Beryl Koener (1), Luc Vandecasteele (2), Caroline Eliacheff (3), Jacques Robert (4), Magali Pignard (5), Claudio Rubiliani (6), Patrick K. Hunter (7), Sophie F. Dechêne (8), Jean-Paul Leclercq (9), Jean-Pierre Lebrun (10), Céline Masson (11)Published in the journal : December 2024Category : Psychiatrie infanto-juvénile
There has been an exponential increase in the number of minors diagnosed with “gender dysphoria” over the past two decades. Specialized clinics in Ghent, Liège, and Antwerp treat them using the Dutch protocol, an approach described as “affirmative” of the desired gender, based on the administration of GnRH agonists followed by gender-affirming hormones.
Many clinicians are unaware of this protocol’s lack of evidence-based foundation, the many biases fostered by the World Professional Association for Transgender Health (WPATH) that promotes it, and the scandal that has erupted in various countries following its misuse. These have been revealed by the National Health Service (NHS) in the United Kingdom (UK) thanks to the Cass Review and by a report on the transidentification of minors in the French Senate. The European Society of Child and Adolescent Psychiatry (ESCAP) recently called for a halt to the routine use of the Dutch protocol for gender-dysphoric minors.
The aim of the present article is to outline the origins and foundations of this protocol, to document the drifts and biases that have occurred worldwide, and to present the current recommendations.
This article presents the advantages of mobile intervention in perinatal child psychiatry and the collaboration among healthcare professionals to provide individualized care to infants and families facing mental health challenges. After describing the framework of mobile intervention in perinatal child psychiatry, a clinical case is presented, outlining the analysis of the request, the initial observations, the establishment of a network around the family, and the clinical evolution. Guidelines for networked care and the benefits of this approach are also detailed. This article emphasizes the importance of a flexible and collaborative approach to ensure tailored care for infants and their families.
Stéphanie Mazzone1, Anne Wintgens2, Valentine d’Aspremont3, Adeline Hanzir4, Estelle Mousset5, Sophie Vanhalewyn6, Emmanuel de Becker7Published in the journal : February 2023Category : Psychiatrie infanto-juvénile
Two clinical aspects are discussed this year for the Child and Adolescent Psychiatry Service of the Cliniques universitaires Saint-Luc. They describe the help and care offers implemented to cope with the increase of mental distress situations of children, adolescents, and their families. The first part concerns the deployment of the reference center for Autism Spectrum Disorder, namely the establishment of an early stimulation group for young children awaiting diagnosis and a “parent training” group after diagnosis. The second part encompasses the consolidation of legal time within the SOS-Children team of the Clinics; where we will show the merits and contributions of this specific function in complex cases of child abuse.
Child and adolescent psychiatrists are commonly confronted with complaints of insomnia raised by their adolescent patients. In Belgium, there are currently no official recommendations for managing insomnia in children under 18 years of age. Given this context, child and adolescent psychiatrists often have to make off-label therapeutic choices for the treatment of pediatric insomnia. The purpose of this study was to investigate the practices of child and adolescent psychiatrists confronted with sleep disorders in adolescents attending their outpatient practice. Based on a qualitative methodology, semi-structured interviews were conducted involving 10 child and adolescent psychiatrists using French language and working in the Brussels-Capital Region.
Facing the multiple repercussions of the pandemic crisis in terms of young patients’ and their entourage’s mental health, we have maintained our creativity within the psychiatric service for children and adolescents of our clinics. As part of this contribution, we have highlighted two axes for the past year 2021, the first concerning a specific clinical activity based on multi-disciplinarity, with emphasis made on the aspects of prevention, awareness, preparation, and adaptation; the second involved the field of teaching in a domain as complex as it is feared.
A difficulty for professionals in regular contact with psychic suffering often lies in the multiple repercussions of the situations encountered. Indeed, medico-psycho-social situations, which are usually worrying, exert a violent potential impact. Violence can be expressed in a noisy way or more insidiously, and on the societal level, as well. The systemic approach and its holistic declination provide relevant avenues of management. This contribution recalls the precise functions of this systemic approach, emphasizing the concepts of belonging and disengagement, while providing among other things a most original medium: the belonging program.
Delphine Jacobs1, Alexandre Riolo2, Sophie Symann1, Anne Wintgens1, Emmanuel de Becker3Published in the journal : February 2021Category : Psychiatrie infanto-juvénile
The COVID-19 crisis has had a particular impact on the mental health of children and youth. Access to care has been rendered more complex, owing to interposed screens, management limitations, and a decreased possibility for calling on third instances. This contribution highlights several support areas presented by the Psychiatric Service for Children and Adolescents of the Saint-Luc clinics.
The current crisis is simultaneously disrupting and stabilizing adults, as well as children and adolescents, or maybe even grieving them. Along with the phenomenon’s scale, opinions of all kinds are multiplying, fueling more the feeling of insecurity and consequent anguish. In addition to the largely relayed physical concerns, our aim has been to draw attention to psychic and relational health, while focusing on the youngest society members. After recalling the notion and concept of anxiety disorder, we have proposed several therapeutic axes.
Child and youth abuse is a societal as well as medical issue. Over time, its management has changed. As a physician, it is essential to recognize the clinical signs and know how to think and act in case of concern and suspicion. When a child describes acts of abuse, the physician must do everything in his power to provide him with help, while being bound by professional secrecy. The physician can break this secret in case of imminent, serious, and urgent risk endangering the child's life. Nowadays, it is known that child abuse has consequences for the adults of tomorrow and is associated with increased physical and psychological problems.
We propose guidelines for the care of abused children, taking into account the particularity of the Belgian system.
This study has focused on the specificity of twins’ attachment, along with its impact on their development. To this end, adult twins were invited to revisit the experience of their relationship. When analyzing these testimonies, differences in the process and rhythm of twin empowerment compared to the singular child became apparent. Based on these findings, new practical recommendations pertaining to educating twins can be outlined. One can, thus, challenge the widely held assertion that it is crucial to "untwin" the twins at any price.