[The hyperkinetic child. Psychopathological aspects (author's transl)]

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.