Daniel Dassa - Academia.edu (original) (raw)
Papers by Daniel Dassa
Annales médico-psychologiques, 1993
The American journal of psychiatry, 1993
Dans cet article, nous utilisons les categories degagees par Husserl: la conscience du temps inti... more Dans cet article, nous utilisons les categories degagees par Husserl: la conscience du temps intime de l'homme (temps constituant - temps constitue); le corps comme instance primordiale du temps par le jeu des geneses passives et des geneses actives. Sur ces bases, nous abordons, par l'analyse phenomenologique, la problematique du temps et du corps dans differents types psychopathologiques. Cette approche concerne la schizophrenie et la paranoia. La depression est envisagee apres une relecture critique de l'ouvrage de L. Binswanger: « Melancolie et manie». De ces analyses nous tirons argument pour la plus fine definition du soin a apporter aux patients dans le champ de la pathologie psychique.
The Primary Care Companion For CNS Disorders, 2018
Use of Amphetamines is becoming increasingly frequent, inducing a wide range of complications, am... more Use of Amphetamines is becoming increasingly frequent, inducing a wide range of complications, among which comes severe vascular conditions and psychiatric episodes. Here we present the case of a 24 year old man admitted for psychotic symptoms whose physical examination revealed a Superior Vena Cava Syndrome. Chest (CT)-scan showed up severe thrombosis and stenosis of superior vena cava. Malignancies, coagulation disorders, auto-immune diseases were ruled out. Thrombus could not be removed despite several radiological intervention attempts. Psychosis was treated successfully with atypical anti-psychotic (Clozapine). When reviewing history, the patient reports an intense crystal Methamphetamine abuse in the past. We retained Methamphetamine as the most relevant etiology for both psychosis and thrombosis. This unexpected association between Methamphetamine, psychotic symptoms and vascular condition raises the question of a tendency to abnormal vascular and inflammatory processes in schizophrenia. This case aims at enjoining practitioners to be cautious and proposing systematic radiological exams in psychotic patients with a Methamphetamine abuse history.
The Canadian Journal of Psychiatry, 2001
(2). Short-term effi cacy and ab sence of drug-induced switch has been dem on strated with venla ... more (2). Short-term effi cacy and ab sence of drug-induced switch has been dem on strated with venla fax ine treat ment of bi po lar de pres sion (3,4). The fol low ing case, how ever, describes a pa tient who de vel oped hy pomanic symp toms on a thera peu tic dos age of ven la fax ine.
The Canadian Journal of Psychiatry, 2004
Objective: This study was designed to analyze the language of patients with schizophrenia exhibit... more Objective: This study was designed to analyze the language of patients with schizophrenia exhibiting negative symptoms during a 3-month period. Method: The computer-assisted ALCESTE method was used to simultaneously analyze the subjects' oral behaviour and speech patterns at various levels. Results: The tested subjects had very specific speech patterns. Most significantly, analysis of the underlying syntactic processes showed that the patients exhibited a sense of identity, however minimum, based on their own pathologies and on the surrounding world. In our previous study, no such characteristics were observed in the discourse of schizophrenia patients with delusions (exhibiting positive symptoms). This suggests that the minimum sense of identity that develops in patients with schizophrenia allows them to avoid positive symptoms. Conclusion: In studies of language production by subjects suffering from schizophrenia, it is necessary to distinguish between patients with positive symptoms and those with negative symptoms. The speech patterns of these 2 groups have to be analyzed separately, which has not been done previously, since the groups differ in too many respects.
Psychopharmacology, 2016
Objective The objectives are to determine the rate of potentially inappropriate psychotropic (PIP... more Objective The objectives are to determine the rate of potentially inappropriate psychotropic (PIP) prescription at discharge in the elderly psychiatric inpatients and to determine whether PIP is associated with lowered functioning outcomes. Methods Sociodemographic, clinical, and treatment data for all inpatients aged ≥ 65 years consecutively hospitalized during 1 year in 13 psychiatry departments was analyzed. PIP+/ PIP− groups were defined according to the French-updated Beers criteria. Daily functioning was evaluated by the daily living (ADL) scale. Logistic regression analysis was used to estimate odds ratios for the association between PIP administration at discharge and respectively functioning and potential confounding factors. Results Data was obtained for 327 patients. Overall, 124 (37.9 %) patients were males, and the mean age was 73.9 years (SD = 5.6); 163 (49.8 %) patients were diagnosed with affective disorders and 89 (27.2 %) with schizophrenia/schizotypal/delusional disorders. Overall, 249 (76.1 %) had one or more PIP medications, mainly anxiolytics (69.9 %) and hypnotics (17.2 %). In a multivariate analysis, PIP prescription at discharge has been associated with patient lowered personal care functioning, independently of age, gender, and psychiatric or somatic diagnoses (OR = 0.88 (0.79-0.97, p = 0.01). Key points • In the current increasingly fragmented health care systems, special attention must be given to potentially inappropriate psychotropic (PIP) prescription in older population suffering from psychiatric disorders and consuming a large range of medicines. • Using the Beers criteria, the present study demonstrates the high prevalence of PIP prescription, which concerns a large panel of drugs but mostly anxiolytics and hypnotics independently of the psychiatric or somatic diagnoses and sociodemographic characteristics. • Our study have demonstrated for the first time an association between PIP prescription and lowered functioning. Further longitudinal studies should confirm a causal relation. • Our study raises the need of a greater health literacy concerning geriatric conditions in non-geriatrician practitioners who care elderly in hospital.
BMC psychiatry, Jan 15, 2016
Previous studies showed functional improvement in stable patients with schizophrenia treated with... more Previous studies showed functional improvement in stable patients with schizophrenia treated with risperidone long-acting injection (LAI). We therefore re-investigated functional improvement with risperidone LAI in remitted patients, in comparison with stable patients. The study was conducted in real-life conditions because of the high heterogeneity of the patients' situations. This was a multi-centre, prospective observational cohort study involving adult schizophrenia-spectrum chronic patients who were previously treated with risperidone LAI for 6 months. Remission was evaluated using the consensus criteria proposed by the Remission in Schizophrenia Working Group (RSWG). The primary endpoint was global functioning (assessed with the Global Assessment of Functioning scale, GAF) after one year of treatment. Social functioning was a secondary outcome. The analysis included 1490 patients. Attrition rate was 9.1 % at the end of the study. 27.7 % of patients were in remission after ...
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 1996
A statistically significant increased risk of schizophrenia for individuals born in winter has be... more A statistically significant increased risk of schizophrenia for individuals born in winter has been reported. The increase risk is of the order of S-1 5%. The seasonal effect is more marked among females. This winter birth effect suggests some environmental agents, probably a neuropathogen one, acting on the foetus. The present study sought to test the environmental damage hypothesis by application of the family history of psychiatric disorder distinction to season of birth data divided according to sex and using a control population. From computer records, all patients admitted to the psychiatric department of Marseilles Timone hospital between January 1984 and December 1989 who satisfied DSM III , DSM III R criteria for schizophrenia were identified. Patients were then classified into two groups : family history of psychiatric disorder versus no family history. Division according to the sex was carried on after two groups were formed. The data show (1) a significant excess of births in the early months of the year (p < 0.05) for all patients with no family history of psychiatric disorder, (7) a significant excess of births for females (p < 0.05) with no family history. These results provide indirect support for the neurodevelopmental theory of schizophrenia.
L'Encéphale, 1996
link_to_subscribed_fulltex
Annales médico-psychologiques, 1995
Atypical neuroleptics can be defined as dopamine receptor blockers which differ from typical neur... more Atypical neuroleptics can be defined as dopamine receptor blockers which differ from typical neuroleptics in that they have a markedly lower or absent propensity for the induction of parkinsonian side effects or tardive dyskinesias. The authors are studying varied molecules considering their mechanism of action. The differences between atypical and typical neuroleptics may relate to regional specificity in site of actions and receptor binding profile. The authors insist on clozapine, which is a D2 antagonist and in which many other systems might be involved. New neural models may help understand these interactions. The Swerdlow and Koob's model is a unified hypothesis of cortico-striato-pallido-thalamic function which can explain psychoses, depression, dyskinesias and Parkinsonian disorders. The authors make a linkage between this model and Davis's hypothesis. This author hypothesizes that schizophrenia is characterized by abnormally low prefrontal dopamine activity leading ...
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2011
A case of porencephalic cyst in a schizophrenic patient with history of postnatal encephalitis Si... more A case of porencephalic cyst in a schizophrenic patient with history of postnatal encephalitis Sir: Porencephaly, which is an extremely rare congenital abnormality of the central nervous system, is a fluid-filled cavitation in the brain that may communicate with the intracerebral cerebrospinal fluid spaces. Two types are described (Verity et al., 2003): type 1 or encephaloclastic porencephaly and type 2 or schizencephalic porencephaly. Most cases result from a vascular lesion, either hemorrhagic or thrombosis (Douzenis et al., 2010). In rare cases, congenital cysts on the left temporal and frontal lobes associated with psychosis have been described (
Cardiovascular psychiatry and neurology, 2012
Objective. The aim of this study is to assess the relationships of cardiovascular risk factors wi... more Objective. The aim of this study is to assess the relationships of cardiovascular risk factors with verbal learning and memory in patients with schizophrenia. Methods and Design. cross-sectional study. Inclusion Criteria. Diagnosis of schizophrenia according to the DSM-IV-TR criteria. Data Collection. Sociodemographic information, clinical characteristics, anthropometric measurements, blood tests, and episodic memory using the California Verbal Learning Test (CVLT). Analysis. A multivariate analysis using multiple linear regressions was performed to determine variables that are potentially associated with verbal learning and memory. Results. One hundred and sixty-eight outpatients participated in our study. An association was found between the metabolic syndrome (MetS) and memory impairment on measures of verbal learning, and short- and long-term memory. Among the different components of MeTS, hypertriglycerides, abdominal obesity, and low HDL cholesterol were the only factors assoc...
Objective: The development of advanced methods based on progress in data analysis and computer te... more Objective: The development of advanced methods based on progress in data analysis and computer technology has led to a better understanding of the structure of discourse and the abnormalities occurring in the syntax and semantics of psychotic subjects'speech patterns. In the present study, discourse a nalysis was performed o n the language produced b y a hebephrenic patient, which was collected d uring a period o f several months. Method: The method used here involves the use of the Alceste software program to model the main patterns of word d istribution occurring in a c orpus, with a view to identifying the repetitive language patterns most frequently used by the speaker. Results and Conclusion: : Hebephrenic subject produced specific speech without any semantic or syntactic impairments and language communication disturbances but with a poverty of content of speech, however. He used very simple, linear forms of speech (metonymic speech) without any digressions, metaphors, ima...
Psychological Reports, 2004
Language, which is unique in each subject, can reflect how a patient copes with disease. The meth... more Language, which is unique in each subject, can reflect how a patient copes with disease. The method ALCESTE used here made it possible at the same time to analyse the subject's verbal behavior and speech patterns at several levels. The present study was designed to analyse during a 3-mo. period the language production of subjects with paranoia exhibiting delusional disorder (nonbizarre delusions without any hallucination) of imaginative subtype. The subjects produced very specific speech without any semantic or syntactic impairment and disruption in language or thinking processes, but with a poverty of speech content. The main feature of the study was the analysis of the underlying syntactic processes showing that the tested patients presented a “hard” sense of identity: the patient found always a strong place for himself among the various types of discourse whatever their topics.
Psychiatry Research, 1997
The evolution of the kinetic parameters, maximal velocity <V,,> and Michaelis constant (K,), of L... more The evolution of the kinetic parameters, maximal velocity <V,,> and Michaelis constant (K,), of L-tryptophan (L-TRP) uptake into red blood cells (RBC) was studied in 30 depressed patients in a drug-free state (DO) and after 1 week (D7) and 4 weeks (D28) of a treatment involving a variety of antidepressant drugs, including SSRIs and tricyclics. At DO, 76% of patients exhibited abnormal values of V,,, which were either higher (36%) or lower (40%) than the control range (control V,, mean f 1 SD.). High and low K, values were observed in parallel with high and low V,, values. At D7, individual values of V,, varied drastically compared to their corresponding value at DO, whatever the pretreatment value of the parameter. The magnitude of the V,, variation during the first week of treatment was found to be significantly larger in the treatment responders than in the non-responders. At D28, V,, values of all the responders to treatment were within the control range, whatever their pretreatment V,, value. On the contrary, non-responders had Vmav values that were significantly lower than those of the controls. Changes in K, followed changes in V,, during antidepressant treatment. In conclusion, normalization of L-TRP transport kinetics was concomitant with a clear alleviation of depressive symptoms, indicating that RBC L-TRP uptake is dependent on clinical state. Moreover, early reactivity of the V,, as soon as the first week of treatment may be useful as a predictive index of clinical outcome at D28.
Psychiatric Genetics, 2000
The dopamine D3 receptor gene is of potential interest in the physiopathology of affective disord... more The dopamine D3 receptor gene is of potential interest in the physiopathology of affective disorder because of its expression pattern in brain structures controlling various aspects of behaviour, cognition and emotions. Moreover, it encodes for a receptor protein that is a target for psychotropic drugs, which turn out to be efficient in the treatment of this disorder. Two polymorphisms have been described at this locus (the Bal I and the Msp I Restriction Fragment Length Polymorphisms) that are useful in genetic studies. We therefore researched these polymorphisms in 60 patients suffering from bipolar affective disorder who were compared with 60 healthy volunteers. No statistical difference was observed between the whole patient sample versus the controls. However, one subgroup [homozygous for the (2-2) Bal I polymorphism] exhibits a characteristic clinical pattern consisting of: manic monopolar form of bipolar disorder, low age of onset and initiation by an acute delusional episode. A gender distribution difference for the Bal I polymorphism (chi 2 = 6.61, degrees of freedom = 1, P = 0.01) was then noted, the bipolar females being preferentially heterozygous, and the males homozygous. These results could involve the dopamine D3 receptor locus as a minor effect gene in the manic depression condition.
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 1995
Serres Florence, Daniel Dassa, Jean-Michel Azorin, RCgine Jeanningros : Decrease in red blood cel... more Serres Florence, Daniel Dassa, Jean-Michel Azorin, RCgine Jeanningros : Decrease in red blood cell Ltryptophan uptake in schizophrenic patients : Possible link with loss of impulse control. Prog. Neuro-Psychopharmacol. & Biol. Psychiatr. 1995, 19(5): 903-913. 1. Kinetic parameters of erythrocyte L-tryptophan (TRP) uptake (Vmax, maximal velocity and Km, Michaelis constant) were determined in 19 neuroleptic-free schizophrenic patients and in 19 healthy volunteers. Both Vmax and Km values were significantly lower in schizophrenic patients than in controls. Mean Vmax value was found to be lower in patients who had attempted suicide than in patients who had not. No difference was observed when patients were subdivided on the basis of the violence of suicide attempts. A significant negative correlation was observed between Vmax and scores on the loss of impulse control item as assessed on the PANS scale. Decrease in red blood cell L-TRP uptake reflects a disturbance in the peripheral metabolism of TRP that may result in a deficiency of the plasma L-TRP availability on which the central serotonin (5HT) synthesis closely depends. In addition, the results suggest that the alteration in RBC L-TRP uptake is associated with loss of impulse control in schizophrenic patients.
PLoS ONE, 2012
Objective: The aim of this study was to examine the complex relationships among neurocognition, i... more Objective: The aim of this study was to examine the complex relationships among neurocognition, insight and nonadherence in patients with schizophrenia. Methods: Design: Cross-sectional study. Inclusion criteria: Diagnosis of schizophrenia according to the DSM-IV-TR criteria. Data collection: Neurocognition was assessed using a global approach that addressed memory, attention, and executive functions; insight was analyzed using the multidimensional 'Scale to assess Unawareness of Mental Disorder;' and nonadherence was measured using the multidimensional 'Medication Adherence Rating Scale.' Analysis: Structural equation modeling (SEM) was applied to examine the non-straightforward relationships among the following latent variables: neurocognition, 'awareness of positive symptoms' and 'negative symptoms', 'awareness of mental disorder' and nonadherence. Results: One hundred and sixty-nine patients were enrolled. The final testing model showed good fit, with normed x 2 = 1.67, RMSEA = 0.063, CFI = 0.94, and SRMR = 0.092. The SEM revealed significant associations between (1) neurocognition and 'awareness of symptoms,' (2) 'awareness of symptoms' and 'awareness of mental disorder' and (3) 'awareness of mental disorder' and nonadherence, mainly in the 'attitude toward taking medication' dimension. In contrast, there were no significant links between neurocognition and nonadherence, neurocognition and 'awareness of mental disorder,' and 'awareness of symptoms' and nonadherence. Conclusions: Our findings support the hypothesis that neurocognition influences 'awareness of symptoms,' which must be integrated into a higher level of insight (i.e., the 'awareness of mental disorder') to have an impact on nonadherence. These findings have important implications for the development of effective strategies to enhance medication adherence.
Annales médico-psychologiques, 1993
The American journal of psychiatry, 1993
Dans cet article, nous utilisons les categories degagees par Husserl: la conscience du temps inti... more Dans cet article, nous utilisons les categories degagees par Husserl: la conscience du temps intime de l'homme (temps constituant - temps constitue); le corps comme instance primordiale du temps par le jeu des geneses passives et des geneses actives. Sur ces bases, nous abordons, par l'analyse phenomenologique, la problematique du temps et du corps dans differents types psychopathologiques. Cette approche concerne la schizophrenie et la paranoia. La depression est envisagee apres une relecture critique de l'ouvrage de L. Binswanger: « Melancolie et manie». De ces analyses nous tirons argument pour la plus fine definition du soin a apporter aux patients dans le champ de la pathologie psychique.
The Primary Care Companion For CNS Disorders, 2018
Use of Amphetamines is becoming increasingly frequent, inducing a wide range of complications, am... more Use of Amphetamines is becoming increasingly frequent, inducing a wide range of complications, among which comes severe vascular conditions and psychiatric episodes. Here we present the case of a 24 year old man admitted for psychotic symptoms whose physical examination revealed a Superior Vena Cava Syndrome. Chest (CT)-scan showed up severe thrombosis and stenosis of superior vena cava. Malignancies, coagulation disorders, auto-immune diseases were ruled out. Thrombus could not be removed despite several radiological intervention attempts. Psychosis was treated successfully with atypical anti-psychotic (Clozapine). When reviewing history, the patient reports an intense crystal Methamphetamine abuse in the past. We retained Methamphetamine as the most relevant etiology for both psychosis and thrombosis. This unexpected association between Methamphetamine, psychotic symptoms and vascular condition raises the question of a tendency to abnormal vascular and inflammatory processes in schizophrenia. This case aims at enjoining practitioners to be cautious and proposing systematic radiological exams in psychotic patients with a Methamphetamine abuse history.
The Canadian Journal of Psychiatry, 2001
(2). Short-term effi cacy and ab sence of drug-induced switch has been dem on strated with venla ... more (2). Short-term effi cacy and ab sence of drug-induced switch has been dem on strated with venla fax ine treat ment of bi po lar de pres sion (3,4). The fol low ing case, how ever, describes a pa tient who de vel oped hy pomanic symp toms on a thera peu tic dos age of ven la fax ine.
The Canadian Journal of Psychiatry, 2004
Objective: This study was designed to analyze the language of patients with schizophrenia exhibit... more Objective: This study was designed to analyze the language of patients with schizophrenia exhibiting negative symptoms during a 3-month period. Method: The computer-assisted ALCESTE method was used to simultaneously analyze the subjects' oral behaviour and speech patterns at various levels. Results: The tested subjects had very specific speech patterns. Most significantly, analysis of the underlying syntactic processes showed that the patients exhibited a sense of identity, however minimum, based on their own pathologies and on the surrounding world. In our previous study, no such characteristics were observed in the discourse of schizophrenia patients with delusions (exhibiting positive symptoms). This suggests that the minimum sense of identity that develops in patients with schizophrenia allows them to avoid positive symptoms. Conclusion: In studies of language production by subjects suffering from schizophrenia, it is necessary to distinguish between patients with positive symptoms and those with negative symptoms. The speech patterns of these 2 groups have to be analyzed separately, which has not been done previously, since the groups differ in too many respects.
Psychopharmacology, 2016
Objective The objectives are to determine the rate of potentially inappropriate psychotropic (PIP... more Objective The objectives are to determine the rate of potentially inappropriate psychotropic (PIP) prescription at discharge in the elderly psychiatric inpatients and to determine whether PIP is associated with lowered functioning outcomes. Methods Sociodemographic, clinical, and treatment data for all inpatients aged ≥ 65 years consecutively hospitalized during 1 year in 13 psychiatry departments was analyzed. PIP+/ PIP− groups were defined according to the French-updated Beers criteria. Daily functioning was evaluated by the daily living (ADL) scale. Logistic regression analysis was used to estimate odds ratios for the association between PIP administration at discharge and respectively functioning and potential confounding factors. Results Data was obtained for 327 patients. Overall, 124 (37.9 %) patients were males, and the mean age was 73.9 years (SD = 5.6); 163 (49.8 %) patients were diagnosed with affective disorders and 89 (27.2 %) with schizophrenia/schizotypal/delusional disorders. Overall, 249 (76.1 %) had one or more PIP medications, mainly anxiolytics (69.9 %) and hypnotics (17.2 %). In a multivariate analysis, PIP prescription at discharge has been associated with patient lowered personal care functioning, independently of age, gender, and psychiatric or somatic diagnoses (OR = 0.88 (0.79-0.97, p = 0.01). Key points • In the current increasingly fragmented health care systems, special attention must be given to potentially inappropriate psychotropic (PIP) prescription in older population suffering from psychiatric disorders and consuming a large range of medicines. • Using the Beers criteria, the present study demonstrates the high prevalence of PIP prescription, which concerns a large panel of drugs but mostly anxiolytics and hypnotics independently of the psychiatric or somatic diagnoses and sociodemographic characteristics. • Our study have demonstrated for the first time an association between PIP prescription and lowered functioning. Further longitudinal studies should confirm a causal relation. • Our study raises the need of a greater health literacy concerning geriatric conditions in non-geriatrician practitioners who care elderly in hospital.
BMC psychiatry, Jan 15, 2016
Previous studies showed functional improvement in stable patients with schizophrenia treated with... more Previous studies showed functional improvement in stable patients with schizophrenia treated with risperidone long-acting injection (LAI). We therefore re-investigated functional improvement with risperidone LAI in remitted patients, in comparison with stable patients. The study was conducted in real-life conditions because of the high heterogeneity of the patients' situations. This was a multi-centre, prospective observational cohort study involving adult schizophrenia-spectrum chronic patients who were previously treated with risperidone LAI for 6 months. Remission was evaluated using the consensus criteria proposed by the Remission in Schizophrenia Working Group (RSWG). The primary endpoint was global functioning (assessed with the Global Assessment of Functioning scale, GAF) after one year of treatment. Social functioning was a secondary outcome. The analysis included 1490 patients. Attrition rate was 9.1 % at the end of the study. 27.7 % of patients were in remission after ...
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 1996
A statistically significant increased risk of schizophrenia for individuals born in winter has be... more A statistically significant increased risk of schizophrenia for individuals born in winter has been reported. The increase risk is of the order of S-1 5%. The seasonal effect is more marked among females. This winter birth effect suggests some environmental agents, probably a neuropathogen one, acting on the foetus. The present study sought to test the environmental damage hypothesis by application of the family history of psychiatric disorder distinction to season of birth data divided according to sex and using a control population. From computer records, all patients admitted to the psychiatric department of Marseilles Timone hospital between January 1984 and December 1989 who satisfied DSM III , DSM III R criteria for schizophrenia were identified. Patients were then classified into two groups : family history of psychiatric disorder versus no family history. Division according to the sex was carried on after two groups were formed. The data show (1) a significant excess of births in the early months of the year (p < 0.05) for all patients with no family history of psychiatric disorder, (7) a significant excess of births for females (p < 0.05) with no family history. These results provide indirect support for the neurodevelopmental theory of schizophrenia.
L'Encéphale, 1996
link_to_subscribed_fulltex
Annales médico-psychologiques, 1995
Atypical neuroleptics can be defined as dopamine receptor blockers which differ from typical neur... more Atypical neuroleptics can be defined as dopamine receptor blockers which differ from typical neuroleptics in that they have a markedly lower or absent propensity for the induction of parkinsonian side effects or tardive dyskinesias. The authors are studying varied molecules considering their mechanism of action. The differences between atypical and typical neuroleptics may relate to regional specificity in site of actions and receptor binding profile. The authors insist on clozapine, which is a D2 antagonist and in which many other systems might be involved. New neural models may help understand these interactions. The Swerdlow and Koob's model is a unified hypothesis of cortico-striato-pallido-thalamic function which can explain psychoses, depression, dyskinesias and Parkinsonian disorders. The authors make a linkage between this model and Davis's hypothesis. This author hypothesizes that schizophrenia is characterized by abnormally low prefrontal dopamine activity leading ...
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2011
A case of porencephalic cyst in a schizophrenic patient with history of postnatal encephalitis Si... more A case of porencephalic cyst in a schizophrenic patient with history of postnatal encephalitis Sir: Porencephaly, which is an extremely rare congenital abnormality of the central nervous system, is a fluid-filled cavitation in the brain that may communicate with the intracerebral cerebrospinal fluid spaces. Two types are described (Verity et al., 2003): type 1 or encephaloclastic porencephaly and type 2 or schizencephalic porencephaly. Most cases result from a vascular lesion, either hemorrhagic or thrombosis (Douzenis et al., 2010). In rare cases, congenital cysts on the left temporal and frontal lobes associated with psychosis have been described (
Cardiovascular psychiatry and neurology, 2012
Objective. The aim of this study is to assess the relationships of cardiovascular risk factors wi... more Objective. The aim of this study is to assess the relationships of cardiovascular risk factors with verbal learning and memory in patients with schizophrenia. Methods and Design. cross-sectional study. Inclusion Criteria. Diagnosis of schizophrenia according to the DSM-IV-TR criteria. Data Collection. Sociodemographic information, clinical characteristics, anthropometric measurements, blood tests, and episodic memory using the California Verbal Learning Test (CVLT). Analysis. A multivariate analysis using multiple linear regressions was performed to determine variables that are potentially associated with verbal learning and memory. Results. One hundred and sixty-eight outpatients participated in our study. An association was found between the metabolic syndrome (MetS) and memory impairment on measures of verbal learning, and short- and long-term memory. Among the different components of MeTS, hypertriglycerides, abdominal obesity, and low HDL cholesterol were the only factors assoc...
Objective: The development of advanced methods based on progress in data analysis and computer te... more Objective: The development of advanced methods based on progress in data analysis and computer technology has led to a better understanding of the structure of discourse and the abnormalities occurring in the syntax and semantics of psychotic subjects'speech patterns. In the present study, discourse a nalysis was performed o n the language produced b y a hebephrenic patient, which was collected d uring a period o f several months. Method: The method used here involves the use of the Alceste software program to model the main patterns of word d istribution occurring in a c orpus, with a view to identifying the repetitive language patterns most frequently used by the speaker. Results and Conclusion: : Hebephrenic subject produced specific speech without any semantic or syntactic impairments and language communication disturbances but with a poverty of content of speech, however. He used very simple, linear forms of speech (metonymic speech) without any digressions, metaphors, ima...
Psychological Reports, 2004
Language, which is unique in each subject, can reflect how a patient copes with disease. The meth... more Language, which is unique in each subject, can reflect how a patient copes with disease. The method ALCESTE used here made it possible at the same time to analyse the subject's verbal behavior and speech patterns at several levels. The present study was designed to analyse during a 3-mo. period the language production of subjects with paranoia exhibiting delusional disorder (nonbizarre delusions without any hallucination) of imaginative subtype. The subjects produced very specific speech without any semantic or syntactic impairment and disruption in language or thinking processes, but with a poverty of speech content. The main feature of the study was the analysis of the underlying syntactic processes showing that the tested patients presented a “hard” sense of identity: the patient found always a strong place for himself among the various types of discourse whatever their topics.
Psychiatry Research, 1997
The evolution of the kinetic parameters, maximal velocity <V,,> and Michaelis constant (K,), of L... more The evolution of the kinetic parameters, maximal velocity <V,,> and Michaelis constant (K,), of L-tryptophan (L-TRP) uptake into red blood cells (RBC) was studied in 30 depressed patients in a drug-free state (DO) and after 1 week (D7) and 4 weeks (D28) of a treatment involving a variety of antidepressant drugs, including SSRIs and tricyclics. At DO, 76% of patients exhibited abnormal values of V,,, which were either higher (36%) or lower (40%) than the control range (control V,, mean f 1 SD.). High and low K, values were observed in parallel with high and low V,, values. At D7, individual values of V,, varied drastically compared to their corresponding value at DO, whatever the pretreatment value of the parameter. The magnitude of the V,, variation during the first week of treatment was found to be significantly larger in the treatment responders than in the non-responders. At D28, V,, values of all the responders to treatment were within the control range, whatever their pretreatment V,, value. On the contrary, non-responders had Vmav values that were significantly lower than those of the controls. Changes in K, followed changes in V,, during antidepressant treatment. In conclusion, normalization of L-TRP transport kinetics was concomitant with a clear alleviation of depressive symptoms, indicating that RBC L-TRP uptake is dependent on clinical state. Moreover, early reactivity of the V,, as soon as the first week of treatment may be useful as a predictive index of clinical outcome at D28.
Psychiatric Genetics, 2000
The dopamine D3 receptor gene is of potential interest in the physiopathology of affective disord... more The dopamine D3 receptor gene is of potential interest in the physiopathology of affective disorder because of its expression pattern in brain structures controlling various aspects of behaviour, cognition and emotions. Moreover, it encodes for a receptor protein that is a target for psychotropic drugs, which turn out to be efficient in the treatment of this disorder. Two polymorphisms have been described at this locus (the Bal I and the Msp I Restriction Fragment Length Polymorphisms) that are useful in genetic studies. We therefore researched these polymorphisms in 60 patients suffering from bipolar affective disorder who were compared with 60 healthy volunteers. No statistical difference was observed between the whole patient sample versus the controls. However, one subgroup [homozygous for the (2-2) Bal I polymorphism] exhibits a characteristic clinical pattern consisting of: manic monopolar form of bipolar disorder, low age of onset and initiation by an acute delusional episode. A gender distribution difference for the Bal I polymorphism (chi 2 = 6.61, degrees of freedom = 1, P = 0.01) was then noted, the bipolar females being preferentially heterozygous, and the males homozygous. These results could involve the dopamine D3 receptor locus as a minor effect gene in the manic depression condition.
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 1995
Serres Florence, Daniel Dassa, Jean-Michel Azorin, RCgine Jeanningros : Decrease in red blood cel... more Serres Florence, Daniel Dassa, Jean-Michel Azorin, RCgine Jeanningros : Decrease in red blood cell Ltryptophan uptake in schizophrenic patients : Possible link with loss of impulse control. Prog. Neuro-Psychopharmacol. & Biol. Psychiatr. 1995, 19(5): 903-913. 1. Kinetic parameters of erythrocyte L-tryptophan (TRP) uptake (Vmax, maximal velocity and Km, Michaelis constant) were determined in 19 neuroleptic-free schizophrenic patients and in 19 healthy volunteers. Both Vmax and Km values were significantly lower in schizophrenic patients than in controls. Mean Vmax value was found to be lower in patients who had attempted suicide than in patients who had not. No difference was observed when patients were subdivided on the basis of the violence of suicide attempts. A significant negative correlation was observed between Vmax and scores on the loss of impulse control item as assessed on the PANS scale. Decrease in red blood cell L-TRP uptake reflects a disturbance in the peripheral metabolism of TRP that may result in a deficiency of the plasma L-TRP availability on which the central serotonin (5HT) synthesis closely depends. In addition, the results suggest that the alteration in RBC L-TRP uptake is associated with loss of impulse control in schizophrenic patients.
PLoS ONE, 2012
Objective: The aim of this study was to examine the complex relationships among neurocognition, i... more Objective: The aim of this study was to examine the complex relationships among neurocognition, insight and nonadherence in patients with schizophrenia. Methods: Design: Cross-sectional study. Inclusion criteria: Diagnosis of schizophrenia according to the DSM-IV-TR criteria. Data collection: Neurocognition was assessed using a global approach that addressed memory, attention, and executive functions; insight was analyzed using the multidimensional 'Scale to assess Unawareness of Mental Disorder;' and nonadherence was measured using the multidimensional 'Medication Adherence Rating Scale.' Analysis: Structural equation modeling (SEM) was applied to examine the non-straightforward relationships among the following latent variables: neurocognition, 'awareness of positive symptoms' and 'negative symptoms', 'awareness of mental disorder' and nonadherence. Results: One hundred and sixty-nine patients were enrolled. The final testing model showed good fit, with normed x 2 = 1.67, RMSEA = 0.063, CFI = 0.94, and SRMR = 0.092. The SEM revealed significant associations between (1) neurocognition and 'awareness of symptoms,' (2) 'awareness of symptoms' and 'awareness of mental disorder' and (3) 'awareness of mental disorder' and nonadherence, mainly in the 'attitude toward taking medication' dimension. In contrast, there were no significant links between neurocognition and nonadherence, neurocognition and 'awareness of mental disorder,' and 'awareness of symptoms' and nonadherence. Conclusions: Our findings support the hypothesis that neurocognition influences 'awareness of symptoms,' which must be integrated into a higher level of insight (i.e., the 'awareness of mental disorder') to have an impact on nonadherence. These findings have important implications for the development of effective strategies to enhance medication adherence.