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Biomedical subjects

M C Mouren-Simeoni

Publications and source records attributed to M C Mouren-Simeoni.

At least 19 recordsLinked to original sources
PubMed1998

Asthma severity and psychopathology in a tertiary care department for children and adolescent.

The purpose of this study was to evaluate the relationships between severe asthma, type and incidence of psychiatric problems in a pediatric population. A group of 92 children and adolescents (63 boys and 29 girls) (mean age 11.7) was investigated over one year by a pediatric pneumology/allergy service unit. The psychopathological problems of two groups were compared: "mild" (n = 12) and "moderate/severe" (n = 80) persistent asthma as defined by the National Heart Lung and Blood Institute (NIH). Various questionnaires were completed by the patients including the CBCL and the CPRS. The patients were examined by an experienced psychologist using the French version of the revised semi-structured diagnostic interview Kiddie-SADS. Twelve cases with intermittent or mild persistent asthma and 80 cases with moderate and severe persistent asthma were found. The child gender ratio and the social class of the parents did not differ significantly across groups. Moderate/severe asthma was more often associated with DSM-IV psychiatric disorders. Similarly, there were more symptoms in the severe group as indicated by several questionnaires. The hyperactivity index (CPRS) was higher for the severely affected group, who also exhibited fewer daytime activities. Social skills, school skills, and self esteem were, overall, on a similar level as those of the mildly affected group. Severe persistent asthma and moderate persistent asthma were not significantly different for the prevalence of psychiatric disorders and symptoms, even if children with severe asthma had a trend toward being diagnosed with more DSM-IV anxiety disorders and higher STAIC scores. Both of them had significantly higher total CBCL scores and CPRS hyperactivity index than intermittent and mild asthma. Moderate and severe persistent asthma appears to be associated with both incidence and particular categories of psychiatric problems, particularly anxiety disorders and anxious/depression symptoms. These observations suggest that it would be valuable to pay more attention to psychopathological problems of children suffering from severe asthma.

Adolescent↗
PubMed1997

[Insulin-dependent diabetes mellitus in children and in adolescents: value of pedopsychiatric follow-up].

UNLABELLED: To assess the type of mental disorders met in the medical follow-up of insulin-dependent diabetic children (IDDM) and adolescents and their relationships with metabolic control (HbA1C) in young IDDM patients who consult in a department of child psychiatry. POPULATION AND METHODS: Twenty boys and 37 girls (mean age: 14.7 +/- 4.1 years and mean duration of IDDM: 5.6 +/- 4.3 years were followed during 1 year by the same child psychiatrist (mean duration of follow-up: 22 months). They were assessed with several clinical interviews (mean: three by subject); mental disorders were classified according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, third edition revised (DSM III-R). RESULTS: The study showed the importance of emotional disorders, 30 patients presenting at least an anxiety disorder and 17 an affective disorder, 11 a major depressive disorder and eight a dysthymic disorder. The most frequent anxiety disorders were phobias and overanxious disorders. Two patients had an anorexia nervosa, one a bulimia nervosa and nine an eating disorder not otherwise specified. There were ten diagnoses of disruptive behaviour disorders, one toxic substance abuse and 11 adaptation disorders. Seven subjects had a reading and writing learning disorder, three a coordination disorder and three a borderline IQ. Familial factors seemed very important. Nine patients had a parent-child problem, four sibling rivalry disorder and two an attachment disorder. Family problems (conflicts, separations, economical difficulties...) were found in 63% of cases. The mother or the father had mental disorders in 24 cases (42%). The diabetic patients with mental disorders had poor metabolic control (HbA1C = 9.9 +/- 2.4%) and ten subjects (18%) had already somatic complications. Some mental disorders were significantly associated with high HbA1C. The poorer metabolic controls were observed for eating disorders. Somatic complications were associated only with IDDM duration. CONCLUSIONS: This study shows the presence of typical DSM III-R mental disorders in IDDM children and adolescents, principally emotional disorders, and their association with a higher somatic risk, maximum for eating disorders. It shows the interest of collaboration between diabetologist and child psychiatrist. The exact prevalence of these disorders should be assessed by epidemiological studies.

Adolescent↗
PubMed1997

Systematic screening for fragile X syndrome in a cohort of 574 mentally retarded children.

In this study, we evaluated the prevalence of the fragile X syndrome in a cohort of 574 mentally retarded children. The only inclusion criterion was the diagnosis of mental retardation according to the DSM-IIIR classification. We used a PCR-based strategy for the diagnosis of fragile X syndrome to facilitate systematic screening. This diagnostic scheme is based on an initial PCR to eliminate most fragile X-negative patients followed by Southern blotting for fragile X syndrome diagnosis. Altogether, 403 boys and 171 girls were tested. The prevalence of this genetic disorder was 1.9% (11/574) in the whole cohort and 2.5% (10/403) in boys. Only one case of fragile X syndrome was detected among the 171 girls tested (0.6%). Clinical examination, especially in the youngest children, was often unremarkable, and the only reason for suspecting fragile X syndrome was the presence of mental retardation. Thus, a systematic screening for the fragile X syndrome in mentally retarded children seems justified because of the importance of a precise diagnosis in genetic counseling.

Adolescent↗
PubMed1995

Eating and emotional disorders in adolescent obese girls with insulin-dependent diabetes mellitus.

OBJECTIVE: To study eating and emotional disorders in adolescent insulin-dependent diabetic (IDDM) girls. METHODS: 98 adolescent girls, aged 13-19 years, were studied: 15 obese and 37 non-obese IDDM girls, 22 obese non-diabetic and 24 non-obese girls, DSM-III-R eating disorders (anorexia nervosa, bulimia nervosa, eating disorders NOS) and eating habits (snacking, sweet compulsions) were evaluated by a semi-structured diagnostic interview (Kiddie-SADS-E and Eating Habits Interview). Emotional disorders were assessed using self-questionnaires (State-Trait Anxiety Inventory for Children, Beck Depression Inventory, Coopersmith Self-Esteem Inventory). Psychological characteristics were correlated with BMI and, for IDDM girls, with HbA1C. RESULTS: IDDM and non-diabetic obese girls showed high rates of eating disorders NOS (sub-clinical bulimia: 60 and 41%, respectively) and they had more extra-snacks than non-obese girls, suggesting that obesity was the main risk factor for additional eating disorders. However, non-obese IDDM girls had more eating disorders NOS (sub-clinical bulimia: 27%) than did the normal girls (4%). Three IDDM girls had typical bulimia nervosa, while none of the non-diabetic did. The risk of depression was increased by both IDDM and obesity (16 and 18% dysthymia, respectively; 8% in normal girls); both factors cumulated in obese IDDM girls (47% dysthymia). Obesity was linked to marked changes in self-esteem scores and mild effects on anxiety. IDDM had little effect on anxiety and none on self-esteem; it even seemed to preserve the self-esteem of obese girls. Patients with bulimia nervosa had poorer metabolic control than other girls with IDDM. There was no correlation between HbA1C and eating or emotional disorders. CONCLUSIONS: Adolescent IDDM girls are at increased risk of eating and emotional disorders. Obesity appears to be an important factor for psychiatric complications; more obese IDDM girls suffered from eating disorders NOS sub-clinical bulimia), dysthymia, anxiety disorders, depression and low self-esteem (Family Satisfaction SEI sub-score) than did non-obese IDDM girls.

Adolescent↗
PubMed1995

[Eating disorders and metabolic balance in a population++ of young adults with insulin-dependent diabetes].

We have compared the prevalence of Eating Disorders in a population of 69 out-patients with Insulin-Dependent Diabetes Mellitus including a sample of diabetic young women (average year: 23 years) with two control populations (45 medicine out-patients and 54 girl students). The diabetic population didn't present no more eating disorders--measured by self-report questionnaires (EAT, BITE) than the control population. In a sample of 40 diabetic subjects--having participated in a diagnostic structured interview (LENTCA) based on DSM-III-R criteria: nobody has anorexia nervosa, one woman has bulimia nervosa, the lifetime prevalence of bulimia nervosa not otherwise specified was 21% for men and 43% for women. Bulimia Disorders--measured by self report questionnaire (BITE) and noncompliance were linked with poor glycemic control.

Adult↗
PubMed1994

[The current status of post-traumatic stress syndrome in children].

The Disorder of Post-Traumatic Stress belongs to the category of Anxiety Disorders. It consists of a group of symptoms which develop, with a variable period of latency, after an event which is outside the range of usual human experience and generally generates a feeling of intense fear in the child. The typical characteristic resulting clinical picture resembles that observed in adults (reexperiencing the traumatic event, persistent avoidance of stimuli associated with the trauma, neuro-vegetative hyperactivity) and is molded by the child's development. The long-term outcome of this disorder remains unclear; but it appears to be most favorable in children than in adults. Several factors could either "predispose" the child to this disorder or "protect" him (her) from it: the degree and duration of exposure to the traumatic event, the nature of the trauma, the presence of preexisting psychiatric conditions, the level of cognitive development and gender of the child, and the presence or absence of family support. Those therapeutic approaches which have demonstrated their usefulness in adults (group therapy, psychodynamic individual therapy...) remain to be applied to children and evaluated in this age group.

Child↗
PubMed1993

[Panic attacks and panic disorders in the child].

Panic disorders in adults have been the object of many studies. They are better known in adolescents but have been noticed insufficiently in children although panic disorder is potentially dangerous at that age. After demographic considerations, the clinical aspects are examined and illustrated using two detailed observations.

Anxiety, Separation↗
PubMed1993

[Anorexia nervosa in a prepubescent child].

Anorexia nervosa in prepubescent patients is a serious pathology, which is often misunderstood, not exceptional and on the increase. Our study focuses on 13 case histories of children between eight and 12 years of age who met Tanner's first criterion (absence of puberty) and presented a substantial weight loss and a morbid fear of gaining weight. More specifically, we studied in our sample the general epidemiological data, the clinical features related to development (effect on growth, refusal of hydration), depressive comorbidity and a rather deteriorating evolution for the majority of our patients. Our results were compared with the data from the literature.

Age Factors↗
PubMed1993

[Eating disorders in an adolescent population with insulin-dependent diabetes].

The existence of a relationship between Insulin-Dependent Diabetes and eating disorders has recently been observed, but its prevalence and impact on somatic functioning remain poorly understood. These dimensions were evaluated in a population of 52 insulin-dependent diabetic adolescent girls and compared with evaluations of matched subjects from the general population. Results showed that the occurrence of anorexia nervosa is rare, the occurrence of unspecified eating disorders is frequent (35%) and the occurrence of bulimia nervosa is nearly six percent. Poor metabolic control as reflected in blood levels of glycosylated hemoglobin (HBA1C) was found in bulimic subjects and a tendency to be overweight was found in subjects with an unspecified eating disorder. Since such disorders frequently involve dietary restrictions, the role of a restrictive pattern in the occurrence of eating disorders is raised.

Adolescent↗
PubMed1993

[Post-traumatic stress syndrome in children].

Posttraumatic stress disorder is a form of anxiety disorder which is poorly known in children and manifests as a series of symptoms occurring after an extraordinary event outside the range of usual human experiences and responsible for a feeling of terror. Virtually pathogmonic symptoms include re-experiencing the event through play and ceaselessly repeated behaviors (re-enactments), cognitive distortions when relating the facts (chronological errors, belief in omens), changes in attitudes towards others and life in general, and neurovegetative hyperactivity (hypervigilance, startle responses, difficulties controlling impulses). Although adequate follow-up data are lacking, the disorder can probably become chronic in children, as in adults. This nosographic entity raises the theoretical issue of the roles of life events and individual vulnerability. A number of factors may either "predispose" or "protect" the child: degree and duration of exposure to the trauma, nature of the event, preexistence of psychiatric disorders, level of cognitive development, sex, degree of social support, and containing or noncontaining attitude of the family. Treatments advocated in adults (pharmacotherapy, cognitive and behavioral therapies, group therapy) remain to be used and evaluated in children.

Adolescent↗
PubMed1993

[A prospective study on the behavior of pediatric intensive care unit nurses, concerning the care given to suicidal children].

Pediatric intensive care units use sophisticated medical technology and are staffed by deeply committed nurses who are subjected to significant psychological stress. This stress varies with the type of patient and influences the style and quality of care. With this respect, children and adolescents admitted after a suicidal attempt are considered catalysts. However, there have been no systematic studies of how pediatric intensive care nurses respond emotionally to their interactions with these patients. This epidemiological study conducted in five Parisian Teaching Hospital pediatric intensive care units used a specially designed questionnaire to evaluate nurses' responses on the basis of style of care. Children under 16 years of age admitted after attempted suicide were studied comparatively with same age children admitted for status asthmaticus or encephalopathy with seizures. Results highlighted the differences in nurses' psychological responses to these situations and their difficulties in interacting with patients. This study provides strict methodological guidelines for investigating an issue often discussed emotionally or on the basis of anecdotal data.

Adolescent↗
PubMedDate not supplied

[Towards an early diagnosis of gender identity disorders].

This paper deals with children's gender identity disorders on a bibliographical basis. Their etiopathogeny, their scarce but dramatical evolution towards transsexualism and their treatment are described. The record of a personal case illustrates these topics. A consistent basis, made of the various clinical patterns found by different authors is built and enriched, contributing to an earlier assessment of gender identity disorders.

Adolescent↗
PubMedDate not supplied

[Eating disorders in a student population. Epidemiologic data].

Most epidemiologic studies about eating disorders have emphasized the frequency of bulimic syndromes and occasional bulimic behaviors among students. The variability of clinical rates and diagnostic criteria used, partly explains the heterogeneousness of those studies. In our study, we used the BULIT questionnaire on a population of speech-therapy students, including all three years levels of training. 548 questionnaires were then analysed. We chose 88 as a discriminative score for occasional bulimic behaviors, and 102 for bulimic syndromes, as previously proposed by the authors of the questionnaire. We found that occasional bulimic behaviors and bulimic syndromes are less frequent in our sample compared to other studies. Nevertheless, a more precise analysis of the different items showed: a feeling of dissatisfaction towards eating habits, an exagerated fear of loss of control, frequent dysphoric feelings after overeating episodes. These findings confirm that eating is a very important concern in student population. These clinical symptoms could be considered as risk factors for eating disorders bulimia type, and might help prevention in such a population.

Adult↗