Evolutionary Dysharmonie

The evolutionary dysharmonie or atypical disorder of the development indicates an abnormal maturation of certain psychological functions, as well in the intellectual field as emotional. The normal development of other functions differentiates the dysharmonies from a total Retard of development.

They are disorders early, appearing before six years, and multi-factorial.

Historical development

Male Pierre
T. Simon and G. Vermeylen introduce a harmonic and antagonistic debilitated .
Roger Misès formalized the evolutionary dysharmonie such as it appears in the French Classification of the mental disorders of the child and the teenager (CFTMEA).

Presentation

The symptomatology of the evolutionary dysharmonies is variable, and can include for example Angoisse, terrors, ritualism, stereotyped language. A convergence from point of view has been emerging for several years between the French and Anglo-Saxon pédopsychiatrie.

Criteria of diagnosis of the MCDD, the dysharmonies

1. The regulation of the emotional state and the anxiety is faded beyond what is observed in comparable children of ages, and appears by several of the following behaviors: - anxiety or intense and generalized tension; - fears and phobias often unusual or singular - recurring episodes of panic or anxiety submerging the subject; - episodes of disorganization of the behavior punctuated by definitely immature, primitive or violent conduits; - frequent idiosyncrasic or odd reactions of anxiety.

2. Social behavior and relational sensitivity are constantly faded, and appear by various types of disorders: - social disinterest, detachment, avoidance, or return to oneself, in spite of obvious competences; - relationships to the pars strongly faded; - marked disorders of the emotional ties, important degree of ambivalence with respect to the adults; - major limitations of the capacities of empathy or the exact comprehension of the affects of others.

3. Deterioration of the cognitive process (disorder of the thought) appearing by certain following difficulties: - irrationality, intrusions sudden in the normal process of thought, magic thoughts, neologisms or repetition of words stripped of direction, thoughts décousues, ideas odd and of an obvious inconsistancy; - incapacity to distinguish reality and imaginary interior life; - perplexity and confusion (disorders of the comprehension of the social processes or difficulty of keeping its organized thoughts); - illusions, prevalent ideas including/understanding of the phantasms of omnipotence, of the paranoid concerns, hyperinvestissement of imaginary characters, imposing phantasms, exceptional capacities and a referential ideation.

4. The syndrome appears at the time of the first years of the life.

5. The child is neither autistic, nor schizophrenic

Criteria of Diagnosis of the complex and multiple disorders of the development in three principal fields of operation, according to Tordjman S, Ferrari P., Golse B and Al " Dysharmonies psychotiques" and " Multiplexing Developmental Disorder" : history of a convergence. Psychiat Child, XL (2): 473-504.

Dysharmonies functional calculuses

The functional dysharmonies mark defects in the capacities of investment, of the school difficulties, unsuited communication less specific than the autistic relation .

These dysharmonies extends to disorders from the language, Psychomotricité, cognitive functions:

Dyspraxie
dysgnosy
dysphasy, echolalia S
bad orientation in time and space

Depressive component

There is also dysharmonie within the meaning of Personality disorder; the depressive Anguish mark a feeling of insecurity, being able to lead to the development of ritual. There is difficulty of separation (individuation).

Inhibition or Hyperactivity
enuresis, Encoprésie

Differential diagnosis

International classifications (CIM 10, DSM IV) are not recut with French classification (CFTMEA-R).

1. The diagnosis of dysharmonie evolutionary, in the CFTMEA-R can take time. He asks to exclude the possibility:

of hoop nets nevrotic (category 2)
of psychoses (category 1)
of disorders of the instrumental functions (category 6) when they are well individualized and nonrelated to a basic evolutionary disturbance answering the criteria of the evolutionary dysharmonie.

The evolutionary dysharmonie is distinguished from the overdrawn early Psychose and the Dysharmonie psychotic. It is also possible to distinguish the antagonistic deficiencies from slope psychotic and the antagonistic deficiencies of slope nevrotic . On these points of view, classification appears of such a smoothness that it is at the bottom difficult to control it. It is acted in fact of an old debate between a French approach in the clinical search of smoothness and a more pragmatic Anglo-Saxon approach.

2. When one is based on international classifications, the diagnosis inscit in the Invading Disorders of the Development (TED)

The emergence of the concept of Multiple Complex Developpmental Disorders (MCDD) returns account in the Anglo-Saxon literature of a convergence from point of view with the traditional French approach. This emergence questions on the need for clarifying the place of the disorders invasions of the development not specified within the family of the autistic disorders, since the latter are more frequent than the typical autism.

References

Disorder of the infantile development
Neurosis | infantile Psychosis
Personality disorder borderline

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