[Manic-depressive psychoses in adolescence. Influence of life change events. Study of family dynamics]. / Psychose maniaco-dépressive à l'adolescence. Influence des événements de vie. Etude de la dynamique familiale.

A sample of 38 adolescents hospitalized for a major depressive episode melancholic type or a manic episode during the course of a bipolar disorder (according to the DSM III-R Criteria) was examined with particular emphasis on precipating life events and family relationships. Psychosocial stressors in the year preceding onset of the affective disorder were found in a very high proportion of cases (about 80%). Stressors are most often severe. All of these stressors have to do with loss or threat of loss, particularly the most frequent one: the sentimental failure. Analyzing results of a familial dynamic questionnaire, we showed in the MDD sample the prevalence of two psychopathological index: maternal rejection, parental dysharmony.

Driving ability in sleep apnoea patients before and after CPAP treatment: evaluation on a road safety platform.

Sleepiness is considered to be the major cause of increased traffic accidents in patients with obstructive sleep apnoea syndrome (OSAS). Until now, OSAS patients' driving ability has been assessed using driving simulators, but no assessment in a more natural driving environment has been carried out to date. The aim of the present study was to evaluate driving parameters in OSAS and in controls on a road safety platform, and to compare them with attentional in-laboratory measures before and after continuous positive airway pressure treatment. The parameters measured were: reaction time; distance to stop and number of collisions on the platform; maintenance of wakefulness; and sustained, selective and divided attention in laboratory. Patients exhibited much longer reaction times than controls, leading to a lengthening of the vehicle's stopping distance of 8.8 m at 40 km.h(-1) and to twice the number of collisions. Patients did not demonstrate objective sleepiness or selective and sustained attention deficits. Divided attention deficits were found. However, they did not allow the prediction of real driving impairment. After CPAP treatment, there was no longer any difference between patients and controls regarding driving and attention performances. Driving abilities are significantly impaired in obstructive sleep apnoea syndrome. After continuous positive airway pressure treatment, deficits were normalised. This stresses the importance of evaluating attentional parameters in apnoeic patients and of offering continuous positive airway pressure treatment even to non-sleepy subjects.