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The case of a bipolar 17-year-old girl who developed prolonged vivid hallucinations and a dissociative state involving self-destructive behaviour following the use of Salvia divinorum is presented. The herb has mostly short-term (10–15 min) hallucinogenic properties. Salvatorin A, the main active compound, is a highly selective agonist of the kappa-opioid receptor. The plant is available at tobacco or other specialized stores in many countries such as France, UK, Canada, and USA, where it is legal. The clinical case reported in this article suggests that the recreational use of Salvia divinorum may result in serious psychiatric consequences in vulnerable individuals. [ABSTRACT FROM AUTHOR]

The basic need for the child to be close to a significant adult which is posited in the attachment theory, is increased when the child is living in a traumatic family environment. Access to mentalization is restricted as long as the traumatic situation is lasting. Admitting the child in a therapeutic foster family will help him retrieve an autonomous intrapsychic organization. This therapeutic device provides a secure succession of separation and reunion periods. Fostering a child a few nights per week promotes the development of a secure attachment pattern between the parents and the child. This process triggers the representational capacities of the child. Thanks to the memorization of the space-time components of the therapeutic frame, it opens the road for working on traumatic memories. [Copyright &y& Elsevier]

This retrospective study aimed at examining, through the review of medical charts, the relationship between four variables associated with the development of the Narcissistic Personality Disorders in children and adolescents:

Introduction: Despite the high rate of somatic symptom disorder (TSS) in the pediatric population, etiological mechanisms remain poorly understood. Previous studies conducted in youths with anxiety, eating disorder, or autistic disorder support a relation between difficulties in the perception of sensory signals (i.e., interoception) and difficulties in identifying emotions., Method: A cross-sectional study was carried out at the University Hospital of Amiens-Picardie in 19 young people aged 9 to 17 hospitalized in the pediatric ward for TSS. A mental heartbeat tracking task was used to assess interoceptive accuracy, awareness and sensibility. The Porges Body Perception Questionnaire (PBPQ) was used to assess interoceptive attention. Other questionnaires were used to assess associated clinical dimensions such as depression, anxiety, emotional dysregulation and alexithymia., Results: The mean interoceptive accuracy score was lower in TSS subjects compared to expected scores in the general population (33% error vs. 20%). A statistically significant correlation was found between, on the one hand, interoceptive sensibility and the "avoidance" subscore of the ECAP (r=0.51) and, on the other hand, between interoceptive awareness and the total score of the Child Depression Inventory (r=0.51). A significant relationship was found between the PBPQ scale total score and the Children-Toronto Alexithymia Scale total score (r=0.42), in particular with the "difficulty expressing emotions" subscore (r=0.62)., Conclusion: This study confirms that interoceptive difficulties occur in young patients with severe TSS. Our finding adds empirical evidence supporting the relations between interoceptive difficulties, alexithymia and somatic symptoms in children and adolescents., (Copyright © 2022 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Chronic idiopathic intestinal pseudo-obstruction is a rare and serious chronic disease starting in childhood, which can affect the entire digestive tract. It is caused by a peristalsis intestinal disorder that leads to occlusions without any obvious obstruction. Few studies have been carried out regarding the prognosis of this illness. This disease is often diagnosed by a process of elimination, but some histological anomalies have been present in the digestive wall of certain patients. This clinical case concerns a 17-year-old girl affected by CIPO and eating disorders. It seems difficult to discriminate between digestive disorders and eating disorders. What psychological effects can this severe pathology have? Are eating disorders induced by CIPO? These questions are raised in this article through the example of this patient's somatopsychic complexity and the ensuing difficulties in her overall care., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Background: Little is known on the phenomenology and potential prognosis factors of bipolar episodes in adolescents. In particular, very few studies examine this issue on inpatients in the European context of free access to care., Objective: To assess the follow-up in adulthood of acute manic and mixed episodes in hospitalized adolescents and the predictive value of psychological testing., Methods: 80 subjects, aged 12 to 20 years, consecutively hospitalized for a manic or mixed episode between 1994 and 2003, were contacted in 2005-2006 for a follow-up assessment. 5 patients refused, 20 were lost, 55 patients were assessed by direct and complete interview (67%) or by phone and treating psychiatrist (33%)., Results: At index episode, the sample was characterized by severe impairment, high rates of psychotic features (N = 50, 62,5%), a long duration of stay (mean = 80,4 days), and an overall good improvement at discharge from hospital (86% very much or much improved). Half had a psychological testing before discharge. At follow-up (mean average 5 years), 35 patients still had a diagnosis of bipolar disorder. Eight changed life-time diagnosis for schizoaffective disorder and 11 for schizophrenia. Mortality and morbidity were severe with one subject who died from cardiac failure, and 91% of patients who had at least one relapse. Patients without relapse (N = 5) and patients showing a good social functioning (N = 19) remained with a diagnosis of bipolar disorder. Using a clinical global impression method, psychological testing (blind with follow-up status) was significantly correlated with transition to schizophrenia spectrum disorder., Conclusion: Contrarily to what is seen in less severe sample of bipolar disorder, changes in life time diagnosis can occur during follow-up after a manic or mixed episode in adolescence, as many patients are in the schizophrenia spectrum in adulthood.

Symptoms of behavioral activation in children and adolescents have been reported as possible adverse effects of treatment with fluoxetine and sertraline. A 15-year-old with a single major depressive episode, dissociative periods, and anxious hyperventilation attacks was started on sertraline 50 mg (1 mg/kg) daily and, within 4 days, raised to 100 mg daily. All major symptoms resolved by 4 weeks with no apparent side effects or adverse behavioral changes. Ratings of Global Assessment of Functioning and Clinical Global Impression Severity of Illness ratings reflected marked clinical improvement. The adolescent remained euthymic for 6 months but then experienced a return of some depressive symptoms. Within 3 days of raising the dose to 150 mg daily, the patient began to exhibit difficulty in falling asleep, hypermotoric behavior, and hypertalkativeness (in association with tremor and blurred vision). This episode was not of sufficient duration and did not fulfill a sufficient number of DSM-IV criteria to qualify as hypomania. The symptoms of behavioral activation lasted for 3 days and disappeared when sertraline was discontinued, but depressive and hyperventilation symptoms returned quickly. Reinstatement of 100 mg produced enduring recovery without the adverse effects. This case appears to suggest that rapid dose elevation may not be as important as dose quantity in eliciting adverse behavioral effects from sertraline. Judging from the few cases now in the medical literature, it appears that sertraline-induced behavioral activation may emerge at doses that vary considerably among individual youths (25-200 mg daily). In short, this drug-induced behavioral activation appears to be dose-dependent, but dose threshold varies widely among patients.

Objective: To establish whether consensus exists among 3 diagnostic systems that outline criteria for narcissistic personality disorders (NPDs) in children (Kernberg), in adolescents (Bleiberg), and in adults primarily (DSM-IV) and to identify age-related criteria for preadolescents., Method: A comparative analysis was used to determine the rate of concordance for the 9 DSM-IV criteria for NPD., Results: There is a high concordance among the 3 systems for DSM criteria, suggesting that NPD can be identified among preadolescents., Conclusions: Preliminary ways of adapting DMS-IV criteria for NPD in this age group are discussed.