Background: Pediatric-onset Crohn's disease (CD) may represent a more severe form of disease. The aim of this study was to describe long-term outcome and identify associated risk factors of complicated behavior in a large population-based pediatric-onset CD cohort. Patients and methods: Cases included all patients recorded in the EPIMAD registry diagnosed with definite or probable CD between January 1988 and December 2004, under the age of 17 years at the time of diagnosis, with at least two years of follow-up. Results: Five hundred and thirty-five patients were included. Median follow-up was 11.1 years[IQR, 7.3-15.0]. At the end of follow-up, 8% (n = 44) of patients had pure ileal disease (L1), 8% (n = 44) had pure colonic disease (L2), and 83% (n = 439) had ileocolonic disease (L3). L4 disease and perianal disease were observed in 42% (n = 227) and 16% (n = 85) of patients, respectively. At the end of follow-up, 58% (n = 308) of patients presented complicated disease behavior (B2, 39% and B3, 19%), and 42% (n = 163) of patients with inflammatory behavior at diagnosis had evolved to complicated behavior. During followup, 86% of patients (n = 466) received at least one course of corticosteroids, 67% (n = 357) of patients had been exposed to immunosuppressants and 35% (n = 187) of patients received at least one anti-TNF agent. Forty-three percent (n = 230) of patients underwent at least one intestinal resection. The overall mortality rate was 0.93% and the SMR was 1.6[0.5-3.8] (p = 0.20). Five cancers were reported with a crude cancer incidence rate of 1.1% and an SIR of 3.3[1.2-7.0] (p = 0.01). In a multivariate Cox model, ileal (HR, 1.87 [1.09-3.21], p = 0.022) or ileocolonic (HR, 1.54[1.01-2.34], p = 0.042) and perianal lesions at diagnosis (HR, 1.81[1.13-2.89], p = 0.013) were significantly associated with complicated behavior. Conclusion: About 80% of patients with pediatric-onset CD presented extensive ileocolonic disease during follow-up. The majority of patients evolved to complicated behavior. Surgery, cancer and mortality were observed in 43%, 0.9% and 0.9% of patients, respectively. (c) 2018 Editrice Gastroenterologica Italiana S. r. l. Published by Elsevier Ltd. All rights reserved.

BACKGROUND:Necrotizing enterocolitis (NEC) is the most frequent life-threatening gastrointestinal disease experienced by premature infants in neonatal intensive care units. The challenge for neonatologists is to detect early clinical manifestations of NEC. One strategy would be to identify specific markers that could be used as early diagnostic tools to identify preterm infants most at risk of developing NEC or in the event of a diagnostic dilemma of suspected disease. As a first step in this direction, we sought to determine the specific gene expression profile of NEC.METHODS:Deep sequencing (RNA-Seq) was used to establish the gene expression profiles in ileal samples obtained from preterm infants diagnosed with NEC and non-NEC conditions. Data were analyzed with Ingenuity Pathway Analysis and ToppCluster softwares.RESULTS:Data analysis indicated that the most significant functional pathways over-represented in NEC neonates were associated with immune functions, such as altered T and B cell signaling, B cell development, and the role of pattern recognition receptors for bacteria and viruses. Among the genes that were strongly modulated in neonates with NEC, we observed a significant degree of similarity when compared with those reported in Crohn's disease, a chronic inflammatory bowel disease.CONCLUSIONS:Gene expression profile analysis revealed a predominantly altered immune response in the intestine of NEC neonates. Moreover, comparative analysis between NEC and Crohn's disease gene expression repertoires revealed a surprisingly high degree of similarity between these two conditions suggesting a new avenue for identifying NEC biomarkers.

Les maladies inflammatoires chroniques de l’intestin (MICI) de l’adolescent (10–17ans) ont une évolution plus péjorative pouvant justifier un traitement rapidement agressif. Peu de données sont disponibles sur l’évolution à long terme de l’incidence des MICI chez les adolescents. Le but de notre étude était d’étudier les variations d’incidence et de présentation clinique des MICI dans cette population entre 1988 et 2008.

Functional constipation is a common pediatric problem in general practice and even more so in pediatric gastroenterology clinics. Treatment is often delayed with psychosocial and digestive consequences. However, treatment is well codified and effective. Hyperosmotic mineral water, diet, and endoanal medications are not treatments for established constipation, whatever the age. The lactulose/lactitol-based medications are authorized and effective before 6 months of age and polyethylene-glycol for infants over 6 months. Mineral oil is less prescribed. The rule for treatment is a sufficient dose for a long time. In case of fecal impaction with or without fecal incontinence, the first stage is fecal disimpaction, using a high dose of PEG the first few days, or repeated phosphate enemas. Education regarding the adaptation of toilets and a daily bowel movement should restore colic motility and avoid relapses when the treatment is discontinued. Psychological concerns should be evaluated and treated.

Inspissated bile syndrome (IBS) is a rare neonatal disease. In the majority of cases, it resolves spontaneously and treatment is conservative. Follow-up is recommended with close monitoring of laboratory tests. When IBS does not resolve spontaneously, a catheter can be inserted into the gallbladder for cholangiography, which allows irrigation and drainage. Despite this treatment, some biliary tract obstruction may persist. We report on the case of a 3-month-old infant whose continuous biliary obstruction caused by IBS was successfully managed by interventional radiology with the association of N-acetylcysteine and glucagon. Even as first-line agents, these would allow more rapid clearance of gallstones and prevent infectious complications of indwelling catheters as well as decrease the need for surgery.

Results: A total of 436 patients were diagnosed with PIBD over six years in cohort 1 (265 CD, 115 UC, 56 IBDU) compared to 478 children over five years in cohort 2 (286 CD, 126 UC, 66 IBDU).Median age at diagnosis in cohort 2 (60% males) was 12.3 years, similar to cohort 1 (58% males) at 11.9 years.The adjusted incidence rate increased from 7.8/100,000/year (95%CI 7.1-8.6) in cohort 1 (2003)(2004)(2005)(2006)(2007)(2008) to 10.4/100,000/year (95%CI 9.6-11.5) in cohort 2 (2009-2013) (p<0.001).This significant increase was also seen individually for CD (4.7/100,000/year [95%CI 4.2-5.4]compared to 6.3/100,000/year [95%CI 5.6-7.0][p<0.0001])and UC (2.1/100,000/year [95%CI 1.7-2.5]compared to 2.7/100,000/year [95%CI 2.3-3.3][p=0.009]).There was a non-significant increase in IBDU from 1.0/100,000/year (95%CI 0.7, 1.3) in cohort 1 to 1.4/100,000/year (95%CI 1.1, 1.8) in cohort 2 (p=0.07).Conclusions: There continues to be an ongoing rise in incident PIBD (and both CD and UC) in 2009-13 in this national, populationbased study compared to recent historical data, with a further significant rise of 33%.The reasons behind this continued increase remain unclear and further research is needed to elucidate potential factors in aetiopathogenesis.

Le Crohn (MC) et la Rectocolite hémorragique (RCH) sont des Maladies Inflammatoires Chroniques de l’Intestin (MICI). Le registre EPIMAD, un des plus importants registre de recueil de données des MICI, indique une augmentation des MICI à 70% pour 2000-2006 dans le nord de la France. L’augmentation d’incidence nous paraissait plus importante, et les maladies plus sévères. L’objectif était d’établir l’incidence des MICI de la population âgée entre 0 et 15 ans de façon exhaustive entre 2000 et 2011. Nous avons collecté les cas incidents de la région HN de manière rétrospective entre 2000 et 2011, à partir de 2 sources de recueils : hospitalières et Caisse Primaire d’Assurance Maladie. 122 nouveaux cas de MICI ont été identifiés entre 2000 et 2011. Entre 2009-2011, on note 44 cas de MICI contre 13 cas pour 2000-2002. L’incidence de MC a été multipliée par 2 et l’incidence de la RCH a fait un bond de près de 3,5 fois sa valeur pour 2009-2011, comparé à 2000-2002. A 2 ans d’évolution de la maladie, les MICI sont quatre fois plus traités par Imurel et onze fois plus par anti-TNF pour 2009-2011. Les MICI sont trois fois plus présentes, et plus sévères ces dix dernières années en Haute-Normandie. Ceci a des implications en terme de santé publique et de recherche des mécanismes en cause.

To describe the ambulatory proton pump inhibitor (PPI) prescription in French children, its trends, and the impact of French (2014) and international (2018) clinical guidelines.We described PPI prescription rates based on national dispensation data in French children (IQVIA's Xponent database, 2009-2019). Using a segmented linear regression, we assessed the impact of clinical guidelines on PPI prescription rates. Analyses were performed for the overall pediatric population and by age subgroups (infants <2 years old, children 2-11 years old, adolescents 12-17 years old).During the study period, 8 060 288 pediatric PPI prescriptions were filled, with a mean PPI prescription rate of 52.5 per 1000 inhabitants per year. Between 2009 and 2019, the PPI prescription rate increased by 41% in the overall pediatric population (+110% in infants). The PPI prescription rate showed seasonal patterns with peaks in winter. After the release of French guidelines, significant decreases in trends of prescription rates occurred overall (change in trend −0.28, 95% CI -0.34;-0.23) and across all age groups. In infants, this change in trend was not sufficient to reverse the PPI prescription rate that was still increasing over time. In children, the PPI prescription rate slightly decreased and in adolescents, it was stable. After the release of international guidelines, a significant decrease in trend occurred in adolescents only (change in trend −0.26, 95% CI -0.47; −0.04).The pediatric PPI prescription rate in France was high, displayed a major increase over the last decade, mainly among infants, and was modestly affected by clinical guidelines.

Les coliques infantiles sont un problème courant mais souvent inexpliqué et multifactoriel. Le but de ce travail était de déterminer les caractéristiques à la naissance des enfants qui présentaient des coliques (Rome III). Les paramètres : anthropométriques, terme, rang de fratrie, allaitement, tabagisme, IMC et profession des parents ont été comparés entre 2 populations de nourrissons : 422 contrôles vs 100 avec coliques. Une régression logistique multiple et une analyse factorielle de correspondance multiple ont été réalisées pour rechercher les caractéristiques liées à la survenue de coliques entre 2 semaines et 3 mois d'âge. Cinq variables (p< 0,05) ont été identifiées. Les coliques étaient plus fréquentes chez les nourrissons de rang de naissance ≥ 2 (Odds ratio avec IC à 95% vs < 2, OR = 2,81 [1,77 ; 4,47]), nés d'une mère cadre ou chef d'entreprise (OR vs autres = 2,54 [1,45 ; 4,44]), d'un père en surpoids ou obèse (OR vs IMC < 25 kg/m2 = 1,93 [1,19, 3,10]), d'une mère fumeuse (OR vs non fumeuse = 1,93 [1,06 ; 3,51]) et nés avant 40 SA (OR vs ≥ 40 = 1,91 [1,19 ; 3,07]). Ces 5 facteurs n'expliquent cependant que 9% de la variance totale (aire sous la courbe ROC =0,71). Les paramètres recueillis à la naissance ne suffisent pas à prédire le risque ultérieur de coliques.

Les inhibiteurs de la pompe à protons (IPP) sont une classe pharmacologique ayant pour objectif de réduire l'acidité des sécrétions gastriques. Ils sont prescrits chez 11 % des enfants dans notre établissement.Évaluer la pertinence des prescriptions d'IPP en pédiatrie.Un audit clinique ciblé selon la méthodologie proposée par la Haute Autorité de santé s'est déroulé entre le 27 et le 31 août 2018 dans les services de pédiatrie de notre établissement. Le critère principal de jugement était l'indication de l'IPP. Le référentiel principal était les recommandations de l'European society of pediatric gastroenterology, hepatology and nutrition.Trente patients ont été inclus. L'âge moyen était de 8,6 ans. L'indication était conforme chez 19 patients. Les indications non conformes étaient : deux préventions du risque d'ulcère lié à la prescription d'anti-inflammatoires non stéroïdiens (AINS), une endoscopie pour biopsie, quatre préventions du risque d'ulcère lié à la corticothérapie, une greffe de cellules souches hématopoïétiques et trois mucites.L'échantillon de patients inclus dans l'étude était représentatif de la population pédiatrique ayant eu des IPP dans notre établissement. Les non-conformités relevées pouvaient être justifiées dans certains cas. Dans la littérature, une seule étude rapportait un taux de conformité des indications des IPP en pédiatrie. Ce taux, de l'ordre de 34 %, était très inférieur à celui retrouvé dans notre établissement (p < 0,01).Le suivi des dernières recommandations pour la prescription des IPP est plutôt bon. Une fiche de bon usage va être diffusée afin de parfaire les pratiques.Proton Pump Inhibitors (PPIs) are a pharmacological class designed to reduce the acidity of gastric secretions. They are prescribed for 11 % of the children in our institution.To assess the relevance of PPI prescriptions in pediatrics.A clinical audit according to the methodology proposed by the High Authority of Health was carried out between August 27 and August 31, 2018 in the pediatric departments of our institution. The main judgement criteria were the indication of the PPI. The main guidelines are the recommendations of the European society of pediatric gastroenterology, hepatology and nutrition.Thirty patients were included. The average age was 8.6 years. The indication was compliant in 19 patients. The non-compliant indications were: two ulcer risk preventions related to the prescription of non-steroidal anti-inflammatory drugs (NSAIDs), one endoscopic biopsy, four ulcer risk preventions related to corticosteroid therapy, one hematopoietic stem cell transplantation and three mucositis.The sample of patients included in the study was representative of the pediatric population with PPIs in our institution. The non-conformities identified could be justified in some cases. Only one study reported a compliance rate for PPI indications in pediatrics in the literature. This rate, in the order of 34 %, was much lower than that found in our institution (P < 0.01).The respect of the latest recommendations for the prescription of PPIs is quite good. A usage sheet will be diffused to improve the practices.

Les connaissances sur la maladie cœliaque vivent une révolution, avec la mise au point de tests sérologiques sensibles et spécifiques. Ces tests appliqués à un dépistage de masse montrent que la prévalence des sujets sensibilisés à la gliadine est élevée, atteignant jusqu’à 1/80 dans certaines études. Le spectre des symptômes est vaste, allant des formes totalement asymptomatiques cliniquement et histologiquement aux formes bruyantes classiques du nourrisson avec diarrhée chronique, dénutrition et anorexie. Les formes asymptomatiques font l’objet d’une discussion sur les enjeux d’un dépistage de masse. Si les formes typiques ne posent pas de problème diagnostique, les formes atypiques sont nombreuses, comme le sont les pathologies et antécédents devant faire évoquer cette maladie. Les médecins devraient avoir en mémoire ces points d’appel pour améliorer la couverture diagnostique d’atteintes parfois peu bruyantes mais exposant potentiellement à des complications à court ou long terme.

S64Poster presentations (FC), C-reactive protein (CRP), blood leukocytes, and the Lichtiger Index (clinical score).Methods: UC patients undergoing complete colonoscopy were prospectively enrolled and scored clinically and endoscopically in an independent fashion.Fecal and blood samples were analyzed in UC patients and controls.Results: We enrolled 228 UC patients and 52 controls.Endoscopic disease activity correlated best with FC (Spearman's rank correlation coefficient r = 0.821), followed by the Lichtiger Index (r = 0.682), CRP (r = 0.556), and leukocytes (r = 0.401).FC was the only marker discriminating between different grades of endoscopic activity (grade 0, 20±11 mg/g; grade 1, 44±34 mg/g; grade 2, 111±74 mg/g; grade 3, 330±332 mg/g; grade 4, 659±319 mg/g; P = 0.0018 for discriminating grade 0 vs. 1 and P < 0.001 for discriminating all other grades).FC had the highest overall accuracy (91%) to detect endoscopically active disease (modified Baron Index 2), followed by the Lichtiger Index of 4 (77%), CRP larger than 5 mg/L (69%) and blood leukocytosis (58%).Conclusions: FC better correlated with the endoscopic disease activity than clinical activity, CRP, and blood leukocytes.The strong correlation with endoscopic disease activity suggests that FC represents a useful biomarker for noninvasive monitoring of disease activity in UC patients.

The knowledge regarding celiac disease has increased dramatically in recent years, due to the availability of accurate serologic markers. Mass screening studies have shown that the prevalence of sensitization can be as high as 1/80. The range of symptoms is wide, from the classic growth failure, denutrition and diarrhea in infancy to clinically and histologically asymptomatic sensitized subjects. The interest of a routine mass screening is debated. The classical celiac disease in infancy is well known. Atypical symptoms and potentially associated disease are more frequent and potentially confounding. Physicians should be aware of any clue for celiac disease in atypical cases in order to improve the diagnostic yield, and therefore avoiding short or long term consequences.

L’espace de compréhension concernant les traumatismes psychiques s’est considérablement densifié au cours des quinze dernières années jusqu’à entraîner une véritable révolution conceptuelle aux confins de notions psychiatriques, psychologiques, neurobiologiques, sociologiques, anthropologiques, etc. Toutefois, malgré tous ces enrichissements, notamment des descriptions séméiologiques dans les mondes anglophones et francophones contemporains, le sous-diagnostic et les diagnostics tardifs des troubles post-traumatiques (TSPT), au stade des souffrances intenses, restent nombreux. Soit parce que les origines traumatiques des troubles demeurent tues, du fait même de leurs caractéristiques cliniques, c’est-à-dire « l’expérience indicible » constitutive de la dissociation dans le langage. Soit encore parce que le système de soin et les réseaux de praticiens se heurtent à des conceptions infranchissables lesquelles témoignent sans doute, sans le savoir, du processus psychotraumatique diffusant jusque dans les discours théoriques, au point de les rendre peu opérants. L’heure est à la construction d’un nouveau modèle. Basée sur une méthodologie linguistique, l’étude standardisée informatique et manuelle du discours de patients blessés psychiques nous a récemment permis de définir la notion de syndrome psycholinguistique traumatique (SPLIT).Notre nouvelle perspective nourrit pour ambition de dépasser les impasses diagnostiques et thérapeutiques auxquelles se confrontent encore trop de personnes blessées psychiques. Davantage objectifs que les approches séméiologiques et psychométriques, les marqueurs linguistiques ouvrent la voie au phénotypage digital du trouble de stress post-traumatique et permettent de mieux évaluer les soins recommandés. Après discussion des travaux précurseurs repérables dans la littérature, nous construisons un outil psycholinguistique permettant le repérage des sujets blessés psychiques.Le matériau d’analyse exploratoire comprend deux corpus de récits d’événements traumatiques nommés respectivement « Bataclan » (n = 20 ; recueilli parmi des personnes rescapées des attentats de Paris en 2015) et « guerre d’Afghanistan » (n = 15 ; recueilli parmi des soldats français déployés) à partir desquels nous avons constitué un groupe de témoins appariés. Les récits ont été transcrits et segmentés en propositions afin de référencer les pauses silencieuses, les pauses d’hésitation, les allongements vocaliques, les amorces de mots, les énoncés incomplets, les répétitions contiguës. Ont également été comptabilisées les caractéristiques de cohérence narrative, certains champs lexicaux (concernant la mort, les émotions, etc.), les données spatio-temporelles, les références à la personne (pronoms personnels et génériques notamment), et certaines figures de style. Afin de confirmer la validité de l’échelle SPLIT-10, nous l’avons testée sur deux corpus de récits traumatiques supplémentaires : le corpus « Nice » (n = 20) recueilli dans les jours suivant l’attaque perpétrée à Nice (14 juillet 2016) et le corpus « agression sexuelle » (n = 20) composé de témoignages de personnes victimes d’une seule agression sexuelle survenue à l’âge adulte.Les analyses ont permis d’éliminer les caractéristiques non pertinentes soit parce qu’elles étaient non significatives, soit parce qu’elles étaient trop fréquentes et/ou en pratique difficilement discriminantes : lexique des émotions, temps verbaux, pronoms non génériques, cohérence narrative. Inversement, les critères apparaissant les plus pertinents afin de différencier les récits traumatiques et non traumatiques sont les suivants : lexique concernant la mort, les parties du corps et l’irréalité ; verbes de perception, de mouvement ou de position du corps ; contexte spatial dont l’appréciation des distances ; pronoms génériques ; mention de l’heure et de la durée de l’événement ; énoncés incomplets ; répétitions contiguës ; métaphores. Afin de faciliter sa passation, nous retenons finalement une échelle à 10 items que nous exemplifions critère par critère, puis en test global. Nos résultats montrent que l’échelle SPLIT-10 discrimine significativement les récits traumatiques des récits non traumatiques.Les items de la SPLIT-10 correspondent à 5 sous-syndromes psycholinguistiques : référence à la mort (item no 1), déréalisation (items nos 2 à 4), dépersonnalisation (items nos 5 à 7), reviviscences (items nos 8 et 9) et indicibilité (item no 10). Si ces items s’avèrent compatibles avec les critères du TSPT retenus par le DSM-5 (tout comme ceux concernant le trouble de stress aigu), les marqueurs linguistiques que nous avons identifiés apparaissent nettement plus détaillés et spécifiques du traumatisme psychique que les symptômes psychiatriques habituellement décrits. Au sens où elle rend précisément compte de la dissociation, la SPLIT-10 est syndromiquement davantage cohérente que la définition du TSPT dans la nosographie. Il conviendrait de répliquer notre étude par des corpus multicentriques plus vastes, notamment en contrôlant les comorbidités et les types d’événements traumatiques uniques ou complexes, et en focalisant sur les traumas survenant dans l’enfance où le langage est en cours de construction. Aussi, le cut-off de la SPLIT-10 retenu à 5 pourrait être revu à la hausse, voir être adapté en fonction de la longueur de la production verbale. Enfin, il faudrait mener une analyse de faisabilité en pratique clinique courante mesurant l’efficacité de praticiens formés à l’utilisation de ce nouvel outil. Au-delà des 10 items que nous avons retenus, il apparaîtrait intéressant d’élaborer une échelle plus complexe en intégrant de nombreuses autres caractéristiques linguistiques utilisables à des fins de recherche fondamentale.Autant qu’elle infiltre le discours théorique tentant de la saisir, la dissociation traumatique restait, jusqu’à il y a peu, une notion difficilement modélisable. Nouvelle conception de la dissociation, le syndrome psycholinguistique traumatique témoigne de la « blessure du langage » constitutive du trauma. La grille SPLIT-10 apparaît ici davantage objective que l’analyse clinique ou que les échelles et questionnaires basées sur la nosographie (lesquels appellent toujours l’appréciation subjective des symptômes par le patient et/ou le praticien). Mais loin de dénier toute subjectivité, complétant les approches linguistiques lexicales et syntaxiques, l’analyse sémantique du discours pourrait également offrir de mieux caractériser la spécificité de ce qui a fait traumatisme chez un sujet singulier. Enfin, permettant de s’extraire de la dissociation traumatique, l’analyse pragmatique de l’interaction dialogique entre le patient et le clinicien s’avèrera fondamentale afin de comprendre les mécanismes thérapeutiques efficaces.The search for understanding psychological trauma has grown considerably over the past fifteen years, leading to a real conceptual revolution at the crossroads of psychiatric, psychological, neurobiological, sociological, anthropological fields, etc. However, despite all these enrichments of semiological descriptions, the under-diagnosis and late diagnoses of post-traumatic disorders, at the stage of intense suffering, remain numerous. Either because the traumatic origins of the disorders remain unclear, due to their very clinical characteristics, that is to say the “unspeakable experience” constituting dissociation in language, or because the healthcare system and the networks of practitioners come up against impassable conceptions which undoubtedly reflect the psychotraumatic process spreading even in theoretical discourse, to the point of rendering them ineffective. Now is the time to build a new model. Based on a linguistic methodology, the standardized computerized and manual study of the speech of psychically injured patients recently enabled us to define the notion of traumatic psycholinguistic syndrome (SPLIT).Our new perspective aims to overcome the diagnostic and therapeutic obstacles with which too many people with mental health injuries still face. More objective than semiological and psychometric approaches, linguistic markers pave the way for the digital phenotyping of post-traumatic stress disorder and make it possible to better assess the recommended care. After discussing the pioneering work in the literature, we build a psycholinguistic tool allowing the identification of psychically injured subjects.The exploratory analysis material includes two corpora of traumatic event narratives called “Bataclan” (n = 20 collected among survivors of the Paris attacks in 2015) and “Afghanistan War” (n = 15 collected among French soldiers deployed), which are matched to a control group. The narratives were transcribed and segmented into clauses and the following linguistic characteristics were analyzed: disfluencies (silent pauses, hesitation pauses, vocalic lengthenings, incomplete words, incomplete utterances, contiguous word repetitions), narrative coherence, certain lexical fields (concerning death, emotions, etc.), spatio-temporal reference, references to the person (personal and generic pronouns in particular), and non-literal language were also taken into account. In order to confirm the validity of the SPLIT-10 scale, we tested it on two additional corpora of traumatic narratives: the “Nice” corpus (n = 20) collected in the days following the attack perpetrated in Nice ( July, 2016) and the “sexual assault” corpus (n = 20) composed of testimonies from people who were victims of a single sexual assault that occurred during adulthood.Linguistic characteristics which proved irrelevant either because they were insignificant, or because they were too frequent and/or in practice difficult to discriminate were eliminated: lexicon of emotions, verbal tenses, non-generic pronouns, narrative coherence. Conversely, the criteria appearing to be the most relevant in order to differentiate between traumatic and non-traumatic narratives were the following ones: lexicon concerning death, body parts and unreality; verbs of perception, movement or position of the body; spatial context including the appreciation of distances; generic pronouns; mention of the time and duration of the event; incomplete utterances; repetitions; and non-literal language. These criteria constitute a 10-item scale that we exemplify criterion by criterion, then as a global test. The results show that the SPLIT-10 scale significantly discriminates between traumatic and non-traumatic narratives.The SPLIT-10 items correspond to 5 psycholinguistic sub-syndromes: reference to death (item No. 1), derealization (items Nos. 2 to 4), depersonalization (items Nos. 5 to 7), flashbacks (items Nos. 8 and 9) and unspeakable (item No. 10). While these items turn out to be compatible with the criteria for PTSD retained by the DSM-5 (like those concerning acute stress disorder), the linguistic markers that we have identified appear to be much more detailed and specific to the psychological trauma than the usually described psychiatric symptoms. Because it accurately accounts for dissociation, SPLIT-10 is syndromically more consistent than the definition of PTSD in the nosography. It would be useful to replicate our study by considering larger multicenter corpora by controlling comorbidities, by varying the types of unique and complex traumatic events, and by focusing specifically on traumas occurring in childhood where language is still being constructed. In addition, the cut-off of SPLIT-10 retained at 5 could be revised upwards, or even be adapted according to the length of the verbal production. Moreover, a feasibility analysis should be carried out in current clinical practice measuring the effectiveness of practitioners trained in the use of this new tool. Beyond the 10 items that we have retained, it would be finally interesting to develop a more complex scale by integrating many other linguistic characteristics that can be used for fundamental research purposes.As much as it infiltrates the theoretical discourse trying to grasp it, traumatic dissociation has until now remained a notion difficult to model. As a new clinical approach to dissociation, the traumatic psycholinguistic syndrome reflects the “injury of language” constituting the trauma. The definition of the SPLIT-10 scale appears more objective than the usual clinical analysis or the scales and questionnaires based on the nosography, which calls for the subjective assessment of symptoms by the patient and/or the practitioner. Nevertheless, far from denying all subjectivity, complementing lexical and syntactic linguistic approaches, the semantic analysis of discourse also offers to better characterize the specificity of what caused the trauma in a singular subject. Finally, allowing to get out of traumatic dissociation, the pragmatic analysis of the dialogical interaction between the patient and the clinician will prove to be fundamental in order to understand the effective therapeutic mechanisms.