Clinophilia refers to the fact of always wanting to stay in bed, or by extension, to stay at home and no longer wanting, or no longer being able to go out. It is not a disease as such, it is more the symptom of multiple psychiatric pathologies. The situation in which the patient cannot get out of bed at all remains an extreme case. Treatments consist of treating the pathology concerned: depression, psychosis or anxiety disorder. Psychotherapies are also very effective, especially cognitive behavioral therapies, known as CBT, or interpersonal therapies (IPT).

Definition of clinophilia

Clinophilia means, etymologically “the fact of loving to lie down”. It is, in fact, a tendency to always want to be in bed, and by extension, a tendency to want to stay at home. “The situation where one cannot get out of bed is an extreme case, which was more common in the past, when people were more reluctant to go to a psychiatrist.“, Explains Doctor Nicolas Neveux, psychiatrist-psychotherapist in Paris.

In fact, clinophilia today refers more to wanting to stay in the place that is safest, so at home. “We are mammals, that is, animals without a shell, like turtles … We therefore need to find ourselves in our cave“, Sums up Dr. Neveux vividly. 

Clinophilia is not a pathology in itself: it is the symptom of several psychiatric pathologies.

Causes of clinophilia

When a person is not doing well, they will tend to withdraw into the place that secures them the most. She will then be tempted to stay at home, even in her bed: a place where she is comfortable, safe. A place where she is reassured.

Clinophilia is a very unspecific symptom of a pathology, which can be found in several psychiatric illnesses.

• An almost constant symptom in depression, clinophilia is then linked to a lack of vitality, which prevents you from doing things, and from leaving your home.
• Clinophilia can also be caused by psychoses, including schizophrenia or paranoid psychoses. There, the fact of wanting to stay lying down is linked to a delusional element. For example, in paranoid psychosis, the patient feels persecuted, he is afraid to go outside, where he believes he will be in danger: his clinophilia is then due to his delusional thinking, and not here to a lack of vital momentum. Another example: the dissociative syndrome which characterizes the schizophrenic person will cause them to be totally inhibited. In a situation of apragmatism, she will be unable to take action and do something concrete.
• Patients with anxiety disorders may also have the symptom of clinophilia. Thus, agoraphobic people will find it difficult to leave their homes, because of their phobia. Likewise, people with a phobia of dogs will want to stay at home, for fear of crossing one in the street. In these people, clinophilia again has different reasons: these patients have enough energy to come out, they are also fully conscious and not delusional, but here it is their fear that outweighs the reasoning.

Diagnostic

«In the context of these different possible diagnoses, clinophilia cannot be considered as a separate element, but must on the contrary be taken into consideration with regard to the other symptoms that accompany it.“, Underlines Doctor Neveux. Thus, clinophilia is unlikely to be a symptom of schizophrenia, which affects about 1% of the population, if no other feature of schizophrenia is associated with it. 

Clinophilia is more likely to be linked to depression, a mental disorder that affects more than 300 million people worldwide according to the WHO, and affects about one in four people at least once in their life.

Clinophilia will be easily diagnosed by the attending physician or psychiatrist. Thus, the patient will easily mention his lack of desire to go out on his own. He will indicate, often on his own, that he prefers to stay at home, or even in bed, and will respond when the doctor asks him the question. Sometimes it is his entourage who can also report it.

Persons concerned

No personality is more affected than another. Clinophilia is an intercurrent pathology. Even a very active person can develop clinophilia the day they get depressed. There are therefore no personalities more concerned than others. However, clinophilia may be increased in cases of passive-aggressive personality disorder.

Risk factors

Clinophilia, a common and common symptom of various pathologies, presents the risk factors linked to those of the pathology that will give rise to it.

• The risk factors for schizophrenia are complex, and linked to cannabis use, to toxic substances such as LSD. The genetic determinants are real, the other factors remain very debated.
• The risk factors for depression and anxiety disorders are personality disorders, problems related to poor cognitive patterns. Life events can also trigger it. In addition, genetic factors can come into play.

All toxicants, especially alcohol, are very important risk factors.

Clinophilia is expressed by wanting to stay lying down, or wanting to stay at home all the time. It is a symptom and not a disease in itself, which can also be observed in burnout, and in the taking of toxicants such as cannabis.

Amotivation syndrome, which designates a lack of motivation, can also be associated with clinophilia: it is typically illustrated by the adolescent who smokes cannabis, who stays in his room all day and does nothing wrong. ‘other.

The treatments for clinophilia will be integrated into a general treatment, within an adapted management of the diagnosed disorder: anti-depressants for depressions, antipsychotics for psychotic disorders, anxiolytics for anxiety disorders.

Psychotherapeutic approaches are particularly suitable in the care of clinophilia: TCC and TIP.

• The principle of cognitive behavioral therapy (CBT) is to make the person understand that staying at home, even if it reassures them in the short term, is something negative. The goal is to get the patient to react proactively. The disorder can sometimes be old, like the fear of dogs: the objective is, then, to make the patient aware that it is more difficult to stay at home than the risk of having to face a dog. is inappropriate. CBT therefore consists of a positive restructuring of thought patterns.
• Interpersonal therapies (IPT) aim to emphasize the importance and the benefits that the bond of attachment to the other brings to oneself. They highlight the benefits of social interaction, and the group, which will help the patient to get better, to feel happy. Interaction with one another makes human beings feel good. This work on oneself, which is also a work of attachment, therefore leads one to realize the importance of the link to the other in order to be balanced.

Either of these psychotherapies can be very helpful in treating clinophilia. CBT will lead to the identification of its dysfunctions, and will help the patient to provide answers. IPT will re-establish links with others.

There isn’t much about the prevention of clinophilia. The care will focus mainly on treating the symptoms, TCC and TIP being also a way of preventing a symptom of clinophilia from occurring again, or at least a way of already having methods to react in the event of a new episode. .

The social bond, that is to say the fact of having a strong support of relations, with quality bonds, is in itself a protective factor of psychiatric pathologies. For Doctor Neveux, “motivation also comes from oneself, through the practice of motivating actions that encourage people to leave«.