{"title":"Utilité des lits de crise en pédopsychiatrie : expérience du dispositif de l’hôpital Vincent Van Gogh","authors":"W. Binti Kayumba , M. Delcommenne , R. Guillaume","doi":"10.1016/j.neurenf.2023.05.002","DOIUrl":"10.1016/j.neurenf.2023.05.002","url":null,"abstract":"<div><p>The notions of crisis and emergency are frequently mixed up by family members, as well as by many professionals, although they are not synonymous. In child psychiatry, an emergency is an acute pathological situation which is associated with the idea that the child's life is in danger. While an emergency requires immediate care, a crisis requires the development of new ways of seeing and navigating the world, as well as new adaptive mechanisms to deal with these changes. Following the new child-adolescent mental health policy developed by the Belgian Ministry of Public Health in 2015, the therapeutic unit for adolescents (10 to 18-year-old) at the Vincent Van Gogh Hospital dedicated two of its fifteen beds to the treatment of child psychiatric crises. The objective of this paper is to present the functioning of the “crisis beds” device within the hospital unit. We will begin with a definition of the notion of crisis and of the theoretical models of intervention offered in clinics. This will be followed by an explanation of the historical context behind the implementation of the crisis beds in the Vincent Van Gogh hospital and a description of how this device works. We will conclude with an overview of three clinical cases which illustrate the extent of the treatment provided in the crisis unit and the different possible outcomes at the end of the stay. The influence of individual intrapsychic and systemic factors on the crisis and its aftermath will be highlighted through these cases.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 8","pages":"Pages 419-426"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44880899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Toussaint , M. Roze , V. Marchand , D. Rousseau
{"title":"Le programme PEGASE : un parcours de soin précoce visant à limiter les conséquences délétères de la maltraitance et/ou de la négligence sur la santé et le développement des jeunes enfants protégés","authors":"E. Toussaint , M. Roze , V. Marchand , D. Rousseau","doi":"10.1016/j.neurenf.2023.09.004","DOIUrl":"10.1016/j.neurenf.2023.09.004","url":null,"abstract":"<div><p>Young children in residential nurseries constitute a particularly vulnerable population due to their overexposure to traumatic experiences. In addition to these negative events that are at the origin of the protection measure, there are traumas that can be generated by the rupture, the separation and the placement. Additionally, convergent research has highlighted wide-ranging negative trajectories attributable to both the short and long-term consequences of abuse and neglect and their neurobiological impact on health and development. As a result, while child maltreatment was once considered a social problem, it is now recognized by the WHO as a global public health problem. There is an urgent need to equip child protection services to be able to respond to the unique, specific and particular needs of trauma-exposed children as soon as possible; the first months in child welfare service can provide a powerful opportunity. The PEGASE experiment of a coordinated care pathway, implemented in April 2019, aims to improve the identification of developmental delays and psychological disorders in children under the age of three, as well as the provision of early care.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 8","pages":"Pages 411-418"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134994407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trouble développemental de la coordination et schéma corporel : l’entraînement du couplage perception-action en intervention psychomotrice","authors":"H. Arramon , M. Blanchet , C. Maïano , G. Cadoret","doi":"10.1016/j.neurenf.2023.05.005","DOIUrl":"10.1016/j.neurenf.2023.05.005","url":null,"abstract":"<div><h3>Hypothesis</h3><p>Developmental coordination disorder (DCD) is explained by a defect of the perception-action coupling (PAC) prior to the intentional motor disorder, thus disrupting internal representations including the body schema. The study postulated that training the PAC through motor dissociation exercises would help children with DCD to implicitly develop their body schema (i.e., a function-oriented intervention with a bottom-up approach), observable through motor skills, spatial functions and self-perception.</p></div><div><h3>Method</h3><p>A remote intervention was proposed to 13 children, aged 7 to 10 years, with DCD. Twice a week, for eight weeks, they watched video sessions each composed of an exercise of adaptation of the temporal adjustment of a motor pattern, an exercise of succession of segmental positions or of combination of distinct simultaneous movements, and an exercise of stabilization of an object on oneself during a postural sequence.</p></div><div><h3>Results</h3><p>The practice of motor dissociations in the exercises allowed the children to significantly improve their motor skills (e.g., balance, jumping, coordination, manual speed and precision), spatial functions (e.g., mental rotation and visuo-constructive praxis) and self-perception (e.g., perceived physical appearance) with effect sizes ranging from moderate to high: min.: <em>d</em> <!-->=<!--> <!-->0.549 and <em>P</em> <!-->=<!--> <!-->0.048; max.: <em>d</em> <!-->=<!--> <!-->0.883 and <em>P</em> <!-->=<!--> <!-->0.001.</p></div><div><h3>Conclusion</h3><p>The results suggest that PAC training refines sensorimotor representations with transfer effects on motor skills, spatial functions and self-perception. Future studies should confirm this interpretation. In summary, the study shows the effectiveness of a remote intervention in rehabilitation, validates the bottom-up approach, and underlines the importance of supporting children with DCD in the development of their body schema.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 8","pages":"Pages 389-398"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44808994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Agenda","authors":"","doi":"10.1016/j.neurenf.2023.10.001","DOIUrl":"https://doi.org/10.1016/j.neurenf.2023.10.001","url":null,"abstract":"","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 7","pages":"Pages 386-387"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Le Lidec , C. Michelon , C. Vernhet , A. Baghdadli
{"title":"Impact d’un programme d’éducation thérapeutique du patient sur la qualité de vie d’enfants avec TDAH et celle de leurs parents","authors":"O. Le Lidec , C. Michelon , C. Vernhet , A. Baghdadli","doi":"10.1016/j.neurenf.2023.07.004","DOIUrl":"10.1016/j.neurenf.2023.07.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Patient education is a holistic therapeutic approach that focuses on the needs of individuals with a chronic condition and aims to improve quality of life. The patient education program “Living better with ADHD” is aimed at children and adolescents with ADHD from 8 to 14 years old and their parents. It consists of 5 themed group sessions and 2 semi-structured individual interviews. The aim of this study was to investigate the change in quality of life of the children and their parents who benefited from the program.</p></div><div><h3>Patients and method</h3><p>This is a prospective monocentric study of 35 families who participated in the “Living better with ADHD” program between February 2022 and July 2022 and completed the quality of life questionnaires KIDSCREEN-27 for children and WHOQOL-BREF for parents, pre-intervention and then 6 weeks later.</p></div><div><h3>Results</h3><p>There was an improvement in the children's quality of life in the area of physical wellbeing and a trend towards an improvement in the quality of life in the “school environment”. This change was not correlated with any of the socio-demographic or clinical variables examined. On the other hand, there was no change in parental quality of life.</p></div><div><h3>Conclusion</h3><p>These preliminary results suggest the value of therapeutic education for children with ADHD. Given the limitations of our method, randomized controlled trials should investigate the effects on quality of life for the long term.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 7","pages":"Pages 356-363"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47518035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"La spécialité de la psychiatrie de l’enfant et de l’adolescent en Espagne. La route longue et sinueuse","authors":"F. Cardelle-Pérez , M.D. Domínguez-Santos","doi":"10.1016/j.neurenf.2023.06.005","DOIUrl":"10.1016/j.neurenf.2023.06.005","url":null,"abstract":"<div><h3>Objectives</h3><p>August 3, 2021 marks an important milestone in the history of psychiatry in Spain with the establishment of the title of specialist in child and adolescent psychiatry. Until then, Spain remained one of the few European countries where this measure had not been implemented. This article aims to examine the development of child and adolescent psychiatry, highlighting the various contributions that have made it possible.</p></div><div><h3>Method</h3><p>A literature review was conducted to trace the historical evolution of child and adolescent psychiatry.</p></div><div><h3>Results</h3><p>The advancements in child and adolescent psychiatry worldwide are first presented, followed by an examination of the specific case of Spain. It is evident that the development of child and adolescent psychiatry in Spain has been slower compared to neighboring countries. Additionally, there is concerning heterogeneity in its implementation within the Spanish state.</p></div><div><h3>Discussion</h3><p>The findings suggest the emergence of new challenges, including the need to develop training programs and clinical guidelines based on scientific evidence. Ensuring effective, quality, and equitable mental healthcare services for children within the national health system is essential, with particular attention to patients with severe mental disorders.</p></div><div><h3>Conclusion</h3><p>The introduction of the specialist title in child and adolescent psychiatry in Spain represents a significant advancement. However, new challenges need to be addressed, such as the formulation of evidence-based training plans and clinical guidelines. It is crucial to establish measures that ensure appropriate and equitable care for children and adolescents with mental disorders.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 7","pages":"Pages 376-385"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49227498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Approche systémique des rumeurs à l’adolescence. Le haut potentiel : facteur de vulnérabilité ou facteur de protection ?","authors":"N. Duriez","doi":"10.1016/j.neurenf.2023.07.002","DOIUrl":"10.1016/j.neurenf.2023.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>In this article, we focus on the experiences of gifted adolescents who are victims of bullying in the form of rumors. How do they experience this relational aggression and this social isolation when belonging to a peer network is essential at this age? Are they more vulnerable or more resilient? A systemic perspective led us to consider all the factors within these perpetrator-victim-management team systems that are involved in the rumor spreading.</p></div><div><h3>Patients and method</h3><p>We conducted a qualitative study of three situations based on Lazarus and Folkman's transactional model to analyze the processes at work within each system in the rumor spreading.</p></div><div><h3>Results</h3><p>The results show that the teenager who spreads the rumor does so in the name of his or her anti-violence values, without considering the context in which the events took place and the subjective experience of the protagonists. It is also a way for him or her to establish his or her popularity within the group. Each of the three gifted boys reacted differently. Struggling to identify the roles of victim and perpetrator, the institution administrator did not perceive the situation as a case of bullying and may even have credited the rumor.</p></div><div><h3>Discussion</h3><p>Our discussion focuses on the personal and family factors of the population in this study, the current societal context with the MeToo movement and the cancel culture, and the limitations of school-based anti-bullying interventions. These three studies show the need to alert and inform education professionals to a systemic understanding when it comes to the spreading of these rumors in adolescence. These acquired skills will then allow them to be more efficient as mediators in these situations, sometimes with dramatic consequences for vulnerable individuals.</p></div><div><h3>Conclusion</h3><p>Giftedness appears as a secondary characteristic compared to emotional competencies. Nevertheless, certain personality traits often observed in gifted subjects, such as overexcitability or a particular sense of humor, are active in transactions between the different systems.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 7","pages":"Pages 339-348"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42461387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Letot , L. Vitte , C. Boiteau , G. Apter , A. Untas , E. Devouche
{"title":"L’interaction précoce parent–bébé à travers le prisme du père. Un regard rétrospectif sur la recherche des dernières décennies","authors":"J. Letot , L. Vitte , C. Boiteau , G. Apter , A. Untas , E. Devouche","doi":"10.1016/j.neurenf.2023.08.002","DOIUrl":"https://doi.org/10.1016/j.neurenf.2023.08.002","url":null,"abstract":"<div><p>After many years of research focused on the mother-infant dyad, the literature has gradually turned its attention to father-infant interactions. This literature review aims to provide a synthesis of knowledge on the father-infant dyad. Thus, the first part summarizes a set of works that have explored paternal behaviour within the father-baby dyad in comparison with maternal behaviour observed within the mother-baby dyad. In the second part, the article explores the early father-baby exchange as a subsystem of the family system, a triadic approach which allows a direct comparison of the two parents and gives access to different dyadic configurations. A third part presents more contemporary studies, carried out in particular from the neonatal period, with a look at the situations of vulnerability which remain less invested when it comes to the father than when it comes to the mother. Finally, we end the article with a reflection on the father, a partner of the baby who is still understudied, in a societal context that is nonetheless evolving in terms of the place he is given.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 7","pages":"Pages 370-375"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Du bébé à la famille : de l’observation du nourrisson à la thérapie familiale psychanalytique : au-delà des différences de pratique, quelques points de convergence","authors":"C. Mille , M. Braun , M. Paolucci","doi":"10.1016/j.neurenf.2023.07.005","DOIUrl":"https://doi.org/10.1016/j.neurenf.2023.07.005","url":null,"abstract":"<div><p>Psychoanalytic family therapy and infant observation according to the Esther Bick method differ a priori in their aims. One is a psychotherapeutic device while the other is a training course for psychotherapists. Both approaches have psychoanalytic theory, its epistemology and ethics, as their common basis. The clinicians are guided by the families they meet, whether they are suffering or “normally well”. Thinking jointly about these two systems makes it possible to overcome the debate that opposes the “real baby”, of direct and developmental observation, and the “true baby”, reconstructed on the couch. In fact, the observer in training is witness to the narration of fantasmatic and transgenerational elements, weaving a psychic cradle that welcomes the “real baby” and where the construction of the “true baby” begins. Family therapists are naturally attentive to these plural constructions and imaginaries, and to the claims of these eternal babies that families still carry within them. Both approaches involve attention to the archaic, to affective and sensory experiences, and both rely on the group: the observer witnesses the birth or remodeling of the family group, while the support group participates in the transformation of the observed material in search of elaboration. In the same way, the neo-group, composed of the family therapists and the families, supports a space of containing reverie, which facilitates the re-establishment of a new form of fantasmatic circulation. The observer, by his presence, modifies the family system in which he is in fact included, families testify to the benefit they derive from these meetings, and therapeutic applications at home have thus been set up to support families in difficulty, while at the same time, practitioners defend the interest of psychoanalytical family work in perinatal care. The articulation of these two systems gives us a glimpse of fruitful perspectives for training, prevention and psychotherapeutic support.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 7","pages":"Pages 364-369"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trouble dissociatif de l’identité et adolescence : quels enjeux cliniques ?","authors":"P. Espi","doi":"10.1016/j.neurenf.2023.09.002","DOIUrl":"https://doi.org/10.1016/j.neurenf.2023.09.002","url":null,"abstract":"<div><p>In child psychiatry services we are seeing more and more adolescents reporting “dissociative” symptoms, and it is no longer rare for the diagnosis of dissociative identity disorder to be evoked. The increased visibility of certain psychiatric symptoms may be related to better identification and increased training of clinicians, but it may also be related to changes in societal contexts that may favor the emergence or maintenance of certain forms of expression of psychological suffering. Adolescence also contains its own identity reorganizations and dialectics which necessarily color the disorders and their significance, and which sometimes must be deciphered beyond the act or the inaugural syndromic form. We propose here to discuss our interrogations in relation to dissociative identity disorder in adolescence and some of the psychopathological issues that are raised.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 7","pages":"Pages 349-355"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}