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

Organiser les soins pour les phases critiques de rétablissement : exemple de Lausanne

Résumé. Les interventions ambulatoires pour gérer les périodes critiques de rétablissement sont organisées à Lausanne sur quatre fondements : une bonne connaissance du paradigme de rétablissement, des interventions de type case management, la collaboration entre membres du réseau et le fait que l’objectif final soit que l’intervention ait un impact dans la vie réelle de la personne souffrante. L’objectif de cet article est de décrire différents types d’interventions qui cherchent à rassembler les éléments précités : le suivi intensif dans le milieu, le traitement et intervention précoce dans les troubles psychotiques, le case management de transition et le soutien à l’emploi de type IPS. L’avantage de ces interventions est de se focaliser sur les ressources de la personne, au moment où elle en a le plus besoin, de manière intensive et spécifique. Leur efficacité durable et leur pertinence reposent sur la collaboration avec le réseau médicosocial existant. En effet, seule une connexion étroite avec celui-ci permet de garantir la continuité du suivi et le maintien des acquis sur le long terme. Abstract. Organizing care for critical recovery phases: The example of Lausanne. The management of critical recovery periods for outpatients in Lausanne are organized around four principles: a firm knowledge of the recovery paradigm, a clinical case management model, collaboration with other members in the network, and a focus on the real-life impact of interventions. The goal of this article is to describe different types of interventions based on these principles: assertive outreach, early intervention in psychosis, transitional case management, and IPSstyle employment support. These interventions focus on the individual’s resources, at the moment when they need them the most, in an intensive, specific way. Collaboration with the existing medical-social network helps to sustain the effectiveness and relevance of these interventions. Indeed, only this close connection can ensure continuity in follow-up processes and maintain long-term recovery

French Translation and Validation of Three Scales Evaluating Stigma in Mental Health

Objective: The concept of stigma refers to problems of knowledge (ignorance), attitudes (prejudice) and behavior (discrimination). Stigma may hinder access to care, housing and work. In the context of implementation of programs such as “housing first” or “individual placement and support” in French speaking regions, validated instruments measuring stigma are necessary. “Attitudes to Mental Illness 2011” is a questionnaire that includes three scales measuring stigma through these three dimensions. This study aimed to translate, adapt and validate these three scales in French. Methods: The “Attitudes to Mental Illness 2011” questionnaire was translated into French and back-translated into English by an expert. Two hundred and sixty-eight nursing students completed the questionnaire. Content validity, face validity, internal validity and convergent validity were assessed. Long-term reliability was also estimated over a three-month period. Results: Experts and participants found that the questionnaire’s content validity and face validity were appropriate. The internal validities of the three scales were also considered adequate. Convergent validity indicated that the scales did indeed measure what they were supposed to. Long-term stability estimates were moderate; this pattern of results suggested that the construct targeted by the three scales is adequately measured but does not necessarily represent stable and enduring traits. Conclusions: Because of their good psychometric properties, these three scales can be used in French, either separately, to measure one specific dimension of stigma, or together, to assess stigma in its three dimensions. This would seem of paramount importance in evaluating campaigns against stigma since it allows measures to be adapted according to campaign goals and the target population