title: [Taking care of teenagers hospitalized after a suicidal gesture or a suicidal threat].
abstract: Teenagers' suicidal gestures are a major problem of public health and it is important to understand its meaning. A global taking care of teenagers hospitalized after a suicide attempt or a suicidal threat by the pediatric teams and by the team of child psychiatry, having links with each department, is essential in the Necker - Enfants Malades hospital in Paris. The protocole of care has been recently strengthened by the integration of a deep psychological checkup with the projective tests Rorschach and Thematic Apperception Test (TAT) during the hospitalization, a psychological follow-up from a distance of the suicidal gesture and a second psychological checkup one year later in order to observe the evolution of the psychic functioning. The projective tests offer a special way to express the own intimate problematic while respecting the subject's need to remain hidden. These tests, analyzed with a psychodynamic interpretation, help the clinician to precise the psychic diagnosis, which is very important for the future therapeutic orientation, and offer to the patient a medium to express the hidden meaning of his gesture. To consider suicidal gesture not only as a dead end of identificatory process but also as an attempt to start up again this process may favor a therapeutic mobilization of psychic resources. Self-attack may signify a struggle against melancholy, the prospect of death appearing less frightening than those of madness. Suicidal gesture may express a transitory developmental breakdown but identificatory process may be revived if the suffering of the teenager may be listened, contented, elaborated and linked to meaning.
authors.affiliation: Service de pédopsychiatrie, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France. nathkernier@wanadoo.fr
authors.forename: N
authors.initials: N
authors.lastname: de Kernier
authors.forename: P
authors.initials: P
authors.lastname: Canouï
authors.forename: B
authors.initials: B
authors.lastname: Golse
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000359:Aftercare; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005500:Follow-Up Studies; D005602:France; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D010348:Patient Care Team; D011386:Projective Techniques; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy; D012017:Referral and Consultation; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology*