Ménière's disease and anxiety disorders

Diagnosis of Menière's Disease is based upon the wellknown labyrinthic syndrome (hypoacusia, tinnitus and dizziness) which manifests with the typical abscessual, recurrent and unforeseeable course. Many Menière patients also report panic attacks, agoraphobia and anxiety which make evaluation of labyrinthic symptoms difficult, affect the onset and maintenance of vestibular compensation and require specific treatments which are very different from those for the control of endolymphatic hydrops. In order to analyse the nature and the meaning of the association of the vestibular and psychiatric symptoms, a comparison has been made between patients presenting Menière's disease, and a group of patients with dizziness resulting from other vestibular diseases. Socio-demographic data were collected and anxiety tests were used to evaluate, the depression and phobia. An interview ad hoc was also programmed for the psychiatric diagnosis. A previous psychiatric history, age, sex, marital status as well as education appear to have a variable effect upon the onset and evolution of panic-phobic symptoms, following onset of Menière's disease. These conclusions, which require confirmation with further studies, allow early characterisation of Menière's disease patients of great predictive usefulness as far as concerns the development of psychiatric sequelae of a panic-phobic nature. This evolution is far more frequent in females being enhanced by middle age, low level of education, long-standing Menière's disease and large number of attacks of dizziness. Onset of panic-phobic attacks is more rare in males in whom the condition is associated with young age, high level of education, lack of setting up of a family nucleus with children.

Dependence, locus of control, parental bonding, and personality disorders: a study in alcoholics and controls

Personality traits, socio-cultural factors, and dysfunctional family systems are considered to be important in the aetiology and clinical development of alcoholism. Particularly, conflict and issues involving psychological (emotional) dependence have long been associated with alcohol addiction. The present work, part of a more extensive study to validate a new rating scale to measure emotional dependence, the Dependence Self-rating Scale (DSRS), assesses dependence, orientation of locus of control, parental bonding perceptions, and personality disorders (PDs) in alcoholic and non-alcoholic samples. The alcoholics showed a prevalence of PDs of 31.3%. The most frequent is the Schizoid PD (40%) followed by the Dependent PD (20%). Subjects with antisocial PD were not included in our selection criteria. The alcoholics scored higher on the DSRS than the controls, but this difference was not statistically significant. By making a comparison between subjects with and without PDs, the DSRS scores were significantly higher in alcoholics with PDs. No significant differences between alcoholics and non-alcoholics in the parental perceptions and locus of control were seen. These findings are sufficiently coherent to encourage further studies on psychological emotional dependence in alcoholics using the DSRS.

Depression in elderly people treated with amineptine (Survector 100): a synopsis

Aging is one of the most important current problems. In fact, according to statistics, the elderly population of the world is continuously increasing, and depression represents the most frequent psychiatric problem in the aged. It is well known that the antidepressive treatment of the aged imposes particular problems because of the frequent presence of cardiovascular problems, ocular hypertension, and prostatic hypertrophia. Amineptine (Survector 100) is devoid of anticholinergic and cardiotoxic effects. For this reason we have studied it in the treatment of elderly depressed patients. This study comes from a multicenter clinical trial (32 hospital centers) in which 324 patients were recruited; it includes 63 depressed patients over the age of 60 years. The diagnosis of depression was stated according to DSM-III diagnostic criteria and INSERM classification, and assessed by Hamilton Depression Rating Scale (HDRS) (26 items). The patients were treated with amineptine (200 mg/day) for 39.3 days (mean). The overall clinical efficacy was positive in 68% of cases; the clinical judgment was confirmed by a decrease in the mean score of HDRS (after the 7th day). The good acceptability (clinical, cardiovascular) was also confirmed. The different biochemical parameters were generally not modified during the treatment. Amineptine appeared to be an antidepressant treatment that combines efficacy and a very good level of safety, essential qualities for the treatment of elderly depressed patients.