Evrard, R. (2013). Psychopathologie et expériences exceptionnelles : une revue de la littérature. L'Evolution Psychiatrique, 78(1), 155-176. 1 Introduction Plusieurs chercheurs dans le champ de la santé mentale ont perçu une interface possible entre clinique et parapsychologie, l'étude scientifique des phénomènes dits paranormaux. Celle-ci reçut des appellations variées : « métapsychiatrie » [1], « parapsychiatrie » [2], « parapsychologie clinique » [3], « parapsychoanalyse » [4], etc. Ce champ intermédiaire était au carrefour de plusieurs écoles de psychologie, avant de s'autonomiser pour devenir une spécialité à part entière : la « clinique des expériences exceptionnelles », dont la « psychologie anomalistique » est le pendant dans les sphères de la recherche et de l'enseignement. Cette revue de littérature a pour but d'introduire à ces domaines, dont les dernières décennies ont été riches d'avancées, principalement en Angleterre et en Allemagne. L'accent sera mis sur certaines des interactions entre la psychopathologie et les expériences exceptionnelles, et non sur les recherches empiriques visant à découvrir la nature ontologique de ces vécus. Cette mise en garde semble nécessaire car le « paranormal » a plus souvent donné lieu à des polémiques infinies qu'à des examens scientifiques dépassionnés [5-6]. Approches du discours parapsychologiqueOn constate plusieurs croisements possibles entre psychopathologie et parapsychologie ([7], pp. 8-9) : l'implication de cliniciens dans l'étude scientifique du paranormal ou sa critique ; la rencontre dans une pratique clinique de manifestations d'allure paranormale (par exemple, [8]) ; la coloration de certains troubles par des thèmes ou des pratiques relevant du champ du paranormal ; l'utilisation de vocabulaire à thème parapsychologique dans la nosographie ; la prise de position, dans un

Background Integrative and complementary health approaches (ICHA) are often pursued by patients facing chronic illnesses. Most of the studies that investigated the factors associated with ICHA consumption have considered that the propensity to use ICHA is a stable or fixed characteristic of an individual. However, people may prefer using ICHA in some situations and not in others, depending on the characteristics of the illness to face. Moreover, the attitude toward ICHA may differ within a single individual and between individuals so that ICHA can be used either in addition to (i.e., complementary attitude) or in place of (i.e., alternative attitude). The present study aimed at examining distinct patterns of attitudes toward ICHA in people hypothetically facing chronic illnesses that differed according to severity and clinical expression. Methods We conducted a web-based study including 1807 participants who were asked to imagine that they had a particular chronic illness based on clinical vignettes (mental illnesses: depression, schizophrenia; somatic illnesses: rheumatoid arthritis, multiple sclerosis). Participants were invited to rate their perceived distress and social stigma associated with each illness as well as its perceived treatability. They also rated their belief in treatment effectiveness, and their treatment preference. Four patterns of treatment choice were determined: strictly conventional, weak or strong complementary, and alternative. Bayesian methods were used for statistical analyses. Results ICHA were selected as complementary treatment option by more than 95% of people who hypothetically faced chronic illness. The complementary attitude towards ICHA (in addition to conventional treatment) was more frequent than the alternative one (in place of conventional treatment). Factors driving this preference included employment status, severity of illness, age and perceived distress, social stigma and treatability of the illness. When the label of illnesses was included in the vignettes, patterns of treatment preference were altered. Conclusions This study provides evidence that “medical pluralism” (i.e., the integration of ICHA with conventional treatment) is likely the norm for people facing both mental or somatic illness. However, our result must be interpreted with caution due to the virtual nature of this study. We suggest that taking attitudes toward ICHA into account is crucial for a better understanding of patients’ motivation to use ICHA. Electronic supplementary material The online version of this article (10.1186/s12906-019-2490-z) contains supplementary material, which is available to authorized users.

Les expériences réputées psychotiques dans la population générale : essai de problématisation Résumé : Des études épidémiologiques et psychométriques récentes ont mis en évidence la présence sous-estimée d'hallucinations et de délires chez de nombreux individus n'ayant pas reçu le diagnostic de psychose. Comment les modèles psychologiques rendent-ils compte de ce « continuum psychotique » ? Cet article décrit les éléments clefs d'un débat principalement anglo-saxon en tentant d'y introduire un point de vue critique qui prend sa source dans une psychopathologie psychanalytique. Cette critique porte notamment sur le type de mesures effectuées qui, pour la plupart, passent par des questionnaires avec des items venant fixer dans le registre de la psychose certaines croyances ou certains vécus, repositionnant le discours psychiatrique face à la « bizarrerie » de certaines « expériences exceptionnelles ». Après avoir présenté une alternative méthodologique basée sur des entretiens diagnostiques semistructurés et des critères différentiels issus de la psychanalyse, nous interrogerons les enjeux de cette évaluation de la psychose. Mots-clefs : prévalence des troubles mentaux dans la population généralecontinuum psychotiqueexpériences exceptionnellesdiagnostic différentielmodèles psychologiques de la psychose Psychosis-like experiences in non-clinical population: review of some issues

Near-death experiences (NDEs) are usually associated with clinical death, although this association remains controversial. A look back to the early understanding of these experiences, since the end of the 19th century, reveals a different picture than presented in contemporary descriptions. Indeed, the more historical accounts linked NDEs with various forms of intellectual and physical achievements which, in some cases, helped to produce rescue actions for the individual when facing life-threatening situations. This “energy of despair” seems to occur in a subset of NDEs, in which the experiencer becomes suddenly afraid by the prospect of his or her own death. First, we have provided a selective literature review on this topic, ranging from Albert Heim’s (1892) personal testimony to contemporary research. We next developed a theoretical psychodynamic approach to understanding NDEs, by which we attempted to integrate their psychological and evolutionary functions. We discuss possible distinctions among “fear-death” experiences, acute dying experiences, and “true” NDEs, and conclude that these experiences may reside on the same continuum. We consider that some, but not all, of these experiences have a common trigger of subjective agony, which can sometimes coincide with a real danger. The phenomenological differences among these experiences may reside in opportunities for rescue actions as perceived by the experiencer.

At the turn of the twentieth century there was a wave of delusions which had a direct link to spiritism in their form and content. These so-called spiritist or mediumistic delusions were the object of detailed study, and clinicians assigned them a place in nosography, especially in France. This work of classification was carried out as a function of the convictions and paradoxes that these delusions aroused; it also made it possible to question the relationship between pathology and belief. It is therefore important to emphasize certain ideological views of psychiatry on para-normality. We observed both a reductionist discourse concerning these domains, and at the same time their utilization in the construction of psychiatric knowledge.