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Abstract: Global Management of autistic people primarily requires behavioral and educational therapy. There is actually no psychopharmacological agent that is efficient on the core symptoms of autism, especially the social and communicative impairments. However psychotropic medications are widely prescribed in this population and as mush as one out two people with autism receives at least one medication. In this population, medications are mainly directed at the frequently associated behavioral symptoms such as aggression toward self or others, tantrums, hyperactivity, severe repetitive behaviors. The goal of this article is to provide a review of the existing controlled studies in this area. The presented studies aim the following therapeutic classes: atypical antipsychotics, selective serotonin reuptake inhibitors (SSRI), psychostimulants and antiepileptics. The studies and their main results in terms of efficiency and safety are presented in tables. Atypical antipsychotics, especially risperidone and aripiprazole have been shown to be useful in the treatment of behavioral symptoms. SSRI seem to have limited interest for the management of repetitive behaviors. Stimulants can help in case of hyperactivity and attention deficit associated with Autism spectrum disorders. Antiepileptics show promising results, but the best indications for this class are not clear. For sleep disturbances, melatonin can be a safe and efficient option. Challenging behaviors requires careful investigation to understand their origin in order to provide the specific management. The first answer should be environmental and educational. Somatic or mental diseases should be carefully assessed. Medication use in this vulnerable population should carefully evaluate the benefit/risk balance. Medications should be prescribed at the minimum dose for the minimum duration. [Copyright &y& Elsevier]

Abstract: Because of the close relationship between child and adolescents with their environment, Psychiatric emergencies in this population are very specific. Situations seen and their management are different from psychiatric adult emergencies. Beside real psychiatric emergencies, we often see situations characterised by psychological distress with an important social component. Our retrospective study compares two populations of youth people seen in the outpatient psychiatric emergency unit of the Pitié-Salpêtrière hospital in Paris. We analyse 196 cases seen during 1992 and 314 seen during 2002. The purpose is to evaluate the evolution of demographic and clinical characteristics of these two populations. The results are completed by a previous study conducted in 1981. Main demographic results are: 1) a dramatic increase of the number of patients seen; 2) a significant decrease of the mean age of consultation (13.6 yo in 1992 vs 12.3 yo in 2002); 3) sex-ratio stay the same, with more girls among old ages and more boys among young ages; 4) families themselves ask for consultation more and more often (58% in 2002). Clinical results are: 1) main reason of consultation stays acting-out disorders, especially in boys (50% in 1992 and 2002); 2) a greater proportion of patients has a psychiatric follow-up at the time of the consultation (38.2% in 1992; 55.4% in 2002); 3) major depression is the first diagnosis in 1992 (24.2%) and 2002 (35.8%); 4) psychiatric hospitalisation occurs in 34.2% in 1992 vs 19.8% in 2002, but absolute numbers remains stable. These results might be useful for the public health system in order to improve our answers for these requests more and more numerous for patients younger and younger. [Copyright &y& Elsevier]

Abstract: Sensory-motor integration approach of severe pervasive developmental disorders has become more popular during the recent years thank to André Bullinger''s research in the field of infant development. In this second paper, we aim to report a clinical illustration starting at the sensory-motor assessment as a key for therapeutic proposal in psychomotor therapy. The treatment included two sessions per week in classical room and in pool, alternatively. Technical interventions during sessions are presented and articulated with the sensory-motor assessment. Course of general functioning during the two years of treatment as well as comparison of yearly sensory-motor assessment are summarized. [Copyright &y& Elsevier]

Abstract: Hypersexuality is a frequent symptom in bipolar episode in teenagers. It can (1) favour at risk behaviours and put the adolescent in a dangerous situation, a rape being the first clinical manifestation of a manic episode; (2) induce sexual delusional ideas and/or false allegations of sexual abuse as psychotic features are frequent in this age range. In the present paper, we briefly report four recent cases seen a tour institution, and discuss the clinical, therapeutic and forensic implications of such situations. [Copyright &y& Elsevier]