Papers by François Ferrero
Springer eBooks, 1999
Managed care has entered the lexicon of health-care reform, but confusion still surrounds its mea... more Managed care has entered the lexicon of health-care reform, but confusion still surrounds its meaning and purpose. It seeks to cut the costs of health care while maintaining its quality, but the evidence that it is able to achieve these aims is mixed. Managed care is not a discrete activity but a spectrum of activities carried out in a range of organizational settings. Due to its constantly changing nature, managed care is a difficult concept but it has in common an attempt to influence and modify the behavior and practice of doctors and other health professionals towards cost-effective care (Fairfield1).
Revue médicale de la Suisse romande, 2004
During the past few years, a renewal of interest in the study and treatment of schizophrenic diso... more During the past few years, a renewal of interest in the study and treatment of schizophrenic disorders has quite fortunately become noticeable, undoubtedly thanks in part to different works concerning early psychoses and the development of new therapeutic approaches. Psychopharmacology occupies a significant position in the treatment plan and the range of therapeutic options has grown larger since the appearance of the second generation of antipsychotics. However, if we take note of the conclusions of the task force of the World Psychiatric Association, there is still much to do in order to provide "evidence based" proof that shows the superiority of the second generation of these medications and, most importantly, in order to make comparisons between them. This work also reviews some of the difficulties connected to maintenance treatment and brings up the complex issue of the therapeutic approach of schizophrenic disorders.
Validation of risk and needs assessment instruments used to predict, and reduce, recidivism and m... more Validation of risk and needs assessment instruments used to predict, and reduce, recidivism and misconduct is of ethical, practical and scientific importance. We argue for a focus on variable (i.e. changeable over time) risk factors, and that validation begins with establishing construct validity. The Finnish Risk and Needs Assessment Form, in Finnish Riski-ja tarvearvio (RITA), is a semi-structured interview form adapted from the Offender Assessment System used in England and Wales and consists primarily of variable risk factors. In this study, we examined the construct validity and internal reliability of RITA. The results suggest that the original RITA sections do not provide an adequate statistical model for describing the relationship between scored questions, and we, therefore, offer an improved model. In our proposed model, several scores are influenced by more than one dimension of risk and the dimensions correlate with each other considerably. We suggest that the dimensions that can be measured with RITA are Problems managing economy, Alcohol problems, Resistance to change, Drug abuse and associated behaviour, Aggressiveness and Employment problems. All factors except Drug abuse and associated behaviour had very good internal reliability. We propose this new model to be used in future research with, and in development of, RITA.
PubMed, 1995
An overview of the literature indicates that violence in psychiatry is caused by a minority of pa... more An overview of the literature indicates that violence in psychiatry is caused by a minority of patients. Despite the lack of precise definition, between 3 and 10% of patients shows an assaultive behaviour, at least once during the hospitalisation, but, fortunately, injuries are exceptional. The authors present some results of a research project evaluating the frequency and the cost of violence.
Schweizer Archiv für Neurologie und Psychiatrie =, Jan 16, 2002
Journal of Clinical Epidemiology, Apr 1, 2002
In assessing the efficacy of therapy for schizophrenia, the effect of medication on relapse needs... more In assessing the efficacy of therapy for schizophrenia, the effect of medication on relapse needs to be distinguished from the influence of relapse on medication. Typically, effective medication prevents relapse, but relapse generally induces medication. Conventional analyses using either treatment or disease as outcome do not separate these two effects. We propose an alternate approach that uses both treatment and schizophrenic relapse as random variables. Data from 58 schizophrenic patients, with up to 60 consecutive monthly determinations of antipsychotic medication and schizophrenic events, were analyzed using a bivariate transition model with random effects. This analysis revealed that the risk of current schizophrenic relapse is reduced by continuous medication (previous month and current month) but not necessarily by discontinuous medication.
Revue médicale suisse, Sep 21, 2005
PLOS ONE, Jun 9, 2011
Objective: to assess the levels and determinants of interleukin (IL)-1b, IL-6, tumour necrosis fa... more Objective: to assess the levels and determinants of interleukin (IL)-1b, IL-6, tumour necrosis factor (TNF)-a and C-reactive protein (CRP) in a healthy Caucasian population. Methods: population sample of 2884 men and 3201 women aged 35 to 75. IL-1b, IL-6 and TNF-a were assessed by a multiplexed particle-based flow cytometric assay and CRP by an immunometric assay. Results: Spearman rank correlations between duplicate cytokine measurements (N = 80) ranged between 0.89 and 0.96; intra-class correlation coefficients ranged between 0.94 and 0.97, indicating good reproducibility. Among the 6085 participants, 2289 (37.6%), 451 (7.4%) and 43 (0.7%) had IL-1b, IL-6 and TNF-a levels below detection limits, respectively. Median (interquartile range) for participants with detectable values were 1.17 (0.48-3.90) pg/ml for IL-1b; 1.47 (0.71-3.53) pg/ml for IL-6; 2.89 (1.82-4.53) pg/ml for TNF-a and 1.3 (0.6-2.7) ng/ml for CRP. On multivariate analysis, greater age was the only factor inversely associated with IL-1b levels. Male sex, increased BMI and smoking were associated with greater IL-6 levels, while no relationship was found for age and leisure-time PA. Male sex, greater age, increased BMI and current smoking were associated with greater TNF-a levels, while no relationship was found with leisure-time PA. CRP levels were positively related to age, BMI and smoking, and inversely to male sex and physical activity. Population-based levels of several cytokines were established. Increased age and BMI, and to a lesser degree sex and smoking, significantly and differentially impact cytokine levels, while leisure-time physical activity has little effect.
Acta Psychiatrica Scandinavica, Mar 1, 2008
Schweizer Archiv für Neurologie und Psychiatrie =, Aug 26, 2009
specialised care and medical follow-up, greater attention to physical environment), but it should... more specialised care and medical follow-up, greater attention to physical environment), but it should be taken into account that client appreciation is also influenced by socio-demographic and clinical characteristics.
European Psychiatry, Oct 2, 2011
American Journal of Medical Genetics, 2004
American Journal of Medical Genetics, 2002
PubMed, Sep 19, 2007
Knowledge about the income of patients with chronic psychotic disorder and how they use the money... more Knowledge about the income of patients with chronic psychotic disorder and how they use the money may help to provide appropriate clinical and social assistance. Fifty-seven outpatients with schizophrenia treated in Geneva, Switzerland, were studied. Mean income was 3866 Swiss francs (4209 for those with the Swiss disability fund). Only a minority of patients live on meager resources with insufficient comfort. A 4 weeks follow-up showed that patients disposed of a mean of 400 Swiss francs discretionary money. Twenty eight percent of this money was used for leisure activities. This psychiatric and social system allows stabilized patients with psychosis to get what they need in terms of financial support and housing. However, patients should be helped to use their discretionary money in ways more prone to help recovery.
International Journal of Psychiatry in Clinical Practice, 2003
ABSTRACT
PubMed, Mar 1, 1995
Sixty-seven first episode schizophrenic patients (PSE-Catego criteria) have been included in this... more Sixty-seven first episode schizophrenic patients (PSE-Catego criteria) have been included in this study in order to evaluate their prognosis and the factors predictive of their evolution. Potential predictive factors consisted of anamnestic and demographic data, scores on the Disability Assessment Schedule (DAS-WHO) and relatives' Expressed Emotion index (EE), measured by the Camberwell Family Interview (CFI). The outcome was assessed monthly by the Global Assessment Scale (GAS/DSM III-R). At four years, 39 patients (58%) were still being followed. 33% of the patients presented a good evolution (EGF > or = 51) and 67% of the patients a bad evolution (EGF < 51). Four factors predictive of the psychosocial adaptation were extracted using regression analysis: premorbid psychosocial evolution, EE, sex and psychiatric family history. These 4 factors predicted correctly 85% of cases. Moreover, the monthly follow-up of these patients pointed to three types of evolution: the patients presenting a good and stable evolution (22%), those presenting a bad and stable evolution (33%) and those presenting an oscillating evolution which fluctuated between good and bad periods (44%). However, no predictive factors of the psychosocial adaptation of these oscillating patients could be identified through the statistical analysis. These results take all their importance regarding the treatment of schizophrenic patients, for whom the therapeutic plans which have to be settled should take into account their prognosis in the most precise manner. Moreover, the predictive value of EE on psychosocial adaptation for a 4 years period is confirmed.
Psychothérapies, 2002
Distribution électronique Cairn pour Médecine & Hygiène. © Médecine & Hygiène. Tous droits réserv... more Distribution électronique Cairn pour Médecine & Hygiène. © Médecine & Hygiène. Tous droits réservés pour tous pays. La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.
European Archives of Psychiatry and Clinical Neuroscience, Aug 1, 2003
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Papers by François Ferrero