References of "Psychiatrie de l'Enfant (La)"
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See detailBipolarité et ADHD. Recherche sémiologique : cotinuum développemantal de la petite enfance à l'âge adulte et diagnostic différentiel
SCHOLL, Jean-Marc ULg; PHILIPPE, Paule ULg

in Psychiatrie de l'Enfant (La) (2012), 55(1), 125-195

Child psychiatrists are largely inexperienced in diagnosing bipolarity. Studies have shown that it takes them an average of about twelve years after the initial appearance of the relevant symptoms to ... [more ▼]

Child psychiatrists are largely inexperienced in diagnosing bipolarity. Studies have shown that it takes them an average of about twelve years after the initial appearance of the relevant symptoms to arrive at a correct diagnosis. A second set of problems has to do with the still unresolved controversies regarding the nature of the continuum, if any, linking the clinical entities that are manifested in childhood, adolescence, and adulthood. In the case of children, for example, comorbidity involving attention disorders with or without hyperactivity (ADHD) can be expected to occur with frequency. Nevertheless, the clinical symptomology of ADHD, and especially of attention deficits, tends to escape the awareness of psychiatrists who work with adults. The above reflections suggest the need for studies focusing on the developmental evolution of the relevant semeiology, especially since little work has been done to bring together specialists in child and adult psychiatry for this purpose. The present article attempts to fill this need. It also seeks to redress the imbalance due to the fact that most previous studies have been designed solely on the basis of a categorial semeiology that assembles a set of criteria deemed necessary to obtain a diagnosis and that approaches the clinical symptomology in light of semeiological presuppositions that are thought to be identical and are expected to hold in all cases. This article therefore offers a panoramic and detailed presentation of a dimensional and developmental semeiology of ADHD and bipolarity. The goal of the study presented in this article is to identify more precisely the clinical symptomologies of bipolarity and ADHD from early childhood on through adulthood and to refine the relevant differential diagnosis by means of a simultaneous analysis of these two clinical phenomena. The method of this study, which is qualitative, involved the following two steps. First, it examined the relevant phenomena and clinical anamnesis in order to discover the greatest possible number of semeiological micro-signs, with the goal of establishing a "dimensional semeiology". Second, it included subjects of different ages in order to identify a "developmental semeiology". With this intention, we observed 170 children and 55 adults with bipolar symptoms and 14 children and 7 adults with ADHD (both sets of subjects without other comorbidity), attempting to look each time as freshly as possible, without limiting ourselves to the criteria typical of categorial diagnosis. For ADHD, this study introduces new semeiological concepts. These concepts revolve around three distinctions: between (1) a preponderance of divergent attention and a preponderance of convergent attention; between (2) the semeiology of pre-attentional difficulties (relating to ambient noise and excessive information flow) and the semeiology of attention disorders per se; between (3) simple impulsiveness and an impulsiveness related to disruptive behavior. As a third step, we present the developmental evolution of the relevant clinical phenomena. For bipolarity, the study highlights a "simple manic bipolar temperament" comprising seven semeiological axes: 1. a "super-energetic" form; 2. sleep disorders; 3. an "uneasiness in the situation of being alone"; 4. "expressive emotional colors" ; 5. excitability, disinhibitions, and cravings; 6. a preponderance of divergent attention over convergent attention; 7. the tendency to hyperactivity. The description of the clinical symptomology of "uneasiness in the situation of being alone" – which¬ is the most original aspect of this research – reflects an incapacity to remain alone with oneself in a calm manner. This discomfort is to be distinguished from separation anxiety, though there can be a continuum between them; it is not a pathognomonic symptom of bipolarity, yet it does seem to be systematically present as a part of it. After having treated bipolarity, we go on to lay out the criteria for the differential diagnosis between "simple manic bipolar temperament" and ADHD. At this point, we propose an original classification of bipolar disorders in childhood, made up of three semeiological sub-groups of bipolar states, to which we add a fourth semeiological group for unipolar depressions. Various comorbidities can enter the scene and modify the basic clinical picture. Lastly, we sketch a differential diagnosis with respect to schizoaffective disorder. In discussing the results presented here, we suggest the possibility of a new "dimensional and developmental nosology". At the time of this writing, a further stage of the research outlined in this article is underway with the aim of establishing a quantitative analysis of the semeiology outlined here. [less ▲]

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See detailLes remparts de l'intime: hypothèse sur les non-dits dans le processus de (méta-)révélation chez l'enfant victime d'abus sexuel
Bullens, Quentin ULg

in Psychiatrie de l'Enfant (La) (2010), LIII(2), 431-452

When a child victim of sexual abuse tells us that he has not said everything, it may be tempting to try to pierce the secret, to encourage him to get it off his chest once and for all, as some parents ... [more ▼]

When a child victim of sexual abuse tells us that he has not said everything, it may be tempting to try to pierce the secret, to encourage him to get it off his chest once and for all, as some parents suggest. However, our wish has been to take the reader toward another perception of these things left unsaid. First of all, by defining several variables which make it possible to evaluate the meta-aspect of such revelations. Then, by interesting ourselves in what this meta-revelation tells us avout the child's state, but also about the state of the therapeutic process in relation to Winnicott's contribution. Finally, thinking about the way in which such a process should be approached so as not to neglect the child's declarations but so as not to risk causing more violence toward what may have been the most precious thing for him at the moment of the torment following his revelation. [less ▲]

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See detailClassification diagnostique 0-3 ans : Recherche sémiologique sur les troubles de la régulation
Scholl, Jean-Marc ULg

in Psychiatrie de l'Enfant (La) (2007), L(1), 179-203

In the Diagnostic Classification Zero to Three, Regulation Disorders of Sensory Processing refer to children’s difficulties in regulating emotions, behaviours and motor skills in response to sensory ... [more ▼]

In the Diagnostic Classification Zero to Three, Regulation Disorders of Sensory Processing refer to children’s difficulties in regulating emotions, behaviours and motor skills in response to sensory stimulation. This article presents a research program that aims to specify more accurately the semiology of micro-signs – identifiable¬ in the clinical symptoms and in anamnesis – of¬ Regulation Disorders. We give here the results of a preliminary stage of research, which consists of a qualitative microanalysis of 90 Regulation Disorder cases in children between 7 months and 5 years old. We give particular attention to visual-spatial processing, auditory-verbal processing, the perception of the affects, the modalities of their expression, the “energy level” of the child, the organisation of the buccal sphere, the hyper- or hyposensitivity of each sensory channel, and all symptoms having a connection to some constitutional platform. This preliminary stage serves as the basis of a questionnaire which is at heart of the second step of the research. We will further clarify the specific signs of Regulation Disorders and their frequency, comparing the results of this anamnestic questionnaire using a control sample and a sample of children with Regulation Disorders. This study aims to contribute to a more accurate description of the clinical pictures of these children and to enrich multidisciplinary exchanges and psychotherapeutic practices. [less ▲]

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See detailLe passage à la paternité: une approche clinique
Naziri, Despina ULg; Dragonas, Th.

in Psychiatrie de l'Enfant (La) (1994), 37(2), 601-629

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