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Summary: Sleep deprivation is highly prevalent in the general population and related to lifestyle in industrialized countries. There has been an increase in this reduction of sleep for half a century and adolescents are particularly affected. Given the magnitude of this sleep restriction, it seems important to focus its mechanisms and its neurocognitive, endocrine, metabolic, weight, psychological and school consequences on adolescents. This sleep deprivation is described and the solutions that can be proposed to adolescents and their family or school environment to increase sleep duration and decrease the negative consequences of their current sleep deprivation are reviewed. [Copyright &y& Elsevier]

Abstract: Objective: To determine developmental communication profiles in young autistic children with mental retardation. Methods: A group of 19 autistic children (mean age=43 months) were matched with a group of 11 mentally retarded children (mean age=39 months) on mental age (17,6 months). All of these children were without speech (less than 5 words of vocabulary). Communication skills were assessed with the Guidetti-Tourrette scales (ECSP), French adaptation of the Seibert-Hogan scales. Results: Autistic children displayed a much lower score than mentally retarded children in the 3 functions of early social communication (behavior regulation, social interaction and joint attention). The developmental communication profiles was the same in the 2 groups. Discussion: The results showed evidence of distortion in autistic children development: they displayed important deficits in communication skills, in comparison with cognitive skills. Autistic children mainly displayed requesting gestures: they used adults to help them to reach a goal, instead of regarding them as social partners. However, young children who have mental age less than 18 months mainly use the same functions of communication, with or without autistic trouble. Conclusions: There is a same developmental sequence in communication skills in young children, with or without autistic trouble. [Copyright &y& Elsevier]

Since the 50s, the role of implicit theories in the organization and interpretation of information has gained increasing acceptance among both cognitive and social psychologists. These implicit theories refer to the two different assumptions people may make about the malleability of personal attributes. They may believe that a highly valued personal attribute, such as intelligence or morality, is fixed, i.e. a nonmalleable trait-like entity (entity theory), or that the attribute is a malleable quality that can be changed and developed (incremental theory). The identification of these two theories allows us to understand the cognition, emotion and behavior of individuals in achievement situations. Many studies carried out in the primary school show that children who hold an entity theory of personal attribute (i.e. they consider badness like a stable quality) have a strong tendency to attribute their failures to a fixed trait. They are more likely to attribute failures to their bad abilities. In contrast, children who hold an incremental theory of personal attribute (i.e. they consider badness as a malleable quality) are more likely to understand the same negative outcomes in terms of specific factors: they attribute them to a lack of effort. In addition, several studies have shown that entity theorists are more likely than incremental theorists to react helplessly in the face of failure. They are more likely to show negative affect and behaviors. This helpless response pattern is characterized by a lack of persistence. In contrast, incremental theorists try harder and develop better strategies and continue to work. Finally, several studies demonstrate that environmental factors play an important role in the implicit theories elaboration. [Copyright &y& Elsevier]

Résumé Introduction Le refus scolaire anxieux est apparu avec les lois de Jules Ferry instituant l’obligation scolaire en 1882. Dans les classifications psychiatriques internationales, le refus scolaire anxieux n’apparaît pas comme un diagnostic en soi. L’objectif principal de cette étude était de décrire les troubles psychopathologiques d’adolescents en refus scolaire suivis en hôpital de jour. L’objectif secondaire était de comparer le niveau d’anxiété, d’affects dépressifs, d’estime de soi, de solitude, d’attachement aux parents et aux pairs et de qualité de vie de ces adolescents, à celui d’adolescents scolarisés. Matériel et méthode Le groupe refus scolaire était composé de 22 patients suivis en l’hôpital de jour. Le groupe témoin comprenait 21 adolescents scolarisés. Les troubles psychopathologiques ont été définis grâce au questionnaire semi-dirigé d’évaluation diagnostique kiddie-schedule for affective disorders and schizophrenia (KIDDIE-SADS). L’intensité des troubles a été évaluée par des échelles d’auto-évaluation. Résultats Les principaux diagnostics observés chez les adolescents en refus scolaire étaient la phobie sociale (59 %), l’anxiété de séparation (50 %), l’épisode dépressif caractérisé (32 %) et le trouble anxieux généralisé (18 %). Par rapport aux adolescents scolarisés, les adolescents en refus scolaire présentaient un niveau d’anxiété, d’affects dépressifs, un sentiment de solitude significativement plus élevés, une estime de soi et une qualité de vie plus faible. La perception de l’attachement de ces adolescents à leurs mères et à leurs pairs était plus faible. Conclusion Les adolescents en refus scolaire ont des troubles sévères, dominés par des profils psychopathologiques variés. Ces difficultés ont un impact sur le sentiment de solitude et la qualité de vie. L’attachement semble jouer un rôle dans ce trouble. Summary Introduction School refusal appeared when formal education became compulsory in 1882, with the Jules Ferry laws. In international psychiatric classifications, school refusal does not appear as a diagnosis by itself, but it co-exists and is inherent to the symptoms of other psychiatric conditions, in particular of anxiety and depressive disorders. The main goal of this study was to describe psychopathological disorders in teenagers presenting school refusal followed in a day hospital setting. The second goal was to measure the level of anxiety, depressive emotion, self-esteem, loneliness, attachment to parents and peers, as well as quality of life, and to compare these with teenagers in school. Material and methods Two groups of individuals participated in this study. The first group consisted of 22 adolescents presenting school refusal followed in the Espace Arthur day hospital in Marseille. The control group included 23 teenagers in school. The psychopathological profile of teenagers with school refusal was defined using the semi-directed KIDDIE-SADS questionnaire. The level of psychopathology was assessed in the two groups through self-evaluation scales. Results The results showed that among teenagers with school refusal, four main diagnoses were found: social phobia (59%), separation anxiety disorder (50%), depression (32%), and generalized anxiety disorder (18%). Compared to teenagers in school, those with school refusal had significantly higher levels of anxiety, depression, and loneliness. In addition, they had low self-esteem, and the perception of attachment to their mother and to peers was also less secure. In line with this, they also showed poor quality of life. Conclusion Adolescents with school refusal show a wide variety of psychopathological symptoms, mainly inherent to anxiety and depressive disorders. These difficulties have an impact on the quality of life, loneliness, and self-esteem. Moreover, attachment to parents and peers seems to play an important role in this condition. [ABSTRACT FROM AUTHOR]

Résumé Introduction Il existe peu d’études concernant les problèmes médicaux rencontrés chez les enfants placés à l’Aide sociale à l’enfance (ASE). L’objectif de notre étude était de décrire la population des mineurs placés à l’ASE et ayant fait l’objet d’une notification à la MDPH (Maison départementale des personnes handicapées) des Bouches-du-Rhône au 1 er janvier 2014. Patients et méthodes Le registre informatique de l’ASE et celui de la MDPH ont été croisés afin d’en extraire les données administratives. Après une analyse des dossiers médicaux MDPH, les informations sur les enfants placés (âge gestationnel, déficiences, pathologies) ont été codées. Résultats Parmi les 2965 mineurs placés (0,7 % des mineurs de notre région), 506 (17 %) avaient une notification à la MDPH, contre 2,5 % en population générale. Parmi eux, 80,2 % avaient été confiés suite à une mesure de placement et 50 % des notifications MDPH concernaient les orientations vers un établissement scolaire et médico-social. On a noté 2,1 déficiences par enfant, dont 35,9 % étaient des déficiences du psychisme, 26,4 % des déficiences du langage et de la parole et 21,6 % des déficiences intellectuelles cognitives. Les pathologies rencontrées étaient pour 71 % des troubles mentaux et du comportement. Les enfants les plus jeunes et placés en famille d’accueil présentaient plus de pathologies et de déficiences d’organe et peu d’atteintes du psychisme. Les enfants présentant des troubles du comportement étaient en général plus âgés et placés en foyer. Discussion Le taux de notification MDPH est 7 fois plus élevé parmi les enfants placés qu’en population générale. Ce lien entre enfance en danger et handicap est difficile à expliquer, et la psychopathologie des enfants placés complexe. Ces résultats illustrent la nécessité d’un suivi adapté aux besoins spécifiques de ces enfants. Summary Introduction By the end of 2011, 275,000 children in France were included in the Aide sociale à l’enfance (ASE, Child Welfare System). Half of these children were entrusted to public care. There is limited data on these children. The MDPH (Maison départementale des personnes handicapées) is an administrative body assisting in the care of disabled children, through material, financial, and human means. Analyzing MDPH medical records can provide medical information about these children. The aim of this study was to describe the characteristics of children left to the ASE with a record at MDPH in Bouches-du-Rhône. Methods We extracted administrative data from two registers, the ASE register and the MDPH register. The MDPH medical files of each patient were analyzed and their medical information was coded: gestational age, deficiencies, and pathologies. Results In Bouches-du-Rhône, 2965 children were entrusted, 506 (17%) of whom were known by the MDPH: 30.6% of the entrusted children known by MDPH were taken into foster care and 48% were in residential group homes. Half of the MDPH notifications concerned a referral to a school or medico-social institution. By analyzing the medical data, we observed an average of 2.1 deficiencies per child. The types of deficiencies were distributed as follows: 35.9% were psychological deficiencies, 26.4% were speech deficiencies, and 21.6% were intellectual cognitive deficiencies. The most common pathology was mental and behavioral disorder (71% of diagnoses). Discussion The MDPH notification rate in children entrusted to public care was seven times higher than in the general population. Overall, explaining the relation between child abuse and neglect and disability is difficult. The psychopathology of these children is complex. These results show the importance of specific medical monitoring for these children. [ABSTRACT FROM AUTHOR]

Summary: We report a case of schizophrenia with partial agenesis of the corpus callosum in a 14-year-old girl. Diagnosis of schizophrenia was confirmed in the longitudinal follow-up and partial agenesis of the corpus callosum was found on brain MRI at the prodromal stage of disease. The prodromal symptom was progressive deterioration of social and academic adjustment in a context of non-specified psychotic disorder in the father. We found no abnormality in the development but a history of seizures that did not require specific treatment. Follow-up at 8 months showed an increase in negative symptoms and the onset of delusional symptoms and disorganization leading to the prescription of antipsychotic treatment. A review of the literature shows that agenesis of corpus callosum is the most reliable brain morphology abnormality in schizophrenia and is related to the neurodevelopmental and abnormal brain connectivity hypothesis in schizophrenia. Although this abnormality may be a marker of disease severity, our case report highlights the lack of longitudinal follow-up to allow the characterization of a specific outcome pattern of schizophrenic adolescents with partial agenesis of the corpus callosum. [ABSTRACT FROM AUTHOR]

Summary: The treatment of children with pervasive developmental disorders (PDD) has not been systematically assessed in French day-care units. In this prospective study, 11 children with a diagnosis of PDD were followed up for 2years in a day-care unit in the Marseille university hospital. The treatment they received is based on an initial assessment by the “Centre Ressources Autisme” (CRA PACA) and further included a continued observation of the child and an assessment of the child''s abilities and needs. This treatment used various therapeutic approaches 10h weekly and also included parental counseling and coordinated work with schools. Treatment in our day-care unit can be categorized as eclectic, non-intensive therapy. It is based on methods such as TEACCH (Treatment and Education of Autistic and related Communication handicapped Children), Floor Time Play, speech and language therapy, developmental therapy, and psychotherapy. International studies on intensive behavioral therapies suggest that this treatment is superior to non-behavioral and/or non-intensive treatment. They suggest its efficiency is due both to the nature of the treatment (behavioral) and to its intensity (more than 25h a week). In this study, the CRA diagnosed children using the ADI and ADOS. The 11 children (mean age, 3years 5months) were tested twice, with the Vineland and CARS scales. The first assessment was on admission to the day hospital and the second was 2years later. The results showed developmental progress with a mean increase of 13.5 months at the Vineland Scale, and a decrease of the autism severity score on the CARS. The treatment presented here proves to be efficient; if compared to similar results in international studies, we obtained better results than their eclectic intensive or non-intensive treatment comparison group. [Copyright &y& Elsevier]