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1.
Eur Child Adolesc Psychiatry ; 26(1): 5-23, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27662894

RESUMO

The aim of this literature review was to examine the evidence for psychotherapeutic and pharmacological treatments in subjects with severely dysregulated mood and to identify potential areas for improvements in research designs. A literature search was conducted using several databases for published (PubMed, PsycINFO) and ongoing (clinical trial registries) studies conducted in youths who met NIMH's criteria for Severe Mood Dysregulation (SMD) or the DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder (DMDD). Eight completed studies were identified: three randomized trials, four open pilot studies and one case report. Seven ongoing studies were found in trial registries. The available evidence suggests potential efficacy of psychotherapies which have previously been developed for internalizing and externalizing disorders. The two main pharmacological strategies tested are, first, a monotherapy of psychostimulant or atypical antipsychotic such as risperidone, already used in the treatment of severe irritability in youths with developmental disorders; and second, the use of a serotonergic antidepressant as an add-on therapy in youths treated with psychostimulant. Ongoing studies will further clarify the effectiveness of psychotherapeutic interventions for DMDD individuals and whether they should be given alone or in conjunction with other treatments. The short duration of the trials for a chronic disorder, the low number of studies, the lack of placebo or active comparator arm, and restrictive inclusion criteria in most of the controlled trials dramatically limit the interpretation of the results. Finally, future research should be conducted across multiple sites, with standardized procedures to measure DMDD symptoms reduction, and include a run-in period to limit placebo effect.


Assuntos
Medicina Baseada em Evidências/normas , Transtornos do Humor/psicologia , Transtornos do Humor/terapia , Adolescente , Antipsicóticos/uso terapêutico , Doença Crônica , Medicina Baseada em Evidências/métodos , Feminino , Humanos , Humor Irritável , Masculino , Transtornos do Humor/diagnóstico , Projetos Piloto , Psicoterapia/métodos , Psicoterapia/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Risperidona/uso terapêutico
2.
Int J Mol Sci ; 18(5)2017 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-28468274

RESUMO

In mammals, the circadian clocks network (central and peripheral oscillators) controls circadian rhythms and orchestrates the expression of a range of downstream genes, allowing the organism to anticipate and adapt to environmental changes. Beyond their role in circadian rhythms, several studies have highlighted that circadian clock genes may have a more widespread physiological effect on cognition, mood, and reward-related behaviors. Furthermore, single nucleotide polymorphisms in core circadian clock genes have been associated with psychiatric disorders (such as autism spectrum disorder, schizophrenia, anxiety disorders, major depressive disorder, bipolar disorder, and attention deficit hyperactivity disorder). However, the underlying mechanisms of these associations remain to be ascertained and the cause-effect relationships are not clearly established. The objective of this article is to clarify the role of clock genes and altered sleep-wake rhythms in the development of psychiatric disorders (sleep problems are often observed at early onset of psychiatric disorders). First, the molecular mechanisms of circadian rhythms are described. Then, the relationships between disrupted circadian rhythms, including sleep-wake rhythms, and psychiatric disorders are discussed. Further research may open interesting perspectives with promising avenues for early detection and therapeutic intervention in psychiatric disorders.


Assuntos
Relógios Circadianos , Peptídeos e Proteínas de Sinalização do Ritmo Circadiano/genética , Ritmo Circadiano , Transtornos Mentais/genética , Transtornos do Sono-Vigília/genética , Sono , Vigília , Animais , Transtorno do Espectro Autista/etiologia , Transtorno do Espectro Autista/genética , Transtorno Bipolar/etiologia , Transtorno Bipolar/genética , Transtorno Depressivo Maior/etiologia , Transtorno Depressivo Maior/genética , Humanos , Transtornos Mentais/etiologia , Esquizofrenia/etiologia , Esquizofrenia/genética , Transtornos do Sono-Vigília/etiologia
3.
J Nerv Ment Dis ; 204(2): 153-5, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26825265

RESUMO

This study examined the relationship between peritraumatic reactions, posttraumatic stress disorder (PTSD) symptoms, somatic complaints, and quality of life in Tunisians exposed to the events of the Arab Spring. Participants (n = 60) completed an online survey 1 year after the events, assessing peritraumatic distress, peritraumatic dissociation, PTSD symptoms, somatic complaints, and physical and mental quality of life. Results showed that peritraumatic dissociation was independently associated with increased PTSD symptoms and somatic complaints 12 months after the events. Multiple mediator mediation analyses revealed that somatic complaints (not PTSD symptoms) were the only independent mediators of the relationships between peritraumatic dissociation and both physical and mental quality of life. Assessing peritraumatic dissociation soon after trauma exposure among the North African population might help identify individuals at risk for PTSD. Furthermore, the impact of trauma on quality of life may be better explained by somatic complaints than PTSD symptoms among North Africans.


Assuntos
Acontecimentos que Mudam a Vida , Transtornos Psicofisiológicos/psicologia , Qualidade de Vida/psicologia , Violência/psicologia , Adulto , Feminino , Humanos , Masculino , Política , Escalas de Graduação Psiquiátrica , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Tunísia/epidemiologia
4.
Epilepsy Behav ; 44: 110-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25678031

RESUMO

Children with epilepsy and their parents face many social and psychological difficulties that remain insufficiently studied in sub-Saharan Africa. The aim here was to assess the quality of life of children with epilepsy and their parents. A community-based cross-sectional survey was conducted in two urban areas and four rural areas of Gabon. Children were screened through key informants, medical sources, and a door-to-door survey. They were clinically selected based on their medical history and a clinical exam conducted by the investigating physician. Electroencephalography had not been carried out because of a lack of material and financial resources. The quality of life of children and their parents was assessed by a structured interview of parents using a questionnaire. Of 317 suspected cases on screening, 83 children with epilepsy were identified. Their mean age was 11.9±4.4years. Twelve percent of the children had neurosensory abnormalities on clinical exam. Sixty-three percent of them attended school; factors associated with schooling were higher score on the sociability subscale, specialized medical advice, and antiepileptic drug treatment. Sociability difficulties, anxiety, cognitive impairment, and behavioral disorders were suspected in 39.8%, 45.8%, 49.4%, and 42.2% of children, respectively. A total of 48.2% of parents expressed a poor quality of life related to their children's illness. A higher score on the cognition subscale, urban residence, specialized medical advice, and a stable income in the household were predictive of poor parental quality of life. Epilepsy influences many aspects of a child's life and the life of the child's parents. Care should incorporate a cognitive assessment of the child and emphasize information for patients and their relatives.


Assuntos
Comportamento Infantil/psicologia , Transtornos Cognitivos/psicologia , Cognição , Epilepsia/psicologia , Pais/psicologia , Qualidade de Vida , Adolescente , Criança , Transtornos Cognitivos/etiologia , Estudos Transversais , Feminino , Gabão , Humanos , Masculino , Apoio Social , Fatores Socioeconômicos , Inquéritos e Questionários
5.
Front Psychol ; 15: 1389463, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38979073

RESUMO

Background: Body image disorders are well documented in anorexia nervosa (AN); however, knowledge of interoceptive awareness (IA) in this population remains poor. This descriptive study investigated whether and how the representation of the interior of the body may have an impact on IA. Methods: The representations and knowledge of the body interior were evaluated with a drawing task in 34 women with AN and 34 healthy controls (HCs). A lexicometric analysis was performed on the vocabulary used to describe the drawn body parts in a structured interview. It was assumed that the conceptual representation of the body interior could be affected by or influence IA. Thus, the relationship between IA, measured with the heartbeat task and the ischemia-induction test, and the drawings was explored. Other scales, such as those of body shape, awareness or satisfaction, were used to assess affective representations of the body. Results: The drawing, lexicometric and IA results were similar in the two groups. No correlations were found among IA, body representation scores and representation level of body interior. Only the representation of bones by the AN group was significantly different. Discussion: Increased visual attention to the skeleton or greater awareness of bone health could explain the stronger representation of bones in the AN group. The psychophysical therapy received by some AN participants (73%) did not seem to have influenced IA. Our results do not support a relationship between IA and the representation of the body interior.Clinical trial registration:https://clinicaltrials.gov/, identifier NCT03988218.

6.
Depress Anxiety ; 27(7): 652-7, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20013986

RESUMO

BACKGROUND: Motor vehicle accidents (MVAs) are the main cause of Posttraumatic stress disorder (PTSD) in industrialized countries. This includes the frequently occurring but understudied situation of parents learning that their children were injured. However, unlike in other types of trauma survivors, little is known about the predictors of PTSD symptoms in mothers whose child has suffered an MVA. METHODS: A group of 72 mothers and 28 fathers were prospectively assessed for peritraumatic distress, peritraumatic dissociation, and PTSD symptoms 1 and 5 weeks after their child had suffered an MVA. RESULTS: Levels of peritraumatic distress and dissociation were comparable to other trauma victims, 18% of the mothers were considered to be suffering from probable PTSD. In mothers, significant positive correlations were found between PTSD symptoms and peritraumatic distress (r=.34) and dissociation (r=.37), whereas mothers' PTSD symptoms were associated with decreased peritraumatic dissociation in fathers (r=-.37). Even after controlling for covictim/witness status, peritraumatic distress was a predictor of mothers' PTSD symptoms, explaining 14% of the variance. CONCLUSIONS: Peritraumatic response and PTSD symptoms should be routinely assessed among parents whose child has experienced a traumatic event.


Assuntos
Acidentes de Trânsito/psicologia , Mães/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Criança , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , Índice de Gravidade de Doença , Ferimentos e Lesões/classificação
7.
J Clin Exp Neuropsychol ; 41(1): 1-14, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29923455

RESUMO

INTRODUCTION: Several authors have suggested the existence of motor disorders associated with developmental coordination disorder (DCD) in individuals with autism spectrum disorder (ASD). However, there are few comparative studies of psychomotor profiles that include assessments of neurological soft signs in children with ASD or DCD. We used a neuropsychomotor assessment for children with ASD from a standardized neurodevelopmental examination to understand the nature of the difficulties these children encounter. To uncover the differences and similarities in psychomotor profiles, we compared the profiles of children with ASD with those of children with DCD and focused on two recently described DCD subgroups: visuospatial-constructional (VSC) and mixed (MX). METHODS: We compared 18 children with ASD and 58 children with DCD (33 with VSC-DCD and 25 with MX-DCD) who were assessed with a battery of French-language tests (the NP-MOT) to evaluate the neuropsychomotor functions associated with visual perception and visual-spatial-motor structuring. RESULTS: Although there were similarities between the profiles of children with ASD and those with DCD (VSC-DCD or MX-DCD), these similarities were not associated with the predictive diagnostic markers that characterized subtypes of DCD. Instead, many variables (visuospatial-motor structuration, synkinetic movements, dynamic balance, manual dexterity, coordination, praxis, bodily spatial integration, and digital perception) differed among the three groups; the best performance was observed in the children with ASD. CONCLUSION: The neuropsychomotor profiles of children with ASD and those with VSC-DCD or MX-DCD differed, and these differences are discussed. Our results highlight that impairments of ASD are specific about lateralization disturbances and support the hypothesis of proprioceptive impairment due to visual fixation problems influenced by muscular tone in relation to the subcortical and cortical structures and possible interhemispheric disorder. Thus, some neuropsychomotor functions that underpin both gestures and a set of motor skills are affected.


Assuntos
Transtorno do Espectro Autista/complicações , Transtornos Motores/complicações , Transtornos das Habilidades Motoras/complicações , Destreza Motora/fisiologia , Adolescente , Transtorno do Espectro Autista/fisiopatologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Transtornos Motores/fisiopatologia , Transtornos das Habilidades Motoras/fisiopatologia , Desempenho Psicomotor/fisiologia , Percepção Visual/fisiologia
8.
Disaster Med Public Health Prep ; 13(2): 144-146, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29916338

RESUMO

In the actual context of terrorism targeting children and families, it seems essential to describe different experiences of pediatric psychological emergency devices after such unexpected mass trauma. Here we testify our experience of the psychological emergency care setup dedicated to children and families during the first 48 hours after the terrorist attack of Nice, France, on July 14, 2016. Activated within the hour following the attack, the device included two child psychiatry teams turning over each day, receiving at least 163 individuals (99 children and 64 adults) within the first 2 days. (Disaster Med Public Health Preparedness. 2019;13:144-146).


Assuntos
Planejamento em Desastres/métodos , Serviços de Saúde Mental/normas , Psicologia da Criança/métodos , Terrorismo/estatística & dados numéricos , Adolescente , Criança , Serviços de Saúde da Criança/normas , Serviços de Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Planejamento em Desastres/tendências , França , Humanos , Serviços de Saúde Mental/estatística & dados numéricos , Psicologia da Criança/tendências , Terrorismo/psicologia
9.
PLoS One ; 13(9): e0202080, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30192749

RESUMO

The objective of this study was to quantify the possible decrease in school performance at five years of age in preterm children associated with parental separation or divorce, and to test whether this effect varies according to the child's age at the time of the separation. This study included 3,308 infants delivered at < 35 weeks of gestation born between 2003 and 2011 who were enrolled in the population-based LIFT cohort and who had an optimal neurodevelopmental outcome at two years of age. These infants were evaluated by their teachers to assess their abilities and behavior when they had reached five years of age, using the Global School Adaptation (GSA) questionnaire. The mean GSA score was 50.8 points. Parental separations (assessed as parents either living together or living separately) were associated with a decrease in school performance at five years of age, although this was only the case for children who exhibited difficulties at school (3.7 points, p < 0.01). A decrease in school performance only occurred when parental separations took place between 3 and 5 years after the child's birth. Parental separation was associated with a decrease in these children's levels of motivation, autonomy, and manual dexterity. This study indicates that preterm infants of parents who had separated are particularly at risk of a lower scholar performance.


Assuntos
Desempenho Acadêmico/normas , Divórcio , Pais , Instituições Acadêmicas , Criança , Desenvolvimento Infantil , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Inquéritos e Questionários
10.
Schizophr Res ; 200: 68-76, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-28659239

RESUMO

OBJECTIVES: Pediatric catatonia is a rare and life-threatening syndrome. Around 20% of juvenile catatonia is associated with organic condition (Consoli et al., 2012). Autoimmune conditions represent a diagnostic and therapeutic challenge since specific antibodies can be missed. To facilitate decision making, we recently formulated a causality assessment score (CAUS) using a stepwise approach and an immunosuppressive therapeutic challenge (Ferrafiat et al., 2016). Our objectives were to validate retrospectively CAUS and to define its threshold for an accurate distinction between organic catatonia and non-organic catatonia, and specifically between autoimmune catatonia and non-organic catatonia. METHOD: To obtain a sufficient number of cases with organic catatonia, we pooled two samples (N=104) - one from a child psychiatry center, the other from neuro-pediatrics center - expert in catatonia and autoimmune conditions. Organic conditions were diagnosed using a multidisciplinary approach and numerous paraclinical investigations. Given the binary classification needs, we used receiver operating characteristic (ROC) analysis (Peacock and Peacock, 2010) to calculate the best classification threshold. RESULTS: The cohort included 67 cases of non-organic catatonia and 37 cases of organic catatonia. ROC analysis showed that the CAUS performance in discriminating both organic catatonia vs. non-organic catatonia, and autoimmune catatonia vs. non-organic catatonia was excellent (Area Under the Curve=0.99). In both analyses, for a CAUS threshold≥5, accuracy equaled to 0.96. CONCLUSION: Regarding juvenile catatonia, the use of the CAUS score algorithm combining a therapeutic challenge and a threshold≥5 may help to diagnose and treat autoimmune conditions even without formal identification of auto-antibodies.


Assuntos
Algoritmos , Doenças Autoimunes/complicações , Catatonia/diagnóstico , Catatonia/terapia , Adolescente , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/terapia , Catatonia/etiologia , Catatonia/imunologia , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos , Curva ROC , Estudos Retrospectivos
11.
Neurophysiol Clin ; 47(4): 261-268, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28784338

RESUMO

OBJECTIVE: Motor disorders are known in autism spectrum disorder (ASD), but muscle tone assessments are rarely performed. Muscle tone underpins movement. We investigated muscle tone in 34 ASD children using a standardized neuro-developmental battery, which uses the French norms for muscular tone in children. METHODS: Dangling and extensibility were used to examine passive muscle tone in the upper and lower limbs and the body axis. A comparison between muscles of the right and left sides enabled the determination of tonic laterality. RESULTS: We found a disharmonious tonic typology, with a tonic component for the muscles of the trunk and the proximal muscles of the lower limbs and a laxity component for the ankles and the proximal and distal muscles of the upper limbs (wrists and shoulders). No establishment of tonic laterality was found in the upper limbs in 61% of ASD children (P<0.001). CONCLUSION: The disturbed tonic organization influenced by subcortical structures, such as the cerebellum, may partially explain the motor disorders, and indefinite tonic laterality may also be linked to low hemispheric brain dominance described in autism. This preliminary examination is necessary before any gross motor assessments to understand the nature of movement disorders, explore typologies and highlight possible soft neuro-motor signs.


Assuntos
Transtorno do Espectro Autista/complicações , Transtornos Motores/fisiopatologia , Hipotonia Muscular/fisiopatologia , Criança , Pré-Escolar , Feminino , Humanos , Extremidade Inferior/fisiopatologia , Masculino , Transtornos Motores/complicações , Transtornos Motores/diagnóstico , Hipotonia Muscular/complicações , Hipotonia Muscular/diagnóstico , Fenótipo , Extremidade Superior/fisiopatologia
12.
BMJ Open ; 7(11): e017845, 2017 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-29150469

RESUMO

OBJECTIVE: The objective of this study was to investigate both the effects of low gestational age and infant's neurodevelopmental outcome at 2 years of age on the risk of parental separation within 7 years of giving birth. DESIGN: Prospective. SETTING: 24 maternity clinics in the Pays-de-la-Loire region. PARTICIPANTS: This study included 5732 infants delivered at <35 weeks of gestation born between 2005 and 2013 who were enrolled in the population-based Loire Infant Follow-up Team cohort and who had a neurodevelopmental evaluation at 2 years. This neurodevelopmental evaluation was based on a physical examination, a psychomotor evaluation and a parent-completed questionnaire. OUTCOME MEASURE: Risk of parental separation (parents living together or parents living separately). RESULTS: Ten percent (572/5732) of the parents reported having undergone separation during the follow-up period. A mediation analysis showed that low gestational age had no direct effect on the risk of parental separation. Moreover, a non-optimal neurodevelopment at 2 years was associated with an increased risk of parental separation corresponding to a HR=1.49(1.23 to 1.80). Finally, the increased risk of parental separation was aggravated by low socioeconomic conditions. CONCLUSIONS: The effect of low gestational age on the risk of parental separation was mediated by the infant's neurodevelopment.


Assuntos
Desenvolvimento Infantil , Estado Civil , Pais , Nascimento Prematuro/epidemiologia , Criança , Pré-Escolar , Feminino , França , Idade Gestacional , Humanos , Lactente , Lactente Extremamente Prematuro , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Estudos Longitudinais , Masculino , Casamento/psicologia , Casamento/estatística & dados numéricos , Gravidez , Nascimento Prematuro/psicologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
13.
PLoS One ; 12(12): e0188831, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29216234

RESUMO

BACKGROUND: The need for early treatment of autism spectrum disorders (ASD) necessitates early screening. Very few tools have been prospectively tested with infants of less than 12 months of age. The PREAUT grid is based on dyadic assessment through interaction and shared emotion and showed good metrics for predicting ASD in very-high-risk infants with West syndrome. METHODS: We assessed the ability of the PREAUT grid to predict ASD in low-risk individuals by prospectively following and screening 12,179 infants with the PREAUT grid at four (PREAUT-4) and nine (PREAUT-9) months of age. A sample of 4,835 toddlers completed the Checklist for Autism in Toddlers (CHAT) at 24 months (CHAT-24) of age. Children who were positive at one screening (N = 100) were proposed a clinical assessment (including the Children Autism Rating Scale, a Developmental Quotient, and an ICD-10-based clinical diagnosis if appropriate) in the third year of life. A randomly selected sample of 1,100 individuals who were negative at all screenings was followed by the PMI team from three to five years of age to identify prospective false negative cases. The clinical outcome was available for 45% (N = 45) of positive children and 52.6% (N = 579) of negative children. RESULTS: Of the 100 children who screened positive, 45 received a diagnosis at follow-up. Among those receiving a diagnosis, 22 were healthy, 10 were diagnosed with ASD, seven with intellectual disability (ID), and six had another developmental disorder. Thus, 50% of infants positive at one screening subsequently received a neurodevelopmental diagnosis. The PREAUT grid scores were significantly associated with medium and high ASD risk status on the CHAT at 24 months (odds ratio of 12.1 (95%CI: 3.0-36.8), p < 0.001, at four months and 38.1 (95%CI: 3.65-220.3), p < 0.001, at nine months). Sensitivity (Se), specificity, negative predictive values, and positive predictive values (PPVs) for PREAUT at four or nine months, and CHAT at 24 months, were similar [PREAUT-4: Se = 16.0 to 20.6%, PPV = 25.4 to 26.3%; PREAUT-9: Se = 30.5 to 41.2%, PPV = 20.2 to 36.4%; and CHAT-24: Se = 33.9 to 41.5%, PPV = 27.3 to 25.9%]. The repeated use of the screening instruments increased the Se but not PPV estimates [PREAUT and CHAT combined: Se = 67.9 to 77.7%, PPV = 19.0 to 28.0%]. CONCLUSIONS: The PREAUT grid can contribute to very early detection of ASD and its combination with the CHAT may improve the early diagnosis of ASD and other neurodevelopmental disorders.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos
14.
J Physiol Paris ; 110(4 Pt B): 461-466, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-29154930

RESUMO

Suicide remains one of the leading causes of death among young people, and suicidal ideation and behavior are relatively common in healthy and clinical populations. Suicide risk in childhood and adolescence is often approached from the perspective of nosographic categories to which predictive variables for suicidal acts are often linked. The cascading effects resulting from altered clock genes in a pediatric population could participate in biological rhythm abnormalities and the emergence of suicide attempts through impaired regulation of circadian rhythms and emotional states with neurodevelopmental effects. Also, early trauma and stressful life events can alter the expression of clock genes and contribute to the emergence of suicide attempts. Alteration of clock genes might lead to desynchronized and abnormal circadian rhythms impairing in turn the synchronization between external and internal rhythms and therefore the adaptation of the individual to his/her internal and external environment with the development of psychiatric disorders associated with increased risk for suicide attempts.


Assuntos
Comportamento do Adolescente/psicologia , Proteínas CLOCK/genética , Comportamento Infantil/psicologia , Ritmo Circadiano/genética , Epigênese Genética/genética , Tentativa de Suicídio/psicologia , Adolescente , Comportamento do Adolescente/fisiologia , Criança , Comportamento Infantil/fisiologia , Emoções/fisiologia , Humanos
15.
Front Psychol ; 7: 1292, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27672371

RESUMO

BACKGROUND: Altered motor performance has been described in Autism Spectrum Disorders (ASD) with disturbances in walking; posture, coordination, or arm movements, but some individuals with ASD show no impairment of motor skills. The neuro-developmental processes that underpin the performance of neuro-psychomotor functions have not been widely explored, nor is it clear whether there are neuro-psychomotor functions specifically affected in ASD. Our objective was to focus on the semiology of motor disorders among children with ASD using a neuro-developmental assessment tool. METHOD: Thirty-four children with ASD, with or without intellectual deficit (ID) were recruited in a child psychiatry department and Autism Resource Centers. Initial standard evaluations for diagnosis (psychiatric; psychological; psychomotor) were supplemented by a standardized assessment battery for neuro-developmental psychomotor functions (NP-MOT). RESULTS: The results of some NP-MOT tests differed between children with ASD with ID and those without. However, on the NP-MOT battery, neither of the two groups did well in the bi-manual and finger praxia tests (36 and 52% respectively failed). Manual and digital gnosopraxia showed some deficit (63 and 62% respectively failed). Postural deficits were found in tests for both static equilibrium (64%) and dynamic (52%). There were also difficulties in coordination between the upper and lower limbs in 58% of children. We found 75% failure in motor skills on the M-ABC test. Concerning muscular tone, significant laxity was observed in distal parts of the body (feet and hands), but hypertonia was observed in the proximal muscles of the lower limbs (reduced heel-ear angle). DISCUSSION: The results of manual and digital gnosopraxia tests point to a planning deficit in children with autism. A gesture programming deficit is also highlighted by the poor results in manual praxis, and by failures in the M-ABC tests despite prior training of the child. However, concerning global motor function, a significant difference was observed between children with and without ID. Our findings suggest a semiology of tone deregulation between proximal versus distal muscles, indeterminate tonic laterality, postural control deficit (proprioceptive), impairment of inter-hemispheric coordination (corpus callosum), and neurological soft signs such asdysdiadochokinesia, which leads us to hypothesize a general impairment of motor functions.

16.
Schizophr Res ; 176(2-3): 378-386, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27377978

RESUMO

INTRODUCTION: Despite the increased recognition of catatonia in children and adolescents, no specific assessment instrument has been validated in this population. METHOD: Within the context of a prospective study on catatonia, we developed the Pediatric Catatonia Rating Scale (PCRS, maximum score=60), adapted from the Bush and Francis Catatonia Rating Scale for its use in child and adolescent inpatients. We assessed the psychometric properties of the PCRS by measuring its internal consistency, construct validity, and factor structure. Bivariate analyses were performed to compare the different diagnostic patient groups across the extracted factors. RESULTS: Internal consistency was moderate (Cronbach's α for total score=0.67) suggesting multidimensionality. Multiple factors underlie the PCRS items, as revealed by factor analysis. Four distinct dimensions of catatonic symptoms were identified and accounted for 44% of total variance: a "negative withdrawal" factor (with mutism, negativism, and social withdrawal), a "catalepsy" factor (with posturing and waxy flexibility), an "abnormal movements" factor (with mannerisms and stereotypes) and an "echo phenomenon" factor (with echolalia and echopraxia). Receiver operating characteristic (ROC) analysis showed that the PCRS performance in discriminating individuals with catatonia vs. those without catatonia was excellent for a threshold≥9 (Area Under the Curve=0.983) in this sample. DISCUSSION: These results support the validity of the PCRS among children and adolescent inpatients. With regard to such analyses, the internal structure of catatonic syndrome in children and adolescents is roughly comparable with the adult form, except the lack of a "hyperactive/excitement" dimension.


Assuntos
Catatonia/diagnóstico , Índice de Gravidade de Doença , Adolescente , Catatonia/complicações , Catatonia/tratamento farmacológico , Criança , Pré-Escolar , Análise Fatorial , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/diagnóstico , Transtornos Mentais/tratamento farmacológico , Estudos Prospectivos , Psicometria , Curva ROC
17.
BMJ Open ; 6(4): e011020, 2016 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-27053275

RESUMO

INTRODUCTION: In France, over recent years, the prescription rate of antipsychotic (AP) remained stable in children and adolescents. Prescription of second-generation antipsychotics increased, whereas prescription of first-generation antipsychotics decreased. Off-label prescriptions are very frequent in this population. Adverse events (AEs) in youth treated with AP are common and may be severe. AEs have hitherto been poorly monitored in naturalistic studies independent from industry. METHOD AND ANALYSIS: We describe a French prospective multicentre study in an AP-naïve paediatric population named Etude de la Tolérance des AntiPsychotique chez l'Enfant (ETAPE). The study started in April 2013. So far, 200 patients have been included. The inclusion criteria are: male or female inpatients aged from 6 to 18 years, treated with an AP drug for less than 28 days, never been treated or having received AP for less than 3 months, discontinued at least 6 months prior to inclusion. These assessments of AE are performed at inclusion, as well as at 3, 6, 9 and 12 months after the introduction of the AP. The monitoring period will end in May 2016. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethics Committee 'Sud Méditerrané V' (number 12.082) and by the French National Agency for Medicines and Health Products Safety (number 2012-004546-15). All patients and their parents signed informed consent on enrolment in the study. We will submit the results of the study to relevant journals and offer national and international presentations. This study will enable better characterisation of the prescription of AP drugs. The results will further help to develop quality standards and recommendations for monitoring AE during the prescription of AP. TRIAL REGISTRATION NUMBER: NCT02007928.


Assuntos
Antipsicóticos/efeitos adversos , Monitoramento de Medicamentos , Transtornos Mentais/tratamento farmacológico , Pediatria , Prescrições , Adolescente , Antipsicóticos/uso terapêutico , Criança , Feminino , França , Humanos , Incidência , Masculino , Estudos Prospectivos , Projetos de Pesquisa , Esquizofrenia
19.
PLoS One ; 9(12): e112603, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25460912

RESUMO

BACKGROUND: Although the reliable and valid Child Post-Traumatic Stress Reaction Index (CPTS-RI) is a widely used measure of posttraumatic stress disorder (PTSD) symptoms in children, it has not been validated in French-speaking populations. The present study aims to assess the psychometric properties of the CPTS-RI in three samples of French-speaking school-children. METHODS: Data was obtained from three samples. Sample 1 was composed of 106 children (mean (SD) age = 11.7(0.7), 50% females) victims of an industrial disaster. Sample 2 was composed of 50 children (mean (SD) age = 10.8(2.6), 44% females) who had received an orthopaedic surgical procedure after an accident. Sample 3 was composed of 106 children (mean (SD) age = 11.7(2.2), 44% females) admitted to an emergency department after a road traffic accident. We tested internal consistency using Cronbach's alpha. We examined test-retest reliability using intraclass correlation coefficient. In order to assess the convergent validity of the French version of the CPTS-RI and the Clinician Administered PTS Scale-Child and Adolescent (CAPS-CA), spearman-correlation coefficient was computed. To verify the validity of the cut-off scores, a ROC curve was constructed which evaluated the sensitivity and specificity of each score compared to the diagnosis with the CAPS-CA. We also used principal components analysis with varimax rotation to study the structure of the French version of the CPTS-RI. RESULTS: Cronbach's alpha coefficient was 0.87 for the French version of the CPTS-RI. Two-week test-retest intraclass correlation coefficient (n = 30) was 0.67. The French version of the CPTS-RI was well correlated with the CAPS-CA (r = 0.76, p < 0.001). Taking the CAPS-CA as the diagnostic reference, with a diagnostic cut-off of >24 for the CPTS-RI, the sensitivity and specificities were 100% and 62.6%, respectively. The French version of the CPTS-RI demonstrated a three-factor structure. CONCLUSIONS: The CPTS-RI is reliable and valid in French-speaking children.


Assuntos
Idioma , Psicometria/métodos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adolescente , Criança , Feminino , França , Humanos , Masculino , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários
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