Child and Adolescent Psychiatry & Mind-body Approaches in …pitiesalpetriere.aphp.fr/wp-content/blogs.dir/134/files/2018/01/... · About me [1] • Child and Adolescent Psychiatrist

Child and Adolescent Psychiatry& Mind-body Approachesin Traditional Chinese Medicine : Suggestions over Treatments and PreventionWhat Occidental Psychiatry can learn about Traditional Chinese Medicine ?

Dr Marie Ducloy, Child and Adolescent Psychiatrist

30/11/2017

Acknowlegment

•  Thanks to

•  Pr Baumelou,

•  Dr Bingkai Liu

Child and Adolescent Psychiatry & TCM : Suggestions over Treatments and Prevention, Dr Ducloy, 30/11/2017

About me [1]

•  Child and Adolescent Psychiatrist :

•  in medical office in Paris

•  Attached Practitioner in Sainte-Anne Psychiatric Hospital in Paris : research field/Virtual Medicine

•  DUPRAC (2016-2017), DUMETRAC (2017-2018), La Pitié University

•  Hospital works : Sainte-Anne hospital, Robert Debré hospital

•  Research works : Pasteur Institute

•  Personal practicing in meditation and yoga


On-going work

•  Present work during last year

•  Extract from a manuscript

•  Using Medical Research criteria,

•  Medical Literature systematic Review

•  Not a conclusive study or document, but on-going work


Table of content

•  1. Health and Disease over Occidental Medicine and Traditional Chinese Medicine

•  2. Child development in Child and Adolescent Psychiatry and Traditional Chinese Medicine

•  3. Main Child and Adolescent psychiatric troubles

•  4. Diagnosis over Child and Adolescent Psychiatry and TCM

•  5. Evidence-based Medicine and Mind-body approaches in TCM

•  6. Discussion, Conclusion


1. Health and disease


•  Health [2] :

•  a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

•  But Occidental Medicine defines disease first

•  Hippocratis (460-370 BC) :

•  defines disease instead of health

•  Time considered as linear

1. Health and Disease in Occidental Medicine (OM)


Organ as basic unit, Disease due to organic damage,

but lack of brain knowledge

1. Health and Disease in Traditional Chinese Medicine (TCM)•  ⻩黄帝内经 Huangdi Neijing [3] :

•  during Han dynasty (206 BC-220 AD)

•  Health as natural inner and outer balance [4]

•  道德經 Daodejing [5] : ⽼老老⼦子 Laozi (200 BC)

•  origins of 道 Dao

•  Time considered as circular


氣 Qi as basic element, Diseases due to Qi imbalance

1. Child and Adolescent Psychiatry and TCM


Interest of TCM Mind-body approaches in Child and Adolescent Psychiatry ?

•  Traditional Chinese Medicine :

•  Use of Traditional Pharmacology

•  Use of Mind-Body approaches

•  Child and Adolescent Psychiatry :

•  Recent Occidental Medicine issue (1929-1945) [6]

•  Use of limited Pharmacology

•  Use of Psychological approaches

•  Use of few Mind-Body approaches

2. Child development



•  From in utero to birth :

2. Child development : Embryology

Sensory organs development [7]


2. Child development in Child and Adolescent Psychiatry

Sensorimotor development

[8]

Fine Motor skills

Global Motor skills

Langage



Emotional development : Attachement

theory[9]

Reactions to emotional

needs

Inner emotional security /

Possibility to explore

Inner emotional insecurity / Symptoms



Cognitive development

[10]



Social development

[11]

Social interactions

Non-verbal communication

Verbal communication

Behaviors



Emotional development : Attachement

theory

Cognitive development

Social development

[9]

[10]

[11]

Sensorimotor development

[8]


2. Child 氣 Qi developmentin TCM

Progressive process

3. Main Child and Adolescent psychiatric troubles



•  Autism Spectrum Disorders [12]:

•  Impairement in social communication

•  Restricted and repetitive patterns of behavior, interests

•  during early childhood

•  clinically significant

•  frequently associated with physical and genetic troubles


•  TCM : 五迟 Wu Chi as developmental delay including [13] :

•  ⽴立迟 Li Chi : motor developmental delay,

•  ⾏行行迟 Xing Chi : intellectual delay

•  语迟 Yu Chi : langage delay

•  some Sp like ASD


•  Attention Deficit Hyperactivity Disorder [14]:

•  Impulsivity

•  Attention deficit

•  +/- Hyperactivity

•  frequently associated with somatic and genetic troubles


•  TCM : No equivalent

•  Possible Blader fire

•  Yin-Yang Dysharmony

•  Heart-Kidney defect [15]


•  Disruptive Mood Dysregulation Disorder [16]:

•  Important and durable Sadness or Anger

•  Insomnia

•  Hyperresponsiveness

•  Tachypsychia

•  Before 12 yo


•  TCM : Emotions dysregulation [17] :

•  喜 xi excess : Happiness excess from Heart

•  怒怒 nù : Anger from Liver fire

•  悲 béi : Sadness from Lung

•  Zheng phenotype : depression


•  Anxiety, Body complains [18]:

•  Specific phobia

•  Obsessive Compulsive Disorder

•  Headache, Stomach/Back Pain


•  TCM :

•  恐 kông : Fear from Kidney

4. Diagnosis over Child and Adolescent Psychiatry and TCM


4. Diagnosis over Child and Adolescent Psychiatry and TCM


•  Psychiatric inventory :

•  Interview

•  Examination

•  Maybe neurologic exam

•  Specific tests

•  TCM :

•  神 Shen Observation

•  Pulse

5. Evidence-based Medicine and Mind-body approaches in TCM




•  Using Medical Research approach, Literature review

•  PubMed :

•  "Traditional Chinese Medicine” : 30 533 articles

•  “Traditional Chinese Medicine" AND “Psychiatry" : 203 articles

•  "Traditional Chinese Medicine" AND “Children" : 314 articles

Evolution of article numbers about TCM on PubMed per year



•  Meditation on Child and Adolescent population [19]:

•  Attention regulation

•  Emotional and mood regulation

•  Well-being

•  Depressive Sp,

•  Anxiety, Pain

For schools, patients and parents

How ?



•  Meditation on Child and Adolescent population [20,21,22]:

How ?

Decreased Amygdale activity

Decreased Inner and Medial Brain Structure activity

Decreased Pre-Frontal Cortex activity

Decreased insula and singula activity

Interaction between meditation and pain-related brain activation in MRI session.

General linear modeling analyses detected a significant interaction in SI (z=68) between

meditation and rest in the presence of noxious stimulation. There was a significant activation of the contra lateral SI during heat stimulation while

subjects were not meditating. Meditation significantly reduced activation in SI during noxious

heat stimulation. Slice locations correspond to standard stereotaxic space.





•  Tuina Massage in Child and Adolescent population [23]:

•  Weight increase in Anorexia Nervosa

•  Pain and Body complains

•  Needs to be continuous to be effective



•  Acupuncture [24]:

Biological

effects ?

•  Qi regulation


•  Depression



•  Acupuncture :

Biological

issues ?

MEK1 in hypothalamus and hippocampus

(ERK)-cAMP-(CREB) signalling modification

NO, PGE2, iNOS, COX-2, NF-kB, IL-1, IL-6 in hippocampus and PFC

Primary motor cortex activation

Interhemispheric inhibition

•  Attention regulation

•  Emotional regulation

•  Sleep disorder




•  Taiji Quan in Child and Adolescent population [25]:

•  Qi Gong in Child and Adolescent population [26]:

•  Autistic Sp

•  Self-regulation in ASD

•  Chronic Headache

6. Discussion, Conclusion


6. Discussion, Conclusion

•  TCM and Child and Adolescent Psychiatry : interest in global care

•  Lack of Body-Mind Approaches in Child and Adolescent Psychiatry

•  No use of Mind-body TCM treatments in Child and Adolescent Psychiatry today

•  Complementarity of Mind-Body TCM

•  New prevention and treatment perspectives

•  And if we (OM) can learn about TCM, maybe TCM can also learn from us


The usefulness of a pot comes from its emptiness.Laozi ⽼老老⼦子 , Daodejing 道德經

Thank you for your attention.

Dr Marie [email protected]


Documents

Child and Adolescent Psychiatry & Mind-body Approaches in …pitiesalpetriere.aphp.fr/wp-content/blogs.dir/134/files/2018/01/... · About me [1] • Child and Adolescent Psychiatrist