[Course of an adolescent diagnosed as schizophrenic: uncertainty]

This paper reports the case of a female patient hospitalized twice at a twelve-year interval in the same department. During the first hospitalization at the age of fifteen clinical findings and results of projective tests had led to consider schizophrenia. The patient had been entered upon a Sakel cure. Twelve years later, this twenty-seven-year-old patient has no symptoms pointing to schizophrenia. Her mental organization and the nature of the relationships she establishes with others rather suggest pathologic personality organizations which are now better known, especially narcissic pathology. While the answers to projective tests performed at a twelve-year interval are very similar, the interpretation of these tests no longer focuses upon the same issues. This observation is especially interesting as an illustration of the developments which have taken place in the psychopathological approach and as material for an a posteriori discussion of the Sakel cure which has now been practically abandoned. Lastly, this observation clearly shows that strict focusing upon the diagnostic neurosis-psychosis alternative is an oversimplification. From this viewpoint, the wide field of conditions designated as "borderline" has led to more dynamic discussions and more subtle therapeutic choices.