[Therapeutic aspects of dysthymic disorders?].
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Chronic Disease↗
Biomedical subjects
T Brochier
Publications and source records attributed to T Brochier.
[Current concept of mood disorders. Impact on the therapeutic management].
The unipolar-bipolar distinction underlines the recurrence of the disorder (40 to 80% of unipolars and 95% of bipolars) and also the transition from one subtype to the other (10 to 15% of unipolars will become bipolars). Some semiological forms of depressive illness may give clues concerning the required management modalities. Depressions with psychotic features have a good response to ECT or to TCAs+neuroleptics. As other authors, Quitkin et al. find a good response of atypical depression to MAOIs. The comorbidity of mood disorders with personality disorders may be of poor prognosis. Akiskal suggested the presence of a depressive personality, Hudson and Pope suggest the notion of an affective disorders spectrum in which bulimia and OCD have a good response to serotoninergic antidepressants, whereas panic disorders have a good response to clomipramine, imipramine and MAOIs. Patient management should start with taking both the history of the disease and patient's previous treatment with a much precision as possible. Today the focus is on the particular progressive forms of resistant and chronic depressions, among which there are patients who have not received adequate treatment, and of rapid cyclers. The hypothesis of hypothyroïdism in rapid cyclers has been suggested recently. Carbamazepine and Valproate seem to be efficacious in several recent open studies and in controlled for carbamazepine. The initiation of chemotherapy to prevent the recurrences of depression takes into account the unipolar or bipolar aspect of the mood disorder. Lithium has emerged as the prophylactic agent of choice in bipolar disorders, especially if the index episode is manic. Early prophylaxis is justified when the first episode is manic or after two depressive episodes.(ABSTRACT TRUNCATED AT 250 WORDS)
Antidepressive Agents↗
[New anti-psychotic drugs].
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Antipsychotic Agents↗
[Prediction of the efficacy of thymoregulators].
Among clinical factors, the compliance amounts to 47 to 82% of the patients. Recent data contradict the classical poor response of unipolar patients to lithium. Most studies realized on bipolar patients concern bipolars type I. Bipolar patients type II often show comorbidity factors which predict poor response to lithium or carbamazepine. The clarity of mood disorders and the frequency of cyclers have a bearing on the treatment response. But hypothyroidisms described in rapid cyclers do not predict response to L. thyroxine. We should also take into account the sequence of episodes and the type of index episode. The data concerning other possible mood stabilizers are scarce. Among biological parameters, the results are very upsetting. The calcium levels, serotonin levels, the red blood cell/plasma lithium ratio essentially predict tolerance or compliance. The various psychological tests do not enable us to identify a sub-group of patients responding to lithium. The remaining difficulties in the predictive capacity enhance the importance of establishing for each patient the precise history of the illness and previous treatments.
Antidepressive Agents↗
[Relations between intelligence and perversion. Small essay on ethics].
Excepted vegetarians, everybody let kill and may kill for self-defence. The killed-one suffers and dies. Perversity is to kill or to let suffer without personnal life's saving's necessity--for the treasure of the "perverse subject". We think that such subjects must not be considered as non responsible, excepted when they present a mental retardation. The sexual perversions are probably not the most dangerous: the most are subjects using a personnal high level of intelligence to domination and destruction, including in the sexual behaviours.
Adult↗
[Lithium as founding the concept of endogenous mental disease].
The abnormal life--potentially the death--of the cell can be restored by a metalloid--lithium--which is nearly as common as sodium in the mineral world. This established fact grounds indirectly, contrary to apparent and scientific logic, the concept of endogenous brain disease which was until then an abstract concept because of a lack of objective evidence. Seven case reports are described.
Adult↗
[Psychological and psychiatric problems in kidney transplantation].
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Humans↗
[The lithium test, test of endogenous criteria].
The lithium-test (Li-T) requests hospitalisation of the patient, administration of Li to obtain a plasma/level of at the lust 0, 8 mEq/l, since the third to the eight day. It improve depressions, acute delusions, pseudo-dementias: the field of the lithiodépendent endogenic diseases as to be enlarged. The Li-T may distinguish between this lithiodependence of the other, non-lithiodépendent, in dysthymic psychotic disorders.
Adult↗
[Non-verbal clinical psychiatric aspects].
Mimic, involuntary movements, agitation or immobility, are parts of description, comprehension and evaluation of any human behaviour, normal or not: they were included in the classic european psychiatries. They almost disappear from the actual scales of evaluation, or from the training through scales. It seems possible to complete such scales, exclusively verbal, by scales of behaviours-suicidal attempt being a good instance of such behaviours.
Facial Expression↗
[Stress and depression].
Can modern life foster more depression life? Neuroendocrine, epidemiological and even immunological approaches allow us to suppose a passage between stress and depression, far beyond the archetype of exhaustion depression (break down syndrome).
Antibody Formation↗
[Obsessive-compulsive disorder and the study of thyroid function].
We evaluated thyroid function (T3, T4, TSH) and TRH Test in 17 patients with obsessive-compulsive disorder (DSM III criteria and at least 1 year duration) not associated to major depression (absence of DSM III criteria and depression Hamilton scale score, 17 items, below 16). Blood tests were performed following a drug-free period of at least 2 weeks. We accidentally discovered one case of hyperthyroidism with the diagnosis of Graves' disease. In the remaining group (n = 16), basal values of thyroid hormones and TSH were normal. 12.5% (2 cases) showed a blunted delta TSH (less than 5 mUl/l) and 0% a high delta TSH (greater than 20 mUl/l). A significant degree of negative correlation was only noted between delta TSH and age (r = -0.65). Lastly, we report a curious comorbidity between OCD and Graves' disease found in 3 cases within a population of 50 OC patients (or 6%) recruited in our psychiatric unit. The characteristics of these observations will be presented.
Adult↗
[Biomedical researches: for whom? for what? how?].
The law of December 20th 1988 provides for the protection of those people who lend themselves to clinical research, both patients and healthy subjects. The ex-expert clinicians are confronted with new drugs and protocols of experimentation enacted by industry. Grey areas still exist, authors try to limit them for want of being able to through light on them, today.
Clinical Trials as Topic↗