Encephale
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Multicenter Study Clinical Trial
[Long-acting injectable risperidone: naturalistic study in three hospitals in Aquitaine].
Injectable risperidone is the first long-acting second-generation antipsychotic. A middle-term naturalistic study has been conducted with the first treated patients of three psychiatric hospitals in Aquitaine. ⋯ Despite the small size of the sample, this study presents a view of the use of the drug in realistic conditions and appears to show that long-acting injectable risperidone is probably the most appropriate treatment for stable, discharged patients.
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Multicenter Study Comparative Study Controlled Clinical Trial
[Is the suicidal risk assessment scale RSD of predictive value?].
A part (60% to 70%) of those who are going to act out their suicide consult a doctor the month before. Studies have shown the need to improve the practitioner's capacity to diagnose depression. The assessment of the suicidal risk is crucial. The search for suicidal risk factors helps to define the populations at risk. However, it doesn't provide information concerning the possibility of acting out in the short term. And how does one react when faced with those who do not present any of the risk factors? Psychometric instruments attempt to help the therapist in his/her reasoning. SUICIDAL RISK ASSESSMENT: Among them, the suicidal risk assessment scale RSD should be mentioned. Its objective is to estimate the seriousness of the suicidal risk, with 11 levels. It is built around a possible will to commit suicide rather than a single assessment of the frequency of suicidal ideas. Its construction in hierarchical order permits the progressive assessment of the suicidal risk, in the form of a semi-structured interview. Hence, the suicidal risk assessment scale RSD looks for the existence of death wishes (levels 1-2), of suicide ideations and its frequency (levels 3-4-5), and of a passive desire to die (level 6). Level 7 shows the onset of a decision making process, except that the patient is still inhibited by various important factors in his/her life. More often, the fear of inflicting immense suffering to his/her loved ones or for religious beliefs, is found. From level 8, determination has made way to hesitation. An active death wish exists, and although the plan remains undefined, the act is decided on. At level 9 the methods of application are developed and a plan is established. The ultimate level exists when there is a start in the preparation of the act of suicide (level 10). This hierarchical order has been confirmed by some epidemiological studies. ⋯ Thus, the RSD appears of interest, from a clinical point of view, by providing a -diagnostic, or a scientific approach.
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Multicenter Study
[Clinical and therapeutic characteristics of social phobia in French psychiatry (Phoenix study)].
Only few clinical epidemiologic studies have been conducted on social phobia in France to date. It is however a frequent disorder, with often severe alteration of social adaptation and quality of life, and for which effective treatments exist. Thus, it seems really important to further explore how these patients are nowadays identified and treated in psychiatry. ⋯ On the whole, this study confirmed the severity and the morbidity of social phobia in a very large sample of French psychiatric patients. The depressive disorders, suicidal risk, and social impairment associated with this condition should incite to more detect and treat it. Seeing the long duration of the disease in our sample, and the lack of specific therapies in many cases, the identification and the treatment of social phobia must be improved, and the role of the psychiatrists in this process seems very important.
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Multicenter Study
[Psychotropic drug use and mental psychiatric disorders in France; results of the general population ESEMeD/MHEDEA 2000 epidemiological study].
The use of psychotropic drugs is high in France and has increased over the last two decades. To date, no national study evaluating psychotropic drug use in the context of the diagnosis of psychiatric disorders has been performed. Such data has now been generated in the ESEMeD/MHEDEA 2000 study, which has allowed comparison of the situation in France with that in five other European countries (Germany, Belgium, Spain, the Netherlands and Italy). ⋯ Over the last two decades, use of AX-HY seems to have decreased in France, even though it remains higher than that observed in the other European countries participating in this study. This high use can be explained in part by the observation that, in around half the cases, it corresponds to occasional use. In contrast, the use of antidepressants has increased. In subjects with recent mood disorders or anxiety disorders, the use of AX-HY remains higher than that of antidepressants. Finally among users of AX-HY, only half of them had presented a mood disorder, anxiety disorder or alcohol use disorder during their lifetime, whereas this proportion rose to 80% for users of antidepressants.
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Multicenter Study Comparative Study Clinical Trial
[Concurrent validation of the suicidal risk assessment scale (R.S.D.) with the Beck's suicidal ideation scale].
The prevention of suicide is a top priority in mental health. The determination of high risk suicidal groups is not sufficient. The expressing suicidal ideas is not a protective factor, but in contrary a risk factor to take into account, or even to search and to quantify: 80% of the subjects who attempt to commit suicide or commit suicide express such ideas months before. ⋯ Moreover, a score of 7 and more on the suicidal risk assessment scale RSD seems to represent a risk level judged particularly significant by the experimenters. In effect, the existence of such a suicidal risk was a criteria of exclusion and no patient with a level superior to 6 on suicidal risk assessment scale RSD was included. In conclusion, the utilisation of the suicidal risk assessment scale RSD could be interesting in the prevention of suicide.