Les effets psychologiques de l'isolement ont déjà été décrits dans la littérature (expéditions polaires, sous-marins, prison). Néanmoins l'échelle du confinement mis en oeuvre à l'occasion de la pandémie à COVID-19 est inédite. Il nous faut non seulement relire les études publiées, mais aussi anticiper les problèmes psychologiques qui pourraient survenir pendant ou à distance du confinement. Nous avons fait le choix d'aller au-delà de la littérature COVID-19 pour examiner les implications des conséquences connues du confinement : l'ennui, l'isolement social, le stress, le manque de sommeil. L'anxiété, le trouble de stress post-traumatique, la dépression et les conduites suicidaires, les conduites addictives, les violences domestiques sont des effets décrits du confinement, mais les mécanismes d'émergence de ces troubles et leurs interrelations restent à étudier. Par exemple, quels sont les mécanismes d'émergence du trouble de post-traumatique dans le cadre du confinement ? Nous rappelons aussi les points de vigilance à garder sur des conséquences telles que les troubles des conduites alimentaires, les hallucinations, curieusement ignorées dans la littérature sur le confinement, alors qu'une vaste littérature fait le lien entre isolement social et hallucinations. Du fait de conséquences psychopathologiques larges, il nous faut partir à la recherche des différents symptômes pour permettre leur prise en charge. Nous résumons rapidement les approches diagnostiques et thérapeutiques déjà mises en place, comme la télémédecine, qui connaît un développement rapide à l'occasion de la crise du COVID-19. AbstractThe psychological effects of isolation have already been described in the literature (polar expeditions, submarines, prison). Nevertheless, the scale of confinement implemented during the COVID-19 pandemic is unprecedented. In addition to reviewing the published studies, we need to anticipate the psychological problems that could arise during or at a distance from confinement. We have gone beyond the COVID-19 literature in order to examine the implications of the known consequences of confinement, like boredom, social isolation, stress, or sleep deprivation. Anxiety, post-traumatic stress disorder, depression, suicidal or addictive behaviours, domestic violence are described effects of confinement, but the mechanisms of emergence of these disorders and their interrelationships remain to be studied. For example, what are the mechanisms of emergence of post-traumatic stress disorders in the context of confinement? We also remind the reader of points of vigilance to be kept in mind with regard to eating disorders and hallucinations. Hallucinations are curiously ignored in the literature on confinement, whereas a vast literature links social isolation and hallucinations. As with domestic violence, we need to look for these symptoms in order to enable management. Due to the broad psychopathological consequences, we have to look for these various symptoms to manage them. We quickly summarize the diagnostic and therapeutic...

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Patients with schizophrenia display an impaired sense of temporal continuity, and we showed that they judge events as being simultaneous even in case of large onset asynchronies. We check here whether this means a fusion of events in time, or on the contrary, a segregation of events and a deficit in coding time-event structure. Subjects decided whether 2 squares were displayed simultaneously or asynchronously on the screen and gave their response by hitting a left or right response key. The implicit processing of asynchrony was explored by means of the Simon effect, which refers to the finding that manual responses are biased to the side of the stimulus. We checked whether responses were biased to the side of the first or second square, when squares were asynchronous and displayed on opposite sides. Results revealed an enlarged time window in patients irrespective of the squares' position (intra- vs interhemispheric presentation). But for asynchronies eliciting "synchronous" judgments, patients' responses were biased to the side of the first square. In contrast, controls were biased in all cases to the side of the second square. The inverse effects observed below thresholds in patients and controls cannot be attributed to a generalized deficit. In controls, elementary predictive mechanisms would allow anticipation of upcoming events, whereas patients appear to process squares as if isolated rather than following each other. Predictive mechanisms would be impaired in patients, who would rather rely on reactive mechanisms in order to perceive asynchrony.

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Unlike diazepam, lorazepam has repeatedly been shown to impair perceptual priming as well as explicit memory. To determine whether this deleterious effect was due to an impairment in acquisition of information, 60 healthy volunteers were randomly assigned to five treatment groups (placebo, lorazepam 0.026 or 0.038 mg/kg, diazepam 0.2 or 0.3 mg/kg) and successively performed perceptual priming tasks and a free-recall task. Priming performance on information learned before or 2 h after drug administration, i.e. at the peak concentration of lorazepam, was assessed under the influence of the drugs, using a picture-fragment and a word-stem completion task. Free-recall performance was altered by both drugs. Lorazepam decreased priming performance when information was acquired after, but not before, drug administration, indicating that the drug alters the acquisition of information. Lorazepam also impaired the ability to identify fragmented pictures, but there was no evidence that this perceptual effect accounts for the priming impairment. Surprisingly, diazepam also decreased priming when information was acquired after drug administration, suggesting that, at least in certain circumstances, the two benzodiazepines may exert similar effects on priming measures.

Clinical observations suggest that the experience of time phenomenology is disturbed in schizophrenia, possibly originating disorders in dynamic cognitive functions such as language or motor planning. We examined the subjective evaluation of temporal structure using an experimental approach involving judgments of simultaneity of simple, visually presented stimuli. We included a priming procedure, ie, a subthreshold presentation of simultaneous or asynchronous stimuli. This allowed us to evaluate the effects of subthreshold synchrony and to check for bias effects, ie, changes in the criteria used by the subjects to rate the stimuli. Primes were adapted to the responses of the subjects. Bias effects were thus expected to yield a change in the efficiency of the prime and to induce a change in the amplitude of the priming effect. Nineteen outpatients with schizophrenia and their individually matched controls participated in the study. In all tests, patients required longer delays between stimuli to detect that they were asynchronous. In other words, they judged stimuli to be synchronous even when their onset was separated by delays of 100 milliseconds and even more in some cases. These results contrasted with preserved effects of subthreshold synchrony. Our findings argue against the hypothesis that the patients' responses were influenced by biases. We conclude that the subjective evaluation of simultaneity/asynchrony is impaired in schizophrenia, thus leading to impairment in the phenomenology of event-structure coding. The method used in the present study provides a novel approach to the assessment of those disturbances related to time in patients with schizophrenia.

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The concept of the minimal self refers to the consciousness of oneself as an immediate subject of experience. According to recent studies, disturbances of the minimal self may be a core feature of schizophrenia. They are emphasized in classical psychiatry literature and in phenomenological work. Impaired minimal self-experience may be defined as a distortion of one’s first-person experiential perspective as, for example, an “altered presence” during which the sense of the experienced self (“mineness”) is subtly affected, or “altered sense of demarcation,” i.e., a difficulty discriminating the self from the non-self. Little is known, however, about the cognitive basis of these disturbances. In fact, recent work indicates that disorders of the self are not correlated with cognitive impairments commonly found in schizophrenia such as working-memory and attention disorders. In addition, a major difficulty with exploring the minimal self experimentally lies in its definition as being non-self-reflexive, and distinct from the verbalized, explicit awareness of an “I.” In this paper, we shall discuss the possibility that disturbances of the minimal self observed in patients with schizophrenia are related to alterations in time processing. We shall review the literature on schizophrenia and time processing that lends support to this possibility. In particular we shall discuss the involvement of temporal integration windows on different time scales (implicit time processing) as well as duration perception disturbances (explicit time processing) in disorders of the minimal self. We argue that a better understanding of the relationship between time and the minimal self as well of issues of embodiment require research that looks more specifically at implicit time processing. Some methodological issues will be discussed.