Separation Practices in Children and Adolescents Admitted for Suicidal Behavior: A National Survey of French Psychiatrists.

Objectives: To assess practices of French psychiatrists regarding their management of children and adolescents with suicidal behaviors, focusing on the use of a separation protocol in which the youths are separated from their relatives. Methods: In 2017, we conducted an online cross-sectional survey of French psychiatrists caring for children and adolescents. Participants were asked to describe their practice of a separation protocol in children and adolescents admitted for suicidal behavior. Our main analysis followed a descriptive approach. We also explored whether participant characteristics were associated with the use of a separation protocol. Results: The response rate was 218/2403 (9,1%); 57.9 % of respondents worked in a University hospital, and 60% of respondents reported routinely hospitalizing children. A separation protocol was set up by 91.1% of survey participants (systematically 39.6%, on a case-by-case basis 51.5%). The mean age from which a separation protocol was indicated was above 11 years; 64% of participants reported a separation period of ≤ 48 h. The most common (87%) criterion cited for establishing a separation period was family relationship difficulties. The most common (80.9%) reason to justify the use of a separation protocol was to allow a better clinical assessment. Exploratory analyses did not identify any participant characteristics associated with the use of a separation protocol (p > 0.2 for all). Conclusion: The use of a separation protocol in children and adolescents admitted for suicidal behavior is a widespread practice in France, despite the deprivation of liberty it implies. This raises the question of the relevance and usefulness of such a practice.

[Early detection of mental disorders in infants or children]. / Repérage des troubles psychiques du bébé et de l'enfant.

Early detection of babies or children mental disorders enables specific diagnosis and care in the very early life of the distressed children. It is critical to make all physicians able to identify early signs. Autism, depression, anguage and learning disorders are pathologies whose early diagnosis enables early care thus limiting the negative impact on child and family lives. In the specific context of child abuse, it is our duty to detect alarming signs as soon as possible to fully protect the abused baby or child.

[Somatoform disorders in adolescence]. / Troubles somatoformes de l'adolescent.

Somatoform disorders are fairly common in adolescents. These disorders are frequently met by all professionals like pediatricians, neurologists and general physicians. Studies on adolescence encountered bias to evaluate frequency of these disorders because of variations in the diagnostic criteria used by different workers and diversity of units concerned. Actually, there is no consensus about taking care these patients. Paediatricians remain the first step and link for the care which is often complicated and needs multidisciplinary approach. The recognition of somatoform disorders requires two complementary diagnostic processes in order to propose a fitted treatment for adolescents for whom symptoms always are the reflection of a suffering that has to be identified, evaluated and cared.