Neuropsychiatrie de l''Enfance et de l''Adolescence最新文献

{"title":"Niveau d’anxiété et refus scolaire dans les troubles anxieux chez l’adolescent","authors":"S. Lopez Sanchez ,&nbsp;H. Denis ,&nbsp;L. Moulis ,&nbsp;M. Peries ,&nbsp;A. Baghdadli","doi":"10.1016/j.neurenf.2023.05.008","DOIUrl":"10.1016/j.neurenf.2023.05.008","url":null,"abstract":"<div><h3>Objectives</h3><p>The primary objective was to compare the level of anxiety on the Multidimensional Anxiety Scale for Children in two groups of anxious secondary school children, one group out of school meeting the criteria of School Refusal and the other in school. The secondary objective was to compare these groups on other clinical, sociodemographic and therapeutic parameters.</p></div><div><h3>Patient and method</h3><p>Retrospective observational study of 34 school-going anxious teenagers recruited at the University Hospital of Montpellier, compared with 55 out of school anxious teenagers meeting the criteria of Anxious School Refusal recruited in a multicentre study.</p></div><div><h3>Results</h3><p>There was no significant intergroup difference in median scores on the Multidimensional Anxiety Scale for Children (<em>P</em> <!-->=<!--> <!-->0.49), but a significant intergroup difference in median scores was found on the Behavioural Anxiety and Phobia Scale with higher total scores in the School Refusal group (151.5 [130.5; 169.0] vs. 125.0 [94.0; 139.0], <em>P</em> <!-->&lt;<!--> <!-->0.01). The School Refusal group was more likely to have a panel of anxiety disorders including agoraphobia, separation anxiety, depressive disorders, more impaired global functioning and more likely to receive psychotropic medication (<em>P</em> <!-->&lt;<!--> <!-->0.01). There were no significant intergroup differences in sociodemographic characteristics except age.</p></div><div><h3>Discussion</h3><p>The absence of significant intergroup differences in the level of anxiety measured with the Multidimensional Anxiety Scale for Children could be related to a lower level of anxiety in the school refusal group due to school refusal. The higher anxiety score with the Behavioural Anxiety and Phobia Scale in the refusal group could be related to their better sensitivity. The clinical picture in the refusal group, both more severe and with co-morbidities, is comparable to what is described in the literature.</p></div><div><h3>Conclusion</h3><p>A higher level of anxiety was not associated with school refusal according to main endpoints in teenagers with anxiety disorders. However, this group had other criteria of greater clinical severity that justify early identification.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 5","pages":"Pages 233-239"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47340664","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":"Reconstruction in Salvage Surgery for Head and Neck Cancers.","authors":"Nageswara R Noothanapati, Nisha R Akali, Rahul Buggaveeti, Deepak Balasubramanian, Jimmy Mathew, Subramania Iyer, Krishnakumar Thankappan","doi":"10.1177/19433875221109248","DOIUrl":"10.1177/19433875221109248","url":null,"abstract":"<p><strong>Introduction: </strong>Salvage surgery is the treatment option in recurrences and second primary tumors. This paper aimed to study the options and outcomes of reconstruction and the predictors of poor reconstructive outcomes in salvage surgery for head and neck cancers.</p><p><strong>Study design: </strong>This is a retrospective study of all patients who underwent reconstructive flap surgery as part of salvage surgery for head and neck cancers between the years 2004 and 2017.</p><p><strong>Methods: </strong>The initial treatment may be single modality radiotherapy or surgery or multimodality with combinations of surgery, radiotherapy, and chemotherapy. Any pathology that required surgical salvage was included. Any procedures done purely as reconstructive surgery were excluded. Predictor variables included demographical, clinical, and treatment factors. The outcome parameter was the occurrence of any flap-related complication or not. The complications and morbidity related to the procedures are reported.</p><p><strong>Results: </strong>Ninety-three patients underwent loco-regional flaps (LRF group), and 100 had free flaps (FF group). Pectoralis major flap was the commonest flap used in 68 patients (73.1%). Anterolateral thigh (ALT) flap was the commonest free flap and comprised 41% of the FF group. Any skin-related complication was seen in 35 patients (37.6%) and 41 (41%), respectively, in LRF and FF subsets. Any flap-related complication was seen in 16 patients (17.2%) and 29 patients (29%), respectively, in LRF and FF subsets. A summary measure \"any one of the complications\" was seen in 46 (49.5%) and 57 (57%), respectively, in LRF and FF subsets. Univariate and multivariate analysis for any flap-related complication identified no statistically significant predictor.</p><p><strong>Conclusions: </strong>Soft tissue flaps were preferred in salvage reconstruction, though the defects had a bony component. In the microvascular free flap reconstruction era, pectoralis major flap has shifted its role from a \"workhorse flap\" to a \"salvage flap.\" About half of the patients develop some complications. Flap-related complications are also common. In salvage surgery, it is important that an appropriate flap is selected, suitable for the setting, according to the indications, neck, and patient conditions.</p>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"60 1","pages":"211-221"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77196149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agenda","authors":"","doi":"10.1016/j.neurenf.2023.08.001","DOIUrl":"10.1016/j.neurenf.2023.08.001","url":null,"abstract":"","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 5","pages":"Pages 283-284"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43706649","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":"Profils cliniques et prise en charge des enfants et adolescents transgenres dans une consultation spécialisée d’Île-de-France","authors":"C. Lagrange,&nbsp;J. Brunelle,&nbsp;F. Poirier,&nbsp;H. Pellerin,&nbsp;N. Mendes,&nbsp;G. Mamou,&nbsp;N. Forno,&nbsp;L. Woestelandt,&nbsp;D. Cohen,&nbsp;A. Condat","doi":"10.1016/j.neurenf.2023.05.001","DOIUrl":"10.1016/j.neurenf.2023.05.001","url":null,"abstract":"<div><h3>Context</h3><p>French clinical data on the medical management of transgender children and adolescents are scarce. Yet, the topic regularly comes to the forefront of the media.</p></div><div><h3>Method</h3><p>In this article, we propose to retrospectively describe all the children and adolescents received since 2012 in the largest specialized gender identity consultation for children and adolescents in Île-de-France. In addition to their sociodemographic characteristics, we study the presence or not of gender incongruence according to the ICD 11 criteria, the psychiatric and social vulnerabilities, and describe the main management modalities proposed: social transition, puberty blockage, hormonal transitions and/or rare surgical transitions. These last three proposals were discussed in multidisciplinary concertation meetings.</p></div><div><h3>Results</h3><p>We collected 239 youths aged 3 to 20 years. The mean age at which youth and their families were seen at the first appointment was 14.5 years (±<!--> <!-->3.16). In all, 91% of the sample had gender incongruence, with 32% expressing gender incongruence before puberty. Two-thirds were youth assigned female at birth (<em>P</em> <!-->&lt;<!--> <!-->0.05). In terms of psychopathology, depressive and anxiety disorders, as well as suicidality, came well ahead of other psychiatric co-occurrences. School ostracism and rejection were common. Compared to the general adolescent population, the young people in the specialized consultation are much more exposed to discrimination and insults, and even sexual aggression in the public space, than their peers, and the internalization of transphobia by these young people is particularly important. In all, 40% of the young people made a social transition before the first consultation and 74% and 61% of them did so within the family and at school (the average age of social transition at school<!--> <!-->=<!--> <!-->15.13 years). In all, 35% of the young people made the name change official at the town hall (the average age<!--> <!-->=<!--> <!-->16.26 years). Puberty blockers were used by 11% of the youths who had reached puberty (mean age<!--> <!-->=<!--> <!-->13.9 years, mean time to initiation<!--> <!-->=<!--> <!-->10 months). In total, fewer than half of the youths (44%) received masculinizing or feminizing sex hormone treatment (mean age<!--> <!-->=<!--> <!-->16.9 years, mean time to initiation<!--> <!-->=<!--> <!-->14 months). In all, 8.7% of the young people who received sex hormone treatment underwent fertility preservation. Requests for surgery before the age of 18 remain very rare. The most frequent are torsoplasties (20%) performed at a mean age of 18.44 years and never before 16 years.</p></div><div><h3>Conclusion</h3><p>The results of this cohort are close to those reported by other European centers in terms of the higher proportion of young people assigned female at birth. However, they differ with a lower proportion of hormonal treatment. So","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 5","pages":"Pages 270-280"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46825065","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":"Le sentiment de compétence parentale des mères victimes d’abus sexuel(s) infantile(s) : un modèle structural","authors":"M. Delhalle,&nbsp;A. Blavier","doi":"10.1016/j.neurenf.2023.05.003","DOIUrl":"10.1016/j.neurenf.2023.05.003","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study was to investigate the impact of childhood sexual abuse on the parental sense of competence and to propose a structural model, taking into account the cumulative effect of the different types of abuse.</p></div><div><h3>Participants and method</h3><p>The participants were 1904 mothers of children aged 3 to 8. They were asked to complete an online form that included a sociodemographic questionnaire, the Childhood Trauma Questionnaire - Short Form (CTQ-SF), and the Questionnaire d’Auto-Évaluation de la Compétence Éducative Parentale (QAECEP).</p></div><div><h3>Results</h3><p>Our results confirm the link between sexual abuse and intrafamilial abuse. They suggest that the experience of childhood sexual abuse impacts mothers' parental sense of competence when it occurs in situations of multiple and severe abuses. Furthermore, our statistical analyses indicate that maternal psychological well-being and the presence of child disorders mediate the association between the mother's childhood experience and her parental sense of competence.</p></div><div><h3>Discussion</h3><p>It seems that the parental sense of competence is impacted by sexual abuse when it is part of multiple traumas leading to symptoms of complex post-traumatic stress disorder. Psychological well-being of the mother and the absence of disorders in the child demonstrates a protective role in the parental sense of competence of mothers with histories of childhood abuse. These findings have implications for interventions for mothers experiencing parenting difficulties. Our results suggest that taking into account the parental sense of competence and the childhood experiences is essential for providing appropriate interventions.</p></div><div><h3>Conclusions</h3><p>This study confirms the importance of integrating the mother's childhood experiences to better understand her parenting difficulties and to be able to intervene on her difficulties of traumatic origin.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 5","pages":"Pages 249-258"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47253705","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":"Violence conjugale, maltraitance, separation et resilience de l’enfant : illustration clinique projective","authors":"Justine Renauld,&nbsp;Mélanie Laurent,&nbsp;Nadine Demogeot,&nbsp;Claude de Tychey","doi":"10.1016/j.neurenf.2023.01.002","DOIUrl":"10.1016/j.neurenf.2023.01.002","url":null,"abstract":"<div><p>Our aim is to present, using a psychanalytic theoretical model of resilience, the clinical projective study of a child facing domestic violence, separation from parents, child abuse and emotional deprivation generated by a maternal figure. We want to show psychodynamic roots of resilience related mainly to intrapsychic resources of the child. These resources are related to a wealth of imaginary space, quality of mentalization and flexibility of defense mechanisms approached by the Rorschach and the test of stories.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 5","pages":"Pages 259-269"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47379147","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":"Dépistage, diagnostic et prise en charge du TDAH chez l’enfant et l’adolescent : point de vue des parents en Suisse-Romande","authors":"F. Brodard ,&nbsp;A. Radice ,&nbsp;M. Bader","doi":"10.1016/j.neurenf.2023.05.004","DOIUrl":"10.1016/j.neurenf.2023.05.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Attention deficit hyperactivity disorder (ADHD) is one of the most frequently diagnosed disorders in children and adolescents, but its prevalence may vary depending on the context.</p></div><div><h3>Objective</h3><p>This study aimed to investigate parents’ experiences of the diagnostic process and proposed treatments for their child with ADHD. This will allow to discuss the concordance between parents’ experiences in a French-speaking region and the “good practices” recommended in international guidelines.</p></div><div><h3>Method</h3><p>An ad hoc questionnaire was completed online by 128 parents of children aged between 5 and 18 diagnosed with ADHD.</p></div><div><h3>Results</h3><p>Descriptive analyses showed that more than half of the parents encountered difficulties in obtaining a timely and accurate diagnosis for their child. Furthermore, perceived quality of listening varied depending on the profession of the diagnostician, as well as in the treatments recommended. The diagnosis was most often received as a relief, but parents expressed frustration with the lack of trained professionals to offer treatment alternatives to medication.</p></div><div><h3>Conclusion</h3><p>These findings emphasize the importance of improving access to quality information for the public and providing training for front-line professionals. The diagnosticians should improve their consideration of the child and the impact of the disorder on the family, as well as their knowledge of the disorder and treatment alternatives. Professionals should also receive training in evidence-based treatments such as parenting programs. Ultimately, improving the diagnostic process and access to appropriate treatments for ADHD in French-speaking regions can have a positive impact on the well-being of affected children and their families.</p></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"71 5","pages":"Pages 223-232"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48018917","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":"« Faut pas rêver » : des petites histoires de vie à la Maison de l’Orée","authors":"C. Saladin","doi":"10.3917/cead.009.0011","DOIUrl":"https://doi.org/10.3917/cead.009.0011","url":null,"abstract":"J’explique le devenir d’enfants autistes ou psychotiques vers l’adolescence, accueillis dans un hôpital de jour en Essonne dirigé par Tony Lainé. Soignants et parents se préoccupent de ceux qui ne peuvent réintégrer le circuit scolaire ou professionnel. Ils créent ensemble une association qui promeut la création de petits lieux de vie dans la cité, pour lutter contre l’exclusion de ces personnes de la société humaine et favoriser des situations adaptées à chacun dans sa singularité.","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"49 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72367405","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":"Le cadre et la marge","authors":"Mohand Hamidouche, Anne-Marie Royer","doi":"10.3917/cead.009.0095","DOIUrl":"https://doi.org/10.3917/cead.009.0095","url":null,"abstract":"En parcourant l’histoire d’une institution, nous revisitons l’évolution du placement des enfants et des adolescents depuis deux siècles. La multiplication des textes de loi ces dernières décennies entretient nos questionnements et notre quête de modèles de fonctionnement. La peur des changements s’estompe dès lors que nous gardons à l’esprit ce qui fait le cœur de nos métiers. Il s’agit d’accompagner sur un temps suffisamment long des jeunes qui ne peuvent se construire que dans un lien de confiance où éduquer revient à transmettre des savoir-faire et des savoir-être en leur ouvrant des perspectives d’évolution. Pour ce faire le cadre de référence où l’évaluation permanente devient culture institutionnelle doit être validé et soutenu par le métacadre qui tolère une marge où les essais-erreurs et les prises de risque – comme l’aménagement d’espaces d’intimité – dans l’accompagnement des jeunes sont tolérés. Aussi, devant la diversité des problématiques nous devons pouvoir compter sur un réseau de partenaires extérieurs.","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84539868","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":"Éditorial","authors":"Angelo Persico, Anne-Marie Royer","doi":"10.3917/cead.009.0007","DOIUrl":"https://doi.org/10.3917/cead.009.0007","url":null,"abstract":"","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72867704","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}