Facteurs prédictifs du devenir des patients psychotiques et états limites hospitalisés à la Clinique Dupré pour des projets soins études

Long-term hospitalization is often proposed in the initial phases of treatment of psychotic adolescents or borderline cases. A review of the literature on the subject shows that although hospitalization appears to be indispensable in certain severe cases, the value of this approach is more difficult to justify later on, particularly when as at the Dupré Clinic of Sceaux patient management includes periods of hospitalization of up to or even more than twelve months in the context of a specific approach which combines treatment and study. It therefore seems logical to consider as one of the main priorities the introduction of assessment criteria to evaluate the utility of our complex mental healthcare system, and to attempt to more objectively justify the impressions obtained from an analysis of a large number of case histories which demonstrate the positive effects of our specific treatment-combined with-study project in a wide variety of clinical situations. Another important issue is that of determining the relevant clinical or contextual elements that can provide better indications for a project, and assist in making choices on the duration of hospitalization and the development of our institutional projects. Following a review of reports in the literature on the outcome of adolescents hospitalized for psychiatric disorders and the brief presentation of a specific project at the Dupré Clinic, this article describes a preliminary study made at this institution with the aim of resolving some of the above-mentioned questions. The results of this preliminary study have been presented and its major methodological and theoretical limitations have been discussed; some propositions have also been put forward so that an attempt can be made to improve upon these limitations in subsequent studies.