Les implications des modèles explicatifs biologiques sur les pratiques cliniques en psychiatrie

Les modèles explicatifs de nature biologique connaissent une popularité croissante en psychiatrie. La raison de cette tendance idéologique est examinée de façon critique et des évidences contradictoires sont soulignées. Une conception exclusivement biologique des troubles psychiatriques semble plus prescriptive que descriptive des faits démontrés. Les modèles biologiques, d'apparence plus «scientifique», exercent une attraction particulière sur les professionnels de formation biomédicale et, en ce sens, comportent des implications importantes pour la pratique psychiatrique. Leurs influences sur la pratique clinique, la formation professionnelle et la recherche sont revues et discutées.The explanatory models of a biological nature are growing in popularity in psychiatry. The reason for this ideological tendency is studied and contradictory evidences are underlined. It seems that an exclusively biological conception of psychiatric disorders is more prescriptive than descriptive of the facts. Biological models, seemingly more "scientific" are particularly of interest to the professionals with a bio-medical training, and, in this sense, bear important implications for the practice of psychiatry. Their influences on clinical practice, professional training and research are reviewed and discussed

La contrainte en psychiatrie: actualités et perspectives

La contrainte reste encore fréquemment utilisée en psychiatrie et tend à être considérée comme une nécessité, face à un patient en danger ayant perdu sa capacité de discernement. Cet article vise à rapporter et à discuter l'état actuel des connaissances scientifiques sur ce sujet. Les différentes mesures associées à la contrainte participent avec la maladie au stress vécu par les patients et pourraient compromettre leur adhésion aux offres de soins. La contrainte exercée, le statut légal et la contrainte ressentie sont trois dimensions à intégrer dans notre réflexion. Des pressions symboliquement négatives, positives ou légales sont exercées sur les patients et conduisent à s'interroger sur le développement d'alternatives à l'usage de la contrainte. L'introduction des directives anticipées dans des lois cantonales suisses pourrait ouvrir la voie à des modalités de collaboration différentes et mieux acceptées par les patients. [Auteurs]]]> Coercion ; Psychiatry ; Commitment of Mentally Ill ; Physician-Patient Relations oai:serval.unil.ch:BIB_B5BBAA6ED093 2022-05-07T01:25:32Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_B5BBAA6ED093 Significant reproductive skew in the facultatively polygynous ant Pheidole pallidula info:doi:10.1046/j.1365-294X.2003.02036.x info:eu-repo/semantics/altIdentifier/doi/10.1046/j.1365-294X.2003.02036.x info:eu-repo/semantics/altIdentifier/pmid/14653800 Fournier, D. Aron, S. Keller, L. info:eu-repo/semantics/article article 2004-01 Molecular Ecology, vol. 13, no. 1, pp. 203-10 info:eu-repo/semantics/altIdentifier/pissn/0962-1083 <![CDATA[Reproductive skew - the extent to which reproduction is unevenly shared between individuals in a social group - varies greatly between and within animal species. In this study, we investigated how queens share parentage in polygynous (multiple queen) colonies of the Mediterranean ant Pheidole pallidula. We used highly polymorphic microsatellites markers to determine parentage of gynes (new queens), males and workers in P. pallidula field colonies. The comparison of the genotypes of young and adult workers revealed a very low queen turnover (less than 2%). The first main finding of the study of reproductive skew in these colonies was that there was a significant departure from equal contribution of queens to gyne, male and worker production. Reproductive skew was greater for male production than for queen and worker production. There was no relationship between the magnitude of the reproductive skew and the number of reproductive queens per colony, their relatedness and the overall colony productivity, some of the factors predicted to influence the extent of reproductive skew. Finally, our study revealed for the first time a trade-off in the relative contribution of nestmate queens to gyne and worker production. The queens contributing more to gyne production contributed significantly less to worker production

La contribution de variables sociales à la prédiction de la dépression postnatale

Vu le fréquent déni de l'importance des facteurs sociaux associés à l'émergence de la dépression postnatale non psychotique, le but de cette étude est de vérifier de façon précise si des variables sociales, mesurées en début de grossesse, contribuent ou non à la prédiction de la dépression postnatale. On a suivi 369 sujets primipares ou secondipares du début de leur grossesse jusqu'au sixième mois après leur accouchement. Les analyses montrent l'importance de la contribution des variables sociales, mesurées en début de grossesse, celles-ci constituant un bon tiers de l'ensemble des variables significatives.Considering the frequent denial of the importance of social factors associated with non psychotic postnatal depression, the objective of this study is to check whether social variables contribute or not to the prediction of postnatal depression. 369 subjects, primiparous or secondiparous, were followed up from early pregnancy up to the sixth month after delivery. Analyses show the importance of the social variables measured at the beginning of the pregnancy, these constituting one third of all the significant variables

Eating and weight related cognitions in people with Schizophrenia : A case control study

BACKGROUND: Patients with antipsychotic-induced weight gain (WG) regularly report on unsuccessful dietary trials, which suggests strong biological weight gain drive that is extremely hard to overcome with thoughts, such that behaviour doesn't change despite some intent to change. The purpose of the present study was to assess cognitions specifically related to restrained eating in severely overweight patients with schizophrenia treated with antipsychotic drugs. METHODS: Forty outpatients with schizophrenia and 40 controls without psychiatric disability were included. Both groups were composed of one subgroup severely overweight (defined as a BMI > 28), and a comparison sample (BMI<28). The revised version of the Mizes Anorectic cognitive questionnaire (MAC-R) was used in this cross-sectional case-control study. RESULTS: Gender was significantly related to eating disorders cognition, women scoring higher than men. Patients with schizophrenia in general scored higher on the MAC-R total scale and on the MAC-R subscale 2, the latter score representing rigid weight regulation and fear of weight gain. When comparing the two groups of subjects with BMI < 28, it appeared that patients with schizophrenia also scored higher on MAC-R total scale, the subscales 2 and 3, the latter subscale 3, indicating altered self control and self-esteem. CONCLUSION: As is the case in weight gain of subjects without schizophrenia, the present results suggest that the cognitive distortions, as assessed by the MAC-R, may play an important role in weight gain also in patients with schizophrenia, and in weight gain associated with antipsychotic pharmacotherapy. Particular attention to these processes may help to improve the management of antipsychotic drugs induced weight gain

Swiss Psychiatrists Beliefs and Attitudes about Cannabis Risks in Psychiatric Patients: Ideologically Determined or Evidence-based?

The objective of this survey was to assess the beliefs of Swiss psychiatrists about the risks associated with cannabis, and to assess their prohibitive attitudes toward their patients. Eighty-two doctors agreed to fill-up the questionnaire. Cluster analysis retained a 3-cluster solution. Cluster 1: "Prohibitionists” believed that cannabis could induce and trigger all forms of psychiatric disorder, and showed a highly prohibitive attitude. Cluster 2: "Causalists” believed that schizophrenia, but not other psychiatric disorders, could be induced and triggered. Cluster 3: "Prudent liberals” did not believe that psychiatric disorders could be induced by cannabis, and were generally less prohibitiv

Perceived coercion and need for hospitalization related to psychiatric admission

Psychiatric hospitalization constitutes a moment of major stress to the point that occurrences of posttraumatic stress disorders have been described. Feelings of coercion are usual, whatever the legal status of admission. Patients may also consider afterwards that they needed hospitalization even if they refused it initially. A cross-sectional survey has been conducted among the inpatients of a Swiss psychiatric hospital to assess their subjective view of admission with emphasis on legal status, perceived coercion and need for hospitalization. Eighty-seven questionnaires were completed and analyzed. Results indicated that 74% of patients felt that they had been under pressure to be hospitalized, whether or not they were involuntarily admitted. Seventy percent felt their admission was necessary. More involuntary patients reported a subjective lack of improvement. Clinicians could decrease feelings of coercion of their patients while discussing need for hospitalization, legal status and subjective feeling of coercion as different dimensions. An argument is presented to favor positive pressure from social environment over legal involuntary commitment in many hospitalization