The healing rock: Open-air adolescent psychiatric consultations

This short narrative describes the challenges of adapting consultation settings to both the needs of adolescents with psychiatric disorders and to the institutional constraints. We show how interior and exterior healing spaces may coexist and thereby enrich each other.Ce court récit décrit les défis que représente l'adaptation des lieux de consultation à la fois aux aux besoins des adolescents souffrant de troubles psychiatriques et aux contraintes institutionnelles. Nous montrons comment les espaces de soins extérieurs et intérieurs peuvent coexister, et ainsi s'enrichir mutuellement

Being Human in Medicine: Beyond Hierarchy

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Case Report Of Ganser Syndrome In A 14-year-old Girl: Another Face Of Depressive Disorder ?

International audienceABSTRACT: The Ganser syndrome is rare in children and in adolescents. A case of Ganser syndrome in a 14-year-old girl, with three of the four essential features, is presented. After rapid resolution in two weeks, Ganser symptoms reappear seven months later accompanied, this second time, by previous depressive symptoms. This report raises the possibility of Ganser syndrome as a manifestation of depressive disorder in adolescence

The Quest for Meaning Around Self-Injurious and Suicidal Acts: A Qualitative Study Among Adolescent Girls

Introduction: Suicide and non-suicidal self-injury (NSSI) are major problems in adolescent psychiatry and share numerous clinical characteristics. The principal objective of this study is to describe the subjective experience of adolescent girls and young women who present NSSI and/or suicidal behaviors and to determine the common aspects and the specificities of each experience.Method: This exploratory study is based on a procedure that is qualitative, phenomenological, and inductive. The data were collected from two semi-structured interviews each of 18 girls and young women aged 12–21 years, who were receiving care from a psychiatrist specializing in adolescents and who at least once had harmed themselves by NSSI or attempted suicide, or both. The thematic data analysis was performed by applying the methods of interpretative phenomenological analysis.Results: The results are described around four superordinate themes: relationships with the self, with others/otherness, with the body, and with death; they are then subdivided into 13 themes. Several themes appeared common to both types of behavior, especially the relational dimension of self-harming acts. The process of separation-individuation seems complex for these youth.Conclusion: The results underline the relational aspects of the self-harming behavior (NSSI or suicidal) among adolescent girls. These aspects also appear to be expressed in the family sphere, the social sphere, in contact with peers, and also at a societal level when the community no longer addresses adolescents' difficulties. When the process of subjectification does not appear to reach completion, self-aggressive behavior is seen as an ultimate attempt to regain a feeling of autonomy

Multimodal analysis of the non-verbal aspects of stress in normal and pathological situations

Le stress est omniprésent et consubstantiel à la vie, mais son excès peut être source de conséquences néfastes tant pour la santé mentale que physique d’un individu. Les mesures du stress ont évolué parallèlement au développement de ses modélisations et des techniques avec, plus récemment, une approche intégrative de ses différents modes d’expression avec l’essor de l’informatique affective. Évaluer et comprendre le stress passe par la capacité à mesurer et analyser ses différents modes, dont les aspects non verbaux constituent une composante essentielle. Ce travail décrit le cheminement allant de considérations générales sur l’évolution des modèles du stress et de ses mesures à la construction d’une expérience originale permettant de le mesurer en différenciant le stress auto et hétéroperçu. Il a pour objectif principal de proposer une méthode d’analyse multimodale des aspects non verbaux du stress et de valider les algorithmes qui permettent sa classification. Nous montrons son intérêt en situation expérimentale auprès de volontaires non pathologiques confrontés à une tâche cognitive arithmétique dans un contexte d’évaluation sociale. Nous donnons des exemples du développement de son utilisation dans trois autres contextes : celui de la recherche fondamentale sur l’évaluation des mécanismes sous-tendant l’efficacité d’une technique de soin, celui de la recherche clinique portant sur l’évaluation d’une thérapie cognitivo-comportementale en population pathologique ainsi que celui de la recherche en pédagogie avec l’évaluation des impacts des enseignements par simulation. Nous évoquons les enjeux de l’évaluation du stress et de l’interprétation des résultats en recherche fondamentale et clinique. Nous discutons de leur intérêt transdisciplinaire et intégratif dans l’évolution des connaissances sur la psychopathologie, l’amélioration de la qualité des soins, la formation en santé et plus généralement sur le fonctionnement de l’être humain.Stress is omnipresent and consubstantial to life, but its excess can have harmful consequences on an individual’s mental and physical health. Stress measurements have evolved in parallel with the development of its modeling and technological progress, with more recently, an integrative approach of its different modes of expression with the rise of affective computing. Assessing and understanding stress requires the ability to measure and analyze its various modes, of which non-verbal aspects are an essential component. This work describes the process from general considerations on the evolution of models of stress and its measurements to the construction of an original experiment that permits to measure it by differentiating between self-stress and hetero- perceived stress. Its main objective is to propose a multimodal stress analysis method and to validate the algorithms for its classification. We show its interest in an experimental setting where healthy volunteers are confronted with a cognitive arithmetic task in a social evaluation context. We provide examples of development of the use of multimodal stress analysis in three other contexts: fundamental research on the evaluation of the mechanisms underlying the effectiveness of psychiatric care techniques, clinical research on the evaluation of cognitive behavioral therapy in adiseased population, and pedagogical research with the evaluation of the impacts of simulated teachings. In the discussion, we address the issues of stress assessment and the interpretation of results in basic and clinical research. We refer to their transdisciplinary and integrative interest in the evolution of knowledge on psychopathology, the improvement of the quality of care, healthcare training and more generally on the functioning of the human being

Du daguerrotype à la photo-elicitation (revue systématique de la littérature et exemple d utilisation contemporaine de la photographie dans la recherche clinique en psychiatrie)

PARIS7-Xavier Bichat (751182101) / SudocSudocFranceF

Une clinique de l'altérité face à la COVID-19. Migrations, Masques et Talismans à l'île de La Réunion

Ce poster a obtenu le 1er prix pour un poster et le 1er prix de la meilleure recherche au 23ème congrès international de la revue l'Autre.International audienc

Un état des lieux du risque suicidaire à l’adolescence

International audienceSuicidal behaviour in adolescence is a major public health issue. It is the consequence of a sum of individual, relational and environmental difficulties that weaken the subject in a period of great vulnerability. The main aspects of their care consist in developing a good therapeutic link and adapting the adolescent's environment. Prevention is the concern of everyone, especially healthcare professionals who are regularly consulted before suicidal acts.Les conduites suicidaires à l’adolescence sont un enjeu majeur de santé publiqueElles font suite à une constellation de difficultés individuelles, relationnelles et environnementales, qui fragilisent le sujet dans une période de grande vulnérabilitéLe soin passe par le lien thérapeutique et l’adaptation de l’environnement de l’adolescentLa prévention est l’affaire de tous, et particulièrement des soignants, qui sont régulièrement sollicités avant un passage à l’acte

Approche anthropologique de la pandémie de covid-19 : pratiques thérapeutiques néo-traditionnelles d’un fundi à l’île de La Réunion

International audienceThis article presents an ethnographic field survey carried out on Reunion Island during the first year of the covid-19 pandemic. This study concerns the neo-traditional therapeutic practices of a fundi originating from the Comoros archipelago. Our objective is to identify and analyze the mechanisms at work in the processes of reinterpreting biomedicine during this pandemic context. Our analysis shows how this collective ordeal is transformed into a professional resource by a fundi. Health recommendations such as containment measures and barrier gestures push the fundi to adapt its practice through the establishment of « ritual teleconsultations ». Our field also shows a fundi that gives meaning to this pandemic through plural explanatory models (biomedical and sacred) and the manufacture of talismanic objects called hirizi integrated into protective masks. The findings show the use of traditional syncretic therapy practices that are not new. In all cases, recourse to religion is omnipresent through magico-Islamic ritual practices, the fundi of which builds symbolic effectiveness by transposing them to the biomedical model.Cet article présente une enquête ethnographique de terrain réalisée à l'île de La Réunion durant la première année de pandémie de la covid-19. Cette étude concerne les pratiques thérapeutiques néo-traditionnelles d'un fundi originaire de l'archipel des Comores. Notre objectif est d'identifier et d'analyser les mécanismes à l'oeuvre dans les processus de réinterprétation de la biomédecine durant ce contexte pandémique. Notre analyse montre comment cette épreuve collective est transformée en ressource professionnelle par un fundi. Les recommandations sanitaires telles que les mesures de confinement et les gestes barrières poussent le fundi à adapter sa pratique à travers la mise en place de « téléconsultations rituelles ». Notre terrain décrit également un fundi qui donne sens à cette pandémie à travers des modèles explicatifs pluriels (biomédicaux et sacrés) et la fabrication d'objets talismaniques nommés hirizi intégrés à des masques de protection. Les conclusions montrent l'utilisation de pratiques thérapeutiques traditionnelles syncrétiques qui ne sont pas nouvelles. Dans tous les cas, le recours au religieux est omniprésent à travers des pratiques rituelles magico-islamiques dont le fundi construit l'efficacité symbolique en les transposant au modèle biomédical

Comment améliorer l’adhésion aux soins des adolescents suicidants après une prise en charge aux urgences : une revue de la littérature

International audienceOBJECTIVES:Suicidal adolescents admitted in an Emergency Department (ED) present a high risk of suicidal reattempts. Poor observance of follow-up in this particular group imped the efficacity of the treatment. We propose to summarize the international literature on ED interventions promoting suicidal adolescents' adherence to care. METHOD:We carried out a comprehensive review of papers listed in PubMed, PsycInfo, and CINHAL databases using keywords about adolescence, suicide, and ED. We also manually consulted the main journals specialized in suicidology (Crisis and Suicide and Life-Threatening Behavior) and adolescence (Journal of the American Academy of Child and Adolescent Psychiatry, Journal of Adolescent Health, Neuropsychiatrie de l'Enfance et de l'Adolescence). We selected the relevant articles describing or evaluating one or more interventions initiated in the ED and designed to promote adolescent adherence to post-emergency care. The results are presented in a narrative review form. RESULTS:Interventions are organized in three groups: interventions that take place solely at the ED (problem-solving interventions and educational interventions directed to families) and interventions that take place during and after emergency care (we included in this group the ED-Care program, the FISP program, and the SAFETY program), to which should be added interventions that take place prior to care, in particular specific trainings for medical and paramedical teams. Small samples and barriers in measuring adherence to care make statistical comparisons difficult, yet the interventions that seem most effective are those that target the time both during and after ED discharge, those which are implemented most rapidly after discharge, those which actively include parents, and those which involve an implication of the families about barriers to follow-up. CONCLUSION:Our results show an effectiveness of complete programs on short-term compliance but no conclusion can be drawn on long-term effects. Most comprehensive care programs are based on the principle of adolescent compliance, which remains problematic. Until today, no ideal protocol exists to improve short-term as well as long-term compliance to care among adolescents after a suicide attempt. We have to improve our understanding of facilitators and barriers to follow-up using quantitative as well as qualitative research studies. Although it is well established that parents' involvement in the early stages of care is essential, little is known about the underlying processes. In these situations, qualitative studies could help to better target interventions that lead more particularly to follow up compliance in adolescence