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Résumé L’évaluation des psychothérapies, pour des raisons ayant trait à la fois au respect de règles de santé publique et à l’amélioration de nos connaissances et de nos pratiques, est devenue une étape incontournable. L’efficacité des psychothérapies, et particulièrement des Thérapies Comportementales et Cognitives (TCC), est aujourd’hui largement documentée dans le traitement des épisodes dépressifs et dans la prévention de leurs rechutes. Les travaux récents portent leurs efforts sur l’amélioration des prises en charge afin d’optimiser encore le gain en termes de prévention de rechutes. C’est dans ce cadre que la démarche MBCT prend toute sa place. Certains auteurs ont montré qu’adjoindre une démarche MBCT améliorait encore le gain en termes de rechute après une TCC auquel le patient avait été répondeur (Vittengl et Jarrett, 2015) lui permettant d’améliorer sa qualité de vie. En revanche, la question du pourquoi elles fonctionnent, dans quelles conditions, pour quels individus particuliers ainsi que l’identification des mécanismes et processus de changement sont encore très d’actualité. Pour ce faire, l’évaluation de l’effet d’une pratique en MBCT a utilisé à la fois des mesures se voulant directes (auto-questionnaires) et des mesures plus indirectes du changement (épreuves neuropsychologiques, mesures psychologiques, techniques d’imagerie cérébrale, etc.). Cette communication se propose de faire le point sur ces mesures, les résultats qu’elles ont apportés et les hypothèses qu’elles ont soulevées respectivement dans la littérature internationale de la dépression unipolaire. The assessment of psychotherapies, for reasons related both to the respect of public health rules and to the improvement of our knowledge and our practices, has become an unavoidable stage. The effectiveness of psychotherapies, and particularly of Cognitive and Behavioral Therapies (CBT), is now widely documented in the treatment of depressive episodes and in the prevention of relapses. Recent work focuses on improving care to further optimize the gain in relapse prevention. It is within this framework that the MBCT approach takes its place. Studies have shown that joining an MBCT approach further improves the gain in relapses after CBT to which the patient had responded (Vittengl et Jarrett, 2015). On the other hand, the question of why they work, under what conditions, for which particular individuals and the identification of the mechanisms and processes of change are still very current. In order to do this, the evaluation of the effect of a practice in MBCT used both direct measures (self-questionnaires) and more indirect measures of change (neuropsychological tests, psychological measures, brain imaging, etc.). The purpose of this paper is to review the results of these measures, the results they have produced and the hypotheses they have raised in the international literature on unipolar disorder. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Fight against discrimination and stigmatization of people living with mental health disorder has become one of the most important political public health objectives. It has been identified as one of the five priorities of the 2008 European Pact for Mental Health and Well-Being. Stigmatization impacts the quality of life and jeopardizes the social integration. It has been shown that compliance to medical care was also impacted by individuals’ perception of their stigmatization. Numerous international programs targeting general population have been elaborated since the last decades, but those communication strategies haven’t raised the interests of researchers and academics. Hence, very few data are available to set new objectives to lower the social impact of stigmatization in people living with mental health condition. Material and methods: This paper examines the rational and effectiveness of different anti-stigma campaign targeting mental health. By reviewing the scientific literature and policy documents on different strategies to address and lower stigmatization, we identified a typology of stigma-orientated actions and policies. Communication campaigns are the most common instrument used to address stigmatization. They are sometimes associated with communication programs targeting representations in general population through campaigns as well as representations in subgroups, through local and/or national actions. Specific information and training for journalists have also been experienced. Results: Very few researches have observed convincing effects of anti-stigma campaigns in general population. Evaluations of the communication campaigns have revealed that they had a limited impact on representations. Attitudes towards people living with a mental disorder were still negative 5 years after the Changing Mind campaign, although there was an impact on the perceived distance by the respondents (how people living with mental health condition feel different from us). Actions targeting media and journalists led to ambivalent results, with a rise of positively connoted journal articles as well as negatively connoted papers. Conclusions: Campaigns targeting general objectives have not been proven to be effective. Some authors state that they should be replaced by local actions and programs, orientated to specific subgroups and should (a) associate the psychiatric services users and their families, (b) empower people living with mental health conditions, (c) be developed upon the experience of people who are been stigmatized. The rational of past communication campaigns as well as global communication programs were impaired by the absence of an operational definition of the problem addressed (discrimination, stigma, and stigmatization). Lack of empirical data on stigmatization jeopardizes the effects of these campaigns and their potential development. Conflict of interests in people managing the campaigns and the absence of systematic evaluation are also pointed as limitation for future developments. [Copyright &y& Elsevier]

Abstract: The specificity of cancer is at the origin of emotional, cognitive and behavioural reactions in old age as well as in other stages of life. It is important to understand the particularities due to ageing to be able to listen to, to help express emotions, to inform and to better support patients. That is why in this paper the authors envisage the psychological vulnerability of elderly persons, the psychological processes at work from the first symptom of cancer to the treatment phase via investigations and announcing the diagnosis. Finally they evoke the psychopathological disorders that arise with elderly patients with cancer and the specificities of the diagnosis approach. [Copyright &y& Elsevier]