Payet Maymouna Mourouvaye, Bonfils Nicolas A, Ouss Lisa, Fourcade Lola J, Touati-Pellegrin Marie, Golse Bernard, Cohen Jérémie F, Woestelandt Laure
Child and Adolescent Psychiatry Department, Necker-Enfants Malades Hospital, APHP, Université de Paris, Paris, France.
Université de Paris, Faculty of Medicine, Paris, France.
Front Pediatr. 2022 Jul 22;10:860267. doi: 10.3389/fped.2022.860267. eCollection 2022.
To assess practices of French psychiatrists regarding their management of children and adolescents with suicidal behaviors, focusing on the use of a separation protocol in which the youths are separated from their relatives.
In 2017, we conducted an online cross-sectional survey of French psychiatrists caring for children and adolescents. Participants were asked to describe their practice of a separation protocol in children and adolescents admitted for suicidal behavior. Our main analysis followed a descriptive approach. We also explored whether participant characteristics were associated with the use of a separation protocol.
The response rate was 218/2403 (9,1%); 57.9 % of respondents worked in a University hospital, and 60% of respondents reported routinely hospitalizing children. A separation protocol was set up by 91.1% of survey participants (systematically 39.6%, on a case-by-case basis 51.5%). The mean age from which a separation protocol was indicated was above 11 years; 64% of participants reported a separation period of ≤ 48 h. The most common (87%) criterion cited for establishing a separation period was family relationship difficulties. The most common (80.9%) reason to justify the use of a separation protocol was to allow a better clinical assessment. Exploratory analyses did not identify any participant characteristics associated with the use of a separation protocol ( > 0.2 for all).
The use of a separation protocol in children and adolescents admitted for suicidal behavior is a widespread practice in France, despite the deprivation of liberty it implies. This raises the question of the relevance and usefulness of such a practice.
评估法国精神科医生对有自杀行为的儿童和青少年的管理做法，重点关注使用一种将青少年与亲属分开的分离方案。
2017年，我们对负责照料儿童和青少年的法国精神科医生进行了一项在线横断面调查。参与者被要求描述他们在收治有自杀行为的儿童和青少年时使用分离方案的做法。我们的主要分析采用描述性方法。我们还探讨了参与者的特征是否与分离方案的使用有关。
回复率为218/2403（9.1%）；57.9%的受访者在大学医院工作，60%的受访者报告经常收治儿童。91.1%的调查参与者制定了分离方案（39.6%为系统性制定，51.5%为根据具体情况制定）。建议采用分离方案的平均年龄在11岁以上；64%的参与者报告分离期≤48小时。确定分离期最常见（87%）的标准是家庭关系困难。证明使用分离方案合理的最常见（80.9%）理由是便于进行更好的临床评估。探索性分析未发现任何与分离方案使用相关的参与者特征（所有特征的P>0.2）。
在法国，对有自杀行为的儿童和青少年使用分离方案是一种普遍做法，尽管这意味着剥夺自由。这就引发了这种做法的相关性和实用性的问题。
