[AIDS, burnout and fear of knowing. Dialectic observations for the benefit of clinical psychology and liaison psychiatry]. / Sida, burn-out et horreur de savoir. Remarques dialectiques pour la psychologie médicale et la psychiatrie de liaison.

A review of the literature regarding burn-out provide a sample of specific variables that describes the phenomenon. This could potentially leads to the emergence of a set of actions intending to facilitate the task of health workers (at least if personnel managers pay it attention). However, it does not preclude the risk of burn-out, neither does it explain its nature. This syndrome seems to be more prevalent in certain medical departments and it occurs to us--through careful listening to health workers and AIDS patients--that, to learn about something that affects health workers, we have to ask patients, supposing they were in the first line. We then realized that knowledge makes distress.

Moclobemide versus clomipramine in the treatment of depression: a double-blind multicentre study in Belgium.

Moclobemide and clomipramine were compared for efficacy, tolerance and safety in 63 mixed endogenous and nonendogenous depressed patients. Treatment was given for at least 4 weeks in a double-blind, randomized, parallel-group design. The mean Hamilton Rating Scale for Depression score decreased gradually during treatment with no differences between groups. Two patients on clomipramine and none on moclobemide were withdrawn for lack of efficacy, and poor tolerance caused 3 patients on moclobemide and 7 on clomipramine to stop treatment prematurely. Patients with endogenous depression responded better to clomipramine, whereas nonendogenous disorders did better on moclobemide. Adverse events were more frequent in the clomipramine group and more of these were severe or very severe than for moclobemide. Thus, although no significant difference in efficacy was seen, moclobemide appeared to be tolerated better than clomipramine. The numbers were small, however, and many patients received concomitant medication, and the results are therefore difficult to interpret.

[Psychological management in critical care units. History of a long way]. / La prise en charge psychologique en réanimation. Histoire d'une "longue marche".

Some concepts of the General Systems Theory issued from the Social Sciences are used by Liaison psychiatrist and psychologist in the Intensive Care Unit. Human system, interaction process and circular causality, all concepts from the Systemic approach, are useful in order to describe and analyse both vital and existential crisis situation of the patient. As an expansion of the therapeutic context, the relationship among the patient, the family and the medical team are defined in terms of a partnership instead of a power conflict. Then, attention is focused on the distress resulting from these stressful situations, influenced by the "pangs of death". Emphasizing the importance and the role of anxiety allows to recognize a place for it and to offer to everybody an opportunity to talk about it. Finally, the psychotherapeutic function can be defined as the creation of a place given to the person as a Subject, based on the recognition of the fundamental misunderstanding of human illness.

[The patient as "demander": myth or reality? Preliminary correlative study]. / Le patient (...) "demandeur": mythe ou réalité? Une étude corrélative préliminaire.

It is often referred to the patient's "demand" in an attributive way, the patient being so considered as a "demander". The purpose is here to clear the way determining an attributive use of the concept and to test its relevance. Is there really a profile characterising this type of patient or is it only an abuse of language? While the results do not support the hypothesis of a patient's specific profile, an interaction pattern of supply and demand is suggested. The patient's difficulty to express a demand is considered with reference to psychosomatic disorders.