Working memory control in patients with schizophrenia: a PET study during a random number generation task.

OBJECTIVE: The authors' goal was to investigate brain regions involved in the deficiency of working memory control processes in patients with schizophrenia. METHOD: Regional cerebral blood flow was measured with positron emission tomography in eight men with stabilized schizophrenia and eight healthy men while they were performing a graded random number generation task. Twelve scans were made for each subject. Covariations between randomness of responses and regional activation were analyzed. RESULTS: The pattern of covariation between randomness of responses and activation in the anterior cingulate and superior parietal regions differed between patients and healthy subjects. CONCLUSIONS: These results suggest a cinguloparietal dysfunction underlying the impairment of working memory control processes during a random number generation task in patients with schizophrenia.

Clinical and economic comparison of sertraline and fluoxetine in the treatment of depression. A 6-month double-blind study in a primary-care setting in France.

In a double-blind study in a primary-care setting in France, outpatients fulfilling DSM IV criteria for a major depressive episode were randomised to receive sertraline (50 to 150 mg/day; n = 122) or fluoxetine (20 to 60 mg/day; n = 120). Assessments, including clinical evaluation [Montgomery-Asberg Depression Rating Scale (MADRS), Clinical Global Impressions (CGI)] and quality of life [Functional Status Questionnaire (FSQ)], were made at study entry and after 4 and 6 months of treatment. Use of medical services, absences from work and productivity losses were recorded for calculation of direct and indirect costs from both the overall societal perspective and in terms of sickness insurance. In total, 231 patients (116 receiving sertraline, 115 receiving fluoxetine) were included in an intention-to-treat analysis assessed up to the last visit. Statistically significant clinical and quality-of-life improvements from baseline were observed in both treatment groups, with no between-group differences. Utilisation of medical resources was higher in fluoxetine-treated patients, with significantly more consultations with specialists. The 2 treatment groups were similar in terms of number of hospitalisations and duration of stay, whether related to depression or not. There were no significant differences between groups for work or productivity losses. Cost comparisons favoured sertraline treatment from both the societal (FF7780 vs FF8706) and sickness insurance (FF2936 vs FF3224) viewpoints, with cost differentials of FF926 and FF288, respectively. From the societal perspective, the total cost per patient over the 6-month course of the trial, irrespective of the study treatment given, was FF8241, and the corresponding sickness insurance cost was FF3079. At the time of the study, FF1 = $US0.1993.

[Transient delusional disorders and schizophrenia. Comparative catamnestic study of 2 groups of patients]. / Bouffées délirantes et schizophrénie. Etude catamnestique comparative de deux groupes de patients.

The authors investigated, in 1982, the situation of two groups of patients who had spent at least 8 days in the Psychiatric Clinic of the Strasbourg University Hospital in 1972, one group of whom had been diagnosed as suffering from "bouffée délirante aiguë" (B.D.A.), and another, from schizophrenia. In 1982, the former consisted of 43 people, 26 women and 17 men, and the latter of 72, 24 women and 48 men. The catamnesis was elaborated on the basis of social security files and information provided by physicians. All possible precautions were taken to protect professional secrecy and patients' anonymity. The data collected were subjectived to statistical analysis to establish correlations between certain variables and, on the basis of these variables, the traditional French classification was compared with that of the D.S.M. III. The outcome of patients suffering from B.D.A. was significantly better than those considered as schizophrenics. However, in 11 out of 26 patients with a B.D.A. diagnosis in 1972, there was an evolution towards schizophrenia, whereas 10 of the 44 schizophrenics displayed no handicap 10 years later. As regards the comparison between the prognostic values of the traditional French classification and D.S.M. III, the latter appeared more restrictive as to the diagnosis of schizophrenia with perhaps a clearer prognostic value. This catamnistic study further reinforces the arguments in favour of the existence of the B.D.A. as a clinical category. Further in-depth research in the genetic, biological and psychopathological fields should yield answers to the many questions still remaining.