[Treatment of bipolar depressions - between treatment urgency and therapeutic risks]

The depression is the subject of a conceptual bursting, and authors propose a dichotomy "unipolar/bipolar" depression, with sometimes unclear limits. Moreover, within the group of the bipolar depression several under groups were identified, with revolutionary therapeutic repercussions. In this article, we propose to: point out the bipolar spectrum - Give a progress report on the incurred risks of the prescription of the antidepressants for a depression belonging to the bipolar spectrum - Propose therapeutic recommendations, while referring to a recent literature

[Clinical and therapeutic aspects of depression in the elderly]

Depression in older people slightly differs from that of younger subjects. However, the distinctive symptoms are often eclipsed by misleading ones: in the first place somatic complaints, then anxiety, dementia-like and psychotic symptoms. On the nosographic plan, the exogenous depressions are the most frequent and the least sensitive to antidepressants. The endogenous depressions are the rarest but most dangerous because of the high suicidal risk that they involve. The comorbidities are dominated by somatic disorders, more particularly those related to the side effects of polymedication, and Parkinson's disease. On the therapeutic plan, the serotonin-selective reuptake inhibitors are the antidepressants prescribed in the first intention because of their safe use. The tricyclic antidepressants are generally very toxic for elderly people; this is why they aren't recommended in the first intention. The recommended posologies are half of those usually efficient. Equivalent posologies to those used in younger people could be reached progressively, if the treatment is well tolerated. The forms with psychotic symptoms require an antipsychotic- antidepressant association. The curative treatment should be pursued during at least six months of remission to avoid relapse. A prophylactic treatment [antidepressant in the absence of manic, hypomanic or mixed episode in the antecedents, otherwise thymoregulator] during several years is recommended due to the high risk of recurrence

[Ekbom syndrome about 3 cases]

In addition to their common embryonic origin, the psychism and skin maintain privileged relations on several accounts. These relations can be found disturbed particularly among old people whose brain as well as skin have undergone the effects of senility. Ekbom syndrome or delusional parasitosis shows dermato-psychological intrications especially among the elderly. Through three clinical observations, the authors remind the clinical signs of this syndrome and discuss its psychopathological elements and its therapy. This syndrome is probably more frequent that described. To treat it adequately, it's important to situate it in nosographic context. This goes above all through a collaboration of the different involved disciplines