4 results on '"Da Fonseca D"'
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2. Trouble déficitaire de l'attention avec hyperactivité chez l'adulte
- Author
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Grosse, E.-M., Da Fonseca, D., Fakra, E., Poinso, F., and Samuelian, J.-C.
- Subjects
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ATTENTION-deficit hyperactivity disorder , *CHILDREN with attention-deficit hyperactivity disorder , *ADOLESCENT psychopathology , *CHILD psychology , *MENTAL health - Abstract
Abstract: The Attention-Deficit and Hyperactivity Disorder is frequent and well known in childhood and in child psychiatry. However, this disorder is widely under-diagnosed in adults. There has been a greater interest in this disorder for several decades: Several studies have indicated a persistence of symptoms beyond childhood and adolescence in up to 66% of cases, which leads to a prevalence of 5% in the general population of adults. This disorder is diagnosed on clinical presentation. The diagnostic criteria in adults are facilitated if the first symptoms of this disorder are detected before the age of seven. The symptoms are similar to those observed in children, even thought attention deficits are more frequent than impulsiveness or psychomotor hyperactivity in this population. Very often, patients diagnose their disorder on their own via journals or Internet, and then they try to find a specialist. The DSM-IV and ICD-10 criteria for adults include several items typically found in children suffering from this disorder, and differentiate several subtypes. This paper tries to clarify the functioning of this disorder, with the objective of a better knowledge and treatment for patients who are seriously handicapped by their trouble. Whereas there is a gender ratio of 4:1 (males: females) in children, women are as much concerned as men in the adult forms. The daily life of patients suffering from hyperactivity is disturbed in nearly all fields, including work, relationships and leisure. The disorder can lead to severe consequences for patients and their environment, including loss of work, separations, accidents and chaotic lifestyles. Hyperactivity can be difficult to distinguish from some of the other psychiatric disorders - mostly borderline or dissocial behaviour -, such as bipolar or conduct disorders. However, it can also occur in co-morbidity of any one of these disorders, and this in up to 60% of the cases. Nevertheless, it is important to mention that this disorder is usually present before the onset of the other co-morbid disorders. Multiple etiological factors seem to be implicated in this disorder. Several studies have highlighted the possible contribution of perinatal, neurobiological, neuroanatomical, neuropsychological and genetic factors. The abnormality most explored is the imbalance between noradrenergic and dopaminergic systems. Similarly, genetic studies underline the aberrations found in the dopamine transporter gene and in the D2 and D4 receptor genes. For general practitioners, social workers, forensic institutions or courts, it is important to realise that these patients can beneficiate from an adequate and effective treatment. Pharmacological treatments are the same as the ones for children, they include méthylphénidate and atomoxetine but also antidepressants and antihypertonics. Beside pharmacotherapy, psycho-education can significantly improve symptoms and results in improving self-management of daily life difficulties. [Copyright &y& Elsevier]
- Published
- 2007
- Full Text
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3. Étude du développement cognitif et de la pensée logique dans l'anorexie mentale
- Author
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Poinso, F., Da Fonseca, D., Camera, E., Zarro, C., Guelfi, J., Duverger, H., and Vialettes, B.
- Subjects
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ANOREXIA nervosa , *EATING disorders , *SCHOOL children , *HOSPITAL care , *CHILD psychology - Abstract
Abstract: Patients with anorexia nervosa are usually presented as studious pupils, proposing their school performances to avoid the hospitalisation. Their real intellectual level is discussed in the literature, by taking into account of their state of denutrition, of the possibly associated depression and the psychopathological aspects of the cognitive investment. Population and methodology: This study includes a population of 21 teenagers and adults with anorexia nervosa hospitalized in an endocrinology unit. They were evaluated using the IQ scales of Weschler and the scales of logical thought. Results: These patients with anorexia nervosa have a normal IQ (average QIG=102). On the other hand, 19 patients out of 21, present either a delay (50%), or a normal cognitive disharmony (45%). Conclusions: The intellectual performances measured by the psychometric tests do not differentiate this group of patients from the general population. But these patients have a form of concrete thought, revealed by the tests of logical thought, which show their difficulties of accession to the abstract or formal thought of adolescence. We make the hypothesis of a link between the refusal of the sexual body and the immaturity of the new cognitive processes of the adolescence as the formal thought. [Copyright &y& Elsevier]
- Published
- 2006
- Full Text
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4. Actes auto-agressifs avec substance chez les moins de 18 ans : étude prospective des cas régulés par le centre antipoison et de toxicovigilance de Marseille.
- Author
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Le Gall, A., Reynoard, J., Boulamery, A., Glaizal, M., Schmitt, C., Torrents, R., Da Fonseca, D., and Simon, N.
- Subjects
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SELF-poisoning , *SUICIDAL behavior , *EMERGENCY medical services , *DISEASE relapse , *CHILD psychology - Abstract
Notre objectif principal était de décrire les caractéristiques des actes auto-agressifs avec substance des sujets de moins de 18 ans pris en charge dans le cadre de la régulation téléphonique d'urgence du centre antipoison et de toxicovigilance de Marseille. Cette étude est descriptive, prospective et quantitative. Elle est monocentrique et a été réalisée au sein du centre antipoison et de toxicovigilance de Marseille. Elle a inclus l'ensemble des sujets de moins de 18 ans pour lesquels un avis au centre antipoison et de toxicovigilance de Marseille a été sollicité au décours d'un acte auto-agressif avec une substance toxique (dont des médicaments) entre le 1er octobre 2021 et le 31 janvier 2022. Les 308 sujets inclus étaient âgés de 11 à 17 ans avec un âge moyen de 14,9 ans (±1,5) pour les filles et 14,6 (±1,7) pour les garçons (p = 0,234). Le sex-ratio était de 0,14. Deux cent quarante patients (77,9 %) avaient déjà un suivi antérieur psychologique ou psychiatrique. Il s'agissait d'une récidive de tentative de suicide dans 43,8 % des cas (n = 135). Le recours aux services des urgences était quasiment systématique (n = 277, 89,9 %). Il s'agissait en majorité de mono-intoxications (n = 193, 62,7 %). Les intoxications étaient dans la plupart des cas médicamenteuses (n = 281, 91,2 %). Les antalgiques-antipyrétiques étaient la classe médicamenteuse la plus utilisée (n = 147 patients, 47,7 %), suivis par les anxiolytiques (n = 62, 20,1 %). Le paracétamol s'est avéré la substance la plus ingérée (n = 108, 35,1 %). Cent six patients sont restés asymptomatiques (34,4 %). Sur les 308 sujets inclus, 78,6 % étaient hospitalisés pour une durée moyenne de 4 ans jours. Deux cent quarante-neuf jeunes (80,8 %) avaient eu au moins un avis psychiatrique et 200 (64,9 %) avaient un rendez-vous pour une consultation psychiatrique à la sortie. Les caractéristiques démographiques des jeunes suicidants et celles de l'intoxication étaient globalement similaires à celles retrouvées dans la littérature. Le taux de récidive est plus élevé que dans la littérature. Plus de deux ans après le début de la pandémie de SARS-CoV-2, le mal-être de la jeunesse est toujours là alors que l'offre de soin est déjà saturée. Pour inverser la tendance d'ici 2027, le ministère de la Santé et de la Prévention a actualisé sa stratégie nationale de prévention par différents moyens. Une étude au décours pourrait être intéressante pour voir l'impact de ces mesures. Cette étude, même limitée dans le temps et l'espace, complète d'autres indicateurs peu nombreux et partiels, et montre que la crise de santé mentale pédiatrique s'aggrave, en particulier chez les plus jeunes adolescents, avec un taux de récidive qui augmente. Il faut rester vigilant et continuer à mettre en place des actions de dépistage et des moyens de prévention notamment des récidives. To describe poison exposures in case of self-poisoning subjects younger than 18 years old reported to the Marseille Poison Control Center. This is a descriptive, monocentric and prospective review of self-poisoning patients aged < 18 years who reported to the Marseille Poison Control Center from 1st October 2021 to 31st January 2022. The 308 subjects included were aged 11 to 17 years with an average age of 14.9 years (±1.5) for girls and 14.6 (±1.7) for boys (P = 0.234). The sex ratio was 0.14. Two hundred and forty patients (77.9%) already had prior psychological or psychiatric follow-up. It was a recurrence of suicide attempts in 43.8% of cases (n = 135). The use of an emergency department was almost systematic (n = 277, 89.9%). Most of these were mono-intoxications (n = 193, 62.7%). The poisonings were in most cases drug-induced (n = 281, 91.2%). Analgesics-antipyretics were the most used drug class (n = 147 patients, 47.7%), followed by anxiolytics (n = 62, 20.1%). Paracetamol proved to be the most ingested substance (n = 108, 35.1%). One hundred and six patients remained asymptomatic (34.4%). Of the 308 cases included, 78.6% were hospitalized for an average of four days. Two hundred forty-nine cases (80.8%) had one psychiatric evaluation in an emergency department and 200 (64.9%) will have an appointment for a psychiatric consultation on discharge. The demographic characteristics of young suicides and those of intoxication were globally like those found in the literature although our recurrence rate was higher than those in the literature. More than two years after the start of the SARS-CoV-2 pandemic, the malaise of young people remains while the care offer is already saturated. To reverse the trend by 2027 the French Ministry of Health and Prevention has updated its national prevention strategy by various means. A subsequent study could be interesting to see the impact of these measures. This study is limited but seems to complement some indicators, which shows that the pediatric mental health crisis is worsening, especially among the youngest adolescents who have an increased recurrence rate. We must remain vigilant and continue to implement screening actions and means of prevention, particularly of recurrences. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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