References of "Encéphale (L')"
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See detailTypus melancholicus et mélancolie : Synthèse théorique à partir d’un cas clinique
Englebert, Jérôme ULg; Stanghellini, Giovanni

in Encéphale (L') (in press)

Objective: The objective of this paper is to propose, starting from the description of a clinical emblematic case, a theoretical synthesis of the work of phenomenological psychopathology dedicated to ... [more ▼]

Objective: The objective of this paper is to propose, starting from the description of a clinical emblematic case, a theoretical synthesis of the work of phenomenological psychopathology dedicated to melancholia and typus melancholicus (TM), a clinical concept that describes the premorbid personality vulnerable to major depression (“melancholia” for the psychopathological tradition). Method: This is phenomenological analysis of a case study of melancolia, of its premorbid personality and pathogenic triggering situation. We adopt two main phenomenological keys to understanding the develpment of melancholia : role-identity theory and desynchronization theory. The former understands melancholia as a disorder of identity triggered by the loss of the social role with which one has previously over-identifed. The latter sees melancholia as the effect of the desynchronisation from the social environment that further develops into an inhibition of the conative–affective dynamics of life. We present the case of Jonas (64 years old), whose mother (94 years old) recently died. Before his mother’s death, Jonas’ life was entirely orchestrated by the caring for his mother and synchronized in time with this (e.g., he used to go to her house every 4 hours, took all his meals with her, etc.). Jonas, in addition to being hyper-synchronized and hyper-syntonic, fulfills all diagnostic criteria for TM, including “orderliness”, “conscientiousness”, “hyper/heteronomia” and “intolerance of ambiguity”. TM’s attach a disproportioned importance to their social roles (or external representations of identity) at the expense of their own ego-identity. Results: The passage from pre-morbid personality to melancholia is triggered by the death of Jonas’ mother that entails a profound depersonalization. Desynchronization and role loss cause Jonas fall into this severe depersonalization, whose core feature is the feeling of the loss of feeling. Conclusions: This original contribution demonstrates a clinical case can contribute to the construction and refinement of theoretical and conceptual frameworks (like princeps Tellenbach's studies). Over-synchronized tempo and over-identification with social role are emblematically in this case the two sides of the same coin. A parallelism can be established between synchronization (with the mother) and respect for the role at the expense of own identity. The clinical case of Jonas highlights a conceptual bridge between the model of melancholia as loss of social role and the model of melancholia as desynchronization. [less ▲]

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See detailLes contenus anatomiques au test de Rorschach : comparaison des réponses de sujets infirmiers à une population contrôle.
Englebert, Jérôme ULg; Thiltges, Esther ULg; Wertz, Céline ULg et al

in Encéphale (L') (2013), 39(2), 94-100

Introduction: The study of answer contents at Rorschach test leads to numerous debates and controversies. On a pragmatic point of view, the recurrent question is to understand the meaning of a content (or ... [more ▼]

Introduction: The study of answer contents at Rorschach test leads to numerous debates and controversies. On a pragmatic point of view, the recurrent question is to understand the meaning of a content (or its repetition) in a protocol. On a discursive and perceptive point of view, it is hazardous to give an interpretation other than descriptive and contextual. Indeed, no one interpretative theory or analysis method is able to determine with certainty and rigour a strict correlation between people’s psychological functioning and the contents they perceive. Methods: In this empirical context, we studied the “anatomy” answers (frequencies and formal qualities) in a nurse population (N=38) matched with a control group (non medical subjects, N=38). The Rorschach test was administrated according to the recommendations of Integrated System. Results: The average of An+Xy answers was clearly and significantly higher in nurse population (3.58) than in the control group (0.89) and than in the three comparative norms that we selected (from 0.96 to 1.83). Concerning the formal quality, the repeated-measures analysis of variance showed a significant interaction effect: although subjects in the control group gave a similar number of ordinary, unusual and minus forms for An+Xy answers, the nurses gave more wrong (minus) forms (1.79) than unusual forms (1.21) and finally than ordinary forms (0.58). un nombre significativement plus élevé de mauvaises formes (1.79) que de formes inhabituelles (1.21) et finalement que de formes ordinaires (0.58). Discussion: Two hypotheses may be suggested in order to explain our findings. From one part, there is highly probable that our results are linked to the everyday body confrontation in nurse job. From another part, we suggest that by giving An+Xy answers, nurses tend to reveal some idiosyncratic characteristics in order to show their own identity. Indeed, our nurse subjects were selected because of their job and then they complied with the social identity that was implicitly expected. This is congruent with the complex functioning in social reality: in a social group, people will not verbalize all of their perceptions, they will preferentially verbalize perceptions that define their social identity. On the contrary, if some perceptions do not comply with subject’s identity, these perceptions will be less frequently verbalized despite the fact that they were perceived. Concerning the second main finding, the inadequate formal quality of answers given by nurses emphasizes a visual misrepresentation conditioning by one’s job. This effect is interesting on a psychological point of view because it suggests that this tendency to perceive more anatomical contents arises to the detriment of the “reality”. Finally, our findings allowed us to suggest hypothesis on the role of identity on answer contents at Rorschach test according to the context and to formulate some recommendations about the content use in the Rorschach interpretation. [less ▲]

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See detailOcytocine, hormone altruiste pleine de promesses ?
Scantamburlo, Gabrielle ULg

in Encéphale (L') (2012)

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See detailOcytocine et dépression. Perspective psychoneuroendocrinienne.
Scantamburlo, Gabrielle ULg

in Encéphale (L') (2011), 37

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See detailExploration neurodéveloppementale de la mémoire de travail par neuroimagerie fonctionnelle
Noro, Magali; Linotte, Sylvie; Ansseau, Marc ULg et al

in Encéphale (L') (2011), 37

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See detailOcytocine plamsatique et dimensions de personnalité dans la dépression unipolaire
Scantamburlo, Gabrielle ULg; Reggers, Jean; Hansenne, Michel ULg et al

in Encéphale (L') (2010), 36

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See detailFacteurs genetiques de l'alcoolo-dependance Revue des principales donnees de la litterature.
Pinto, Emmanuel ULg; Ansseau, Marc ULg

in Encéphale (L') (2009), 35(5), 461-9

INTRODUCTION: Alcohol dependence is a complex and multifactorial disease resulting both from neurobiological mechanisms and environmental factors. It is frequently associated with comorbid psychiatric ... [more ▼]

INTRODUCTION: Alcohol dependence is a complex and multifactorial disease resulting both from neurobiological mechanisms and environmental factors. It is frequently associated with comorbid psychiatric disorders or with specific personality or behavioral features. Although action can be taken on the environment in order to decrease the risk of the illness, current methods used to prevent or to treat this pathology show moderate efficacy: problematic consumption of ethanol in the general population as well as relapse rates under treatment in dependent patients remain indeed very high. LITERATURE FINDINGS: It is therefore of major importance to broaden our knowledge of alcohol dependence and its comorbidities so as to improve both their prevention and treatment. In this perspective, recent progress in the field of neurosciences may contribute to achieve this goal. Precisely, genetics is a promising way benefiting from many advances in genetic epidemiology, cellular and molecular biology, neuroimaging and pharmacology. In parallel with a better understanding of the neurobiology of addictions and associated behaviors, these techniques led to the identification of brain mechanisms in which a genetic variation may influence the individual vulnerability towards alcohol dependence. Moreover, there is growing evidence that alcoholism results from the interaction of genetic and environmental factors influencing both its expression and its course. Given the fact that alcohol-dependence seems highly heritable (50 to 60% of the variance in both men and women), this review assesses the role of some of the genomic regions linked with the disease, as well as the principal variants of candidate genes identified as specifically involved in the predisposition. Polymorphisms of genes influencing alcohol metabolism, GABAergic, dopaminergic and serotonergic neurotransmission seem, indeed, at stake in the development of alcohol-dependence and its related features such as personality, behavior, impulse control or craving. In the future, a better characterization of the links between genotypes and phenotypes will probably increase our ability to treat alcoholic patients. [less ▲]

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See detailEvaluation d'un an de parcours de patients schizophrenes en service psychiatrique liegeois
Sarto, D.; Desseilles, Martin ULg; Martin, Michel ULg et al

in Encéphale (L') (2006), 32(5, Pt 1), 722-8

OBJECTIVE: The study was aimed at assessing the clinical evolution and mobility of schizophrenic patients within the healthcare network of the Psychiatric Platform of Liege (Belgium) after a one-year ... [more ▼]

OBJECTIVE: The study was aimed at assessing the clinical evolution and mobility of schizophrenic patients within the healthcare network of the Psychiatric Platform of Liege (Belgium) after a one-year follow-up period. MATERIAL: and methods. The study material consisted of a random sample of 184 patients with schizophrenia drawn from the population of schizophrenic patients treated in the Liege psychiatric care network. The characteristics of these patients have been described previously (18). The 184 patients were followed-up for one-year and reassessed at the end of this period. Mobility (ie, changes between psychiatric care institutions, including home) was recorded for each patient within the institutional network. The diagnosis of schizophrenia was based on the DSM IV. Demographic, social and global functioning (GAF scale) data were collected from the "Resume psychiatrique Minimum (RPM)", a clinical summary which has been imposed by the Belgian Ministry of Public Health for each psychiatric hospital stay. Symptom components were derived from the Psychosis Evaluation tool for Common Use by Caregivers (PECC). RESULTS: Among the 184 patients enrolled in the initial analysis, 6 refused to participate in the follow-up study. The 178 remaining schizophrenic patients included 131 men (74%) and 47 women (26%) with a mean age of 43.1 +/- 13.6 and 48.8 +/- 14.9 years, respectively (p<0.05). The majority of patients (53%) suffered from paranoid schizophrenia. At baseline, 63% of the patients were hospitalised full-time, 6% part-time and 31% received ambulatory care. During the one-year follow-up period, 4 patients died, including one from suicide. When considering mobility, 48% of the patients experienced at least one change of institution, whereas 52% of the patients didn't change at all (see figure 1). The total number of changes over the 1-year period amounted 189, yielding a mean value of 1.1 changes per patient per year. Changes mostly occurred between institutions of similar care setting (see figure 2). Transfers (30%) were also observed directly between hospital and home. A multivariate Poisson regression analysis showed that the number of changes was unrelated to gender and initial care setting but decreased with age (p<0.0001). It was also higher for patients with schizo-affective disorders (2.5 +/- 1.9, p<0.01) or with residual type (1.2 +/- 1.8; p<0.05) than for patients with other types of schizophrenia (ranging from 0.3 +/- 0.5 to 0.9 +/- 1.4). No association was found with initial GAF or PECC, except for negative symptoms (p<0.05). After one year, despite the high proportion of institutional changes (48% of the patients), the distribution of the patients according to care setting remained the same (p=0.77). However, GAF scores significantly improved from 39.7 +/- 16.1 to 44.4 +/- 16.1 (p<0.0001) and likewise for total PECC scores (70 +/- 19.1 vs 63.2 +/- 19.4, p<0.001). Excitatory and disease perception items of the PECC remained unchanged. CONCLUSION: The present study reveals that mobility within the institutional network did affect about half of the schizophrenic patients. Mobility was related to age, type of schizophrenia and disease evolution. Changes occur mainly between psychiatric structures of similar care setting but also directly from hospital to home without passing through an intermediate care structure. Further efforts should be made to provide schizophrenic patients with a more coordinated care provision throughout the course of their disease. [less ▲]

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See detailLipides, dépression et suicide
Colin, A.; Reggers, Jean ULg; Castronovo, Vincenzo ULg et al

in Encéphale (L') (2003), 29(1, JAN-FEB), 49-58

Polyunsatured fatty acids are made out of a hydrocarbonated chain of variable length with several double bonds. The position of the first double bond (omega; omega) differentiates polyunsatured omega3 ... [more ▼]

Polyunsatured fatty acids are made out of a hydrocarbonated chain of variable length with several double bonds. The position of the first double bond (omega; omega) differentiates polyunsatured omega3 fatty acids (for example : alpha-linolenic acid or alpha-LNA) and polyunsatured omega6 fatty acids (for example : linoleic acid or LA). These two classes of fatty acids are said to be essential because they cannot be synthetised by the organism and have to be taken from alimentation. The omega3 are present in linseed oil, nuts, soya beans, wheat and cold water fish whereas omega6 are present in maize, sunflower and sesame oil. Fatty acids are part of phospholipids and, consequently, of all biological membranes. The membrane fluidity, of crucial importance for its functionning, depends on its lipidic components. Phospholipids composed of chains of polyunsatured fatty acids increase the membrane fluidity because, by bending some chains, double bonds prevent them from compacting themselves perfectly. Membrane fluidity is also determined by the phospholipids/free cholesterol ratio, as cholesterol increases membrane viscosity. A diet based on a high proportion of essential polyunsatured fatty acids (fluid) would allow a higher incorporation of cholesterol (rigid) in the membranes to balance their fluidity, which would contribute to lower blood cholesterol levels. Brain membranes have a very high content in essential polyunsatured fatty acids for which they depend on alimentation. Any dietary lack of essential polyunsatured fatty acids has consequences on cerebral development, modifying the activity of enzymes of the cerebral membranes and decreasing efficiency in learning tasks. Epidemiological data - The prevalence of depression seems to increase continuously since the beginning of the century. Though different factors most probably contribute to this evolution, it has been suggested that it could be related to an evolution of alimentary patterns in the Western world, in which polyunsatured omega fatty acids contained in fish, game and vegetables have been largely replaced by polyunsatured omega6 fatty acids of cereal oils. Some epidemiological data support the hypothesis of a relation between lower depression and/or suicide rates and a higher consumption of fish. These data do not however prove a relation of causality. Cholesterol and depression - Several cohort studies (on nondepressed subjects) have assessed the relationship between plasma cholesterol and depressive symptoms with contradictory results. Though some results found a significant relationship between a decrease of total cholesterol and high scores of depression, some other did not. Studies among patients suffering from major depression signalled more constantly an association between low cholesterol and major depression. Besides, some trials showed that clinical recovery maybe associated with a significant increase of total cholesterol. Cholesterol and suicidal behaviour - The hypothesis that a low cholesterol level may represent a suicidal risk factor was discovered accidentally following a series of epidemiological studies which revealed an increase of the suicidal risk among subjects with a low cholesterol level. Though some contradictory studies do exist, this relationship has been confirmed by several subsequent cohort studies. These findings have challenged the vast public health programs aimed at promoting the decrease of cholesterol, and even suggested to suspend the administration of lipid lowering drugs. Recent clinical studies on populations treated whith lipid lowering drugs showed nevertheless a lack of significant increase of mortality, either by suicide or accident. In addition, several controlled studies among psychiatric patients revealed a decrease of the concentrations of plasma cholesterol among patients who had attempted suicide in comparison with other patients. Polyunsaturated fatty acids and depression - In major depression, all studies revealed a significant decrease of the polyunsaturated omega3 fatty acids and/or an increase of the omega6/omega3 ratio in plasma and/or in the membranes of the red cells. In addition, two studies found a higher severity of depression when the level of polyunsaturated omega fatty acids or the ratio omega3/omega6 was low. Parallel to these modifications, other biochemical perturbations have been reported in major depression, particularly an activation of the inflammatory response system, resulting in an increase of the pro-inflammatory cytokines (interleukins: IL-1beta, IL-6 and interferon gamma) and eicosanoids (among others, prostaglandin E2) in the blood and the CSF of depressed patients. These substances cause a peroxidation and, consequently a catabolism of membrane phospholipids, among others those containing polyunsaturated fatty acids. The cytokines and eicosanoids derive from polyunsaturated fatty acids and have opposite physiological functions according to their omega or omega6 precursor. Arachidonic acid (omega6) is, among others, precursor of pro-inflammatoty prostaglandin E2 (PGE2), whereas polyunsaturated W fatty acids inhibit the formation of PGE2. It has been shown that a dietary increase of polyunsaturated W fatty acids reduced strongly the production of IL-1beta, IL-2, IL-6 and TNF-alpha (tumor necrosis factor-alpha). In contrast, diets with a higher supply of linoleic acid (omega6) increased significantly the production of pro-inflammatory cytokines, like TNF-alpha. Therefore, polyunsaturated omega3 fatty acids could be associated at different levels in the pathophysiology of major depression, on the one hand through their role in the membrane fluidity which influences diverse steps of neurotransmission and, on the other hand, through their function as precursor of pro-inflammatory cytokines and eicosanoids disturbing neurotransmission. In addition, antidepressants could exhibit an immunoregulating effect by reducing the release of pro-inflammatory cytokines, by increasing the release of endogenous antagonists of pro-inflammatory cytokines like IL-10 and, finally, by acting like inhibitors of cyclo-oxygenase. Therapeutic use of fatty acids - Data available concerning the administration of supplements of DHA (docosahexanoic acid) or other polyunsaturated fatty acids omega3 are limited. In a double blind placebo-controlled study on 30 patients with bipolar disorder, the addition of polyunsaturated omega3 fatty acids was associated with a longer period of remission. Moreover, nearly all the other prognosis measures were better in the omega3 group. Very recently, a controlled trial showed the benefits of adding an omega3 fatty acid, eicosopentanoic acid, among depressed patients. After 4 weeks, six of the 10 patients receiving the fatty acid were considered as responders in comparison with only one of the ten patients receiving placebo. Conclusions Some epidemiological, experimental and clinical data favour the hypothesis that polyunsaturated fatty acids could play a role in the pathogenesis and/or the treatment of depression. More studies however are needed in order to better precise the actual implication of those biochemical factors among the various aspects of depressive illness. [less ▲]

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See detailImplication de la neurohypophyse dans le stress psychique
Scantamburlo, Gabrielle ULg; Ansseau, Marc ULg; Legros, Jean-Jacques ULg

in Encéphale (L') (2001), 27(3, May-Jun), 245-59

Effects of different psychological stimuli on oxytocin (OT) and vasopressin (AVP) secretion are reviewed in animals and in humans. The secretion of neuropituitary hormones is also discussed in various ... [more ▼]

Effects of different psychological stimuli on oxytocin (OT) and vasopressin (AVP) secretion are reviewed in animals and in humans. The secretion of neuropituitary hormones is also discussed in various psychiatric diseases such an anorexia nervosa, bipolar disorder, schizophrenia and obsessive-compulsive disorder. AVP and OT are secreted into the hypophyseal portal circulation by neurons which project from the paraventricular nucleus to the external zone of the median eminence. AVP and OT-containing neurons in the suprachiasmatic and paraventricular nuclei project to limbic areas, including the hippocampus, the subiculum, the ventral nucleus of the amygdala and the nucleus of the diagonal band. Specific AVP receptors which are pharmacologically different from the pressor and antidiuretic AVP receptors have been found in the anterior pituitary. OT receptors have been identified in a variety of forebrain sites. The neurohypophyseal secretion is regulated by the cholinergic muscarinic, histaminergic and beta-adrenergic systems. Stress alters the secretion of one or more of the hypothalamic factors which interact at the pituitary to increase the secretion of ACTH. AVP and OT have been shown to modulate the effect of Corticotropin-Releasing Factor (CRF) on ACTH secretion and appear to play a key role in mediating the ACTH response to stress. Although AVP is a relatively weak secretagogue for ACTH, it markedly potentiates the activity of CRF both in vitro and in vivo. The role of OT is more complex. In vitro, OT stimulates ACTH release at high doses whereas in human it inhibits ACTH secretion at low doses. The type of stressor appear to determine the relative importance of these secretatogues in ACTH response. Several recent studies indicate that psychological stressors display a similar degree of variety of secretagogue release patterns as was found earlier for physical stressors. A bewildering array of technique produces a bewildering array of conclusions. In rats, OT may be an important secretagogue during a novel stimulus, whereas the role for AVP is less clear. Indeed two studies out of ten suggest a stimulating role for AVP. In response to frustration and submission, OT and AVP are secreted. Regarding social isolation, results are difficult to interpret and the role of AVP could be species-dependent. In contrast plasma OT levels do not change. After restraint, ACTH release is primarily mediated by the active increase of OT and AVP does not appear to play a role. When restraint is associated with moderate levels of physical components and during immobilisation, all two secretagogs are involved in the ACTH response. With fear, ACTH response appears to be driven by OT. In humans, one study indicates that high emotionality women increase plasma OT in response to uncontrollable noise. Various neuroendocrine dysregulations have been observed in psychiatric disease. Either an increase or a decrease of the hypothalamic-pituitary-adrenal (HPA) function have been described in several illnesses. Effects of OT appear to be reciprocal to the effects of AVP. OT has been called the "amnestic" neuropeptide due to its capacity to attenuate memory consolidation and retrieval. AVP exhibits a central activating action on mood, memory and selective attention. Underweight patients with anorexia nervosa have abnormally high levels of centrally directed AVP and reduced OT levels. These modifications could enhance the retention of cognitive distortions of aversive consequences of eating. Patients with bipolar disorder show a biphasic secretion of AVP. Depressive episodes are associated with decreased vasopressinergic activity whereas manic episodes involve an increased release. AVP might be responsible for an increased catecholamine activity. In addition, lithium could act as an antagonist to AVP. In schizophrenic patients, studies using the apomorphine stimulation suggest increased oxytoninergic and decreased vasopressinergic functions. These findings are consistent with the beneficial role of AVP on schizophrenic symptoms noted in several trials. The increased OT could be responsible for "positive" symptomatology such as delusions and hallucinations. Obsessive compulsive disorder (OCD) includes a range of cognitive and behavioral disturbances that could be influenced by OT. In animals, several studies have emphasized the role of AVP in promoting repetitive grooming behaviors and maintaining conditioned response to aversive stimuli. In OCD patients, one study have reported that AVP/OT ratio was negatively correlated with symptom severity. However, an independent report found similar AVP concentrations in OC patients without a personal or family history of tic disorder and in normal subjects. Whether these modifications are only a consequence of the central disturbances or whether those peptides could participate in the pathogenesis of these affections remains to be elucidated. [less ▲]

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See detailLe potentiel lent P300. Interet clinique dans trois pathologies mentales et neurobiologie: une revue.
Charles, G.; Hansenne, Michel ULg

in Encéphale (L') (1992), 18(3), 225-36

P300 is a late component of evoked potential which meet special relevance to the study of cognitive processes. P300 indexes categorization processes and the context updating of memory. Its latency ... [more ▼]

P300 is a late component of evoked potential which meet special relevance to the study of cognitive processes. P300 indexes categorization processes and the context updating of memory. Its latency reflects the stimulus evaluation time, and P300 amplitude is related to some psychological variables such as expectancy, attention and stimulus significance. In this review, clinical correlation between P300 components and mental diseases are reported, especially dementia, schizophrenia and depression. Delayed P300 latency has been found in Alzheimer disease and in other forms of dementia. Reduced P300 amplitude as well as altered topography has been reported in schizophrenia. In depression, reduced P300 amplitude has been related with longer reaction time. Unfortunately, the diagnosis utility of P300 seems limited. The authors also propose an overview of the actual knowledge on neurobiological findings in the generation of the P300 wave. Anatomical data point out the importance of the limbic system, more specifically, of the hippocampus and the locus coeruleus, in generating and modulating P300 wave. Data from the literature on the psychopharmacological modifications induced by cholinergic, catecholaminergic and other agents, are reviewed. Although the dopaminergic and noradrenergic systems are of some importance, these data emphasise the importance of the cholinergic system for the generation and modulation of P300 amplitude and latency. The value and interpretation of these neurobiological and clinical findings are discussed. [less ▲]

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See detailEffets de la sénescence sur les neurones GABAergiques
Delwaide, P. J.; Delwaide, Jean ULg

in Encéphale (L') (1987), 13

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