@article{pmid41865642,

title = {Prevalence and mental health correlates of non-suicidal self-injury in elementary school children},

author = {Shadi Hadj-Youssef and Alessia Civita and Elise Chartrand and Catherine Malboeuf-Hurtubise and Julia Fuoco and Tianna Loose and Isabelle Ouellet-Morin and Nancy Heath and Nathalie Maltais and Imke Baetens and Michel Spodenkiewicz and Sylvana Côté and Marie-Claude Geoffroy},

doi = {10.1016/j.psychres.2026.117097},

issn = {1872-7123},

year  = {2026},

date = {2026-06-01},

journal = {Psychiatry Res},

volume = {360},

pages = {117097},

abstract = {BACKGROUND: Non-suicidal self-injury (NSSI) is relatively common in adolescence and associated with mental health symptoms, yet the prevalence of NSSI and mental health correlates in childhood remain poorly understood.nnOBJECTIVE: Document the lifetime prevalence of NSSI in elementary-school children and concurrent associations with self- and teacher-reported mental health symptoms and peer problems.nnMETHODS: Cross sectional analysis of 859 children (mean age=10.9 years; n = 419 males) from 33 elementary schools in Quebec, Canada who completed a self-report measure of NSSI (5-item Self-Mutilation subscale; Self Harm Inventory) and self- and teacher-report measures of concurrent mental health, including depressive symptoms (Children's Depression Inventory-Short-Form; self-reported only), emotional distress, withdrawal, impulsive/hyperactive/inattentive behaviors, disruptive behaviors, prosocial behaviors, and peer relationship difficulties (victimization) (Social Behavior Questionnaire). Mental health symptoms were transformed into z-scores.nnRESULTS: Lifetime prevalence of NSSI (any method, at least once) was 28.2 %, with no sex differences between males (26.7 %) and females (29.4 %) (p=.403), with scratching being the most frequently reported method (17.2 %). Children reporting NSSI had significantly poorer mental health across indicators examined in both self- and teacher reports, although associations were generally smaller for teacher-reported symptoms. To illustrate, for 1 standard deviation increase in self-reported symptom scores, odds of NSSI were 2.31 times higher for depressive symptoms (95 % CI 1.82-2.92), and 1.70 times higher for peer victimization (95 % CI 1.46-1.99). Associations were stronger among children endorsing multiple NSSI methods compared to those reporting only one.nnCONCLUSION: NSSI (especially scratching) is present in late childhood and associated with worse mental health symptoms and peer problems.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40925767,

title = {[Towards an integrative understanding of complex trauma]},

author = {Marion Robin and Michel Spodenkiewicz and Jean Belbèze and Maurice Corcos},

doi = {10.1016/j.encep.2025.06.007},

issn = {0013-7006},

year  = {2025},

date = {2025-12-01},

journal = {Encephale},

volume = {51},

number = {6S},

pages = {S9--S16},

abstract = {The body of knowledge on trauma is rapidly expanding. Since 2022, the WHO has been calling for the history of adversity to be systematically taken into account when assessing the state of health of all individuals. But at this stage, our understanding of the precise mechanisms of complex trauma remains incomplete. In fact, its pathophysiology lies at the crossroads of neurobiological, psychological and relational fields of study. The aim of this review is to set out the key elements of this scientific literature in order to move towards a more global and comprehensive vision, which remains a challenge. The clinical forms of complex trauma are analyzed in the light of the neurobiology of chronic and early stress, cognitive-emotional disorders, and relational and attachment imbalances. Four dimensions each play a major role in the psycho-traumatic equation: characteristics relating to adversity factors, circumstances of onset, any prior vulnerabilities, and environmental resources (particularly relational support). Borderline personality disorder appears to be one of the faces of complex trauma, and a valuable model for understanding a pathophysiology that takes place in two stages, in which previous psychobiological changes contribute to the disproportionate or unrelated appearance of symptoms in relation to current environmental factors. This pathophysiology of a profound link between early experiences, alterations in the self and affective regulation disorders in adolescence or adulthood, raises new questions about the definition and understanding of psychiatric disorders, and first and foremost personality disorders, which are at the crossroads of the shift from "simple" trauma to complex trauma. Understanding the mechanics of trauma ultimately involves a shift from a symptom-centered approach to a dual approach involving the symptom in a synchronic (instantaneous) perspective and the patient's history in a diachronic (temporal evolution) perspective. It is also a shift from the subject to his or her environment, which calls for a global and systemic vision.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40645654,

title = {Association of hyperactivity-impulsivity and inattention symptom profiles with suicide attempt: an 18-year population-based cohort study},

author = {Michel Spodenkiewicz and Ayla Inja and Samuele Cortese and Cedric Galera and Isabelle Ouellet-Morin and Sylvana M Côté and Michel Boivin and Frank Vitaro and Mara Brendgen and Ginette Dionne and Johanne Renaud and Richard E Tremblay and Gustavo Turecki and Marie-Claude Geoffroy and Massimilano Orri},

doi = {10.1136/bmjment-2025-301725},

issn = {2755-9734},

year  = {2025},

date = {2025-07-01},

journal = {BMJ Ment Health},

volume = {28},

number = {1},

abstract = {BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) symptomatology in childhood is associated with a high risk of suicide attempt later in life. However, symptom presentation in ADHD is heterogeneous, and little is known about how suicide risk varies according to different profiles of ADHD symptoms and sex.nnOBJECTIVE: The aim was to investigate the longitudinal associations between childhood profiles of ADHD symptoms (ie, hyperactivity-impulsivity and inattention) and youth suicide attempt in males and females, separately.nnMETHODS: This population-based cohort study used data from three longitudinal cohorts: the Quebec Longitudinal Study of Child Development (QLSCD), the Quebec Longitudinal Study of Kindergarten Children (QLSKC) and the Quebec Newborn Twin Study (QNTS) for a total of 4399 participants (1490 from the QLSCD, 2134 from the QLSKC and 775 from the QNTS; 50% females) followed up from ages 6-23 years. Symptoms of hyperactivity-impulsivity and inattention were assessed by teachers five times from ages 6-12 years. Suicide attempt in adolescence and young adulthood (by age 23) was self-reported. Multitrajectory modelling was used to identify profiles of ADHD symptoms, and regression analysis was used to test their association with suicide attempt, adjusting for childhood socioeconomic and clinical characteristics.nnFINDINGS: We identified four ADHD symptom profiles with distinct associations with suicide attempt for males and females. Compared with those with persistently low symptoms, females with persistently high inattention and hyperactivity-impulsivity (OR: 2.54, CI 1.39 to 4.63) or high inattention and low hyperactivity-impulsivity (OR: 1.81, CI 1.21 to 2.70) were at higher risk of suicide attempt, while, among males, only those with decreasing hyperactivity-impulsivity and inattention over time (OR: 2.23, CI 1.20 to 4.13) were at higher risk of suicide attempt.nnCONCLUSIONS: Risk of suicide attempt in children with ADHD symptoms varies according to both symptom profile and sex, the highest risk being for females with high inattention symptoms (with or without hyperactivity), and males with decreasing symptoms.nnCLINICAL IMPLICATIONS: Taking into account differences in both sex and ADHD symptoms profile may be relevant to more accurately identify and manage suicide risk in individuals with high ADHD symptoms, though caution is needed when generalising our population-based findings to clinical populations.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39510873,

title = {Suicide attempts in Martinique and Reunion Island and appointments no-show},

author = {Comsar Ndiaye and Antone Messiah and Erick Gokalsing and Nelly Lislet and Claire Gillet and Eric Rene and Noor Atwan and Louis Jehel and Michel Spodenkiewicz},

doi = {10.1016/j.encep.2024.03.007},

issn = {0013-7006},

year  = {2025},

date = {2025-06-01},

journal = {Encephale},

volume = {51},

number = {3},

pages = {240--248},

abstract = {OBJECTIVES: Studies on suicidal behaviors in the French overseas territories remain rare. Although mental health resources are limited, some patients identified as being at risk of suicide do not attend the specialist consultations scheduled after identification or screening. Thus, the objective of our study was, firstly to provide a descriptive profile of patients followed up for a suicide attempt in Martinique and Reunion Island, and secondly to explore the risk factors associated with appointments no-show during follow-up.nnMETHODS: We conducted an ancillary retrospective cross-sectional study using data from the APSOM study. Data were collected on 255 patients aged at least 16, admitted to hospital emergency departments after a suicide attempt and followed up in ambulatory care, including 137 in Martinique and 118 in Reunion Island. The characteristics of the sample were described by means [min, max] and proportions [95% confidence intervals]. Differences according to the presence of appointments no-show or not were analyzed using comparison tests of means and percentages (Chi, Fisher and Wilcoxon). Factors associated with appointments no-show were analyzed using a bootstrapped multivariate logistic regression model.nnRESULTS: The mean age of patients was 35 years [16-84 years]. Women were predominant with a sex ratio of 2.4:1 (71% women). Unemployment affected 37% [28%, 46%] of patients in Martinique and 49% [40%, 59%] in Reunion Island. Psychoactive substances consumption at the time of the suicidal act was observed in 36% [27%, 45%] of patients in Martinique and 34% [26%, 44%] in Reunion Island. The average number of suicide attempts was two per patient [1-20]. Finally, we found no significant association with appointments no-show except for center. Patients from Reunion Island were associated with better compliance than patients from Martinique (OR: 0.20 [0.05-0.65], P<0.012).nnCONCLUSION: Our study provides a description of suicide attempts admitted to hospital and followed up in ambulatory care in two French overseas territories and suggests interesting approaches for adapting prevention strategies to the socioeconomic context and cultural realities of these territories, particularly outreach interventions for the most vulnerable patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38824046,

title = {Suicidal thoughts and behavior of adolescents with depression in Reunion Island - evolution before and after the initial Covid-19 lockdown},

author = {Josee Aoun and Coline Copin and Miléna Portelette and Massimiliano Orri and Michel Spodenkiewicz},

doi = {10.1016/j.encep.2024.02.006},

issn = {0013-7006},

year  = {2025},

date = {2025-04-01},

journal = {Encephale},

volume = {51},

number = {2},

pages = {154--159},

abstract = {BACKGROUND: The number of patients consulting with suicidal thoughts and behavior in the health care centers have increased since the Covid-19 pandemic. This increase has been particularly important among adolescents. Most often these patients are diagnosed with anxiety or depressive symptoms. We only have a limited amount of information on depression and STB in adolescents since epidemiological monitoring in health care institutions is based on computerized coding derived from ICD-10. This coding system is very specific for the different forms of depression yet fails to provide accurate coding for suicidal thoughts and behavior. The objectives of this study were to compare the numbers of adolescents with depression who were admitted with suicidal thoughts and behavior before and after the initial Covid-19 lockdown and to highlight possible gender disparities.nnMETHODS: Patients' medical charts for this retrospective research were obtained from the Department of Adolescent Psychiatry at the University Hospital Centre of Reunion Island, manually screened, and then analyzed. We included all adolescents diagnosed with depression who had had their first consultation between January 1, 2019 and July 31, 2021. The number of patients presenting suicidal thoughts, self-harm and suicide attempts were compared before and after the initial Covid-19 lockdown.nnRESULTS: Three hundred and sixty-one adolescents diagnosed with depression participated in the study (33.5% males, 66.5% females). Their average age was 16 (SD=1.7). The number of admitted patients increased from 9 to 16 new adolescents with depression and STB each month between the period before and after the first lockdown, with a large proportion of female patients (increase of 74.1%).nnCONCLUSION: This study showed an increase in the number of adolescents consulting for suicidal thoughts or behavior in an adolescent psychiatry department in Reunion Island after the initial Covid-19 lockdown. They were mainly female. This increase has strained an already overburdened mental health system by doubling the number of adolescents that each health care provider has had to help which increases the risk of inadequate care by rapidly increasing the workload but with constant resources.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38755318,

title = {Qualitative study of the lived experience of methylphenidate prescribed for children with a fetal alcohol spectrum disorder},

author = {Clémentine Morin and Bérénice Doray and Cécilia Dumar and Jude Balit and Nicolas Bouscaren and Michel Spodenkiewicz},

doi = {10.1007/s00787-024-02457-z},

issn = {1435-165X},

year  = {2024},

date = {2024-12-01},

journal = {Eur Child Adolesc Psychiatry},

volume = {33},

number = {12},

pages = {4219--4235},

abstract = {Fetal Alcohol Spectrum Disorders (FASD) refer to physical, cognitive, and behavioural symptoms in an individual whose mother consumed alcohol during pregnancy. It is the leading cause of non-genetic avoidable mental disability, with an estimated worldwide prevalence of 1%. Attention Deficit Hyperactivity Disorder (ADHD) diagnostic criteria are met for 50-80% of patients with FASD. Methylphenidate (MPH) is the first-line pharmacological treatment for ADHD. This study aims to explore the lived experience of children with FASD taking MPH and their caregivers to adapt prescribing modalities by considering different ways to administer the drugs. We hope to improve the therapeutic alliance between the children and their caregivers by gaining an insiders' view of the medication perception. Semi-structured interviews with children and their caregivers were conducted in this qualitative study. Data collection by purposive sampling continued until we reached theoretical sufficiency. Data were analysed using interpretative phenomenological analysis. We conducted 16 semi-structured interviews: 8 with the children aged 7-12, 5 boys and 3 girls and 8 with their caregivers. The analysis showed that inadequate palatability and capsule form experiences were the leading causes of children's non-adherence to the treatment. MPH appeared to be a valuable aid for caregivers even if they had concerns about its potential toxicity. However, it is necessary to identify caregivers' expectations concerning MPH to adapt the prescription in terms of choice of specialty and intake modalities. Regular support was required to reduce caregivers' fears of dependence, personality transformation and long-term adverse effects. Information on palatability should be given when prescribing MPH to children with ADHD as well as its possible side effects or toxicity. It highlights the need for further studies of the experience of palatability of drugs prescribed to children. When prescribing a treatment, children should be more involved in medical counselling and it is necessary to understand the child's perspectives to co-construct common representations for better therapeutical adherence.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39201890,

title = {First Description of a Large Clinical Series of Fetal Alcohol Spectrum Disorders Children and Adolescents in Reunion Island, France},

author = {Laëtitia Sennsfelder and Susie Guilly and Sonia Henkous and Christophe Lebon and Sébastien Leruste and Pauline Beuvain and Fanny Ferroul and Stéphanie Benard and Frédérique Payet and Meissa Nekaa and Maité Bagard and Magaly Lauret and Virginie Hoareau and Aurélie Caillier and Stéphanie Robin and Justine Lanneaux and Léa Etchebarren and Michel Spodenkiewicz and Jean-Luc Alessandri and Godelieve Morel and Bérénice Roy-Doray},

doi = {10.3390/children11080955},

issn = {2227-9067},

year  = {2024},

date = {2024-08-01},

journal = {Children (Basel)},

volume = {11},

number = {8},

abstract = {BACKGROUND: Despite several diagnostic guidelines, Fetal Alcohol Spectrum Disorders (FASDs) remain underdiagnosed or misdiagnosed, delaying the care of these patients and support for families.nnOBJECTIVE: This study aims to help professionals caring for these children and their families to suspect this diagnosis earlier and to provide the most appropriate follow-up.nnMETHODS: A retrospective chart review with monocentric recruitment was performed at the Genetics Unit of the University Hospital of Reunion Island. A total of 147 children and adolescents with FASDs were included.nnRESULTS: Prenatal alcohol exposure was associated with paternal alcohol consumption in 42.9%, and a high rate of prematurity (33.3%) was observed. Sixty percent of children or adolescents were placed in foster families. Learning difficulties without cognitive deficits were found in 65.8% of cases (50/76). Postural control and fine motor skills disabilities were described, respectively, in 54.7% (35/64) and 72.5% (50/69) of cases. A systematic genetic assessment was carried out, identifying in these FASD patients an associated Copy Number Variation (CNVs) in 22.6% of cases.nnCONCLUSION: Children with FASDs combine significant vulnerabilities, associating exposure to alcohol during the preconception and/or the prenatal period, prematurity, complex familial and sociocultural living conditions, and a genetic anomaly in almost a quarter of cases.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39013644,

title = {Identifying suicidal risk factors in the French Overseas Territories with multimethod psychological autopsy (AUTOPSOM): a mixed-methods study protocol},

author = {Maya Amiot and Stéphane Amadéo and Sylvie Merle and Mathieu Guidère and Louis Jehel and Monique Seguin and Michel Spodenkiewicz},

doi = {10.1136/bmjopen-2023-079405},

issn = {2044-6055},

year  = {2024},

date = {2024-07-01},

journal = {BMJ Open},

volume = {14},

number = {7},

pages = {e079405},

abstract = {INTRODUCTION: Understanding suicide in more isolated territories is a challenge because of the entanglement of cultural identity with historical, geographical and sociocultural specificities. This knowledge is a necessary precondition for the implementation of targeted prevention strategies in regions such as the French overseas territories (FOT), where data concerning suicidal risk factors is still incomplete. We aim to untangle sociocultural and clinical suicide risk factors by integrating a novel anthropological and psycholinguistic approach into the psychological autopsy method. This article describes the protocol of the clinical study 'Contribution of Psychological Autopsy to the Understanding of Suicidal Behaviours in Overseas France' (AUTOPSOM study), designed to identify common or new specific suicide risk factors in four FOT.nnMETHODS AND ANALYSIS: A multicentre epidemiological study will be carried out in four FOTs (French Polynesia, Martinique, La Reunion and French Guiana) and at a comparison site in mainland France (La Somme). The methodology will be based on a mixed-methods (quantitative and qualitative) approach using a psychological autopsy to collect clinical data and life events in the deceased's life. We implemented an exploratory multimethod strategy that combines a succession of epidemiological, anthropological, psycholinguistic and psychological methods with a semiautomated analysis of the discourse of relatives bereaved by suicide.nnETHICS AND DISSEMINATION: The study protocol (first version) was approved by the French Ethics Committee (CPP OUEST II, approval #22.04267.000122) and the Ethics Committee of French Polynesia (JOPF of 5 April 2022; CEPF opinion n°91 of 29 March 2022). The overall results and the perspectives established at the end of the study will be communicated to the bereaved relatives according to their will and serve for local suicide prevention purposes.nnTRIAL REGISTRATION NUMBER: NCT05773898.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38685108,

title = {Pathways and identity: toward qualitative research careers in child and adolescent psychiatry},

author = {Andrés Martin and Madeline DiGiovanni and Amber Acquaye and Matthew Ponticiello and Débora Tseng Chou and Emilio Abelama Neto and Alexandre Michel and Jordan Sibeoni and Marie-Aude Piot and Michel Spodenkiewicz and Laelia Benoit},

doi = {10.1186/s13034-024-00738-8},

issn = {1753-2000},

year  = {2024},

date = {2024-04-01},

journal = {Child Adolesc Psychiatry Ment Health},

volume = {18},

number = {1},

pages = {49},

abstract = {OBJECTIVE: Qualitative research methods are based on the analysis of words rather than numbers; they encourage self-reflection on the investigator's part; they are attuned to social interaction and nuance; and they incorporate their subjects' thoughts and feelings as primary sources. Despite appearing well suited for research in child and adolescent psychiatry (CAP), qualitative methods have had relatively minor uptake in the discipline. We conducted a qualitative study of CAPs involved in qualitative research to learn about these investigators' lived experiences, and to identify modifiable factors to promote qualitative methods within the field of youth mental health.nnMETHODS: We conducted individual, semi-structured 1-h long interviews through Zoom. Using purposive sample, we selected 23 participants drawn from the US (n = 12) and from France (n = 11), and equally divided in each country across seniority level. All participants were current or aspiring CAPs and had published at least one peer-reviewed qualitative article. Ten participants were women (44%). We recorded all interviews digitally and transcribed them for analysis. We coded the transcripts according to the principles of thematic analysis and approached data analysis, interpretation, and conceptualization informed by an interpersonal phenomenological analysis (IPA) framework.nnRESULTS: Through iterative thematic analysis we developed a conceptual model consisting of three domains: (1) Becoming a qualitativist: embracing a different way of knowing (in turn divided into the three themes of priming factors/personal fit; discovering qualitative research; and transitioning in); (2) Being a qualitativist: immersing oneself in a different kind of research (in turn divided into quality: doing qualitative research well; and community: mentors, mentees, and teams); and (3) Nurturing: toward a higher quality future in CAP (in turn divided into current state of qualitative methods in CAP; and advocating for qualitative methods in CAP). For each domain, we go on to propose specific strategies to enhance entry into qualitative careers and research in CAP: (1) Becoming: personalizing the investigator's research focus; balancing inward and outward views; and leveraging practical advantages; (2) Being: seeking epistemological flexibility; moving beyond bibliometrics; and the potential and risks of mixing methods; and (3) Nurturing: invigorating a quality pipeline; and building communities.nnCONCLUSIONS: We have identified factors that can support or impede entry into qualitative research among CAPs. Based on these modifiable findings, we propose possible solutions to enhance entry into qualitative methods in CAP (pathways), and to foster longer-term commitment to this type of research (identity).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38388880,

title = {Scoping review on the role of the family doctor in the prevention and care of patients with foetal alcohol spectrum disorder},

author = {Sébastien Leruste and Bérénice Doray and Thierry Maillard and Christophe Lebon and Catherine Marimoutou and Michel Spodenkiewicz},

doi = {10.1186/s12875-024-02291-x},

issn = {2731-4553},

year  = {2024},

date = {2024-02-01},

journal = {BMC Prim Care},

volume = {25},

number = {1},

pages = {66},

abstract = {BACKGROUND: Foetal alcohol spectrum disorder (FASD) is the leading preventable cause of nongenetic mental disability. Given the patient care pathway, the General Practitioner (GP) is in the front line of prevention and identification of FASD. Acknowledging the importance of the prevalence of FASD, general practitioners are in the front line both for the detection and diagnosis of FASD and for the message of prevention to women of childbearing age as well as for the follow-up.nnOBJECTIVES: The main objective of the scoping review was to propose a reference for interventions that can be implemented by a GP with women of childbearing age, their partners and patients with FASD. The final aim of this review is to contribute to the improvement of knowledge and quality of care of patients with FASD.nnMETHODS: A scoping review was performed using databases of peer-reviewed articles following PRISMA guidelines. The search strategy was based on the selection and consultation of articles on five digital resources. The advanced search of these publications was established using the keywords for different variations of FASD: "fetal alcohol syndrome," "fetal alcohol spectrum disorder," "general medicine," "primary care," "primary care"; searched in French and English.nnRESULTS: Twenty-three articles meeting the search criteria were selected. The interventions of GPs in the management of patients with FASD are multiple: prevention, identification, diagnosis, follow-up, education, and the role of coordinator for patients, their families, and pregnant women and their partners. FASD seems still underdiagnosed.nnCONCLUSION: The interventions of GPs in the management of patients with FASD are comprehensive: prevention, identification, diagnosis, follow-up, education, and the role of coordinator for patients, their families, and pregnant women and their partners. Prevention interventions would decrease the incidence of FASD, thereby reducing the incidence of mental retardation, developmental delays, and social, educational and legal issues. A further study with a cluster randomized trial with a group of primary care practitioners trained in screening for alcohol use during pregnancy would be useful to measure the impact of training on the alcohol use of women of childbearing age and on the clinical status of their children.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38487023,

title = {Obstacles and facilitators to preventing fetal alcohol spectrum disorder: a qualitative study with general practitioners},

author = {Sébastien Leruste and François Baelen and Bérénice Doray and Thierry Maillard and Catherine Marimoutou and Michel Spodenkiewicz},

doi = {10.3389/fmed.2024.1280349},

issn = {2296-858X},

year  = {2024},

date = {2024-01-01},

journal = {Front Med (Lausanne)},

volume = {11},

pages = {1280349},

abstract = {BACKGROUND: Fetal Alcohol Spectrum Disorders are the leading cause of non-genetic intellectual disability. The damage caused, although completely preventable, is irreversible and requires lifelong support. General Practitioners have an important role in the prevention of Fetal Alcohol Spectrum Disorders. However, evidence suggests that General Practitioners do not monitor systematically alcohol consumption among pregnant women.nnOBJECTIVES: The aim of this study was to understand the barriers and motivations of General Practitioners in the prevention of Fetal Alcohol Spectrum Disorders on Reunion Island.nnMETHODS: A qualitative research study was conducted by conducting semi-structured individual interviews with general practitioners. Participants were selected by random or snowball sampling. General practitioners who worked only in unscheduled care services were excluded from this study. After the interviews were transcribed, a verbatim analysis was performed according to the principles of grounded theory.nnRESULTS: Twenty interviews were conducted by two researchers between November and December 2020. General practitioners expressed discomfort in addressing alcohol consumption and excessive drinking in women. They had inaccurate theoretical knowledge and a lack of practical experience with Fetal Alcohol Spectrum Disorders. They also showed little knowledge of the Fetal Alcohol Spectrum Disorders care pathway available on Reunion Island. Both patients and general practitioners expressed discomfort when discussing women's alcohol consumption. Conflicting government policies were highlighted as alcohol promotion campaigns overshadowed Fetal Alcohol Spectrum Disorders prevention initiatives.nnCONCLUSION: General practitioners should be open and non-judgmental in their interactions with women and couples, with a focus on early detection and short-term intervention. General practitioners should be better educated about Fetal Alcohol Spectrum Disorders and have a clearer understanding of the Fetal Alcohol Spectrum Disorders care pathway.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38375324,

title = {Actions to prevent and identify fetal alcohol spectrum disorders to be implemented in general practice: a consensus},

author = {Sébastien Leruste and Alice Pouilley-Bax and Bérénice Doray and Thierry Maillard and Frédérick Monin and Coralie Loubaresse and Catherine Marimoutou and Michel Spodenkiewicz},

doi = {10.3389/fmed.2024.1278973},

issn = {2296-858X},

year  = {2024},

date = {2024-01-01},

journal = {Front Med (Lausanne)},

volume = {11},

pages = {1278973},

abstract = {INTRODUCTION: Fetal alcohol exposure is the most common preventable cause of non-genetic intellectual disability. Fetal Alcohol Syndrome (FAS) is characterized by intellectual disability and distinctive facial features and affects 0.1% of live births, representing approximately 800 cases per year in France. Fetal Alcohol Spectrum Disorder (FASD) are 10 times more common than FAS, with an estimated 8,000 cases per year, and are associated with behavioral and social maladjustment in both children and adults, as well as various malformations. General practitioners play a key role in preventing and identifying FASD through their involvement in pregnancy and child monitoring.nnMETHODS: Qualitative study using the Delphi method. Items were developed from the literature and semi-structured interviews with field professionals and health institutions. A panel of multi-professional experts, mostly general practitioners, was recruited.nnRESULTS: 24 initial actions were submitted to the experts. At the end of the first round, six actions reached a consensus and six were reformulated for the second round. At the end of the second round, three actions reached a consensus, for a total of 11 consensus actions. Four of these actions seem particularly relevant for rapid implementation, namely systematic proposal of pre-conceptional consultations for women planning pregnancy, systematic identification of environmental factors during child monitoring, systematic distribution of information on fetal alcohol exposure during pre-conception or early pregnancy, and the publication of a leaflet for general practitioners on the identification of children with FAS or FASD and the contact details of relevant associations.nnCONCLUSION: Prevention and identification of FASD can be improved through short and general training supports for general practitioners. Early screening of FASD is crucial for children, and should be maintained throughout their monitoring. This study could be used for communication and dissemination of information based on the consensus obtained.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39839316,

title = {Scoping review on prevention of suicidal thoughts and behaviors in adolescents: methods, effectiveness and future directions},

author = {Josée Aoun and Michel Spodenkiewicz and Catherine Marimoutou},

doi = {10.3389/frcha.2024.1367075},

issn = {2813-4540},

year  = {2024},

date = {2024-01-01},

journal = {Front Child Adolesc Psychiatry},

volume = {3},

pages = {1367075},

abstract = {INTRODUCTION: Despite the extensive implementation of suicide prevention strategies targeting suicidal thoughts and behaviors (STB) in adolescents, there remains a concerning lack of improvement in the situation. In this comprehensive scoping review, our objective was to provide insights into prevention methods for suicidal thoughts and behaviors directed towards adolescents, including their effectiveness, public perception, and potential adaptations.nnMETHOD: A scoping review was conducted, encompassing 71 articles including systematic review, clinical trials and qualitative studies for a wider understanding. Most articles included focus generally on adolescents aged 10-20.nnRESULTS: No single intervention has shown expected effectiveness, collective efforts have laid a solid foundation for suicide prevention. Promising interventions include cognitive-behavioral therapy (CBT) and incorporating Technology-based interventions. However, challenges persist in promoting help-seeking behaviors and addressing barriers such as stigma, the natural impulsive nature of adolescents and difficulty in selecting and defining data and designs.nnDISCUSSION: This review underscores the need for a holistic approach to suicide prevention, integrating social, emotional, and psychological dimensions. Successful interventions target underlying issues like depression and loneliness rather than solely focusing on suicidal thoughts and behaviors (STB). Combining direct and indirect interventions is a sensible approach for both immediate and long-term results. Understanding Generation Z's unique needs, influenced by technology and diverse perspectives, is crucial for effective prevention.nnCONCLUSION: Involving adolescents and adopting patient-centered healthcare with outcome measures like Patient Perceived Outcome Measures can enhance suicide prevention efforts by prioritizing safety and patient experiences.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38057936,

title = {The role of general practitioners in Reunion in detecting alcohol use in pregnant women and identifying fetal alcohol spectrum disorder: a qualitative study},

author = {Sébastien Leruste and Louise Delfarguiel and Bérénice Doray and Coralie Loubaresse and Laetitia Sennsfelder and Thierry Maillard and Catherine Marimoutou and Michel Spodenkiewicz},

doi = {10.1186/s13690-023-01221-0},

issn = {0778-7367},

year  = {2023},

date = {2023-12-01},

journal = {Arch Public Health},

volume = {81},

number = {1},

pages = {210},

abstract = {BACKGROUND: Fetal Alcohol Spectrum Disorder (FASD) is the leading cause of non-genetic intellectual disability and social maladjustment in children. International guidelines recommend abstinence from alcohol during pregnancy. Réunion is the most affected of all French regions with an estimated Fetal Alcohol Spectrum (FAS) prevalence of 1.2‰ births. General practitioners (GPs) are at the forefront of identifying patients with FASD.nnOBJECTIVE: To understand how GPs identify FASD.nnMETHODS: Qualitative study using a grounded theory approach, through semi-structured face-to-face interviews with GPs. Interviews were conducted with the aim of reaching theoretical saturation. These were transcribed verbatim and then analyzed by four researchers to ensure triangulation of the data.nnRESULTS: GPs reported barriers to the identification of FASD: challenges in overcoming social taboos and paradoxical injunctions, the influence of limited knowledge and experience, non-specific and highly variable symptoms, ambiguous classification and method of diagnosis involving the mobilization of a multidisciplinary team and lengthy consultations. Conversely, they felt competent to identify neurodevelopmental disorders of any cause, but were concerned about the long waiting time to access specialized care. From the perspective of GPs, it is crucial to prioritize promotion and training aimed at improving the identification and coordination of care pathways for children diagnosed with neurodevelopmental disorders, such as FASD.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35124719,

title = {Early-treatment stage for adolescents with depression and their parents: An IPSE qualitative study},

author = {Jordan Sibeoni and Massimiliano Orri and Emilie Manolios and Michel Spodenkiewicz and Mathilde Labey and Laurence Verneuil and Anne Revah-Levy},

doi = {10.1007/s00787-022-01952-5},

issn = {1435-165X},

year  = {2023},

date = {2023-08-01},

journal = {Eur Child Adolesc Psychiatry},

volume = {32},

number = {8},

pages = {1415--1426},

abstract = {The period at the start of treatment of adolescents with depression is both crucial and complex. Adolescents' and parents' perspectives on that early-treatment stage are important but have not yet been explored. The present study explores the lived experience of the early-treatment stage among adolescents with major depressive disorder and their parents and aims to cross their perspectives. This French qualitative multicentre study followed the five stages IPSE approach. Semi-structured interviews with adolescents with depression and with their parents were conducted. Data collection by purposive sampling continued until we reached theoretical sufficiency. Forty-seven participants-20 adolescents, 27 parents-were included. Data analysis produced a structure of lived experience based on two axes: (1) what leads to care: what is shown, what is seen, describing a dynamic process of showing and seeing around the start of treatment and (2) the start of treatment: knowing and sharing everyone's explanations. Results suggest some early therapeutic alliance facilitators, that is, first to be able to see the depressive manifestations and directly address the issue of depression based on what is shown and seen, second to give the opportunity to both adolescents and parents to share their views and explanations about the adolescent's distress, and finally to explicitly name this distress depression to first agree on the term to use.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37189943,

title = {Description of Copy Number Variations in a Series of Children and Adolescents with FASD in Reunion Island},

author = {Laëtitia Sennsfelder and Susie Guilly and Sébastien Leruste and Ludovic Hoareau and Willy Léocadie and Pauline Beuvain and Meïssa Nekaa and Maïté Bagard and Stéphanie Robin and Justine Lanneaux and Léa Etchebarren and Marilyn Tallot and Michel Spodenkiewicz and Jean-Luc Alessandri and Godelieve Morel and Maud Blanluet and Paul Gueguen and Bérénice Roy-Doray},

doi = {10.3390/children10040694},

issn = {2227-9067},

year  = {2023},

date = {2023-04-01},

journal = {Children (Basel)},

volume = {10},

number = {4},

abstract = {BACKGROUND: Fetal Alcohol Spectrum Disorders (FASD) are the most common cause of neurocognitive impairment and social inadaptation, affecting 1 birth in 100. Despite the existence of precise diagnostic criteria, the diagnosis remains difficult, often confounded with other genetic syndromes or neurodevelopmental disorders. Since 2016, Reunion Island has been a pilot region for the identification, diagnosis, and care of FASD in France.nnOBJECTIVE: To evaluate the prevalence and the types of Copy Number Variations (CNV) in FASD patients.nnMETHODS: A retrospective chart review of 101 patients diagnosed with FASD in the Reference Center for developmental anomalies and in the FASD Diagnostic Center of the University Hospital was performed. Records of all patients were reviewed to obtain their medical history, family history, clinical phenotype, and investigations, including genetic testing (CGH- or SNP-array).nnRESULTS: A rate of 20.8% (n = 21) of CNVs was found including 57% (12/21) of pathogenic variants and 29% (6/21) of variants of uncertain signification (VUS).nnCONCLUSION: A particularly high number of CNVs was found in children and adolescents with FASD. It reinforces the plea for a multidisciplinary approach for developmental disorders to explore both environmental factors, such as avoidable teratogens and intrinsic vulnerabilities, especially genetic determinants.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38146283,

title = {Symptoms characteristics of personality disorders associated with suicidal ideation and behaviors in a clinical sample of adolescents with a depressive disorder},

author = {Anthony Joseph Gifuni and Michel Spodenkiewicz and Geneviève Laurent and Sasha MacNeil and Fabrice Jollant and Johanne Renaud},

doi = {10.3389/fpsyt.2023.1269744},

issn = {1664-0640},

year  = {2023},

date = {2023-01-01},

journal = {Front Psychiatry},

volume = {14},

pages = {1269744},

abstract = {INTRODUCTION: Pathological personality traits have repeatedly been identified as important risk factors for suicidal ideation and behaviors. Moreover, impulsive-aggressive traits, have shown a consistent association with suicidal behaviors across the lifespan. Adolescence represents a critical period for the emergence of different personality traits, mood disorders, and suicidal behaviors, but the relationship between these variables remain poorly understood.nnMETHODS: These variables were examined in a cross-sectional case-control design involving three groups: 30 adolescents with a depressive disorder and past suicide attempt (Mean Age = 16.2, Females = 26), 38 adolescents with a depressive disorder but without past suicide attempt (Mean age = 16.0, Females = 29), and 34 healthy adolescent controls (Mean age = 15.2, Females = 22). Suicidal ideations were indexed using Suicidal Behavior Questionnaire (SBQ-R), psychiatric disorder assessed using a semi-structured questionnaire (K-SADS-PL), depressive symptoms with the Beck Depressive Inventory (BDI), symptoms characteristics of personality disorders with the Scheduled Clinical Interview for the DSM-IV (SCID-II) screening questionnaire, and impulsivity with the Barratt Impulsivesness Scale (BIS).nnRESULTS: Findings showed that impulsivity ( = 11.0,  < 0.0001) and antisocial symptoms characteristics of personality disorders ( < 0.001, d = 0.70) displayed the most robust association with adolescent suicide attempts. Borderline symptoms characteristics of personality disorders did not discriminate attempters from non-attempters but presented high correlations with suicidal ideation and depression severity. In an item-wise analysis, suicide attempt status was uniquely correlated with symptoms characteristics of an antisocial personality disorder. Suicide attempt status also correlated with non-suicidal self-injury and a chronic feeling of emptiness.nnDISCUSSION: The caveats of this cross-sectional study include the stability of symptoms characteristics of personality disorders in adolescence and the limited sample size. In sum, suicidal behaviors were characteristically correlated with increased impulsivity and antisocial symptoms characteristics of personality disorders, but other symptoms characteristics of personality disorders were relevant to adolescent depression and suicidal ideation. Understanding the emergence of symptoms characteristics of personality disorders and suicidal behaviors in a developmental context can ultimately inform not only the neurobiological origin of suicidal behaviors, but also provide new avenues for early detection and intervention.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36360811,

title = {Health Impacts of the COVID-19 Lockdown Measure in a Low Socio-Economic Setting: A Cross-Sectional Study on Reunion Island},

author = {Adrian Fianu and Hind Aissaoui and Nadège Naty and Victorine Lenclume and Anne-Françoise Casimir and Emmanuel Chirpaz and Olivier Maillard and Michel Spodenkiewicz and Nicolas Bouscaren and Michelle Kelly-Irving and Emmanuelle Rachou and Cyrille Delpierre and Patrick Gérardin},

doi = {10.3390/ijerph192113932},

issn = {1660-4601},

year  = {2022},

date = {2022-10-01},

journal = {Int J Environ Res Public Health},

volume = {19},

number = {21},

abstract = {In March 2020, the French government implemented nation-wide measures to reduce social contact and slow the progression of the emerging coronavirus responsible for COVID-19, the most significant being a complete home lockdown that lasted 8 weeks. Reunion Island is a French overseas department marked by large social inequalities. We draw the hypothesis that distancing and lockdown measures may have contributed to an increase in the social inequalities in health (SIH) on Reunion Island. The aim of our study was to describe the SIH during lockdown in the Reunionese population. We implemented a cross-sectional telephone survey conducted between 13 May and 22 July 2020, using a retrospective data collection on the lockdown period. A total of 892 adult participants (≥18 years) were recruited in the 114 large Reunionese neighborhoods using the quota method within the national "White Pages" telephone directory. Degraded psychological states, an increase in addictive behaviors, difficulties in accessing food, a decrease in physical activity, delayed medical appointments, violence against women, and health problems in children were driven by the socio-economic characteristics of the population, most often to the disadvantage of social groups exposed to poor living conditions. These results suggest that the COVID-19 lockdown contributed to an increase in SIH.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36561636,

title = {Suicidal ideation and behavior in youth in low- and middle-income countries: A brief review of risk factors and implications for prevention},

author = {Johanne Renaud and Sasha Leigh MacNeil and Lakshmi Vijayakumar and Michel Spodenkiewicz and Sylvanne Daniels and David A Brent and Gustavo Turecki},

doi = {10.3389/fpsyt.2022.1044354},

issn = {1664-0640},

year  = {2022},

date = {2022-01-01},

journal = {Front Psychiatry},

volume = {13},

pages = {1044354},

abstract = {Although global rates of suicide have dropped in the last 30 years, youth in low- and middle-income countries (LMICs) continue to be highly represented in suicide statistics yet underrepresented in research. In this review we present the epidemiology of suicide, suicidal ideation, and suicide attempts among youth in LMICs. We also describe population-level (attitudes toward suicide, socioeconomic, and societal factors) and individual-level clinical and psychosocial risk factors, highlighting specific considerations pertaining to youth in LMICs. These specific considerations in risk factors within this population can inform how multi-level prevention strategies may be targeted to meet their specific needs. Prevention and intervention strategies relying on the stepped-care framework focusing on population-, community-, and individual level targets while considering locally- and culturally relevant practices are key in LMICs. In addition, systemic approaches favoring school-based and family-based interventions are important among youth. Cross-culturally adapted multimodal prevention strategies targeting the heterogeneity that exists in healthcare systems, suicide rates, and risk factors in these countries should be accorded a high priority to reduce the burden of suicide among youth in LMICs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35547648,

title = {Attitudes, Barriers, Motivations to Sun Protection in Reunion Island's Schools: Qualitative Study},

author = {Sebastien Leruste and Mathilde Marx and Cassie Ah-Mouck and Lindsay Yap-Chim and Nathalie Sultan-Bichat and Marie Beylot-Barry and Michel Spodenkiewicz and Jessica Dumez and Antoine Bertolotti},

doi = {10.2147/RMHP.S341565},

issn = {1179-1594},

year  = {2022},

date = {2022-01-01},

journal = {Risk Manag Healthc Policy},

volume = {15},

pages = {895--900},

abstract = {The incidence of melanoma in Reunion Island is on the rise and is now one of the highest worldwide. Although the main risk factor of melanoma is sun exposure during childhood, sun protection measures remain insufficient in Reunionese schools. From November 2019 to November 2020, we conducted a qualitative study to explore the attitudes, barriers, and motivations to sun protection among the main actors of children's protection in Reunion Island. Individual semi-directive interviews were performed with 14 children aged 6 to 10 years, 13 parents, and 13 teachers. The interviews were recorded and transcribed. Relevant data were coded, triangulated, analyzed, and then modeled following the methodology of grounded theory. Sufficiency of the data was sought. All 40 participants described their sun protection habits. Protection was lower during school activities than during leisure activities. Parents identified several practical and financial barriers to sun protection. Teachers pointed out the lack of adequate infrastructure and sun protection training. Responsibility for children's protection was a point of disagreement between parents and teachers. Children limited their use of protection, mainly for reasons of comfort. Children's sun protection in schools is the responsibility of educational staff, parents, and society at large. Improving communication between these various actors is necessary. Sun safety campaigns and reorganization of the school environment would allow for better protection of the child population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}