[Anorexia athletica's place in female sports athletes]. / Place de l'anorexia athletica chez la sportive intensive.

This work analyzes the links between eating disorders and intensive exercise training and tries to define the anorexia athletica's place in this context. Through a review of the literature, we examined the arguments favoring the hypothesis of a "princeps" disorder, which would orientate girls towards some sports, and the arguments, which emphasize the capacity of some sports to lead to the apparition of these eating disorders. The description of a clinical case allows the evocation of the complexity of this relationship showing that intensive exercise training may be a facilitatory factor as well as a limitatory factor of the severity of the anorexia nervosa. In this situation, it seems interesting to use the anorexia athletica's concept to improve coach and doctor's vigilance around the young female athlete. Lastly, we propose to replace the concept of sport by "exercise practice" where the intensity, the sport "centration", the weight stress became risk factors and to define populations at risk (adolescents, females). Based on these data, prevention actions should be started in populations particularly exposed.

[Evaluation of the use of psychotropic drugs from urine samples from subjects attending for the first time a clinic specializing in opium addiction]. / Evaluation de l'usage des psychotropes à partir d'échantillons urinaires chez des sujets s'adressant pour la première fois à une consultation spécialisée pour toxicomanie opiacée.

OBJECTIVES: Determine how well drug abusers requesting care accept urine sampling and the reliability of this method for evaluating drug use. METHODS: Subjects attending a specialized drug abuse clinic for the first time were requested to provide a urine sample for semiquantitative analysis using an immunological technique to identify the following substances: barbiturates, benzodiazepines, opiates, cocaine, amphetamines, cannabis, and dextropropoxyphen. RESULTS: All 98 subjects included in the study accepted the urine sample. More than 80% of the samples were positive for 1, 2 or 3 substances. The most frequent were, in decreasing order, opiates, cannabis, benzodiazepines and dextropropoxyphen. Among the opiate-positive subjects (70%), 80% were positive for 2 other substances, usually cannabis and benzodiazepines. Two-thirds of the cocaine-positive cases were observed among the most recently seen subjects. Among the 27 opiate-negative subjects, 16 stated they used buprenorphine. CONCLUSION: Within the setting of this study, urine sampling appeared to be well accepted by drug abusers. Urinalysis gave an objective evaluation of drug use and can be useful on an individual level providing complementary information to the overall examination. Urine sampling can also provide indicators for studying the evolution of drug use practices in different populations, both in a clinical and non-clinical setting.

[Administration of high dose levothyroxine in treatment of rapid cycling bipolar disorders. Review of the literature and initial therapeutic application apropos of 6 cases]. / Utilisation de lévothyroxine à haute dose dans le traitement des troubles bipolaires à cycles rapides. Revue de la littérature et premières applications thérapeutiques à propos de 6 cas.

INTRODUCTION: Rapid cycling among bipolar disorders was characterized in 1974 by Dunner and Fieve by at least 4 episodes per year, lithium resistance, female predominance. The idea of using thyroid hormones is based on frequent coexisting thyroid dysfunction. Thyroid hormones where first used in the forties, and more recently (table I) in open label and blind trials (Stancer et Persad, 1982; Bauer et Whybrow, 1990). OBJECTIVE: Open label study of levothyroxine in rapid cycling bipolar disorder. MATERIAL AND METHODS: Six subjects (4 females and 2 males, mean age 45.5 years at onset of bipolar disorder) meeting DMS III-R criteria for rapid cycling bipolar disorder were consecutively included in an open label study of levothyroxine. Subject characteristics are presented in table II. RESULTS: After almost two years follow-up results appear positive in 67% of cases (2 complete remissions, 2 partial remissions and 2 failures). CONCLUSION: Our cases, with data reported in the literature, support the potential efficacy of levothyroxine for treatment of rapid cycling bipolar disorder patients. We suggest a protocol for the good application of this potential new treatment (table III).