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Guardia D.,UDSL | Rolland B.,CHULille | Karila L.,Hopital University Paul Brousse | Cottencin O.,UDSL
Current Pharmaceutical Design | Year: 2011

Lifetime prevalence estimates for binge eating disorder (BED) and bulimia nervosa (BN) are 3.5% and 1.5% among women and 2.0% and 0.5% among men, respectively. Night eating syndromes (NES) affect 1.1%-1.5% of the general population. All of these disorders induce an impaired quality of life and significant disability. Symptom overlaps are reported between substance use disorders and eating disorders such as BED, BN and NES. A growing body of evidence suggests that γ-amino-butyric acid (GABA) and glutamate modulation pathways might be useful targets in the treatment of alcohol and substance use disorders. Their involvement in the reward process and in the regulation of food intake could be the source of new pharmacological strategies for the treatment of eating disorders. We review published data on the efficacy and safety of drugs targeting the GABA and glutamate modulation pathways for the treatment of BED, BN and NES. Preliminary results indicate that baclofen and topiramate are effective in reducing binge eating, craving and weight gain. However, the potential clinical drug-placebo difference is not detected for acamprosate and lamotrigine. Limitations of these studies are discussed. In view of these data, first- and second-line pharmacological interventions are proposed. © 2011 Bentham Science Publishers Ltd.

Reynaud M.,Hopital University Paul Brousse
Annales Medico-Psychologiques | Year: 2010

The relations between amorous passion and addiction have long been noted. Recent advances in neurobiology have allowed us to reexamine the relations between these two states and to better understand their clinical symptoms. Methods: We compare clinical, neuropsychological, neurobiological and neuroimaging data in love passion versus substance addictions. Results: The clinical description of the amorous state includes: unrestrained desire and sexual pleasure; feeling of euphoria; powerful motivation to the " object of his love" ; a cognitive mechanism characterised by a focalised attention, pervasive memories, intrusive thoughts; emotional exacerbation and emotional dependence with need for the other, aroused by his absence. Criteria for love addiction (differing from love passion), including the notion of suffering and continued behaviour despite adverse consequences, inspired from the DSM-IV criteria could be evaluated. The neurophysiological model for all addictions can be applied to love addicts: the desired object is overrated. The rewarding value and its memory trigger a major motivation: simple desire has become a need; cortical control has become insufficient. For love as well as addictions, dopamine codes the value of pleasure. Love and drugs are potent pleasure modulators of dopamine flux. Oxytocin pathways, clearly implicated in love attachment, are also an important pathway towards understanding the mechanisms of dependence. Imagery data on various drug addictions and imagery data on sexual desire, orgasm and amorous relationships, enable their mechanisms and activated circuits to be compared and their similarities analysed. Conclusion: Love and addictions are comprised of liking, wanting and needing. Refining of clinical, neurobiological and neuro-imaging studies will further elucidate these similarities and should provide a better understanding and improved treatment of these states. © 2010 Elsevier Masson SAS.

Francois H.,Assistance Publique Hopitaux de Paris | Francois H.,University Paris - Sud | Durrbach A.,Assistance Publique Hopitaux de Paris | Durrbach A.,University Paris - Sud | And 10 more authors.
American Journal of Transplantation | Year: 2013

Immunization using live attenuated vaccines represents a contra-indication after solid organ transplantation (SOT): consequently, transplant candidates planning to travel in countries where yellow fever is endemic should be vaccinated prior to transplantation. The persistence of yellow fever vaccine-induced antibodies after transplantation has not been studied yet. We measured yellow-fever neutralizing antibodies in 53 SOT recipients vaccinated prior to transplantation (including 29 kidney recipients and 18 liver recipients). All but one (98%) had protective titers of antibodies after a median duration of 3 years (min.: 0.8, max.: 21) after transplantation. The median antibody level was 40 U/L (interquartile range: 40-80). For the 46 patients with a known or estimated date of vaccination, yellow-fever antibodies were still detectable after a median time of 13 years (range: 2-32 years) post-immunization. Our data suggest there is long-term persistence of antibodies to yellow fever in SOT recipients who have been vaccinated prior to transplantation. The authors find long-term persistence of vaccine-induced yellow fever antibodies in solid organ transplant recipients immunized prior to transplantation, and they suggest that yellow fever vaccination should be carefully evaluated in transplant candidates who plan travel to an endemic country after transplantation. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

Bourdier L.,Paris West University Nanterre La Defense | Maria A.-S.,Hopital University Paul Brousse | Maria A.-S.,University Paris - Sud | Maria A.-S.,Institute Mutualiste Montsouris | And 4 more authors.
Journal de Therapie Comportementale et Cognitive | Year: 2016

Seventy-five women with restrictive AN were recruited in the larger context of a randomized controlled trial (Trecogam, ClinicalTrial.gov id: NCT01772394). A few weeks following their admission in the hospital, participants completed a series of self-reports evaluating perceived EI (Trait Meta-Mood Scale [TMMS]), eating disorders symptomatology (Eating Disorders Examination Questionnaire [EDEQ]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]). TMMS scores of the patients suffering from AN were compared to scores of healthy women collected for the validation of the French TMMS (Maria, 2014). Focused Principal Components Analyses (fPCA) were conducted on each dimension of the TMMS to explore the relationship between these dimensions and the clinical variables. Finally, in order to determine the impact of anxiety and depression on the link between TMMS dimensions and eating disorders symptomatology, partial correlations were conducted. © 2015 Association française de thérapie comportementale et cognitive. In the present study, inter-group comparisons showed that patients had lower scores for the three dimensions of TMMS than healthy women of a similar age. Regarding BMI, no link was found with any of the three TMMS scores. Results showed that only TMMS Repair scores were associated with EDEQ scores. Levels of depression and anxiety were significantly associated with the TMMS Clarity and Repair scores. When these HADS scores were taken into account, the link between TMMS Repair and EDEQ scores was no longer significant (rajusted HADSCombining double low lineg'.09; NS). © 2015 Association française de thérapie comportementale et cognitive. Our results are coherent with the literature suggesting that people suffering from AN present serious emotional difficulties (Brockmeyer et al., 2012; Fox et al., 2013; Harrison et al., 2009, 2010; Oldershaw et al., 2011). Data also suggests that patients who report greater difficulties in emotional regulation present a higher level of eating disorders symptoms. However, in line with the only study on EI and severity of eating orders symptomatology (Hambrook et al., 2012), results show that this link was not present when the level of depression and anxiety was taken into account, suggesting that anxio-depressive affects play a role in this link.Anorexia nervosa (AN) is a difficult-To-Treat illness characterized, inter alia, by an intense fear of weight gain and disturbed body image (APA, 2013). Current models of AN implicate socio-emotional difficulties in the development and maintenance of the illness (Schmidt and Treasure, 2006; Treasure and Schmidt, 2013). These difficulties have rarely been addressed through the concept of emotional intelligence (EI). EI can be defined as the ability to express, perceive, understand and reason with emotion and the ability to regulate emotion in oneself and others (Mayer and Salovey, 1997). Among non-clinical samples, studies showed that eating disorders are associated with a low level of EI (Costarelli et al., 2009; Filaire et al., 2011; Zysberg and Rubanov, 2010). To date, only one study raised this question in a clinical sample of patients suffering from AN and found no link between EI levels and eating disorders symptomatology (Hambrook et al., 2012). The main aim of this study was to evaluate EI levels in a large sample of women hospitalized for severe AN, and to explore links between EI and Body Mass Index (BMI), duration of illness, eating disorders symptomatology, anxiety and depression. © 2015 Association française de thérapie comportementale et cognitive.

Karila L.,University Paris - Sud | Karila L.,Hopital University Paul Brousse | Karila L.,French Institute of Health and Medical Research | Liot K.,Hopital University Paul Brousse | And 2 more authors.
Revue Medicale de Liege | Year: 2010

Although the term workaholism is widely used, there is very little consensus about its meaning. Since the seventies, workaholism has been described as a work addiction such as drug or alcohol addiction. Similarities with other addictions include craving, withdrawal, tolerance, progressive involvement, and denial. Although considerable attention has been devoted to the concept of workaholism in recent years, little empirical research has been undertaken to further the understanding of this phenomenon. The existence of different types of workaholism has been described. Questionnaires were developed to assess this concept. This heterogeneous disease has negative health, personal, family relationships and professional consequences. Many therapeutic interventions are possible for this unknown addictive trouble. The objective of this paper is to gain a better understanding and knowledge regarding the phenomenon of workaholism. Data obtained for this review are based on a Medline, EMBASE, PsycINFO, Google Scholar search of English- and French-language articles published between 1968 and 2009.

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