Acta psychiatrica Belgica最新文献

Aggression and violence are frequently experienced both in the community and the institutions. General attempts have been made to categorize research literature on aggressive behavior in animal as in man. Most of the studies are often deficient in the description and categorization of human aggressive behaviours and there is no well-defined status provided for these behaviors by modern nosography. The determinants of violence involve many levels and require psychological, dynamic and socio-environmental approaches but also extensive investigation into the underlying biological mechanisms.

This articles reviews current research investigating the role played by psychosocial factors in affective disorders. Besides individual vulnerability factors of cognitive or intrapsychic type, family dysfunctions appear to be related to onset and course of depressive symptomatology. These data should stimulate the development of systemic studies focusing on affective disorders.

The romantic fictions of the mythomaniac are fascinating in the conviction they arouse in others and in the ambiguous connections their author keeps with reality. When behind his fables, Mr D. reveals a demand for love, it essentially represents a desperate search of identity realized through stories he successively tests with us. So, confronting him without any therapeutical support to the imaginary nature of his productions would just mean depriving him of any possible meaning.

Although hospital is getting more rationalized and nursing tasks are very heavy and fatiguing, innovation appears in geriatric organization. That does not only correspond to technocratic or regular preoccupation but also to ethical one as a figure of human subject comes into sight. Innovation and ethical thought are elaborated in small groups of protected enclaves which progressively play a part in legitimation of therapeutic activity.

Exclusion is first defined: considered as a constraint, it is distinct from a marginal act, identified as a choice. The notion of having a depressive attitude is then reviewed according to local variations of expression. It is examined within a psycho-social-economic perspective and also considering personal identification elements. The depression of people being excluded is evaluated through 3 criteria: devaluation, cumulative insecurity and indifference. These criteria allow the evaluation of our mediation: family interviews, family and/or intervening persons working group, basis of educational programs for mental health.

This paper discusses the nosographic significance of schizoaffective disorder. Follow-up studies, genetic and familial studies, response to treatment studies, and neurobiological data are summarized and analysed. Methodological issues and importance of diagnostic criteria are also examined. Current opinion supports heterogeneity of schizoaffective disorder, among which schizophrenia variants or affective disorder variants. Some patients could present another disease. In that case, they are categorized in the sub-type "other" of the RDC classification for schizoaffective disorder.

Fourty-five schizophrenic inpatients were randomly assigned to bromperidol or sulpiride in an 8 week single-blind clinical trial. No statistically significant differences were observed for final global improvement rating. Regarding BPRS items and compared to sulpiride, bromperidol was particularly effective to relieve emotional withdrawal and hallucinatory behavior, although the only significant between group difference was in favour of sulpiride for improvements of somatic concern. No significant differences were observed for all PES items, although sulpiride was found more effective for hypochondriasis and neurotic complaint as was bromperidol for hallucination and disturbance of self-conscious. The rate of side-effects and abnormal laboratory test results were comparable in the two groups. They were not severe enough to require termination of administration. Bromperidol and sulpiride are concluded to have different clinical profile in the treatment of schizophrenic hospitalized patients.

This paper reminds the concept of a unitary nosological and pathogenic process that may be traced back to Joseph Guislain (1797-1860). The "phrénalgie initiale" was regarded as the initial stage of psychic illness by Guislain (Leçons orales, Ghent, 1852). That vision inspired the work of Wilhelm Griesinger (1817-1869) who further elaborated the concept of "Einheitspsychose" (Psychose unique--Unitary psychosis). That concept partially inspired Emil Kräpelin (1856-1926). Current classification systems like ICD-10 and DSM-III-R attempt to synthesize different views and the concept of unitary psychosis is actualized in the contemporary transnosography.

This paper reviews different psychotherapeutic and drug treatments for Post Traumatic Stress Disorder (PTSD). Psychotherapeutic treatments have changed from the abreaction technique to more classical psychodynamic approaches and recently to cognitive and behavioral techniques. Many drugs have been used in the treatment of PTSD but most of the studies were not controlled and included very few patients. More recently, double blind controlled studies have been performed comparing imipramine, desipramine, amitriptyline, phenelzine and placebo. A global efficacy has been found but the improvement was more closely related to associated symptoms, namely anxiety and depression, than to the core symptoms of PTSD.

Clinical psychology often borrows vocabulary from medicine as well as its analysis schemes and explanation models. This survey will deal with all analysis schemes used by the clinical psychologist, explicitly or implicitly, to make it possible to understand the psychological functioning, and work on it as soon as a problem arises.