Psychopathology And Functioning Among Children Of Treated Depressed Fathers And Mothers

Objective: Recent findings suggest that remissions of maternal depression are associated with decrease in offspring psychopathology. Little is known about the offspring effects of decrease in paternal depression. Method: The offspring of married fathers and married mothers were compared. The analysis was restricted to married parents to control for the confounding effect of single parenthood which was more prevalent among depressed mothers. At baseline all parents met criteria for major depressive disorder (MDD), and participated in a 3 month randomized controlled trial to treat depression with a 6 month follow-up. Married parents (N¼43) and their children aged 7–17 years (N¼78) were assessed independently through direct interviews of children and parents at baseline and followed for 9 months. Child assessors were blind to the clinical status of parents and uninvolved in their treatment. Results: At baseline, children of depressed fathers, compared to children of depressed mothers, had significantly fewer psychiatric disorders (11% vs. 37%; p¼ 0.012) and less impairment as measured by the Columbia Impairment Scale (6.5 vs. 11.6; p¼0.009). Over time, with treatment of parental depression, the prevalence of most child symptoms decreased among children of depressed mothers, but changed little among children of depressed fathers. Limitations: The main limitation of the study is the small number of fathers and their offspring included in the study. Conclusion: Maternal as compared to paternal depression had a greater impact on children. With treatment of parental depression the differential prevalence of child symptoms by parental gender narrowed over time. The clinical implication is that children may benefit from treatment of their depressed parents

Treatment Of Maternal Depression In A Medication Clinical Trial And Its Effect On Children

Objective: Observational studies show that when a depressed mother’s symptoms remit, her children’s psychiatric symptoms decrease. Using randomized treatment assignment, the authors sought to determine the differential effects of a depressed mother’s treatment on her child. Method: The study was a randomized double-blind 12-week trial of escitalopram, bupropion, or the combination of the two in depressed mothers (N=76), with independent assessment of their children (N=135; ages 7–17 years). Results: There were no significant treatment differences in mothers’ depressive symptoms or remission. Children’s depressive symptoms and functioning improved significantly among those whose mothers were in the escitalopram group (compared with those whose mothers were in the bupropion and combination treatment groups). Only in the escitalopram group was significant improvement of mother’s depression associated with improvement in the child’s symptoms. Exploratory analyses suggested that this may be due to changes in parental functioning: Mothers in the escitalopram group reported significantly greater improvement, compared with the other groups, in their ability to listen and talk to their children, who as a group reported that their mothers were more caring over the 12 weeks. Maternal baseline negative affectivity appeared to moderate the effect of maternal treatment on children, although the effect was not statistically significant. Children of mothers with low negative affectivity improved in all treatment groups. Children of mothers with high negative affectivity improved significantly only for those whose mothers were in the escitalopram group. Conclusions: The effects of the depressed mother’s improvement on her children may depend on her type of treatment. Depressed mothers with high anxious distress and irritability may require medications that reduce these symptoms in order to show the effect of her remission on her children

Corticoïdes et grossesse (indications et précautions)

La prescription d'une corticothérapie chez la femme enceinte n'est pas un acte anodin : il faut tenir compte des changements physiologiques liés à la grossesse, de la pharmacocinétique des molécules utilisées au cours de cet événement et de l'expérience acquise en matière de tératogenèse animale ou humaine. Les corticoïdes sont très largement utilisés dans les thérapeutiques actuelles pour leur activité anti-inflammatoire, immuno-modulatrice et anti-allergique. Au cours de la grossesse, le placenta devient progressivement plus vascularisé et moins épais. Ceci facilite le passage trans-placentaire et augmente la quantité de médicament parvenant au fœtus. Le passage placentaire des corticoïdes se fait par diffusion passive. Il est fonction du poids moléculaire du corticoïde C'est pourquoi, le choix de la molécule est important qu'il s'agisse d'une indication maternelle ou fœtale. Les indications maternelles sont très variées. Il peut s'agir de pathologies très fréquentes telle que l'asthme ou de pathologies plus rares telle que le lupus. En effet, les progrès thérapeutiques de la prise en charge de ces jeunes femmes atteintes d'un lupus, permettent aujourd'hui d'envisager une grossesse. L'instauration systématique d'une corticothérapie est bien tolérée, sans incidence sur la morbidité materno-fœtale et permet un taux proche de 95% d'enfants vivants, peu différent de celui de la population française. La principale indication fœtale de prise de corticoïdes au cours de la grossesse est le traitement de la prévention de la maladie des membranes hyalines au cours d'une menace d'accouchement prématuré. En effet, les corticoïdes ayant des récepteurs au niveau des poumons, leur action est directe sur la maturation pulmonaire du fœtus. Toutes ces prescriptions peuvent mener les patientes à de nombreuses questions, c'est pourquoi le pharmacien a un rôle très important. En effet, il doit écouter et rassurer la patiente par rapport à l'appréhension de cette thérapeutique lourde et délicate, mais il doit aussi encourager à une bonne observance du traitement. Enfin, le pharmacien peut rappeler les bons conseils hygiéno-diététiques de la prise de corticoïdes.AMIENS-BU Santé (800212102) / SudocSudocFranceF

Étude des liens entre les troubles du comportement alimentaire, l'anxiété et la dépression, au travers de la comorbidité anxieuse et dépressive chez les sujets anorexiques et boulimiques

PARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Tumeurs angiomateuses de l'orbite

Two cases of orbital angiomata demonstrate how these tumors may be benign or malignant and the effect of histological diagnosis on treatment. A benign capillary angioma in a 4 mth old child was completely removed through a transfrontal approach. In a man aged 53, a malignant angiosarcoma which was highly invasive from the onset of clinical symptoms was treated by wide excision combined with radiotherapy and chemotherapy, achieving a 7 yr survival in a good general condition. Histological diagnosis of these tumors is sometimes very difficult because of their polymorphous character.SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe

Eating disorder or oesophageal achalasia during adolescence: diagnostic difficulties

International audienceMarine was a fourteen and a half-year-old adolescent female hospitalized for an eating disorder (ED) of the anorexic type with purging behaviors. She has had a complicated life course, made up of disruptions and discontinuities, both family and school. Since the age of five, Marine had been intermittently treated in psychiatry for a diagnosis of oppositional defiant disorder. The current illness started with spontaneous and induced vomiting associated with major weight loss (body mass index, 15.27 kg m−2). The diagnosis of anorexia nervosa was established after several opinions from professionals in five Parisian university pediatric departments, where additional investigations were carried out without any somatic cause being identified. In this context, Marine was transferred to a child psychiatry unit. There, she had acute dyspnea during the insertion of a nasogastric tube. As a result, a new specialized opinion was sought from a pediatric gastroenterologist and further explorations were performed (oeso-gastroduodenal transit and manometry), leading to the conclusion to an oesophageal achalasia requiring surgical treatment. This case report highlights that the exclusion of any organic disorder should be a priority in the diagnostic assessment of an ED. Oesophageal achalasia is a rare differential diagnosis and should be considered in case of swallowing difficulties or dysphagia. Health care professionals should take care to provide appropriate somatic follow-up for patients with psychiatric disorders

DOI: 10.1017/S0033291704004295 Printed in the United Kingdom Cognitive control in childhood-onset obsessive–compulsive disorder: a functional MRI study

Background. Failure to resist chronic obsessive–compulsive symptoms may denote an altered state of cognitive control. We searched for the cerebral regions engaged in this dysfunction. Method. Differences in brain regional activity were examined by event-related functional magnetic regional imaging (fMRI) in a group of adolescents or young adults (n=12) with childhood-onset obsessive–compulsive disorder (OCD), relative to healthy subjects. Subjects performed a conflict task involving the presentation of two consecutive and possibly conflicting prime and target numbers. Patients ’ image dataset was further analysed according to resistance or non-resistance to symptoms during the scans. Results. Using volume correction based on a priori hypotheses, an exploratory analysis revealed that, within the prime-target repetition condition, the OCD subjects activated more than healthy subjects a subregion of the anterior cingulate gyrus and the left parietal lobe. Furthermore, compared with ‘resistant ’ patients, the ‘non-resistant ’ OCD subjects activated a bilateral network including the precuneus, pulvinar and paracentral lobules. Conclusions. Higher regional activations suggest an abnormal amplification process in OCD subjects during the discrimination of repetitive visual stimuli. The regional distribution of functional changes may vary with the patients ’ ability to resist obsessions

The Research on Eating and Adolescent Lifestyle (REAL) Study Protocol: A Shared Biopsychosocial Model for Predicting Eating Disorders and Obesity in Adolescents

This manuscript describes the rationale, design and methods of the Research on Eating and Adolescent Lifestyles Study (REAL), which from 2006-2013, aimed to test an integrative biopsychosocial model of cross-sectional and longitudinal predictors and developmental mechanisms for both eating disorders (EDs) and obesity in a large sample of Canadian youth. The present study examined predictors from four main areas of risk: biological (e.g. weight status, pubertal stage), environmental (e.g. societal influences), individual (e.g. self-perception), and eating and weight specific behaviors (e.g. disordered eating) to test direct and indirect paths for both ED and obesity simultaneously as outcomes. Participants were recruited based on a convenience sample from 43 urban and rural public schools, and data collection ran from 2006-2013. The cross sectional sample consisted of 3043 males and females in grades 7-12. The longitudinal sample was comprised of 1197 students in grades 7 and 9 who completed annual follow ups for 7 years. The REAL study is unique as it proposes a biopsychosocial model to explain EDs and obesity in adolescents under parallel processes within a single model, and is more integrative and comprehensive than previous models. Findings from this study were intended to inform prevention initiatives and further the understanding of the etiological similarities amongst EDs and obesity in a large sample of both male and female youth across adolescence

The relation between weight-based teasing and psychological adjustment in adolescents

OBJECTIVE: To determine the prevalence of weight-based teasing, and evaluate its association with depression, anxiety and unhealthy eating behaviour in a large sample of adolescents in the Ottawa (Ontario) area. METHODS: A total of 1491 adolescents from public and private middle schools and high schools in rural and urba

Boulimie à début précoce

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