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Biomedical subjects

O Halfon

Publications and source records attributed to O Halfon.

At least 19 recordsLinked to original sources
PubMed2006

[School refusal].

Pediatrician are often questioned by school refusal which relies on a wide range of psychopathological features and necessitates specific approaches. This disabling condition remains underestimated and is still increasing. A poor prognosis associated with a prolonged school absence is the common hallmark of school refusals, regardless of its heterogeneity. Its seriousness warrants early identification and prompt intervention by childhood healthcare professionals, teachers and social workers. A specialized treatment is needed, closely linked with families and school. Promising developments come from a functional rather than symptomatic concept of school refusal. They offer tailored interventions which fit the clinical diversity of school refusals. After a brief historical summary and current definitions of school refusal, the authors review the main clinical features and comorbidity before taking up treatment modalities.

Anxiety, Separation↗
PubMed2004

Predictive factors of social disability in anorexic and bulimic patients.

OBJECTIVES: The purpose of this study was to determine whether subjects suffering from anorexia nervosa (AN) or bulimia nervosa (BN) would demonstrate more severe social disability than a control group; and whether social disability could be best explained as a function of the eating disorder itself or as a function of comorbid anxiety or depressive disorders. METHOD: Subjects were 166 AN subjects, 105 BN subjects and 271 control subjects matched for age, sex and socio-economic status. Prevalence of anxiety or depressive disorders was assessed (through the Mini International Neuropsychiatric Interview), and social functioning was measured (through the Groningen scale). RESULTS: The majority of AN and BN subjects demonstrated social disability in the "social role" (leisure time, time spent with friends) and the "occupational role" (work or educational activities). A regression analysis was employed to uncover predictive factors of social disability. Eating disorders (AN and BN), anxiety disorders and depression accounted for a large portion of social disability. DISCUSSION: Anxiety and depressive disorders appear to play an important role in the type of social disability demonstrated in eating disorder patients. Therapeutic implications are discussed.

Adolescent↗
PubMed2004

Personality trait risk factors for attempted suicide among young women with eating disorders.

OBJECTIVE: - Clinical observations and a review of the literature led us to hypothesize that certain personality and character traits could provide improved understanding, and thus improved prevention, of suicidal behaviour among young women with eating disorders. METHOD: - The clinical group consisted of 152 women aged between 18 and 24 years, with DSM-IV anorexia nervosa/restrictive type (AN-R = 66), anorexia nervosa/purging type (AN-P = 37), bulimia nervosa/non-purging type (BN-NP = 9), or bulimia nervosa/purging type (BN-P = 40). The control group consisted of 140 subjects. The assessment measures were the Minnesota Multiphasic Personality Inventory-second version (MMPI-2) scales and subscales, the Beck Depression Inventory (BDI) used to control for current depressive symptoms, plus a specific questionnaire concerning suicide attempts. RESULTS: - Suicide attempts were most frequent in subjects with purging behaviour (30.0% for BN-P and 29.7% for AN-P). Those attempting suicide among subjects with eating disorders were mostly students (67.8%). For women with AN-R the scales for 'Depression' and 'Antisocial practices' represented significant suicidal risk, for women with AN-P the scales for 'Hysteria', 'Psychopathic deviate', 'Shyness/Self-consciousness', 'Antisocial Practices', 'Obsessiveness' and 'Low self-esteem' were risk indicators and for women with BN-P the 'Psychasthenia', 'Anger' and 'Fears' scales were risk indicators. CONCLUSION: - This study provides interesting results concerning the personality traits of young women with both eating disorders and suicidal behaviour. Students and those with purging behaviour are most at risk. Young women should be given more attention with regard to the risk of suicide attempts if they: (a). have AN-R with a tendency to self-punishment and antisocial conduct, (b). have AN-P with multiple physical complaints, are not at ease in social situations and have antisocial behaviour, or (c). if they have BN-P and tend to be easily angered with obsessive behaviour and phobic worries. The MMPI-2 is an interesting assessment method for the study of traits indicating a risk of suicidal behaviour in young subjects, after controlling for current depressive pathology.

Adolescent↗
PubMed2001

Psychoactive substance consumption in eating disorders.

Research investigating the comorbidity between eating disorders and substance-use disorders have reported positive but contrasting results. The aim of this study was to further explore this association by studying patterns of consumption of the entire range of psychoactive substances (alcohol, specific drugs, prescribed psychotropics) in a large sample (N=271) of eating-disorder DSM-IV subtypes. Results show that subjects suffering from anorexia of the restrictive type show significantly less drug-consumption behaviors and alcohol abuse and/or dependence disorders than purging anorexic and bulimic subjects. No difference was found in the total consumption of psychotropics among the four groups of eating disorders. However, more than half of eating-disorder subjects are regular consumers of psychotropics. Among these regular consumers, bulimics self-prescribe and increase their doses of psychotropics significantly more than anorexics. Features of impulsivity that are associated with purging and bulimic behaviors could play a specific role in these patterns of comorbidity and account for such differences.

Journal Article↗
PubMed2001

Evaluation of the Adolescent Drug Abuse Diagnosis instrument in a Swiss sample of drug abusers.

OBJECTIVE: The aim of this study was to evaluate a French language version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument in a Swiss sample of adolescent illicit drug and/or alcohol users. PARTICIPANTS AND SETTING: The participants in the study were 102 French-speaking adolescents aged 13-19 years who fitted the criteria of illicit drug or alcohol use (at least one substance--except tobacco--once a week during the last 3 months). They were recruited in hospitals, institutions and leisure places. Procedure. The ADAD was administered individually by trained psychologists. It was integrated into a broader protocol including alcohol and drug abuse DSM-IV diagnoses, the BDI-13 (Beck Depression Inventory), life events and treatment trajectories. RESULTS: The ADAD appears to show good inter-rater reliability; the subscales showed good internal coherence and the correlations between the composite scores and the severity ratings were moderate to high. Finally, the results confirmed good concurrent validity for three out of eight ADAD dimensions. CONCLUSIONS: The French language version of the ADAD appears to be an adequate instrument for assessing drug use and associated problems in adolescents. Despite its complexity, the instrument has acceptable validity, reliability and usefulness criteria, enabling international and transcultural comparisons.

Adolescent↗
PubMed2001

Factorial structure of the Sensation-Seeking Scale-Form V: confirmatory factorial analyses in nonclinical and clinical samples.

OBJECTIVE: The factor structure of the Sensation-Seeking Scale (SSS)-Form V was studied in 2 large French samples, using confirmatory factorial analyses (CFA) to test the 4-dimensional model of sensation seeking postulated by Zuckerman. METHOD: The study included 769 healthy subjects and 659 patients who met the DSM-IV criteria for substance use disorders or eating disorders and completed the SSS. The correlation matrices for each of the samples were analyzed using CFA. RESULTS: In each sample, we found the 4-factor model to be replicable. CONCLUSION: The multidimensionality of sensation seeking is supported by the results, and the 4-dimensional model of sensation seeking identified by Zuckerman can be explored in French-speaking people.

Adolescent↗
PubMed2001

[Psychoactive drug use in a declared non-addicted control sample and comorbidity. Results of a study in 860 French-speaking subjects].

AIMS: This study, conducted within the framework of a broader research program of the INSERM 494013 Dependence Network, was designed to estimate illicit drug use and tobacco smoking in a declared non-addicted sample and to determine whether illicit drug users differ from non-users in terms of comorbidity. METHODS: The study was conducted in an "all and sundry" sample of subjects. Patterns of drug use and comorbid factors (psychiatric disorders, suicide attempts, repeated accidents, social inadaptation) were assessed using a semi-structured interview (heteroevaluation, MINI DSM IV interview, Gröningen). RESULTS: Among 860 subjects, 107 (12.4%) used illicit drugs and 26 of these 107 (24.3%) were dependent users or abusers. Specific analysis of non-dependent non-abuser subjects who had used illicit drugs (70 occasional and 11 regular users) showed a higher rate of use in younger subjects (12.7% in the 15-24 year group, 5.7% in the 24-49 year group) and men. Except for repeated accidents (OR=5.5 [1.6-18.5]), comorbid disorders were not more frequent in non-users than in users. CONCLUSION: Besides use for recreational purposes, the rate of use of illicit drugs with abuse or dependence was high in our non-clinical sample. Although no specific comorbid psychiatric disorders were identified among non-dependent non-abuser subjects who had used illicit drugs, the frequency of repeated accidents evidenced the ill-fated side effects of illicit drugs and/or the specific biopsychological vulnerability of these subjects. This highlights the importance of not neglecting drug abuse.

Accidents↗
PubMed2000

[Pertinence of the addiction concept in eating behavior disorders].

From a psychodynamic perspective, dependence disorders, irrespective of the object of addiction, can be seen as the expression of the subject's neurobiological, psychopathological, cultural and social vulnerability. Since vulnerability strengthens and reorganizes the personality, it can drive these subjects to perpetuate pathological behaviors. In this light, behavior disorders belong to the field of addiction diseases, especially considering that the underlying psychopathological structures are close to those observed in addiction, that depression plays a central role, and that their development into toxic addictive behavior (drugs, alcohol, psychotrope) is frequent.

Adolescent↗
PubMed1996

Self-esteem and mental health in early adolescence: development and gender differences

A longitudinal study of a general population (n=219; M age: 12, 13 and 14), was carried out between 1990 and 1993 over 3 years in Lausanne (Switzerland). Several questionnaires, validated in French, were used: Perceived Competence Scale, Social Support Appraisal and a questionnaire on mental health developed in our research Unit. We attempted to answer the following questions: Is there a global change in self-esteem during early adolescence? If so, does the way in which the young person perceives himself vary according to the social and relational environment? What are the differences between boys and girls in the development of self-esteem? What is the relation between self-esteem and mental health?As to the specific differences according to gender, results show that girls tend to have a poorer self-esteem than boys, whatever the domains taken into consideration. Differences are more significant with reference to appearance and athletic performance. As far as the development of self-esteem is concerned, there is no major change, notably when considering global perception. Results of a factor analysis underscore the fact that girls' self-esteem is more global and less differentiated by domain while boys separate the scholastic and behavioral part of their experience from the social. Global self-esteem has more influence on the level of depressive mood in girls than in boys.

Journal Article↗
PubMed1995

An epidemiological and clinical approach to adolescent suicide. A comparison between suicidal and non-suicidal clinical groups in a health foundation center for French students.

Suicidal behaviour among young people represents a major public health problem. This study seeks to compare the major sociological, clinical, schooling and family features of suicidal and non-suicidal subgroups of adolescents hospitalised in the Health Foundation Center for French Students of neufmoutiers en Brie (France). All these adolescents suffered from the severe mental disorders. The adolescents from the suicidal subgroup presented significantly fewer psychoses and more mood disorders than those of the non-suicidal subgroup. Half of the patients from the suicidal subgroup presented some features of personality disorders, mostly borderline personality disorders. Nevertheless, their global functioning was more frequently improved between admission and discharge than was the case for the non-suicidal group.

Adolescent↗
PubMed1986

[Psychopharmacology of panic attacks].

A new type of anxiety state has recently been identified: the panic attack. This condition is qualitatively distinct from other anxiety disturbances and its treatment is different. Sodium lactate seems to play an essential role in the triggering of panic attacks through the intermediary of catabolic, physicochemical mechanisms or by alteration of adrenergic neurotransmission. Anxiety may be autonomised into two sub-groups, based on the effects of psychotropic drugs: phobic and anxiety states. The presence or absence of panic attacks is essential as it has diagnostic and therapeutic implications: M.A.D.I. or tricyclic antidepressors have a specific action on panic attacks but are ineffective on anticipatory, chronic, phobic or other forms of anxiety. Which are improved by benzodiazepines which; themselves, have very little effect on panic attacks.

Antidepressive Agents↗
PubMed1985

[Panic attacks in adolescents].

Anxiety has been the object of many therapeutic attempts, often in the absence of well-founded indications and often yielding inconclusive results. We obtained good results in two adolescents for whom we used a new classification system based upon the differential action of psychotropic drugs on anxiety. More specifically, this approach singled out the panic disorder by demonstrating that patients with this disorder react specifically to antidepressant drugs. More extensive studies are clearly needed to confirm that these results, well established for adult patients, also apply to an adolescent population.

Acute Disease↗
PubMed1985

Treatment of childhood and adolescent depression with mianserin.

The efficacy of mianserin in treating adult depression is now well established. Since there are no publications concerning the use of mianserin in children, the authors set up an open pilot study of 110 depressed children and adolescents aged 8-19 years. The average dose of mianserin was 1 mg/kg/day. Efficacy of treatment was noticeable by the end of the first week and was maintained throughout the 60 day study period. Evaluation was based on both clinical observations and changes in scores obtained from 80 subjects. Side-effects were minimal leading to temporary withdrawal of treatment in only seven cases. The profile of mianserin in children and adolescents is similar to that of adults. It is an antidepressant with an anxiolytic component, and has a regulating effect on sleep. In view of its efficacy, compliance, and the very low incidence of side-effects, mianserin appears to be a useful treatment for depression in children and adolescents. The results of this open study justify the development of further controlled studies.

Adolescent↗