Comparative cardiovascular side effects of medications for attention-deficit/hyperactivity disorder in children, adolescents and adults: protocol for a systematic review and network meta-analysis.

INTRODUCTION Pharmacotherapy is an important component of the multimodal treatment of attention-deficit/hyperactivity disorder (ADHD). Cardiovascular safety of medications for ADHD is of concern from a clinical and public health standpoint. We aim to conduct a network meta-analysis (NMA) comparing the effects of available medications for ADHD on blood pressure (diastolic and systolic), heart rate and ECG parameters over the short-term and long-term treatment. METHODS AND ANALYSIS Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for protocols and NMAs will be followed. We will include parallel group or cross-over randomised controlled trials (RCTs) conducted in patients with a primary diagnosis of ADHD (no age limits). We will search an extensive number of electronic databases (including MEDLINE, CINAHL, CENTRAL, EMBASE, ERIC, PsycINFO, OpenGrey, Web of Science) from their inception and contact study authors/drug manufacturers to gather relevant unpublished information. No language restrictions will be applied. The main outcomes (assessed at 12 weeks, 26 weeks and 52 weeks) will be: (1) change in diastolic and systolic blood pressure (mm Hg); (2) change in heart rate, measured in beats/min; (3) change in any available ECG parameters. We will conduct random effects of NMA using standardised mean differences with 95% CIs for continuous outcomes and ORs with 95% CIs for dichotomous outcomes. We will use the Cochrane risk of bias tool-version 2 to assess the risk of bias of included RCTs and the Confidence In Network Meta-Analysis tool to evaluate the confidence of evidence contributing to each network estimate. Sensitivity analyses will investigate effects at different dose regimens. ETHICS AND DISSEMINATION No institutional review board approval will be necessary. The results of this systematic review and meta-analysis will be presented at national and international conferences and published in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42021295352

Dual training as clinician-scientist in child and adolescent psychiatry : are we there yet?

Peer reviewe

Correction to: The child and adolescent psychiatry: study of training in Europe (CAP‑STATE)

n/

Consumption of psychotropic drugs and mental health care following a mass traumatic event : a pharmacoepidemiological approach focusing on children and adolescents using the french national health data system

Contexte : Les données sur l'utilisation des soins de santé mentale en population pédiatrique après une attaque terroriste sont relativement limitées. De plus, plusieurs études ont mis en évidence la complexité et les variations temporelles dans l'utilisation des services de santé mentale et des psychotropes après un attentat. L'objectif principal de cette thèse est d'évaluer l'impact à court et moyen terme chez les enfants et les adolescents de l'attaque terroriste du 14 juillet 2016 à Nice en termes d'utilisation des ressources de santé mentale, à partir des données du Système National des Données de Santé (SNDS), l'une des plus importantes bases de données médico-administratives du monde. Méthodes et résultats : Nous avons d'abord réalisé une revue systématique (PROSPERO CRD42021225296) pour décrire l'utilisation du SNDS pour la recherche dans le champ de la santé mentale. Au total, 152 études, sélectionnées parmi 15 265 articles examinés lors de la phase de screening, ont été analysées en détail. Cette revue systématique a mis en évidence une exploitation relativement faible de la base de données du SNDS dans le domaine de la recherche en santé mentale au regard des possibilités qu'elle offre, avec un faible nombre d'études méthodologiques et un net retard dans certains domaines comme les études épidémiologiques ou d'économie de la santé, et dans des populations spécifiques, en particulier les enfants et les adolescents. Nous avons identifié trois études qui ont utilisé le SNDS pour examiner l'impact de trois catastrophes : la canicule d'août 2003, la tempête Xynthia de 2010 et une catastrophe industrielle. Cependant, ces trois études étaient centrées sur les adultes et les données chez les enfants et les adolescents font défaut. De plus, il n'y avait pas d'étude portant sur des attentats terroristes et ces études analysaient uniquement la consommation de psychotropes et ne considéraient pas la consommation globale de soins (étude numéro 1). Nous avons ensuite mené une étude quasi-expérimentale avec utilisation de séries témoins pour estimer l'impact à court et moyen terme sur la consommation de psychotropes dans le département des Alpes-Maritimes, après l'attentat au camion-bélier du 14 juillet 2016 à Nice. Nous avons utilisé des modèles de type autoregressive integrated moving average (ARIMA) pour réaliser une analyse de séries temporelles interrompues trimestrielles du 1er janvier 2012 au 31 décembre 2018, afin d'examiner la consommation de psychotropes dans les Alpes-Maritimes par rapport à trois départements témoins. Entre 2012 et 2018, nous avons observé une diminution globale de la prévalence d'utilisation des médicaments psychotropes chez les adultes, et chez les enfants et adolescents, dans les départements témoins uniquement, contrastant avec une augmentation (+8%) dans les Alpes-Maritimes, particulièrement marquée en 2017 et 2018. Le seul écart visuellement détectable entre les valeurs prédites et observées concernait l'incidence d'utilisation des psychotropes chez les enfants et les adolescents (modèle ARIMA (0,1,1) x (1,1,0)4 avec un test de Box-Ljung non significatif [khi² = 11,343 ; df = 24 ; p = 0,986]). Cette différence visuelle n'était pas statistiquement significative pour le changement de pas (estimation ± erreur standard [SE] = 0,187 ± 0,228 ; p = 0,413) ou le changement de pente (estimation ± SE = 0,020 ± 0,056 ; p = 0,724) (étude numéro 2). Enfin, nous avons développé le protocole de l'étude PaEDiatric IMPact of terrorist AttaCks in general populaTion (PEDIMPACT) visant à évaluer l'impact à court et moyen terme chez les enfants et les adolescents de l'attaque terroriste de Nice du 14 juillet 2016 sur l'utilisation globales des ressources en santé mentale, c'est-à-dire : 1) l'utilisation de médicaments psychotropes ; 2) les hospitalisations liées à la santé mentale ; et 3) les visites ambulatoires (étude numéro 3).Background: The literature on mental healthcare use in pediatric population after a terror attack is relatively scarce. Moreover, several studies have highlighted the complexity of variations in patterns of care and psychotropic drug use after these attacks. The main objective of this thesis is to evaluate the short- and middle-term impact in children and adolescents of the terror attack in Nice on July 14th, 2016, on use of mental health resources using data from the French National Health Data System (Système National des Données de Santé [SNDS]), one of the largest nationwide claims and hospital databases in the world. Methods and Results: We first conducted a systematic review (PROSPERO CRD42021225296) to describe the use of the SNDS for research in the field of mental health. A total of 152 studies were analyzed in detail out of the 15,265 articles screened for eligibility. This systematic review highlighted a relatively poor exploitation of the SNDS database in the field of psychiatric research with regard to the great possibilities it offers, with a low number of methodological studies and a clear lag in certain fields such as epidemiological or health economics studies and in specific populations, in particular children and adolescents. We identified three studies which used the SNDS to examine the impact of three major disasters: the August 2003 heatwave, the 2010 Xynthia storm, and an industrial disaster. However, these three studies were conducted on adults and data on children and adolescents are lacking. In addition, there was no study on terrorist attacks and these studies focused on the consumption of psychotropic drugs and did not consider the overall consumption of psychiatric care (study number 1). We then conducted a quasi-experimental study with control series to estimate the short- and middle-term impact on psychotropic drug use in Nice, after the truck-ramming attack on July 14th, 2016. We used autoregressive integrated moving average (ARIMA) models to conduct a quarterly interrupted time series analysis from 1 January 2012 to 31 December 2018, to examine drug use in the Nice geographic region vs. three control regions. Between 2012 and 2018, there was an overall decrease in the prevalence of psychotropic drug use for adults and for children and adolescents in the control areas, contrasting with an increase (+8%) in the Nice region, particularly marked in 2017 and 2018. The only visually detectable discrepancy between predicted and observed values was for the incidence of psychotropic drug use among children and adolescents (ARIMA (0,1,1) x (1,1,0)4 model with a non-significant Box-Ljung test [chi-square = 11.343; df = 24; p = 0.986]). This visual difference was not statistically significant in either step change (estimate ± standard error [SE] = 0.187 ± 0.228; p = 0.413) or slope change (estimate ± SE = 0.020 ± 0.056; p = 0.724) (study number 2). Last, we developed the protocol of the PaEDiatric IMPact of terrorist AttaCks in general populaTion (PEDIMPACT) study to evaluate the short- and middle-term impact in children and adolescents of the terror attack in Nice on July 14th, 2016 on use of mental health resources namely 1) use of psychotropic medications and 2) mental health-related hospitalizations and 3) outpatient visits (study number 3). Perspectives: This thesis is a first step towards the implementation of future studies aiming to link mental health care consumption data from the SDNS to data from a clinical cohort of children and adolescents exposed to a terrorist attack or another type of mass-trauma event. The aim would be to identify a potential link between mental health care consumption and certain exposure factors (level and proximity of exposure to the disaster, having seen dead or injured people, having been injured, having lost a close relative, presence of psychiatric symptoms or disorders, etc.) and thus to better characterize pediatric post-disaster mental health

Consommation de psychotropes et de soins en santé mentale à la suite d'un événement traumatique de masse : une approche pharmaco-épidémiologique centrée sur l'enfant et l'adolescent à partir du Système National des Données de Santé

Contexte : Les données sur l'utilisation des soins de santé mentale en population pédiatrique après une attaque terroriste sont relativement limitées. De plus, plusieurs études ont mis en évidence la complexité et les variations temporelles dans l'utilisation des services de santé mentale et des psychotropes après un attentat. L'objectif principal de cette thèse est d'évaluer l'impact à court et moyen terme chez les enfants et les adolescents de l'attaque terroriste du 14 juillet 2016 à Nice en termes d'utilisation des ressources de santé mentale, à partir des données du Système National des Données de Santé (SNDS), l'une des plus importantes bases de données médico-administratives du monde. Méthodes et résultats : Nous avons d'abord réalisé une revue systématique (PROSPERO CRD42021225296) pour décrire l'utilisation du SNDS pour la recherche dans le champ de la santé mentale. Au total, 152 études, sélectionnées parmi 15 265 articles examinés lors de la phase de screening, ont été analysées en détail. Cette revue systématique a mis en évidence une exploitation relativement faible de la base de données du SNDS dans le domaine de la recherche en santé mentale au regard des possibilités qu'elle offre, avec un faible nombre d'études méthodologiques et un net retard dans certains domaines comme les études épidémiologiques ou d'économie de la santé, et dans des populations spécifiques, en particulier les enfants et les adolescents. Nous avons identifié trois études qui ont utilisé le SNDS pour examiner l'impact de trois catastrophes : la canicule d'août 2003, la tempête Xynthia de 2010 et une catastrophe industrielle. Cependant, ces trois études étaient centrées sur les adultes et les données chez les enfants et les adolescents font défaut. De plus, il n'y avait pas d'étude portant sur des attentats terroristes et ces études analysaient uniquement la consommation de psychotropes et ne considéraient pas la consommation globale de soins (étude numéro 1). Nous avons ensuite mené une étude quasi-expérimentale avec utilisation de séries témoins pour estimer l'impact à court et moyen terme sur la consommation de psychotropes dans le département des Alpes-Maritimes, après l'attentat au camion-bélier du 14 juillet 2016 à Nice. Nous avons utilisé des modèles de type autoregressive integrated moving average (ARIMA) pour réaliser une analyse de séries temporelles interrompues trimestrielles du 1er janvier 2012 au 31 décembre 2018, afin d'examiner la consommation de psychotropes dans les Alpes-Maritimes par rapport à trois départements témoins. Entre 2012 et 2018, nous avons observé une diminution globale de la prévalence d'utilisation des médicaments psychotropes chez les adultes, et chez les enfants et adolescents, dans les départements témoins uniquement, contrastant avec une augmentation (+8%) dans les Alpes-Maritimes, particulièrement marquée en 2017 et 2018. Le seul écart visuellement détectable entre les valeurs prédites et observées concernait l'incidence d'utilisation des psychotropes chez les enfants et les adolescents (modèle ARIMA (0,1,1) x (1,1,0)4 avec un test de Box-Ljung non significatif [khi² = 11,343 ; df = 24 ; p = 0,986]). Cette différence visuelle n'était pas statistiquement significative pour le changement de pas (estimation ± erreur standard [SE] = 0,187 ± 0,228 ; p = 0,413) ou le changement de pente (estimation ± SE = 0,020 ± 0,056 ; p = 0,724) (étude numéro 2). Enfin, nous avons développé le protocole de l'étude PaEDiatric IMPact of terrorist AttaCks in general populaTion (PEDIMPACT) visant à évaluer l'impact à court et moyen terme chez les enfants et les adolescents de l'attaque terroriste de Nice du 14 juillet 2016 sur l'utilisation globales des ressources en santé mentale, c'est-à-dire : 1) l'utilisation de médicaments psychotropes ; 2) les hospitalisations liées à la santé mentale ; et 3) les visites ambulatoires (étude numéro 3).Background: The literature on mental healthcare use in pediatric population after a terror attack is relatively scarce. Moreover, several studies have highlighted the complexity of variations in patterns of care and psychotropic drug use after these attacks. The main objective of this thesis is to evaluate the short- and middle-term impact in children and adolescents of the terror attack in Nice on July 14th, 2016, on use of mental health resources using data from the French National Health Data System (Système National des Données de Santé [SNDS]), one of the largest nationwide claims and hospital databases in the world. Methods and Results: We first conducted a systematic review (PROSPERO CRD42021225296) to describe the use of the SNDS for research in the field of mental health. A total of 152 studies were analyzed in detail out of the 15,265 articles screened for eligibility. This systematic review highlighted a relatively poor exploitation of the SNDS database in the field of psychiatric research with regard to the great possibilities it offers, with a low number of methodological studies and a clear lag in certain fields such as epidemiological or health economics studies and in specific populations, in particular children and adolescents. We identified three studies which used the SNDS to examine the impact of three major disasters: the August 2003 heatwave, the 2010 Xynthia storm, and an industrial disaster. However, these three studies were conducted on adults and data on children and adolescents are lacking. In addition, there was no study on terrorist attacks and these studies focused on the consumption of psychotropic drugs and did not consider the overall consumption of psychiatric care (study number 1). We then conducted a quasi-experimental study with control series to estimate the short- and middle-term impact on psychotropic drug use in Nice, after the truck-ramming attack on July 14th, 2016. We used autoregressive integrated moving average (ARIMA) models to conduct a quarterly interrupted time series analysis from 1 January 2012 to 31 December 2018, to examine drug use in the Nice geographic region vs. three control regions. Between 2012 and 2018, there was an overall decrease in the prevalence of psychotropic drug use for adults and for children and adolescents in the control areas, contrasting with an increase (+8%) in the Nice region, particularly marked in 2017 and 2018. The only visually detectable discrepancy between predicted and observed values was for the incidence of psychotropic drug use among children and adolescents (ARIMA (0,1,1) x (1,1,0)4 model with a non-significant Box-Ljung test [chi-square = 11.343; df = 24; p = 0.986]). This visual difference was not statistically significant in either step change (estimate ± standard error [SE] = 0.187 ± 0.228; p = 0.413) or slope change (estimate ± SE = 0.020 ± 0.056; p = 0.724) (study number 2). Last, we developed the protocol of the PaEDiatric IMPact of terrorist AttaCks in general populaTion (PEDIMPACT) study to evaluate the short- and middle-term impact in children and adolescents of the terror attack in Nice on July 14th, 2016 on use of mental health resources namely 1) use of psychotropic medications and 2) mental health-related hospitalizations and 3) outpatient visits (study number 3). Perspectives: This thesis is a first step towards the implementation of future studies aiming to link mental health care consumption data from the SDNS to data from a clinical cohort of children and adolescents exposed to a terrorist attack or another type of mass-trauma event. The aim would be to identify a potential link between mental health care consumption and certain exposure factors (level and proximity of exposure to the disaster, having seen dead or injured people, having been injured, having lost a close relative, presence of psychiatric symptoms or disorders, etc.) and thus to better characterize pediatric post-disaster mental health

Primary care physicians' experience of caring for children with parents with mental health illness: a qualitative study among French general practitioners and paediatricians

Abstract Background Parental psychiatric disorders can have a significant impact on child development and the parent-infant bond, with a high risk of attachment disorders. Early identification of difficulties in the parent–child relationship is essential to prevent consequences for the child. Childcare practitioners have a major role to play in this early detection process, through regular mandatory consultations during the first two years of a child's life. Thus, the aim of this study was to collect the experience of private practitioners in their care of children of parents with a mental health illness. Method This is a cross-sectional, observational, qualitative study. Data were collected by means of semi-structured interviews with eleven general practitioners and private paediatricians between February and July 2021 in Toulouse and its suburbs. We only included practitioners who had followed children of parents with a mental health illness. The interviews were recorded with the agreement of the participants, before being transcribed anonymously. The data were analysed with NVivo software using interpretative phenomenological analysis. Results Three main themes emerged from the results, which were further divided into several sub-themes. Addressing psychiatric disorders presents a risk for the therapeutic relationship. Practitioners express a need to preserve this relationship with the parent in joint care. Care is difficult and is permeated by the parents' emotional issues. Furthermore, practitioners face a conflict between their concerns for the parent–child bond and their desire not to stigmatise these families. They express a feeling of isolation in these follow-ups. This stressful care has a significant emotional impact on the doctors. Access to psychiatric training and multidisciplinary collaboration seem to be essential to improve the follow-up experience for practitioners, as these factors strengthen inter-professional connections. Conclusion Practitioners describe a parent-doctor relationship at risk, which is underpinned by the fear of care placement. This study illustrates the need to strengthen multidisciplinary work by promoting interprofessional exchanges, in order to improve the experience of practitioners in this care process. Addressing practitioners’ fear of discussing parental psychiatric illness is very important, so as not to delay the implementation of preventive actions that are likely to improve the developmental prognosis for children

Description and evaluation of a French grief workshop for children and adolescents bereaved of a sibling or parent

International audienceBackground: Childhood bereavement is common, and is associated with elevated symptoms of grief with distress and impairment. However, few developmentally appropriate interventions to support grieving children are available to date. In Toulouse, France we developed an innovative four-session group intervention to support grieving families and evaluated its feasibility and acceptability. Methods: The workshop consists of four sessions over 4 months, open to children bereaved of a sibling or parent, and co-facilitated by two mental health professionals. After an intake assessment, children were placed into closed groups according to age and relation to the deceased. The session content was balanced between creative activities and grief-related discussions. Overall satisfaction was evaluated in March-April of 2020 by an 8-question online survey of children and parents having participated between 2011 and 2019. Freeform commentaries were analysed using the thematic synthesis process. Results: Of the 230 emails sent in March 2020, 46 children and 81 parents agreed to participate (55% response rate). The families reported an overall high level of satisfaction regarding the intervention that was rated as good to excellent. A majority of respondents considered their participation in the workshop helpful and in accordance with their expectations. Most would recommend the workshop to a friend, and would participate again in the group if needed. The group intervention helped reduce social isolation, facilitated grief expression, and supported the creation of a sense of community among bereaved families. Conclusions: Encouraging community and mutual support among grieving families is fundamental in bereavement care. Our four-session workshop held over 4 months and led by mental health professionals aimed to help reduce social isolation and foster coping skills through artistic creation and group discussion. Our results highlight the potential need for family bereavement support over a longer period and a provision of a variety of services. Our intervention model is feasible for families, and further studies examining its efficacy are warranted

Career Choice and Attractiveness of Child and Adolescent Psychiatry as a Medical Specialty: A National French Questionnaire Survey

International audienceContext: The shortage of child and adolescent psychiatrists in France affects access to early interventions and mental health services and impacts therapeutic practices and prescribing trends. This study aimed to describe factors associated with choosing child and adolescent psychiatry (CAP) as a career specialty and with assessing the level of attractiveness of this discipline and its predictors.Methods:We generated a self-report questionnaire using a modified two-step Delphi approach. The survey was conducted from January 13 to February 16, 2020, and targeted French child and adolescent psychiatrists or psychiatrists, mainly working with children and/or adolescents. We used a logistic regression model to assess the factors associated with the perception of CAP as attractive. A thematic qualitative analysis of the free comments section of the questionnaire was performed.Results: Of 863 doctors contacted by email, the response rate was 77.4% (668 respondents). Two-thirds of respondents were female and had an official specialization in CAP. One-third were aged between 31 and 40 years. The main reasons for choosing to specialize in CAP were interest in working with children (64.2%), interest in psychotherapy (52.8%), and influence of an internship in CAP during medical studies (46.0%), although only one-third of respondents actually did an internship. Over half of respondents (57.3%) identified personal factors as implicated in their choice of CAP, mainly personal psychotherapy (22.2%) and personal trauma (14.4%). Although only 58.4% of respondents perceived CAP as attractive, 97.8% had no regret about their choice, and 83.5% would make the same career choice today. A positive perception by respondents' surroundings for choosing CAP at the time of the choice was associated with a perception of CAP as currently attractive by respondents (odds ratio: 1.82; 95% confidence interval: 1.27–2.60; p = 0.001).Conclusion: CAP is in crisis and faces many challenges in France, with an urgent need to redress its demographics. Many child and adolescent psychiatrists do not regret their choice and would choose the same specialty today. To increase its attractiveness, better visibility during medical school, enhanced academic recognition, and increased remuneration seem promising

Mère souffrant de trouble de personnalité limite : quels soins spécifiques en période périnatale ? Une revue de la littérature

Le trouble de personnalité limite (TPL) est un trouble fréquent et grave, caractérisé par une instabilité de l’image de soi, une instabilité affective et des relations interpersonnelles. Les femmes atteintes de TPL entameraient une grossesse et accoucheraient autant que les autres femmes. Or, selon plusieurs études, les mères TPL auraient une sensibilité diminuée aux signaux de leur bébé et une mauvaise interprétation de leurs émotions ; ceci interférerait dans la mise en place d’une interaction mère-bébé de qualité et dans le développement psychoaffectif du bébé, avec le risque de développer des pathologies psychiatriques à l’âge adulte. Ainsi, plusieurs équipes ont élaboré des soins spécifiques pour les mères souffrant de TPL. Objectifs Cette revue de la littérature a pour objectif principal de répertorier les interventions développées auprès des mères TPL en période périnatale (de la grossesse jusqu’aux 18 mois du nourrisson). L’objectif secondaire est d’évaluer l’efficacité de certaines de ces interventions.Méthode Nous avons interrogé 5 bases de données : PUBMED/MEDLINE, EMBASE, CINAHL, EBM REVIEWS et PSYCINFO, la littérature grise, les recommandations de certains pays, le site Web Google.ca et OpenGray. Nous avons utilisé des mots clés pour repérer les articles : Borderline personality disorder, Mothers, Women, Woman, Maternal, Perinatal, Perinatology, Postnatal, Postpartum, Pregnant, Pregnancy(ies), Infant(s), Infancy, Baby(ies), Newborn(s), Offspring(s), Young child, Young children. Pour être inclus, un article devait être écrit en anglais ou en français et publié entre 1980 et 2020 (une veille bibliographique a été effectuée jusqu’en décembre 2021) ; il devait traiter d’intervention(s) préventive(s) et/ou thérapeutique(s) ciblant les mères souffrant de TPL en période périnatale.Résultats La recherche a généré 493 articles et 20 articles ont été sélectionnés. Deux grands types d’interventions se sont détachés : certaines sont centrées sur la dyade mère-bébé, d’autres sont centrées sur la mère seule. Parmi elles, on relève des thérapies déjà établies pour les patients TPL en population générale ou des psychothérapies mère-bébé plus spécifiques. Les interventions sont majoritairement pluridisciplinaires, précoces et intensives. Quatre articles ont testé l’efficacité de leur programme : selon les articles, les effets bénéfiques sur les interactions dyadiques apparaissent en général après plusieurs semaines de traitement, et pour certains programmes les effets peuvent persister dans le temps ; 3 auteurs montrent une diminution de la symptomatologie dépressive maternelle. Seules l’Australie et la Suisse ont publié des recommandations visant spécifiquement les mères TPL en période périnatale.Conclusion Les interventions auprès des mères TPL en période périnatale peuvent s’appuyer sur des modèles théoriques réflexifs ou en lien avec la dérégulation émotionnelle dont souffrent ces mères. Elles doivent être précoces, intensives et pluriprofessionnelles. Compte tenu du manque d’évaluation de l’efficacité aucun type de soin ne se distingue actuellement, ainsi il apparaît important de pouvoir continuer les investigations.Borderline personality disorder (BPD) is a common and severe disorder characterized by unstability of self-image, unstable affect, and unstable interpersonal relationships. Women with BPD would give birth as much as other women, but according to several studies, BPD mothers have a reduced sensitivity to their babies and a poor interpretation of their emotions; this would interfere in mother-baby interaction and in psycho-affective development of the baby, with the risk to develop psychiatric pathologies in adulthood. In this context several professionals have developed different interventions for mothers suffering from BPD.Objectives The main objective of this literature review is to list the interventions developed for BPD mothers during the perinatal period (from pregnancy to the 18 months of infant). The secondary objective is to assess the effectiveness of some of these interventions.Method We have screened five databases: PUBMED/MEDLINE, EMBASE, CINAHL, EBM REVIEWS and PSYCINFO, gray literature, recommendations of some countries, Google.ca website and OpenGray.We used keywords to screen the articles: Borderline personality disorder; Mothers, Women, Woman, Maternal, Perinatal, Perinatology, Postnatal, Postpartum, Pregnant, Pregnancy(ies), Infant(s), Infancy, Baby(ies), Newborn(s), Offspring(s), Young child, Young children. To be included, an article had to be written in English or French and published between 1980 and 2020 (a bibliographic watch was then carried out until December 2021); it had to deal with preventive and/or therapeutic intervention(s) targeting mothers suffering from BPD in the perinatal period.Results The search have generated 493 articles and 20 articles were selected. We have identified two main types of interventions: some are centered on the mother-baby dyad, others are centered only on the mother. Among them, there are therapies established for BPD patients in the general population, or specific mother-baby psychotherapies. Interventions are multidisciplinary, intervene early and intensively. Four articles have analysed the effectiveness of their program: according to the studies, the beneficial effects on dyadic interactions generally appear after several weeks of treatment, and for some programs the effects may persist over time; three authors show a reduction of maternal depressive symptoms. Only Australia and Switzerland have published recommendations targeting BPD mothers in the perinatal period.Conclusion Interventions with BPD mothers in the perinatal period can be based on reflexives theoreticals models or be in connection with the emotional dysregulation from which these mothers suffer. They must be early, intensive and multi-professional. Given the lack of studies that have analysed the efficacy of their programs, no intervention currently stands out, so it seems important to continue the investigations