title: [Unexpected outings of Alzheimer patients living in retirement homes: Therapeutic perspectives].
abstract: OBJECTIVE
  Various behavior disorders can occur during Alzheimer's disease, in particular unexpected outings. This article aims at understanding the diverse mechanisms present during a "runaway" episode, which can manifest in an acute way. The authors bring to light through clinical examples what is at work from a psychological perspective in order to create new accompaniment methods.
  
  
  METHODS
  First, the authors reviewed the literature on runaway episodes in order to point out necessary themes for reflection. Then, from a Freudian theoretical model, they brought to light four fundamental mechanisms: hallucinations, false recognition, non-recognition, and recognition. These are mainly, although not exhaustively, understood from perceptions, memory-traces, indications of quality, and memories. This theory was questioned by means of presented clinical cases. Various post-Freudian models allowed the authors to emphasize the pathological experience in the role of perceptions and the functions, which come into play in the psychic economy. By going back and forth between theory and clinical cases, the authors underline the importance of perception in the phenomenon of unexpected outings. Finally, the Lacanian psychoanalytical theories provide a framework to question clinical cases but also provide answers to the criticisms found in the diverse reserved models.
  
  
  RESULTS
  Through this study the authors hypothesize that the runaway episodes are not senseless but result from the interaction between the effects of the brain damage and the anxiety, which they arouse in the subjectivity of the person suffering from Alzheimer's. Leaning on false-recognitions, hallucinations, and non-recognitions such as were described in "Project for a scientific psychology", the authors put forward the hypothesis that these mechanisms express themselves in an imaginary relation, as in psychosis.
  
  
  CONCLUSIONS
  The question of whether the runaway episodes of Alzheimer's sufferers can be classified as psychotic breakouts with a loss of touch with reality, or if the runaway episodes could be prevented by offering enough reassurance and support, is open to further debate.
authors.affiliation: EA 3522, université Paris VII, CRMPS, 5, rue Thomas-Mann, 75013 Paris, France. Electronic address: brossard.frederic@aol.fr.
authors.forename: F
authors.initials: F
authors.lastname: Brossard
authors.affiliation: Université Paris VII et Lille III, CRMPS, 5, rue Thomas-Mann, 75013 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Caron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D040561:Assisted Living Facilities; D001519:Behavior; D006801:Humans
keywords: Fugue; Perception; Psychotherapy; Psychothérapie; Runaway; Trauma; Traumatisme