Initial results with bright light (phototherapy) in affective psychoses

The biological foundations of light-treatment and their relation to neurophysiological and biochemical mechanisms were discussed. We developed an apparatus for treatment and report of first experiences in affective psychosis. In addition to a decrease of depressivity and anxiety we found an unequivocal tendency to normalization of sleep-behaviour. The farther clinical and paraclinical investigations has to show the position of this method of treatment in the total conception of a biological therapy.     

Clinical differentiation of borderline syndromes from the psychoses

The discrimination of borderline syndromes from the psychoses is often a difficult task clinically. The problem most often arises in the acute setting in which a crisis has arisen--the typical example being that of acute hospitalization. The clinician's task is to assess the patient's apparently psychotic symptoms and behaviors to determine whether they are the manifestations of an underlying psychotic process, or whether they reflect a more or less transient regression from a somewhat higher level of habitual functioning. Some discrimination between these categories is possible even in the acute presentation, since borderline patients only exceptionally demonstrate Schneiderian first-rank symptoms or any other discriminating indices of psychosis. While the differentiation may be clear cut between the psychotic and the higher-order, better functioning borderline, there may be less precision in discriminating between the lower-order borderline forms or transient borderline states and psychoses. We have focused on this area of differentiation in this study. The discriminating indices are both short- and long-term. The differentiation cannot be adequately made without longer-term evaluation of the patient. Nonetheless, on a short-term basis, evaluation of the patient's behavior can point the diagnosis in one direction or other. The presence of a clear precipitant; the presence of intense (often verbalized) anger; the patient's attempts to engage the therapist in an intense, dependent, clinging and demanding relationship, usually in manipulative fashion; the partial, fragmentary, often circumscribed and ego-alien quality of the patient's psychotic productions; the marked tendency to act-out feelings, particularly anger, in a way that gains increased attention and concern from doctors, family, friends, or hospital staff; the persistence of some degree of reality testing and areas of significant realistic functioning; the transient nature of regressive manifestations and the ready reversal of regression in structured environments and with appropriate therapeutic management, particularly adequate limit-setting--all point toward a borderline diagnosis. Moreover, these factors carry an accumulative weight so that the more of these factors that can be validated, the more secure the diagnosis of borderline psychopathology. On a longer-term basis, beyond a few days, one would expect the above indices to be better discriminated. In addition, there is greater opportunity to study patterns of patient behavior--both his interaction with staff and other patients and with the therapist.(ABSTRACT TRUNCATED AT 400 WORDS)     

Lateralization of hand-movements in patients with affective psychoses during an interview situation: An attempt at a physiological interpretation

Summary The results of video analysis of non-verbal interview behavior of patients with affective psychoses were discussed. Characteristic differences were shown for the left-right distribution of certain hand movement types in studies of normal subjects by Kimura (1973) with an essentially comparable technique. A neurodynamic interpretation of such findings was attempted. First we discussed the shortcomings of current neuropsychological interpretations and concluded that they present a challenge to establish a conceptual framework, which would permit the resolution of both neurodynamic and developmental points of view. Finally, we examined the heuristic value of such a conceptual framework. We noted that it is marked by the concept of inter-hemispheric coordination, and applied this concept to our findings as well as to hypotheses in depression research obtained by other methods.     

Clinical and psychopathological research on attachment: the contribution of the psychic envelopes model

This paper proposes to put into perspective the attachment model (Bowlby) and that of psychic envelopes (Anzieu) so as to grasp the contribution of attachment theory to the field of psychopathology. Having laid the foundations of the epistemological debate between these two models, relying on a discussion of the stakes inherent in the psychoaffective development approach, the author refers to current forms of psychopathology, which draw massively on the borderline and narcissistic concepts, in order to discuss the sense and benefits of the “skin–ego” model as an alternative and complement to attachment theory. Beyond altering reference models in psychopathology, this debate and related inputs lead to consider therapeutic applications through a combination of the notion of “caregiving group” – a group version of the attachment figure – and the notion of therapeutic offer as a necessary alternative to the ideology of demand.     

Perceptions of job characteristics and affective work outcomes for women and men

One hundred twenty-three men and women participated in a study designed to assess their attitudes about job dimensions and affective work outcomes. This study found that very few differences existed between women's and men's perceptions of job dimensions and work outcomes. It was also shown that little difference existed between men's and women's perceptions of positive relationships between job dimension and affected work outcomes. The authors concluded that differences that exist in work attitudes are artifacts of hierarchical position and sex-role stereotyping and will disappear when women are allowed to move into jobs that are characterized by the presence of high levels of intrinsic job dimensions.     

The role of the symptom in psychopathological states

Abstract.— Four approaches to the role of symptoms in psychopathological states are discussed. These are: Prepsychoanalytic psychiatry, psychoanalysis, family communication theory, and the view that symptoms as a sign of mental illness do not exist. The latter comprises labelling theory and social learning theory. Particular interest is attached to the contentions of symptom substitution and symptomatic treatment. Both are rejected as myths. A theory of action is briefly outlined, and on the basis of this, an alternative interpretationof phenomena ordinarily conceptualized as mental pathology is suggested. The concepts of "psychopathology" and "symptoms" are redefined in accordance with present knowledge, and the importance of formulating human action in an ethical frame of reference is pointed out.     

Validity of the Millon Clinical Multiaxial Inventory in the assessment of affective disorders

The Millon Clinical Multiaxial Inventory (MCMI) was administered to 270 adult outpatients with major affective disorders at the same time that a semistructured, diagnostic interview was conducted by a clinician. The mood of the patient was then rated, and the clinician completed the Hamilton Depression Rating Scale and the Mania Rating Scale. A consensual diagnosis was arrived at by the team of investigators using DSM-III criteria. Significant correlations were found between four MCMI affective scales and the global mood state of the patient. Analysis of covariance indicated that the MCMI affective scales are significantly related to DSM-III affective disorders even after the effect of the current mood of the patient is partialled out. The clinical usefulness of each of the scales is discussed.