Encephale
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Comparative Study Clinical Trial Controlled Clinical Trial
[A controlled study of irrational interpretations of intrusive thoughts in obsessive-compulsive disorder].
Recent research suggested that the irrational interpretations of intrusive thoughts might be cognitive structures underlying obsessive compulsive disorder (OCD). We present a study on intrusive thoughts and their interpretations in 36 patients suffering from OCD (DSM IV criteria), compared with 36 sex and age matched non clinical subjects, with the Intrusive Thoughts and their Interpretations Questionnaire-revised version (ITIQ-r). This questionnaire measures intrusive thoughts intensity and three types of interpretation: responsibility, guilt and inferiority. The measures of OCD, of depression, of social phobia and of anxiety have been used. ⋯ OCD patients reported more frequent intrusive thoughts and higher irrational interpretations than controls. The higher the intrusive thoughts, the higher the irrational interpretations. The multiple regression showed that both intrusive thoughts and irrational interpretations were respectively predicted by obsessional compulsive pathology (the Obsessive Thoughts Checklist or the Y-BOCS). The Y-BOCS was the only predictor for inferiority interpretation, but there was no significant predictor for responsibility or for guilt interpretations. Responsibility correlated only with aggressive intrusive thoughts. Guilt was related to intrusions about fear of loss. Inferiority was highly correlated with intrusive thoughts about perfectionism and sexuality.
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As shown by a recent decree of the supreme court, the legal aspect of information given before consent is more and more important. At beginning, the written consent was reserved to particular cases, as biomedical research for example. ⋯ We may imagine that this evolution paradoxically results in a worse integration of subjectivity. Then, it seems necessary to stress the clinical aspect so as to give to the consent concept its legitimity back: it consists in an ethical and humanistic acknowledgement of alterity.
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Review Comparative Study
[Cost of illness: an inextricable maze or an aid in decision making? The case of schizophrenia].
The cost of schizophrenia has been a major point of interest abroad. In the United States, two authors evaluated the direct cost of the illness. According to Gunderson and Mosher (13), it reaches US $25,625 million. ⋯ This point tempers largely the interest of these studies as a tool in order to hierarchise Public Health priorities. Moreover, the elaboration of structures equivalencies between the different countries is an ambitious enterprise and make difficult comparisons of the studies. Finally, the lack of transparency of some of them limits their credibility.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[Comparison of 6 different methods for lorazepam withdrawal. A controlled study, hydroxyzine versus placebo].
154 outpatients with generalized anxiety (DSM III-R criteria), followed by general practitioners, gave an informed written consent to participate in this multicenter, randomized, placebo controlled study previously approved by a legal ethic committee (CCPPRB). The patients had to be long term consumers (at least 3 months) of 2 mg daily of lorazepam and were withdrawn using transiently an antihistaminic anxiolytic (hydroxyzine or placebo TAD) according to 6 different procedures defining 6 parallel groups: hydroxyzine 50 mg, abrupt or progressive withdrawal; hydroxyzine 25 mg, abrupt or progressive withdrawal; placebo, abrupt or progressive withdrawal. Following this 4 week-period of withdrawal, the patients were without any treatment for a post-study follow up 2 month-period. Clinical evaluations for anxiety (HARS, Zung), sleep (Spiegel), BZD withdrawal syndrome (Tyrer), adverse reactions and clinical global impression (CGI) were performed at D0, D7, D14, D28, D35 and D88. Investigators opinion and patients attitude towards BZD were collected at D88. ⋯ These results proved a significant improvement of anxiety, a decrease of side effects in both the groups treated with hydroxyzine and a reduction of withdrawal symptomatology in hydroxyzine 50 mg group. When a patient is engaged to be withdrawn from of a lorazepam long term treatment, it can therefore be proposed as a support a transient prescription of hydroxyzine 25 mg TAD to markedly anxious patients and of hydroxyzine 50 mg TAD to patients presenting a withdrawal symptomatology.
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Firstly suicide and parasuicide are defined and their respective characteristics are described. Some classifications of suicide and suicidal behaviors are analysed, mainly those which emphasize the clinical aspects. Certain models which undertake to explain the suicide are briefly reviewed, namely those which see the suicide as a deviant behaviour as well as those which see the suicide as a disease. ⋯ Suicidal risk factors, namely biomedical, psychological, social, cultural, environmental and symptomatic are analysed. The predictive evaluation of suicide is pointed out and some suicide prevention strategies are discussed. Finally the dependence of suicide on individual life cycles, on psychological, social and cultural conditions and on cultures and societies cycles is considered.