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1
Felber, Werner, i Thomas Reuster. "The Fading of Psychosis". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-134488.
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Arslanturk, Pinar. "Amour et transfert dans les psychoses". Thesis, Aix-Marseille, 2016. http://www.theses.fr/2016AIXM3016.
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Freud s'était intéressé à la question de l'étiologie et les spécificités de la relation d'objet dans les psychoses dès le fondement de sa théorie. Il avait buté sur la possibilité du traitement des sujets psychotiques par la psychanalyse puisqu'ils lui paraissaient inaptes au transfert à cause d'une part de l'état anobjectal primitif de leur narcissisme et d'autre part de leur régression au stade autoérotique. Lacan, dans son retour à Freud, revient sur les spécificités de la structure et cerne la question. Il étoffe ainsi son hypothèse selon laquelle la forclusion du Nom-du-Père et la réapparition dans le réel de ce qui est forclos seraient la cause de la psychose. Ce travail de recherche est une mise en tension entre la rencontre avec trois femmes dont le diagnostic de psychose est avéré et l'approche de Freud et de Lacan des psychoses pour cerner notre question de recherche. De là, notre hypothèse sera la suivante : l'amour et le transfert ont des dimensions bien particuliers dans les névroses et dans les psychoses. Néanmoins ils restent des organisateurs de la vie du sujet pour toutes les structures psychiques. À travers l'amour, le sujet psychotique essaie de suppléer : au défaut dans la symbolisation dû à la forclusion du Nom-du-Père ; au défaut de la signification phallique ; et au défaut dans la localisation de la jouissance de l'Autre. L'amour fait symptôme dans les psychoses. Il est une des seules défenses que le sujet a contre le Réel et, constitue une tentative de guérisonFreud has focused his research on the etiology of psychosis and the specificities of object relations in psychosis since the foundation of his theory. He has confronted with the impossibility of the treatment of the psychotic patient by his methods because they seem to be incapable of transference due to their narcissism and their regression to the autoerotic stage of the development. After Freud, Lacan questions the specificities of the psychotic structure and identifies the foreclosure of the Name of the Father, a primordial signifier, as the etiologic source of the psychosis.This thesis is a tension between case studies of three psychotic women and the approach of Freud and Lacan. Our hypothesis is: love and transference have unique dimensions in neurosis and psychosis. However they still organize the life of the subject in all the structures psyches.Through love, the psychotic subject tries to compensate structural fault. It is one of the only defenses against the Real and it is an attempt to cure. The psychotic subject can form an ego by identifying with the love object. In this case, love is articulated in three registers defined by Lacan: the real, the imaginary and the symbolic. If the psychotic slides purely to the narcissistic side, if the love is based solely on the imaginary register, the deadly side of love, Thanatos, can take over
3
Felber, Werner, i Thomas Reuster. "The Fading of Psychosis". Karger, 2001. https://tud.qucosa.de/id/qucosa%3A27570.
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Gómez, de Regil Lizzette M. de Gpe. "Schizophrenia and related psychoses: studies of the early stages of psychosis". Doctoral thesis, Universitat Autònoma de Barcelona, 2010. http://hdl.handle.net/10803/32078.
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Actualmente se reconoce que la psicosis no implica un deterioro inevitable, y que un primer episodio puede seguir varios cursos, entre la recuperación completa y el curso crónico. Una perspectiva actual ve las características de la psicosis en un continuo (desde una variación de la personalidad normal hasta la esquizofrenia) que incluye manifestaciones atenuadas que pueden o no evolucionar en psicosis. De ahí el creciente interés por predecir el resultado a lo largo de las diferentes etapas del continuum, estudiando aquellos factores que pudieran señalar el inicio del trastorno y/o predecir las consecuencias de un primer episodio. Más aún, con el desarrollo de nuevos antipsicóticos, el concepto de resultado se ha extendido más allá de la prevención de recaídas y remisión de los síntomas, adoptando medidas más positivas y amplias como la calidad de vida. Se discuten tres cambios importantes en la perspectiva que ha guiado el estudio de la esquizofrenia y las psicosis relacionadas y se aporta evidencia con cinco estudios empíricos. En primer lugar, la idea de que la esquizofrenia es el punto final en un continuum de psicosis se trata en el estudio “Psychotic-like symptoms and positive schizotypy are associated with mixed and ambiguous handedness in an adolescent community sample” (Anexo 1). Su principal hallazgo es que las medidas de dimensión positiva de la predisposición a la psicosis tanto a nivel rasgo como de síntoma subclínico están asociadas con patrones de preferencia manual atípica (como en pacientes con esquizofrenia), particularmente con la ambigüedad manual en la ejecución de acciones primarias. En segundo lugar, el concepto de que el curso de la psicosis es heterogéneo y se puede predecir de manera fiable e influenciar en su fase temprana es el tema de dos estudios: “Predictors of outcome in the early course of first-episode psychosis” (Capítulo 2) y “Predictors of short-term course in Mexican first-episode psychosis patients” (Capítulo 3). Ambos estudios aportan evidencia de la heterogeneidad en el curso de la psicosis, con algunos pacientes mostrando incluso una recuperación total. El principal hallazgo es que factores de línea base predicen el resultado a corto plazo en pacientes con un primer episodio psicótico. Sin embargo, la predicción varía según el criterio seleccionado (diagnóstico, síntomas residuales o recaídas) y el origen de los participantes (España o México), destacando la necesidad de tomar en consideración tales diferencias y el hecho de que pudieran explicar las inconsistencias de resultados reportados en la literatura. En tercer lugar, la idea de que las medidas de resultado en la psicosis se han extendido más allá de la remisión de los síntomas incluyendo la calidad de vida de los pacientes e incluso la de sus familiares se trata en dos estudios: “Quality of life: relation to illness course, illness perception and functioning in short-term course psychosis patients” (Anexo 2) y “Predictors of expressed emotion, burden and quality of life in relatives of short-term course psychosis patients” (Anexo 3). El principal hallazgo en la muestra de pacientes es que los síntomas residuales, más que las recaídas o el diagnóstico en sí mismo, tienen un efecto negativo en la calidad de vida; efecto totalmente mediado por la representación emocional de la enfermedad y el nivel de funcionamiento. El principal hallazgo en las díadas paciente-familiar es que la percepción de la enfermedad de los familiares y el estrés psicológico, predijeron significativamente sus niveles de emoción expresada, sobrecarga y calida de vida, por encima del estatus clínico y funcional del paciente. Las principales contribuciones de los estudios en apoyo a las nuevas perspectivas en el estudio de la psicosis son discutidas junto con sus limitaciones y algunas propuestas de futura investigación.Nowadays there is a general agreement that schizophrenia no longer means an inescapable pathway to deterioration, and that a first episode of psychosis might follow various courses, from a full recovery to a chronic course. Also, there is a current perspective that sees psychosis features on a continuum (from a normal personality variation to schizophrenia) involving attenuated manifestations which may or not evolve into psychosis. Therefore, interest has grown to predict the outcome at different stages of the psychosis continuum, studying factors that might signal the onset of illness and/or predict outcome after the first episode of psychosis. Moreover, with the development of novel antipsychotics with fewer side-effects the concept of outcome criteria has extended beyond relapse prevention and symptom remission, adopting more positive and wide-reaching measures such as quality of life. Three important changes in the perspective that have guided the study of schizophrenia and related psychosis are discussed and supporting evidence is provided through five empirical studies. Firstly, the idea that schizophrenia is the endpoint of a psychosis continuum is addressed in the study “Psychotic-like symptoms and positive schizotypy are associated with mixed and ambiguous handedness in an adolescent community sample” (Appendix 1). The main finding of the study is that both trait and symptom-like measures of positive psychosis proneness are associated with patterns of atypical handedness (resembling the pattern observed in schizophrenia patients), particularly with ambiguous handedness across primary actions. Secondly, the concept that the course of psychosis is heterogeneous and can be fairly predicted and influenced in its early phase is addressed in two studies: “Predictors of outcome in the early course of first-episode psychosis” (Chapter 2) and “Predictors of short-term course in Mexican first-episode psychosis patients” (Chapter 3). Both studies provide evidence of the heterogeneity in the early course of psychosis, with a number of patients even showing a complete recovery. The main finding is that baseline factors can reliably predict the short-term outcome of first-episode psychosis patients. Nevertheless, their predictive value varies with the selected outcome criteria (diagnosis, residual symptomatology and relapse course) and origin of participants (Spain or Mexico), which indicates the need to take such differences into account and the fact that they might explain some of the inconsistent findings reported in the literature. Thirdly, the idea that the outcome measures in psychosis have expanded beyond symptom remission in order to embrace patients' quality of life and even that of their relatives is addressed in two studies: “Quality of life: relation to illness course, illness perception and functioning in short-term course psychosis patients” (Appendix 2) and “Predictors of expressed emotion, burden and quality of life in relatives of short-term course psychosis patients” (Appendix 3). The main finding from the sample of patients is that residual symptoms, rather than subsequent relapses or diagnosis per se, have a deteriorating effect on their quality of life, and this effect is fully mediated by their emotional representation of illness and level of functioning. The main finding from the patient-relative dyads is that relatives' levels of expressed emotion, burden and quality of life were significantly predicted by their perception of illness and psychological distress above patients' clinical and functional status. The studies' main contributions in support to the new perspectives in the study of psychosis are discussed, along with their limitations and some directions for further research.
5
Castagnini, Augusto Cesare. "Reactive psychoses". Thesis, University of Cambridge, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611857.
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Pommier, Gérard. "L'écriture comme solution dans la psychose". Aix-Marseille 1, 2000. http://www.theses.fr/2000AIX10017.
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L'etude des effets therapeutiques de l'ecriture dans les psychoses s'appuie sur les travaux de la psychiatrie classique. Freud s'est servi des ecrits d'un paranoiaque pour etablir la premiere etude psychanalytique sur la psychose. A partir de la dissociation du code et du message, on pose l'hypothese de leur association grace au transfert. Apres freud, lacan a examine james joyce pour lequel l'ecriture a une fonction redemptrice de suppleance de sa carence paternelle. Pour l'ecrivain louis wolfson, les langues etrangeres sont une defense contre la langue maternelle. En refondant le nom du pere et en se defendant contre la pulsion, l'ecriture repare le clivage du moi psychotique. L'instance de la lettre dans l'inconscient montre une homologie entre l'ecriture tracee sur le papier et la litteralite des formations de l'inconscient, comme le revelent huit cas cliniques. On a specifie ensuite le desir de l'ecrivain en general. L'exemple de paul valery permet de determiner la difference entre "ecrire a quelqu'un" et "ecrire a personne". Puis, le rapport a l'ecriture de louis althusser a permis de detailler la particularite de la parole maniaque et l'effet therapeutique de l'ecriture. Dans la manie, la signification des phrases est pulverisee par les jeux de mots et cette destruction a comme consequences l'elimination de l'interlocuteur, puis du locuteur. L'ecriture stabilise cet effet puisque son interlocuteur est etemel. Le probleme du transfert ainsi pose dans les psychoses oscille entre la destruction narcissique par agression erotisee du semblable et l'appel a une stabilisation des significations persecutantes. Le transfert dans les psychoses impose une position specifique de l'analyste, qui a comme perspective de programmer un temps subjectif; resultat positif dont l'inconvenient est d'engendrer une analyse infinie. La perspective conclusive de cette these est celle des potentialites therapeutiques d'un recoupement du transfert analytique par la refondation des significations grace a l'ecriture.
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Robertson, Denise L. "Making Sense of Psychosis: Parental Attributions for Problem Behaviour in Recent Onset Psychosis". Thesis, Griffith University, 2008. http://hdl.handle.net/10072/365597.
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The onset of a psychotic disorder causes much distress, and has negative health consequences, for the affected individuals and their families. As the highest risk time for initial onset of psychoses is in late adolescence and early adulthood, most people developing psychoses live with their parents. Often the sufferer has little insight into their deteriorating mental health, and is reliant on parents to identify that there is a problem and to seek treatment for the sufferer. However, during the onset of psychoses behaviour often gradually deteriorates, and the family members are often confused about what might be causing the changes in the young person. This confusion about what to attribute the problem behaviours to has at least two potentially important effects. First, family members seem unlikely to seek treatment for the young person until they recognize psychiatric disorder is at least contributing to the young persons’ behaviour. Consistent with this possibility, it is known that there is usually a substantial delay (of two or more years) between the initial onset of psychiatric symptoms and young people accessing treatment. Second, relatives often suffer considerable distress and care giver burden as a psychosis develops in their offspring. The attributions they make for the emerging abnormal behaviours of their offspring might well mediate the extent of that suffering. Two studies were conducted. The first examined the attribution of parents of young people with and without a recent onset psychoses for abnormal behaviour in young people. The second study examined whether parent attributions predicted distress and care giver burden in parents of young people with recent onset psychoses...Thesis (PhD Doctorate)
Doctor of Philosophy in Clinical Psychology (PhD)
School of Psychology
Griffith Health
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Lacoste, Nicolas. "Continuité "normal-pathologique" des symptômes psychotiques : étude à propos de 139 sujets contrôles et psychiatriques". Bordeaux 2, 1999. http://www.theses.fr/1999BOR23049.
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Kanemoto, Kousuke. "Postictal psychoses : A comparison with acute interictal and chronic psychoses". Kyoto University, 1997. http://hdl.handle.net/2433/202236.
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Cadiet, Laurent. "Structures des psychoses". Electronic Thesis or Diss., Paris 8, 2014. http://www.theses.fr/2014PA080006.
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La politique de ce travail de thèse est la démonstration d'une conception structurale (Autre dans l'Un) et borroméenne (Un dans l'Autre) des psychoses selon deux axes : La barrière épistémo-somatique de la psychiatrie : abstraction psychologique de la pensée consciente et manifestation naturaliste du corps propre. Le sujet cartésien est appréhendé en fonction d'un manque-à-être et d'un manque-à-avoir. Cette dichotomie Imaginaire, cette méconnaissance narcissique a été exploitée afin de distinguer les psychoses selon la signification (paranoïa classique et schizophrénie) et celles selon l'incorporation (sadomasochisme et paraphrénie). Considérer la continuité de la jouissance, de l'Un, et mesurer comment la discontinuité de l'Autre opère pour en réguler le flot. Cette régulation est spécifique à la psychose, la névrose ou la perversion. Les éléments structuraux distingués des éléments Imaginaires permettent d'accéder à une clinique orientée par les formules de la sexuation.Le matériel clinique classique des paranoïas et des mélancolies, selon la signification et l'incorporation, a donc été exploité selon ces deux axes et envisagé à la lumière du matériel psychanalytique de Freud et Lacan. Les concepts cruciaux de forclusion du Nom-du-Père, celle du sens, et surtout l'objet a. Il se présente comme extrait mais non-séparé (a) pour les psychoses schizoparaphréniques ou non-extrait (ao) pour les psychoses paranoïaques.La thèse débouchera sur la pertinence de la clinique borroméenne et du sinthome plus engagé vers l'Un. C'est toute une clinique du nouage et de la contingence qui reste à envisager. Une appréhension de la singularité clinique et pratique du sujet psychotique en dépendThe policy of this thesis work is demonstrating a structural design and borromeenne of the psychoses according to two dimensions : The epistemo-somatic barrier of psychiatry : psychological abstraction of conscious thought and naturalistic expression of the own body. The Cartesian subject is apprehended as a function of a lack-to-be and a lack-to-have. This imaginary dichotomy, this narcissistic ignorance has been exploited in order to distinguish the psychosis according the meaning (classic paranoia and schizophrenia) and those according to the incorporation (sadomasochism and paraphrenia). Consider the continuity of the enjoyment of the One, and measure how the discontinuity of the other operates to regulate the flow. This regulation is specific to psychosis, neurosis or perversion. The structural elements distinguished from imaginary elements allow you to access to a clinic guided by the formulas of sexuation. The classic clinical material of paranoias and melancholies, depending on the meaning and incorporation, has therefore developed according to these two issues and considered in the light of the psychoanalytic material of Freud and Lacan. The crucial concepts of foreclosure du Nom-du-Père, that of the meaning, and especially the object has. It looks like extracted but non-separated for psychosis schizoparaphreniques or unextracted for paranoid psychosis. This thesis work will lead to the relevance of the borromeenne clinic and the sinthome more committed towards the One. It is a clinic of the knot and the contingency which remains to consider. Apprehension of the singularity clinical and practical of the psychotic subject depends on it
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Cadiet, Laurent. "Structures des psychoses". Thesis, Paris 8, 2014. http://www.theses.fr/2014PA080006.
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La politique de ce travail de thèse est la démonstration d'une conception structurale (Autre dans l'Un) et borroméenne (Un dans l'Autre) des psychoses selon deux axes : La barrière épistémo-somatique de la psychiatrie : abstraction psychologique de la pensée consciente et manifestation naturaliste du corps propre. Le sujet cartésien est appréhendé en fonction d'un manque-à-être et d'un manque-à-avoir. Cette dichotomie Imaginaire, cette méconnaissance narcissique a été exploitée afin de distinguer les psychoses selon la signification (paranoïa classique et schizophrénie) et celles selon l'incorporation (sadomasochisme et paraphrénie). Considérer la continuité de la jouissance, de l'Un, et mesurer comment la discontinuité de l'Autre opère pour en réguler le flot. Cette régulation est spécifique à la psychose, la névrose ou la perversion. Les éléments structuraux distingués des éléments Imaginaires permettent d'accéder à une clinique orientée par les formules de la sexuation.Le matériel clinique classique des paranoïas et des mélancolies, selon la signification et l'incorporation, a donc été exploité selon ces deux axes et envisagé à la lumière du matériel psychanalytique de Freud et Lacan. Les concepts cruciaux de forclusion du Nom-du-Père, celle du sens, et surtout l'objet a. Il se présente comme extrait mais non-séparé (a) pour les psychoses schizoparaphréniques ou non-extrait (ao) pour les psychoses paranoïaques.La thèse débouchera sur la pertinence de la clinique borroméenne et du sinthome plus engagé vers l'Un. C'est toute une clinique du nouage et de la contingence qui reste à envisager. Une appréhension de la singularité clinique et pratique du sujet psychotique en dépendThe policy of this thesis work is demonstrating a structural design and borromeenne of the psychoses according to two dimensions : The epistemo-somatic barrier of psychiatry : psychological abstraction of conscious thought and naturalistic expression of the own body. The Cartesian subject is apprehended as a function of a lack-to-be and a lack-to-have. This imaginary dichotomy, this narcissistic ignorance has been exploited in order to distinguish the psychosis according the meaning (classic paranoia and schizophrenia) and those according to the incorporation (sadomasochism and paraphrenia). Consider the continuity of the enjoyment of the One, and measure how the discontinuity of the other operates to regulate the flow. This regulation is specific to psychosis, neurosis or perversion. The structural elements distinguished from imaginary elements allow you to access to a clinic guided by the formulas of sexuation. The classic clinical material of paranoias and melancholies, depending on the meaning and incorporation, has therefore developed according to these two issues and considered in the light of the psychoanalytic material of Freud and Lacan. The crucial concepts of foreclosure du Nom-du-Père, that of the meaning, and especially the object has. It looks like extracted but non-separated for psychosis schizoparaphreniques or unextracted for paranoid psychosis. This thesis work will lead to the relevance of the borromeenne clinic and the sinthome more committed towards the One. It is a clinic of the knot and the contingency which remains to consider. Apprehension of the singularity clinical and practical of the psychotic subject depends on it
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Cros, Stéphanie Charline. "Prise en charge thérapeutique des psychoses : intérêt des nouveaux neuroleptiques". Bordeaux 2, 2000. http://www.theses.fr/2000BOR2P028.
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Giudicelli, Laurence. "Trouble schizo-affectif : étude de l'évolution et état actuel du concept". Bordeaux 2, 1993. http://www.theses.fr/1993BOR23056.
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Schiro, Michel. "Retards de diagnostic et de prise en charge des psychoses infantiles : approche historique et clinique". Bordeaux 2, 1991. http://www.theses.fr/1991BOR23063.
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Marga, Philippe. "Psychose et modes de suppléance". Paris 13, 1997. http://www.theses.fr/1997PA131004.
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Ce travail de recherche se propose d'examiner le problème de l'entrée dans la psychose et tout particulièrement les modes de suppléance, c'est à dire les stratégies que le sujet peut mettre en place pour retarder ou éviter l'entrée dans la psychose. L'étude du délire dans sa fonction freudienne d'auto-guérison permet de ne pas les confondre. Apres le repérage préliminaire des concepts utilises, nous avons effectue une recherche sur l'historique de la folie pour en arriver a l'approche de Freud et aux prolongements que Lacan a pu proposer. La crise psychotique y est examin2e ce qui donne corps a une clinique différentielle des psychoses. Les modes de suppléances sont articules aux trois registres lacaniens que sont le réel, le symbolique et l'imaginaire, en précisant qu'ils sont susceptibles de se combiner ou de se présenter en alternance dans le processus qui retient notre intérêt. Le premier mode de suppléance examine concerne la fonction de l'écrit a partir de l'œuvre de j. Joyce, de t. Bernhard, d'a. Artaud et de quelques écrits recueillis dans un cadre clinique. Les conduites addictives sont examinées pour leur valeur de suppléance et sont suivies par l'étude des conduites psychopathiques. Les conduites passionnelles trouvent leur place dans cette étude ainsi que le problème du transsexualisme et la fonction du phénomène psychosomatique. Le phénomène de sublimation pulsionnelle est étudie afin de voir s'il peut se mettre en place dans la structure psychotique. Le concept de sinthome, que l'on distingue de celui de symptôme, est retenu pour qualifier le processus qui semble être à l’ origine des modes de suppléance, et il parait s'articuler avec ce que Lacan repère comme la constitution de l'ego. La stabilisation et le problème du déclenchement sont appréhendes au regard de la fonction de l'autre dans la psychose, fonction qui diffère selon les modalités de décompensationThe object of this work is to approach the problem of the entering into the psychosis and more particularly the strategies used by the subject in order to put back or avoid that one : "les modes de supleance". The study of delirium in his fonction of self-recovery according to s. Freud allow to no fuse theses ones. After having located, in first, all the concepts used, we have made an historical search on the madness in order to explain the approach of s. Freud and after the extensions proposed by j. Lacan. The psychotic crisis is examined and suggest a differential clinic of the psychosis. "les modes de suppleances" are connected to the three registers of j. Lacan which are "le reel, le symbolique et l'imaginaire" these ones may appear combined or be presents alternatively. The first "mode de suppleance" examined is the fonction of the writing in the works of j. Joyce, t. Bernhard, a. Arthaud and some writings collected as part of clinic context. The addictive behaviours are examined for their value of suppleance. After we have studied the psychopatics behaviours, the pationnels behaviours, the problem of the transexual relations and the fonctions of the psychosomatics phenomena. The phenomenon of pulsionnal sublimation is studied in order to see he can put oneself in the psychotic structure. The concept of "sinthome" different from the one of symptom is used to qualify the processus who seem be at the origin of "les modes de suppleance". The stabilisation and the problem of the entering into the psychosis are analysed relatively to the functions of the "autre" in the psychosis, that one different according to the modalities of begining of the crisis
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Tortelli, Andrea. "Incidence, prévalence et facteurs de risque sociaux de psychose chez la population migrante en France L’importance de la recherche épidémiologique psychiatrique sur les populations migrantes en France Capital social, santé mentale et immigration". Thesis, Paris Est, 2018. http://www.theses.fr/2018PESC0031.
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L’association entre psychose et migration a largement été établie dans plusieurs études en Europe. Ce risque est en lien avec le processus d’immigration en tant que tel, mais il découle aussi de la qualité de l’interaction entre les groupes migrants et la population du pays d’accueil, et plus largement ses institutions et son contexte social. En France, un français sur quatre a des origines immigrées sur deux générations. Malgré ce fait, les études épidémiologiques psychiatriques de la population migrante en France sont récentes et peu nombreuses, et l’existence des groupes migrants ayant un risque accru de troubles psychiatriques ainsi que les facteurs de risque associés sont encore mal connus.Ma thèse consiste a à l’étude de l'incidence et de la prévalence de psychose dans la population migrante (et descendants) en France, l’identification des groupes les plus vulnérables et les facteurs de risque environnementaux associésMigrant status and ethnic minority position have been associated to an increased risk of psychosis in many European countries in the last decades. A variation of this risk is observed in migrants and their descendants, across countries and different ethnic groups. Findings suggest a modulation of this risk by cumulative individual and environmental psycho-social adversity experienced during the migration process and in the host country, such as trauma, discrimination, isolation, inequalities in the access to the welfare and health system, employment, housing and regular status. France is the European country where migration is the most important (11% of general population) and the most ancient, as the result of many waves of migration from different countries since the 19th century. However, epidemiological studies on mental health problems in migrant populations are very recent in comparison to other European countries, and data are still lacking.This work will focus on the study of the incidence and the prevalence of psychosis among migrants and their descendants in France, and associated environmental risk factors
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LOBIDEL, ARMELLE. "Passion et psychoses passionnelles". Lille 2, 1988. http://www.theses.fr/1988LIL2M348.
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CARE, PHILIPPE. "Dictionnaire des psychoses infantiles". Amiens, 1992. http://www.theses.fr/1992AMIEM018.
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Hides, Leanne, i n/a. "An Examination of the Influence of Cannabis Use on Psychotic Symptom Exacerbation and Relapse in Early Psychosis". Griffith University. School of Applied Psychology, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030922.130049.
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There has been concern about the impact of cannabis use on the onset, course and relapse of psychosis. Evidence from retrospective and a small number of prospective studies has suggested that cannabis use may precipitate a latent psychosis, exacerbate psychotic symptoms and increase the likelihood of psychotic relapse. The purpose of the current study was to examine the influence of cannabis use on psychotic symptom exacerbation and relapse within the stress vulnerability-coping model of psychosis. Two studies were conducted. The influence of cannabis use on the onset and course of psychosis was retrospectively examined in the first study. The second study prospectively examined the influence of cannabis use on psychotic symptom exacerbation and relapse over a 6-month period. The influence of the severity of psychotic symptoms on a relapse in cannabis use was also explored. Eighty-four participants were assessed at admission, 81 of whom were followed up for a 6-month period. Measures consisted of structured diagnostic interviews and self-report measures of stress, medication compliance, family functioning, premorbid adjustment, quality of life, substance use and psychotic symptoms. The onset of cannabis use clearly preceded the onset of psychosis. Cannabis use was predictive of the severity of psychotic and general psychopathology symptoms at admission. Both the frequency and quantity of cannabis use was predictive of time to psychotic relapse over the 6-month follow up period. Psychotic symptom severity was predictive of a substantial increase in the quantity but not the frequency of cannabis use. Cannabis use was related to the onset, course and relapse of psychosis.
20
Hides, Leanne. "An Examination of the Influence of Cannabis Use on Psychotic Symptom Exacerbation and Relapse in Early Psychosis". Thesis, Griffith University, 2003. http://hdl.handle.net/10072/366456.
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There has been concern about the impact of cannabis use on the onset, course and relapse of psychosis. Evidence from retrospective and a small number of prospective studies has suggested that cannabis use may precipitate a latent psychosis, exacerbate psychotic symptoms and increase the likelihood of psychotic relapse. The purpose of the current study was to examine the influence of cannabis use on psychotic symptom exacerbation and relapse within the stress vulnerability-coping model of psychosis. Two studies were conducted. The influence of cannabis use on the onset and course of psychosis was retrospectively examined in the first study. The second study prospectively examined the influence of cannabis use on psychotic symptom exacerbation and relapse over a 6-month period. The influence of the severity of psychotic symptoms on a relapse in cannabis use was also explored. Eighty-four participants were assessed at admission, 81 of whom were followed up for a 6-month period. Measures consisted of structured diagnostic interviews and self-report measures of stress, medication compliance, family functioning, premorbid adjustment, quality of life, substance use and psychotic symptoms. The onset of cannabis use clearly preceded the onset of psychosis. Cannabis use was predictive of the severity of psychotic and general psychopathology symptoms at admission. Both the frequency and quantity of cannabis use was predictive of time to psychotic relapse over the 6-month follow up period. Psychotic symptom severity was predictive of a substantial increase in the quantity but not the frequency of cannabis use. Cannabis use was related to the onset, course and relapse of psychosis.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Applied Psychology
Full Text
21
Pauillac, Pascale. "Age de début des troubles psychotiques : étude sur une cohorte de 59 patients psychotiques hospitalisés pour la première fois en psychiatrie". Bordeaux 2, 1997. http://www.theses.fr/1997BOR23053.
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Rix, K. J. B. "Food antibodies in acute psychoses". Thesis, University of Aberdeen, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.593354.
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Rix, K. J. B. "Food additives in acute psychoses". Thesis, University of Aberdeen, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.332704.
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REINERT, PATRICE. "Equitation therapeutique et psychoses infantiles". Reims, 1990. http://www.theses.fr/1990REIMM036.
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25
Crutchfield, Audra. "Negative affect and positive symptoms of psychosis". Thesis, University of North Texas, 2009. https://digital.library.unt.edu/ark:/67531/metadc12109/.
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The current study utilized structural equation modeling (SEM) to examine the factor-to-factor relations and temporal associations between disturbances in negative affect (NA) and positive symptoms of psychosis (PP). Data were drawn from a large, public-domain data set (MacArthur Violence Risk Assessment Study). A dimensional approach was used to conceptualize and identify latent variables of NA (depression, anxiety, and guilt) and PP (hallucinations, delusions, and thought disorder) among individuals with a diagnosis of primary psychotic disorder. Results showed that anxiety, guilt, and depressed mood modeled an NA latent variable, and that hallucinations and unusual thought content modeled a PP latent variable. As predicted, results revealed strong, significant cross-sectional (synchronous) associations between NA and PP at each measured time-frame, suggesting that NA and PP occurred concurrently within the sample. Contrary to predictions, no significant cross-lagged effect between NA and PP was identified (10 weeks and 20 weeks respectively).
26
Prudent, Cécile. "Etude des psychoses dissociées : Approche clinique et projective comparées". Thesis, Université de Lorraine, 2018. http://www.theses.fr/2018LORR0069/document.
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La recherche que nous avons développée dans notre thèse a eu pour objectif l’étude des psychoses dissociées à travers une approche clinique et projective comparées. C’est à travers une révision de la littérature des psychoses, que nous avons, dans un premier temps, mis en évidence les diverses positions au sein de la nosographie psychiatrique dans un contexte historique, puis actuel. Nous avons croisé cette perspective à une approche issue de l’application du modèle métapsychologique, dont les jalons ont été posés par Freud (1911, 1920, 1924, 1940). En outre, nous avons mis en évidence une opposition entre Freud et Bleuler à travers leurs échanges épistolaires parus en 2016, et cela à propos de la question de l’autisme. La recherche que nous avons conduite est composée de plusieurs études. La première étude vise la comparaison statistique des indicateurs au test de Rorschach (Nina Rausch de Traubenberg, 1990) entre la population tout-venant ([n=310], (de) Tychey et al., 2012) et entre la population psychiatrique psychotique (n=81). Tous les diagnostics ont été réalisés en double aveugle au test de Rorschach et selon une double approche nosographique dans la clinique (psychanalytique et psychiatrique). La seconde étude est une analyse qualitative contrastée, constitué de 5 cas cliniques, consacrée à une investigation approfondie des psychés de cas cliniques exemplaires représentatifs des trois sous-groupes de référence de la population de l'étude. La troisième étude est longitudinale sur un cas clinique à 24 mois d’intervalles en test/re-test nous permettant de valider la fiabilité du diagnostic de paranoïa, dont nous assistons pourtant à l’évanouissement nosographique.Pour conclure, nous avons dégagé et validé l’indicateur de la représentation de soi intitulé : le degré de représentation de soi entière unitaire, qui permet notamment de discriminer les structures et les organisations entre elles. La psychose dissociée, reconnue pour représenter la faillite du narcissisme primaire est apparue comme une population adéquate au développement de ces travaux sur l’évaluation du narcissismeIt is thought a depth psychosis literature review, that we have, in a first time, highlighted various positions within the psychiatric nosography, in an historic and then, in a current context. We cross a perspective called objective to an approach more subjective, however very rewarding: the metapsychological model, whose milestones were thrown by Freud (1911, 1920, 1924, 1940). In addition, we highlighted an opposition between Freud and Bleuler thought their epistolary exchanges published in 2016 in French. This about, question of autism that Freud (1911) designated as well as a retreat of the libido on the Ego; contrarily to Bleuler (1911). To us, that epistemological and theoretical cleavages, have influenced the current nosography (DSM-5, A.P.A., 2013). The empirical research developed in this thesis, aimed at the study of dissociated psychosis through a clinical and projective compared approaches. Indeed, this research is composed by many studies: the first was aimed at the statistical comparisons of Rorschach’s indicators (Nina Rausch de Traubenberg, 1990) between non-clinical population ([n= 310], (de) Tychey et al., 2012) and clinical population, psychiatrist, and more specifically: psychosis dissociated ([in]patient [n= 81]). Within the first study, in a second time, we proceeded to the statistical comparisons between the three subgroups of the sample, constitute of: 25 subjects diagnosed with paranoia, 30 subjects diagnosed with schizophrenia and 26 diagnosed with paranoid schizophrenia. All diagnostics were realized in double bind et and according to a double approach (psychoanalytic and psychiatrist). The second study is a qualitative analysis contrasted, devoted to the deeply psychic investigation of exemplary clinical cases, representatively of three subgroups from the population’s study (paranoia; schizophrenia paranoid; pure schizophrenia). The sample is itself constituted of limits’ subgroups suffering from psychotic decompensations and hospitalized on a long court. In the qualitative study of clinical contrasted cases, we presented firstly, a subject from a pure paranoia structure: Catherine, an autopunitive feminine paranoia case.Secondly, we presented the analysis of a clinical picture from schizophrenic structure: Joseph, from which megalomaniac Ego and invasive delirium will surely arrested the lector; and finally, we analysed a pure schizophrenia case: Doug, which psychic desert particularly challenges us in conter-transferential’s dynamic. Then, to illustrated closer that we understand by sliding of an a-structure to a dissociated psychosis (and not to a melancholic proceed, as well as that is permitted by Bergeret [1974]), we analysed the cases of Jordan and Ali. Ali was initially inscribed in an a-structure (Bergeret, 1974), from which he decompensed secondarily in a paranoiac organisation; Jordan on other hands, decompensed secondarily in a pure schizophrenia
27
Flemal, Simon. "D’une étude métapsychologique de la fonction délirante dans les processus psychiques de la schizophrénie". Thesis, Lyon 2, 2011. http://www.theses.fr/2011LYO20050.
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En nous étayant des théories issues de l’épistémologie psychanalytique, nous concevons la schizophrénie comme résultant d’une expérience traumatique primaire n’ayant pu être intégrée au sein de la subjectivité. Ce traumatisme, nous le rattachons moins à un évènement en tant que tel qu’à la position impensable qu’il désigne pour le sujet. Ainsi, en nous inspirant de la pensée de P. Aulagnier et de R. Roussillon, nous suggérons que le noyau traumatique conditionnant le développement d’une problématique schizophrénique se rapporte à la position d’objet pulsionnel, ou de non-désir, à laquelle se trouve identifié le sujet au sein des premiers échanges avec son environnement. Face à l’impensable de cette position identificatoire, le sujet se voit contraint de s’extraire de la scène relationnelle avec ses objets primaires, se clivant par la même opération du capital représentatif qui lui est associé. Dans ces conditions, nous pensons que le délire, moins d’apparaître comme une production pathologique dépourvue de sens, correspond à un mode de réponse face au retour hallucinatoire de l’impensé traumatique. Aussi, à partir d’une méthodologie qualitative basée sur l’analyse d’une douzaine de cas cliniques, nous mettons en évidence trois principales fonctions du délire dans la schizophrénie. La première, conceptualisée sous le terme de « fonction contenante », procède à la mise en forme et à la transformation signifiante de ce qui ne put être symbolisé de l’expérience traumatique. La seconde, nommée « fonction localisante », tente de situer en dehors du sujet le débordement pulsionnel inhérent au traumatisme primaire. La troisième, appelée « fonction identifiante », permet à la personne délirante de s’attribuer un énoncé identificatoire qui, de manière auto-créée, supplée à l’énigme de son histoire insensée.Enfin, l’analyse de nos données cliniques souligne que ces trois fonctions de l’activité délirante ne se réalisent pas de façon aléatoire mais qu’elles s’articulent selon une logique particulière. Ainsi, nous suggérons qu’à partir de sa triple opération le délire schizophrénique tend à se déployer en un « processus délirant », par lequel le sujet peut rendre pensable et supportable la position traumatique à laquelle il a été identifié au cours de son histoireBy following theories from the psychoanalytical epistemology, we consider schizophrenia as the result of a primary trauma that has not been assimilated within the subjectivity. We connect less this traumatism with an event than with the unthinkable position the subject is identified to. Therefore, being inspired by the thought of P. Aulagnier and R. Roussillon, we suggest that the traumatic nucleus which conditions the development of schizophrenia is related to the position of instinctual object, or of non-desire, to which the subject is identified within the first exchanges with his environment. In view of this unthinkable position, the subject is forced to remove himself from the relationship with his primary objects, splitting off from the representative capital that is associated with it. In these conditions, we think that the delusion appears less as a meaningless pathological production than as a way of answering to the hallucinatory return of the traumatic unthought. From a qualitative methodology based on the analysis of a dozen clinical cases, we highlight three main functions of the delusion in schizophrenia. The first, conceptualized under the term «containing function», carries out the shaping and the significant transformation of what could have not been symbolized of the traumatic experience. The second, called «localizing function», tries to locate outside of the subject the instinctual overflow inherent to the primary trauma. The third, named «identifying function», enables the delusional person to assume an identificatory principle which, in a self-created way, compensates for the enigma of his senseless history.Finally, the analysis of our clinical data underlines that these three functions of the delusional activity are not randomly accomplished but are organized according to a particular logic. Thus from its triple operation, we suggest that the schizophrenic delusion tends to develop into a «delusional process», by which the subject can make thinkable and bearable the traumatic position to which he was identified during his history
28
De, Battista Julieta. "Le désir dans les psychoses : problématique et incidences de la cure à partir de l’enseignement de Jacques Lacan". Thesis, Toulouse 2, 2012. http://www.theses.fr/2012TOU20033/document.
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Trente ans après la mort de Lacan, les conséquences concernant la cure tirées de son enseignement sur les psychoses méritent une révision pour la période 1981-2011. Aujourd’hui, de nombreux analystes lacaniens traitent des patients psychotiques et essayent de rendre compte des effets. Pourquoi la psychanalyse s’avère-t-elle opérante dans l’abord des psychotiques? Bien que les effets de l’abord analytique soient reconnus par les analystes, leur théorisation entraîne des paradoxes comme celui qui soutient qu’il n’y a pas de désir dans les psychoses. Dans la mesure où Lacan a promu une éthique analytique fondée sur la fonction du désir de l’analyste comme ressort du transfert, l’exil du désir psychotique de la théorisation est contradictoire avec l’idée d’une cure possible. Celle-ci risque de se transformer en une thérapeutique. Cette recherche propose de réintroduire le concept de désir dans la théorisation de la cure analytique des psychoses. Tout d’abord, cette thèse s’est révélée nécessaire pour élucider les modifications de la position subjective repérées dans des cas de patients mélancoliques dont la présentation mortifiée initiale a connu une réversion vers la persécution. Le passage d’un désir aboli à un essai d’instituer le désir dans l’Autre exige de considérer que la psychose aussi est une affaire de désir. La question ne serait pas celle de l’absence du désir, sinon celle des modalités de support du désir que chaque patient psychotique pourrait mettre en place. L’abord analytique démontre à ce niveau son efficacité, qui n’est pas toujours garantie car dépendante d’une rencontre entre le psychotique et le désir de l’analysteThirty years after Lacan’s death, the consequences around the cure derived from his teaching on psychosis deserve a review for the period 1981-2011. Today, many Lacanian analysts treat psychotic patients and try to account the effects. Why psychoanalysis appeared to be operative addressing psychotics? Although the effects of the analytical approach are recognized by analysts, their theory leads to paradoxes such as the one which states that there is no desire in the psychoses. Insofar as Lacan has developed an analytical ethic based on the function of the desire of the analyst as the essence of transference, the exclusion of the psychotic desire from the theory is contradicts to the idea of a possible cure. This could turn into a therapeutic treatment. This investigation suggests that the concept of desire should be integrated in the theories concerning the analytic treatment of psychoses. First of all, this hypothesis seems to be necessary to account for changes in the subjective position identified in cases of melancholic patients whose initial mortification had a reversion to persecution. The passage of an abolished desire to a restitution of desire in the Other implies the statement that psychosis is also a matter of desire. The point is not the absence of desire, but the ways that every psychotic subject can implement for support of the desire. The analytical approach demonstrates its effectiveness at this level, but this effectiveness is never guaranteed because it depends always on a meeting of the psychotic with the analyst’sdesire
29
Andrews, H. "The diagnosis of the puerperal psychoses". Thesis, University of Nottingham, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.383029.
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30
Dawson, Elisabeth. "Molecular genetic studies of the psychoses". Thesis, King's College London (University of London), 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.307610.
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31
SAMUELIAN, MASSAT CATHERINE. "Psychoses schizo-affectives : concept et realite". Aix-Marseille 2, 1988. http://www.theses.fr/1988AIX20470.
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32
Badji, Bougoul. "Les psychoses puerpérales en milieu sénégalais". Paris 5, 1986. http://www.theses.fr/1986PA05H048.
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La thèse comprend trois parties composées chacune de deux chapitres. La première partie donne une perception de la cosmogonie au Sénégal, étudié la constitution de la personne-personnalité au sein de l'univers cosmique, avec toutes les significations attachées a cette notion. La deuxième partie dégage la perception que l'on a de la femme, de l'accouchement, le sens et la signification de l'enfantement, et introduit la clinique du meret (acception locale de la psychose puerperale) avec 10 observations commentées à la lumière des représentations culturelles. On aboutit à la victimisation de la parturiente soit par la communauté humaine soit par des éléments du monde invisible. Monde visible et monde invisible coexistent, et la personne-personnalité est en relation avec le monde invisible au niveau de ses éléments constitutifs, en particulier au niveau de l'élément vital du "cœur" appelé fitt. Dans certaines rencontres soudaines de la personne-personnalité avec un élément du monde invisible (jinne, seytane. . . ), il peut se produire une disjonction entre les deux pôles majeurs de la personne-personnalité, entre personne et personnalité, signe du trouble mental. La troisième partie (théorie du meret), après des généralités sur la maladie mentale en Afrique noire et au Sénégal, et la question de l'interprétation, analyse l'hypothèse de la rivalité pathologique cause du trouble mental, une notion dont les mobiles paraissent être la jalousie, l'envie, le pouvoir ou l'autorité. Cette notion expliquerait les idées et les sentiments de persécution, et la raison pour laquelle ego serait violente par un agresseur qui lui est extérieur : demm (sorcier-anthropophage), rab (ancetre ou aieul), jinne, seytane, un tiers par maraboutage-fetichageThis thesis is made up three parties of two chapters each one. The first party presents the cosmogony in Senegalese assumption, studies how the person-personality is structured, with many significations about it. The second party shows the significations to be woman, to gi ving birth and introduces the meret (traditional explanation of puerperale psychosis) clinical with ten observations based on the cultural representations. By this way, we end at the victimization of the woman who gives birth attacked or by the human community (visible world) or by any elements of the invisible world like rab (ancestor), jinne, seyta ne, demm (sorcerer). The person-personality is into touch with the invisible world by his own elements, particularly the heart in its vital element called in Senegal language fitt (reed feet). Sudden meetin gs between the person-personality and any elements of the invisible world (jinne, seytane. . . ) produce a disjunction between person and personality, the two terms of real personality: the mental disorder. The third and last party, the meret theory, after some generalities on mental health in black Africa and in Senegal and the question of interpretation considering cultural data from that is examinated and diagnosed the personality disorder, analyses the assumption of pathological rivalry, an idea which reins appear in jalousy, power or authority. That could explain and elucidate the feelings and persecut ion ideas without paranoia
33
Flemal, Simon. "D'une étude métapsychologique de la fonction délirante dans les processus psychiques de la schizophrénie". Doctoral thesis, Universite Libre de Bruxelles, 2011. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209824.
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En nous référant aux théorisations de l’épistémologie psychanalytique, nous concevons la schizophrénie comme résultant d’une expérience traumatique primaire n’ayant pu être intégrée au sein de la subjectivité. Ce traumatisme, nous le rattachons moins à un évènement en tant que tel qu’à la position impensable qu’il désigne pour le sujet. Ainsi, en nous inspirant de la pensée de P. Aulagnier et de R. Roussillon, nous suggérons que le noyau traumatique conditionnant le développement d’une problématique schizophrénique se rapporte à la position d’objet pulsionnel, ou de non-désir, à laquelle se trouve identifié le sujet au sein des premiers échanges avec son environnement. Face à l’impensable de cette position identificatoire, le sujet se voit contraint de s’extraire de la scène relationnelle avec ses objets primaires, se clivant par la même opération du capital représentatif qui lui est associé. Dans ces conditions, nous pensons que le délire, moins d’apparaître comme une production pathologique dépourvue de sens, correspond à un mode de réponse face au retour hallucinatoire de l’impensé traumatique. Aussi, à partir d’une méthodologie qualitative basée sur l’analyse d’une douzaine de cas cliniques, nous mettons en évidence trois principales fonctions du délire dans la schizophrénie. La première, conceptualisée sous le terme de « fonction contenante », procède à la mise en forme et à la transformation signifiante de ce qui ne put être symbolisé de l’expérience traumatique. La seconde, nommée « fonction localisante », tente de situer en dehors du sujet le débordement pulsionnel inhérent au traumatisme primaire. La troisième, appelée « fonction identifiante », permet à la personne délirante de s’attribuer un énoncé identificatoire qui, de manière auto-créée, supplée à l’énigme de son histoire insensée.
Enfin, l’analyse de nos données cliniques souligne que ces trois fonctions de l’activité délirante ne se réalisent pas de façon aléatoire mais qu’elles s’articulent selon une logique particulière. Ainsi, nous suggérons qu’à partir de sa triple opération le délire schizophrénique tend à se déployer en un « processus délirant », par lequel le sujet peut rendre pensable et supportable la position traumatique à laquelle il a été identifié au cours de son histoire.
By following theories from the psychoanalytical epistemology, we consider schizophrenia as the result of a primary trauma that has not been assimilated within the subjectivity. We connect less this traumatism with an event than with the unthinkable position the subject is identified to. Therefore, being inspired by the thought of P. Aulagnier and R. Roussillon, we suggest that the traumatic nucleus which conditions the development of schizophrenia is related to the position of instinctual object, or of non-desire, to which the subject is identified within the first exchanges with his environment.
In view of this unthinkable position, the subject is forced to remove himself from the relationship with his primary objects, splitting off from the representative capital that is associated with it. In these conditions, we think that the delusion appears less as a meaningless pathological production than as a way of answering to the hallucinatory return of the traumatic unthought. From a qualitative methodology based on the analysis of a dozen clinical cases, we highlight three main functions of the delusion in schizophrenia. The first, conceptualized under the term «containing function», carries out the shaping and the significant transformation of what could have not been symbolized of the traumatic experience. The second, called «localizing function», tries to locate outside of the subject the instinctual overflow inherent to the primary trauma. The third, named «identifying function», enables the delusional person to assume an identificatory principle which, in a self-created way, compensates for the enigma of his senseless history.
Finally, the analysis of our clinical data underlines that these three functions of the delusional activity are not randomly accomplished but are organized according to a particular logic. Thus from its triple operation, we suggest that the schizophrenic delusion tends to develop into a «delusional process», by which the subject can make thinkable and bearable the traumatic position to which he was identified during his history.
Doctorat en Sciences Psychologiques et de l'éducation
info:eu-repo/semantics/nonPublished
34
Debruge, Eric. "Les comportements à effet auto-vulnérant dans les psychoses infantiles précoces : apport des théories comportementales et psychanalytiques". Montpellier 1, 1988. http://www.theses.fr/1988MON11094.
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Gomar, Gallardo Juan Antonio. "Rythme et psychose infantile". Thesis, Sorbonne Paris Cité, 2016. http://www.theses.fr/2016USPCD059.
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Cette thèse a pour objectif de montrer l’importance du rythme comme socle thérapeutique dans la prise en charge de la psychose infantile. Le rythme sera abordé selon deux points de vue :D’une part, comme élément communicationnel originaire entre l’enfant et la mère, il permet les premières associations de sens et par là, des mises en forme initiales (représentation de chose) du contact avec l’altérité. Les continuités et discontinuités dans le contact avec l’extérieur peuvent devenir, grâce à la régularité et la répétition qui constituent le rythme, des présences et des absences.D’autre part, l’articulation interne du rythme nous révèle une structure ternaire codifiée par les chiffres (1-0-1). Le chiffre Un est entendu comme une présence et le chiffre Zéro comme une presentia in absentia. Cette structure permettrait la négativation de la présentation pulsionnelle et l’introduction de l’enfant dans les préambules de la figuration moïque et la triangulation oedipienneThe aim of this study is to demonstrate the importance of rhythm in the treatment of infantile psychosis. This rhythm is studied from two perspectives.First, as the first means of communication between mother and child, rhythm enables children to experience their first sensory associations and thus to structure their first representations of contact with otherness. Continuity and discontinuity with otherness could become presences and absences, thanks to the regularity and repetition inherent in the rhythm.Secondly, the inner speech of this rhythm reveals a ternary structure codified by the digital sequence (1-0-1). 1 is understood as a presence, 0 as a presentia in absentia.This structure would allow the negativation of the inner drive representation and would introduce the child to the preambles of Ego and Oedipus triangulation
36
White, Angela M. "'Working with families' : the evaluation of a brief family intervention in recent-onset psychosis /". [St. Lucia, Qld.], 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18452.pdf.
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Tang, Yee-man, i 鄧綺汶. "Determinants of long-term outcome in psychotic disorders: a 13-year prospective study". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B49617771.
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Motivations
The growing interest in the investigation of longitudinal course and outcome of psychotic disorders grew from the Kraepelinian view of schizophrenia, which was considered a disease with progressive downhill course. With emerging evidence-based findings suggesting outcome heterogeneity, prospective studies have strived to identify factors influencing the course and outcome. The paucity of prospective long-term studies has prevented us from knowing the enduring impacts of predictors.
Using a prospective cohort of 153 psychosis patients, the study aimed to determine the outcome of global functioning, remission, functional recovery, and recovery at 13 years following the first-episode psychosis. Prognostic values of a range of baseline and early outcome predictors were examined. Specific research interests included the explorations of the enduring impact of duration of untreated psychosis (DUP), the longitudinal relationship between neurocognition and functional outcome, and the added predictive ability of early outcome predictors.
Methods
This study attempted to follow up the 153 patients at 13 years following their first episode onset of psychosis. Prior investigations collected a comprehensive profile of demographics, premorbid adjustment, clinical symptoms, and neurcognition at baseline. Early outcomes at 3 years including remission, relapse, primary negative symptoms, and unemployment were also ascertained. In this current investigation, living subjects were invited to an interview in order to assess their outcomes of global functioning, remission, functional recovery, and recovery at 13 years. Appropriate regression models were applied to identify predictors of long-term outcomes. Standardized mortality ratios (SMRs) for all-cause mortality and suicide were also determined.
Results
Ninety-six patients were successfully interviewed. Their mean (s.d.) score of global functioning was 64.3 (16.5). Considerable proportions of patients fulfilled criteria for remission (47%), functional recovery (33%), and recovery (16%) at 13 years. Higher level of global functioning was predicted by a married status at study entry and being in remission and employed at 3 years. Remission was predicted by a shorter DUP and better premorbid social adjustment. Functional recovery was predicted by better premorbid social adjustment, better baseline visual memory, and being employed at 3 years. No baseline and early outcome predictors of recovery could be identified. Addition of early outcome predictors significantly increased the variance explained for global functioning and improved model discrimination between patients who had functional recovery and those who had not. SMRs for all-cause mortality and suicide were 6.07 and 24.80, respectively.
Discussion
A prolonged DUP may intensify the progression of negative symptoms and lead to less likelihood of remission. The study has confirmed the enduring adverse impact of DUP but its reversibility is still in doubt. As the significance of visual memory in functional outcome has not received consistent support from literature, more prospective long-term studies are in need to re-examine the relationship. Early outcome predictors appear to be more relevant to functional outcome than clinical outcome.
Discussion
A prolonged DUP may intensify the progression of negative symptoms and lead to less likelihood of remission. The study has confirmed the enduring adverse impact of DUP but its reversibility is still in doubt. As the significance of visual memory in functional outcome has not received consistent support from literature, more prospective long-term studies are in need to re-examine the relationship. Early outcome predictors appear to be more relevant to functional outcome than clinical outcome.published_or_final_version
Psychiatry
Doctoral
Doctor of Philosophy
38
江寶盈 i Po-ying Kong. "Relationship between self-reflection and insight in early psychosis patients using guided illness model questionnaire (GIM) / y Kong Po Ying, Cathy". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192950.
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Insight impairment is commonly reported in psychosis patients and such impairment leads to poor outcome and it also causes burden to the family and caregivers. It is as yet unclear what causes unawareness of illness therefore it is essential to find out the key element to form this fundamental correlation.
Wiffen and David proposed that self-reflective processing may have similar cognitive mechanisms as theory of mind processing, but this does not imply that the processes cannot be affected independently. Lysaker et al. demonstrated that better meta-cognitive skills, such as the ability to think about one’s own thoughts were related to better insight in schizophrenia patients. An increasing number of studies suggest that patients lacking insight into their own illness, were fully capable of recognizing the illness and symptoms in other patients. This indicated that insight impairment only happened at the self-recognition level.
The ability of integrating information from outside world to the self is seen as a factor in gaining insight, therefore self-reflection ability are commonly seen as key features of awareness of mental illness. Previous studies of chronic schizophrenia patients show that their ability to accept the biological model of their own psychotic symptoms, assessed with Guided Illness Model Questionnaire (GIM) questionnaire, has a positive association with their neuropsychological function and awareness of illness However, it has not been common to use GIM questionnaire in early stage psychosis patients.
This study aims are (1) use Guided Illness Model Questionnaire (GIM) to assess the self-reflection ability of early stage psychosis patients (2) explore the relationship between self-reflection and insight (3) Cognitive functions, particular executive functions, will be evaluated with self-reflection ability and insight. Insight will be measured by scale to assess unawareness of mental disorder (SUMD). Results show self-reflection ability is related with insight impairment and executive function, especially processing speed and attention contributes to self-reflection ability and poor insight. Further investigation reveals that self-reflection ability acts as a mediator for poor insight. This study concludes that executive functioning is the basic-order process for gaining insight and self-reflection could act as higher-order process as mediator for provoking insight for psychosis patients.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
39
Cheung, Sze-ki, i 張斯琪. "The relationship of DUP, DUI, negative symptom severity and functional outcome among people with psychosis in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192962.
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Empirical studies had demonstrated inconsistencies between duration of untreated psychosis (DUP) and outcome measures including negative symptoms severity and functional outcome. Therefore, this study aimed to investigate how either the construct of duration of untreated psychosis (DUP) or duration of untreated illness (DUI) acted on associating and predicting negative symptoms, its sub-domains and functional outcome among psychotic population in Hong Kong.
Totally three hundred and forty five subjects were recruited from in-patient and out-patient setting in hospitals under hospital authority. DUP and DUI were assessed by semi-interviewed with subjects, their family members and other significant others. And the Scale of Assessment of Negative Symptoms (SANS) and Social and Occupational Functioning Assessment Scale (SOFAS) were adopted as assessment tools to measure negative symptoms severity and functioning of individual respectively. Regression models were used to analyse how DUI and DUP differed in associating and predicting different variables.
Results showed that DUI took a more significant role in associating and predicting negative symptoms and functional outcome in which it demonstrated stronger positive correlation with negative symptoms and stronger negative correlation with functional outcome. DUI was also found to act as a potential predictor for both negative symptom severity and functional outcome. At the same time, among all sub-domains, anhedonia showed mild positive correlation with both DUI and DUP while other four didn’t show similar association.
The results provided increased insight that DUI might play a more significant role in determining the development of negative symptoms and functional outcome than DUP. Yet, limitations on various aspects had been addressed in this study such as the high level of heterogeneity of our sample and potential confounders which partially correlated with the outcome parameter. Also, no causal relationship had been yield between DUI / DUP and outcome variables. Further investigation was suggested on dividing the sample into sub-group to draw information regarding the characteristics of associations. Meanwhile, better control on potential confounding variables might help generating clearer picture on how independent variables associated with each other.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
40
劉嘉敏 i Ka-man Nicole Lau. "The role of religious support in social functioning, social support and stigma in patients with psychotic disorders". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192966.
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Aims: Psychosis is associated with serious stigma, impacting a person's psychosocial functioning. Religious group membership may provide social support for patients recovering from psychosis, while there may also be additional clinically beneficial effects of religiosity. We test the primary hypothesis that patients with religious group membership have better social support and functioning, compared with patients who are not attached to any religious group, with or without other group activities. The qualities that may contribute to clinical and social improvements in patients with religion are explored.
Methods: This study uses a cross-sectional design with semi-structured interviews and questionnaires. A total of 63 participants were recruited from out-patient clinics: (1) 12 patients with religious group background (Catholic or Protestant); (2) 16 patients with no religious background participating in other community groups; (3) 15 patients with no religious background and other community activities; and (4) 20 healthy controls without religious background for comparison of social support and social functioning.
Results: ANOVA analyses show that religious group was significantly better than community-activity group, followed by non-religious group in interpersonal functioning and social support. Healthy controls, though, had advantages in social functioning over the community-activity and non-religious groups, they were not significantly better than the religious group in interpersonal functioning, perceived social functioning or social support. This study discovers that the internal qualities, namely private practice, intrinsic experience, and subjective importance of religion, predict the clinical outcomes and social functioning, instead of the collective features of religion.
Discussion: The findings confirm that the religious group had better social functioning and social support than the community-activity group, suggesting that apart from the emphasis on community activities, religion is also valuable in building up social functioning and support. Among different areas of religion, frequency of private practice, intrinsic experience and subjective importance significantly correlated with clinical outcome, medication compliance, social functioning, social support, perceived stigma and experienced stigma. It may imply that the internal qualities have a greater impact on functioning and outcomes than the communal activities. The semi-structured interviews revealed that patients obtained positive aspects of religion, namely, comfort, support, sense of control, and meanings of illness. Ways of dealing with mental illness through religion were mentioned in the interviews.
Significance: The study shows that religion and religiosity also play an important role in social functioning and mental health even more so than community activities. The ways of living with symptoms may also be helpful to patients with psychotic symptoms. The spiritual interventions in treatment of psychosis could be considered in case management.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
41
Leung, Hoi-ting Michelle, i 梁愷婷. "Development and validation of a standardised measure of the self-stigma for early psychosis patients". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192968.
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Objective: To develop and validate a standardized self-stigma scale to capture the self-stigma level of early psychosis patients with lack of insight of their own mental condition. This bridges the research gap for existing scales measuring self-stigma in early psychosis patients. Method: We used qualitative data from focus groups and individual interviews with early psychosis patients to develop a pilot scale with15 concern issues and 48 items. We recruited 40 early psychosis patients in order to validate the scale. Of these, 15 were invited to complete the questionnaire twice within two to three weeks’ time for measuring the test-retest reliability for the scale. Results: The final self-stigma scale with 15concern issues and 32 items was produced. The self-stigma scale scores were positively correlated with depression, medication side-effects, positive and negative symptoms, insight, social withdrawal, perceived devaluation and discrimination, as well as experienced stigma. While the self-stigma scores were negatively correlated with social functioning and self-disclosure. However, their correlation with the self-stigma scale all served as discriminant validity. Discussion: The self-report questionnaire, which could be completed within ten to fifteen minutes, might help us understand more about the role of self-stigma in early psychosis patients in both research and clinical settings, also, its future applications were discussed.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
42
梁聖琳 i Shing-lam Leung. "The relationship of self-stigma and insight to social functioning in people with first episode psychosis". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192969.
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Background Many researches have studied stigma among people with mental illness, mainly focusing on its relationship with insight, psychological well-being and clinical outcomes. Psychotic disorder is described as a condition that influences one’s affect, thoughts and behaviors, with psychiatric symptoms including disorganized speech and bizarre behaviors, which frighten the general population. Common scales used in literatures to study stigma target the general population’s attitude towards mental illness instead of self-stigma, the internalized stereotypes of people suffering from psychotic disorders. Insight is likely to be different at different stages of schizophrenic spectrum disorder, but current evidence was mostly done in chronic schizophrenia patients.
Aim This study explored the correlational association between self-stigma, insight and social functioning among people with first episode psychotic disorder and if self-stigma and insight were predictors of social functioning.
Method Self-stigma, insight and social functioning were assessed among using structured interviews and questionnaires. Thirty-three out patients from the Early Intervention Team at Queen Mary Hospital in Hong Kong diagnosed with schizophrenic spectrum disorder participated in the study. The internalized stigma of mental illness scale was used to assess self-stigma; the unawareness of mental disorder scale was used to assess level of insight; and the social and occupational functioning assessment scale was used to assess level of social functioning.
Results The linear regression analysis showed that self-stigma and insight were not significant predictors of social functioning (r = 0.67, β= -0.289, p < 0.05; adjusted R² = 0.39). However the regression analysis showed the subscale stereotype endorsement was a significant predictor of social functioning (r = 0.690, β= -0.333, p < 0.05; adjusted R² = 0.420) and accounted for 47.6% of the variance in social functioning levels. Moreover, the bivariate correlational analysis showed significant negative correlational relationships between self-stigma and social functioning, and insight and social functioning. There was no correlational relationship between self-stigma and level of insight.
Conclusion Results showed that self-stigma and insight play different roles towards social and role functioning. Although analysis did not show a significant outcome indicating self-stigma and insight being the predictors of functioning, data showed that the values were close to being significant.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
43
Miao, Ho-Yee, i 苗可兒. "Predictors of medication adherence in early psychosis". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192971.
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Medication adherence is a well-known barrier in hindering successful pharmacological treatment, particularly in early psychosis patients. The aims of promotion and implementation of early intervention service not only change patient’s trajectory of long-term outcome positively but also broaden a therapeutic window by detecting patient’s medication non-adherence attitudes and behaviors in the very early stage of illness. Needless to say, the rate of non-adherent to medication in early psychosis is high due to a variety of potential risk factors. The consequences of medication non-adherence are devastating. In adherence research, the researchers devote their life to investigate in this aspect.
As suggested by previous studies, a basket of consistent and inconsistent as well as strong or weak predictors are relevant to medication adherence. However, they tend to examine the medication adherence attitudes and behaviors together. Since someone behavior is not the same as his/her attitude toward medication adherence, the current study thus explores them separately. Given very scanty studies addressing the issue, this study focuses on asking whether different sets of baselines predictors contribute to medication adherence attitudes and behaviors differently are true.
Within a six-month period of follow-up, 340 first episode psychosis patients have been included in the sample. We assessed various patient-related, medication-related, and environmental-related constructs (age, gender, martial status, education level, occupation, living condition, family history of mental illness, mode of onset, premorbid functioning, DUP, hospitalization, symptoms severity, level of insight, type of medication, medication side effects, and therapeutic alliance) at baseline as well as measured their medication adherence attitude and behaviors at six-month follow-up period. The result of the study are in accord with our hypothesis that different groups of risk factors contribute to medication adherence attitude and behaviors differently in the first six months of treatment of early psychosis patients. After putting the same set of variables into analyses on medication adherence attitudes and behaviors separately, findings reveal that DUP, insight, side effect on psychic aspect, and patients’ rating on communication effectiveness with clinicians are the significant predictors for medication adherence attitudes while gender, experienced hospitalization, and psychopathology severity are the influential indicators in predicting medication adherence behaviors. Our data indeed fills in the adherence research gap to address what predictors affect medication adherence attitude and behavior differently.
The implication is that if we just put medication adherence attitude and behavior together into the discussion, it would oversimplify the medication adherence phenomenon. Our study serves as a cornerstone to obtain a better understanding in the dynamic process of medication treatment decision-making in terms of patients’ medication adherence attitudes and behaviors separately. We hope our findings as the stimuli to move on to next step by exploring whether a wider context of speculation, the structural barriers in our mental healthcare services delivery system and family involvement, influences medication adherence in early psychosis.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
44
吳愷晴 i Hoi-ching Iris Ng. "Humor recognition and appreciation deficits in early psychosis". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192972.
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Humor recognition and appreciation are important aspects to enhance psychological well-being and enrich social relationships and interactions. The present study hypothesized that first-episode psychosis (FEP) patients with adult onset in the Chinese society have deficits in humor recognition and appreciation compared with healthy controls. It also predicted FEP patients with a diminished ability in recalling humorous stimuli. Moreover, this study sought to explore the potential associations of humor recognition and appreciation deficits with measures of clinical symptoms, psychosocial and neurocognitive functioning, and self-perception towards hope and recovery among FEP patients.
Thirty FEP patients with a DSM-IV diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, brief psychotic disorder or delusional disorder were compared with 30 healthy controls matched for gender, age and education years on a humor task comprising six comedy video clips. Humor recognition was measured by the detection of total ‘standard humorous moments’ in the comedy clips. Humor appreciation was measured by self-report Visual Analogue Scale (VAS) funniness ratings. Percentage of recalled ‘standard humorous moments’ was also measured. Changes in positive and negative mood states were measured using Positive and Negative Affect Schedule (PANAS). Patients were assessed for clinical symptoms, psychosocial functioning, self-perception towards recovery and hope, and a battery of neuropsychological tests measuring executive function, working memory, intelligence quotient, semantic and visuospatial memory, and selective attention.
FEP patients had a lower number in detection of total ‘standard humorous moments’, in total VAS funniness rating, and in percentage of recalled ‘standard humorous moments’ compared with healthy controls. Patients and healthy controls did not differ in positive and negative mood changes induced by the comedy clips. In patients, humor recognition had significant negative correlation with negative symptoms and significant positive correlation with self-perception towards hope. Recall of ‘standard humorous moments’ had significant negative correlation with negative symptoms and significant positive correlation with immediate and delayed recall using working memory. Both humor recognition and appreciation had no correlation with psychosocial and neurocognitive functioning.
FEP patients had impaired humor recognition, appreciation and recall compared with healthy controls. The degree of humor recognition and recall deficits may be, respectively, associated with the extent of negative symptoms and attributed to impairments in the neurocognitive domain of working memory. Potentials of humorous stimuli in inducing a positive impact on mood for the patient population were found, providing insight for the introduction of humor therapy as a new form of intervention that could further improve psychological well-being.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
45
Cheung, Lok-ka Lily, i 張樂嘉. "Premorbid functioning : correlations with social functioning and clinical symptoms in first-episode psychosis, using baseline data from the JCEP 4-year RCT study". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192976.
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The current study analysed baseline data from the Jockey Club Early Psychosis (JCEP) 4-year RCT study (still underway). The aims were to (1) examine whether the correlations between premorbid functioning and the outcome variables of social functioning and clinical symptoms were significant in baseline measurements of the JCEP study, and (2) pave the way for the examination of the persistence of these correlations at 4 year follow-up, after the completion of the JCEP study.
360 first-episode adult-onset psychosis patients with schizophrenia-spectrum disorders were recruited from all inpatient and outpatient psychiatric units in Hong Kong since 2009. Premorbid functioning was measured by the Premorbid Adjustment Scale (PAS). Social functioning was measured by the Role Functioning Scale (RFS) and Social and Occupational Functioning Assessment Scale (SOFAS). Clinical symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS), and Scale for Assessment of Positive Symptoms (SAPS).
Premorbid adjustment was significantly correlated with social functioning and negative symptoms; patients with poorer premorbid adjustment had worse social functioning and more severe negative symptoms. Positive symptoms were not significantly correlated with premorbid adjustment. There were no gender differences in premorbid adjustment. The majority of patients had a pattern of good premorbid adjustment (adequate to good levels of premorbid adjustment across all age-specific time periods). There were no significant differences in the outcome variables between the premorbid adjustment patterns. The current study findings have important clinical implications, in terms of advising the use of more effective and personalized interventions and treatment regimens on patients. In addition, the examination of premorbid adjustment facilitates early detection and identification of high risk psychosis individuals, which may help to reduce the duration of untreated psychosis.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
46
Tang, Suet-chung Lawson, i 鄧雪松. "Self-referential information processing in psychotic disorders". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206569.
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Motivations
Ideas and delusions of reference (I/DOR) are common psychotic symptoms and can be defined as self-referential experiences in excess of the amount of evidence available in the immediate environment. A putative neurocognitive mechanism is increased automatic attention capture by self-referential (SR) information. This study was carried out to test the hypotheses that 1) compared with patients with no I/DOR, those who have the symptom have increased attentional shift to SR information and 2) there is a positive correlation between the severity of I/DOR and the extent of attentional shift to SR information. Clinical and cognitive correlates of I/DOR were also explored.
Methods
Patients with I/DOR (n=20, mean age 25.2±7.9 years, 4 men) and without I/DOR (n=17, mean age 28.6±8.2 years, 10 men) matched for age and education were assessed for positive symptoms, negative symptoms, mood symptoms and basic neurocognition. I/DOR were phenomenologically assessed using the Ideas of Reference Interview Scale (IRIS). In an interference task, patients were instructed to respond to computerized Stroop tasks while ignoring a voice clip presented binaurally with the subject’s own name (SON) embedded in certain trials. Within-subject differences in reaction time and accuracy between Stroop trials with and without SON were used as parameters to measure the degree of attentional shift to SR information.
Between-group and within-subject differences in the reaction time and accuracy in the interference task were analysed using 2×2 mixed-ANOVA. Bivariate correlation was used to explore the relationship between IRIS scores and performance in the interference task. Stepwise linear regression analysis was used to explore the correlates of I/DOR.
Results
There was statistically significant interaction between conditions with and without SON and patient groups on the reaction time of the interference task (p=0.048). Simple main effects showed the mean difference of reaction time between conditions with and without SON was statistically significant in patients with I/DOR (p=0.001) but not in patients without I/DOR (p=0.862). Parameters used in the interference task correlated highly with IRIS global score and subscores on pervasiveness, self-referential discrepancy, conviction and frequency (r=0.328-0.517, range; p<0.05), unaltered by other clinical and cognitive variables except depressive symptoms and social anxiety. Regression analysis showed that I/DOR were related to depressive symptoms, social anxiety and attentional shift to SON.
Discussion
The significant interaction and simple main effect suggest that I/DOR are associated with a heightened attentional shift to SR information. The robust correlations between IRIS scores and attentional shift to SON provide some evidence to support the continuum hypothesis of I/DOR. The possible roles of emotions in the pathogenesis of I/DOR are discussed.
Significance
With the use of well-matched patient samples and an ecologically valid paradigm based on known human cognitive functions, the present study provided first empirical evidence for a theoretical link between cognitive anomaly and a key psychotic symptom. The SON paradigm provides a promising tool for further research and can potentially be developed into a neurocognitive parameter of I/DOR. The present study also shed light on the complexity of I/DOR in relation to other symptoms to inform future studies.published_or_final_version
Psychiatry
Master
Master of Research in Medicine
47
Tsui, Wing-sang, i 徐咏笙. "The relationship between public stigma associated with psychosis and previous contact with service users". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206601.
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Objectives: Stigma is believed to be one of the major barriers for the recovery process of persons with psychosis. Stigma-reducing program is believed to be able to enhance public knowledge and to improve treatment outcome as well as to alleviate discrimination and stigma. The current study therefore aimed at examining the level of public stigma of psychosis and its relationship with public attitudes towards patients with psychosis. The relationship of public’s stigma level, previous contact of persons with psychosis and the social distance scores on vignette will be studied.
Method: Seventy-seven subjects were recruited from public health talks on psychosis organized by the Jockey Club Early Psychosis Project (JECP).Public stigma towards psychosis would be tested by two scales: the validated tool The Public Stigma Scale (Chan et al., 2009; Mak et al., 2012) and The Social Distance Scales (Chung, Chen & Liu2001). Other assessments included subjects’ previous contact with patients of psychosis and their history of working in the medical field.
Results: The mean age of the subjects was 43.51 years (SD= 13.295); 23(32.5%) were male and 52 were female. In all, 15 (19.5%) had the history of working in medical field and 62(80.5%) worked in non-medical field; 49(63.6%) had pervious contact with the patients with psychosis while 28 (36.4%) did not have such experience. In our study, no correlation was found between overall stigma and number of contacts. Also, no correlation was found between overall stigma with gender and occupation. And we found that The Public Stigma and social distance were correlated. Subjects who had lower scores in the public stigma scale were related with less rejecting attitudes towards patient with psychosis.
Conclusion: In this study, we found that pervious contact did not have significant correlation with the stigma and attitude. Gender and history of working in medical field difference also did not have significant correction with stigma and attitudes. Further studies are recommended to explore more effective strategies in stigma-reducing programme.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
48
Wilquin, Hélène. "Repérage des psychoses débutantes : approche expérience et études expérimentales du sens d'agentivité et de l'horloge interne lors de la production de mouvements volontaires". Lille 3, 2011. http://www.theses.fr/2011LIL30006.
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L'émergence de troubles psychotiques est le plus souvent précédée par une phase dite "prodomique". Cette phase est marquée par l'apparition des premiers signes de la pathologie. Or, ces derniers revêtent un caractère aspécifique, rendant le dépistage précoce des psychoses difficile. La première partie du présent travail apporte une réflexion, et un retour d'expérience clinique, quant à cette notion de repérage précoce des psychoses chez les adolescents. Ces observations cliniques nous ont amenées à tester l'hypothèse selon laquelle des déficits, on observables directement par le clinicien, mais rapportés subjectivement par les patients pourraient être objectivées par la réalisation de tâches expérimentales. C'est ainsi qu'est abordée, en seconde partie du document, la question de la présence de distorsions temporelles dans la patholgie de la schizophrénie. Plus précisément, nous tentons de préciser la nature de ces distorsions, et testons l'hypothèse de leur apparition précoce dans l'évolution de la pathologie. La réalisation de trois études expérimentales, utilisant des tâches de synchronisation sensori-motrice, nous a permis de tester ces hypothèses. La première vise à confirmer l'existence de distorsions temporelles dans la pathologie de la schizophrénie au travers de l'utilisation d'une tâche de production de séquences de rythmes. Les deux études suivantes testent les hypothèses d'un dysfonctionnement de l'horloge interne et de déficits d'intégration temporelle chez les patients. Enfin, notre quatrième étude teste l'hypothèses d'un déficit d'agentivité d'origine précoce dans l'apparition de la pathologie psychotique, en lien avec des altérations de l'intégration temporelleThe emergence of frank psychosis is often preceded by a "prodromal" phase. This period of time is characterized by non specific and subtle signs and suggests the early manifestations of the disorder. This phase typically occurs in adolescents, and the none specificity of the clinical signs renders its detection difficult. The first section of the thesis is a return of clinical experience around the problem of the early detection of psychosis. The psychopathological observations that are reported led to the hypothesis that patients reveal a constellation of deficits ; none that are directly observable by the clinician. Nevertheless, these abnormalities are subjectively reported by the patients and may be revealed objectively through the sue of behavioral tasks. The second section of the thesis concentrates on a set of experimental tasks that aim at a better understanding of the origin and nature of the temporal distortions that characterize schizophrenia. More specifically, using spatio-temporal tapping tasks, our aim was to test the hypothesis that time disorders arise early on, right at the emergence of the illness. A first experiment was to run to confirm the presence of timing deficits in schizophrenia in a sensorimotor synchronization task. The two following studies were aimed at showing that these timing deficits were not associated to a dysfunctional internal clock but rather to a fundamental impairment in the integration mechanisms required for action planning. Finally, the last study assess whether early deficit in sense of agency could occur early, at the prodromal period, these perturbations being potentially associated with temporal integration deficits
49
Benamozig, Guy. "Enfermement et psychose : ces maladies de l'excès". Paris 5, 1993. http://www.theses.fr/1993PA05H008.
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A partir d'une monographie d'un cas de psycho-névrose obsessionnelle, nous tentons d'analyser les différentes représentations de l'enfermement et de la psychose (maladies de l'excès). Notre expérience clinique nous a aidé à décoder l'histoire d'un patient (HMPA "homme de marbre aux pieds d'argile) enferme dans une véritable forteresse. Cet univers du doute, de la vérification n'a pu s'appréhender qu'à partir d'un autre type d'outils thérapeutiques, (accompagnement, soutien c'est-à-dire une prise en charge réelle). L'analyste devient alors un passeur, un "go-between". La mise en place de "rituels de dérivation" permet au délire (qui a son ancrage dans le réel) de s'extérioriser, alors que des rituels efficients éviteraient probablement leur expression dans la psychose ou d'autres équivalents. C'est le travail que nous menons depuis plusieurs années. Afin d'éviter le piège d'une interprétation qui deviendrait à son tour une clôture, nous avons souhaité étayer notre étude sur la résistance a l'enfermement, par des témoignages de personnes ayant été confrontées à différents types de réclusion (déportés, détenus, reclus volontaires ou involontaires). Le recours à ces récits et descriptions littéraires, a pu également rendre compte, du point de vue de la création, de ce sentiment d'exclusion et d'enfermementWe have analysed from a case study of psychoneurotic obsessional patient many different representations of confinment and psychosis (exces of diseases). Our clinical and analytical experience helps to discover the history of a patient "HMPA" (homme de marbre aux pieds d'argile"), who has imprisoned himself in a veritable stronghold. The world of doubt and verification can be understood globaly by therapeutic methods such as companionship and support: an active kind of therapy. In this way, the analyst becomes a go-between and both his past and present environment. The expression of "derived rituals" allows the patient's delirium (which has a real origin) to break free and expose itself. The creation of modern rituals would probably present people from performinf "harmfull rituals", such as drug abuse, prostitution and suicide in order their expression through psychosis. To avoid the trap of in interpretation which becomes in itself an imprisonment, we support our study on the resistance of imprisonment with the accounts of people who have themself been imprisoned, such as deportees, prisoners and other reclusives. The access helps to literary descriptions also to unterstand these feelings of exclusion and confinement
50
Li, Suk-man Connie. "Vocal affect perception and social functioning of individuals with early psychosis in Hong Kong". Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41715299.
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