102 results on '"Mouren Mc"'
Search Results
2. CERVELET ET COGNITION: UNE PISTE POUR LES TROUBLES PSYCHIATRIQUES?
- Author
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SEPTIER, M., MOUREN, MC., and MASSAT, I.
- Abstract
THIS STUDY PROVIDE A LITERATURE REVIEW TO BETTER UNDERSTAND THE INVOLVEMENT OF THE CEREBELLUM IN COGNITION. ANIMAL TESTING HAS HELPED, FIRST, TO HIGHLIGHT THE CONNECTIONS BETWEEN THE CEREBELLUM AND THE FRONTAL CORTEX. THEN, IN HEALTHY SUBJECTS, BRAIN ANATOMY COULD BE BEST DESCRIBED THANKS TO NEW IMAGING TECHNIQUES AS FMRI: PEOPLE SHOW CEREBELLAR ACTIVATIONS DURING TASKS INVOLVING EXECUTIVE FUNCTIONS. PATIENTS WITH CEREBELLAR PATHOLOGY PRESENT AN IMPAIRMENT OF EXECUTIVE FUNCTIONS. SOME ABNORMALITIES WERE ALSO FOUND IN PATIENTS WITH PSYCHIATRIC DISORDERS, ESPECIALLY IN ADHD AND BIPOLAR DISORDER: THERE IS A REDUCTION IN THE VOLUME OF THE CEREBELLUM; AND IN ADHD, A HYPOACTIVATION IN TASKS INVOLVING WORKING MEMORY IN FMRI. WORK DONE DURING THE LAST DECADE ON THE CEREBELLUM DESCRIBES AND EXPLAINS PART OF ITS INVOLVEMENT IN COGNITION. [ABSTRACT FROM AUTHOR]
- Published
- 2016
3. White-Matter Connectivity and Autism Symptomatology: a Diffusion MRI Study
- Author
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Bargiacchi, A, primary, Cachia, A, additional, Chabane, N, additional, Boddaert, N, additional, Philippe, A, additional, Brunelle, F, additional, Mouren, MC, additional, Samson, Y, additional, Laurier, L, additional, and Zilbovicius, M, additional
- Published
- 2009
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4. Unlicensed and off-label use of psychotropic medications in French children: a prospective study
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Serreau, R, primary, Le Heuzey, MF, additional, Gilbert, A, additional, Mouren, MC, additional, and Jacqz-Aigrain, E, additional
- Published
- 2004
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5. Family therapy in the treatment of adolescent anorexia nervosa: current research evidence and its therapeutic implications.
- Author
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Cook-Darzens S, Doyen C, Mouren MC, Cook-Darzens, S, Doyen, C, and Mouren, M-C
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- 2008
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6. Attention-deficit/hyperactivity disorder (ADHD) and binge eating.
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Cortese S, Bernardina BD, and Mouren MC
- Published
- 2007
7. Effectiveness of iron supplementation in a young child with attention-deficit/hyperactivity disorder.
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Konofal E, Cortese S, Lecendreux M, Arnulf I, and Mouren MC
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- 2005
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8. Gaze direction detection in autism spectrum disorder.
- Author
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Forgeot d'Arc B, Delorme R, Zalla T, Lefebvre A, Amsellem F, Moukawane S, Letellier L, Leboyer M, Mouren MC, and Ramus F
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- Adolescent, Adult, Case-Control Studies, Child, Female, Humans, Interpersonal Relations, Male, Middle Aged, Young Adult, Autism Spectrum Disorder psychology, Fixation, Ocular
- Abstract
Detecting where our partners direct their gaze is an important aspect of social interaction. An atypical gaze processing has been reported in autism. However, it remains controversial whether children and adults with autism spectrum disorder interpret indirect gaze direction with typical accuracy. This study investigated whether the detection of gaze direction toward an object is less accurate in autism spectrum disorder. Individuals with autism spectrum disorder (n = 33) and intelligence quotients-matched and age-matched controls (n = 38) were asked to watch a series of synthetic faces looking at objects, and decide which of two objects was looked at. The angle formed by the two possible targets and the face varied following an adaptive procedure, in order to determine individual thresholds. We found that gaze direction detection was less accurate in autism spectrum disorder than in control participants. Our results suggest that the precision of gaze following may be one of the altered processes underlying social interaction difficulties in autism spectrum disorder., (© The Author(s) 2016.)
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- 2017
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9. Atypical Social Judgment and Sensitivity to Perceptual Cues in Autism Spectrum Disorders.
- Author
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Forgeot d'Arc B, Ramus F, Lefebvre A, Brottier D, Zalla T, Moukawane S, Amsellem F, Letellier L, Peyre H, Mouren MC, Leboyer M, and Delorme R
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- Adolescent, Adult, Autism Spectrum Disorder psychology, Child, Emotions physiology, Female, Humans, Male, Middle Aged, Visual Perception physiology, Young Adult, Autism Spectrum Disorder diagnosis, Cues, Facial Expression, Interpersonal Relations, Judgment physiology, Photic Stimulation methods
- Abstract
Evaluation of faces is an important dimension of social relationships. A degraded sensitivity to facial perceptual cues might contribute to atypical social interactions in autism spectrum disorder (ASD). The current study investigated whether face based social judgment is atypical in ASD and if so, whether it could be related to a degraded sensitivity to facial perceptual cues. Individuals with ASD (n = 33) and IQ- and age-matched controls (n = 38) were enrolled in this study. Watching a series of photographic or synthetic faces, they had to judge them for "kindness". In synthetic stimuli, the amount of perceptual cues available could be either large or small. We observed that social judgment was atypical in the ASD group on photographic stimuli, but, contrarily to the prediction based on the degraded sensitivity hypothesis, analyses on synthetic stimuli found a similar performance and a similar effect of the amount of perceptual cues in both groups. Further studies on perceptual differences between photographs and synthetic pictures of faces might help understand atypical social judgment in ASD.
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- 2016
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10. Role of ADHD symptoms as a contributing factor to obesity in patients with MC4R mutations.
- Author
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Porfirio MC, Giovinazzo S, Cortese S, Giana G, Lo-Castro A, Mouren MC, Curatolo P, and Purper-Ouakil D
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- Humans, Models, Biological, Mutation genetics, Reward, Attention Deficit Disorder with Hyperactivity complications, Feeding Behavior physiology, Obesity etiology, Receptor, Melanocortin, Type 4 genetics
- Abstract
Besides the crucial role of genetic susceptibility in the development of early-onset obesity, it has been shown that feeding behavior could contribute to increased body weight. A significant association between obesity/overweight and ADHD has been reported, suggesting that these two conditions, despite their heterogeneity, might share common molecular pathways. Although the co-occurrence of obesity and ADHD is increasingly supported by empirical evidence, the complex pathogenetic link between these two conditions is still unclear. Here, we focus on the relationship between MC4R gene mutations and ADHD in children with early-onset obesity. Mutations in the gene MC4R lead to the most common form of monogenic obesity. We hypothesize that dysregulated eating behavior in a subset of patients with MC4R mutation might be due to comorbid ADHD symptoms, underpinned by abnormal reward mechanisms. Therefore, we speculate that it is possible to prevent obesity in a subset of patients with MC4R mutation, even if these patients are genetically programmed to "be fat", via an appropriate treatment of ADHD symptoms. We hope that our paper will stimulate further studies testing if the early screening for ADHD symptoms and their appropriate treatment may be an effective way to prevent obesity in a subset of children with MC4R mutation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
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- 2015
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11. [Cognitive remediation therapy for children and adolescents with anorexia nervosa in France: an exploratory study].
- Author
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Asch M, Esteves J, De Hautecloque D, Bargiacchi A, Le Heuzey MF, Mouren MC, and Doyen C
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- Adolescent, Anorexia Nervosa psychology, Body Image, Body Mass Index, Child, Feasibility Studies, Female, Hospitalization, Humans, Male, Neuropsychological Tests, Patient Acceptance of Health Care psychology, Patient Satisfaction, Personality Inventory, Set, Psychology, Anorexia Nervosa therapy, Cognitive Behavioral Therapy methods, Psychotherapy, Group methods
- Abstract
Objective: Cognitive remediation therapy (CRT) seems to be increasingly interesting in the treatment of anorexia nervosa for adult patients. We attempted to apply this support to a group of young inpatients, initially to assess its feasibility and acceptability, and then to improve its content for therapeutic application and future research., Methods: Ten 12- to 17-year-old inpatients with primary DSM-IV diagnosis of anorexia nervosa participated in a 10-week intervention program with a one-hour group session of CRT per week. All 10 patients were assessed before the intervention and those who completed the 10 sessions were assessed after. Assessment included a clinical examination by a psychiatrist, a battery of clinical inventories, and set-shifting tests. Moreover, each patient wrote a letter providing feedback on the intervention for subsequent analysis., Results: Only two patients completed all 10 sessions, the other eight who were discharged from the hospital in the meantime could not attend the sessions for practical reasons. After the 10 sessions, an improvement in BMI and in measured levels of some psychopathological symptoms was observed in our two patients. Most neuropsychological task performances were improved after cognitive remediation. Feedback from the 10 patients was generally positive., Conclusion and Implications for Practice: This preliminary investigation suggests that cognitive remediation therapy is acceptable and feasible in this population. Replication of these findings requires a larger sample, improvement of the trial design, more sensitive measures, and another training format to avoid loss of so many participants., (Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2014
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12. [Anorexia nervosa in the light of neurocognitive functioning: New theoretical and therapeutic perspectives].
- Author
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Martinez G, Cook-Darzens S, Chaste P, Mouren MC, and Doyen C
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- Adolescent, Anorexia Nervosa physiopathology, Anorexia Nervosa therapy, Attention physiology, Brain physiopathology, Cognition Disorders physiopathology, Cognition Disorders therapy, Comprehension physiology, Female, Humans, Neuropsychological Tests, Problem Solving physiology, Social Skills, Young Adult, Anorexia Nervosa diagnosis, Anorexia Nervosa psychology, Cognition Disorders diagnosis, Cognition Disorders psychology
- Abstract
Introduction: Anorexia nervosa is a serious psychiatric disorder, for which very few validated therapeutic strategies exist. The specific sociocognitive style of anorexic patients has already been described in the 1960s: it involves a concrete style with abstraction difficulties. Current neuropsychological tests have contributed to a more precise definition of these difficulties., Neuropsychological Data: IS THERE A SPECIFIC COGNITIVE PROFILE?: Contrary to common beliefs, these patients' intellectual performances are not superior to those of the general population. However, detailed comparisons of profiles on the Weschler Scales suggest difficulties in synthesizing information and better abilities in concrete problem solving., Excessive Attention to Details: The dominant hypothesis concerning the attentional dimension is the existence of a weakness in central coherence, resulting in superior detail processing and a weakness in global integration. This trend appears to be stable even after the normalization of nutritional status., Impaired Cognitive Flexibility: The impairment of set-shifting abilities leads to rigidity, expressed by inflexibility and perseveration, both in reasoning and behaviour. This reduced cognitive flexibility appears to persist after recovery, and may constitute a familial trait. In addition, this likely endophenotype seems to be independent from obsessional traits., Controversial Social Skill: Alexithymia is frequently described in anorexic individuals. It is the verbal description of feelings which seems to be particularly impaired. It may explain underlying difficulties in empathy. Indeed, these subjects have lower scores on emotional tests drawn from the theory of mind. These cognitive abnormalities are well documented in pervasive developmental disorders. NEUROANATOMICAL DATA: NEUROIMAGING IN SUPPORT OF LIMBIC AND FRONTO-STRIATAL ABNORMALITIES: Evidence from neuroimaging suggests abnormalities in cortical and subcortical structures, involving the temporal and orbito-frontal lobes. Various functional hypotheses are formulated, involving fronto-striatothalamic circuits, amygdala or insula. IS ANOREXIA NERVOSA A DEVELOPMENTAL DISORDER?: Pervasive developmental disorders are over-represented among anorexic subjects in comparison to the general population. Conversely, restrictive and selective eating disorders are more frequent among individuals presenting an autistic spectrum disorder., Therapeutic Implications and Future Directions: In view of the common cognitive and neuroanatomical data that are found in anorexia nervosa and neurodevelopmental disorders, we adhere to the hypothesis that anorexia nervosa may be similar to a neurodevelopmental disorder. Clinical observations suggest that this hypothesis may be especially relevant in the early forms of anorexia nervosa. These cognitive data confirm the potential relevance of new therapeutic modalities such as cognitive remediation. Initial results from its application to anorexia nervosa seem promising., Conclusion: A review of the recent literature highlights the possible existence of a developmental impairment of cortical and subcortical structures, associated with specific abnormalities in cognitive development such as a weakness in central coherence, reduced set-shifting ability and poor social skills. On this basis, cognitive remediation may be a promising therapeutic innovation., (Copyright © 2013. Published by Elsevier Masson SAS.)
- Published
- 2014
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13. [Cardiovascular risks and management during Attention Deficit Hyperactivity Disorder treatment with methylphenidate].
- Author
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Bange F, Le Heuzey MF, Acquaviva E, Delorme R, and Mouren MC
- Subjects
- Blood Pressure drug effects, Child, Cooperative Behavior, Drug Monitoring, Guideline Adherence, Heart Rate drug effects, Humans, Interdisciplinary Communication, Long-Term Care, Referral and Consultation, Risk Factors, Attention Deficit Disorder with Hyperactivity drug therapy, Central Nervous System Stimulants adverse effects, Central Nervous System Stimulants therapeutic use, Death, Sudden, Cardiac etiology, Methylphenidate adverse effects, Methylphenidate therapeutic use, Myocardial Infarction chemically induced, Stroke chemically induced
- Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common of the pediatric neuropsychiatric disorders. Methylphenidate is an important element of therapeutic strategies for ADHD. Clinicians are interested in the safety of methylphenidate. Because this drug raises heart rate and blood pressure, concerns have been raised about its cardiovascular safety. Concerns were based on case reports of sudden cardiac death in methylphenidate users, plausible pharmacological pathways involving well-established stimulant effects on heart rate and blood pressure. Until recently, data were limited to a number of observational studies too small to examine serious cardiac events. In the past two years, large retrospective, population-based cohort studies were performed. These studies did not show any evidence that methylphenidate was associated with an increase in risk of myocardial infarction, sudden cardiac death, or stroke. Treatment of children with methylphenidate is not significantly associated with an increase in the short term or mid-term risk of severe cardiac events. For many, available data now will be seen as reassuring. But gaps persist in the methodical and comprehensive assessments of the safety of methylphenidate. Analyses cannot be generalized to children with long-term use of stimulants. Furthermore, long-term effects of slight increases in heart rate or blood pressure are unknown. Stimulant administration continues to have a detectable adrenergic effect even after years of treatment. In the MTA study, greater cumulative stimulant exposure was associated with a higher heart rate at years 3 and 8. Although less severe, such adverse cardiac events are nonetheless alarming to patients. This adrenergic effect may have clinical implications, especially for individual patients with underlying heart abnormalities and it deserves further investigation. More research is necessary to optimize a safe use of methylphenidate regarding its cardiovascular effects. In light of the controversies surrounding the increase in the number of children being diagnosed with ADHD, the broad use of methylphenidate in these patients, and cardiovascular concerns about it, this article addresses topics of clinical significance. For ease of use by practitioners, the article summarizes the guidelines stated by the European Medicines Agency over the appropriate pretreatment evaluation and cardiovascular assessment. It advocates a thorough history and physical examination before initiating methylphenidate to treat patients with ADHD, with an emphasis on the identification of risk factors for sudden death. A cardiac sub-specialist consultation is mandatory in case of history or physical examination findings. In other cases, an electrocardiographic screening is recommended in order to check out previously unrecognized heart disease., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)
- Published
- 2014
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14. [Controlled drug consumption rooms].
- Author
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Allilaire JF, Costentin J, Goullé JP, Hamon M, Laqueille X, Lejoyeux M, Mouren MC, Olié JP, Nordmann R, and Tillement JP
- Subjects
- Drug Overdose prevention & control, France, Humans, Needle-Exchange Programs, Policy Making, Communicable Disease Control methods, Harm Reduction, Public Facilities, Substance Abuse, Intravenous complications
- Published
- 2013
15. Brain iron levels in attention-deficit/hyperactivity disorder: a pilot MRI study.
- Author
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Cortese S, Azoulay R, Castellanos FX, Chalard F, Lecendreux M, Chechin D, Delorme R, Sebag G, Sbarbati A, Mouren MC, Bernardina BD, and Konofal E
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- Adolescent, Attention Deficit Disorder with Hyperactivity physiopathology, Case-Control Studies, Caudate Nucleus chemistry, Child, Female, Humans, Magnetic Resonance Imaging, Male, Pilot Projects, Putamen chemistry, Thalamus chemistry, Attention Deficit Disorder with Hyperactivity metabolism, Brain Chemistry, Ferritins blood, Iron Deficiencies
- Abstract
Objective: Brain iron deficiency has been supposed to be involved in the pathophysiology of ADHD. Available studies assessing iron in ADHD are based on serum ferritin, a peripheral marker of iron status. To what extent serum ferritin correlates with brain iron (BI) is unclear. The main aim of this study was to compare BI, estimated with magnetic resonance imaging (MRI) in the putamen, pallidum, caudate, and thalamus, between children with and without ADHD. The secondary aim was to assess the correlation between serum ferritin and BI levels., Methods: Thirty-six children (18 with and 18 without ADHD, the latter including nine healthy controls and nine psychiatric controls) completed MRI and blood sampling. Brain iron levels were estimated by imaging T2*., Results: Children with ADHD showed significantly lower estimated BI in right and left thalamus compared to healthy controls. Estimated BI did not differ significantly between children with ADHD and psychiatric controls. Children with ADHD had significantly lower levels of serum ferritin than healthy as well as psychiatric controls. Serum ferritin and T2* values did not correlate significantly in most regions., Conclusions: Low iron in the thalamus may contribute to ADHD pathophysiology.
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- 2012
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16. [On-screen games: from excess to addiction].
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Mouren MC, Lejoyeux M, and Le Heuzey MF
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- Adolescent, Adult, Child, Humans, Behavior, Addictive, Video Games
- Published
- 2012
17. Genetic and functional analyses of SHANK2 mutations suggest a multiple hit model of autism spectrum disorders.
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Leblond CS, Heinrich J, Delorme R, Proepper C, Betancur C, Huguet G, Konyukh M, Chaste P, Ey E, Rastam M, Anckarsäter H, Nygren G, Gillberg IC, Melke J, Toro R, Regnault B, Fauchereau F, Mercati O, Lemière N, Skuse D, Poot M, Holt R, Monaco AP, Järvelä I, Kantojärvi K, Vanhala R, Curran S, Collier DA, Bolton P, Chiocchetti A, Klauck SM, Poustka F, Freitag CM, Waltes R, Kopp M, Duketis E, Bacchelli E, Minopoli F, Ruta L, Battaglia A, Mazzone L, Maestrini E, Sequeira AF, Oliveira B, Vicente A, Oliveira G, Pinto D, Scherer SW, Zelenika D, Delepine M, Lathrop M, Bonneau D, Guinchat V, Devillard F, Assouline B, Mouren MC, Leboyer M, Gillberg C, Boeckers TM, and Bourgeron T
- Subjects
- Adaptor Proteins, Signal Transducing genetics, Adaptor Proteins, Signal Transducing metabolism, Adult, Alternative Splicing genetics, Cell Line, Child, Child, Preschool, Female, Gene Dosage genetics, Gene Expression Regulation, Humans, Male, Neurons cytology, Protein Isoforms genetics, Protein Isoforms metabolism, RNA Splice Sites genetics, Receptors, Nicotinic genetics, Receptors, Nicotinic metabolism, Synapses pathology, Tissue Distribution, alpha7 Nicotinic Acetylcholine Receptor, Child Development Disorders, Pervasive genetics, Nerve Tissue Proteins genetics, Sequence Deletion genetics, Synapses genetics
- Abstract
Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disorders with a complex inheritance pattern. While many rare variants in synaptic proteins have been identified in patients with ASD, little is known about their effects at the synapse and their interactions with other genetic variations. Here, following the discovery of two de novo SHANK2 deletions by the Autism Genome Project, we identified a novel 421 kb de novo SHANK2 deletion in a patient with autism. We then sequenced SHANK2 in 455 patients with ASD and 431 controls and integrated these results with those reported by Berkel et al. 2010 (n = 396 patients and n = 659 controls). We observed a significant enrichment of variants affecting conserved amino acids in 29 of 851 (3.4%) patients and in 16 of 1,090 (1.5%) controls (P = 0.004, OR = 2.37, 95% CI = 1.23-4.70). In neuronal cell cultures, the variants identified in patients were associated with a reduced synaptic density at dendrites compared to the variants only detected in controls (P = 0.0013). Interestingly, the three patients with de novo SHANK2 deletions also carried inherited CNVs at 15q11-q13 previously associated with neuropsychiatric disorders. In two cases, the nicotinic receptor CHRNA7 was duplicated and in one case the synaptic translation repressor CYFIP1 was deleted. These results strengthen the role of synaptic gene dysfunction in ASD but also highlight the presence of putative modifier genes, which is in keeping with the "multiple hit model" for ASD. A better knowledge of these genetic interactions will be necessary to understand the complex inheritance pattern of ASD., Competing Interests: The authors have declared that no competing interests exist.
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- 2012
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18. [Videogame addiction: a danger for only at-risk children or for all children].
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Le Heuzey MF and Mouren MC
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- Adolescent, Attention Deficit Disorder with Hyperactivity psychology, Child, Humans, Risk Factors, Behavior, Addictive psychology, Video Games adverse effects
- Abstract
With the rapid growth in the number of children and adolescents having access to videogames, there is a risk of addictive behavior, especially among those with underlying mental illnesses. Yet there is no consensual definition of videogame addiction. Depression, anxiety disorders and hostility are all associated with overuse, but attention-deficit hyperactivity disorder (ADHD) is the most significant predictor.
- Published
- 2012
19. Should metabolic diseases be systematically screened in nonsyndromic autism spectrum disorders?
- Author
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Schiff M, Benoist JF, Aïssaoui S, Boespflug-Tanguy O, Mouren MC, de Baulny HO, and Delorme R
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- Child, Demography, Female, Humans, Male, Syndrome, Child Development Disorders, Pervasive complications, Mass Screening, Metabolic Diseases complications, Metabolic Diseases diagnosis
- Abstract
Background: In the investigation of autism spectrum disorders (ASD), a genetic cause is found in approximately 10-20%. Among these cases, the prevalence of the rare inherited metabolic disorders (IMD) is unknown and poorly evaluated. An IMD responsible for ASD is usually identified by the associated clinical phenotype such as dysmorphic features, ataxia, microcephaly, epilepsy, and severe intellectual disability (ID). In rare cases, however, ASD may be considered as nonsyndromic at the onset of a related IMD., Objectives: To evaluate the utility of routine metabolic investigations in nonsyndromic ASD., Patients and Methods: We retrospectively analyzed the results of a metabolic workup (urinary mucopolysaccharides, urinary purines and pyrimidines, urinary creatine and guanidinoacetate, urinary organic acids, plasma and urinary amino acids) routinely performed in 274 nonsyndromic ASD children., Results: The metabolic parameters were in the normal range for all but 2 patients: one with unspecific creatine urinary excretion and the other with persistent 3-methylglutaconic aciduria., Conclusions: These data provide the largest ever reported cohort of ASD patients for whom a systematic metabolic workup has been performed; they suggest that such a routine metabolic screening does not contribute to the causative diagnosis of nonsyndromic ASD. They also emphasize that the prevalence of screened IMD in nonsyndromic ASD is probably not higher than in the general population (<0.5%). A careful clinical evaluation is probably more reasonable and of better medical practice than a costly systematic workup.
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- 2011
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20. Bulimic behaviours and psychopathology in obese adolescents and in their parents.
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Isnard P, Quantin L, Cortese S, Falissard B, Musher-Eizenman D, Guedeney A, Frelut ML, and Mouren MC
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- Adolescent, Anxiety psychology, Body Mass Index, Child, Cross-Sectional Studies, Depression psychology, Emotions, Fathers psychology, Female, France, Humans, Linear Models, Male, Psychiatric Status Rating Scales, Severity of Illness Index, Surveys and Questionnaires, Adolescent Behavior, Bulimia psychology, Mothers psychology, Obesity psychology, Psychology, Adolescent
- Abstract
Objective: To help identify and advance the understanding of the potential mechanisms underlying the association between parents' and adolescents' psychological maladjustment in obesity, we evaluated bulimic behaviours and psychopathology in a clinical sample of obese adolescents and in their parents., Methods: This is a cross-sectional cohort study including 115 severely obese, treatment-seeking adolescents aged 12-17 years (mean age: 14.2; mean body mass index z-score: 4.32), and their parents (115 mothers and 96 fathers). Adolescents filled out the Bulimic Investigatory Test, Edinburgh (BITE), the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory for Children (STAIC). Their parents completed the General Health Questionnaire (GHQ) and the BITE. A child psychiatrist filled out the Montgomery and Asberg Depression Rating Scale (MADRS) and the Brief Scale for Anxiety (BSA) for the adolescents., Results: Obese adolescents demonstrated significant correlations between the severity of bulimic symptoms and the degree of emotional symptomatology, such as depression and anxiety, but not with the severity of obesity. Psychopathological maladjustment and bulimic symptoms in obese adolescents were significantly associated with the maternal psychopathological disturbances, especially anxiety and somatisation in mother. In fact, maternal psychopathology, not maternal bulimic symptoms, was the factor most strongly associated with bulimic behaviours in obese adolescents., Discussion: These results highlight the importance of including an adolescent and parental psychiatric assessment (bulimic, depressive and anxiety symptoms), particularly maternal psychopathology in the treatment of severely obese adolescents.
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- 2010
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21. Mutation screening of NOS1AP gene in a large sample of psychiatric patients and controls.
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Delorme R, Betancur C, Scheid I, Anckarsäter H, Chaste P, Jamain S, Schuroff F, Nygren G, Herbrecht E, Dumaine A, Mouren MC, Råstam M, Leboyer M, Gillberg C, and Bourgeron T
- Subjects
- Adaptor Proteins, Signal Transducing metabolism, Adult, Aged, Alleles, Amino Acid Sequence, Amino Acid Substitution, Child, Female, Gene Frequency, Genotype, Humans, Male, Middle Aged, Molecular Sequence Data, Mutation, Pedigree, Protein Isoforms genetics, Protein Isoforms metabolism, Adaptor Proteins, Signal Transducing genetics, Child Development Disorders, Pervasive genetics, Obsessive-Compulsive Disorder genetics, Schizophrenia genetics
- Abstract
Background: The gene encoding carboxyl-terminal PDZ ligand of neuronal nitric oxide synthase (NOS1AP) is located on chromosome 1q23.3, a candidate region for schizophrenia, autism spectrum disorders (ASD) and obsessive-compulsive disorder (OCD). Previous genetic and functional studies explored the role of NOS1AP in these psychiatric conditions, but only a limited number explored the sequence variability of NOS1AP., Methods: We analyzed the coding sequence of NOS1AP in a large population (n = 280), including patients with schizophrenia (n = 72), ASD (n = 81) or OCD (n = 34), and in healthy volunteers controlled for the absence of personal or familial history of psychiatric disorders (n = 93)., Results: Two non-synonymous variations, V37I and D423N were identified in two families, one with two siblings with OCD and the other with two brothers with ASD. These rare variations apparently segregate with the presence of psychiatric conditions., Conclusions: Coding variations of NOS1AP are relatively rare in patients and controls. Nevertheless, we report the first non-synonymous variations within the human NOS1AP gene that warrant further genetic and functional investigations to ascertain their roles in the susceptibility to psychiatric disorders.
- Published
- 2010
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22. Search for copy number variants in chromosomes 15q11-q13 and 22q11.2 in obsessive compulsive disorder.
- Author
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Delorme R, Moreno-De-Luca D, Gennetier A, Maier W, Chaste P, Mössner R, Grabe HJ, Ruhrmann S, Falkai P, Mouren MC, Leboyer M, Wagner M, and Betancur C
- Subjects
- Adolescent, Adult, Child, Chromosome Deletion, DiGeorge Syndrome complications, DiGeorge Syndrome genetics, Female, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder complications, Prader-Willi Syndrome complications, Prader-Willi Syndrome genetics, Segmental Duplications, Genomic, Sequence Deletion, Syndrome, Young Adult, Chromosomes, Human, Pair 15 genetics, Chromosomes, Human, Pair 22 genetics, DNA Copy Number Variations, Gene Dosage, Obsessive-Compulsive Disorder genetics
- Abstract
Background: Obsessive-compulsive disorder (OCD) is a clinically and etiologically heterogeneous syndrome. The high frequency of obsessive-compulsive symptoms reported in subjects with the 22q11.2 deletion syndrome (DiGeorge/velocardiofacial syndrome) or Prader-Willi syndrome (15q11-13 deletion of the paternally derived chromosome), suggests that gene dosage effects in these chromosomal regions could increase risk for OCD. Therefore, the aim of this study was to search for microrearrangements in these two regions in OCD patients., Methods: We screened the 15q11-13 and 22q11.2 chromosomal regions for genomic imbalances in 236 patients with OCD using multiplex ligation-dependent probe amplification (MLPA)., Results: No deletions or duplications involving 15q11-13 or 22q11.2 were identified in our patients., Conclusions: Our results suggest that deletions/duplications of chromosomes 15q11-13 and 22q11.2 are rare in OCD. Despite the negative findings in these two regions, the search for copy number variants in OCD using genome-wide array-based methods is a highly promising approach to identify genes of etiologic importance in the development of OCD.
- Published
- 2010
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23. Temperament and character dimensions associated with clinical characteristics and treatment outcome in attention-deficit/hyperactivity disorder boys.
- Author
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Purper-Ouakil D, Cortese S, Wohl M, Aubron V, Orejarena S, Michel G, Asch M, Mouren MC, and Gorwood P
- Subjects
- Adolescent, Child, Cooperative Behavior, Exploratory Behavior, Humans, Internal-External Control, Longitudinal Studies, Male, Motivation, Paris, Personality Assessment statistics & numerical data, Psychometrics, Reward, Treatment Outcome, Attention Deficit Disorder with Hyperactivity drug therapy, Attention Deficit Disorder with Hyperactivity psychology, Central Nervous System Stimulants therapeutic use, Character, Methylphenidate therapeutic use, Temperament
- Abstract
Background: Although differential patterns of temperament and character have been documented in subjects with attention-deficit/hyperactivity disorder (ADHD), few studies have investigated relations between these dimensions, clinical features of ADHD, and treatment outcome., Methods: Ninety-five boys with ADHD and 87 controls participated in the study; 88.5% of the referred patients were reassessed after optimal titration of methylphendiate treatment., Results: Compared with controls, boys with ADHD showed a temperament profile of high novelty seeking, low reward dependence, and persistence, as well as low scores on both self-determination and cooperativeness character dimensions. No significant differences were found between subjects with ADHD and controls in harm avoidance. Temperament and character traits were related to specific symptom domains and comorbidity but did not predict global severity of ADHD. Persistent and immature children with ADHD were more likely to experience short-term remission., (2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
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24. Reduced 3-O-methyl-dopa levels in OCD patients and their unaffected parents is associated with the low activity M158 COMT allele.
- Author
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Delorme R, Betancur C, Chaste P, Kernéis S, Stopin A, Mouren MC, Collet C, Bourgeron T, Leboyer M, and Launay JM
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Heterozygote, Humans, Male, Middle Aged, Parents, Polymorphism, Single Nucleotide, Alleles, Anxiety genetics, Anxiety metabolism, Catechol O-Methyltransferase genetics, Obsessive-Compulsive Disorder genetics, Obsessive-Compulsive Disorder metabolism
- Abstract
The catechol-O-methyltransferase (COMT) gene is considered as a candidate gene in obsessive-compulsive disorder (OCD). Specifically, the COMT low-activity M158 allele has been suggested to be associated with OCD. However, there is no study reporting that COMT activity is decreased in OCD patients and that the decrease is mediated by the V158M polymorphism. Therefore, the purpose of our study was to assess COMT activity in OCD by measuring plasma levels of 3-O-methyl-dopa (3-OMD), which result from the methylation of levodopa by COMT, and to investigate the relationship between 3-OMD levels and the V158M polymorphism. We also examined whether 3-OMD levels represented an endophenotype, associated with the genetic liability to OCD, by assessing unaffected relatives of OCD patients. We assessed plasma 3-OMD levels in a sample of drug-free OCD probands (n = 34) and their unaffected parents (n = 63), and compared them with controls (n = 85). The COMT V158M polymorphism was genotyped in all participants. Lower plasma 3-OMD levels were found in OCD probands and their unaffected parents compared to controls. The COMT M158 allele was associated with reduced plasma 3-OMD levels in a co-dominant manner, both in OCD probands and their relatives, but not in controls. Our results suggest that COMT activity could act as a limiting factor for the production of 3-OMD in OCD patients and in their relatives. These findings further support a role of COMT in the susceptibility to OCD and provide evidence that 3-OMD levels could represent an endophenotype in OCD., ((c) 2009 Wiley-Liss, Inc.)
- Published
- 2010
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25. Using videotaped vignettes to improve the teaching quality in child and adolescent psychiatry.
- Author
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Delorme R, Chaste P, Scheid I, Cortese S, and Mouren MC
- Subjects
- Humans, Adolescent Psychiatry education, Child Psychiatry education, Quality of Health Care, Teaching methods, Videotape Recording
- Published
- 2010
26. [Treatment of anorexia nervosa in young patients in a special care unit at Robert-Debré Hospital (Paris): guidelines and practical methods].
- Author
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Yon L, Doyen C, Asch M, Cook-Darzens S, and Mouren MC
- Subjects
- Adolescent, Ambulatory Care, Child, Combined Modality Therapy, Cooperative Behavior, Evidence-Based Medicine, Family Practice, Family Therapy, Humans, Interdisciplinary Communication, Nutrition Assessment, Nutritional Support, Practice Guidelines as Topic, Psychoanalytic Therapy, Psychotherapy, Group methods, Weight Gain, Anorexia Nervosa therapy, Hospitalization, Patient Care Team, Psychiatric Department, Hospital, Psychotherapy methods
- Abstract
There are no official guidelines for the treatment of anorexia nervosa in young patients. Some recommendations have been proposed by a group of British experts (N.I.C.E., 2004), based on results from controlled studies. Our inpatient care unit takes into account the different dimensions of anorexia nervosa in this subgroup of young patients and proposes an integrated approach including medical care, nutritional care, and psychological care, as suggested by the N.I.C.E. recommendations. We attempt to take into account variables that are unique to these young patients. More specifically, we insist on weight restoration that will permit adequate growth and we do not systematically separate the patient from his or her family. In addition, family therapy or counseling is systematically provided. The aim of this approach is to support parents, to provide psychoeducational guidance, and to help the family acquire new behaviors and new ways of understanding the eating disorder. Most patients are treated on an outpatient basis, but inpatient care is offered when the patient displays severe medical conditions or a severe comorbid psychiatric illness. Anorexia nervosa is a protracted disorder that requires multidisciplinary outpatient medical follow-up, including the intervention of a general practitioner and a psychiatric team.
- Published
- 2009
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27. [Off-label use of psychotropic medications in pediatric wards: a prospective study].
- Author
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Winterfeld U, Le Heuzey MF, Acquaviva E, Mouren MC, Brion F, and Bourdon O
- Subjects
- Adolescent, Child, Child, Preschool, Drug Administration Schedule, Female, Hospitals, Pediatric, Hospitals, Teaching, Humans, Infant, Infant, Newborn, Male, Medical Records Systems, Computerized, Paris, Prospective Studies, Psychotropic Drugs administration & dosage, Mental Disorders drug therapy, Off-Label Use statistics & numerical data, Psychotropic Drugs therapeutic use
- Abstract
Purpose: The aim of this study was to investigate the use of psychotropic medications for both labeled and off-labeled indications in a French paediatric teaching hospital., Methods: A prospective analysis of all psychotropic drug prescriptions was conducted during a 6-month interval. Details were recorded from the computerized prescription order entry system. They included demographic data (sex, age and weight) and psychotropic medications (name, dosage, schedule, route of administration and indication). The physicians specified the indication when prescribing the psychotropic medication. All prescriptions were assessed for off-label use. Off-label prescriptions were defined as: use of a different dose or dose schedule, use for an indication not included in the license or approved for adults only, drug use outside the age range of the product license, use of medicines for which no paediatric information was available, use when the product was contraindicated, use of drug preparations that were manufactured by the hospital pharmacy, use of licensed drugs that were modified by the hospital pharmacy and use of new drugs available under a special manufacturing license. Each prescription was compared with data available in the National French Formulary., Results: A total of 1629 drug prescriptions were written for 472 patients. Sixty-eight percent of all drug prescriptions were for off-label uses: indication not included in the license or approved for adults only in 40%, no paediatric information available in 37%, different dose or dose schedule in 7%, licensed drugs that were modified by the hospital pharmacy in 5%, administration to children outside the age range of the product license in 4%, drug preparations that were manufactured by the hospital pharmacy in 4%, contraindication in 2% and new drugs available under a special manufacturing license in 1%. Sixty-six percent of the patients were prescribed a psychotropic drug in an off-label manner. Over half of the off-label prescriptions were given to adolescents (62%), followed by children (29%), infants (8%) and neonates (1%). The percentage of off-label prescriptions by age was: neonates 91%; adolescents 74%; children 59% and infants 58%. The percentage of off-label prescriptions by medication class are presented in decreasing order of prescription frequency: anxiolytics 65%; antipsychotics 69%; antidepressants 92%; antiepileptics 51%; stimulants 30%; antiparkinsonians 100% and hypnotics 100%. The 5 drugs most commonly prescribed off label were risperidone (12%), clobazam (12%), amitriptyline (11%), hydroxyzine (10%) and diazepam (7%). Nearly half (47%) of all off-label prescriptions were associated with 3 indications: anxiety (24%), disruptive behaviour (12%) and pain (11%)., Conclusion: The high rates of off-label prescription documented here and elsewhere highlight the need for further controlled clinical trials to evaluate the risks and benefits of psychotropic medication in children and adolescents.
- Published
- 2009
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28. Sleep disturbances and serum ferritin levels in children with attention-deficit/hyperactivity disorder.
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Cortese S, Konofal E, Bernardina BD, Mouren MC, and Lecendreux M
- Subjects
- Adolescent, Anemia, Iron-Deficiency blood, Anemia, Iron-Deficiency epidemiology, Attention Deficit Disorder with Hyperactivity diagnosis, Child, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Male, Nocturnal Myoclonus Syndrome epidemiology, Retrospective Studies, Severity of Illness Index, Sleep Wake Disorders diagnosis, Attention Deficit Disorder with Hyperactivity epidemiology, Ferritins blood, Sleep Wake Disorders blood, Sleep Wake Disorders epidemiology
- Abstract
Background: A subset of children with attention-deficit/hyperactivity disorder (ADHD) may present with impairing sleep disturbances. While preliminary evidence suggests that iron deficiency might be involved into the pathophysiology of daytime ADHD symptoms, no research has been conducted to explore the relationship between iron deficiency and sleep disturbances in patients with ADHD. The aim of this study was to assess the association between serum ferritin levels and parent reports of sleep disturbances in a sample of children with ADHD., Subjects: Sixty-eight consecutively referred children (6-14 years) with ADHD diagnosed according to DSM-IV criteria using the semi-structured interview Kiddie-SADS-PL., Measures: parents filled out the Sleep Disturbance Scale for Children (SDSC) and the Conners Parent Rating Scale (CPRS). Serum ferritin levels were determined using the Tinaquant method., Results: Compared to children with serum ferritin levels >or=45 microg/l, those with serum ferritin levels <45 microg/l had significantly higher scores on the SDSC subscale "Sleep wake transition disorders" (SWTD) (P = 0.042), which includes items on abnormal movements in sleep, as well as significantly higher scores on the CPRS-ADHD index (P = 0.034). The mean scores on the other SDSC subscales did not significantly differ between children with serum ferritin >or=45 and <45 microg/l. Serum ferritin levels were inversely correlated to SWTD scores (P = 0.043)., Conclusion: Serum ferritin levels <45 microg/l might indicate a risk for sleep wake transition disorders, including abnormal sleep movements, in children with ADHD. Our results based on questionnaires set the basis for further actigraphic and polysomnographic studies on nighttime activity and iron deficiency in ADHD. Research in this field may suggest future trials of iron supplementation (possibly in association with ADHD medications) for abnormal sleep motor activity in children with ADHD.
- Published
- 2009
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29. Psychometric properties of a French version of the junior temperament and character inventory.
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Asch M, Cortese S, Perez Diaz F, Pelissolo A, Aubron V, Orejarena S, Acquaviva E, Mouren MC, Michel G, Gorwood P, and Purper-Ouakil D
- Subjects
- Adolescent, Child, Factor Analysis, Statistical, Female, France, Humans, Male, Translations, Character, Personality Inventory, Psychometrics standards, Surveys and Questionnaires, Temperament
- Abstract
The junior temperament and character inventory (JTCI) has been developed for the assessment of temperament and character dimensions in childhood based on Cloninger's model of personality. We evaluated the psychometric proprieties of a French child and parent-rated version of the JTCI based on a previous German version, and assessed the correlations between the JTCI dimension scores and the scores on the child behavior checklist (CBCL) in a community sample of French children and adolescents aged 10-16 years. We used data from 452 child-rated and 233 -parent-rated JCTI. The psychometric properties (internal consistency and external validity in relation to the emotionality activity sociability (EAS) questionnaire) of the French JTCI were adequate in the parent-rated version. The parent-rated JTCI had overall better psychometric qualities than the child-rated version, but for both versions of the JTCI the confirmatory factor analysis showed low fit between the observed data and the original model. Dimensions of the EAS model were significantly correlated with the temperament scales of the JTCI. Further studies are required to improve the psychometric properties of the child-rated JTCI, and to provide insight about lacking fit of our data with the theoretical model.
- Published
- 2009
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30. The use of prn medication in a child and adolescent mental health inpatient service in France.
- Author
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Winterfeld U, Le Heuzey MF, Acquaviva E, Mouren MC, Brion F, and Bourdon O
- Abstract
Objective. The aim of this study was to investigate the use of "as needed" (pro re nata or prn) psychotropic medication in a child and adolescent psychiatric inpatient population. The study was carried out on the psychiatry ward of a paediatric teaching hospital in Paris, France. Methods. A prospective analysis of prn psychotropic drug prescriptions and administrations was conducted for all patients hospitalised over a period of 4 months. The study group consisted of 187 patients. Results. In total, 93 prn prescriptions were written, for 27% of the patients (51) but only 14% (26) received a total of 76 administrations. Antipsychotic drugs accounted for 54% of the prescriptions, anxiolytics for 33%, antiepileptic drugs for 8%, antiparkinsonian drugs for 4% and hypnotic drugs for 1%. Anxiety was the reason given for 67% of the prn administrations, with hydroxyzine used in 69% of these cases. Disruptive behaviour accounted for 22% of prn administrations, with antipsychotic drugs accounting for 88% of these administrations. Insomnia accounted for 8% of prn administrations, and antipsychotic drug-induced dystonia accounted for 3% of such administrations. Conclusion. Controlled studies are required to assess the efficacy and safety of prn medication and the conditions in which its use is indicated.
- Published
- 2009
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31. The relationship between body size and depression symptoms in adolescents.
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Cortese S, Falissard B, Angriman M, Pigaiani Y, Banzato C, Bogoni G, Pellegrino M, Cook S, Pajno-Ferrara F, Bernardina BD, Mouren MC, and Maffeis C
- Subjects
- Adolescent, Age Factors, Body Mass Index, Child, Depression epidemiology, Female, Humans, Male, Sex Factors, Social Class, Thinness physiopathology, Depression physiopathology
- Abstract
Objective: To evaluate the relationship between body size and depressive symptoms, as well as the moderating effects of age, sex, and socioeconomic status (SES), in a sample of young adolescents., Study Design: The study group comprised 678 young adolescents (age 11 to 14 years). Body mass index (BMI) z scores were used to estimate body size. Depression symptoms were assessed using the Children's Depression Inventory (CDI). The spline function was used to examine the shape of the relationship between BMI z score and depressive symptoms., Results: In the total sample, CDI scores were lowest for BMI z scores between -1 and -0.5. CDI scores increased progressively for BMI z scores > 0. In boys, CDI scores increased for BMI z scores > 2, whereas in girls, CDI scores increased for BMI z scores > -0.5 and < -1. Age did not have a significant moderating effect. SES had a moderating effect only in boys (P = .011)., Conclusions: The relationship between body size and depressive symptoms in young adolescents is curvilinear and is moderated by sex. Heavier-than-average and underweight girls, as well as obese boys, had the highest depression scores.
- Published
- 2009
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32. MRI findings in 77 children with non-syndromic autistic disorder.
- Author
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Boddaert N, Zilbovicius M, Philipe A, Robel L, Bourgeois M, Barthélemy C, Seidenwurm D, Meresse I, Laurier L, Desguerre I, Bahi-Buisson N, Brunelle F, Munnich A, Samson Y, Mouren MC, and Chabane N
- Subjects
- Autistic Disorder pathology, Brain Mapping, Child, Demography, Female, Humans, Male, Syndrome, Temporal Lobe abnormalities, Autistic Disorder diagnosis, Magnetic Resonance Imaging
- Abstract
Background: The clinical relevance of MR scanning in children with autism is still an open question and must be considered in light of the evolution of this technology. MRI was judged to be of insufficient value to be included in the standard clinical evaluation of autism according to the guidelines of the American Academy of Neurology and Child Neurology Society in 2000. However, this statement was based on results obtained from small samples of patients and, more importantly, included mostly insufficient MRI sequences. Our main objective was to evaluate the prevalence of brain abnormalities in a large group of children with a non-syndromic autistic disorder (AD) using T1, T2 and FLAIR MRI sequences., Methodology: MRI inspection of 77 children and adolescents with non-syndromic AD (mean age 7.4+/-3.6) was performed. All met the DSM-IV and ADI -R criteria for autism. Based on recommended clinical and biological screenings, we excluded patients with infectious, metabolic or genetic diseases, seizures or any other neurological symptoms. Identical MRI inspections of 77 children (mean age 7.0+/-4.2) without AD, developmental or neurological disorders were also performed. All MRIs were acquired with a 1.5-T Signa GE (3-D T1-FSPGR, T2, FLAIR coronal and axial sequences). Two neuroradiologists independently inspected cortical and sub-cortical regions. MRIs were reported to be normal, abnormal or uninterpretable., Principal Findings: MRIs were judged as uninterpretable in 10% (8/77) of the cases. In 48% of the children (33/69 patients), abnormalities were reported. Three predominant abnormalities were observed, including white matter signal abnormalities (19/69), major dilated Virchow-Robin spaces (12/69) and temporal lobe abnormalities (20/69). In all, 52% of the MRIs were interpreted as normal (36/69 patients)., Conclusions: An unexpectedly high rate of MRI abnormalities was found in the first large series of clinical MRI investigations in non-syndromic autism. These results could contribute to further etiopathogenetic research into autism.
- Published
- 2009
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33. Lack of association of the dopamine transporter gene in a French ADHD sample.
- Author
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Wohl M, Boni C, Asch M, Cortese S, Orejarena S, Mouren MC, Gorwood P, and Purper-Ouakil D
- Subjects
- Adolescent, Alleles, Attention Deficit Disorder with Hyperactivity diagnosis, Chi-Square Distribution, Child, Confidence Intervals, Female, France, Humans, Linkage Disequilibrium, Male, Microsatellite Repeats, Mothers statistics & numerical data, Odds Ratio, Polymorphism, Genetic, Severity of Illness Index, Attention Deficit Disorder with Hyperactivity genetics, Dopamine Plasma Membrane Transport Proteins genetics, Genetic Predisposition to Disease
- Abstract
Discrepancies in the role of the 40 bp VNTR polymorphism of the dopamine transporter gene (DAT1) in attention-deficit hyperactivity disorder (ADHD) could be due to various sources of genetic or phenotypical heterogeneity. We therefore analyzed a sample of 146 ADHD children and their parents, with a transmission disequilibrium test (TDT) design, assessing age, inattention, and hyperactivity dimensions and total score of the ADHD Rating Scale, the number of errors and the total score at Stroop Color-Word test, and the total score at the Trail Making Test. The TDT for 10-repeat (10-R) allele shows a perfect lack of transmission bias (Mc Nemar chi(2) = 0) and PBAT analyses showed no role of this polymorphism for any of the studied endophenotypes. Lack of statistical power is always a possibility, but with a sample size above the average of the majority of previous studies, and an odds ratio (number of transmitted versus untransmitted 10-R allele) of 1.00 exactly, this possibility may be considered as not very likely., (Copyright 2008 Wiley-Liss, Inc.)
- Published
- 2008
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34. Pharmacogenetics of methylphenidate response in attention deficit/hyperactivity disorder: association with the dopamine transporter gene (SLC6A3).
- Author
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Purper-Ouakil D, Wohl M, Orejarena S, Cortese S, Boni C, Asch M, Mouren MC, and Gorwood P
- Subjects
- Adolescent, Attention Deficit Disorder with Hyperactivity diagnosis, Attention Deficit Disorder with Hyperactivity genetics, Chi-Square Distribution, Child, DNA genetics, DNA isolation & purification, Genotype, Homozygote, Humans, Meta-Analysis as Topic, Microsatellite Repeats, Odds Ratio, Polymorphism, Genetic, Probability, Treatment Outcome, Attention Deficit Disorder with Hyperactivity drug therapy, Central Nervous System Stimulants therapeutic use, Dopamine Plasma Membrane Transport Proteins genetics, Methylphenidate therapeutic use, Pharmacogenetics methods
- Abstract
Pharmacogenetic studies investigating the 40-bp VNTR polymorphism at SLC6A3 and methylphenidate response have shown conflicting results and large differences in study design and efficacy endpoints. Our objective was to investigate the relation between the 3'-VNTR at SLC6A3 and variability in methylphenidate response in a sample of 141 ADHD children and adolescents, assessed before and after methylphenidate treatment with both clinical and neuropsychological outcome measures. 10-R homozygotes were significantly overrepresented in the low response group, but no genotype effect was shown in cognitive variables improvement. A meta-analysis of pharmacogenetic studies with comparable data (responders vs. non-responders) on a total of 475 subjects showed a significant association between the 10-10 genotype and low rates of methylphenidate response (mean Odds Ratio = 0.46; 95% CI [0.28-0.76]). Heterogeneity between these studies did not reach a significant level but, as publications with different endpoints were excluded from this meta-analysis, our results do not rule out a possible influence of study design., (Copyright 2008 Wiley-Liss, Inc.)
- Published
- 2008
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35. Psychotropic medication use in the child and adolescent psychiatry wards of a French hospital.
- Author
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Winterfeld U, Le Heuzey MF, Acquaviva E, Mouren MC, Brion F, and Bourdon O
- Subjects
- Adolescent, Child, Child, Preschool, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Male, Paris, Prospective Studies, Psychiatric Department, Hospital, Drug Labeling, Mental Disorders drug therapy, Practice Patterns, Physicians' statistics & numerical data, Psychotropic Drugs therapeutic use
- Abstract
Objective: The aim of this study was to investigate the use of psychotropic medication in children and adolescents hospitalised in a psychiatric ward., Methods: A prospective analysis of psychotropic drug prescriptions was conducted for all patients hospitalised in two acute psychiatric hospitalisation units of a paediatric teaching hospital in Paris, France. The study group consisted of 187 patients and was characterised in terms of age, sex, prior psychiatric hospitalisation and DSM-IV-Tr diagnosis. All prescriptions were assessed for off-label use., Results: Overall, 46% of patients received at least one dose of psychotropic medication. Antipsychotic drugs were the most frequently prescribed drugs (44%), regardless of diagnosis. Ninety percent of patients who received antipsychotic drugs did not have psychosis. We found that 69% of the 421 prescriptions written were for off-label uses. The percentage distribution of off-label prescriptions by medication class was as follows: antipsychotic drugs, 90%; anxiolytics, 28%; stimulants, 26%; antidepressants, 89%; antiepileptic drugs, 89% and antiparkinsonian drugs, 91%., Conclusion: The extensive use of drugs for off-label indications in children and adolescents suggests that prospective post-marketing studies should be carried out to evaluate efficacy and safety.
- Published
- 2008
- Full Text
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36. Attention-deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature.
- Author
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Cortese S, Angriman M, Maffeis C, Isnard P, Konofal E, Lecendreux M, Purper-Ouakil D, Vincenzi B, Bernardina BD, and Mouren MC
- Subjects
- Attention Deficit Disorder with Hyperactivity drug therapy, Attention Deficit Disorder with Hyperactivity epidemiology, Central Nervous System Stimulants adverse effects, Central Nervous System Stimulants therapeutic use, Humans, Obesity drug therapy, Obesity epidemiology, Weight Loss drug effects, Attention Deficit Disorder with Hyperactivity complications, Obesity complications
- Abstract
Recent studies suggest a possible comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and obesity. To gain insight into this potential association, we performed a systematic review of the literature excluding case reports, non-empirical studies, and studies not using ADHD diagnostic criteria. Empirically based evidence suggests that obese patients referred to obesity clinics may present with higher than expected prevalence of ADHD. Moreover, all reviewed studies indicate that subjects with ADHD are heavier than expected. However, data on the prevalence of obesity in subjects with ADHD are still limited. As for the mechanisms underlying the potential association between ADHD and obesity, ADHD might lead to obesity via abnormal eating behaviors, impulsivity associated with binge eating might contribute to ADHD in obese patients, or, alternatively, both obesity and ADHD might be the expression of common underlying neurobiological dysfunctions, at least in a subset of subjects. In patients with obesity and ADHD, both conditions might benefit from common therapeutic strategies. Further empirically based studies are needed to understand the potential comorbidity between obesity and ADHD, as well as the possible mechanisms underlying this association. This might allow a more appropriate clinical management and, ultimately, a better quality of life for patients with both obesity and ADHD.
- Published
- 2008
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37. [Psychopathology of children reared in lesbian families: literature review].
- Author
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Orgibet A, Le Heuzey MF, and Mouren MC
- Subjects
- Adolescent, Adult, Age Factors, Child, Child Abuse, Sexual, Child, Preschool, Cohort Studies, Divorce, Epidemiologic Studies, Female, Follow-Up Studies, Heterosexuality, Homosexuality, Male, Humans, Insemination, Artificial, Longitudinal Studies, Male, Mother-Child Relations, Prejudice, Psychological Tests, Risk Factors, Sexual Behavior, Single-Parent Family, Surveys and Questionnaires, Time Factors, Family psychology, Homosexuality, Female, Mental Disorders epidemiology
- Abstract
For several years, a growing number of children raised in lesbian families have been noticed. Even if this number is not really known, it appears clearly that more and more psychiatrists will have to care for children which will present this family configuration. The problem then is to know if this type of education has an incident on the psychopathology of children or not. The purpose of this article is not to give answer or to take side but just to help physicians to make a point of what is known about this subject in international literature.
- Published
- 2008
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38. Effects of iron supplementation on attention deficit hyperactivity disorder in children.
- Author
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Konofal E, Lecendreux M, Deron J, Marchand M, Cortese S, Zaïm M, Mouren MC, and Arnulf I
- Subjects
- Attention Deficit Disorder with Hyperactivity complications, Biomarkers blood, Caregivers, Child, Child, Preschool, Disability Evaluation, Double-Blind Method, Female, Ferritins blood, Humans, Male, Parents, Pilot Projects, Placebos, Restless Legs Syndrome complications, Restless Legs Syndrome drug therapy, Surveys and Questionnaires, Treatment Outcome, Attention Deficit Disorder with Hyperactivity drug therapy, Attention Deficit Disorder with Hyperactivity physiopathology, Dietary Supplements, Ferrous Compounds administration & dosage, Iron Deficiencies
- Abstract
Iron deficiency has been suggested as a possible contributing cause of attention deficit hyperactivity disorder (ADHD) in children. This present study examined the effects of iron supplementation on ADHD in children. Twenty-three nonanemic children (aged 5-8 years) with serum ferritin levels <30 ng/mL who met DSM-IV criteria for ADHD were randomized (3:1 ratio) to either oral iron (ferrous sulfate, 80 mg/day, n = 18) or placebo (n = 5) for 12 weeks. There was a progressive significant decrease in the ADHD Rating Scale after 12 weeks on iron (-11.0 +/- 13.9; P < 0.008), but not on placebo (3.0 +/- 5.7; P = 0.308). Improvement on Conners' Parent Rating Scale (P = 0.055) and Conners' Teacher Rating Scale (P = 0.076) with iron supplementation therapy failed to reach significance. The mean Clinical Global Impression-Severity significantly decreased at 12 weeks (P < 0.01) with iron, without change in the placebo group. Iron supplementation (80 mg/day) appeared to improve ADHD symptoms in children with low serum ferritin levels suggesting a need for future investigations with larger controlled trials. Iron therapy was well tolerated and effectiveness is comparable to stimulants.
- Published
- 2008
- Full Text
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39. Does excessive daytime sleepiness contribute to explaining the association between obesity and ADHD symptoms?
- Author
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Cortese S, Konofal E, Dalla Bernardina B, Mouren MC, and Lecendreux M
- Subjects
- Animals, Brain-Derived Neurotrophic Factor deficiency, Brain-Derived Neurotrophic Factor physiology, Disorders of Excessive Somnolence physiopathology, Humans, Mice, Mice, Knockout, Models, Biological, Activity Cycles physiology, Attention Deficit Disorder with Hyperactivity physiopathology, Circadian Rhythm, Obesity physiopathology, Sleep physiology, Wakefulness physiology
- Abstract
Recent studies suggest a significant association between obesity and attention-deficit/hyperactivity disorder (ADHD). The factors underlying this newly described comorbidity are still unclear and unexplored. In the present article, we propose that excessive daytime sleepiness (EDS) contributes to explaining the association between ADHD and obesity. The background for this hypothesis comes from studies on the association between ADHD and EDS, as well as from investigations on EDS in obese individuals. Available studies suggest that ADHD behaviours are significantly associated with EDS. Moreover, increasing evidence indicates that obesity is significantly associated with EDS independently of sleep-disordered breathing (SDB) or any other sleep disorders. Given the relationship between EDS and ADHD behaviors, we hypothesize that the higher than expected rates of EDS in obese individuals contribute to explaining the association between obesity and ADHD behaviors. We further speculate on the role of the brain derived neurotrophic factor (BDNF) and other molecules such as the proinflammatory cytokines IL-6 and TNF-alpha. Our hypothesis generates potentially relevant clinical and therapeutic implications. From a clinical standpoint, it may suggest to systematically look for ADHD symptoms (including hyperactivity and impulsivity) in obese patients described as sleepy. With regard to the therapeutic implications, we suggest that wake-promoting agents with anorexigenic effect, such as mazindol, might be particularly indicated for the treatment of ADHD symptoms in obese patients, since they might address both ADHD symptoms and weight reduction. In conclusion, considering the burden that ADHD adds to obesity, we believe that further studies on the comorbidity between obesity and ADHD are necessary. Research on the role of EDS might allow advancements in this field, suggesting a more effective management and, ultimately, a better quality of life of patients with both obesity and ADHD.
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- 2008
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40. [Münchhausen syndrome by proxy].
- Author
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Le Heuzey MF and Mouren MC
- Subjects
- Adult, Child, Diagnosis, Differential, Female, Humans, Mother-Child Relations, Munchausen Syndrome by Proxy psychology, Munchausen Syndrome by Proxy diagnosis
- Abstract
Münchhausen syndrome by proxy is a factitious disorder, a disease produced or simulated by a parent, the mother in most cases. Clinical presentation is miscellaneous (factitious bleeding, epilepsy, apnea are frequent) and unusual. Physicians participate in the abuse by their therapeutic and diagnostical measures. It is very important to think about this diagnostic in any ambiguous situation in order to evaluate and protect the child.
- Published
- 2008
- Full Text
- View/download PDF
41. Attention-deficit/hyperactivity disorder, Tourette's syndrome, and restless legs syndrome: the iron hypothesis.
- Author
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Cortese S, Lecendreux M, Bernardina BD, Mouren MC, Sbarbati A, and Konofal E
- Subjects
- Adult, Case-Control Studies, Child, Clinical Trials as Topic, Ferritins blood, Humans, Attention Deficit Disorder with Hyperactivity physiopathology, Iron Deficiencies, Models, Biological, Restless Legs Syndrome physiopathology, Tourette Syndrome physiopathology
- Abstract
Preliminary but increasing evidence suggests that attention-deficit/hyperactivity disorder (ADHD), Tourette's syndrome (TS), and restless legs syndrome (RLS) may be comorbid. In the present article, we hypothesize that ADHD, TS, and RLS may be part of a spectrum, and that iron deficiency contributes to the pathophysiology underlying this spectrum. Iron deficiency might lead to ADHD, RLS and TS symptoms via its impact on the metabolism of dopamine and other catecholamines, which have been involved into the pathophysiology of ADHD, TS, and RLS. We speculate that the catecholaminergic systems are differently impacted in each of the three disorders, contributing to a different specific phenotypic expression of iron deficiency. MRI studies assessing brain iron levels in ADHD, TS, and childhood RLS, as well as genetic studies on the specific molecular pathways involved in iron deficiency, are greatly needed to confirm the iron hypothesis underlying ADHD, TS, and RLS. This body of research may set the basis for controlled trials assessing the effectiveness and tolerability, as well as the most appropriate dose, duration and type (oral vs. intravenous) of iron supplementation. In conclusion, the iron hypothesis may help us progress in the understanding of pathophysiological links between ADHD, RLS, and TS, suggesting that iron supplementation might be effective for all these three impairing conditions.
- Published
- 2008
- Full Text
- View/download PDF
42. Parent reports of sleep/alertness problems and ADHD symptoms in a sample of obese adolescents.
- Author
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Cortese S, Maffeis C, Konofal E, Lecendreux M, Comencini E, Angriman M, Vincenzi B, Pajno-Ferrara F, Mouren MC, and Dalla Bernardina B
- Subjects
- Adolescent, Anxiety Disorders diagnosis, Anxiety Disorders epidemiology, Child, Depressive Disorder diagnosis, Depressive Disorder epidemiology, Female, Humans, Male, Observer Variation, Severity of Illness Index, Arousal physiology, Attention Deficit Disorder with Hyperactivity epidemiology, Attention Deficit Disorder with Hyperactivity physiopathology, Obesity epidemiology, Parents, Sleep Wake Disorders epidemiology
- Abstract
Objective: Recent evidence suggests an association between obesity and Attention Deficit/Hyperactivity Disorder (ADHD) or ADHD traits. The characteristics of obese subjects with a higher probability of ADHD symptoms are still unclear. We explore the hypothesis that obese adolescents with sleep/alertness problems represent a subgroup at high risk for ADHD traits, independently from associated symptoms of anxiety/depression. The aim of this study was to assess the relationship between parent reports of sleep/alertness problems and ADHD traits in a clinical sample of obese adolescents, controlling for symptoms of anxiety/depression., Methods: Seventy obese subjects (age range, 10-16 years) were included. The parents filled out the Sleep Disturbance Scale for Children (SDSC), the Conners Parents Rating Scale-Revised (Short Version) (CPRS-R:S), and the Child Behavior Checklist (CBCL). The ADHD Rating Scale (ADHD-RS) was completed by a child psychiatrist., Results: Using multiple regression models controlling for symptoms of anxiety/depression, scores of excessive daytime sleepiness on the SDSC were significantly associated with ADHD traits on the CPRS-R:S as well as on the ADHD-RS., Conclusions: Obese adolescents described as excessively sleepy by their parents may be at higher risk of ADHD symptoms, independently from symptoms of anxiety/depression. Although the clinician may overlook a potential diagnosis of ADHD in obese adolescents described as sleepy, the results of this study suggest to systematically look for symptoms of ADHD in this subgroup of obese patients. Further studies using objective methods to assess sleep/alertness disturbances are needed to gain insight into the relationship between sleep/alertness disturbances and ADHD in obese individuals.
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- 2007
- Full Text
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43. Predictors of diagnostic delay in a clinical sample of French children with attention-deficit/hyperactivity disorder.
- Author
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Purper-Ouakil D, Cortese S, Wohl M, Asch M, Acquaviva E, Falissard B, Michel G, Gorwood P, and Mouren MC
- Subjects
- Adolescent, Child, Female, France, Humans, Linear Models, Male, Multivariate Analysis, Time Factors, Attention Deficit Disorder with Hyperactivity diagnosis, Early Diagnosis, Health Services Needs and Demand, Referral and Consultation statistics & numerical data
- Abstract
Background: Early recognition of attention-deficit/hyperactivity disorder (ADHD) may improve the educational and psychosocial outcome of most affected children. To date, factors associated with diagnostic delay of ADHD have not specifically been addressed. Aims of this study were to evaluate the mean diagnostic delay (time between first consultation and definite diagnosis) in a clinical sample of French children with ADHD referred to an outpatient university clinic, and to determine associated factors., Method: A total of 129 consecutively referred ADHD patients aged 6-16 years. A detailed history of the children was obtained from their parents. The Kiddie-SADS-PL, the ADHD-Rating Scale, and the Clinical Global Impression Scale were used for clinical assessment., Results: Mean diagnostic delay was 32.89 months. A previous suspicion of ADHD by any health care professional, therapist or teacher was significantly associated with a reduced diagnostic delay. Co-morbidity with anxiety/depressive disorders and previous contact with a mental health professional were associated with a significant delay in diagnosis., Conclusion: Delay in diagnosis of ADHD in France is among the longest reported. Children with co-morbid anxiety or depressive disorders are particularly at risk of having a significant delay in the diagnosis. Health professionals, therapists and teachers may play a relevant role to accelerate the diagnostic procedure.
- Published
- 2007
- Full Text
- View/download PDF
44. Switching to the bingeing/purging subtype of anorexia nervosa is frequently associated with suicidal attempts.
- Author
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Foulon C, Guelfi JD, Kipman A, Adès J, Romo L, Houdeyer K, Marquez S, Mouren MC, Rouillon F, and Gorwood P
- Subjects
- Adolescent, Adult, Anorexia Nervosa diagnosis, Anorexia Nervosa mortality, Anxiety Disorders diagnosis, Anxiety Disorders mortality, Anxiety Disorders psychology, Body Mass Index, Bulimia Nervosa diagnosis, Bulimia Nervosa mortality, Comorbidity, Depressive Disorder, Major diagnosis, Depressive Disorder, Major mortality, Depressive Disorder, Major psychology, Female, Humans, Impulsive Behavior diagnosis, Impulsive Behavior mortality, Impulsive Behavior psychology, Interview, Psychological, Male, Multivariate Analysis, Paris, Regression Analysis, Retrospective Studies, Risk Factors, Suicide, Attempted prevention & control, Suicide, Attempted statistics & numerical data, Survival Analysis, Anorexia Nervosa psychology, Bulimia Nervosa psychology, Suicide, Attempted psychology
- Abstract
Objective: Anorexia nervosa has the highest suicide mortality ratio of psychiatric disorders, suicide being associated with many factors. We assessed the first lifetime occurrence of these factors taking into account their possible overlap., Method: Three hundred and four in- and out-patients with anorexia nervosa (DSM-IV) were systematically recruited in three hospitals of Paris suburbs, between December 1999 and January 2003. Patients were assessed by a face-to-face interview (DIGS). Current eating disorder dimensions were measured, and patients interviewed by a trained clinician to assess minimal BMI and, retrospectively, the age at which anorexia nervosa, major depressive disorder, anxiety disorders and switch to bingeing/purging type occurred for the first time, if applicable., Results: Major depressive disorder (p<0.001) and subtype switch from the restrictive to the bingeing/purging type (p<0.001) were the two factors significantly more frequently occurring before suicidal attempts, and remained involved when a multivariate analysis is performed, whether syndromic or dimensional measures are being used. Taking into account lifetime occurrence with a survival analysis, the switch to bingeing/purging type of anorexia appears as a major predictive factor, with a large increase of the frequency of suicidal attempts (OR=15) when compared to patients with neither major depressive disorder nor bingeing/purging type., Conclusions: Bingeing/purging type of anorexia nervosa is largely associated with suicidal attempts, and may deserve specific attention. If confirmed on a prospectively designed study, these results would argue for early detection and/or more intensive and specific therapeutic intervention on this aspect of bingeing and purging behaviors.
- Published
- 2007
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45. Impact of restless legs syndrome and iron deficiency on attention-deficit/hyperactivity disorder in children.
- Author
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Konofal E, Cortese S, Marchand M, Mouren MC, Arnulf I, and Lecendreux M
- Subjects
- Attention Deficit Disorder with Hyperactivity diagnosis, Child, Child, Preschool, Comorbidity, Dopamine blood, Electronic Data Processing, Female, Ferritins blood, Humans, Male, Prevalence, Restless Legs Syndrome diagnosis, Severity of Illness Index, Anemia, Iron-Deficiency complications, Anemia, Iron-Deficiency epidemiology, Attention Deficit Disorder with Hyperactivity epidemiology, Attention Deficit Disorder with Hyperactivity etiology, Restless Legs Syndrome epidemiology, Restless Legs Syndrome etiology
- Abstract
Objective: Increasing evidence suggests a significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and restless legs syndrome (RLS). Iron deficiency may underlie common pathophysiological mechanisms in subjects with ADHD plus RLS (ADHD+RLS). To date, the impact of iron deficiency, RLS and familial history of RLS on ADHD severity has been scarcely examined in children. These issues are addressed in the present study., Methods: Serum ferritin levels, familial history of RLS (diagnosed using National Institutes of Health (NIH) criteria) and previous iron supplementation in infancy were assessed in 12 ADHD+RLS children, 10 ADHD children and 10 controls. RLS was diagnosed using NIH-specific pediatric criteria, and ADHD severity was assessed using the Conners' Parent Rating scale., Results: ADHD symptom severity was higher, although not significantly, in children with ADHD+RLS compared to ADHD. The mean serum ferritin levels were significantly lower in children with ADHD than in the control group (p<0.0005). There was a trend for lower ferritin levels in ADHD+RLS subjects versus ADHD. Both a positive family history of RLS and previous iron supplementation in infancy were associated with more severe ADHD scores., Conclusions: Children with ADHD and a positive family history of RLS appear to represent a subgroup particularly at risk for severe ADHD symptoms. Iron deficiency may contribute to the severity of symptoms. We suggest that clinicians consider assessing children with ADHD for RLS, a family history of RLS, and iron deficiency.
- Published
- 2007
- Full Text
- View/download PDF
46. Predictors of late menarche and adult height in children with anorexia nervosa.
- Author
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Rozé C, Doyen C, Le Heuzey MF, Armoogum P, Mouren MC, and Léger J
- Subjects
- Adolescent, Adult, Age Distribution, Age of Onset, Child, Comorbidity, Humans, Longitudinal Studies, Predictive Value of Tests, Retrospective Studies, Young Adult, Anorexia Nervosa epidemiology, Body Height physiology, Menarche physiology, Puberty, Delayed diagnosis, Puberty, Delayed epidemiology
- Abstract
Objectives: The onset of anorexia nervosa (AN) during childhood can affect the timing of puberty and adult height. The aim of the study was to evaluate the determinants of late menarche and adult height in children with AN., Patients and Methods: We carried out a retrospective, longitudinal, university hospital-based study. All prepubertal or early pubertal girls diagnosed with AN between 1998 and 2002 were selected for the study. Participants (n = 33) were studied at a median age of 21 (19.8-24.3) years. AN was diagnosed at 11.8 (10.7-12.3) years., Results: Patients with AN reached menarche at significantly greater ages than their mothers [15.4 (13.5-16.8) vs. 13.2 (12.0-14.5) years, P < 0.01]. Chronological age at onset of AN and lowest body mass index (BMI) were important independent predictive factors for delayed menarche (P < 0.01). Adult height was 165.0 (163.0-172.0) cm, 2.5 (-1.5 to 5.0) cm above target height. Twelve patients (36%) did not reach their target height and had a median height deficit of -3.9 cm with respect to their target height. The duration of hospitalization, a marker of disease severity and chronicity, was an independent predictor of the difference between adult height and target height for a given individual (beta coefficient = -0.07; P = 0.01). The other factors studied (i.e. age at onset of AN, pubertal stage at diagnosis of AN, lowest BMI reached, associated comorbidity if any, type of AN, age at menarche) had no significant effect on adult height., Conclusion: The intensity of the disease affects the timing of menarche but not adult height in most patients. Hospitalization, despite often being an effective means of managing AN, does not reduce the impact of AN on growth.
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- 2007
- Full Text
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47. Attention-deficit/hyperactivity disorder, binge eating, and obesity.
- Author
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Cortese S, Isnard P, Dalla Bernardina B, and Mouren MC
- Subjects
- Attention Deficit Disorder with Hyperactivity epidemiology, Body Mass Index, Bulimia, Bulimia Nervosa epidemiology, Causality, Comorbidity, Humans, Obesity epidemiology, Attention Deficit Disorder with Hyperactivity psychology, Bulimia Nervosa psychology, Obesity psychology
- Published
- 2007
- Full Text
- View/download PDF
48. Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents.
- Author
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Cortese S, Isnard P, Frelut ML, Michel G, Quantin L, Guedeney A, Falissard B, Acquaviva E, Dalla Bernardina B, and Mouren MC
- Subjects
- Adolescent, Anthropometry methods, Anxiety psychology, Body Constitution, Child, Cross-Sectional Studies, Depression psychology, Female, Humans, Male, Psychiatric Status Rating Scales, Puberty, Attention Deficit Disorder with Hyperactivity psychology, Bulimia psychology, Obesity psychology
- Abstract
Objective: Preliminary evidence suggests a comorbidity between attention-deficit/hyperactivity disorder (ADHD) and obesity. This study was carried out to identify the clinical characteristics of obese adolescents with a higher probability of ADHD and advance the understanding of the potential factors underlying the comorbidity between obesity and ADHD. We evaluated the association between ADHD symptoms and bulimic behaviors, depressive and anxiety symptoms, degree of obesity, pubertal stage, age and gender in a clinical sample of obese adolescents., Design: Cross-sectional study., Subjects: Ninety-nine severely obese adolescents aged 12-17 years., Measurements: Subjects filled out the Bulimic Investigatory Test, Edinburgh, the Beck Depression Inventory and the State-Trait Anxiety Inventory for Children. Their parents completed the Conners Parent Rating Scale, which assesses ADHD symptoms. The degree of overweight was expressed as body mass index-z score. Puberty development was clinically assessed on the basis of Tanner stages., Results: Bulimic behaviors were significantly associated with ADHD symptoms after controlling for depressive and anxiety symptoms. The degree of overweight, pubertal stage, age and gender were not significantly associated with ADHD symptoms., Conclusion: Obese adolescents with bulimic behaviors may have a higher probability to present with ADHD symptoms independently from associated depressive or anxiety symptoms. The degree of overweight, pubertal stage, age and gender might not be useful for detecting obese adolescents with ADHD symptoms. Therefore, we suggest systematic screening for ADHD in obese adolescents with bulimic behaviors. Further studies are needed to understand which specific dimension of ADHD primarily accounts for the association with bulimic behaviors. Future research should also investigate the causal link between bulimic behaviors and ADHD and explore potential common neurobiological alterations. This may lead to a better understanding of the effectiveness of stimulants for the treatment of bulimic behaviors in obese subjects.
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- 2007
- Full Text
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49. Family trios analysis of common polymorphisms in the obestatin/ghrelin, BDNF and AGRP genes in patients with Anorexia nervosa: association with subtype, body-mass index, severity and age of onset.
- Author
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Dardennes RM, Zizzari P, Tolle V, Foulon C, Kipman A, Romo L, Iancu-Gontard D, Boni C, Sinet PM, Thérèse Bluet M, Estour B, Mouren MC, Guelfi JD, Rouillon F, Gorwood P, and Epelbaum J
- Subjects
- Adolescent, Adult, Age of Onset, Agouti-Related Protein, Alleles, Body Mass Index, Body Weight genetics, Body Weight physiology, DNA genetics, Female, Gene Frequency, Genotype, Ghrelin, Humans, Linkage Disequilibrium genetics, Male, Polymorphism, Genetic genetics, Psychiatric Status Rating Scales, Anorexia Nervosa genetics, Anorexia Nervosa psychology, Brain-Derived Neurotrophic Factor genetics, Intercellular Signaling Peptides and Proteins genetics, Peptide Hormones genetics
- Abstract
Anorexia nervosa (AN) affects 0.3% of young girls with a mortality of 6%/decade and is strongly familial with genetic factors. Ghrelin is an upstream regulator of the orexigenic peptides NPY and AgRP and acts as a natural antagonist to leptin's effects on NPY/AgRP-expressing neurons, resulting in an increase in feeding and body weight. Obestatin which counteracts ghrelin action on feeding is derived from the same propeptide than ghrelin. BDNF has been involved in body weight regulation and its Val66Met polymorphism associated with AN. We therefore re-investigated the association between AN and the Leu72Met and Gln90Leu polymorphisms of the prepro-ghrelin/obestatin gene, the Ala67Thr polymorphism of AgRP and the Val66Met polymorphism of BDNF taking into account clinical subtypes (restrictive--ANR--and bingeing/purging--ANB--subtypes). Family trios study of these 4 single nucleotide polymorphisms were performed in 114 probands with AN and both their parents recruited in two specialized French centres. A transmission disequilibrium was observed for the Leu72Met SNP of the preproghrelin gene and for the Ala67Thr SNP of the AgRP gene. When stratified by clinical subtype, these two polymorphisms were preferentially transmitted for the trios with a bingeing/purging proband. An excess of transmission of the Gln90Leu72 preproghrelin/obestatin haplotype in patients with AN was observed. These results do not provide evidence for a preferential transmission of the 66Met allele of BDNF but support the hypothesis that ghrelin and AGRP polymorphisms confers susceptibility to AN. Further simultaneous analysis of genetic variants of the biological determinants of energy metabolism and feeding behaviour in very large populations should contribute to the understanding of the high degree of heritability of eating disorders and to the description of pathophysiological patterns leading to life-threatening conditions in a highly redundant system.
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- 2007
- Full Text
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50. [School phobia or school refusal: controversial concepts].
- Author
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Mouren MC and Delorme R
- Subjects
- Adolescent, Child, Family psychology, Female, Humans, Male, Phobic Disorders diagnosis, Phobic Disorders psychology, Phobic Disorders therapy
- Abstract
For some time the concept of "school phobia" has been associated with anxiety disorders in children and adolescents, and especially with separation anxiety. The scope of this concept is now being broadened to include other underlying disorders such as antisocial disorders and behaviors such as school truancy, which were previously among the differential diagnoses. The term "school refusal" is now preferred in the literature, being more in line with reports of increasingly complex patient and family situations. This article reviews the main clinical, psychopathological and therapeutic dimensions of school refusal. The aims are to increase child-health professionals' awareness of this disorder and to describe a treatment plan centered on school attendance. Indeed, early detection and appropriate treatment can considerably improve these children's outcome.
- Published
- 2006
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