[Spanish adaptation and validation of an anxiety scale derived from the AMDP (AMDP-AT) system. I: Adaptation and convergent validity]. / Adaptación española y validación de una escala de ansiedad derivada del sistema AMDP (AMDP-AT). I: Adaptación y validez convergente.

The Spanish translation and adaptation of the 17-item Scale extracted from the francophone extension of the AMPD scales, the AMPD-AT, has been filled out in 120 anxious, depressed and other psychiatric patients along with numerous other rating scales measuring anxiety (Hamilton, Zung, STAI, VAS), depression (Hamilton, VAS), and global psychopathology (AMPD-SY, CGI). The results point to a higher correlation with psychic anxiety than with somatic anxiety and with state anxiety than with trait anxiety. The correlations are lower with depression scales than with anxiety scales. The AMPD-AT shows as an special advantage the possibility to be used into the AMPD-System (in order to extract a score of anxiety in the context of a psychopathological profile) or independently as a scale of psychic anxiety.

[Assessment of the clinical activity of fluoxetin (Prozac) according of the "Stars of Liège" model]. / Evaluation de l'activité clinique de la fluoxétine (Prozac) selon "les étoiles de Liège".

Ten psychiatrists have independently rated the clinical profile of fluoxetin (Prozac) at the daily dose of 20 mg according to a "Stars of Liège" model comprising three parameters of therapeutic activity (antidepressant, psychostimulant and anxiolytic) and three parameters of side-effects (anticholinergic, sedative and hypotensive). Each parameter, graduated from 0 to 5 (no, very weak, weak, moderate, potent, very potent effect) was rated by each investigator according to his personal experience with at least 10 patients. Mean ratings given to fluoxetine show a moderate antidepressant effect, equal to amitriptyline (Rédomex, Tryptizol 75 mg/d, clomipramine (Anafranil 75 mg/d and nialamide (Niamide 100 mg/d, weak psychostimulating and anxiolytic effects, a very weak sedative effect and a lack of anticholinergic and hypotensive effects. Digestive side-effects of moderate intensity were also noted as well as a very weak anorexia. The important variability between investigators in the rating of the clinical profile of fluoxetine suggests that more experience is needed in order to define better its physiognomy.

Is phosphodiesterase inhibition a new mechanism of antidepressant action? A double blind double-dummy study between rolipram and desipramine in hospitalized major and/or endogenous depressives.

Unlike conventional antidepressants, rolipram (a new approach in the treatment of depression) stimulates both the presynaptic and the postsynaptic component of monoaminergic transmission. Several double blind trials are under way to assess the clinical efficacy and safety of this compound. The present study was a randomized, 4-week interindividual double blind double-dummy comparison with desipramine in inpatients with major (DSM-III) and/or endogenous (ICD-9) depressions. After a minimum washout period of three days the patients received either 0.50 mg rolipram or 25 mg desipramine orally t.i.d. for the first three days, then 0.75 mg rolipram or 50 mg desipramine t.i.d. until day 28. Rating tests were based principally on the AMDP-system and the HAMD scale. The study showed no differences between the two drugs as regards the efficacy, but a definite trend in favour of rolipram as regards the side effects and, in particular, anticholinergic effects.

[A problem detected by the AMDP rating of the Mar. case: the relation between phobia and obsession]. / Un problème révélé par la cotation AMDP du cas Mar.: les relations entre phobie et obsession.

The rating of the videotaped interview of the Mar. case during three meetings of the French-speaking section of the AMDP has revealed the problem of the relationships between phobia and obsession. These ratings triggered a critical reflection based on the theoretical framework from the literature, on the clinical material (the videotaped interview) and on the pragmatic difficulties which appeared during the discussions of the ratings.

[Preliminary results of a double-blind study between rolipram and desipramine in hospitalized patients with major depressive symptoms]. / Résultats préliminaires d'une étude en double aveugle entre le rolipram et la désipramine chez des déprimés majeurs hospitalisés.

Rolipram facilitates the postsynaptic neurotransmission of NA through a completely new mechanism of action, namely, an inhibition of the inactivation of the second messenger (the cyclic AMP) by phosphodiesterase. In the present study, Rolipram is compared to a classical tricyclic antidepressant which facilitates the NA transmission through an inhibition of its presynaptic reuptake: Desipramine. Preliminary results on 12 Rolipram patients vs. 9 Desipramine patients indicate that Rolipram has an antidepressant potency comparable to Desipramine with less anticholinergic and hypotensive side effects. This study also illustrates that a 14-factor AMDP profile gives much more information than a single total score such as the Hamilton score.

[Spanish adaptation and validation of the anxiety scale of the French-language AMDP]. / Adaptation et validation espagnoles de l'échelle d'anxiété de l'AMDP francophone.

The Spanish translation of the 17-item Anxiety Scale extracted from the francophone extension of the AMDP scales, the AMDP-AT, has been filled out in 72 anxious, depressed and other psychiatric patients along with numerous other scales measuring global psychopathology (CGI, AMDP-SY), anxiety (VAS, Hamilton, Zung, Spielberger) and depression (VAS, Hamilton). The results point to a higher correlation with psychic anxiety than with somatic anxiety, and with state anxiety than with trait anxiety. The correlations are lower with depression scales than with anxiety scales but the mean scores in depressed vs. anxious patients do not differ significantly, which indicates that the AMDP-AT, like the HAMA, needs a preselection of anxious patients according to other criteria. The authors also report the results of correlations between AMDP-AT items and the total score, of a principal components analysis and of a stepwise regression.

[Zuclopenthixol acetate and haloperidol in acute psychoses. Results of the AMDP subgroup in a multicenter Belgian study]. / L'acétate de zuclopenthixol et l'halopéridol dans la psychose aigüe. Résultats du sous-groupe AMDP d'une étude multicentrique belge.

The efficacy of i.m. cis(Z)-clopenthixol in aggressive, agitated and delusional patients is well established but it necessitates, as for all other parenteral neuroleptics, several injections daily. Zuclopenthixol acetate is the first injectable neuroleptic characterized simultaneously by a short latency of action (2-3 h) and by a long duration of action (2-3 days). Within the frame of a Belgian multicentre study of zuclopenthixol acetate and haloperidol, a group of French-speaking psychiatrists added the AMDP scales to the basic protocol. The results of this AMDP subsample of 20 Acetate vs. 13 Haloperidol patients do not allow the demonstration of statistically significant differences between both neuroleptics because of the smallness and unbalance of the sample, but they indicate that both antipsychotics are very active and that a comprehensive rating scale such as the AMDP gives a much better differentiated clinical picture of a new drug than the total scores of short, so-called "economical" rating scales.

[Open study of clotiazepam (Clozan) in ambulatory anxious patients centered on a multifactorial evaluation using the AMDP and on a study of the rebound effect]. / Etude ouverte du clotiazépam (Clozan) chez des patients anxieux ambulatoires centrée sur une évaluation multifactorielle par l'AMDP et sur l'étude de l'effet rebond.

The efficacy and tolerance of the first thienodiazepine, clotiazepam, is well established but its clinical spectrum and the possibility of a rebound effect upon its cessation needed further research. Moreover, the validity of the AMDP Anxiety scale had been tested but not yet its sensitivity to change. Clotiazepam was given in an "open" design to 42 anxious outpatients at the dosage of 3 X 5 to 3 X 10 mg daily during 1 month, followed by a 1-week "single blind" placebo period. No other psychotropic drug was needed in 74% of the cases. A battery of observer rating scales (CGI, VAS, HAMA, BPRS, AMDP-4 and -5, AMDP-AT) confirmed the anxiolytic and tensiolytic efficacy of clotiazepam as well as its excellent tolerance. The 13-factor AMDP profile proved superior to short scales in the sample description and in the illustration of the clinical spectrum of the drug. Both the HAMA and the AMDP-AT were sensitive to change but the HAMA more significantly than the AMDP-AT.

[Scales, factor analysis and subscales of the French-language AMDP system]. / Les échelles, analyses factorielles et sous-échelles de l'AMDP francophone.

The 4th and 5th forms of the AMDP-System consist of a Psychopathology Scale (100 + 15 items) and of a Somatic Scale (40 + 7 items); the total duration of the interview and filling out is 45 to 60 mn. On the basis of a decade of research done or initiated in Liège, the French-speaking section of the AMDP has contributed to the System with several improvements: the inclusion of write-in or "reserve" items to the standard scales, esp. on anxiety (generating Anxiety and Dramatization factors missing in the German version as well as an Anxiety Subscale); modifications of the somatic scale (adopted in the 1979 German revision); modification of the item scaling from 0-3 to 0-4, the category "severe" being subdivided in "severe" and "extremely severe" (adopted in all other translations); elaboration and preliminary validation of a BPRS-like Syndromic Scale (AMDP-SY); inclusion of a semi-structured interview for the AMDP-4 and of a standardized interview for the AMDP-5. A multicentre Franco-Belgian factor analysis and several drug trials in France and Belgium confirm the validity, sensitivity and factorial stability of the AMDP scales. The subscales (Mania-Depression, Anxiety, Schizophrenia) are potentially useful but need further research except for the Anxiety subscale, which has been validated in Belgium and Spain and is free of somatic symptoms, an advantage in psychosomatics (e.g. cancer research).

[History, description and application of the AMDP system and its derivative systems (AGP, FPDS)]. / Historique, description et applications du système AMDP et des systèmes dérivés (AGP, FPDS).

The AMP-System was born in Nurnberg in 1960; the XXth anniversary of its French adaptation was celebrated in Strasburg in October 1986: from Nurnberg to Strasburg, the european vocation of the AMDP-System has steadily grown. The AMDP-System is made of two parts: a part on history data (AMDP-1 to -3) and a part on the present psychiatric and somatic state (AMDP-4 and -5). The Psychopathology Scale contains 100 items + 15 "French" items (mainly on anxiety); the somatic scale, 40 + 7 items, all graded from 0 to 4; the interview and completion of the two scales takes ca. 45 to 60 mn. The reliability, validity, sensitivity and factorial reproducibility of these scales have been demonstrated in French as well as in German. The french-speaking section of the AMDP has definitely contributed to the improvement of the original System: semi-structured interview, anxiety factor vs. scale, syndromic scale etc. There presently exist two Systems derived from the AMDP: one for gerontopsychiatry (the AGP System) and one for forensic psychiatry (the FPDS System).

The AMDP-system in clinical psychopharmacology.

The AMDP-System has been developed in Europe by the Association for Methodology and Documentation in Psychiatry the standardised documentation of psychiatric files and for the measurement of change in drug trials. It is increasingly used in the French-speaking and German-speaking countries by clinical psychopharmacologists for teaching classical German psychopathological concepts to students and for the multicentre and multifactorial evaluation of drug changes. The AMDP-System consists of three anamnestic forms and of two comprehensive rating scales on present psychopathology (100 items + write-in items) and somatic complaints (40 items + write-in items).

Open multicentre trial of zuclopenthixol in mania and schizophrenia based on the AMDP scales.

A total of 95 schizophrenic or manic patients received zuclopenthixol (cis(Z)-clopenthixol) either intramuscularly or orally during a period of 2 to 4 weeks in mean daily doses of 25 mg (i.m.) or 75 mg (p.o.). They were rated with the CGI, VAS, MSS, BPRS, and AMDP scales. Zuclopenthixol proved to be a potent antimanic, anti-aggressive and antidelusional neuroleptic already from the second day of injection. Very few anticholinergic and extrapyramidal side effects as well as little somnolence were seen and the local tolerance was excellent. The 14-factor AMDP profile proved valid, sensitive to change and highly differentiated.

The AMDP-system in clinical psychopharmacology.

The AMDP-system, elaborated by the Association for Methodology and Documentation in Psychiatry, comprises three anamnestic forms and two rating scales on present psychopathological and somatic states. Moreover, three subscales have been developed in order to assess more specifically anxiety, manic/depressive, and schizophrenic symptomatology. The psychometric properties of the AMDP-system (interrater reliability, validity, homogeneity, sensitivity) and its availability in most European languages make it an ideal instrument for the assessment of clinical changes in drug trials, with the possibility of using the comprehensive scale for the early evaluation of a new drug and of reserving the short subscales for later clinical development.