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1.
目的探讨肿瘤坏死因子-α(TNF-α)基因 238位点和 308位点G/A及干扰素-γ(TFN-γ) 874位点A/T单核苷酸多态性与婴儿巨细胞病毒(CMV)肝炎的关系。方法对CMV肝炎患儿87例和同期入院非CMV肝炎患儿89例,应用ABIPrism7700高通量荧光PCR系统进行测定TNF-α基因 238和 308及TFN-γ 874位点单核苷酸多态性。结果婴儿CMV肝炎患儿TNF-α基因 238和 308位点与对照组比较无显著性差异。IFN-γ 874位点在婴儿CMV肝炎患儿中AA型64例,AT型20例,TT型3例;对照组AA型45例,AT型26例,TT型18例,两组基因型和A/T等位基因频率分布存在显著差异(P=0.001,P<0.001)。结论IFN-γ单核苷酸多态性与婴儿CMV肝炎的易感性有一定的相关性;TNF-α 238和 308单核苷酸多态性与CMV肝炎易感性可能无关。  相似文献   

2.
目的探讨肿瘤坏死因子-α(TNF-α)G-308A多态性和自发性早产(SPTB)易感性的关联。方法收集753例SPTB患儿为病例组,681例足月新生儿为对照组,利用Sequenom Mass ARRAY~?SNP检测技术对TNF-α基因G-308A多态性位点进行单核苷酸多态性检测。结果病例组和对照组等位基因G、A分布频率之间的差异无统计学意义(P=0.35);GG、GA、AA基因型构成比之间的差异也无统计学意义(P=0.64)。Logistic回归分析发现TNF-α基因G-308A位点与SPTB的遗传易感性不相关(OR=0.85,95%CI:0.61~1.19,P=0.35)。结论 TNF-α基因G-308A多态性位点与SPTB遗传易感性不相关。  相似文献   

3.
目的 致热因子白细胞介素1(IL-1β)基因多态性是否参与热性惊厥(FS)的发病目前仍存在争议,该研究将探讨中国北方汉族儿童热点基因IL-1β-511T 的单核苷酸(SNP)rs16944 多态性与 FS 发病的关联性。方法 用 SNaPshot SNP 分型技术对 141 例单纯型 FS 患儿和 130 例健康对照进行 IL-1β-511T 基因rs16944 位点分型,比较该 SNP 基因型和等位基因频率的差异。结果 与对照组相比,病例组rs16944 多态性的基因型和等位基因频率差异均无统计学意义(P>0.05);rs16944 多态性3 种基因型 A/A、A/G、G/G 的FS 患儿的临床特征比较,显示首次惊厥的年龄(χ2=19.491,Pχ2=9.317,Pχ2=26.798,P结论 IL-1β-511T 基因 rs16944 多态性与北方汉族儿童单纯FS 的发病无关联,但其基因型不同可能与患儿FS 的发生及预后有关。  相似文献   

4.
目的 研究TNF-α基因启动子-238、-308位点G/A单核苷酸多态性与幼年特发性关节炎(JIA)及其各亚型间的相关性.方法 评估127例JIA患儿及106例健康儿童的临床资料.JIA的诊断和分型参照2001年国际风湿病学联盟标准.所有标本提取DNA后采用聚合酶链反应-限制性片段长度多态性方法进行TNF-α基因多态性分析.结果 1.JIA患儿和健康对照组TNF-α-238G和A等位基因表达频率分布:JIA患几分别为92.9%和7.1%,健康对照组为95.3%和4.7%,二组比较无统计学差异(X2=1.149P=0.284);而多关节型[类风湿因子(RF)阴性]与健康对照组比较有统计学差异(X2=7.621 P=0.006),其与A等位基因的表达有相关性(r=0.174 P<0.05).2.JIA患儿和健康对照组TNF-α-308 G和A等位基因表达频率分布:JIA患儿分别为94.1%和5.9%;健康对照组为95.3%和4.7%.二者比较无统计学差异(X2=0.322 P=0.571);而多关节型(RF阴性)与健康对照组比较亦有统计学差异(X2=7.621 P=0.006),其与A等位基因的表达有相关性(r=0.174 P<0.05).结论 TNF-α基因-238、-308位点A型基因在JIA关节损害中具有一定作用,为TNF-α在JIA治疗中提供间接依据.  相似文献   

5.
目的探讨IFN_γ基因和TNF_α基因单核苷酸多态性(SNP)与HBV宫内感染的遗传易感因素。方法选择在确定时期内乙肝疫苗随访门诊定期随访儿童中凡属宫内HBV感染免疫失败者为Ⅰ组、未感染且免疫有效者为Ⅱ组,另选非HBV高危的健康儿童作对照组Ⅲ组,应用实时荧光定量PCR技术检测IFN_γ基因 874A/TSNP及CA重复序列,TNF_α基因-238G/A、-308G/ASNP。结果IFN_γ 874A等位基因频率Ⅰ组显著高于Ⅱ组和Ⅲ组(χ2=7.238、5.199,P均<0.05);CA重复序列12次频率(CA12) 明显低于Ⅱ组(χ2=7.548,P<0.01);TNF_α-238A等位基因频率Ⅰ组显著高于Ⅱ组和Ⅲ组(χ2=6.797、9.513,P均<0.01),-308位点等位基因频率Ⅰ组与Ⅱ组和Ⅰ组与Ⅲ组间差异无显著性(χ2=1.361、0.051,P均>0.05)。结论干扰素γ 874位点A等位基因占优势、IFN_γCA重复序列基因多态性和肿瘤坏死因子α-238A等位基因占优势对决定个体宫内HBV感染遗传易感性有一定意义,而TNF_α-308位点G/A等位基因单核苷酸多态性对个体乙肝病毒宫内感染易感性并无作用。  相似文献   

6.
Yang J  Li CR  Li YB  Li RX  Sun LB  Huang HJ  Wang GB 《中华儿科杂志》2003,41(8):598-602
目的探讨肿瘤坏死因子α(TNF-ɑ)和白细胞介素10(IL-10)基因启动子区多态性与中国汉族儿童川崎病的易感性和临床表型的关系.方法应用聚合酶链反应-限制性内切酶片段长度多态性分析(PCR-RFLP)方法检测TNF-ɑ和IL-10基因启动子区4个多态性位点,对96例川崎病患儿及160例正常对照儿童进行相关性分析.结果 (1)中国汉族健康儿童TNF-ɑ基因-308(A/G)位点等位基因频率与日本人和美国白人正常人群相近;而IL-10基因-1082(G/A)、-819(C/T)、-592(A/C)3个位点等位基因频率与英国正常人群差异有显著性(P均<0.01);(2)TNF-ɑ基因-308位点等位基因频率在川崎病组和健康对照组间差异无显著性;IL-10 -1082、-819、-592的3个位点等位基因频率和单体型在两组之间比较差异亦无显著性;(3)临床表型分析发现,TNF-α-308 A基因型在静脉注射免疫球蛋白(IVIG)非敏感型川崎病患者中的发生频率高于TNF-α-308 G基因型,比较差异有显著性(67% vs 5%,χc2=90.48,P<0.01),前者发生静脉注射用IVIG非敏感型川崎病的相对危险度(RR)是后者的42.25倍(RR 95% CI=15.81~112.88,P<0.01).IL-10-1082A/-819T/-592A单体型在川崎病合并冠状动脉损伤患者中的发生频率高于Non-ATA单体型, 比较差异有显著性 (52%vs 20%,χ2=18.36, P<0.01), IL-10基因启动子区ATA单体型合并冠状动脉损伤的RR是Non-ATA单体型的4.26倍(RR 95% CI=2.20~8.25,P<0.01).结论 TNF-α、IL-10基因启动子区多态性可能是影响川崎病疗效和预后的重要因素.  相似文献   

7.
目的探讨我国中部汉族人群中MPO基因的单核苷酸多态性(SNP)位点(rs2333227,—643G/A)多态性与川崎病(KD)及其临床特点的相关性。方法采用病例对照研究方法,选取237例典型KD患儿和249例正常儿童作为研究对象。利用PCR-RFLP的方法测定SNP位点多态性分布;并收集KD患儿临床资料。结果 KD患儿SNP位点(rs2333227)的基因型(GG、GA、AA)频率与正常儿童相比差异有统计学意义(P=0.039),且等位基因频率差异亦存在统计学意义(P=0.012),G等位基因为风险因子。该SNP位点GG基因型的患儿手足水肿的比例高于其他基因型的患儿,差异具有统计学意义(P=0.029)并与腹腔积液的特点相关(P=0.028);该SNP位点多态性与结膜充血、皮疹、冠状动脉损伤肝脏肿大、脾脏肿大、小叶性肺炎等影像学特点无关(P0.05)。结论 MPO基因SNP位点(rs2333227)与KD的易感性相关,G等位基因为风险因子;且该SNP位点多态性可能与部分临床特点相关。  相似文献   

8.
目的 探讨过敏性紫癜(HSP)患儿血浆纤维蛋白原水平及β纤维蛋白原基因FGB-455G/A、-148C/T、-448G/A基因多态性的相关性.方法 采集528例HSP患儿及180例健康儿童末梢血标本,应用PCR限制性片段长度多态性(FGB-RFLP)技术,检测FGB-455G/A、-148C/T、-448G/A基因型,并检测158例HSP患儿和100例健康儿童的血浆纤维蛋白原水平.结果 HSP患儿FGB-455G/A位点的GG型和-448G/A位点的GG型出现频率比健康儿童明显增高,差异有统计学意义(P < 0.01).HSP患儿FGB-455G/A位点的G等位基因、-148C/T 位点的C等位基因、-448G/A位点的G等位基因出现频率较健康儿童明显增高,差异有统计学意义 (P < 0.05).FGB-455G/A位点GG基因型发生HSP的相对危险性(OR)为2.39(95%CI,1.66 ~ 3.39);HSP患儿的血浆纤维蛋白原水平较健康儿童明显增高,差异有统计学意义(P < 0.01);FGB-455G/A位点GG基因型HSP患儿的纤维蛋白原水平明显高于AG + AA基因型,差异有统计学意义(P < 0.05).结论 HSP发病可能与β纤维蛋白原FGB-455G/A和-488A/G基因多态性及其水平相关;FGB-455A/G位点GG基因型可能是HSP的危险基因.  相似文献   

9.
目的 研究雌激素受体α基因(ESR1)、β基因(ESR2)单核苷酸多态性(SNP)与尿道下裂易感性之间的关系。方法 选择2013年11月至2014年5月我院收治的384例尿道下裂患儿作为研究组,同期非尿道下裂患儿411例作为对照组。选取目前报道较多的热点SNP位点结合SNP公共数据库,对2个基因共13个SNP位点应用多重单碱基延伸SNP分型技术作基因分型检测。对每个位点的两种等位基因进行卡方检验,对共显性、频率低的等位基因为显性,频率低的等位基因为隐性及叠加作用4种遗传模型进行Logistic回归分析,同时进行单倍体分析。了解ESR1、ESR2单核苷酸多态性与尿道下裂发病的相关性。结果 检验结果显示,研究组与对照组比较,在ESR2基因的SNP位点rs1256040差异有统计学意义(P=0.019),其余位点检测结果差异均无统计学意义(P〉0.05)。使用SNPStats软件对每个位点进行回归分析,发现ESR2基因SNP rs1256040在共显性、频率低的等位基因为显性及叠加作用的3种遗传模型中差异有统计学意义(P值分别为0.041、0.014和0.016)。单倍体分析结果显示,研究组和对照组在ESR2-Block2(rs10483774和rs2987983)差异有统计学意义(P=0.043);其余各单倍体型中,两组频率分布差异均无统计学意义(P〉0.05)。结论 ESR2基因单核苷酸多态性可能和中国北方人群尿道下裂易感性相关,ESR2基因rs1256040位点的基因型G/A、G/G可能是决定尿道下裂易感性的一个重因素。  相似文献   

10.
目的 探讨儿童IL-17A启动子区域(-197G/A和-692C/T)基因多态性与儿童哮喘易感性的关系,为能进一步寻找到哮喘的候选基因从而为患病高风险儿童早期预防奠定基础。方法 选取2013年8月至2015年8月门诊随访或住院的哮喘患儿65例为哮喘组,另选取同期行健康体检儿童70例为健康对照组,采集两组儿童外周静脉血,应用序列特异性引物聚合酶链反应(SSP-PCR)法检测IL-17A基因-197G/A和-692C/T两个位点的单核苷酸多态性(SNP),统计分析两组间基因型及等位基因分布频率的差异。结果 IL-17A基因-692C/T位点哮喘组患儿TT基因型的分布频率(29%)显著高于健康对照组(16%)(P=0.012);哮喘组-692T等位基因分布频率(52%)显著高于健康对照组(42%)(P=0.039);罹患儿童哮喘的风险T等位基因携带者是C等位基因携带者的1.413倍(OR=1.413,95%CI:1.015~1.917);而IL-17A基因-197G/A位点基因型及等位基因分布频率在哮喘组和健康对照组间比较差异无统计学意义(P > 0.05)。结论 IL-17A基因启动子区域-692C/T位点基因多态性与儿童哮喘的易感性相关,-692T等位基因携带者更易罹患儿童哮喘,而IL-17A-197G/A位点多态性与儿童哮喘的易感性无显著相关。  相似文献   

11.
Solid-organ transplantation is the optimal long-term treatment for most patients with end-stage organ failure. After solid-organ transplantation, short-term graft survival significantly improved (1). However, due to chronic allograft nephropathy and death with functioning graft, long-term survival has not prolonged remarkably (2). Posttransplant immunosuppressive medications consist of one of the calcineurin inhibitors in combination with mycophenolate mofetil (MMF) or azathioprine (Aza) and steroids. All of them have different adverse effects, among which posttransplant diabetes mellitus (PTDM) is an independent risk factor for cardiovascular (CV) events and infections causing the death of many transplant patients and it may directly contribute to graft failure (3). According to the criteria of the American Diabetes Association (4), diabetes mellitus (DM) is defined by symptoms of diabetes (polyuria and polydipsia and weight loss) plus casual plasma glucose concentration ≥ 11.1 mmol/L or fasting plasma glucose (FPG) ≥ 7.0 mmol/L or 2-h plasma glucose level ≥ 11.1 mmol/L following oral glucose tolerance test (OGTT). This metabolic disorder occurring as a complication of organ transplantation has been recognized for many years. PTDM, which is a combination of decreased insulin secretion and increased insulin resistance, develops in 4.9/15.9% of liver transplant patients, in 4.7/11.5% of kidney recipients, and in 15/17.5% of heart and lung transplants [cyclosporine A (CyA)/tacrolimus (Tac)-based regimen, respectively] (5). Risk factors of PTDM can be divided into non-modifiable and modifiable ones (6), among which the most prominent is the immunosuppressive therapy being responsible for 74% of PTDM development (7). Emphasizing the importance of the PTDM, numerous studies have determined the long-term outcome. On the basis of these studies, graft and patient survival is tendentiously (8) or significantly (9, 10) decreased for those developing PTDM.  相似文献   

12.
Carney complex is a multiple endocrine neoplasia (MEN) syndrome that affects the adrenal cortex, the pituitary and thyroid glands, and the gonads. The complex is also associated with skin and mucosa pigmentation abnormalities and myxoid and other neoplasms of mesenchymal and neural crest origin. Thus, this syndrome also belongs to another group of genetic disorders, the lentiginoses (or lentigenoses), which include the Peutz-Jeghers, LEOPARD, arterial dissections and lentiginosis, and Laugier-Hunziker syndromes, Cowden disease and Ruvalcaba-Myhre-Smith (Bannayan-Zonana) syndrome and the centrofacial, benign patterned and segmental lentiginoses, all of which can be associated with a variety of developmental defects. The inheritance of Carney complex, just like that of the other MENs and the lentiginoses, is autosomal dominant. Genetic loci or genes have been identified for Carney complex, Peutz-Jeghers and Ruvalcaba-Myhre-Smith syndromes, but not for other lentiginoses. Elucidation of the molecular defects responsible for these disorders is expected to shed light on aspects of early neural crest differentiation, the regulation of pigmentation, the development of autonomous endocrine function, and endocrine and nonendocrine tumorigenesis.  相似文献   

13.
Bibliometric data published by the Institute of Scientific Information in Philadelphia (ISI), and which was previously discussed in Acta Paediatrica , has increasingly been used despite all the relevant and severe criticism that has been raised against this method of evaluating individual research results and grading scientific journals. It is obvious that the present trend regarding the use of bibliometric data as a basis for priorities and funding of research and for the promotion of individual scientists favours American-oriented research projects at the expense of those that are based on concepts of predominantly European relevance.

Conclusion: For the future of non-American research, it is important that no single super-power, i.e. the USA, should dominate scientific priorities. The condition for efficient European competition is that European Centres with high levels of competence for creative research and training of scientists from all over the world are established. In addition, it is important that the results of European research are published in prestigious European journals, as was the situation before World War II.  相似文献   

14.
The World Health organisation recommends breast feeding infants for the first six months of life. When this breast feeding does not occur either through parental choice or medical need, infant formulas will be required. There is a bewildering array of formulas on the UK market for many different requirements. When faced with an unsettled infant many parents (and health care professionals) will experiment with the infant formula available and often attend the paediatric clinic looking for help and advice. It is therefore essential that paediatricians understand what milks are available and what the key differences between different products are. This review attempts to provide a simple guide through many of the formulations currently available in the UK; and offers advice for the dietary management of the child with extra calorie requirements, infants with cow's milk protein allergy, gastro oesophageal reflux disease, apparent unresolved hunger and infantile colic. Whatever the underlying condition, there is likely to be an infant formula that is suitable in this generation of ever expanding formulations.  相似文献   

15.
In recent years, measurement of serum osteocalcin has been introduced for assessment of bone turnover in patients treated with exogeneous glucocorticoids. Studies in children with asthma on inhaled glucocorticoids, however, have shown inconsistent results. The aim of the present study is to assess bone turnover in prepubertal children and in adolescents with asthma treated with inhaled budesonide using three different osteocalcin assays: the Pharmacia Osteocalcin CAP FEIA, the CIS OSTK-PR and CIS IRMA ELSA-OSTEO assays. Two studies were conducted: 1) a randomised double blind two-period crossover study of 22 prepubertal children aged 5-12 years. In one period 800 μg budesonide was given once in the morning, in the other 400 μg was given twice daily; 2) a randomised double blind placebo controlled two period crossover study of inhaled budesonide 400 μg twice daily in fourteen 13-16 year old adolescents with pubertal stages II-V. In both studies, treatment periods were of four weeks duration, and blood samples were collected at the last day of each period. In the prepubertal children none of the osteocalcin assays detected any statistically significant differences between any of the periods. In the adolescent group reduced levels of osteocalcin were seen during budesonide treatment. The suppression reached statistical significance with the CAP FEIA (P = 0.03) and the OSTK-PR (P =0.01) assays, but not with the ELSA-OSTEO assay (P = 0.06). Correlation analyses showed statistically significant correlation coefficients varying between 0.58 and 0.91 (P=0.03 and P < 0.0001, respectively). The effect of inhaled glucocorticoids on serum osteocalcin may depend on the assay applied, and inhaled glucocorticoids have differential effects in children and adolescents.  相似文献   

16.
We investigated the intra-acinar pulmonary vascular muscularization in the developing human fetal lung between the 17th and 24th gestational weeks, that is, during the canalicular phase of lung development. Fifteen hypoplastic and 25 normal developed lungs were included in this study using monoclonal alpha -smooth muscle (sm) actin antibodies for smooth muscle detection. Computer-aided image analysis was performed for morphometrical measurements and statistical evaluation. Alphasm-actin-immunoreactive intra-acinar vessels down to a luminal diameter of less than 10 mu m were detected in hypoplastic as well as in normally developed lungs. Crucial differences presented as follows: significantly higher density of intra-acinar vessels, especially due to alpha -sm-actin-negative vessels less than 30 mu m in luminal diameter, in the control group; significantly higher alpha -sm-actin immunoreactivity per section unit as well as per vessel in the hypoplastic lung group. As suggested by others, alpha-sm-actin-positive cells of the intra-acinar vessel wall in the developing human lung were demonstrated to be smooth muscle cells, their immediate precursors, and pericytes. We conclude that the increased alpha -sm-actin immunoreactivity represents muscularization of the vessel wall in functional terms and may be regarded as one structural cause among others for the establishment of persistent fetal circulation in hypoplastic lungs.  相似文献   

17.

Background

The emotional and psychological impact of chronical disease among children is considerable. The aim of this study was to explore the emotional representations of sickle cell children followed up at Bordeaux University Hospital in both qualitative and quantitative ways.

Methods

Prospective observational study, conducted from February to May 2010 among 22 sickle cell children (SS, SC and Sβ) followed at Bordeaux University Hospital and among their parents. A questionnaire evaluating depressive symptoms and emotional representations was proposed to children and to their parents separately, measuring their child's emotions. Children were asked to draw themselves during sickle cell crisis and without any painful episode, in order to illustrate their perception of their disease.

Results

Emotional and psychological impact on sickle cell children was important in this study. Eighty-six percent of children have commonly had negative feelings such as sadness, anger or fear. Thirty-six percent of them had depressive symptoms. Parents largely underestimated this impact. Drawings and answers to the questionnaire emphasized an important lack of disease understanding, social consequences, and depressive affects.

Conclusion

Psychological and emotional difficulties in sickle cell children should be identified and supported. Resources for psychological and educational support are necessary to improve the quality of life of sickle cell patients in France.  相似文献   

18.
Parenteral lipids are susceptible to light-induced peroxidation, particularly under phototherapy. Ascorbic acid is protective. The aim of this study was to investigate whether dark delivery tubing and/or coadministration of multivitamin preparations could prevent peroxidation of Intralipid without undue vitamin loss. In experiments carried out on the benchtop, lipid peroxidation occurred in ambient light and was more extensive under phototherapy. Dark tubing decreased peroxide formation, but only by about 65%. In simulated clinical conditions in which solutions were pumped through standard clear or dark minibore plastic tubing, Intralipid accumulated lipid peroxides as measured by the FOX assay (280 µM) or as triglyceride hydroperoxides (52 µM). Multivitamin preparations (MVIP or completely, and were fully protective when used with dark tubing. There was loss of riboflavin (65% from Soluvit and 35% from MVIP) in clear tubing but this was decreased to 18% and 11%, respectively, in dark tubing. Ascorbate loss was 20% (MVIP) and 50% (Soluvit) and only slightly less in dark tubing. Ascorbate loss was also seen in the absence of Intralipid and is due to riboflavin-induced photo-oxidation.Conclusion: Multivitamin preparations protect Intralipid against light-induced formation of lipid hydroperoxides, and administering multivitamins with Intralipid via dark delivery tubing provides a practical way of preventing peroxidation of the lipid while limiting vitamin loss. This procedure should be considered for routine use as well as with phototherapy. Soluvit/Vitlipid) inhibited peroxide formation almost  相似文献   

19.

Background

The SociaBillyQuizz is a therapeutic game designed for social skills training groups with children and adolescents. Using an entertaining method, this media requests several dimensions: exposure, cognition, communication skills, imagination, emotional expression and sign decoding. In this preliminary study, the setting includes two groups of six adolescents, one with social anxiety disorder and the other with Asperger syndrome.

Objective

To evaluate, in an exploratory study, the effects of a therapeutic device involving this game for these two clinically different groups of adolescents.

Methods

During 26 of 1 hour weekly sessions, two adolescents groups participate to a program including the SociaBillyQuizz and cognitive behavioral therapies. The groups are moderated by two therapists. The SociaBillyQuizz is a board game for two to six players; its goal is to collect points by answering instructions from the different thematic cards. There are four thematic cards: action cards (players have to do something), brainstorming cards (players have to use their imagination and demonstrate cognitive flexibility), interview cards (players have to express themselves about what they think or feel) and mystery cards (unexpected instructions). According to the groups’ clinical characteristics, some aims are specifically highlighted. In the anxiety disorder group, the cognitive dimension is privileged and in the Asperger syndrome group, we emphasise the pretend, cognitive flexibility and theory of mind. The effects are measured by the Rathus Assertiveness Schedule and the Fear Avoidance Hierarchy (FAH) for the social anxiety disorder group and by the Faux Pas Recognition Test and the Social Responsiveness Scale (parent version) for the Asperger group.

Results

These assessment tools indicate, for both groups, a significant increase of the scores corroborating the observed clinical effects. For eleven of the twelve adolescents, a clinical interview 6 months after the retest shows a continuity of therapeutic benefit.

Discussion

These early results suggest that a social skills training device featuring the SociaBillyQuizz produces clinical improvements in these two groups of adolescents. In future researches, with control group and more complete follow-up, nature and effectiveness of its contribution should be specified.

Conclusion

In this preliminary study, the SociaBillyQuizz appears to be an interesting therapeutic tool that can increase implication, motivation, participation and cohesiveness of the group. It also makes easier the cognitive-behavioural-strategies learning.  相似文献   

20.

Aim of this study

In this article we wish to question the effects of incarceration on minors. The history of prison reveals that it is the work of a humanist and philanthropic discourse that ensued from the effects of revolutionary ideas. However, from the moment of its reform – that transformed it from a place of confinement to a penal institution – it has only demonstrated its dysfunctional aspect. Our objective is to initiate a reflection on the effects of incarceration, whether it be collective or individual and in particular when it involves adolescents.

Patients and methods

Applying a clinical method, we are analyzing four specific cases: either within a psychiatric department for people under criminal justice control, or in an adult detention center.

Results

The starting point for the “antisocial” behavior is situated, according to our study, at the time of adolescence. Indeed the presence of violence, aggressiveness, and impulsiveness, in other words the “behavioral disorders”, is a constant in each case that is presented. The heart of this, the unifying theme between the psychopathology and the delinquency/criminality, is a feeling of exclusion: an exclusion already present in childhood/adolescence and that is reactivated, in a second instance, by imprisonment. Similarly, identity and identification – already clearly involved in acting out, crime or criminal offences – undergo a further weakening.

Discussion

Through a historical reminder of the questions surrounding criminality and criminals, we will demonstrate that it is not solely a case of finding the causes, undoubtedly important though they be, but of inventing solutions for and with these subjects who have committed a crime or criminal offence. As is indicated in the results, juvenile detention centers appear to further muddle questions of identity and identification, leading to an unleashing of violence and aggressiveness. Thus an experience of abandonment and of exclusion re-enforces that of belonging. The challenge, as much for psychiatry as for psychoanalysis, is to find solutions that enable these youngsters to overcome their violence rather than actualize it.

Conclusion

The incarceration of minors increases and inscribes an aggressiveness and violence that, at the start, was only a need to belong: to the social being, to society, to the social tie. It is not so much the question of the structure or the type of underlying disorder – behavioral, of the personality or psychiatric – that is in question, but rather the effects of a deprivation of freedom that could lead to decompensation, acting out, repeat offending, and to the crystallizing of violence as a mode of discourse.  相似文献   

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