Integrative accompaniments for subjects with disabling mental disorders: a neo-evolutionary design of the psychosocial rehabilitation

International audienceFor several years, research in neuropsychology and neurocognition was widely developed. Its application was particularly beneficial in psychiatry mainly when it can highlight the difficulties of subjects who are strongly hampered by severe and disabling disorders. These disorders can then defeat all attempts in term of social reintegration for users, so dear to the community psychiatry. In order to improve the assessm ent of the needs and working lines of the sanitary accompaniment of these patients principally diagnosed as chronic psychotic, the Jury - les - Metz hospital has developed a specific procedure. This process combines neuropsychological assessments (RL RI 16, St roop, Birchwood Insight Scale, WCST, AIPSS ...) and a more subjective approach which also includes projective tests (Rorschach ...) interpreted with a psychoanalytic angle. During these appraisals, we regularly noticed a consistency between some cognitive disorders and some psychopathological aspects. In other words, we noticed that some aspects revealed by the Rorschach test may refer to elements identified by neuropsychological tests. For example, we noticed that the deficit in social cognition can be emp hasized in another aspect in projective tests. In addition, metacognitive difficulties and, anchoring in the reality evaluated by the Rorschach, appear to be related. Finally, executive functions sometimes seem connected to the connection difficulties betw een affects and representations mediated by reflections on symbolization in the Rorschach test. Through this paper, we try to build bridges between these different tools in order to stress the possible existing overlap between psychoanalysis and neuropsych ology. We will conclude our discussion by opening the discussion on possible approaches to this research, especially in the field of neuropsychoanalysis