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1.
肺炎支原体肺炎及支气管哮喘HLA-DRB1基因位点频率研究   总被引:18,自引:0,他引:18  
为探讨肺炎支原体(MP)肺炎的免疫致病机理及其与支气管哮喘9简称哮喘)之间的关系。应用颗粒凝集法检测29例MP肺炎患儿,40例哮喘患儿及92例正常对照组的血清MP特异性IgM抗体,PCR-SSOP法标记HLA-DRB1等痊基因位点。结果显示MP肺炎组,哮喘组的DRB1*08基因频率明显低于正常对照组(P=0.035)。但MP肺炎组与哮喘组之间差异无显著性,哮喘组中除DRB*08外,DRB1*02基因出现频率亦较正常人显著降低(P=0.041);各组间HLA-DRB1*04,07,09,10,11,12基因频率虽有所变化,但均无统计学差异。提示MP肺炎与哮喘有着极为相似的遗传易感性。  相似文献   

2.
反复呼吸道感染患儿HLA-DRR1等位基因分析   总被引:1,自引:0,他引:1  
目的 探讨HLA-DRB1基因多态性与反复呼吸道感染(RRI)的遗传关联性.方法 采用序列特异性引物-聚合酶链反应(SSP/PCR)技术对43例RRI小儿和41例健康小儿HLA-DRB1的19个等位基因进行分析,计算各个位点的基因分布频率和相对危险性RR值;并进行卡方检验,筛选有意义基因.结果 RRI患儿HLA-DRB1*9和HLA-DRB1*12的分布频率明显高于健康儿童,HLA-DRB1*7的分布频率明显低于健康儿童.观察组与对照组比较P<0.05,差异有显著性,其它各位点差异无显著性.疾病组与正常组之间进行逐个等位基因的比较,以相对危险性RR值计算,HLA-DRB1*9的RR值为3.95,HLA-DRB1*12的RR值为3.16.HLADRB1*7的RR值为0.30.结论 HLA-DRB1*9和HLA-DRB1*12可能是RRI小儿的易感基因.HLA-DRB1*7可能是RRI小儿的保护基因.  相似文献   

3.
目的 通过对幽门螺杆菌(Helicobacter pylori,HP)感染、免疫性血小板减少症(immune thrombocytopenia,ITP)、ITP合并HP感染患儿及健康儿童进行HLA-DRB1*03、*04、*07、*11、*14等位基因检测,探究HP感染及ITP的易感性基因及保护性基因。方法 收集北京儿童医院2014年5月至2015年1月HP感染患儿、ITP患儿、HP感染合并患儿及健康儿童的全血标本,提取全血DNA,应用PCR-SSP方法检测四组患儿HLA-DRB1*03、*04、*07、*11、*14等位基因表达频率,对比不同性别、不同组别之间基因表达频率的差异性。结果 选取的136例汉族儿童中,检测的5种HLA-DRB1等位基因分布频率分别为HLA-DRB1*04(21.32%)、HLA-DRB1*07(19.12%)、HLA-DRB1*14(15.44%)、HLA-DRB1*11(11.76%)、HLA-DRB1*03(8.82%)。分别比较以上5种等位基因在男女性别间的频率表达,差异无统计学意义;在比较HP组与健康对照组、ITP组与健康对照组、HP+ITP组与HP组、HP+ITP组与ITP组以上5种等位基因表达频率的差异性后发现,HLA-DRB1*07等位基因在ITP患儿和健康儿童的表达频率分别为:30.5%、9.7%(OR值=4.1,χ2=4.393,P=0.036),差异具有统计学意义;HP感染合并ITP患儿携带HLA-DRB1*14等位基因的频率明显高于单一HP感染患儿(OR值=4.8,χ2=5.435,P=0.02);在比较相同组别、不同性别间5种等位基因的分布频率后发现,HLA-DRB1*04等位基因在HP感染女童中的表达频率(40%)明显高于HP感染男童(4.8%),经统计学分析,此等位基因在两组间的表达频率差异具有显著性(P=0.013)。结论 HLA-DRB1*07基因可能是ITP的易感性基因;HLA-DRB1*14(+)的HP感染患儿继发ITP的可能性更大,HLA-DRB1*04基因可能是女童感染HP的易感性基因。  相似文献   

4.
目的 探讨广西壮、汉族人类白细胞抗原(HLA)-B、-DR位点的基因多态性与儿童哮喘发病的关联性.方法 将3代居住广西南宁地区无血缘关系的84例哮喘儿童(汉族57例,壮族27例)和168例无哮喘和特应性疾病的健康人(汉族83例,壮族85例)纳入研究.所有哮喘儿童应用强生法玛西亚系统检测其血清总IgE水平、10种吸入性变应原皮肤点刺试验和肺功能检测.利用基因芯片法检测HLA-B的40个和HLA-DR的26个等位基因.分别计算汉族和壮族人群中哮喘和健康对照组基因频率,进行x2检验,分别比较组间基因频率差异和危险性分析,计算基因与哮喘的关联强度比值比(OR值).结果 HLA-B位点共检出27个等位基因,HIA-DR检出21个等位基因.HLA-B46、HLA-DRB1~0.983)、7.885(0.896~69.399)和2.782(1.188~6.516),且HLA-DR B1*070X等位基因在本组壮族人群中未见出现.壮族人群中,HLA-B56、-861和-DRB1*1001等位基因在哮喘与健康对照组间有分布差异,哮喘与健康对照组比较有显著差异,组间HLA-B56经x2检验有统计学意义(x2=6.588 P<0.01),HLA-DRB1*1001经Fisher精确概率法检验有统计学意义(P=0.043);HLA-B56和HLA-DRB1*1001的OR值(95%CI)分别为9.432(1.713~51.932)和10.50(1.044~105.590).而HIA-B61等位基因在壮族哮喘患者中未见出现.结论 HLA-B和HLA-DR的基因多态性在壮、汉族间分布有差异;HLA-B56和HLA-DRB1*1001等位基因可能为壮族人群的哮喘易感基因;而汉族人群中HLA-DRB1*070X和HLA-DRB1*11XX等位基因是易感基因,HLA-B46等位基因可能为保护基因.*070X和HLA-DRB1*11XX等位基因仅在汉族的哮喘与健康人群分布有差异,哮喘与健康对照组比较有显著差异(Pa<0.05),OR值(95%CI)分别为0.388(0.153  相似文献   

5.
目的探讨CD4^+CD45RA和CD4^+CD45RO分子在支气管哮喘患儿中的表达及其意义。方法分别收集支气管哮喘发作期28例、支气管哮喘缓解期27例、健康对照儿童20例抗凝静脉血100μL,采用异硫氰酸荧光素(FITC)标记的抗CIM单抗、藻红蛋白(PE)标记的抗CD45RA单抗和PE-菁蓝色素荧光素(PE—Cy5)标记的抗CD45RO单抗,流式细胞仪检测各组儿童外周血CD4^+T淋巴细胞表面CD45RA和CD45RO的表达。采用SPSS13.0软件进行统计学分析。结果与健康对照和支气管哮喘缓解组患儿比较,支气管哮喘发作组患儿CD4^+CD45RA^+T细胞明显减少(q=12.47,8,39Pa〈0.05),CD4^+CD45RO^+T细胞显著升高(q=9.50,8.30Pa〈0.05),CD4^+CD45RA^+/CD4^+CD45RO^+细胞比值显著降低(q=8.96,6.21P。〈0.05);支气管哮喘缓解组患儿CD4^+CD45RA^+T细胞较健康对照组明显升高(q=3.08P〈0.05),CD4^+CD45RO^+T细胞及CD4^+CD45RA^+/CD4^+CD45RO^+细胞比值与健康对照组比较差异无显著性(q=0.45,2.02Pa〉0.05)。结论外周血CD4^+CD45RA^+和CD4^+CD45RO^+T淋巴细胞平衡失调可能参与支气管哮喘的发病。  相似文献   

6.
慢性咳嗽和喘息性疾病支气管肺泡灌洗液成分分析   总被引:18,自引:0,他引:18  
目的 分析慢性咳嗽及喘息性疾病患儿支气管肺泡灌洗液成分。方法 应用免疫组化及ELISA方法,对哮喘(13例)、慢性咳嗽(10例)、婴幼儿喘鸣(8例)患儿和对照组(8例)共39例的支气管肺泡灌洗液进行细胞学分析及上清液IL-5浓度测定。结果 哮喘患儿支气管肺泡灌洗液嗜酸性粒细胞为3.0%(0.7%-8.8%),上皮细胞为3.0%(0.7%-12.0%),IL-5为1.7ng/L(0-16.0ng/L),与慢性咳嗽组及婴幼儿喘鸣组相比,差异有非常显著意义(P<0.01);2例慢性咳嗽及3例婴幼喘鸣儿哮酸性粒细胞亦有异常增多,与组内其他必相比差异有显著意义;婴幼儿喘鸣组中性粒细胞明显增多。结论 哮喘患儿支气管肺泡灌洗液以嗜酸性粒细胞和上皮细胞明显增多为其特征性改变;慢性咳嗽患儿中有嗜酸性粒细胞异常增多者,应注意与哮喘鉴别;婴幼儿喘鸣者以中性粒细胞增多为著,抗哮喘治疗应慎重。  相似文献   

7.
目的探讨信号转导子及转录激活因子2(STAT2)基因单核苷酸多态位点rs2066807C→G多态性与潍坊地区汉族人群儿童哮喘的关系。方法应用PCR-限制性内切酶多型性法,对92例支气管哮喘患儿(哮喘组)和98例健康儿童(健康对照组)STAT2基因rs2066807C→G多态性进行检测,计算基因型和等位基因频率,组间比较采用χ2检验。相关疾病的基因型风险率以参与风险及比值比(OR)表示,95%可信区间(95%CI)计算采用Miettinen法。结果STAT2基因rs2066807C→G多态位点CC、CG、GG基因型频率,哮喘组患儿分别为0、3.4%、96.6%,健康对照组分别为0、6.1%、93.9%;C和G等位基因频率,哮喘组为1.6%和98.4%,健康对照组为3.1%和96.9%。哮喘组STAT2基因各基因型和等位基因频率和健康照组比较差异均无统计学意义(Pa>0.05)。携带CG基因型和C等位基因的儿童发生支气管哮喘的相对风险OR值分别为0.34(95%CI:0.05~4.96)和0.33(95%CI:0.05~4.93)(Pa>0.05)。结论STAT2基因rs2066807C→G多态性与潍坊地区儿童支...  相似文献   

8.
利用寡核苷酸探针杂交技术及聚合酶链反应技术,检测了临床表现为肾病综合征的36例患儿人类白细胞抗原(HLA)-DR基因频率的分布;其中9例为IgA肾病,27例为非IgA系膜增殖性肾炎。分别与255例正常汉族人HLA-DR基因频率进行比较,发现IgA肾病患儿HLA-DR4基因频率明显高于正常人[DR4:19.4%vs9.0%,Pc<0.05,相对危险系数(OR)=2.98];而非IgA系膜增殖性肾炎HLA-DR12(5)基因频率明显高于正常人[DR12(5):13.9%vs3.9%,Pc<0.01,OR=4.52]。提示HLA-DR4、HLA-DR12(5)分别与临床表现为肾病综合征的儿童IgA肾病和非IgA系膜增殖性肾炎具有明显相关性。  相似文献   

9.
目的探讨肺炎支原体感染与儿童哮喘发病的关系。方法支气管哮喘患儿362例,肺炎患儿288例,正常对照组30例,分别采用颗粒凝集法检测血清肺炎支原体IgM(MP—IgM)抗体;同时采用同位素放射免疫法测定哮喘患儿血清总IgE。结果(1)支气管哮喘患儿MP-IgM阳性率49.45%,显著高于肺炎患儿MP—IgM阳性率39.24%,上述两组均显著高于正常对照组6.67%;(2)在各年龄组支气管哮喘患儿MP—IgM阳性率比较中,发现学龄期儿童MP-IgM阳性率最高;(3)MP—IgM阳性的支气管哮喘患儿血清总IgE水平明显高于MP-IgM阴性哮喘患儿的血清总IgE。结论儿童肺炎支原体感染与儿童哮喘发病密切相关。  相似文献   

10.
目的:研究广东地区汉族幼年特发性关节炎(JIA)患儿HLA-DRB1位点等位基因多态性分布特点。方法:采用序列特异性引物-聚合酶链反应(SSP-PCR)技术对94例JIA患儿和226例健康儿童HLA-DRB1的13个等位基因进行分析,并分析上述基因在各组中的分布。结果:JIA患儿HLA-DRB1*08(P=0.0014,OR=2.26)的分布频率明显高于健康儿童,HLA-DRB1*12(P=0.032,OR=0.55)的分布频率明显低于健康儿童。在JIA全身型及多关节型中HLA-DRB1*08明显增高,而HLA-DRB1*15在JIA全身型及少关节型中明显降低,观察组与对照组比较P<0.05,差异有统计学意义,其他各位点差异无统计学意义。结论: HLA-DRB1*08可能是JIA小儿的易感基因。HLA-DRB1*12可能是JIA小儿的保护基因,其中HLA-DRB1*08是全身型及多关节型的易感基因,而HLA-DRB1*15与全身型及少关节型保护基因密切相关。[中国当代儿科杂志,2010,12(5):333-337]  相似文献   

11.
Solid-organ transplantation is the optimal long-term treatment for most patients with end-stage organ failure. After solid-organ transplantation, short-term graft survival significantly improved (1). However, due to chronic allograft nephropathy and death with functioning graft, long-term survival has not prolonged remarkably (2). Posttransplant immunosuppressive medications consist of one of the calcineurin inhibitors in combination with mycophenolate mofetil (MMF) or azathioprine (Aza) and steroids. All of them have different adverse effects, among which posttransplant diabetes mellitus (PTDM) is an independent risk factor for cardiovascular (CV) events and infections causing the death of many transplant patients and it may directly contribute to graft failure (3). According to the criteria of the American Diabetes Association (4), diabetes mellitus (DM) is defined by symptoms of diabetes (polyuria and polydipsia and weight loss) plus casual plasma glucose concentration ≥ 11.1 mmol/L or fasting plasma glucose (FPG) ≥ 7.0 mmol/L or 2-h plasma glucose level ≥ 11.1 mmol/L following oral glucose tolerance test (OGTT). This metabolic disorder occurring as a complication of organ transplantation has been recognized for many years. PTDM, which is a combination of decreased insulin secretion and increased insulin resistance, develops in 4.9/15.9% of liver transplant patients, in 4.7/11.5% of kidney recipients, and in 15/17.5% of heart and lung transplants [cyclosporine A (CyA)/tacrolimus (Tac)-based regimen, respectively] (5). Risk factors of PTDM can be divided into non-modifiable and modifiable ones (6), among which the most prominent is the immunosuppressive therapy being responsible for 74% of PTDM development (7). Emphasizing the importance of the PTDM, numerous studies have determined the long-term outcome. On the basis of these studies, graft and patient survival is tendentiously (8) or significantly (9, 10) decreased for those developing PTDM.  相似文献   

12.
Carney complex is a multiple endocrine neoplasia (MEN) syndrome that affects the adrenal cortex, the pituitary and thyroid glands, and the gonads. The complex is also associated with skin and mucosa pigmentation abnormalities and myxoid and other neoplasms of mesenchymal and neural crest origin. Thus, this syndrome also belongs to another group of genetic disorders, the lentiginoses (or lentigenoses), which include the Peutz-Jeghers, LEOPARD, arterial dissections and lentiginosis, and Laugier-Hunziker syndromes, Cowden disease and Ruvalcaba-Myhre-Smith (Bannayan-Zonana) syndrome and the centrofacial, benign patterned and segmental lentiginoses, all of which can be associated with a variety of developmental defects. The inheritance of Carney complex, just like that of the other MENs and the lentiginoses, is autosomal dominant. Genetic loci or genes have been identified for Carney complex, Peutz-Jeghers and Ruvalcaba-Myhre-Smith syndromes, but not for other lentiginoses. Elucidation of the molecular defects responsible for these disorders is expected to shed light on aspects of early neural crest differentiation, the regulation of pigmentation, the development of autonomous endocrine function, and endocrine and nonendocrine tumorigenesis.  相似文献   

13.
Bibliometric data published by the Institute of Scientific Information in Philadelphia (ISI), and which was previously discussed in Acta Paediatrica , has increasingly been used despite all the relevant and severe criticism that has been raised against this method of evaluating individual research results and grading scientific journals. It is obvious that the present trend regarding the use of bibliometric data as a basis for priorities and funding of research and for the promotion of individual scientists favours American-oriented research projects at the expense of those that are based on concepts of predominantly European relevance.

Conclusion: For the future of non-American research, it is important that no single super-power, i.e. the USA, should dominate scientific priorities. The condition for efficient European competition is that European Centres with high levels of competence for creative research and training of scientists from all over the world are established. In addition, it is important that the results of European research are published in prestigious European journals, as was the situation before World War II.  相似文献   

14.
The World Health organisation recommends breast feeding infants for the first six months of life. When this breast feeding does not occur either through parental choice or medical need, infant formulas will be required. There is a bewildering array of formulas on the UK market for many different requirements. When faced with an unsettled infant many parents (and health care professionals) will experiment with the infant formula available and often attend the paediatric clinic looking for help and advice. It is therefore essential that paediatricians understand what milks are available and what the key differences between different products are. This review attempts to provide a simple guide through many of the formulations currently available in the UK; and offers advice for the dietary management of the child with extra calorie requirements, infants with cow's milk protein allergy, gastro oesophageal reflux disease, apparent unresolved hunger and infantile colic. Whatever the underlying condition, there is likely to be an infant formula that is suitable in this generation of ever expanding formulations.  相似文献   

15.
In recent years, measurement of serum osteocalcin has been introduced for assessment of bone turnover in patients treated with exogeneous glucocorticoids. Studies in children with asthma on inhaled glucocorticoids, however, have shown inconsistent results. The aim of the present study is to assess bone turnover in prepubertal children and in adolescents with asthma treated with inhaled budesonide using three different osteocalcin assays: the Pharmacia Osteocalcin CAP FEIA, the CIS OSTK-PR and CIS IRMA ELSA-OSTEO assays. Two studies were conducted: 1) a randomised double blind two-period crossover study of 22 prepubertal children aged 5-12 years. In one period 800 μg budesonide was given once in the morning, in the other 400 μg was given twice daily; 2) a randomised double blind placebo controlled two period crossover study of inhaled budesonide 400 μg twice daily in fourteen 13-16 year old adolescents with pubertal stages II-V. In both studies, treatment periods were of four weeks duration, and blood samples were collected at the last day of each period. In the prepubertal children none of the osteocalcin assays detected any statistically significant differences between any of the periods. In the adolescent group reduced levels of osteocalcin were seen during budesonide treatment. The suppression reached statistical significance with the CAP FEIA (P = 0.03) and the OSTK-PR (P =0.01) assays, but not with the ELSA-OSTEO assay (P = 0.06). Correlation analyses showed statistically significant correlation coefficients varying between 0.58 and 0.91 (P=0.03 and P < 0.0001, respectively). The effect of inhaled glucocorticoids on serum osteocalcin may depend on the assay applied, and inhaled glucocorticoids have differential effects in children and adolescents.  相似文献   

16.
We investigated the intra-acinar pulmonary vascular muscularization in the developing human fetal lung between the 17th and 24th gestational weeks, that is, during the canalicular phase of lung development. Fifteen hypoplastic and 25 normal developed lungs were included in this study using monoclonal alpha -smooth muscle (sm) actin antibodies for smooth muscle detection. Computer-aided image analysis was performed for morphometrical measurements and statistical evaluation. Alphasm-actin-immunoreactive intra-acinar vessels down to a luminal diameter of less than 10 mu m were detected in hypoplastic as well as in normally developed lungs. Crucial differences presented as follows: significantly higher density of intra-acinar vessels, especially due to alpha -sm-actin-negative vessels less than 30 mu m in luminal diameter, in the control group; significantly higher alpha -sm-actin immunoreactivity per section unit as well as per vessel in the hypoplastic lung group. As suggested by others, alpha-sm-actin-positive cells of the intra-acinar vessel wall in the developing human lung were demonstrated to be smooth muscle cells, their immediate precursors, and pericytes. We conclude that the increased alpha -sm-actin immunoreactivity represents muscularization of the vessel wall in functional terms and may be regarded as one structural cause among others for the establishment of persistent fetal circulation in hypoplastic lungs.  相似文献   

17.

Background

The emotional and psychological impact of chronical disease among children is considerable. The aim of this study was to explore the emotional representations of sickle cell children followed up at Bordeaux University Hospital in both qualitative and quantitative ways.

Methods

Prospective observational study, conducted from February to May 2010 among 22 sickle cell children (SS, SC and Sβ) followed at Bordeaux University Hospital and among their parents. A questionnaire evaluating depressive symptoms and emotional representations was proposed to children and to their parents separately, measuring their child's emotions. Children were asked to draw themselves during sickle cell crisis and without any painful episode, in order to illustrate their perception of their disease.

Results

Emotional and psychological impact on sickle cell children was important in this study. Eighty-six percent of children have commonly had negative feelings such as sadness, anger or fear. Thirty-six percent of them had depressive symptoms. Parents largely underestimated this impact. Drawings and answers to the questionnaire emphasized an important lack of disease understanding, social consequences, and depressive affects.

Conclusion

Psychological and emotional difficulties in sickle cell children should be identified and supported. Resources for psychological and educational support are necessary to improve the quality of life of sickle cell patients in France.  相似文献   

18.
Parenteral lipids are susceptible to light-induced peroxidation, particularly under phototherapy. Ascorbic acid is protective. The aim of this study was to investigate whether dark delivery tubing and/or coadministration of multivitamin preparations could prevent peroxidation of Intralipid without undue vitamin loss. In experiments carried out on the benchtop, lipid peroxidation occurred in ambient light and was more extensive under phototherapy. Dark tubing decreased peroxide formation, but only by about 65%. In simulated clinical conditions in which solutions were pumped through standard clear or dark minibore plastic tubing, Intralipid accumulated lipid peroxides as measured by the FOX assay (280 µM) or as triglyceride hydroperoxides (52 µM). Multivitamin preparations (MVIP or completely, and were fully protective when used with dark tubing. There was loss of riboflavin (65% from Soluvit and 35% from MVIP) in clear tubing but this was decreased to 18% and 11%, respectively, in dark tubing. Ascorbate loss was 20% (MVIP) and 50% (Soluvit) and only slightly less in dark tubing. Ascorbate loss was also seen in the absence of Intralipid and is due to riboflavin-induced photo-oxidation.Conclusion: Multivitamin preparations protect Intralipid against light-induced formation of lipid hydroperoxides, and administering multivitamins with Intralipid via dark delivery tubing provides a practical way of preventing peroxidation of the lipid while limiting vitamin loss. This procedure should be considered for routine use as well as with phototherapy. Soluvit/Vitlipid) inhibited peroxide formation almost  相似文献   

19.

Background

The SociaBillyQuizz is a therapeutic game designed for social skills training groups with children and adolescents. Using an entertaining method, this media requests several dimensions: exposure, cognition, communication skills, imagination, emotional expression and sign decoding. In this preliminary study, the setting includes two groups of six adolescents, one with social anxiety disorder and the other with Asperger syndrome.

Objective

To evaluate, in an exploratory study, the effects of a therapeutic device involving this game for these two clinically different groups of adolescents.

Methods

During 26 of 1 hour weekly sessions, two adolescents groups participate to a program including the SociaBillyQuizz and cognitive behavioral therapies. The groups are moderated by two therapists. The SociaBillyQuizz is a board game for two to six players; its goal is to collect points by answering instructions from the different thematic cards. There are four thematic cards: action cards (players have to do something), brainstorming cards (players have to use their imagination and demonstrate cognitive flexibility), interview cards (players have to express themselves about what they think or feel) and mystery cards (unexpected instructions). According to the groups’ clinical characteristics, some aims are specifically highlighted. In the anxiety disorder group, the cognitive dimension is privileged and in the Asperger syndrome group, we emphasise the pretend, cognitive flexibility and theory of mind. The effects are measured by the Rathus Assertiveness Schedule and the Fear Avoidance Hierarchy (FAH) for the social anxiety disorder group and by the Faux Pas Recognition Test and the Social Responsiveness Scale (parent version) for the Asperger group.

Results

These assessment tools indicate, for both groups, a significant increase of the scores corroborating the observed clinical effects. For eleven of the twelve adolescents, a clinical interview 6 months after the retest shows a continuity of therapeutic benefit.

Discussion

These early results suggest that a social skills training device featuring the SociaBillyQuizz produces clinical improvements in these two groups of adolescents. In future researches, with control group and more complete follow-up, nature and effectiveness of its contribution should be specified.

Conclusion

In this preliminary study, the SociaBillyQuizz appears to be an interesting therapeutic tool that can increase implication, motivation, participation and cohesiveness of the group. It also makes easier the cognitive-behavioural-strategies learning.  相似文献   

20.

Aim of this study

In this article we wish to question the effects of incarceration on minors. The history of prison reveals that it is the work of a humanist and philanthropic discourse that ensued from the effects of revolutionary ideas. However, from the moment of its reform – that transformed it from a place of confinement to a penal institution – it has only demonstrated its dysfunctional aspect. Our objective is to initiate a reflection on the effects of incarceration, whether it be collective or individual and in particular when it involves adolescents.

Patients and methods

Applying a clinical method, we are analyzing four specific cases: either within a psychiatric department for people under criminal justice control, or in an adult detention center.

Results

The starting point for the “antisocial” behavior is situated, according to our study, at the time of adolescence. Indeed the presence of violence, aggressiveness, and impulsiveness, in other words the “behavioral disorders”, is a constant in each case that is presented. The heart of this, the unifying theme between the psychopathology and the delinquency/criminality, is a feeling of exclusion: an exclusion already present in childhood/adolescence and that is reactivated, in a second instance, by imprisonment. Similarly, identity and identification – already clearly involved in acting out, crime or criminal offences – undergo a further weakening.

Discussion

Through a historical reminder of the questions surrounding criminality and criminals, we will demonstrate that it is not solely a case of finding the causes, undoubtedly important though they be, but of inventing solutions for and with these subjects who have committed a crime or criminal offence. As is indicated in the results, juvenile detention centers appear to further muddle questions of identity and identification, leading to an unleashing of violence and aggressiveness. Thus an experience of abandonment and of exclusion re-enforces that of belonging. The challenge, as much for psychiatry as for psychoanalysis, is to find solutions that enable these youngsters to overcome their violence rather than actualize it.

Conclusion

The incarceration of minors increases and inscribes an aggressiveness and violence that, at the start, was only a need to belong: to the social being, to society, to the social tie. It is not so much the question of the structure or the type of underlying disorder – behavioral, of the personality or psychiatric – that is in question, but rather the effects of a deprivation of freedom that could lead to decompensation, acting out, repeat offending, and to the crystallizing of violence as a mode of discourse.  相似文献   

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