Asunto(s)
Trastorno Autístico/diagnóstico , Tamizaje Masivo , Factores de Edad , Niño , Preescolar , Diagnóstico Diferencial , Humanos , LactanteRESUMEN
Mental health problems today account for a rising number of visits to general practitioners, which require collaboration between general practitioners and psychiatrists. A KAP study (Knowledge, Attitudes, Practice) was carried out among general practitioners of three towns in the "Meurthe et Moselle" region, in the common territory shared by both a child and an adult psychiatric sector. Twenty-three doctors participated in the study. General practitioners know the different psychiatric structures but they do not know their areas of speciality or how they are organised. All recognise the high frequency of mental health problems among their patients, the most frequent being depressive pathologies. They have a negative image of the sector which is perceived as a complex "world" from which they feel excluded as soon as they refer a patient because of the difficulty they have in communicating with psychiatrists.
Asunto(s)
Medicina Familiar y Comunitaria , Conocimientos, Actitudes y Práctica en Salud , Psiquiatría , Adolescente , Adulto , Niño , Recolección de Datos , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
After reviewing epidemiological literature on the relationships between depression in parents and onset of a psychiatric disturbance in children as well as investigations of the interactions between a depressed mother and her infant, the authors discuss the psychoanalytical concepts of these interactions and the findings of their research. This epidemiological research is based on the assumption that depression in the mother during pregnancy and the first few months of the post-partum constitutes a risk factor for the onset of an early psychosis in the child. This research is a comparative study between a group of mothers with early onset psychotic children and a group of mothers with non patient children, the age and sex of the children in both groups being equally distributed. The methodology includes two instruments aimed at a retrospective assessment of mothers' depression: the SADS-LA questionnaire and a standardized scoring system for semi-structured interviews investigating the mother's feelings during pregnancy and early development of her baby. Results show that there is a statistically significant relationship between a major depressive condition in the mother during pregnancy and/or during the first year of the infant's life and the onset of an autism in the child. It might be that major depressive conditions starting before delivery could by themselves account for the risk. Depression in the mother therefore constitutes a risk factor for early psychosis, the relative risk being about four. This study also emphasizes particular features of the mother's depressive conditions: difficulties to accept the real child, difficulties in perceiving the infant's psychic evolution, decrease of interactive skills. The statistically significant relationship in no way points to a linear causal relationship, which hypothesis seems to be negated by the statistical findings of this research.
Asunto(s)
Trastornos Generalizados del Desarrollo Infantil/epidemiología , Trastorno Depresivo/complicaciones , Madres/psicología , Trastornos Puerperales/complicaciones , Trastornos Generalizados del Desarrollo Infantil/etiología , Trastornos Generalizados del Desarrollo Infantil/psicología , Preescolar , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Humanos , Entrevista Psicológica , Relaciones Madre-Hijo , Trastornos Puerperales/diagnóstico , Trastornos Puerperales/psicología , Factores de RiesgoRESUMEN
The referrals for urgent psychiatric treatment were studied systematically to improve our understanding of the acute forms of psychological distress in children and adolescents and the crisis situations which disrupt the usual relationships between the child and his family. During the last 12 months, 212 requests for urgent psychiatric opinion in children under 18 years of age were received. The following points were analyzed: --general: age, sex, geographical distribution of the patients and their families, present family conditions, socio-economic class, origin of the urgent referral; --psychological or psychopathological: presenting symptoms, organisation of the personality of the child or adolescent, previous psychological or psychiatric history; --practical: the emergency management, ulterior orientation. The authors conclude with some remarks on the possible lines of action in the emergency situations.
Asunto(s)
Intervención en la Crisis (Psiquiatría) , Trastornos Mentales/terapia , Enfermedad Aguda , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Relaciones Padres-Hijo , Factores Sexuales , Factores SocioeconómicosRESUMEN
From our experience in the pedopsychiatric emergency unit at the Salpêtrière Hospital, we discuss the concept of psychiatric emergency in children and adolescents. In 90% of cases, patients are adolescents aged 14 to 18 years. The acting out and the ensuing emergency consultation seem to be a propitious time for establishing a relationship with the adolescent, meeting his difficulties from a psychological rather than affective standpoint and instituting an exchange with the family.