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

In the family, in the city or in places of inclusion, mixed situations are rich for children with disabilities as well as for typical children and contribute to the implementation of the principles of the United Nations Convention. By identifying the factors that promote or hinder peer relationships for young children aged 1 to 6 with disabilities, this research aimed to help improve practices in order to support inclusive situations and limit the isolation of these children. Thirty-two children who had motor, or intellectual and motor disabilities, or multiple disability, were observed for 18 months, at home, in inclusive settings and in specialised settings, using observation booklets filled in by parents or professionals depending on the place of observation. Research interviews were conducted at the end of the study with participating parents and professionals. The verbatims of the observations and interviews were subject to a thematic content analysis. After noting that children with disabilities were more isolated than others, six factors were identified as promoting or hindering interaction : (i) the relational experience of children with disabilities with familiar children, (ii) the size of the group of children in which they evolved, (iii) the intervention of the adult in the relationships between children, (iv) the characteristics of the pathology, (v) the character traits of the children, and finally (vi) the material and human environment in which they were welcomed. The discussion conclusion focuses on an analysis of the processes at work in the creation of interactions between children with disabilities and their peers, which opens up clinical perspectives in terms of support for children and their families.

Objectives

Using a qualitative method, this study explored the experiences and opinions of mothers facing visitor restrictions in maternity wards during the COVID-19 pandemic in Europe.

Population and methods

A total of 16 women between the ages of 29 and 38 years were recruited. They gave birth between April 2020 and July 2022 in metropolitan France or the Netherlands. Each participant had an individual and semi-directional telephonic interview which was transcribed and subjected to thematic content analysis.

Results

Visitor restrictions in maternity wards were a source of great apprehension for participants, which is the first theme of our thematic analysis. The unknown, changes in restrictions and mentions of other mothers who had experienced such restrictions were often sources of fear, anxiety and a heavy mental load for these participants. The second theme was the yearning and related to the lack of emotional and physical support that mothers felt when their family and friends were not allowed in the maternity ward; this theme also highlighted the central place given to the new-born's siblings in this ward. The third theme was the traumatic experience of mothers who have experienced the restriction of their partner. These results underline the need for participants to be accompanied by their partners throughout their stay in the maternity ward. Finally, tranquillity was the last theme and was related to the absence of family and friends during postpartum care, something that participants had differing opinions about but that most agreed would have given them a better first postpartum experience in the maternity ward.

Discussion

Whether viewed as positive or negative, visitor restrictions have a significant impact on how mothers experience their childbirth and stay in a maternity ward.

Conclusions

If a new wave of the pandemic were to occur, these results would encourage policy makers to rethink visitor restrictions in maternity wards and consider the need for every mother to be surrounded there by the people of her choice.

Background

Anthropology is a discipline recently recognized as a science describing the relationship humans establish with the environment.

Objectives

To investigate the relationship between anthropology and neuroscience in EDs and cover the themes of (1) the relation between neuroscience and anthropology and (2) studies on neuroanthropology applicable to eating disorders.

Methods

A search was performed in the PubMed and SocINDEX databases.

Results

Most of publications (n = 13) approach health, anthropology, and culture. Publications about neuroscience ad anthropology (n = 8) were discussed with a focus on neural areas, such as the amygdala and the interactions between emotions about food and emotional eating.

Discussion

There is a notion of a two-way hand where we modify and are modified by the environment, and, in this process (anthropological manifestations) are possible because of the enormous complexity and multifunctionality of the brain and EDs development. In other words, culture is the result of human brain development.

Conclusions

Considering the relationship between the biological aspects and sociocultural involved in eating disorders (EDs), the changes in the environment and new adaptations, established beauty standards, and the emergence of disordered eating behaviors indicate that the social-cultural aspects could be possible facilitators of neural changes.

Objectives

This pilot study aims at evaluating the effectiveness of music therapy in decreasing anxiety and dysmorphophobia experienced in a care unit during the institutional and distressful moment of weighing.

Patients and method

We adapted a technique of receptive music therapy, the so-called DéPi-AM for psychomusical relaxation, with eight adolescent girls (14;8 ± 2 years;4) hospitalized for four months on average for restrictive anorexia nervosa. The participants received eight music therapy sessions followed by eight control evaluation sessions without music therapy. Quantitative data were collected in three evaluation conditions (pre-session, post-session, and no music therapy).

Results

Results suggest that music therapy significantly reduces perceived anxiety (as measured by the STAI-Y A; P = 0.01, and the “EVN”; P = 0687). Moreover, compared to the control condition, music therapy significantly contributed to a reduction in the systolic blood pressure (P = 0.03) and heart frequency (P = 02). Results additionally showed that this weighing time significantly increases all physiological constants (systolic blood pressure; P = 0.01, diastolic blood pressure; P = 0.05, and heart frequency; P = 0.04) in contrast to another trivial, emotionally “neutral” day.

Discussion

This first quantitative study on the effectiveness of music therapy in adolescents suffering from anorexia nervosa shows encouraging results. The proved anxiety-provoking effect of this strategic institutional time in the care of these adolescents legitimizes the use and benefits of this type of therapeutic group. Undoubtedly, methodological limitations constrain the generalization of findings. Future studies should adopt a mixed (quantitative and qualitative) and transversal methodology. They would surely contribute to refine the profile of those patients, for whom this therapy appears to represent a promising care approach.

Conclusions

Overall findings suggest a positive impact of receptive music therapy in decreasing experienced and perceived anxiety. Integrating programs such as the “DéPi-AM” into the therapeutic intervention offered by the care unit could therefore represent a key element when accompanying hospitalized patients during a key and anxious period.

Objectives

To describe poison exposures in case of self-poisoning subjects younger than 18 years old reported to the Marseille Poison Control Center.

Patients and method

This is a descriptive, monocentric and prospective review of self-poisoning patients aged < 18 years who reported to the Marseille Poison Control Center from 1st October 2021 to 31st January 2022.

Results

The 308 subjects included were aged 11 to 17 years with an average age of 14.9 years (±1.5) for girls and 14.6 (±1.7) for boys (P = 0.234). The sex ratio was 0.14. Two hundred and forty patients (77.9%) already had prior psychological or psychiatric follow-up. It was a recurrence of suicide attempts in 43.8% of cases (n = 135). The use of an emergency department was almost systematic (n = 277, 89.9%). Most of these were mono-intoxications (n = 193, 62.7%). The poisonings were in most cases drug-induced (n = 281, 91.2%). Analgesics-antipyretics were the most used drug class (n = 147 patients, 47.7%), followed by anxiolytics (n = 62, 20.1%). Paracetamol proved to be the most ingested substance (n = 108, 35.1%). One hundred and six patients remained asymptomatic (34.4%). Of the 308 cases included, 78.6% were hospitalized for an average of four days. Two hundred forty-nine cases (80.8%) had one psychiatric evaluation in an emergency department and 200 (64.9%) will have an appointment for a psychiatric consultation on discharge.

Discussion

The demographic characteristics of young suicides and those of intoxication were globally like those found in the literature although our recurrence rate was higher than those in the literature. More than two years after the start of the SARS-CoV-2 pandemic, the malaise of young people remains while the care offer is already saturated. To reverse the trend by 2027 the French Ministry of Health and Prevention has updated its national prevention strategy by various means. A subsequent study could be interesting to see the impact of these measures.

Conclusion

This study is limited but seems to complement some indicators, which shows that the pediatric mental health crisis is worsening, especially among the youngest adolescents who have an increased recurrence rate. We must remain vigilant and continue to implement screening actions and means of prevention, particularly of recurrences.

The migratory journey of unaccompanied refugee minors is often marked by hardship and can give rise to complex post-traumatic stress disorders. Their care in France can also be complex. Several studies have investigated this issue, finding both diagnostic difficulties and an increased representation of psychosis-related diagnoses. Other studies have shown the value of a transcultural vision of the situation. By means of a clinical case that is highly representative of the difficulties encountered by professionals dealing with these patients, we attempt to provide a more global vision, both in terms of diagnosis to avoid misdiagnosis and in terms of treatment.

Objectives

The impact of maltreatment (physical, psychological or severe neglect) on the psychological, affective and cognitive functioning and body experience of children aged six to twelve years using projective media.

Methodology

A qualitative and partially quantitative and prospective study of the following variables: quality of life, emotional and psychopathological functioning, intellectual functioning, psychic functioning and body image. Investigation tools: Wisc-V, depression scale (MDI-C), quality of life self-assessment survey (AUQUEI), CAT, self-portrait, modeling of figurines in plasticine and semi-directive interview.

Population

Ten children aged six to twelve years, in care at Clairs-Vallons (a medical-psychological residential institution, Belgium).

Results

The maltreatment of a child has an impact on the probability of depression (higher than average), on anxiety, on intelligence quotient (more heterogeneous profiles), on self-esteem and on the defensive mechanisms of children. The primary defense mechanisms are to affect distancing, inhibition, cleavage and fragmentation. Disturbances of the body image are noted by the realization of fragmented, damaged and perforated bodies of the figurine models. The models are disproportioned, see-through, some parts of the body left unassembled or juxtaposed. The analysis of the data highlights separation anxieties linked to the disorganized/disoriented attachment style (difficulties in managing separation anxiety), insecurity or anxiety about a part of the body, a certain inability to elaborate a sufficiently organized psychic envelope, a tendency to flee and a hostility in the social relationship.

Conclusion

Abuse has a significant impact on the psychological development of children aged 6–12 years. The integration of the more physical aspects, in particular through the use of modeling, allows access to the traumatic bodily experience and to the (non)-integration of sensory, emotional and relational experiences of the child.

Objectives

The purpose of this study is to conduct a systematic review of studies conducted on autism spectrum disorder (ASD) and attachment. We explore the possibility for children with ASD to establish a secure attachment relationship with their caregiver compared to neurotypical children. Given the current knowledge on ASD and attachment, we expect that ASD is a vulnerability factor in the construction of secure attachment. We also hypothesize that the presence of an associated intellectual disability potentiates the risks for children with ASD to develop insecure attachment compared to children with ASD without associated intellectual disability.

Method

We identified on the following databases, PsycInfo, Pubmed, Francis, and Pascal, studies on attachment types in individuals with ASD. Twenty-three articles were selected for our analysis.

Results

Their analysis shows that, overall, children with ASD seem to be more likely to develop an insecure type of attachment. There is an over-representation of the disorganized/disoriented type reinforced by the presence of an intellectual disability. However, the risk of developing an insecure attachment is not verified in the whole corpus and these observations are not always scientifically valid (sometimes, there are no inferential statistics because too few subjects; sometimes the results are not statistically significant). Furthermore, we were able to highlight a strong heterogeneity in the indices used in the studies (e.g., characteristics of the population included or measures of attachment), which may bias the interpretation of these studies or at least make them impossible to generalize.

Conclusion

Further research is needed to define the study population more rigorously in order to minimize bias in the research (language level, intellectual efficiency, theory of mind, presence or absence of comorbidities, etc.). Future work should allow us to better understand the links between ASD and attachment fragility, which seem to us to be more complex and multifactorial than what the first studies were able to put forward.