Denis Grabot

Childhood history of behavioral inhibition and comorbidity status in 256 adults with social phobia

BACKGROUND Behavioral inhibition (BI), a heritable temperament, predisposes one to an increased risk of social phobia. Recent investigations have reported that BI may also be a precursor to anxiety as well as depressive and alcohol-related disorders, which are frequently comorbid with social phobia. In the present study, we explored the relationship between BI and psychiatric disorders in 256 adults with a primary diagnosis of social phobia. METHODS BI severity was retrospectively assessed with the Retrospective Self-Report of Inhibition (RSRI). The severity of social phobia and the presence of comorbid diagnoses were evaluated with the Liebowitz Social Anxiety Scale (LSAS) and the Mini-International Neuropsychiatric Interview, respectively. RESULTS The RSRI score was significantly and positively correlated with both the LSAS score and the occurrence of a major depressive disorder. No significant association was found with other anxiety and substance-related disorders. LIMITATION The assessment of BI was retrospective and self-reported. CONCLUSION A childhood history of BI was associated with an increased risk of depressive comorbidity in social phobia.

A naturalistic follow-up study of French-speaking opiate-maintained heroin-addicted patients: Effect on biopsychosocial status ☆

The purpose of this study was to evaluate the impact of opiate maintenance pharmacotherapy (OMP) on the biopsychosocial status of opiate-addicted patients in a cultural environment (France) that is not favorable to OMP and where methadone is not available. Buprenorphine and laudanum (opium tincture), which, to our knowledge, has not been reported previously in the scientific literature for OMP, were used in this study of a group of 18 opioid-dependent subjects. At time of initiation of OMP, mean age was 33 years, sex ratio male: female was 14:4, average duration of drug use was 11.2 years. Six patients received laudanum p.o., 15 g daily; 12 patients received buprenorphine sublingual 2 to 4 mg daily. This group of patients was selected because of persistent relapse and impairment after an average of 5.7 drug-free-oriented treatments over a period of 6.8 years. Initial evaluation and follow-up were made by way of a 150-min semi-structured interview using the Lifetime Retrospective Evaluation Score Table (LREST) and the Addiction Severity Index (ASI). Results showed that body weight and scores for physical and psychological health, socioprofessional status, and family relationships improved significantly after 14 months of OMP. These results show that highly impaired opiate-addicted patients doing poorly in drug-free treatment can respond to OMP even though methadone is not available and the idea of OMP is not favored.

Missbrauch und Misshandlung in der Kindheit und Autoaggressionen in der Adoleszenz. Ein Vergleich junger Frauen aus Deutschland und Frankreich

Beinahe alle Psychotherapeutinnen und Psychotherapeuten, die sexuell traumatisier-te Patientinnen behandeln, berichten davon, dass ein Grosteil dieser Patientinnen sich immer wieder absichtlich selber verletzt. Und auch diejenigen Arzte und Psychologen, die in ihrer taglichen Arbeit mit solchen Patientinnen konfrontiert sind, die sich selber Verletzungen und Wunden am Korper zufuhren, konstatieren ubereinstimmend, dass viele dieser Frauen von sexuellen Traumatisierungen in der Kindheit berichten.

Use of midazolam for ECT anesthesia: effects on antidepressive efficacy and seizure duration. Preliminary findings*

Midazolam is a short acting benzodiazepine that has been used for electroconvulsive therapy (ECT) anesthesia. The purpose of this study was to determine whether midazolam used for this purpose would impair the antidepressive efficacy of ECT. In a double-blind random-assignment study midazolam was compared to methohexital on the antidepressive efficacy of bilateral ECT as measured by the reduction in the Montgomery Asberg Depression Rating Scale (MADRS) scores and seizure duration. Sixteen DSM-III-R major depressive disorder patients with melancholia were included. Midazolam and methohexital did not differ in their effects on the MADRS score or seizure duration; no correlation was found between seizure duration and outcome of depression for either group. Our preliminary findings do not support the claim that benzodiazepines should not be used during bilateral ECT.