Troubles mentaux et violence

Epidemiologic and clinical studies are presented of persons with mental disorders and a history of violent behavior. Knowledge of the risk factors associated with acts of violence committed by mentally disordered persons is essential for the initiation of preventive programs. The aim of this paper is therefore to introduce epidemiologic and clinical elements useful in assessing these risk factors. Furthermore, intervention strategies are described to deal with violence in mentally ill patients

Comportements violents (Réflexion psychodynamique)

L'auteur s'attache à distinguer dans ce texte les notions d'agressivité et de violence. Il se réfère à la réflexion théorique de Bergeret et donne des illustrations cliniques à propos de deux patients. Une telle différenciation améliore la compréhension des passages à l'acte et favorise mite meilleure prise en charge thérapeutique.In this article, the author seeks to distinguish between the notions of aggressivity and violence. He refers to Bergeret's theories and gives clinical illustrations using two patients. This differentiation will improve comprehension of events leading to acts of violence, and will enable better therapeutic interventions

Le psychiatre face au refus de traitement : une démarche clinique et juridique

La situation de refus de traitement pharmacologique par un patient psychiatrique est explorée dans cet article. Les principes cliniques fondamentaux et le processus dans lequel se trouve engagé le psychiatre sont exposés en articulation avec les principes juridiques et la démarche judiciaire. Des vignettes cliniques illustrent concrètement ces différents aspects.In this article, the authors discuss refusal of treatment by psychiatric patients. Basic clinical principles as well as the process in which the psychiatrist must engage are exposed with the legal aspects. Clinical vignettes concretely illustrate these different aspects.En este artfculo se explora la situaciôn del rechazo del tratamiento farmacolôgico por un paciente. Son expuestos los principios clfnicos fundamentales, articulados con los principios jurîdicos y el proceso judicial en el que se encuentra comprometido el psiquiatra. Las vinuelas clinicas ilustran concretamente cada uno de los diferentes aspectos

La judiciarisation des patients psychiatriques : éléments de réflexion et applications pratiques

Parmi les solutions possibles en réponse aux gestes violents des patients psychiatriques, la judiciarisation demeure une alternative souvent méconnue qui peut pourtant s'avérer bénéfique et efficace. Comment choisir de façon éclairée, la judiciarisation face à la violence de certains patients ? Lorsque l'on opte pour cette voie, comment s'applique-t-elle et quelles sont les démarches à suivre ? Pour répondre à ces questions, il nous est apparu essentiel d'engager d'abord une réflexion plus globale sur l'utilisation de la sanction en psychiatrie. Nous évoquons ensuite les avantages et les inconvénients du processus de judiciarisation. Finalement, nous présentons les modalités d'application de la judiciarisation telles qu'elles ont été conçues et réfléchies à la clinique de dangerosité de l'Institut Philippe Pinel de Montréal.Prosecution of psychiatric patients: elements of reflections and practical applications Among possible solutions in response to violent behaviours of psychiatric patients, prosecution might not be an alternative as well-known. This measure may be potentially beneficial for patients. How can prosecution be chosen as an option when faced with violent patients? When this option is considered, how should it be applied and what are the different steps to follow? To answer these questions, it appeared essential to first proceed to a comprehensive reflection on the recourse of sanction in psychiatry. We then describe advantages and disadvantages of the judicial process. Finally, we illustrate applications as they were conceived and elaborated at the Clinique de dangerosité de l'Institut Philippe Pinel de Montréal.La judiciarisación de patientes siquiátricos: Elementos de reflexión y aplicacíones practicas Entre las soluciones posibles para responder a los gestos violentos de los patientes siquiátricos, la judiciarisación queda una alternativa frecuentemente desconocida la cual puede sin embargo revelarse benéfica y eficaz. ¿Como escoger de manera iluminada la judiciarisación frente a la violencia de ciertos patientes? Cuando se opta por este camino, ¿como se aplica y cuales son los pasos a seguir? Para responder a estas preguntas, nos pareció esencial empeñar primero una reflexión más global sobre la utilisación de la sanción en siquiatría. Después, evocamos las ventajas y los inconvenientes del proceso de judiciarisación. Finalmente, presentamos las modalidades de aplicación de judiciarisación tal como han sido conceptualisadas y reflexionadas en la clinica de peligrosidad del Instituto Philippe Pinel de Montréal

High-sensitive Optical Pulse-Shape Characterization using a Beating-Contrast-Measurement Technique

Ultrahigh-speed optical transmission technology, such as optical time domain multiplexing or optical signal processing is a key point for increasing the communication capacity. The system performances are strongly related to pulse properties. We present an original method dedicated to short pulse-shape characterization with high repetition rate using standard optical telecommunications equipments. Its principle is based on temporal measurement of the contrast produced by the beating of two delayed optical pulses in a highbandwidth photodetector. This technique returns firstly reliable informations on the pulse-shape, such as pulsewidth, shape and pedestal. Simulation and experimental results evaluate the high-sensitivity and the high-resolution of the technique allowing the measurement of pulse extinction ratio up to 20 dB with typical timing resolution of about 100 fs. The compatibility of the technique with high repetition rate pulse measurement offers an efficient tool for short pulse analysis

Triggering the LBL time projection chamber

A fast digital trigger was built for the LBL Time Projection Chamber (TPC) installed in the PEP-4 detector at SLAC. The TPC is an innovative High Energy Physics detector which will provide particle identification from dE/dx information within the tracking volume. The TPC trigger uses discriminator signals from 2220 dE/dx wire channels to require a track of ionization in the TPC which originates from the colliding beam intersection region. The trigger processing is performed as the ionization drifts onto the proportional wires and is completed 17 ..mu..s after beam crossing. This report describes the basic operation of the TPC detector and its trigger; a pretrigger which uses prompt TPC information from the endcap region; and the electronic implementation. The trigger can be tested with realistic simulated patterns of ionization deposits in the TPC which are stored in local memories. Test results from electronic simulations and first results of a test with cosmic rays are shown

Initial test results of an ionization chamber shower detector for a LHC luminosity monitor

A novel, segmented, multi-gap, pressurized gas ionization chamber is being developed for optimization of the luminosity of the LHC. The ionization chambers are to be installed in the front quadrupole and zero degree neutral particle absorbers in the high luminosity IRs and sample the energy deposited near the maxima of the hadronic/electromagnetic showers in these absorbers. The ionization chambers are instrumented with low noise, fast, pulse shaping electronics to be capable of resolving individual bunch crossings at 40 MHz. In this paper we report the initial results of our second test of this instrumentation in an SPS external proton beam. Single 300 GeV protons are used to simulate the hadronic/electromagnetic shower produced by the forward collision products from the interaction regions of the LHC. The capability of instrumentations to measure the luminosity of individual bunches in a 40 MHz bunch train is demonstrated

Development of a detector for bunch by bunch measurement and optimization of luminosity in the LHC

The front IR quadrupole absorbers (TAS) and the IR neutral particle absorbers (TAN) in the high luminosity insertions of the LHC each absorb approximately 1.8TeV of forward collision products on average per pp interaction ({approximately}235W at design luminosity 1034cm-2s-1). This secondary particle flux can be exploited to provide a useful storage ring operations tool for optimization of luminosity. Novel segmented, multi-gap, pressurized gas ionization chambers are proposed for sampling the energy deposited near the maxima of the hadronic/ electromagnetic showers in these absorbers. The system design choices have been strongly influenced by optimization of signal to noise ratio and by the very high radiation environment. The ionization chambers are instrumented with state of the art low noise, fast, pulse shaping electronics capable of resolving individual bunch crossings at 40 MHz. Data on each bunch are separately accumulated over multiple bunch crossings until the desired statistical accuracy is obtained. At design luminosity approximately 2x103 bunch crossings suffice for a 1% luminosity measurement