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Biomedical subjects

Yves Lecrubier

Publications and source records attributed to Yves Lecrubier.

10 recordsLinked to original sources
PubMed2006

Physical components of depression and psychomotor retardation.

The role of somatic symptoms in patients with depression has been historically underestimated and underrecognized. Results of the World Health Organization Collaborative Project on psychological problems in general health care have established somatization as a frequently cited feature of depression in patients seen by primary care physicians, and a number of ensuing studies have supported these data. Approximately 73% of patients with depression are affected by lack of energy and fatigue. In addition, patients with depression experience a greater number of somatic symptoms, including back and chest pain, abdominal pain, headache, fatigue, and weakness, than do patients with general anxiety and patients with no psychiatric diagnosis. Additional studies have reported a correlation between depression and psychomotor retardation, indicating that psychomotor retardation comprises a much broader spectrum of depression than was originally thought. To date, this research has focused primarily on the Parkinsonian-like gait and stride observed in patients with depression compared with the normal gait and stride observed among healthy control subjects. In addition, data have indicated significantly improved psychomotor retardation in patients with depression after 3 months of treatment.

Depressive Disorder↗
PubMed2006

Consensus statement and research needs: the role of dopamine and norepinephrine in depression and antidepressant treatment.

During a special session, the faculty identified several specific areas related to the role of dopamine and norepinephrine in depression and antidepressant treatment that either warrant the clinician's attention or are in need of more research. Areas of interest include fatigue and lethargy in depression, treatment strategies for treatment-resistant depression, the somatic presentation of depression, neurobiology of fatigue and its role in determining treatment, symptom rating scales, and sexual side effects. In addition, the faculty discussed the importance of patient psychoeducation and self-management as well as the ways in which disease models of depression affect treatment.

Antidepressive Agents↗
PubMed2004

Quality of life in patients with bipolar I depression: data from 920 patients.

OBJECTIVE: To determine the impact of acute depression on quality of life (QOL) in patients with bipolar I disorder and to compare these results with published data on QOL in patients with unipolar depression. METHODS: Quality of life was assessed using the SF-36 in bipolar patients (n = 958) who had recently experienced an episode of acute bipolar depression and participated in a large randomized, double-blind, safety and efficacy trial. Seven studies that included SF-36 data from patients with unipolar depression were identified in the published literature and descriptive comparisons of SF-36 scores were made between the unipolar depression trials and this bipolar depression trial. RESULTS: There were 920 patients who completed the SF-36. Mean transformed scores, which could range from 0 to 100, were very low in bipolar depressed patients for the role-physical (36.7), vitality (22.4), social functioning (29.9), role-emotion (11.4), and mental health (31.0) subscales. Mean SF-36 scores for all subscales were significantly and inversely correlated (p < 0.0001) with the HAM-D indicating that patients with milder depressive symptoms had better QOL. Further, the mean SF-36 scores for the bipolar sample were consistently lower compared with published data on QOL in unipolar depression on four of the eight subscales: general health; social functioning; role-physical, and role-emotional. CONCLUSIONS: While both unipolar and bipolar depression have serious detrimental effects on patient QOL, our results suggest that some aspects of QOL may be worse in bipolar depression.

Acute Disease↗
PubMed2004

Posttraumatic stress disorder in primary care: a hidden diagnosis.

Posttraumatic stress disorder (PTSD) is common worldwide, with prevalence rates ranging from 1% to nearly 40%, depending on the population studied. The disability and natural course of PTSD in psychiatric patients have been well characterized. However, even though the primary care setting has been described as the "de facto mental health care system," surprisingly little is known about PTSD in primary care. Available data from primary care clinics in the United States and Israel suggest that PTSD may be as prevalent in this setting as has been reported in large epidemiologic studies. Patients may be unlikely to endorse traumatic experiences or may not consider them related to their current psychological problems. The prevalence of PTSD in primary care may indeed be higher than expected because of underreporting of domestic violence and other histories of trauma. Recognition of PTSD in primary care could be greatly improved if simple trauma histories were integrated into routine medical examinations. Primary care clinicians who maintain a high index of suspicion for PTSD in their patients with positive histories of trauma plus symptoms of depression or anxiety or other signs of psychological distress, suicidal thoughts or actions, alcohol or substance abuse, or excessive health care service utilization may increase the recognition rate of this disorder in their practices.

Anxiety↗
PubMed2004

Consensus statement update on posttraumatic stress disorder from the international consensus group on depression and anxiety.

OBJECTIVE: To provide an update to the "Consensus Statement on Posttraumatic Stress Disorder From the International Consensus Group on Depression and Anxiety" that was published in a supplement to The Journal of Clinical Psychiatry (2000) by presenting important developments in the field, the latest recommendations for patient care, and suggestions for future research. PARTICIPANTS: The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Other faculty who were invited by the chair were Randall D. Marshall, Charles B. Nemeroff, Arieh Y. Shalev, and Rachel Yehuda. EVIDENCE: The consensus statement is based on the 7 review articles in this supplement and the related scientific literature. CONSENSUS PROCESS: Group meetings were held over a 2-day period. On day 1, the group discussed topics to be represented by the 7 review articles in this supplement, and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all faculty. CONCLUSION: There have been advancements in the science and treatment of posttraumatic stress disorder. Attention to this disorder has increased with recent world events; however, continued efforts are needed to improve diagnosis, treatment, and prevention of posttraumatic stress disorder.

Adult↗
PubMed2003

Prevalence and comorbidity of affective disorders in persons making suicide attempts in Hungary: importance of the first depressive episodes and of bipolar II diagnoses.

BACKGROUND: The purpose of this study was to investigate the prevalence and comorbidity of affective disorders, especially current major depressive episode and bipolar disorder among suicide attempters in Hungary. METHODS: Using a structured interview (Mini International Neuropsychiatric Interview) determining 16 Axis I psychiatric diagnoses defined by the DSM-IV and a semistructured interview collecting background information, the authors examined 100 consecutive suicide attempters, aged 18-65. RESULTS: Eighty-eight percent of the attempters had one or more current diagnoses on Axis I. In 69% it was major depressive episode and 60% of them were suffering their first episode. Thirty-five percent of the patients with current major depressive episode had had hypomanic (n=19) or manic (n=5) episodes in the past. Seventy percent of the individuals received two or more current diagnoses on Axis I. Eighty-six percent of all current Axis I disorders (except major depressive episode) were diagnosed together with a current major depressive episode. The diagnosis of current major depressive episode and the number of current psychiatric disorders was significantly and positively related to the number of suicide attempts, but the diagnosis of past major depressive episode was not. LIMITATIONS: This study included suicide attempters who had presented selfpoisoning, but not individuals with very high risk of fatality. CONCLUSIONS: In suicide attempters there is a very high prevalence of affective disorders, especially major depression, first episode of major depression and bipolar II disorder. This study underlines the importance of early detection and treatment of psychiatric disorders for the prevention of suicidal behavior.

Adolescent↗
PubMed2003

Anxiety and impulsivity levels identify relevant subtypes in adolescents with at-risk behavior.

BACKGROUND: Impulsivity (I) and anxiety (A) were hypothesized to be crucial clinical features in adolescents with at-risk behavior. We therefore classified them into sub-groups according to these two major dimensions. The study examined the relevance of these groups by describing their major diagnoses and behavioral characteristics. METHODS: During a 1-year period, all in-patients consecutively admitted for at-risk behavior, except those with a previous psychotropic treatment and/or schizophrenic disorders, were rated for anxiety and impulsivity, and categorized into four groups: impulsive and anxious (IA), impulsive and non-anxious (Ia), non-impulsive and anxious (iA), non-impulsive and non-anxious (ia). We assessed the main behavioral disturbances (suicide attempt, carving, violence, delinquency, substance abuse, and eating disorder) and the main current axis I disorder in each sub-group. RESULTS: A total of 69 patients were included. In the IA group 62% exhibited hypomanic episodes and 87% recurrent suicide attempts. In the Ia group all exhibited conduct disorders, 93% were males, 80% delinquents, and 100% violent with others. Both groups reported a high percentage of cannabis use (67%). The iA group exhibited anorexia nervosa (73%) with a major depressive episode. The ia patients were mainly non-violent, first suicide attempts with low risk. LIMITATIONS: Long-term data are needed to assess the stability of these groups. CONCLUSIONS: We found that sub-typing adolescents with at-risk behavior into four groups according to their level of anxiety and impulsivity was highly predictive of being suicidal with mood disorders (AI), delinquent with conduct disorder (Ia), anorectic or depressed (Ai), and with substance abuse associated only to impulsivity. It is likely that this sub-typing of patients may be useful for prevention and therapeutics. The impulsive-anxious group (IA) appears closely related to the soft bipolar spectrum. A replication and follow-up data are now needed.

Adolescent↗
PubMed2002

Amisulpride vs. risperidone in chronic schizophrenia: results of a 6-month double-blind study.

This multicenter, double-blind, randomized study evaluated the efficacy, safety and functional effects of two atypical antipsychotics, amisulpride and risperidone, in patients with chronic schizophrenia (DSM IV) with a recent worsening of symptoms. It was planned as a non-inferiority trial. 309 patients received amisulpride (400-1,000 mg/day) or risperidone (4-10 mg/day) for six months. Amisulpride was demonstrated to be not inferior to risperidone with respect to the decrease in Positive and Negative Syndrome Scale (PANSS) total score from baseline (90% 2-sided confidence interval (-5.6; 4.0)). Symptomatic improvement measured with the Brief Psychiatry Rating Scale (BPRS), the PANSS positive subscale, and the Bech Rafaelsen Melancholia Scale was similar in both groups. Amisulpride was significantly (p <.05) superior to risperidone in terms of response (>/=50% improvement in PANSS and BPRS total scores or "very much/much improved" on the Clinical Global Impression Scale) and also demonstrated better functional effects and subjective response. Both treatments were well tolerated and had a similar low incidence of extrapyramidal symptoms; however, amisulpride was associated with less weight gain and endocrine/sexual symptoms.

Adolescent↗
PubMed2001

A Proposed Algorithm for Improved Recognition and Treatment of the Depression/Anxiety Spectrum in Primary Care.

The International Consensus Group on Depression and Anxiety has held 7 meetings over the last 3 years that focused on depression and specific anxiety disorders. During the course of the meeting series, a number of common themes have developed. At the last meeting of the Consensus Group, we reviewed these areas of commonality across the spectrum of depression and anxiety disorders. With the aim of improving the recognition and management of depression and anxiety in the primary care setting, we developed an algorithm that is presented in this article. We attempted to balance currently available scientific knowledge about the treatment of these disorders and to reformat it to provide an acceptable algorithm that meets the practical aspects of recognizing and treating these disorders in primary care.

Journal Article↗