A. Seghers - Academia.edu (original) (raw)
Papers by A. Seghers
Journal of The International Neuropsychological Society, Aug 26, 2005
Acne et adolescence constituent des facteurs de risques pour l'apparition des troubles depres... more Acne et adolescence constituent des facteurs de risques pour l'apparition des troubles depressifs. L'association entre isotretinoine et depression n'a pas ete mise en evidence par des etudes systematiques. Cependant certains rapports de cas suggerent une possibilite de lien de causalite a savoir d'une part l'existence d'une relation temporelle entre l'exposition a l'isotretinoine et l'apparition de la depression, et d'autre part une recidive des symptomes depressifs a la reintroduction du medicament ce qui constitue un signal important de causalites (rechallenge positif). L'isotretinoine est un traitement efficace qui a transforme le pronostic des acnes severes. Cependant, les medecins traitants doivent informer les patients avec ou sans antecedents psychiatriques que l'isotretinoine est susceptible d'entrainer un etat depressif, parfois severe et eventuellement un risque de suicide.
La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne, 2012
Systemic lupus erythematosus (SLE) is an autoimmune disease, which primarily affects skin and joi... more Systemic lupus erythematosus (SLE) is an autoimmune disease, which primarily affects skin and joints. Peripheral neurologic syndrome and central nervous system (CNS) manifestations are common in lupus patients but are not always attributable to lupus itself. A classification, published in 1999 by the American College of Rheumatology (ACR) research committee, described 12 CNS syndromes and seven peripheral neurologic syndromes compatible with "neuropsychiatric systemic lupus erythematosus" (NPSLE). Despite this consensus, studies which have been published since 1999 have reported a prevalence of NPSLE varying from 20 to 97 %, which shows the diagnosis difficulty and the heterogeneity of neuropsychiatric manifestations in SLE. In order to understand the limits of this classification, we propose in this first part an exhaustive review of publications describing neuropsychiatric manifestations according to the ACR 1999 classification. We also detail case definitions, prevalenc...
Increasing awareness of eGFR monitoring We are grateful to the Journal for highlighting the impor... more Increasing awareness of eGFR monitoring We are grateful to the Journal for highlighting the important issue of epidermal growth factor receptor (eGFR) monitoring in psychiatric patients prescribed lithium. 1 We recently carried out an audit of renal function monitoring across Camden and Islington NHS Foundation Trust. The aim was to assess whether renal investigations for grade 3 chronic kidney disease and referrals for specialist advice are being documented according to the 2006 Royal Colleges of Physicians and General Practitioners and Renal Association guidance 2 in the notes of those psychiatric in-patients currently prescribed lithium across the Trust. These guidelines were recommended to psychiatrists in October 2007 (www.rcpsych.ac.uk/ members/rcpsychnews/october2007.aspx). Currently, eGFR is not part of the Trust-wide lithium blood-monitoring documentation. A total of 303 sets of in-patients' notes were reviewed from across the Trust. An audit tool was designed to record patient information relating to the lithium regime and serial recording of eGFR. It was also recorded whether investigative parameters were documented to have been carried out in the presence of abnormal eGFR results. Requests for specialist medical opinions were also noted. Electronic pathology results were used where there was no written record in patient notes. Of 18 in-patients prescribed lithium: (a) 3 (16.7%) patients had one-off abnormal results with other values recorded within the normal range; 2 Royal College of Physicians, Renal Association. Chronic Kidney Disease in Adults. UK Guidelines for Identification, Management and Referral, 2006. Royal Colleges of Physicians and General Practitioners and Renal Association.
The International Journal of Neuropsychopharmacology, 2006
Acta psychiatrica Belgica
Reactive Psychosis can be a matter of controversy with respect to its pragmatic use. This is espe... more Reactive Psychosis can be a matter of controversy with respect to its pragmatic use. This is especially true in the Scandinavian countries, where two streams of opinion clash, one satisfied with the DSMIII's notion of "Brief Reactive Psychosis", supplemented with information on other Axes, and one stressing the advantage of retaining the wider range of the Scandinavian notion, and even of linking it up with the "Cycloid Psychosis". A certain consensus has emerged to recognize that further research is absolutely necessary to close the debate.
La grossesse, l'enfant virtuel et la parentalité, 2004
Université catholique de Louvain
Acta Psychiatrica Belgica, 2009
Nous rapportons ici le cas d'un « fou rire prodromique » d'un AVC ischemique embolique du... more Nous rapportons ici le cas d'un « fou rire prodromique » d'un AVC ischemique embolique du tronc basilaire chez une patiente ayant presente egalement des cephalees, une hemiparesie gauche et une symptomatologie d'allure psychiatrique. Le « fou rire prodromique » est un terme introduit par Fere pour definir le rire pathologique qui precede la survenue d'un deficit neurologique aigu. Nous nous proposons de faire le diagnostic differentiel du rire pathologique en psychiatrie et en neurologie en decrivant plus largement les pathologies neurologiques susceptibles de presenter une symptomatologie d'allure psychiatrique.
Archives internationales de pharmacodynamie et de thérapie
This article reviews critically the present status of lithium in the treatment and prophylaxis of... more This article reviews critically the present status of lithium in the treatment and prophylaxis of manic-depressive illness compared to the two anticonvulsant drugs, carbamazepine and valproic acid. Lithium is used successfully in the prophylaxis and treatment of manic-depression. The mechanism by which it exerts its effects is still not very clear. There is much evidence to indicate that lithium may exert its therapeutic action by interfering with the metabolism of phosphoinositides which play an important role in synaptic transmission. Because of lithium's narrow therapeutic/toxic ratio, blood concentration monitoring is crucial. Published data suggest that, compared to lithium, carbamazepine is similar in its relative specificity in treating mania. It is often faster in achieving its antimanic effects and best established as an alternative for patients not responding or intolerant to lithium. Carbamazepine is a good substitute for lithium when severe renal problems exclude the...
Journal of Neural Transmission, 1995
Depression and Anxiety, 2005
Reports on the severity and reversibility of cognitive disturbances in major depression in the li... more Reports on the severity and reversibility of cognitive disturbances in major depression in the literature diverge due to methodological biases. The present study, using a precise methodology, examined attention and executive functions in 20 relatively young, depressed patients presenting a first or second episode of unipolar major depression without psychotic or melancholic characteristics and all being treated with the same psychopharmacological treatment (sertraline) to investigate the changes in potential attentional and executive loss during a subacute period of treatment of 7 weeks. We compared their performance with a group of 26 control subjects who were administered the same cognitive tests. This study confirmed psychomotor slowing associated with attentional and executive disturbance in adults with major depression. Conscious attentional interference for words with a negative emotional valence also was shown. After the first weeks of treatment, the effect of the antidepressant treatment with sertraline was accompanied by a beneficial effect on psychomotor slowing on attentional and executive functions.
Neuropsychiatrie de l'Enfance et de l'Adolescence, 2012
Current therapeutic …, 2002
... Phase IV Study of Remission Rates in Outpatients and Inpatients with Major Depression Treated... more ... Phase IV Study of Remission Rates in Outpatients and Inpatients with Major Depression Treated with Venlafaxine Michel Dierick, MD,' Andre De Nayer ... 5. Schweizer E, Feighner J, Mandos LA, Rickels K. Comparison of venlafaxine and imipramine in the acute treatment of major ...
European psychiatry, 1998
The use of a placebo control group in the evaluation of a new product is today considered by most... more The use of a placebo control group in the evaluation of a new product is today considered by most as a necessary condition of experimental drug research. Placebo response is an essential consideration in all clinical trials. If not properly controlled, incorrect and dangerous conclusion may be inferred for a product efficacy and safety profile. However, the inclusion of a placebo group in clinical trials in neuropsychiatric research raises several ethical and scientific questions. Whereas in certain indications, such as suicidal patients and severe and psychotic depression, the use of a placebo is generally not accepted, it is difficult to assess drug efficacy. This article discusses the concept of placebo in clinical trials, the occurrence of adverse events after placebo treatment and the high response rate of placebo in neuropsychiatric clinical research. The experimental methodology to adequately control all the factors involved is also analysed and discussed. 0 1998 Elsevier, Paris placebo / clinical trial I methodology / neuropsychiatric research / nocebo reaction The term 'placebo' has been widely used to refer to clinical effects. In British pharmacology, the usual meaning of placebo is thus understood as "neutral substance". A placebo is, in theory, a pharmacologically inert substance. Considering that the term 'placebo' means 'I shall please', the emphasis of a placebo medication may be argued as more adapted to please rather than to benefit the patient. In recent years, the definition of placebo has been made more precise in including the notion of 'specific effect' [65] 'A placebo is defined as any therapy or component of *Correspondence and reprints: 127, rue Henri Prou,
Acta psychiatrica …, 2009
Nous rapportons ici le cas d'un « fou rire prodromique » d'un AVC ischemique embolique du... more Nous rapportons ici le cas d'un « fou rire prodromique » d'un AVC ischemique embolique du tronc basilaire chez une patiente ayant presente egalement des cephalees, une hemiparesie gauche et une symptomatologie d'allure psychiatrique. Le « fou rire prodromique » est un terme introduit par Fere pour definir le rire pathologique qui precede la survenue d'un deficit neurologique aigu. Nous nous proposons de faire le diagnostic differentiel du rire pathologique en psychiatrie et en neurologie en decrivant plus largement les pathologies neurologiques susceptibles de presenter une symptomatologie d'allure psychiatrique.
Annals of the New York Academy of Sciences, 1997
Depression and Anxiety, 2005
Reports on the severity and reversibility of cognitive disturbances in major depression in the li... more Reports on the severity and reversibility of cognitive disturbances in major depression in the literature diverge due to methodological biases. The present study, using a precise methodology, examined attention and executive functions in 20 relatively young, depressed patients presenting a first or second episode of unipolar major depression without psychotic or melancholic characteristics and all being treated with the same psychopharmacological treatment (sertraline) to investigate the changes in potential attentional and executive loss during a subacute period of treatment of 7 weeks. We compared their performance with a group of 26 control subjects who were administered the same cognitive tests. This study confirmed psychomotor slowing associated with attentional and executive disturbance in adults with major depression. Conscious attentional interference for words with a negative emotional valence also was shown. After the first weeks of treatment, the effect of the antidepress...
European …, 1996
The hypothesis that lithium is the most appropriate and efficacious pharmacological treatment in ... more The hypothesis that lithium is the most appropriate and efficacious pharmacological treatment in the therapy of manic-depressive illness was examined in a meta-analysis. The efficacy of lithium was compared with that of the antiepileptics, carbamazepine and valproic acid. Data sources include the Medline database and relevant references from articles. Only randomised controlled clinical trials with a double-blind assessment of outcomes were included. Lithium levels were required to be within the therapeutic range of 0.4-1.5 mmol/l. The effect sizes were measured by the odds ratio using the Mantel-Haenszel method. No significant difference was observed between the treatment effect of the 3 drugs compared. While the efficacy of the 3 treatments was identical, there is a general tendency in favour of the antiepileptics in the treatment of manic depression with regard to adverse events and treatment tolerance. The impact and importance of this study seriously question the relevance of today's practice of prescribing lithium in the acute management of manic-depressive illness.
Journal of The International Neuropsychological Society, Aug 26, 2005
Acne et adolescence constituent des facteurs de risques pour l'apparition des troubles depres... more Acne et adolescence constituent des facteurs de risques pour l'apparition des troubles depressifs. L'association entre isotretinoine et depression n'a pas ete mise en evidence par des etudes systematiques. Cependant certains rapports de cas suggerent une possibilite de lien de causalite a savoir d'une part l'existence d'une relation temporelle entre l'exposition a l'isotretinoine et l'apparition de la depression, et d'autre part une recidive des symptomes depressifs a la reintroduction du medicament ce qui constitue un signal important de causalites (rechallenge positif). L'isotretinoine est un traitement efficace qui a transforme le pronostic des acnes severes. Cependant, les medecins traitants doivent informer les patients avec ou sans antecedents psychiatriques que l'isotretinoine est susceptible d'entrainer un etat depressif, parfois severe et eventuellement un risque de suicide.
La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne, 2012
Systemic lupus erythematosus (SLE) is an autoimmune disease, which primarily affects skin and joi... more Systemic lupus erythematosus (SLE) is an autoimmune disease, which primarily affects skin and joints. Peripheral neurologic syndrome and central nervous system (CNS) manifestations are common in lupus patients but are not always attributable to lupus itself. A classification, published in 1999 by the American College of Rheumatology (ACR) research committee, described 12 CNS syndromes and seven peripheral neurologic syndromes compatible with "neuropsychiatric systemic lupus erythematosus" (NPSLE). Despite this consensus, studies which have been published since 1999 have reported a prevalence of NPSLE varying from 20 to 97 %, which shows the diagnosis difficulty and the heterogeneity of neuropsychiatric manifestations in SLE. In order to understand the limits of this classification, we propose in this first part an exhaustive review of publications describing neuropsychiatric manifestations according to the ACR 1999 classification. We also detail case definitions, prevalenc...
Increasing awareness of eGFR monitoring We are grateful to the Journal for highlighting the impor... more Increasing awareness of eGFR monitoring We are grateful to the Journal for highlighting the important issue of epidermal growth factor receptor (eGFR) monitoring in psychiatric patients prescribed lithium. 1 We recently carried out an audit of renal function monitoring across Camden and Islington NHS Foundation Trust. The aim was to assess whether renal investigations for grade 3 chronic kidney disease and referrals for specialist advice are being documented according to the 2006 Royal Colleges of Physicians and General Practitioners and Renal Association guidance 2 in the notes of those psychiatric in-patients currently prescribed lithium across the Trust. These guidelines were recommended to psychiatrists in October 2007 (www.rcpsych.ac.uk/ members/rcpsychnews/october2007.aspx). Currently, eGFR is not part of the Trust-wide lithium blood-monitoring documentation. A total of 303 sets of in-patients' notes were reviewed from across the Trust. An audit tool was designed to record patient information relating to the lithium regime and serial recording of eGFR. It was also recorded whether investigative parameters were documented to have been carried out in the presence of abnormal eGFR results. Requests for specialist medical opinions were also noted. Electronic pathology results were used where there was no written record in patient notes. Of 18 in-patients prescribed lithium: (a) 3 (16.7%) patients had one-off abnormal results with other values recorded within the normal range; 2 Royal College of Physicians, Renal Association. Chronic Kidney Disease in Adults. UK Guidelines for Identification, Management and Referral, 2006. Royal Colleges of Physicians and General Practitioners and Renal Association.
The International Journal of Neuropsychopharmacology, 2006
Acta psychiatrica Belgica
Reactive Psychosis can be a matter of controversy with respect to its pragmatic use. This is espe... more Reactive Psychosis can be a matter of controversy with respect to its pragmatic use. This is especially true in the Scandinavian countries, where two streams of opinion clash, one satisfied with the DSMIII's notion of "Brief Reactive Psychosis", supplemented with information on other Axes, and one stressing the advantage of retaining the wider range of the Scandinavian notion, and even of linking it up with the "Cycloid Psychosis". A certain consensus has emerged to recognize that further research is absolutely necessary to close the debate.
La grossesse, l'enfant virtuel et la parentalité, 2004
Université catholique de Louvain
Acta Psychiatrica Belgica, 2009
Nous rapportons ici le cas d'un « fou rire prodromique » d'un AVC ischemique embolique du... more Nous rapportons ici le cas d'un « fou rire prodromique » d'un AVC ischemique embolique du tronc basilaire chez une patiente ayant presente egalement des cephalees, une hemiparesie gauche et une symptomatologie d'allure psychiatrique. Le « fou rire prodromique » est un terme introduit par Fere pour definir le rire pathologique qui precede la survenue d'un deficit neurologique aigu. Nous nous proposons de faire le diagnostic differentiel du rire pathologique en psychiatrie et en neurologie en decrivant plus largement les pathologies neurologiques susceptibles de presenter une symptomatologie d'allure psychiatrique.
Archives internationales de pharmacodynamie et de thérapie
This article reviews critically the present status of lithium in the treatment and prophylaxis of... more This article reviews critically the present status of lithium in the treatment and prophylaxis of manic-depressive illness compared to the two anticonvulsant drugs, carbamazepine and valproic acid. Lithium is used successfully in the prophylaxis and treatment of manic-depression. The mechanism by which it exerts its effects is still not very clear. There is much evidence to indicate that lithium may exert its therapeutic action by interfering with the metabolism of phosphoinositides which play an important role in synaptic transmission. Because of lithium's narrow therapeutic/toxic ratio, blood concentration monitoring is crucial. Published data suggest that, compared to lithium, carbamazepine is similar in its relative specificity in treating mania. It is often faster in achieving its antimanic effects and best established as an alternative for patients not responding or intolerant to lithium. Carbamazepine is a good substitute for lithium when severe renal problems exclude the...
Journal of Neural Transmission, 1995
Depression and Anxiety, 2005
Reports on the severity and reversibility of cognitive disturbances in major depression in the li... more Reports on the severity and reversibility of cognitive disturbances in major depression in the literature diverge due to methodological biases. The present study, using a precise methodology, examined attention and executive functions in 20 relatively young, depressed patients presenting a first or second episode of unipolar major depression without psychotic or melancholic characteristics and all being treated with the same psychopharmacological treatment (sertraline) to investigate the changes in potential attentional and executive loss during a subacute period of treatment of 7 weeks. We compared their performance with a group of 26 control subjects who were administered the same cognitive tests. This study confirmed psychomotor slowing associated with attentional and executive disturbance in adults with major depression. Conscious attentional interference for words with a negative emotional valence also was shown. After the first weeks of treatment, the effect of the antidepressant treatment with sertraline was accompanied by a beneficial effect on psychomotor slowing on attentional and executive functions.
Neuropsychiatrie de l'Enfance et de l'Adolescence, 2012
Current therapeutic …, 2002
... Phase IV Study of Remission Rates in Outpatients and Inpatients with Major Depression Treated... more ... Phase IV Study of Remission Rates in Outpatients and Inpatients with Major Depression Treated with Venlafaxine Michel Dierick, MD,' Andre De Nayer ... 5. Schweizer E, Feighner J, Mandos LA, Rickels K. Comparison of venlafaxine and imipramine in the acute treatment of major ...
European psychiatry, 1998
The use of a placebo control group in the evaluation of a new product is today considered by most... more The use of a placebo control group in the evaluation of a new product is today considered by most as a necessary condition of experimental drug research. Placebo response is an essential consideration in all clinical trials. If not properly controlled, incorrect and dangerous conclusion may be inferred for a product efficacy and safety profile. However, the inclusion of a placebo group in clinical trials in neuropsychiatric research raises several ethical and scientific questions. Whereas in certain indications, such as suicidal patients and severe and psychotic depression, the use of a placebo is generally not accepted, it is difficult to assess drug efficacy. This article discusses the concept of placebo in clinical trials, the occurrence of adverse events after placebo treatment and the high response rate of placebo in neuropsychiatric clinical research. The experimental methodology to adequately control all the factors involved is also analysed and discussed. 0 1998 Elsevier, Paris placebo / clinical trial I methodology / neuropsychiatric research / nocebo reaction The term 'placebo' has been widely used to refer to clinical effects. In British pharmacology, the usual meaning of placebo is thus understood as "neutral substance". A placebo is, in theory, a pharmacologically inert substance. Considering that the term 'placebo' means 'I shall please', the emphasis of a placebo medication may be argued as more adapted to please rather than to benefit the patient. In recent years, the definition of placebo has been made more precise in including the notion of 'specific effect' [65] 'A placebo is defined as any therapy or component of *Correspondence and reprints: 127, rue Henri Prou,
Acta psychiatrica …, 2009
Nous rapportons ici le cas d'un « fou rire prodromique » d'un AVC ischemique embolique du... more Nous rapportons ici le cas d'un « fou rire prodromique » d'un AVC ischemique embolique du tronc basilaire chez une patiente ayant presente egalement des cephalees, une hemiparesie gauche et une symptomatologie d'allure psychiatrique. Le « fou rire prodromique » est un terme introduit par Fere pour definir le rire pathologique qui precede la survenue d'un deficit neurologique aigu. Nous nous proposons de faire le diagnostic differentiel du rire pathologique en psychiatrie et en neurologie en decrivant plus largement les pathologies neurologiques susceptibles de presenter une symptomatologie d'allure psychiatrique.
Annals of the New York Academy of Sciences, 1997
Depression and Anxiety, 2005
Reports on the severity and reversibility of cognitive disturbances in major depression in the li... more Reports on the severity and reversibility of cognitive disturbances in major depression in the literature diverge due to methodological biases. The present study, using a precise methodology, examined attention and executive functions in 20 relatively young, depressed patients presenting a first or second episode of unipolar major depression without psychotic or melancholic characteristics and all being treated with the same psychopharmacological treatment (sertraline) to investigate the changes in potential attentional and executive loss during a subacute period of treatment of 7 weeks. We compared their performance with a group of 26 control subjects who were administered the same cognitive tests. This study confirmed psychomotor slowing associated with attentional and executive disturbance in adults with major depression. Conscious attentional interference for words with a negative emotional valence also was shown. After the first weeks of treatment, the effect of the antidepress...
European …, 1996
The hypothesis that lithium is the most appropriate and efficacious pharmacological treatment in ... more The hypothesis that lithium is the most appropriate and efficacious pharmacological treatment in the therapy of manic-depressive illness was examined in a meta-analysis. The efficacy of lithium was compared with that of the antiepileptics, carbamazepine and valproic acid. Data sources include the Medline database and relevant references from articles. Only randomised controlled clinical trials with a double-blind assessment of outcomes were included. Lithium levels were required to be within the therapeutic range of 0.4-1.5 mmol/l. The effect sizes were measured by the odds ratio using the Mantel-Haenszel method. No significant difference was observed between the treatment effect of the 3 drugs compared. While the efficacy of the 3 treatments was identical, there is a general tendency in favour of the antiepileptics in the treatment of manic depression with regard to adverse events and treatment tolerance. The impact and importance of this study seriously question the relevance of today's practice of prescribing lithium in the acute management of manic-depressive illness.