[PerCaDim study: relationship between categorical and dimensional approaches of personality]. / Étude PerCaDim : relations entre approches dimensionnelle et catégorielle de la personnalité

PURPOSE: Personality and its disorders have been the subject of many studies in philosophy, psychology or medicine. Current nosology gives preference to categorical classifications, but a dimensional approach may also be considered. Supported by Cloninger's psychobiological model, it refers to concepts of temperament (novelty seeking, reward dependence, harm avoidance and persistence) and character dimensions (self-directedness, cooperativeness and self-transcendence). Categorical and dimensional approaches do not appear antinomic, and the PerCaDim study tries to verify the hypothesis of correlations existing between them. SUBJECTS AND METHODS: One hundred and eleven patients completed two personality inventories. The dimensional approach was assessed using the TCI-125 (short version of the Temperament and Character Inventory) (Cloninger et al., 1993 [9]), which includes four dimensions of temperament and three dimensions of character. The categorical approach was assessed using Vragenlijst Kenmerken voor van de Persoonlijkheid (VKP) (Duijsens et al., 1993 [15,16]), which defines personality disorders according to DSM III-R (APA, 1987 [1]). RESULTS: The PerCaDim study reveals significant relationships between the dimensions of temperament and character and personality disorders. For dimensions of temperament: novelty seeking is correlated negatively with schizoid personality and positively with antisocial, borderline, histrionic, narcissistic and sadistic personalities. Ten out of 13 personalities from DSM III-R are positively correlated with harm avoidance. Cluster A and obsessive-compulsive personality disorders have negative correlations with reward dependence, whereas five pathological personalities have positive correlations with persistence. For dimensions of character: all personality disorders are negatively correlated with self-directedness. Cooperativeness is negatively correlated with six personality disorders. Among the dimensions of character, only self-transcendence has positive correlations with personality disorders. DISCUSSION: The PerCaDim study highlights various relationships between dimensional and categorical approaches of personality. It shows negative correlations between reward dependence and cluster A personality disorders, positive correlations between novelty seeking and cluster B personality disorders and between harm avoidance and cluster C personality disorders. Self-directedness and cooperativeness character's dimensions seem to reflect the subject's adaptation, because negative correlations were found with all personality disorders. It may be surprising that correlations appear positive between self-transcendence dimension and 12 personality disorders. This result is not striking for "psychotic" personalities, but may be questionable for other personalities. CONCLUSION: These results confirm previous findings that Cloninger's dimensions can objectify personality disorders. Few dimensions of the Temperament and Character Inventory can be considered as vulnerability factors. The use of the Temperament and Character Inventory will most certainly be of good help in the future to detect or prevent a personality disorder in some subjects at risk.

Social and cultural representation of Epilepsy in elderly aged 65 and more, during a community survey in two French Departments (Hautevienne and Creuse).

BACKGROUND: Epilepsy is often associated with discrediting representations even in the developed countries. The prevalence of disease is 3-5 in thousand. PURPOSE: Our purpose was to assess social and cultural representation of epilepsy in the elderly in two French departments (Haute-Vienne and Creuse). METHODS: An analysis of the answers given by 380 (190 in Haute-Vienne and 190 in Creuse) persons aged 65 and more, selected with the method of quota, during a face to face interview using a questionnaire which explores the representations of epilepsy. The interview was done in 2003 during the local step of an international multi centric community survey entitled "Mental disorders: Image and Realities in community sample". RESULTS: Beliefs in supernatural causes of epilepsy, witchcraft, curse and punishment are more important in elderly aged 65 and more prevalent compared to the younger subjects; it's the opposite for social causes (conflicts, bereavements, stress). The alimentary interdictions are also persistent. Medical assistance keep a good place in the knowledge of the therapy of epilepsy. It showed that those aged 65 and more in Haute-Vienne had social and cultural representation of epilepsy, generally more pessimistic than those of the persons aged less than 65. CONCLUSION: The study confirmed a decrease in the stigma about epilepsy. This data suggest a better consideration of the social and cultural representations in the fight against epilepsy even in western countries.

Combined use of an antigen and antibody detection enzyme-linked immunosorbent assay for cysticercosis as tools in an epidemiological study of epilepsy in Burundi.

OBJECTIVE: To evaluate the benefits of the detection of both circulating antibodies (Ab) and antigens (Ag) for the diagnosis of cysticercosis in people with epilepsy. Neurocysticercosis is a cause of neurological diseases world-wide, especially epilepsy. The clinical symptoms of neurocysticercosis are non-specific and diagnosis is often difficult. METHODS: Serum samples were collected from subjects in a matched case-control study for epilepsy in the Kiremba area, Burundi, between March and April 2001 (epileptic cases=303; controls without epilepsy=606). The enzyme-linked immunosorbent assay (ELISA) was used for the detection of antibodies (Ab-ELISA) and circulating Ag (Ag-ELISA). RESULTS: The Ab-ELISA revealed 58.7% positivity in epilepsy cases and 31.4% in healthy controls; and Ag-ELISA revealed 38.3% positivity in epilepsy cases and 20.0% in controls. The matched odds ratios were 3.6 (95% CI: 2.5-4.9) for Ab-ELISA, and 2.9 (95% CI: 2.1-4.3) for Ag-ELISA. CONCLUSION: Both Ag- and Ab-ELISA detected a significantly higher number of seropositives among people with epilepsy than among controls. The risk of epilepsy was high in cases with a positive Ag-ELISA, although less important than in cases with positivity for Ab-ELISA. Dead or degenerating cysticerci appear to be more frequently associated with epilepsy than living cysts. The high number of people with circulating Ag of Taenia solium suggests that the study area is a focus of active transmission of the parasite.