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Resume Introduction La COVID-19 s’est accompagnee de mesures restrictives. Encourageant le maintien des liens sociaux chez les jeunes, l’OMS soutient l’initiative #PlayApartTogether (jouer ensemble a distance), malgre l’ajout recent de l’addiction aux jeux video (JV) a la CIM-11. Une incomprehension peut naitre du caractere paradoxal de ces deux messages. Methode Nous avons effectue une revue de la litterature internationale, afin d’argumenter les benefices et risques de la pratique du JV, durant cette crise sanitaire. Resultats Il s’avere qu’il est difficile de degager un consensus. Durant la pandemie, pratiquer des JV semble pouvoir favoriser un bien-etre psychique de l’adolescent. Les JV, dits prosociaux, sont un moyen de maintenir le lien a l’autre. Certains JV, quant a eux, mobilisent physiquement. Souffrir au prealable d’anxiete ou de depression peut mener vers une veritable addiction. La litterature non specifique de la periode COVID-19 fait etat de l’amelioration des cognitions associees a une pratique reguliere du JV. La pratique des JV prosociaux pourrait etre benefiques sur le comportement ; alors, violence virtuelle et violence en vie reelle ne sont pas associees. Il n’a pas ete etabli de surrisque de suicide abouti chez les joueurs. Conclusion La litterature argumente le benefice de la pratique des JV actuellement. Ceux dits prosociaux sont a privilegier. Il faut, toutefois, rester attentif concernant le risque addictif, en particulier chez le jeune avec depression preexistante ou nouvellement apparue, et ayant une grande conscience de l’impact du virus, eminemment anxiogene.

Resume Contexte Dans les services de psychiatrie de l’enfant et de l’adolescent, le nombre d’hospitalisations pour anorexie mentale (AM) est en augmentation ces dernieres annees. En etat de denutrition severe, ces patients peuvent presenter des perturbations de leurs fonctions immunitaires. Forts de ce constat, beaucoup de praticiens avaient fait le choix d’eviter les hospitalisations longues lors de la premiere vague de COVID-19, par peur de contages et de probable risque augmente de forme grave chez ces patients. Est-ce que cette strategie est toujours d’actualite pour la seconde vague ? Un risque majore de forme grave a-t-il ete identifie chez le patient adolescent AM ? Methode Nous avons rappele les recommandations francaises sur le sujet que nous avons completees par une revue de la litterature internationale via Medline, Google Scholar ainsi que les donnees de l’organisme americain Center for Disease Control and Prevention. Resultats L’evolution des connaissances sur la pandemie a clairement etabli un plus faible risque de contamination chez l’enfant et l’adolescent. Il n’a pas ete montre que l’AM ou faible poids corporel constituaient un risque de forme severe de COVID-19. A l’inverse, le confinement aggrave la symptomatologie chez au moins un tiers de ces patients. Conclusion Au final, il apparait judicieux de ne pas reproduire la strategie de retour a domicile precoce chez les adolescents atteints d’AM. Les donnees actuelles appuient la necessite d’une continuite des soins, ainsi que la poursuite des prises en charges hospitalieres quand elles sont necessaires.

International audience; L’exposition au traumatisme est une expérience fréquemment vécue par les enfants et les adolescents, la prévalence du trouble stress post-traumatique (TSPT) dans cette population étant probablement sous-estimée. Si la plupart vont faire preuve de capacités de résilience leur permettant de surmonter ces épreuves, un certain nombre d’entre eux vont toutefois présenter des réactions très diverses, allant de perturbations minimes de la vie de l’enfant à des tableaux cliniques sévères interférant fortement avec le développement psychoaffectif, parmi lesquels le TSPT. Dans le DSM-5, les troubles liés à des traumatismes ont été autonomisés des autres troubles anxieux et des troubles du spectre obsessionnel. Plus récemment, la CIM-11 a proposé un nouveau diagnostic appelé TSPT complexe, qui rapproche du champ du psychotraumatisme certains troubles psychiatriques à forte composante traumatique développementale, en particulier les troubles de personnalité borderline. Malgré la grande hétérogénéité des réactions psychotraumatiques chez l’enfant et l’adolescent, une triade clinique est classiquement décrite, associant des symptômes de répétition, des manifestations d’évitement et une hyperactivité neurovégétative. De multiples approches thérapeutiques sont possibles, mais la trauma-focused cognitive behavioral therapy, une thérapie limitée dans le temps, qui associe des exercices d’exposition, de remodelage cognitif et d’augmentation des capacités d’adaptation et de résilience, est la plus validée et la plus largement utilisée. Beaucoup reste à faire concernant l’identification des facteurs de risque et des facteurs protecteurs, la description des différentes trajectoires possibles suites à un traumatisme, le développement d’instruments psychométriques et leur validation en français, et l’évaluation et l’implémentation de thérapies efficaces et accessibles.

Objectives Pediatric catatonia is a rare and life-threatening syndrome. Around 20% of juvenile catatonia is associated with organic condition (Consoli et al., 2012). Autoimmune conditions represent a diagnostic and therapeutic challenge since specific antibodies can be missed. To facilitate decision making, we recently formulated a causality assessment score (CAUS) using a stepwise approach and an immunosuppressive therapeutic challenge (Ferrafiat et al., 2016). Our objectives were to validate retrospectively CAUS and to define its threshold for an accurate distinction between organic catatonia and non-organic catatonia, and specifically between autoimmune catatonia and non-organic catatonia. Method To obtain a sufficient number of cases with organic catatonia, we pooled two samples ( N = 104) – one from a child psychiatry center, the other from neuro-pediatrics center – expert in catatonia and autoimmune conditions. Organic conditions were diagnosed using a multidisciplinary approach and numerous paraclinical investigations. Given the binary classification needs, we used receiver operating characteristic (ROC) analysis (Peacock and Peacock, 2010) to calculate the best classification threshold. Results The cohort included 67 cases of non-organic catatonia and 37 cases of organic catatonia. ROC analysis showed that the CAUS performance in discriminating both organic catatonia vs. non-organic catatonia, and autoimmune catatonia vs. non-organic catatonia was excellent (Area Under the Curve = 0.99). In both analyses, for a CAUS threshold ≥ 5, accuracy equaled to 0.96. Conclusion Regarding juvenile catatonia, the use of the CAUS score algorithm combining a therapeutic challenge and a threshold ≥ 5 may help to diagnose and treat autoimmune conditions even without formal identification of auto-antibodies.

En 2030, la depression occupera la premiere cause mondiale de morbidite selon l’Organisation mondiale de la sante. Le passage a l’acte suicidaire en est la complication la plus redoutee. Chez l’adolescent, une place croissante est accordee aux traitements non medicamenteux, et en particulier aux psychotherapies. Peu connue en France, malgre d’excellentes evaluations internationales, la therapie interpersonnelle est une psychotherapie breve, structuree, en 12 a 16 seances a un rythme hebdomadaire, centree sur un domaine interpersonnel problematique actuel. Quatre ont ete montres comme significativement correles a l’emergence de la depression : le deuil, la transition de role, les conflits et le deficit interpersonnel. Elle a fait les preuves de son efficacite dans le traitement aigu ambulatoire de la depression de l’adulte et de l’adolescent, et plusieurs projets de recherche ont teste sa validite, avec plus ou moins de reussite, dans d’autres contextes, d’autres groupes de sujets, et dans d’autres pathologies psychiatriques. Chez l’adolescent, elle presente un interet indeniable, mais sa forme originale doit etre adaptee aux particularites propres a cette population. Cet article expose des generalites sur la therapie interpersonnelle, puis les elements propres a sa realisation avec des adolescents depressifs [Resume d'auteur]

Suicide remains one of the leading causes of death among young people, and suicidal ideation and behavior are relatively common in healthy and clinical populations. Suicide risk in childhood and adolescence is often approached from the perspective of nosographic categories to which predictive variables for suicidal acts are often linked. The cascading effects resulting from altered clock genes in a pediatric population could participate in biological rhythm abnormalities and the emergence of suicide attempts through impaired regulation of circadian rhythms and emotional states with neurodevelopmental effects. Also, early trauma and stressful life events can alter the expression of clock genes and contribute to the emergence of suicide attempts. Alteration of clock genes might lead to desynchronized and abnormal circadian rhythms impairing in turn the synchronization between external and internal rhythms and therefore the adaptation of the individual to his/her internal and external environment with the development of psychiatric disorders associated with increased risk for suicide attempts.

Resume L’examen psychomoteur fait partie des examens recommandes par la Haute autorite de sante (HAS) pour le depistage et le diagnostic des troubles du spectre de l’autisme (TSA). Pourtant, l’evaluation standardisee et normee n’est pas systematique dans le cadre d’un bilan psychomoteur aupres de ces enfants, souvent presentes comme difficilement evaluables. But de l’etude Mettre en evidence l’interet et la faisabilite d’une passation d’une batterie d’evaluations standardisees en psychomotricite (la batterie d’evaluations des fonctions neuro-psychomotrices de l’enfant : NP-MOT) aupres d’enfants avec TSA, en analysant les possibilites d’evaluation de ces enfants issues d’une etude recente portant sur l’evaluation des fonctions neuro-psychomotrices d’enfants avec TSA. Patients et methode Au total, 34 enfants âges de 4 a 11 ans et de tout niveau d’efficience ont passe un bilan psychomoteur incluant la batterie normee NP-MOT. Resultats tous les enfants ont pu etre evalues a partir de la batterie NP-MOT, quel que soit leur niveau d’efficience. Conclusion L’evaluation a partir d’un outil standardise, valide et presentant des normes de references est possible dans l’examen psychomoteur d’enfants avec un TSA. L’utilisation d’outils standardises a visee developpementale, comme la batterie NP-MOT, doit etre encouragee aupres des psychomotriciens, mais aussi par les prescripteurs medecins, dans la mesure ou une telle evaluation permet une analyse semiologique et etiologique des troubles psychomoteurs dans les TSA, encore peu connue, mais dont le retentissement peut etre profitable a une meilleure orientation de la prise en charge.

In the actual context of terrorism targeting children and families, it seems essential to describe different experiences of pediatric psychological emergency devices after such unexpected mass trauma. Here we testify our experience of the psychological emergency care setup dedicated to children and families during the first 48 hours after the terrorist attack of Nice, France, on July 14, 2016. Activated within the hour following the attack, the device included two child psychiatry teams turning over each day, receiving at least 163 individuals (99 children and 64 adults) within the first 2 days. (Disaster Med Public Health Preparedness. 2019;13:144–146)

Motor symptomatology in autism is currently poorly understood, and still not included in the autism spectrum disorder (ASD) diagnostic criteria, although some studies suggest the presence of motor disturbances in this syndrome. We provide here a literature review on early motor symptoms in autism, focusing on studies on psychomotor issues (tone, postural control, manual dexterity, handedness, praxis). The approach adopted in research to study altered motor behaviors is generally global and there is no detailed semiology of the motor or neuromotor disorders observed in people with ASD. This global approach does not enable understanding of the neuro-developmental mechanisms involved in ASD. Identification of clinical neuro-psychomotor profiles in reference to a standard would help to better understand the origin and the nature of the disorders encountered in ASD, and would thus give new directions for treatment.

International audience; The objective of this study was to quantify the possible decrease in school performance at five years of age in preterm children associated with parental separation or divorce, and to test whether this effect varies according to the child's age at the time of the separation. This study included 3,308 infants delivered at < 35 weeks of gestation born between 2003 and 2011 who were enrolled in the population-based LIFT cohort and who had an optimal neurodevelopmental outcome at two years of age. These infants were evaluated by their teachers to assess their abilities and behavior when they had reached five years of age, using the Global School Adaptation (GSA) questionnaire. The mean GSA score was 50.8 points. Parental separations (assessed as parents either living together or living separately) were associated with a decrease in school performance at five years of age, although this was only the case for children who exhibited difficulties at school (3.7 points, p < 0.01). A decrease in school performance only occurred when parental separations took place between 3 and 5 years after the child's birth. Parental separation was associated with a decrease in these children's levels of motivation, autonomy, and manual dexterity. This study indicates that preterm infants of parents who had separated are particularly at risk of a lower scholar performance.

Background: Suicide is the second leading causes of death among 15- to 19-years old.The onset of adverse life events represent important proximal risk factors for suicidal beahviors.The objectives of this study are to determine the patterns. Methods and Findings: This study used a case-control design in which a sample of 136 adolescents who had attempted suicide was contrasted with 658 community controls. The measures included sociodemographic factors; the Adolescent Life Change Event Scale (ALCES), which is a self-administered questionnaire that explores the onset of stressful life events; and the State Worry Questionnaire (SWQ), which measures the level of worries across five distinct domains. According to the results of multiple logistic regressions, adolescents who had attempted suicide reported elevated rates of both stressful life events and worries. Multiple logistic regression analysis showed that adolescents who had attempted suicide were more likely to have experienced three categories of life events were more specifically associated with suicidal attempt: (1) stressful life events related to one’s family characteristics (parental divorce/separation); (2) the disruption of an affective relationship (e.g., a romantic break-up or the death of a close friend); or (3) legal or disciplinary problems (e.g., school disciplinary problems or expulsion). These life events were associated with a definite increase in the total SWQ score, specifically on the SWQ “aimless future” subscale. Conclusions: This data indirectly confirms that a surge in adolescents’s level of worry is one of the mechanism by which a stressful life event could precipitate suicidal behaviors. However, particular attention should be paid to the assessment of suicidality in context of disruptive disorders in adolescents, as the social consequences of these symptoms represent an important risk for suicidal behaviors, and moreover, irrespective of the level of worry.

Background The need for early treatment of autism spectrum disorders (ASD) necessitates early screening. Very few tools have been prospectively tested with infants of less than 12 months of age. The PREAUT grid is based on dyadic assessment through interaction and shared emotion and showed good metrics for predicting ASD in very-high-risk infants with West syndrome. Methods We assessed the ability of the PREAUT grid to predict ASD in low-risk individuals by prospectively following and screening 12,179 infants with the PREAUT grid at four (PREAUT-4) and nine (PREAUT-9) months of age. A sample of 4,835 toddlers completed the Checklist for Autism in Toddlers (CHAT) at 24 months (CHAT-24) of age. Children who were positive at one screening (N = 100) were proposed a clinical assessment (including the Children Autism Rating Scale, a Developmental Quotient, and an ICD-10-based clinical diagnosis if appropriate) in the third year of life. A randomly selected sample of 1,100 individuals who were negative at all screenings was followed by the PMI team from three to five years of age to identify prospective false negative cases. The clinical outcome was available for 45% (N = 45) of positive children and 52.6% (N = 579) of negative children. Results Of the 100 children who screened positive, 45 received a diagnosis at follow-up. Among those receiving a diagnosis, 22 were healthy, 10 were diagnosed with ASD, seven with intellectual disability (ID), and six had another developmental disorder. Thus, 50% of infants positive at one screening subsequently received a neurodevelopmental diagnosis. The PREAUT grid scores were significantly associated with medium and high ASD risk status on the CHAT at 24 months (odds ratio of 12.1 (95%CI: 3.0–36.8), p < 0.001, at four months and 38.1 (95%CI: 3.65–220.3), p < 0.001, at nine months). Sensitivity (Se), specificity, negative predictive values, and positive predictive values (PPVs) for PREAUT at four or nine months, and CHAT at 24 months, were similar [PREAUT-4: Se = 16.0 to 20.6%, PPV = 25.4 to 26.3%; PREAUT-9: Se = 30.5 to 41.2%, PPV = 20.2 to 36.4%; and CHAT-24: Se = 33.9 to 41.5%, PPV = 27.3 to 25.9%]. The repeated use of the screening instruments increased the Se but not PPV estimates [PREAUT and CHAT combined: Se = 67.9 to 77.7%, PPV = 19.0 to 28.0%]. Conclusions The PREAUT grid can contribute to very early detection of ASD and its combination with the CHAT may improve the early diagnosis of ASD and other neurodevelopmental disorders.

Summary Objective Motor disorders are known in autism spectrum disorder (ASD), but muscle tone assessments are rarely performed. Muscle tone underpins movement. We investigated muscle tone in 34 ASD children using a standardized neuro-developmental battery, which uses the French norms for muscular tone in children. Methods Dangling and extensibility were used to examine passive muscle tone in the upper and lower limbs and the body axis. A comparison between muscles of the right and left sides enabled the determination of tonic laterality. Results We found a disharmonious tonic typology, with a tonic component for the muscles of the trunk and the proximal muscles of the lower limbs and a laxity component for the ankles and the proximal and distal muscles of the upper limbs (wrists and shoulders). No establishment of tonic laterality was found in the upper limbs in 61% of ASD children (P Conclusion The disturbed tonic organization influenced by subcortical structures, such as the cerebellum, may partially explain the motor disorders, and indefinite tonic laterality may also be linked to low hemispheric brain dominance described in autism. This preliminary examination is necessary before any gross motor assessments to understand the nature of movement disorders, explore typologies and highlight possible soft neuro-motor signs.

A detailed assessment of laterality in children with Autism Spectrum Disorder (ASD) was realized, including handedness and other measures (muscle tone, manual performance, dominant eye), using a standardized battery for the developmental assessment of neuro-psychomotor functions. The results of the laterality tests relating to cerebral hemisphere organization (spontaneous gestural laterality and tonic laterality) were different in ASD children, and indicate that the cerebral organization could be disrupted. These assessments, added to the observations of usual laterality most often reported in the literature, provide better understanding of the developmental organization from the pathophysiological point of view in children with ASD.

ObjectiveThe objective of this study was to investigate both the effects of low gestational age and infant’s neurodevelopmental outcome at 2 years of age on the risk of parental separation within 7 years of giving birth.DesignProspective.Setting24 maternity clinics in the Pays-de-la-Loire region.ParticipantsThis study included 5732 infants delivered at Outcome measureRisk of parental separation (parents living together or parents living separately).ResultsTen percent (572/5732) of the parents reported having undergone separation during the follow-up period. A mediation analysis showed that low gestational age had no direct effect on the risk of parental separation. Moreover, a non-optimal neurodevelopment at 2 years was associated with an increased risk of parental separation corresponding to a HR=1.49(1.23 to 1.80). Finally, the increased risk of parental separation was aggravated by low socioeconomic conditions.ConclusionsThe effect of low gestational age on the risk of parental separation was mediated by the infant’s neurodevelopment.

Resume Des temoignages de reactions psychotraumatiques datent de 2000 ans avant Jesus-Christ et au cours de l’histoire de nombreuses observations de troubles post-traumatiques ont ete rapportees. Mais l’interet pour ces troubles est bien plus recent. Ce concept, cree pour decrire les troubles dont souffraient des adultes, ne recouvre qu’une partie des aspects des syndromes lies aux traumatismes psychiques chez l’enfant. Les publications scientifiques sur le sujet se sont multipliees ces dernieres annees mais jusqu’a recemment bien moins de travaux concernaient les sujets jeunes. Avant d’aborder les distinctions entre les notions de traumatisme, d’evenements de vie, de stress, voire de risque, nous nous interesserons aux specificites historiques du traumatisme de l’enfant, a sa reconnaissance tardive et aux avancees effectuees. Les specificites de la nature des traumatismes chez l’enfant, celles de la symptomatologie et de leurs evolutions seront aussi abordees. L’impact et les consequences du traumatisme sont differents chez un etre en devenir, les possibilites d’adaptation le sont aussi.

In this paper, we look back at some of the earliest psychoanalytic approaches to trauma. The theoretical feasibility of reconciling psychoanalytic and neurobiological accounts of the effects of severe stress is examined. First, several epistemic considerations about the concepts of falsifiability and complexity in science are discussed with regard to neuroscience and psychoanalysis. We report the decisive discussions and descriptions of shell shock and hysteria that laid the foundation for the modern notions of dissociation and posttraumatic stress disorder (PTSD). We particularly underline the differences between "traumatic memory", which merely and unconsciously repeats the past, and "narrative memory", which narrates the past as past. Then, the construction of the modern concept of PTSD is described and the classification of conversion and dissociative disorders is questioned. In the next section, several recent neurobiological findings in patients with PTSD are reviewed. We place particular emphasis on cognitive impairment and cognitive bias relative to threatening stimuli, and on a general pattern of facilitated and heightened activation of the amygdala for threat-related stimuli, which are both recognized symptoms of PTSD. A possible meeting point between Cannon's and Freud's theoretical concepts is discussed in the frame of a deregulation of the stress system which helps not only to regulate homeostasis but also to adjust behaviour to external threats. We conclude that, although psychoanalysis and neuroscience may reciprocally complement and enlighten each other, their objects and methods, and thence their concepts, are fundamentally different.

International audience; This study examined the relationship between peritraumatic reactions, posttraumatic stress disorder (PTSD) symptoms, somatic complaints, and quality of life in Tunisians exposed to the events of the Arab Spring. Participants (n = 60) completed an online survey 1 year after the events, assessing peritraumatic distress, peritraumatic dissociation, PTSD symptoms, somatic complaints, and physical and mental quality of life. Results showed that peritraumatic dissociation was independently associated with increased PTSD symptoms and somatic complaints 12 months after the events. Multiple mediator mediation analyses revealed that somatic complaints (not PTSD symptoms) were the only independent mediators of the relationships between peritraumatic dissociation and both physical and mental quality of life. Assessing peritraumatic dissociation soon after trauma exposure among the North African population might help identify individuals at risk for PTSD. Furthermore, the impact of trauma on quality of life may be better explained by somatic complaints than PTSD symptoms among North Africans.

Introduction In France, over recent years, the prescription rate of antipsychotic (AP) remained stable in children and adolescents. Prescription of second-generation antipsychotics increased, whereas prescription of first-generation antipsychotics decreased. Off-label prescriptions are very frequent in this population. Adverse events (AEs) in youth treated with AP are common and may be severe. AEs have hitherto been poorly monitored in naturalistic studies independent from industry. Method and analysis We describe a French prospective multicentre study in an AP-naive paediatric population named Etude de la Tolerance des AntiPsychotique chez l9Enfant (ETAPE). The study started in April 2013. So far, 200 patients have been included. The inclusion criteria are: male or female inpatients aged from 6 to 18 years, treated with an AP drug for less than 28 days, never been treated or having received AP for less than 3 months, discontinued at least 6 months prior to inclusion. These assessments of AE are performed at inclusion, as well as at 3, 6, 9 and 12 months after the introduction of the AP. The monitoring period will end in May 2016. Ethics and dissemination The study protocol was approved by the Ethics Committee ‘Sud Mediterrane V’ (number 12.082) and by the French National Agency for Medicines and Health Products Safety (number 2012-004546-15). All patients and their parents signed informed consent on enrolment in the study. We will submit the results of the study to relevant journals and offer national and international presentations. This study will enable better characterisation of the prescription of AP drugs. The results will further help to develop quality standards and recommendations for monitoring AE during the prescription of AP. Trial registration number NCT02007928.

International audience; The aim of this literature review was to examine the evidence for psychotherapeutic and pharmacological treatments in subjects with severely dysregulated mood and to identify potential areas for improvements in research designs. A literature search was conducted using several databases for published (PubMed, PsycINFO) and ongoing (clinical trial registries) studies conducted in youths who met NIMH’s criteria for Severe Mood Dysregulation (SMD) or the DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder (DMDD). Eight completed studies were identified: three randomized trials, four open pilot studies and one case report. Seven ongoing studies were found in trial registries. The available evidence suggests potential efficacy of psychotherapies which have previously been developed for internalizing and externalizing disorders. The two main pharmacological strategies tested are, first, a monotherapy of psychostimulant or atypical antipsychotic such as risperidone, already used in the treatment of severe irritability in youths with developmental disorders; and second, the use of a serotonergic antidepressant as an add-on therapy in youths treated with psychostimulant. Ongoing studies will further clarify the effectiveness of psychotherapeutic interventions for DMDD individuals and whether they should be given alone or in conjunction with other treatments. The short duration of the trials for a chronic disorder, the low number of studies, the lack of placebo or active comparator arm, and restrictive inclusion criteria in most of the controlled trials dramatically limit the interpretation of the results. Finally, future research should be conducted across multiple sites, with standardized procedures to measure DMDD symptoms reduction, and include a run-in period to limit placebo effect.

International audience; Children with epilepsy and their parents face many social and psychological difficulties that remain insufficiently studied in sub-Saharan Africa. The aim here was to assess the quality of life of children with epilepsy and their parents. A community-based cross-sectional survey was conducted in two urban areas and four rural areas of Gabon. Children were screened through key informants, medical sources, and a door-to-door survey. They were clinically selected based on their medical history and a clinical exam conducted by the investigating physician. Electroencephalography had not been carried out because of a lack of material and financial resources. The quality of life of children and their parents was assessed by a structured interview of parents using a questionnaire. Of 317 suspected cases on screening, 83 children with epilepsy were identified. Their mean age was 11.9±4.4years. Twelve percent of the children had neurosensory abnormalities on clinical exam. Sixty-three percent of them attended school; factors associated with schooling were higher score on the sociability subscale, specialized medical advice, and antiepileptic drug treatment. Sociability difficulties, anxiety, cognitive impairment, and behavioral disorders were suspected in 39.8%, 45.8%, 49.4%, and 42.2% of children, respectively. A total of 48.2% of parents expressed a poor quality of life related to their children's illness. A higher score on the cognition subscale, urban residence, specialized medical advice, and a stable income in the household were predictive of poor parental quality of life. Epilepsy influences many aspects of a child's life and the life of the child's parents. Care should incorporate a cognitive assessment of the child and emphasize information for patients and their relatives.

International audience; In mammals, the circadian clocks network (central and peripheral oscillators) controls circadian rhythms and orchestrates the expression of a range of downstream genes, allowing the organism to anticipate and adapt to environmental changes. Beyond their role in circadian rhythms, several studies have highlighted that circadian clock genes may have a more widespread physiological effect on cognition, mood, and reward-related behaviors. Furthermore, single nucleotide polymorphisms in core circadian clock genes have been associated with psychiatric disorders (such as autism spectrum disorder, schizophrenia, anxiety disorders, major depressive disorder, bipolar disorder, and attention deficit hyperactivity disorder). However, the underlying mechanisms of these associations remain to be ascertained and the cause–effect relationships are not clearly established. The objective of this article is to clarify the role of clock genes and altered sleep–wake rhythms in the development of psychiatric disorders (sleep problems are often observed at early onset of psychiatric disorders). First, the molecular mechanisms of circadian rhythms are described. Then, the relationships between disrupted circadian rhythms, including sleep–wake rhythms, and psychiatric disorders are discussed. Further research may open interesting perspectives with promising avenues for early detection and therapeutic intervention in psychiatric disorders.

BACKGROUND: Although the reliable and valid Child Post-Traumatic Stress Reaction Index (CPTS-RI) is a widely used measure of posttraumatic stress disorder (PTSD) symptoms in children, it has not been validated in French-speaking populations. The present study aims to assess the psychometric properties of the CPTS-RI in three samples of French-speaking school-children. METHODS: Data was obtained from three samples. Sample 1 was composed of 106 children (mean (SD) age = 11.7(0.7), 50% females) victims of an industrial disaster. Sample 2 was composed of 50 children (mean (SD) age = 10.8(2.6), 44% females) who had received an orthopaedic surgical procedure after an accident. Sample 3 was composed of 106 children (mean (SD) age = 11.7(2.2), 44% females) admitted to an emergency department after a road traffic accident. We tested internal consistency using Cronbach's alpha. We examined test-retest reliability using intraclass correlation coefficient. In order to assess the convergent validity of the French version of the CPTS-RI and the Clinician Administered PTS Scale-Child and Adolescent (CAPS-CA), spearman-correlation coefficient was computed. To verify the validity of the cut-off scores, a ROC curve was constructed which evaluated the sensitivity and specificity of each score compared to the diagnosis with the CAPS-CA. We also used principal components analysis with varimax rotation to study the structure of the French version of the CPTS-RI. RESULTS: Cronbach's alpha coefficient was 0.87 for the French version of the CPTS-RI. Two-week test-retest intraclass correlation coefficient (n = 30) was 0.67. The French version of the CPTS-RI was well correlated with the CAPS-CA (r = 0.76, p < 0.001). Taking the CAPS-CA as the diagnostic reference, with a diagnostic cut-off of >24 for the CPTS-RI, the sensitivity and specificities were 100% and 62.6%, respectively. The French version of the CPTS-RI demonstrated a three-factor structure. CONCLUSIONS: The CPTS-RI is reliable and valid in French-speaking children.

Introduction Le tonus musculaire est a la base du mouvement et son role dans le controle postural est essentiel. Pourtant, le tonus musculaire est rarement etudie dans les troubles du spectre de l’autisme (TSA), malgre la description de nombreux troubles moteurs dans cette pathologie. Materiel et methodes Nous avons etudie le tonus musculaire et la motricite chez 34 enfants avec TSA en utilisant une batterie neuro-developpementale standardisee basee sur des normes francaises chez l’enfant (NP-MOT). Le ballant et l’extensibilite ont ete utilises pour etudier le tonus de fond (passif) au niveau des membres superieurs et inferieurs et de l’axe corporel. La comparaison de la resistance entre les deux hemicorps a permis la determination d’un hemicorps dominant et l’identification d’une lateralite neuromusculaire (tonique). Resultats Nous avons trouve une typologie tonique dysharmonique, avec une hypertonie au niveau des muscles du tronc et des muscles proximaux des membres inferieurs, ainsi qu’une plus grande laxite pour les muscles distaux des membres inferieurs (chevilles) et pour les muscles proximaux et distaux des membres superieurs (poignets et epaules). L’absence de dominance tonique d’un hemicorps sur l’autre a ete constatee de facon significative en comparaison aux normes de la batterie NP-MOT ( p Discussion–conclusion Cette dysregulation tonique phenotypique pourrait expliquer certains des troubles moteurs decrit dans les TSA, notamment les troubles du controle et de l’adaptation de la posture et de l’anticipation. L’examen du tonus musculaire apparait etre un examen preliminaire indispensable, avant toute evaluation de la motricite globale afin de comprendre la nature des troubles moteurs en jeu, dont la presence de signes neurologiques mineurs pouvant coexister.

BackgroundAlthough the reliable and valid Peritraumatic Distress Inventory (PDI–C) and Peritraumatic Dissociative Experiences Questionnaire (PDEQ) are useful for identifying adults at risk of developing acute and chronic posttraumatic stress disorder (PTSD), they have not been validated in school-aged children and their predictive values remain unknown in this population. This study aims to assess the psychometric properties of the children versions of these two measures (PDI-C and PDEQ-C) in a sample of French-speaking school-children.MethodsOne-hundred and thirty-three consecutive victims of road traffic accidents, aged 8–15 years, were recruited into this longitudinal study via the emergency room. The peritraumatic reactions were assessed at baseline and PTSD symptoms were assessed 1 month later.ResultsCronbach's alpha coefficients were 0.8 and 0.77 for the PDI-C and PDEQ-C, respectively. The 1-month test-retest correlation coefficient (n = 33) was 0.77 for both measures. The PDI-C demonstrated a two-factor structure while the PDEQ-C displayed a one-factor structure. As with adults, the two measures were intercorrelated (r = 0.52) and correlated with subsequent PTSD symptoms and diagnosis (r = 0.21–0.56; P < 0.05).ConclusionsThe children versions of the PDI and PDEQ are reliable and valid in children.

Adolescents (12-18 years old) and young adults (18-25 years old), are more likely than older adults to drive-or agree to be driven-recklessly or while intoxicated, to use illicit or dangerous substances and to engage in both minor and more serious antisocial behaviour. Numerous factors during adolescence may lead to or favour initiation of drug use, such as sensation-seeking, gregariousness and social conformity. These aspects, however, cannot be dissociated from the increased sex drive and quest for an integrated self. In the separation-individuation process, relationships with peers play many different roles: a field for experimentation, emotional support, a place for "projection" and "identification", and the possibility of finding a partner. Unsurprisingly, therefore, drug use generally takes place in a group setting. Despite evidence of heightened real-world risk-taking, laboratory studies have yet to yield consistent evidence that adolescents, when on their own, are more inclined towards risky behaviour than their elders. Moreover, their comprehension and reasoning abilities in risky decision-making situations are roughly equivalent to those of adults. Structural and functional neuroimaging studies have shown that neural circuitry undergoes major reorganization during adolescence, particularly in those regions of the brain relating to executive functions, the self and social cognition, and that the "emotional brain" may play a role in that reorganization. Age-related decreases in gray matter volume mainly reflect a reduction in the number of synapses and the complexity of axonal ramifications. By 18-20 years old, most of the subcortical white matter and association pathways have reached a plateau. Risk-taking behavior and novelty-seeking may provide, with an appropriate feed back, a mechanism to optimize brain development in adolescence.

Background: Motor vehicle accidents (MVAs) are the main cause of Posttraumatic stress disorder (PTSD) in industrialized countries. This includes the frequently occurring but understudied situation of parents learning that their children were injured. However, unlike in other types of trauma survivors, little is known about the predictors of PTSD symptoms in mothers whose child has suffered an MVA. Methods: A group of 72 mothers and 28 fathers were prospectively assessed for peritraumatic distress, peritraumatic dissociation, and PTSD symptoms 1 and 5 weeks after their child had suffered an MVA. Results: Levels of peritraumatic distress and dissociation were comparable to other trauma victims, 18% of the mothers were considered to be suffering from probable PTSD. In mothers, significant positive correlations were found between PTSD symptoms and peritraumatic distress (r=.34) and dissociation (r=.37), whereas mothers' PTSD symptoms were associated with decreased peritraumatic dissociation in fathers (r=-.37). Even after controlling for covictim/witness status, peritraumatic distress was a predictor of mothers' PTSD symptoms, explaining 14% of the variance. Conclusions: Peritraumatic response and PTSD symptoms should be routinely assessed among parents whose child has experienced a traumatic event. Depression and Anxiety 0:1-6, 2009. (c) 2009 Wiley-Liss, Inc. Language: en

Introduction Des troubles moteurs ont ete decrits dans les Troubles du spectre autistiques (TSA), toutefois tous les enfants atteints de TSA ne montrent pas de diminution des performances motrices. La nature et l’origine des perturbations motrices dans les TSA ne sont pas claires. L’objectif de cette etude est mettre en evidence la semiologie des troubles moteurs aupres d’enfants avec TSA, a l’aide d’une batterie standardisee francaise d’evaluation developpementale des fonctions neuro-psychomotrices de l’enfant (NP-MOT). Materiel et methodes Trente-quatre enfants (4–11 ans) presentant un TSA selon les criteres du DSM-4-TR ont ete inclus, quel que soit leur niveau d’efficience. Les evaluations de premieres instances (ADI ; WISC-IV ou KABC-II/figure de Rey/tour de Londres ; NEEL ; M-ABC/EMG/perceptions visuelles) ont ete completees par la batterie standardisee NP-MOT. Resultats Les enfants sans deficience intellectuelle presentent de meilleurs resultats aux batteries M-ABC (maitrise de balle) et NP-MOT. Soixante quinze pourcent des enfants avec TSA remplissent les criteres d’un Trouble de l’acquisition de la coordination (TAC) a la batterie M-ABC. Comme pour la batterie M-ABC, l’equilibre statique et l’equilibre dynamique est deficitaire (64 % et 52 %) a la batterie NP-MOT, ainsi que les coordinations generales (58 %). Les praxies bi-manuelles sont echouees pour 64 %, les gnosopraxies manuelles et digitales egalement (63 % et 60 %, respectivement). Discussion–conclusion Un deficit de planification motrice et de programmation sont mis en evidence au NP-MOT, aux praxies manuelles et digitales, s’inscrivant dans le cadre d’un TAC (dyspraxie). Mais les echecs en motricite globale (M-ABC), aux praxies bi-manuelles et un deficit tonico-postural (NP-MOT) suggerent un dysfonctionnement plus global de la coordination dans le TSA.

Introduction Il existe peu de donnees sur la lateralite dans la litterature sur les Troubles du spectre autistique (TSA) et les resultats des etudes restent difficilement interpretables du fait de methodologies diverses, basees sur l’observation, sur des questionnaires ou sur une definition non consensuelle de la dominance manuelle. L’objectif de cette etude est de faire une evaluation fine et complete de la lateralite a partir d’une batterie standardisee francaise d’evaluation developpementale des fonctions neuro-psychomotrices de l’enfant (NP-MOT). Materiel et methodes Trente-quatre enfants (4–11 ans) presentant un TSA selon les criteres du DSM-4-TR ont ete inclus et examines au niveau de leur lateralite selon quatre axes : – la lateralite tonique des membres superieurs et inferieurs a partir de l’examen passif du tonus ; – la lateralite gestuelle spontanee ; – psychosociale au niveau des membres superieurs ; – la lateralite fonctionnelle manuelle, pedestre et oculaire. Nous avons egalement determine un indice de dominance manuelle a partir d’une epreuve de performance manuelle. Les enfants ont ete compare a une norme de reference, quel que soit leur niveau d’efficience. Resultats Le taux de gauchers est plus important (p Discussion–conclusion Les lateralites gestuelle spontanee, tonique et visuelle ne sont pas mises en place chez les enfants avec TSA, suggerant une organisation cerebrale hemispherique differente.

Un nombre important d’enfants qui consultent en pedopsychiatrie presente une clinique avec des histoires traumatiques qui ont empeche la constitution d’une aire transitionnelle permettant la creation d’un espace psychique differenciant reel et imaginaire et la possibilite de creer un espace pour la pensee. Si la resilience permet a un certain nombre d’enfants de construire leur personnalite dans ces situations, pour beaucoup l’accrochage au perceptif, la non-liaison par les representations empechent la mise en œuvre d’un processus de representance dans lequel une representation et le refoulement de celle-ci peuvent se constituer. Le traumatisme est, des l’origine, au cœur de la theorie psychanalytique, importante au sein de l’œuvre de Freud, elle est toujours articulee avec l’excitation. Comment aider ces enfants a devenir resiliant et a surmonter le traumatisme ? La psychotherapie et la mise en mot sont souvent inoperants. Le travail de groupe psychanalytique permet cette mise en representation en passant par le travail emotionnel, par la mise en jeu corporelle et motrice, puis par la figurabilite, par la representation et parfois, mais exceptionnellement par la mise en parole. Ce type de traitement qui est directement inspire par la psychanalyse nous parait etre une reponse tres importante a la clinique d’aujourd’hui ou le traumatisme dans toutes ses acceptions joue un role preponderant.