Maurice Corcos - Academia.edu (original) (raw)

Papers by Maurice Corcos

Annales Medico-psychologiques, 2003

Les troubles des conduites alimentaires tels que l'anorexie mentale et la boulimie constituent un... more Les troubles des conduites alimentaires tels que l'anorexie mentale et la boulimie constituent un des problèmes de santé publique majeur à l'adolescence, de par le pronostic de ces affections et leurs fréquentes conséquences psychologiques et sociales. Ces pathologies s'avèrent comporter des conséquences somatiques graves, qui à leur tour retentissent sur l'état psychique et contribuent à entretenir le trouble. Différents modèles étiopathogéniques s'étayant sur des soubassements neurobiologiques ont été évoqués. Même s'ils ne peuvent constituer à eux seuls un déterminisme causal, ils pourraient expliquer une vulnérabilité biologique sous-jacente au trouble ainsi que les mécanismes d'autorenforcement « fixant » la maladie et réorganisant la personnalité autour de la conduite alimentaire. Ces approches constituent des apports non négligeables quant à la compréhension du trouble mais dont les implications thérapeutiques à l'heure actuelle sont encore limitées.

European Psychiatry, 2002

The interpersonal dependency inventory comprised three subscales called Emotional reliance of ano... more The interpersonal dependency inventory comprised three subscales called Emotional reliance of another person (ER), lack of social self confidence (LSS) and Assertion of autonomy (AUT). Several formula have been developed for deriving whole-scale scores.The aim of the study on 621 addictive subjects was to determine the best formula using the DSM-IV dependent personality disorder as gold standard. The formula 3

Neuropsychiatrie de l'Enfance et de l'Adolescence, 2011

ABSTRACT Psychoanalysis highlights borderline symptoms during adolescence through an underlying p... more ABSTRACT Psychoanalysis highlights borderline symptoms during adolescence through an underlying psychopathology. Kernberg's conceptualization of borderline symptoms is represented with borderline organization. Nevertheless, such conceptual organization of symptoms during adolescence hardly agrees with borderline disorder diagnosis. After considering validity of borderline personality disorder at the adolescence, a dimensional approach of such disorder would be more appropriate both with adult and adolescent people. In that sense, borderline organization and borderline personality disorder would be closer than before. Future DSM-V should answer this question.

International Journal of Eating Disorders, 2005

First, we measured both emotional awareness and alexithymia to understand better emotion-processi... more First, we measured both emotional awareness and alexithymia to understand better emotion-processing deficits in eating disorder patients (EDs). Second, we increased the reliability of the measures by limiting the influence of confounding factors (negative affects). Seventy females with eating disorders were compared with 70 female controls. Participants completed the Beck Depression Inventory (BDI; depression), the Hospital and Anxiety Depression Scale (HADS; anxiety), the Toronto Alexithymia Scale (TAS; alexithymia), and the Level of Emotional Awareness Scale (LEAS). EDs exhibited higher alexithymia scores and lower LEAS scores, with an inability to identify and describe their own emotions, as well as an impairment in mentalizing others&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; emotional experience. Whereas alexithymia scores were related to depression scores, LEAS scores were not. After controlling for depression, alexithymia scores were similar in EDs and controls. The marked impairment in emotion processing found in EDs is independent of affective disorders. Thus, the joint use of TAS and LEAS suggests a global emotion-processing deficit in EDs.

Objective: Some studies suggest that inaccuracy in recognizing and describing emotional states, c... more Objective: Some studies suggest that inaccuracy in recognizing and describing emotional states, combined with a highly descriptive mode of expression, as in alexithymia, may influ- ence the immune response. We therefore investigated in healthy women the relationship between alexithymia and circulating levels of IL-1, IL-2 and IL-4. Method: Seventeen mentally and physically healthy women aged between 20 and 25 years

Int. J. Eat. Disord., 2006

The objective of the present work is to determine whether the prevalence of depressive and anxiet... more The objective of the present work is to determine whether the prevalence of depressive and anxiety disorders varies in subgroups of eating disorders (ED) according to age, ED duration, mode of care provision, and body mass index (BMI). Using the Mini International Neuropsychiatric Interview (MINI), the frequency of anxiety and depressive disorders was evaluated in 271 ED participants. Their prevalence was compared in subgroups of anorexics (AN-R and AN-BN) and bulimics (BN), both before and after controlling for potential confounding variables. Current or lifetime comorbidity of anxiety and depressive disorders did not differ between AN-R and AN-BN groups. Social phobia, panic disorders, and obsessive-compulsive disorder (OCD) were significantly more frequent in AN-BN and AN-R groups. Panic disorder was more frequent in the BN group. Several confounding factors, in particular those identified in the present study, may explain previous conflicting results on the frequency of anxiety and depressive disorders in ED. Nevertheless, the study confirmed that OCD is more frequent in AN, even after controlling for confounding factors.

Psychiatry Research, 2005

Excessive interpersonal dependency has been described in depression and addictive disorders. More... more Excessive interpersonal dependency has been described in depression and addictive disorders. Moreover, excessive dependency and suicidality are linked in psychiatric subjects, but their relationships have not been studied in specific addictions. Separate samples of female anorectic patients (n=150), female bulimic patients (n=95), male (n=150) or female (n=68) alcoholics, male (n=94) or female (n=54) drug abusers and non-psychiatric control subjects (n=683)

Psychoneuroendocrinology, 2003

A number of findings from clinical and animal studies indicate that pro-inflammatory cytokines ma... more A number of findings from clinical and animal studies indicate that pro-inflammatory cytokines may play roles in eating disorders. The measurement of pro-inflammatory cytokines (IL-1, IL-6, TNFα), which are known to decrease food intake, provides highly variable data from which firm conclusions cannot be drawn. In most of the longitudinal studies where pro-inflammatory cytokines have been shown to be impaired

An association has been reported between high levels of alexithymia and depression in patients wi... more An association has been reported between high levels of alexithymia and depression in patients with eating disorders. This study has examined alexithymic features and depressive experiences in patients with DSM-IV eating disorder (restricting anorexia, n = 105; purging anorexia, n = 49; bulimia, n = 98) and matched controls (n = 279). The subjects were assessed with the Toronto Alexithymia Scale (TAS-20); the Beck Depression Inventory; and the Depressive Experiences Questionnaire, which defines two types of depressive personality style (dependent and self-critical). The patients had high levels of alexithymic features and depressive symptoms. Comparisons of alexithymic features between patients and controls after adjustment for depression showed a significant difference between bulimic patients and controls for the TAS Difficulty Identifying Feelings factor, and between restricting anorexic patients and controls for the TAS Difficulty Describing Feelings factor. With regard to depressive personality styles, only scores on the self-critical dimension were significantly higher in bulimic patients than in restricting anorexic patients and controls. In the entire group of eating disorders, dependency was associated with the TAS Difficulty Identifying Feelings factor only in anorexic patients. Selfcriticism, on the other hand, was associated with the TAS Difficulty Identifying Feelings factor in all subtypes of eating disorders, although the relationship was significantly stronger in restricting anorexic than in bulimic patients. The results of 0165-1781/$ -see front matter D (M. Speranza).

Substance Use & Misuse, 2004

Alexithymia, depressive feelings, and dependency are interrelated dimensions that are considered ... more Alexithymia, depressive feelings, and dependency are interrelated dimensions that are considered potential ''risk factors'' for addictive disorders. The aim of this study was to investigate the relationships between these dimensions and to define a comprehensive model of addiction in a large sample of addicted subjects, whether affected by an eating disorder or presenting an alcohol-or a drug use-related disorder. The participants in this study were gathered from a multicenter collaborative study on addictive behaviors conducted in several psychiatric departments in France, Switzerland, and Belgium between January 1995 and March 1999. The clinical sample was composed of 564 patients (149 anorexics, 84 bulimics, 208 alcoholics, 123 drug addicts) of both genders with a mean age of 27.3 AE 8 years. A path analysis was conducted on the 564 dependent patients and 518 matched controls using the scores of the Toronto Alexithymia Scale, the Depressive Experiences Questionnaire, and the Interpersonal Dependency Inventory. Statistical analyses showed good adjustment (Goodness of Fit Index ¼ 0.977) between the observable data and the assumed model, thus supporting the hypothesis that a depressive dimension, whether anaclitic or self-critical, can facilitate the development of dependency in vulnerable alexithymic subjects. This result has interesting clinical implications because identifying specific patterns of relationships leading from alexithymia to dependency can provide clues to the development of targeted strategies for at-risk subjects.

Psychosomatic Medicine, 2001

Recent studies have indicated that the inflammatory cytokines could be implicated in anorexia ner... more Recent studies have indicated that the inflammatory cytokines could be implicated in anorexia nervosa and in its complications. To determinate the potential role of interleukins (IL-1, IL-2, IL-4, IL-6, IL-10), interferon (IFN gamma), tumor necrosis factor (TNF-alpha), and transforming growth factor (TGF-beta2) in anorexia nervosa, serum concentrations of these cytokines were measured in patients suffering from anorexia nervosa in comparison to healthy subjects. Twenty-nine anorexic women according to DSM-IV criteria participated in the study. The control group consisted of 20 healthy women without eating disorders, mood disorders, and immunological disorders. We find that serum IL-2 and TGF-beta2 concentrations were both significantly decreased in anorexic patients, although the other cytokines did not differ significantly between the two groups. Our results show that in patients with anorexia nervosa, there are lower levels of specific cytokines (especially IL-2 and TGF-beta2). These levels may reflect the combination of impaired nutrition and weight loss, therefore, the dysregulation of these cytokines may contribute in anorexia's complications. Follow-up studies should examine the effects of parameters such as starvation, psychopathologic factors, and psychoneuroendocrinological perturbation which could affect interplay between cytokines, neuropeptides, and neurotransmitters.

Psychopathology, 2002

The aim of the study was to determine the comorbidity of dependent personality disorder (DPD) and... more The aim of the study was to determine the comorbidity of dependent personality disorder (DPD) and separation anxiety disorder (SAD) in large nonclinical and clinical samples. Using a cross-sectional method, the relationship between these disorders was studied in 784 healthy subjects and in 708 subjects presenting with various addictive behaviors. DPD was significantly associated with SAD in healthy subjects, alcoholics, drug abusers and anorectic and bulimic patients. The comorbidities of SAD and DPD suggest that specific therapeutic strategies could be discussed. Moreover, longitudinal studies are required to determine if SAD constitutes a risk factor for DPD.

Psychopathology, 2008

The evaluation of alexithymic deficits has become increasingly desirable in health and psychopath... more The evaluation of alexithymic deficits has become increasingly desirable in health and psychopathology research. The purpose of this study was to calculate alexithymia cutoff scores for a recently developed self-report alexithymia questionnaire: the Bermond-Vorst Alexithymia Questionnaire Form B (BVAQ-B). Three hundred subjects (47 eating-disordered patients and 253 healthy individuals) completed the BVAQ-B and the 20-item Toronto Alexithymia Scale (TAS-20). The TAS-20 was used as a gold standard for this research, with its previously established cutoff scores serving as diagnostic criteria for determining the presence or absence of alexithymia. The BVAQ-B cutoff score selection was based on the examination of psychometric data (i.e., the sensitivity and specificity of the BVAQ-B scores and receiver operating characteristic curve analyses) and of clinical data (i.e., BVAQ-B mean score of the control subjects, who were mostly nonalexithymic, and BVAQ-B mean score of a group of patients with eating disorders, the majority of whom were alexithymic). This research found that the most appropriate BVAQ-B cutoff scores for determining the absence and presence of alexithymia were 43 and 53, respectively. In light of these findings, we believe that the BVAQ-B may also lend itself to a categorical evaluation of alexithymia, with these cutoff scores determining its absence or presence.

Psychoneuroendocrinology, 2004

Some studies suggest that inaccuracy in recognizing and describing emotional states, combined wit... more Some studies suggest that inaccuracy in recognizing and describing emotional states, combined with a highly descriptive mode of expression, as in alexithymia, may influence the immune response. We therefore investigated in healthy women the relationship between alexithymia and circulating levels of IL-1, IL-2 and IL-4. Seventeen mentally and physically healthy women aged between 20 and 25 years completed psychological questionnaires to assess alexithymia (Toronto Alexithymia Scale: TAS) and depressed mood (Hospital Anxiety and Depression Scale: HAD). Serum concentrations of IL-1, IL-2 and IL-4 were measured by ELISA. We found a significant positive correlation between serum levels of IL-4 and TAS score (r=0.55; p=0.021) and between factor 1 of the TAS (difficulty in identifying feelings) and IL-4 (r=0.57; p=0.017) while serum IL-1 and IL-2 were not detected in ten and six patients, respectively. Although there was a significant correlation between age and IL-4 levels, a linear regression with BMI, age, depressed mood and TAS as independent variables showed that only alexithymia could predict significantly increased levels of IL-4. Alexithymia and difficulty in identifying feelings could be associated with increased levels of IL-4 which may result in chronic impairment of pro/anti-inflammatory cytokine balance with psychological and somatic consequences. Nevertheless, these intriguing findings would deserve replication and extension in a larger sample of subjects.

Psychological Reports, 2008

Psychiatry Research, 2003

Women who were referred with an eating disorder (ED) were compared with a matched normal control ... more Women who were referred with an eating disorder (ED) were compared with a matched normal control group to answer the following questions: What are the frequencies of anxiety disorders in cases of anorexia and bulimia nervosa diagnosed according to DSM-IV criteria? Are anxiety disorders significantly more frequent among women with an eating disorder than among women from the community? We assessed the frequencies of six specific anxiety disorders among 271 women with a current diagnosis of anorexia or bulimia nervosa and 271 controls, using the Mini-International Neuropsychiatric Interview, French DSM-IV version. A lifetime comorbidity with at least one anxiety disorder was found in 71% of both the anorexic and the bulimic subjects, significantly higher than the percentage of controls with an anxiety disorder. The prevalence was significantly higher in the eating disorder groups than in controls for most types of anxiety disorder, and between 41.8 and 53.3% of comorbid cases had an anxiety disorder preceding the onset of the eating disorder. Anxiety disorders are significantly more frequent in subjects with eating disorders than in volunteers from the community, a finding that has important etiological and therapeutic implications. ᮊ

Psychiatry Research, 2000

We compared alexithymia and depression ratings for non-hospitalized women meeting DSM-IV criteria... more We compared alexithymia and depression ratings for non-hospitalized women meeting DSM-IV criteria for Ž . Ž . Ž . anorexia nervosa n s 32 and bulimia nervosa n s 32 to ratings for healthy women n s 74 . Alexithymia was Ž . evaluated by the Toronto Alexithymia Scale TAS-20 and depression by the Hospital Anxiety and Depression Scale Ž . HAD . TAS and HAD scores were significantly higher in anorexic compared to bulimic patients, although these two Ž . scales were significantly and positively correlated r s 0.53, Ps 0.001 . After taking depression into account as a Ž . confounding variable, rates of alexithymia did not vary according to the type of eating disorder anorexia or bulimia . ᮊ

PLoS ONE, 2012

Research on treatments in anorexia nervosa (AN) is scarce. Although most of the therapeutic progr... more Research on treatments in anorexia nervosa (AN) is scarce. Although most of the therapeutic programs used in 'real world practice' in AN treatment resort to multidisciplinary approaches, they have rarely been evaluated.

L'Encéphale, 2010

Dependent personality disorder is a new diagnosis introduced in the third version of the DSM (DSM... more Dependent personality disorder is a new diagnosis introduced in the third version of the DSM (DSM-III). Contrary to other disorders of personality, as the borderline or the schizotypal personalities, there are no specific interviews or questionnaires focusing on dependent personality. Thus the study of dependent personality disorder requires the use of global interviews or questionnaire as the SCID -II or SIDP-IV. Recently, Tyrer and colleagues (2004) have proposed an 8-item questionnaire, the DPQ (Dependent Personality Questionnaire). Each item of the DPQ is rated from 0 to 3 with a total score ranging from 0 to 24. Using a sample of 30 psychiatric patients presenting various diagnoses and a dependent personality disorder for the half of the sample, the authors have determined the cutoff score allowing the diagnosis of DSM-IV Dependent Personality Disorder. A cutoff of 10 was associated with the best sensitivity (87.5%), specificity (87.5%) and positive predictive value (87.5%). Moreover, the value of the Youden coefficient (Sensitivity+Specificity - 100) was 75. The aim of the study was to present the French version of the DPQ and to determine its psychometric properties as well as the cutoff score. One hundred and thirty-eight psychiatric inpatients (97 females, 41 males) with a mean age of 42.26 years were included in the study. The patients were hospitalized in an inpatients unit receiving mood disorders, neurotic disorders or suicide attempters. The subjects filled out the French versions of the DPQ and the Personality Disorders Questionnaire of Hyler, PDQ-4+. Using the PDQ-4+ two groups were built: 25 subjects filled out the diagnoses of dependent personality disorder and 20 subjects did not meet any criteria of dependent personality disorder. Then, for different values of the DPQ, sensitivity, specificity and positive predictive value and Youden indicia (Sensitivity+Specificity - 100) were calculated. The best values of Youden indicia (74) were obtained for the cutoff of 13 on the DPQ. The corresponding sensitivity, specificity and positive predictive value were respectively 84, 90 and 91.3%. The French version of the DPQ is now available and permits detection of dependent personality in French populations. Our results must be replicated using structured interviews of personality disorder instead of questionnaires (PDQ-4+) and other samples with different prevalence of dependent personality disorders must be used to test the potential cutoff scores of the DPQ.