Showing papers by "Angèle Consoli published in 2015"
TL;DR: Assessment of risk factors associated with very acute behavioral crises in adolescents with ASD admitted to a dedicated neurobehavioral unit found no influence of age, gender, socio-economic status, migration, level of ID, or history of seizure on improvement of GAFS score at discharge.
73 citations
TL;DR: As in adults, BZDs should be the first-line symptomatic treatment for catatonia in young patients, and ECT should be a second option, and the absence of an association between the response to treatment and the underlying psychiatric condition suggests thatCatatonia should be considered as a syndrome.
Abstract: We aimed to (1) describe the treatment used in a large sample of young inpatients with catatonia, (2) deter- mine which factors were associated with improvement and (3) benzodiazepine (BZD) efficacy. From 1993 to 2011, 66 patients between the ages of 9 and 19 years were consecu- tively hospitalized for a catatonic syndrome. We prospec- tively collected sociodemographic, clinical and treatment data. In total, 51 (77 %) patients underwent a BZD trial. BZDs were effective in 33 (65 %) patients, who were asso- ciated with significantly fewer severe adverse events (p = 0.013) and resulted in fewer referrals for electrocon- vulsive therapy (ECT) (p = 0.037). Other treatments included ECT (N = 12, 18 %); antipsychotic medications, mostly in combination; and treatment of an underlying medical condition, when possible. For 10 patients, four different trials were needed to achieve clinical improvement. When all treatments were combined, there was a better clinical response in acute-onset catatonia (p = 0.032). In contrast, the response was lower in boys (p = 0.044) and when posturing (p = 0.04) and mannerisms (p = 0.008) were present as catatonic symptoms. The treatment response was independent of the underlying psychiatric or systemic medical condition. As in adults, BZDs should be the first-line symptomatic treatment for catatonia in young patients, and ECT should be a second option. Additionally, the absence of an association between the response to treatment and the underlying psychiatric condition suggests that catatonia should be considered as a syndrome.
50 citations
Journal Article•
TL;DR: The results suggest that adolescents who retain high scores for depression or hopelessness, who remain depressed, or who express a low value for life or an abnormally high connection with the universe are at higher risk for suicidality and should be targeted for more intense intervention.
Abstract: OBJECTIVE: To assess risk and protective factors for suicidality at 6-month follow-up in adolescent inpatients after a suicide attempt. METHODS: One hundred seven adolescents from 5 inpatient units who had a suicide attempt were seen at 6-month follow-up. Baseline measures included sociodemographics, mood and suicidality, dependence, borderline symptomatology, temperament and character inventory (TCI), reasons for living, spirituality, and coping scores. RESULTS: At 6-month follow-up, 41 (38%) subjects relapsed from suicidal behaviours. Among them, 15 (14%) had repeated a suicide attempt. Higher depression and hopelessness scores, the occurrence of a new suicide attempt, or a new hospitalization belonged to the same factorial dimension (suicidality). Derived from the best-fit structural equation modelling for suicidality as an outcome measure at 6-month follow-up, risk factors among the baseline variables included: major depressive disorder, high depression scores, and high scores for TCI self-transcendence. Only one protective factor emerged: coping-hard work and achievement. CONCLUSION: In this very high-risk population, some established risk factors (for example, a history of suicide attempts) may not predict suicidality. Our results suggest that adolescents who retain high scores for depression or hopelessness, who remain depressed, or who express a low value for life or an abnormally high connection with the universe are at higher risk for suicidality and should be targeted for more intense intervention. Improving adolescent motivation in school and in work may be protective. Given the sample size, the model should be regarded as exploratory. Language: en
49 citations
TL;DR: Measures of psychopathology and other cognitive abilities, in addition to ToM, are required to establish a specific association between maltreatment and the cognitive dimension of ToM.
Abstract: Compared to the large number of studies exploring difficulties in emotion recognition in maltreated children, few (N=12) have explored the cognitive aspect of theory of mind, i.e., the ability to understand others’ thoughts and intentions. A systematic review of these studies shows inconsistent results regarding cognitive theory of mind tasks. Youths with a history of maltreatment are more likely to fail at false belief tasks (N=2). However, results are less conclusive regarding other tasks (perspective-taking tasks, N=4; and hostile attribution tasks, N=7). Additionally, only one study controlled for potential psychopathology. Measures of psychopathology and other cognitive abilities, in addition to theory of mind, are required to establish a specific association between maltreatment and the cognitive dimension of theory of mind.
36 citations
TL;DR: Girls with severe depressive symptoms were more likely to present physical aggressive behaviors than boys, and the role of irritability in these differences will be needed to explore.
Abstract: Background: The relationship between depression and aggressive behaviors in adolescents has previously been reported in clinical and epidemiological studies. However, there is conflicting evidence concerning the effect of gender on this relationship. This study tested whether the link between depressive symptoms and physical aggression differed between boys and girls in a large community-based sample of adolescents. Methods: A cross-sectional sample of adolescents aged 15–19 (N = 6,677) was studied within the 2007 ESPAD national survey. Depressive symptoms were assessed using the Adolescent Depression Rating Scale. We distinguished adolescents with subthreshold levels of depressive symptoms and adolescents with clinically significant levels of depressive symptoms. Physical aggressive behaviors in the last year were reported using items from the Antisocial Behavior Scale. Results: After adjusting for confounding variables, the odds-ratio between depressive symptoms and physical aggressive behaviors was around 1.4. This relationship was stronger for girls than for boys in presence of clinically significant levels of depressive symptoms, but did not differ between the genders in the case of subthreshold levels of depressive symptoms.
11 citations
TL;DR: Perisse et al. as mentioned in this paper investigated the troubles du comportement severes of adolescents atteints of the spectre autistique (TSA) atteintes of the TSA, and concluded that these troubles are caused by the causes organiques (epilepsie, pathologies), environnementales (absence de soins, trouble de l-adaptation) and psychiatriques (catatonie, episode depressif majeur, trouble bipolaire, schizophrenia) of adolescents.
Abstract: Resume Objectifs A l’adolescence, certains sujets souffrant de troubles du spectre autistique (TSA) presentent des troubles du comportement severes Cet article resume les deux premieres annees d’activite d’une unite nouvelle dediee a ces situations complexes Methodes Apres deux etudes colligeant les facteurs de risque de decompensation aigue parmi les adolescents et jeunes adultes atteints de TSA admis en unite neurocomportementale pluridisciplinaire specialisee (Perisse et al, 2010 ; Guinchat et al, 2015), nous proposons de resumer les principaux enseignements cliniques que nous avons acquis et d’illustrer, au travers de trois situations cliniques paradigmatiques, la pertinence de notre approche pluridisciplinaire Resultats Les etiologies les plus frequentes de decompensation aigue parmi les patients atteints de TSA sont les causes organiques (epilepsie, pathologies douloureuses), environnementales (absence de soins, trouble de l’adaptation) et psychiatriques (catatonie, episode depressif majeur, trouble bipolaire, schizophrenie) Apres la demarche diagnostique, traiter l’epilepsie, les pathologies douloureuses, les comorbidites psychiatriques et les causes environnementales a ete particulierement utile En outre, une plus longue duree d’hospitalisation etait correlee a un score plus eleve a l’echelle de fonctionnement global a la sortie, et ce meme apres ajustement des facteurs confondants Les observations cliniques rapportent la demarche diagnostique et la conduite du traitement d’une cause organique intriquee a des desordres lies a une iatrogenie medicamenteuse (cas 1), d’une comorbidite psychiatrique non autistique (cas 2), et d’une communication environnementale deviante avec consequences developpementales (cas 3) Conclusion Les troubles severes du comportement des adolescents autistes peuvent etre dus a des facteurs de risque environnementaux, psychiatriques ou somatiques (epilepsie, pathologies algiques) La pertinence de la prise en charge de ces troubles du comportement en unites neurocomportementales specialisees est soutenue par les resultats recueillis apres deux ans d’activite
9 citations