title: [Affective dependency and psychiatry: a discord].
abstract: BACKGROUND
  The term "loving dependence" is increasingly used by professionals of the relation of help and the patients themselves. It joins in the wider spectre of the interpersonal dependency. More and more patients suffering from this disorder are coming for psychiatric consultation. However, this notion remains vague and absent in the vocabulary of the psychiatrists. Globally, this term describes the functioning of certain patients who present a fear of not being loved and a dependency on another person. The fear of not being loved provokes a fear of abandonment or incites development of strategies to be loved (seduce, help). Dependency on another person is a consequence of the lack of confidence in the capabilities of the individual. The other person reassures them because this person does what the patient is afraid of doing, because he/she does not feel capable. The lack of confidence in own's capabilities can also incite the individual to become a perfectionist and successful. The fear of not being loved and of not being competent is determined partly in the person's childhood. These impressions are real and/or the individuals are hypersensitive.
  
  
  OBJECTIVE
  The article describes the emotional, cognitive and behavioural levels, the various types of interpersonal dependency: dependences of type "umbilical cord", "rescuer", "stereotype" and "against dependence". The objective is to specify the concept better on clinical level, with the aim of defining criteria and pathological limits. This is the first stage before beginning rigorous scientific research. The stakes are high. There are relationships with anxiety, depressive disorders, alcoholism, food behaviour disorders, suicide and somatic pathologies.
  
  
  CONCLUSIONS
  Dependency seems to be the consequence of a pathological expression of the normal dimensions of the personality: the need to be loved and valued (admired). The onset of dependency occurs in stages, when the person is weakened by events of life or by depression. The impression not to have been loved and/or valued in childhood is vulnerability. We detail the common points and the differences between the types of described dependences and the diagnostic categories of the DSM. The category-specific classification of the DSM is not adapted to making a diagnosis in these patients. To diagnose a pathological personality, the patient has to be constantly in a functioning of pathological intensity, which is not still the case. This is a real problem, because these clinical situations are very frequent. We defend a dimensional approach of the personality disorders. A meeting between the psychiatry and the relationally dependent person is possible, on one hand in a dimensional classification of personality disorders and, on the other, by working on self-esteem. The relational dependency and self-esteem share the same appearances and the same causes. There are two different names from the same identity.
authors.affiliation: Service du Dr Lajugie, EPSM Lille métropole, rue du Général-Leclerc, BP 10, 59487 Armentières cedex, France. cversaevel@epsm-lille-metropole.fr
authors.forename: C
authors.initials: C
authors.lastname: Versaevel
mesh_terms: D000328:Adult; D000339:Affect; D001010:Anxiety, Separation / Q000175:diagnosis / Q000523:psychology; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000628:therapy; D002648:Child; D015897:Comorbidity; D003674:Defense Mechanisms; D003858:Dependency, Psychological; D003859:Dependent Personality Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006677:Histrionic Personality Disorder / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008149:Love; D008960:Models, Psychological; D010553:Personality Development; D010817:Physician-Patient Relations; D012307:Risk Factors; D020377:Self Efficacy