ObjectifsNotre objectif principal était de décrire les caractéristiques des actes auto-agressifs avec substance des sujets de moins de 18 ans pris en charge dans le cadre de la régulation téléphonique d’urgence du centre antipoison et de toxicovigilance de Marseille.Patients et méthodeCette étude est descriptive, prospective et quantitative. Elle est monocentrique et a été réalisée au sein du centre antipoison et de toxicovigilance de Marseille. Elle a inclus l’ensemble des sujets de moins de 18 ans pour lesquels un avis au centre antipoison et de toxicovigilance de Marseille a été sollicité au décours d’un acte auto-agressif avec une substance toxique (dont des médicaments) entre le 1er octobre 2021 et le 31 janvier 2022.RésultatsLes 308 sujets inclus étaient âgés de 11 à 17 ans avec un âge moyen de 14,9 ans (±1,5) pour les filles et 14,6 (±1,7) pour les garçons (p=0,234). Le sex-ratio était de 0,14. Deux cent quarante patients (77,9 %) avaient déjà un suivi antérieur psychologique ou psychiatrique. Il s’agissait d’une récidive de tentative de suicide dans 43,8 % des cas (n=135). Le recours aux services des urgences était quasiment systématique (n=277, 89,9 %). Il s’agissait en majorité de mono-intoxications (n=193, 62,7 %). Les intoxications étaient dans la plupart des cas médicamenteuses (n=281, 91,2 %). Les antalgiques-antipyrétiques étaient la classe médicamenteuse la plus utilisée (n=147 patients, 47,7 %), suivis par les anxiolytiques (n=62, 20,1 %). Le paracétamol s’est avéré la substance la plus ingérée (n=108, 35,1 %). Cent six patients sont restés asymptomatiques (34,4 %). Sur les 308 sujets inclus, 78,6 % étaient hospitalisés pour une durée moyenne de 4 ans jours. Deux cent quarante-neuf jeunes (80,8 %) avaient eu au moins un avis psychiatrique et 200 (64,9 %) avaient un rendez-vous pour une consultation psychiatrique à la sortie.DiscussionLes caractéristiques démographiques des jeunes suicidants et celles de l’intoxication étaient globalement similaires à celles retrouvées dans la littérature. Le taux de récidive est plus élevé que dans la littérature. Plus de deux ans après le début de la pandémie de SARS-CoV-2, le mal-être de la jeunesse est toujours là alors que l’offre de soin est déjà saturée. Pour inverser la tendance d’ici 2027, le ministère de la Santé et de la Prévention a actualisé sa stratégie nationale de prévention par différents moyens. Une étude au décours pourrait être intéressante pour voir l’impact de ces mesures.ConclusionsCette étude, même limitée dans le temps et l’espace, complète d’autres indicateurs peu nombreux et partiels, et montre que la crise de santé mentale pédiatrique s’aggrave, en particulier chez les plus jeunes adolescents, avec un taux de récidive qui augmente. Il faut rester vigilant et continuer à mettre en place des actions de dépistage et des moyens de prévention notamment des récidives.

BACKGROUND:In recent years, social networks (SNs) have increasingly become a core activity adolescent's daily life. Their impact on mental health is an actual worldwide concern. This massive usage of social network has been suggested to increase the risk of depressive and anxiety disorders, as well as alterations in sleep quality and quantity. In particular, it has been suggested that it could increase concerns about body image and thereby encourage eating disorders. Aiming at further investigating these relations, this study examined, for the first time, the links between the clinical profile of adolescents with anorexia nervosa and SNs use patterns. METHODS:The sample included 131 adolescent girls with anorexia nervosa who completed an online survey assessing their SNs practices in terms of duration, intensity and function of SNs use, misuse and addictive tendencies, as well as the number of online peers. Clinical characteristics such as eating behaviours, body image perception, depression, anxiety and sleep quality were also assessed. RESULTS:showed that adolescents with anorexia nervosa spend more than 3 h per day on SNs. Those spending 5 h per day or more preferred a passive use, with limited connection with peers and greater clinical difficulties. In addition, high problematic use of SNs significantly aggravated eating behaviour, dysmorphophobia, depressive symptoms and sleep impairment. The activities performed on SNs were not significantly associated with variations in clinical characteristics. CONCLUSION:Presents findings suggests that a profile of social networking marked by a problematic, prolonged and passive use, is associated with more severe symptomatology in adolescent girls with anorexia nervosa. These first data could inspire professionals to encourage a SNs use favouring care and recovery, thereby supporting adolescents with an eating disorder but also their relatives.

PURPOSE The recent Covid-19 pandemic and its lockdown measures raised concerns about people's mental health, leading to an increased interest in identifying vulnerable groups especially at risk for mental distress. This cross-sectional study investigated the impact of this unprecedented situation on sleeping patterns and emotionality in adolescents with anorexia nervosa (AN). METHODS Variations in sleeping patterns and emotionality of two groups of adolescents with AN, assessed before (N = 50) and during (N = 51) the Covid-19 lockdown were analysed. We further investigated these variations over time, considering the two lockdown periods in France. RESULTS Adolescents self-reported significantly more sleep difficulties and lower rates of positive emotions during lockdown, compared to those evaluated before it. Furthermore, present findings overall suggest that as the lockdown progresses, adolescents with AN show an increased deterioration of sleep quality, as indicated by greater insomnia severity levels. They also show a significant decrease in the subjective experience of positive emotionality, in particular in feelings of tenderness. CONCLUSIONS These sleep and emotionality alterations may have amplified the severity and the incidence of AN in adolescents during the Covid-19 pandemic. These features may therefore represent therapeutic targets to optimise care of adolescents with AN. This is particularly urgent, considering kinetics of the deterioration. Tools such as those provided by cognitive behavioural therapy for insomnia and by the positive psychology framework seem appropriate to guide clinicians in this context. LEVEL OF EVIDENCE Level V, descriptive study (evaluation data retrospectively studied).

Autism spectrum disorder (ASD) are neurodevelopmental conditions characterised by deficits in social communication and interaction and repetitive behaviours. Maternal immune activation (MIA) during the mid-pregnancy is a known risk factor for ASD. Although reported in 15% of affected individuals, little is known about the specificity of their clinical profiles. Adaptive skills represent a holistic approach to a person's competencies and reflect specifically in ASD, their strengths and difficulties. In this study, we hypothesised that ASD individual with a history of MIA (MIA+) could be more severely socio-adaptively impaired than those without MIA during pregnancy (MIA-). To answer this question, we considered two independent cohorts of individuals with ASD (PARIS study and FACE ASD) screened for pregnancy history, and used supervised and unsupervised machine learning algorithms. We included 295 mother-child dyads with 14% of them with MIA+. We found that ASD-MIA+ individuals displayed more severe maladaptive behaviors, specifically in their socialization abilities. MIA+ directly influenced individual's socio-adaptive skills, independent of other covariates, including ASD severity. Interestingly, MIA+ affect persistently the socio-adaptive behavioral trajectories of individuals with ASD. The current study has a retrospective design with possible recall bias regarding the MIA event and, even if pooled from two cohorts, has a relatively small population. In addition, we were limited by the number of covariables available potentially impacted socio-adaptive behaviors. Larger prospective study with additional dimensions related to ASD is needed to confirm our results. Specific pathophysiological pathways may explain these clinical peculiarities of ASD- MIA+ individuals, and may open the way to new perspectives in deciphering the phenotypic complexity of ASD and for the development of specific immunomodulatory strategies.

Cette étude pilote évalue les effets de la musicothérapie sur l'anxiété et la dysmorphophobie, en unité de soin juste avant un moment institutionnel anxiogène, celui de la pesée. Nous avons utilisé et adapté une technique de musicothérapie réceptive, le DéPi-AM (détente psychomusicale) auprès de 8 adolescentes âgées entre 13 et 17 ans (14,8 ± 2 ans et 4 mois) hospitalisées 4 mois en moyenne pour anorexie mentale restrictive. Les participantes ont bénéficié de 8 semaines de musicothérapie à raison d'une séance par semaine avant la pesée hebdomadaire, suivies de 8 semaines contrôles sans musicothérapie avant la pesée. Des données quantitatives ont été recueillies dans trois conditions d'évaluation avant la pesée hebdomadaire (avant séance, après séance, sans musicothérapie). On retrouve une réduction significative de l'anxiété perçue à la STAI-Y A (p=.01) et une réduction tendancielle du niveau d'anxiété perçue à l'EVN (p = 0687) avant la pesée avec musicothérapie versus sans musicothérapie. De plus, notre étude montre une réduction significative de la tension artérielle systolique (p = 0,03) et de la fréquence cardiaque (p = 0,02) avant la pesée hebdomadaire avec musicothérapie en comparaison à la condition contrôle sans musicothérapie. Aussi, les résultats indiquent une augmentation significative de l'ensemble des constantes physiologiques au moment de la pesée (tension artérielle systolique : p = 01 ; tension artérielle diastolique : p = 05 ; fréquence cardiaque : p = 04) comparé aux constantes prises au même moment de la journée un jour sans pesée. Cette première étude quantitative en musicothérapie chez l'adolescent souffrant d'anorexie mentale rend compte de plusieurs résultats encourageants sur la réduction de l'anxiété perçue et vécue. En optant pour des données physiologiques, nous avons souhaité rendre plus objectifs les résultats des questionnaires et ceux observés cliniquement. La diminution des constantes physiologiques pouvant traduire une diminution de l'anxiété vécue. L'objectivation du caractère anxiogène de ce temps institutionnel crucial et stratégique dans le parcours de soin de ces adolescents, légitimise la présence de ce type de groupe de relaxation. Des limites méthodologiques contraignent la généralisation des résultats. De futures études devront adopter une méthodologie mixte (quantitative et qualitative) et transversale. Elles contourneront la forte hétérogénéité de cette pathologie et affineront le profil de patients pour qui cette thérapeutique pourrait s'avérer pertinente. Les résultats tendent à montrer un impact positif d'une prise en charge groupale en musicothérapie réceptive sur la réduction de l'anxiété vécue et perçue. Des dispositifs originaux de détente psychomusicale comme le DéPi-AM peuvent faire partie intégrante de l'offre de soins proposés à des patients hospitalisés pour mieux les accompagner dans des temps institutionnels clés et anxiogènes. This pilot study aims at evaluating the effectiveness of music therapy in decreasing anxiety and dysmorphophobia experienced in a care unit during the institutional and distressful moment of weighing. We adapted a technique of receptive music therapy, the so-called DéPi-AM for psychomusical relaxation, with eight adolescent girls (14;8 ± 2 years;4) hospitalized for four months on average for restrictive anorexia nervosa. The participants received eight music therapy sessions followed by eight control evaluation sessions without music therapy. Quantitative data were collected in three evaluation conditions (pre-session, post-session, and no music therapy). Results suggest that music therapy significantly reduces perceived anxiety (as measured by the STAI-Y A; P = 0.01, and the "EVN"; P = 0687). Moreover, compared to the control condition, music therapy significantly contributed to a reduction in the systolic blood pressure (P = 0.03) and heart frequency (P = 02). Results additionally showed that this weighing time significantly increases all physiological constants (systolic blood pressure; P = 0.01, diastolic blood pressure; P = 0.05, and heart frequency; P = 0.04) in contrast to another trivial, emotionally "neutral" day. This first quantitative study on the effectiveness of music therapy in adolescents suffering from anorexia nervosa shows encouraging results. The proved anxiety-provoking effect of this strategic institutional time in the care of these adolescents legitimizes the use and benefits of this type of therapeutic group. Undoubtedly, methodological limitations constrain the generalization of findings. Future studies should adopt a mixed (quantitative and qualitative) and transversal methodology. They would surely contribute to refine the profile of those patients, for whom this therapy appears to represent a promising care approach. Overall findings suggest a positive impact of receptive music therapy in decreasing experienced and perceived anxiety. Integrating programs such as the "DéPi-AM" into the therapeutic intervention offered by the care unit could therefore represent a key element when accompanying hospitalized patients during a key and anxious period.

AbstractBackgroundWhile adult outcome in autism spectrum disorder (ASD) is generally measured using socially valued roles, it could also be understood in terms of aspects related to health status – an approach that could inform on potential gender differences.MethodsWe investigated gender differences in two aspects of outcome related to health-status, i.e. general functioning and self-perceived health status, and co-occurring health conditions in a large multi-center sample of autistic adults. Three hundred and eighty-three participants were consecutively recruited from the FondaMental Advanced Centers of Expertise for ASD cohort (a French network of seven expert centers) between 2013 and 2020. Evaluation included a medical interview, standardized scales for autism diagnosis, clinical and functional outcomes, self-perceived health status and verbal ability. Psychosocial function was measured using the Global Assessment of Functioning scale.ResultsWhile autistic women in this study were more likely than men to have socially valued roles, female gender was associated with poorer physical and mental health (e.g. a 7-fold risk for having three or more co-occurring physical health conditions) and a poorer self-perceived health status. Psychosocial function was negatively associated with depression and impairment in social communication. Half of the sample had multiple co-occurring health conditions but more than 70% reported that their visit at the Expert Center was their first contact with mental health services.ConclusionsTo improve objective and subjective aspects of health outcome, gender differences and a wide range of co-occurring health conditions should be taken into account when designing healthcare provision for autistic adults.

AbstractObjectiveExecutive functions (EFs) inefficiencies in anorexia nervosa (AN), especially in set‐shifting and central coherence, suggest a link between AN and autism spectrum disorders (ASDs). This study aimed at comparing EF profiles in AN and ASD, and investigating clinical variables associated with the identified EF difficulties.MethodOne hundred and sixty‐two adolescents with AN or ASD completed self‐report questionnaires assessing depression, anxiety and autism symptoms. Parents completed the behaviour rating of executive functions parent‐form (BRIEF‐P). Besides comparing EFs in AN and ASD, we also analysed clinical variables scoring below and above the mean age score across the all sample. We additionally examined the relationship between clinical variables and the BRIEF‐P indexes in AN.ResultsParticipants with ASD had greater EF difficulties than participants with AN on all BRIEF‐P scales. In the whole sample, higher autistic features were related to poorer EF. In AN, lower body mass index and particularly higher autism‐spectrum quotient (BRI: Beta = 0.55; p < 0.001 and GEC: Beta = 0.50; p < 0.001) were most strongly associated with poorer EF.ConclusionAlthough participants with ASD showed greater difficulties, autistic traits were related to alter EFs in AN. Exploring further this dimension can undeniably allow better adaptive cognitive remediation programs.

Aim. - MPH is the more often prescribed stimulant for Attention Deficit Hyperactivity Disorder (ADHD), but it has been estimated that 30% of patients do not adequately respond or cannot tolerate it. Therefore, some other therapies are needed, such as cognitive behavioral therapy. Cognitive behavioral therapy is an intervention proposed over several sessions and aimed at modifying behavior by teaching different techniques that participants can re-use to control their symptoms. In our Institute, we used a program centered on attentional and metacognitive functions. It consists of a series of workshops performed in group at the rate of one workshop of 90 minutes per week for 12 weeks. Positive effects on the behavior of adolescents with ADHD have been reported by parents and educators, but the effects of the program on specific cognitive processes have never been precisely investigated. Method. - In the present study, we evaluated the impact of the program on impulsive control in adolescents with ADHD who are known to present impaired impulsive control. Impulsive control is required each time there is a conflict between an inappropriate prepotent action and a goal-directed action. At an experimental level, impulsive control can be studied with conflict tasks, such as the Simon reaction time task. Interpreted within the theoretical framework of the so-called "Dual-process activation suppression" (DPAS) model, this task is a powerful conceptual and experimental tool to separately investigate the activation and inhibition of impulsive actions, which is almost never done in studies about impulsive control. Twenty adolescents followed the program and were tested before and at the end of the program by using dynamic analyses of performance associated with DPAS model. Results. - The results have shown an improvement of the impulsive control after three months of cognitive behavioral therapy, and this improvement was due to both a decrease of the propensity to trigger impulsive actions and an improvement of inhibitory processes efficiency. Conclusion. - This program could be a relevant alternative to the stimulant medication, more particularly when parents are reluctant with medication or when the adolescent suffers from important side effects. (C) 2021 L'Encephale, Paris.

Introduction. - The French day hospital program specialized in eating disorders (ED) opened in January 2018. Our study presents preliminary data on clinical profiles of patients with anorexia nervosa (AN). We describe more specifically clinical characteristics of patients with early onset AN and according to their therapeutics orientations. Then, we compare the weight gain of patients managed only in day-patient (DP) treatment with those managed initially inpatient (IP) treatment and relays in DP.Methods. - Ninety-two patients with AN, aged between 8 and 18 years, were evaluated with several questionnaires (EDI-2, EDE-Q, BSQ, EDS-R, CDI, STAI-Y, VSP-A, EPN-13).Results. - Patients with early onset AN, n = 23 (25.3%), presented more restrictive behaviors, less marked dietary symptomatology, a lower degree of clinical perfectionism and a less marked feeling of ineffectiveness than adolescent patients with AN. Regarding the choice of hospitalization modality (DP alone or IP-DP), the only difference highlighted was the severity of patient undernutrition. Among the patients who were treated (IP-DP n = 27 vs DP alone n = 25), the weight evolution after one month and at discharge was favorable for both groups. Conclusion. - These preliminary data suggest the effectiveness of DP in the care of AN in children and adolescents. (c) 2022 L'Encephale, Paris.

Cette revue de questions s’intéresse aux freins psychosociaux à l’insertion professionnelle des adultes présentant un Trouble du Spectre de l’Autisme sans déficience intellectuelle (TSA-SDI) en milieu ordinaire de travail, encore peu étudiés, particulièrement en France. Malgré la loi de 2005 sur l’égalité des droits et des chances des personnes handicapées et les quatre plans autisme qui se sont succédés, des freins importants subsistent dans l’accompagnement du parcours professionnel et dans les conditions d’accès à l’emploi de ces personnes. Une revue systématique de la littérature a été réalisée sur les bases de données PubMed et APA PsycInfo. La littérature analysée fait état de plusieurs principaux facteurs impactant le parcours professionnel. La stigmatisation à l’égard de ces personnes, le manque de connaissance du TSA, les différents manques d’adaptation de structuration des parcours professionnels, sont autant de freins régulièrement évoqués. Des leviers existent mais demandent à être développés et formalisés.

The present study investigated how enhancing motivation by delivering positive feedback (a smiley) after a successful trial could affect interference control in adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and in their typically developing (TD) peers. By using a Simon task within the theoretical framework of the "activation-suppression" model, we were able to separately investigate the expression and the inhibition of impulsive motor behavior. The experiment included 19 adolescents with ADHD and 20 TD adolescents in order to explore whether data found in adolescents with ADHD were similar to those found in TD adolescents. Participants performed the Simon task in two conditions: a condition with feedback delivered after each successful trial and a condition with no feedback. The main findings were that increasing motivation by delivering positive feedback increased impulsive response in both groups of adolescents. It also improved the efficiency of impulsive motor action inhibition in adolescents with ADHD but deteriorated it in TD adolescents. We suggest that 1/increased motivation could lead adolescents to favor fast responses even if incorrect, and 2/the differential effect of feedback on the selective suppression of impulsive motor action in both groups could be due to different baseline DA levels.

Purpose The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians’ advice to continue treatment at AMHS. Methods Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians’ transition recommendations. Results Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. Conclusion Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services.

Purpose: The recent COVID-19 pandemic, and its consequent lockdown measures raised concerns about people’s mental health. Identified vulnerable groups may be especially at risk. This study investigated the impact of this unprecedent situation on sleeping patterns and emotionality in adolescents with anorexia nervosa (AN). Methods: Variations in sleeping patterns and emotionality of 101 adolescents with AN, assessed during the pandemic (Covid-19 Group), and the year before (No-Covid-19 Group) were analyzed. We further investigated these variations over time: before the lockdown, 9 months later and after the lockdown. Results: Adolescents in the Covid-19 Group had significantly higher rates of sleep alterations and lower rates of positive emotions, compared to the No-Covid-19 Group. A higher insomnia severity index score and a tendency to lengthen sleep latency time were also associated with the pandemic period. Considering three different groups of patients over time, the kinetics of the impact of the changes shows that the worsening of values is not strictly limited to the acute lockdown phase but is increasing over time. Conclusions: These sleep and emotionality features could have participated to increase severity and incidence of AN in adolescents during the Covid-19 pandemic. As such, these features could represent therapeutic targets to optimize the care of adolescents with AN, particularly urgent to improve considering the kinetic of the deterioration. Tools such as those provided by cognitive behavioral therapy for insomnia (CBTi) and by the positive psychology seem appropriate to guide clinicians in this context. Level of evidence: Level V, descriptive study (evaluation data retrospectively studied).

Problematic physical activity (PPA) is a symptom commonly present in patients suffering from anorexia nervosa (AN). This study aims to refine the clinical description of children with early-onset AN and adolescents with standard-onset AN and associated PPA, in order to better understand their associated features, and to offer them adapted care and physical activity programs. 107 participants treated at the Salvator University Hospital Centre of Marseille for AN were retrospectively evaluated by the Exercise Dependence Scale Revised concerning PPA. Other self-report questionnaires were used to evaluate eating disorder, anxiety and depressive symptoms, quality of life, emotions, sleep, and attention deficit disorder with or without hyperactivity. In the entire sample, the presence of PPA was associated with significantly higher levels of eating disorder (EDI-2: p = 0.001) and body image concerns (p = 0.002), anxiety (STAI-Y-trait: p = 0.013) and depression (p = 0.006), as well as significantly lower psychological well-being (p < 0.001) and quality of life (p < 0.001) and impaired sleep (PSQI: p = 0.008). The early-onset group showed a lower prevalence of PPA than the standard-onset group (p < 0.05) but their clinical symptomatology, when this symptom was present, was significantly more severe (EDI-2: p < 0.01; BSQ: p < 0.05; CDI: p < 0.05; STAI-Y-trait: p < 0.05). PPA appears to be associated with more severe features in patients with early-onset AN, which seems to differ from standard-onset. It seems necessary to refine our knowledge on the involvement of PPA in the severity of AN, especially in patients with early-onset AN who remain little studied so far. Level V, descriptive study (evaluation data retrospectively studied).

Virtual reality is a new technology that can be used to model an environment with which an individual can interact using all five senses. It is notably used in psychiatry for anxiety disorders and addictions, and its use in eating disorders has been growing in recent years. Indeed, virtual reality offers interesting advantages, such as its ability to personalize any environment, which is also more secure and controllable. Recent studies show promising results in the understanding, evaluation, and therapeutic management of eating disorders. The use of avatars in anorexia nervosa allows for a correct assessment of the perceptual (body image distortion) and cognitive-affective (body dissatisfaction) components of the body image disorder in a similar way to conventional methods, but also for a better understanding of them. Moreover, avatars allow the development of innovative therapeutic protocols and are thus used in the context of exposure therapy. The new body swapping protocol, based on a multisensory illusion, offers particularly promising results in the reduction of body image disorder. For bulimia nervosa and binge eating disorder, virtual reality has made it possible to better characterize the triggering mechanisms of binge eating episodes through studies that have observed different responses to food-related environments and stimuli. At the therapeutic level, virtual reality cue exposure therapy has the most empirical support. Its aim is to reduce or eliminate the anxiety and craving felt by a patient in response to exposure to food or other food-related cues by preventing the patient from consuming food, and results show clear reductions in anxiety, craving and binge eating episodes. While all these results seem to indicate a bright future for virtual reality in eating disorders, further studies are needed to validate the positive impact of its use, but also its limitations. Notably, cyber sickness could alter the smooth running of virtual reality therapy sessions by causing nausea and disorientation. Moreover, it is important to verify that a therapeutic protocol does not lose its effectiveness when it is transposed into virtual reality. However, virtual reality seems to be a therapeutic tool that is better accepted by patients, and even better by adolescents, which is very interesting for eating disorders since adolescents are the most affected. Virtual reality could therefore help motivate patients to pursue treatment and reduce the dropout rate while offering good therapeutic results. Thus, studies conducted in recent years have shown that virtual reality is a promising tool in the understanding, assessment and treatment of eating disorders, and future research should confirm this, particularly in the adolescent population. (C) 2021 L'Encephale, Paris.

Purpose The presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports. Participants Seven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at. Findings to date This cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year. Future plans Analysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared. Trial registration number NCT03013595 .

The deficit in "interference control" found in children with Attention Deficit Hyperactivity Disorder (ADHD) could be due to two distinct processes, which are not disentangled in most studies: a larger susceptibility to activating prepotent response impulses and a deficit in suppressing them. Here, we investigated the effect of 1/ADHD and 2/ methylphenidate (MPH), on these two components of interference control. We compared interference control between untreated children with ADHD, children with ADHD under MPH, and typically developing children performing a Simon task. The main findings were that 1/ children with ADHD were more susceptible to reacting impulsively and less efficient at suppressing impulsive actions, and 2/ MPH improved the selective inhibition of impulsive actions but did not modify the strength of response impulse. This work provides an example of how pharmacological interventions and selective responses to them can be used to investigate and further our understanding of cognitive processing.

Les théories implicites de la personnalité correspondent aux croyances concernant la malléabilité des capacités humaines. Selon la théorie de l’entité, ces caractéristiques sont fixes et immuables alors que selon la théorie incrémentielle, ces capacités sont des qualités contrôlables que les gens peuvent changer.