[Space and psychopathology. From semiology to a therapeutic framework]. / Espace et psychopathologie. De la sémiologie au cadre thérapeutique.

Space is a fundamental aspect of the human being, but it is often neglected in clinical psychology. A clinical examination has to take into account the different dimensions of space, which is acted, organized, inhabited, experienced, represented and imagined. A clinical examination also consists in different stages: the person who is talking about his spatial organisation is looked at, listened to and his spatial representations are studied. Failures in the spatial organisation have consequences on the treatment course, and especially on the way the therapeutic environment can be experienced and accepted. Adjustments could be foreseen according to the clinical diagnostical study. The environment is the trustee of archaic glischocaric anguishes, but the patient keeps his own representation of his environment. The study of spatial marks implies looking for the fundamental marks of the human being as well as the existence of a mystical space that has to be differenciated from a pathological space.

Is major depressive disorder in adolescence a distinct diagnostic entity?

The concept of major depressive disorder in childhood and adolescence is reviewed and it is suggested that contemporary enthusiasm for this diagnosis may have outrun the evidence that it is a distinct categorical entity. To test the hypothesis that major depression is not a qualitatively distinct disorder in adolescence, but rather a continuously distributed, noncategorical syndrome, the behavioral rating scales (CBCL-P) of 216 hospitalized adolescent patients were analyzed first by principal components analysis and then by cluster analysis. Three behavioral syndromes were isolated by principal components analysis. Of three groups of patients identified by a subsequent cluster analysis, one was consistent with the concept of a categorically distinct "nuclear" depression. However, a noncategorical continuously distributed depressive syndrome appears to affect a larger number of patients in this age group, and the "nuclear" disorder may be less prevalent than is currently assumed. One explanation of these findings would combine a categorical model of nuclear depression with a dimensional model of dysthymia.

[Epilepsy, mourning and psychotherapy]. / Epilepsies, deuils et psychothérapies.

The authors, starts with the apparent generalized lack of sense, the non sense, about everything to do with epilepsy; he tries to understand the meaning of this excess of non sense. He first tries to find the possible utility for the psychic economy of the patient and his environment. Then, based on beginnings of meaning which do emerge, particularly at the time of the first crisis, he sketches the broad lines for a possible framework of psychotherapy; this is followed by a more theoretical discussion. This attempted synthesis is based in particular on the frequency of observations of the patient's identification with a double of his death. The author adopts for his purpose the concept of the crypt from which is derived the notion of the double of the self. Finally, a hypothesis is proposed which aims at understanding the mechanism of the constitution of this double, based on the family secret. To construct this hypothesis the author uses the comparison between real and imaginary doubles, trying to find in that the sense of the lack of sense.