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《Annales médico-psychologiques》2020,178(4):436-438
The former alienist doctors had already noted that the “insane” can sometimes commit acts of wisdom and that the reasonable person can occasionally commit acts of madness. The present study recalls three famous classic French treatises on the civil and penal capacity of the mentally ill and on the power of nuisance of the insane whose psychic abnormality remains unknown to those around them. They are La folie lucide, by Ulysse Trélat (1861), La raison dans la folie, by Victor Parant (1888) and La raison chez les fous, by Paul Voivenel (1926). 相似文献
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《Annales médico-psychologiques》2022,180(1):66-69
The pandemic has transformed our relationship to time, as it has disrupted our work habits. To understand how these changes affect our world view, it is useful to examine the fundamental patterns that govern our relationship to time, which can be called Destiny, Progress, Hypertemps and Deadlines. What are the links between them? And above all, like leaving a conflicting vision of opposition to build a more peaceful relationship to time. À time when “having time” could retain meaning? 相似文献
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D. Bailly 《L'Encéphale》2017,43(1):69-74
Objective
To review the options for psychosocial interventions in pediatric bipolar disorders.Methods
A comprehensive literature review of randomized clinical trials and open-label studies was conducted.Results
Randomized controlled trials show that psychosocial interventions involving families (i.e. family-focused treatment) or individual and family therapy (i.e. multi- or individual-family psychoeducational psychotherapy, child- and family-focused cognitive-behavioral therapy, dialectical behavior therapy) may be effective through added benefit to pharmacotherapy. All these interventions share numerous common therapeutic elements such as psychoeducation and skills training. Individual interventions (i.e. interpersonal and social rhythm therapy and cognitive-behavioral therapy) are to date less well documented. However that may be, outcome studies remain few, and numerous methodological limitations (small sample sizes, designs not very rigorous) restrict the interpretability and generalisability of their results. In addition, most studies were conducted in specialty centers with highly trained therapists, and the feasibility and acceptability of these interventions in practice settings remain to be shown.Conclusion
Despite recent developments in identifying effective psychosocial interventions, numerous critical gaps remain, and more longitudinal studies are needed to clarify how these interventions work. 相似文献5.
M.-E. Lampin A. Dorkenoo M.-D. Lamblin A. Botte F. Leclerc S. Auvin 《Revue neurologique》2010,166(6-7):648-652
Morbidity and mortality are high in children with refractory status epilepticus (RSE). Here, we assess the efficacy of midazolam for RSE in children.MethodsThis was a retrospective analysis of 29 children admitted to the Lille University Hospital pediatric intensive care unit (PICU) for RSE between May 2006 and July 2008. The onset of the study corresponded with a new therapeutic protocol applied in the PICU for RSE where midazolam was proposed as the first-line treatment (bolus ten continuous infusion until control) to be replaced by thiopenthal in case of failure.ResultsWe recorded 29 patients with RSE during the study period: 26 were treated with midazolam, including two where midazolam replaced thiopenthal because of hypotension. Midazolam successfully controlled RSE in 58% of patients. Mean delay to cessation of RSE was 48 ± 65 minutes. Hypotension was observed in 8% of midazolam-treated patients and 71% of thiopenthal-treated patients. Overall mortality was 15% (4/26). Two deaths occurred long after the cessation of RSE. None of the deaths occurred in midazolam-treated patients.ConclusionMidazolam is an efficient treatment for RSE in children. Morbidity and mortality appear to be lower with midazolam compared with other antiepileptic drugs used for the treatment of RSE. 相似文献
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Salvatore Settineri Emanuele Maria Merlo Fabrizio Turiaco Carmela Mento 《L'évolution Psychiatrique》2018,83(2):333-342
Objective
This article sets out to clarify the relationship between the organic pathologies and the images of the corresponding organs. In this type of construction, it is as if the mind were confronted with an internally generated form of pareidolia. As in maladjustment, manifestations of pareidolia undergo change when the organ is damaged; it is thought that the subject has a distortion in the production of images. In this work, we compared two very different diseases: a skin disease (psoriasis) and a heart disease (coronary heart disease). Here is the hypothesis we propose.Method
The method closest to our interpretative approach is that of Rorschach, according to studies by Rauch de Traubenberg, through which it is possible to understand representations of the Self and the Body. This method, in addition to its purely nosographic objectives, approaches the subjective complexity of the somatic and therefore psychic suffering of psoriasis and cardiac patients.Results
The maladaptive dimension of mental suffering caused by damaged psychic objects emerges from the analysis of observational group protocols. This can be understood in terms of the representation of the Self and the Body. Psoriatic subjects are more compromised in their representations of the Self, while those who have suffered a heart attack have more fragmented representations of the Body.Discussion
Despite these differences in the representation of damaged organs and the specificities of the two instances, it seems clear that the attempt at representation, under the influence of the damaged organ, is accompanied by maladjustment.Conclusions
These results suggest that the scope for generating representations of the internal world are strongly influenced by somatic problems that are disabling from the existential point of view. 相似文献7.
Selective serotonin reuptake inhibitors (SSRIs) are the most prescribed antidepressant treatment for treat major depressive disorders. Despite their effectiveness, only 30% of SSRI-treated patients reach remission of depressive symptoms. SSRIs by inhibiting the serotonin transporter present some limits with residual symptoms. Increasing not only serotonin but also norepinephrine and dopamine levels in limbic areas seems to improve remission. Anatomical relationships across serotoninergic, dopaminergic and noradrenergic systems suggest tight reciprocal regulations among them. This review attempts to present, from acute to chronic administration the consequences of SSRI administration on monoaminergic neurotransmission. The serotonin neurons located in the raphe nucleus (RN) are connected to the locus coeruleus (locus coeruleus), the key structure of norepinephrine synthesis, through GABAergic-inhibiting interneurons. Activation of the 5-HT2A receptors expressed on GABAergic interneurons following SERT-inhibition induces an increase in serotonin leading to inhibitory effect on NE release. Similarly, the serotonin neurons exert negative regulation on dopaminergic neurons from the ventral tegmental area (VTA) through a GABAergic interneuron. These interneurons express the 5-HT2C and 5-HT3 receptors inducing an inhibitory effect of 5-HT on DA release. Positive reciprocal connections are also observed through direct projections from the locus coeruleus to the RN and from the VTA to the RN through α1 and D2 receptors respectively, both stimulating the serotoninergic activity. Acute SSRI treatment induces only a slight increase in 5-HT levels in limbic areas due to the activation of presynaptic 5-HT1A and 5-HT1B autoreceptors counteracting the effects of the transporter blockade. No change in NE levels and a small decrease in the dopaminergic neurotransmission is also observed. These weak changes in monoamine in the limbic areas after acute SSRI treatment seems to be one of key point involved in the onset of action. Following desensitization of the 5-HT1A and 5-HT1B autoreceptors, chronic SSRI treatment induces a large increase in the 5-HT neurotransmission. Changes in 5-HT levels at the limbic areas results in a decrease in NE transmission and an increase in DA transmission through an increase in the post-synaptic D2 receptors sensitivity and not from a change in DA levels, which is mainly due to a desensitization of the 5-HT2A receptor. The observed decrease of NE neurotransmission could explain some limits of the SSRI therapy and the interest to activate NE system for producing more robust effects. On the other hand, the D2 sensitization, especially in the nucleus accumbens, stimulates the motivation behavior as well as remission of anhedonia considering the major role of DA release in this structure. Finally, we need to take into account the key role of each monoaminergic neurotransmission to reach remission. Targeting only one system will limit the therapeutic effectiveness. Clinical evidences, including the STAR*D studies, confirmed this by an increase of the remission rate following the mobilization of several monoaminergic transmissions. However, these combinations cannot constitute first line of treatment considering the observed increase of side effects. Such an approach should be adapted to each patient in regard to its particular symptoms as well as clinical history. The next generation of antidepressant therapy will need to take into consideration the interconnections and the interrelation between the monoaminergic systems. 相似文献
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Lucas Bloc Dominique Pringuey Mareike Wolf-Fédida 《Annales médico-psychologiques》2018,176(3):236-242
Objectives
In a phenomenological approach, eating disorders imply a mode of being in the world, a mode of existence in which the act of eating occupies central position and becomes a source of suffering as a result of incapacity to have control over eating habits. In this article, our objective is to analyze the hyperphagic experience, which is experienced in obesity.Patients or Materials and Methods
The phenomenological approach to the body discusses the current habitual dimension of eating and observes a certain imbalance between the body as subject and the body as object in the hyperphagia experienced in obesity. Contributions by Merleau-Ponty's philosophical phenomenology, as well as Tatossian's clinical phenomenology are the basis of our study. After that, we approach the hyperphagia experienced in obesity, assessing clinical interviews with Louise and Marine. Used in the form of vignettes in order to illustrate the hyperphagia experienced in obesity, these interviews of phenomenological nature, realized right in the heart of an obesity medicine service in Paris, allow us to understand the meanings of the patients’ experience. The questions proposed concerned the state of being obese, as a mode of being-in-the-world, as well as the eating experience.Results
Inspired by a phenomenological approach to the body, it might be understood that the hyperphagic body is in a short-circuit, or rather in an imbalance between the body as subject and the body as object. On the one hand, the hyperphagic person does not feel their own body — body feelings are not experienced. On the other hand, they lose connection and contact with themselves and with others. Such connection would be the supplier of the means for a possible control over the act of eating. There is a rapid alternation between being and having a body, and that is anchored in the imbalance that results in the pathological process characterized by the condition of not being able to stop overeating. The clinical interviews allowed us to have direct contact with the experiences of two patients and four strands were explored: the body and the other one in obesity, body feelings and loss of control, the act of eating as a means to fulfill feelings of emptiness as well as the need for something to happen, and the non-addictive dimension of hyperphagia.Conclusions
It is observed that the great suffering experienced by an obese person with hyperphagia is connected to a body condition, the impossibility of not eating and not being able to control the urge to eat. The act of eating is experienced as an imposition and not as a choice, an urge that suppresses an individual's liberty and that frequently incites guilty feelings. The body is believed to be controlled by the urge to eat, and it is thoroughly crisscrossed by our relations with our own bodies, with others and with food. 相似文献12.
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Bastien Vajou Benoit Fromage Bernard Andrieu Gilles Galopin 《L'évolution Psychiatrique》2018,83(1):29-43
Objective
This paper shows how the mediation of the plant world through immersion in and reconnection with it can contribute to the development of self-determination in pathological situations.Method
On the basis of a literature review, the article identifies and analyses different experimental situations. It is structured in three parts, presenting the use of the mediation of plants and trees and its influence on self-determination in what we think, what we do and of who we are.Results
The plant world is naturally perceived as an external entity, thus providing a environment favorable to the self-determination of individuals in different pathological situations. It also possesses an internal resonance in humans, which is developed here in an innovative method of mediation specific to the tree.Discussion
By integrating the complex process of mediation by the plant world, it is possible to propose a process of accompaniment of people in situations of post-pathological stress.Conclusion
Mediation using the world of plants is an important issue in the accompaniment of different therapeutic approaches. More research is needed to identify and better understand the processes involved. 相似文献18.
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