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Deltour V, Poujol AL, Laurent A. Post-traumatic stress disorder among ICU healthcare professionals before and after the Covid-19 health crisis: a narrative review. Ann Intensive Care 2023; 13:66. [PMID: 37477706 PMCID: PMC10361923 DOI: 10.1186/s13613-023-01145-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The ICU (intensive care unit) involves potentially traumatic work for the professionals who work there. This narrative review seeks to identify the prevalence of post-traumatic stress disorder (PTSD) among ICU professionals; how PTSD has been assessed; the risk factors associated with PTSD; and the psychological support proposed. METHODS Three databases and editorial portals were used to identify full-text articles published in English between 2009 and 2022 using the PRISMA method. RESULTS Among the 914 articles obtained, 19 studies met our inclusion criteria. These were undertaken primarily during the Covid-19 period (n = 12) and focused on nurses and assistant nurses (n = 10); nurses and physicians (n = 8); or physicians only (n = 1). The presence of mild to severe PTSD among professionals ranged from 3.3 to 24% before the pandemic, to 16-73.3% after the pandemic. PTSD in ICU professionals seems specific with particularly intense intrusion symptoms. ICU professionals are confronted risk factors for PTSD: confrontation with death, unpredictability and uncertainty of care, and insecurity related to the crisis COVID-19. The studies show that improved communication, feeling protected and supported within the service, and having sufficient human and material resources seem to protect healthcare professionals from PTSD. However, they also reveal that ICU professionals find it difficult to ask for help. CONCLUSION ICU professionals are particularly at risk of developing PTSD, especially since the Covid-19 health crisis. There seems to be an urgent need to develop prevention and support policies for professionals.
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Affiliation(s)
- Victoire Deltour
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Anne-Laure Poujol
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Alexandra Laurent
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France.
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France.
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Azoulay E, Souppart V, Kentish-Barnes N, Benhamou Y, Joly BS, Zafrani L, Joseph A, Canet E, Presne C, Grall M, Zerbib Y, Provot F, Fadlallah J, Mariotte E, Urbina T, Veyradier A, Coppo P. Post-traumatic stress disorder and quality of life alterations in survivors of immune-mediated thrombotic thrombocytopenic purpura and atypical hemolytic and uremic syndrome. J Crit Care 2023; 76:154283. [PMID: 36931181 DOI: 10.1016/j.jcrc.2023.154283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/20/2023] [Accepted: 02/22/2023] [Indexed: 03/17/2023]
Abstract
Thrombotic thrombocytopenic purpura (iTTP) and atypical hemolytic-uremic syndrome (aHUS), once in remission, may cause long-term symptoms, among which mental-health impairments may be difficult to detect. We conducted telephone interviews 72 [48-84] months after ICU discharge to assess symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) and the 36-item Short Form questionnaire (SF-36). Of 103 included patients, 52 had iTTP and 51 aHUS; 74% were female, median age was 39 y (31-54), and 39 (38%) patients were still taking treatment. Symptoms of anxiety, PTSD and depression were present in 50%, 27% and 14% of patients, respectively, with no significant difference between the iTTP and aHUS groups. Patients with PTSD symptoms had significantly greater weight gain and significantly worse perceived physical and/or emotional wellbeing, anxiety symptoms, and depression symptoms. The SF-36 physical and mental components indicated significantly greater quality-of-life impairments in patients with vs. without PTSD symptoms and in those with aHUS and PTSD vs. iTTP with or without PTSD. In the aHUS group, quality of life was significantly better in patients with vs. without eculizumab treatment. Factors independently associated with PTSD symptoms were male sex (odds ratio [OR], 0.11; 95%CI, 0.02-0.53), platelet count ≤20 G/L at acute-episode presentation (OR, 2.68; 1.01-7.38), and current treatment (OR, 2.69; 95%CI, 1.01-7.36). Mental-health screening should be routine in patients with iTTP and aHUS to ensure appropriate care.
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Affiliation(s)
- Elie Azoulay
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Médecine Intensive et Réanimation, APHP, Hôpital Saint Louis, Paris, France,; Famirea Study Group, APHP, Hôpital Saint Louis, Paris, France.
| | - Virginie Souppart
- Médecine Intensive et Réanimation, APHP, Hôpital Saint Louis, Paris, France,; Famirea Study Group, APHP, Hôpital Saint Louis, Paris, France
| | - Nancy Kentish-Barnes
- Médecine Intensive et Réanimation, APHP, Hôpital Saint Louis, Paris, France,; Famirea Study Group, APHP, Hôpital Saint Louis, Paris, France
| | - Ygal Benhamou
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Département de médecine interne, Hôpital universitaire de Rouen, Université de Normandie, Rouen, France
| | - Bérangère S Joly
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Service d'hématologie biologique, laboratoire ADAMTS13, Hôpital Lariboisière, AP-HP Nord, Université Paris Cité, Paris, France; EA3518, Institut de recherche Saint Louis, Université Paris Cité, Paris, France
| | - Lara Zafrani
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Médecine Intensive et Réanimation, APHP, Hôpital Saint Louis, Paris, France
| | - Adrien Joseph
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Médecine Intensive et Réanimation, APHP, Hôpital Saint Louis, Paris, France
| | - Emmanuel Canet
- Médecine Intensive et Réanimation, CHU de Nantes, France
| | - Claire Presne
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Service de Néphrologie, Médecine Interne, Hémodialyse, Transplantation du CHU d'AMIENS PICARDIE, France
| | - Maximilien Grall
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Département de médecine interne, Hôpital universitaire de Rouen, Université de Normandie, Rouen, France
| | - Yoann Zerbib
- Médecine Intensive et Réanimation, CHU d'Amiens, France
| | - François Provot
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Département de néphrologie, dialyse et transplantation, Université de Lille, CHU de Lille, France
| | - Jehane Fadlallah
- Département d'immunologie clinique, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Eric Mariotte
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Médecine Intensive et Réanimation, APHP, Hôpital Saint Louis, Paris, France
| | - Tomas Urbina
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Médecine Intensive et Réanimation, APHP, Hôpital Saint-Antoine, France
| | - Agnès Veyradier
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Service d'hématologie biologique, laboratoire ADAMTS13, Hôpital Lariboisière, AP-HP Nord, Université Paris Cité, Paris, France; EA3518, Institut de recherche Saint Louis, Université Paris Cité, Paris, France
| | - Paul Coppo
- Centre National de Référence des MicroAngiopathies Thrombotiques, Paris, France; Service d'Hématologie, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM UMRS 1138, Centre de Recherche des Cordeliers, Paris, France
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[Latent posttraumatic stress disorder in psychiatry at the Mohammed VI university hospital in Oujda]. L'ENCEPHALE 2023; 49:50-56. [PMID: 34887079 DOI: 10.1016/j.encep.2021.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/20/2021] [Accepted: 09/30/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Posttraumatic stress disorder (PTSD) is a severe psychiatric disorder following exposure to a traumatic event. It is rarely diagnosed alone. High comorbidity has been observed between PTSD and other psychiatric disorders. OBJECTIVES The purpose of this work is to evaluate the prevalence of latent PTSD in a population followed in a service of psychiatry and to describe the associated factors. MATERIALS AND METHODS It is a descriptive cross-sectional study of 300 patients treated for psychiatric disorders, using a hetero-questionnaire containing sociodemographic data, personal and family history, clinical and therapeutic data, and characteristics of the traumatic event. The MINI was used to screen for PTSD and assess suicidal risk. RESULTS Exposure to a traumatic event is reported by 46.7% of patients, and PTSD by 19.7%. The suicidal risk is 47.7% in the presence of this comorbidity. An ESPT is significantly associated with a schizoaffective disorder and significant suicidal risk. The recentness of the traumatic event, the presence of a state of acute stress and the absence of family psychological support are significantly associated with the occurrence of PTSD. CONCLUSION A significant number of patients with a psychiatric disorder have undiagnosed PTSD, thus explaining their clinical deterioration. Screening and treatment of the underlying PTSD would help to improve their management.
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Alleaume C, Peretti-Watel P, Beck F, Leger D, Vaiva G, Verger P. Incidence of PTSD in the French population a month after the COVID-19 pandemic-related lockdown: evidence from a national longitudinal survey. BMC Public Health 2022; 22:1500. [PMID: 35932014 PMCID: PMC9356417 DOI: 10.1186/s12889-022-13880-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In view of experts' warnings about the potential negative mental health consequences of the sudden nationwide lockdowns implemented in many countries to limit the spread of the COVID-19 pandemic, we sought to study the incidence of posttraumatic stress disorder (PTSD) after traumatic events related to this unprecedented lockdown in the French general population. METHODS This longitudinal study among adults (aged =18) consisted of two surveys: the first during the last days of the lockdown and the second a month later. We estimated PTSD incidence with the PCL-5 and ran multiple Poisson regression models to identify factors associated with PTSD. RESULTS Among the 1736 participants, 30.1% reported at least one traumatic event. PTSD incidence was 17.5% (95% confidence interval CI = 15.7-19.3). It was higher in participants who reported multiple traumatic events, who had high COVID-19-related media use, who had general anxiety disorder (GAD-7) during the lockdown, and who had GAD, depression (PHQ-9), or sleep problems 1 month later. In addition, 43.1% of people with PTSD reported suicidal thoughts. CONCLUSIONS These results should help clinicians to target people who are at high risk of developing PTSD after a pandemic-related lockdown and could benefit from preventive measures. Collaboration between the media and mental health professionals could be envisioned to inform the population about care resources. Follow-up recommendations should also be disseminated to general practitioners to facilitate PTSD screening and ensure that they are aware of the appropriate management.
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Affiliation(s)
- Caroline Alleaume
- Southeastern Health Regional Observatory (ORS Paca), Faculté des Sciences Médicales et Paramédicales, 27 Bd Jean Moulin 13385, CEDEX 5, Marseille, France.
| | - Patrick Peretti-Watel
- Southeastern Health Regional Observatory (ORS Paca), Faculté des Sciences Médicales et Paramédicales, 27 Bd Jean Moulin 13385, CEDEX 5, Marseille, France.,Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - François Beck
- CESP, University Paris Sud, Faculté de médecine UVSQ, Inserm, University Paris-Saclay, Villejuif, France
| | - Damien Leger
- Université de Paris, EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France.,APHP- Hôtel-Dieu, Centre du sommeil et de la Vigilance, Paris, France
| | - Guillaume Vaiva
- U1172 INSERM Lille Neurosciences & Cognitions, Centre National de Ressources & Résilience pour les psychotraumatismes (Lille - Paris), Lille, France
| | - Pierre Verger
- Southeastern Health Regional Observatory (ORS Paca), Faculté des Sciences Médicales et Paramédicales, 27 Bd Jean Moulin 13385, CEDEX 5, Marseille, France
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Paiva J, Melani M, Gonçalves RM, Luz MP, Mendlowicz MV, Figueira I, von Arcosy C, Ventura P, Berger W. Predictors of response to cognitive-behavioral therapy in patients with posttraumatic stress disorder: a systematic review. JORNAL BRASILEIRO DE PSIQUIATRIA 2022. [DOI: 10.1590/0047-2085000000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective Posttraumatic stress disorder (PTSD) is a highly prevalent and disabling disorder. Even when treated with the first-line intervention, cognitive-behavioral therapy (CBT), 45% of the patients continue suffering from this disorder. Therefore, knowing the factors that could foresee who will respond to CBT would be of great value to the treatment of these patients. Thus, we have systematically reviewed the literature to identify the variables that could predict response to CBT in patients suffering from PTSD. Methods Following the PRISMA 2020 guidelines, we searched the electronic databases ISI Web of Science, Scopus, PsycINFO, MEDLINE, and PTSDpubs until November 2021. Two authors have independently conducted study selection and data extraction. Studies that examined possible predictors of response to therapy on a sample of adults (18-65 years), both genders, with and without comorbidities were considered eligible. The characteristics of the studies were synthesized in a table. The risk of bias was assessed by the Cochrane risk of bias quality assessment tool. Results Twenty-eight studies comprising 15 variables were selected. Among those, eight showed a low risk of bias, 19 showed some concerns, and one showed a high potential risk of bias. The therapeutic relationship was the only variable considered to be a predictor of a good response to therapy. All other variables showed conflicting results. Conclusions The most promising variable, although scientifically weak, is the therapeutic relationship. Additional randomized clinical trials should be conducted to clarify the role of this variable as a predictor of response to CBT in patients with PTSD.
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Bentz L, Vandentorren S, Fabre R, Bride J, Pirard P, Doulet N, Baubet T, Motreff Y, Pradier C. Mental health impact among hospital staff in the aftermath of the Nice 2016 terror attack: the ECHOS de Nice study. BMC Public Health 2021; 21:1372. [PMID: 34246247 PMCID: PMC8272451 DOI: 10.1186/s12889-021-11438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The Nice terror attack of July 14, 2016 resulted in 84 deaths and 434 injured, with many hospital staff exposed to the attack, either as bystanders on site at the time of the attack ('bystander exposure') who may or may not have provided care to attack victims subsequently, or as care providers to victims only ('professional exposure only'). The objective of this study is to describe the impact on mental health among hospital staff by category of exposure with a particular focus on those with 'professional exposure only', and to assess their use of psychological support resources. METHOD An observational, cross-sectional, multicenter study conducted from 06/20/2017 to 10/31/2017 among all staff of two healthcare institutions in Nice, using a web questionnaire. Collected data included social, demographic and professional characteristics; trauma exposure category ('bystanders to the attack'; 'professional exposure only'; 'unexposed'); indicators of psychological impact (Hospital Anxiety and Depression Scale); PTSD (PCL-5) level; support sought. Responders could enter open comments in each section of the questionnaire, which were processed by inductive analysis. RESULTS 804 staff members' questionnaires were analysed. Among responding staff, 488 were exposed (61%): 203 were 'bystanders to the attack', 285 had 'professional exposure only'. The staff with 'professional exposure only' reported anxiety (13.2%), depression (4.6%), suicidal thoughts (5.5%); rates of full PTSD was 9.4% and of partial PTSD, 17.7%. Multivariate analysis in the 'professional exposure only' category showed that the following characteristics were associated with full or partial PTSD: female gender (OR = 2.79; 95% CI = 1.19-6.56, p = 0.019); social isolation (OR = 3.80; 95% CI = 1.30-11.16, p = 0.015); having been confronted with an unfamiliar task (OR = 3.04; 95% CI = 1.18-7.85; p = 0.022). Lastly, 70.6% of the staff with 'professional exposure only' with full PTSD did not seek psychological support. CONCLUSION Despite a significant impact on mental health, few staff with 'professional exposure only' sought psychological support. Robust prevention and follow-up programs must be developed for hospital staff, in order to manage the health hazards they face when exposed to exceptional health-related events such as mass terror attacks. STUDY REGISTRATION Ethical approval for the trial was obtained from the National Ethics Committee for Human Research (RCBID N° 2017-A00812-51).
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Affiliation(s)
- Laurence Bentz
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
| | - Stéphanie Vandentorren
- Santé publique France, French national public health agency, Direction scientifique et internationale, F-94415 Saint-Maurice, France
- Université Bordeaux, INSERM UMR 1219, Vintage team, F-33000 Bordeaux, France
| | - Roxane Fabre
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
- Côte d’Azur University, CoBTeK lab, Nice University Hospital, CMRR, Nice, France
| | - Jeremy Bride
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
- Côte d’Azur University, Nice University Hospital, Policlinique, Medical and psychological emergency unit (CUMP 06), Nice, France
- Paris 13 Sorbonne University - Paris Cité, Laboratoire UTRPP (EA 4403), Villetaneuse, France
| | - Philippe Pirard
- Santé publique France, French national public health agency, Non-Communicable Diseases and Trauma Division, F-94415 Saint-Maurice, France
- Team MOODS, CESP, Inserm 1178, Paris-Saclay University, UVSQ, Villejuif, France
| | - Nadège Doulet
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
| | - Thierry Baubet
- Centre National de Ressources et de Résilience (CN2R), Lille/Paris, France
- UTRPP ER 4403, Sorbonne Paris Nord University, Villetaneuse, France
- Assistance Publique - Hôpitaux de Paris, Avicenne Hospital, Child and adolescent psychopathology, psychiatry and addiction, Bobigny, France
| | - Yvon Motreff
- Santé publique France, French national public health agency, Non-Communicable Diseases and Trauma Division, F-94415 Saint-Maurice, France
- Sorbonne Université, Inserm, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F-75012 Paris, France
| | - Christian Pradier
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
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Py-Leroy É, Calteau M, Brulin L, Thomas G. [A day for families of military patients with post-traumatic stress disorder]. Soins Psychiatr 2021; 42:38-42. [PMID: 34266549 DOI: 10.1016/j.spsy.2021.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The treatment of post-traumatic stress disorder is one of the priorities of the armed forces' health service, but there are few measures for families, who are nevertheless the first to be affected. At the Robert-Picqué army training hospital in Bordeaux, an information and exchange day for carers was set up in 2018. It takes place once every term. Here is a look at how it works, its benefits and its limitations.
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Affiliation(s)
- Élodie Py-Leroy
- Service de psychiatrie, hôpital d'instruction des armées Robert-Picqué, 351 route de Toulouse, 33140 Villenave-d'Ornon, France.
| | - Mareva Calteau
- Service de psychiatrie, hôpital d'instruction des armées Robert-Picqué, 351 route de Toulouse, 33140 Villenave-d'Ornon, France
| | - Laurent Brulin
- Service de psychiatrie, hôpital d'instruction des armées Robert-Picqué, 351 route de Toulouse, 33140 Villenave-d'Ornon, France
| | - Gilles Thomas
- Service de psychiatrie, hôpital d'instruction des armées Robert-Picqué, 351 route de Toulouse, 33140 Villenave-d'Ornon, France
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Prevalence of and factors associated with post-traumatic stress disorder among French university students 1 month after the COVID-19 lockdown. Transl Psychiatry 2021; 11:327. [PMID: 34045442 PMCID: PMC8157529 DOI: 10.1038/s41398-021-01438-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 01/05/2023] Open
Abstract
The COVID-19 pandemic and quarantine measures have sparked debate regarding their traumatic nature. This cross-sectional study reports the prevalence rate of probable post-traumatic stress syndrome (PTSD) and associated factors among French university students. A total of 22,883 students completed the online questionnaire. The prevalence rate of probable PTSD, assessed using the PTSD Checklist for DSM-5, was 19.5% [19.0-20.0]. Female (1.32 [1.21-1.45]) or non-binary gender (1.76 [1.35-2.31]), exposure to a non-COVID-19-related traumatic event (3.37 [3.08-3.67]), having lived through quarantine alone (1.22 [1.09-1.37]), poor quality of social ties (2.38 [2.15-2.62]), loss of income (1.20 [1.09-1.31]), poor quality housing (1.90 [1.59-2.26]), low-quality of the information received (1.50 [1.35-1.66]) and a high level of exposure to COVID-19 (from 1.38 [1.24-1.54] to 10.82 [2.33-76.57] depending on the score) were associated with PTSD. Quarantine was considered potentially traumatic by 78.8% of the students with probable PTSD. These findings suggest the pandemic context and lockdown measures could have post-traumatic consequences, stimulating debate on the nosography of PTSD.
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Trouble de stress post-traumatique en milieu pénitentiaire. Encephale 2020; 46:493-499. [DOI: 10.1016/j.encep.2020.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 11/17/2022]
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Prise en charge du psychotraumatisme en médecine générale : état des lieux dans le Pas-de-Calais et élaboration d’un temps de formation destiné aux professionnels. ANNALES MEDICO-PSYCHOLOGIQUES 2020. [DOI: 10.1016/j.amp.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Traumatismes psychiques, trouble de stress posttraumatique et syndrome coronarien aigu : une synthèse des données de la littérature. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2020. [DOI: 10.1016/j.ejtd.2019.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Al Joboory S, Soulan X, Lavandier A, Bouchard JP. [Psychological traumas in adults (1/2)]. REVUE DE L'INFIRMIERE 2020; 69:41-43. [PMID: 32532443 DOI: 10.1016/j.revinf.2020.02.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
When subjected to potentially traumatic events, adults can develop psychological trauma with varying levels of severity. For preventive and therapeutic purposes, these psychological traumas must be assessed and managed by psychologists and/or psychiatrists who are well trained and experienced in performing these complex professional acts.
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Affiliation(s)
- Samantha Al Joboory
- Centre d'accueil spécialisé dans le repérage et le traitement des traumatismes psychiques (Caspertt), centre hospitalier de Cadillac, 31, rue des Cavaillès, 33310 Lormont, France; Institut psycho-judiciaire et de psychopathologie (IPJP), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France
| | - Xavier Soulan
- Centre d'accueil spécialisé dans le repérage et le traitement des traumatismes psychiques (Caspertt), centre hospitalier de Cadillac, 31, rue des Cavaillès, 33310 Lormont, France; Institut psycho-judiciaire et de psychopathologie (IPJP), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France; Cellule d'urgence médico-psychologique (CUMP) de Bordeaux, centre hospitalier Charles-Perrens, 121, rue de la Béchade, CS 81285, 33 076 Bordeaux cedex, France
| | - Alix Lavandier
- Centre d'accueil spécialisé dans le repérage et le traitement des traumatismes psychiques (Caspertt), centre hospitalier de Cadillac, 31, rue des Cavaillès, 33310 Lormont, France; Institut psycho-judiciaire et de psychopathologie (IPJP), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France
| | - Jean-Pierre Bouchard
- Institut psycho-judiciaire et de psychopathologie (IPJP), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France; Unité pour malades difficiles (UMD), pôle de psychiatrie médico-légale (PPML), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France.
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Fraysse C, Gignoux-Froment F, Juzan N, Cazes N, Poinso F, Paul F. Mesure de la prévalence du trouble de stress post-traumatique chez les marins-pompiers de Marseille. ANNALES FRANCAISES DE MEDECINE D URGENCE 2020. [DOI: 10.3166/afmu-2020-0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectif : En France, peu d’études ont exploré la prévalence du trouble de stress post-traumatique (TSPT) chez les pompiers. Une étude de 2007 retrouve un taux de 1 %, identique à celui de la population générale. Or, les pompiers sont surexposés aux interventions potentiellement traumatogènes et sont donc à risque de traumatismes vicariants, c’est-à-dire par procuration. L’objectif de notre étude était d’estimer la prévalence du TSPT chez les marins-pompiers du bataillon de marins-pompiers de Marseille.
Matériel et méthodes : Durant six mois, les marins-pompiers se présentant à leur visite médicale périodique au service médical d’unité ont rempli un autoquestionnaire comprenant des données sociodémographiques, professionnelles et la Posttraumatic Stress Disorder Checklist Scale (PCLS) avec un seuil à 44.
Résultats : Parmi les 356 sauveteurs inclus, soit un taux de réponse de 86 %, 4 % (IC 95 % : [2 ; 7]) avaient un TSPT. Les facteurs associés étaient une fatigue durable, des répercussions négatives sur la vie familiale, professionnelle, sociale et le ressenti d’un manque de soutien institutionnel.
Conclusion : Ces résultats confirment que les sauveteurs constituent une population à risque. Afin de comparer avec les études internationales, de nouvelles recherches avec la PCL-5 seraient souhaitables.
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Al Joboory S, Soulan X, Lavandier A, Saint Jammes JT, Dieu E, Sorel O, Bouchard JP. Psychotraumatologie : prendre en charge les traumatismes psychiques. ANNALES MEDICO-PSYCHOLOGIQUES 2019. [DOI: 10.1016/j.amp.2019.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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15
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Guillen A, Curot J, Birmes PJ, Denuelle M, Garès V, Taib S, Valton L, Yrondi A. Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures. Front Psychiatry 2019; 10:303. [PMID: 31130885 PMCID: PMC6509224 DOI: 10.3389/fpsyt.2019.00303] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/17/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Patients with psychogenic nonepileptic seizures (PNESs) have often been exposed to traumatic events, which is a risk factor for suicidal behavior. This would suggest that the severity of suicidal ideation is greater in PNES than in patients suffering only from epileptic seizures (ESs). However, these psychiatric symptoms may be underestimated in the ES population. The specific features or similarities between the psychiatric clinical profiles of these two groups should be elaborated to improve therapeutic management. Our study is the first to compare suicidal ideation, suicide risk, posttraumatic stress disorder (PTSD), and depression disorder simultaneously in both groups, in a tertiary care epilepsy center. Material and methods: We prospectively enrolled patients hospitalized for video-electroencephalography (EEG) monitoring to assess repeated seizures before an ES or a PNES diagnosis was made. During the psychiatric consultation that accompanied the video EEG, we rated the severity of suicidal ideation and depressive symptoms, suicidal risk, traumatic exposure history, and PTSD symptoms. Results: Eighteen subjects were enrolled and diagnosed with PNES, and 42, with ES. The PNES group reported more exposures to traumatic events and more intense PTSD symptoms (median: 17 vs. 27; p = 0.001). The severity of suicidal ideation did not differ significantly between the two groups. Conclusion: It is the severity of PTSD symptoms in PNES patients that differentiates them from ES patients, although exposure to traumatic events is also frequent in ES patients. We demonstrated that suicidal ideation and suicide risk are equally high in the ES and PNES groups. Therefore, both groups require extreme vigilance in terms of suicidal risk.
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Affiliation(s)
- Abel Guillen
- Explorations Neurophysiologiques (Neurophysiological Investigations), Hôpital Pierre Paul Riquet, CHU Purpan (Toulouse University Hospital), Toulouse, France
| | - Jonathan Curot
- Explorations Neurophysiologiques (Neurophysiological Investigations), Hôpital Pierre Paul Riquet, CHU Purpan (Toulouse University Hospital), Toulouse, France
- Centre de Recherche Cerveau et Cognition (Brain and Cognition Research Centre), University of Toulouse, Toulouse, France
- Centre National de la Recherche Scientifique CerCo (CerCo National Scientific Research Centre), Toulouse, France
| | - Philippe Jean Birmes
- Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Marie Denuelle
- Explorations Neurophysiologiques (Neurophysiological Investigations), Hôpital Pierre Paul Riquet, CHU Purpan (Toulouse University Hospital), Toulouse, France
| | - Valérie Garès
- University of Rennes, INSA, CNRS, IRMAR-UMR 6625, Rennes, France
| | - Simon Taib
- Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France
- Service de Psychiatrie et Psychologie Médicale (Department of Psychiatry and Medical Psychology), CHU de Toulouse (Toulouse University Hospital), Toulouse, France
| | - Luc Valton
- Explorations Neurophysiologiques (Neurophysiological Investigations), Hôpital Pierre Paul Riquet, CHU Purpan (Toulouse University Hospital), Toulouse, France
- Centre de Recherche Cerveau et Cognition (Brain and Cognition Research Centre), University of Toulouse, Toulouse, France
- Centre National de la Recherche Scientifique CerCo (CerCo National Scientific Research Centre), Toulouse, France
| | - Antoine Yrondi
- Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France
- Service de Psychiatrie et Psychologie Médicale (Department of Psychiatry and Medical Psychology), CHU de Toulouse (Toulouse University Hospital), Toulouse, France
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Underner M, Goutaudier N, Peiffer G, Perriot J, Harika-Germaneau G, Jaafari N. [Influence of post-traumatic stress disorder on asthma]. Presse Med 2019; 48:488-502. [PMID: 31005500 DOI: 10.1016/j.lpm.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/04/2019] [Accepted: 03/05/2019] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Exposure to a traumatic event may not only lead to a large variety of mental disorders, such as post-traumatic stress disorder (PTSD) but also respiratory symptoms and/or respiratory diseases, as asthma. OBJECTIVES Systematic literature review of data on the impact of post-traumatic stress disorder on asthma. DOCUMENTARY SOURCES Medline, on the period 1980-2018 with the following keywords: "PTSD" or "post-traumatic stress disorder" or "post-traumatic stress disorder" and "asthma", limits "title/abstract"; the selected languages were English or French. Among 141 articles, 23 abstracts have given use to a dual reading to select 14 studies. RESULTS While PTSD may develop 4 weeks after being exposed to a traumatic event during which the physical integrity of the person has been threatened, it might also develop several months or years later. PTSD has been reported to be a risk factor for asthma and also a factor that might enhance a preexisting asthma. It is also important to note that this relation has been highlighted among several populations, traumatic events and regardless the gender and/or cultural factors. Despite its impact on the development of asthma, in asthmatic patients, PTSD may be responsible for poor asthma control, increased rates of healthcare use (visit in the emergency department and/or hospitalization for asthma) and poor asthma-related quality of life. The study of the association between PTSD and asthma have to take into account some potentially confounding factors, such as smoking status and dust exposure (e.g.: asthma following the terrorist attacks of the World Trade Center). Less is known regarding the potential mechanisms involved in the association between PTSD and asthma. Several factors including the nervous system, the hypothalamo-pituitary-adrenal axis, the inflammatory response and the immune system may explain the association. CONCLUSION PTSD is a risk factor for the development of asthma and for the worsening of preexisting asthma. In asthmatic patients, it is of primary importance to systematically screen potential PTSD that might be developed after a traumatic event or a preexisting traumatic condition. Moreover, after exposure to a traumatic event, a special attention needs to be paid to somatic reactions such as asthma. The majority of studies having been conducted on American samples, replicating studies among European samples appears of prime importance in order to add a body of knowledge on the association between somatic and psychiatric conditions.
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Affiliation(s)
- Michel Underner
- Université de Poitiers, centre hospitalier Henri-Laborit, unité de recherche clinique, 86021 Poitiers, France.
| | - Nelly Goutaudier
- Université de Poitiers, centre de recherches sur la cognition et l'apprentissage, UMR CNRS 7295 MSHS, 86073 Poitiers cedex 9, France
| | - Gérard Peiffer
- CHR Metz-Thionville, service de pneumologie, 57038 Metz, France
| | - Jean Perriot
- Centre de tabacologie, dispensaire Émile-Roux, 63100 Clermont-Ferrand, France
| | - Ghina Harika-Germaneau
- Université de Poitiers, centre hospitalier Henri-Laborit, unité de recherche clinique, 86021 Poitiers, France
| | - Nematollah Jaafari
- Université de Poitiers, centre hospitalier Henri-Laborit, unité de recherche clinique, 86021 Poitiers, France
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Pignon B, Amad A, Pelissolo A, Fovet T, Thomas P, Vaiva G, Roelandt JL, Benradia I, Rolland B, Geoffroy PA. Increased prevalence of anxiety disorders in third-generation migrants in comparison to natives and to first-generation migrants. J Psychiatr Res 2018; 102:38-43. [PMID: 29597072 DOI: 10.1016/j.jpsychires.2018.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 02/26/2018] [Accepted: 03/19/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION We sought to examine the prevalence of anxiety disorders associated with migration in the first-, second- and third-generation. METHODS The French Mental Health in the General Population cross-sectional survey interviewed 38,694 individuals using the MINI. The prevalence of lifetime anxiety disorders, and comorbidities was compared between migrants and non-migrants and by generation. All analyses were adjusted for age, sex, and income and education levels. RESULTS In comparison to natives, pooled anxiety disorders were more common among migrants (25.3% vs. 20.7%, OR = 1.24) and among the three studied generations of migrants. Moreover, the prevalence rate of the pooled anxiety disorders was significantly higher in third-generation migrants, in comparison to first-generation (26.7% vs. 22.6%, OR = 1.14). Prevalence rates were higher in migrants for panic disorder (6.6% vs. 5.3%, OR = 1.20), general anxiety disorder (15.0% vs. 12.0%, OR = 1.24), posttraumatic stress disorder (1.0% vs. 0.6%, OR = 1.51), but not for social anxiety disorder. In comparison to natives, migrants with anxiety disorders had higher prevalence rates of suicide attempts (14.0% vs. 12.8% for natives), psychotic disorders (8.3% vs. 5.7%), unipolar depressive disorder (29.5% vs. 25.4%), bipolar disorder (5.0% vs. 4.0%), and addictive disorders (9.6% vs. 6.2% for alcohol use disorder, 8.2% vs. 4.1% for substance use disorders). CONCLUSION Migration was associated with a higher prevalence of all anxiety disorders, in the first, second and third generation, and associated with more psychiatric comorbidities. Moreover, the prevalence increased across generations, and was significantly higher among third-generation migrants, in comparison to first-generation.
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Affiliation(s)
- Baptiste Pignon
- AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Inserm, U955, Team 15, UPEC, Université Paris-Est, Faculté de médecine, Créteil, 94000, France; Fondation FondaMental, Créteil, 94000, France.
| | - Ali Amad
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, CHU Lille, Pôle de Psychiatrie, Unité CURE, F-59000, Lille, France; Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, F-59000, Lille, France
| | - Antoine Pelissolo
- AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Inserm, U955, Team 15, UPEC, Université Paris-Est, Faculté de médecine, Créteil, 94000, France; Fondation FondaMental, Créteil, 94000, France
| | - Thomas Fovet
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, CHU Lille, Pôle de Psychiatrie, Unité CURE, F-59000, Lille, France
| | - Pierre Thomas
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, CHU Lille, Pôle de Psychiatrie, Unité CURE, F-59000, Lille, France
| | - Guillaume Vaiva
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, CHU Lille, Pôle de Psychiatrie, Unité CURE, F-59000, Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Equipe Eceve Inserm UMR 1123, Lille, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Equipe Eceve Inserm UMR 1123, Lille, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie, Pôle UP-MOPHA, CH Le Vinatier, Univ. Lyon, 69500, Bron, France; CRNL Inserm U1028/CNRS UMR5292, CH Le Vinatier, 69678, Bron Cedex, France
| | - Pierre A Geoffroy
- Inserm, U1144, Paris, F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, F-75013, France; AP-HP, GH Saint-Louis, Lariboisière, F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475, Paris Cedex 10, France; Fondation FondaMental, Créteil, 94000, France
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de Fouchier C, Kedia M. Trauma-related mental health problems and effectiveness of a stress management group in national humanitarian workers in the Central African Republic. INTERVENTION 2018. [DOI: 10.4103/intv.intv_9_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Ladois-Do Pilar Rei A, Chraïbi S. [Patients assaulted in psychiatric institutions: Literature review and clinical implications]. Rev Epidemiol Sante Publique 2017; 66:53-62. [PMID: 29223515 DOI: 10.1016/j.respe.2017.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/30/2017] [Accepted: 10/20/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The psychiatric ward is a place where all forms of violence are treated. Occasionally, this violence involves acts of aggression between patients in emergency psychiatric units or hospital wards. Such events can lead to the development or worsening of posttraumatic stress disorder. METHODS To establish the context, we first examined the epidemiology data concerning posttraumatic stress disorder in psychiatric patients who were frequently exposed to assaults. Secondly, we examined the issue of sexual and physical assaults between patients receiving treatment in a psychiatric ward. In this context, we studied possible occurrence of posttraumatic stress disorder associated with exposure to assaults of this kind. RESULTS In certain cases, potentially traumatic exposure to violence was unknown to the medical staff or not taken into consideration. This would induce a risk of later development of posttraumatic stress disorder that would not be treated during the stay in psychiatry. CONCLUSION To date, few scientific studies have focused on the proportion of patients assaulted by other patients during treatment in a psychiatric ward and the subsequent development of peritraumatic reactions and/or posttraumatic stress disorder associated with these assaults. We know that an insufficient number of public and private health institutions report the existence of such facts to the competent authorities. Also, a minority of clinicians and caregivers are trained in screening and management of trauma victims. Yet, these issues are particularly relevant in the scope of public health and health promotion.
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Affiliation(s)
- A Ladois-Do Pilar Rei
- Centre hospitalier de Lannemezan, CMP Théophile-Gautier, 1, rue Théophile-Gautier, 65000 Tarbes, France.
| | - S Chraïbi
- Laboratoire cliniques pathologique et interculturelle (LCPI), université Toulouse Jean-Jaurès, 5, allées Antonio-Machado, 31058 Toulouse, France
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Guardia D, Salleron J, Roelandt JL, Vaiva G. [Prevalence of psychiatric and substance use disorders among three generations of migrants: Results from French population cohort]. Encephale 2016; 43:435-443. [PMID: 27644920 DOI: 10.1016/j.encep.2016.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Mental health of migrant populations has become a major public health issue since these populations more often suffer from mental health problems than host populations. The influence of the migration process on the emergence of these disorders and its impact on future generations is uncertain. This study provides an estimate of the prevalence of mental disorders among three generations of migration. METHOD The study was conducted in the general population by the French Collaborating Center of the World Health Organization, in France, on a sample of 37,063 people aged 18 and older. The subjects interviewed were selected by a quota sampling method and, thus, were representative of the general population in the 47 study sites in France. This method develops a sample of subjects with the same characteristics as the general population on predefined issues, such as age, sex, educational level and socioprofessional category. The designation of migrant status was based on the country of birth of the subject, the subject's parents and the subject's grandparents. We defined a migrant as first generation (a subject born abroad; n=1911), second generation (at least one parent born abroad; n=4147), or third generation (at least one grandparent born abroad; n=3763) of migrants. The diagnostic tool used was the Mini International Neuropsychiatric Interview (MINI). The MINI is a brief structured diagnostic interview developed by psychiatrists for ICD-10 and DSM-IVTR psychiatric disorders in the general population. The comparisons by generation of migrants were performed by chi-square test for qualitative variables and by an analysis of variance for quantitative variables. The same tests were used to compare the presence of mental disorders according to the characteristics of the population. Factors with a P-value less than 0.2 were entered in a multivariable logistic regression to assess the relationship between the generation of migrants and the presence of mental disorders, adjusting for the confounding factors. RESULTS Thirty-eight per cent of migrant subjects have psychological difficulties, versus 30 % in the host population. These results are observed on three successive generations of migrants. Migration status increases risk of depressive disorders (OR=1.555), bipolar disorder (OR=1.597, CI=1.146-2.227), post-traumatic stress disorder (OR=1.615), substance abuse (OR=2.522) and alcohol abuse (OR=1.524), and drug dependence (OR=2.116). This risk is maintained at the second and third generation. The migration process affects mental health of population regardless of socioeconomic status or geographic origin. CONCLUSION The consideration of migration and generation of migration shows a specific psychopathological risk profile. This is related to the joint action of a migratory past and precarious socioeconomic situation.
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Affiliation(s)
- D Guardia
- Service de psychiatrie de l'adolescent, clinique Lautréamont, 1, rue de Londres, 59120 Loos, France.
| | | | - J-L Roelandt
- Centre collaborateur OMS, EPSM Lille métropole, 59260 Hellemmes, France
| | - G Vaiva
- CHU de Lille, 59037 Lille cedex, France
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Arnal R, Ayhan G, Pinganaud É, Basurko C, Jehel L. Le trouble de stress post-traumatique parmi les détenus en centre pénitentiaire en Guyane française. SANTE MENTALE AU QUEBEC 2016. [DOI: 10.7202/1036974ar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Soumis à des mouvements de population importants, la Guyane française et son centre pénitentiaire abritent une population métissée chez qui l’histoire récente a laissé une empreinte forte (tremblement de terre en Haïti, guerre civile au Suriname, violence liée à l’orpaillage et au trafic de stupéfiants). Ces événements de vie négatifs apparaissent comme autant de vecteurs potentiels de psychotraumatismes. Dans ces conditions, il nous a paru essentiel de mettre l’accent sur le repérage du trouble de stress post-traumatique (TSPT) dans cette population sensible. À l’aide d’entretiens d’accueil dédiés, nous nous sommes proposé de repérer les TSPT, de décrire sur un plan sociodémographique la population étudiée et de rechercher les comorbidités psychiatriques. Le résultat principal de cette étude était une prévalence du TSPT de 17 % chez les arrivants en détention. Le MINI 5.0 a montré une prévalence plus élevée des pathologies psychiatriques dans le groupe présentant un TSPT avec un lien très fort (p < 0,005) pour l’épisode dépressif majeur actuel, l’épisode maniaque ou hypomaniaque actuel et le risque suicidaire. Cette étude appuie la nécessité d’avoir un dépistage systématique du TSPT chez les arrivants en détention. Cette pathologie est à la fois fréquente dans cette population et invalidante, mais ce sont ses comorbidités, dont le potentiel suicidaire, qui font tout l’enjeu d’un repérage précoce.
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Affiliation(s)
- Romain Arnal
- Interne en psychiatrie, CHU de Martinique, service de psychiatrie et psychologie médicale et addictologie
| | - Gülen Ayhan
- Interne en santé publique, Centre d’investigation clinique CIC 1424 INSERM/DGOS, Centre hospitalier de Cayenne, Cayenne, France
| | - Éric Pinganaud
- Infirmier de secteur psychiatrique, UFPI, Centre hospitalier de Cayenne, Cayenne, France
| | - Célia Basurko
- M.D. (santé publique), Centre d’investigation clinique CIC 1424 INSERM/DGOS, Centre hospitalier de Cayenne, Cayenne, France
| | - Louis Jehel
- M.D. (psychiatrie), Ph. D., Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France – CHU de Martinique, service de psychiatrie et psychologie médicale et addictologie – Université des Antilles
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22
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Vierling V, Etori S, Valenti L, Lesage M, Pigeyre M, Dodin V, Cottencin O, Guardia D. Prévalence et impact de l’état de stress post-traumatique chez les patients atteints de troubles du comportement alimentaire. Presse Med 2015; 44:e341-52. [DOI: 10.1016/j.lpm.2015.04.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 02/23/2015] [Accepted: 04/01/2015] [Indexed: 11/29/2022] Open
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État de stress post-traumatique et consommation de soins sur l’année écoulée : étude menée auprès de 340 militaires français de cinq unités combattantes de l’armée de terre. Encephale 2015; 41:444-53. [DOI: 10.1016/j.encep.2015.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 08/05/2014] [Indexed: 11/20/2022]
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Messiah A, Acuna JM, Castro G, de la Vega PR, Vaiva G, Shultz J, Neria Y, De La Rosa M. Mental health impact of the 2010 Haiti earthquake on the Miami Haitian population: A random-sample survey. DISASTER HEALTH 2015; 2:130-137. [PMID: 26753105 DOI: 10.1080/21665044.2015.1014216] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study examined the mental health consequences of the January 2010 Haiti earthquake on Haitians living in Miami-Dade County, Florida, 2-3 years following the event. A random-sample household survey was conducted from October 2011 through December 2012 in Miami-Dade County, Florida. Haitian participants (N = 421) were assessed for their earthquake exposure and its impact on family, friends, and household finances; and for symptoms of posttraumatic stress disorder (PTSD), anxiety, and major depression; using standardized screening measures and thresholds. Exposure was considered as "direct" if the interviewee was in Haiti during the earthquake. Exposure was classified as "indirect" if the interviewee was not in Haiti during the earthquake but (1) family members or close friends were victims of the earthquake, and/or (2) family members were hosted in the respondent's household, and/or (3) assets or jobs were lost because of the earthquake. Interviewees who did not qualify for either direct or indirect exposure were designated as "lower" exposure. Eight percent of respondents qualified for direct exposure, and 63% qualified for indirect exposure. Among those with direct exposure, 19% exceeded threshold for PTSD, 36% for anxiety, and 45% for depression. Corresponding percentages were 9%, 22% and 24% for respondents with indirect exposure, and 6%, 14%, and 10% for those with lower exposure. A majority of Miami Haitians were directly or indirectly exposed to the earthquake. Mental health distress among them remains considerable two to three years post-earthquake.
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Affiliation(s)
- Antoine Messiah
- INSERM Research Unit U-1178 "Mental Health and Public Health"; Suicide and Psychotrauma in Overseas Territories team; Villejuif, France
| | - Juan M Acuna
- Department of Medical and Health Sciences Research; Herbert Wertheim College of Medicine; Florida International University; Miami, FL USA
| | - Grettel Castro
- Department of Medical and Health Sciences Research; Herbert Wertheim College of Medicine; Florida International University; Miami, FL USA
| | - Pura Rodríguez de la Vega
- Department of Medical and Health Sciences Research; Herbert Wertheim College of Medicine; Florida International University; Miami, FL USA
| | - Guillaume Vaiva
- INSERM Research Unit U-1178 "Mental Health and Public Health"; Suicide and Psychotrauma in Overseas Territories team; Villejuif, France; CNRS PSYCHIC Team; CHRU Lille et Universités de Lille; Lille, France
| | - James Shultz
- Center for Disaster & Extreme Event Preparedness (DEEP Center); University of Miami Miller School of Medicine; Miami, FL USA
| | - Yuval Neria
- Department of Psychiatry; The New York State Psychiatric Institute; New York, NY USA
| | - Mario De La Rosa
- Robert Stempel College of Public Health and Social Work; Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD); Florida International University; Miami, FL USA
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Goodfellow B, Calandreau F, Roelandt JL. Psychiatric Epidemiology in New Caledonia. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2014. [DOI: 10.2753/imh0020-7411390104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Benjamin Goodfellow
- a Georges Pompidou European Public Hospital Emergency Department, French WHO Collaborating Center (WHOCC), Paris
| | - Fanny Calandreau
- b General Psychiatry Department, Albert Bousquet Hospital, Nouméa, New Caledonia
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Mazur VML, Chahraoui K, Bissler L. [Psychopathology of asylum seekers in Europe, trauma and defensive functioning]. Encephale 2014; 41:221-8. [PMID: 24661581 DOI: 10.1016/j.encep.2013.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 11/26/2013] [Indexed: 10/25/2022]
Abstract
Refugees seeking asylum are a particularly vulnerable population. It has been observed that among the most commonly-occurring disorders exhibited in this population, there is a high incidence of post-traumatic stress disorder, generalized anxiety disorder, and depression. These disorders may be linked to the difficult paths that refugees are forced to undertake, as well as to different traumatic events which are particularly destructive psychologically (deliberate physical, sexual and/or psychological violence, traumatic bereavements in the context of war, or social and political instability, socio-economic, familial or administrative difficulties), which compromise their view of their short-term futures. In the face of the weight of these life events, the question of the psychological resources of the individual is at the forefront of our understanding of mental health and the capacity to adjust to trauma. Our study aims to apprehend in a dynamic way, the different strategies used by asylum seekers in our western countries to adjust psychologically to traumatic and stressful events. The aim of this research is to study the links between mental health and anxious and depressive psychopathologies as well as the defensive modalities of these subjects. One hundred and twenty adult asylum seekers, living in refugee centres in Slovakia, France and Norway have agreed to participate in this study. We tried to assess the psychopathological disorders manifesting in these populations, notably PTSD, major depression and generalized anxiety disorder. Using the DSQ-60 we also tried to establish the links between the psychopathologies observed in this population and the defence mechanisms employed. Our results reveal that 60% of subjects do indeed suffer from psychopathological disorders with an important comorbidity of PTSB and depression (64.2%). Furthermore, the seriousness of the symptoms is correlated with less adaptive defence mechanisms (a higher incidence of defence mechanisms such as acting-out and distorted self-image). The recourse to mechanisms such as affiliation, repression and idealization is found to be used less by the study's target group. Rather, they tend to resort to defence mechanisms such as projection, low self-esteem, withdrawal, acting-out and hypochondria. Our results highlight the importance of the affiliation mechanism, which holds the potential to facilitate adaptation and resilience in these vulnerable subjects. It could also be offered as part of a therapeutic care proposal.
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Affiliation(s)
- V M-L Mazur
- Laboratoire de psychologie médicale et de psychopathologie, pôle AAFE, université de Bourgogne, Esplanade Erasme, 21000 Dijon, France
| | - K Chahraoui
- Laboratoire de psychologie médicale et de psychopathologie, pôle AAFE, université de Bourgogne, Esplanade Erasme, 21000 Dijon, France.
| | - L Bissler
- Laboratoire de psychologie médicale et de psychopathologie, pôle AAFE, université de Bourgogne, Esplanade Erasme, 21000 Dijon, France
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Bordron A, Massoubre C, Lang F, Grosselin A, Billard S. Évaluation de la santé psychique d’un échantillon de pompiers ligériens : étude transversale descriptive. ARCH MAL PROF ENVIRO 2013. [DOI: 10.1016/j.admp.2013.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Berna G, Vaiva G, Ducrocq F, Duhem S, Nandrino JL. Categorical and dimensional study of the predictive factors of the development of a psychotrauma in victims of car accidents. J Anxiety Disord 2012; 26:239-45. [PMID: 22177942 DOI: 10.1016/j.janxdis.2011.11.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 08/22/2011] [Accepted: 11/20/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to evaluate the predictive factors of the emergence of complete PTSD and subsyndromal PTSD (defined as individuals exposed to a traumatic event with at least one psychopathological impact, such as hyperarousal, avoidance or persistent re-experiencing) following a motor vehicle accident (MVA). METHODS We recruited 155 adult MVA patients, physically injured and admitted to trauma service, over two years. In the week following the accident, patients were asked to complete questionnaires assessing their social situation (sex, age, marital and employment status, prior MVA or trauma), comorbidity (MINI), distress (PDI) and dissociation (PDEQ) experienced during and immediately after the trauma. An evaluation using the CAPS was conducted six months after the trauma to assess a possible PTSD. RESULTS At six months, 25.8% of the participants developed subsyndromal symptoms and 7.74% developed complete PTSD. The three symptoms that best discriminated the groups were dysphoric emotion, perceived life threat and dissociation. Logistic regression results showed that the strongest predictor of PTSD was the perceived life threat. In addition, a dimensional approach to the results revealed significant correlations between (1) peritraumatic distress and persistent re-experiencing or hyperarousal and (2) dissociation score and avoidance strategy. The presence of a prior traumatic event reinforces avoidance strategies. CONCLUSIONS Our results stress that peritraumatic factors (especially the perception of a life threat) are good predictors of PTSD development. A dimensional perspective allows better identification of psychological complications following an MVA.
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Affiliation(s)
- G Berna
- Univ Lille Nord de France, F-59000 Lille, France
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Bernardy-Prud'homme A, Braillon A, Noël H, Chaine FX, Bruyelle J, Loas G, Dubois G. [Assessment of targeted clinical audit in suicide attempt]. Encephale 2011; 37 Suppl 1:S27-35. [PMID: 21600330 DOI: 10.1016/j.encep.2010.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Accepted: 04/02/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Suicide attempt is a serious condition that is frequent in France. Picardie ranks fifth in France for suicide (418 deaths in 2005 for 1,890,000 inhabitants). Suicide attempt is one of the priorities of the regional public health program. The National Agency for Accreditation and Evaluation in Health (Anaes) has designed targeted clinical audits (TCA) on various conditions to promote this method as the basic tool for quality improvement. AIM We investigated the contribution of TCA for improving the quality of care of suicide attempt within a regional framework in Picardie. METHODS TCA were conducted in 12 state hospitals (eight Surgical Medicine and Obstetrics, three specialized in psychiatry, one local) between 2004 and 2006. The standards from the Anaes had 16 criteria in three fields: care on admission (n=10); assessment of family and social environment (n=2); management for after hospital care (n=4). A project manager and a MD certified in health care quality supported the medical (MD certified in acute care and in psychiatry) and nursing staff of the emergency wards. All the wards analyzed 30 patients' files for the first cycle, set up and implemented improvement actions and then performed the second cycle of data collection. RESULTS All wards fully satisfied the protocol with 30 patients' files per cycle and two cycles. In all wards the teams consisted of physicians (both certified for emergency or psychiatry) and others care providers (nurses, psychologists, social workers, secretary). For the first cycle, three criteria (patient assessment, somatic examination and coordination) met the 100% target for more than half of the wards while three criteria (sociofamily and environmental evaluation, management for after hospital care, monitoring of follow-up) did not conform by more than 50% in more than half of the wards. All wards implemented changes after the first cycle with a total of 29 interventions, each one specifically devoted to improving a particular criterion. Intervention included better coordination and communication, protocol design and reminders, and information tools. The second cycle showed modest and mixed changes. After the interventions only one criteria reached the 100% target in one ward; the degree of conformity decreased in nine cases (with a mean of -23%) and increased in 16 cases (+19%). Globally, three criteria improved by less than 10% while three slightly decreased. DISCUSSION G. Shaw introduced clinical audits in 1989 to boost a poorly performing system within the "clinical governance" framework, a condition quite different from the French healthcare system in 2005. Therefore, the validation of clinical audit in a different context appeared necessary. Anaes has not yet published the evaluation of this method in a peer reviewed journal. Observed changes are modest and mixed. Moreover, the true impact on care delivery appears limited and one cannot rule out that the observed improvements are in fact related to an improvement in traceability or due to Hawthorne's effect. Quality improvement methods must be evaluated and validated by scientific methods such as for new treatments with clinical research. CONCLUSION The feasibility of the method was excellent, due to the methodological and technical support, however the method did not significantly improve the quality of care.
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