La confusion mentale : sa place dans l’histoire de la psychiatrie en France

Abstract

ObjectivesThis paper endeavours to trace the complex history of “mental confusion” in order to determine its place in psychiatric nosography in France. MethodologyFrom the first clinical observations (Pinel, Esquirol, Georget, Delasiauve, etc.), we followed the confused history of mental confusion. To do this we confronted numerous writings in classic psychiatry with contemporary research (psychiatric and psychoanalytical). ResultsThe history of psychiatry tells us that states of confusion (distraction, incoherent and confused thought, disorientation, etc.) can be found in many complaints or pathologies. The contribution of the psychoanalytic view is that the distinction between “state” and “structure” can guide us in our clinical practice. DiscussionWe note that mental confusion was observed at an early date but it was named and differentiated from other types of alienation only with the writings of Delasiauve (1851), before being neglected for some time following the work by Baillarger. Its place in psychiatric nosography was variable. It appears that a distinction between “state” of confusion and a clinical “structure” characterised by confusion is essential. ConclusionWe conclude that it is difficult to treat mental confusion as a single, specific syndrome or as a single clinical entity, nor can symptomatic manifestations alone suffice to establish a differential diagnosis.