Encephale
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Post-operative neuropsychiatric manifestations represent a frequent situation and may be due to several aetiologies. The responsibility of vitamin B12 deficiency must be evoked, especially in case of anaesthesia with a currently used substance: nitrous oxide. ⋯ Through this observation, the authors underline the necessity to search for vitamin B12 deficiency in the case of cognitive features following general anaesthesia.
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Studies of the psychology of gifted children frequently refer to their relatively immature affective development in terms of their intellectual capacities and the relational difficulties they experience with regard to their peers, teachers, close acquaintances and sometimes their parents. From a psychopathological viewpoint, various types of problem have been observed such as depressive symptoms, motor instability coupled with hyperactivity, attentional deficits, impulsivity and a fall in self-esteem. ⋯ The gifted children in our study therefore manifested a lack of self-esteem, and in particular a lack of academic self-esteem, coupled with depressive symptoms. For Coopersmith (1984), self-esteem is a function of experienced events in the various sectors in question, while Gibello (1992) sees a link between inhibition or academic disinvestment and everything that may generate anxiety and/or depression in the subject. We can hypothesize that the difficulties experienced by these children derive, at least in part, from their specific characteristics, namely their internal and social dysschynchronism (Terrassier, 1981). Among its other effects, this dyssynchronism leads to a school life that is often difficult or even chaotic, resulting in a general level of self-esteem, and more particularly an academic self-esteem, that is lower than the mean. These considerations might then, in their turn, generate psychopathological symptoms such as depression or hyperactivity (Revol et al., 2002) which have repercussions that affect the effectiveness of the children's school work. This study suggests the need to verify whether similar results are observed in gifted children who do not attend special classes and children who have not yet been identified as gifted. Furthermore, our results indicate that these children are liable to a specific vulnerability in the emotional and behavioral domains that needs to be emphasized. They stress the need for early preventive measures to combat the emotional and behavioral difficulties experienced by gifted children and emphasize the importance of continuing to conduct this type of study in order to explain and specify the origin of these difficulties.
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Consumption rates of anxiolytic drugs, and especially of benzodiazepines, remain very high in France compared to other Western countries, whereas clinical guidelines limit their indications to short term treatments and only for some precise anxiety disorders. Recent epidemiologic surveys in the community indicated that more than 15% of people used once or more an anxiolytic drug in the past year. The issue of chronic treatments is particularly crucial because of their poor benefit/risk ratio in most anxiety disorders (limited efficacy, cognitive side effects, withdrawal and dependence problems). ⋯ These data are in line with the knowledge of a lack of efficacy of benzodiazepines in depressive and most anxiety disorders, despite long term treatment. They also confirm the current guidelines which recommend prescribing serotoninergic antidepressants, and not benzodiazepines, when long term treatments are needed for severe and chronic affective disorders. This epidemiologic study leads to the conclusion that a specific and attentive diagnostic assessment should be done in all patients receiving benzodiazepines for more than three months, in order to purpose in many cases other long term therapeutic strategies.