History and functions of “Units for Difficult Patients” (Part 1). From “secure ward” to “Unit for Difficult Patients”: Over a century of care in Villejuif, France; [Histoire et fonctions des Unités pour Malades Difficiles (1re partie). Du quartier de sûreté à l'Unité pour Malades Difficiles de Villejuif, plus d'un siècle de prise en charge]

This article is the first in a series of three, dedicated to the history and functions of what is known as a UMD in France: Unités pour Malades Difficiles, or “Units for Difficult Patients”. This particular article focuses on the oldest such secure structure, UMD Henri Colin, created in 1910 in Villejuif as a quartier de sûreté, or a “secure ward”. The article aims to detail evolutions in treatment and the types of patient treated over more than one hundred years, parallel to social change. Four distinct chronological periods are examined, for their perspective on professional practice as much as for the reasons given for patients’ admission and the psychopathological profiles of “dangerous” patients. Clinical vignettes are used to illustrate this historical evolution. © 2019