Support for the association between the rare functional variant I425V of the serotonin transporter gene and susceptibility to obsessive compulsive disorder.
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Adolescent↗
Biomedical subjects
M C Mouren-Simeoni
Publications and source records attributed to M C Mouren-Simeoni.
[Neuropsychiatric abnormalities and continuous spikes and waves during slow sleep syndrome: a case report].
UNLABELLED: Continuous spikes and waves during slow wave sleep syndrome (CSWS) is a seldom form of epilepsy which may manifest by neurocognitive and/or psychiatric abnormalities, with or without clinical seizures. CASE REPORT: A 5-year-old child was presented with a language disorder and behaviour abnormalities. A standard electroencephalograph (EEG) showed left tempororolandic spikes waves without any electrical discharges. Cerebral imaging excluded an underlying expansive disease. A continuous EEG recording revealed a CSWS syndrome by showing continuous and diffuse spike waves during slow wave sleep. Thanks to antiepileptic medications and orthophonic therapy, evolution was positive. CONCLUSION: In complex cases of language and behavioural disorders, it is necessary to perform an EEG even in the absence of convulsive seizures, to diagnose a CSWS syndrome. Given the etiological and treatment difficulties concerning the CSWS, a treatment with antiepileptic seems necessary. EEG normalisation under antiepileptic medications usually leads to significant, although partial, neuropsychological improvement. Furthermore, orthophonic therapy seems useful as a complement to pharmacological treatment.
Anticonvulsants↗
DSM-IV mental disorders and neurological complications in children and adolescents with human immunodeficiency virus type 1 infection (HIV-1).
AIM: - To study the types of psychiatric problem encountered in children infected with the human immunodeficiency virus (HIV) and their relationship to central nervous system disorder and the severity of infection. METHODS: - 17 HIV-infected children presenting with psychiatric problems were included. Mental disorders were evaluated according to DSM-IV criteria. Neurological disorders and progressive encephalopathy (presence or absence) diagnosis were evaluated by clinical and radiological examination. The severity of infection was assessed by the percentage of CD4 lymphocytes. RESULTS: - The most frequent diagnoses were major depression (MDD: 47%) and attention deficit hyperactivity disorder (ADHD: 29%). Major depression diagnosis was significantly associated with neuroimaging or clinical neurological abnormalities (p < 0.01). In contrast, no association was found between hyperactivity diagnosed according to DSM-IV criteria and central nervous system disorder. Percentage of CD4 lymphocytes were close to 0 for more than 80% of children presenting with psychiatric complications. CONCLUSION: - The very low % of CD4 lymphocytes of these children suggest that the appearance of a psychiatric complication should be regarded as a factor indicating severe HIV infection. Depressive disorders may be a clinical form of encephalopathy.
AIDS Dementia Complex↗
Alexithymia in insulin-dependent diabetes mellitus is related to depression and not to somatic variables or compliance.
OBJECTIVES: To assess the prevalence of alexithymia in insulin-dependent diabetic mellitus (IDDM) outpatients. To examine whether alexithymia is associated with diabetic somatic variables, depression, and compliance. METHOD: Our sample comprised 69 diabetic outpatients followed in a university hospital. We assessed the prevalence of alexithymia (26-item Toronto Alexithymia Scale, TAS-26) and the relationships among alexithymia, depression (13-item Beck Depression Inventory, BDI-13), somatic diabetic variables (glycosylated hemoglobin, number of mild or severe hypoglycemia, somatic complications), and compliance (observer-rater scale completed by diabetologist). RESULTS: The prevalence of alexithymia in IDDM patients was low (14.4%). Alexithymia and depression, as measured by TAS-26 and BDI-13 scores, respectively, correlated with each other. Alexithymia was not correlated with glycemic control, somatic complications, or compliance. CONCLUSION: In our sample, alexithymia was related to depression and not to somatic factors or compliance.
Adult↗
A study of posttraumatic disorders in children who experienced an industrial disaster in the Briey region.
OBJECTIVES: To study posttraumatic disorders in children who were directly and indirectly involved in an industrial disaster; to assess the respective impact of traumatism exposure, parental disorders and sociodemographic variables on the posttraumatic disorders of the children. METHODS: The children were assessed with self-administered questionnaires (STAIC, CDI, IES) and questionnaires filled in by parents (CPRS, CBCL). Parents were assessed with the GHQ-28. Forty-three exposed children were compared with 44 children who were exposed to the same risk (indirectly exposed group) and with a control group of 50 unexposed children. RESULTS: The exposed group obtained significantly higher anxiety and trauma-related scores than the control group and the threatened group, as well as higher scores of behavioural symptoms and of parental disorders. Indirectly exposed children did not have higher rates of symptoms than control children. The younger exposed children exhibited the highest psychopathological scores. Low sociodemographic status was associated with more disorders. There were no differences on questionnaire scores between girls and boys. Children's disorders correlated with disorders in both parents; but this only accounted for part of the variance, a finding which supports the hypothesis of a direct impact of the trauma on the child, irrespective of parental clinical status, SES of the family, children's age and gender. CONCLUSIONS: Children's and parent's disorders interact in a complex fashion which needs further study.
Adolescent↗
High levels of nocturnal activity in children with attention-deficit hyperactivity disorder: a video analysis.
Sleep disturbances can lead to symptoms of attention-deficit hyperactivity disorder (ADHD) in children. In the present study, we compared the sleep patterns of 30 children with ADHD, with those of 19 controls matched for age (5-10 years) and sex. Sleep patterns were recorded during one night, using polysomnography (PSG) and a video system in the sleep laboratory. Both ADHD children and controls were medication free and showed no clinical signs of sleep and alertness problems. An infrared camera was used to record all types of movement, which were scored and analyzed using specific software (Observer(R) 3.0; Noldus International, The Netherlands). No significant differences in sleep variables were found between ADHD children and controls. Polysomnography data showed no significant difference between the two groups. Attention-deficit hyperactivity disorder children moved more often than controls (upper limbs, P < 0.04; lower limbs, P < 0.03; all types, P < 0.003). The duration of movements was significantly longer in ADHD children (upper limbs, P < 0.03; all types, P < 0.02). The results of the video analysis were consistent with previous findings that ADHD children have higher levels of nocturnal activity than controls. This activity concerned mostly upper and lower limb movements. Futher studies are required to determine why noctural activity does not affect sleep continuity in a more significant way and whether it should be treated specifically.
Attention Deficit Disorder with Hyperactivity↗
[Electroconvulsive therapy in the adolescent: clinical considerations apropos of a series of cases].
OBJECTIVE: To report on observations of 6 adolescents treated with electroconvulsive therapy (ECT) and to compare the data with literature data. METHOD: We conducted a retrospective study of our division charts of adolescents treated with ECT and hospitalized in the last 20 years. We also undertook a computer search in several databases (including Medline) to identify the reported observations on this treatment. RESULTS: We studied the charts of 6 adolescents aged 14 to 16 years. There were 3 cases of major depressive disorder (including 1 case of delusion of negation), 2 cases of neuroleptic malignant syndrome, and 1 case of schizoaffective disorder with catatonic characteristics. Four adolescents received ECT as a first-line treatment. They were given an average of 9 ECT, which was judged to be efficacious. Tolerance was adequate, and in this series, ECT does not seem to have caused alterations to long-term cognitive functions. No relapse was noted after a minimum of one-year follow-up. CONCLUSIONS: For some severe psychiatric disorders in adolescents, ECT could be a treatment with a good efficacy and tolerance profile.
Adolescent↗
[Cardiac consequences of adolescent anorexia nervosa].
Cardiac complications are common in adolescent anorexia nervosa and are the cause of a third of deaths. Some workers have reported prolongation of the QT interval and cases of sudden death in these patients. The aim of this study was two-fold: to assess the cardiac complications of anorexic adolescents and to determine the outcome after renutrition in the hospital setting. This was a prospective study of 48 consecutive cases (45 girls) with an average age of 14 +/- 2 years, admitted to the paedopsychiatric unit and fulfilling the DSM-IV criteria of anorexia nervosa. The digitised ECG, Holter ECG and echocardiography were recorded before and after renutrition. Anorexia nervosa was severe with a body mass index < 14 in 2/3 of cases. Over 2/3 of patients had bradycardia with a heart rate < 50/min in half the cases but normal chronotropic function on Holter monitoring. Prolongation of the QTc interval was demonstrated (QTc > 440 ms in 11/44 cases). Echocardiographic abnormalities, in particular left ventricular dysfunction (24/46) and pericardial effusion (12/46) were reversible after renutrition. There were no clinical or biological predictive factors for the occurrence of cardiac complications on admission. The authors confirm that cardiac complications of anorexia nervosa are common, usually benign and always reversible after renutrition in hospital. Therefore, most electrical abnormalities normalise with the heart rate and echocardiographic abnormalities with improvement of conditions of load.
Adolescent↗
Opiate antagonists in children and adolescents.
Naltrexone a pure opioid antagonist, well tolerated in young patients, has been found to be an interesting treatment in some disorders in children and adolescents. Naltrexone has been first tried in mental retardation and autism disorders in children and adolescents. Symptoms like self-injury behaviours, hyperactivity, stereotyped and ritualistic conducts appear to be improved in a subgroup of children with the opiate antagonist. But new controlled studies still need to be done before recommending naltrexone in autism. Preliminary results in the treatment of alcoholic adolescents seem to support the efficacy of naltrexone on abstinence when combined with a supportive psychotherapy. In adults, results found with the use of naltrexone in eating disorders are different, when considering the duration and the dosage of the treatment and the kind of eating disorder (bulimia, binge eating or anorexia nervosa). Studies in children and adolescents are needed before proposing naltrexone in eating disorders. We resumed here the results found with this treatment in these indications.
Adolescent↗
Prevalence of DSM IV anxiety and affective disorders in a pediatric population of asthmatic children and adolescents.
A series of 82 children and adolescents with moderate and severe persistent asthma was studied. Their psychopathological problems were compared to those of 82 healthy subjects, matched for age, sex and socio-economic status. The patients completed the Child Depression Inventory, an inventory of fears and anxiety (ECAP) and the Coopersmith Self Esteem Inventory. Parents of asthmatic children filled in the Child Behavior Check List to assess their social competence. The patients were examined with the revised Kiddie Schedule for Affective Disorders and Schizophrenia. There were more anxiety symptoms in the asthmatic group than in the control group. Asthmatics were not significantly more depressed than controls and their self-esteem was as good. We found 29 anxiety disorders, four affective disorders and four disruptive behavior disorders. Generalized anxiety disorder was the main diagnosis (n=24). The asthmatic subgroup presenting anxiety and affective disorders had poorer self esteem, fewer activities and worse social competence than other asthmatics and controls. Adolescents did not seem to have more emotional disturbances than younger patients. Girls did not have more DSM IV anxiety or affective disorders than boys.
Activities of Daily Living↗
Whole blood serotonin and plasma beta-endorphin in autistic probands and their first-degree relatives.
BACKGROUND: Whole blood serotonin (5-HT) and C-terminally directed beta-endorphin protein immunoreactivity (C-ter-beta-EP-ir) are known to be elevated in autistic subjects and might be possible markers of genetic liability to autism. This study thus investigates the familial aggregation of 5-HT and of C-ter-beta-EP-ir levels in first degree relatives of autistic probands. METHODS: In a sample of 62 autistic subjects and 122 of their first-degree relatives, compared to age and sex-matched controls, we measured 5-HT by radioenzymology and C-ter-beta-EP-ir by radioimmunoassay. RESULTS: We confirm the previously reported familiality of hyperserotoninemia in autism as mothers (51%), fathers (45%) and siblings (87%) have elevated levels of 5-HT, and we reveal presence of elevated levels of C-ter-beta-EP-ir in mothers (53%) of autistic subjects. CONCLUSIONS: Familial aggregation of quantitative variables, such as concentration of neurotransmitters, within unaffected relative could serve as an intermediate phenotype and might thus help the search of genetic susceptibility factors in autism.
Adolescent↗
Prevalence of DSM-IV disorders in children and adolescents with asthma versus diabetes.
OBJECTIVE: To evaluate the relationships between asthma and type and incidence of psychiatric problems in a pediatric population. METHODS: A series of 93 children and adolescents with asthma presenting during a 1-year period to a pediatric pneumology and allergy service was studied. Their psychopathological problems were compared with those of 93 children with insulin-dependent diabetes mellitus (IDDM). Various questionnaires were completed by the patients: the Child Depression Inventory (CDI), the State-Trait Anxiety Inventory for Children (STAIC), and the Coopersmith Self-Esteem Inventory (SEI). Their parents were administered the Child Behavior Checklist (CBCL). The patients were examined using the revised Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-R). RESULTS: There were more symptoms in the asthma group than in the IDDM group, as indicated by total CBCL scores, internalization and externalization CBCL subscores, and the STAIC scores. Asthma was often associated with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) psychiatric disorders. We found 30 anxiety disorders, 5 affective disorders, and 6 disruptive behaviour disorders. Asthmatic children did not seem to be more depressed than the IDDM group, and their self-esteem, overall, was good. However, the asthma subgroup presenting with psychiatric disorders had poorer self-esteem and social competence. Adolescents did not seem to suffer more psychiatric disturbances than did younger patients. Girls did not suffer more psychiatric disturbances than did boys. CONCLUSION: Asthma appears to be associated both with higher overall incidence of psychiatric problems than in IDDM and with particular categories of psychiatric problems. In particular, the problems include anxiety disorders, internalizing symptoms, and disruptive behaviours.
Adolescent↗
Asthma severity and psychopathology in a tertiary care department for children and adolescent.
The purpose of this study was to evaluate the relationships between severe asthma, type and incidence of psychiatric problems in a pediatric population. A group of 92 children and adolescents (63 boys and 29 girls) (mean age 11.7) was investigated over one year by a pediatric pneumology/allergy service unit. The psychopathological problems of two groups were compared: "mild" (n = 12) and "moderate/severe" (n = 80) persistent asthma as defined by the National Heart Lung and Blood Institute (NIH). Various questionnaires were completed by the patients including the CBCL and the CPRS. The patients were examined by an experienced psychologist using the French version of the revised semi-structured diagnostic interview Kiddie-SADS. Twelve cases with intermittent or mild persistent asthma and 80 cases with moderate and severe persistent asthma were found. The child gender ratio and the social class of the parents did not differ significantly across groups. Moderate/severe asthma was more often associated with DSM-IV psychiatric disorders. Similarly, there were more symptoms in the severe group as indicated by several questionnaires. The hyperactivity index (CPRS) was higher for the severely affected group, who also exhibited fewer daytime activities. Social skills, school skills, and self esteem were, overall, on a similar level as those of the mildly affected group. Severe persistent asthma and moderate persistent asthma were not significantly different for the prevalence of psychiatric disorders and symptoms, even if children with severe asthma had a trend toward being diagnosed with more DSM-IV anxiety disorders and higher STAIC scores. Both of them had significantly higher total CBCL scores and CPRS hyperactivity index than intermittent and mild asthma. Moderate and severe persistent asthma appears to be associated with both incidence and particular categories of psychiatric problems, particularly anxiety disorders and anxious/depression symptoms. These observations suggest that it would be valuable to pay more attention to psychopathological problems of children suffering from severe asthma.
Adolescent↗
Psychological adjustment of children and adolescents with cystic fibrosis.
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Adaptation, Psychological↗
[Insulin-dependent diabetes mellitus in children and in adolescents: value of pedopsychiatric follow-up].
UNLABELLED: To assess the type of mental disorders met in the medical follow-up of insulin-dependent diabetic children (IDDM) and adolescents and their relationships with metabolic control (HbA1C) in young IDDM patients who consult in a department of child psychiatry. POPULATION AND METHODS: Twenty boys and 37 girls (mean age: 14.7 +/- 4.1 years and mean duration of IDDM: 5.6 +/- 4.3 years were followed during 1 year by the same child psychiatrist (mean duration of follow-up: 22 months). They were assessed with several clinical interviews (mean: three by subject); mental disorders were classified according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, third edition revised (DSM III-R). RESULTS: The study showed the importance of emotional disorders, 30 patients presenting at least an anxiety disorder and 17 an affective disorder, 11 a major depressive disorder and eight a dysthymic disorder. The most frequent anxiety disorders were phobias and overanxious disorders. Two patients had an anorexia nervosa, one a bulimia nervosa and nine an eating disorder not otherwise specified. There were ten diagnoses of disruptive behaviour disorders, one toxic substance abuse and 11 adaptation disorders. Seven subjects had a reading and writing learning disorder, three a coordination disorder and three a borderline IQ. Familial factors seemed very important. Nine patients had a parent-child problem, four sibling rivalry disorder and two an attachment disorder. Family problems (conflicts, separations, economical difficulties...) were found in 63% of cases. The mother or the father had mental disorders in 24 cases (42%). The diabetic patients with mental disorders had poor metabolic control (HbA1C = 9.9 +/- 2.4%) and ten subjects (18%) had already somatic complications. Some mental disorders were significantly associated with high HbA1C. The poorer metabolic controls were observed for eating disorders. Somatic complications were associated only with IDDM duration. CONCLUSIONS: This study shows the presence of typical DSM III-R mental disorders in IDDM children and adolescents, principally emotional disorders, and their association with a higher somatic risk, maximum for eating disorders. It shows the interest of collaboration between diabetologist and child psychiatrist. The exact prevalence of these disorders should be assessed by epidemiological studies.
Adolescent↗
Systematic screening for fragile X syndrome in a cohort of 574 mentally retarded children.
In this study, we evaluated the prevalence of the fragile X syndrome in a cohort of 574 mentally retarded children. The only inclusion criterion was the diagnosis of mental retardation according to the DSM-IIIR classification. We used a PCR-based strategy for the diagnosis of fragile X syndrome to facilitate systematic screening. This diagnostic scheme is based on an initial PCR to eliminate most fragile X-negative patients followed by Southern blotting for fragile X syndrome diagnosis. Altogether, 403 boys and 171 girls were tested. The prevalence of this genetic disorder was 1.9% (11/574) in the whole cohort and 2.5% (10/403) in boys. Only one case of fragile X syndrome was detected among the 171 girls tested (0.6%). Clinical examination, especially in the youngest children, was often unremarkable, and the only reason for suspecting fragile X syndrome was the presence of mental retardation. Thus, a systematic screening for the fragile X syndrome in mentally retarded children seems justified because of the importance of a precise diagnosis in genetic counseling.
Adolescent↗
Eating and emotional disorders in adolescent obese girls with insulin-dependent diabetes mellitus.
OBJECTIVE: To study eating and emotional disorders in adolescent insulin-dependent diabetic (IDDM) girls. METHODS: 98 adolescent girls, aged 13-19 years, were studied: 15 obese and 37 non-obese IDDM girls, 22 obese non-diabetic and 24 non-obese girls, DSM-III-R eating disorders (anorexia nervosa, bulimia nervosa, eating disorders NOS) and eating habits (snacking, sweet compulsions) were evaluated by a semi-structured diagnostic interview (Kiddie-SADS-E and Eating Habits Interview). Emotional disorders were assessed using self-questionnaires (State-Trait Anxiety Inventory for Children, Beck Depression Inventory, Coopersmith Self-Esteem Inventory). Psychological characteristics were correlated with BMI and, for IDDM girls, with HbA1C. RESULTS: IDDM and non-diabetic obese girls showed high rates of eating disorders NOS (sub-clinical bulimia: 60 and 41%, respectively) and they had more extra-snacks than non-obese girls, suggesting that obesity was the main risk factor for additional eating disorders. However, non-obese IDDM girls had more eating disorders NOS (sub-clinical bulimia: 27%) than did the normal girls (4%). Three IDDM girls had typical bulimia nervosa, while none of the non-diabetic did. The risk of depression was increased by both IDDM and obesity (16 and 18% dysthymia, respectively; 8% in normal girls); both factors cumulated in obese IDDM girls (47% dysthymia). Obesity was linked to marked changes in self-esteem scores and mild effects on anxiety. IDDM had little effect on anxiety and none on self-esteem; it even seemed to preserve the self-esteem of obese girls. Patients with bulimia nervosa had poorer metabolic control than other girls with IDDM. There was no correlation between HbA1C and eating or emotional disorders. CONCLUSIONS: Adolescent IDDM girls are at increased risk of eating and emotional disorders. Obesity appears to be an important factor for psychiatric complications; more obese IDDM girls suffered from eating disorders NOS sub-clinical bulimia), dysthymia, anxiety disorders, depression and low self-esteem (Family Satisfaction SEI sub-score) than did non-obese IDDM girls.
Adolescent↗
[Eating disorders and metabolic balance in a population++ of young adults with insulin-dependent diabetes].
We have compared the prevalence of Eating Disorders in a population of 69 out-patients with Insulin-Dependent Diabetes Mellitus including a sample of diabetic young women (average year: 23 years) with two control populations (45 medicine out-patients and 54 girl students). The diabetic population didn't present no more eating disorders--measured by self-report questionnaires (EAT, BITE) than the control population. In a sample of 40 diabetic subjects--having participated in a diagnostic structured interview (LENTCA) based on DSM-III-R criteria: nobody has anorexia nervosa, one woman has bulimia nervosa, the lifetime prevalence of bulimia nervosa not otherwise specified was 21% for men and 43% for women. Bulimia Disorders--measured by self report questionnaire (BITE) and noncompliance were linked with poor glycemic control.
Adult↗