Evolution Psychiatrique最新文献

{"title":"Hospitalisations sans consentement : repères historiques et contemporains de l’intervention judiciaire dans le contrôle des mesures","authors":"Alice Viterbo (Praticien hospitalier contractuel)","doi":"10.1016/j.evopsy.2024.02.004","DOIUrl":"10.1016/j.evopsy.2024.02.004","url":null,"abstract":"<div><h3>Objectives</h3><div>The question of judicial control emerged with the debates surrounding the law of 30 June 1838 instituting psychiatric hospitalization. However, it was systematically rejected until the law of 5 July 2011. This article examines the conditions under which such control was introduced.</div></div><div><h3>Method</h3><div>The aim is to analyze the debates surrounding the protection of the rights of mental patients hospitalized under judicial control during the proposed reforms to compulsory hospitalization. The reasons for the exclusion of judicial control from the 1838 and 1990 legislation will first be examined, before looking at the conditions leading to judicial review in 2011.</div></div><div><h3>Results</h3><div>The introduction of systematic judicial control appears to be the result of the mobilization of patients’ associations, who brought the Question Prioritaire de Constitutionnalité (QPC) before the courts. This ability to use the law reflects a more developed legal knowledge, due to the legal route taken to assert their claims. This method of imposing reform bypasses the usual channels for reform.</div></div><div><h3>Discussion</h3><div>The reform has therefore led to the decision to unify litigation and to a systematic hearing by the <em>juge des libertés et de la détention</em> (JLD) for any patient hospitalized without consent.</div></div><div><h3>Conclusion</h3><div>The use of the QPC as a strategy for imposing reforms in psychiatry has flourished in the years since the reform, in particular to question the legality of other psychiatric practices. However, the ability of the law to prevent these decisions from being arbitrary needs to be questioned.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 145-160"},"PeriodicalIF":0.6,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Christine Maigne, Plan 2, 2014","authors":"Norbert Godon (artiste, conférencier)","doi":"10.1016/j.evopsy.2024.03.001","DOIUrl":"10.1016/j.evopsy.2024.03.001","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 417-418"},"PeriodicalIF":0.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction à une pulsion du mouvement à partir de « L’esquisse d’une Psychologie » de S. Freud. Le cas des mouvements autistiques","authors":"Vanessa Pilas-Le Fur (Doctorante au LAPCOS (UPR 7278), Psychologue clinicienne) ,&nbsp;Frédéric Vinot (Maître de Conférences, HDR, en Psychopathologie clinique – Professeu associé)","doi":"10.1016/j.evopsy.2024.02.002","DOIUrl":"10.1016/j.evopsy.2024.02.002","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this article is to identify the psychic function of those movements referred to as “wandering and roaming including the motor agitation that certain patients are presenting.” These considerations, which interested the first alienists, are still relevant in contemporary psychopathology, in particular regarding hyperactivity in autism, which will be our main focus. Based on the psychoanalytical concept of the drive, we propose an economic model leading from the body to the psyche, a model of the movement drive operating in clinical psychology.</div></div><div><h3>Method</h3><div>For this purpose, we will combine data from an epistemological study of the movement drive hypothesis with research on hyperactivity (Jean Bergès, Jean-Marie Forget) and autism (Marie Couvert or Marie Christine Laznik). An in-depth study of one of Freud's pre-psychoanalytical texts will enable us to identify Freud's special interest in the question of movement (<em>Bewegung</em>) rather than motor skills, and its effects on the psychic structuring of the new-born child at the dawn of its encounter with its environment.</div></div><div><h3>Results</h3><div>It will then be possible to develop a model of a movement drive and its structuring effects: on the body, from motor agitation to the appropriate action, and on the psyche by the construction of the subject's own singular spaces. On the basis of this theoretical model, we will identify what we call “continuous walking” in autistic subjects.</div></div><div><h3>Discussion</h3><div>We will then discuss whether or not each individual/human subject is able to move within the space produced by the structure; in other words, the possibility of a differential diagnosis based on the question of movement and the appropriation of space.</div></div><div><h3>Conclusion</h3><div>The movement drive finds coherence in psychoanalytical writings, and proves to be effective for thinking about the support of the suffering individual/human subject, taking into account the articulation between body, psyche, and space.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 1","pages":"Pages 45-58"},"PeriodicalIF":0.6,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspects scientifiques et cliniques des médiations thérapeutiques : quelle prise en soin pour les victimes de l’explosion du port de Beyrouth ?","authors":"Odette Chesnot (Art-thérapeute, Docteur en psychologie clinique, Membre de la Société Medico-Psychologique, Fondatrice de l’Association libanaise des victimes du terrorisme, Consultante à l’UNODC (Office des Nations Unis contre la drogue et le crime)) ,&nbsp;Silke Schauder (Professeure de psychologie clinique et psychopathologie à l’UPJV, Co-responsable de la spécialité Arts-plastiques Art-thérapie à l’Université Paris Cité, Psychologue clinicienne, art-thérapeute, Membre de la SFPE-AT et du groupe de recherche sur les processus de création Pandora)","doi":"10.1016/j.evopsy.2024.02.001","DOIUrl":"10.1016/j.evopsy.2024.02.001","url":null,"abstract":"<div><h3>Objectives</h3><div>After reviewing current research in art therapy, this article discusses the therapeutic effectiveness of clay workshops in cases of individual or collective traumas. Specifically, it advocates for the interest and specific indication of this method, which promotes health-generating creative processes. How do these processes facilitate identity reconstruction and psychological repair for the victims?</div></div><div><h3>Method</h3><div>In a clay workshop, 10 group sessions, spread over a year, were offered to four women and four men who survived the explosion on August 4th, 2020, at the port of Beirut. Using a case study involving the analysis of a patient's artistic productions, the psychic processes facilitated by this type of therapy were highlighted. Determining inclusion in the group, clinical progress was assessed using Traumaq, which provides a comprehensive evaluation of clinical aspects related to trauma, such as anxiety, depression, memory disorders, and difficulties regaining a sense of security. Administered at the beginning, midway, and at the end of treatment, the PCL-5 Post-traumatic Stress Disorder Checklist aimed at identifying different trauma characteristics, allowing for a quantitative assessment of the patient's clinical evolution. Finally, six individual sessions, combined with the analysis of productions in the group workshop, provided qualitative elements necessary for a clinical understanding of the patient.</div></div><div><h3>Results</h3><div>Notably, symbolization through clay and the independence of art therapy from language skills were highlighted as key factors in helping heavily traumatized individuals overcome mutism, depression, and shock. Thus, resorting to non-verbal expression allowed patients to avoid re-traumatization through an immediate narrative of the explosion. Their PCL-5 scores significantly decreased at the end of treatment, indicating an important clinical improvement. Heightened self-esteem and the return of the ability to relate to others were observed, supporting the patients’ desire to recommit to new projects.</div></div><div><h3>Discussion</h3><div>Emotional and behavioral reactions such as avoidance, hypervigilance, dysphoria, and flashbacks in the patient were alleviated through the secure, relaxing, and sensory experience of working with clay. In the workshop, the group dimension emerged strongly, demonstrating the importance of sharing the experience of both the medium and the traumatic event.</div></div><div><h3>Conclusion</h3><div>These encouraging results invite further research into creative processes in art therapy. By expanding the studied cohorts, diversifying the media and the evaluative tools used, and by extending the indication to other pathologies, the effectiveness of art therapy will be even better demonstrated.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 661-678"},"PeriodicalIF":0.6,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Henri Ey et le LSD : analyse d’un pré-rapport de 1958 sur les expériences thérapeutiques menées à Bonneval","authors":"Zoë Dubus (Docteure en histoire contemporaine, postdoctorante à l’Université de Saskatchewan, College of Arts, Science, Department of History, Bénéficiaire de la bourse Banting du Conseil de recherches en sciences humaines (CRSH) canadien, Chercheuse associée à l’unité PSYCOMadd de l’hôpital Paul Brousse de Paris, membre du réseau scientifique de l’Institut des humanités en médecine du CHUV de Lausanne)","doi":"10.1016/j.evopsy.2024.01.007","DOIUrl":"10.1016/j.evopsy.2024.01.007","url":null,"abstract":"<div><h3>Objective</h3><p>In 1958, a medical team at Bonneval Hospital, headed by the famous psychiatrist Henri Ey, decided to experiment with a promising new psychotropic substance: LSD. This was one of the first research projects of its kind in France. Until then, only a Parisian team, led by Jean Delay, had published similar essays. Yet Henri Ey's team never published their results. Only an internal report was written, then lost – or destroyed during the period when studies on psychedelics were halted – by the institution where it had been filed. After months of research, an older part of this report was found in an archive.</p></div><div><h3>Methods</h3><p>Despite the fact that the document is not complete (in particular, the self-experiments carried out by the medical team are missing), it is a unique source for understanding the French context of psychedelic research in the 1950s–1960s. The archive presents 19 cases of female patients, aged between 17 and 59, all with a low level of education. The dose was usually 100 to 150<!--> <!-->μg and was mainly injected. Each case report describes the patient's characteristics, medical history and, in some cases, biographical details. Next comes the course of the session (which is unique, except for one patient who receives LSD twice), sometimes minute by minute, with a few comments from the doctors and transcriptions of some of the patient's words. Each report concludes with a brief analysis by the medical team of the session and its aftermath. This article analyzes the protocol used to carry out these trials, as well as the patients’ reactions to the treatment, and compares the method used to those developed at the same time in Anglo-American countries.</p></div><div><h3>Results</h3><p>In a very specific way, the context of therapeutic use of psychedelics in France stands in stark contrast to the methodological developments observed in other Western countries at the same time. The concepts of set and setting, which were being developed at the time, were not adopted by the French teams, who remained within the framework of shock therapy. Patients were given no information concerning the expected effects, no support to reassure them during the experience, and their requests for contact were systematically interpreted in erotic terms. Despite their panic (which could go as far as vomiting), some were left alone. Doctors also sought to refine what they knew about reactions to LSD, and did not hesitate to test their patients to observe their behavior, for example by trying to make them believe that the injection they had received did not actually contain any substance. Under these conditions, session reports were mostly tinged with anguish and even terror. Although the team reported one case of recovery and 4 cases of “slight improvement,” the majority of patients experienced a worsening of their condition as a result of the experience.</p></div><div><h3>Discussion</h3><p>This exceptional archive gives","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 377-398"},"PeriodicalIF":0.6,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140084008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ne pas faire sans blanc. À propos de… « Psychothérapie de l’invisible. Le sens et la preuve » de Gilles Marcellot","authors":"Gaëtan Collignon (Psychologue clinicien, Doctorant)","doi":"10.1016/j.evopsy.2024.01.006","DOIUrl":"10.1016/j.evopsy.2024.01.006","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 4","pages":"Pages 852-856"},"PeriodicalIF":0.6,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Processus de maternité et fonctionnement limite : une approche longitudinale à l’aide du Rorschach","authors":"Julia Neyroud (Psychologue) ,&nbsp;Rose-Angélique Belot (Psychologue clinicienne, Professeure des Universités, Psychologie clinique et Psychopathologie) ,&nbsp;Pascal Roman (Professeur de Psychologie clinique, Psychopathologie et Psychanalyse)","doi":"10.1016/j.evopsy.2023.12.005","DOIUrl":"10.1016/j.evopsy.2023.12.005","url":null,"abstract":"<div><h3>Objectives</h3><p>This article aims to study the psychic changes during maternity in primiparous women without psychic and organic disorders and to put into perspective the reorganizations during the maternity process in patients with a borderline psychic functioning.</p></div><div><h3>Method</h3><p>This paper is based on longitudinal data collected with the Rorschach test. Two clinical cases revealing this processual dynamic will be analyzed and discussed.</p></div><div><h3>Results</h3><p>The analysis of Rorschach protocols of two women with different psychic elaboration capacities reveals an experience of boundary invasions linked to the precariousness of psychic envelopes between the end of pregnancy and the beginning of postpartum, followed by a reinforcement of certain defensive mechanisms post-delivery in order to compensate for the state of disorganization linked to the processes of motherhood.</p></div><div><h3>Discussion</h3><p>The analysis of these data will allow us to observe modalities of psychic arrangements specific to the maternity process as well as reorganizations, close to a “symbolization catastrophe”.</p></div><div><h3>Conclusion</h3><p>The psychic dispositions of women during maternity allow us to detect borderline arrangements of psychic functioning during this period.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 283-298"},"PeriodicalIF":0.6,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140465320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le cas de Monsieur Y. : du traumatisme à l’exception","authors":"Jessica Tran The (Psychologue clinicienne, Maître de Conférences)","doi":"10.1016/j.evopsy.2023.12.006","DOIUrl":"https://doi.org/10.1016/j.evopsy.2023.12.006","url":null,"abstract":"<div><p>The objective of this article is to clarify the specificities of the psychoanalytic approach to trauma, based on the study of a single clinical case. Whereas contemporary discourses tend to emphasize the role of lived events in the emergence of a psychopathological picture, we aim to demonstrate how psychoanalysis operates a shift in perspective vis-à-vis deterministic and linear explanatory models. Focusing on the case of a psychotic patient in his fifties who had lost his sight following a gunshot wound, we demonstrate how psychoanalysis invites us not to place the emphasis intrinsically on a past event. Rather, it suggests looking at the singular and unpredictable response of the subject as an individual, in a diachronic perspective that takes into account the importance of temporality and hindsight. In this way, I was able to study how this patient gradually integrated the traumatic event into a singular subjective construct. In turn, this allowed me to understand the stabilizing mechanisms of this construct, through the prism of the Freudian hypothesis of delusion as an “attempt at healing”.</p></div><div><h3>Method</h3><p>The method I adopted is that of the single case study. This approach was chosen as it is the only one that can illustrate the singularity of the subject's response in its diachronic character. In particular, I deliberately chose the style of an analytical case study. This differs from the ideal of scientific objectivity insofar as the psychoanalytic technique is characterized by the importance given to the transferential dimension in the cure, and thus calls upon the subjectivity of the therapist. Thus, I endeavored to reconstruct the history of this patient in its diachronic unfolding, by recounting the biographical and anamnestic elements as they appeared during the clinical encounter. To support this further, I integrated elements from the archival consultation of medical records. I then studied the evolution of the patient's subjective position through the prism of Freudian and Lacanian theories on psychosis.</p></div><div><h3>Results</h3><p>A psychoanalytic approach made it possible to demonstrate that in this patient, his position as the object of an injury predated the occurrence of his wounding by firearm. This later event was thus initially reintegrated, by him, within the framework of the logic of the delusion of persecution that predated it. Nevertheless, the social recognition of his position as a victim may have induced in him a pacifying effect. He was able to reinterpret the event in the aftermath, based on the construct of a position of exception. In that position, he assumed the figure of the ‘seer’ who played the role of naming, leading to a significant appeasement of the persecution anxieties.</p></div><div><h3>Discussion</h3><p>Here I propose a discussion of the possible similarities between the position of exception constructed by this patient, and the cases of President Schreber and the writer","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 323-355"},"PeriodicalIF":0.6,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141095202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CV2 - editorial board","authors":"","doi":"10.1016/S0014-3855(24)00010-0","DOIUrl":"https://doi.org/10.1016/S0014-3855(24)00010-0","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 1","pages":"Page CO2"},"PeriodicalIF":0.6,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014385524000100/pdfft?md5=b47caf6018e963596d51c593b52e10fc&pid=1-s2.0-S0014385524000100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139738716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Science et soin du psychisme dans l’œuvre de Georges Canguilhem","authors":"Luc Surjous (psychiatre, pédopsychiatre)","doi":"10.1016/j.evopsy.2024.01.005","DOIUrl":"10.1016/j.evopsy.2024.01.005","url":null,"abstract":"<div><h3>Objectives</h3><p><em>L’Essai sur quelques problèmes concernant le normal et le pathologique</em>, a medical thesis defended in 1943 by Georges Canguilhem (1905–1995), is certainly the best-known French text on the epistemology of medicine. Canguilhem, then a young philosopher, medical student, and member of the French Resistance, defends the self-determination of the living individual, capable of judging what is normal or pathological – categories subsequently adopted by medicine and physiology – as well as a conception of the medical practice tailored to the singular situation. His argumentation is largely based on the theories of psychiatrists, yet excludes psychopathology from its scope. It is this paradox, little studied until now, that I attempt to resolve in this article.</p></div><div><h3>Methods</h3><p>I have conducted an extensive study of the texts on psychology and mental care in G. Canguilhem's archives, his recently published complete works, and current academic research.</p></div><div><h3>Results</h3><p>I propose to return to the two problems presented at the beginning of the <em>Essai</em>: “that of the relationship between science and technology, and that of norms and the normal”. Canguilhem responds to the latter by proposing the concept of vital normativity, which follows on from earlier work on psychology, presented in high school courses in the 1930s and in a <em>Traité de psychologie</em>, never published, which already promoted a subject able to value, to commit, and thus to escape from the determinism of his environment and organism. Regarding the relationship between science and technology, which Canguilhem began to conceptualize at the very end of the 1930s, in his <em>Essai</em>, he proposes a path that reverses that of positivism, moving from clinical practice to science, in which the former is clarified by the latter; however, scientific psychology cannot play a role equivalent to physiology in psychological care. Indeed, Canguilhem considers psychology's claim to objectivity incompatible with the respect for subjectivity that his <em>psychologie réflexive</em>, on the contrary, defends. To conclude, I examine Canguilhem's few writings on psychotherapy, as well as those on psychopharmacology.</p></div><div><h3>Discussion</h3><p>I discuss the clinical consequences of the inability of scientific psychology to play a role in psychotherapy similar to that of physiology in medicine.</p></div><div><h3>Conclusion</h3><p>Canguilhem's conception of psychological care is essentially a defense of human dignity, based on a philosophical, not a scientific, theory of the individual.</p></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"89 2","pages":"Pages 357-376"},"PeriodicalIF":0.6,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139877713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}