Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.03.005
A. Vachez-Gatecel , F. de Sainte Maréville
Because it is within the possibility of caring for others, touch is at the very basis of ethics. It is central to the work of touch professionals, especially when dealing with children and adolescents in the field of child psychiatry. Questions are raised daily, and post-coup work becomes necessary because of the ambivalence and confusion surrounding this sense. This article focuses on the practice of psychomotricians. Their experience is invaluable in establishing a therapeutic and ethical framework for achieving the right distance between carer and cared-for. Two clinical vignettes illustrate this practice regarding touch but not without first addressing the historical-medical-philosophical dimension of this sense. Psychomotricians draw on the phenomenology of Merleau-Ponty, among others. Merleau-Ponty's thinking is based on touch, the sense of mediation between the surface and depth of being, but also on the paradigm of our relationship with the world, which is highlighted by the experience of touching–touched. It is only through rigorous elaboration and reflection that the use of touch in child psychiatry, whatever the pathological difficulties, can be therapeutic: containing and enveloping without embracing, exciting or coercing…
{"title":"Éthique du toucher en psychiatrie de l’enfant et de l’adolescent : dialectique entre théorie et pratique","authors":"A. Vachez-Gatecel , F. de Sainte Maréville","doi":"10.1016/j.neurenf.2025.03.005","DOIUrl":"10.1016/j.neurenf.2025.03.005","url":null,"abstract":"<div><div>Because it is within the possibility of caring for others, touch is at the very basis of ethics. It is central to the work of touch professionals, especially when dealing with children and adolescents in the field of child psychiatry. Questions are raised daily, and post-coup work becomes necessary because of the ambivalence and confusion surrounding this sense. This article focuses on the practice of psychomotricians. Their experience is invaluable in establishing a therapeutic and ethical framework for achieving the right distance between carer and cared-for. Two clinical vignettes illustrate this practice regarding touch but not without first addressing the historical-medical-philosophical dimension of this sense. Psychomotricians draw on the phenomenology of Merleau-Ponty, among others. Merleau-Ponty's thinking is based on touch, the sense of mediation between the surface and depth of being, but also on the paradigm of our relationship with the world, which is highlighted by the experience of touching–touched. It is only through rigorous elaboration and reflection that the use of touch in child psychiatry, whatever the pathological difficulties, can be therapeutic: containing and enveloping without embracing, exciting or coercing…</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 6","pages":"Pages 322-327"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134776","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}
Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.06.002
A. Joffroy-Frixons , P. Colas , K. Abed , M. Gruel , M. Habib
The so-called Non-Verbal Learning Disabilities (NVLD) syndrome is a type of learning disorder that is frequently discussed in clinical, educational, and community contexts, particularly in Anglo-Saxon countries and Quebec. However, its nosographic identity remains undefined, which hinders the early identification of affected children and adolescents and consequently delays diagnosis and the implementation of appropriate intervention protocols. In France, the term is gradually gaining recognition among professionals involved in learning disorders, while its specific impacts on daily, academic, and social life are also becoming more acknowledged. This article has three main objectives: 1/to provide an overview of current knowledge regarding the presentation and mechanisms of the disorder through a brief literature review focused on recent publications, including two meta-analyses and a summary of the few neuroimaging studies dedicated to it; 2/to address ongoing questions regarding the clinical reality of the disorder and its classification among learning disabilities and, more broadly, neurodevelopmental disorders (NDDs) by analyzing a cohort of 89 patients recently admitted to the Résodys center which is specialized in the care of severe learning disorders in the PACA region of France; 3/finally, in light of these findings, to examine the relevance of a new set of diagnostic criteria for clinicians, adopting a dimensional rather than categorical approach to better support affected children and adolescents. We thus propose a new perspective on this syndrome—one that no longer focuses on deviation from the norm but rather on two key observations: the multiplicity of moderately or partially affected cognitive domains, and the intra-individual performance discrepancies among these domains, particularly verbal and nonverbal. From this standpoint, our clinical experience diverges from a portion of the recent literature that equates NVLD with visuospatial disorder. More than an isolated cognitive deficit, the hallmark of this syndrome seems to lie in the coexistence of subtle impairments across several domains—even at a subclinical level. Though still limited, neuroimaging data tend to support the hypothesis of impaired connectivity among neural networks that jointly contribute to several of the cognitive functions involved.
{"title":"Le syndrome de dysfonctions non verbales (SDNV) : actualisation des connaissances et analyse d’une cohorte de 89 patients traités dans le centre expert Resodys","authors":"A. Joffroy-Frixons , P. Colas , K. Abed , M. Gruel , M. Habib","doi":"10.1016/j.neurenf.2025.06.002","DOIUrl":"10.1016/j.neurenf.2025.06.002","url":null,"abstract":"<div><div>The so-called Non-Verbal Learning Disabilities (NVLD) syndrome is a type of learning disorder that is frequently discussed in clinical, educational, and community contexts, particularly in Anglo-Saxon countries and Quebec. However, its nosographic identity remains undefined, which hinders the early identification of affected children and adolescents and consequently delays diagnosis and the implementation of appropriate intervention protocols. In France, the term is gradually gaining recognition among professionals involved in learning disorders, while its specific impacts on daily, academic, and social life are also becoming more acknowledged. This article has three main objectives: 1/to provide an overview of current knowledge regarding the presentation and mechanisms of the disorder through a brief literature review focused on recent publications, including two meta-analyses and a summary of the few neuroimaging studies dedicated to it; 2/to address ongoing questions regarding the clinical reality of the disorder and its classification among learning disabilities and, more broadly, neurodevelopmental disorders (NDDs) by analyzing a cohort of 89 patients recently admitted to the Résodys center which is specialized in the care of severe learning disorders in the PACA region of France; 3/finally, in light of these findings, to examine the relevance of a new set of diagnostic criteria for clinicians, adopting a dimensional rather than categorical approach to better support affected children and adolescents. We thus propose a new perspective on this syndrome—one that no longer focuses on deviation from the norm but rather on two key observations: the multiplicity of moderately or partially affected cognitive domains, and the intra-individual performance discrepancies among these domains, particularly verbal and nonverbal. From this standpoint, our clinical experience diverges from a portion of the recent literature that equates NVLD with visuospatial disorder. More than an isolated cognitive deficit, the hallmark of this syndrome seems to lie in the coexistence of subtle impairments across several domains—even at a subclinical level. Though still limited, neuroimaging data tend to support the hypothesis of impaired connectivity among neural networks that jointly contribute to several of the cognitive functions involved.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 6","pages":"Pages 304-313"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134910","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}
Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.07.002
M. Perrier Genas , J. Boutinaud
Objectives
This article presents an implementation of the GAPPEA grid (Grille Alternative Psychomotricité Environnement Affectivité–Alternative Psychomotor Environment Affectivity Grid), based on the needs encountered in clinical practice in CAMSP with regards to babies born prematurely and their families.
Patients and method
The grid was tested on a cohort of 81 8-month-old babies (8 months of age, real or corrected, including premature babies) involving the networking of several dozen psychomotor therapists around its use.
Results
In addition to the feedback received from the psychomotricians who took part in the study and who emphasised the points of interest, the use of the grid made it possible to specify certain particularities and weaknesses in the psychomotor development of premature babies (sensory irritability, prevalence of hyper-extension patterns, undesirable effects of sitting, etc.) as well as their impact on the psychomotor development of premature babies. It also defined their impact on interactions with parents (which were measured here via their effects on carrying, feeding, play and communication).
Discussion
In light of this experiment, the use of the grid enabled an in-depth clinical reading of the potential and difficulties of the babies concerned, facilitating better identification of certain clinical signs and their issues. It also defined precise indications for thinking about their care and guiding parents on very concrete aspects.
Conclusions
The use of the grid in this context underlines the relevance of its handling, thus opens the possibility of diversifying its use and improving it in the future through other research by using it as a support. It offers a practical and useful tool for psychomotricians in their assessment and care activities in the field of therapeutic support for babies and their parents.
{"title":"Mise à l’épreuve de la Grille Alternative Psychomotricité Prématurité Environnement Affectivité (GAPPEA) via la clinique de la prématurité","authors":"M. Perrier Genas , J. Boutinaud","doi":"10.1016/j.neurenf.2025.07.002","DOIUrl":"10.1016/j.neurenf.2025.07.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This article presents an implementation of the GAPPEA grid (Grille Alternative Psychomotricité Environnement Affectivité–Alternative Psychomotor Environment Affectivity Grid), based on the needs encountered in clinical practice in CAMSP with regards to babies born prematurely and their families.</div></div><div><h3>Patients and method</h3><div>The grid was tested on a cohort of 81 8-month-old babies (8 months of age, real or corrected, including premature babies) involving the networking of several dozen psychomotor therapists around its use.</div></div><div><h3>Results</h3><div>In addition to the feedback received from the psychomotricians who took part in the study and who emphasised the points of interest, the use of the grid made it possible to specify certain particularities and weaknesses in the psychomotor development of premature babies (sensory irritability, prevalence of hyper-extension patterns, undesirable effects of sitting, etc.) as well as their impact on the psychomotor development of premature babies. It also defined their impact on interactions with parents (which were measured here via their effects on carrying, feeding, play and communication).</div></div><div><h3>Discussion</h3><div>In light of this experiment, the use of the grid enabled an in-depth clinical reading of the potential and difficulties of the babies concerned, facilitating better identification of certain clinical signs and their issues. It also defined precise indications for thinking about their care and guiding parents on very concrete aspects.</div></div><div><h3>Conclusions</h3><div>The use of the grid in this context underlines the relevance of its handling, thus opens the possibility of diversifying its use and improving it in the future through other research by using it as a support. It offers a practical and useful tool for psychomotricians in their assessment and care activities in the field of therapeutic support for babies and their parents.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 5","pages":"Pages 266-275"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021085","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}
Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.04.002
X. Benarous , C. Hanin , D. Cohen
Objectives
This article examines how relational aspects contribute to the effectiveness of prescribing psychotropic drugs to children and adolescents. This psychological component is often referred to as the “placebo effect” or “non-specific effects” in clinical research.
Method
This narrative review synthesizes data from epidemiological studies, clinical trials, and experimental psychology regarding the relational factors that influence response levels to psychotropic medications in the pediatric population.
Results
The literature findings have been integrated into a theoretical model inspired by systems theory and developmental psychology. This interactionist model emphasizes the connections between the pre-existing perceptions of medication held by parents and children, and how these perceptions influence their beliefs and attitudes toward medication.
Discussion
Representations of medication are shaped by developmental issues and parental life experiences. These factors can be addressed during consultations to mitigate their effects. The prescriber has a crucial role in acknowledging these representations and assisting in their interpretation. Clinical examples are provided to illustrate how these representations manifest during treatment.
Conclusions
Guidelines for best practices must consider the significance of relational factors at every stage of prescribing psychotropic medications to children and adolescents to optimize their therapeutic effects.
{"title":"Aspects relationnels impliqués dans l’efficacité des psychotropes chez l’enfant et l’adolescent : modèles théoriques, illustrations cliniques, recommandations","authors":"X. Benarous , C. Hanin , D. Cohen","doi":"10.1016/j.neurenf.2025.04.002","DOIUrl":"10.1016/j.neurenf.2025.04.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This article examines how relational aspects contribute to the effectiveness of prescribing psychotropic drugs to children and adolescents. This psychological component is often referred to as the “placebo effect” or “non-specific effects” in clinical research.</div></div><div><h3>Method</h3><div>This narrative review synthesizes data from epidemiological studies, clinical trials, and experimental psychology regarding the relational factors that influence response levels to psychotropic medications in the pediatric population.</div></div><div><h3>Results</h3><div>The literature findings have been integrated into a theoretical model inspired by systems theory and developmental psychology. This interactionist model emphasizes the connections between the pre-existing perceptions of medication held by parents and children, and how these perceptions influence their beliefs and attitudes toward medication.</div></div><div><h3>Discussion</h3><div>Representations of medication are shaped by developmental issues and parental life experiences. These factors can be addressed during consultations to mitigate their effects. The prescriber has a crucial role in acknowledging these representations and assisting in their interpretation. Clinical examples are provided to illustrate how these representations manifest during treatment.</div></div><div><h3>Conclusions</h3><div>Guidelines for best practices must consider the significance of relational factors at every stage of prescribing psychotropic medications to children and adolescents to optimize their therapeutic effects.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 6","pages":"Pages 328-335"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134777","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}
Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.05.004
D. Tiberghien , M. Caire
Au XIXe siècle, Louis Delasiauve (1804–1893), Auguste Voisin (1829–1898), Paul Moreau de Tours (1844–1908), Désiré-Magloire Bourneville (1840–1909) furent de ceux qui, parmi les aliénistes, ont les premiers porté un intérêt aux troubles mentaux chez l’enfant, bien avant que ne naisse la psychiatrie de l’enfant, en 1937. Justine Tobolowska est dans ce domaine l’une des premières et principales pionnières, en un temps où la médecine s’ouvre peu à peu aux femmes. Née le 10 février 1875 à Varsovie du temps de la Pologne russe, elle s’expatrie en France en 1893 et débute ses études de médecine à Paris l’année suivante. Successivement externe des hôpitaux de Paris (1895–1897) et interne provisoire des asiles d’aliénés de la Seine (1898), elle soutient en 1900 sa thèse de doctorat consacrée aux illusions dans les rêves. Après quelques publications avec Eugène-Bernard Leroy (1871–1932), elle s’oriente vers la psychiatrie infantile par sa rencontre avec André Collin (1879–1926), fondateur de la psychopédiatrie (1924), une spécialité éphémère assimilée par la suite à la neuropsychiatrie infantile. Dans les années 1920, J. Tobolowska exerce avec lui au dispensaire de la rue de Jouy, à Paris. En 1924, elle est sa collaboratrice dans un centre de psychopédiatrie installé dans une école publique de la ville de Suresnes. Dans les années 1930, elle assure aussi des consultations de neuropsychiatrie à l’Institut de prophylaxie de Paris fondé par Arthur Vernes (1879–1976), le futur Institut Vernes. Les quelques publications qu’elle nous a laissées la montrent avant tout clinicienne, où la question du développement de l’enfant a toute son importance, comme l’enseignait A. Collin. Au regard de son parcours médical et de sa collaboration avec A. Collin, J. Tobolowska apparaît ainsi la première femme psychiatre de l’enfant et de l’adolescent. Féministe en herbe, elle décède le 12 septembre 1937 à Bayonne, probablement dans les suites d’une intervention chirurgicale. Elle a 62 ans.
At the end of the 19th century the medical profession was still considered to be a man's job. During that century, Louis Delasiauve (1804–1893), Paul Moreau de Tours (1844–1908), Auguste Voisin (1829–1898), and Désiré-Magloire Bourneville (1840–1909) were adult alienists; they were nevertheless interested in mental disorders in children even before the birth of child psychiatry (1937). Justine Tobolowska (1875–1937) was born on 10 February 10, 1875, in Warsaw during the time of Russian Poland. In 1893, she arrived alone in France having come to Paris to study medicine. Her father was a doctor and had remained in Warsaw with his wife and his two other children. In 1894, she passed the externat examination at the Paris hospitals. Between 1895 and 1897 she received master's degrees in neurology and psychiatry with the topics being : Gilbert Ballet (1853–1916), Philippe Chaslin (1857–1923), and Gaston Deny (1947–1923). Her pediatric master's deg
在19世纪，Louis Delasiauve (1804 - 1893), Auguste Voisin (1829 - 1898), Paul Moreau de Tours (1844 - 1908), Desire -Magloire Bourneville（1840 - 1909）是最早引起人们对儿童精神疾病兴趣的精神病学家，早在1937年儿童精神病学出现之前。贾斯汀·托博洛夫斯卡（Justine Tobolowska）是这一领域的早期和主要先驱之一，当时医学正逐渐向女性开放。她于1875年2月10日出生于俄罗斯波兰统治时期的华沙，1893年移居法国，次年在巴黎开始学医。她先后在巴黎医院（1895 - 1897年）和塞纳河精神病患者收容所（1898年）担任外部人员，1900年，她完成了关于梦中的幻觉的博士论文。在与尤金-伯纳德·勒罗伊（Eugene -Bernard Leroy， 1871年- 1932年）发表了几篇论文后，她通过与安德烈·科林（Andre Collin， 1879年- 1926年）的接触，转向了儿童精神病学，后者是精神病学（1924年）的创始人，这是一个短暂的专业，后来被纳入儿童神经精神病学。20世纪20年代，J. Tobolowska和他一起在巴黎Jouy街的药房工作。1924年，她在苏雷内斯市一所公立学校的精神病学中心与他合作。20世纪30年代，她还在巴黎的预防研究所（Institue de preparylaxie）担任神经精神病学顾问，该研究所由阿瑟·凡尔纳（Arthur Vernes, 1879 - 1976）创立，后来更名为凡尔纳研究所。她留下的为数不多的出版物表明，她首先是一名临床医生，正如a . Collin所教导的那样，儿童发展的问题非常重要。考虑到她的医疗记录以及她与A. Collin的合作，J. Tobolowska成为第一位女性儿童和青少年精神病学家。她是一名女权主义者，1937年9月12日在巴永去世，可能是由于手术。在19世纪末，医学职业仍然被认为是男性的工作。在那个世纪，Louis Delasiauve (1804 - 1893), Paul Moreau de Tours (1844 - 1908), Auguste Voisin（1829 - 1898）和Desire -Magloire Bourneville（1840 - 1909）是成年的外星人；尽管如此，他们还是对儿童精神障碍感兴趣，甚至在儿童精神病学诞生之前（1937年）。Justine Tobolowska（1875 - 1937）于1875年2月10日出生在俄罗斯波兰时期的华沙。1893年，她独自来到法国，来到巴黎学医。她的父亲是一名医生，与妻子和另外两个孩子留在华沙。1894年，她通过了巴黎医院的外部检查。1895年至1897年间，她获得了神经学和精神病学的硕士学位，主题包括：吉尔伯特芭蕾舞团（1853 - 1916）、菲利普·查斯林（1857 - 1923）和加斯顿·丹尼（1947 - 1923）。她的儿科硕士学位的主题是朱尔斯·科姆比（1853 - 1947）和加斯顿·瓦里奥（1855 - 1930）。1898年，她成为塞纳河疯人院的临时居民。两年后，她发表了关于梦中的幻觉的论文。从1900年到1906年，她在Salpetriere临终关怀医院工作，去年她申请了英国国籍。1901年和1902年，她与尤金-伯纳德·勒罗伊（Eugene -Bernard Leroy）发表了两篇关于梦的论文，之后她转向了儿童精神病学；他们从幻觉出现的心理条件以及它们与同时出现的想法和梦的过程的关系的角度来研究幻觉。1910年至1915年间，托博洛夫斯卡向《正常与病理心理学杂志》（Journal de Psychologie Normale et Pathologiae）提交了许多书评，在这些书评中，她展示了自己对儿童心理学和教育学的兴趣。她和Andre Collin（1879 - 1926）一起接受了精神病学的训练，这是一个短命的专业，后来被称为儿童神经精神病学。她在Leopold -Robert街7号（巴黎，第14区）开了一家诊所。1924年，她与a·科林（A. Collin）在苏雷内斯镇一所公立学校（朱尔斯·费里学校）建立的儿科心理学中心工作，在那里，她被错误地指控在未经父母同意的情况下对待儿童。20世纪30年代，她还在阿瑟·凡尔纳（Arthur Vernes, 1879 - 1976）创立的巴黎预防研究所（Institut de Prephylaxie de Paris）提供神经精神病学咨询，该研究所后来成为凡尔纳研究所。她是Societe Clinique de Medecine Mentale（1913年）和放射之友协会（1929年）的通讯成员。她留给我们的为数不多的出版物表明，正如a . Collin所教导的那样，她是第一个也是最重要的临床医生，儿童发展问题是最重要的。从她的医学生涯和与A. Collin的合作，托博洛夫斯卡似乎是第一个通过归化（1906年）成为法国人的外国妇女，她是法国最早的儿童和青少年精神病学家之一。 托博洛斯卡是一位崭露头角的女权主义者，她没有后代，于1937年9月在巴约纳去世，死因可能是在朱尔斯·拉福尔卡德（1865-1942）的私人外科诊所做了一次手术。她享年62岁。
{"title":"Justine Tobolowska (1875–1937), élève d’André Collin (1879–1926), première femme psychiatre de l’enfant et de l’adolescent","authors":"D. Tiberghien , M. Caire","doi":"10.1016/j.neurenf.2025.05.004","DOIUrl":"10.1016/j.neurenf.2025.05.004","url":null,"abstract":"<div><div>Au XIX<sup>e</sup> siècle, Louis Delasiauve (1804–1893), Auguste Voisin (1829–1898), Paul Moreau de Tours (1844–1908), Désiré-Magloire Bourneville (1840–1909) furent de ceux qui, parmi les aliénistes, ont les premiers porté un intérêt aux troubles mentaux chez l’enfant, bien avant que ne naisse la psychiatrie de l’enfant, en 1937. Justine Tobolowska est dans ce domaine l’une des premières et principales pionnières, en un temps où la médecine s’ouvre peu à peu aux femmes. Née le 10 février 1875 à Varsovie du temps de la Pologne russe, elle s’expatrie en France en 1893 et débute ses études de médecine à Paris l’année suivante. Successivement externe des hôpitaux de Paris (1895–1897) et interne provisoire des asiles d’aliénés de la Seine (1898), elle soutient en 1900 sa thèse de doctorat consacrée aux illusions dans les rêves. Après quelques publications avec Eugène-Bernard Leroy (1871–1932), elle s’oriente vers la psychiatrie infantile par sa rencontre avec André Collin (1879–1926), fondateur de la psychopédiatrie (1924), une spécialité éphémère assimilée par la suite à la neuropsychiatrie infantile. Dans les années 1920, J. Tobolowska exerce avec lui au dispensaire de la rue de Jouy, à Paris. En 1924, elle est sa collaboratrice dans un centre de psychopédiatrie installé dans une école publique de la ville de Suresnes. Dans les années 1930, elle assure aussi des consultations de neuropsychiatrie à l’Institut de prophylaxie de Paris fondé par Arthur Vernes (1879–1976), le futur <em>Institut Vernes</em>. Les quelques publications qu’elle nous a laissées la montrent avant tout clinicienne, où la question du développement de l’enfant a toute son importance, comme l’enseignait A. Collin. Au regard de son parcours médical et de sa collaboration avec A. Collin, J. Tobolowska apparaît ainsi la première femme psychiatre de l’enfant et de l’adolescent. Féministe en herbe, elle décède le 12 septembre 1937 à Bayonne, probablement dans les suites d’une intervention chirurgicale. Elle a 62 ans.</div></div><div><div>At the end of the 19th century the medical profession was still considered to be a man's job. During that century, Louis Delasiauve (1804–1893), Paul Moreau de Tours (1844–1908), Auguste Voisin (1829–1898), and Désiré-Magloire Bourneville (1840–1909) were adult alienists; they were nevertheless interested in mental disorders in children even before the birth of child psychiatry (1937). Justine Tobolowska (1875–1937) was born on 10 February 10, 1875, in Warsaw during the time of Russian Poland. In 1893, she arrived alone in France having come to Paris to study medicine. Her father was a doctor and had remained in Warsaw with his wife and his two other children. In 1894, she passed the externat examination at the Paris hospitals. Between 1895 and 1897 she received master's degrees in neurology and psychiatry with the topics being : Gilbert Ballet (1853–1916), Philippe Chaslin (1857–1923), and Gaston Deny (1947–1923). Her pediatric master's deg","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 5","pages":"Pages 239-243"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021081","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}
Autism is considered a major public health issue in France and internationally. In contrast to other countries, where multiple epidemiological studies have been carried out for many years, scientific data on the prevalence of autism in France remains scarce. This article aims to provide reliable figures by way of the National Health Data System (SNDS) and to update the currently available epidemiological studies.
Method and results
The prevalence of autism via the SNDS was 0.1% in 2010, rising to 0.2% in 2022. It was four times higher among males than females. The prevalence of autism via the SNDS was significantly higher in children and decreased with age. Among children aged 8, it doubled between 2010 and 2022, rising from 0.45 to 0.94%. More specifically, this prevalence of autism via the SNDS rose from 0.7 to 1.5% for 8-year-old boys and from 0.2 to 0.4% for girls. Among children aged 0 to 10, the diagnosis peak was at age 3, with a steep rise between ages 1 and 3. Between 2010 and 2022, the proportion of autistic patients aged 0 to 17 living in unfavorable social conditions rose from 29 to 42.4%.
Conclusion
Estimating the prevalence of autism is essential for informing public authorities and adapting the needs of care, education and social intervention services. Epidemiological research on autism and the data contained in the SNDS contribute to this effort aimed at assisting patients and their families.
{"title":"Prévalence des diagnostics d’autisme via le système national de données de santé. Analyse rétrospective de cohorte sur la période 2010–2022","authors":"Sébastien Ponnou , Xavier Briffault , Victor Aragno , Benoît Thomé , Brigitte Chamak","doi":"10.1016/j.neurenf.2025.01.006","DOIUrl":"10.1016/j.neurenf.2025.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>Autism is considered a major public health issue in France and internationally. In contrast to other countries, where multiple epidemiological studies have been carried out for many years, scientific data on the prevalence of autism in France remains scarce. This article aims to provide reliable figures by way of the National Health Data System (SNDS) and to update the currently available epidemiological studies.</div></div><div><h3>Method and results</h3><div>The prevalence of autism via the SNDS was 0.1% in 2010, rising to 0.2% in 2022. It was four times higher among males than females. The prevalence of autism via the SNDS was significantly higher in children and decreased with age. Among children aged 8, it doubled between 2010 and 2022, rising from 0.45 to 0.94%. More specifically, this prevalence of autism via the SNDS rose from 0.7 to 1.5% for 8-year-old boys and from 0.2 to 0.4% for girls. Among children aged 0 to 10, the diagnosis peak was at age 3, with a steep rise between ages 1 and 3. Between 2010 and 2022, the proportion of autistic patients aged 0 to 17 living in unfavorable social conditions rose from 29 to 42.4%.</div></div><div><h3>Conclusion</h3><div>Estimating the prevalence of autism is essential for informing public authorities and adapting the needs of care, education and social intervention services. Epidemiological research on autism and the data contained in the SNDS contribute to this effort aimed at assisting patients and their families.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 5","pages":"Pages 276-288"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021086","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}
Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.06.006
L. Montecchio , L. Verneuil , E. Manolios , J. Mathé , A. Revah-Levy , J. Sibeoni
Introduction
Gender dysphoria in children is a relatively recent concept with often criticized diagnostic criteria. Management of these cases remains challenging and typically follows multidisciplinary discussions within specialized teams: there is currently no consensus, and the heterogeneity of approaches is underpinned by numerous ethical and ideological questions. The diversity of clinical presentations, coupled with high comorbidity rates, force the clinician to deal with complex diagnostic and therapeutic challenges. It seems relevant to better understand the role and place of psychiatric follow-up in this specific context.
Objective
To deeply explore and describe the lived experiences of child psychiatrists involved in the care of children under 12 years old, consulting for gender incongruence. This exploratory approach aims to propose concrete recommendations for improving the quality of care for these children and to understand the challenges these child psychiatrists face.
Method
CHOICE is a multicentric and retrospective exploratory study, conducted between 2021 and 2023, based on semi-structured interviews with 12 French-speaking child psychiatrists who encountered prepubescent children with gender incongruence using the IPSE method introduced for qualitative research in medicine. The IPSE method uses a constructivist paradigm and a phenomenological and experiential approach. Recruitment, following the principle of purposive sampling, continued until data saturation was reached. Data analysis, consisting of a descriptive individual phase and a group structuring phase, was carried out using NVIVO software.
Results
The inductive analysis revealed a clinician experience structured around three main axes. The first axis focused on the social experience of child psychiatrists and the interaction between psychiatry and society, where there was a medical injunction within the societal and a societal injunction within the medical. The second axis related to the intimate experience and its impact in clinical practice. Finally, the third axis questioned the ethical experience of child psychiatrists, exploring how to perform their work effectively when there is a significant risk of being influenced by both internal and external factors.
Conclusion
The experiences of child psychiatrists emerge as being deeply influenced by political, social and societal issues that go beyond medical questions and the intersubjective dimension that plays out in their work with patients. Child psychiatrists must find a balance between the answer to immediate expectations and supporting the child's identity development. Societal challenges make this process complex, and the study's findings show that these tensions can hinder the care of the children and families they encounter.
{"title":"L’expérience vécue des pédopsychiatres amenés à prendre en charge des enfants prépubères avec incongruence de genre : une étude qualitative IPSE","authors":"L. Montecchio , L. Verneuil , E. Manolios , J. Mathé , A. Revah-Levy , J. Sibeoni","doi":"10.1016/j.neurenf.2025.06.006","DOIUrl":"10.1016/j.neurenf.2025.06.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Gender dysphoria in children is a relatively recent concept with often criticized diagnostic criteria. Management of these cases remains challenging and typically follows multidisciplinary discussions within specialized teams: there is currently no consensus, and the heterogeneity of approaches is underpinned by numerous ethical and ideological questions. The diversity of clinical presentations, coupled with high comorbidity rates, force the clinician to deal with complex diagnostic and therapeutic challenges. It seems relevant to better understand the role and place of psychiatric follow-up in this specific context.</div></div><div><h3>Objective</h3><div>To deeply explore and describe the lived experiences of child psychiatrists involved in the care of children under 12 years old, consulting for gender incongruence. This exploratory approach aims to propose concrete recommendations for improving the quality of care for these children and to understand the challenges these child psychiatrists face.</div></div><div><h3>Method</h3><div>CHOICE is a multicentric and retrospective exploratory study, conducted between 2021 and 2023, based on semi-structured interviews with 12 French-speaking child psychiatrists who encountered prepubescent children with gender incongruence using the IPSE method introduced for qualitative research in medicine. The IPSE method uses a constructivist paradigm and a phenomenological and experiential approach. Recruitment, following the principle of purposive sampling, continued until data saturation was reached. Data analysis, consisting of a descriptive individual phase and a group structuring phase, was carried out using NVIVO software.</div></div><div><h3>Results</h3><div>The inductive analysis revealed a clinician experience structured around three main axes. The first axis focused on the social experience of child psychiatrists and the interaction between psychiatry and society, where there was a medical injunction within the societal and a societal injunction within the medical. The second axis related to the intimate experience and its impact in clinical practice. Finally, the third axis questioned the ethical experience of child psychiatrists, exploring how to perform their work effectively when there is a significant risk of being influenced by both internal and external factors.</div></div><div><h3>Conclusion</h3><div>The experiences of child psychiatrists emerge as being deeply influenced by political, social and societal issues that go beyond medical questions and the intersubjective dimension that plays out in their work with patients. Child psychiatrists must find a balance between the answer to immediate expectations and supporting the child's identity development. Societal challenges make this process complex, and the study's findings show that these tensions can hinder the care of the children and families they encounter.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 6","pages":"Pages 336-349"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134778","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}
Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.05.005
K. Abou Assi , S. Jean
<div><div>The National Strategy for Neurodevelopmental Disorders published in France in November 2023 underscores the importance of implementing therapeutic education programs for adolescents and adults with Attention Deficit Hyperactivity Disorder (ADHD). While these programs are integral to the knowledge component of the recommended multimodal approach for ADHD, specific guidelines regarding the content and structure of such programs remain undefined. This paper endeavors to bridge this gap by systematically reviewing literature to discern objectives and methodologies essential for incorporating into therapeutic education programs aimed at children and adolescents with ADHD. Given the sparse representation of therapeutic education in global literature, this systematic literature review (SLR) also considers studies focusing on psychoeducation and cognitive-behavioral learning strategies which demonstrate efficacy in individuals clinically diagnosed with ADHD aged 8 to 19 years. Professional databases such as PubMed, APA PsycINFO, and Psychology and Behavioral Sciences Collection were consulted during this review. Of the 604 identified articles, only 15 met inclusion criteria, allowing for the derivation of comprehensive guidelines and insights necessary for shaping future research and clinical practices in this domain. The current body of research on therapeutic education remains notably limited due to several factors, such as reliance on specific program evaluations, absence of replication, and lack of exploration into cultural nuances. Additionally, there is a shortage of research addressing the unique implications of gender differences in ADHD, particularly regarding hormonal influences on symptoms across the menstrual cycle in females. These gaps highlight the urgent need for a wider array of studies to develop more inclusive and adaptable therapeutic programs tailored to the individual needs of diverse populations. Moreover, determining the most effective format of interventions, whether delivered in group, individual, or hybrid settings, continues to present a challenge. The results of this SLR provide foundational themes to include in therapeutic programs, which should emphasize understanding ADHD symptomatology, developing organizational skills, enhancing time management, promoting self-autonomy, practicing emotional regulation, and fostering appropriate social communication skills. These programs should primarily employ cognitive-behavioral strategies and prioritize parental involvement to reinforce the generalization and retention of acquired skills. It is imperative to note that while these topics address ADHD management, they fail to adequately cover associated risks and comorbidities, such as anxiety, oppositional behaviors, substance abuse, or prolonged screen time. Therefore, future research should focus on a more comprehensive understanding of these factors to refine and extend the therapeutic education content. This paper also h
{"title":"Lignes directrices pour les programmes d’éducation thérapeutique destinés aux enfants et adolescents présentant un trouble déficit de l’attention avec ou sans hyperactivité : les résultats d’une revue systématique de la littérature","authors":"K. Abou Assi , S. Jean","doi":"10.1016/j.neurenf.2025.05.005","DOIUrl":"10.1016/j.neurenf.2025.05.005","url":null,"abstract":"<div><div>The National Strategy for Neurodevelopmental Disorders published in France in November 2023 underscores the importance of implementing therapeutic education programs for adolescents and adults with Attention Deficit Hyperactivity Disorder (ADHD). While these programs are integral to the knowledge component of the recommended multimodal approach for ADHD, specific guidelines regarding the content and structure of such programs remain undefined. This paper endeavors to bridge this gap by systematically reviewing literature to discern objectives and methodologies essential for incorporating into therapeutic education programs aimed at children and adolescents with ADHD. Given the sparse representation of therapeutic education in global literature, this systematic literature review (SLR) also considers studies focusing on psychoeducation and cognitive-behavioral learning strategies which demonstrate efficacy in individuals clinically diagnosed with ADHD aged 8 to 19 years. Professional databases such as PubMed, APA PsycINFO, and Psychology and Behavioral Sciences Collection were consulted during this review. Of the 604 identified articles, only 15 met inclusion criteria, allowing for the derivation of comprehensive guidelines and insights necessary for shaping future research and clinical practices in this domain. The current body of research on therapeutic education remains notably limited due to several factors, such as reliance on specific program evaluations, absence of replication, and lack of exploration into cultural nuances. Additionally, there is a shortage of research addressing the unique implications of gender differences in ADHD, particularly regarding hormonal influences on symptoms across the menstrual cycle in females. These gaps highlight the urgent need for a wider array of studies to develop more inclusive and adaptable therapeutic programs tailored to the individual needs of diverse populations. Moreover, determining the most effective format of interventions, whether delivered in group, individual, or hybrid settings, continues to present a challenge. The results of this SLR provide foundational themes to include in therapeutic programs, which should emphasize understanding ADHD symptomatology, developing organizational skills, enhancing time management, promoting self-autonomy, practicing emotional regulation, and fostering appropriate social communication skills. These programs should primarily employ cognitive-behavioral strategies and prioritize parental involvement to reinforce the generalization and retention of acquired skills. It is imperative to note that while these topics address ADHD management, they fail to adequately cover associated risks and comorbidities, such as anxiety, oppositional behaviors, substance abuse, or prolonged screen time. Therefore, future research should focus on a more comprehensive understanding of these factors to refine and extend the therapeutic education content. This paper also h","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 6","pages":"Pages 350-357"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134779","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}
Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.03.004
K. Faure
The purpose of this article is to put into perspective certain theoretical insights (without going into depth) and clinical observations with the common thread being the movement of the beginnings of life, in its valency of physical movements, emotional movements as well as movement psychics. Indeed, within the framework of our perinatal child psychiatry unit, the early observation of babies in vulnerable environments revealed “changing” early disorders. The manifestations/expressions were very disparate, having only somato-psychic disorganization in common, and were marked by their intensity and extreme contrasts, by a chaotic temporality, not only physiological and tonic states, but also states of vigilance of babies and again early interactions. Starting from the repertoire of these signs/symptoms of babies’ suffering, the recognized experience of pediatricians, psychiatrists and psychoanalysts directed us towards dynamic clinical thinking in its neurophysiological and psychosomatic dimensions. Our research was oriented towards the movements, rhythms, and sensorialities of the first stages of life. Clinical observations of twin babies raised our awareness of these physical aspects of their conditions and testified to the value of the neonatal environment in terms of adaptation/adjustment/attunement. A progressive somato/corporal/psychic organization is discussed during the first weeks of life for neonatologists, the first nine months of the baby's life according to psychosomaticians, or even the first 1000 days for psy-perinatalists. Experiences and lived experiences provide material for thought and vice versa, towards a state of transitionality (corporeal and psychological) of ways of being and existing in these early ages. Emotionality reveals itself as a fundamental essence to the first corporo-psychic envelopes, its originally takes the form of a co-hosted rhythmic movement, it is a source of vital momentum and generator of a delicate somato-psychic balance towards a complex development/growth dynamic. Over the course of these cross-reflections, a contemporary clinical thought of the archaic was established, at the same time corporeal, developmental, psychodynamic and psychoanalytic.
{"title":"Partition rythmique et orchestration symbolique du corps. En partant de l’observation émotionnelle de bébés jumeaux","authors":"K. Faure","doi":"10.1016/j.neurenf.2025.03.004","DOIUrl":"10.1016/j.neurenf.2025.03.004","url":null,"abstract":"<div><div>The purpose of this article is to put into perspective certain theoretical insights (without going into depth) and clinical observations with the common thread being the movement of the beginnings of life, in its valency of physical movements, emotional movements as well as movement psychics. Indeed, within the framework of our perinatal child psychiatry unit, the early observation of babies in vulnerable environments revealed “changing” early disorders. The manifestations/expressions were very disparate, having only somato-psychic disorganization in common, and were marked by their intensity and extreme contrasts, by a chaotic temporality, not only physiological and tonic states, but also states of vigilance of babies and again early interactions. Starting from the repertoire of these signs/symptoms of babies’ suffering, the recognized experience of pediatricians, psychiatrists and psychoanalysts directed us towards dynamic clinical thinking in its neurophysiological and psychosomatic dimensions. Our research was oriented towards the movements, rhythms, and sensorialities of the first stages of life. Clinical observations of twin babies raised our awareness of these physical aspects of their conditions and testified to the value of the neonatal environment in terms of adaptation/adjustment/attunement. A progressive somato/corporal/psychic organization is discussed during the first weeks of life for neonatologists, the first nine months of the baby's life according to psychosomaticians, or even the first 1000 days for psy-perinatalists. Experiences and lived experiences provide material for thought and vice versa, towards a state of transitionality (corporeal and psychological) of ways of being and existing in these early ages. Emotionality reveals itself as a fundamental essence to the first corporo-psychic envelopes, its originally takes the form of a co-hosted rhythmic movement, it is a source of vital momentum and generator of a delicate somato-psychic balance towards a complex development/growth dynamic. Over the course of these cross-reflections, a contemporary clinical thought of the archaic was established, at the same time corporeal, developmental, psychodynamic and psychoanalytic.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 5","pages":"Pages 249-257"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021083","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}
Pub Date : 2025-09-01DOI: 10.1016/j.neurenf.2025.06.005
A. Yelnik (Professeur émérite, Membre correspondant de l’Académie nationale de médecine)
Children, and their close entourage, growing up with severe disabilities will face a change in the medical and medico-social environment in adolescence, imposed simply because of a transition to the legal age of adulthood. These changes involve significant risks of disruption in care, as well as life and educational projects. The National Academy of Medicine, through its transdisciplinary medical perspective, wished to make its contribution, based on the local responses already provided, to promote good practice in the support of the transition of the disabled child to adulthood, for all situations of severe motor and associated or psychiatric disabilities, highlighting their common points. These recommendations have been drawn up for the attention of administrative and legal decision-makers and for professionals in the medical and medico-social sectors.
{"title":"Passage de l’enfant handicapé à l’âge adulte, recommandations de l’Académie nationale de médecine","authors":"A. Yelnik (Professeur émérite, Membre correspondant de l’Académie nationale de médecine)","doi":"10.1016/j.neurenf.2025.06.005","DOIUrl":"10.1016/j.neurenf.2025.06.005","url":null,"abstract":"<div><div>Children, and their close entourage, growing up with severe disabilities will face a change in the medical and medico-social environment in adolescence, imposed simply because of a transition to the legal age of adulthood. These changes involve significant risks of disruption in care, as well as life and educational projects. The National Academy of Medicine, through its transdisciplinary medical perspective, wished to make its contribution, based on the local responses already provided, to promote good practice in the support of the transition of the disabled child to adulthood, for all situations of severe motor and associated or psychiatric disabilities, highlighting their common points. These recommendations have been drawn up for the attention of administrative and legal decision-makers and for professionals in the medical and medico-social sectors.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 5","pages":"Pages 237-238"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021080","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}
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