French clinicians unanimously reject the term ‘schizo-affective’ in favor of two specific French diagnostic categories: the ‘bouffees délirantes polymorphes, Magnan-type’ and the ‘dysthymic schizophrenias’. The present article presents the results of two recent nationwide investigations into French clinicians actual opinions and diagnostic practices in this field. It provides operational definitions based upon empirical diagnostic criteria and compares the two concepts with related concepts from other schools.
SummaryThe Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the International Personality Disorder Examination (IPDE) constitute part of a family of instruments which have been designed for the assessment of mental disorders as defined by the explicit diagnostic criteria and algorithms in ICD 10 and DSM III-R. They have been developed at the request of the World Health Organization and the United States Alcohol, Drug Abuse, and Mental Health Administration to foster a common language in the mental health field, to facilitate comparisons of clinical and research findings from different settings, countries and cultures, and to improve the scientific basis of diagnosis and classification in psychiatry. This report describes the background, purpose and essential features of the three instruments.
Tyrosine hydroxylase (TH), the rate-limiting enzyme in the metabolism of catecholamines, is considered a candidate gene in bipolar affective disorder (BPAD) and has been the subject of numerous linkage and association studies. Taken together, most results do not support a major gene effect for the TH gene in BPAD. Genetic and phenotypic heterogeneity may partially explain the difficulty of confirming the exact role of this gene using both association and linkage methods. Four hundred one BPAD patients and 401 unrelated matched controls were recruited within a European collaborative project (BIOMED1 project in the area of brain research, European Community grant number CT 92-1217, project leader: J. Mendlewicz) involving 14 centers for a case-control association study with a tetranucleotide polymorphism in the TH gene. Patients and controls were carefully matched for geographical origin. Phenotypic heterogeneity was considered and subgroup analyses were performed with relevant variables: age at onset, family history, and diagnostic stability. No association was observed in the total sample or for subgroups according to age at onset (n = 172), family history alone (n = 159), or high degree of diagnostic stability and a positive family history (n = 131). The results of this association study do not confirm the possible implication of TH polymorphism in the susceptibility to BPAD.
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