This article presents two clinical cases of probable onset of schizophrenia, characterized by the organization of a central symptom of hypochondria, signaling the subject’s non-belonging to the moment of pubertary transformation. In both cases, neuroleptics proved to be less useful than anti-depressants. This observation prompts three comments. The first is that it is necessary to respect a certain coherence between the rules of prescription and the clinical field of reference. The second is that antidepressants may be useful in this type of onset of schizophrenia with hypochondriacal symptoms. The third is that the neuroleptic treatment is interwoven with the subject’s narcissistic economy, an economy already implicated in the formation of the hypochondriacal symptom, which would explain the usefulness of antidepressants in this case.

Adolescence, 2009, T. 27, n°3, pp. 797-807.