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Apports des données en vie réelle à la sécurité des antipsychotiques chez l’enfant et l’adolescent 儿童和青少年抗精神病药物安全性的真实数据
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.02.002
D.A. Merino , A.O. Gérard , A. Destere , F. Askenazy , F. Montastruc , M.-D. Drici , S. Thümmler
The use of antipsychotics (APs) in child and adolescent psychiatry poses major challenges, both in terms of iatrogenesis and drug abuse. Analyzing real-world data from the international pharmacovigilance database (VigiBase®) revealed age-dependent safety profiles with increased reports of alertness disorders, seizures, and aggression in young children, while adolescents were subject to higher rates of depression, abuse, and dependence. Risperidone, aripiprazole, quetiapine, and olanzapine were the most frequently implicated antipsychotics, with olanzapine associated with catatonia and quetiapine notably linked to abuse in adolescents. Nutritional disorders related to antipsychotics were more frequently reported in children and adolescents, with risperidone showing a high disproportionality signal. Adolescents exhibited specific safety concerns, including a signal for non-alcoholic steatohepatitis associated with aripiprazole. Despite the limitations of pharmacovigilance methods, these studies help quantify adverse drug event frequencies in specific subgroups and detect emerging or rare signals. These pharmacoepidemiological analyses emphasize the importance of rigorous, ongoing benefit-risk assessment when prescribing antipsychotics in the pediatric population.
在儿童和青少年精神病学中使用抗精神病药物(APs)在医源性和药物滥用方面都提出了重大挑战。通过分析国际药物警戒数据库(VigiBase®)的真实世界数据,揭示了儿童警觉性障碍、癫痫发作和攻击行为的报告与年龄相关的安全性特征,而青少年的抑郁、滥用和依赖率更高。利培酮、阿立哌唑、喹硫平和奥氮平是最常涉及的抗精神病药物,奥氮平与紧张症有关,喹硫平与青少年滥用密切相关。与抗精神病药物相关的营养失调在儿童和青少年中更为常见,利培酮显示出高歧化信号。青少年表现出特定的安全问题,包括阿立哌唑相关的非酒精性脂肪性肝炎的信号。尽管药物警戒方法存在局限性,但这些研究有助于量化特定亚组的药物不良事件频率,并检测新出现的或罕见的信号。这些药物流行病学分析强调了在儿科人群中开抗精神病药物处方时进行严格、持续的获益-风险评估的重要性。
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引用次数: 0
Les médiations thérapeutiques et art-thérapies dans la prise en charge des mineurs non accompagnés (MNA) : Une évidence ? 无人陪伴未成年人(NMs)护理中的治疗和艺术治疗调解:证据?
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.01.007
Mathilde Fragonas , Jean-Luc Sudres

Context

In a complex global political and social context, France takes in migrants including unaccompanied minors, mainly from West Africa and Asia. The adversity they have had to face can lead to psychological distress which has an impact on their well-being and quality of life.

Objective

The aim of this article is to provide a synopsis of the psychopathological and socio-cultural difficulties that these children and adolescents may present when they arrive in France. This study focuses on indications and applications of therapeutic/art therapeutic mediations (more specifically theatre) offered to migrant populations.

Method

A literature review was carried out on the psychological support offered in an intercultural context to migrant children and adults. Searches were conducted on bibliographic databases (EBSCP, PubMed and Google Scholar) in addition to grey literature and field practices, to identify the therapeutic mediation/art therapy used. A clinical example is also presented based on clinical practices in an institution.

Results

The effects in migrant populations are recognized by the scientific community, helping to reduce symptoms of adaptive stress due to acculturation and/or post-traumatic stress, anxiety and depression, to increase existential satisfaction and the development of hope, to reduce behavioral difficulties such as hyperactivity, and to play a role in the development of emotional and social skills, self-esteem and resilience. However, few studies have focused specifically on Unaccompanied Minors, even though they present real needs. A clinical focus was placed on the relevance of dramatherapy (therapeutic mediation through theatre), with the development of a standardised and reproducible programme. However, given the extent of their needs and the effectiveness of such therapeutic options, it is very surprising that few studies have focused specifically on unaccompanied minors.

Conclusion

In view of the effectiveness of mediation and art therapy with migrant populations, it seems appropriate and necessary to offer psychological care of this type to unaccompanied minors. Given the increasing numbers of these young people arriving in France, we aim to point out the importance to design and test intervention programs using mixed research methods to assess their clinical impact and to carry out additional standardisation work with recommendations for good practice and training for practitioners.
在复杂的全球政治和社会背景下,法国接收移民,包括主要来自西非和亚洲的无人陪伴的未成年人。他们不得不面对的逆境可能导致心理困扰,从而影响他们的健康和生活质量。目的本文的目的是提供这些儿童和青少年到达法国时可能出现的精神病理和社会文化困难的概述。本研究的重点是提供给流动人口的治疗/艺术治疗药物(更具体地说是戏剧)的适应症和应用。方法对跨文化背景下对流动儿童和成人的心理支持进行文献综述。在书目数据库(EBSCP、PubMed和谷歌Scholar)以及灰色文献和实地实践中进行检索,以确定所使用的治疗调解/艺术疗法。并结合某机构的临床实践,提出了一个临床实例。结果在流动人口中的作用得到了科学界的认可,有助于减少由于文化适应和/或创伤后应激、焦虑和抑郁引起的适应性压力症状,增加存在满意度和希望的发展,减少行为困难,如多动,并在情感和社交技能、自尊和恢复力的发展中发挥作用。然而,很少有研究专门关注无人陪伴的未成年人,即使他们有真正的需求。临床重点放在戏剧疗法(通过戏剧进行治疗调解)的相关性上,并制定了标准化和可重复的方案。然而,考虑到他们的需求程度和这种治疗选择的有效性,很少有研究专门关注无人陪伴的未成年人,这是非常令人惊讶的。结论鉴于流动人口调解和艺术治疗的效果,对无人陪伴的未成年人进行此类心理护理是适当和必要的。鉴于这些年轻人抵达法国的人数不断增加,我们的目标是指出使用混合研究方法设计和测试干预计划的重要性,以评估其临床影响,并开展额外的标准化工作,为从业人员提供良好的实践和培训建议。
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引用次数: 0
Association of internet gaming disorder and psychosocial factors: Results from a longitudinal study 网络游戏障碍与心理社会因素的关联:一项纵向研究的结果
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.01.005
Constance Prieur , Olivier Phan
The prevalence of Internet Gaming is high among adolescents in France. Some adolescents develop Internet Gaming Disorder (IGD) as they neglect school, family life and social activities offline. IGD is known to interact with other mental health problems, such as social anxiety and depression. The objective of this study was to identify the trajectory of development of IGD. The Pelleas Survey, as it is a longitudinal study, allowed to identify some socio-psychological pre-existing factors to IGD with a second wave survey at six months. Students from 11 to 18 years old were surveyed at school. Prevalence of IGD was 12% in the sampling. Depression was found to be as high as 11%. We found that pre-existing depression was a risk factor for IGD. These results suggest that some adolescents try to cope with depression with IGD.
在法国青少年中,网络游戏的普及率很高。一些青少年由于忽视学校、家庭生活和线下社交活动而患上了网络游戏障碍(IGD)。众所周知,IGD与其他心理健康问题相互作用,如社交焦虑和抑郁。本研究的目的是确定IGD的发展轨迹。Pelleas调查是一项纵向研究,可以在六个月后进行第二波调查,以确定一些社会心理因素对IGD的影响。11至18岁的学生在学校接受了调查。样本中IGD患病率为12%。抑郁症的比例高达11%。我们发现,先前存在的抑郁症是患IGD的一个危险因素。这些结果表明,一些青少年试图用IGD来应对抑郁症。
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引用次数: 0
Analyse de livre 图书分析
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.02.004
P. Duverger
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引用次数: 0
Au-delà des silences : explorer le « faire fratrie » dans le contexte de la déficience intellectuelle 超越沉默:在智力缺陷的背景下探索“兄弟情谊”
Q4 Medicine Pub Date : 2025-04-05 DOI: 10.1016/j.neurenf.2025.03.003
A. Frenk-Renaud , A. Courtinat-Camps
This research examines sibling experiences within families where one child has an intellectual disability, giving a voice to all members, including the child with the disability. Unlike studies focused on parental perceptions, it directly explores the lived experiences of siblings, who are often overlooked, particularly younger ones. Through an exploratory approach, the study highlights the uniqueness of sibling dynamics and the meaning each child attributes to their relationships within the family. We initially met with four sibling groups, consisting of children aged 4 to 18, each sharing a common history with their brothers and sisters but experiencing it in a unique way. To illustrate these singular positions, we focused on one sibling group composed of four brothers and sisters, the eldest of whom — Florian — has an intellectual disability. Thematic analyses revealed ambivalent interactions marked by conflicts, violence, and moments of complicity. These relationships oscillated between solidarity and rivalry, often exacerbated by parental expectations or redistributed responsibilities. Barbara, for instance, embodied a “functional eldest” assuming a parental role due to her brother's disability. These responsibilities can foster altruistic behaviors but also mask latent suffering. Silence around the disability is a recurring theme. Children avoid discussing it, which reinforces their isolation and limits their understanding of the challenges associated with disability. Florian verbalized a feeling of exclusion, while his siblings sometimes expressed guilt or incomprehension. This research underscores the importance of recognizing children's voices, whether they have a disability or not, to understand their perceptions and support their development. It highlights the necessity of specific support systems to assist families facing disability-related challenges.
这项研究调查了家庭中有一个孩子有智力障碍的兄弟姐妹的经历,给所有成员,包括残疾的孩子一个发言权。与关注父母看法的研究不同,它直接探讨了兄弟姐妹的生活经历,而兄弟姐妹往往被忽视,尤其是年幼的兄弟姐妹。通过一种探索性的方法,该研究强调了兄弟姐妹动态的独特性,以及每个孩子在家庭关系中所赋予的意义。我们最初会见了四个兄弟姐妹小组,由4到18岁的孩子组成,每个人都与他们的兄弟姐妹分享共同的历史,但以独特的方式经历它。为了说明这些独特的位置,我们把重点放在一个由四个兄弟姐妹组成的兄弟姐妹群体上,其中最大的弗洛里安有智力障碍。专题分析揭示了以冲突、暴力和共谋时刻为特征的矛盾互动。这些关系在团结和竞争之间摇摆,往往因父母的期望或责任的重新分配而恶化。比如芭芭拉,由于她哥哥的残疾,她就扮演了一个“功能性老大”的角色。这些责任可以促进利他行为,但也掩盖了潜在的痛苦。围绕残疾的沉默是一个反复出现的主题。儿童避免讨论这个问题,这加剧了他们的孤立,限制了他们对残疾相关挑战的理解。弗洛里安用语言表达了一种被排斥的感觉,而他的兄弟姐妹有时会表达内疚或不理解。这项研究强调了认识儿童声音的重要性,无论他们是否有残疾,都能理解他们的看法并支持他们的发展。它强调需要具体的支助系统来帮助面临与残疾有关的挑战的家庭。
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引用次数: 0
Les hallucinations de l’enfant : à la limite de la dissociation et de la psychose ! 孩子的幻觉:接近分离和精神病的边缘!
Q4 Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.neurenf.2025.01.003
J. Moussaoui , B. Oneib , F. El Ghazouani
Hallucinations in children are frequently a subject of heated debate; they are common symptoms in child psychiatry consultations, which are important to define quickly. Often occurring in a context of dissociation, anxiety or post-trauma, they are often resolved without resorting to pharmacological treatment. A non-psychiatric or psychotic etiology must be ruled out because its prognosis may be guarded. We report the case of a five-year-old child presenting visual and auditory hallucinations by exposing our diagnostic approach to fuel the debate around the limit of childhood psychosis regarding hallucinations.
儿童的幻觉经常是一个激烈争论的话题;它们是儿童精神病学咨询中常见的症状,重要的是要迅速确定。通常发生在分离,焦虑或创伤后的背景下,他们往往不诉诸药物治疗就能解决。非精神或精神病因必须排除,因为其预后可能是谨慎的。我们报告了一个五岁儿童出现视觉和听觉幻觉的病例,通过暴露我们的诊断方法来引发关于儿童精神病关于幻觉的限制的辩论。
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引用次数: 0
Agenda 议程
Q4 Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.neurenf.2025.02.001
{"title":"Agenda","authors":"","doi":"10.1016/j.neurenf.2025.02.001","DOIUrl":"10.1016/j.neurenf.2025.02.001","url":null,"abstract":"","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 2","pages":"Pages 119-121"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454528","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}
引用次数: 0
Implication des parents dans un centre de diagnostic d’autisme : étude qualitative de leur vécu 父母在自闭症诊断中心的参与:对他们生活的定性研究
Q4 Medicine Pub Date : 2025-01-31 DOI: 10.1016/j.neurenf.2024.11.009
M. Ben Amara , N. Pommepuy , A. Révah-Levy , J. Ingelaere , J. Sibeoni , P. Zylberberg

Objective

The aim of this study was to explore the parent's lived experiences of the diagnostic assessment of autism spectrum disorder within the framework of UNIDEP, an expert center with the specificity of including parents during all of the assessment sessions by means of their presence with professionals behind a one-way mirror.

Methods

We conducted a monocentric and retrospective qualitative study following the five-stage Inductive Process to analyze the Structure of lived Experience method. Data collection was through semi-structured interviews with parents who had undergone the diagnostic evaluation experience at UNIDEP and who had received an autism spectrum disorder diagnosis for their child. Data analysis was based on an individual descriptive phase and a group structuring phase with the help of NVIVO software. The recruitment of parents according to the principle of purposive sampling continued until data saturation.

Results

Ten parents were included which allowed this sample to reach data saturation. The inductive thematic analysis revealed an experience of parents structured around three axes: 1. Getting involved and being involved by professionals: active involvement of parents, quality of reception and assistance provided by professionals; 2. A shift in the parent's position and a different way of observing: being able to observe the child differently, what the assessment framework allows them to observe; and finally, 3. Being able to acquire knowledge, understanding and the ability to evolve.

Discussion

Our results suggest that the practical modalities of the diagnostic process that enhanced the feeling of parental involvement were the One-way mirror system and the permanent assistance by professionals. These modalities were integrated into a structured process that allowed parents to progressively evolve on a journey of understanding, and induced reflection about parenting and co-parenting.

Conclusion

This study allowed us to question the concrete modalities of human and material organization of our diagnostic practice in light of the richness of experiences that this framework can foster.
目的本研究的目的是在联合国发展计划署(undp)的专家中心框架内,探讨父母对自闭症谱系障碍诊断评估的生活体验,该专家中心的特点是在所有评估环节中都包括父母,通过他们与专业人员在单向镜子后的方式在场。方法采用五阶段归纳法进行单中心回顾性定性研究,分析生活体验法的结构。数据的收集是通过与在开发计划署接受过诊断评价经验的父母进行的半结构化访谈进行的,他们的孩子被诊断为自闭症谱系障碍。在NVIVO软件的帮助下,数据分析基于个体描述阶段和群体结构阶段。按照有目的抽样原则对家长进行招募,直至数据饱和。结果10名家长被纳入本样本,使本样本达到数据饱和。归纳的主题分析揭示了围绕三个轴的父母体验:1。参与和被专业人士参与:家长的积极参与,专业人士提供的接待和帮助的质量;2. 家长立场的转变和观察方式的改变能够以不同的方式观察孩子,评估框架允许他们观察到什么;最后是3。能够获得知识,理解和进化的能力。我们的研究结果表明,增强父母参与感的诊断过程的实际模式是单向镜像系统和专业人员的永久协助。这些模式被整合到一个结构化的过程中,允许父母在理解的旅程中逐步发展,并引发对养育子女和共同养育子女的反思。结论:这项研究使我们能够根据该框架可以培养的丰富经验,对诊断实践中人类和物质组织的具体模式提出质疑。
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引用次数: 0
Exploration de la projection vers l’avenir de jumeaux ayant vécu la maladie et le deuil de leur double à l’aide du dessin d’une personne cueillant une pomme sur un arbre 通过画一个人从树上摘苹果,探索在双胞胎生病和悲伤中幸存下来的双胞胎的未来前景
Q4 Medicine Pub Date : 2025-01-31 DOI: 10.1016/j.neurenf.2025.01.004
B. Plouvier, E. Bouteyre-Verdier

Objective

Few studies have been carried out in the field of pediatric palliative care concerning the experience of siblings, especially of twins. While some research has highlighted the impact of a child's disease and bereavement on his or her siblings, to our knowledge, no study became interested in the projection into the future of children and teenagers who have experienced the disease and bereavement of a twin.

Methods

Using the Person Picking an Apple from a Tree drawing (Gantt and Tabone, 1998) and a semi-directive interview, this study examined the way in which two teenagers aged twelve and seventeen who have experienced their twin's disease and lost, project themselves into the future.

Results

These teenagers’ projection into the future is marked by the experience of their double's disease and bereavement. Strong fears of disease transmission and death were identified, making them worried of their future and of becoming parents. The identity upheaval and the need to learn to live without the other were particularly noticed.

Discussion

Questioning the way in which bereavement is experienced before reaching adulthood, the collected data raise the question of how to support these bereaved twins (and, more broadly, siblings) in the face of growing questions about death.

Conclusions

This study confirms the need to give voice to these bereaved siblings and offer them appropriate therapeutic support.
目的在小儿姑息治疗领域,关于兄弟姐妹尤其是双胞胎的经验研究很少。虽然一些研究强调了儿童的疾病和丧亲之痛对他或她的兄弟姐妹的影响,但据我们所知,没有研究对经历过疾病和丧亲之痛的儿童和青少年对未来的预测感兴趣。方法采用《从树上摘苹果的人》(Gantt and Tabone, 1998)和半指导性访谈,本研究考察了两个分别为12岁和17岁的青少年,他们经历了双胞胎的疾病,并失去了他们,他们对未来的规划。结果这些青少年对未来的预测以双亲的疾病和丧亲经历为特征。对疾病传播和死亡的强烈恐惧使他们对自己的未来和成为父母感到担忧。身份的剧变和学会在没有他人的情况下生活的需要尤其引人注目。讨论:收集到的数据质疑了人们在成年前经历丧亲之痛的方式,并提出了一个问题:在面对越来越多的关于死亡的问题时,如何支持这些丧亲的双胞胎(以及更广泛地说,兄弟姐妹)。结论本研究证实了我们有必要为这些失去亲人的兄弟姐妹发声,并为他们提供适当的治疗支持。
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引用次数: 0
Inceste au sein d’une fratrie : spécificités cliniques, modèles explicatifs, qualification juridique et principes de la prise en charge 兄弟姐妹中的乱伦:临床特征、解释模型、法律资格和照顾原则
Q4 Medicine Pub Date : 2025-01-17 DOI: 10.1016/j.neurenf.2025.01.001
H. Albadine , L. Mesquida , A. Revet
Sibling sexual abuse is the most widespread form of incest and is often perceived as being normal, consensual sexual exploration. As little is revealed by the victims and little is reported by healthcare professionals, this can have serious physical and psychological consequences for the victims. This article develops, in the field of child and adolescent psychiatry, the perspectives opened by the law of 21 April 2021 aimed at protecting minors from sexual offences and incest and by the report of the “Commission indépendante sur l’inceste et les violences sexuelles faites aux enfants” (CIIVISE ; Independent Commission on Incest and Sexual Violence against Children) published in November 2023. The aim of this study is to help healthcare professionals gain a better knowledge and understanding of this complex phenomenon, to appreciate its scale, to have access to theoretical models to guide their understanding, to be aware of recent legal developments and their resulting medico-legal obligations, and to provide them with practical guidelines for caring for patients and their families. Disclosure of incest usually leads to a major family crisis requiring multidisciplinary care for the victim, the perpetrator and the family as a whole, through individual and group interventions. Professional secrecy can be broken when it comes to reporting abuse of minors, and prevention is crucial. Thus the question of incest should be raised more systematically during interviews. Finally, this article highlights the need for future work aimed at establishing precise protocols and recommendations for professionals.
兄弟姐妹性虐待是最普遍的乱伦形式,通常被认为是正常的,双方同意的性探索。由于受害者透露的情况很少,卫生保健专业人员报告的情况也很少,这可能对受害者造成严重的身心后果。在儿童和青少年精神病学领域,本文发展了2021年4月21日旨在保护未成年人免遭性犯罪和乱伦侵害的法律以及“防止乱伦和未成年人性暴力侵害委员会”的报告所开辟的视角(文明社会;《乱伦和性暴力侵害儿童问题独立委员会》于2023年11月出版。本研究的目的是帮助医疗保健专业人员更好地了解和理解这一复杂现象,了解其规模,获得理论模型来指导他们的理解,了解最近的法律发展及其产生的医疗法律义务,并为他们提供照顾患者及其家属的实用指导方针。揭露乱伦通常会导致重大的家庭危机,需要通过个人和团体干预,对受害者、肇事者和整个家庭进行多学科的照顾。当涉及到报告虐待未成年人时,职业保密可以被打破,预防是至关重要的。因此,在采访中应该更系统地提出乱伦问题。最后,本文强调了未来工作的需要,旨在为专业人员建立精确的协议和建议。
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引用次数: 0
期刊
Neuropsychiatrie de l''Enfance et de l''Adolescence
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