Michel Maron - Academia.edu (original) (raw)
Papers by Michel Maron
L'Encéphale
The Psychiatry department of the University Hospital Centre of Lille has developed, over the last... more The Psychiatry department of the University Hospital Centre of Lille has developed, over the last 10 years, a treatment network for psychiatric disorders during pregnancy or in the post-partum period. There are liaison consultations in the maternity department, screening and management of psychopathological disorders in the perinatal period, training of midwives, support of patients seeking genetic counselling, collaboration with teams providing "medically-assisted procreation", etc. For severe disorders of the post-partum period (severe depression, serious alteration of mother-child interaction, puerperal psychosis), the Psychiatry department has a specialized unit where 3 "mother-child" groups can be admitted. This unit is particularly effective if the patients and their family understand this healthcare system and stick to it to a certain extent. Even if improvements are always possible, cases in which situations occur as an emergency, are when dysfunctions ar...
Clinical Effectiveness in Nursing, 2006
L'Encéphale, 2012
Le trouble bipolaire s'associe à un risque suicidaire élevé. Parmi les principaux facteurs de ris... more Le trouble bipolaire s'associe à un risque suicidaire élevé. Parmi les principaux facteurs de risque il semble utile d'insister sur l'importance des liens existants entre d'une part les conduites suicidaires et d'autre part les différents sous-types de troubles bipolaires, les modalités évolutives ou les caractéristiques cliniques des épisodes. On peut ainsi mettre en évidence qu'une évolution du trouble marquée par une grande fréquence d'épisodes dépressifs comme dans le cadre d'une polarité prédominante dépressive ou que le caractère mixte d'un épisode récurrent semblent être des facteurs associés à une élévation du risque suicidaire tout au long de la maladie. Les mécanismes en jeu sont cependant mal identifi és. Reconnaître ces modalités évolutives spécifi ques conduit à envisager des modalités interventionnelles particulières basées sur le repérage clinique d'une symptomatologie mixte lors d'un épisode récurrent pour un traitement adapté ou sur le dépistage et l'évaluation précis dans l'histoire de la maladie de la présence d'états dépressifs pour tenter de les prévenir. © L'encéphale, Paris, 2012. Tous droits réservés.
Journal of Affective Disorders, 1993
Using single photon emission computerized tomography (SPECT) with a 99mTc-HMPAO perfusion techniq... more Using single photon emission computerized tomography (SPECT) with a 99mTc-HMPAO perfusion technique, we studied the regional cerebral blood flow (rCBF) of 42 drug-free inpatients suffering from Major Depression' (n = 21) or dysthymia with the super-imposed diagnosis of a major depressive episode (n = 21). The patients with Major Depression had a significantly lower frontal and posterior rCBF ratio than those with Double Depression. Left frontal region indices showed a slight overlap between the two groups. There was no correlation between the severity of the illness and the rCBF indices. Different qualitative cerebral dysfunctions may be implicated in these two affective disorder sub-types.
Journal of Affective Disorders, 2006
Background: Postnatal depression is a major public health problem. The aim of this study is to va... more Background: Postnatal depression is a major public health problem. The aim of this study is to validate the use of the Edinburgh Postnatal Depression Scale (EPDS) in the early postpartum, and to identify the markers for risk of postnatal depression. Methods: 815 women filled out an EPDS and general information questionnaire between the third and the fifth day postpartum. The women with an EPDS score of N 8 and a randomized control group from those with scores of b 8 were contacted 8 weeks postpartum. 363 women therefore had a structured diagnostic interview by telephone at 8 weeks postpartum (MINI-DSM-IV), without knowledge of their EPDS scores, to screen for a major or minor depressive episode. Results: The sensitivity of EPDS was measured as 0.82 [0.78-0.86], with a positivity threshold of 9.5/30. For an estimated prevalence for all depressive episodes of 16.1%, the positive predictive value of EPDS was measured as 42.8% [39.1-46.5%]. Multivariate risk analysis using logistical regression identified the following as risk markers for postnatal depression: previous history of depression (postnatal or other), unemployment, premature delivery or stopping breast-feeding in the first month for nonmedical reasons. Conclusion: The use of EPDS between the third and fifth day postpartum is valid. An EPDS score of N 10 should be completed by a clinical assessment and suitable management. The risk markers identified here are clinical indices that can be used for first-line early screening by non-psychiatric health workers.
European Psychiatry, 1996
Background: Neuroleptic malignan' syndrome (NMS) is a potentially lethal adverse effect to neurol... more Background: Neuroleptic malignan' syndrome (NMS) is a potentially lethal adverse effect to neuroleptic drugs. Methods: We report on 2 cases where NMS dramatically improved with carbamazepine. Inc,!dental removal and reapplication of carbamazepine atte,:ts to its effectiveness for this condition. Results: ,4 34-year-old woman treated for a major depressive disorder experienced NMS with a phenothiazine. Her condition dramatically improved in 8 hours after she was administered carbamazepine. Since carbamazepine was discontinued, NMS recurred in 10 hours and remitted anew within less than 24 hours aider reintroduction. A 31-year-old woman experiencing a s'chizoaffective disorder displayed NMS with aphenothiazine and a bu~,rophenone. NMS completely resolved within 8 hours after she was administered carbamazepine. NMS recurred within 12 hours after carbamazepine discontinuation. Conclusions: These data thus accoimt for a cause-effect relationship between carbamazepine administration and NMS relief and argue against the neuroleptic withdrawal to be responsible by itself for NMS relief Biol Psychiatry 1998;43:303-305 © 1998 Socie~' of Biological Psychiatry.
L'Encéphale
The Psychiatry department of the University Hospital Centre of Lille has developed, over the last... more The Psychiatry department of the University Hospital Centre of Lille has developed, over the last 10 years, a treatment network for psychiatric disorders during pregnancy or in the post-partum period. There are liaison consultations in the maternity department, screening and management of psychopathological disorders in the perinatal period, training of midwives, support of patients seeking genetic counselling, collaboration with teams providing "medically-assisted procreation", etc. For severe disorders of the post-partum period (severe depression, serious alteration of mother-child interaction, puerperal psychosis), the Psychiatry department has a specialized unit where 3 "mother-child" groups can be admitted. This unit is particularly effective if the patients and their family understand this healthcare system and stick to it to a certain extent. Even if improvements are always possible, cases in which situations occur as an emergency, are when dysfunctions ar...
Clinical Effectiveness in Nursing, 2006
L'Encéphale, 2012
Le trouble bipolaire s'associe à un risque suicidaire élevé. Parmi les principaux facteurs de ris... more Le trouble bipolaire s'associe à un risque suicidaire élevé. Parmi les principaux facteurs de risque il semble utile d'insister sur l'importance des liens existants entre d'une part les conduites suicidaires et d'autre part les différents sous-types de troubles bipolaires, les modalités évolutives ou les caractéristiques cliniques des épisodes. On peut ainsi mettre en évidence qu'une évolution du trouble marquée par une grande fréquence d'épisodes dépressifs comme dans le cadre d'une polarité prédominante dépressive ou que le caractère mixte d'un épisode récurrent semblent être des facteurs associés à une élévation du risque suicidaire tout au long de la maladie. Les mécanismes en jeu sont cependant mal identifi és. Reconnaître ces modalités évolutives spécifi ques conduit à envisager des modalités interventionnelles particulières basées sur le repérage clinique d'une symptomatologie mixte lors d'un épisode récurrent pour un traitement adapté ou sur le dépistage et l'évaluation précis dans l'histoire de la maladie de la présence d'états dépressifs pour tenter de les prévenir. © L'encéphale, Paris, 2012. Tous droits réservés.
Journal of Affective Disorders, 1993
Using single photon emission computerized tomography (SPECT) with a 99mTc-HMPAO perfusion techniq... more Using single photon emission computerized tomography (SPECT) with a 99mTc-HMPAO perfusion technique, we studied the regional cerebral blood flow (rCBF) of 42 drug-free inpatients suffering from Major Depression' (n = 21) or dysthymia with the super-imposed diagnosis of a major depressive episode (n = 21). The patients with Major Depression had a significantly lower frontal and posterior rCBF ratio than those with Double Depression. Left frontal region indices showed a slight overlap between the two groups. There was no correlation between the severity of the illness and the rCBF indices. Different qualitative cerebral dysfunctions may be implicated in these two affective disorder sub-types.
Journal of Affective Disorders, 2006
Background: Postnatal depression is a major public health problem. The aim of this study is to va... more Background: Postnatal depression is a major public health problem. The aim of this study is to validate the use of the Edinburgh Postnatal Depression Scale (EPDS) in the early postpartum, and to identify the markers for risk of postnatal depression. Methods: 815 women filled out an EPDS and general information questionnaire between the third and the fifth day postpartum. The women with an EPDS score of N 8 and a randomized control group from those with scores of b 8 were contacted 8 weeks postpartum. 363 women therefore had a structured diagnostic interview by telephone at 8 weeks postpartum (MINI-DSM-IV), without knowledge of their EPDS scores, to screen for a major or minor depressive episode. Results: The sensitivity of EPDS was measured as 0.82 [0.78-0.86], with a positivity threshold of 9.5/30. For an estimated prevalence for all depressive episodes of 16.1%, the positive predictive value of EPDS was measured as 42.8% [39.1-46.5%]. Multivariate risk analysis using logistical regression identified the following as risk markers for postnatal depression: previous history of depression (postnatal or other), unemployment, premature delivery or stopping breast-feeding in the first month for nonmedical reasons. Conclusion: The use of EPDS between the third and fifth day postpartum is valid. An EPDS score of N 10 should be completed by a clinical assessment and suitable management. The risk markers identified here are clinical indices that can be used for first-line early screening by non-psychiatric health workers.
European Psychiatry, 1996
Background: Neuroleptic malignan' syndrome (NMS) is a potentially lethal adverse effect to neurol... more Background: Neuroleptic malignan' syndrome (NMS) is a potentially lethal adverse effect to neuroleptic drugs. Methods: We report on 2 cases where NMS dramatically improved with carbamazepine. Inc,!dental removal and reapplication of carbamazepine atte,:ts to its effectiveness for this condition. Results: ,4 34-year-old woman treated for a major depressive disorder experienced NMS with a phenothiazine. Her condition dramatically improved in 8 hours after she was administered carbamazepine. Since carbamazepine was discontinued, NMS recurred in 10 hours and remitted anew within less than 24 hours aider reintroduction. A 31-year-old woman experiencing a s'chizoaffective disorder displayed NMS with aphenothiazine and a bu~,rophenone. NMS completely resolved within 8 hours after she was administered carbamazepine. NMS recurred within 12 hours after carbamazepine discontinuation. Conclusions: These data thus accoimt for a cause-effect relationship between carbamazepine administration and NMS relief and argue against the neuroleptic withdrawal to be responsible by itself for NMS relief Biol Psychiatry 1998;43:303-305 © 1998 Socie~' of Biological Psychiatry.