Self-injurious behaviour in children: A treatable catatonic syndrome
Notice bibliographique
Résumé
There is an excellent reason for pub-lishing a paper on an unusual paediat-ric syndrome – self-injurious behaviour (SIB) – in a general psychia-try journal: it is among the few paedi-atric conditions that are highly treatable. The repetitive stereotypic catatonic movements in children with autism and intellectual disabilities, which can have such injurious conse-quences, respond readily to such standard treatments of catatonia as benzodiazepines and electroconvul-sive therapy (ECT). The authors of this paper have discovered this in their respective domains of inquiry: Lee Wachtel, leading a neurobehav-ioural service in a paediatric hospital, and Edward Shorter, who ascertained that in many historical accounts of paediatric SIB other symptoms of cat-atonia were present as well, reinforc-ing Wachtel’s hypothesis of SIB as a form of catatonia. This hypothesis thus has two important pillars of sup-port: the readiness with which SIB responds to anti-catatonic remedies in the clinic today, and the historical evidence that SIB fits in with larger syndromes of catatonia.Thanks to the efforts of Max Fink and the circle of scholars building upon his findings, catatonia has expanded steadily from a subtype of schizophrenia into an independent syndrome that may occur in a variety of psychiatric and non-psychiatric ill-nesses. The reinsertion of the catato-nia diagnosis into psychiatry is being officially recognized in the newly-released DSM-5. We feel that this recognition represents one of the most important developments in psy-chiatric nosology today.SIB is classically defined as any self-inflicted act resulting in bodily harm. It afflicts approximately 5–30% of indi-viduals with intellectual disability (ID), and has negative effects on physical health as well as sharply impairing global psychosocial functioning.It is remarkable to discover that the inclusion of self-injury in the cata-tonic spectrum is not new. In fact, strong evidence of this concomitance can be traced in the international psy-chiatric literature beginning in the late 19th century. The historical evidence of catatonia in self-injury patients offers fascinating parallels to modern self-injurious presentations, raising the central question as to how this rich historical knowledge escaped incorporation into classic models of SIB assessment and treatment, partic-ularly when modern medicine has possessed a safe and efficacious treat-ment for catatonia, namely ECT, for nearly eight decades.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
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Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».