[Elaboration, perlaboration, in the course of antidepressant chemotherapy]

From the results of an 8 years naturalistic and pragmatical study in a Care Unit for Patients with Dysthymic Disorders at Hôtel-Dieu-Pont-L'Abbé (France), the author points out that there is during long term antidepressive therapies a facilitating action in the psychoaffective elaboration and maturation. The author stresses the importance of agonistic molecules in the serotonin which seem to favour a psychological "working-through" probably because of the lifting of compulsive-obsessive mechanisms present in chronic an residual depressions. The authors underlines the importance of naturalistic and pragmatical studies as an alternative or as a complement to protocolar and controlled studies which are often biased. These biases are increased because of complicated psychometrics and by recent legal measures which tend to lessen the clinical credibility of these "controlled" studies.