[Comparison between DSM III and CIM 9 in the data processing on computerized system. Study of 4000 records]. / Confrontation D.S.M. III et CIM 9 dans l'exploitation saisie sur système informatisé (1). Etude portant sur environ 4,000 dossiers.

The authors expose the results of a confrontation between ICD 9 and the D.S.M. III's classification published by APA. This work is the issue of a collected data system'use (S.D.P.A.) which is a basic tool for epidemiological programm, applied in military psychiatrics department (actually 18 services have got computer sets). It is evident that military structure (centralized dans homogeneous), and the size of the samples, are good conditions for psychiatric epidemiology. The authors recall the different stages and the difficulties on the field, for such a wide scale application. The use of two principal world-known classifications raise up unanticiped remarks: indeed, we consider the logical structure of D.S.M. III's axis I as better than ICD 9 classification. Meanwhile, the axis III, IV and V caused a disappointment, for both clinicians and programm's responsibles. In fact, there were some statistical biases and a little gain of informations. The former system (applied for 1976) was more efficient. Some hypothesis about that insufficient acceptability and reliability are proposed as also an important project for system's modifications from 1989.

[Physical and psychological traumatism. Dialectic of singular tragedy and biology]. / Traumatisme somatique et traumatisme psychique. La dialectique du tragique singulier et du biologique.

A good clinical assessment and a strict hospital's organization characterized essentially by the best climate of cooperation between the different departments permits now to control and to prevent some surgical sequelae. For a long time (approximately the 50's) generalists physicians, psychiatrists, behaviourists, have been limited in diagnosis and treatment afterwards. They could not take preventive measures, because the lack or insufficient acknowledge about this area. In fact, every surgical intervention implies psychic and existential, acute or long term disorders. A briefly summarized clinical case illustrate principles for the practice. The preventive approach of the post-surgical psychic troubles concern a lot of elements related to the patient's environement: social interactions, technic cares, types of drugs, style of relation between the specialized teams and patient, social and professional support and so on... The events, even the apparently minor, have to be enough mastered into the resuscitation's setting. The most important trouble is the "post-traumatic stress disorder" (cf D.S.M. III R), or (in the european traduction) a "névrose traumatique". It is a stress or illness of the whole existence, especially in the case of delayed subtype. The authors emphasize the notion of "second traumatism", often withdrived from social, familial and medical supports.

[Contributions and difficulties of the social approach in psychiatry: apropos of the American Forces and veterans in Vietnam. 3. Pathogenic and therapeutic problems in veterans]. / Les apports et les difficultés de l'approche sociale en psychiatrie: à propos des forces américaines au Vietnam et des vétérans. Troisième partie: Les problèmes pathogéniques et thérapeutiques chez les vétérans.

Especially among a wide psychiatric population, the risk of a mingling between etiology, pathogenesis and description, peculiarly between correlations and explanations, is an important stumbling-block. However, like as acute war diseases, the part of a previous psychical vulnerability appears to be less important than the classical one which is played by "stressors", chiefly in case of their summation. Here, interfere not only combat "traumas", but also the circumstances of the readjustment after returning. In spite of interesting contributions to the mechanisms of traumatic neurosis followed up after Vietnam conflict, the reflection about intrusive-repetitive syndrome does not seem to have given rise to new developments. Concerning the therapeutics, the opinions about the results achieved--particularly with psychotherapies, in fact delicate and protracted--are more pessimistic than that of the authors.

[Simulation of mental disorders. 1. Psychopathologic and psychosociodynamic aspects in a military environment]. / La simulation des troubles psychiques. 1. Les aspects psychopathologiques et psychosociodynamiques en milieu militaire.

In this paper, the author studies the malingering as a problem in the relationship between the doctor, patients and environment. Our field is the military community. After descriptive approach in the psychopathological disorders, the psychopathological and psychodynamic points of view give us the possibility to reach the most important level. This author's ideas are as follow--malingering is not a diagnostic but will be amount the general conditions of the relationship between doctor and his patient. The malingering is in some community, more one behavior of suspicion about some people than an attribution supported by facts. Finally, the suspicion of malingering as to be considered as an expression of the psychic phenomena in real groups funermore in the psychanalytical approach of the groups.

[Apropos of a case of sleep hypochondriasis]. / A propos d'un cas d'hypocondrie du sommeil.

About one case of an important sleeplessness for 4 years, the authors show the characteristics of this moan, which they would want to call it "Sleeping hypochondria". This hypochondria is very "efficient" because the sleeping quality is always subjective. More, patient and therapeut especially invest it. Oftenly, hypnotics are ordained. In this case, the confusion between offered and real symptoms could be grown. In fact, the last one is the patient moan, his speech subject. The treatment of this particular case, by paradoxical injunction, allowed to create a breaking of the patient system. The paradoxical cure, by made-self prescription, allows to understand much better the "insomnia work" in the aggressive relationship with the therapeut.