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Biomedical subjects

F Ladame

Publications and source records attributed to F Ladame.

At least 19 recordsLinked to original sources
PubMed1999

Anxiety disorders, comorbidity, and suicide attempts in adolescence: a preliminary investigation.

The prevalence of anxiety disorders and associated DSM-III-R diagnoses were measured in a sample of 80 female adolescents aged between 15 to 20 years consulting an outpatient psychiatric service for adolescents. The suicide attempt group (SA) included 40 patients evaluated within 24 h after attempted suicide. This is compared to 40 consecutive patients consulting the same center but without any history of suicide attempt (the no attempt group, NA). The global prevalence of anxiety disorders was similar in both groups (SA: 65% vs. NA: 60%, NS) as was the relative importance of the different disorders in each group, generalized anxiety being the most frequent specific anxiety disorder. The most striking difference between the two groups was in the prevalence of affective disorders in 90% (SA) vs. 32.5% (NA) (P < 0.001), leading to high rates of comorbidity on axis I in the SA group. Of the 24 patients with anxiety disorders who attempted suicide, 21 (95%) fulfilled criteria for associated major depression, compared to five out of 21 (24%) patients with anxiety disorders who had not attempted suicide. Adolescents with anxiety disorders developing major depression are at a high risk for suicide. The depression may be of short duration (less than two weeks) when compared to that of the anxiety disorder (greater than six months). To improve suicide prevention, our findings if confirmed should encourage clinicians to perform a close follow-up of adolescents with anxiety disorders for an early detection of sudden depressive breakdowns.

Adolescent↗
PubMed1999

Common risk factors in adolescent suicide attempters revisited.

The principle risk factors for suicide attempts in adolescents discussed in the literature are examined on the basis of data from a study carried out at the Geneva University Hospitals. 148 adolescents aged between 15 and 19 years form the sample. The results concerning mental disorders at the time of the suicide attempt confirm the clear predominance of affective disorder as well as the elevated frequency of comorbidity. Other main risk factors include suicidal behavior in family members and among acquaintances, poor state of health, poor integration into school or professional life, as well as sexual abuse.

Adolescent↗
PubMed1995

The importance of dreams and action in the adolescent process.

The author argues that after puberty dreams and action are indicators of the capacity of the psychic apparatus to perform the work of binding drive energy. He notes that the development of adult sexuality always involves risk and that effective dream activity affords a definitive solution to the problem of incestuous and parricidal temptations, which attain an unprecedented pitch of intensity with the onset of sexual and procreative potency in adolescence. The author illustrates his thesis by the case of an adolescent patient with particular sexual pathology who broke down at the age of 17 and who, once he became able to dream in the course of analysis, had less need to act out. A 'work of the negative' is presented as a paradoxical but important element in psychic development. Dreaming and action are stated to be inseparable and to constitute an essential safety valve that facilitates the developmental process. A discussion of the connections between dreams and initiation leads to some ethnological considerations on sexuality and society, and the paper ends with a plea not to overlook the death drive.

Adolescent↗
PubMed1994

Prospective study of psychological development of adolescent female athletes: initial assessment.

PURPOSE: This study aimed at assessing the impact of physical training on psychological functioning at the onset of a prospective study of psychological and somatic maturation of adolescent female athletes. METHODS: Twenty-seven highly trained gymnasts aged 12.7 +/- 1.1 year (mean +/- SD, training load = 18-26 hr/week) and 16 age-matched but moderately trained swimmers (13.0 +/- 0.9 yr, training load 4-15 hr/wk) were submitted to standardized somatic and psychiatric examinations during training camps. RESULTS: Gymnasts were significantly shorter, lighter and thinner (p < 0.001) than swimmers. Their bone age was moderately but significantly retarded (-1.42 +/- 0.99 yr, p < 0.001) in contrast with swimmers in whom it was adequate for chronological age (+0.28 +/- 0.94 year, ns). Only 7.4% of gymnasts had already had menarche in contrast with 50% of age-matched swimmers (p = 0.003). Psychological functioning was considered as normal in all subjects. However, seven athletes including 3/27 gymnasts and 4/16 swimmers (p = 0.394) were considered as subjects "at risk" to develop a manifest mental disorder over time. Ten gymnasts (41.7%) presented with a global delay in psychological maturation, whereas no such case was observed among swimmers (p = 0.015). No correlation could be established between psychological delay and pubertal retardation (p = 0.210). CONCLUSION: Strenuous training in gymnastics for more than 1 yr has so far no detectable interference with the normal maturational events of adolescence. The outcome of athletes at risk to develop psychopathology as well as those with a global delay in psychological maturation who presented as if they were still in the latency period, remains uncertain.

Adolescent↗
PubMed1994

[The child, growth and high-level sports].

The hormonal response to a short but intense session of physical exercise should be distinguished from the endocrine adaptation to systematic physical conditioning. The normal child is perfectly equipped to handle stress situations such as those generated by leisure sport: the transient increase in stress hormones has no deleterious effect on growth and puberty. For highly trained children and adolescents, standardized dynamic testing will provide little information on the state of their endocrine system. In addition, the effects of training should be differentiated from those of various bias of selection. In young elite athletes, as for adult athletes, the alterations of the endocrine system result from an inappropriate physical conditioning programme for the individual level of tolerance. Whereas it has been shown that the gonadal function is predominantly affected (pubertal delay, menstrual dysfunction), alterations of growth hormone and cortisol productions have also been reported. Anomalies of pubertal growth should be searched for among elite adolescent athletes: there are data suggesting that their growth potential should probably not be affected below 15 weekly hours of training. However, children do not respond to stress in a uniform manner and one should be prepared to detect the occasional athlete with inadequate growth at lower training intensities. This seems to be the case when training starts before puberty as well as in physical activities associated with a strict weight control. When growth and/or puberal progression become inappropriate, the only logical therapy consists in reducing markedly or stopping training temporarily: in this situation, there is no medical justification whatsoever to initiate a substitutive therapy.

Adolescent↗
PubMed1991

Puberty and psychological development.

Emphasis is placed on the body and its role in shaping our relationship to reality. Puberty is responsible for integrating an irreversible body image either masculine or feminine. Pubertal pathology in which the fantasies about physical bisexuality remain ensconced can make working through psychical bisexuality a more arduous task.

Adolescent↗
PubMed1991

Adolescence and the repetition compulsion.

I describe the connexion between the failure of the procedures of adolescence and the establishment of a psychical economy dominated by the repetition compulsion. The concept of the repetition compulsion appears as early as in 1914, in 'Remembering, repeating and working-through', but is not clearly specified as a characteristic of instinctual functioning until 1919 and 1920, in 'The "Uncanny" and 'Beyond the pleasure principle'. In these two works, Freud presents what amounts to a model of the disorganization of the mental apparatus observed in 'breaks' in the adolescent process when the capacity to bind instinctual excitation in the primary process is swamped. Decompensation is precipitated by the change in the reality principle (de facto infantile impotence becoming adult potency). The repetition compulsion, in the strict sense of the term, is a matter of 'crude', unbound instincts. Moreover, the idea emerges from Freud's two texts that the instinctual demand manifested through the repetition compulsion is the persistence of the incestuous and parricidal wish. This is borne out by my analytical experience, as the two treatments I adduce to illustrate the theory show.

Adolescent↗
PubMed1983

[Psychiatry of adolescence. The Geneva experience].

The authors report the epidemiologic analysis of patients seen in the Outpatient Department of Psychiatry of Adolescence at Geneva, followed by a typologic attempt. Six groups of adolescents are exemplified. Although diagnosis is never a significant characteristic, the other variables influence our choices and therapeutic possibilities Psychotherapy proves adequate and efficient at outset in approximately half the patients. For the "others", specific modalities must be evolved in order to enable psychotherapeutic work in a subsequent phase.

Adolescent↗