Pascal Janne

Moclobemide versus fluoxetine for a major depressive episode.

The efficacy and tolerability of moclobemide (300–600 mg daily) and fluoxetine (20–40 mg daily) were compared in a 6-week, double-blind study of 65 inpatients and 34 outpatients suffering from major depressive episodes (DSM III-R). No statistically significant differences between the two treatment groups were noted regarding efficacy (HDRS, CGI) or safety (adverse events, laboratory examination, vital signs). Moclobemide (300–600 mg daily) and fluoxetine (20–40 mg daily) would thus appear to be comparable both in antidepressant efficacy and tolerability. Doubling the low dosage in non-responders after 3 weeks resulted in a statistically significant improvement of CGI in the moclobemide group by comparison with the fluoxetine group at study end, suggesting that 600 mg moclobemide/day can still improve the patients condition, while 40 mg fluoxetine/day does not. Sexual dysfunction was reported in two patients taking fluoxetine.

Overuse of emergency care in psychiatry

In an open study relating psychiatric emergencies in a general hospital, the authors observe that only in 30% of cases does the reason for emergency referral of patients by their general practitioner involve the concept of danger. In view of the results of this study, it would seem beneficial, if one wishes to reduce the number of psychiatric admissions, to improve the training of general practitioners in general psychiatry and in the treatment of mood disorders in particular.

ADOLESCENCE AND DIAGNOSTICS

The major diagnostic categories (schizophrenia, borderline disorder, depression) are reviewed and the difficulties in applying this “adult” classification to adolescence are noted. The reasons for these are numerous, i.e., history of the discovery of diseases, the similarities in psychodynamic functioning between the pathological and the “normal” in adolescence, and prognosis which varies depending on age. How, then, does one distinguish between the pathological and the normal at this age, and is the concept of crisis at all useful?

Induction of a schizophreniform disorder by a spinal cord stimulator.

Received July 10, 1998; revised July 22, 1998; accepted August 20, 1998. From the Department of Psychosomatic Medicine and the Interdisciplinary Clinic on Pain, Universite Catholique de Louvain, Cliniques de Mont-Godinne, Yvoir, Belgium. Address correspondence and reprint requests to Dr. Zdanowicz, Universite Catholique de Louvain, Cliniques de Mont-Godinne, Department of Psychosomatic Medicine, 55330 Yvoir, Belgium. Copyright 1999 The Academy of Psychosomatic Medicine. In pain clinics—especially in teaching hospitals—before proceeding to spinal cord stimulation and/or implantation, a psychiatric and psychometric assessment is usually recommended to identify “at-risk patients,” that is, essentially patients showing schizophrenia and other psychotic disorders, lack of compliance, and/or other psychopathological abnomalities related to pain disorders. In some cases (as in schizotypical disorders), it remains somewhat difficult to ascertain such prognostic evaluations: may we deprive the patient of a pain-relief technique because of a hypothetical psychotic breakdown? The present case outlines the difficulty of applying such guidelines in practice and especially pinpoints the “floating point” problems encountered about whether accepting or rejecting indications of spinal cord stimulation. In this case, the patient does not really meet the full criteria for any Cluster A personality disorder, according to DSM-IV.

Reframing “Reframing”: Another Look at “Reframing” Inspired by a Sonnet by Charles Baudelaire

Even if rarely discussed in the current systemic literature, “reframing” remains a key concept and technique in systemic family therapy. With reference to Baudelaires poem entitled “The Frame,” we attempt to highlight and revisit reframing attitudes and interventions in clinical practice with families.

Erratum: Impact of medical specialists' locus of control on communication skills in oncological interviews (British Journal of Cancer (2003) 88 (502-509))

Correction to: British Journal of Cancer (2003) 88, 502–509. doi: 10.1038/sj.bjc.6600797 Unfortunately because of a typesetting error, Tables 1 and 3 were reproduced incorrectly. The correct versions are printed below: The publisher would like to apologise for any inconvenience this may have caused.

La dimension familiale du processus suicidaire, une étude empirique

A retrospective study was carried out on 44 patients with major depression to study familial characteristics and to determine whether this patient population could be prospectively characterized. Two groups were differentiated: the first consisted of suicidal depressive patients, and the second consisted of non-suicidal depressive patients. A discriminant analysis was then made on two variables: health locus of control for the depressive patient, and the adaptability and cohesion factors for the existing couple, the original family and the nuclear family. This analysis provided a psychological profile of the suicidal patient and his family based on the individuals health locus of control, and indicated certain psychological and familial predisposing factors. The results showed that the family has a considerable influence on the health of a suicidal depressive subject compared to that of a non-suicidal depressive individual. The capacity for adaptability is less and the attitudes are more rigid in the former subjects family than in the latter individuals family. These results have been discussed