ABSTRACT
UNLABELLED: The activity of child consultation-liaison psychiatry within the hospital can be defined as: the clinical, therapeutic and preventive care given by the staff members of the children psychiatric department, and their studies on pedagogy and research, in the other departments of the children hospital. MATERIAL AND METHODS: Our study focused on the consultation-liaison interventions (N = 215) carried out in the Children Hospital of Tours (France) for 1 year (November 1999-October 2000): it dealt with their characteristics and those of the examined population. It aimed at describing qualitatively and quantitatively this activity and its evolution, by means of a prospective collection of information, and a comparison of some of them with researches carried on previously in the same setting. RESULTS: Child consultation-liaison psychiatry plays a major part in pediatric hospital today. This activity increased by 33% since 1994. The nature of needs for pediatrics care has evolved, and crisis situations are now most dominant. Child psychiatry diagnoses are very varied: the most frequent ones concern adaptation troubles. The agreement on the suggested medical follow-up amounts to more than 50%.
Subject(s)
Child Psychiatry , Hospitals, Pediatric/statistics & numerical data , Referral and Consultation , Adolescent , Child , Child, Preschool , Female , France , Humans , Infant , Infant, Newborn , Interprofessional Relations , Male , Mental Disorders/diagnosis , Prospective StudiesABSTRACT
OBJECTIVE: Known since the first descriptions in 1943, diseases related to autism and associated disorders have incited a growing body of work. Both theoretical interrogations (what is the pathogenic role of autism?) and practical measures (management, screening) are implied. Nevertheless the frequency of autism-related disease has varied from 10 to 37% depending on the series reported. We studied the frequency of these factors in a population of children with major development disorders cared for at the Tours university hospital over a 39-month period. PATIENTS AND METHODS: We reviewed retrospectively the medial features of 295 children examined in our psychiatry and neurophysiology unit for children at the Tours center for major development disorders (based on the DSM IV diagnostic criteria) between September 1995 and December 1998. We divided these factors into 4 categories: hereditary diseases, serious medical conditions, minimal physical disorders and ante- or perinatal antecedents. RESULTS: Among these 295 children, 26.5% had a proven or probable hereditary disease, 19% had a serious medical condition and 21.7% had minimal physical disorders. Among the children with a serious medical condition, 34.4% also had ante- or perinatal antecedents. Among the 33% without any medical factor, 77% also had ante- or perinatal antecedents. CONCLUSION: Our data point out the quantitative importance of medical factors associated with major development disorders. They imply a close multidisciplinary collaboration between child psychiatrists, pediatricians and geneticists in order to identify these disorders and develop an integrated management scheme. On a more theoretical level, it appears possible to identify subgroups of children among such a population based on associated diseases and neuropsychological patterns. This dimension would be useful for research into the pathogenic mechanisms involved.
Subject(s)
Autistic Disorder/complications , Adolescent , Analysis of Variance , Autistic Disorder/genetics , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies , Sex DistributionABSTRACT
Total creatine kinase (CK) and its myocardial isoenzyme (CK-MB) were determined in 71 children with isolated acute head injury (N = 30), with head injury and polytrauma but without chesttrauma (N = 11) and with head injury and polytrauma including chest trauma (N = 30) on the second and third day after injury. Electrocardiograms were recorded in 56/71 children on each of the first three days in hospital. Elevations of CK-MB isoenzyme over 6% respectively over 10% of total CK are found as frequently in children with head injury without chest trauma as in children with head trauma and chest trauma. In addition there is no significant correlation between the level of the CK-MB and the incidence of ECG features characteristically associated with heart contusion. This study shows that the determination of CK-MB cannot be used as a criterion for diagnosing heart contusion in children with head injury. The finding of CK-MB in the serum of 53% children with isolated head injury exceeding 6% of total CK, and in the serum of 33% children exceeding 10% of total CK strongly suggests myocardial damage to be a frequent complication of cerebral damage with consecutive extreme sympathetic stimulation.
