Malarrive J, Bourgeois M
Ann Med Psychol (Paris). 1976 Jan;1(1):107-19.
The hyperkinetic syndrome, such as it is abundantly described in the literature of American authors, is clearly defined by the association in a young child, essentially at the beginning of schooling, of hyper-activity, psycho-motor instability, affective and learning disorders, emotional lability, immaturity, etc. It would appear that psycho-stimulants (in particular amphetamines) bring about a spectacular improvement in these children, representing a therapeutic test that confirms the diagnosis. In America, insistence is placed on the physiopathogeny of the disorders, and on the minimal cerebral dysfunction. This pathology, which, it would appear, does not seem to have been recognised in France, where the psychomotor instability is only one among many symptoms. We report here a synthetic clinical study of hyperkinetic children observed over a period of several years. They are particular in that they were seen at an early age (between 18 months and 4 years old). The psychopathological study of the early stages (which is usually missing in the literature) makes it possible to objectify a preliminary phase dominated by negative signs, of the "silent series": depressive and regressive tendencies, later hidden by agitation. We underline the importance of the early distorsion of the mother-child link, which appears to be a determining factor in the appearance of the hyperkinetic syndrome. These date (which tend to contradict many studies) lead one to reject the chemotherapy solution, and in particular psychostimulants for the greater majority of cases, and rather to intervene at an early stage, and ideally speaking preventively, to instigate above all a psychotherapy of the child and often of the mother (co-therapy), to restore a good level of communication, and the mother-child link. This in-depth approach should make it possible to avoid a purely symptomatic treatment, with its uncertain effects, and its often undersirable evolution.
多动综合征，正如美国作者的文献中大量描述的那样，在幼儿中，尤其是在入学初期，通过多动、精神运动不稳定、情感和学习障碍、情绪不稳定、不成熟等症状的关联而被明确界定。似乎精神兴奋剂（特别是苯丙胺）能使这些儿童有显著改善，这是一种证实诊断的治疗性测试。在美国，人们强调这些障碍的生理病理发生机制以及最小脑功能障碍。而这种病理情况在法国似乎未被认可，在法国，精神运动不稳定只是众多症状之一。我们在此报告一项对多动儿童进行数年观察的综合性临床研究。这些儿童的特殊之处在于他们年龄较小（18个月至4岁之间）。对早期阶段的心理病理学研究（这在文献中通常缺失）使得能够客观化一个以消极症状为主导的初步阶段，即“沉默系列”：抑郁和退行倾向，随后被躁动所掩盖。我们强调母婴关系早期扭曲的重要性，这似乎是多动综合征出现的一个决定性因素。这些数据（往往与许多研究相矛盾）使人们摒弃化学疗法，尤其是在大多数情况下摒弃精神兴奋剂，而是倾向于在早期进行干预，理想情况下是预防性干预，首先要对儿童，而且通常也要对母亲进行心理治疗（联合治疗），以恢复良好的沟通水平和母婴关系。这种深入的方法应能避免纯粹的对症治疗，其效果不确定且往往会有不良的发展。
