Los conceptos que inspiran el trabajo de los psicoanalistas de pareja y familia: Estudio preliminar del análisis cuantitativo en el contenido de una encuesta

The author's purpose in the present paper is to explore core psychoanalytic concepts that lend support to clinical practice for the members of the International Association of Psychoanalysis of Couple and Family (AIPPF). To achieve this goal the authors have developed a tool that allows to collect information (self-administered questionnaire), briefly presented. The questionnaire requests each member to sort out important concepts in the five following areas: individual psychoanalysis, intersubjective psychoanalysis, group psychoanalysis, family psychoanalysis, couple psychoanalysis, as well as to outline these concepts on three levels: theory, clinic, practice and technique. The sample obtained corresponds to 22 responses which the authors discuss and analyze in detail. In their conclusions, the authors draw attention to the fact that different theoretical orientations are present in couple and family therapy and that the responses to the questionnaire were pondered and on occasion are original and manifest current notions. It can also be observed that current change in family configurations has marked the standpoint concerning certain clinical aspects and links. The authors conclude by highlighting the value of this work to develop new research on more specific aspects, among which several subjected to a more refined approach in recent studies in the institution are mentioned.En este trabajo los autores se proponen explorar qué conceptos psicoanalíticos centrales que hacen de soporte de la práctica clínica para los miembros de la Asociación Internacional de Psicoanálisis de Pareja y Familia (AIPPF). Para ello los autores han desarrollado un instrumento que permite recolectar la información (cuestionario autoadministrado), que exponen brevemente. En el cuestionario se le solicita a cada miembro que mencione los conceptos de importancia en cinco terrenos: psicoanálisis individual, psicoanálisis intersubjetivo, psicoanálisis de grupo, psicoanálisis de familia, psicoanálisis de pareja, y que especifique dichos conceptos en tres niveles: el de la teoría, el de la clínica, el de la práctica y técnica. La muestra obtenida corresponde a 22 respuestas, que los autores comentan y analizan en detalle. En sus conclusiones, los autores destacan que, respecto de la terapia de pareja y familia, están presentes diferentes orientaciones teóricas, que las respuestas al cuestionario han sido meditadas, y que en ocasiones resultan originales y con un aire de modernidad. También se observa que el cambio en las configuraciones familiares en la actualidad ha dejado una marca en los modos de pensar algunos aspectos de la clínica y de los vínculos. Los autores terminan el trabajo destacando la utilidad de este trabajo para desarrollar nuevas investigaciones sobre aspectos más puntuales, entre los cuales mencionan varios que están siendo objeto de un enfoque más refinado en estudios recientes en la institución

A Novel 8-Predictors Signature to Predict Complicated Disease Course in Pediatric-onset Crohn’s Disease: A Population-based Study

International audienceBackground The identification of patients at high risk of a disabling disease course would be invaluable in guiding initial therapy in Crohn’s disease (CD). Our objective was to evaluate a combination of clinical, serological, and genetic factors to predict complicated disease course in pediatric-onset CD. Methods Data for pediatric-onset CD patients, diagnosed before 17 years of age between 1988 and 2004 and followed more than 5 years, were extracted from the population-based EPIMAD registry. The main outcome was defined by the occurrence of complicated behavior (stricturing or penetrating) and/or intestinal resection within the 5 years following diagnosis. Lasso logistic regression models were used to build a predictive model based on clinical data at diagnosis, serological data (ASCA, pANCA, anti-OmpC, anti-Cbir1, anti-Fla2, anti-Flax), and 369 candidate single nucleotide polymorphisms. Results In total, 156 children with an inflammatory (B1) disease at diagnosis were included. Among them, 35% (n = 54) progressed to a complicated behavior or an intestinal resection within the 5 years following diagnosis. The best predictive model (PREDICT-EPIMAD) included the location at diagnosis, pANCA, and 6 single nucleotide polymorphisms. This model showed good discrimination and good calibration, with an area under the curve of 0.80 after correction for optimism bias (sensitivity, 79%, specificity, 74%, positive predictive value, 61%, negative predictive value, 87%). Decision curve analysis confirmed the clinical utility of the model. Conclusions A combination of clinical, serotypic, and genotypic variables can predict disease progression in this population-based pediatric-onset CD cohort. Independent validation is needed before it can be used in clinical practice