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

Considering the increase in terrorist attacks worldwide in recent years and their particularly devastating nature, research following these events, including the World Trade Center attacks of September 11th, 2001, has intensified with greater attention to the mental health of survivors. To assess the impact of terrorist acts on children and adolescents, this systematic review used PubMed, Scopus, PsychINFO, and ProQuest databases without publication date limitations. Only studies assessing posttraumatic stress symptoms and psychological, social, and developmental consequences in children and adolescents in the months and years following direct or indirect exposure to terrorist acts were included. Data were extracted according to a range of predefined fields, and studies were checked for reliability using a study quality assessment tool. Eighteen articles were included: thirteen quantitative descriptive studies, four qualitative studies, and one that used a mix of quantitative and qualitative methods. The articles highlight the various difficulties faced by children and adolescents who have been exposed to terrorism during their development (such as posttraumatic stress disorder, neurocognitive, sensorimotor, emotional disorders, etc.), sometimes concomitant with the loss of a loved one killed during the event, and the trauma of their parent also having repercussions on them, effects that are even more important the older they are.

Introduction

Sexual violence in schools among children and adolescents is a public health problem. Its frequency and its short- and long-term consequences are often underestimated due to the non-specific socio-demographic and clinical characteristics of the victims.

Aim

To describe the socio-demographic and clinical characteristics of child victims of sexual violence in schools.

Materials and methods

We conducted a retrospective, descriptive and analytic study of 30 psychiatric expert reports carried out for children and adolescents who had been exposed to sexual violence in the school environment. Patients were presented to the department of child psychiatry of the CHU Hédi Chaker of Sfax, following requisitions from the national police services. The psychiatric expert reports were collected over a period of six months from January 2019 to June 2019.

Results

The average age of our patients was 11.7 ± 3 years, 57% of whom were male. The perpetrator of the sexual violence was a male in 86.7% of cases, a minor at the time of the events in 53.3% of cases and a teacher or a member of the school staff in 30% of cases. Sexual abuses consisted of sexual touching in 56.6% of cases, exhibitionism in 30% of cases and anal penetration in 26.7% of cases. Sexual abuse was repeated in 53% of cases, mainly for exposure to pornography. The victim's expert examination concluded to mainly anxiety symptoms (in 76.7% of cases) and sleep disorders (in 46.7% of cases). A post-traumatic stress disorder was retained in 16.7% of cases.

Conclusion

The results of our study suggest that sexual violence in the school environment can concern different socio-demographic classes. Sexual violence between minors seems quite frequent and the clinical manifestations presented by the victims are non-specific. This encourages the conduct of awareness-raising campaigns among workers with children to prevent this phenomenon.

Introduction

Fetal alcohol spectrum disorders (FASD) are a category of neurodevelopmental disorders resulting from prenatal exposure to alcohol, with a prevalence similar to that of autism, affecting approximately 1% of births in France. Despite their significant impact on the lives of affected children and their families, research on validated therapies to assist individuals with FASD has been limited compared to other neurodevelopmental disorders. This literature review aims to provide an overview of knowledge regarding psychomotor therapies that have shown positive outcomes on the psychomotor, cognitive, and social functions of children with FASD.

Methods

A systematic literature review following PRISMA guidelines covered a 20-year period (2002–2022). The search included studies, published in French or English, with or without control groups, examining the effectiveness of psychomotor therapies in children and adolescents with FASD.

Results

Out of 1198 references, ten studies involving a total of 296 children with FASD (10 to 100 patients per study) were selected. Nine of these studies included a control group. Interventions such as the “Alert Program® for Self-Regulation”, “Cognitive Control Therapy”, specific training programs for attention or social skills were identified as psychomotor interventions with the highest level of evidence of effectiveness in areas frequently disrupted in children with FASD (emotional management, cognitive functions, and social skills). Replication of studies, predominantly conducted in North America, and more detailed exploration of sensorimotor difficulties or interventions aiming to address them, remain to be carried out. As with other neurodevelopmental disorders, multimodal and early psychomotor interventions appear to be the most useful. The playful dimension and parental involvement are described as essential ingredients contributing to the effectiveness of each psychomotor therapeutic approach.

Child and adolescent obesity is definitely a pathology the understanding of which has faced dramatic changes in recent years thanks to the identification of the genetic background of some cases and an amazing increase in the knowledge of its biological background. The adipose tissue is an endocrine organ in permanent communication with other ones, including the appetite regulation centres of the brain and the neuroendocrine system of the digestive tract. A precise analysis of the trajectory of weight gain and its associated manifestations such as abnormal physical or developmental features and complications is mandatory while facing a child or adolescent with obesity. A close cooperation with reference centres for childhood obesity and nutrigenomics research units leading to the diagnosis of genetic forms, likely to be underdiagnosed, may allow the use of targeted and efficient drug treatment. A recent double-blind study has shown that a Glucagon like peptide 1 (GLP1) analogue, a key contributor of appetite regulation from intestinal origin, has a major beneficial impact on adolescents with obesity of polygenic origin. Further studies are still required to ensure the long-term effect and the lack of side effects of such a treatment. However, such results already challenge the indication of bariatric surgery. While prevention still must be a priority, many other molecules and therapeutic approaches are underway for the most frequent metabolic and chronic childhood disorder.

Childhood obesity is a significant public health concern due to its adverse effects on both physical and mental health. It cannot dispense with a comprehensive psychiatric examination, particularly in the search for an eating behavior disorder. In this review article, we present, in the first part, eating disorders most specifically related to obesity (binge eating disorder, loss of control overeating, and night eating syndrome) as well as associated psychiatric comorbidities. In the second part, we examine specific factors (emotional eating, cognitive restriction, and social stigmatization) that may contribute to the emergence of eating disorders in young individuals with obesity. This psychopathological approach will facilitate a more comprehensive understanding of the complex issue of childhood obesity, potentially leading to more effective therapeutic and preventive strategies.