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Atypical anorexia nervosa (AAN) has historically been underrecognized by clinicians due to traditional markers of low weight as indicative of malnutrition. Inadequate case identification can lead to treatment delays while placing children and adolescents with AAN at further risk of medical and psychiatric sequalae. The accompanying article in this journal issue examines the challenges of determining weight-based treatment goals for this population. In this commentary, we elaborate on this discussion and question the validity of weight stabilization as a treatment target in child and adolescent AAN. Furthermore, we address: (1) the role of weight and historical, variable, and stable growth curves in shaping treatment goals; (2) future growth targets, including numeric and remission targets; and; (3) the impact of weight stigma and implicit weight bias in clinical decision-making. We argue that target weights must take a secondary role in the treatment of AAN, shifting the focus to the mental, behavioural, and nutritional aspects of this disorder. In addition, we recommend that clinicians acknowledge and mitigate fears around weight gain and weight-based social rejection for young people and families in treatment. [ABSTRACT FROM AUTHOR]

Cette revue de la littérature cherche à explorer le psychotraumatisme chez l'enfant et l'adolescent en tant que facteur de risque d'émergence de troubles psychotiques. Une revue de la littérature sur les bases PubMed et Google Scholar sélectionnant les études postérieures à 1994 utilisant les critères du DSM-IV ou DSM-5 retient 33 études de fort niveau de preuve, principalement des études prospectives et des méta-analyses d'études rétrospectives. Les événements traumatiques vécus dans l'enfance apparaissent comme un facteur de risque de développer des troubles psychotiques avec un risque multiplié par 2 ou 3 par rapport à la population n'ayant pas vécu d'évènement traumatique. De surcroît, l'accumulation des évènements traumatiques majore ce risque qui peut être multiplié par 4 au-delà de 3 traumatismes. Par ailleurs, chez les patients cumulant vécu traumatique et symptômes psychotiques, ces derniers sont plus sévères et plus résistants. Finalement, plusieurs dimensions de la symptomatologie psychotraumatique se révèlent être de robustes facteurs médiateurs entre le trauma et troubles psychotiques. Le repérage des antécédents traumatiques, la prise en charge précoce des enfants ayant vécus des événements traumatiques chroniques et répétés, ainsi que la prévention de la revictimation par la construction d'institutions sensibles au trauma, apparaissent comme des actions de prévention des troubles psychotiques. This literature review aims to explore childhood and adolescent trauma as a risk factor for the emergence of psychotic disorders. This literature review is based on PubMed and Google Scholar with studies selected after 1994 in order to use DSM-IV or DSM-5 criteria for Post-Traumatic Stress Disorder (PTSD). A total of 33 studies with a robust level of evidence were included in the current research, mainly prospective studies and meta-analyses of retrospective studies. Traumatic events in childhood and adolescent years were a risk factor for developing psychotic disorders with a 2-to-3-fold increase in risk compared to individuals without any trauma history. In addition, the accumulation of traumatic events increased this risk to more than 4-fold after 3 traumatic events. Furthermore, in patients with psychosis symptoms and a history of traumatic events, symptoms were more severe and more resistant. Finally, multiple dimensions of post traumatic symptoms appeared to mediate the relation between trauma and psychotic emergence. Spotting traumatic events in life, taking care of chronic and repetitive trauma as soon as possible and preventing revictimization by building trauma sensitive institutions appear to be a way of preventing psychosis outcomes. [ABSTRACT FROM AUTHOR]

Pour préserver la santé des jeunes de la classe d'âge 5–17 ans, l'Organisation mondiale de la santé recommande des niveaux d'activité physique consistant à cumuler au moins 60 minutes par jour d'activité physique d'intensité modérée à soutenue. En France, les jeunes forment le groupe d'âge le plus actif et sont globalement en bonne santé, mais leur niveau d'activité physique et/ou sportive est insuffisant et baisse de génération en génération. L'éducation physique et sportive et les pratiques sportives de loisirs ne suffisent pas à compenser la baisse de l'activité physique dans la vie quotidienne. Les analyses démontrent que l'inactivité est un fort contributeur de la surcharge pondérale et d'obésité, facteurs qui eux sont délétères pour la santé. De plus, il est reconnu que le niveau d'activité physique dans l'enfance/adolescence conditionne le niveau d'activité à l'âge adulte. Les filles et les garçons ont les mêmes aptitudes physiques avant la puberté. Leur potentiel en endurance aérobie étant très élevé, il n'y a pas lieu de les brider par crainte de fatigue ou d'épuisement au cours d'efforts inférieurs à 10 à 15 minutes. En revanche, leur potentiel de force reste modeste, et le potentiel de résistance est faible. L'enfant est « prêt » à la compétition sportive lorsqu'il recherche de lui-même à comparer ses habiletés à celles de ses pairs. Pour les sports d'équipe, l'enfant doit de plus comprendre ce qui est sous-jacent au processus compétitif : stratégie et coopération au sein du groupe. Cela n'advient généralement qu'entre 10 et 12 ans. Blessures de surutilisation, syndrome de surentraînement, voire burn out sont possibles chez le jeune sportif. Les séquelles de ces troubles pouvant être importantes sur la croissance osseuse et le développement psychologique du jeune, il convient d'être vigilant et réactif dès l'apparition des prodromes. [ABSTRACT FROM AUTHOR]

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Objectifs : Mesurer l’ampleur des manifestations buccales chez les enfants et adolescents VIH positif fréquentant le milieu hospitalier de Kinshasa et en identifier les facteurs associés. Méthodes : Il s’est agi d’une étude transversale analytique, conduite dans deux hôpitaux pédiatriques de Kinshasa (RDC), du 01 mai 2017 au 15 janvier 2018, chez des enfants et adolescents VIH positif âgés de 0 à 19 ans. Les manifestations buccales ont été diagnostiquées selon les critères cliniques de Ramos-Gomez et al. La régression logistique, en analyse univariée et multivariée, exprimée en Odds ratio (OR) avec leur intervalle de confiance estimée à 95%, a été exploitée pour rechercher les facteurs associés aux manifestations buccales.Résultats : Quatre cent vingt-deux patients étaient inscrits (219 filles et 203 garçons), l’âge médian était de 13 ans (IIQ : 10 ans–16 ans) ; 402 patients (95,3%) recevaient les ARV ; 359 patients (85,1%) présentaient une ou plusieurs manifestations buccales. La carie dentaire était présente chez 161 patients (38,9%). Le sexe féminin (ORa : 2,478 ; IC à 95 % [1,30 – 4,69]) ; p = 0,005) et l’hygiène buccale modérée et mauvaise (ORa : 4,54 ; IC à 95% [1,74 – 11,835] ; p = 0,006) étaient les facteurs associés aux manifestations buccales.Conclusion : Les manifestations buccales chez les enfants et adolescents VIH positif sont encore très fréquentes dans notre milieu, à l’ère de la thérapie antirétrovirale. Cette situation indique la nécessité d’inclure la santé buccodentaire dans la prise en charge des enfants et adolescents VIH positif.

L'hallucination acoustico-verbale (HAV) présente un taux de prévalence de 12 % chez les enfants et les adolescents. Elle est considérée comme un phénomène développemental transitoire et bénin. Sa persistance à l'adolescence peut être associée à des diagnostics psychiatriques plus sévères. Le trouble de stress post traumatique (TSPT) est défini par des souvenirs traumatiques intrusifs répétitifs associés à des symptômes de reviviscences sensorielles (flashbacks). Bien que l'hallucination ne soit pas décrite comme un symptôme du TSPT, la littérature rapporte un risque de développer des HAV plus important chez les personnes présentant un TSPT. La clinique des hallucinations associées à un TSPT est un sujet d'étude. Nous proposons d'étudier les mécanismes en jeu dans le développement et l'évolution des HAV dans le cadre d'un TSPT en population pédiatrique. Quatre cas cliniques sont présentés afin d'illustrer ce sujet à partir d'enfants et d'adolescents présentant un diagnostic de TSPT (DSM 5) associé à des HAV sans trouble du spectre de la schizophrénie (DSM 5) associé. Les HAV présentées par nos patients peuvent être associées à des reviviscences traumatiques mais aussi à d'autres types d'hallucinations plus élaborées. Elles représentent plusieurs voix malveillantes au contenu négatif. Des liens thématiques et émotionnels peuvent être établis entre ces hallucinations et les traumatismes en question. Ils permettraient de comprendre l'hallucination comme une « ré-expérience » indirecte du traumatisme. Nous proposons un modèle de continuum de symptômes entre la reviviscence sensorielle et l'hallucination dont le risque futur est la constitution progressive vers un trouble psychotique. Le repérage de l'hallucination dans la population pédiatrique est un enjeu majeur pour le clinicien. L'hallucination est une expérience considérée à tort comme appartenant au trouble du spectre de la schizophrénie et ne suffit pas à retenir ce diagnostic. Auditory-verbal hallucination (AVH) has a prevalence rate of 12 % in children and adolescents. It is considered to be a transient and benign developmental phenomenon. Its persistence into adolescence may be associated with more severe psychiatric diagnoses. Post-traumatic stress disorder (PTSD) is defined by repetitive intrusive traumatic memories associated with symptoms of sensory reliving (flashbacks). Although hallucination is not described as a symptom of PTSD, the literature reports a greater risk of developing AVH in individuals with PTSD. The clinical aspect of hallucinations associated with PTSD is a topic of study. We propose to study the mechanisms involved in the development and evolution of AVH in the context of PTSD in a pediatric population. Four clinical cases are presented to illustrate this topic from children and adolescents with a diagnosis of PTSP (DSM 5) associated with AVH without associated schizophrenia spectrum disorder (DSM 5). The AVH presented by our patients can be associated with traumatic reliving but also with other types of more elaborate hallucinations. They represent several malevolent voices with negative content. Thematic and emotional links can be established between these hallucinations and the traumas in question. They allow us to understand the hallucination as an indirect "re-experience" of the trauma. We propose a model of a continuum of symptoms between sensory re-experiencing and hallucination whose future risk is the progressive constitution towards a psychotic disorder. The identification of the hallucination in the pediatric population is a major challenge for the clinician. Hallucination is an experience wrongly considered as belonging to the schizophrenia spectrum disorder and is not sufficient to retain this diagnosis. [ABSTRACT FROM AUTHOR]

Sexual violence against children and adolescents is a public health problem that constitutes a serious violation of human rights, and that can lead to a series of short, medium, and long-term consequences on the victim's cognitive, emotional and physical spheres. Furthermore, children and adolescents with disabilities are at greater risk of suffering interpersonal violence than the general population, including sexual violence. We can understand, therefore, that psychological treatment can be important to promote resilience in this population and to assist in coping mechanisms. The purpose of this narrative review is to discuss what are the main scientific evidence related to psychological treatment to promote resilience in children and adolescents with disabilities who have suffered sexual violence. As main results, it was found that most treatment protocols for children and adolescents victims of sexual violence exclude people with disabilities from their sample, and, because of that, studies that are focused on this specific population are scarce in the literature. Given this scenario, the importance of developing empirical studies that provide scientific evidence and treatment guidelines for children and adolescents with disabilities who are victims of sexual violence is emphasized, as well as the investment in improving the skills of professionals in this area. [ABSTRACT FROM AUTHOR]

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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. Exposure to a traumatic event is frequent in children and adolescents with the prevalence of Posttraumatic Stress Disorder (PTSD) probably being underestimated in this age group. PTSD is associated with distress and interference that can range from minor disruptions in the child's or adolescent's life, to severe and debilitating consequences impacting their development. Reactions to trauma exposure are defined according to their timeframe : peri-traumatic reactions (lasting minutes to hours), Acute Stress Disorder (ASD; between two days and one month) and PTSD (when symptoms persist more than one month). While a variety of symptoms are described in children and adolescents in response to trauma exposure and constitute the spectrum of reactions to trauma, PTSD is characterized by the association of three core symptoms: 1) re-experiencing the traumatic event in the form of vivid intrusive memories, flashbacks, or nightmares; 2) avoidance of thoughts and memories of the event; 3) persistent perceptions of heightened current threat, for example associated to hypervigilance or enhanced reactivity and exaggerated startle response. In the DSM-5, ASD and PTSD are distinct from anxiety disorders and obsessive-compulsive disorders, and included in a distinct category are Trauma and Stressor-Related Disorders. More recently, the ICD-11 adopted Complex PTSD as a new diagnostic category, which requires meeting the ICD-1 PTSD symptoms and three clusters that represent disturbances in self-organization (affect dysregulation, negative self-concept and disturbances in relationships), bridging the gap between trauma-related disorders and other complex developmental disorders including borderline personality disorder. Emerging evidence suggests that Individual Psychological Debriefing within the first three months of a traumatic event may increase the risk for PTSD in children and adolescents, and caution is warranted. Among the many existing interventions and programs for PTSD, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), a time-limited therapy that combines exposure, cognitive processive remodeling and enhancement of coping skills, is the most empirically validated for PTSD. Eye Movement Desensitization and Reprocessing (EMDR), an integrative psychotherapy based on bilateral brain stimulation through side-to-side eye movements or hand tapping, has also recently been found to be effective in children and adolescents. Although significant advances have recently been made, more research focusing on the understanding of the underlying mechanism and the risk factors of trauma and stressor-related disorders in children and adolescents as well as the implementation of evidence-based and accessible interventions is definitely warranted. [ABSTRACT FROM AUTHOR]

Introduction: Suicide represents a significant public health issue among children and adolescents. However, in this population, while the literature seems to support a link between suicidal risk and neurodevelopmental disorders, there are still few studies on the subject. The psychopathological description of children who have realized a suicide attempt with a high potential for lethality, which can be defined as "serious", appears to resemble that of children who have died by suicide. This study aimed to characterize the dimensional aspects of the neurodevelopmental profile of a population of children and adolescents hospitalized at Necker-Enfants-Malades Hospital for a serious suicide attempt., Methods: This is an observational, prospective, and single-center study. Questionnaires for collecting general information and dimensional scales of neurodevelopment (Autism-Tics, ADHD, and Other Comorbidities Inventory, Social Responsiveness Scale, and Conners-3 for parents) were used. This study included 21 patients aged 9 to 15 years at the time of their hospitalization., Results: The results supported the presence of at least one neurodevelopmental disorder (autistic traits, attention-deficit/hyperactivity disorder, learning disorder, or motor disorder) in 70% (n=14) of the subjects, and at least one behavioral disorder (oppositional defiant disorder, conduct disorder) in 65% (n=13) of these subjects., Conclusion: The observed frequency of traits indicative of neurodevelopmental disorders in our population was higher than that observed in the general population, without the presented symptoms being eligible for categorical diagnosis. Considering the dimensional aspects of neurodevelopmental symptoms would therefore enable better identification of children at suicidal risk and more tailored interventions to contribute to the prevention of suicide in children., (Copyright © 2024 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

In 2004, the European and American authorities released a black-box warning on antidepressants indicating an association with an increased risk of suicidality (suicidal ideation and behavior) in young people. Until today, this issue remained controversial. The present review gives an overview on the relationship between antidepressant therapy and the risk of suicide and suicidality, respectively: there is no evidence of an increased risk of suicide, but of an increased rate of suicidality during the first period after starting an antidepressant treatment in young patients. Importantly, this risk was not higher than before treatment initiation. However, an intensified supervision is needed especially during the first weeks of treatment. Finally, the risk posed by untreated depression is far greater than a risk associated with antidepressant treatment. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Leisure/Loisir: Journal of the Canadian Association for Leisure Studies is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sante Mentale au Quebec is the property of Revue Sante Mentale au Quebec and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The purpose of this qualitative study was to explore the experiences of youth with Tourette Syndrome (TS). Method: Thirteen participants with TS were recruited from a large tertiary care hospital to complete semi-structured interviews and two questionnaires pertaining to demographic information and tic severity. Thematic analysis was utilized to systematically analyze the data. Results: Three main themes were identified: 1) beliefs about TS; 2) TS related distress and impairment; and, 3) coping with TS. Conclusion: The findings from this study suggest that most participants were aware of their tics but unaware of the cause of tics/TS. The interviews also highlighted that, for most participants, TS caused emotional, social, physical, and/or occupational impairment. Despite their distress, participants provided several suggestions for coping with TS and for supporting those who are diagnosed with this condition. [ABSTRACT FROM AUTHOR]

Objective: This study presents a comprehensive report of children and adolescents who engaged in self-harm during their admission to a psychiatric inpatient unit. Method: A chart review was conducted on all admissions to an acute care psychiatric inpatient unit in a Canadian children's hospital over a one-year period. Details on patients with self-harm behaviour during the admission were recorded, including: demographics, presentation to hospital, self-harm behaviour and outcome. Baseline variables for patients with and without self-harm behaviour during admission were compared. Results: Self-harm incidents were reported in 60 of 501 (12%) admissions during the one-year period of the study. Fourteen percent of patients (50 of 351) accounted for total number of 136 self-harm incidents. Half of these incidents (49%) occurred outside of the hospital setting, when patients were on passes. Using the Beck Lethality Scale (0-10), mean severity of the self-injury attempts was 0.33, and there were no serious negative outcomes. Conclusion: Self-harm behaviour during inpatient psychiatric admission is a common issue among youth, despite safety strategies in place. While self-harm behaviour is one of the most common reasons for admission to psychiatric inpatient unit, our understanding of nature of these acts during the admission and contributing factors are limited. Further research is required to better understand these factors, and to develop strategies to better support these patients. [ABSTRACT FROM AUTHOR]

Résumé Pour préserver la santé des jeunes de la classe d’âge 5–17 ans, l’Organisation mondiale de la santé recommande des niveaux d’activité physique consistant à accumuler au moins 60 minutes par jour d’activité physique d’intensité modérée à soutenue. En France, les jeunes forment le groupe d’âge le plus actif et sont globalement en bonne santé, mais leur niveau d’activité physique et/ou sportive demeure insuffisant et baisse de génération en génération. L’éducation physique et sportive et les pratiques sportives de loisirs ne suffisent pas à compenser la baisse de l’activité physique dans la vie quotidienne. La relation « dose–réponse » entre le niveau d’activité physique et l’impact sur la santé n’est pas aussi clairement établie chez les jeunes que chez les adultes. Les analyses démontrent que l’inactivité est un fort contributeur de la surcharge pondérale et d’obésité, facteurs qui eux sont délétères sur la santé. Les filles et les garçons ont les mêmes aptitudes physiques avant la puberté. Leur potentiel en endurance aérobie étant très élevé, il n’y a pas lieu de les brider par crainte de fatigue ou d’épuisement au cours d’efforts inférieurs à 10 à 15 minutes. En revanche, leur potentiel de force reste modeste, et le potentiel de résistance est faible. L’enfant est « prêt » à la compétition sportive lorsqu’il recherche de lui-même à comparer ses habiletés à celles de ses pairs. Pour les sports d’équipe, l’enfant doit de plus comprendre ce qui est sous-jacent au processus compétitif : stratégie et coopération au sein du groupe. Cela n’advient généralement qu’entre 10 et 12 ans. Blessures de surutilisation, syndrome de surentraînement, voire burnout sont possibles chez le jeune sportif. Les séquelles de ces troubles pouvant être importantes sur la croissance osseuse et le développement psychologique du jeune. Il convient d’être vigilant et réactif dès l’apparition des prodromes. [ABSTRACT FROM AUTHOR]

Objective: Traumatic brain injury (TBI) is the most common cause of death and disability in children and adolescents. Psychopathology is an established risk factor for, and a frequent consequence of, TBI. This paper reviews the literature relating psychopathology and TBI. Method: Selective literature review. Results: The risk of sustaining a TBI is increased by pre-existing psychopathology (particularly ADHD and aggression) and psychosocial adversity. Even among individuals with no psychopathology prior to the injury, TBI is frequently followed by mental illness especially ADHD, personality change, conduct disorder and, less frequently, by post-traumatic stress and anxiety disorders. The outcome of TBI can be partially predicted by pre-injury adjustment and injury severity, but less well by age at injury. Few individuals receive treatment for mental illness following TBI. Conclusion: TBI has substantial relevance to mental health professionals and their clinical practice. Available evidence, while limited, indicates that the risk for TBI in children and adolescents is increased in the presence of several, potentially treatable mental health conditions and that the outcome of TBI involves a range of mental health problems, many of which are treatable. Prevention and management efforts targeting psychiatric risks and outcomes are an urgent priority. Child and adolescent mental health professionals can play a critical role in the prevention and treatment of TBI through advocacy, education, policy development and clinical practice. [ABSTRACT FROM AUTHOR]

Résumé La maladie chronique est définie par sa durée, qui est supérieure à un an. Elle requiert des soins spécialisés. Elle impose des limites fonctionnelles et affecte les différentes sphères de la vie : familiales, sociales, scolaires et les activités qui leur sont reliées. Dix à 20 % des enfants et des adolescents vivent avec une maladie chronique et ils ressentent plus de stress, d’anxiété et de symptômes de dépression que leurs pairs (8 %) en bonne santé. Ces jeunes sont aussi souvent marginalisés parce qu’ils sont différents de leurs pairs. Afin de diminuer le stress vécu des ateliers d’écriture sont créés. En France, l’écriture est employée dans différents milieux, notamment en psychiatrie auprès d’adultes et d’adolescents. Des études empiriques avec groupes contrôles, aux États-Unis, ont montré que l’écriture, dite expressive (écriture au « je » par laquelle une personne exprime un vécu intense et les émotions ressenties lors de cet événement) pouvait avoir un impact positif sur les symptômes psychiques et physiologiques. Elle a été comparée à l’écriture « neutre » et à l’absence d’écriture. La majorité des études ont eu lieu en milieu adulte, mais il en existe, cependant, quelques-unes concernant les jeunes. Dans cet article nous proposons d’examiner brièvement, d’abord, les études en milieu adulte pour mieux comprendre le processus d’écriture et son impact sur la santé. Par la suite, nous nous attarderons aux quelques études en milieu pédiatrique et scolaire où elle a été utilisée pour amener les jeunes à exprimer leurs émotions et leur vécu et nous examinerons les stratégies utilisées pour inciter les jeunes à exprimer leur vécu. L’emploi de l’écriture « expressive » en pédiatrie, auprès des adolescents atteints d’une maladie chronique, amènerait une diminution des symptômes physiologiques et psychologiques. Elle aurait aussi un impact sur la cognition en amenant une meilleure exploitation des ressources personnelles pour s’adapter à la situation, car le fait d’écrire contribuerait à donner un sens aux événements vécus. Elle favoriserait également l’introspection et pourrait devenir complémentaire aux traitements médicaux, en diminuant la détresse psychologique. Ten to 20% of children and adolescents live with chronic disease. Chronic disease is defined by long-term duration and the need for specialized care. It entails functional limitations in various spheres of life as compared to the lifestyle enjoyed by the healthy population. Teenagers with chronic illness are often marginalized or rejected by their peers, simply because they are different. They have higher levels of stress (internalized and externalized anxiety, symptoms of depression) than their healthy peers (20% vs. 8%). Eighteen percent of adolescents with chronic disease require psychological intervention. In 1986, Pennebaker published a study analyzing the effects of verbal and nonverbal emotional expression among health any adults. He showed significant links between written expression of emotion (particularly of negative emotions) and positive well-being. Other researchers also found a cathartic effect of written emotional disclosure on painful or traumatic events. In France, writing is now used in various settings, such as workshops in psychiatry. Empirical studies, made in United States with adults and teenagers, have shown that expressive writing (subjective writing wherein a person expresses the wealth of emotions experienced during a particularly disturbing event) had a positive impact on psychological and physiological symptoms. Most studies, however, have been conducted in adults, while the number of pediatric studies is limited. In this paper, we will start by briefly reviewing the research in adults to better understand the process of written emotional disclosure and its impact on health. We will then examine studies in the pediatric population and in school settings, where the technique has been used to encourage participants to express their emotions and experiences. We will also examine studies that used control groups comparing expressive writing with neutral writing. The use of expressive writing in adolescents with chronic disease is shown to reduce both psychological and physiological symptoms. Expressive writing increases cognitive function by rallying coping resources within oneself, as the sheer fact of writing contributes to making sense of and finding meaning to a particular event. Expressing writing draws on the capacity for introspection and facilitates maturation. It can be seen as complementary to medical intervention, by relieving stress, anxiety, depression, and other symptoms of psychological distress. [ABSTRACT FROM AUTHOR]

This article studies the effect of birth order and low household economic resources on school attendance and labor market participation among the population of minors in Mexico. Drawing on data from the Child Labor Center, this work estimates a series of multivariate probit models with different specifications, aiming to minimize problems related to the endogeneity of the sample. The analysis reveals that first-born children are less likely to attend school and more likely to participate in the labor market than their siblings. This relationship is stronger in families where child labor is a response to a lack of economic resources, which suggests that it is the result of the greater income-earning capacity of first-born children. [ABSTRACT FROM AUTHOR]

Objective: To conduct a scoping review on the use of technology to deliver mental health services to children and youth in order to identify the breadth of peer-reviewed literature, summarize findings and identify gaps. Method: A literature database search identified 126 original studies meeting criteria for review. Descriptive numerical summary and thematic analyses were conducted. Two reviewers independently extracted data. Results: Studies were characterized by diverse technologies including videoconferencing, telephone and mobile phone applications and Internet-based applications such as email, web sites and CD-ROMs. Conclusion: The use of technologies plays a major role in the delivery of mental health services and supports to children and youth in providing prevention, assessment, diagnosis, counseling and treatment programs. Strategies are growing exponentially on a global basis, thus it is critical to study the impact of these technologies on child and youth mental health service delivery. An in-depth review and synthesis of the quality of findings of studies on effectiveness of the use of technologies in service delivery are also warranted. A full systematic review would provide that opportunity. [ABSTRACT FROM AUTHOR]

Objectives: Auditory-verbal hallucinatory experiences (AVH) represent a prevalence of 12% in the general pediatric population. They are most often considered as a transient and benign developmental phenomenon, associated with mood and anxiety disorders. The persistence of AVHs for several years and into adolescence would represent a poor prognosis of progression into a psychiatric disorder, and more particularly psychotic disorder. The alteration of social and emotional cognitive markers are described as prodromal of this unfavorable progression which should be considered within the continuum between subclinical and clinical signs of the "psychosis phenotype". The objective of this study was to assess these markers in children and adolescents with AVH and their correlation with the presence and persistence of hallucinations., Methods: Multicenter prospective case-control study, longitudinal over 6months. Patients were included based on the presence of HAV on clinical examination. Forty subjects aged 8 to 16years from a clinical pediatric population were included. They were divided into two groups according to the Diagnostic Interview Schedule for Children-Child version (DISC-C): a group with AVH ("AVH+"), and a group without HAV ("AVH-"). A diagnosis of schizophrenia spectrum disorder was a non-inclusion criterion according to the criteria of DSM-5 (K-SADS-PL). This group was matched to the control group without AVH (AVH-) according to sex, age (±6months) and associated psychiatric diagnoses assessed by the MINI-Kid. The marker of social cognition was assessed with the NEPSY II test. The emotional marker was assessed with the self-questionnaires: EED IV, which highlights the emotions currently being felt by the subject, and the BAVQ-R, which categorizes the child's emotions in reaction to AVH., Results: No significant link was found between the social and emotional cognition markers and the presence of AVH at T0. At 6months, 50% of subjects in the AVH+ group suffered from persistent AVH and 18% progressed to a diagnosis of schizophrenia spectrum disorder. The persistence of AVH was not significantly correlated with the marker of social cognition, but it was significantly correlated with the presence of negative emotions (sadness, fear, hostility and anger) and inversely correlated with emotions of joy., Conclusion: In this study, AVH experiences in the pediatric population are not linked to markers of social cognition, but negative emotions appear as early markers of AVH persistence., Gov Identifier: NCT02567500., (Copyright © 2021. Published by Elsevier Masson SAS.)

Objective: The focus of this paper is to explore how a developmental perspective can advance understanding of the clinical trajectory into bipolar disorder (BD) and clarify controversies regarding the diagnosis in youth. Method: In this selective review, we focus on findings from longitudinal studies of general population and high-risk pediatric cohorts in order to inform our understanding of the development of BD in youth. Also highlighted are related aspects of the debate about the diagnosis in young children and a discussion of the implications of the findings for advancing early detection and intervention clinical and research efforts. Results: Evidence overwhelmingly suggests that BD typically onsets in adolescence and early adulthood, with the depressive polarity of the illness dominating the early course. Non-specific childhood antecedents have been noted in some high-risk individuals. However, in youth without a confirmed familial risk of BD, manic-like symptoms have little prognostic significance for BD and not uncommonly form part of the normative adolescent experience. Over-emphasis of symptoms and reliance on parent report alone, alongside the relative neglect of the child's developmental stage and risk profile, contributes to the over diagnosis in young children and under recognition of BD early in the clinical course. Conclusions: Longitudinal population and high-risk studies over development have made major contributions to our understanding of the early natural history of BD in youth. Implications call for a different diagnostic approach to facilitate accurate identification of youth in the early clinical stages of psychiatric disorders and to differentiate between the emerging illness trajectories and transient normative symptoms in childhood and adolescence. [ABSTRACT FROM AUTHOR]

Aggressive behaviors could be considered as a dynamic of communication, in which aggression is a language to be understood, to be deciphered by two protagonists : the aggressor coping with a stressful and threatening situation and the aggressed individual coping with an aggressive acting out. The following questions are addressed: (a) What does aggression mean to the aggressor, what does it mean to the aggressed individual? (b) What does the aggressor want or try to express, and why does he or she use this mode of expression and action over another? (c) How does the aggressed individual react, and what is the impact of his or her response on the aggressor? This article reviews studies on the definition of aggression, its measurement, its developmental role and its associated risk factors in children and adolescents. First, aggression in children and adolescents with typical and atypical development is examined based on a developmental approach, clinical case studies in child and adolescent psychiatry, and an empirical study on aggression in autism. Then, in light of these studies, the problem of violence among younger and younger children and adolescents, is discussed. Finally, taking together these studies and discussion, a model is proposed that accounts for factors involved in aggressive behaviors and for different possible levels of intervention. Physical and/or psychic threats generate stress and may therefore lead to offensive or defensive aggression. Stress has to be considered in its physiological dimension (biological stress responses) and psychological dimension (perceived stress). This model reveals a vicious circle: when the main response to aggression is repression, it may reinforce physical/psychic threats and stress perceived by the aggressor, and in turn aggressive behaviors. Intervention can occur at three levels: the stressful situation, the aggressor (perception of the stressful situation and his or her response), and the aggressed individual (perception of the aggression and his or her response). This model, like all models, is limited but it offers a discussion and perspectives to understand the different links that form the "chain of aggressive behavior" and the relationships between exposure to violence and expression of violence. The article concludes on the interest of a muldisciplinary approach to aggression integrating physiological, psychological and sociological dimensions., (Copyright © 2022. Published by Elsevier Masson SAS.)

Objective: Studies show that primary care clinicians struggle with the assessment and treatment of eating disorders in adults. There are no known studies examining current practices of clinicians with respect to eating disorders in children and adolescents. The following study describes the key practices of primary care clinicians in Ontario, Canada, around the screening, assessment, and treatment of eating disorders in children and adolescents. Method: A 24-item survey was developed to obtain information from family physicians and psychologists about presenting complaints and current practices related to the assessment and treatment of eating disorders. Results: Findings of this study suggest that despite discipline-specific differences, a large proportion of clinicians do not routinely screen for eating disorders, and when eating disorders are assessed and treatment is initiated, family members are not routinely involved in the process. Conclusion: In Ontario, primary care clinicians may benefit from more training and support to better identify and treat children and adolescents with eating disorders. In particular, clinicians may require additional training around screening, multi-informant assessment methods, as well as appropriate therapy techniques. [ABSTRACT FROM AUTHOR]

Abstract: North American epidemiological studies establish that 50% of young people in need of protection and child welfare have received mental health diagnoses. In the juvenile justice system, it seems that 50% to 60% of young offenders respond positively to some criteria for a mental disorder. The extent of use of services related to mental health by foster children or youth raised the question of psychotropic drugs use and compliance. If some authors and clinicians may assume that the nature of secured institutions, with what it involves in terms of monitoring and control, guarantees an excellent compliance. However, pilot studies we conducted show that this is not the case. To study adherence, the World Health Organization stated in 2003 that it implies some patient characteristics, but also clinical (eg: illness and treatment), family (eg: parental involvement) and contextual (eg: team care and health system) ones. The study of health behaviors has recently moved from a cognitive behavioral centered model on to a systemic/sociological one which incorporates interactions between the individual and his social environment. From an optimal use standpoint, adherence is studied as a contextualized set of behaviors and attitudes. Therefore, to understand compliance, it seems very important to understand the subjective theories of disease that will be developed by the youth and the working alliance he will establish with the pharmaco-prescriber. [Copyright &y& Elsevier]

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Obesity is associated with autonomic nervous system dysfunction. The aim of the study was to evaluate baroreflex sensitivity, an indicator of autonomic nervous function, in 20 obese children and adolescents in comparison with 20 age- and sex-matched nonobese subjects. All subjects were examined in the supine position over a period of 50 min. Systolic blood pressure (SBP) and RR intervals were monitored continuously. Baroreflex sensitivity was assessed by cross-spectral analysis of SBP and RR interval oscillations (BRS index) and SBP and heart rate oscillations (BRSf index) within the low frequency range (0.04-0.15 Hz). Sensitivity was determined in 3 time intervals of 3 min each to evaluate changes during rest. The BRS index was significantly lower in obese children and adolescents than in the nonobese control group (p = 0.002). Significant changes in the BRS index over time (p = 0.004) were found only in nonobese subjects. In contrast, the BRSf index increased over time in both groups (p = 0.01), and no significant between-group difference was detected. In conclusion, obese children and adolescents show decreased resting baroreflex sensitivity with less variation compared with nonobese subjects. The BRS and BRSf indices appear to be only partially correlated. [ABSTRACT FROM AUTHOR]

Copyright of Caderno CRH is the property of Universidade Federal da Bahia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Losing a loved one is among the most common and stressful traumatic events that a child or and adolescent can experience and can be associated with mental health and somatic disorders, as well as a range of life issues and potentially negative outcomes that may impact longitudinal development. Complicated grief, a disorder that has been studied primarily among adults, has received increasing recognition among children and adolescents in recent years. The demonstration of the distinctive character of grief reactions in relation to major depressive disorder and posttraumatic stress disorder has resulted in the inclusion of "persistent complex bereavement disorder" in an annex section of DSM-5 and of "prolonged grief disorder" in ICD-11. The grieving process in children and adolescents is not linear and is often characterised by periods of regression. Developmental phases should be taken into account to understand and clinically describe grief reactions occurring during childhood and adolescence. There are currently numerous interventions for bereaved children and adolescents, but little evidence to support them. More research focusing on the understanding of the underlying mechanisms and the risk factors for complicated grief among children and adolescents, as well as the implementation of evidence-based interventions, is definitely warranted., (Copyright © 2020 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)