Search

Aim: To present the activities of a Mobile Intensive Care Unit in France., Methods: We summarize participant recruitment as well as the diagnostic procedures and therapeutic interventions offered to individuals with an at-risk mental state or first-episode psychosis (FEP)., Results: Since its inception in 2010, 266 individuals from 16 to 30 years old living in an area of 120 000 citizens have been recruited by the Mobile Intensive Care Unit. Patients are evaluated by clinical and neuropsychological assessments, and therapeutic interventions include medication, individual case management and both individual and group cognitive behavioural therapy. Diagnostic assessments are also provided for the patients outside of our geographic area., Conclusions: The Mobile Intensive Care Unit is a functional unit enabling young adults with a high-risk mental state or FEP to receive high standard of care and mobile management over 2 years, aimed at diminishing the risk of transition to chronic disease and decreasing functional impairment., (© 2018 John Wiley & Sons Australia, Ltd.)

Unlabelled: Sinistrality characterized by an excess of non-right handedness has been reported in schizophrenic patients. Two factors, sex and kind of evaluation of handedness have contributed to major discrepancies across studies., Aim: The hypothesis tested was that schizophrenic patients show a sinistral shift in handedness compared to controls taking into account the sex and using a continuum scoring system for evaluating handedness., Methods: Seventy-three (73.1% males) schizophrenic patients (DSMIV) and 81 (64.2% males) controls were evaluated with the Edinburgh Handedness Inventory (EHI [Neuropsychologia, 9 (1971) 97])., Results: The EHI score mean difference between patients with schizophrenia and control group was not significant when sex was taken into account., Conclusion: Schizophrenic patients taken as a whole did not show a sinistral shift in handedness even if the sex and the continuum score for handedness were considered.

Pharmacological and clinical findings suggest that the dopamine transporter (DAT) gene may be involved in the genetic predisposition to schizophrenia. Linkage of a Taq I VNTR polymorphism in the DAT gene to schizophrenia was studied in multiplex schizophrenic families from Rouen, France (n = 10) and the Island of La Réunion (n = 21). Neither the lod score method nor nonparametric methods (the affected pedigree member method of Weeks and Lange [1988] and the sibling method of Green and Woodrow [1977]) provided any evidence for linkage. An association study, carried out within a group of 91 unrelated schizophrenic patients from Rouen and 91 matched control subjects, examined a 40 base-pair repeat polymorphism located in the 3' nontranslated end of the DAT mRNA. There was no significant difference in allelic or genotypic frequencies between the two groups. These results exclude any substantial involvement of the DAT gene in the pathogenesis of schizophrenia in the population studied.

Whereas Chapman's social and physical scales are the most used instruments for the assessment of anhedonia in schizophrenia, no French translation has been still validated by the authors. Therefore, the aim of this study was first to translate into French the both scales, and after back translation, to obtain the agreement of the original authors. Second, the aim was to establish values and to establish the cut-off beyond of which French subjects could be considered as anhedonic. One hundred and twenty-three subjects were included: 72 control subjects without mental disorders and 51 stable schizophrenic patients defined by the DSM III-R, ICD 9, ICD 10, RDC or Feighner criteria. According to the literature, schizophrenic patients had higher scores for both scales than control subjects (p < 0.001; Student t test). The social anhedonia scores are different due to cultural variations. The distribution of physical anhedonia scores in control subjects or in schizophrenic patients differed from normal distributions (respectively, p < 0.05; p < 0.0001; Shapiro-Wilks test). The distribution of social anhedonia scores differed from normal distributions (p < 0.01) only in schizophrenic patients but not in control subjects. By maximising the Younden indice [Sensitivity + Specificity -1], the cut-off of the physical anhedonia score was 18 (Younden indice = 0.45), and the cut-off of the social anhedonia score was 12 (Younden indice = 0.24). In using this cut-off, the French physical anhedonia scale had a good positive predictive value (evaluated by logistic regression) for schizophrenia. Therefore, a patient with a physical anhedonia score beyond 18 have a probability of 64% to be schizophrenic. In contrast, the social anhedonia scale was less discriminant for schizophrenia. Indeed, patient with a social anhedonia score beyond 12 have a probability of 52% to be schizophrenic. This French version of Chapman's anhedonia scales could be considered as an useful instrument to assess anhedonia, in particular physical anhedonia, in schizophrenic patients.

We investigated the frequency of a rare variant of a common microsatellite tetrarepeat allele in the tyrosine hydroxylase gene in 2 independent ethnic groups of schizophrenic patients and their matched controls. In a French population we found the rare variant allele in 5 of 94 (5%) unrelated chronic schizophrenic patients and in none of 145 unaffected controls, thus yielding a significant association (p < 0.01) between schizophrenia and the tyrosine hydroxylase gene. Similarly, in a replication study, we found the rare allele in 4 of 44 (9%) unrelated chronic schizophrenic patients and in none of 44 unaffected controls in a Tunisian population. Albeit the reason of this association is at the moment unknown, it is possible that this polymorphism in the tyrosine hydroxylase gene may be involved in the regulation of its activity.

A new structural polymorphism (Ser311/Cys311) in the dopamine D2 receptor (DRD2) gene has recently been reported to be associated with schizophrenia, particularly in patients with a positive family history of schizophrenia (Arinimi et al., 1994). However these findings remain controversial (Asherson et al., 1994; Nanko et al., 1994; Nöthen et al., 1994; Shaikh et al., 1994). Thus we investigated the role of the Cys311 mutation in schizophrenia using both association and family studies. First, we screened for the Cys311 mutation in 113 unrelated Caucasian schizophrenics (mean age 42 +/- 0.6; 34 females and 79 males) including 25 familial cases, and 184 unrelated controls (mean age 49 +/- 0.5, 74 females and 110 males) free of any psychiatric disorders. Diagnoses were ascertained according to DSM-III criteria (Campion et al., 1994). All patients and controls were native to the area of Rouen.