18

Although it is absent from the literature in child psychiatry and from contemporary international classifications in adult psychiatry, paranoia deserves particular attention in child psychiatry. A large-scale epistemological study going back over the history of psychiatry, along with a critical reflection on the development of clinical concepts, reveals the usefulness of granting paranoia a central position in our attempt to understand psychotic pathologies. Although it began in the modern period of psychiatry, the clinical concept of paranoia had to wait until the end of the nineteenth century to find its final form in Kraepelin’s definition in his sixth treatise. From the beginning of his study of mental illness in the 1930s, Lacan gave it a central position in the field of psychotic pathologies, making a first attempt to find a link between classical clinical work and the beginnings of psychoanalysis. Promoted as the third entity by Kraepelin alongside dementia praecox, which had become known as schizophrenia, and, on the other hand, manic-depressive psychosis, more generally called bipolar disorder, paranoia maintains close links through connections and fine distinctions with these two mastodons, never being assimilated with either one. Its acquaintances do not stop with psychotic pathologies. Mood pathologies overlap them quite often, and personality traits or structures can be directly affiliated with paranoia. Like a widespread, invisible framework, it infiltrates the whole of the classification edifice. A critical reading of the classics and nosographies shows the parallel between the disappearance of the paranoid entity, the abandonment of psychoanalytic references in order to address mental disorders, and the arrival of cognitive sciences. However, child psychiatry seems to be resisting this evolution. What can be said of paranoia in child psychiatry? Questioning this clinical concept from the perspective of a clinical case concerning a child’s development, we attempt to contribute to the understanding of the first movements of psychic life, in reference to hypotheses by Klein as well as the elaborations of Golse and Roussillon about the birth of the object.