[Psychiatrist or psychoanalyst? An unfounded problem].
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Biomedical subjects
Publications and source records attributed to P Gutton.
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Hospitalizing an adolescent after an acting out is frequent. The necessity to act, and the urgency of the act in adolescence has been observed as well in adolescents that have health problems as in adolescents in good health. It is not possible to separate the acts that are symptoms of a pathological organization from the acts that are an expression of a normal psychology, but there is a tendency to conceive as psychopathological that which comes into conflict with, and that which is a transgression to, the laws of the social environment, and the biological laws. It is important for the clinical physician to know the social projections on the adolescent. In certain cases, the act is a play out of the fantasy organization of the adolescent and is a reflection of the personality of the subject: in other cases the symptom-acts are a summary of a past relationship, towards which it expresses an ending or a split; the act in an adolescent is all the more a symptom that it is isolated from a relationship.
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Twenty-seven hemophiliacs between the ages of 12 and 17 volunteered in a self-infusion training program. An attempt was made to define a teaching method. It consisted of teaching them about the disease so as they would be able to recognise the site of their bleeding and the limitations of self-treatment. They also acquired dexterity in infusing themselves with various antihemophilic factor concentrates. Systematic clinical and psychological studies were undertaken and showed that this method of treatment gave a considerable improvement of the overall disability. At the same time the number of transfusions almost doubled. Self-treatment has been found successful among children over 13 years of age who are strongly motivated, intelligent, sensitive, and able to adapt themselves to concrete situations. This training has failed in 30% of the children in whom psychological disturbances have been found. In spite of this failure, a psychological improvement was noted.
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