Objectives: Our aim was to compare the effects of an unwanted intrusive thought on executive function in a group of people with Obsessive Compulsive Disorder (OCD) and in a healthy group. Method: The Behavior Rating I...Objectives: Our aim was to compare the effects of an unwanted intrusive thought on executive function in a group of people with Obsessive Compulsive Disorder (OCD) and in a healthy group. Method: The Behavior Rating Inventory of Executive Function Adult (BRIEF-A) was used to measure executive dysfunction in everyday life in people with OCD. The study participants underwent either an intrusive thought induction or neutral thought induction prior to the administration of three computer-based tests of executive function. Results: The BRIEF-A results confirmed the impairment of executive function in everyday life for patients with OCD. In the number-letter task, patients with OCD displayed a longer reaction time (relative to the controls). There were no intergroup differences in the local-global task. In the go/no-go task, there was a significant impairment (p = 0.03) in the OCD group (with more commission errors than controls). There was a non-significant trend towards an effect of thought induction in both groups in the number-letter task. However, intrusive thought induction did not have a greater effect than neutral thought induction on the OCD group in any of the tasks. Conclusions: Intrusive thought induction has no effect on executive function in the two groups. The two groups differed with regard to two executive tasks.展开更多
Benzodiazepines are psychotropic medications for effective management of anxiety. However, after over 50 years of unrestrained prescription use, prescribers realize the severity of side effects in select patients. The...Benzodiazepines are psychotropic medications for effective management of anxiety. However, after over 50 years of unrestrained prescription use, prescribers realize the severity of side effects in select patients. The most challenging of these side effects is the emergence of a physiological dependence that explains virtual impossibility of successful withdrawal that can ensure sustained abstinence. We propose a method for successful withdrawal using substitution and innovative downward tapering of diazepam oral solution for all benzodiazepines to attain sustained remission. Our protocol reported here allowed not only successful withdrawal for all of 20 patients included in this pilot study but also helped in totally weaning them off of benzodiazepines demonstrating absence of relapse even 2 years after the total discontinuance.展开更多
A marked increase in antipsychotic prescriptions has been observed in most countries since the introduction of second-generation antipsychotics. Misuse could partly explain this rise. We described the use of antipsych...A marked increase in antipsychotic prescriptions has been observed in most countries since the introduction of second-generation antipsychotics. Misuse could partly explain this rise. We described the use of antipsychotic medication in France. This retrospective analysis was conducted on the sample “Echantillon généraliste de beneficiaries” from the French National Insurance Healthcare System. All reimbursements for antipsychotic medications in 2010 were identified. Antipsychotics use was described in terms of patient’s profiles and condition of use. In 2010, we identified 11,729 single patients with at least one reimbursement for antipsychotic medication (2.23% of French health insurance beneficiaries). The mean age in the population was 54 (sd 20) years. Forty-one percent had declared psychiatric disorder and 15% had a psychiatric follow-up for unknown diseases. Schizophrenia, others psychosis and personality disorders were the three main diagnoses of psychiatric disease. Patients without declared psychiatric disorders and without psychiatric follow-up accounted for 23% (aged between 15 and 65) and 20% (aged 65 years and over) of the population using antipsychotics. Forty-five percent of patients aged between 15 and 65 had more than 3 months of treatment refunded. Patients aged 65 years and over were 69% without dementia and 47% had more than three months of treatment of antipsychotics refunded during the year. These results suggested that antipsychotic treatments were used in France at long term in particular for patients without declared psychiatric disorder or psychiatric follow-up.展开更多
The human striatum is essential for both lowand high-level functions and has been implicated in the pathophysiology of various prevalent disorders,including Parkinson's disease(PD)and schizophrenia(SCZ).It is know...The human striatum is essential for both lowand high-level functions and has been implicated in the pathophysiology of various prevalent disorders,including Parkinson's disease(PD)and schizophrenia(SCZ).It is known to consist of structurally and functionally divergent subdivisions.However,previous parcellations are based on a single neuroimaging modality,leaving the extent of the multi-modal organization of the striatum unknown.Here,we investigated the organization of the striatum across three modalities—resting-state functional connectivity,probabilistic diffusion tractography,and structural covariance—to provide a holistic convergent view of its structure and function.We found convergent clusters in the dorsal,dorsolateral,rostral,ventral,and caudal striatum.Functional characterization revealed the anterior striatum to be mainly associated with cognitive and emotional functions,while the caudal striatum was related to action execution.Interestingly,significant structural atrophy in the rostral and ventral striatum was common to both PD and SCZ,but atrophy in the dorsolateral striatum was specifically attributable to PD.Our study revealed a cross-modal convergent organization of the striatum,representing a fundamental topographical model that can be useful for investigating structural and functional variability in aging and in clinical conditions.展开更多
文摘Objectives: Our aim was to compare the effects of an unwanted intrusive thought on executive function in a group of people with Obsessive Compulsive Disorder (OCD) and in a healthy group. Method: The Behavior Rating Inventory of Executive Function Adult (BRIEF-A) was used to measure executive dysfunction in everyday life in people with OCD. The study participants underwent either an intrusive thought induction or neutral thought induction prior to the administration of three computer-based tests of executive function. Results: The BRIEF-A results confirmed the impairment of executive function in everyday life for patients with OCD. In the number-letter task, patients with OCD displayed a longer reaction time (relative to the controls). There were no intergroup differences in the local-global task. In the go/no-go task, there was a significant impairment (p = 0.03) in the OCD group (with more commission errors than controls). There was a non-significant trend towards an effect of thought induction in both groups in the number-letter task. However, intrusive thought induction did not have a greater effect than neutral thought induction on the OCD group in any of the tasks. Conclusions: Intrusive thought induction has no effect on executive function in the two groups. The two groups differed with regard to two executive tasks.
文摘Benzodiazepines are psychotropic medications for effective management of anxiety. However, after over 50 years of unrestrained prescription use, prescribers realize the severity of side effects in select patients. The most challenging of these side effects is the emergence of a physiological dependence that explains virtual impossibility of successful withdrawal that can ensure sustained abstinence. We propose a method for successful withdrawal using substitution and innovative downward tapering of diazepam oral solution for all benzodiazepines to attain sustained remission. Our protocol reported here allowed not only successful withdrawal for all of 20 patients included in this pilot study but also helped in totally weaning them off of benzodiazepines demonstrating absence of relapse even 2 years after the total discontinuance.
文摘A marked increase in antipsychotic prescriptions has been observed in most countries since the introduction of second-generation antipsychotics. Misuse could partly explain this rise. We described the use of antipsychotic medication in France. This retrospective analysis was conducted on the sample “Echantillon généraliste de beneficiaries” from the French National Insurance Healthcare System. All reimbursements for antipsychotic medications in 2010 were identified. Antipsychotics use was described in terms of patient’s profiles and condition of use. In 2010, we identified 11,729 single patients with at least one reimbursement for antipsychotic medication (2.23% of French health insurance beneficiaries). The mean age in the population was 54 (sd 20) years. Forty-one percent had declared psychiatric disorder and 15% had a psychiatric follow-up for unknown diseases. Schizophrenia, others psychosis and personality disorders were the three main diagnoses of psychiatric disease. Patients without declared psychiatric disorders and without psychiatric follow-up accounted for 23% (aged between 15 and 65) and 20% (aged 65 years and over) of the population using antipsychotics. Forty-five percent of patients aged between 15 and 65 had more than 3 months of treatment refunded. Patients aged 65 years and over were 69% without dementia and 47% had more than three months of treatment of antipsychotics refunded during the year. These results suggested that antipsychotic treatments were used in France at long term in particular for patients without declared psychiatric disorder or psychiatric follow-up.
基金This work was supported by the Deutsche Forschungsgemeinschaft(GE 2835/1-1,El 816/4-1)the Helmholtz Portfolio Theme 4 Supercomputing and Modelling for the Human Brain'and the European Union's Horizon 2020 Research and Innovation Programme under Grant Agreement No.785907(HBP SGA2)We gratefully acknowledge financial support from the China Scholarship Council(201606750003).
文摘The human striatum is essential for both lowand high-level functions and has been implicated in the pathophysiology of various prevalent disorders,including Parkinson's disease(PD)and schizophrenia(SCZ).It is known to consist of structurally and functionally divergent subdivisions.However,previous parcellations are based on a single neuroimaging modality,leaving the extent of the multi-modal organization of the striatum unknown.Here,we investigated the organization of the striatum across three modalities—resting-state functional connectivity,probabilistic diffusion tractography,and structural covariance—to provide a holistic convergent view of its structure and function.We found convergent clusters in the dorsal,dorsolateral,rostral,ventral,and caudal striatum.Functional characterization revealed the anterior striatum to be mainly associated with cognitive and emotional functions,while the caudal striatum was related to action execution.Interestingly,significant structural atrophy in the rostral and ventral striatum was common to both PD and SCZ,but atrophy in the dorsolateral striatum was specifically attributable to PD.Our study revealed a cross-modal convergent organization of the striatum,representing a fundamental topographical model that can be useful for investigating structural and functional variability in aging and in clinical conditions.
