[Feasibility of a psychoeducation group for patients with anorexia nervosa: An open study]. / Faisabilité d'un groupe de psychoéducation dans l'anorexie : une étude ouverte.

INTRODUCTION: Management of anorexia nervosa is difficult and few treatments have shown their effectiveness, justifying the exploration of new therapeutic approaches. Available evidence suggests an interest of psychoeducational groups in a significant number of psychiatric disorders. In patients suffering from anorexia, to date there are few groups or interventions available. We aimed to assess the feasibility and acceptability of a psycho-educational program promoting information about the disease and presenting techniques that can help to cope with anorexia and the functional impact it causes. The exploratory secondary objectives were to evaluate if such a group is associated with clinical improvement. METHOD: Twenty-seven patients suffering from anorexia nervosa, in three groups, received eight weekly interventions in addition to their usual care. The study was open-label and non-randomized. Patients were assessed three times (baseline, at the end of the group and three months later). The assessments were both qualitative (Eating Disorder Examination questionnaire, The Anorexia Nervosa Stage of Change Questionnaire, the Eating Disorders Quality of Life questionnaire, Work and Social Adjustment Scale) and qualitative. RESULTS: Seventy-eight percent of participants attended more than 75 % of the sessions. Seventy percent of participants found the group useful, and 95 % said it helped them improve their knowledge of the disease and its consequences. The average BMI of participants changed significantly with an average increase of 2.5kg between baseline and the three month assessment. There was an improvement of the eating disorders features in EDE-Q for the total score and for all subscores. The improvement in the total score was significant at the end of the group sessions, while the improvement in the sub scores became significant at three months. There was also a significant mood improvement at the end of the group. Finally, there was a significant improvement in daily functioning with a decrease in Work and Social Adjustment Scale scores and an improvement in quality of life. On qualitative assessment, patients were satisfied with the care proposal. They were able to appreciate the support and sharing of experience provided by the group formula. Most of them reported changes in their daily lives, either in their relationship to care and illness, or in their relationships with their loved ones, their leisure/work, their mood or their eating behavior. CONCLUSION: Both qualitative and quantitative results suggest that this group psychoeducation program is feasible and well accepted by patients in addition to usual management. Although the methodology does not allow any conclusions, the clinical improvements observed during the group are encouraging with regard to the safety of this type of intervention and its possible effectiveness and argue for a controlled study.

[Electroencephalography and the confusional syndrome in a hospital center specializing in psychiatry]. / Electroencéphalographie et syndrome confusionnel dans un centre hospitalier spécialisé en psychiatrie.

In psychiatric hospitals confusional states are frequent and represent about 20% of requests for EEG's. This study, covering a one year period, at S-Jean de Dieu psychiatric hospital in Lyon, revealed among all EEG's carried out for a confusional state the existence of a high proportion of pathological signs (59%). Etiological research demonstrates that a large proportion of these patients is diagnosed as senile dementia. Nevertheless, even if pure organic causes are rare, EEG remains an indispensable complement to clinical practice.

[Violent behavior (psychodynamic reflection).]. / Comportements violents (Réflexion psychodynamique).

In this article, the author seeks to distinguish between the notions of aggressivity and violence. He refers to Bergeret's theories and gives clinical illustrations using two patients. This differentiation will improve comprehension of events leading to acts of violence, and will enable better therapeutic interventions.

[The psychiatrist faced with refusal of treatment : clinical and legal aspects.]. / Le psychiatre face au refus de traitement : une démarche clinique et juridique.

In this article, the authors discuss refusal of treatment by psychiatric patients. Basic clinical principles as well as the process in which the psychiatrist must engage are exposed with the legal aspects. Clinical vignettes concretely illustrate these different aspects.

[Prosecution of psychiatric patients: elements of reflections and practical applications.]. / La judiciarisation des patients psychiatriques : éléments de réflexion et applications pratiques.

Among possible solutions in response to violent behaviours of psychiatric patients, prosecution might not be an alternative as well-known. This measure may be potentially beneficial for patients. How can prosecution be chosen as an option when faced with violent patients? When this option is considered, how should it be applied and what are the different steps to follow? To answer these questions, it appeared essential to first proceed to a comprehensive reflection on the recourse of sanction in psychiatry. We then describe advantages and disadvantages of the judicial process. Finally, we illustrate applications as they were conceived and elaborated at the Clinique de dangerosité de l'Institut Philippe Pinel de Montréal.

[Homicide in the psychotic patient: a study of 24 cases with reference to prediction of short-term outcome]. / L'homicide chez le patient psychotique: une étude de 24 cas en vue d'une prédiction à court terme.

This research analyses retrospectively a population of 24 psychotic patients, hospitalized in a maximum security institution for the criminality insane and who have committed or attempted to commit murder. The main focus is on finding the clinical elements which are associated with increased homicidal risk, in the short term. With that aim in mind, nine patients that were in contact with a mental health professional, during the month preceding the homicide, were studied more specifically. It seems that in addition to the elements usually described in the literature, the association of depressive and paranoid features in the psychotic is a risk factor for homicide in the short term.

[An inventory for the evaluation of dangerousness in mental patients]. / Un inventaire pour l'évaluation de la dangerosité des patients psychiatriques.

The authors of the article propose an inventory for the systematic assessment of the dangerousness of psychiatric patients. This clinical tool is qualitative and is helpful in a case-by-case approach. The prediction of violent behaviour is discussed; quantitative and qualitative research perspectives are also mentioned.