Wilson's disease (WD), a rare genetic disorder responsible for copper accumulation in the body, is fatal if left untreated. Although there are effective treatments, adherence to treatment tends to be low. We evaluated the medication adherence of 139 patients using the Morisky scale. Adherence was correlated with age at diagnosis and at inclusion in the study, the form of the disease, the treatment, the duration of treatment, delivery and storage problems, depression, anxiety, the level of education, and the biological data. 32.4% of the patients had low adherence; their levels of exchangeable copper were significantly higher than those of the patients with high or medium adherence (P = .049). The average age of the patients at the time of the study was significantly higher in those with high adherence than in those with medium or low adherence (P = .043). 75.9% of the patients with high adherence had a neurological form and 26.7% of the patients with low adherence were asymptomatic (P = .0090). The duration of treatment was significantly longer in the patients with high adherence than in those with medium or low adherence (P = .0192). The type of treatment (chelators or zinc) had no impact on the level of adherence. Forty‐four percent of the patients experienced problems dispensing and storing medications. Despite the availability of effective treatments for this rare disease, adherence problems occur with Wilson's disease in particular in asymptomatic patients. Although different factors are involved, sustained multidisciplinary management on a case‐by‐case basis is necessary.

Résumé Lʼarticle constitue un exemple dʼutilisation des épreuves projectives dans la recherche, dans une perspective de psychopathologie psychanalytique. Il présente la démarche suivie pour construire une métholologie projective adaptée à une recherche longitudinale en psychiatrie. Celle-ci porte sur des patients déprimés, dont certains ont pour symptôme un trouble de la sphère affective : la diminution ou lʼabsence de réactions et dʼéprouvés affectifs. Lʼhypothèse porte sur le rôle de lʼagressivité dans ce symptôme. Sont présentées et illustrées les trois grilles (des représentations, des sensations, des affects) élaborées pour chaque épreuve projective (Rorschach et TAT)

Abstract. Motherhood, listed by the World Health Organization as a period of fragility and vulnerability, involves significant changes at the individual, family and social level. Becoming a mother entails a number of risk factors to take into account. It is therefore necessary to carry out studies on general populations not suffering from psychopathological disorders to better understand these risk factors linked to motherhood. This study was carried out in France with a nonconsulting population in the postnatal phase ( N = 30) using the Rorschach test, as it presents numerous advantages to appreciate the psychic and corporeal transformations linked to birth. The quantitative results of the test were compared with recently updated norms ( De Tychey et al., 2012 ). Eight values of the psychogram remained normative (F%, F+%, W%, Dd%, M, C, H%, P) reflecting the characteristics of a general population; conversely, eight other values of the psychogram (R, D%, S%, A%, RC%, m, E, Anguish Index%) differed significantly from general population norms. These results increase knowledge to help appreciate the complexity of the psychic processes at work during the postnatal period, and to prevent psychopathological disorders. It is thus possible to distinguish these disorders from those that are transitory and classically linked to the upheaval caused by the onset of motherhood.

Elève de Rosine Debray, l’auteure développe l’apport de la méthodologie projective à la notion d’économie psychosomatique en s’attachant plus particulièrement à l’étude de l’une de ses composantes, la mentalisation, concept central dans la théorie de l’Ecole psychosomatique de Paris. L’auteure propose alors des indices « projectifs » susceptibles de rendre compte de la qualité fonctionnelle du préconscient, laquelle détermine la qualité de la mentalisation, en termes d’épaisseur, de fluidité et de permanence.

No abstract