Pub Date : 2025-10-01DOI: 10.1016/j.amp.2025.03.005
Jean-Luc Martinot , Marie Laure Paillère , Alice V. Chavanne , Éric Artiges
Precursors are evoked upstream of the Capgras’ syndrome. Then, an analogy is suggested between the need for prognostic classification linked to the saturation of the asylum population at the dawn of the 20th century, and the current overflow of the psychiatric healthcare system. The contemporary situation justifies the search for information useful to mitigate ill mental health in at-risk adolescents. The article presents recent research reports on adolescents at-risk of emotional dysregulation, stemming from a longitudinal cohort database of European adolescents. The database analyses have revealed new brain and psychometric predictors of emotional dysregulation in adolescents. New early indicators were derived from easy-to-administer questionnaires, exploring emotions, symptoms and affective traits, sleep, early adversity and stress, puberty. Findings suggest that the physiology and stages of brain development could be taken into account for decisions regarding Mental Health. Studies on adolescent brain development have implications for public health, in terms of the age of protection for adolescents, and targeted prevention upstream of care.
{"title":"Nouveaux précurseurs de dérégulation émotionnelle et cerveau adolescent « à risque » : implications pour la prévention","authors":"Jean-Luc Martinot , Marie Laure Paillère , Alice V. Chavanne , Éric Artiges","doi":"10.1016/j.amp.2025.03.005","DOIUrl":"10.1016/j.amp.2025.03.005","url":null,"abstract":"<div><div>Precursors are evoked upstream of the Capgras’ syndrome. Then, an analogy is suggested between the need for prognostic classification linked to the saturation of the asylum population at the dawn of the 20th century, and the current overflow of the psychiatric healthcare system. The contemporary situation justifies the search for information useful to mitigate ill mental health in at-risk adolescents. The article presents recent research reports on adolescents at-risk of emotional dysregulation, stemming from a longitudinal cohort database of European adolescents. The database analyses have revealed new brain and psychometric predictors of emotional dysregulation in adolescents. New early indicators were derived from easy-to-administer questionnaires, exploring emotions, symptoms and affective traits, sleep, early adversity and stress, puberty. Findings suggest that the physiology and stages of brain development could be taken into account for decisions regarding Mental Health. Studies on adolescent brain development have implications for public health, in terms of the age of protection for adolescents, and targeted prevention upstream of care.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 780-788"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.amp.2024.11.005
Lana Kheirallah , Jean Belbeze , Hassan Rahioui
<div><div>Persistent depressive disorder (PDD), newly developed in DSM-5, merges the diagnoses of chronic major depressive disorder with that of dysthymia. In comparison with the characterized depressive episode, PDD is distinguished by a more marked negative impact on the quality of life, a greater risk of hospitalization and suicide attempts, an often-earlier onset, and a duration of several years to several decades. The treatment of PDD is faced with a high rate of treatment failure or partial remission. In terms of psychotherapy, the only specific psychotherapy adapted to chronic depression is the Cognitive-Behavioral Analysis System of Psychotherapy (CBASP). The initial trial showed that it had effects comparable to those of antidepressants and significantly increased efficacy when combined with medication. Subsequent trials, however, showed mixed results. Until now, PDD does not seem to answer to any know validated therapy for depression. One of the hypotheses that can explain this lack of results is attachment insecurity. Indeed, attachment insecurity is increasingly tackled in literature without being taken into consideration in conventional therapies. Although depression is multifactorial in origin, we now know that insecure attachment is a major risk factor for developing depression. In previous studies, insecure attachment is significantly associated with long-term depression. Considering this, the Attachment Integrated Therapy was adapted for PDD from an attachment-based approach. We felt it was essential to integrate the attachmental dimension in this conception since we raise relational problems, especially those that originate in early relationships. AIT is a time-limited therapy that was developed to support clients with insecure attachment whose security requires a direct and profound restructuring of attachment. AIT focuses mainly on what underlies the activation of the attachment system (in the event of threats to the relationship with the attachment figure), namely the representations of the self and of others by working on the concepts of self-confidence and confidence in others and their link with self-esteem. Secondarily, by enabling the patient to develop attachment interaction skills. To achieve these two objectives, the AIT was developed in line with Bowlby's recommendations. Although Bowlby did not develop a therapy founded on his theory, he nevertheless identified five therapeutic tasks that can guide the attachment-oriented therapist in shaping their work. The purpose of the study was to assess the results of AIT on PDD, found at the beginning (T1) at end of therapy (T2), and one year after therapy (T3) on three levels: depressive symptoms, attachment insecurity and social support. This study included eleven clients, suffering from PDD followed in an outpatient setting, at the Sainte-Anne hospital in Paris. The assessments were conducted on three levels: Depressive symptomatology (MINI, BDI-II), Attachment (RSQ) and S
{"title":"Thérapie Intégrée d’Attachement pour le trouble dépressif persistant : une étude pilote","authors":"Lana Kheirallah , Jean Belbeze , Hassan Rahioui","doi":"10.1016/j.amp.2024.11.005","DOIUrl":"10.1016/j.amp.2024.11.005","url":null,"abstract":"<div><div>Persistent depressive disorder (PDD), newly developed in DSM-5, merges the diagnoses of chronic major depressive disorder with that of dysthymia. In comparison with the characterized depressive episode, PDD is distinguished by a more marked negative impact on the quality of life, a greater risk of hospitalization and suicide attempts, an often-earlier onset, and a duration of several years to several decades. The treatment of PDD is faced with a high rate of treatment failure or partial remission. In terms of psychotherapy, the only specific psychotherapy adapted to chronic depression is the Cognitive-Behavioral Analysis System of Psychotherapy (CBASP). The initial trial showed that it had effects comparable to those of antidepressants and significantly increased efficacy when combined with medication. Subsequent trials, however, showed mixed results. Until now, PDD does not seem to answer to any know validated therapy for depression. One of the hypotheses that can explain this lack of results is attachment insecurity. Indeed, attachment insecurity is increasingly tackled in literature without being taken into consideration in conventional therapies. Although depression is multifactorial in origin, we now know that insecure attachment is a major risk factor for developing depression. In previous studies, insecure attachment is significantly associated with long-term depression. Considering this, the Attachment Integrated Therapy was adapted for PDD from an attachment-based approach. We felt it was essential to integrate the attachmental dimension in this conception since we raise relational problems, especially those that originate in early relationships. AIT is a time-limited therapy that was developed to support clients with insecure attachment whose security requires a direct and profound restructuring of attachment. AIT focuses mainly on what underlies the activation of the attachment system (in the event of threats to the relationship with the attachment figure), namely the representations of the self and of others by working on the concepts of self-confidence and confidence in others and their link with self-esteem. Secondarily, by enabling the patient to develop attachment interaction skills. To achieve these two objectives, the AIT was developed in line with Bowlby's recommendations. Although Bowlby did not develop a therapy founded on his theory, he nevertheless identified five therapeutic tasks that can guide the attachment-oriented therapist in shaping their work. The purpose of the study was to assess the results of AIT on PDD, found at the beginning (T1) at end of therapy (T2), and one year after therapy (T3) on three levels: depressive symptoms, attachment insecurity and social support. This study included eleven clients, suffering from PDD followed in an outpatient setting, at the Sainte-Anne hospital in Paris. The assessments were conducted on three levels: Depressive symptomatology (MINI, BDI-II), Attachment (RSQ) and S","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 789-796"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.amp.2024.11.014
Noémie Sudol , Mathilde Moisseron-Baudé , Charles Martin-Krumm , Christian Heslon , Tristan Hamonniere
Context
Therapists must manage high emotional demands due to the nature of their work. Emotional regulation is crucial not only for their personal well-being but also for the quality of the therapeutic relationship. Ineffective emotional regulation can compromise the therapeutic relationship and increase the risk of burnout. While many studies have explored emotional regulation by therapists during sessions, few have investigated how these emotions are managed outside of sessions, particularly through the social sharing of emotions (SSE) after an interaction with a patient. SSE allows people to express and share emotions with their social environment, which can help regulate negative emotions and strengthen social bonds.
Materials and methods
This study aims to explore the use of SSE among therapists. A sample of 140 French psychologists completed an online questionnaire on the characteristics of emotional sharing outside of therapy following emotions felt during a session. Participants were asked to recall a negative emotional event related to their therapeutic relationship with a patient. Then, they described the intensity and valence of the emotions experienced, and their use of SSE (sharing partner, frequency, and other modalities). Data were analyzed using descriptive statistics and correlations.
Results
In total, 98.57% of participants engaged in SSE after emotionally charged events related to their practice, primarily on the same day as the event. The most frequent sharing partners were colleagues (62.3%) and life partners (55.1%), followed by peer therapists and supervisors. On average, SSE was initiated by the participants themselves and occurred shortly after the emotional event. The frequency of sharing was positively correlated with the intensity of the emotions felt (emotional intensity at the time of the event: tau = 0.245; p < 0.001 and emotional intensity at the time of the study: tau = 0.151; p = 0.026). However, there was no significant correlation with the timing of sharing or its exhaustiveness. Higher emotional intensity was associated with more frequent SSE, suggesting an increased need for sharing when facing intense emotions.
Conclusion
The results show that therapists widely use SSE as an emotional regulation strategy, primarily with colleagues and life partners. This highlights the importance of this emotional regulation strategy in their professional practice. Sharing plays a crucial role in providing emotional support, strengthening professional bonds, and facilitating the management of difficult emotions. However, sharing can sometimes become repetitive and unresolved, leading to rumination. Furthermore, excessive sharing with close ones raises ethical and professional concerns, as well as emotional repercussions for the surr
由于治疗师的工作性质，他们必须管理高情绪需求。情绪调节不仅对他们的个人健康至关重要，而且对治疗关系的质量也至关重要。无效的情绪调节会损害治疗关系，增加倦怠的风险。虽然许多研究都探讨了治疗师在治疗期间的情绪调节，但很少有人研究在治疗之外如何管理这些情绪，特别是在与患者互动后通过情绪的社会分享（SSE）。SSE允许人们与他们的社会环境表达和分享情绪，这有助于调节负面情绪，加强社会联系。材料与方法本研究旨在探讨心理治疗师对自我情感体验的使用。140名法国心理学家完成了一份关于治疗外情感分享特征的在线调查问卷，调查对象是在治疗期间感受到的情绪。参与者被要求回忆与他们与病人的治疗关系有关的负面情绪事件。然后，他们描述了所经历的情绪的强度和效价，以及他们对SSE（分享伴侣、频率和其他模式）的使用。使用描述性统计和相关性分析数据。结果98.57%的被试在经历了与练习相关的情绪刺激事件后，主要发生在事件当天。最常见的共享伙伴是同事（62.3%）和生活伴侣（55.1%），其次是同伴治疗师和主管。平均而言，SSE是由参与者自己发起的，发生在情绪事件发生后不久。分享频率与感受到的情绪强度呈正相关（事件发生时的情绪强度：tau = 0.245; p < 0.001；研究发生时的情绪强度：tau = 0.151; p = 0.026）。然而，与分享的时间或其穷竭性没有显著的相关性。较高的情绪强度与更频繁的SSE相关，这表明面对强烈情绪时，分享的需求增加。结论心理治疗师普遍使用SSE作为情绪调节策略，主要针对同事和生活伴侣。这突出了这种情绪调节策略在他们的专业实践中的重要性。分享在提供情感支持、加强专业联系和促进管理困难情绪方面起着至关重要的作用。然而，分享有时会变得重复和未解决，导致沉思。此外，与亲密的人过度分享会引发道德和专业问题，以及对周围环境的情感影响。重要的是要优先考虑SSE的专业设置，以最大限度地提高其效益，同时最大限度地降低情绪过载和共同反思的风险。因此，该研究强调了促进一个专业环境的重要性，这种环境鼓励同事或同伴之间的社交情绪分享，同时避免亲密的人过度参与。未来的研究应该探索如何构建这种分享，以最大限度地提高情感和职业利益，同时最大限度地降低情绪过载的风险和对亲密关系的间接影响。有针对性的干预措施，如定期监督和同伴支持小组，可以加强治疗师的情绪恢复能力，提高他们的职业幸福感，进而提高为患者提供的护理质量。
{"title":"Le partage social des émotions chez 140 psychologues-psychothérapeutes français","authors":"Noémie Sudol , Mathilde Moisseron-Baudé , Charles Martin-Krumm , Christian Heslon , Tristan Hamonniere","doi":"10.1016/j.amp.2024.11.014","DOIUrl":"10.1016/j.amp.2024.11.014","url":null,"abstract":"<div><h3>Context</h3><div>Therapists must manage high emotional demands due to the nature of their work. Emotional regulation is crucial not only for their personal well-being but also for the quality of the therapeutic relationship. Ineffective emotional regulation can compromise the therapeutic relationship and increase the risk of burnout. While many studies have explored emotional regulation by therapists during sessions, few have investigated how these emotions are managed outside of sessions, particularly through the social sharing of emotions (SSE) after an interaction with a patient. SSE allows people to express and share emotions with their social environment, which can help regulate negative emotions and strengthen social bonds.</div></div><div><h3>Materials and methods</h3><div>This study aims to explore the use of SSE among therapists. A sample of 140 French psychologists completed an online questionnaire on the characteristics of emotional sharing outside of therapy following emotions felt during a session. Participants were asked to recall a negative emotional event related to their therapeutic relationship with a patient. Then, they described the intensity and valence of the emotions experienced, and their use of SSE (sharing partner, frequency, and other modalities). Data were analyzed using descriptive statistics and correlations.</div></div><div><h3>Results</h3><div>In total, 98.57% of participants engaged in SSE after emotionally charged events related to their practice, primarily on the same day as the event. The most frequent sharing partners were colleagues (62.3%) and life partners (55.1%), followed by peer therapists and supervisors. On average, SSE was initiated by the participants themselves and occurred shortly after the emotional event. The frequency of sharing was positively correlated with the intensity of the emotions felt (emotional intensity at the time of the event: tau<!--> <!-->=<!--> <!-->0.245; <em>p</em> <!--><<!--> <!-->0.001 and emotional intensity at the time of the study: tau<!--> <!-->=<!--> <!-->0.151; <em>p</em> <!-->=<!--> <!-->0.026). However, there was no significant correlation with the timing of sharing or its exhaustiveness. Higher emotional intensity was associated with more frequent SSE, suggesting an increased need for sharing when facing intense emotions.</div></div><div><h3>Conclusion</h3><div>The results show that therapists widely use SSE as an emotional regulation strategy, primarily with colleagues and life partners. This highlights the importance of this emotional regulation strategy in their professional practice. Sharing plays a crucial role in providing emotional support, strengthening professional bonds, and facilitating the management of difficult emotions. However, sharing can sometimes become repetitive and unresolved, leading to rumination. Furthermore, excessive sharing with close ones raises ethical and professional concerns, as well as emotional repercussions for the surr","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 797-806"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.amp.2024.09.026
Benoit Brun , Fabrice Berna , Jean-Marie Danion
For some twenty years now, the individual project and, more broadly, life's project, have informed the practices of caregivers and social workers within social and medico-social services. While project-based care has been the subject of considerable interest in the literature, we felt it would be useful to contribute to and clarify the meaning of these different concepts and the way in which projects influence the practice of social and mental health care. We also wanted to discuss more specifically the care of persons with mental disabilities. A psychiatric handicap may indeed appear to be an obstacle for the project methodology. However, these potential obstacles must be weighed against the prospects offered by the concept of recovery in mental health. Finally, we wanted to examine the ethical issues involved in caring for these persons, which seems to be justified by the fact that it enables those patients to achieve a “good life”, which also requires us to question the concept of autonomy.
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Pub Date : 2025-10-01DOI: 10.1016/j.amp.2025.05.003
Emmanuel Drouin , Marion Hendrickx
This article explores the fundamental importance of clinical observation in psychiatry by assessing a case report drafted by Gaëtan Gatian de Clérambault (1872–1934) in 1901, during his internship at the Sainte-Anne Asylum (Paris, France). The detailed observation of patient M.’s complex clinical picture illustrates the method based on questioning and observation developed by de Clérambault under the influence of his mentors [notably Valentin Magnan (1835–1916)]. This approach was characterized by meticulous attention to the details of the patient's behaviour and discourse and had a profound influence on the French school of psychiatry–particularly through its impact on Jacques Lacan (1901–1981). This article highlights the importance of clinical observation in psychiatry training and emphasizes the need to learn how to “look” before making a diagnosis. It argues that an approach based on close observation and apprenticeship is essential for maintaining the richness and depth of psychiatric practice, faced with the current trend towards the rapid categorization of mental disorders. The article closes by emphasizing the importance of preserving this legacy in contemporary psychiatric training and practice.
本文通过评估Gaëtan Gatian de clacimrambault(1872-1934) 1901年在法国巴黎圣安妮精神病院实习期间起草的一份病例报告，探讨了临床观察在精神病学中的根本重要性。对病人M.复杂的临床图像的详细观察，说明了de cl rambault在其导师（特别是Valentin Magnan(1835-1916)）的影响下发展起来的基于提问和观察的方法。这种方法的特点是对病人行为和话语细节的细致关注，对法国精神病学学派产生了深远的影响，尤其是对雅克·拉康（Jacques Lacan, 1901-1981）的影响。这篇文章强调了临床观察在精神病学培训中的重要性，并强调了在做出诊断之前学会如何“看”的必要性。它认为，面对当前精神障碍快速分类的趋势，基于密切观察和学徒制的方法对于保持精神病学实践的丰富性和深度至关重要。文章最后强调了在当代精神病学培训和实践中保留这一遗产的重要性。
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The accurate identification of patients is a serious global healthcare concern. Errors in this regard may have egregious consequences, such as administering the wrong medication to a patient, using an incorrect blood type for a blood transfusion, or assigning newborns to the wrong parents. To reduce the occurrence of these types of incidents, identity bracelets are commonly issued to patients upon their admission into a hospital setting. However, just how diligently this procedure is followed by staff, and how aware patients are of the importance of an identity bracelet as part of their hospital admission process, is rarely quantified. Identity bracelets are particularly important in psychiatry due to the nature of severe mental disorders, which can make it difficult or even impossible for the patients to confirm their identity. However, bracelets can be refused by psychiatric patients and their use can cause reluctance among caregivers.
Objectives
This study aims to assess patients’ and staff's awareness, opinion, and perception of the protocols of assignment of identity bracelets in a department of a public psychiatric hospital (Ville Évrard hospital, France).
Materials and methods
In this pilot, single-center study, both patients and staff members completed either a paper- or web-based questionnaire. The questionnaires focused on their understanding and perception of patient identification procedures, particularly the use of identity bracelets.
Results
(1) Regarding the staff survey, 42 participants, aged 20 to 65 years, were included: 26.2% were doctors, 21.4% secretaries, 19.0% nurses, 9.5% psychologists, 7.1% social workers, and 16.7% from other professions. On average (standard deviation), these staff members had worked in the Ville Évrard hospital for 6.9 years (7.4). Only 19.0% of respondents reported having a good or excellent understanding of the patient identification procedure. However, 72.5% considered the procedure to be useful. Notably, the majority of staff members (66.7%) reported that identity bracelets were not used in their department. (2) Regarding the patient survey, a total of 68 patients participated. For the majority of patients (65.7%), identity monitoring presented no disadvantages, and some even felt reassured by it. However, a small minority considered it was a means of data collection (2.9%) and a surveillance system (2.9%) that infringed upon their freedom. The majority of patients was familiar with identity bracelets (88.2%) and held a positive opinion of them (56.7%). However, only a minority of patients (10.3%) reported being offered the bracelet during their psychiatric hospitalization. Interestingly, 80.9% of these same patients reported having worn a bracelet while at general medical care services. At the end of the questionnaire, patients recommended two things: discreetly calling patients asid
{"title":"L’identitovigilance en psychiatrie","authors":"Samir Jabri , Aurélia Horpin , Fanny Thomas , Dominique Januel , Virginie Moulier , Noomane Bouaziz","doi":"10.1016/j.amp.2024.01.016","DOIUrl":"10.1016/j.amp.2024.01.016","url":null,"abstract":"<div><h3>Background</h3><div>The accurate identification of patients is a serious global healthcare concern. Errors in this regard may have egregious consequences, such as administering the wrong medication to a patient, using an incorrect blood type for a blood transfusion, or assigning newborns to the wrong parents. To reduce the occurrence of these types of incidents, identity bracelets are commonly issued to patients upon their admission into a hospital setting. However, just how diligently this procedure is followed by staff, and how aware patients are of the importance of an identity bracelet as part of their hospital admission process, is rarely quantified. Identity bracelets are particularly important in psychiatry due to the nature of severe mental disorders, which can make it difficult or even impossible for the patients to confirm their identity. However, bracelets can be refused by psychiatric patients and their use can cause reluctance among caregivers.</div></div><div><h3>Objectives</h3><div>This study aims to assess patients’ and staff's awareness, opinion, and perception of the protocols of assignment of identity bracelets in a department of a public psychiatric hospital (Ville Évrard hospital, France).</div></div><div><h3>Materials and methods</h3><div>In this pilot, single-center study, both patients and staff members completed either a paper- or web-based questionnaire. The questionnaires focused on their understanding and perception of patient identification procedures, particularly the use of identity bracelets.</div></div><div><h3>Results</h3><div>(1) Regarding the staff survey, 42 participants, aged 20 to 65 years, were included: 26.2% were doctors, 21.4% secretaries, 19.0% nurses, 9.5% psychologists, 7.1% social workers, and 16.7% from other professions. On average (standard deviation), these staff members had worked in the Ville Évrard hospital for 6.9 years (7.4). Only 19.0% of respondents reported having a good or excellent understanding of the patient identification procedure. However, 72.5% considered the procedure to be useful. Notably, the majority of staff members (66.7%) reported that identity bracelets were not used in their department. (2) Regarding the patient survey, a total of 68 patients participated. For the majority of patients (65.7%), identity monitoring presented no disadvantages, and some even felt reassured by it. However, a small minority considered it was a means of data collection (2.9%) and a surveillance system (2.9%) that infringed upon their freedom. The majority of patients was familiar with identity bracelets (88.2%) and held a positive opinion of them (56.7%). However, only a minority of patients (10.3%) reported being offered the bracelet during their psychiatric hospitalization. Interestingly, 80.9% of these same patients reported having worn a bracelet while at general medical care services. At the end of the questionnaire, patients recommended two things: discreetly calling patients asid","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 835-839"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ageing is often presented solely through the lens of loss and bereavement. When mental disorders occur in the elderly, the “deficit” approach results in the overconsumption of psychotropic drugs, implicitly confirming the lack of hope felt by others. The societal proposals for assisting people in death, that sometimes result from this, overshadow the profound experience of the elderly, where a number of studies have confirmed that it is possible to provide them with an outlook for hope. The recovery paradigm has contributed to bringing forth a new perspective for people with “severe” mental disorders, focused on “empowerment” and “connectedness” with the social world. Can this also be relevant for elderly people even though the pending horizon of death is an undeniable reality of their experience? Several studies have confirmed the value of this paradigm for informing interventions in this population, particularly through narrative programs.
Objectives
Based on a narrative group proposal of guided autobiography, we wanted to clarify to what extent the central dimensions of recovery such as hope, empowerment and “connection” could be taken into account and highlighted in the care of depressed elderly people.
Method
A ten-session group guided autobiography program, using written and oral communication, was developed and proposed to 3 groups of from 5 to 8 participants in a psychiatric day hospitalization unit for the elderly. In weekly one-and-a-half hour sessions, participants discussed and wrote about their life experiences in relation to a given theme. The 10 themes – one per session – had been selected through working with depressed elderly people during a pre-study meeting: Time, Family and Relatives, Work and Activity, Money, Sex and Gender, Food, Body and Health, Death, Travel, and Arts. Five participants in each group were able to complete the entire evaluation process. At the beginning and end of the program, their mood was evaluated with the Montgomery-Åsberg Depression Rating Scale, and relation to time was assessed by the Zimbardo Time Perspective Inventory. Observation grids were used to track the changes in people's participation and the characteristics of their texts. At the end of the 10 sessions, an interview was conducted with each person which was subsequently analyzed according to the Interpretative Phenomenological Analysis (IPA) method, in order to reconstitute their experience.
Results
In addition to the symptomatic improvement measured with the MADRS, the observation grids and The Time Perspective profiles suggest changes indicative of recovery processes in almost all the individuals. The analysis of the interviews also highlights evidence of experiential recovery.
Discussion
The therapeutic group proposal would appear to favor several dimensions of recovery, such as hope, connectio
{"title":"Quel rétablissement chez la personne âgée dépressive ? Effets d’un dispositif groupal d’autobiographie guidée","authors":"Ketty Steward , Arnaud Plagnol , Renald Asvazadourian","doi":"10.1016/j.amp.2025.04.004","DOIUrl":"10.1016/j.amp.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Ageing is often presented solely through the lens of loss and bereavement. When mental disorders occur in the elderly, the “deficit” approach results in the overconsumption of psychotropic drugs, implicitly confirming the lack of hope felt by others. The societal proposals for assisting people in death, that sometimes result from this, overshadow the profound experience of the elderly, where a number of studies have confirmed that it is possible to provide them with an outlook for hope. The recovery paradigm has contributed to bringing forth a new perspective for people with “severe” mental disorders, focused on “empowerment” and “connectedness” with the social world. Can this also be relevant for elderly people even though the pending horizon of death is an undeniable reality of their experience? Several studies have confirmed the value of this paradigm for informing interventions in this population, particularly through narrative programs.</div></div><div><h3>Objectives</h3><div>Based on a narrative group proposal of guided autobiography, we wanted to clarify to what extent the central dimensions of recovery such as hope, empowerment and “connection” could be taken into account and highlighted in the care of depressed elderly people.</div></div><div><h3>Method</h3><div>A ten-session group guided autobiography program, using written and oral communication, was developed and proposed to 3 groups of from 5 to 8 participants in a psychiatric day hospitalization unit for the elderly. In weekly one-and-a-half hour sessions, participants discussed and wrote about their life experiences in relation to a given theme. The 10 themes – one per session – had been selected through working with depressed elderly people during a pre-study meeting: Time, Family and Relatives, Work and Activity, Money, Sex and Gender, Food, Body and Health, Death, Travel, and Arts. Five participants in each group were able to complete the entire evaluation process. At the beginning and end of the program, their mood was evaluated with the Montgomery-Åsberg Depression Rating Scale, and relation to time was assessed by the Zimbardo Time Perspective Inventory. Observation grids were used to track the changes in people's participation and the characteristics of their texts. At the end of the 10 sessions, an interview was conducted with each person which was subsequently analyzed according to the Interpretative Phenomenological Analysis (IPA) method, in order to reconstitute their experience.</div></div><div><h3>Results</h3><div>In addition to the symptomatic improvement measured with the MADRS, the observation grids and The Time Perspective profiles suggest changes indicative of recovery processes in almost all the individuals. The analysis of the interviews also highlights evidence of experiential recovery.</div></div><div><h3>Discussion</h3><div>The therapeutic group proposal would appear to favor several dimensions of recovery, such as hope, connectio","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 807-812"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.amp.2025.03.003
Céline Leclercq, Isabelle Hansez
<div><div>Due to the increasing number of burnout cases, prevention and management of burnout have become major concerns, underscoring the importance of further research to better delineate this phenomenon. To provide a contemporary understanding rooted in the experiences of workers, this article introduces a qualitative approach to the experience of burnout as a temporal process. Some authors emphasize burnout as a state, while others identify it as a process integrating symptomatology alone or associating it with changes in the work context. According to a temporal perspective focused on both symptomatology and the professional context, a narrative review of the literature was conducted to investigate the evolution of burnout. The bibliographic databases Medline (Ovid) and Psycinfo (Ovid), as well as Google Scholar, were consulted. Inclusion and exclusion criteria were defined to select relevant studies, including thematic relevance, adult population, qualitative or descriptive methodology while excluding papers lacking full-text availability and irrelevant contexts. A narrative analysis was conducted, involving a thorough examination of the methodologies, findings, and limitations of the chosen studies. Results were synthesized and classified to discern common themes concerning the temporal progression of burnout. This research identified four stages that depict this temporal process: engagement and enthusiasm with a high job ideal (stage 0), weakening of the ideal (stage 1), protective withdrawal (stage 2) and confirmed burnout (stage 3). At stage 0, individuals are fully engaged in their work, driven by idealistic enthusiasm. They invest a lot of energy in their tasks, considering work as a major source of personal accomplishment. At this stage, signs of burnout are rare. In stage 1, professional ideal begins to show signs of weakness. Work hindrance stressors and conflicting events start to diminish initial enthusiasm. Despite efforts exerted to exhaustion, individuals are confronted with obstacles that question their progress and professional fulfillment, resulting in a feeling of stagnation and doubt. At stage 2, a protective withdrawal occurs. What was once a source of work satisfaction is now perceived as a threat. Individuals develop strategies to protect themselves from harmful situations and begin to adopt an increasing cynicism towards organizational values. Work-related issues also start to impact their personal lives. Finally, in stage 3, burnout is confirmed. The ideal of a fulfilling job has completely disappeared, and individuals find themselves unable to maintain their usual functioning. Often triggered by a critical event, burnout manifests as intense emotional and physical distress, potentially leading to sick leave and an increased risk of depression. Doubts arise about their identity and personal worth, marking the beginning of an awareness and a reassessment of their relationship with work. Without being prescriptive or e
{"title":"Les stades du burnout selon une perspective temporelle : revue narrative","authors":"Céline Leclercq, Isabelle Hansez","doi":"10.1016/j.amp.2025.03.003","DOIUrl":"10.1016/j.amp.2025.03.003","url":null,"abstract":"<div><div>Due to the increasing number of burnout cases, prevention and management of burnout have become major concerns, underscoring the importance of further research to better delineate this phenomenon. To provide a contemporary understanding rooted in the experiences of workers, this article introduces a qualitative approach to the experience of burnout as a temporal process. Some authors emphasize burnout as a state, while others identify it as a process integrating symptomatology alone or associating it with changes in the work context. According to a temporal perspective focused on both symptomatology and the professional context, a narrative review of the literature was conducted to investigate the evolution of burnout. The bibliographic databases Medline (Ovid) and Psycinfo (Ovid), as well as Google Scholar, were consulted. Inclusion and exclusion criteria were defined to select relevant studies, including thematic relevance, adult population, qualitative or descriptive methodology while excluding papers lacking full-text availability and irrelevant contexts. A narrative analysis was conducted, involving a thorough examination of the methodologies, findings, and limitations of the chosen studies. Results were synthesized and classified to discern common themes concerning the temporal progression of burnout. This research identified four stages that depict this temporal process: engagement and enthusiasm with a high job ideal (stage 0), weakening of the ideal (stage 1), protective withdrawal (stage 2) and confirmed burnout (stage 3). At stage 0, individuals are fully engaged in their work, driven by idealistic enthusiasm. They invest a lot of energy in their tasks, considering work as a major source of personal accomplishment. At this stage, signs of burnout are rare. In stage 1, professional ideal begins to show signs of weakness. Work hindrance stressors and conflicting events start to diminish initial enthusiasm. Despite efforts exerted to exhaustion, individuals are confronted with obstacles that question their progress and professional fulfillment, resulting in a feeling of stagnation and doubt. At stage 2, a protective withdrawal occurs. What was once a source of work satisfaction is now perceived as a threat. Individuals develop strategies to protect themselves from harmful situations and begin to adopt an increasing cynicism towards organizational values. Work-related issues also start to impact their personal lives. Finally, in stage 3, burnout is confirmed. The ideal of a fulfilling job has completely disappeared, and individuals find themselves unable to maintain their usual functioning. Often triggered by a critical event, burnout manifests as intense emotional and physical distress, potentially leading to sick leave and an increased risk of depression. Doubts arise about their identity and personal worth, marking the beginning of an awareness and a reassessment of their relationship with work. Without being prescriptive or e","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 8","pages":"Pages 818-828"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.amp.2025.04.009
Dominick Gamache , Yann le Corff , Claudia Savard
<div><h3>Introduction</h3><div>Research and clinical practice in the field of personality disorders (PD) have taken a major and decisive turn in recent years with the publication of the Alternative Model of Personality Disorders (AMPD) in the fifth edition of the <em>Diagnostic and Statistical Manual of Mental Disorders</em> and with the introduction of a purely dimensional model in the latest edition of the International Classification of Diseases (ICD-11). Along with the general criteria of PD described in the previous versions of the DSM, the AMPD defines personality pathology based on two main dimensional criteria. The first one refers to the severity of personality dysfunction in the spheres of self (including Identity and Self-direction elements) and interpersonal relationships (referring to Empathy and Intimacy elements). Each element can be classified in a severity level ranging from 0 (few or no alteration) to 4 (extreme alteration). The second criterion describes five pathological domains of personality, broken down into 25 pathological facets: Negative affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. To diagnose a PD in the AMPD model, a person must present a moderate alteration (level 2) in at least two elements and a significant elevation in at least one pathological facet. The AMPD is considered a hybrid model as categorical diagnosis of six PDs (antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, schizotypal) can be made using algorithms including specific pathological facets for each PD. For its part, the model developed in the ICD-11 relies on a general criterion of personality dysfunction to establish the presence and intensity of PD based on a five-point severity continuum: (a) no personality disorder, (b) presence of personality difficulties (without a clear personality disorder), (c) mild personality disorder, (d) moderate personality disorder, or (e) severe personality disorder. Optionally, the clinician can also indicate the presence of five trait domains qualifiers, akin to those found in the AMPD: Negative affectivity, Detachment, Dissociality, Disinhibition, and Anankastia. A specifier for borderline patterns can also be applied. Despite being relatively recent, these models have already generated a lot of interest in the PD research community; however, there are only limited published works devoted to these models intended for French-speaking researchers and clinicians.</div></div><div><h3>Objective</h3><div>The aim of this article is to provide a guide for French-speaking researchers and clinicians, to promote a smooth transition between the traditional categorical approach and the two emerging dimensional models of PD described above.</div></div><div><h3>Method</h3><div>After a brief introduction to the two dimensional models and their respective scoring procedures for the diagnosis of PD, the similarities and distinctions between categorical PD diagnoses and these new dimensiona
{"title":"Du catégoriel au dimensionnel : description et illustration clinique pour favoriser une transition harmonieuse dans la conceptualisation des troubles de la personnalité","authors":"Dominick Gamache , Yann le Corff , Claudia Savard","doi":"10.1016/j.amp.2025.04.009","DOIUrl":"10.1016/j.amp.2025.04.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Research and clinical practice in the field of personality disorders (PD) have taken a major and decisive turn in recent years with the publication of the Alternative Model of Personality Disorders (AMPD) in the fifth edition of the <em>Diagnostic and Statistical Manual of Mental Disorders</em> and with the introduction of a purely dimensional model in the latest edition of the International Classification of Diseases (ICD-11). Along with the general criteria of PD described in the previous versions of the DSM, the AMPD defines personality pathology based on two main dimensional criteria. The first one refers to the severity of personality dysfunction in the spheres of self (including Identity and Self-direction elements) and interpersonal relationships (referring to Empathy and Intimacy elements). Each element can be classified in a severity level ranging from 0 (few or no alteration) to 4 (extreme alteration). The second criterion describes five pathological domains of personality, broken down into 25 pathological facets: Negative affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. To diagnose a PD in the AMPD model, a person must present a moderate alteration (level 2) in at least two elements and a significant elevation in at least one pathological facet. The AMPD is considered a hybrid model as categorical diagnosis of six PDs (antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, schizotypal) can be made using algorithms including specific pathological facets for each PD. For its part, the model developed in the ICD-11 relies on a general criterion of personality dysfunction to establish the presence and intensity of PD based on a five-point severity continuum: (a) no personality disorder, (b) presence of personality difficulties (without a clear personality disorder), (c) mild personality disorder, (d) moderate personality disorder, or (e) severe personality disorder. Optionally, the clinician can also indicate the presence of five trait domains qualifiers, akin to those found in the AMPD: Negative affectivity, Detachment, Dissociality, Disinhibition, and Anankastia. A specifier for borderline patterns can also be applied. Despite being relatively recent, these models have already generated a lot of interest in the PD research community; however, there are only limited published works devoted to these models intended for French-speaking researchers and clinicians.</div></div><div><h3>Objective</h3><div>The aim of this article is to provide a guide for French-speaking researchers and clinicians, to promote a smooth transition between the traditional categorical approach and the two emerging dimensional models of PD described above.</div></div><div><h3>Method</h3><div>After a brief introduction to the two dimensional models and their respective scoring procedures for the diagnosis of PD, the similarities and distinctions between categorical PD diagnoses and these new dimensiona","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 696-702"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.amp.2024.08.020
Nadine Larivière , Jacinthe Lavoie-Tremblay , Lionel Cailhol , Pierre David
Introduction
In the field of Cluster B personality disorders (PDs), studies have primarily focused on borderline personality disorder (BPD), predominantly including women. Moreover, studies comparing various Cluster B PDs have examined some clinical features between men and women, particularly symptoms, without considering social characteristics.
Objectives
This study aims to compare the social and clinical characteristics of women and men with Cluster B PDs, using a database from a specialized service for persons with a PD.
Methods
Clinical variables examined included the severity of psychopathology as assessed by clinicians and perceived PD symptoms. These were measured using validated tools and entered into the service's database. Social variables included for example marital status and social network, and were systematically collected upon entry into the service. Additionally, therapy goals, part of the initial assessment, were qualitatively compared.
Results
Socially, there was no statistically significant difference between men (n = 103) and women (n = 283) regarding marital status, education, source of income, and number of leisure activities. Men had a more limited social network than women (P < 0.001). According to the Borderline Personality Questionnaire (BPQ), more women scored in the BPD diagnostic range compared to men (P < 0.001). Analysis of BPQ dimensions showed that women exhibited more dissociative symptoms (P = 0.04). Also, the proportion of women reporting substance use in the last month was significantly higher (P = 0.04). Regarding therapy goals, improving relationships with oneself and others was most common among women, while men's goals mainly focused on managing symptoms and activities of daily life (e.g., finding a job, adopting healthier lifestyle habits).
Conclusion
This study contributes to considering sex and gender in service provision for people with Cluster B PDs. While there are several similarities between men and women, some social differences support the addition of interventions targeting everyday life elements, such as lifestyle habits for men.
{"title":"Comparaison de caractéristiques sociales et cliniques en fonction du sexe chez des personnes ayant un trouble de la personnalité du groupe B","authors":"Nadine Larivière , Jacinthe Lavoie-Tremblay , Lionel Cailhol , Pierre David","doi":"10.1016/j.amp.2024.08.020","DOIUrl":"10.1016/j.amp.2024.08.020","url":null,"abstract":"<div><h3>Introduction</h3><div>In the field of Cluster B personality disorders (PDs), studies have primarily focused on borderline personality disorder (BPD), predominantly including women. Moreover, studies comparing various Cluster B PDs have examined some clinical features between men and women, particularly symptoms, without considering social characteristics.</div></div><div><h3>Objectives</h3><div>This study aims to compare the social and clinical characteristics of women and men with Cluster B PDs, using a database from a specialized service for persons with a PD.</div></div><div><h3>Methods</h3><div>Clinical variables examined included the severity of psychopathology as assessed by clinicians and perceived PD symptoms. These were measured using validated tools and entered into the service's database. Social variables included for example marital status and social network, and were systematically collected upon entry into the service. Additionally, therapy goals, part of the initial assessment, were qualitatively compared.</div></div><div><h3>Results</h3><div>Socially, there was no statistically significant difference between men (<em>n</em> <!-->=<!--> <!-->103) and women (<em>n</em> <!-->=<!--> <!-->283) regarding marital status, education, source of income, and number of leisure activities. Men had a more limited social network than women (<em>P</em> <!--><<!--> <!-->0.001). According to the Borderline Personality Questionnaire (BPQ), more women scored in the BPD diagnostic range compared to men (<em>P</em> <!--><<!--> <!-->0.001). Analysis of BPQ dimensions showed that women exhibited more dissociative symptoms (<em>P</em> <!-->=<!--> <!-->0.04). Also, the proportion of women reporting substance use in the last month was significantly higher (<em>P</em> <!-->=<!--> <!-->0.04). Regarding therapy goals, improving relationships with oneself and others was most common among women, while men's goals mainly focused on managing symptoms and activities of daily life (e.g., finding a job, adopting healthier lifestyle habits).</div></div><div><h3>Conclusion</h3><div>This study contributes to considering sex and gender in service provision for people with Cluster B PDs. While there are several similarities between men and women, some social differences support the addition of interventions targeting everyday life elements, such as lifestyle habits for men.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 7","pages":"Pages 715-724"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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