Encephale
-
Borderline personality disorder (BPD) is a serious public health problem. It is associated with high levels of mental health service utilization, an important degree of psychosocial impairment and a high rate of suicide (10%). BPD is a common psychiatric disorder and the most frequent personality disorders. Approximately, 15 to 50% of psychiatric inpatients and 11% of psychiatric outpatients meet current criteria for BPD. Recurrent suicidal threats, gestures or behaviour or self-mutilation are common in patients suffering from borderline personality disorder. However, despite their similarities, self-mutilation behaviour differs from suicide attempts by the lack of systematic suicidal intentions. The purpose of our study is to examine the relationships between self-mutilations, suicide and related therapeutic approach. ⋯ These findings highlight the possibility of self-mutilation as a risk factor of suicide in borderline personality disorder. Nevertheless, to reinforce this assertion, further studies on large sample of borderline patients, with or without self-mutilation, are needed. Moreover, prospective controlled studies on the various treatment models in suicidal BPD patients are necessary.
-
Electroconvulsive therapy, a standard treatment in mood disorders, is sometimes also indicated in psychotic disorders, especially in the treatment of refractory schizophrenia. In this instance, maintenance electroconvulsive therapy (M-ECT) can also become a long-term treatment. This paper presents the effects of M-ECT in the treatment of refractory schizophrenia using a retrospective analysis. Previous works showed that electroconvulsive therapy is effective on catatonia, anxiety with somatisation, lack of compliance, opposition, delusions especially with hallucinations and persecution, anorexia, agitation, carelessness, aggressive behaviour and moral pain. It is ineffective on bewilderment, somatic complaints and negative symptoms. ⋯ Maintenance electroconvulsive therapy combined with medication may be an efficient alternative to pharmacological treatment alone in refractory schizophrenia. Alternative therapeutical strategies are crucial in this domain, due to the important public health problem it raises. There are few randomised prospective controlled clinical trials regarding this treatment and further clinical investigations are necessary, notably to define standardized criteria for M-ECT programs.
-
Review
[Anxiety and depression in children and adolescents with migraine: a review of the literature].
The authors review the literature on anxiety and depression in children and adolescents who experience migraine headaches. For over a century, clinicians and researchers have noticed potential links between migraine and certain psychopathological traits. More recently, rigorous methodological studies have confirmed some of those links. For example, several reviews have shown a strong comorbidity in adults between migraine, major depression and certain anxiety disorders. As for children and adolescents, no recent work has thoroughly reviewed the literature specifically on the topic of migraine, anxiety, and depression. ⋯ Questionnaires created specifically for a research project, or containing vague terminology, such as "psychosocial disorders", should never be used. Future studies should rely on assessment tools validated for the specific population.
-
Comparative Study
[Confirmative study of a French version of the Exercise Dependence Scale-revised with a French population].
Since the first writings on excessive exercise, there has been an increased interest in exercise dependence. One of the major consequences of this increased interest has been the development of several definitions and measures of exercise dependence. The work of Veale [Does primary exercise dependence really exist? In: Annet J, Cripps B, Steinberg H, editors. Exercise addiction: Motivation for participation in sport and exercise.Leicester, UK: Br Psychol Soc; 1995. p. 1-5.] provides an advance for the definition and measure of exercise dependence. ⋯ The principal component analysis results in a six-factor structure, which accounts for 68.60% of the total variance. Because principal component analysis presents a six-factor structure differing from the original seven-factor structure, two models were tested, using confirmatory factor analysis. The first model is the seven-factor model of the original version of the EDS-R and the second is the model produced by the principal component analysis. The results of confirmatory factor analysis presented the original model (with a seven-factor structure) as a good model and fit indices were good (X(2)/ddl=2.89, Root Mean Square Error of Approximation (RMSEA)=0.061, Expected Cross Validation Index (ECVI)=1.20, Goodness-of-Fit Index (GFI)=0.92, Comparative Fit Index (CFI)=0.94, Standardized Root Mean Square (SRMS)=0.048). These results showed that the French version of EDS-R has an identical factor structure to the original. Therefore, the French version of EDS-R was an acceptable scale to measure exercise dependence and can be used on a French population.
-
To determine the specific clinical aspects of patients with suicidal behaviour by firearm and investigate the specificities of the suicide method. ⋯ Some clinical characteristics have been reported as far as suicide attempters by firearm are concerned. Actually, there are some significant differences between suicide attempters by firearm and other suicide attempters. These results are very important for the perspective of preventing suicidal behaviour. However, it is essential to continue studies on the clinical aspects according to the method used in attempted and completed suicide.