Annales medico-psychologiques最新文献

{"title":"Amélioration des troubles moteurs et de la symptomatologie autistique par une approche centrée sur l’axe corporel : à propos de deux cas","authors":"Sylvie Pussino,&nbsp;François Darchen","doi":"10.1016/j.amp.2026.02.005","DOIUrl":"10.1016/j.amp.2026.02.005","url":null,"abstract":"<div><div>Motor dysfunction is commonly associated with autism spectrum disorders (ASD). However, even if it may represent an intrinsic dimension of ASD it is not thought of as a relevant therapeutic target. Here we describe the postural, motor, and autistic characteristics of two children with ASD, a girl aged 3 years and 9 months and a boy aged 4 years and 7 months at enrollment, and their evolution over 20 or 23 months in response to interventions targeting these postural characteristics. Both met DSM-5 diagnosis criteria for ASD. In both cases, asymmetric postures, twisting around the longitudinal axis, and underuse of the hands, particularly the thumbs, were observed. The children were repeatedly encouraged to engage in motor experiences involving their spatial cues and body axes and to correct their postures. We assessed more than fifty items describing motor particularities, communication, and social interactions. We observed a progressive and synchronous improvement in most of the items. In particular, communication and interaction skills improved in a similar way to motor skills. CARS scores also improved from 36 at initial assessment to 26 at the end of the follow-up for the boy and from 39.5 to 30 for the girl. These results suggest that motor dysfunction is an intrinsic dimension of autism and that interventions aimed at improving motor organization around a ‘body axis’ could benefit children with ASD.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 6","pages":"Pages 420-428"},"PeriodicalIF":0.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148571866","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":"Impact des lignes de crise sur la santé mentale des vétérans : une revue systématique de la littérature","authors":"Céliane Da Silva,&nbsp;Nathalie Forestier,&nbsp;Maïlys Friderich,&nbsp;Francky Teddy Endomba,&nbsp;Jean-Christophe Chauvet-Gélinier","doi":"10.1016/j.amp.2025.11.007","DOIUrl":"10.1016/j.amp.2025.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Providing mental health and psychological support to military personnel and veterans is a global public health challenge given the prevalence of wars and conflicts around the world and the threat of terrorist attacks. In this context, mental health crisis lines are of interest, and have been widely studied in the general population, particularly for suicide prevention. However, to our knowledge, there has been no synthesis published on the impact of these lines on the psychological wellbeing of military personnel and veterans. Therefore, the aim of this review was to examine the impact of crisis lines on the mental health of US military personnel and veterans.</div></div><div><h3>Methods</h3><div>After registering our protocol with the International Prospective Register of Systematic Reviews (PROSPERO number<!--> <!-->=<!--> <!-->CRD42024564800), we systematically searched PubMed/MEDLINE and Web of Science for relevant articles published up to 18 June 2024. As outcomes of interest in eligible studies, we targeted the short-term effects (e.g., suicidal ideation) and medium- to long-term consequences (e.g., subsequent adherence to mental healthcare) of veterans’ contacts with crisis hotline (phone calls, chat, and text messages). We assessed the methodological quality of the included studies using ROBINS-E (Risk of Bias in Non-randomized Studies–of Exposure) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines.</div></div><div><h3>Results</h3><div>Of the 273 articles initially identified, six were included in our review. Sample sizes ranged from 155 to 9010, with a total of 11,401 participants, a male predominance, and a mean age from 46 to 50 years (three studies). Most of included studies (five on six) used national database. Three studies examined the referrals for care provided following each call. Two studies focused specifically on the effect on suicidal thoughts, and one study examined the rate of care engagement following a call. The effect of crisis lines was found to be positive for each outcome, according to the respective studies. Specifically, there were significant reductions in psychological distress and suicidal ideations, and a positive effect on subsequent adherence to mental health care. The risk of bias was high in two studies and moderate in the other four. The domains that showed the most concern and bias were those related to confounding factors and missing data.</div></div><div><h3>Conclusion</h3><div>The promising results of this review on US military personnel and veterans highlight the potential benefits of crisis lines for armed forces. It seems valuable to strengthen these findings with studies involving other military/veteran populations worldwide, particularly in France.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 6","pages":"Pages 446-454"},"PeriodicalIF":0.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148557275","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 cannabidiol : ivresse subjective et potentiel thérapeutique","authors":"François-Rodolphe Ingold ,&nbsp;Charles D. Kaplan ,&nbsp;Christian Sueur ,&nbsp;Dan Tan","doi":"10.1016/j.amp.2025.04.005","DOIUrl":"10.1016/j.amp.2025.04.005","url":null,"abstract":"<div><div>The authors describe the history of cannabidiol, from its discovery by Adams in 1940 to the current popularization of its use. Its place and functions in relation to other cannabinoids are discussed as well as its potential therapeutic indications. The notion of well-being, as manifested through a subjective altered state of mind as well as the social uses of this molecule is analysed and related to its clinical interest.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 5","pages":"Pages 365-368"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148193567","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":"Folie à deux : éléments d’analyse d’un système","authors":"Chloé Marotte ,&nbsp;Lionel Dantin","doi":"10.1016/j.amp.2025.04.010","DOIUrl":"10.1016/j.amp.2025.04.010","url":null,"abstract":"<div><div>In a relatively small scientific literature, it appears that the psychiatric entity “Folie à deux”, whose incidence remains difficult to assess (estimated from 1.7 to 2.6%, Wehmeier et al., 2003), is mainly approached in the light of case studies (Arnone et al., 2006). In line with this work, our article relates the case of a 51-year-old patient, Mrs. A, from her hospitalization in psychiatric unit until one year after her release, by retracing the significant elements of her history, with an attempt to explicit the different cognitive biases at work. This article proposes to adopt a systemic interpretative framework, through a questioning of the family dynamics surrounding the patient and her evolution. Upon her admission, the Positive and Negative Syndrome Scale (Kay et al., 1987; Lancon et al., 1999) was used, suggesting a diagnosis of late onset schizophrenia, characterized by a predominance of persecutory themes. Over time, her mood improved with Olanzapine, and her persecutory ideas diminished, although she did not criticize her beliefs. Interviews with Mrs. A. and her parents revealed cognitive biases such as external attributional style among the parents. The patient and her mother displayed also arbitrary inferences, overgeneralization and bias against disconfirmatory evidence. The PDQ-4+ personality questionnaire (Hyler, 1994; Laconi et al., 2016) highlighted paranoiac traits in both parents. Mrs. A. background revealed a social isolation, with elements indicating a possible premorbid schizoid personality; the onset of her delusions coincided with conflicts involving neighbors. She was hospitalized for one month; therapeutic alliance was established, facilitating her follow-up despite the cessation of medication. One year later, she manifests a partial insight into her delusions. Although cognitive biases persisted, she also manifested a less restriction in daily life activities. We propose then a systemic interpretative framework, drawing on principles from the Palo-Alto's school: the family dynamics play a crucial role in the emergence of shared delusions and the relationship between Mrs. A and her mother exhibits characteristics of both symmetry and complementarity. The delusional process may represent an attempt to equalize the power dynamics within their relationship. In conclusion, this article posits that the delusions experienced by Mrs. A and her mother can be understood as an emergent property of their family system. The interplay of their personalities and the dynamics of their relationship contributed to the development and maintenance of “Folie à Deux”. This case underscores the importance of considering systemic factors in the assessment and treatment of this trouble.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 5","pages":"Pages 318-322"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148193559","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 jeu vidéo et les formes primaires du double","authors":"Johann Jung (Psychologue clinicien, Docteur en psychopathologie et psychologie clinique, Maître de conférences, Habilité à diriger des Recherches, Université Lumière Lyon 2) ,&nbsp;Guillaume Gillet (Psychologue clinicien, psychothérapeute, Centre Hospitalier de Saint-Cyr au Mont-d’Or, Doctorant en psychopathologie et psychologie clinique à l’Université Lumière Lyon 2)","doi":"10.1016/j.amp.2025.04.011","DOIUrl":"10.1016/j.amp.2025.04.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This article examines the subjectivizing effects of the materialization of psychic processes in video games, especially through “primary forms of the double” that is, proto-representational and non-anthropomorphic forms of the double encoded within the software's source code and actualized through the player's engagement.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Our work is based on a review of psychoanalytic literature on the double and on an analysis of the video game &lt;em&gt;Flowers&lt;/em&gt;, approached from the perspective of a “clinical” examination of technological devices.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The study of the double enables us to identify its origins, variations (animic, auto-erotic, narcissistic material), and functions (defensive, regulatory, and creative). It further clarifies the double's essential role in both the creative and theorizing processes of psychoanalytic metapsychology and in the transitional construction of subjectivity, through two phases emerging within early interactions of adjustment and attunement between the mother and her infant. The detailed presentation and clinical analysis of the progression, play modalities, and content of the video game &lt;em&gt;Flowers&lt;/em&gt; thus lead to exploring primary manifestations of the double, unfolding through the specific characteristics of this software and responding to the player's actions via their manipulation of the hardware interface and the effects produced within the immersive digital-virtual environment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The &lt;em&gt;Flowers&lt;/em&gt; software offers an immersive experience within a containing space endowed with transformative properties, alongside play modalities that simulate the early stages of an intersubjective relationship, in a prenarrative form, producing a sensation of simultaneously belonging to this ensemble and being distinct from it. Its use evokes transmodal correspondence, consensuality, and envelopment, echoing relational modalities between the subject and their primary environment. It invites the player to invest in and subjectively appropriate the software environment, projecting their corporeality into the imagery and engaging in sensorimotor forms of symbolization, drawing on the emergence of transitional experiences of doubling with the machine-software dyad. The specific properties of this software, particularly its self-animation function, allow the player to experience a quasi-magical power of animation within a responsive-interactive video universe, supporting the actualization of an animic doubling process. Two types of double experiences are described: the first — the found-created double — corresponds to the narcissistic illusion of encountering oneself in contact with the invested and perceived object, thereby accessing an initial subjectivizing nucleus. The second — the destroyed-found double — refers to the disillusionment associated with a form of resistance, an alterity that the player","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 5","pages":"Pages 303-308"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148193557","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":"Psychotropes et personnalité borderline : prescrire, ne pas prescrire, déprescrire ?","authors":"Fabrice Berna ,&nbsp;Maeva Musso ,&nbsp;Sébastien Weibel ,&nbsp;Matthias Brunn","doi":"10.1016/j.amp.2026.03.011","DOIUrl":"10.1016/j.amp.2026.03.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Context&lt;/h3&gt;&lt;div&gt;Therapeutic recommendations for borderline personality disorder emphasize the importance of offering, as first-line treatment, structured psychotherapies aimed at improving emotional regulation skills and reducing self-harming behaviors. Psychopharmacological recommendations suggest limiting psychotropic drugs to short-term use in case of acute situations associated with severe symptoms. However, analysis of psychotropic prescriptions for borderline personality disorder shows widespread use of psychotropic drugs (96% have received at least one psychotropic drug), mostly in combination therapy (50% take three or more psychotropic drugs, 19% to 26% take four or more) and prescribed on a long-term basis. This finding contradicts therapeutic recommendations and contradicts (1) the results of numerous randomized controlled trials that fail to provide solid evidence of clinical efficacy on the main therapeutic goals for borderline personality disorder, (2) population-based studies that show an increased risk of rehospitalization, suicide attempts, and even death associated with use of antidepressants, antipsychotics, and benzodiazepines. This risk was only reduced by the use of certain psychostimulants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We analyze some individual (involving patients and prescribers) and structural (psychiatrist training, healthcare system organization) factors of the over-medicalization or over-medication of borderline personality disorder in France. We discuss the fact that the fragility of the concept of borderline personality disorder could explain its very high comorbidity with mood, anxiety, or psychotic disorders, with a risk of overdiagnosis justifying the overmedication described above. We also discuss how the training of psychiatrists, with its greater emphasis on psychopharmacology and less on psychotherapy, may facilitate easier and quicker reliance on medication despite non-pharmacological interventions that should be offered as first line treatment. More structural aspects in France also explain the lower use of psychotherapy, which is insufficiently reimbursed compared to other countries. We also question some cognitive biases among psychiatrists in their application of the principles of “evidence-based medicine”: the confidence they place in prescribing medication may lead them to overestimate its benefits while neglecting the iatrogenic effects of their prescriptions. Finally, we discuss relational issues surrounding the prescription of medication from the patients’ perspective, which may contribute to this overuse.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We propose ways to limit this overmedication: strengthening psychotherapy training for psychiatrists, improving access to non-pharmacological interventions, deprescribing psychotropic drugs, and the use of open-label placebos. We stress that deprescribing psychotropic drugs requires careful protocols in order to minimizing the withdrawal effec","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 5","pages":"Pages 340-346"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148193564","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":"Analyse de livres","authors":"","doi":"10.1016/j.amp.2025.12.001","DOIUrl":"10.1016/j.amp.2025.12.001","url":null,"abstract":"","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 5","pages":"Pages 370-374"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148193562","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":"L’hypothèse du continuum bipolarité-schizophrénie au risque psycholinguistique des ruptures discursives","authors":"Vincent-Thomas Barrouillet ,&nbsp;Maxime Amblard ,&nbsp;Sadeq Haouzir ,&nbsp;Thibault Delage ,&nbsp;Michel Musiol","doi":"10.1016/j.amp.2024.12.005","DOIUrl":"10.1016/j.amp.2024.12.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Topic&lt;/h3&gt;&lt;div&gt;The relationship between bipolarity and schizophrenia has been the subject of research in neurosciences, neuropsychology and cognitive psychopathology over the past few decades. This research has led to the formulation of a hypothesis suggesting that the two pathologies might be situated on a continuum. This hypothesis has been incorporated into the most recent mental disorders classifications with the introduction of the “schizoaffective disorder”, which encompasses both psychotic and thymic symptoms. In this study, we examine the hypothesis of such a continuum in the context of the pragmatic discontinuities that occur in dialogue with a psychologist and either a schizophrenic or a bipolar patient. Furthermore, the aim is to delineate the cognitive and psycholinguistic impairments observed in the schizophrenic group in comparison to the bipolar group.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methodology&lt;/h3&gt;&lt;div&gt;This study compares two matched corpora of clinical interviews with patients diagnosed with bipolar disorder and schizophrenia, conducted under identical conditions. To ensure the highest level of anonymity, the two corpora were disidentified. The interviews were conducted in a non-directive manner, with the objective of creating a conducive environment for the patients to express themselves freely, to enhance their confidence and to maintain the interaction as long as possible. During the course of the conversation, the patients were never contradicted. In order to create two balanced corpora, portions of the larger schizophrenia corpus were removed. Subsequently, an exhaustive search was conducted through inter-judge agreement to identify “discontinuities”, defined as specific breaks in a dialogue, which indicate incoherence in the dynamical structure of discourse. The concept of “discontinuity” has been previously formalized and is based on a precise definition of the patients’ involvement in the dialogue and their ability to maintain coherence in their discourse. These pragmatic discontinuities were then formally analyzed using “hierarchical modelling”, which reveals the dynamic structuring of the speech acts in a dialogic interaction and objectively highlights the discontinuities.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 25 discontinuities were identified in both corpora. The aforementioned discontinuities were observed in three bipolar conversational sequences and 11 schizophrenic ones. The sequences were then classified into categories in accordance with the principal features of their discontinuities. Firstly, three of the schizophrenic sequences were found to exhibit an “inaccessible non-literal meaning”. The sequences in question exhibit an oddity to such an extent that the meaning of the sequence is “broken” by the discontinuity. Secondly, four schizophrenic sequences were identifier and designated as “loss of the non-literal meaning”. In such instances, the schizophrenic patients exhibit a regression process whereby","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 5","pages":"Pages 323-335"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148193558","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":"Narcissisme pathologique et trouble de personnalité narcissique : un regard nouveau sur un concept ancien","authors":"Martin Blay ,&nbsp;Miguel Duarte ,&nbsp;Valentin Rey ,&nbsp;Mario Speranza ,&nbsp;Elsa Ronningstam","doi":"10.1016/j.amp.2025.03.008","DOIUrl":"10.1016/j.amp.2025.03.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Pathological narcissism (PN), and its categorical corollary narcissistic personality disorder (NPD), are common disorders in the general population that are associated with a major psychosocial impact. This disorder significantly affects interpersonal relationships, emotional regulation, and overall functioning, often leading to distress both for affected individuals and those around them. Despite strong epidemiological evidence supporting its clinical relevance and emerging research on effective therapeutic interventions, PN with/without NPD remains an underdiagnosed and underutilized diagnostic, notably in France and other French-speaking countries. This lack of recognition may be linked to conceptual confusion, historical biases, and limited integration of recent advances into clinical training and practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;This literature review, using the narrative hermeneutic approach, aims to fill this gap by providing a comprehensive synthesis of the history, epidemiology, typical clinical presentations, and most recent therapeutic approaches of narcissistic pathology. Our review includes major international literature reviews, systematic or not, with or without meta-analyses, published in peer-reviewed scientific journals. When literature reviews were unavailable, we relied on the most up-to-date empirical studies to ensure a broad and contemporary perspective. These works were selected subjectively (i.e. based on the quality of the works, but also on our clinical experience).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Narcissism as a psychological construct has evolved from its origins in mythology and psychoanalytic theory to a modern understanding grounded in personality research. The most recent conceptualizations of NP describe it as a dysregulation of self-esteem, fluctuating between too high and too low and depending on the validation, valorization and/or admiration of the social environment. The categorical diagnosis of NPD (whose prevalence is around 1% in the general population) does not capture the full extent of narcissistic pathology, as it represents only one facet of narcissism – grandiosity – and neglects the other – vulnerability. Research indicates that PN and NPD are associated with high levels of psychiatric comorbidity, including mood disorders, anxiety disorders, substance use disorders, and suicidality, contributing to severe functional impairment. Its etiology is multifactorial, including genetic, neurobiological, psychological, and environmental factors. In daily practice, patients mostly present in vulnerable states, and clinical presentations are often polymorphous, narcissistic pathology being often masked by other issues (depression, anxiety, emotional dysregulation…). This is problematic given that untreated narcissistic pathology can lead to treatment resistance and drop-out. However, this disorder can be improved by psychotherapy, even though robust well-desig","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 5","pages":"Pages 290-302"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148193556","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":"L’attachement de la femme enceinte : une clé de compréhension des symptômes dépressifs, de l’attachement maternofœtal et des représentations maternelles","authors":"Jaqueline Wendland,&nbsp;Mélina Lemaire,&nbsp;Isabelle Varescon","doi":"10.1016/j.amp.2025.02.008","DOIUrl":"10.1016/j.amp.2025.02.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and objectives&lt;/h3&gt;&lt;div&gt;Pregnancy is a developmental crisis with multiple impacts on the mother-to-be and the unborn baby. The psychic dynamics of the pregnant woman can, in turn, have a considerable effect on the bond between mother and fetus, and on the mother's behavior and mental health after childbirth. A woman's bond with her child develops during pregnancy, and is accompanied by the representations she develops of herself as a future mother, and of her future baby. Pregnancy is a time of great vulnerability, as evidenced by the frequency and intensity of depressive symptoms. Because of this vulnerability, the perinatal period activates the pregnant woman's attachment system. The aim of this study is therefore to investigate the extent to which the attachment strategies of mothers-to-be have an impact on their depressive symptomatology, their maternal representations and their prenatal attachment (maternal-fetal bond). To our knowledge, no study has jointly evaluated these variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Two hundred and twelve pregnant women have been invited to participate in the study during their prenatal appointments in two Parisian maternities in France. They completed questionnaires and scales assessing, respectively: attachment strategies (Relationship Scale Questionnaire [RSQ]), prenatal attachment (Prenatal Attachment Inventory [PAI]), prenatal depression (Edinburgh Postnatal Depression Scale [EPDS]), and representations of themselves as future mothers and of their future children (scales from the Stern's R Interview).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Mothers mean age is 32 years. Most participants have higher education qualifications (81.13%), compared with 59.4% of women in the French general population, according to data from the latest French national perinatal survey in 2021. Overall, 84.9% of the women in our sample are employed, also a higher proportion than in the general population of French women (67.9%). Similarly, 46.23% of the women are managers, compared with 17.8% of women in the general population. With regard to obstetrical data, 38.68% of women in our sample are primiparous, compared with 41.3% in the general population. Women are at an average of 28.35 weeks’ amenorrhea at the time of their participation in the study (SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;7.88; min&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;12; max&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;42). Nearly a quarter of women (24.06%) report having experienced complications in previous pregnancies, as well as in the current pregnancy. Regarding attachment strategies, participants have a slightly higher mean than the general population in the French validation study of the RSQ for the secure strategies (m&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;3.2&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;m&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;3.13), and lower for fearful (m&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2.6&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;3), preoccupied (m&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2.78&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;2.97) and detached (m&lt;!--&gt; &lt;!--&gt;=&lt;!--","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"184 5","pages":"Pages 309-317"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148193560","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}