Le miroir social des souffrances adolescentes : entre maladie du symbolique et aveu généralisé

The psychological suffering of adolescents is a subject that has drawn an increasing amount of attention on the part of the public authorities, local and associative bodies, and of course psychotherapists themselves. While the psychiatric treatment of adolescent disorders is based upon wide ranging nosographic categories that are specific to this age group, new and clinical forms are appearing on the scene, as if they were, an expression of new suffering. This sudden visibility on the social front regarding problematical adolescent behavior has brought with it a concomitant increase in explanations attempting to put into perspective the diversity of so-called “deviant” behavioral patterns in adolescents in relation to the development of a new malaise in contemporary civilization. The author of this study has examined this phenomenon from an anthropological point of view, and has critically examined the possible link between the modifications in the present-day social environment, and the various types of behaviour that are considered to be indicative of underlying psychic suffering. By puting the social explanations of adolescent suffering into perspective vis a vis the proposed solution, such as this multiplied counselling services, the author shows the emergence of a widespread system involving and promoting a generalized “confession” and disclosure of the intimate, in wich listening to what is been said becomes less important than the underlying constraints on expression that it imposes.     

Simultaneous Bilateral Tibial Tuberosity Avulsions—Over 6-Year Follow-up

Abstract Simultaneous bilateral avulsions of the tibial tuberosity are rare injuries. The authors found only five reported cases in the orthopedic literature. We add a further case of bilateral avulsions of the tibial tuberosity with the longest reported follow-up.     

Le psychodrame individuel chez les adolescents

The purpose of this paper is to present the psychoanalytic individual psychodrama, as practiced in France within a psychiatric institution. After an overview of historical and theoretical issues, authors present a case report concerning the outcome of an adolescent suffering from schizophrenia, after ten years of treatment. The case analysis highlights the re-investment of mental functioning and the recover of the free association ability. Specially, authors describe the last year of the treatment and the pathways by which main psychical conflicts have been elaborated.     

青少年特发性脊柱侧凸青春期生长发育形态学特征

目的探讨青少年特发性脊柱侧凸(adolescentidiopathicscoliosis,AIS)患儿青春期生长发育的形态学特征。方法对256例12～16岁(平均14.1岁)AIS女性患儿及462例12～16岁(平均14.3岁)健康非侧凸女孩的大体形态学资料进行分析。AIS诊断标准为冠状面上>10°的脊柱侧凸畸形。观测指标包括身高、坐高、臂长及月经状况。采用Bjure公式计算校正身高及校正坐高。AIS组及对照组的各项指标进行比较分析。结果AIS组与对照组的年龄构成比较,差异无统计学意义(P>0.05)。从研究群体看,AIS组的身高、坐高以及臂长与对照组比较,差异无统计学意义(P>0.05),但校正身高、校正坐高显著高于对照组(P<0.01),且月经来潮早于对照组(P<0.01)。从各年龄组看,12岁时,AIS组的校正身高、校正坐高、臂长与对照组相比差异无统计学意义(P>0.05),甚至AIS组校正前平均身高低于对照组。13～15岁,AIS组的校正身高、校正坐高、臂长显著高于对照组(P<0.01)。16岁时,虽然AIS组的校正身高及校正坐高略高于对照组(P<0.05),但身高、坐高以及臂长与对照组比较差异无统计学意义(P>0.05)。结论AIS患儿青春期生长发育存在形态学的异常,这可能与其发病机制有关。     

Should harm minimization as an approach to adolescent substance use be embraced by junior and senior high schools?: Empirical evidence from An integrated school- and community-based demonstration intervention addressing drug use among adolescents

The objective of this demonstration project was to determine if school-based harm minimization drug education was potentially acceptable and effective for junior and senior high school students in Nova Scotia. We conducted a four-year quasi-experimental intervention using mixed quantitative and qualitative methodologies. The intervention was a co-operative participatory research project with various activities determined by the participants. The project involved a partnership of four schools, two school boards, two regional addiction services, the provincial department of health, and a university. The outcomes evaluation was based on a sample of 1117 and 849 students in the intervention schools, compared with 3755 and 4247 students in the rest of the province, in 1998 and 2002, respectively. The evaluation of acceptability was based on an analysis of 491 documents generated from 1998 to 2002. The outcomes of effectiveness were specific risks and harmful consequences associated with substance use. We found that harm minimization was an acceptable approach to drug education targeting the senior high school population, and there was also some evidence of effectiveness in that age group in that the prevalence of several risks and negative consequences of substance use decreased significantly in the intervention schools relative to the rest of the province. In junior high school, harm minimization was found to not be an acceptable approach to drug education. This demonstration project provides evidence that school-based harm minimization may be acceptable and effective in senior high schools but may not be acceptable in junior high schools.     

5～14岁男性体格发育水平与性器官发育关系的研究

目的：探讨男性青少年体格发育水平与性器官发育关系。方法：收集4854例5—14岁男性青少年的身高、体重并计算出体质指数，测量阴茎的长度、周长和睾丸的纵径、横径，观察二者之间的关系。结果与结论：身高与阴茎的长度、周长和睾丸的纵径均呈二次方程曲线关联，而与睾丸横径无明显关联。体重和体质指数与阴茎有长度、周长和睾丸的纵径、横径无明显关联。     

Risperidone exerts potent anti-aggressive effects in a developmentally immature animal model of escalated aggression.

BACKGROUND: Risperidone has been shown to be clinically effective for the treatment of aggressive behavior in children, yet no information is available regarding whether risperidone exhibits aggression-specific suppression in preclinical studies that use validated developmentally immature animal models of escalated aggression. Previously, we have shown that exposure to low doses of the psychostimulant cocaine-hydrochloride (.5 mg/kg intraperitoneally) during the majority of pubertal development (postnatal days [P]27-57) generates animals that exhibit a high level of offensive aggression. This study examined whether risperidone exerts selective aggression-suppressing effects by using this pharmacologic animal model of highly escalated offensive aggression. METHODS: Experimental hamsters were tested for offensive aggression after the acute administration of risperidone (.05-1.0 mg/kg, intraperitoneally). RESULTS: Risperidone dose-dependently reduced the highly aggressive phenotype, with a significant reduction observed at .1-.2 mg/kg for most aggressive responses measured. Experimental animals treated with higher doses of risperidone (.3-1.0 mg/kg) showed significant reductions in aggression and social interest toward intruders, indicating more general behavioral inhibition. CONCLUSIONS: These studies provide evidence that risperidone exerts specific aggression-suppressing effects in a developmentally immature animal model of escalated aggression.     

Case report: Concordant traumatic brainstem contusion delayed diagnosis in a young man with Wilson's disease

Wilson's disease is a hereditary autosomal recessive disorder of copper metabolism. The corresponding gene locus has been localized on the long arm of chromosome 13. Three different clinical variants of the disease can be distinguished: hepato-cerebral, abdominal/hepatic, and central nervous type. The heterogeneity of symptoms can cause problems in differential diagnosis, especially when another concordant disorder can also explain the pathogenesis of symptoms. The case report of a young man who suffered from brainstem contusion demonstrates the possibilities of misinterpretation because presenting symptoms could be attributed either to traumatic brain injury followed by adjustment disorder or Wilson's disease. Clinical signs included leftsided hemiparesis, bilateral gaze direction nystagmus, marked dysarthria with consecutive pervasive mutism, choreo-athetoid movements, spasmodic torticollis and diplopia dependent on gaze direction. Slit lamp examination showed Kayser-Fleischer's corneal ring. EEG- and computer assisted tomography investigations revealed non-specific findings. The patient was treated with D-Penicillamine. Alternative treatment with oral zinc preparations is discussed.

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Zusammenfassung Beim Morbus Wilson handelt es sich um eine autosomal rezessiv vererbte Störung des Kupferstoffwechsels. Der Genort konnte auf dem langen Arm des Chromosoms 13 lokalisiert werden. Klinisch können aufgrund ihrer Symptomatik drei Verlaufsformen (hepato-zerebraler, abdominalhepatischer und zerebraler Typ) unterschieden werden. Die Vielfalt der Symptome kann differentialdiagnostische Schwierigkeiten bereiten. Das Beispiel eines jungen Mannes mit einer traumatischen Hirnstammkontusion zeigt, wie die Diagnose der hepato-lentikulären Erkrankung dadurch erschwert wurde, daß die Pathogenese der Symptome durch die Hirnstammkontusion und darauf folgende Anpassungsstörungen erklärt worden war. Die Symptomatik bestand aus linksseitiger Hemiparese, lateralem Blickrichtungsnystagmus, Dysarthrie mit nachfolgendem universalem Mutismus, choreo-athetodischen Bewegungsstörungen, Torticollis spasmoidicus und blickrichtungsabhängigem Auftreten von Doppelbildern. Bei der Spaltlampenuntersuchung stellte sich der Kayser-Fleischer Ring dar. EEG- und computertomographische Untersuchungen erbrachten nur unspezifische Befunde. Die Behandlung erfolgte mit D-Penicillamin. Die alternative Behandlung mit oraler Gabe von Zinksalzen wird diskutiert.

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Résumé La maladie de Wilson est une affection héréditaire autosomale recessive concernant le métabolisme cuivré. Le locus du gène a été situé sur le bras long du chromosome 13. Du point de vue clinique on distingue trois formes symptomatologiques: le type hepato-cérébral, hepato-abdominal et cérébral. La diversité des signes cliniques peut poser des problèmes de diagnostic différentiel, car d'autres affections peuvent se présenter avec cette même Symptomatologie. Nous rapportons ici l'exemple d'un homme jeune, porteur d'une maladie de Wilson et victime d'une contusion traumatique du tronc cérébral, dont les signes cliniques ainsi que les troubles du comportement pouvaient été autant rapportés à la contusion du tronc cérébral qu'à l'affection métabolique.La Symptomatologie comprenait une hemiparesie gauche, un nystagmus lateralisé, une dysarthrie avec mutisme secondaire universel, des mouvements choréo-athétosiques, un torticolis spasmodique et une diplopie dépendante de la direction du regard. L'examen à la lampe à fente permettait à mettre en evidence un anneau de Kayser Fleischer. L'EEG et le scanner cérébral ne montraient pas d'anomalies specifique.Le traitement a consisté en l'administration de D-Penicillamine. Traitment alternative avec les sels de zinc est discuté.

     

Body piercing: issues in adolescent health.

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