As the importance of psycho-social factors in medicine is increasingly stressed, it is believed that attitudes towards psycho-social issues in medicine should be taken into account in the selection of medical students. The first step of a longitudinal study concerning the impact of medical studies on the students of a French-Canadian University gave us the opportunity to appraise the adequacy of Parlow & Rothman's (1974) ATSIM scale, a measure of attitudes towards psycho-social issues in medicine. We found the following correlations: (1) High scores on the ATSIM scale were negatively correlated with a relatively closed value system (high scores for dogmatism), (2) openness towards psycho-social factors in medicine and empathy were positively correlated, (3) There was a stronger correlation between the ATSIM scale and acceptance of absortion for social conditions than between acceptance of abortion for physical risks and this scale (this shows the social orientation of the ATSIM scale), and (4) hight scorers on the ATSIM scale seem to be more 'sensitive, forthright and expedient' than low scorers. Our results suggest that Parlow & Rothman's (1974) ATSIM scale might be a useful tool in the selection of medical students and further research is needed.

Tobie Nathan's recent synthesis of 15 years of clinical work with migrant patients is presented and discussed. His clinical approach represents a unique attempt to integrate therapeutic techniques used in non-Western cultures and psychodynamic therapy by introducing three main parameters: (i) the patient's mother tongue; (ii) 'traditional' etiologic theories (explanatory models) specific to the patient's culture of origin; and (iii) a group setting with a multicultural group of therapists. Nathan's focus on technique makes it possible to identify important elements of the therapeutic process: the material arrangement of the therapeutic setting (illustrating the main therapeutic idea) and specific logical processes such as analogical thinking, mediation, and reversal. The main premises and therapeutic implications of this pluritheoretical approach are summarized.

La mondialisation des marchés, la rationalisation économique, la rapidité des moyens de communication, l’introduction des nouvelles technologies ont profondément modifié les entreprises. Ces phénomènes ont remis en question les pratiques de gestion traditionnelles pour faire face à un accroissement de la concurrence et pour atteindre des niveaux de performance et de production optimaux. Ces bouleversements ont aussi des effets directs sur les travailleurs, les exposant à des degrés de tension et à des situations de plus en plus contraignantes au point de vue mental. À partir de l’analyse d’une enquête en psychodynamique menée auprès de machinistes travaillant dans une usine du secteur aéronautique ayant vécu récemment d’importantes transformations organisationnelles et technologiques, la demande excessive de formation manifestée par les travailleurs apparaît rapidement comme une réponse défensive et presque obligée pour contrer la peur et l’anxiété découlant du travail. Cette peur et cette anxiété résultent, entre autres, de l’organisation du travail et des exigences extrêmes de précision et de qualité imposées par les pièces fabriquées, destinées à un moteur de véhicule de transport de passagers. L’analyse de contenu réalisée permet de mettre en lumière une organisation du travail qui place des machinistes devant un phénomène de double contrainte. Ils sont confrontés à une injonction qui leur demande d’être un machiniste excellent et productif dans un environnement fortement sanctionné. À ce paradoxe pragmatique, vient s’ajouter le fait que l’organisation du travail introduit un système de verrouillage qui vient bloquer toutes les voies possibles de résolution du paradoxe. Les machinistes se retrouvent ainsi dans une impasse. Pris dans ce contexte, comment survivre psychiquement ?For the past decades, in a world of high competition, firms struggle to regain an advantage over foreign competition. Thus, new management trends, usually based on price reduction, high quality products and speed production are now part of strategic reorganization plans of high impact on work organization particularly in terms of large demands put on workers, and take a heavy toll on workers. Thus the incidence of mental health problems in the work place has risen sharply in recent years and currently counts as one of the leading causes of work absenteeism. A study based on the psychodynamic of work was conducted among machine operators working in a high-technology company in the aviation sector. Important management and technological transformations were recently introduced in the factory. The content analysis of the study shows that the work organization places the operator in a double bind situation. They are caught between an injunction where the capacity of making a high quality product is directly opposed to that demanding speed production. Moreover, severe and arbitrary sanctions are applied when the operators do not comply with either injunction. The operators are put in a deadlock situation that creates fear and anxiety. They a...

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Certain personality traits or disorders in combination with clinical signs complicate the diagnosis and treatment of depression. The approaches to the relationships between personality and mood disorders vary. Some see important links between normal personality types (or temperaments) and depression, while others see certain temperaments as sub-syndromic variants of mood disorders. Finally, a third approach proposes an analysis, drawing on Robins and Guze's criteria, of the validity of psychiatric diagnoses for determining whether this frequent comorbidity of depression and personality disorders (DSM-III) is consistent with a nosologic relationship, or is merely some definitional or other artefact. A category-based diagnostic approach provides little clarification; in some studies, a dimensional model attempts to better define the links between depression, temperament and personality and clarify the content of the apparently heterogeneous notion of depression, with therapeutic implications. Research in this area should lead to the development of increasingly specific therapeutic approaches to depression.