[Effect of antidepressant treatment on sense of dyscontrol: preliminary studies]

Cumulative data in the field of phenomenology, neurobiology and psychopharmacology indicate "discontrol" as a dimension probably linked to serotonin central activity and frequently observed in major depression and other related disorders. A new questionnaire for evaluating this dimension is proposed: Behavioral Discontrol Scale (BDS). The BDS was constructed in 1990 and validated through multiple clinical studies: the first validation study included 166 patients (subdivided in 4 subgroups, anxious, depressed, alcohol abusers and bulimics fulfilling DSM III-R criteria) and 35 controls. The second validation study concerned a large clinical population suffering from major depression according tho DSM III-R criteria (n = 1360 patients). The episodes classified as psychogenic or neurotic and characterised as "agitated, anxious, impulsive and/or suicidal"' showed the highest scores on discontrol (p < 0.001). Following these initial studies, the present study was conducted to evaluate prospectively the sensitivity of BDS to change under different antidepressant treatments (serotonergic versus other agents). Preliminary data were obtained within a group of 62 outpatients suffering from major depression (DSM III-R criteria), treated naturalisticly and followed on a 4 weeks period. Results showed that discontrol is sensitive to change, especially in the fluoxetine group (decrease at day 28 by 35% vs 23% and 24% in other groups, p = 0.17). Changes of discontrol scores was shown to be related to benzodiazepine (BZD) combination to antidepressant treatment. In fact, in the group "with BZD" (n = 42), the magnitude of BDS score variation was less important than in the group "without BZD" (n = 19): respectively.(ABSTRACT TRUNCATED AT 250 WORDS)