Les crises de boulimie à l’adolescence

Binge eating, bulimia nervosa, binge eating disorder, anorexia-bulimia are terms often used without really knowing what precisely one is referring to. Otherwise, there are many articles concerning anorexia nervosa in medical literature, a disease, which can be seen and fascinates. These eating disorders are frequent in today's society; medical, psychological and social consequences are important.     

Trachéobronchomalacie de l’enfant : de l’abstention à l’interventionnel

Tracheomalacia (TM) or bronchomalacia (BM) refers to softness or weakness of the trachea or the bronchi. Its management is not evidenced-based. Conservative therapy is preferred in milder cases, since the outcome is usually favourable within the first 2 years of life. The clinical utility of non-specific treatments (anti-inflammatory agents, bronchodilators, antibiotics, physiotherapy) has not been proven by clinical trials. Treatment of symptomatic cases should be discussed on an individual basis. Airway surgery should be avoided, and non-invasive ventilation may be proposed as a temporary measure. In case of very severe cases, aortopexy, trachostomy or stent placement are the preferred treatments. Regular respiratory monitoring until remission is mandatory.     

Complexités du diagnostic d’insomnie à l’adolescence et considérations à propos de ses conséquences

Public health also has its own records. A report from Public Health France (2019) shows a decline in sleep time, which, for the first time, has fallen below seven hours. In the digital era, teenagers are susceptible to these changes: 88% of young people (15–24) are facing a lack of sleep. The causes of insomnia are multifactorial, and – even though they seem concerned with the potential consequences of the disorder – teenagers do not always complain directly. This could lead to an underestimation of screenings and diagnoses.Purpose of the studyThe objective was to explore the complexities of the diagnosis in adolescence and to understand the particularity of the links between this disorder and sleep time, drowsiness, aggressivity and anxio-depressive symptomatology.Population and methodA selection of standardised surveys, methodologically validated by ethics and deontology committees, was proposed to a population of 1250 French teenagers, high school and college students (12–20). It was mainly composed of the Insomnia Severity Index, the Epworth Sleepiness Scale and the Hospital Anxiety and Depression Scale.ResultsThe results confirm a major proportion of insomnia in that population (54,9%, n = 569) in comparison to a smaller portion of teenagers who have the perception of having insomnia (27,4%, n = 284). The gap decreases with the severity of the insomnia. The results show a significant correlation between insomnia and anxio-depressive symptomatology and self-aggression; however, they show an insignificant relationship between diagnosis and sleep time, during the week and on weekends. The relationship between insomnia and daytime sleepiness is also very important. Finally, this research highlights the significant gap between the complaint of insomnia and the actual diagnosis.ConclusionThis study highlights the particularity of insomnia diagnosis for this population and the need to refine the criteria for prevention and screening. Insomnia during the teenager period cannot be defined solely by reference to the person's life or by time criteria.     

Violence et « homosexualité » à l’adolescence

The author wants to point how instinctual violence and what is called “homosexuality”, specialy at adolescence time, are linked up the difficult integration of thee narcissistic imagoinary current in the objectal and sexual imaginary current.     

Spécificités de l’approche psychothérapique d’inspiration analytique à l’adolescence

The commitment of a teenager in an individual psychotherapeutic work often faces multiple obstacles, related to incompatibilities inherent to the process of adolescence, but that often reflect the ups and downs of the work of psychic separation or the vicissitudes of “subjectivation”. Therapeutic setting adjustments, made necessary by the psychic and relationship operating constraints of the concerned adolescents, have been proposed by psychoanalysts, intended to take into account the narcissistic vulnerability of their young patients, and also to put their own associative abilities at their disposal. Exciting contributions of several psychotherapists working with teenagers on these issues will be summarized and extended by the reflections of the author based on his own experience as a psychotherapist and that derived of different supervisory groups he facilitated for several years. Some designs may thus be summarized, illustrated and reformulated in the light of the clinic. In this perspective the issues inherent, to the objectives of the psychotherapeutic work at this age, to the levers that can be used, to the obstacles related, not only to the process of adolescence challenges, but also to parental positions, to the nature of the underlying psychopathological organization and to the counter-transferences reactions of therapists, will be re-examined. In order to better control the potential risks of such an encounter, and to increase profits for young patients, it turns finally essential to rethink the design, and to advocate the strong practitioners’ commitment.