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INTRODUCTION: Closed educational centres (CEC) receive young offenders who most often have a conduct disorder (CD). Mental disorders other than conduct disorder are a negative factor in the effect of educational actions. Moreover, adverse life experiences are frequent vulnerability factors in this population. This article aims to document the prevalence and links between psychiatric disorders, exposure to trauma, and the psycho-behavioural characteristics of adolescents placed in CEC. METHOD: We conducted a multicentre epidemiological study on a sample of 101 adolescents placed in nine closed educational centres in France. Psychiatric disorders were measured by the MINI-KID 2 and Conners Rating Scale questionnaires. Several questionnaires were used to collect sociodemographic data and the psychological profile of each adolescent. RESULTS: Among the adolescents, 90.2% had at least one mental disorder with a predominance of conduct disorder (80%). Comorbidity was also frequently found: among the subjects with conduct disorder, 37% had at least one other psychiatric disorder. Interestingly, the intensity of conduct disorder and the Adverse Childhood Experiences (ACE) score were significantly correlated. Furthermore, two subgroups were identified: adolescents with isolated conduct disorder (44.6%) and adolescents with other psychiatric disorders (45.7%) with or without conduct disorder. The latter subgroup showed higher vulnerability and poorer outcomes in terms of attachment patterns, feelings of abandonment, hostility and impulsivity. CONCLUSION: This study is the first French epidemiological study of mental disorders in juvenile offenders. It suggests that the detection of psychiatric disorders in young people in CEC is an important prerequisite for the implementation of targeted interventions according to different profiles. Furthermore, collaboration between the medical-psychological and judicial fields, in the form of an operational partnership, is necessary to guarantee better support for these young people.

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Autonomy has become the highest value in our society, and while it is having an impact on the debate on a future law on medical assistance in dying, it is also opening the door to a reflection on vulnerability. Although seemingly unaffected, at least initially, psychiatry could join the field of this reflection and bring out the avenues of renewal.

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INTRODUCTION: Posttraumatic stress disorder (PTSD) is a severe psychiatric disorder following exposure to a traumatic event. It is rarely diagnosed alone. High comorbidity has been observed between PTSD and other psychiatric disorders. OBJECTIVES: The purpose of this work is to evaluate the prevalence of latent PTSD in a population followed in a service of psychiatry and to describe the associated factors. MATERIALS AND METHODS: It is a descriptive cross-sectional study of 300 patients treated for psychiatric disorders, using a hetero-questionnaire containing sociodemographic data, personal and family history, clinical and therapeutic data, and characteristics of the traumatic event. The MINI was used to screen for PTSD and assess suicidal risk. RESULTS: Exposure to a traumatic event is reported by 46.7% of patients, and PTSD by 19.7%. The suicidal risk is 47.7% in the presence of this comorbidity. An ESPT is significantly associated with a schizoaffective disorder and significant suicidal risk. The recentness of the traumatic event, the presence of a state of acute stress and the absence of family psychological support are significantly associated with the occurrence of PTSD. CONCLUSION: A significant number of patients with a psychiatric disorder have undiagnosed PTSD, thus explaining their clinical deterioration. Screening and treatment of the underlying PTSD would help to improve their management.

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A study was conducted in the pediatric intensive care and resuscitation unit of the Nice pediatric hospitals, University Hospital Center Lenval (06) from January to March 2015. Its objective was to describe the events and child psychiatric interventions experienced by young patients. Of the 181 individuals managed during the research, 63 met the inclusion criteria.

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Prisoners with all types of psychiatric disorders are numerous in prisons. As a result, access to care is a priority in order to detect, orient and treat these patients. The psychiatric care system in prisons is based on a triptych composed of local care teams, regional medical- psychological services and inter-regional structures, such as specially equipped hospital units. Although policies have now worked to develop access to psychiatric care in prisons, there are still constraints, linked to security, demographics and institutional requirements.

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OBJECTIVE: Multiple informants are often used in the assessment of child psychopathology; however, parent-child agreement is low in child psychiatry. The objective of this exploratory study was to assess informant agreement on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a clinical sample of children with mental disorders and their parents, and to examine health and demographic factors associated with agreement. METHOD: MINI-KID results were analyzed for 88 parent-child dyads. Children were between 8-17 years old and were receiving in- or outpatient services for at least one mental disorder at a pediatric hospital. Kappas were calculated to assess parent-child agreement and logistic regression models were used to identify factors associated with agreement. RESULTS: Agreement was low to moderate (κ=0.19-0.41) across the MINI-KID modules. Household income was associated with agreement for major depression, generalized anxiety, and attention-deficit hyperactivity disorder. Recruitment setting and parent psychological distress were associated with agreement for generalized anxiety and separation anxiety, respectively. Age, sex, and child disability/impairment were not associated with agreement. CONCLUSIONS: Parent-child agreement on the MINI-KID was low to moderate, and few factors were associated with agreement. These initial findings reaffirm the need for multiple informants when assessing psychopathology in children and can be used by health professionals to facilitate parent-child discussions in clinical settings in child psychiatry.

OBJECTIFS: De multiples informateurs sont souvent utilisés pour évaluer la psychopathologie de l'enfant; cependant, l'entente parent-enfant est faible en psychiatrie de l'enfant. L'objectif de la présente étude exploratoire était d'évaluer l'entente des informateurs à l'égard du mini-entretien neuropsychiatrique international pour enfants et adolescents (MINI-KID) dans un échantillon clinique d'enfants souffrant de troubles mentaux et de leurs parents, et d'examiner les facteurs de santé et démographiques associés à l'entente. MÉTHODE: Le résultats du MINI-KID ont été analysés pour 88 dyades parent-enfant. Les enfants avaient entre 8 et 17 ans et recevaient des services ambulatoires ou hospitalisés pour au moins un trouble mental dans un hôpital psychiatrique. Les kappas ont été calculés pour évaluer l'entente parent-enfant et des modèles de régression logistique ont servi à identifier les facteurs associés à l'entente. RÉSULTATS: L'entente était de faible à modérée (κ = 0,19­0,41) dans tous les modules du MINI-KID. Le revenu du ménage était associé à l'entente pour la dépression majeure, l'anxiété généralisée, et le trouble de déficit de l'attention avec hyperactivité. Les paramètres du recrutement et la détresse psychologique parentale étaient associés à l'entente pour l'anxiété généralisée et l'angoisse de séparation respectivement. L'âge, le sexe et la déficience/incapacité de l'enfant n'étaient pas associés à l'entente. CONCLUSIONS: L'entente parent-enfant au MINI-KID était faible à modérée, et peu de facteurs étaient associés à l'entente. Ces premiers résultats réaffirment le besoin de multiples informateurs pour évaluer la psychopathologie des enfants et peuvent être utilisés par les professionnels de la santé pour animer les discussions parent-enfant dans les milieux cliniques de psychiatrie de l'enfant.

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current evolution of society makes it possible to debate the issue of the end of life for people suffering from pathologies in which the vital prognosis is not involved; this concerns psychiatric situations in particular. This debate, which bears the seeds of a real desire to die as a personal choice, is likely to profoundly modify the doctor-patient relationship in the particular field of psychiatry.

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Established in 2010, the specially equipped hospital units are designed to meet the mental health needs of detainees. They can receive, in full hospitalization, psychiatric care suitable to their needs. A Nancy team testifies to its practice with a focus on prevention against suicidal risk.

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Women with mental health problems during the perinatal period need support with parenthood. Guidance from professionals providing the paediatric nursing care must favour the baby's development, but also help the mother assume her role and support the establishment of the mother-baby bond. Mediation when providing paediatric nursing care is a means of supporting parenthood.

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The various traumatic events experienced by young isolated foreigners can weaken them psychologically and cause psychiatric decompensation. A qualitative study, carried out by the Maison de Solenn and the Avicenne hospital, aimed to provide better understanding of the conditions for initiating psychiatric care with these adolescents. The different results show that this type of care for these young migrants must be cross-cultural and multi-disciplinary.

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There is a plethora of applications designed to improve mental healthcare available on the digital market. All the caregivers involved in the field of psychiatric disorders must keep abreast of these advances in order to develop them to benefit patients as early as possible. However, their real efficacy remains unproven and their potential limits are obvious, such as the issue of accessibility for the frailest patients, data protection as well as the quality of the messages conveyed.

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The families of patients with psychiatric disorders are often ill-informed of the consequences of the condition of their loved one. The therapeutic alliance between the family and caregiving team enables the patient to derive the maximum possible benefit from remaining longer at home.

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BACKGROUND: Many clinical and biological parameters have nonlinear chaotic fluctuations. These variations result in unexpected pseudo-random transitions. In these models, few risk factors can lead to unexpected phenomena if oscillations and self-reinforcement patterns occur. Complex rhythms could ease the ability of a physiological system to adapt and react quickly to a constantly changing environment. OBJECTIVES: It has been proposed that several psychiatric disorders and developmental disorders are characterized by a loss of complex rhythm in favor of a more organized pattern. We examine evidence to support these assumptions in literatures. METHODS: We performed a literature review of the main computerized databases (Medline, PubMed) and manual searches of the literature concerning non dynamic rhythms in time series analysis, in adults with psychiatric disorder and children with developmental disorder. These results were interpreted through a developmental approach that highlights the role of the learning process in the emergence of abilities. RESULTS: Analysis of clinical scores and electroencephalographic data have found that subjects with bipolar disorder or schizophrenia, tested over a time series, have lower chaotic rhythms compared with healthy subjects. Growing children share several properties of a complex system: the interdependence of developmental axes (motor, emotional, language, social skills), multiple hierarchical levels (i.e. genetic, biological, environmental, and cultural), the two-way transactions between the child and his environment, and the sensitivity to initial conditions. This could explain the difficulty to predict the emergence of abilities or the long-term prognosis of impairment in children. This limitation is not only due to errors in the explanatory model or the lack of explanatory variable. It is also caused by instability, which is a core characteristic of a chaotic system. CONCLUSION: The study of chaotic rhythms in time-series clinical and nonclinical data (e.g. EEG, functional neuroimaging) could improve the prediction of an acute event, such as relapse of mood disorder. Moreover, the complex rhythms in children may play a major part in synchronicity during interactions with a caregiver, held as essential for later development of self-regulation skills, such as emotional stability.

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