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Stressrelaterad ohälsa är en av de vanligaste sjukskrivningsorsakerna i västvärlden. I Sverige diagnostiseras vanligen långvarig stressrelaterad ohälsa som utmattningssyndrom. Vid utmattningssyndrom är kognitiva besvär ett framträdande symptom som kan vara långvarigt.  Kognitiv nedsättning vid utmattningssyndrom har tidigare fastställts utifrån en normativ ansats, vilket innebär att jämförelse görs med en icke-klinisk normgrupp. En annan metod är att använda en ideografisk ansats, vilket innebär att jämförelse görs med personens premorbida kognitiva nivå. Syftet med denna studie var att undersöka hur stor andel av patienter med utmattningssyndrom som uppvisar kognitiv nedsättning, utifrån en normativ respektive ideografisk ansats, samt hur kognitiv funktion relaterar till arbetsförmåga i patientgruppen. Data i denna studie utgörs av pretestmätningen från RECO-studien i Västerbotten. Patientgruppen bestod av 127 deltagare med utmattningssyndrom och normgruppen av 60 friska deltagare. Samtliga genomförde ett kognitivt testbatteri. Data analyserades med hjälp av olika gränsvärden för att undersöka frekvensen och andelen procent kognitivt nedsatta. Resultatet visade att andelen som uppvisade kognitiv nedsättning ökade då ideografisk ansats användes, men att majoriteten, oavsett ansats, var kognitivt intakta. Vidare sågs signifikanta samband mellan självskattad arbetsförmåga och kognitiv funktion utifrån ideografisk ansats, men inte utifrån normativ ansats. Dessa resultat tyder på att premorbid kognitiv nivå kan vara viktigt att ta hänsyn till vid bedömning av kognitiv funktion vid utmattningssyndrom. Vidare forskning inom området behövs, exempelvis där en större normgrupp används. / Stress-related illness is one of the most common sick leave causes in the Western world. In Sweden long term stress-related illness is usually diagnosed as exhaustion disorder. In exhaustion disorder, cognitive deficits are a prominent symptom that can be long-lasting. Cognitive impairment in exhaustion disorder has previously been determined based on a normative approach, which means that comparison is made with a non-clinical norm group. Another method is to use an idiographic approach, which means that comparison is made with the person's premorbid cognitive level. The aim of this study was to investigate the proportion of patients with exhaustion disorder who display cognitive impairment, based on both normative and idiographic approaches, and how cognitive function relates to work ability in the patient group. The data in this study consists of the pretest measurement from the RECO study in Västerbotten. The patient group consisted of 127 participants with exhaustion disorder and the norm group of 60 healthy participants. All participants completed a cognitive test battery. The data were analysed using different cut-offs ​​to examine the frequency and percentage of cognitively impaired. The results showed that the proportion who showed cognitive impairment increased when the idiographic approach was used, but that the majority, regardless of the approach, were cognitively intact. Furthermore, significant relationships were seen between self-estimated work ability and cognitive function based on an idiographic approach, but not based on a normative approach. These results suggest that premorbid cognitive level may be important to consider when assessing cognitive function in exhaustion disorder. Further research in the area is needed, for example where a larger norm group is used.

L’évolution du droit international contemporain conduit souvent à poser la question de sa fragmentation. L’existence, dans le droit de la mer, d’une double approche, universelle et régionale, contribue à alimenter ce débat.La présente recherche s’intéresse aux relations, en termes d’interactions, que l’universalisme et le régionalisme entretiennent dans le droit de la mer. Elle tente plus précisément d’en comprendre les mécanismes et les enjeux.Dans un premier temps, l’étude est consacrée à l’analyse des interactions normatives et institutionnelles. Il est observé que le dédoublement de l’ordre des mers est plus apparent que réel, universalisme et régionalisme étant engagés dans des relations montrant leur entrelacement.Dans une seconde phase, l’analyse se tourne vers l’impact de ces interactions, non seulement sur les approches universelle et régionale, mais également sur l’ordre des mers. Il apparaît, en effet, que les relations entre ces deux dynamiques influencent décisivement la gouvernance des espaces marins dans leur ensemble. C’est ce dont rendent compte tant la création que l’application effective des règles chargées d'assurer cette gouvernance internationale. / The evolution of contemporary international law often leads to the question of its fragmentation. The presence, in the Law of the Sea, of both a universal and a regional approach contributes towards nourishing this debate.The present research focuses on the relationships, in terms of interaction, between universalism and regionalism within the Law of the Sea. It attempts especially to understand the mechanisms of these interactions and their stakes.At first, the study is devoted to the analysis of normative and institutional interactions. One can observes that the cleavage of the legal order of the seas is more apparent than real, since universalism and regionalism are engaged in relationships showing their intertwining nature.Secondly, the study is turned towards the impact of these interactions, not only on the universal and regional approaches, but also on the legal order of the Sea. Indeed, it appears that the relations between these two components of the Law of the Sea, influence in a decisive way the governance of the oceans as a whole. This influence can be seen in the creation as well as in the effective application of the rules of this international governance.