L’algodystrophie: Une affection psychosomatique exemplaire

Douleur et Analgésie (Impact Factor: 0.09). 11/2000; 13(4):189-199. DOI: 10.1007/BF03013842

ABSTRACT L’algodystrophie, affection relativement fréquente et souvent invalidante, réaction neurovasculaire aberrante et localisée,
interroge au-delà d’un questionnement partisan sur l’origine psychique ou somatique, les fondements d’une maladie psychosomatique.
Notre recherche portant sur 95 patients a privilégié l’abord de la personne sous l’angle psychanalytique. Ce point de vue,
relativise la technique consistant à identifier les patients d’après une batterie de tests, une séméiologie psychiatrique
et caractérielle, et envisage l’étiologie psychique inconsciente de la pathologie. L’algodystrophie est une maladie originale
ancrée à un défaut de la structure inconsciente; elle ne relève ni de la névrose, ni de la psychose et ne présente que rarement
les caractéristiques décrites comme typiques de l’agencement inconscient des affections psychosomatiques. Par certains de
ses aspects, elle s’apparente à ces entités et peut s’associer à une pathologie mentale préexistante, névrose ou psychose,
ou à d’autres affections à connotations psychosomatiques. L’étude, avant tout clinique, considère les conditions mettant en
jeu la réaction psychosomatique d’un être, dans une perspective inspirée parF. Dolto etJ. Lacan. La théorie n’est qu’ébauchée, les perspectives de recherche sur la non univocité des déclenchements d’une maladie psychosomatique
et sur les relations avec les manifestations psychotiques et névrotiques posées. Les conclusions restent ouvertes aux interrogations
et aux critiques.
Reflex Sympathetic Dystrophy (RSD), a relatively ailment wich can often be incapacitating, is a localised deviant neurovascular
reaction, wich calls into question the causes of psychomatic disease over and beyond biased questions about its psychological
or somatic origin. Our review of 95 patient records first favoured a psychoanalytical approach concerning the person. This
angle relativizes methods whereby patients are identified by a series of tests, according to a psychiatric and emotional semeiology,
to consider the unconscious psychic etiology of the pathology. RSD is an odd disease linked to a defect of the unconscious
structure; it is not a type of neurosis or psychosis and only seldom dœs it present caracteristics described as typical of
the unconscious layout of psychosomatic disorders. In some respects, it is related to these entities and can be combined with
a prior mental illness, neurosis or psychosis, or with other affections of a psychosomatic nature. This mostly clinical study
describes the conditions which initiate the psychosomatic reaction of a person, in a perspective inspired byF. Dolto andJ. Lacan. This is only a tentative theoretical approach, formulating prospects for research on the non univocal factors triggering
a psychomatic disease and its connections with psychotic and neurotic manifestations. Our conclusions are open to question
and criticism.

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