Eye-tracking patterns in schizophrenia. An analysis based on the incidence of saccades.

Saccades occurring when tracking a sine-wave target and when fixating a stationary target were studied in the following three groups: schizophrenics, other psychiatric inpatients, and normal controls. The frequency of saccades when tracking and when fixating was significantly greater among schizophrenics than among the two comparison groups. The pattern of occurrence of saccades within cycles of the sine movement was similar in the three groups; the greatest occurrence was at the highest target velocity and the lowest occurrence was at reversal points. The data are interpreted as consistent with the hypothesis of a failure on inhibiting mechanisms.

DSM-III and its reception: a European view.

The author analyzes some elements in the reception of DSM-III in Europe. The worldwide success of a diagnostic classification originally presented as a purely American endeavor is associated with recurrent, albeit not often openly formulated, criticisms. In the history of psychiatric nosologies, the purely descriptive phase was succeeded by a period during which theories were dominant, as in the Kraepelinian system. DSM-III originated in recognition of the existence in the United States of contending psychodynamic and psychosocial orientations and problems of communication, which became even more evident with the growth of psychopharmacology and the influence of the biological school. Whereas ICD offered compromise solutions, DSM-III used a new paradigm based on diagnostic categories and a multiaxial format, which were on the whole easily accepted. Most criticisms involved three points. The first was the atheoretical syndromic approach, seen as a regression and an expression of an American preference for superficial facts and contempt for psychopathology, which was considered in Europe the source of future progress. The second was the introduction of quantification, which was rejected by some in the name of the clinical tradition, which emphasized understanding of the individual case. The third was DSM-III's adherence to alleged American values, such as pragmatism and novelty. The ambivalence of Europeans toward the world expansion of American culture was reinforced by use of English as the language of international scientific communication. The mostly irrational nature of the criticisms contrasts sharply with the general acceptance of DSM-III and its successors, which rests on their objective merits.

A computerized diagnostic system for comparing alternative classification schemes of depression.

The present report presents a computerized system, permitting recording of diagnostic criteria and assignment by diagnostic algorithms as proposed and intended in 7 different classification systems of depression. The potential of the procedure for comparing alternative classifications of depression is presented and discussed.

Measuring the severity of depression through a self-report inventory. A comparison of logistic, factorial and implicit models.

The present study investigates the psychometric adequacy of a self-report inventory of depression (the QD2) with respect to the severity of depressive symptoms, within the framework of a unidimensional model of depressive states. Responses to the 52 QD2 items, by 481 subjects divided into four groups (depressed, psychiatric, somatic and control), were subjected to a Rasch analysis. Results show that 15 items (QSD(R1] display a satisfactory goodness of fit for both items and persons, as defined by the Rasch model. This set of items, solely related to 'pure' depression, gives a measure of the severity of depression, free from anxiety symptoms. The discussion focuses upon the advantages of the Rasch model as compared to traditional tests. The Rasch 15-item solution should provide a parsimonious tool for future studies on the classification of depressive disorders.

Fluvoxamine and imipramine: results of a long-term controlled trial.

Following a multicentre double-blind controlled trial comparing the effects of fluvoxamine and imipramine in depressed inpatients (M.D.E.) 39 patients continued on longer term treatment with maintenance of double-blind conditions (17 on fluvoxamine, 22 on imipramine). The results regarding the reasons for premature interruption of treatment show a slight advantage in favour of fluvoxamine. There were several significant differences in favour of fluvoxamine at the 20th week. The most common side-effects were hot flushes with imipramine and dizziness with fluvoxamine. Overall, despite the small number of patients, the results show a greater clinical tolerance to fluvoxamine than to imipramine.

The birth of the bipolar disorder.

The history of the description by Jean-Pierre Falret of circular insanity, the origin of our present day bipolar disorder, is presented as well as the claims of priority raised by his colleague Jules Baillarger. A detailed account is given of the long-lasting controversy which has often given rise to biased judgments about the respective roles of the two psychiatrists. It is shown that the clinical concept was an expression of Falret's views about the nature of mental disorders and that, through the influence these views had on future nosological systems, the apparently purely picturesque episode corresponds to a landmark in the history of psychiatry.

The historical roots of behavior therapy.

This paper reviews lines of thought that are historically relevant to the emergence of behavior therapy. First consideration is given to animal magnetism, and the reaction against it. Then the influence of German psychiatry is surveyed, followed by various views of disorders of the nervous system. These in different ways affected the Freudian mode of thinking and also Pavlovian theory, and more indirectly experimental psychology.

[DSM-III: the 3d edition of the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association]. / Le DSM-III: troisième édition du manuel diagnostique et statistique des troubles mentaux de l'Association américaine de psychiatrie.

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) published by the American Psychiatric Association in 1980, and now translated in many languages, has raised a great interest in the whole world. It has probably had on psychiatric thinking as important an impact as the Treatise of Psychiatry of E. Kraepelin at the beginning of the century. The evolution of psychiatric nosology and the circumstances of the birth of DSM-III are described. In discussing the general principles and the technical aspects, the influence of several currents of thought are emphasized: recent remedicalization of psychiatry in the United States, suspicion about speculative theories, return to an a-theoretical clinical descriptive nosology, influence of quantitative differential psychology and of the models provided by computer diagnosis. The nature of the two basic principles: the necessity of attaining a proven high interjudge reliability in diagnosis, and the descriptive a-theoretical nature of the description of each category is analyzed. From those principles derive the most original features of the DSM-III: the use of stringent diagnostic criteria, of a possible quantitative nature and the adoption of a multi-axial system. Some of the most striking changes introduced are the logical consequences of the principles e.g. the deletion of the term "neurosis". Others changes such as the introduction of new diagnostic categories or changes in the limits of classical ones (especially schizophrenia and manic-depressive psychosis) reflect a reaction against previous trends of American psychiatry and a strict adherence to a pragmatic and empirical thinking. In addition, the flexibility of its structure allows for the incorporation of new empirical results. In spite of many criticisms, either against the general orientation or against specific positions, some of which are presented in the course of this article, it is concluded that the success of the DSM-III results from a trend in psychiatric thinking not confined to the United States. Its controversial nature has stimulated the reappraisal of old concepts, and it can be considered as an important contribution towards a closer integration of psychiatry to medicine.

[Current developments in psychiatry: current interest of works by A. Quételet and J. Guislain]. / Les développements récents de la Psychiatrie: actualité des oeuvres de A. Quételet et de J. Guislain.

The influence of Adolphe Quételet and Joseph Guislain, born respectively in 1796 and 1797 in Gent, on the most recent developments of Psychiatry has a paradoxical character. Quételet was a mathematician and astronomer, but his interest in statistics led him to organize the standardized collection on data on an international basis and to initiate the measurement of social and pathological behaviours, two trends which dominate present day epidemiological, nosological and clinical research in Psychiatry. Although Guislain is rightly honoured as the organizer of a human system of treatment for the mentally ill in Belgium, his theoretical ideas about the nature of mental disorders, he considered as reactions to a basic disturbance, whose aspects were determined by the physical and psychological peculiarities of the individual, have been practically forgotten. But they provide an alternative to the now prevalent tendency towards a strictly categorical nosology, whose shortcomings are more and more apparent in empirical biological and clinico-epidemiological research.

[Neurasthenia, yesterday and today]. / La neurasthénie, hier et aujourd'hui.

Neurasthenia was described and explained in very mechanistic terms, at the end of the 19th century, by G.M. Beard to account for physical and mental exhaustion and for varied somatic troubles imputed to failure of too much solicited nervous resources. This concept was then universally adopted and gave rise to diverse interpretations, among which was the Freud's one. Later, in Occident, came a deterioration, the diagnostic of neurasthenia giving way to those of anxious or affective disorders. In the same time, at least for ideological and cultural reasons, the concept remained lively in Russia and in Asia. During the last decade the western psychiatry has been led to accept that there are clinical situations focussed on fatigue and fatigability, even if it coined for them new terminologies (post-infectious fatigue, chronic fatigue syndrome, etc.) and while DSMs keep on ignoring neurasthenia, the ICD 10 gives it an important place.

[Panic: attack and disorder. History of the word and concepts]. / Panique: attaque et trouble. Historique du mot et des concepts.

The history of the word panic, of the concepts of Panic attack and of Panic Disorder is a complex one. The adjective word panic, derived from the Greek, stressed initially the intensity of a feeling of unjustified, individual or collective, fear, similar to the reaction provoked, according to the mythology, by the intervention of the God Pan. In their present meanings, the concepts belong to the group of anxiety states, the Panic attack being a symptom characterized by a paroxysmal anxiety which may appear in various psychopathological states, whereas the Panic Disorder is a nosological category whose diagnostic criterium is the appearance, with a definite frequency, of Panic attacks. The disorder is frequently associated to agoraphobia considered, when it exists, as a complication. It is necessary to describe, in addition to the terms and concepts related to panic, the history of the terms angoisse and anxiété (and of the equivalent ones in English and German, since many studies dealing with the subject have been written in those languages) and the history of agoraphobia. The history of the word panic and of the psychiatric concepts to which it is applied today are partially different as are the current meanings of the adjective and the substantive (and today of the verb to panic) from their technical meanings. In the technical vocabulary the substantive word refers on the one side to an abnormal group behaviour whose mechanisms, when it appears in an army by also elsewhere, are studied by social psychopathology. On the other side it has been used until recently, but only in psychiatric texts written in English, for describing acute individual states of high anxiety, eventually associated with other symptoms, and considered as pertaining-in contrast to the Panic attack in its present meaning-to various psychiatric illnesses (melancholic panic, homosexual panic). A description of states similar in their aspects, including the association to agoraphobia, to the present Panic attack, may be found in the literature of the XIXth century. Essential in this respect is the description of anxiety neurosis which Freud isolated in 1895 from neurasthenia and defined by the coexistence of a state of moderate and permanent anxiety and of anxiety attacks, whose manifestations were identical to those of the present Panic attack. Under the influence of Klein's researches which, from 1962 on, demonstrated the differential reactivity to drug therapy of its two component parts, anxiety neurosis was divided in two distinct entities. The term Panic attack-for reasons given in detail by the paper-was proposed for the acute anxiety attack, whereas the state of moderate and permanent anxiety, considered as a completely independent disorder, received the name of Generalized Anxiety Disorder. The concept, with its corresponding nomenclature, was adopted initially in the United States by the RDC (1975), then by the DSM-III (1980). It is accepted today and has been the source of a large number of investigations about its semiological, nosological, epidemiological, etio-pathogenic and therapeutic aspects which fall outside of the scope of this paper.

[The present state of the concept of depression (author transl)]. / Actualisation due concept de dépression.

The author discusses the necessity of clarifying the classical dichotomy: endogenous vs. reactive or neurotic depression. The category of neurotic depression seems to be the most controversial. After mentioning the recent study by Klerman and al., he reports the results of an experimental study by Klerman and al., he reports the results of an experimental study conducted with a random sample of 100 French psychiatrists, who were asked to select, in a list of 32 criteria used in France for the diagnosis, those each considered important. A factor analysis of the answers leads to the description of three independent criteria-dimensions, the 100 psychiatrists being randomly distributed in the three dimensional space. The author concludes that each French psychiatrist has its own idiosyncrasic conception of the diagnosis of neurotic depression.

[Visual tracking disorders in schizophrenia. Review of the literature and methodological considerations]. / Les perturbations de la poursuite visuelle dans la schizophrénie. Revue de la littérature et considérations méthodologiques.

Since Holzman expressed the hypothesis that eye-tracking dysfunctions might be a genetic indicator of schizophrenia, the researches on the performances of schizophrenics in eye-tacking tasks have been numerous. The correlation between the results of all these researches leaves little doubt on the existence of eye-tacking dysfunctions in schizophrenics. But these distrubances must be precised. Up to now, the studies have used tests that were too complex in their interpretation (pendulum test) and they have been limited to a global appreciation of eye-tacking. To take into account the psychological parameters that may interfere with success in this type of tests, the coming researches should focus on elementary eye-motor activities.

[Empirical French criteria for psychoses. II. Consensus of French psychiatrists and provisional definitions]. / Des critères empiriques français pour les psychoses. II. Consensus des psychiatres français et définitions provisoires.

The provisional definitions presented in this report are the first step of an empirical investigation initiated to establish operational definitions for schizophrenia and other non-affective psychoses of classical French nosology. They are the result of French clinicians' agreement on the identification of particular syndromes as distinct mental disorders.

[Empirical French criteria for psychoses. III. Algorithms and decision tree]. / Des critères empiriques français pour les psychoses. III. Algorithmes et arbre de décision.

The present report presents the final results of an empirical investigation initiated to establish operational definitions for schizophrenia and other non-affective psychoses of classical French nosology. For each category, the authors provide diagnostic criteria and algorithms. In addition, they propose a decision tree for the differential diagnosis of psychotic features included in the French classification of mental disorders.

[French empiric criteria for psychoses. I. Situation of the problem and methodology]. / Des critères empiriques francais pour les psychoses. I. Position du problème et méthodologie.

The French classification of mental disorders is a simple nomenclature which provides no definitions nor any other information concerning the categories. The present study describes the methodological guidelines of a nation-wide investigation that was initiated to establish empirical operational definitions for schizophrenia and other non-affective psychoses of classical French nosology.

[Noise, sleep and behavior]. / Bruit, sommeil et comportement.

The negative effects of noise on sleep and behaviour have been related to three mechanisms: a physiological arousal (above a certain threshold of noise), an aversive reaction and an interference with non auditive neurophysiological and mental processes. The perturbation of verbal communication and the effects of sleep are the directly observable consequences. The negative effects of noise above a certain threshold on sleep have been demonstrated both in experimental conditions and in real life. They concern length, EEG pattern, and subjective quality and produce an increase of irritability and tiredness. There is no habituation. In all populations studied, strong discomfort is expressed by 50% of the subjects living in an area with an Ldn of 75 dB in the case of air traffic noise, the same results being obtained with ground traffic for a 5-15 dB higher level. Objective expressions of discomfort: use of aural protections, closing the windows, staying indoor, changing residence, increase linearly with the intensity of noise. Noise influences the incidence of stress-related disorders: hypertension, related cardio-vascular diseases, psychosomatic and psychological disorders. It has been shown by the use of different techniques (epidemiological studies based on the frequency of medical contacts, on the diagnoses made by general practitioners, on the use of specific drugs, and on the examination of the whole population) that the prevalence increases in relation with the level of noise in the vicinity of airports.(ABSTRACT TRUNCATED AT 250 WORDS)

[Epidemiology of depression]. / Epidemiologiia depressii.

According to epidemiological data, 5-6% of the general population are suffering from some kind of depressive disorders. Only a small proportion of them are seen by psychiatrist; others are seen by general practitioners, and many more do not seek medical advice. In a study carried out in France on 400 non-selected patients consulting general practitioners 8% of the patients have a depressive disorder and further 9% anxiety disorders.

[Mental disorders and professional determinants. Study of the time relationship between the beginning of professional life and the first disorder in teachers]. / Troubles mentaux et determinants professionnels. Etude de la relation temporelle entre débuts professionnels et premiers troubles chez des enseignantes.

Analysis of the temporal relation between the beginning of mental illness and the beginning of professional life, according to a comparative anamnestic method applied to a group of teachers (N. = 94) and a matching control group of psychiatric paired out-patients (N. = 95). The results show that the distribution of illness prior to professional activity is linked with the diagnostic category and not with professional determinants, psychosis proving to be more impairing than neurosis. A high-risk age group for first incidence of psychotic disease was found.

[Brief self-evaluation questionnaire for depressive, asthenic and anxious dimensions]. / Questionnaire bref d'auto-évaluation des dimensions dépressive, asthénique et anxieuse.

A short self-rating inventory of 24 items is presented. Factor analysis has shown that it includes three homogenous sub-scales of 8 items each, measuring respectively the depressive mood, the asthenia-fatigue and the anxiety dimensions. The inventory can be used in general practice with ambulatory patient and allows to select for specific therapeutic trials a sub-group of patients characterized by depressive and asthenic symptoms with a relatively low level of anxiety.