Contribution de la Screen for Child Anxiety Related Emotional Disorders au dépistage et au diagnostic des troubles anxieux chez l’enfant d’âge scolaire

Children's anxiety disorders were for a long time viewed as poorly differentiated; however, many researchers recently brought evidence that syndromes similar to adult ones are clearly recognizable among very young children. The best instruments for diagnosing these disorders are time-consuming structured interviews like the Schedule for Affective Disorders and Schizophrenia for School Age Children (Kiddie-SADS). Is it possible to shorten the diagnostic procedure using “paper/pencil” questionnaires as diagnostic tests? The aim of this study was to test the diagnostic value of the Screen for Child Anxiety Related Emotional Disorders (SCARED), which comprises a self-report form and a parent-report form, and assesses four DSM anxious disorders. We examined 69 children aged 6 to 12 (36 boys) addressed to a school psychology facility using both self-report and parent-report SCAREDs and Kiddie-SADSs. Indices were defined, based on threshold-scores on the four SCARED syndrome scales. Theses indices all showed high sensitivity, but have different specificities: maximal for separation anxiety disorder, moderate for panic disorder and social phobia, but poor for generalized anxiety disorder. The SCARED-based indices performed well as screen for these four anxious disorders. In addition, they allow substantial time economy in the process of diagnosing separation anxiety disorder, panic disorder, and social phobia.     

An overview of premenstrual syndrome

Premenstrual syndrome (PMS) is a recurrent disorder that occurs in the luteal phase of the menstrual cycle. It is characterized by intense physical, psychological, and behavioral changes that interrupt interpersonal relationships and disrupt the lives of affected women. Premenstrual syndrome is believed to affect 75% of women of childbearing age. Because no tests can confirm PMS, the diagnosis should be made on the basis of a patient-completed daily symptom calendar and the exclusion of other medical disorders. PMS symptoms occur during the luteal phase of the menstrual cycle and remit with the onset of menstruation or shortly afterward. The aetiology of PMS is still unknown uncertain, but are likely associated with aberrant responses to normal hormonal fluctuations during the menstrual cycle. A wide range of therapeutic interventions has been tested in the treatment of premenstrual symptoms. Most non-pharmacological interventions that have been proven efficacious require a series of interventions. If non-medical approaches are ineffective, drug therapy may be appropriate. Several pharmaceutics agents have been shown to relieve symptoms. Calcium carbonate and selective serotonin reuptake inhibitors have demonstrated excellent efficacy.     

Smoking among school children in Sousse,Tunisia

In order to study smoking habits of children and adolescents from Sousse in Tunisia, we undertook an epidemiological survey on a representative sample of 1569 pupils aged between 13 and 19 years with a global answer rate of 95,4%. The objective of the study was both to describe Tunisian adolescent smoking behaviour and also to evaluate the influence of the home environment, friends and the different socio-demographic factors on acquiring or maintaining the habit. Students were surveyed in schools using a self-administered, anonymous questionnaire. Overall 7,6% of our sample smoked tobacco with prevalence amongst boys being much higher than in girls: 14,7% versus 1,1%; X(2)=103,4, p=0,00001. The smoking prevalence rose with age: in boys it increased from 3,4% at 13 years to 32,3% at 19 years; X(2)=40,9, p=0,0001. 60,6% of youngsters interrogated were exposed to passive smoking at home. Peer smoking behaviour has a clear effect on the tobacco habits of boys. These findings suggest school and medical authorities should design specific programs to limit the spread of the tobacco phenomenon in youngsters.     

Study of overweight and obesity in a population of urban school children in Sousse, Tunisia]

AIM: The aim of this study was to assess the prevalence of obesity and overweight and their relationship with cardiovascular disease risk factors. METHODS: Epidemiological survey based on a representative sample of 1569 urban school children of Sousse, Tunisia. RESULTS: Overweight (BMI > or = 25) was significantly higher in girls (16.1%) than in boys (11.6%); (chi 2 = 8.2; p = 0.004). Obesity (BMI > or = 30) was slightly higher in girls (3.7%) than in boys (2.7%); (chi 2 = 0.89; p = 0.34). Girls had significantly higher BMI, diastolic blood pressure, cholesterol and HDL cholesterol levels than boys who had however significantly higher levels of systolic blood pressure. Overweight was significantly higher in children who did not practice sport at school: 22 versus 13.1% (p < 0.002), in groups of youngsters who were not affiliated to school sport or city associations. Overweight children had a significantly higher levels of cholesterol, HDL cholesterol and means of systolic and diastolic blood pressures. CONCLUSION: These results will serve to set up a regional program of health promotion at schools.     

Tracking of cardiovascular risk factors among school children: a four-year population surveillance in Susa, Tunisia

In order to confirm the phenomenon of tracking of cardiovascular risk factors among school children, we undertook in 2003, a prospective survey of a population of 789 pupils aged 13 to 15 years who had participated in a first investigation on cardiovascular risk factors in 1999. We were able to follow and study 453 pupils (57.4% of the initial population). Prevalences of hypertension and obesity were respectively 11.3% and 6.1% without significant difference between sexes. On the other hand, hypercholesterolemia was significantly more elevated among girls than boys (16.1% versus 9.3%, p = 0.039). Children classified initially as hypertensive, obese or having a hypercholesterolemia were identified 4 years later at a subsequent exam as hypertensive, obese or having a hypercholesterolemia in respectively 25%, 48.9% and 59%. The stability of cardiovascular risk factors among children imposes an early screening for a better management and a policy of cardiovascular health promotion since childhood based essentially on prevention of risk factors in order to reduce the cardiovascular disease burden in adulthood.