Search

Most in vivo studies of striatal D2 receptor (SD2R) density with positron emission tomography in schizophrenia have attempted to relate this variable to the diagnosis of the illness. In the present study, a relationship between SD2R and clinical dimensions of this psychosis was searched for in a highly selected group of young negative schizophrenics (8 drug-naïve and 2 drug-free). The SD2R density index measured in vivo using 76Br-bromolisuride and PET correlated negatively (r = 0.80, P < 0.01) with a psychomotor dimension of schizophrenia involving blunted affect and alogia. The mean SD2R index of the patients did not differ from that of age-matched control subjects. Therefore, this behavioural dimension accounts for the variance of the SD2R, suggesting that the striatal dopamine system modulates symptoms such as flattened affect and alogia. [ABSTRACT FROM AUTHOR]

Background : Clinical data is largely focused on depressive comorbidity in OCD. However in practice, treating resistant or severe OCD sufferers revealed many cases who seem to have an authentic OCD with a hidden comorbid bipolar disorder.Methods : The rate of bipolar comorbidity in OCD was analyzed in a epidemiological survey which we undertook among the members of the French Association of patients suffering from OCD (AFTOC in French). To explore mood comorbidity, we used structured self-rated questionnaires for major depression, hypomania and mania (DSM-IV criteria) and self-rated Angst’s checklist of Hypomania and Cyclothymic Temperament (developped by Akiskal and Hantouche). From a total sample of 780, 453 files (58 %) were returned and analyzed : 76 % had suffered from a major depression (83 % recurrent) and 17 % had attempted suicide.Results : According to DSM-IV definitions of hypomania/mania, 11 % of the total sample were classified as bipolar (3 % as BP-I and 8 % as BP-II). However, 20 % had been recognized as bipolar or cyclothymic before the survey and treated with mood stabilizers. Furthermore, the Hypomania Checklist of Angst showed that 30 % obtained a cut-off score = 10. Analysis on the self-rated questionnaire for Cyclothymic Temperament showed that 50 % scored = 10, and so classified as BPII1/2. Both thresholds for self-rated hypomania and cyclothymia were previously validated by Hantouche et al. (1998). Finally, our analyses showed that anger attacks and suicide behavior were mainly linked to comorbid bipolarity.Conclusion : These data extend clinical research on “bipolar OCD” entity which is largely under-recognized in clinical practice. Also, they implicate cyclothymia in hostility and suicide risk in this population. [Copyright &y& Elsevier]

Background – Recognition of Obsessive-Compulsive Disorder (OCD) in every day practice is a difficult task, especially in primary care, as few epidemiological surveys have been made of it in general medicine. Within this context, a recent survey was undertaken on a national level, involving more than 650 clinicians. The aim of the survey called « AR-TOC » was to show the feasibility of screening OCD in special population of patients presenting « Resistant Anxiety » to anxiolytics or to minor sedatives.Results – Data are presented in a cohort of 5 919 patients. They showed negative response on the screening questionnaire in 40,9 % of the total population, the presence of OCS (obsessive-compulsive syndrome) in 13,9 % and of OCD in 45,2 % (“probable OCD” in 31,2 % and “definite OCD” in 14 %).Principal component analyses were conducted in 3 498 cases presenting OCS or OCD. These analyses have concerned the clinical data which derived from clinician (OCD Screening Questionnaire, OCD-SQ) and self-rated questionnaires (Maudsley Obsessive-Compulsive Inventory, MOCI). Firstly, the results were concordant with the dimensional approach of OCD by identifying clinically meaningful separated subtypes. From the OCD-SQ, three factors were isolated such as “compulsive”, “obsessive” and “mixed” subtypes, and from the MOCI, four factors were identified such as “Property-Cleaning”, “Checking”, “Waste of Time” and “Obsessions with purity”. Factorial scores deriving from MOCI were highly correlated to respective OCD-SQ sub-types and capable to differentiate significantly the different diagnoses of OC phenomena (OCS, Probable OCD and Definite OCD).Conclusion –  “AR-TOC” have succeeded to show the feasibility of screening OCD in patients suffering from resistant anxiety. Moreover, the use of dimensional analyses had resulted in the characterization of separate subtypes based on the dominant obsessive and/or compulsive symptomatology. [Copyright &y& Elsevier]