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Biomedical subjects

R Brunod

Publications and source records attributed to R Brunod.

8 recordsLinked to original sources
PubMed1999

[Theoretical basis of semiology in pediatric psychiatry. II. Semiologic activity in pediatric psychiatry].

This paper considers how the theoretic concepts used in child psychiatry intervene during the first psychiatric consultations with a child and his/her family. Most often, the child does not ask for relief from his/her troubles. Therefore the state of mind of the clinician is of great importance with regard to the balance between objectivity and subjectivity. There are two main ways to deal with the child during the consultation: a direct one with no standardization, and an indirect one using standardized support. Evaluation scales are used to quantify symptoms. The relationships between the theoretic models and practices are illustrated through clinical examples. Knowledge resulting from population studies, and those resulting from the individual observation which are dealing with intersubjectivity, must always be confronted in order to set up the most appropriate therapeutic scheme.

Adolescent↗
PubMed1999

[Theoretical bases of semiology in pediatric psychiatry. I. Theoretical models].

This paper is the first part of a study on the theoretic concepts used in child psychiatry and their functioning during the first consultations with a child and his family. These models have different origins (medicine, psychology, education) and contribute to the true specificity of child psychiatry, which must take into account both the developmental aspect as in pediatrics, and the peculiarity of the human psyche. This gives a special stamp to child psychopathology and some usual ways of thinking (like normality, comparability) are quickly inoperative. The five main theoretic models available in child psychiatry are recalled: the model of the medical semiology which describes symptoms and gives them value, the clinical-anatomical model which tries to set up relationships between structure and function, the developmental and cognitive model which emphasizes the psychomotor and intellectual abilities of the child, the affective model (psychoanalysis and attachment) which studies his/her emotional development, and the environmental model which set the child in his/her conditions of growth. These models only support the thoughts of the consultant who must keep in mind the psychic development as a whole and try to aggregate all his findings in the various fields to extract the main features underlying the child's difficulties.

Affect↗
PubMed1991

[Severe rumination in infants].

Rumination or merycism is a rare but potentially life-threatening condition. Six boys, aged 5 to 14 months, were hospitalized for growth retardation (-2 to -4 SD) and vomiting. In 5 of 6, mothers noticed the vomiting but not rumination. Diagnosis was based on clinical observation only. No significant abnormalities were found by other investigations. A short nutritional rehabilitation followed by mothering performed by the nurses resulted in a weight gain of 1 to 2.3 kg over the next 15 to 90 days. Rumination results from an affective deficiency of the infant and his mother as well. It appears as a destructive autoerotic reaction whose basis is depressive. Characteristic of the infant's recovering stage is a holding response when taken in the arms. However, various psychological perturbations persist after treatment.

Gastroesophageal Reflux↗
PubMed1989

[An infant's "forbidden games" (related to six cases of severe merycism)].

Merycism (pondering, in Anglo-Saxon Literature) is an affectation that has become rare in infants but which is still news because of its potential severity. Although psychosomatic by nature, it compromise the vital prognosis if the diagnosis isn't made and appropriate psychotherapeutical measures taken in good time. Based on six cases of severe merycism, the author studies the sign-language and the diagnostic in order to specify the positive elements that must have brought about the illness. A psychopathological hypothesis of the aberrant behavior leading to this "heavy thinking" is put forth. The various psychopathological mechanisms at play in this problem are then shown based on how frustratingly isolated the baby is. Finally, treatment by intensive nurturing and its behavioral components is described as well as the evolution to a half-way point. The ending goes back to the affective meaning of the problem.

Behavior Therapy↗
PubMed1984

[The dexamethasone suppression test in child and adolescent psychiatry].

The dexamethasone suppression test was performed on 67 children and adolescents who were hospitalized in the child psychopathology unit of Herold Hospital (Paris). We used the DSM-III diagnostic criteria. After 10 preliminary trials using 2 mg/1.73 m2 of dexamethasone, 63 trials were conducted with a dosage of 1 mg/1.73 m2. In 19 cases of anorexia nervosa, non-suppression was associated with the weight reduction, with no other significance attached to the results. In 30 pubertal cases, 11 out of the 20 depressed patients escaped from dexamethasone suppression while none of the 10 non-depressed patients did. Those 5 adolescents who were categorized as depressed with psychotic features all escaped suppression. Criteria of specificity and more specifically the role of weight loss, are discussed. In 8 prepubertal patients (under Thirteen) the 4 depressed cases showed no escape response but this response was noted in 2 out of the 4 other children. These results suggest the presence of neuroendocrinological alterations in depressed pubertal children similar to those observed in some depressed adults. We could not find similar alterations in our small sample of non pubertal children.

Adolescent↗