Encephale
-
Case Reports
[Catatonia in a 14 year-old girl: treatment with clorazepam and carbamazepine, a 10-year follow-up].
Child and adolescent catatonia has been poorly investigated. Moreover, diagnosis criteria only exist for adult psychiatry, and there are no therapeutic guidelines. The aim of this paper is to describe the case of a 14-year-old girl presenting an overlap between psychogenic and neuroleptic induced catatonia, acute treatment and ten year's follow-up. ⋯ The etiopathogenic diagnosis is problematic. Some indices in the familial history may suggest a traumatic event. But one to the total residual amnesia it was never confirmed, and traumatic catatonia are extremely rare. Normal CPK levels, with autonomic disturbance limited to tachycardia and the lack of resolution after discontinuance of medication, argues against a diagnosis of neuroleptic malignant syndrome (NMS). But CPK levels are non specific, and NMS without pyrexia has been described. The occurrence of the catatonic syndrome 21 days after the first dose of a neuroleptic could be diagnostic. This case involved a non organic catatonic psychosis followed by neuroleptic induced catatonia. Catatonia is described as a risk factor for the development of NMS and some consider NMS to be a variant of malignant catatonia. The interest of this report is (1) it reinforces the need to be cautious before prescribing neuroleptics in adolescents presenting with symptoms of catatonia; (2) the complete recovery from catatonia after treatment with intensive care and more than three weeks of intravenous clonazepam without the use of ECT and (3) the effectiveness of carbamazepine over a long period of follow-up. Although trials on carbamazepine in catatonia are published, there are no data available for the control of residual symptoms or the long term prognosis, especially in child and adolescent psychiatry.
-
Comparative Study
[Construct validation study of the Relationship Scales Questionnaire (RSQ) on an adult sample].
The authors present the construct validity of the French version of the Relationship Scales Questionnaire (RSQ) designed by Griffin and Bartholomew (1994), which is the most widely-used self-report concerning adult attachment. ⋯ The construct validity studied on an adult sample confirms the good psychometric properties of the RSQ considering the factor analysis, the test-retest short time reliability and the internal consistency. The factor analysis with three factors provides a different structure of classical descriptions with only two factors, but confirms the most recent results on Attachment Self-Reports that find a factor concerning security and two factors concerning management of insecurity (avoidance and anxiety in relationships). To be confirmed, the results require further research (confirmatory factor analysis, larger sample, other type of population).
-
The victims of a spouse's violence have a high risk of developing mental and physical health symptoms. The efforts aimed at preventing the consequences of domestic violence are encouraged by the current literature as well as the national and international recommendations. They highlight the fact that intervention and treatment programs have more or less failed. ⋯ As a consequence, we deal with the professional and deontological positioning that the medical professionals have towards this device. The network device aims at going beyond the limits of the usual care, both through a pooling of knowledge and multidisciplinary practices. The establishment of common models of intervention (working groups), also suggests a best practice in relation to complex issues: the establishment of a network is a means of establishing the link between professionals. However, professionals in a network should routinely question their practice and ethics and to avoid "confusion of roles" - the risk of multidisciplinary and standard practices. Differences and professional specialisation are essential components of a care offer tailored to the clinical complexity of victims of domestic violence. It now appears necessary to assess the impact of this care at the social, health and psychological levels of victims of domestic violence.