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Cainozoic sedimentation cycles are described from the magmatic arc occupied by the islands of Sumatra and Java and of its backarc area, the Sundashelf. Four sedimentation cycles can be individualized on Sumatra and Java (Fig. 9), each starting with a transgression and terminating with a phase of volcanism and tectonism. The transgression that initiated an additional cycle is known from Northeast Sumatra but its pertinent volcanic end phase if present could not yet be recognized. The succession of sediments of the four complete cycles show a causal related stratigraphic order. They can be regarded as lithotectonic units and are shown to have been caused by geotectonic events. Acceleration of spreading first caused the transgression (Pitman 1978) that initiated the cycle. lt subsequently increased the rate of subduction what in turn produced an increase of tectonic stress and volcanism on the active plate margin. Plusieurs cycles sédimentaires du Cénozoïque appartenant à l'arc magmatique, constitué par les îles de Java et Sumatra et à son arrière-arc , et au plateau continental de la Sonde, sont décrits et discutés. Quatre cycles sédimentaires peuvent être reconnus à Java et Sumatra (f ig. 9), commençant chacun par une transgression et se terminant par une phase volcanique et tectonique. Dans le nord-est de Sumatra, une transgression appartenant à un cinquième cycle a été reconnue : cependant la phase terminale volcanique de ce cycle, si elle n'a jamais existé, n'a pas encore pu être mise en évidence. Le dépôt des couches appartenant aux quatre cycles complets a eu lieu en respectant un ordre stratigraphique bien déterminé. On peut considérer ce dépôt de couches sédimentaires, comme une unité lithotectonique déposée à la faveur des mécanismes géotectoniques. La transgression initiale de chaque cycle a été provoquée par une accélération de l'expansion océanique (Pitman 1978). Cette accélération, par ailleurs, a engendré une accélération de la subduction qui, à son tour, a provoqué une augmentation de l'activité tectonique et du volcanisme sur la marge active de la plate-forme de la Sonde. La phase volcanique qui termine chaque cycle survient avec un décalage maximum de 10 millions d'années par rapport à la phase initiale transgressive.

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Objectif : Caractériser des trajectoires de consommation sur 5 ans d’une cohorte de consommateurs de psychotropes et en identifier les facteurs associés. Méthodes : 286 consommateurs issus de la cohorte SUVIMAX (un essai contrôlé randomisé de prévention primaire) ont accepté de participer à notre étude. Les données proviennent du livret de report de consommation mensuelle qui explore, pour chaque psychotrope consommé entre 1994 et 1998, les rhythmes de consommation. Résultats : La trajectoire continue se caractérise comme une consommation ininterrompue pendant les 5 ans de suivi (53 %), la trajectoire occasionnelle comme une consommation interrompue au moins un mois (47 %). Conclusion : Ce n’est pas la consommation de psychotropes qui est péjorative mais bien la durée et la régularité de la prise, inscrites ici sur 5 ans, qui objectivent la dépendance. La trajectoire est un outil pertinent et opérationnel pour mieux adapter le suivi thérapeutique. Mots clés : psychotropes, trajectoires, dépendance, consommation, continue, occasionnelle Abstract The terms regular, excessive or intermittent consumption do not characterize type of consumption, the profile of the drug user, or the threshold of drug dependence. Objectives: To characterize trajectories of consumption over a 5-year period and identify sociodemographic and medical characteristics, and modes of consumption associated with the types of trajectories. Methods: 286 drug users from the cohort SUVIMAX agreed to take part in our study. SUVIMAX is a controlled randomized primary prevention trial using nutritional doses of a combination of anti-oxidant vitamins and minerals to reduce cardiovascular diseases and cancers.The data came from the questionnaire that examined each psychotropic drug taken between 1994 and 1998, rates of consumption and the beliefs associated with the drug users’ modes of consumption and their dependence profiles. Results: A continuous trajectory is defined as uninterrupted consumption during the 5-year follow-up, and an occasional trajectory as an interruption of consumption for at least 1 month. Only 30% of the drug users with a continuous trajectory considered they could do without psychotropic agents. Conclusion: The consumption of psychotropic drugs is not in itself harmful, but the duration and regularity of drug intake registered over a 5-year period indicate the drug dependence profile. The trajectory is a relevant and operational tool for better adapting therapeutic follow-up. Keywords: psychotropic drugs, trajectory, occasional, continuous, consumption, dependence Texte reçu le 21 mai 2002 ; accepté le 5 juillet 2002 [ABSTRACT FROM AUTHOR]

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Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study aims to determine whether it is possible to identify clinical profiles at risk of violent behaviors (VB) in the early phase of psychotic disorders, on the basis of the main dynamic psychopathological risk factors and describe characteristics of the groups with highest levels of violent behaviors., Method: A total of 265 patients, aged 18 to 35, treated at the Treatment and early Intervention in Psychosis Program (TIPP-Lausanne), a specialized early psychosis program, were included in this study. We conducted a latent-class analysis and a discriminative analysis on the basis of the main dynamic VB risk factors: substance use disorder, impulsivity, positive symptoms, insight, aggression, hostility, anger, emotional instability and adherence to treatment. These factors were evaluated by specialized scales and on the basis of the Positive and Negative Syndrome Scale (PANSS). VB were restricted to physical aggression against people, defined as "serious violence". They were assessed on the basis of a questionnaire listing violent offenses (Swiss Criminal Code) and VB such as assault and battery, information through the forensic psychiatric services and on the basis of the Staff Observation Aggression Scale (SOAS-R scale) during inpatient treatment phase., Results: Four heterogeneous subgroups were identified with respect to the studied clinical characteristics, including two groups with high rates of VB. The first group, comprising 46% of patients with VB, is distinguished by the prevalence of a range of dimensions related to hostility, impulsivity and emotional instability, associated with high levels of substance abuse and positive symptoms. These clinical dimensions are very significant at the statistical level, since they explain 70% of the construction of subgroups (discriminant analysis). The second group with 37% of patients with VB, is characterized by a lack of insight, lack of adherence to treatment and substance use. These two clinical profiles could increase the impairment of cognitive, functional and relational abilities and contribute to the development of VB in this early phase of psychosis. The third subgroup, with a violent behaviors rate of 28.6%, is distinguished by its high proportion of diagnoses of substance abuse (100%) and women (54%). A last subgroup of patients, the largest quantitatively, has a low proportion of VB (15%) and the lowest levels on the studied factors, suggesting that the majority of patients with this profile commit few VB., Conclusion: Our results show that it is possible to identify groups at risk of violent behaviors during the early phase of psychosis on the basis of clinical characteristics that may evolve and therefore be the focus of preventive care. These results highlight the need to target substance use, impulsivity and lack of insight at follow-up in order to prevent VB., (Copyright © 2018 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Therapeutic drug monitoring (TDM), combined in certain situations with pharmacogenetic tests of metabolism, has proven a valuable tool for psychopharmacotherapy. Uncertain drug adherence, suboptimal tolerability, nonresponse at therapeutic doses, or pharmacokinetic drug-drug interactions are typical situations when measurement of medication concentrations is helpful. This article is an adaptation of guidelines recently issued by the AGNP-TDM group (Hiemke et al., www. agnp.de), but its content focuses mainly on the TDM of antidepressants. Finally, the potential benefits of TDM for optimization of pharmacotherapy can only be obtained if the method is adequately integrated into the clinical treatment process.

The National Center of Competence in Research project "SYNAPSY" aims at identifying certain mechanisms of psychiatric and cognitive disorders, in order to improve the understanding and the genesis of such pathologies, and to promote the development of better diagnostic tools and of new therapeutic approaches. It provides an excellent opportunity for clinical psychiatrists and neuroscientists to develop a synergic mode of collaboration. On the basis of questions stemming from clinical practice and in the frame of patients cohorts, various research projects in neuroscience should lead to progresses that may have a considerable impact on clinical practice.

Depressive and schizophrenic patients frequently suffer from sexual dysfunctions. Antidepressants and antipsychotics can aggravate them leading to discontinuation of the treatment. The strategy to decrease these dysfunctions is the following: 1) reducing the dose of medication; 2) changing antidepressant: replace SSRI by moclobemid, trazodone, bupropion, mirtazpine, which do not delay ejaculation; switching to another antipsychotic: quietiapine, olanzapine, aripripazol, which do not increase serum prolactin; 3) taking a drug holiday for two or three days and 4) adding another drug such as sildenafil if impotence, or a dopaminergic agonist (aripripazol, a partial agonist) or cabergoline, in case of hyperprolactinaemia.

The clinical properties of the first antidepressant, imipramine, were described already 50 years ago. Almost all antidepressants are noradrenergic, serotonergic and/or dopaminergic. Pharmaceutical companies experience difficulties in the development of drugs, of which the mecanism of action is related to other neuronal systems. Recently, the dual reuptake inhibitor duloxetine, the atypical antipsychotic quetiapine, desvenlafaxine (the main metabolite of venlafaxine) were developed for the treatment of depression. The noradrenergic and dopaminergic bupropion, in combination with other antidepressants, is a promising drug for the treatment of resistant depression. Finally, agomelatine, by its effects on the receptors of melatonin and on the 5-HT2c receptor, presents a unique pharmacological profile.