A Person-Centred Approach to Severe Mental Illness: The Individual Symptom Complex as Guiding Principle.

Résumé

People with long-term psychiatric disorders often display complex behaviours that cannot be fully explained by existing categories in diagnostic classification systems. As a result, translating such symptom profiles into truly person-centred and recovery-oriented care remains a challenge. This article explores how symptom-focused observation through transdiagnostic dimensions can be integrated within person-centred psychiatric nursing, and oriented toward meaning-making and recovery. A narrative literature approach was used, based on an analysis of theoretical frameworks such as the Research Domain Criteria and practical insights from psychiatric nursing. Structuring behaviour along symptom dimensions such as affect regulation or social cognition provides tools for understanding so-called 'challenging behaviour'. Nurses play a key role in this process, as they interpret symptoms based on individual context, values and needs. Symptom-based approaches only become meaningful when linked to idiographic interpretation. This enhances a recovery-oriented and relational model of person-centred care. Observation instruments such as the Neuropsychiatric Inventory Questionnaire may support nurses in interpreting symptoms, provided they are embedded within relational attunement. Nurses should be recognised as key actors in translating symptom profiles into person-centred interventions within multidisciplinary teams. The analysis is theoretical in nature; practical application requires further empirical validation.