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M F Le Heuzey

Publications and source records attributed to M F Le Heuzey.

At least 19 recordsLinked to original sources
PubMed2001

[Electroconvulsive therapy in the adolescent: clinical considerations apropos of a series of cases].

OBJECTIVE: To report on observations of 6 adolescents treated with electroconvulsive therapy (ECT) and to compare the data with literature data. METHOD: We conducted a retrospective study of our division charts of adolescents treated with ECT and hospitalized in the last 20 years. We also undertook a computer search in several databases (including Medline) to identify the reported observations on this treatment. RESULTS: We studied the charts of 6 adolescents aged 14 to 16 years. There were 3 cases of major depressive disorder (including 1 case of delusion of negation), 2 cases of neuroleptic malignant syndrome, and 1 case of schizoaffective disorder with catatonic characteristics. Four adolescents received ECT as a first-line treatment. They were given an average of 9 ECT, which was judged to be efficacious. Tolerance was adequate, and in this series, ECT does not seem to have caused alterations to long-term cognitive functions. No relapse was noted after a minimum of one-year follow-up. CONCLUSIONS: For some severe psychiatric disorders in adolescents, ECT could be a treatment with a good efficacy and tolerance profile.

Adolescent↗
PubMed1999

[Anorexia nervosa in children and adolescent: new therapeutic approaches].

Classical therapeutic recommendations requires that girls with anorexia nervosa be separated from their parents. Refeeding, and later individual psychodynamic approaches were also emphasized. These guidelines are now broadened towards psychotherapeutic approaches (psychodynamic, familial, cognitive-behavioral) associated with psychoeducational and dietetic strategies. In the Child and Adolescent Psychopathology Unit of Robert-Debre Hospital in Paris, individual therapeutic programs are applied to young anorectic girls and their families. These programs are implemented within an inpatient (full-time, part-time) or outpatient (consultations, weekly day-therapeutic program) framework. In order to forge a therapeutic alliance with parents and restore "parental competences" feelings, we do not separate any longer anorectic girls from their parents during hospitalization, and we have developed an alternative therapeutic model to full-time hospitalization.

Adolescent↗
PubMed1999

[Post-traumatic stress syndrome in children].

Post traumatic stress disorder occurs in children as well as in adults following a stressful traumatic event, either unique and exceptionally severe, or recurrent as in abused children. The main symptoms are repetition, avoidance and neurovegetative activation. Prevention and recognition of this disorder are important. Parents must be sensitized to the necessity of an early management.

Adaptation, Psychological↗
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

[Suicidal children and adolescents].

BACKGROUND: Psychiatric evaluation of suicide attempters is necessary in order to define aspects of primary and secondary prevention of suicidal behavior. POPULATION AND METHODS: All the 80 children and adolescents (66 girls and 14 boys) admitted from September 1989 to September 1992 in a pediatric hospital for suicide attempt have been included in this study. Their mean age was 13 yr 10 mo +/- 1.4 and 81% of them were more than 13 years of age. Evaluation included a structured interview and a scale assessing general psychopathology. RESULTS: Risk factors included previous psychiatric history in the patient (47%), family history of psychiatric disturbances in 33% of the mothers, 15% of the fathers and 13% in both. Recent modification in familial composition was seen in one third of cases and chronic difficulties in parent/child interaction in 92%. A relationship between the non impulsivity of the suicidal gesture, psychiatric history and depression diagnosed at the time of evaluation was also recognized. CONCLUSIONS: Knowledge of these risk factors should help to prevent and treat some aspects of suicidal behavior.

Adolescent↗
PubMed1993

[Attempted suicide by defenestration in children and adolescents].

In adults, suicidal attempts by jumping from elevated sites have been extensively studied and usually occur in patients with major psychiatric disorders such as schizophrenia or melancholia. Among the children and adolescents admitted to the Robert Debré Hospital in Paris for attempted suicide from 1989 through 1992, 8 (1 boy and 7 girls) had jumped out of a window. Ages ranged from 11 1/2 years to 15 years. Two patients had depression but in the six other cases there was no evidence of a psychiatric disorder. The suicidal attempt occurred after a prolonged period of conflicts within the family. Management of such patients proved difficult because of the presence of severe injuries and above all of massive denial on the part of the patient and family.

Adolescent↗
PubMed1988

[Nosology and systems for data recording in child and adolescent psychiatry].

Thanks to a system of classification acceptable to a majority of child psychiatrists, recording mental problems has been a necessity since the 1960's. The two main classifications currently being used are that of the World Health Organization (CIM-9) and that of the American Association of Psychiatry (DSM-III), both of which categorize, with categories proper to children. There are also classifications dealing with dimensions which show child psychopathology better to psychologists. A system of French classification is being studied. The merits of a good classification are well set out. No existing system of classification has them completely. The CIM-9 and DSM-III are being fine-tuned. Whichever system used, date gathering on a particular patient must be rigorous. Studies carried out in Great Britain and the United States have led to the formulation of semi-structured interviews, an evaluation scale and questionnaires that now cover most child and adolescent psychiatry.

Adolescent↗
PubMed1985

[Psychotic symptoms during the evolution of dementia in muco- polysaccharidosis of Hurler-Scheie phenotype].

The case reported concerns a 17 1/2 year-old adolescent presenting with complete alpha-L-iduronidase deficiency. Its phenotype intermediate between Hurler's and Scheie's syndromes and the occurrence of a delirious and hallucinatory condition evolving with acute exacerbations on a constant subdelirious and excited state made this case particular. This case report is compared to the 30 in the Anglo-Saxon literature which shows, in addition to the rarity of psychiatric symptoms (one single case), the multiplicity of the possible phenotypes, reinforcing the hypothesis of a polyallelic or even non allelic mutation.

Adolescent↗
PubMed1982

[Plasma level monitoring of psychotropic drugs in children. II -- Antidepressants (author's transl)].

Children and young adolescents with either depressive syndromes or enuresis were treated with clomipramine for periods of 1 to 9 months. Plasma concentrations of the drug and of its demethylated metabolite were monitored and compared with clinical effects. In children, clomipramine proved rapidly absorbed by the oral route, and its rate of distribution seemed to be related to age since the dose-concentration ratio was lower in the youngest subjects. There was a clear correlation between side-effects and clomipramine levels but not demethyl-chlorimipramine levels. In enuresis, a therapeutic effect was obtained with clomipramine levels of 20 to 60 ng/ml; lower levels were associated with ineffectiveness and higher levels with side-effects. The relationship between daily doses and plasma concentrations varied considerably from one patient to another but was almost constant in the same individual. The results obtained underline the usefulness of routinely monitoring antidepressant plasma levels in children.

Adolescent↗
PubMed1982

[Plasma level monitoring of psychotropic drugs in children. I-Haloperidol (author's transl)].

Monitoring of haloperidol plasma levels during long-term treatment is not commonly practised in adults and even less in children. In this study, haloperidol plasma levels were measured in children and teenagers with psychotic episodes or abnormal movements. Steady state concentrations ranged from 0.7 to 19 ng/ml. They were apparently unrelated to the doses administered (15-285 micrograms/kg/day), and variations of up to 15-fold were observed with the same dosage. In contrast, a significant correlation (p less than 0.02) was determined between age and dose-concentration ratio. Side-effects also seemed to be significantly related to plasma levels (p less than 0.01); they occurred at concentration higher than 6 ng/ml. Therapeutic response was observed with plasma concentrations of 1 to 4 ng/ml in cases with abnormal movements, but no dose-effect relationship was found in patients with psychotic episodes.

Adolescent↗