Encephale
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Numerous studies emphasized the high prevalence of sleep problems in adolescents. However, it remains to be seen whether these problems are developmental or if they are related to pathological conditions. In order to try to answer this question, we conducted an epidemiological study investigating the prevalence and correlates of sleep disorders in a population of high school adolescents. ⋯ In this descriptive study, if some data suggest that pubertal development may be involved in the sleep rates or troubles observed in adolescents, the results also show that persistent sleep disorders are significantly associated with physical, psychological or social difficulties. In summary, this study shows that it is essential to take an interest in the quality of sleep in adolescents, which may be a way to approach their psychosocial difficulties.
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Social phobia (also known as social anxiety disorder) is still not clearly understood. It was not established as an authentic psychiatric entity until the diagnostic nomenclature of the American Psychiatric Association DSM III in 1980. In recent years, increasing attention among researchers has contributed to provide important information about the genetic, familial and temperamental bases of social phobia and its neurochemical, neuroendocrinological and neuroanatomical substrates, which remain to be further investigated. ⋯ Other pharmacologic alternatives seem helpful for the management of social phobia, including venlafaxine, gabapentin, bupropion, nefazodone or augmentation with buspirone. Preliminary studies point to promising effects of these agents. Larger controlled clinical trials are now needed to confirm their potential role in the treatment of social phobia.
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The postpartum is a high-risk period for the occurrence of anxious and depressive episodes. Indeed, during the first few days after delivery, mothers can present postpartum blues symptomatology: fatigue, anxiety, disordered sleeping and a changing mood. Postpartum depression is characterised by a changing mood, anxiety, irritability, depression, panic and obsessional phenomena. ⋯ In conclusion, this scale demonstrates good validity and is fast and easy use in obstetrical services, allowing early detection of women who risk to develop postpartum depression and, in the first week of postpartum, of mothers who suffer from a major postpartum depression. The use of the EPDS for an early screening of the risk of postnatal depression which is essential considering the consequences that postnatal depression can have on the development of the infant, on the quality of the relationship within the couple and on other social relationships. Mothers at risk for postnatal depression should be controlled and surveyed by the health professionals in obstetrical clinics.
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Since the discovery of neuroleptics and the reintegration of people with schizophrenia in the community, psycho-social reeducation became an essential part of the treatment. The Life Skills Profile is a tool of reference for assessment of the dimensions, which have an impact on the adaptation in community. Each item describes an observable behavior, written in common language, to allow the care-givers and the family to evaluate it without having a specific formation. The long version (39 items) is recommended for therapeutic interventions with a person and the short one (20 items) for large scale studies on outcome in community. ⋯ The 39-items version of the Life Skills Profile was not validated in French. However, for clinical practice of social rehabilitation, this tool remains useful for a single person to check specific behaviors, which could hinder his/her integration into the community, to plan specific interventions and to evaluate changes, in addition with other scales. By the validation of the short version of the Life Skills Profile, an instrument is at disposal in French for outcome studies which allow to: 1) quickly assess the social functioning of person suffering of schizophrenia by a caregiver or a family member; 2) to detect insufficient skills in specific domains; and 3) to evaluate therapeutic efficiency.
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The concept of psychopathy has received many definitions for the first days of psychiatry. Recently, the Hare's Psychopathy Check List Revised has been created. This scale has the advantage to investigate the classically characteristic traits of the syndrome (need of stimulation, lack of culpability, superficial activity, lack of empathy, impassivity) and to point out the early development of behavior disturbances. In the American classification (DSM IV), oppositional and aggressive behavior in child and adolescent is grouped under the Conduct Disorder diagnostic criteria. This trouble appears to be a strong predictive factor of psychopathy in adult. Identifying the high risk factors of evolution to psychopathic personality would allow an earlier intervention and prevention by multisystemic interventions for example. The present study aims to evaluate in what measure characteristic traits of psychopathy in adults are present in severe juvenile offenders and to point out, in a second time, the differences between adolescents meeting the DSM IV criteria for Conduct Disorder and a control population by a dimensional personality inventory. ⋯ Regarding to a control group subjects from 15 to 25 years old, adolescent offenders observed in an Institution for Youth Protection show a significantly different profile in the TCI for Harm Avoidance, Reward Dependence and Cooperation. Regarding to adult psychopaths, adolescent offenders partially meet the classical diagnostic triad of psychopathy, what should be indicating that such adolescents already show emotional perturbations: lower harm avoidance, reward dependence and cooperation than control population. This third factor is not characteristic of psychopathy but reflects relational difficulties, which are important in adolescent offenders. So, our study point out the complex psychopathology of adolescent offenders and the coexistence in such adolescents of attachment disorder and the difficulty to treat them because of their multiple lacks (cognitive, psychopathological, familial and scholar). We think important to discuss the necessity of approaches based on the development of personal creative abilities and involving all the professionals concerned in the young's universe. Future researches should compare adolescent offenders and controls randomized for age, sex, socioeconomic, ethnical and cultural status. They also should test specifically the diagnostic triad of psychopathology developed by Cloninger, especially the novelty seeking dimension. Moreover, it would be interesting to integrate these results in a wider protocol and to compare them with clinical, forensic and neurocognitive data, individually and within the familial context.