This work deals with the most famous novel, the Suffering of Prince Sternenhoch, of one of the most controversial Czech authors of first half of 20th century, Ladislav Klima, namely in terms of Klíma's philosophical approach to his literary work and life in general. We derived from the philosophy of Friedrich Nietzsche, whose ideas inspired Klima in many ways. We are comparing the story of love and hate to the theater (David Jařab - first performance at the Divadlo Komedie, Praha 2007) and film (Jan Němec - In the Heat of the Royal Love 1990) adaptation and we are trying to find traces of his doctrine of solipsism and egodeism there, especially in style, composition and main characters. Greater focus was put on the character of Helga, because she represents the most of Klíma's philosophical views. Necessarily, we have touched on the question of will, authority, and the afterlife. Keywords: F. Nietzsche, higher / lower people, solipsism, egodeism, ludibrionism, afterlife, hallucinations, femme fatale

L’hallucination est une expérience subjective vécue en pleine conscience consistant en une perception impossible à distinguer d’une perception réelle, mais survenant en l’absence de tout stimulus en provenance de l’environnement externe. Les symptômes hallucinatoires, qui peuvent concerner toutes les modalités sensorielles, sont retrouvés dans divers troubles neurologiques et psychiatriques mais également chez certains sujets indemnes de toute pathologie. Dans le champ de la psychiatrie, la pathologie la plus fréquemment associée aux hallucinations reste la schizophrénie et la modalité auditive est la plus représentée, puisque 60 à 80% des patients souffrant de ce trouble sont concernés. Le retentissement fonctionnel des hallucinations auditives peut être important, altérant significativement la qualité de vie des patients.Dans ce contexte, la prise en charge de ce type de symptômes s’avère un enjeu considérable pour les personnes souffrant de schizophrénie. Pourtant, les moyens thérapeutiques actuellement disponibles (traitements médicamenteux antipsychotiques notamment) ne permettent pas toujours une rémission complète de la symptomatologie hallucinatoire et l’on considère que 25 à 30% des hallucinations auditives sont « pharmaco-résistantes ». C’est à partir de ce constat que, ces dernières années, ont émergé, pour le traitement des hallucinations auditives, des techniques de neuromodulation comme la stimulation magnétique transcrânienne répétée ou la stimulation électrique transcrânienne par courant continu. Toutefois, les résultats de ces nouvelles thérapies sur les hallucinations auditives résistantes restent modérés et le développement de stratégies alternatives demeure un enjeu de recherche majeur.Actuellement, les travaux en imagerie fonctionnelle permettent d'affiner les modèles physiopathologiques des hallucinations auditives, mais leur intérêt pourrait aller au-delà de la recherche fondamentale, avec possiblement des applications cliniques telles que l'assistance thérapeutique. Ce travail de thèse s’inscrit précisément dans le développement de l’imagerie cérébrale de « capture » des hallucinations auditives, c’est-à-dire l’identification des patterns d’activation fonctionnels associés à la survenue des hallucinations auditives.La première partie de ce travail est consacrée à la détection automatisée des hallucinations auditives en IRM fonctionnelle. L’identification des périodes hallucinatoires survenues au cours d’une session d’IRM fonctionnelle est actuellement possible par une méthode de capture semi-automatisée validée. Celle-ci permet une labellisation des données acquises au cours d’une session de repos en périodes « hallucinatoires » et « non-hallucinatoires ». Toutefois, le caractère long et fastidieux de cette méthode limite largement son emploi. Nous avons donc souhaité montrer comment les stratégies d’apprentissage machine (support vector machine ou SVM, notamment) permettent l’automatisation de cette technique par le développement de classificateurs performants, généralisables et associés à un faible coût de calcul (indispensable en vue d’une utilisation en temps réel). Nous proposons également le développement d’algorithmes de reconnaissance de la période « pré-hallucinatoire », en mettant en évidence que ce type de classificateur présente aussi des performances largement significatives. Enfin, nous avons pu montrer que l’utilisation de stratégies d’apprentissage-machine alternatives au SVM (e.g, le TV-Elastic-net), obtient des performances significativement supérieures au SVM [...] / Hallucination is a transient subjective experience perceived as real, but occurring in the absence of an appropriate stimulation coming from the external environment. Hallucinatory events, which can occur across every sensory modality, are observed in various neurological and psychiatric disorders but also among “non-clinical” populations. The most frequent disorder associated with hallucinations in the field of psychiatry is schizophrenia. Auditory-verbal experiences are particularly frequent, with a lifetime-prevalence of 60 to 80% in patients suffering from schizophrenia. Hallucinations may cause long-term disability and poorer quality of life.In this context, the management of auditory-verbal hallucinations in patients with schizophrenia constitutes a major challenge. However, despite the increasing sophistication of biological and psychosocial research methods in the field, no significant therapeutic breakthrough has occurred in the last decade and a consensus exists that a significant proportion of patients with schizophrenia (i.e., around 25 %), exhibit drug-resistant auditory-verbal hallucinations. Non-pharmacological treatments, such as repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) have been proposed as an option for addressing the unmet medical needs described above. However, these neuromodulation techniques show a moderate effect in alleviating drug-resistant auditory-verbal hallucinations and the development of innovative therapeutic strategies remains a major challenge.In recent years, the number of brain imaging studies in the field of auditory-verbal hallucinations has grown substantially, leading to a better pathophysiological understanding of this subjective phenomenon. Recent progress in deciphering the neural underpinnings of AVHs has strengthened transdiagnostic neurocognitive models that characterize auditory-verbal hallucinations, but more specifically these findings built the bases for new therapeutic strategies. In this regards the development of auditory hallucinations “capture" brain-imaging studies (i.e. the identification of functional patterns associated with the occurrence of auditory hallucinations), was the main topic of this thesis.The first part of this work is devoted to the automatized detection of auditory-verbal hallucinations using functional MRI (fMRI). The identification of hallucinatory periods occurring during a fMRI session is now possible using a semi-automatized procedure based on an independent component analysis applied to resting fMRI data combined with a post-fMRI interview (i.e. the patient is asked to report auditory-verbal hallucinations immediately after acquisition). This “two-steps method” allows for the identification of hallucination periods (ON) and non-hallucination ones (OFF). However, the time-consuming nature of this a posteriori labelling procedure considerably limits its use. In these regards, we show how machine-learning, especially support vector machine (SVM), allows the automation of hallucinations capture. We present new results of accurate and generalizable classifiers which could be used in real-time because of their low computational-cost. We also highlight that algorithms able to identify the "pre-hallucinatory" period exhibit significant performances. Finally, we propose the use of an alternative learning-machine strategy, based on TV-Elastic-net, which achieves slightly better performances and more interpretable discriminative maps than SVM [...]

Onze pacientes com diagnóstico de esquizofrenia pelo DSM-IV-TR e alucinações auditivas mesmo em uso de clozapina foram distribuídos aleatoriamente para receber estimulação magnética transcraniana de repetição (EMTr) ativa (n=6) ou inativa (n=5) no córtex têmporo-parietal esquerdo. Um total de 160 minutos de EMTr a 1 Hz foi administrada ao longo de 10 dias, 90% do limiar motor, com desenho paralelo, com pacientes e avaliadores cegos, em desenho controlado com grupo inativo. Houve um efeito de grupo significativo nos escores da escala de alucinações (realidade e influência: p=0,0360 e p=0,0493 respectivamente) e no subitem sintomas positivos da PANSS. A EMTr ativa em associação com clozapina pode ser administrada com segurança para tratar as alucinações auditivas. Embora a amostra consistia de pacientes extremamente refratários, estes resultados sugerem haver alguns efeitos da EMTr a 1 Hz no córtex têmporo-parietal esquerdo. / Eleven schizophrenics patients according to DSM-IV-TR criteria and experiencing auditory hallucinations in spite of treatment with clozapine were randomly allocated to receive repetitive transcranial magnetic stimulation (rTMS) (n=6) or sham stimulation (n=5) over left temporo-parietal cortex. A total of 160 minutes of 1 Hz rTMS was administered over 10 days at 90% motor threshold, with patients and raters blind to treatment modality, using a sham-controlled, parallel design. There was a significant group effect for the Auditory Hallucinations Rating Scale scores (reality and attencional salience: p=0.0360 and p=0.0493 respectively) and the sub item positive symptoms of PANSS. Active rTMS in association with clozapine can be administered safely to treat auditory hallucinations. Although the sample consisted of extremely refractory patients, the results suggest some effects of 1 Hz rTMS over Left temporoparietal.

Les hallucinations auditives verbales (HAVs) sont des perceptions langagières en l'absence de stimuli externes appropriés. Elles sont un des symptômes les plus invalidants dans la schizophrénie. Parmi les grands types de modèles explicatifs, deux sont particulièrement intéressants : les modèles à origine perceptive, selon lesquels les voix entendues seraient dues à une imagerie mentale et des représentations auditives trop vives et les modèles à origine productive, selon lesquels la parole intérieure est perturbée de telle sorte que les propres pensées verbales du patient sont attribuées à un agent externe. Pour tester le versant moteur des modèles productifs, une expérience de recueil de traces oro-faciales lors des HAVs à l'aide de l'électromyographie de surface a été conduite auprès de patients schizophrènes. Les résultats montrent une tendance à l'augmentation de l'activité musculaire des orbiculaires de la bouche lors des HAVs par rapport à une condition de repos. Pour tester le versant cérébral des modèles, une expérience d'imagerie cérébrale par IRMf lors de tâches de génération de pensée verbale et de perception auditive a été menée auprès de sujets schizophrènes et sujets contrôles et a évoqué une hyper-activation d'un réseau impliquant le cortex temporal et le cortex cingulaire antérieur qui reste à confirmer. La caractérisation phénoménologique des HAVs vécues par les patients a montré que les HAVs diffèrent de la pensée intérieure typique en ce que les voix entendues peuvent être nombreuses et ne sont pas celle du patient lui-même. Ainsi aucun des deux types de modèles considérés isolément n'est satisfaisant pour expliquer les HAVs. Un modèle intégratif multidimensionnel est proposé qui permettrait de mieux rendre compte de la complexité des HAVs. Il existerait, chez les patients schizophrènes une prédisposition perceptive hyper-active couplée à un système de prédiction défaillant. Les deux dysfonctionnements seraient de plus modulés par des facteurs attentionnels, de stress et par un biais cognitif d'externalisation.

The work deals with the lives of people with mental illness - schizophrenia and opportunities that contribute to improving or maintaining their current health status. The theoretical part includes the characteristics of psychotic illness, legal protection of patients, possible treatment and aftercare. The practical part describes and compares three selected services or facilities. This is the Horizon Zlín, therapeutic workshops Kotva Strážnice and day service center Uherské Hradiště - Jarošov. It also includes assessment of the importance of individual therapeutic activities with clients focusing on the reduction of recurrent symptoms of schizophrenia and pointing out the importance of aftercare services and improving the facilities that this follow-up care for people with schizophrenic disorders are provided. A major benefit would be the establishment of other centers, care centers and therapeutic workshops offering services already mentioned, which would benefit not only for patients, their families, but also for the general public.

Onze pacientes com diagnóstico de esquizofrenia pelo DSM-IV-TR e alucinações auditivas mesmo em uso de clozapina foram distribuídos aleatoriamente para receber estimulação magnética transcraniana de repetição (EMTr) ativa (n=6) ou inativa (n=5) no córtex têmporo-parietal esquerdo. Um total de 160 minutos de EMTr a 1 Hz foi administrada ao longo de 10 dias, 90% do limiar motor, com desenho paralelo, com pacientes e avaliadores cegos, em desenho controlado com grupo inativo. Houve um efeito de grupo significativo nos escores da escala de alucinações (realidade e influência: p=0,0360 e p=0,0493 respectivamente) e no subitem sintomas positivos da PANSS. A EMTr ativa em associação com clozapina pode ser administrada com segurança para tratar as alucinações auditivas. Embora a amostra consistia de pacientes extremamente refratários, estes resultados sugerem haver alguns efeitos da EMTr a 1 Hz no córtex têmporo-parietal esquerdo. / Eleven schizophrenics patients according to DSM-IV-TR criteria and experiencing auditory hallucinations in spite of treatment with clozapine were randomly allocated to receive repetitive transcranial magnetic stimulation (rTMS) (n=6) or sham stimulation (n=5) over left temporo-parietal cortex. A total of 160 minutes of 1 Hz rTMS was administered over 10 days at 90% motor threshold, with patients and raters blind to treatment modality, using a sham-controlled, parallel design. There was a significant group effect for the Auditory Hallucinations Rating Scale scores (reality and attencional salience: p=0.0360 and p=0.0493 respectively) and the sub item positive symptoms of PANSS. Active rTMS in association with clozapine can be administered safely to treat auditory hallucinations. Although the sample consisted of extremely refractory patients, the results suggest some effects of 1 Hz rTMS over Left temporoparietal.

This thesis forms a valuable tool of analysis, as well as an important reference guide to anyone interested in communicating, expressing, representing, simulating and or imagining what it is like to experience psychotic phenomena. Understanding what it is like to experience psychotic phenomena is difficult. Those who have experience with it find it hard to describe, and those who do not have that experience find it hard to envision. Yet, the ability to understand is crucial to the interaction with a person struggling with psychotic experiences, and for this help is needed. In recent years, the psychosis simulation projects Mindstorm, Paved with Fear, Virtual Hallucinations and Living With Schizophrenia have been developed as teaching and awareness tools for mental health workers, police, students and family members, so that they can better understand psychotic phenomena. These multimedia projects aim to improve understanding of what a person in psychosis is going through. This thesis represents a journey into taking a closer look at their designs and comparing them to biographical and professional literature. In doing so, throughout the chapters, a set of considerations and design challenges have been created that need to be taken into account when simulating psychosis. After a series of artistic case study labyrinths, Suicide Pigeon, Intruder, and Intruder 2.0, two final ‘do-it-yourself-psychosis’ projects have been created that have taken the aspects collected into account: The Labyrinth and The Wearable. Together these two projects form experiences that may be considered analogous to psychotic experiences. My original contribution to knowledge lies, on the one hand, within the function that both The Labyrinth and The Wearable have on a person’s ability to gain a better understanding of what it feels like to be in psychosis, and on the other hand within the background information provided on the context and urgency of psychosis simulation, how the existing simulations may be improved, and how labyrinthine installation art may contribute to these improvements.

Unlike their European predecessors in the experimentation with hallucinogens and aesthetics who undertook it as an exotic tradition brought from afar, many Latin American and North American authors turned to visionary practices and substances (cannabis, peyote, psilocybin mushrooms and ayahuasca, among others) as a main element of their own cultural heritage and territory. Though commonly restricted to the specific category of "psychedelia," the narratives in this corpus from the 20th century only acquire their true depth once included within a much vaster realm, that of visionary traditions, mostly originated in non-Western sources --with exceptions among divinators, witches and sorcerers in Europe -- both in the Old World of the Orient and Africa, but particularly in the New World, in America. Problematically blurring use and exchange value, the 20th century seized these substances as sources of forbidden pleasures which alienated laborers, while their prohibition generated immense fortunes that destabilized democracies throughout the continent, motivated violence, and funded mafias, guerrillas and paramilitary groups. Yet, visionary plants and practices spread with a transcultural power that even today allows for the survival of ethnic groups and traditional knowledge long hidden, while also feeding urban consumptions that generate innumerable subcultures, time and again misunderstood as a sign of decadence. In this dissertation these "underworld" practices are also manifestations of something prior and parallel to the birth of a culture of mass consumers: they mark an encounter between Indigenous, Afro, rural and mestizo influences in the voices of authors who contributed to culture from the margins of very hierarchical and racist societies, and assumed a leading role in their intellectual debate, capturing its mixtures, dark humor, conflicts and transculturations via writing and films. Initially marginalized in the low worlds of taverns, destitute neighborhoods, crime, prisons and prostitution venues, hallucination and hallucinogens--simultaneously a colonial anathema and a sacred pre-Columbian ritual of transcendence--survive and thrive, passing on to the urban minorities of artists and thinkers I will examine in this dissertation, now even including synthetics like Lysergic Acid Diethylamide (LSD). Late Avant-gardes between the 1950s and 1990s--beatniks, counterculture, yippies and Chicanos in the US, the Onda generation and the "jipitecas'' in Mexico, and the "nadaístas'' and the Cali group in Colombia--partially rescued this knowledge, but, above all, its consumptions, preserving some of them as an original heritage within their metaphysics, politics and aesthetics, and as a core part of many of their ideological and secular inquiries. Banned and misconstrued by the viceregal, republican, national and transnational elites, both in the colonial past, and in the contemporary moment of an hemispheric circuit -- within the geopolitics of Nixon‘s War on Drugs -- visionary and hallucinogenic uses continue shaping much of the cultural panorama of America today. The variety of films and texts observed in this project gives a measure of the true heterogeneity of Latin American and US authors of the 20th century: In their works we reconnect a fracture that divides not only two, but many worlds, while it makes possible, for once, to conceive the simultaneous reality of them all.

Background The base rate of transition from subthreshold psychotic experiences (the exposure) to clinical psychotic disorder (the outcome) in unselected, representative and non-help-seeking population-based samples is unknown. Method A systematic review and meta-analysis was conducted of representative, longitudinal population-based cohorts with baseline assessment of subthreshold psychotic experiences and follow-up assessment of psychotic and non-psychotic clinical outcomes. Results Six cohorts were identified with a 3–24-year follow-up of baseline subthreshold self-reported psychotic experiences. The yearly risk of conversion to a clinical psychotic outcome in exposed individuals (0.56%) was 3.5 times higher than for individuals without psychotic experiences (0.16%) and there was meta-analytic evidence of dose–response with severity/persistence of psychotic experiences. Individual studies also suggest a role for motivational impairment and social dysfunction. The evidence for conversion to non-psychotic outcome was weaker, although findings were similar in direction. Conclusions Subthreshold self-reported psychotic experiences in epidemiological non-help-seeking samples index psychometric risk for psychotic disorder, with strong modifier effects of severity/persistence. These data can serve as the population reference for selected and variable samples of help-seeking individuals at ultra-high risk, for whom much higher transition rates have been indicated.

During an investigation carried out by a police officer or a gendarme, audition reports are written, the length of which can be up to several pages. The high-level goal of this thesis is to study various automatic and reliable text summarization methods to help with this time-consuming task. One challenge comes from the specific, French and judicial data that we wish to summarize; and another challenge comes from the need for reliable and factual models. First, this thesis focuses on automatic summarization evaluation, in terms of both content (how well the summary captures essential information of the source text) and factuality (to what extent the summary only includes information from or coherent with the source text). Factuality evaluation, in particular, is of crucial interest when using LLMs for judicial purposes, because of their hallucination risks. Notably, we propose a light variation of SelfCheckGPT, which has a stronger correlation with human judgment (0.743) than the wide-spread BARTScore (0.542), or our study dataset. Other paradigms, such as Question-Answering, are studied in this thesis, which however underperform compared to these. Then, extractive summarization methods are explored and compared, including one based on graphs via the TextRank algorithm, and one based on greedy optimization. The latter (overlap rate: 0.190, semantic similarity: 0.513) clearly outperforms the base TextRank (overlap rate: 0.172, semantic similarity: 0.506). An improvement of the TextRank with a threshold mechanism is also proposed, leading to a non-negligible improvement (overlap rate: 0.180, semantic similarity: 0.513). Finally, abstractive summarization, with pre-trained LLMs based on a Transformer architecture, is studied. In particular, several general-purpose and multilingual models (Llama-2, Mistral and Mixtral) were objectively compared on a summarization dataset of judicial procedures from the French police. Results show that the performances of these models are highly related to their size: Llama-2 7B struggles to adapt to uncommon data (overlap rate: 0.083, BARTScore: -3.099), while Llama-2 13B (overlap rate: 0.159, BARTScore: -2.718) and Llama-2 70B (overlap rate: 0.191, BARTScore: -2.479) have proven quite versatile and efficient. To improve the performances of the smallest models, empirical prompt-engineering and parameter-efficient fine-tuning are explored. Notably, our fine-tuned version of Mistral 7B reaches performances comparable to those of much larger models (overlap rate: 0.185, BARTScore: -2.060), without the need for empirical prompt-engineering, and with a linguistic style closer to what is expected. / Under en utredning som görs av en polis eller en gendarm skrivs förhörsprotokoll vars längd kan vara upp till flera sidor. Målet på hög nivå med denna rapport är att studera olika automatiska och tillförlitliga textsammanfattningsmetoder för att hjälpa till med denna tidskrävande uppgift. En utmaning kommer från de specifika franska och rättsliga uppgifter som vi vill sammanfatta; och en annan utmaning kommer från behovet av pålitliga, sakliga och uppfinningsfria modeller. För det första fokuserar denna rapport på automatisk sammanfattningsutvärdering, både vad gäller innehåll (hur väl sammanfattningen fångar väsentlig information i källtexten) och fakta (i vilken utsträckning sammanfattningen endast innehåller information från eller överensstämmer med källtexten). Faktautvärdering, i synnerhet, är av avgörande intresse när man använder LLM för rättsliga ändamål, på grund av deras hallucinationsrisker. Vi föreslår särskilt en lätt variant av SelfCheckGPT, som har en starkare korrelation med mänskligt omdöme (0,743) än den utbredda BARTScore (0,542), eller vår studiedatauppsättning. Andra paradigm, såsom Question-Answering, studeras i denna rapport, som dock underpresterar jämfört med dessa. Sedan utforskas och jämförs extraktiva sammanfattningsmetoder, inklusive en baserad på grafer via TextRank-algoritmen och en baserad på girig optimering. Den senare (överlappning: 0,190, semantisk likhet: 0,513) överträffar klart basen TextRank (överlappning: 0,172, semantisk likhet: 0,506). En förbättring av TextRank med en tröskelmekanism föreslås också, vilket leder till en icke försumbar förbättring (överlappning: 0,180, semantisk likhet: 0,513). Slutligen studeras abstrakt sammanfattning, med förutbildade LLM baserade på en transformatorarkitektur. I synnerhet jämfördes flera allmänna och flerspråkiga modeller (Llama-2, Mistral och Mixtral) objektivt på en sammanfattningsdatauppsättning av rättsliga förfaranden från den franska polisen. Resultaten visar att prestandan för dessa modeller är starkt relaterade till deras storlek: Llama-2 7B kämpar för att anpassa sig till ovanliga data (överlappning: 0,083, BARTScore: -3,099), medan Llama-2 13B (överlappning: 0,159, BARTScore: -2,718) och Llama-2 70B (överlappning: 0,191, BARTScore: -2,479) har visat sig vara ganska mångsidiga och effektiva. För att förbättra prestandan för de minsta modellerna utforskas empirisk prompt-teknik och parametereffektiv finjustering. Noterbart är att vår finjusterade version av Mistral 7B når prestanda som är jämförbara med de för mycket större modeller (överlappning: 0,185, BARTScore: -2,060), utan behov av empirisk prompt-teknik och med en språklig stil som ligger närmare vad som förväntas.