Encephale
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Ultra-rapid opioid detoxification (UROD) is an increasingly popular technique for detoxifying patients addicted to opiates. This technique aims at reducing not only the duration but also the intensity of withdrawal by using general anesthesia coupled with a naloxone or naltrexone medication. In this paper the authors attempt to review the history of UROD and the logic of its procedure and results whilst also demonstrating its advantages and limits. ⋯ Ultra-rapid opiate detoxification represents a potentially safe and effective treatment for opiate addicted patients but more rigorous research methods are needed to render this procedure entirely valid.
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Study of depression in North-Africa and Sub-Saharan Africa has shown that, since the seventies, the clinical expression of depression is markedly different from that of depression in the West. Several authors have noted the rareness of guilt themes and the frequency of persecution themes and somatic complaints in depressed Africans, even those living in the West. ⋯ Our study addresses delusional depression: in 73 cases of delusional depression, delusions of guilt were present in 31% of cases, persecution in 48% and hallucinations in 31.5%. A comparison of the sub-groups consulting in 1991 and a second sub-group consulting in 1998 shows a marked increase in guilt (23.5 versus 39%).
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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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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.