Hyperéosinophilie massive révélatrice d’un carcinome bronchopulmonaire

Abstract

Depuis plusieurs années, l’apprentissage de la pleine conscience s’est développé dans une perspective d’intervention psychologique et notamment dans le domaine des addictions. Cependant, à ce jour, très peu de données sont disponibles sur l’efficacité d’une telle approche. La présente étude ouverte et non contrôlée se propose d’exposer les résultats préliminaires d’une intervention de type Mindfulness-Based Relapse Prevention (MBRP), programme en huit séances intégrant des techniques de « pleine conscience » aux techniques classiques de prévention de la rechute, réalisées auprès de 26 patients alcoolo-dépendants répartis dans trois groupes. Ont été évalués, avant et après intervention, la consommation d’alcool, les pensées automatiques, les capacités à faire face, et les niveaux de pleine conscience, d’impulsivité et d’anxiété. Les premiers résultats de cette expérience tendent à montrer que la technique de MBRP est associée à une réduction de la consommation d’alcool, une baisse de l’impulsivité, à une augmentation de la pleine conscience, de la flexibilité cognitive et à un haut degré de satisfaction chez les participants. Dans notre étude, l’approche en MBRP est en outre associée à un maintien de l’abstinence ainsi qu’à une modération, voire une obtention de l’abstinence chez certains participants encore consommateurs. Des études de réplication sont nécessaires puisque celle-ci présente plusieurs limites méthodologiques : faible échantillon, absence de groupe témoin, étude ouverte, malgré des résultats cliniques prometteurs.For several years, the learning of mindfulness has developed in a psychological intervention perspective, particularly in the field of addiction. Presently, the management of addictions with substances is centered on two questions: the motivation in the change of behaviour and in a significant change in alcohol consumption. Concerning alcohol dependence, the evolution of behaviour is variable and characterized by forgiveness episodes and relapses. Over many years, a treatment for the abuse of substance associated with techniques based on full consciousness (Kabat-Zinn, 1990; Segal et al., 2002) Mindfulness-based relapse prevention (MBRP) was developed by Marlatt et al. (2011). The prevention of the relapse therapy, based on full consciousness, is a program of eight sessions integrating techniques of “mindfulness” into the techniques of prevention of the relapse. However, not much research has focused on the MBRP, the publication of the manual regarding this intervention is too recent (Bowen S et al., 2011).We are interested in the active mechanisms, which are at stake in the MBRP. Indeed, the meditation acts presents many mechanisms in the addicting disorders. Our non-controlled research was based on a protocol in order to evaluate the alcohol consummation, mindfulness, impulsiveness, automatic thoughts, anxiety and abilities to cope. The first results are interesting: reduction of alcohol consummation, increase of mindfulness, reduction of trigger relapse, increasing cognitive flexibility and high degree of satisfaction among participants.An intervention MBRP was proposed to 26 patients who were assigned to three groups. They were questioned about their alcohol consumption and assessed by a protocol of seven evaluations before and after the group MBRP: Five Facets Mindfulness (FFMQ), Impulsive Behavior Scale (UPPS), Acceptance and Action Questionnaire (AAQ II), State Trait Anxiety Inventory (STAI-A, STAI-B), Questionnaire of the automatic thoughts (QPA), and The Drug-Taking Confidence Questionnaire (DTCQ-8). This study exposes the preliminary results of an intervention for substance use disorders called mindfulness-based relapse prevention (mbrp) administered to five groups of alcohol dependent patients in a psychiatric department and a department of alcohol science in France.The results show maintained abstinence and a moderation leading to abstinence for the still consuming patients. According to our evaluations, we obtained several significant results after the therapy, despite our small cohort: patients accepted their thoughts and feelings better (FFMQ–judgment); the tendency to give in to the impulses decreased (urgency–UPPS), and their tolerance to anxiety increased (STAI-YA-YB). Moreover, this study appears to confirm that the MBRP program allows an improvement of self-efficiency. The study continues in order to confirm these results on a larger sample and to explore the long-term results, so as to propose a new work-tool for patients and caregivers.