Benjamin WYPLOSZ

My work focuses on the mental health of palliative care patients.

Many people living in palliative care express a psychic suffering that could be considered "normal" in view of their clinical situation and the approaching end of life. This psychic suffering combines symptoms akin to depression, but is more often demoralization (Robinson S et al. J Pain Sympt Manage 2014), a clinical syndrome that has been well-studied in palliative care for several decades, but has not been integrated into the DSM V or the teaching of psychiatric semiology or nosology. Demoralization can border on real existential distress, questioning the meaning of life and the relationship with caregivers, yet remains undetected by the criteria used for the diagnosis of depression, leaving a diagnostic, a fortiori therapeutic, void if it is not specifically explored.

Demoralization is a suffering that leads sufferers to set up defense mechanisms that are sometimes incomprehensible to caregivers and those around them: refusal of care, denial, even aggression. Antidepressants and anxiolytics are of little or no benefit. The prevalence of psychological suffering is not well known in France: that which is considered "normal" as well as that which is considered pathological. Yet, whatever the "normal" nature or otherwise of this suffering, it may be possible to relieve it in the same way as it is possible to relieve the physical pain that "normally" accompanies many fatal illnesses.

The project is of my work is to assess the prevalence, nature and degree of "normal" and pathological psychic suffering in palliative care and to determine whether these symptoms interact with good management and a goal of comfort of life in the broadest sense.

Just as opiates have made it possible to relieve a large proportion of physical pain (which was once considered "normal" during cancer treatment), it is possible that in the near future we will have molecules available to relieve the psychic suffering that blights patients' lives, whether this psychic suffering is "normal" or pathological. Molecules such as serotonin receptor agonists (ARS or psychedelics, Yaden et al. Curr Top Behav Neurosci 2022) or even ketamine (Sholevar et al J Palliat med 2025) could be interesting therapeutic proposals, at least in the most severe cases.

To advance palliative care professionals' knowledge and representations of ARS (or psychedelics), I participated in the creation of the PsilOnco project, which was selected by the PNRFV's AMI in 2021 (Results of the AMI End of Life 2021 | National Platform for End of Life Research). This led to the dispatch, in early May 2025, of a questionnaire to around 680 structures identified as delivering palliative care in France. The questionnaire can be accessed at this address: https://psilonco.limesurvey.net/886343?lang=fr