Une nouvelle conception des études sémiologiques : « l’épidémiologie sémiologique développementale »

in Information Psychiatrique (L') (2011), 87(4), 313-320

The article identifies the focus of interest in semiological studies, presents concepts related to semiology, and proposes a refinement of semiological research by means of an “epidemiological approach to ... [more ▼]

The article identifies the focus of interest in semiological studies, presents concepts related to semiology, and proposes a refinement of semiological research by means of an “epidemiological approach to the study of developmental semiology”. The article begins by sketching the history of developmental psychopathology. Next, it addresses its theoretical foundations, which hitherto have focused primarily on the semiological study of individual childhood development insofar as it is liable to a maladjustment of one sort or another. Now, in our view, the study of development involves two further challenges. On the one hand, it is necessary to disentangle the semiological elements initially observed as part of a total phenomenon. Meeting this challenge requires the creation of new semiological concepts in order to account of our observations. On the other hand, we need to elaborate epigenetic models for the origin of developmental pathways, models that take account of the multiple, continuously interacting factors that characterize such pathways. With these two desiderata in mind, we proceed to the third stage of our exposition, which presents our own approach to semiology. This approach includes the following distinctive features: comparison with normal populations, establishment of a continuum between normal and pathological development, integration of the dimensional and categorical aspects, and attention to the variation of semiological expression during development. This sets the stage for the concluding part of the article, in which we outline a program of semiological research in order to illustrate what we mean by an “epidemiological approach to the study of developmental semiology”. [less ▲]

Feasibility assessment of heroin-assisted treatment in Liège, Belgium

in Acta Psychiatrica Belgica (2011), 111(1), 3-8

A new heroin-assisted treatment, TADAM, has begun in Liège, Belgium. With the number of methadone patients (n=2046) in 2007, we estimated the geographical distribution of methadone treatments in the ... [more ▼]

A new heroin-assisted treatment, TADAM, has begun in Liège, Belgium. With the number of methadone patients (n=2046) in 2007, we estimated the geographical distribution of methadone treatments in the province of Liège, of heroin addicts and of potential participants for TADAM. The methadone treatments were unequally distributed. Some urban areas showed a signifi cant number of heroin addicts: more than 14/1000 of the population aged 15-64. As a conclusion, the trial is appropriately targeted to those high-density addiction areas. [less ▲]

Depression alters "top-down" visual attention: a dynamic causal modeling comparison between depressed and healthy subjects.

in NeuroImage (2011), 54(2), 1662-8

Using functional magnetic resonance imaging (fMRI), we recently demonstrated that nonmedicated patients with a first episode of unipolar major depression (MDD) compared to matched controls exhibited an ... [more ▼]

Using functional magnetic resonance imaging (fMRI), we recently demonstrated that nonmedicated patients with a first episode of unipolar major depression (MDD) compared to matched controls exhibited an abnormal neural filtering of irrelevant visual information (Desseilles et al., 2009). During scanning, subjects performed a visual attention task imposing two different levels of attentional load at fixation (low or high), while task-irrelevant colored stimuli were presented in the periphery. In the present study, we focused on the visuo-attentional system and used "Dynamic Causal Modeling" (DCM) on the same dataset to assess how attention influences a network of three dynamically-interconnected brain regions (visual areas V1 and V4, and intraparietal sulcus (P), differentially in MDD patients and healthy controls. Bayesian model selection (BMS) and model space partitioning (MSP) were used to determine the best model in each population. The best model for the controls revealed that the increase of parietal activity by high attention load was selectively associated with a negative modulation of P on V4, consistent with high attention reducing the processing of irrelevant colored peripheral stimuli. The best model accounting for the data from the MDD patients showed that both low and high attention levels exerted modulatory effects on P. The present results document abnormal effective connectivity across visuo-attentional networks in MDD, which likely contributes to deficient attentional filtering of information. [less ▲]

Le modèle psychobiologique de Cloninger (TCI) et la dépression

in Acta Psychiatrica Belgica (2011), 111(3), 34-38

Le cas clinique du mois. Syndrome sérotoninergique induit par une association isoniazide/venlafaxine

in Revue Médicale de Liège (2011), 66(12), 611-613

Les antidépresseurs du futur : rôle du système glutamatergique.

in Revue Médicale de Liège (2011), 66(4), 195-198

Staff concerns in heroin-assisted treatment centres

in Journal of Psychiatric & Mental Health Nursing (2011)

Heroin-assisted treatment (HAT) is a solution for improving the condition of treatmentresistant heroin addicts. Since 1994, six randomized controlled trials have concluded that HAT is more efficacious ... [more ▼]

Heroin-assisted treatment (HAT) is a solution for improving the condition of treatmentresistant heroin addicts. Since 1994, six randomized controlled trials have concluded that HAT is more efficacious than oral methadone for severe heroin addicts.We visited seven HAT treatment centres in four countries in order to observe diacetylmorphine (DAM) administration and to study the main concerns of the staff. Nurses were concerned by the risk taken if a previously intoxicated patient received his dose of DAM. Another concern was the smuggling of DAM doses. The HAT centres face a dilemma: treating patients while at the same time allowing their risky street habits in the centre. [less ▲]

Effets secondaires sexuels des antidépresseurs

in Revue Médicale de Liège (2011)

L’efficacité du traitement assisté par diacétylmorphine (héroïne pharmaceutique) à l’étranger

in Revue Médicale de Liège (2010), 65(12), 681-687

Before implementing the TADAM project in Belgium (a heroin-assisted treatment trial), our research team studied the trials in other countries. Since 1994, six randomised controlled trials have been ... [more ▼]

Before implementing the TADAM project in Belgium (a heroin-assisted treatment trial), our research team studied the trials in other countries. Since 1994, six randomised controlled trials have been developed using the same treatment model of heroin-assisted treatment (HAT). Each trial concluded that HAT had more efficacy than methadone treatment. We analysed those trials in order to find on which levels patients in a HAT treatment are expected to improve. Improvements appeared after at least six months on the level of street heroin use, (physical and mental) health and criminal behaviour. In the longer term, the continuation of treatment had positive but limited effects on the social level. Due to his higher cost, this treatment should remain a second-line treatment for this special target group: severe heroin addicts, using continuously street heroin in spite of a methadone treatment. [less ▲]

Delirium et anorexie

in Acta Psychiatrica Belgica (2010), 110