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

英文中文

Hommage à Jean Pierre Visier (1933–2024) 向让-皮埃尔-维西埃（1933-2024 年）致敬

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-11-01 DOI: 10.1016/j.neurenf.2024.10.001

M. Maury

引用次数: 0

Agenda 议程

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-11-01 DOI: 10.1016/S0222-9617(24)00182-X

引用次数: 0

Revue systématique des méthodes d’évaluation du traitement sensoriel chez les enfants et adolescents autistes 自闭症儿童和青少年感觉处理评估方法的系统回顾

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-11-01 DOI: 10.1016/j.neurenf.2024.07.004

Sandra Brouche , Fabienne Cazalis , Natalie Rigal

Sensory processing has been a diagnostic criterion for autism spectrum condition since the fifth version of the DSM. However, there is no consensus regarding assessment methods. This article is a systematic review of methods for assessing sensory processing in children and adolescents with autism aged between 0 and 18 years, with three objectives: (1) to identify and organize, using PRISMA, the different methods used in scientific articles for assessing sensory processing in autism; (2) to discuss their advantages and limitations by using the COSMIN checklist; (3) to suggest possible recommendations. Analysis of the 142 articles selected revealed five types of assessment method: questionnaires, psychophysical measurements, electroencephalography, neuroimaging and observation. Questionnaires were the most frequently cited clinical method, while psychophysical tests were the most represented. Each method has limitations in terms of individual utilization due to non-standardized procedures and varied investigation targets. While this systematic review makes it possible to better identify the methods used in the clinical and research fields for sensory processing specificities in children and adolescents on the spectrum, it also highlights the fact that the lack of consensus on assessments is partly due to a problem of definition of this process. Future research will need to agree on a characterization of sensory processing in order to develop a common assessment.

自 DSM 第五版以来，感觉处理一直是自闭症谱系条件的诊断标准之一。然而，对于评估方法还没有达成共识。本文对 0 至 18 岁自闭症儿童和青少年的感觉处理评估方法进行了系统性综述，目的有三：（1）使用 PRISMA 方法识别和整理科学文章中用于评估自闭症儿童感觉处理的不同方法；（2）使用 COSMIN 检查表讨论这些方法的优势和局限性；（3）提出可能的建议。通过对所选的 142 篇文章进行分析，发现了五种评估方法：问卷调查法、心理物理测量法、脑电图法、神经影像学法和观察法。问卷调查是最常被引用的临床方法，而心理物理测试则最有代表性。由于程序不规范和调查对象不同，每种方法在个人使用方面都有局限性。通过此次系统性综述，我们可以更好地确定临床和研究领域针对谱系儿童和青少年感官加工特异性所使用的方法，但同时也强调了一个事实，即对评估缺乏共识的部分原因在于对这一过程的定义问题。未来的研究需要就感官加工的特征达成一致，以便制定共同的评估方法。

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引用次数: 0

Midwives’ perceptions of high-risk pregnancies and their role with vulnerable pregnant women 助产士对高危妊娠的看法及其在弱势孕妇中的作用

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-10-02 DOI: 10.1016/j.neurenf.2024.09.002

S. Catsaros , I. Cacho , J. Wendland

Context

High-risk pregnancy constitutes a factor of vulnerability for women. The role of midwives in caring for these women is crucial, but little is known about their views concerning these complex pregnancies.

Objective

This study aims to increase insight on midwives’ outlook on high-risk pregnancies, their self-perceived roles, the challenges encountered, and their guidance for best practice.

Methods

This qualitative study took place in a maternity clinic of a University Hospital in France. Ten midwives were interviewed, and a thematic analysis was performed. The design of the research followed the COREQ checklist guidelines for reporting qualitative research.

Results

Five themes emerged from the analysis: (1) “Like a bolt from the blue” for the psychological impact and the essential reassurance midwives bring, (2) “Helping women get help” to detect alarming signs and the difficulty to address mental health issues (3) “Human Swiss army knives” for their specific expertise and the human part of their work, (4) “Women and their environment” for taking the time to understand women as a whole and consider the impact of/on their environments, and (5) “Clinical and human setting” for consistent teamwork, respectful of each woman's individuality.

Discussion

This study highlights the necessity of a woman-centred care in high-risk pregnancies. Midwives reflected on their roles in this particular care as they contribute to a more human and respectful approach of women while helping to maintain clinical stability and enhance women's well-being. Midwives advocated for normalizing mental health issues, for approaching women in a holistic way, for providing continuity of care, and for being consistent in teamwork.

背景高危妊娠是妇女易受伤害的一个因素。助产士在照顾这些妇女方面发挥着至关重要的作用，但人们对她们对这些复杂妊娠的看法却知之甚少。本研究旨在深入了解助产士对高危妊娠的看法、她们的自我角色认知、遇到的挑战以及她们对最佳实践的指导。对 10 名助产士进行了访谈，并进行了专题分析。研究设计遵循了定性研究报告的 COREQ 核对表指南。结果分析得出五个主题(1）"犹如晴天霹雳 "是指助产士带来的心理影响和必要的安慰；（2）"帮助妇女获得帮助 "是指发现报警信号和解决心理健康问题的困难；（3）"人类瑞士军刀 "是指她们的特殊专长和工作中的人性化部分；（4）"妇女及其环境 "是指花时间从整体上了解妇女，并考虑环境对妇女的影响；（5）"临床和人文环境 "是指始终如一的团队合作，尊重每位妇女的个性。讨论本研究强调了在高危妊娠中以妇女为中心的护理的必要性。助产士反思了她们在这一特殊护理中的作用，因为她们在帮助维持临床稳定和提高妇女福祉的同时，也为采取更人性化和更尊重妇女的方法做出了贡献。助产士主张将心理健康问题正常化，以全面的方式对待妇女，提供持续的护理，并在团队合作中保持一致。

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引用次数: 0

Les aléas du suivi orthophonique chez l’adolescent avec autisme : les facteurs influençant sa (non) mise en œuvre 自闭症青少年言语治疗跟踪的变数：影响实施（或不实施）的因素

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-10-01 DOI: 10.1016/j.neurenf.2024.05.006

N. Bouaziz , L. Gérémy , J.-M. Baleyte

Objective

This exploratory qualitative study aims to identify factors influencing orientation, access to speech therapy professionals and its maintenance in adolescents with autism. This was carried out by questioning them about their perceptions of the place and objectives of speech therapy concerning teenagers with autism spectrum disorders in a context where adolescents struggle to benefit from it.

Sample and Method

Eight child psychiatry professionals including four child psychiatrists, three speech therapists and a psychomotor-therapist took part. These semi-structured interviews have been analyzed using the Interpretative Phenomenological Analysis (IPA).

Results

The perception of adolescents with ASD as carriers of severe behavioral disorders and unlikely to be e subject to significant clinical changes has an unfavorable influence on the indication for speech therapy at this age. In addition, the management of the shortages in speech therapy is done to the detriment of adolescents in order to prioritize the youngest. Speech therapy follow-ups are experienced as cumbersome with a lack of specific assessments and speech therapy tools for this age.

Discussion

Communication disorders are insufficiently assessed by prescribing professionals who have a more vague representation of the specificities of speech therapy work at this age. In the current situation of speech therapy shortage, speech therapists are torn between the desire to continue to follow an adolescent, whose development potential is not always perceived, and the moral and clinical obligation to take care of toddlers who are generally prioritized.

Conclusion

These results reveal the need for more specific speech therapy assessments and tools for adolescents with autism to better target their communication needs and offer more appropriate care. Precise training on the issue of ASD in adolescence would make it possible to consider the diversity of needs and presentations of disorders at this age. Speech therapy monitoring of adolescents with autism raises questions about possible changes in the practice of speech therapy.

目的这项探索性定性研究旨在确定影响自闭症青少年接受言语治疗的方向、接触言语治疗专业人员的机会以及维持言语治疗的因素。在自闭症谱系障碍青少年难以从中获益的情况下，通过询问他们对言语治疗在自闭症谱系障碍青少年中的地位和目标的看法来实现这一目的。样本和方法八名儿童精神科专业人员参加了此次研究，其中包括四名儿童精神科医生、三名言语治疗师和一名心理运动治疗师。这些半结构式访谈采用解释现象学分析法（IPA）进行了分析。结果认为患有 ASD 的青少年是严重行为障碍的携带者，不太可能出现显著的临床变化，这对该年龄段的言语治疗适应症产生了不利影响。此外，为了优先照顾年龄最小的患者，在处理言语治疗短缺问题时，也会损害青少年的利益。讨论开具处方的专业人员对沟通障碍的评估不足，他们对这一年龄段言语治疗工作的特殊性表述较为模糊。在目前言语治疗人员短缺的情况下，言语治疗师一方面希望继续跟踪青少年，但他们的发展潜力并非总能被察觉；另一方面，他们在道德和临床上又有义务照顾幼儿，而幼儿通常是优先照顾的对象。结论这些结果表明，有必要为患有自闭症的青少年提供更具体的言语治疗评估和工具，以便更好地针对他们的沟通需求提供更适当的护理。针对青少年自闭症问题的精确培训将使我们有可能考虑到这个年龄段自闭症患者的需求和表现的多样性。对自闭症青少年的言语治疗监测提出了言语治疗实践可能发生变化的问题。

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引用次数: 0

Comment concevoir une architecture adaptée aux besoins des personnes avec un trouble du spectre de l’autisme et des comportements défis ? 建筑设计如何满足自闭症谱系障碍和挑战行为患者的需求？

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-10-01 DOI: 10.1016/j.neurenf.2024.07.006

M. Giannitelli, C. Cravero, D. Cohen, M. Karima, J. Lefèvre-Utile

Context

The interaction between individuals with autism spectrum disorders (ASD) and their environment can result in numerous physical, cognitive and behavioral challenges. Evidence-based design is a means to examine the relationship between design and care and use it to achieve a positive impact on patients’ health and well-being.

Method

A literature review was conducted in a multidisciplinary manner (clinicians and architects) and complemented by ethnographic doctoral research focused on people with ASD, ID, and challenging behaviours.

Results

We found 22 articles including 11 original research but only five specifically on individuals with ASD and challenging behaviours. Behavioural disorders or challenging behaviours are mainly influenced by the restrictive dimension of the environment and its sensory characteristics. To take into account the specific needs of people with ASD, interior architecture must distinguish five aspects: (1) interaction-contact between the person with ASD and his or her living space; (2) the intelligibility of the living space (e.g. predictability and routine of daily life); (3) the possibility of modulation between the need and/or avoidance of social interaction in the living space; (4) the balance between well-being and safety; (5) sensory difficulties and adapted facilities (e.g. retreat areas or sensory rooms, acoustics, lighting, temperature).

Discussion

Architecture, as a discipline, uses best design practices to create individualized environments, engaging spaces that fit the specific needs of individuals with autism, helping them to deal with their environment, and encouraging their independence in the hope of preventing the emergence of some severe behavioral disorders and improving the individual's quality of life. More research should be conducted on this topic.

背景自闭症谱系障碍（ASD）患者与环境之间的相互作用会导致许多身体、认知和行为方面的挑战。以证据为基础的设计是研究设计与护理之间关系的一种手段，并利用它对患者的健康和幸福产生积极的影响。方法我们以多学科（临床医生和建筑师）的方式进行了文献综述，并辅之以以自闭症谱系障碍患者、智障者和挑战行为者为重点的人种学博士研究。行为障碍或挑战行为主要受环境的限制性层面及其感官特征的影响。考虑到自闭症患者的特殊需要，室内建筑必须区分以下五个方面：(1) 自闭症患者与其生活空间之间的互动-接触；(2) 生活空间的可理解性（如日常生活的可预测性和常规性）；(3) 在生活空间中需要和/或避免社交互动之间进行调节的可能性；(4) 幸福与安全之间的平衡；(5) 感官障碍和适应性设施（如退避区或感官室）；(6) 与生活空间之间的互动-接触；(7) 与生活空间之间的互动-接触；(8) 与生活空间之间的互动-接触；(9) 与生活空间之间的互动-接触。讨论建筑学作为一门学科，采用最佳设计实践来创造个性化的环境，创造符合自闭症患者特定需求的空间，帮助他们处理环境问题，鼓励他们独立，以防止出现一些严重的行为障碍，提高患者的生活质量。应就此开展更多的研究。

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引用次数: 0

Eco-anxiété : la maladie d’une génération 生态焦虑症：一代人的通病

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-10-01 DOI: 10.1016/j.neurenf.2024.09.003

J.-M. Baleyte (Professeur de pédopsychiatrie)

引用次数: 0

Agenda 议程

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-10-01 DOI: 10.1016/S0222-9617(24)00150-8

引用次数: 0

La triple temporalité du transfert dans la médiation thérapeutique par le jeu de rôle 治疗角色扮演调解中移情的三重时间性

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-10-01 DOI: 10.1016/j.neurenf.2024.05.003

Objectives

Following on from our research into mediation through role-playing games, we are investigating the ways in which transference is expressed given the characteristics of this medium which combines game activity and collective narrations. From this perspective, we hypothesize that it mobilises a specific form of transference at the origin of particular therapeutic movements.

Patients and method

We met with two groups of adolescents (7 adolescents altogether) in a therapeutic mediation through role-playing games, conducted by a psychologist and an educator in an adapted educational institution. We proposed a grid for identifying transference movements, making it possible to characterize the nature of these movements and to differentiate their scene of emergence between group and narrative. We studied the transcripts of all the workshop sessions to highlight the emerging processes and their evolution.

Results

Our results showed that the transference was initially generalised and marked by massive tendencies to express aggression, denial or rejection of the other and the group. Over time, the mode of relationship to the object seemed to evolve, drawing on the transference enabled by the psychologist and the educator and by the link between relationships at the actual and narrative levels.

Discussion

The role-playing game reveals itself as a place of projection of the relational dynamics and representations of the relationships. The medium then reveals the pitfall in the creation of a bond and the recognition of the object's place, and the underlying anxieties. However, it also becomes a transformer of relationships because it allows the emergence of a transference that is first diffracted in the narrative envelope, which secondly authorizes a movement of recovery and a relief of group relationships.

Conclusion

The role-playing game offers spaces for projection that takes account of the suffering linked to the situation of encounter within the group. It is also a place where relational dynamics can unfold, protected from the destructiveness of acting through the prism of narrative and a three-stage transfer that contributes to the process of historicization.

目的继我们对通过角色扮演游戏进行调解的研究之后，我们正在研究这种结合了游戏活动和集体叙述的媒介所具有的特点，即移情的表达方式。从这一角度出发，我们假设它在特定治疗运动的源头调动了一种特定形式的移情。患者和方法我们与两组青少年（共 7 名青少年）会面，通过角色扮演游戏进行治疗调解，由一名心理学家和一名教育工作者在一个适应性教育机构中进行。我们提出了一个用于识别移情运动的网格，从而可以描述这些运动的性质，并区分它们在团体和叙事中出现的场景。我们研究了所有工作坊课程的记录，以突出新出现的过程及其演变。结果我们的研究结果表明，移情最初是泛化的，以表达对他人和团体的攻击、否认或拒绝的大规模倾向为特征。随着时间的推移，与客体的关系模式似乎也在发生变化，它借鉴了心理学家和教育者促成的移情，以及实际和叙事层面的关系之间的联系。角色扮演游戏揭示了在建立联系、认识客体的位置和潜在焦虑过程中存在的隐患。然而，它也成为了关系的转换器，因为它允许出现一种转移，这种转移首先是在叙事包络中的衍射，其次是授权的恢复运动和团体关系的缓解。它也是一个可以展开关系动态的地方，通过叙事的棱镜和有助于历史化进程的三阶段转移，保护了行动的破坏性。

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引用次数: 0

Dynamics of scientific research on mirror neurons 镜像神经元科研动态

Q4 Medicine

Neuropsychiatrie de l''Enfance et de l''Adolescence

Pub Date : 2024-10-01 DOI: 10.1016/j.neurenf.2024.05.005

For more than thirty years, a huge stream of research has enlightened the functions of Mirror Neurons (MNs) in humans and animals. Criticisms have been published, especially since 2010, targeting neuropsychological hypotheses of the MNs which refer to empathy and mind-reading (i.e., high-level processes of action understanding), as well as the extrapolation of the MNs in an attempt to explain the etiology of psychiatric disorders, such as Autism Spectrum Disorder (ASD) and schizophrenia. One would expect that these criticisms be considered with a time lag in the field of psychiatry because they were not originally formulated in that field, that these hypotheses have gained significant popularity, and that criticism of the “broken mirror theory” of ASD emerged at a later stage. We conducted an analysis of publications on MNs on PubMed. We identified 2,595 publications on “Mirror Neuron” from January 1995 until the 27th of May 2023; 443 concerned psychiatric disorders and another 550 publications were related to high-level processes of action understanding. We found no time lag in publications on high-level processes of action understanding of MNs between the peaks of publications on psychiatric disorders and all the other publications (both peaks in June 2014). Our findings indicate effective knowledge dissemination between psychiatric research and other research fields.

三十多年来，大量研究揭示了人类和动物镜像神经元（MNs）的功能。特别是自 2010 年以来，针对镜像神经元的神经心理学假说（指移情和读心术，即高层次的行动理解过程），以及将镜像神经元推而广之以试图解释自闭症（ASD）和精神分裂症等精神疾病的病因学的批评不断发表。由于这些假说并非最初在精神病学领域提出，而且这些假说已大行其道，对 ASD 的 "破镜重圆理论 "的批评也是在后期才出现的，因此我们认为这些批评在精神病学领域的考虑会有一定的滞后性。我们对 PubMed 上有关 MNs 的出版物进行了分析。我们找到了从 1995 年 1 月到 2023 年 5 月 27 日有关 "镜像神经元 "的 2595 篇论文，其中 443 篇涉及精神疾病，另外 550 篇与高层次的行动理解过程有关。我们发现，在有关精神疾病的出版物高峰与所有其他出版物高峰（均在 2014 年 6 月达到高峰）之间，有关镜像神经元高级行动理解过程的出版物并无时间差。我们的研究结果表明，精神病学研究与其他研究领域之间的知识传播是有效的。

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