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Biomedical subjects

M P Bouvard

Publications and source records attributed to M P Bouvard.

At least 19 recordsLinked to original sources

High levels of nocturnal activity in children with attention-deficit hyperactivity disorder: a video analysis.

Sleep disturbances can lead to symptoms of attention-deficit hyperactivity disorder (ADHD) in children. In the present study, we compared the sleep patterns of 30 children with ADHD, with those of 19 controls matched for age (5-10 years) and sex. Sleep patterns were recorded during one night, using polysomnography (PSG) and a video system in the sleep laboratory. Both ADHD children and controls were medication free and showed no clinical signs of sleep and alertness problems. An infrared camera was used to record all types of movement, which were scored and analyzed using specific software (Observer(R) 3.0; Noldus International, The Netherlands). No significant differences in sleep variables were found between ADHD children and controls. Polysomnography data showed no significant difference between the two groups. Attention-deficit hyperactivity disorder children moved more often than controls (upper limbs, P < 0.04; lower limbs, P < 0.03; all types, P < 0.003). The duration of movements was significantly longer in ADHD children (upper limbs, P < 0.03; all types, P < 0.02). The results of the video analysis were consistent with previous findings that ADHD children have higher levels of nocturnal activity than controls. This activity concerned mostly upper and lower limb movements. Futher studies are required to determine why noctural activity does not affect sleep continuity in a more significant way and whether it should be treated specifically.

Attention Deficit Disorder with Hyperactivity↗

Abnormal psychosocial situations among inpatients from a child and adolescent psychiatric department in a teaching hospital in France.

In order to examine the relationships between Associated Abnormal PsychoSocial Situations and psychiatric disorders in children and adolescents, an exploratory analysis using Axis V of the ICD-10 was performed on 1050 child and adolescent psychiatric inpatients. A logistic regression analysis was completed with respect to four groups of DSM-III-R diagnostic categories (Emotional Disorders, Disruptive Behavior Disorders, Specific Developmental Disorders, Non Specific Developmental Disorders). AAPSS were more frequently found in children and adolescents with Emotional Disorders or Disruptive Behavior Disorders than in those with Developmental Disorders but there was no diagnostic specificity in the distribution of AAPSS.

Adolescent↗

Anxiety and depressive disorders in fathers and mothers of anxious school-refusing children.

OBJECTIVE: To examine anxiety and depressive disorders in the mothers and fathers of children with anxious school refusal and to test for the existence of differences in familial aggregation between children suffering from school refusal related to separation anxiety disorder and those suffering from phobic disorder-based school refusal. METHOD: Using a blind standardized diagnostic evaluation (Schedule for Affective Disorders and Schizophrenia-Lifetime version, modified for the study of anxiety disorders; Diagnostic Interview for Genetic Studies; and Schedule for Affective Disorders and Schizophrenia for School-Age Children), the authors compared parental lifetime psychiatric illness for the 2 groups of anxious school refusers. RESULTS: Relationships between specific anxiety disorders in children and their parents revealed increased prevalence of simple phobia and simple and/or social phobia among the fathers and mothers of phobic school refusers, and increased prevalence of panic disorder and panic disorder and/or agoraphobia among the fathers and mothers of school refusers with separation anxiety disorder. Simple and/or social phobia in the father, simple phobia in the mother, and age of the father were associated with the group of phobic school refusers. CONCLUSIONS: The data show the high prevalence of both anxiety and depressive disorders in fathers and mothers of anxious school refusers. Significant differences were observed in familial aggregation considering the subgroups of anxious school-refusing children.

Adolescent↗

[Biological approach to adolescent suicide].

The high rating of suicide attempts and suicide in the general population and among adolescents justifies a lot of research studies, aiming to better define the genetic and biologic factors. The most relevant model and the most admitted is the role of serotonin which at low concentration in the brain causes more violent suicides or suicidal behaviors, as well as more aggressiveness and impulsiveness. It is not excluded that variations linked to the age could determine, among other factors, specific suicidal behaviors related to the adolescence.

Adolescent↗

Modifications of erythrocyte membrane fluidity from patients with anorexia nervosa before and after refeeding.

Erythrocyte membrane characteristics were compared in 15 normal women and 15 women with anorexia nervosa; the patients were studied at hospital admission and again after 1 month of refeeding. At admission, physical properties of erythrocyte membranes, studied with electron spin resonance spectrometry, significantly differed between the anorexic patients and the normal volunteers. Fluidity from the hydrophobic part of the erythrocyte membrane, estimated by the correlation frequency, was decreased in the patients. After 1 month of refeeding, fluidity increased. One of the possible mechanisms of the variation of membrane fluidity could be the effect of cholesterol on membrane structure. Increased cholesterol levels in anorexic subjects could reduce fluidity. These alterations in membrane fluidity could explain some of the neurobiological abnormalities observed in anorexia nervosa.

Adolescent↗

[Suicide in adolescence].

With 1500 death each year, suicide does represent the second cause of death in young people (between 15 and 25 years). There is a clear increase of suicide rate during adolescence, with an higher rate of suicide attempts in females, but an higher mortality in boys. Suicidal behaviors in adolescents are clinically characterized by impulsivity, rhythmicity (during schooling) and seasonality. Risks factors are numerous. However, psychiatric disorders represent the main one, especially depressive states, conduct disorders and their association. In adolescents familial and environment events may have an important role in suicidal behaviors, especially the role of imitation behavior. These different factors interact and constitute dynamic models. The role of each factor can be involved differently considering the sex. Dangerosity of suicide in adolescents should not be under-estimated, as it has been the case in the past. It is particularly true if we consider the high rate of recidive (approximatively 50%) in this population. These data emphasized the importance of a careful evaluation of all suicidal adolescents more precisely of depressive symptoms and aggressive and/or delinquent behavior and of prevention.

Adolescent↗

Low-dose naltrexone effects on plasma chemistries and clinical symptoms in autism: a double-blind, placebo-controlled study.

The effect of month-long naltrexone (NTX) treatment at a daily oral dose of 0.5 mg/kg/day was contrasted with placebo (PLC) in a double-blind study with conjoint clinical and biochemical evaluations of therapeutic effects. Modest clinical benefits were achieved with both PLC and NTX, with marginally better overall results following NTX, and degree of improvement appeared to be related to plasma chemical profiles. Massively elevated levels of beta-endorphin were observed in all children with assays using C-terminal antibody but not with an N-terminal antibody assay. In addition, 70% of the children exhibited abnormally low levels of adrenocorticotropic hormone, and smaller subsets exhibited elevated norepinephrine (60%), arginine-vasopressin (50%), and serotonin (20%). The best clinical responders exhibited the clearest normalization of the elevated plasma chemistries, especially in C-terminal-beta-endorphin and serotonin. There was some evidence of therapeutic carry-over effects in both clinical and biochemical measures in those children who received NTX before PLC. The results suggest that NTX only benefits a subgroup of autistic children, who may be identified by the presence of certain plasma abnormalities. These results suggest a possible linkage between abnormal plasma chemistries, especially those related to the pro-opiomelanocortin system, and autistic symptoms.

Adolescent↗

Difference between plasma N- and C-terminally directed beta-endorphin immunoreactivity in infantile autism.

OBJECTIVE: The authors investigated whether there is excessive opioid activity in infantile autism by measuring plasma beta-endorphin in patients with autism compared with patients who had Rett's syndrome and normal comparison subjects. METHODS: Radioimmunoassays for beta-endorphin using C-terminally and N-terminally directed antisera were applied to plasma samples from 67 children who met both DSM-III-R and ICD-10 diagnostic criteria for infantile autism, 22 girls with Rett's syndrome, and 67 normal children matched in age and sex with the children with autism. RESULTS: Median N-terminally directed beta-endorphin immunoreactivity appeared to be slightly lower in subjects with autism (7 pg/ml) and clearly higher in the girls with Rett's syndrome (40 pg/ml) than in the comparison subjects (9 pg/ml). Median C-terminally directed beta-endorphin immunoreactivity was higher in the girls with Rett's syndrome (35 pg/ml) and much higher in patients with autism (70 pg/ml) than in comparison subjects (8 pg/ml). CONCLUSIONS: These findings demonstrate the existence of a wide discrepancy between C- and N-terminally directed beta-endorphin immunoreactivity among children with autism. Despite the fact that the nature of the antigen recognized in the plasma of autistic children by the C-terminally directed anti-beta-endorphin serum remains to be characterized, the difference between C- and N-terminally directed beta-endorphin immunoreactivity might suggest an abnormal processing of the pro-opiomelanocortin gene in infantile autism.

Adolescent↗

[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↗

[Attention deficit disorder and anxiety disorders: a co-occurrence study].

Recent epidemiological studies have evaluated the concomitant occurrence of several disorders in children. Over the last few years there have been reports from Anglo-Saxon investigators that many children with attention deficit disorder-hyperactivity also have anxiety disorders. This is the first French study addressing this issue. The prevalence and types of anxiety disorders were determined in 50 children with attention deficit disorder-hyperactivity using a questionnaire and a semi-structured interview. Over 40% of subjects had at least one concomitant anxiety disorder meeting DSM-III-R criteria. Hyperanxiety and separation anxiety were the most common anxiety disorders. Among patients with anxiety, over 40% had more than one anxiety disorder. These data are consistent with earlier Anglo-Saxon reports. Symptoms of anxiety which discriminated hyperactive children with and without anxiety disorders were identified.

Anxiety Disorders↗

[Evolution of depression in the child and adolescent].

Outcome of depressive disorder in adolescents is now better known. Despite methodological differences between studies there is an agreement to emphasize frequency of relapse and recurrence in the follow-up (50 to 60%). Others modalities have also been described, anxiety disorders seemed to be the more frequent. For some authors, affective disorder in adolescents could presage manic depressive illness. Psychosocial functioning after the follow-up seems to be impaired as well as in professional, relational, or social fields. These data suggest a clear distinction between affective states in adolescents and symptoms related to psychological transformations of adolescence. We have conducted a follow-up study with adolescents hospitalized in the child and adolescent psychiatric department of R. Debré hospital, for major depressive episode (MDE) or dysthymic disorder (DD). On the 122 patients meeting initially inclusion criteria, 75 have been evaluated after one year follow-up at least. Duration of the follow-up was on average 4 years. 44 met initially DSM III and DSM III-R criteria for MDE and 31 for DD. Rating has been done during a phone interview with a standardized questionnaire. We did use criteria defined by Prien et al. (1984) for relapse, recurrence and remission. Our results showed a good short-term outcome in both groups (72.7% remission in MDE and 80.6% in DD). Relapse rate was superior in the first group. At the end of the follow-up, cumulative probability of recurrence was 52.9% in MDE group and 35.7% in DD group. Chronic evolution was more frequent in TD group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Time and depression in children and adolescents].

The existence of depression in young individuals has often been denied or at least underestimated particularly during adolescence, to the benefit of such other concepts as morosity, inherent in this period of life, and from which depression should be differentiated. Recent epidemiological investigations in the general population have revealed an approximate 2% and 10% prevalence of depression in the child and the adolescent, respectively. This considerable increase in morbidity is associated with a modification of the sex ratio: more boys are affected before puberty, more girls after puberty. In the present work we shall first deal with the semiology and comorbidity of depression as related with the developmental changes occurring in the child and the adolescent. Thus, several studies have shown that the DSM III criteria for affective disorders are consistently applicable to pre-puberty children and adolescents as well. However, depression in the pre-puberty children may be more ostentatious, manifesting itself by psychomotor agitation, somatic complaints and anxiety comorbidity of the type: Separation Anxiety Disorder and phobias. Depressed adolescents may exhibit more anhedonia, more depressive cognition, hypersomnia, weight variations, more alcohol or drug abuse and suicide attempts, and, in one third of them, greater coexistence of anxiety disorders or behavioural disorders. The course of depression at this age is now known, owing to catamnestic studies that proved methodologically satisfactory (we personally managed the follow-up of 75 depressed adolescents over an average 45 months). Depression in the child and the adolescent is not a benign affection, it is a long-lived, recurrent and disabling illness.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗