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Most cited

This page lists all time most cited articles for this title. Please use the publication date filters on the left if you would like to restrict this list to recently published content, for example to articles published in the last three years. The number of times each article was cited is displayed to the right of its title and can be clicked to access a list of all titles this article has been cited by.

Contents

Page 163 of 451

  • Cited by 3

  • Factors associated with borderline personality disorder in major depressive patients and their relationship to bipolarity

  • J.M. Azorin, A. Kaladjian, M. Adida, E. Fakra, R. Belzeaux, E. Hantouche, S. Lancrenon
  • Published online by Cambridge University Press:
    15 April 2020, pp. 463-468
  • Objective

    To analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.

    Methods

    As part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).

    Results

    Compared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.

    Conclusions

    The hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.

  • Cited by 3

  • The assessment of agoraphobic attitudes

  • C Faravelli, S Paterniti
  • Published online by Cambridge University Press:
    16 April 2020, pp. 223-228

  • The Phobic Attitude Scale (PAS) is a new 15-item inventory designed to assess sub-clinical agoraphobic attitudes as well as the severity of pathological avoidance. Its psychometric properties have been examined in three groups of subjects: 41 outpatients suffering from DSM III-R Panic Disorder, with or without agoraphobia, 62 healthy controls and 12 mixed psychiatric patients.The instrument proved to be simple and easy to use. PD patients scored significantly higher than healthy controls, with mixed psychiatric cases showing intermediate values. The Test-Retest procedure gave rise to satisfactory kappa coefficients (0.25 to 1) and the internal consistency was good (Cronbach alpha = 0.86). Factor analysis produced three factors: “crowded and social situations”,“enclosed and open spaces/riding situations” and “simple phobia”.

  • Cited by 3
  • Cited by 3

  • Évolution des idées sur le mécanisme d'action des antidépresseurs : le concept d'hétéro-régulation des récepteurs

  • J.P. Tassin
  • Published online by Cambridge University Press:
    28 April 2020, pp. 62-74

  • Des lès premières années d'utilisation clinique des antidépresseurs, les neurones à sérotonine (5-HT) et à noradrénaline (NA) ont été considérés comme les sites d'action privilégiés de ces médicaments.

    En vingt ans, les idées sur leurs mécanismes d'action ont évolué parallèlement à la progression des connaissances et à l'obtention de nouvelles molécules actives :

    • - Tout d'abord, les effets présynaptiques des traitements aigus (inhibition des monoamines oxydases et inhibition de la recapture des monoamines par les antidépresseurs tricycliques) ont paru expliquer l'effet clinique de ces substances.

    • - Plus tard, les effets post-synaptiques des traitements chroniques (désensibilisation des récepteurs β-adrénergiques et, dans la plupart des cas, la désensibilisation des récepteurs 5-HT2) se sont avérés être une action biochimique commune de ces traitements.

    • - Récemment, les effets synaptiques homologues - en l'occurrence la desensibilisation des récepteurs α2-adrénergiques - ont été considérés comme un préalable à la désensibilisation des récepteurs β-adrénergiques post-synaptiques.

    • - Enfin, les effets synaptiques hétérologies sont proposés comme pouvant rendre compte de Taction clinique des antidépresseurs.

    C'est la stimulation - directe ou indirecte - des récepteurs sérotoninergiques (5-HT2) qui serait nécessaire à l'obtention d'un découplage β lors d'une stimulation des récepteurs β-adrénergiques.

    Les molécules antidepressives n'auraient d'action thérapeutique qu'à condition d'agir de façon synergique sur les transmissions sérotoninergique et noradrénergique.

  • Cited by 3

  • Dietary interferences with lithium therapy

  • P Castrogiovanni, F Pieraccini
  • Published online by Cambridge University Press:
    16 April 2020, pp. 53-54
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  • Cited by 3

  • Évaluation clinique de la personnalité des patients présentant un phénomène de Raynaud

  • S. Consoli, O. Bayle, M. Baudin, J.N. Fiessinger, M. Vayssairat, E. Housset
  • Published online by Cambridge University Press:
    28 April 2020, pp. 288-297

  • Trente sujets présentant un phénomène de Raynaud ont fait l’objet d’une investigation psychodynamique systématique à l’occasion d’une hospitalisation pour bilan étiologique et sans aucune sélection préalable. Par la suite, 14 sujets ont été considérés, d’après des critères physiques cliniques et paracliniques, comme des Raynaud primitifs (RI), 13 comme des Raynaud secondaires (RII), le plus souvent d’origine sclérodermique, et 3 comme des cas douteux. L’âge moyen des RII est plus élevé. L’investigation psychodynamique a été effectuée dans la méconnaissance mutuelle du diagnostic étiologique, de la part du patient (à l’exception de 2 cas) et de l’investigateur. Les résultats sont en faveur de différences significatives dans le fonctionnement mental, l’attitude face à un interlocuteur et les stratégies de gestion des conflits, entre les RI et les RII. Les premiers se singularisent par la relative fréquence des traits de personnalité hystérique et par des comportements d’esquive face à leur propre agressivité, alors que les seconds sont plus distants, plus conformistes, répriment leurs émotions et sont peu capables de demander de l’aide lorsqu’ils se trouvent en situation difficile ; les RII paraissent, encore plus que les RI, fragiles narcissiquement et sensibles à la reconnaissance d’autrui. Aucun des groupes ne montre de prédominance du pattern A. Des événements vitaux éprouvants semblent moduler l’évolution du Raynaud, 1 fois sur 2 en moyenne. De telles constatations sont en faveur d’une dimension «psychosomatique» du Raynaud, les perturbations psychologiques jouant un rôle plus important encore pour les RII que pour les RI, comme le confirme l’établissement de scores dits «de fragilité psychique» et «de qualité défensive», destinés à quantifier l’efficience du fonctionnement mental, de tels scores n’étant pas corrélés à l’âge.

  • Cited by 3

  • Child and adolescent psychiatry training in Europe: Views of trainee representatives for 2009 – 2010 to the European federation of psychiatric trainees

  • E.P. Barrett, A. Nawka, A. Malik, D. Giacco, M. Rojnic Kuzman, M. Simmons, G. Favre
  • Published online by Cambridge University Press:
    16 April 2020, p. 266
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  • Background and objectives

    The European Federation of Psychiatric Trainees (EFPT) is an independent federation of psychiatric trainees’ associations. Previous studies have shown that up to 1/3 of countries surveyed did not have separate CAP training We surveyed trainees to gain insights regarding current training within the member countries of the EFPT.

    Methods

    Ten item Survey of Trainee representatives from 32 countries- using surveymonkey questionnaire.

    Industry standard encryption technology utilisied.

    Results

    27 respondent countries. Response rate 84.4% In many countries CAP and General Adult Psychiatry training were not separate Variable availability of training posts (surplus posts 23%, no posts/ long waits 19.2%) Duration of training: 3 years (19.2%),4 years (23.1%), 5 years (26.9%). In 35% of countries CAP training was entirely separate from commencement of training. In 40%, entry to CAP training occurred after training in general adult psychiatry. Trainees in 61.5% of respondent countries indicate their intention to specialise in CAP before entering training in psychiatry; 15% of trainees can indicate this at any time.

    Conclusions

    This is a survey of trainee representatives to the EFPT of ten items related to CAP training experiences. It highlights significant differences in training experiences in 27 respondent countries. From 2010 the EFPT aims to record detailed information on CAP training yearly. CAP trainees are an integral part of EFPT, and there are specific areas of needs in CAP training.

  • Cited by 3

  • A study on patterns of use of mobile phone and nomophobia in medical undergraduate students during a COVID-19 pandemic lockdown

  • P. Bhatnagar, S. Tarachandra, S. Undaru
  • Published online by Cambridge University Press:
    13 August 2021, p. S671
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  • Introduction

    The governments of various countries enforced a lockdown to contain the COVID -19 pandemic. As the colleges remain closed, the academic teachings for students was conducted online. The mobile phone remained the main source for academics and entertainment during this period.

    Objectives

    To assess patterns of use of mobile phone by Medical Undergraduate students prior to and during the COVID-19 lockdown. To assess Nomophobia among same participants.

    Methods

    This study was done by an online survey method after obtaining approval from the Institutional Ethics Committee. A validated questionnaire on patterns of mobile phone use and the Nomophobia Questionnaire(NMP-Q) was completed by the medical students (n=187) who consented to participate in the study

    Results

    Prior to the pandemic lockdown, 52.9% of the participants used the mobile phones for 2-4 hours per day with 78% of the usage in social media. During lockdown, 89.3% of the participants reported an increase in the usage of mobile phones. 35.65% reported an increase in use by 2-4 hours everyday. About 30.5 % used the mobile phone for 6-8 hours per day. 80.2 % reported a maximum usage for social media. 59.45% reported a maximum usage for online academics. 33.7% frequently checked their phones once in 15 minutes. About 60.43% of the participants were in the moderate and 21.4% in the severe category of nomophobia.

    Conclusions

    There is an increase in mobile phone usage during the lockdown with a significant proportion of students in the moderate and severe category of nomophobia.

    Disclosure

    No significant relationships.

  • Cited by 3

  • Fragile X syndrome. I. An overview on its genetic mechanism

  • B Barbe, P Franke, W Maier, M Leboyer
  • Published online by Cambridge University Press:
    16 April 2020, pp. 227-232

  • A large body of literature has accumulated within the last decade concerning the fragile X syndrome, the most common cause of X-linked mental retardation. The first article of this review summarizes the peculiar genetic mechanisms and molecular biology properties (eg, unstable DNA triplet repeats), which have been characterized since the detection of the FMR-1 gene in 1991. However, the most important question concerning the function of the FMR-1 gene is still an unresolved issue and is in need of future research. The second article of this review addresses the clinical picture, neuropsychological functioning and psychopathological characteristics of pre- and full mutation carriers.

  • Cited by 3

  • Social skills training for chronic psychotic patients: A French study

  • O Chambon, M Marie-Cardine, A Dazord
  • Published online by Cambridge University Press:
    16 April 2020, pp. 77s-84s

  • The aim of this article is to describe the cognitive-behavioral methods for social rehabilitation and psychotherapy of chronic psychotic patients which are nowadays available in French-speaking countries, then to propose a theoretical framework to help integrate these various methods for use in our duly pratice and, finally, to expose our research in this field, especially concerning the topic of quality of life and social skills training programs. We present a study we designed in order to assess the impact of a comprehensive social skills training program upon quality of life of chronic schizophrenic patients. Starting from the point of view that a good psychosocial rehabilitation program is one that improves social skills and social functioning without negative effects on quality of life, we tried to show such qualities in a quite comprehensive rehabilitation program using social skills training methods corresponding to the social readaptative “modules” from Liberman and Wallace's Social and Independant Living Skills Program — “medication management module” — followed by “basic conversational skills module”, and finally, a brief adapted version of “interpersonal problem solving skills module”. We were able to observe the evolution of social skills and functioning of eight schizophrenic patients having benefited from this program, over a one year period, and we compared results regarding quality of life with two control groups made of schizophrenic patients, one of them having benefited from a supportive group therapy in order to study the impact of non-specific factors. The results indicate a clear dissociation between direct benefits of social skills training (knowledge, social skills, social functioning and symptomatology) which all showed a significant improvement in the experimental group, and subjective benefits (self-esteem, sense of self-efficacy, quality of life) which showed no change, as well when consider no intra-group as well as between group comparisons.

  • Cited by 3

  • Failure to identify a male winter-born schizophrenia subgroup clinically

  • J Modestin, O Würmle, R Ammann
  • Published online by Cambridge University Press:
    16 April 2020, pp. 34-39

  • The distribution of 282 Research Diagnostic Criteria (RDC) and of 224 DSM-III-R schizophrenic patients, respectively, by month of their birth was studied. The winter-spring birth rate excess was confirmed with a maximum from January to March. Winterborn and summer-born schizophrenics were compared. No convincing differences were found with regard to a larger set of demographic, psychosocial and clinical variables in univariate comparisons, nor did we succeed in separating and identifying a special winter-born schizophrenia subgroup using the method of cluster analysis. Negative results were obtained in spite of the fact that many of the included variables reflected the course of the illness and the degree of chronicity. Either the set of the variables we used has not been ‘correct’ enough or the separation of a winter-born subgroup is not clinically feasible.

  • Cited by 3
  • Cited by 3

  • The Internet addiction and the correlation with the socio-economic crisis in students of University of applied sciences of Thessaly (TEI of Thessaly)

  • S. Kotrotsiou, V. Katsavria, E. Kotrotsiou, K. Gourgoulianis, M. Gouva, T. Paralikas, C. Hatzoglou
  • Published online by Cambridge University Press:
    23 March 2020, p. S303
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  • Introduction

    Use of the Internet lately has significantly been increased worldwide. The time users spend browsing the Internet is constantly increased resulting to serious consequences incurred in personal, professional and social life.

    Aim

    The purpose was to explore whether the economic crisis is affecting the use and addiction to Internet, whether the economic crisis is a risk factor in the appearance of addiction to the Internet and if the occupation and the existence of extra-curricular activities act as barriers to the development of addiction to the Internet on students.

    Methods

    A questionnaire was prepared based on the diagnostic tool IAT (Internet Addiction Test). The survey was conducted in June of 2014 on 632 students.

    Result

    It was found that 6.2% of the sample population has moderately addictive behavior and 0.5% has a serious addiction. Addiction levels to the Internet are affected by someone working while studying and his monthly income, by daily time spent by the student in activities besides school, by the time spent daily on the Internet and by the operations mostly used. Also found that the risk of developing Internet addiction is higher among students who said they had difficulty paying their bills and Internet subscription and to those who due to economic crisis would stop all their activities in order to obtain money.

    Conclusions

    The economic crisis is a factor that affects on Internet addiction and occupation and activities may act as a deterrent to the emergence of the phenomenon.

    Disclosure of interest

    The authors have not supplied their declaration of competing interest.

  • Cited by 3

  • Tianeptine counteracts the anxiogenic effects of benzodiazepine withdrawal, but not those of exposure to cat odour

  • SE File, N Andrews, H Zangrossi, Jr
  • Published online by Cambridge University Press:
    16 April 2020, pp. 75s-80s

  • Tianeptine is a clinically effective anti-depressant with the unusual profile of increasing 5-HT uptake, thereby decreasing the synaptic availability of 5-HT. In the social interaction test of anxiety in the rat, withdrawal from chronic diazepam treatment produced a significant anxiogenic response that was reversed by acute administration of tianeptine (2.5–10 mg/kg). These doses were without significant effect in the vehicle-treated rats. Exposure of rats to cat odour resulted in anxiogenic responses in the plus-maze and social interaction tests and in decreased exploration. These changes were not reversed by 5 days treatment with tianeptine (2.5–10 mg/kg). Thus, tianeptine may not he effective in all anxiety states, but could be particularly useful in treating patients withdrawn from benzodiazepines.

  • Cited by 3

  • Effects of media stories featuring coping with suicidal crises on psychiatric patients: Randomized controlled trial

  • T. Niederkrotenthaler, J. Baumgartner, A. Kautzky, M. Fellinger, R. Jahn, A. Wippel, M. Koch, D. König-Castillo, A. Höflich, R. Slamanig, A. Topitz, J. Wancata, B. Till
  • Published online by Cambridge University Press:
    04 November 2021, e70
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  • Background

    Accumulating evidence suggests beneficial effects of media stories featuring individuals mastering their suicidal crises, but effects have not been assessed for psychiatric patients.

    Methods

    We randomized n = 172 adult psychiatric patients (n = 172, 97.1% inpatients) to read an educative article featuring a person mastering a suicidal crisis (n = 92) or an unrelated article (n = 80) in a single-blind randomized controlled trial. Questionnaire data were collected before (T1) and after exposure (T2) as well as 1 week later (study end-point, T3). The primary outcome was suicidal ideation as assessed with the Reasons for Living Inventory; secondary outcomes were help-seeking intentions, mood, hopelessness, and stigmatization. Differences between patients with affective versus other diagnoses were explored based on interaction tests.

    Results

    We found that patients with affective disorders (n = 99) experienced a small-sized reduction of suicidal ideation at 1-week follow up (mean difference to control group [MD] at T3 = −0.17 [95% CI −0.33, −0.03], d = −0.15), whereas patients with nonaffective diagnoses (n = 73) experienced a small-sized increase (T2: MD = 0.24 [95% CI 0.06, 0.42], d = 0.19). Intervention group participants further experienced a nonsustained increase of help-seeking intentions (T2: MD = 0.53 [95% CI 0.11, 0.95], d = 0.19) and a nonsustained deterioration of mood (T2: MD = −0.14 [95% CI −0.27, −0.02], d = −0.17).

    Conclusions

    This study suggests that patients with affective disorders appear to benefit from media materials featuring mastery of suicidal crises. More research is needed to better understand which patient groups are at possible risk of unintended effects.

  • Cited by 3

  • Posttraumatic stress disorder checklist military version in latvian language

  • V. Voicehovskis, G. Ancane, J. Voicehovska, L. Umnova, A. Skesters
  • Published online by Cambridge University Press:
    16 April 2020, p. 1088
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  • Introduction

    The Posttraumatic Stress Disorder (PTSD) Checklist (PCL) is a 17-item self-report measure of the 17 DSM-IV symptoms of PTSD. The PCL has a variety of purposes, including screening individuals for PTSD, diagnosing PTSD, monitoring symptom change during and after treatment. There are three versions of the PCL: PCL-C (civilian), PCL-M (military) and PCL-S (specific). PCL-M asks about symptoms in response to “stressful military experiences” and used for active service members and veterans. The PCL-M can be completed by participants of a research study in approximately 5–10 minutes. Interpretation of the PCL-M should be completed by a clinician. There is no valid PCL-M Latvian language version.

    Aims

    The goal of the study is to assess the evaluative and discriminative properties of the Latvian language version of the PCL-M in PTSD risk group patients (PTSD-RGP).

    Methods

    Totally 30 participants (males, Europeans, of average age 26.2, PTSD-RGP - Latvian Contingent of International Operations) were examined. Standart validation protocol was applied for PCL-M Latvian language version's reliability and validity testing: reliability consequence, construct validity, test-retest, Cronbach alpha criterion.

    Results

    Cronbach alpha criterion was more than 0,70 (means reliable response sets), the reliability-consequence scale is from 0.6 to 0.9 (means precise definition). Test-retest by Spearman showed r ≥ 0.75 (means reliable stability).

    Conclusions

    It was concluded that the PLC-M Latvian language version has sufficiently acceptable evaluative and discriminatory properties and is therefore a valid instrument for PTSD measurements in clinical and research studies in Latvian military active service members and veterans.

  • Cited by 3

  • Correlation Between Resilience with Aggression and Hostility in University Students

  • F. Mojrian, A. Homayouni, Z. Rahmedani, M. Alizadeh
  • Published online by Cambridge University Press:
    23 March 2020, p. S611
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  • Resilience as a capacity to withstand stress and calamity is one of the important components of mental health and aggressive is a negative behaviour that can threaten human health. So, the purpose of this study was to investigate the correlation between resilience with aggression and hostility in university students. The research method is correlation, 155 university students were selected by convenience sampling method and responded to Corner & Davidson resilience questionnaires and Boos & Perry aggression and hostility questionnaire. The data were analysed by correlation formula. The results showed that there is a significant and negative correlation between resilience with aggression and hostility, which means when the score of resilience is high, people's aggression and hostility decreases. Therefore, it is recommended to increase the resilience of people by specific teaching programs to reduce the basis of aggression and hostility.

    Disclosure of interest

    The authors have not supplied their declaration of competing interest.

  • Cited by 3

  • Le sommeil de sujets dépressifs endogenes avant, pendant et apres un décalage des horaires de sommeil

  • E. Souêtre, E. Salvati, D. Pringuey, G. Darcourt
  • Published online by Cambridge University Press:
    28 April 2020, pp. 29-48

  • Cette étude décrit la structure et l'organisation temporelle du sommeil de 5 sujets dépressifs endogènes qui participèrent à un processus de décalage en avance de 5 heures des horaires de sommeil maintenu pendant deux semaines.

    Comparée à ces témoins du même âage, I'architecture du sommeil est, chez les dépressifs avant décalage, très perturbée avec, notamment, fragmentation et inefficacité du sommeil, réduction du taux de sommeil lent et raccourcissement de la latence du sommeil paradoxal. L'organisation temporelle semble traduire, elle, une lutte entre tendance au sommeil lent et tendance au sommeil paradoxal.

    Le sommeil des mêmes sujets s'est pratiquement normalisé pendant et surtout après le decalage des horaires de sommeil, exceptée la persistance de la réduction importante de la latence du sommeil paradoxal.

    Il serait ainsi possible d'associer la dépression à une désynchronisation entre rythmicités contrôlant sommeil lent, sommeil paradoxal et d'autres rythmes circadiens. Une resynchronisation forcée par décalage des horaires de sommeil pourrait alors rendre compte des améliorations cliniques et biologiques qui ont été observées.

  • Cited by 3

  • EPA-0054 – Prevalence and Severity of Obsessive-compulsive Disorder and Its Relationships with Dermatological Disease

  • F. Sheikhmoonesi, Z. Hajheidari, A. Masoudzadeh, M. Mozaffari
  • Published online by Cambridge University Press:
    15 April 2020, p. 1
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  • Background:

    most obsessive-compulsive disorder (OCD) patients meet psychiatrists 5 to 10 years after onset of OCD. Its relatively high prevalence ratio and the delay in seeking help suggest that patients with OCD may seek help at nonpsychiatric clinics. the present study was undertaken to provide some epidemiological data on the prevalence and severity of OCD in dermatological patients.

    Method:

    The participants included 265 consecutive patients with primary dermatologic chief complaint. They were visited by a dermatologist and diagnosis of dermatological lesion was done according to ICD-10. All patients were visited by a psychiatry resident and were screened for OCD using the structured clinical interview for DSM-IV-TR (SCID-I). If the diagnosis of OCD has been made, the Yale-Brown obsessive compulsive scale(Y-BOCS) was used to evaluate the severity of OCD. To analyze the data student t-test for quantitative variables and X2 tests for categorical variables.

    Results:

    From the total of 265 patients, 24(9.1%) met the DSM-IV-TR criteria for OCD and 9(37.5%) with OCD had previously been diagnosed with OCD, however, only three were treated pharmacologically. The most symptoms were pathological doubt (29.1%), fear of contamination(29.1%)and washing (54.16%). Severity of OCD according to Y-BOCS was evaluated among patients with OCD. Six (25%) were found with subclinical OCD, 11(45.8%) had mild OCD, six(25%) had moderate OCD, and one (4.2%) was detected with sever OCD.

    Conclusion:

    prevalence of OCD in dermatology clinic was higher compared with general population.

  • Cited by 3

  • Construction et validation d'une nouvvelle échelle biaxiale d'évaluation des états maniaques

  • M.C. Hardy, S. Lancrenon, Y. Lecrubier
  • Published online by Cambridge University Press:
    28 April 2020, pp. 221-231

  • Les nombreuses études consacrées récemment au trouble maniaque et la diversité des essais thérapeutiques proposés dans cette pathologie témoignent du regain d’intérêt qu'elle suscite et impose de revoir les instruments permettant de l’évaluer. Une brève revue est faite des échelles de manie actuellement validées. Aucune n’apparaît réellement satisfaisante.

    Une nouvelle échelle d’évaluation de la symptomatologie maniaque est proposée. La sélection des items de cette échelle n’a pas été faite a priori mais après une analyse réalisée à partir d’une liste de 67 items. Ces 67 items couvraient l’ensemble des symptômes attribués classiquement à la manie. Les données d’une première analyse factorielle, effectuée sur ces 67 items, testés chez 37 maniaques, a permis la sélection de 25 items. Cette deuxième liste de 25 items a été testée chez 24 maniaques inclus dans un protocole de traitement de 2 semaines par la clonidine. Une analyse en composantes principales sur ces 25 items permet de dégager 3 facteurs expliquant respectivement 27.4 %, 11 % et 9 % de la variance (tableau 1).

    Le ler facteur pouvait être interprété comme un facteur d’intensité du tableau maniaque. Le 2ème facteur pouvait être interprété comme un facteur évaluant la composante délirante du tableau.

    L’échelle proposée est une échelle biaxiale.

    - le ler axe peut être considéré comme une échelle d’intensité de la manie (sous-échelle EIM).

    Nous avons retenu pour la constituer les 10 items les mieux corrélés au ler facteur (après rotation Varimax).

    - Le 2ème axe constitue une sous-échelle de délire. L’activité délirante est évaluée indépendamment de l’intensité du tableau maniaque.

    L’EIM (Échelle d’Intensité Maniaque) présente une bonne homogénéité, la corrélation des items au score global à J0, appréciée par le coefficient de corrélations de Pearson est significative (p < 0.01)(tableau 2). La fidélité inter-cotateurs est très satisfaisante, la concordance sur la note globale, appréciée par le coefficient de Spearman et celui de Fisher est proche de l (tableau 3). La validaté, appréciée en utilisant un critère de validité externe (comparaison avec l’échelle de Bech et Rafaelsen) est bonne : les coefficients de corrélation entre les scores de l’échelle de Bech et l’échelle d’intensité de l’état maniaque varient, aux différents temps du protocole de traitement, entre 0.82 et 0.94 (tableau 4). La sensibilité du changement sous traitement est globalement équivalente à celle de l’échelle de Bech et Rafaelsen. Cependant, notre échelle semble plus performante pour évaluer la pathologie légère et pour apprécier finement les différents degrés de l’amélioration (tableau 5).

    Des analyses plus détaillées (notamment de la composition du 3ème axe) sont prévues lorsqu’un plus grand nombre de cas aura été évalué. Il faut enfin relever que les tableaux de validation présentés ici portent sur le nombre de cas le plus éléve de la littérature.

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