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Saint-Sauveur-en-Rue, France

Perouse de Montclos M.-O.,Center Hospitalier Sainte Anne
Archives de Pediatrie | Year: 2011

Child psychiatry consultations specialised in filiation and international adoption help adopted children with psychological troubles and their adoptive parents. Regardless to this experience and to recent issues in the fields of attachment and narrativity, psychotraumatism and transcultural, some psychological risk factors for internationnally adopted children are described, requiring specialised psychological help. © 2011.

Rouillon F.,Center Hospitalier Sainte Anne | Gasquet I.,French Institute of Health and Medical Research | Garay R.P.,University Paris - Sud | Lancrenon S.,Sylia Statistics
Journal of Affective Disorders | Year: 2011

Background: Recently, an unexpected 3-fold higher screen positive rate for bipolar disorder was found among low-income American patients who were seeking primary care at an urban general medicine clinic as compared with the general population of the United States. The social health system in France is characterized by its open access, where most bipolar patients ask for care and where the major problem is diagnosis by the general practitioner (GP). Therefore, we investigated the prevalence of bipolar disorder among patients attending GP offices in France. Methods: This observational, single visit survey was performed among 10,265 patients (47.2 ±18.0 years old, 40% males) attending primary care in 95 GP offices in France. The participating GP made available an MDQ-French version questionnaire to all patients aged 15 years and over, going to his office during a full week, independently of the reason for medical consulting. In addition to the MDQ-French version questionnaire, patients answered items concerning sex, age, professional situation and marital state. Results: One thousand twenty-five (1025) patients did not complete the questionnaire and were excluded from the analysis. Of the 9240 analyzed questionnaires, 8.3% were classified as MDQ positives (MDQ+). MDQ+ patients were significantly younger (41.6 years versus 46.6 years for MDQ- patients, p < 0.0001), more frequently divorced or separated (19.2% versus 8.6%, p < 0.0001) and more frequently unemployed (15.2% versus 6.4%, p < 0.0001). The gender distribution was not significantly different between the two groups. Conclusions: The prevalence of receiving positive screening results for bipolar disease in 9240 patients consulting 95 randomly selected french general practitioners was 8.3%, as assessed by the MDQ questionnaire. This is a similar and unexpected high value as that reported for low-income american patients (9.8%). Besides low socioeconomic status, other factors should explain the high screen positive rate for bipolar disorder in patients attending primary care. © 2010 Elsevier B.V.

Aims: When managing a suicide-attempting patient, the psychiatrist needs to exclude all possibilities of neurological sequellae that might alter or explain the psychiatric presentation. Methods: We present a case-study of intentional hydroxyzine poisoning and a review of the literature on akinetic mutism (AM) and bilateral pallidal lesion (BPL). Results: This case illustrates a clinical situation in which cerebral imagery reoriented the psychiatric management in favour of neurological rehabilitation treatment. The language disturbance, initially interpreted as a manifestation of psychotic negativity, evolved following the discontinuation of the usual treatment from mutism to motor aphasia. Cerebral MRI concluded to a recent BPL. Retrospective interpretation of the initial clinical presentation led to the diagnosis of AM secondary to post-anoxia encephalopathy. Discussion: AM, first described in 1943, is not well-known among psychiatrists, since it belongs to the area of neurology. Yet this diagnosis enables an accurate description of our patient's behaviour. AM is distinct from catatonia by way of certain behavioural features, but above all by the absence of any psychopathological development. This raises the issue of the anatomical-clinical correlation between a behavioural manifestation and a detectable lesion. The causal relationship between the clinical semiology of MA and the radiological semiology of BPL is compromised by the clinical polymorphism of patients with BPL and the anatomical or radiological polymorphism of AM. Conclusion: Like catatonia, AM raises the question of the borderline between neurology and psychiatry. The poor anatomical-clinical correlation and the prognostic uncertainty suggest the need to reappraise AM from a psychopathological and nosographic viewpoint. © 2015 Elsevier Masson SAS.

Guedj-Bourdiau M.-J.,Center Hospitalier Sainte Anne
Annales Medico-Psychologiques | Year: 2011

Home confinement is, at first, a limitation to the family home and then almost exclusively within the bedroom, with social withdrawal, and more or less marked retreat of family relationships; so the rhythm of sleep and meals is not anymore in adequation with the usual domestic cycle. Nowadays, an immoderate use of computers and Internet is almost always associated to this confinement. We use the terms of confinement, social withdrawal, Housebound syndrome, Hikikomori, for former or current descriptions, in various countries, and not only in Japan. On the nosographic level, the associated use of the Internet cannot clearly be called addiction, but these events are sometimes considered as part of various diseases taking into account the particularities of culture, sometimes as a distinct syndrome for future DSM. Regarding 21 cases of these young people that we have met at home, after one, or more, visits of their families, who came by their own to ask for help in an emergency department, we observed that such conduct and confinement tend to recur. It is why, making contact with these young people, and the question of hospitalization can be usefully discussed. © 2011 Elsevier Masson SAS.

Petitjean F.,Center Hospitalier Sainte Anne
Annales Medico-Psychologiques | Year: 2011

This article aims to review current data concerning the therapeutical benefits of psychoeducation for schizophrenic patients and their siblings. Clinical and psychological dimensions such as relapses, quality of life and insight are considered. Many international studies have demonstrated the link between psychoeducation and clinical improvement. In France, we should go on promoting psychoeducation because we still face some resistances to the implementation of psychoeducation programs in some care structures. © 2011 Elsevier Masson SAS.

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