Pub Date : 2025-07-17DOI: 10.1016/j.npg.2025.06.002
Aline Muhigwa, Sandrine Kalenzaga
Alzheimer's disease (AD) is a common degenerative disease characterized by chronic cognitive impairment. Apart from cognitive impairments, psychological and behavioral symptoms of Alzheimer's disease (PBSAD), also known as neuropsychiatric symptoms, are crucial components responsible for morbidity, which can directly affect the quality of life of both patients and professional caregivers. Symptoms such as agitation, depression, anxiety, aggression, apathy, and delusions are common at every stage of AD and may escalate as the disease progresses. While considerable research has been devoted to understanding the impact of PBSAD on family caregivers, there has been less examination of the experiences of professional caregivers. We reviewed the classification and structure of PBSAD, the effects on professional caregiver burden, and the strain caused by the most difficult symptoms on healthcare personnel. Tools like the Neuropsychiatric Inventory (NPI) and various burden assessment scales, including the Zarit Burden Interview, have been utilized to evaluate how often these symptoms occur and their severity, and their effects on caregivers. Agitation and aggression were reported as particularly challenging. This review also describes non-pharmacologic strategies to address PBSAD and reduce formal caregiver burden. Since PBS vary widely in both type and intensity, specific training and supportive networks are required to ensure that health care providers have the tools they need to address these symptoms. A better understanding of the relationship between PBSAD and professional caregiver burden will enable strategies to designed to optimize patient care and foster the wellness of both professional caregivers and the patients themselves.
La maladie d’Alzheimer (MA) est une pathologie neurogénérative fréquente, caractérisée par une détérioration progressive des capacités cognitives. Toutefois, en plus des troubles cognitifs, les manifestations comportementales et psychologiques, connues également sous le nom de symptômes neuropsychiatriques, influencent de manière significative la qualité de vie des patients, de leur entourage et des professionnels soignants. Ces manifestations regroupent des éléments tels que l’agitation, la dépression, l’anxiété, l’agressivité, l’apathie et les délires, apparaissant à tous les stades de la MA. Bien qu’un grand nombre de recherches se soient penchées sur l’impact symptômes psychologiques et comportementaux sur les proches aidants, il existe peu d’études ayant évalué leur impact sur les soignants prenant en charge les patients Alzheimer. La présente revue a pour objectif d’examiner les effets des symptômes psychologiques et comportementaux liés à la maladie d’Alzheimer (SPCMA) sur les soignants professionnels, en particulier dans le contexte français, pour lequel la littérature est rare, avec seulement deux études sur le sujet. Ces études se concentrent sur l’anosognosie et son association au
阿尔茨海默病（AD）是一种以慢性认知障碍为特征的常见退行性疾病。除了认知障碍外，阿尔茨海默病的心理和行为症状（PBSAD），也称为神经精神症状，是导致发病率的关键因素，可直接影响患者和专业护理人员的生活质量。躁动、抑郁、焦虑、攻击、冷漠和妄想等症状在阿尔茨海默病的每个阶段都很常见，并可能随着疾病的进展而升级。虽然有相当多的研究致力于了解PBSAD对家庭照顾者的影响，但对专业照顾者经验的研究却很少。我们回顾了PBSAD的分类和结构，对专业护理人员负担的影响，以及由最困难的症状对医护人员造成的压力。神经精神病量表（NPI）和各种负担评估量表（包括Zarit负担访谈）等工具已被用于评估这些症状发生的频率和严重程度，以及它们对护理者的影响。据报道，躁动和攻击性尤其具有挑战性。本综述还描述了解决PBSAD和减轻正式照顾者负担的非药物策略。由于公共卫生服务的类型和强度差别很大，因此需要专门的培训和支持网络，以确保卫生保健提供者拥有处理这些症状所需的工具。更好地理解PBSAD与专业护理人员负担之间的关系，将有助于制定优化患者护理的策略，并促进专业护理人员和患者自身的健康。阿尔茨海默病（MA）是一种病理：神经型、神经型、人格型、人格型、人格型、渐进式、能力型、认知型。Toutefois， en + des麻烦认知，les表现，comcomementales和psychologiques，连续的抑郁，连续的抑郁，神经精神病学，影响，显著的生活质量，患者生活质量，工作人员生活质量。这些表现分别代表了“激动”、“压抑”、“焦虑”、“激进”、“沮丧”、“沮丧”、“沮丧”、“沮丧”、“沮丧”、“沮丧”和“沮丧”。瞿好一个大数量生物se的数字penchees苏尔的症状psychologiques et comportementaux苏尔les接近帮助的,它存在一些研究ayant安勤科技为了影响苏尔les soignants她以前在les老年痴呆症患者。洛杉矶现在的revue倒目的d 'examiner les运用des症状psychologiques et comportementaux谎言La病d 'Alzheimer (SPCMA)苏尔les soignants来完成,en particulier在contexte法语,倒lequel litterature是罕见的,用seulement两个练习曲在我。这些病例集中于疾病感病，与疾病感病相关的疾病感病，以及与疾病感病相关的重要事件symptômes。这两种表现分别为：<s:1> <s:1> <s:1> <s:1> <s:1> <s:1> <s:1> <s:1> <s:1> <s:1> <s:1> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -L 'impact de ces symptômes sur le fardeau des soignants est est samement （zit Burden Interview）、L ' Index de pression sur le proche aidant （Caregiver Strain Index [CSI]）、qui samvalue le stress哀伤哀伤、体质与社交哀伤。特别纲领，特别是“激越”和“激进”的纲领，是一种努力的象征。这些表现会导致压力的增加，如抑郁和抑郁，持续的疲劳会增加，如焦虑和抑郁，以及对身体的祝福。D ' auterres的表现表明，抑郁和抑郁对患者的抑郁情绪有显著影响，抑郁和抑郁对患者的抑郁情绪有显著影响，抑郁和抑郁对患者的抑郁情绪有显著影响，抑郁和抑郁对患者的抑郁情绪有显著影响。这句的意思是：“我认为，如果你认为你是一个成功的人，你就会认为你是一个成功的人。”没有足够的时间来证明自己是成功的，也没有足够的时间来证明自己是成功的。我们将主要讨论下列问题：1 .在形成过程中：1 .在形成过程中：1 .在形成过程中：1 .在形成过程中：1 .在形成过程中：1 .在形成过程中：1 .在形成过程中：干预措施的实施办法、非<s:1> <s:2> <s:2> <s:2> <s:2>的<s:2> <s:2>的<s:2> <s:2>的······Étant donnise ' efficitrestreest et l 'ampleur ' efficitrestreest et l 'ampleur ' efficitresest est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est est
{"title":"Psychological and behavioral symptoms in Alzheimer's disease: Impact on professional caregivers burden and non-pharmacological management strategies","authors":"Aline Muhigwa, Sandrine Kalenzaga","doi":"10.1016/j.npg.2025.06.002","DOIUrl":"10.1016/j.npg.2025.06.002","url":null,"abstract":"<div><div>Alzheimer's disease (AD) is a common degenerative disease characterized by chronic cognitive impairment. Apart from cognitive impairments, psychological and behavioral symptoms of Alzheimer's disease (PBSAD), also known as neuropsychiatric symptoms, are crucial components responsible for morbidity, which can directly affect the quality of life of both patients and professional caregivers. Symptoms such as agitation, depression, anxiety, aggression, apathy, and delusions are common at every stage of AD and may escalate as the disease progresses. While considerable research has been devoted to understanding the impact of PBSAD on family caregivers, there has been less examination of the experiences of professional caregivers. We reviewed the classification and structure of PBSAD, the effects on professional caregiver burden, and the strain caused by the most difficult symptoms on healthcare personnel. Tools like the Neuropsychiatric Inventory (NPI) and various burden assessment scales, including the Zarit Burden Interview, have been utilized to evaluate how often these symptoms occur and their severity, and their effects on caregivers. Agitation and aggression were reported as particularly challenging. This review also describes non-pharmacologic strategies to address PBSAD and reduce formal caregiver burden. Since PBS vary widely in both type and intensity, specific training and supportive networks are required to ensure that health care providers have the tools they need to address these symptoms. A better understanding of the relationship between PBSAD and professional caregiver burden will enable strategies to designed to optimize patient care and foster the wellness of both professional caregivers and the patients themselves.</div></div><div><div>La maladie d’Alzheimer (MA) est une pathologie neurogénérative fréquente, caractérisée par une détérioration progressive des capacités cognitives. Toutefois, en plus des troubles cognitifs, les manifestations comportementales et psychologiques, connues également sous le nom de symptômes neuropsychiatriques, influencent de manière significative la qualité de vie des patients, de leur entourage et des professionnels soignants. Ces manifestations regroupent des éléments tels que l’agitation, la dépression, l’anxiété, l’agressivité, l’apathie et les délires, apparaissant à tous les stades de la MA. Bien qu’un grand nombre de recherches se soient penchées sur l’impact symptômes psychologiques et comportementaux sur les proches aidants, il existe peu d’études ayant évalué leur impact sur les soignants prenant en charge les patients Alzheimer. La présente revue a pour objectif d’examiner les effets des symptômes psychologiques et comportementaux liés à la maladie d’Alzheimer (SPCMA) sur les soignants professionnels, en particulier dans le contexte français, pour lequel la littérature est rare, avec seulement deux études sur le sujet. Ces études se concentrent sur l’anosognosie et son association au","PeriodicalId":35487,"journal":{"name":"NPG Neurologie - Psychiatrie - Geriatrie","volume":"25 148","pages":"Pages 203-210"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dementia covers a complex spectrum of cognitive disorders characterized by various pathological mechanisms, significantly impacting individuals and society. Currently, over 55 million people are affected worldwide with the economic burden predicted to increase from $2.8 trillion in 2019 to $4.7 trillion by 2030. This paper explores the four predominant dementia types. These are Alzheimer's disease, Vascular dementia, Lewy body dementia, and Frontotemporal dementia. Each exclusive type has discrete etiologies, symptoms, and progression patterns.
Description
Alzheimer's disease, responsible for about 70% of demenetias worldwide, is closely linked to amyloid plaques and tau tangles, while vascular dementia is defined by reduced blood circulation to the brain and cognitive decline. Lewy body dementia is defined by aberrant deposits of alpha-synuclein protein, leading to cognitive fluctuations and visual hallucinations. Frontotemporal dementia is usually seen in younger people and is identified by atrophy of the frontal, prefrontal, and temporal cortex. Recognizing these differences is important for creating targeted interventions and treatments.
Conclusion
This review aims to enhance comprehension of the underlying pathologies, diagnostic challenges, and therapeutic strategies associated with these dementias, ultimately contributing to improved care and management for affected individuals.
{"title":"Deciphering the molecular and neuropathological dimensions of dementia","authors":"Sumit Dutta , Piyush Bhattacharjee , Shaheen Noori , Nilanjan Adhikari , Samar Dule , Mir Irfan Soyel , Malay Besra , Sudarshana Borah , Priyanka Gupta","doi":"10.1016/j.npg.2025.05.002","DOIUrl":"10.1016/j.npg.2025.05.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Dementia covers a complex spectrum of cognitive disorders characterized by various pathological mechanisms, significantly impacting individuals and society. Currently, over 55 million people are affected worldwide with the economic burden predicted to increase from $2.8 trillion in 2019 to $4.7 trillion by 2030. This paper explores the four predominant dementia types. These are Alzheimer's disease, Vascular dementia, Lewy body dementia, and Frontotemporal dementia. Each exclusive type has discrete etiologies, symptoms, and progression patterns.</div></div><div><h3>Description</h3><div>Alzheimer's disease, responsible for about 70% of demenetias worldwide, is closely linked to amyloid plaques and tau tangles, while vascular dementia is defined by reduced blood circulation to the brain and cognitive decline. Lewy body dementia is defined by aberrant deposits of alpha-synuclein protein, leading to cognitive fluctuations and visual hallucinations. Frontotemporal dementia is usually seen in younger people and is identified by atrophy of the frontal, prefrontal, and temporal cortex. Recognizing these differences is important for creating targeted interventions and treatments.</div></div><div><h3>Conclusion</h3><div>This review aims to enhance comprehension of the underlying pathologies, diagnostic challenges, and therapeutic strategies associated with these dementias, ultimately contributing to improved care and management for affected individuals.</div></div>","PeriodicalId":35487,"journal":{"name":"NPG Neurologie - Psychiatrie - Geriatrie","volume":"25 148","pages":"Pages 187-201"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-30DOI: 10.1016/j.npg.2025.04.002
Francesco Ferrara
Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive loss of dopaminergic neurons in the substantia nigra and the accumulation of α-synuclein aggregates. Current pharmacological treatments, including levodopa and dopamine agonists, mainly offer symptomatic relief but do not modify disease progression. The heterogeneity of clinical manifestations and underlying molecular mechanisms has prompted a shift toward personalized medicine and innovative therapeutic strategies. Among emerging approaches, cell-based therapies — such as stem cell transplantation and induced pluripotent stem cells — aim to restore dopaminergic function and are under active investigation in preclinical and early clinical settings. In parallel, digital therapeutics and wearable technologies offer real-time, objective monitoring of motor and non-motor symptoms, enabling more accurate disease tracking and treatment optimization. These digital tools also facilitate remote patient management and adherence to therapy. Artificial intelligence (AI) has become increasingly integrated into PD research and care, with machine learning algorithms demonstrating high accuracy in early disease detection, symptom monitoring, and risk prediction. Notably, AI-based analyses of data from wearable sensors and digital biomarkers have identified prodromal signs of PD years before clinical diagnosis, offering promising avenues for preventive strategies. While no disease-modifying therapies are currently available, combining pharmacological treatments with advanced technologies and a deeper understanding of disease biology may pave the way for more effective and individualized interventions. The integration of AI, digital health, and cell-based therapies is a paradigm shift in the management and future treatment landscape of Parkinson's disease.
{"title":"Parkinson's disease between old drugs and new digital therapies: A pharmacological review","authors":"Francesco Ferrara","doi":"10.1016/j.npg.2025.04.002","DOIUrl":"10.1016/j.npg.2025.04.002","url":null,"abstract":"<div><div>Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive loss of dopaminergic neurons in the substantia nigra and the accumulation of α-synuclein aggregates. Current pharmacological treatments, including levodopa and dopamine agonists, mainly offer symptomatic relief but do not modify disease progression. The heterogeneity of clinical manifestations and underlying molecular mechanisms has prompted a shift toward personalized medicine and innovative therapeutic strategies. Among emerging approaches, cell-based therapies — such as stem cell transplantation and induced pluripotent stem cells — aim to restore dopaminergic function and are under active investigation in preclinical and early clinical settings. In parallel, digital therapeutics and wearable technologies offer real-time, objective monitoring of motor and non-motor symptoms, enabling more accurate disease tracking and treatment optimization. These digital tools also facilitate remote patient management and adherence to therapy. Artificial intelligence (AI) has become increasingly integrated into PD research and care, with machine learning algorithms demonstrating high accuracy in early disease detection, symptom monitoring, and risk prediction. Notably, AI-based analyses of data from wearable sensors and digital biomarkers have identified prodromal signs of PD years before clinical diagnosis, offering promising avenues for preventive strategies. While no disease-modifying therapies are currently available, combining pharmacological treatments with advanced technologies and a deeper understanding of disease biology may pave the way for more effective and individualized interventions. The integration of AI, digital health, and cell-based therapies is a paradigm shift in the management and future treatment landscape of Parkinson's disease.</div></div>","PeriodicalId":35487,"journal":{"name":"NPG Neurologie - Psychiatrie - Geriatrie","volume":"25 148","pages":"Pages 179-186"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-28DOI: 10.1016/j.npg.2025.04.003
Marie-Claire Benetti Papadacci
L’efficacité de l’art-thérapie dans l’accompagnement des patients souffrant de pathologies neurogénératives reste encore difficile à mesurer de manière standardisée, en raison du manque d’outils validés d’évaluation. La grille DATEI ou dispositif art-thérapeutique d’évaluation et d’intervention propose de combler cette lacune, sur quatre axes principaux : l’engagement artistique, l’expression émotionnelle, l’interaction sociale et les capacités cognitives. L’étude a été menée auprès de 15 patients atteints de la maladie d’Alzheimer dans le cadre d’un essai pilote recruté au Centre mémoire de l’hôpital d’Ajaccio. Les premiers résultats obtenus suggèrent une amélioration notable sur ces quatre critères. La grille DATEI semble constituer un cadre structuré permettant d’adapter les interventions en art-thérapie afin de favoriser une prise en charge plus individualisée.
The effectiveness of art therapy in supporting patients with neurodegenerative diseases remains difficult to measure in a standardized manner due to the lack of validated assessment tools. The DATEI Grid, or Art-Therapy Assessment and Intervention Device, has been developed to fill this gap, focusing on four main approaches: artistic engagement, emotional expression, social interaction, and cognitive abilities. The study was conducted with 15 patients diagnosed with Alzheimer's disease as part of a pilot trial recruiting patients at the Memory Center of Ajaccio Hospital. The first results obtained suggest a notable improvement across these four criteria. The DATEI Grid appears to provide a structured framework for adapting art therapy interventions to promote a more individualized approach to patient care.
{"title":"Création de la grille DATEI pour l’évaluation et l’intervention en art-thérapie","authors":"Marie-Claire Benetti Papadacci","doi":"10.1016/j.npg.2025.04.003","DOIUrl":"10.1016/j.npg.2025.04.003","url":null,"abstract":"<div><div>L’efficacité de l’art-thérapie dans l’accompagnement des patients souffrant de pathologies neurogénératives reste encore difficile à mesurer de manière standardisée, en raison du manque d’outils validés d’évaluation. La grille DATEI ou dispositif art-thérapeutique d’évaluation et d’intervention propose de combler cette lacune, sur quatre axes principaux : l’engagement artistique, l’expression émotionnelle, l’interaction sociale et les capacités cognitives. L’étude a été menée auprès de 15 patients atteints de la maladie d’Alzheimer dans le cadre d’un essai pilote recruté au Centre mémoire de l’hôpital d’Ajaccio. Les premiers résultats obtenus suggèrent une amélioration notable sur ces quatre critères. La grille DATEI semble constituer un cadre structuré permettant d’adapter les interventions en art-thérapie afin de favoriser une prise en charge plus individualisée.</div></div><div><div>The effectiveness of art therapy in supporting patients with neurodegenerative diseases remains difficult to measure in a standardized manner due to the lack of validated assessment tools. The DATEI Grid, or Art-Therapy Assessment and Intervention Device, has been developed to fill this gap, focusing on four main approaches: artistic engagement, emotional expression, social interaction, and cognitive abilities. The study was conducted with 15 patients diagnosed with Alzheimer's disease as part of a pilot trial recruiting patients at the Memory Center of Ajaccio Hospital. The first results obtained suggest a notable improvement across these four criteria. The DATEI Grid appears to provide a structured framework for adapting art therapy interventions to promote a more individualized approach to patient care.</div></div>","PeriodicalId":35487,"journal":{"name":"NPG Neurologie - Psychiatrie - Geriatrie","volume":"25 148","pages":"Pages 172-178"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-28DOI: 10.1016/j.npg.2025.04.001
{"title":"La place de la société civile dans la lutte contre les maltraitances doit être maintenue","authors":"","doi":"10.1016/j.npg.2025.04.001","DOIUrl":"10.1016/j.npg.2025.04.001","url":null,"abstract":"","PeriodicalId":35487,"journal":{"name":"NPG Neurologie - Psychiatrie - Geriatrie","volume":"25 147","pages":"Pages 161-162"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-16DOI: 10.1016/j.npg.2025.03.001
F. Brossard
Objectif
En établissement gériatrique, nombreux sont ceux qui connaissent un sentiment de solitude. Le grand âge et la perte d’un étayage social fragilisent un soutien basé sur des liens pourtant établis de longue date. Nul doute que ce sentiment peut être alors proportionnel au désarrimage social.
Patient
Un résident octogénaire mélancolique exprime souffrir de solitude. Son accompagnement est réalisé par un psychologue clinicien sur 3 ans à fréquence d’un entretien bimensuel. La méthode se base à la fois sur la psychologie clinique d’inspiration psychanalytique kleinienne mais aussi phénoménologique. Une analyse dans l’après-coup constitue la réflexion de cet article.
Résultats
La solitude peut être vécue face à un sentiment de confrontation à de mauvais aspects de soi. L’analyse des phénomènes présentés permet de repérer une certaine angoisse d’anéantissement face à une fragilisation du Moi. En effet, différents mécanismes se mettent en place notamment le clivage et la projection. Le but étant de protéger ce qui peut réassurer et demeure fragile.
Discussion
Si la solitude peut posséder une part créative, la situation présentée montre qu’elle peut également amener une part de souffrance. Le narcissisme ouvre une piste intéressante pour continuer de s’aimer soi-même en l’absence d’un autre bien qu’il demeure plus précaire dans la mélancolie.
Conclusion
Si des facteurs sociaux peuvent expliquer la solitude, cet exemple nous enseigne qu’elle peut avoir également une origine psychique. Il convient d’en connaître les différents mécanismes afin qu’un accompagnement psychothérapique puisse prendre en compte l’angoisse et les processus qui en dérivent.
Objective
In geriatric institutions, many residents experience loneliness, often exacerbated by aging and the loss of social support, which weaken long-established ties. This loneliness frequently correlates with social disengagement.
Method
We conducted a clinical case study of a melancholic octogenarian resident experiencing loneliness. Psychological support was provided through bi-monthly interviews with a clinical psychologist over 3 years. A retrospective analysis was performed using phenomenological and clinical psychological approaches grounded in Kleinian psychoanalysis.
Results
Loneliness can emerge as individuals confront negative self-perceptions. Our analysis identified an anxiety of annihilation in response to the fragility of the Ego. In order to reassure and protect the Ego, different mechanisms are employed, notably splitting and projection.
Discussion
While solitude may hold creative potential, it often provokes suffering, as evidenced in our case study. In the absence of social connections, narcissism may serve as a means of sustaining self-
{"title":"La solitude en institution gériatrique : entre état psychique et contexte social","authors":"F. Brossard","doi":"10.1016/j.npg.2025.03.001","DOIUrl":"10.1016/j.npg.2025.03.001","url":null,"abstract":"<div><h3>Objectif</h3><div>En établissement gériatrique, nombreux sont ceux qui connaissent un sentiment de solitude. Le grand âge et la perte d’un étayage social fragilisent un soutien basé sur des liens pourtant établis de longue date. Nul doute que ce sentiment peut être alors proportionnel au désarrimage social.</div></div><div><h3>Patient</h3><div>Un résident octogénaire mélancolique exprime souffrir de solitude. Son accompagnement est réalisé par un psychologue clinicien sur 3 ans à fréquence d’un entretien bimensuel. La méthode se base à la fois sur la psychologie clinique d’inspiration psychanalytique kleinienne mais aussi phénoménologique. Une analyse dans l’après-coup constitue la réflexion de cet article.</div></div><div><h3>Résultats</h3><div>La solitude peut être vécue face à un sentiment de confrontation à de mauvais aspects de soi. L’analyse des phénomènes présentés permet de repérer une certaine angoisse d’anéantissement face à une fragilisation du Moi. En effet, différents mécanismes se mettent en place notamment le clivage et la projection. Le but étant de protéger ce qui peut réassurer et demeure fragile.</div></div><div><h3>Discussion</h3><div>Si la solitude peut posséder une part créative, la situation présentée montre qu’elle peut également amener une part de souffrance. Le narcissisme ouvre une piste intéressante pour continuer de s’aimer soi-même en l’absence d’un autre bien qu’il demeure plus précaire dans la mélancolie.</div></div><div><h3>Conclusion</h3><div>Si des facteurs sociaux peuvent expliquer la solitude, cet exemple nous enseigne qu’elle peut avoir également une origine psychique. Il convient d’en connaître les différents mécanismes afin qu’un accompagnement psychothérapique puisse prendre en compte l’angoisse et les processus qui en dérivent.</div></div><div><h3>Objective</h3><div>In geriatric institutions, many residents experience loneliness, often exacerbated by aging and the loss of social support, which weaken long-established ties. This loneliness frequently correlates with social disengagement.</div></div><div><h3>Method</h3><div>We conducted a clinical case study of a melancholic octogenarian resident experiencing loneliness. Psychological support was provided through bi-monthly interviews with a clinical psychologist over 3 years. A retrospective analysis was performed using phenomenological and clinical psychological approaches grounded in Kleinian psychoanalysis.</div></div><div><h3>Results</h3><div>Loneliness can emerge as individuals confront negative self-perceptions. Our analysis identified an anxiety of annihilation in response to the fragility of the Ego. In order to reassure and protect the Ego, different mechanisms are employed, notably splitting and projection.</div></div><div><h3>Discussion</h3><div>While solitude may hold creative potential, it often provokes suffering, as evidenced in our case study. In the absence of social connections, narcissism may serve as a means of sustaining self-","PeriodicalId":35487,"journal":{"name":"NPG Neurologie - Psychiatrie - Geriatrie","volume":"25 147","pages":"Pages 123-130"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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