of the SANS scores was due to facial mask and bradykinesia, and that 17% of the variance of the MADRS scores was due to facial mask and akathisia. This study shows the interest of evaluating subjective parkinsonism symptoms over objective ones since they are less interrelated to other symptoms, in particular to negatives ones.

Adult↗
PubMedDate not supplied

[Magnetic resonance spectroscopy in schizophrenia].

Numerous studies have shown alterations of some structures and/or cerebral functions in patients with schizophrenia. However, the nature of the neurobiological process which could be at the origin of schizophrenic symptoms is still unknown. Magnetic resonance spectroscopy (MRS) is a unique technique which allows us to estimate the concentrations of endogenous substances which contain natural paramagnetic nuclei such as phosphorus (31P) and hydrogen (proton or 1H). The non invasive character of this technique, the absence of side effects, and the possibility of repetitive evaluations allowing for longitudinal studies, make possible MRS studies on the in vivo cerebral metabolism in schizophrenia. The prefrontal cortex, the hippocampus and the basal ganglia have all been implicated in the pathophysiology of schizophrenia. Therefore these brain regions have been frequently studied using MRS. Both proton and phosphorus spectroscopy have been used to study schizophrenia. Compounds that are detectable by 1H-MRS include N-acetyl aspartate (NAA), choline (Cho), creatine (Cr) and myo-inositol (ml). A deficit in NAA has been consistently shown in both the frontal and temporal lobes suggesting neuronal loss in these areas. Compounds detectable by 31P-MRS include phosphomonoesters (PMEs) and phosphodiesters (PDEs), which largely represent metabolites generated by lipid turnover. 31P-MRS can also detect certain energy-containing phosphorus metabolites such as phosphocreatine (PCr) and nucleotide triphosphates. Decreased levels of PMEs and increased levels of PDEs have been consistently described in the prefrontal lobes suggesting an alteration of phospholipid metabolism. The purpose of this review is to summarize the research on schizophrenia using MRS, to show the utility of this technique in understanding schizophrenia.

Brain↗
PubMedDate not supplied

[Neuropsychiatric symptoms in preventive antimalarial treatment with mefloquine: apropos of 2 cases].

Two observations of severe neuropsychiatric reactions occurring during chemoprophylaxis with mefloquine are reported. The first case regards a 43 years old woman who developed a severe depression with visual and auditive hallucinations and a paranoid delusion. She was treated by clomipramine and risperidone. The second case concerns a 55 years old man who developed an acute psychosis with confusion. He was treated with halopridol during a short time. He presented twice an acute psychosis during a chemoprophylaxis with mefloquine. Several cases of neuropsychiatric side effects with mefloquine chemoprophylaxis or treatment have been described. Authors estimate that one of 250 therapeutic users has severe neuropsychiatric reactions, compared with one of 10,000 to 15,000 in the prophylaxis users. Disorders could last from 15 minutes to several weeks. Women and patients with personal or familial antecedents of psychiatric disorders are more frequently concerned. Alcohol and the association with other antimalarial drugs (like quinine) are two other risk factors. Therefore, some advices may be suggested regarding the use of mefloquine for malaria prophylaxis and treatment.

Adult↗
PubMedDate not supplied

[Eye tracking disorders in schizophrenic patients and their parents].

UNLABELLED: Several studies have confirmed the existence of genetic factors in schizophrenia. However, the genotype predisposing for the disease is not known yet. Nevertheless, those genetic factors in the families of schizophrenic patients urge us to search for genetic vulnerability markers of schizophrenia. Ocular pursuit disorders, in particular, could be one of those vulnerability markers. Eye movements have been often tested in schizophrenia. Most of the schizophrenic patients have eye-tracking disorders and their biological relatives demonstrate an increased prevalence of eye-tracking impairments. The aim of the study was to research if smooth pursuit eye movements could be a vulnerability marker of schizophrenia. In order to have an indication about this hypothesis, impairments of smooth pursuit eye movements were researched in both schizophrenics and their parents. METHODS: Fifteen DSM IV schizophrenic patients stabilized at the time of the inclusion and not treated with lithium, benzodiazepines, barbiturates, or chloral hydrate; 19 parents without history of schizophrenic spectrum disorders (SADSLA and IPDE), and 2 groups of healthy subjects matched in age and sex with probands and with the parents, were included in the study. Parents only were included (fathers or mothers) in order to have an homogeneous population for the genetic risk and age. The eye-tracking paradigm used was a smooth pursuit task. The stimulus was a sinusoidal wave form moving on a horizontal line, with a frequency of 0.4 Hz and an amplitude of 30 degrees. Different parameters were measured: gain (ratio between the eye velocity and the target velocity) and saccades frequencies (catch-up saccades, back-up saccades, anticipatory saccades and square-wave-jerks). For each parameter, analysis of covariance (ANCOVA) with age as covariable was carried out. For the results reaching the significance of 0.05, the Bonferroni correction was applied (level of significance 0.016). The effect size of the parameter was calculated ((the mean of the subjects minus the mean of the matched controls) divided by standard deviation of the two groups). According to Cohen, 0.20 indicates a small effect size, 0.50 indicates a medium effect size and 0.80 indicates a large effect size. RESULTS: Comparison between patients and matched controls: the means of global gain, of gain for the movements to the left and of gain for the movements to the right did not differ significantly between patients and their matched controls. The size effects are 0.31 for the global gain, 0.20 for the movements to the left and 0.41 for the movements to the right. The frequencies of total saccades, catch-up saccades, back-up saccades, anticipatory saccades and square-wave-jerks did not differ significantly between patients and their controls. The size effects for those parameters were 0.09, 0.03, 0.00, 0.39 and 0.63 respectively. Comparison between parents and matched controls: the means of global gain, of gain for the movements to the left and of gain for the movements to the right did not differ significantly between the two groups. The size effects for those parameters were 0.00, 0.05 and 0.17 respectively. The frequency of total saccades did not differ significantly between the groups whereas the size effect was 0.63. The frequency of catch-up saccades was significantly more important in parents than in controls (p = 0.006) and the size effect was 0.80. The other saccadic parameters did not differ significantly between groups, their size effects were 0.24 for the back-up saccades, 0.21 for the anticipatory saccades and 0.00 for the square-wave-jerks. Whereas the gain of the patients had a tendency to be lower than the gain of their controls, no significant difference was observed between patients and their controls. Only a size effect of 0.63 for the frequency of square-wave-jerks was obtained. This large effect size suggests that the difference between patients and controls might be significant in a larger sample. The catch-up saccades frequency between parents and controls was significant. The differences between our study and the previous studies could be due to several factors. The paradigms used were different between the studies and our sample was small (only 15 patients and 19 relatives). Moreover, some patients in the previous studies were treated by lithium, drug well known to modify ocular pursuit and, finally the relatives in the other studies were 10 years older than ours and age is known to alter ocular pursuit. Since an impairment of the smooth pursuit was observed in the relatives of schizophrenic patients but not in the probands, this study does not support the hypothesis that eye-tracking disorders could be considered as a marker of vulnerability of schizophrenia.

Adult↗
PubMedDate not supplied

[Research in schizophrenia: necessity to include patients of multiple diagnostic systems].

The discrepancies of studies on symptomatology and treatment of schizophrenia could be related to the selection of different patients diagnosed by one diagnostic system, different from a study to another. Therefore, we tested whether 14 diagnostic systems could include 51 patients differently as regard to the intensity of positive, negative or depressive symptomatology and to the phase of illness. The distribution of the patients in different sets of diagnosis has been carried out by a computer program and the symptomatology has been evaluated with PANSS and MADRS. Some diagnostic criteria like DSMIII-R, Langfeldt, Taylor, ICD 9 include negative and depressive patients preferentially. Others systems like Berner, Catego, ICD 9, New-Haven, Schneider, include more patients with acute than residual symptoms. These results show the importance of the choice of one or more diagnostic criteria depending on the aim of the study.

Adult↗
PubMedDate not supplied

[Platelet serotonin in infantile autism. Cross-over effects of a dopamine agonist and an antagonist].

In infantile autism, the serotoninergic (5-HT) hypothesis is corroborated by biological dosages and therapeutic effects of fenfluramine which decrease blood serotonin. However other drugs, such as dopaminergic agonists or antagonists, have therapeutic effects. Therefore, we tested the hypothesis that two dopaminergic (DA) drugs have a similar 5-HT effect underlying the therapeutic efficiency. We evaluated in a randomized, double-blind and cross-over study, the effects of a DA agonist (bromocriptine) and a DA antagonist (amisulpride) on platelet 5-HT in infantile autism. The prolactinemia, reflecting the DA action, has been also measured. Nine children, aged from 4 to 13 years, according to the DSM III for infantile autism, received either drug in a random order during four weeks with an in-between placebo period of six weeks. The dosages of platelet 5-HT and serum prolactin were carried out at the beginning and at the end of every phase of treatment (active or placebo) with radioenzymology and radioimmunoassay methods respectively. The principal results on serum prolactin show neither order x treatment interaction, nor order effect but a significant treatment effect (p < 0.01): amisulpride increases serum prolactin whereas bromocriptine decreases according to the usual data. About platelet 5-HT, there is neither order x treatment interaction, nor treatment effect but a significant order effect (p < 0.01). Both drugs increase platelet 5-HT in the first phase of treatment. This order effect could be explained by a remanent effect of amisulpride after 6 wash-out weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Psychiatric manifestations of vitamin B12 deficiency: a case report].

Psychiatric manifestations are frequently associated with pernicious anemia including depression, mania, psychosis, dementia. We report a case of a patient with vitamin B12 deficiency, who has presented severe depression with delusion and Capgras' syndrome, delusion with lability of mood and hypomania successively, during a period of two Months. Case report - Mme V., a 64-Year-old woman, was admitted to the hospital because of confusion. She had no history of psychiatric problems. She had history of diabetes, hypertension and femoral prosthesis. The red blood count revealed a normocytosis with anemia (hemoglobin=11,4 g/dl). At admission she was uncooperative, disoriented in time and presented memory and attention impairment and sleep disorders. She seemed sad and older than her real age. Facial expression and spontaneous movements were reduced, her speech and movements were very slow. She had depressed mood, guilt complex, incurability and devaluation impressions. She had a Capgras' syndrome and delusion of persecution. Her neurologic examination, cerebral scanner and EEG were postponed because of uncooperation. Further investigations confirmed anemia (hemoglobin=11,4 g/dl) and revealed vitamin B12 deficiency (52 pmol/l) and normal folate level. Antibodies to parietal cells were positive in the serum and antibodies to intrinsic factor were negative. An iron deficiency was associated (serum iron=7 micromol/l; serum ferritin concentration=24 mg/l; serum transferrin concentration=3,16 g/l). This association explained normocytocis anemia. Thyroid function, hepatic and renal tests, glycemia, TP, TCA, VS, VDRL-TPHA were normal. Vitamin B12 replacement therapy was started with hydroxycobalamin 1 000 ng/day im for 10 days and iron replacement therapy. Her mental state improved dramatically within a few days. After one week of treatment the only remaining symptoms were lability of mood, delusion of persecution, Capgras' syndrome but disappeared totally 9 days after the beginning of the treatment. A neurologic examination was possible because of cooperation. All the tendon reflexes of inferior members were absent. The plantars were in flexion and there was a left inferior member hypoesthesia. The cerebral scan and EEG were normal. Fundic biopsy, realized by fibroscopy, revealed fundic atrophia and intestinal metaplasia compatible with Biermers' disease. The iron deficiency exploration concluded diet deficiency. Mme V. appeared euphoric, her speech was very rapid with play on words and overactivity. This hypomania state totally disappeared 3 days after. Six Months after her hospitalisation, she presented an hypothyroidism (TSH=3,780; T3=1,35; T4=1,08). A thyroid hormones replacement was started and she continued to receive Monthly B12 replacement. Discussion - This case report illustrates psychiatric manifestations of Biermers' disease. The clinical arguments in favour are: white woman, more than 60 Years old, no history of psychiatric problems, atypical symptoms (confusional state with psychiatric symptoms), fluctuation of symptoms (severe depression with confusional state, delusion of persecution and Capgras' syndrome; delusion with lability of mood and hypomania), dramatic improvement after 9 days of vitamin B12 replacement therapy. The biological arguments are: anemia, vitamin B12 deficiency, normal folate level, atrophia and fundic metaplasia, positive antibodies to parietal cells in the serum, association between Biermers' disease and autoimmune disease (Haschimoto thyroidite). Psychiatric manifestations can occur in the presence of low serum B12 levels but in the absence of the other well recognized neurological and haematological abnormalities of pernicious anemia. Mental or psychological changes may precede haematological signs by Months or Years. They can be the initial symptoms or the only ones. Verbank et al. described the case of a patient with vitamin B12 deficiency in whom hypomania, paranoia and depression had been successively presented during a period of 5 Years before anemia have been developed. The case of Mme V. is similar in the succession of severe depression with delusion of persecution and Capgras' syndrome, delusion with lability of mood and hypomania, during a period of two Months. This report seems to be the first one of a sequence of several psychiatric states with pernicious anemia during a period of two Months with normocytosis anemia. To illustrate this illness we reviewed the literature regarding psychopathology associated with B12 deficiency. The most common psychiatric symptoms were depression, mania, psychotic symptoms, cognitive impairment and obsessive compulsive disorder. The neuropsychiatric severity by vitamin B12 deficiency and the therapeutic efficacy depends on the duration of signs and symptoms. Conclusion - We recommend consideration of B12 deficiency and serum B12 determinations in all the patients with organic mental disorders, atypical psychiatric symptoms and fluctuation of symptomatology. B12 levels should be evaluated with treatment resistant depressive disorders, dementia, psychosis or risk factors for malnutrition such as alcoholism or advancing age associated with neurological symptoms, anemia, malabsorption, gastrointestinal surgery, parasite infestation or strict vegetarian diet. In first intention, B12 deficiency should be researched by serum B12 determination (normal 200-950 pg/ml). Studies of methylmalonic acid and homocysteine showed that they are very sensitive functional indicators of cobalamin status especially when other evidence of cobalamin (B12) deficiency was equivocal. Measurement of methylmalonic acid (normal 73-271 nmol/l) and homocysteine (normal 5,4-13,9 micromol/l) should not replace the measurement of serum cobalamin.

Depression↗
PubMedDate not supplied

[Chemotherapies of negative schizophrenia].

Five years ago, Goldberg claimed that negative symptoms of schizophrenia do respond to neuroleptics. This apparent discovery is, in fact, a very common way of thinking for European schools of psychiatry, specially the French one guided by Delay and Deniker. Initially focused on reserpine and some alerting phenothiazines such as thioproperazine, this opinion has been extended to benzamides in the 1970s. The analysis of the publications devoted to this point indicates that several drugs are actually considered as potent disinhibitors (i.e. active on negative symptoms of schizophrenia): Phenothiazines: As shown in the controlled studies by Itil (1971), Poirier-Littré (1988), fluphenazine and pipotiazine improve the BPRS anergia factor and the SANS score. Butyrophenones: The first description of the "imipramine like" effect of trifluperidol by Janssen (1959) initiated the studies by Gallant (1960), Fox (1963). They compared trifluperidol at low doses versus haloperidol and chlorpromazine at medium and high doses, BPRS anergia factor improved only at low doses. Diphenylbutylpiperidines (DPBP): Meltzer's review (1986) concluded to the efficacy of such drugs on negative symptoms appearing as a specific biochemical relationship effect. A definite analysis about doses leads to a very different interpretation: DPBP low doses and only low doses improved negative symptoms as much as some low doses of phenothiazines. On the opposite, DPBP, phenothiazines and butyrophenones high doses are inefficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Antipsychotic Agents↗
PubMedDate not supplied

[Evaluation trial on the efficacy of neuroleptics on the outcome of schizophrenia].

Feasible and ideal methodological conditions lacking, we have tried an evaluation concerning the efficacy of neuroleptics upon the course of schizophrenia by comparing the evolution of homogeneous studies before and since the neuroleptic period. On the short term, neuroleptics are significantly more effective than the placebo upon schizophrenic symptoms and prevent the relapses in an noteworthy manner. On the long term, the evolution is significantly better for follow-up studies treated by neuroleptics (60% of patients improved) than for the non-treated follow-up studies i.e. before neuroleptic period (27.5% of patients improved). The time of the follow-up has an effect on the course of schizophrenia. Before neuroleptic periods, the schizophrenic process beyond 6 to 10 years was either stabilized or worsened. On the contrary, since the neuroleptic period, the number of improvements continued to increase after 12 years time (79.5% of patients improved for the follow-up beyond 12 years time versus 60% under 12 years). These improvements include paranoid and hebephrenic forms. On the contrary, catatonic forms had decreased very much since the utilization of neuroleptics (they moved from 18 to 28% before neuroleptic periods to 2% after the beginning of utilization of neuroleptics). If neuroleptics have undeniable action upon the schizophrenic symptomatology, they also act, on the long term, upon the social course of schizophrenia (30% of social remission before neuroleptic period versus 50% since neuroleptic period).

Antipsychotic Agents↗
PubMedDate not supplied

[Biochemical effects of neuroleptics].

The biochemical effects of neuroleptic drugs are reviewed step by step. The necessity to go beyond such a didactic way is highlighted considering two points; on the one hand neuroleptic drugs do affect more than one neurotransmitter system and on the other hand monoaminergic and peptidergic system exert reciprocal influences. From this point of view the consequences of the biochemical effects of neuroleptic drugs remain a wide open road for clinical pharmacology.

Animals↗
PubMedDate not supplied

[French translation of the Chapman Social and Physical Anhedonia Questionnaire: validation of the French translation in controls and schizophrenic patients].

Whereas Chapman's social and physical scales are the most used instruments for the assessment of anhedonia in schizophrenia, no French translation has been still validated by the authors. Therefore, the aim of this study was first to translate into French the both scales, and after back translation, to obtain the agreement of the original authors. Second, the aim was to establish values and to establish the cut-off beyond of which French subjects could be considered as anhedonic. One hundred and twenty-three subjects were included: 72 control subjects without mental disorders and 51 stable schizophrenic patients defined by the DSM III-R, ICD 9, ICD 10, RDC or Feighner criteria. According to the literature, schizophrenic patients had higher scores for both scales than control subjects (p < 0.001; Student t test). The social anhedonia scores are different due to cultural variations. The distribution of physical anhedonia scores in control subjects or in schizophrenic patients differed from normal distributions (respectively, p < 0.05; p < 0.0001; Shapiro-Wilks test). The distribution of social anhedonia scores differed from normal distributions (p < 0.01) only in schizophrenic patients but not in control subjects. By maximising the Younden indice [Sensitivity + Specificity -1], the cut-off of the physical anhedonia score was 18 (Younden indice = 0.45), and the cut-off of the social anhedonia score was 12 (Younden indice = 0.24). In using this cut-off, the French physical anhedonia scale had a good positive predictive value (evaluated by logistic regression) for schizophrenia. Therefore, a patient with a physical anhedonia score beyond 18 have a probability of 64% to be schizophrenic. In contrast, the social anhedonia scale was less discriminant for schizophrenia. Indeed, patient with a social anhedonia score beyond 12 have a probability of 52% to be schizophrenic. This French version of Chapman's anhedonia scales could be considered as an useful instrument to assess anhedonia, in particular physical anhedonia, in schizophrenic patients.

Adult↗