RESUMEN
The digital revolution is turning lifestyles and mentalities upside down. The intuitiveness, immediacy and connectivity which characterise new information and communication technologies appeal to teenagers who find in them ways to gain recognition from their peers and to exchange with each other, without having to yield to adults. However, they expect mental health professionals to talk to them, to be engaged in their discussions and to agree to use connected tools as platforms for exchange. A wide variety of such methods can form part of the therapeutic relationship, from smartphones to chat rooms, from teleconsultations to 'cybertherapies', and from video games to serious games.
Asunto(s)
Trastornos Mentales/enfermería , Trastornos Mentales/psicología , Teléfono Inteligente , Apoyo Social , Terapia Asistida por Computador , Adolescente , Humanos , Relaciones Enfermero-Paciente , Grupo Paritario , Consulta Remota , Juegos de Video , Realidad VirtualRESUMEN
Depressive, anxiety and obsessive symptoms frequently co-occur with anorexia nervosa (AN). The relationship between these clinical manifestations and the biological changes caused by starvation is not well understood. It has been hypothesised that reduced availability of tryptophan (TRP) could reduce serotonin activity and thus trigger these comorbid symptoms. The aim of this study, during re-feeding in individuals with AN, was to analyse covariations across measures of nutritional status, depressive and anxiety symptoms, and peripheral serotonin markers. Depressive and anxiety symptoms, nutritional status and serotonin markers--whole blood serotonin content, plasma TRP and the ratio between TRP and large neutral amino acids--were assessed for 42 AN participants at admission to inpatient treatment and after re-feeding. Biological measures were compared to those obtained in 42 non-eating disordered subjects. For those with AN, psychological, nutritional and biological parameters improved significantly during hospitalisation. Levels of serotonin markers were significantly lower in the AN group compared to the control group, at admission and at discharge. Increase in the TRP/LNAA ratio was correlated with a decrease in depressive symptoms. In addition, there was a positive correlation between serotonin levels and symptoms of both anxiety and depression at discharge. We speculate that enhanced TRP availability during re-feeding, as a result of the increase in the TRP/LNAA ratio, could restore serotonin neurotransmission and lead to a decrease in depressive symptoms. The association between serotonin and anxiety and depressive symptoms would be consistent with numerous observations indicating abnormal functioning of the serotoninergic system in AN.
Asunto(s)
Anorexia Nerviosa/sangre , Ansiedad/sangre , Depresión/sangre , Serotonina/metabolismo , Triptófano/sangre , Adolescente , Adulto , Anorexia Nerviosa/complicaciones , Ansiedad/complicaciones , Depresión/complicaciones , Femenino , Humanos , Masculino , Estado Nutricional , Encuestas y CuestionariosRESUMEN
The digital universe, from the internet to video games, arouses mixed feelings in parents of adolescents. However, it is possible to use the growing "digitisation" of the relationships between young people to develop care tools. Avatars or virtual characters, for example, make it possible to develop a relationship with adolescents hospitalised in child psychiatry units.
Asunto(s)
Psiquiatría del Adolescente/instrumentación , Internet , Juegos de Video , Adolescente , Conducta del Adolescente , Comunicación , HumanosRESUMEN
In France, suicide is the second cause of death among young people. Each year, 550 people under 25 years of age take their own lives, and at least 40,000 attempt suicide. One in three young people who attempt suicide relapse during the following year. A related concern is at-risk behavior, particular on the roads (vehicle accidents are the leading cause of death among young people). Death by suicide is three times more frequent among boys than girls, because of diferences in the methods used (hanging or gunshot, in seven out of ten cases), whereas attempted suicide is three times more frequent among girls than boys and involves drug overdose in nine out of ten cases. Better screening of young people at risk is urgently required The author proposes easily recognizable risk factors that he and Marie Choquet (Inserm) identified through a study conducted in schools. These factors are not always recognized by professionals who deal with adolescents. Regarding hospital management, the author advocates a well-defined assessment period to determine the reasons for the crisis, interposed between the initial evaluation and the choice of the most appropriate therapeutic option.