L’évaluation des bains thérapeutiques dans la prise en charge de la douleur des enfants polyhandicapés en SSR pédiatrique

Pain management for children who have severe neurological diseases (polyhandicap), in a pediatric post-acure care and rehabilitation, is daily and work frequently with palliative approach. Cares for these children, with complex illness are a multidisciplinary approach. Treatments establishment or equipment, intervention, adaptation take place with respect and comfort concern about child or adolescent dignity. For this, drug free techniques are more and more integrated in the pain management in hospitals. Balneotherapy is one of them, essentially used for orthopaedic, rhumatological or neurological diseases (hemiplegia for example). Caregivers doesn’t have specific bath for balneotherapy in our establishment, that why we put in place some bath, called “therapeutic bath” or “relaxation bath”. The impression was a better feeling of comfort and better-being on these children. This encourages us to pursue the study to evaluate the real benefits.     

Psychotraumatologie de la guerre en Ukraine : la question de la prise en charge psychologique des victimes réfugiées ou restées en Ukraine

The war in Ukraine is a major poly-traumatic event, which leads to massive population displacements. The question of the evaluation and psychological care of psychotraumatised people is an urgent matter. As many countries hosting refugees are well endowed with a number of psychologists, some of these interested professionals should mobilise themselves and make themselves known to carry out these clinical acts. Priority should be given to trained and experienced psychologists to support victims. The language barrier will have to be overcome. Initially, it would be desirable to make contact or get closer to local and national refugee centres to facilitate these operations. Face-to-face or remote consultations, as developed during the Covid-19 pandemic, are possible. Reinforcements of available and dedicated psychologists, including remotely, from the countries hosting the most refugees are also desirable. The issue of detection, assessment and care of psychologically traumatised people who remained in the Ukrainian territory is probably even more massive. Whether non-combatants or combatants, part of the international psychological community should mobilise, in addition to local colleagues, to provide them with this psychological help. These humanitarian actions would be feasible depending on the evolution of the conflict. Whether it is psychological support for refugees or people still on the Ukrainian soil, models for organizing and coordinating these actions must be carefully thought out and implemented in an evolving way to optimise their effectiveness.     

Place de la psychothérapie intégrative dans la prise en charge des problématiques de radicalisation

Recent waves of attacks in France have led health and justice professionals to meet, exchange and work together, with a goal that is common: the care of people with radicalization issues. The operationalization of this objective macro makes it possible to distinguish the missions of the different actors at stake. Thus, the question of care requires the definition of the object of intervention, the purpose, rehabilitative and/or therapeutic, and the means available. In this interview, members of the ARCA, Erwan Dieu and Olivier Sorel evoke the place of integrative psychotherapy in the management of radicalization issues. The purpose of this discussion is to clarify the functions and objectives of each of the actors at the interface of people presenting this form of radicalism.     

Les accidents vasculaires cérébraux et la prise en charge psychologique à domicile des personnes qui en sont victimes

Stroke is a major public health issue with a high priority. Prevention plays an important role in reducing the impact of the disease. Although quick health intervention reduces death, it results in an increased number of disabled people. The handicap is not always visible, and requires appropriate strategies for the patient. Such approaches aim to allow patients to stay at home, reducing their time spent in the hospital. However, transitioning from the hospital is always a tricky time, as efforts are necessary to adapt and reorganize around the new everyday life of the affected people. In this context, neuropsychology offers interesting perspectives. In-home care not only allows the patient and their family to better deal with a new perception of the body, but also enables personalized support by bringing care within the intimate environment where they live. Post-stroke cognitive impairment decreases the autonomy and introspective capacities of patients. In Limousin, a trained team of itinerant healthcare professionals (HEMIPASS) was founded in 2010 to support patients and their relatives at home. Psychologists Michèle Chazot-Balcon, Elise Henry and the neurologist Jean-Yves Salle from the University Hospital in Limoges, discuss the semiology of stroke, its possible psychological effects, and how to deal with them from the patient's home.     

Intérêts et limites des hospitalisations séquentielles dans la prise en charge des états de stress post-traumatique

Beyond emergency, many patients with Post-Traumatic-Stress-Disorder may evolve into a lasting alteration of their previous health status consisting of polymorphic and durable psychiatric symptomatology. In the Army, the path of these « psychic wounded » is accompanied by different institutional services from recognition to rehabilitation. Thinking the long term psychiatric accompaniment of these patients recquires to question the place of the different interlocutors. In this works we make a feedback about a sequential hospitalization experience taking place in an Army Instruction Hospital by questioning the contributions as the limits. We emphasize notably the difficulty of empirically establishing and reproducing the validity of an therapeutic intervention.     

Impact de la formation théorique et clinique sur les attitudes de stigmatisation des étudiants en médecine envers la psychiatrie et la pathologie psychiatrique

Objective

The aim of the study was to explore whether a medical student education program and clinical posting in psychiatry had an impact on medical students’ stigmatizing attitudes towards psychiatry and psychiatric disorders.

La place de la compréhension des proverbes et des métaphores dans la compréhension des troubles du cours de la pensée dans la schizophrénie : apport de l’évaluation clinique,de l’imagerie cérébrale fonctionnelle et de la neurophysiologie

According to Bleuler (1911), language impairments were indicative of thought disorders, a fundamental feature of schizophrenia. The objectives of the present review are twofold: (1) to present the clinical interest of the use of the tests of proverbs and metaphors comprehension for the evaluation of the characteristics of thought disorders in schizophrenia, and to highlight the heterogeneity of the forms of their interpretations; (2) to present the results from neuroimaging and neurophysiological studies of metaphor comprehension in order to identify the neurocognitive mechanisms underlying metaphorical language comprehension of patients with schizophrenic disorders. Results from the reviewed clinical applications of proverbs tests showed that thought disorders in individuals with schizophrenia are illustrated by different forms of proverb interpretations: literal, concrete, idiosyncratic, over-inclusiveness and unconventional. Results from the reviewed brain imaging and neurophysiological studies showed that these different forms of figurative misinterpretations may be related to different neurocognitive mechanisms: concreteness appears to be related to the dysfunction of the left inferior frontal gyrus and inverted brain lateralization during metaphor processing in individuals with schizophrenia compared to healthy individuals. During novel metaphor comprehension, which is highly effortful, individuals with schizophrenia, relative to controls, demonstrate increased activation of the right precuneus, a region that mediates complex and highly integrated functions including retrieval of episodic memory and mental imagery. These results may suggest that individuals with schizophrenia use mental imagery to support comprehension of both literal and metaphoric language. Furthermore, it was demonstrated that over-inclusive thinking, which is exhibited by individuals with schizophrenia during figurative language comprehension, could be related to very early right hemispheric hyper-activation (when a left early activation is expected) and to reduced bilateral brain activity during semantic processing. Such as reversed brain activation may explain why the individuals with schizophrenia are relatively over reliant on early-stage coarse or large semantic processing and may be prone to form meanings that are idiosyncratic and highly unconventional.