William Pitchot

William Pitchot
University of Liège | ulg · Unit of Psychiatry and Medical Psychology

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189
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Publications

Publications (189)
Article
Psychiatric complications are commonly associated with alcoholism. Psychological symptoms appear during intoxication or in patients with concomitant psychiatric disorders or substance-induced psychiatric disorders. Moreover, the assessment of the psychiatric symptomatology is particularly challenging in patients who express difficulties to accept t...
Article
Clinical care to patients with alcohol dependence by GP's is described in this article. First, we have to destigmatize these patients and their illness. Diagnosis approach is specified. Therapeutic approach is first a motivational approach; subsequently it's like pedagogy : it's coping. Care is both physical and psychological. Empathy all along the...
Article
After having explained what is dyspraxia, we will briefly talk about narcissistic issues related to school term. Indeed, the defensive tools used by children to deal with learning disabilities are varied and not much specific, which will complicate the medical approach. Then we will describe the symptoms that are specific to search in the history a...
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School bullying consists of harassment behaviours in a school setting and is characterized by violence acts, mockery or even humiliations between students. More recently, with the development of new technologies, our society has seen the cyber-bullying born. This new type of harassment "on-line" comes and intersects the harassment at school. After...
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Burnout or professional fatigue syndrome is the result of exposure to a situation in which the strategies of the subject who are supposed to manage the stresses of the environment become outdated and inoperative. An imbalance is created between the demands and the material, operational and psychological resources to cope with them. Many health prof...
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Burnout or professional fatigue syndrome has never been more talked about than in recent times. It is the result of exposure to a situation in which the strategies of the subject who are supposed to manage the stresses of the environment become outdated and inoperative. An imbalance is created between the demands and the material, operational and p...
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Complaints about restlessness, difficulties to focus and impulsivity are amongst the most frequent reasons for child psychiatric consultations. Those complaints refer to the core symptoms of the ADHD. However, the diagnosis of ADHD is delicate to establish and subject to several controversies regarding its etiopathological origins and, therefore, i...
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Les patients dépressifs unipolaires peuvent présenter une détérioration du sentiment de continuité de soi. Les souvenirs définissant le soi sont des souvenirs autobiographiques particuliers qui pourraient consister en des outils d’intervention psychologique visant au rétablissement de ce sentiment de continuité de soi. L’évocation de ces souvenirs...
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Depression is a major public health problem. According to the World Health Organization (OMS), depression is currently the second cause of disability in developing countries. Depression is also one of the most frequent mental illnesses. When treating depression, the main objective is to achieve complete remission and to prevent recurrence. Unfor-tu...
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Objectives. Only few studies investigated treatment strategies for treatment resistant depression (TRD). The objective of this multicentre study was to evaluate TRD patients who did not respond to at least two antidepressants. Methods. A total of 417 patients, who failed to respond to a previous retrospectively assessed antidepressant (AD1), were f...
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Recent advances in the neurobiology of depression have underlined the importance of markers of inflammation, neurotrophins, and hypothalamo-pituitary adrenal (HPA) axis dysfunction in the development of this pathology. These disorders could have some impact on other systems such as the glucose metabolism regulation with an increased risk of insulin...
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In the face of changes that characterise adolescence, a number of youth experience ill-being, as part of a normal developmental process. For some of them, however, this ill-being may represent early signs of a psychopathological process. Regarding depression and psychosis, such early signs are non-specific, which complicates and delays treatment. I...
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Objectives The efficacy of lithium in bipolar disorder is widely accepted for many years. It is still considered as the gold standard in most international guidelines. Lithium is indicated in the treatment of mania, of depressive episodes and in the prevention of mania and depression. The objective of this paper is to focus on scientific data suppo...
Article
In developed countries, suicide is a real public health problem. However, in contrast with a classical idea, suicide is not specific to young people. Indeed, late life suicide is a cause for major concern, particularly for those over 75 years. Psychiatric disorders, and more specifically major depression, are clearly the most important risk factors...
Article
Mutism is a symptom we see in consultation for an absence or lack of langage acquisition and/or for relationship problems (isolation, withdrawal, crisis when breaking up) alerting the family. The differential diagnosis is complex and mutism can be symptomatic of several personality psychopathological structures. After a literature review, we shall...
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Agitation in psychiatry is defined as "a request to which an answer cannot be deferred". If some types of controllable agitation can be solved by human means or psychotropic drugs, others may require the intervention of intensivists who will contribute to the onset of crisis resolution. In addition, an organic aetiology must be carefully excluded a...
Article
Depression is a major public health problem. In the treatment of depression, the main objectives must be complete remission and prevention of recurrence. However, the objective of remission remains difficult in clinical practice. Several pharmacological strategies exist to handle treatment resistant depression and achieve remission. Among these opt...
Article
Psychiatric complications are clearly associated with substance abuse. Psychopathological symptoms appear during intoxication or in patients suffering from substance-induced psychiatric disorders. However, the assessment of the psychiatric symptomatology is particularly challenging in patients who express clear difficulties to accept that the disor...
Article
Cocaine is the second most commonly used illicit drug after cannabis in the general population. Cocaine is a powerful stimulating agent of the central nervous system and a highly addictogenic drug. Somatic and psychiatric consequences of cocaine addiction are major and clinically relevant. The increasing consumption of cocaine and the importance of...
Article
Affective dependency is characterized by emotional distress (insecure attachment) and dependency to another person with a low self-esteem and reassurance need. The paper proposes a reflection on the definition of emotional dependency and the confusion caused by various denominations. Overprotective and authoritarian parenting, cultural and socio-en...
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Hypersexuality disorder has not been added to the list of psychiatric disorders for the Diagnostic and Statistical Manual of Mental Disorders (DSM) V, to be published in May 2013. The evolution of the concept of hypersexuality disorder and its series of different models call into question the controversial context within which its inclusion is cons...
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Gambling is a common activity among almost all societies. Forms of gambling have been present all along history, but new gambling behaviours seem to emerge since the development of internet, in a way that we can consider that society has never offered so many opportunities of developing addictive behaviours. Social representations of sin, deviance...
Article
Patients with treatment-resistant major depressive disorder (MDD) remain a common clinical challenge. This 6-week, randomised, open-label, rater-blinded trial evaluated once-daily extended-release quetiapine fumarate (quetiapine XR; 300mg/day) as add-on to ongoing antidepressant and quetiapine XR monotherapy (300mg/day) compared with add-on lithium...
Article
Today, the term depression has lost its meaning. Recent scientific data suggests a change in our classifications of mental disorders. Depression is frequently used to refer to "normal" sadness, anxiety disorders, personality disorders or adjustment disorders... Moreover, in our society, this diagnosis remains badly accepted. It is really time to be...
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Asenapine is a new atypical antipsychotic. Like other atypicals, asenapine acts as an antagonist at both dopamine D2 and serotonin 5-HT2A receptors. The efficacy of asenapine monotherapy in the treatment of bipolar disorder manic episodes in adults has been demonstrated in two similarly designed randomized placebo-controlled flexible-dose trials of...
Chapter
Treatment-resistant depression (TRD) remains a common condition, with 50–60% of patients not achieving meaningful response following antidepressant treatment. The huge complexity of the phenomenon and the wide variety of parameters that must be taken into account make creating a definition possible, but several attempts have been proposed over the...
Article
In the treatment of depression, the main objective is to reach complete remission. Unfortunately, this objective remains difficult in clinical practice. In fact, complete remission is frequently considered as an unrealistic objective. It is clear that recovering from major depression is a complicated objective, but it is realistic. In the present p...
Article
The interest in sexual dysfunction induced by psychotropic drugs has increased considerably in recent years because of the new-generation antidepressants (AD) and antipsychotics (AP) being put into medical practice. These drugs are widely used to treat not only depression and schizophrenia, but also anxiety and affective disorders. Other, additiona...
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Despite recent clinical and scientific developments in the psychogeriatric field, depression in old age remains an underdiagnosed and undertreated disorder. However, depressive symptoms are frequent in older people and the impact on patients, their family and the society is very important. Depression is also frequently associated with somatic illne...
Article
Bipolar disorder is a multifactorial disease with a strong genetic component. However, environmental factors also play a role in the onset of the disease and in manic and depressive recurrence. The onset of the disorder is the consequence of a complex interaction between genetic and environmental factors. This gene-environment interaction is well i...
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Highlights ► Some patients with panic disorder fail to respond to standard treatments. ► Some studies have suggested that atypical antipsychotics in association with an SSRI could be an option for treatment-refractory panic disorder. ► Efficacy of low doses of quetiapine in addition to an antidepressant in a patient suffering from treatment-resista...
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Treatment-resistant depression (TRD) presents many challenges for both patients and physicians. This review aims to evaluate the current status of the field of TRD and reflects the main findings of a consensus meeting held in September 2009. Literature searches were also conducted using PubMed and EMBASE. Abstracts of the retrieved articles were re...
Article
The last decades have demonstrated the value of early interventions after a traumatic event. The purpose of these interventions is to prevent the development of psychological consequences such as post-traumatic stress disorder. Psychological debriefing is clearly the most popular intervention. However, in the literature, it is subject to a real con...
Article
Isoniazid is a major component of the treatment and prevention of tuberculosis. Besides its antitubercular action, isoniazid is a weak inhibitor of monoamine oxidase. Therefore, a potential risk of interaction with antidepressants exists. We describe the case of a woman treated with venlafaxine for a major depressive episode who developed a seroton...
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Aripiprazole is an atypical antipsychotic with a pharmacological and clinical profile distinct from other atypical antipsychotics. A European multidisciplinary advisory panel of university-based experts in bipolar disorders convened in April 2010 to review new clinical guidelines for the management of mania and the role of aripiprazole in its treat...
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Depressive symptoms and episodes dominate the course of bipolar disorder. However, the therapeutic armamentarium for bipolar depression is limited. Recent evidence points to the efficacy of second generation antipsychotics (SGAs) for the treatment of bipolar depression. We conducted a systematic review and meta-analysis of the efficacy and safety o...
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In occidental countries, breast cancer is the most frequent cancer in women. In the last 30 years, the therapeutical progresses have improved the prognosis and the survival rate. However, despite this hope of recovering, women continue to face the fear of death and vulnerability. Moreover, treatments can induce cognitive, emotional and behavioral r...
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Despite the availability of several antidepressants, the treatment of major depression is far from being satisfactory. With conventional antidepressants, more than 30 to 45% of the patient will not respond or present only partial remission. In the prospect of a better treatment of depression, research tends to develop original molecules, more effec...
Article
Today, tricyclic antidepressants and MonoAmine Oxidase Inhibitors are prescribed less frequently compared to Selective Serotonin Reuptake Inhibitors (SSRIs) or selective serotonin and noradrenalin reuptake inhibitors. These new medications are associated with a better safety profile. The new generation of psychiatrists is not really comfortable wit...
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Over the last two decades, several antidepressants (AD) were marketed. These drugs are not only used for the treatment of depression, but also for many other indications like anxiety disorders, eating disorders, premenstrual syndrome and neuropathic pain of diabetic origin... During several years, sexual side-effects of AD have been ignored. These...
Article
Several acute depression trials suggest that only 35% of the patients achieve remission state with antidepressant monotherapy. An increasing body of evidence is emerging suggesting that multi-action antidepressants might be more effective in treatment-resistant depressed patients than single-action agents. In this context, the purpose of the study...
Article
Depression is a major public health problem. According to the World Health Organization (OMS), depression is currently the second cause of disability in developping countries. Depression is also one of the most frequent mental illnesses. In the treatment of depression, the main objective is to achieve complete remission and to prevent recurrence. U...
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Full-text available
Over the last twenty years, cocaine, amphetamines and MDMA (ecstasy) have found new categories of users, seeking for their stimulating effects. These substances may lead to real dependence and may cause serious somatic and psychiatric damage. In this perspective, we reviewed the available literature concerning problematic psychoactive drug use in B...
Article
We report 3 cases of 3- to 5-year-old children with symptoms suggesting an autistic disorder (language delay or absence of language, communication withdrawal and developmental delay). We believe that these cases should be preferentially interpreted in terms of attachment disorder with autistic withdrawal rather than pure autistic disorder. Their pr...
Article
Zolpidem is an imidazopiridine with hypnotic properties. Compared to benzodiazepines, zolpidem has a mechanism of action that is thought to reduce the risk of dependence or abuse. However, in the past 10 years, several cases of zolpidem abuse, dependence and withdrawal reactions have been described in the litterature. Here, we describe a case of de...
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Cloninger's type II is a severe, early-onset, male-limited, and genetically influenced, impulsive form of alcoholism. Significant association has been reported between the A1 allele of the D2 dopamine receptor (DRD2) gene, substance misuse and personality traits of impulsivity and novelty seeking. We assessed the association between the TaqI A DRD2...
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The purpose of the present study was to assess if AVP-neurophysin is associated with hypercortisolemia and suicidal behaviour in depressed patients. The study included 28 patients subgrouped into suicide attempters (n=13) and nonattempters (n=15). We assessed basal AVP-neurophysins concentrations and post-dexamethasone (DST) cortisol levels. Concen...
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Transcranial magnetic stimulation (TMS), a non-invasive means of electrically stimulating neurons in the human cerebral cortex, is able to modify neuronal activity locally and at distant sites when delivered in series or trains of pulses (repetitive TMS). Research into clinical applications for TMS is very active and has the potential to provide us...
Article
Obsessive-compulsive disorder belongs to anxiety disorders, with a prevalence of 2,5% in the general population. The pathogeny of the disorder includes a probable genetic component but of moderate importance. Neuroimaging studies showed a hyperactivity of the prefrontal cortex and the caudate nucleus which appears to reflect abnormalities in cerebr...
Article
The effect of antidepressants cannot be explained by the classical monoaminergic theory. In particular, that model does not explain the delay in clinical response with antidepressants. Many hypotheses have been developed to understand the mechanism of action of antidepressants, each of them involving the regulation of different receptors. In parall...
Article
Several lines of evidence suggest a major role for dopamine in the pathophysiology of depression. In particular, affective disorders tend to be associated with a decrease in dopaminergic function. Moreover, some data show that antidepressants increase the activity of dopaminergic synapses at the mesolimbic level. In fact, the mesocorticolimbic dopa...
Article
Vasopressin (AVP) and oxytocin (OT) are two chemically similar neurohypophyseal neuropeptides which could be involved in mood disorders. Those two sister neuropeptides might be considered as ago-antagonist hormones. They act as neuromodulators of the stress response. AVP is known as an ACTH stimulating factor synergistic to CRH while OT could act a...
Article
The value of antidepressants in bipolar disorder is the subject of significant controversy. The prescription of antidepressants remains frequent in clinical practice despite international guidelines recommending serious carefulness in their use. Caution should be exerted before the initiation of a treatment for an episode of major depression in a b...
Article
Suicide and attempted suicide are currently considered as an epidemic disease. According to WHO, in the world, one million of individuals commit suicide each year. Every 40 seconds, one person commits suicide and every 3 seconds, one person makes a suicide attempt. Over recent years, the risk of suicide and suicide attempt has considerably increase...
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The short (S) allele of the serotonin transporter gene promoter polymorphism (5-HTTLPR) contributes to the risk of alcohol dependence and co-occurring clinical features. We studied the putative link between this allele and relapse. 48 alcohol-dependent male patients were recruited and genotyped for the 5-HTTLPR. Relapse to alcohol drinking was moni...
Article
Sometimes, the discontinuation of antidepressant therapy is associated with both physical and psychological symptoms. These symptoms are parts of the discontinuation syndrome and are very different from relapse or recurrence. The discontinuation syndrome appears within 1 week and lasts about 3 weeks after discontinuation of the antidepressant. In t...
Article
Vasopressin (AVP) and oxytocin (OT) were the first biologically active peptides to be synthesized. They are two chemically very similar neurohypophyseal neuropeptides which could be involved in mood disorders. Neuropeptides, short-chain amino-acid neurotransmitters and neuromodulators, are attractive therapeutic targets for mood disorders. AVP seem...
Article
Cerebrospinal fluid and plasmatic levels of oxytocin (OT) have been found to change in mood disorders. In post-mortem studies, the numbers of OT-expressing neurons in the paraventricular nucleus have been reported to be increased. Moreover, OT is considered as an endogenous antistress hormone. It has also revealed antidepressive effects. OT may con...
Article
Remission and prevention of recurences are the main objectives in the management of affective disorders. If it is assumed that remission is the ultimate objective of treatment in affective disorders, it is important to be aware of the most effective therapeutic strategies available for achieving this state. However, with conventional agents, severa...
Article
In the treatment of depression, the major objective is remission. Unfortunately, in clinical trials as in naturalistic studies, complete remission rate is very low. Consequences of partial remission or non-response to treatment are well known particularly in terms of risk of relapse, chronicity and quality of life impairment. During the 2006-2007 p...
Article
Duloxetine (Cymbalta is an antidepressant of the class of serotonin noradrenaline reuptake inhibitors. The efficacy of duloxetine 60 mg/day has been well demonstrated in the acute and long term treatment of major depression. The level of effectiveness of duloxetine is particularly high and associated with a shorter latency of action. Duloxetine als...
Article
The first part of this paper outlines the scale, impact and current management of major depressive disorder. Major depressive disorder is a huge public health problem, and despite the availability of a range of effective antidepressants and approaches to therapy, many patients fail to achieve remission, or if they do, they go on to suffer relapse o...
Article
Several lines of evidence suggest a clear relationship between serotonin (5-hydroxytryptamine, 5-HT) hypoactivity and suicidal behavior across several psychiatric diagnoses. Few data are available, however, regarding the possible specific role of 5-HT1A receptors in the biology of suicidality. Therefore, the aim of our study was to use a neuroendoc...
Article
A number of studies have reported abnormalities of neurohypophyseal secretions in major depressive disorder. The purpose of the present study was to test the influence of apomorphine and clonidine injections on plasma vasopressin (AVP)-neurophysins and oxytocin(OT)-neurophysins levels, as direct index of posterior pituitary activation in major depr...
Article
Flesinoxan is a highly potent and selective 5-HT1A agonist. In a recent study, in normal volunteers, flesinoxan induced a significant and dose-dependent increase in adrenocorticotropic hormone (ACTH), cortisol, prolactin (PRL), growth hormone (GH) and a decrease in body temperature. In order to better define the role of 5-HT receptor subtypes in re...