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Preventive perinatal home visits are a powerful and effective tool, particularly to reach the most vulnerable families. These families, who accumulate multiple psycho-social difficulties, seldom use available medical and social institutions and find themselves at greater risk of developing disorders in early parent-child relationship and a subsequent psychopathology. This paper is based on a literature review of home-visiting programs, in France and other countries. Our purpose is both to describe better this practice, which hasn't yet been clearly formalized within institutions, and also to assess its impact and limitations. © Médecine & Hygiène. Tous droits réservés pour tous pays.


Ferreri M.,Service de Pedopsychiatrie
Revue du Praticien | Year: 2014

Pervasive developmental disorders (PDD-ICD10), covering roughly the same entity as the autism spectrum disorders (ASD DSM-IVTR and DSM-V) include a heterogeneous clinical reality. PDD develop in childhood and are characterized by alterations In socialization, communication and behavior disorders with stereotypies and repetitive movements. Autism is included in PDD and has led to many debates in France and to the publication of recommendations and government plans, in recent years. We propose in this article to review the current knowledge of this topic.


Having considered the concepts of intergenerational and transgenerational psychic transmission with regard to the theory of deferred action, the author refers to the available models of transmission processes (according, in succession, to the works of Bion, Bowlby and Stern) before concluding by presenting the system of early interactions between the baby and its caregivers as a narrative space with a double meaning that specifically contributes to constructing the child's identity. © P.U.F.


Golse B.,Service de pedopsychiatrie
Neuropsychiatrie de l'Enfance et de l'Adolescence | Year: 2012

Advances in fetal medicine are now extending the assumptions of Freud and reflections of Bion to allow continuity of thought between life prenatal and postnatal life. Sequential maturation of fetal sensory gives a basis for the reconstructive assumption of Maiello on the existence of a first " sound object" prenatal. From there, the author proposes a theory of trauma in three stages, including a prenatal time and making us able to maintain the theory of the deferred action in the field of very early traumas. © 2012.


Leray M.,Service de pedopsychiatrie
Archives de Pediatrie | Year: 2014

Among the various forms of violence inflicted on a child, psychological violence holds a significant place in terms of frequency, diversity and damage done, as serious and pervasive consequences can be observed on the child's development. This article highlights and assesses the psychological consequences provoked by psychological violences perpetrated by parents, teachers or other children in different situations, such as domestic violence, divorce and school bullying. It also gives some indications for intervention and prevention in those situations. © 2014 Elsevier Masson SAS.


Golse B.,Service de pedopsychiatrie
Archives de Pediatrie | Year: 2014

This work first recalls the definition of joint physical custody, as well as the current legal procedure for obtaining it, its practical implementation, the financial implications for parents, and finally some statistics. Some psychological and psychopathological reflections on the impact of divorce on children are then presented before considering the question of joint physically custody with regard to attachment theory and depending on the age of the child (a great caution seems to be required before three years). The article concludes with a brief discussion of parental alienation syndrome. © 2014.


This article describes several months of the treatment of a three-year-old boy, Jonathan, presenting pervasive developmental disorder. This experience using psychomotor therapy reveals his difficulties from a psycho-dynamic viewpoint. These troubles are centered on the body image and corporal anxieties. Two of Jonathan's most frequent object manipulations illustrate this clinical experience: those with baloons and felt pens. The text also bears witness to the therapeutic process whose aim is to accompany and support Jonathan in the restructuration of his body ego. Psychomotor therapy is based on the verbalisation of the child's manipulations. The recognition of our own feelings during this experience is at the heart of the therapeutic process. The goal is to lead the child toward a consciousness of himself and of the Other in a relationship which is secure and differentiated.


After evoking the origin of the term "cæsura of birth" proposed by Freud in 1926 and adopted by Bion in 1976 to discuss possible continuity between prenatal life and postnatal life, the author attempts to make a connection between this assumption of continuity and the issue of borderline pathologies, in the view of the work of these two authors. The postnatal development heterochronies or disharmonies and narcissistic failures attached to them, may well find some of their origins in anarchic prenatal sensory registrations as well as in a chaotic transition from foetal life to postnatal life, which opens the way to a theory of trauma in three stages. Copyright © 2016 JLE.


In Algeria, child psychiatry is an emerging area of medical specialization which is very late in becoming part of the training for professionals and the provision of services. Due to this, the quality of the treatment of serious mental disorders for children and adolescents is insufficient, diverse, and sometimes non-existant. Currently autism is the major reason for consultation and treatment; the diagnosis is often late and comes when the child already has a significant developmental lag and cannot be enrolled in school - often the reason for the referral. The existing resources in our area are as follows: three units with part-time hospitalization in the capital and its suburbs, 40 child psychiatrists trained during the last two years in collaboration with the WHO, about ten outpatients clinics covering an extended territory with significant socio-demographic and health differences. Only from 18 years of age does the authorities in Algeria recognize autism (in fact as a mental retardation) with a minimal monthly family allowance to parents often at a loss or isolated when faced with an offer of assistance that is limited or difficult to access. Objectives: After having reviewed our sources for this work with the parents concerning autism, we then describe its organization, sequence of events, the difficulties encountered, and discuss propositions for further improvements. Population and method: In this context, the choice and application of a therapeutic method for autistic children needs to take into account the many constraints in terms of infrastructure and human resources. Due to its simplicity and effectiveness, we have, for both theoretical and practical purposes, for the past decade, considered that it was a good strategy to associate the exchange and development therapy with the Schopler's TEACCH program for those children receiving treatment in our daytime hospital service. It also met the professional qualification of our collaborators - most of them psychologists, speech therapists and care assistants. Another reason is that it is indispensable that the mothers of autistic children are involved in the treatment in order to obtain significant gains (Bartoov et al., 2002 [15] and Bartoov et al., 2001 [16]). Results: This therapeutic application was implemented during 2005-2010 for a hundred autistic children and their mothers: 80 of them in daytime medical institution and 20 as outpatients with the same technical support. The mothers as " co-therapists" received a two-hour per month training (from September to June) during three years according to the rules and principles of the teaching activities for autistic children and " the educational strategies of autism" for parental practice, both coming from the TEACCH program (Li et al., 2006 [19] and Velez de la Calle et al., 2008 [20]). Conclusion: This involvement, while less than desirable, is proportional to our resources and nevertheless sufficiently promising and structuring to engage care dynamics and show beneficial effects in cognitive, affective and behavioral fields of the autistic child. After having reviewed our sources for this work with the parents concerning autism, we then describe its organization, sequence of events, the difficulties encountered, and discuss propositions for further improvements. We then carefully examine the difficulties encountered, the means we have in order to make some progress, and we discuss how to evaluate the results, in the context of an experiment which is only beginning in this field in a developping nation. Last, but not least, we also took into consideration the " non-cooperative" mothers in order to adapt our therapy to their personal needs and to elaborate different objectives as far as they are concerned. © 2012 Elsevier Masson SAS.


Da Fonseca D.,Service de Pedopsychiatrie | Fakra E.,Pole University Of Psychiatrie
Encephale | Year: 2010

The study of the premorbid functioning in bipolar disorder allows us to identify several risk factors of the disease. First we will present retrospective studies of adults or teenagers presenting a bipolar disorder and second the studies concerning offspring of parents with bipolar disorder. Despite contradictory results and methodological weaknesses, these studies indicate that anxious disorders and childhood disruptive behaviour disorders may be useful markers of risk for adult bipolar disorder. All these results may open up several interesting perspectives for the prevention ant the treatment of bipolar disorder. © L'Encéphale, 2010.

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