In a consensus-building process a group of experts from 19 European countries (COST Action B6) adapted the terms partial and full remission, relapse, recovery, and recurrence according to principles described by Frank et al. for depression. The empirical validity of the operationalizations was illustrated by longitudinal data on the post treatment course of 233 anorectic and 422 bulimic patients (diagnosed according to DSM-IIIR) from the German Project TR-EAT. These data were collected 2.5 years after admission using the Longitudinal Interval Follow-up Evaluation (LIFE) and statistically explored by survival-analysis. It was demonstrated that these consensus definitions measure what they intend to measure. They open a longitudinal perspective in that one can learn not only whether, but also when and with what probability patients change for the better or worse. Data suggest that persistence of symptom improvement has different implications for anorexia and bulimia nervosa. For example, relapse prevention would be most beneficial for bulimic patients for about 4 months after key symptoms remit, while this would be of less importance for anorexic patients. It is discussed whether and how this longitudinal approach can contribute to an empirically based rationale for targeted and individualized treatment.

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Objective. To compare pain, fatigue, and sicca symptoms; quality of life; and psychological status between patients with primary Sjö gren's syndrome (SS) and those with sicca symptoms but no autoimmune features (sicca asthenia polyalgia syndrome [SAPS]), and to determine whether a psychological pattern can be detected in patients with SAPS, which could suggest psychological distress as the cause. Methods. This cross-sectional, prospective study included 111 patients with primary SS according to the AmericanEuropean Consensus Group criteria and 65 SAPS patients with no focus on lip biopsy and no anti-SSA/SSB antibodies. Pain, fatigue, and sicca symptoms were assessed using visual analog scales; quality of life was assessed using the Short

Background: Personality and emotional factors are thought to influence the onset of psoriasis, the occurrence of relapses, and the sensitivity of this condition to dermatological treatments. Objective:To explore the relationships between emotional disorders and emotional information processing in the one hand, and psoriasis severity and response to treatment on the other. Methods: We recruited 93 patients through an article in the local press. These patients attended three consultations. We evaluated psoriasis severity by Psoriasis Area and Severity Index (PASI) score and response to treatment by change in PASI score from baseline to the 3-month visit. We screened for comorbid mental disorders, using the Mini International Neuropsychiatric Interview. We used the Hospital Anxiety and Depression Scale to assess anxiety and depressive symptoms. Alexithymia (difficulty in identifying and expressing emotions) was evaluated with the 26-item version of the Toronto Alexithymia Scale (TAS-26) and the ability to integrate and differentiate emotions (emotional awareness) was assessed with the Lane and Schwartz Levels of Emotional Awareness Scale (LEAS). Results: Forty patients presented at least one psychiatric diagnosis and 33 were considered alexithymic (TAS ≧73). No psychological score was associated with baseline PASI score, which was higher in men and positively correlated with disease duration. Patients who considered their disease to be stress-reactive tended to have lower LEAS scores (p = 0.052). At the 3-month visit, PASI scores had significantly improved in the subset of patients (n = 67) presenting severe psoriasis at inclusion (PASI >2); emotional awareness and anxiety scores had also improved in these patients (p < 0.001), but dermatological and psychological changes were not statistically related. Dermatological improvement at 3 months with respect to baseline PASI was predicted by longer disease duration (>20 years) and lower baseline LEAS score (p = 0.044 and p = 0.021, respectively). Conclusion: This study demonstrates the value of assessing the ability of patients with psoriasis to process emotional information, as defined by emotional awareness. Patients with low LEAS scores appear to be more reactive to stress, but also to be more responsive to treatment, suggesting the activation of a particular stress physiology by negative affective states that are not experienced.

BackgroundAttempted suicide is a major public health problem, and the efficacies of current postvention protocols vary. We evaluated the effectiveness of telephone follow-up of patients referred to an emergency psychiatric unit for attempted suicide on any further attempt/s over the following year.MethodIn a single-center, controlled study with intent to treat, we evaluated the efficacy of a protocol of telephone follow-up of 436 patients at 8, 30, and 60 days after they were treated for attempted suicide. As controls for comparison, we evaluated patients with similar social and demographic characteristics referred to our emergency psychiatric unit in the year prior to the study who did not receive telephone follow-up after their initial hospitalization. Data were analyzed using logistic regression.ResultsVery early telephone follow-up of our patients effectively reduced recidivism and seemed to be the only protective factor against repeated suicide attempt.ConclusionsImplementing a protocol of early telephone follow-up after attempted suicide could help prevent repeated attempt/s. More controlled studies are needed to assess optimal techniques to prevent such repetition.

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Re cher che origi nale La tra duc tion des ques tion naires et des tests : tech niques et pro blèmes Cath er ine Mas sou bre, PhU 1 , François Lang, PU-PH, PhD 2 , Burkard Jae ger, PhD 3 , Mi chel Jul lien 4 , Jac ques Pel let, PU-PH, PhD 5 Mots clés : tra duc tion, rétro tra duc tion, pré test, comité d'ex perts, équiva lence transcul turelle, In ven taire de Per son nal ité de Freiburg (FPI-R) M al gré le peu d'at ten tion porté aux pro blèmes de tra duction même dans des études in ter na tion ales com paratives (1,2), des pro grès sub stan tiels ont été ac com plis depuis le dé but des années cin quante époque où n'ex is taient pas de guides stan dard isés et validés. Traduire (3,4) im plique le pas sage d'un uni vers source, ab ritant un lan gage, une cul ture et un es pace séman tique, à un uni vers ci ble homo logue et diffé rent. Le but de la tra duc tion des tests est d'ob tenir deux ver sions source et ci ble équiva lentes en re cou rant à une tra duc tion dite « symétri que » qui implique une ad ap ta tion du test à l'u ni vers ci ble. La tra duc tion, gé né rale ment préfé rable à la con cep tion d'un nou vel in stru ment (5) per met la con sti tu tion d'une docu menta tion in ter na tion ale sur des in stru ments com muns, et révèle

The simple perception of an object can potentiate an associated action. This affordance effect depends heavily on the action context in which the object is presented. In recent years, psychologists, psychiatrists, and phenomenologists have agreed that subjects with schizophrenia may not perceive the affordances of people or objects that could lead to a loss of ease in their actions. We examined whether the addition of contextually congruent elements, during the perception of everyday objects, could promote the emergence of object-affordance effects in subjects with schizophrenia and controls. Participants performed two Stimulus–Response-Compatibility tasks in which they were presented with semantic primes related to sense of property (Experiment 1) or goal of action (Experiment 2) prior to viewing each graspable object. Controls responded faster when their response hand and the graspable part of the object were compatibly oriented, but only when the context was congruent with the individual’s needs and goals. When the context operated as a constraint, the affordance-effect was disrupted. These results support the understanding that object-affordance is flexible and not just intrinsic to an object. However, the absence of this object-affordance effect in subjects with schizophrenia suggests the possible impairment of their ability to experience the internal simulation of motor action potentialities. In such case, all activities of daily life would require the involvement of higher cognitive processes rather than lower level sensorimotor processes. The study of schizophrenia requires the consideration of concepts and methods that arise from the theories of embodied and situated cognition.