Decompensations schizophreniformes a l'adolescence des psychoses infantiles connues et traitees

The most frequent evolution of non autistic infantile psychoses is a stabilization on a defective mode, with, at the symptomatic level, very limited affects, little mentalized phobic and obsessional manifestations, a more or less severe and often disharmonic deficit, making nevertheless a social insertion possible, for example in a working center for disabled people. However, there are cases whose evolution seemed favourable during the first years of care and treatment, with possibilities of acquisition and insertion in structures like Medico-Professional Institutions, but which present during adolescence a major psychotic, schizophrenic-like decompensation. From two clinical examples, we will evoke the gravity of the acute picture (mental automatism inducing severe automatic behaviours which can be initially regarded as an obsessional ritualization), and the collapse of the cognitive capacities. These decompensations call for, apart from long- term hospitalizations, a subsequent complex treating procedure linked to several factors: on the one hand, the difficulty of taking into account the current decompensation in relation to the childhood pathology, and on the other hand, the delicate orientation. These adolescents are too deficient to be able to integrate structures for adolescents such as day hospitals or medico-psychological institutions and too young to be admitted and treated in adult units. In such cases, adolescence seems to entail a severance in the evolution of infantile psychoses where a continuity between childhood and adulthood is usually found.