N Dantchev

Publications (9)12.12 Total impact

• Article: [The borderline concept: prognostic implications].

  N Dantchev
  L Encéphale 08/1998; 24 Spec No 1:17-23. · 0.63 Impact Factor
• Article: The measurement of retardation in depression.

  N Dantchev, D J Widlöcher
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  ABSTRACT: The description of clinical features helps to distinguish between depressive illness and nondepressive psychic pain and enables the clinician to decide whether prescription of an antidepressant is beneficial. Psychomotor retardation is probably a central feature of depression, and this review discusses the methods available for measuring it. The Salpêtrière Retardation Rating Scale (SRRS) specifically measures psychomotor retardation; the scale and applications are described. Means of measuring motor and speech activity and an experimental approach for understanding the process underlying psychomotor retardation are reviewed. Comparison of the SRRS and other rating scale scores demonstrates that retardation is related to depression severity and therapeutic change and is a good criterion for prediction of therapeutic effect. The SRRS has been used to show that selective antidepressants target specific clinical dimensions of depression depending on the patient subgroup treated. Measures of motor and speech activity are sensitive to therapeutic response. Choice Reaction Time and Simple Reaction Time tasks are particularly suited for examining psychomotor retardation because they test the decision process while avoiding motivation and attention interference. Psychomotor retardation is a constant and probably central feature of depression. Means available for measuring it can be used to assess the effects of antidepressants on specific clinical dimensions.
  The Journal of Clinical Psychiatry 02/1998; 59 Suppl 14:19-25. · 5.80 Impact Factor
• Article: Circadian pattern of motor activity in major depressed patients undergoing antidepressant therapy: relationship between actigraphic measures and clinical course.

  N Raoux, O Benoit, N Dantchev, P Denise, B Franc, J F Allilaire, D Widlöcher
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  ABSTRACT: The 24-hour motor activity pattern was evaluated in 26 inpatients with major depression at treatment onset and after 4 weeks of antidepressant therapy. Clinical state, depression, and psychomotor retardation, as well as motor activity level and circadian rhythm, were simultaneously assessed. Treatment responders and nonresponders were also considered. Diurnal hypoactivity and reduced 24-hour rhythm amplitude were found at treatment onset. Activity level increased significantly on discharge. The rest-activity cycle for each depressed patient fit a cosine function of 24-hour periodicity. Data tended to show no phase shift but a large intragroup phase variability. Preliminary findings of a negative correlation between basic activity level and clinical improvement, and a trend toward responders having a lower activity level than nonresponders, suggest that activity could be used to predict therapeutic response.
  Psychiatry Research 05/1994; 52(1):85-98. · 2.52 Impact Factor
• Article: [Weight gain and antipsychotic drug treatment].

  E Patri, N Dantchev, M Martinez
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  ABSTRACT: Like the classical neuroleptic drugs, most of the new antipsychotic agents can cause weight gain in patients receiving long-term treatment. However, it remains difficult to rank the different compounds according to their propensity to cause this unwanted side-effect. Recent data suggest that weight gain appears to be essentially related to an increase in appetite in these patients. Thus, it is a fact that the patients' diet represents the main predictive factor for weight gain, independently of the antipsychotic compound prescribed. In contrast to the other and often more disabling side-effects of these treatments, overweight can be effectively prevented by simple hygienic and dietetic measures. It would therefore be advisable to discuss the possibility of this side-effect of antipsychotic treatment with the patient, and to suggest appropriate preventive measures, as part of the therapeutic partnership.
  L Encéphale 26(6):93-7. · 0.63 Impact Factor
• Article: [Decision trees in psychiatric therapy].

  N Dantchev
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  ABSTRACT: The main objective of decision analysis is to offer a theoretical representation of choices made in an environment of uncertainty. This technique is currently under development in a great variety of fields, particularly in medicine, where aid in decision making is the topic of much research. Psychiatry, in turn, is very much concerned by these new developments which could be of particular interest to therapeutics-an area where the large number of studies and date are in great contrast with the lack of consensus concerning the various solutions proposed to patients. Decision analysis utilizes different techniques among which are decision trees. The technique of decision trees goes far beyond a simple graphic representation of reasoning in the form of a chart. Its basic principles is to measure the uncertainty associated with decision making in the hopes of better understanding the rationale of decisions while optimizing the gain versus cost ratio. The goal is to calculate, within a series of decisions, the weight of their importance expressed in terms of usefulness or unpleasantness. In psychiatric therapeutics, only three studies have been published which incorporate the technique of decision trees. Two of these deal with treating depression (Schulberg et al., 1989; Koenig et al., 1993) while the third deals with schizophrenia (Hatcher, 1995). The limits of these techniques are, on one hand, due to their feasibility in that their complexity renders them inapplicable when a great number of variables have to be taken into account or when the amount of necessary data is still insufficient. Moreover, the use of these techniques remains relatively restricted as their expansion depends upon their acceptance by clinical physicians. Also, their use raises questions as to what extent it is possible to rationalize decisions in psychiatry. From a larger perspective, one must consider that these techniques may eventually furnish certain elements which could be integrated to help further the field of decision-making representations for clinical use. These decision-making techniques are still in the experimental stages and remains difficult to apply to clinical practice. However they appear to be of a great interest, not only in communicating knowledge both in teaching and training, but in research as well. They allow us to view the results of epidemiological studies and clinical research from a more global perspective; to make evident the grey areas of our science and to determine new priorities in research.
  L Encéphale 22(3):205-14. · 0.63 Impact Factor
• Article: [Primary Human Immunodeficiency Virus infection revealed by psychiatric symptoms].

  V Renaud, P Brazille, N Dantchev, C Attale, S M Consoli
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  ABSTRACT: Any atypical psychiatric disorder, especially if associated with somatic manifestations and when any psychiatric antecedents are missing, should lead to search for an organic pathology, and notably a Human Immunodeficiency Virus (HIV) infection. In the case of Primary Human Immunodeficiency Virus Infection (PHI), which is often symptomatic, the diagnosis is seldom made, probably because of atypical or non specific manifestations. Therefore, it is essential to consider such a diagnosis, because it may have important clinical and public health consequences (stopping the contamination chain). We present the case of a 38 year-old homosexual man from West Indies, in whom the diagnosis of PHI had been made on the basis of psychiatric symptoms evoking a Major Depressive Episode with a doubt on the presence of psychotic symptoms. To our knowledge, this is the first report of psychiatric PHI found in scientific literature. Clinical presentation was atypical: the patient had no psychiatric history (except probably a schizotypical personality, according to his family), symptoms were atypical (sudden onset and fast improvement) associated with somatic symptoms (fever, headache, sound intolerance), the latter possibly due to a meningo-encephalitis, which had been underestimated and attributed to dehydration in a period when France was faced with an important and unexpected heatwave. Blood samples were performed on admission and revealed a thrombopenia and presence of HIV P24 antigen, testifying a contamination by HIV 2 to 4 weeks earlier, this possibility having been confirmed by the patient. Further analyses found a Western-Blot partially positive test and an HIV viral load of 315 711 Eq copies/mL. The main question about this report is the primary or secondary nature of psychiatric symptoms towards HIV infection, given that in this patient mood alteration could have possibly occurred, before HIV contamination, due to particularities of his personal and professional life. We can also question whether the neurological manifestations of PHI might be changed by a schizotypical personality. Further reports are required to answer these questions.
  L Encéphale 32(4 Pt 1):474-7. · 0.63 Impact Factor
• Article: [Charcot and hysteria].

  D Widlöcher, N Dantchev
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  ABSTRACT: Charcot's work on hysteria has always been controversial. All his attitudes, whether on the theory of the ovary, the hysteroepileptic seizure or the use of hypnosis, have always been charicatured, misunderstood and separated from the wider context of his overall approach. Rereading Charcot's works shows that he developed his approach progressively over a period of more than 20 years before coming to his psychological model of hysteria. This model explains the formation of the symptom and the hysterical conversion via a mechanism of being ignorant of the motor representation. This concept has never been disproven and remains the only theory explaining the formation of the hysteria symptom. Based on Charcot's fundamental contribution, Freud and Janet further developed their work on the psychopathology of hysteria.
  Revue Neurologique 150(8-9):490-7. · 0.49 Impact Factor
• Article: [Significance of studies of motor activity in depression].

  N Dantchev, J F Allilaire, N Raoux
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  ABSTRACT: Actometry is a technique that enables continuous monitoring of spontaneous motor activity. This technique can be applied to the study of depression either by studying qualitative motor activity patterns or by measuring quantitative motor parameters. We present here the results of a quantitative actometric analysis. 13 depressive in-patients were evaluated both clinically by depression scales and by actometry before and after trimipramine treatment. Correlation analysis was made between actometric and clinical rating scores at different moments of the treatment. Some actometric parameters appear to be specific indices of depression and psychomotor retardation. Future prospects for the use of actometric techniques in depression are discussed.
  Annales Médico-psychologiques revue psychiatrique 150(2-3):206-10. · 0.17 Impact Factor
• Article: [Deficit in selective attention and its evolution in depression].

  J Thomas, N Raoux, J Everett, N Dantchev, D Widlöcher
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  ABSTRACT: Selective attention was measured in 34 depressed patients and 34 controls using a computerized version of the Stroop test, that included a manipulation of the stimulus onset asynchrony (SCA) in order to explore the efficacy of cognitive inhibition as a function of depression and of clinical amelioration of degression after therapy. Clinical tests included a measure of psychomotor slowing [Echelle de Ralentissement de Widlöcher (ERD), the Hamilton (Psychiatric Rating Scale for Depression (HAMD), and the Brief Psychiatric Rating Scale (BPRS)]. Selective attention was measured with the Stroop test, which includes four measures: Word, Color, Color-Word, and Color-Word minus Color, or interference. All of these measures were deficient in the depressed patients, particularly Stroop interference. Even when additional time was given to inhibit the Stroop distractor in the SOA condition, depressed subjects still showed significantly inferior performance. After four weeks of anti-depressive treatment, fifteen of the patients were retested, and showed significant improvement on all the Stroop measures, particularly on Stroop interference. The improvement in performance on the attentional measures was comparable in magnitude to that seen on the clinical scales, and suggests that the interference measure can be a sensitive indicator of clinical status in depressed patients.
  L Encéphale 23(2):108-12. · 0.63 Impact Factor