Évaluation des enjeux narcissiques à partir du test de Rorschach au terme d’une psychothérapie

The goal of this study is to evaluate, using the Rorschach, the evolution of one patient's narcissistic investments after two years of psychoanalytically oriented psychotherapy. Both quantitative and qualitative measures of narcissism on the Rorschach were studied in depth in this test-retest study. Results indicate that quantitative measures of narcissism and egocentrism were decreased after two years of psychotherapy. The patient also presented doubt concerning her self-worth, as well as new perceptions of her vulnerabilities and her need for shoring up. Increased flexibility concerning narcissistic investments was evident, which weakened the patient's Ego and containing capacity; this facilitated work on depressive issues.     

Syndrome d’apnée hypopnée obstructif du sommeil en Afrique Sub-saharienne : une revue de la littérature

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is common, under diagnosed and severe. It increases cardiovascular morbidity and mortality, reduces life expectancy and alters the quality of life.The objective of this work was to review the scientific literature on OSAHS in Sub-Saharan Africa from 2009 to September 2019.A search on PubMed, Science Direct, African Index Medicus, African Journals on line and Google scholar found a total of 43 references relevant to the theme.OSAHS publications are scarce in sub-Saharan Africa with no data for 36 countries. Practitioners’ level of knowledge about the disease was low. Polygraphy and / or polysomnography were not available in the majority of Sub-Saharan African countries. The prevalences obtained remained higher than those found in Europe and USA. OSAHS predominated in men, with a peak around 55 years old. The most consistent risk factor was obesity. The association OSAHS chronic pathology remained frequent. The excessive cost of continuous positive pressure, surgery and the lack of health insurance in these countries limited access to treatment.We need to improve the knowledge, in sub-Saharan Africa, of practitioners in the field of sleep medicine, to make polysomnography available in public health structures, to create sleep units in teaching hospitals to strengthen practical training and finally to make accessible treatment.