[Neuroleptic malignant syndrome and general paralysis: a clinical case]. / Le cas clinique du mois. Syndrome malin des neuroleptiques et paralysie générale.

Described in 1960 by Jean Delay in relation to the use of haloperidol, neuroleptic malignant syndrome remains relatively rare, and poorly known by the medical profession. The emergence of the atypical antipsychotic agents and preventive measures which have become general in recent years in hospital departments using dopamine receptor antagonists has not altered the prognosis, which remains potentially fatal in approximately a quarter of cases. This article proposes a descriptive summary of this syndrome in terms of clinical and biological diagnostics as well as of evolution, epidemiology, differential diagnosis and treatment. It describes the case of a patient affected by general paralysis having developed a neuroleptic malignant syndrome, thus the hypothesis what the neuroleptic malignant syndrome preferentially arises in subjects having underlying organic or metabolic problems and provides food for thought regarding the main medical and psychiatric overlaps, the use of dopaminergic agents and the behaviour to be adopted when dealing with a patient presenting with inaugural psychiatric symptomatology.

[Suicide of young adults: psychiatric and psychosocial comorbidity]. / Le suicide des jeunes adultes. Comorbidité psychiatrique et psychosociale.

This paper is concerned with a specific population of young adults who were admitted to the Patrick Dewaere Center, a crisis unit dedicated to suicidal young adults aged 15 to 35. We analysed data from a group of 885 patients hospitalized from July 1996 to November 2003. The psychiatric and psychosocial comorbidity of these young suicidal adults was outlined from data contained in the "Minimum Psychiatric Summary" (MPS). Several observations were made: There was a high prevalence of adaptation disorders (67.3%) contrasting with a rather low proportion of major depressive disorders. There was also a very high prevalence of personality disorders 80%), particularly, histrionical or borderline personality disorders. Diffuse, atypical somatic complaints, mainly related to sleep and appetite, that often failed to yield a precise medical diagnosis, were most frequent. A close relationship between suicide and psychosocial problems was apparent and attested the importance of the quality of social links. The value of short hospitalization among this generally active population was evidenced.