Une approche de la phénoménologie de la dépression par l’Entretien Semi-structuré Multiregistres

Objective. - Whereas instruments are available to diagnose depression and to rate its severity, there is a lack of instruments to assess the phenomenology of depression, i.e., a set of mental phenomena that compose subjective experience. The Algorithmically Structured Systematic Exploration of Subject's State of Mind (Assess_Mind) is based on open questions asked via a structured algorithm. The objective of the present study was to show how the Assess_Mind allows to investigate the depressive phenomenology in patients presenting a major depressive episode. Patients and methods. - Thirty-five patients presenting a major depressive episode were assessed with the Assess_Mind and with a battery of standardized instruments. After hospital admission, two Assess_Mind interviews separated by 24 hours were conducted, and a third interview took place 3 weeks later. Using vignettes drawn from the three interviews conducted in two patients, we illustrate the workings of the Assess_Mind and the clinical material that it reveals. Results. - The Assess_Mind provides a detailed and specific assessment of the patients' phenomenology and of its course over time. Conclusion. - In major depressive episodes, the Assess_Mind should contribute to help clinicians to conduct the initial assessment and to follow the course of patients under treatment. (C) 2010 Elsevier Masson SAS. All rights reserved.