[Feeling of non-acknowledgment at work, disappointment and burnout, an exploratory study]. / Sentiment de non-reconnaissance au travail, déception et burnout : une exploration qualitative.

The feeling of not being acknowledged at work, though frequently reported, is rarely addressed in itself. As the reflection of a subjective position that is as much existential as it is institutional or professional, it emerges through the monitoring of a hospital-based closed discussion group for a period of six years as a screen masking more personal dimensions that are anything but clear to the subjects and rarely thought about in themselves. This leads us to question the system of representations adopted by caregivers and their ability to be satisfied. It imbues the speech of people with burnout syndrome with a tone of profound disappointment and translates a feeling of uselessness, of professional expectations that were probably too high to be satisfied. In effect, it disrupts subjects' relationship to their work, to their professional environment and even to their patients. It consequently deserves to be listened to more attentively.

Anxiety and subjective quality of life preoperatively and 4 months after reduction mammaplasty.

OBJECTIVE: The aim of this study was to evaluate the development of anxiety, psychological distress, and subjective quality of life on the basis of the criteria of satisfaction and expectations in a group of women who had undergone reduction mammaplasty for cosmetic reasons. METHOD: The population consisted of 20 women who had requested breast reduction treatment [mean age, 34.70 (+/-10.94)] for cosmetic reasons. After being informed of the purpose of the study and after giving their written consent, the subjects took part in a psychological examination conducted at two different times (T1, initial medical consultation; T2, 4 months after surgery). At each of these stages, the psychological evaluation consisted of a clinical interview and questionnaires: the Subjective Quality of Life Profile, State-Trait Anxiety Inventory, and the General Health Questionnaire. RESULTS: The results showed that the subjects improved significantly between T1 and T2 in terms of state anxiety (P=.04), trait anxiety (P=.002), sleeping disorders (P=.003), difficulty in enjoying their activities (P=.008), and a number of dimensions of subjective life quality: pain (P=.009), physical appearance (P=.003), social life (P=.03), and inner life (P=.03). The study showed that satisfaction with treatment was correlated with satisfaction with medical relations (P=.05) and medical information (P=.05) at T1 and with greater satisfaction with friendship relations (P=.05), sexual relations (P=.05), and inner life (P=.05) after the operation (P=.01). Conversely, a greater level of anxiety at T3 was correlated with reduced satisfaction with the surgical treatment (P=.05). CONCLUSION: This study demonstrates the importance of evaluating surgical and cosmetic treatment in terms of psychological dimensions and emphasizes the improvement in psychological well-being during the postoperative phase.

Brain injured patients versus multiple trauma patients: some neurobehavioral and psychopathological aspects.

BACKGROUND: The study aims to describe the neurobehavioral and psychopathological disorders in road crash victims with cerebral lesions compared with multiple trauma sufferers with no brain damage. METHODS: This study compares the neuropsychological and psychopathological developments of two groups of road crash victims (25 severe brain injuries (SBI) and 25 multiple traumas (MULT)) on the basis of the Neurobehavioral Scale, the SCL 90-R and the State/Trait Anxiety Scale. RESULTS: On the basis of the Neurobehavioral Scale, it was clear that the SBI patients suffered from significantly more disorders of type factor 1 (self-appraisal and flexible thinking), factor II (withdrawal), factor III (mood swings, irritability, disinhibition, excitement), factor IV (attention, slower motor responses, and mental fatigue), factor V (articulatory problems, problems of oral expression, and oral comprehension) and nonfactored disorders (exaggerated somatic concerns). On the SCL 90-R scale, we observed a higher level of obsessive symptoms in the SBI patients, whereas there was no significant difference between the two groups on the State/Trait Anxiety Scale. Unexpected results indicated that the multiple trauma patients suffered from memory troubles (60%), concept disorganization (32%), loss of initiative (36%), irritability (52%), unusual thought content (40%), mood swings (40%), attention difficulties (24%), suspiciousness (48%), and feelings of guilt (36%). CONCLUSION: Even though multiple trauma sufferers do not receive a psychologic assessment of their cerebral functioning, and do not benefit from any rehabilitation, they exhibit neurobehavioral and psychopathological disorders which need to be taken into account when designing rehabilitation programs. This study points toward new therapeutic methods for the treatment of multiple trauma sufferers.

Precocity of the acquisition of language and type II spinal muscular atrophy in 3-4-year-old children: a study of 12 cases.

We studied the development of language in 3-4-year-old children with type II spinal muscular atrophy (SMA) (10 boys and two girls), aged 36-47 months (mean age 39.83+/-4.68 months) and compared our findings to a control group of 26 healthy children (mean age 40.00+/-4.43 months, 22 boys and four girls). We carried out a lexicogrammatical analysis of the data and we observed significant differences in the "vocabulary", "nouns", "verbs", "words" and "adverbs" variables between the children with SMA and the controls. Three- to four-year-old children suffering from type II spinal muscular atrophy, an autosomal genetic disease causing severe physical handicap (motor, functional, respiratory), presented a higher level of lexical and semantic development than the controls, demonstrating the precocity of development of morphosyntax in these children.

Emotional factors and subjective quality of life in subjects with spinal cord injuries.

OBJECTIVE: To compare depression, subjective perception of quality of life, and social support in patients with spinal cord injuries 4 yr or more after trauma vs. controls. DESIGN: The Rorschach inkblot method, the Diagnostic Interview Schedule Self-Administered, the Progressive Matrix 38, the Social Support Appraisals, and the Subjective Quality of Life Profile were used to assess 33 patients with spinal cord injuries and 33 matched controls. RESULTS: No significant difference was observed for levels of general intelligence and depressive disorders. Subjects with spinal cord injuries assessed the general subjective quality of life as satisfactory, with exceptions for sexuality, physical condition, leisure activities, and holidays. A high degree of satisfaction with medical staff and inward life was observed. Social support was perceived as positive. However, they presented emotional distress, deteriorating perceptions, extreme preoccupation with their bodies, and diffuse anxiety. CONCLUSION: Although quality of life as evaluated by the persons concerned was good, areas of their lives remained unsatisfactory and a source of mental suffering. The next stage would study the factors involved and the means needed to help these subjects improve these aspects of life.