1
|
Zeghari R, Gindt M, Guivarch J, Auby P, Robert P, Rolling J, Schröder C, Valo P, Askenazy F, Fernandez A. July 14th 2016 Nice Terrorist Attack Court Trial: A Protocol on Sleep Quality and Somatic Symptoms as Markers of Risk for Traumatic Reactivation in Adolescents Exposed to This Attack. Healthcare (Basel) 2023; 11:2953. [PMID: 37998445 PMCID: PMC10671086 DOI: 10.3390/healthcare11222953] [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: 09/17/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
The court trial of the 14th of July 2016 terrorist attack in Nice (France) opened in September 2022 and ended in December 2022. Engaging in court proceedings, whether as a victim or a witness, can lead to a significant risk of traumatic reactivation (i.e., the re-emergence of post-traumatic stress symptoms). The present protocol aimed to improve knowledge of the pathophysiology of traumatic reactivation due to the media coverage of the trial by assessing sleep disturbances and somatic symptoms that could reappear if there is a traumatic reactivation. Method and Analysis: This is a monocentric longitudinal study, with recruitment solely planned at the Nice Pediatric Psychotrauma Center (NPPC). We intended to include 100 adolescents aged 12 to 17 years who were directly or indirectly exposed to the attack and included in the "14-7" program). Assessments began one month before the trial, in August 2022, and were scheduled once a month until the end of the trial. A smartwatch recorded sleep activity. Somatic and PTSD symptoms and sleep were assessed through validated questionnaires. The main analyses comprised the variance and regression analyses of predictors of clinical evolution over time. Ethics and Dissemination: The National Ethics Committee "NORD OUEST III" approved the "14-7" program protocol (number 2017-A02212-51). The specific amendment for this research was approved in April 2022 by the same national ethical committee. Inclusions started in August 2022.
Collapse
Affiliation(s)
- Radia Zeghari
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Morgane Gindt
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Jokthan Guivarch
- Department of Child Psychiatry, APHM, 13009 Marseille, France;
- CANOP Institut de Neurosciences de la Timone, UMR 7289, CNRS, Aix Marseille University, 13005 Marseille, France
- Faculty of Medicine, Aix-Marseille University, 13005 Marseille, France
| | - Philippe Auby
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Philippe Robert
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Julie Rolling
- Regional Center for Psychotraumatism Great East, Strasbourg University Hospital, 67000 Strasbourg, France
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 67000 Strasbourg, France
- CNRS UPR3212-Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, 67000 Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, 67091 Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, 67091 Strasbourg, France
| | - Carmen Schröder
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 67000 Strasbourg, France
- CNRS UPR3212-Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, 67000 Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, 67091 Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, 67091 Strasbourg, France
- Expert Centre for High-Functioning Autism, Fondation FondaMental, 67000 Strasbourg, France
| | - Petri Valo
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Florence Askenazy
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Arnaud Fernandez
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| |
Collapse
|
2
|
Fernandez A, Meurice L, Franke F, Vuillermoz C, Gindt M, Askenazy F, Vandentorren S. Impact of the 7/14/2016 Nice terrorist attack on pediatric emergency department visits thanks to syndromic surveillance: a descriptive study. Front Public Health 2023; 11:1248993. [PMID: 37915811 PMCID: PMC10616791 DOI: 10.3389/fpubh.2023.1248993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023] Open
Abstract
Objective Study the impact of 14th July 2016 Nice terrorist attack on Pediatric Emergency Department (PED) visits by youth under 18 years of age. Methods PED visits diagnoses (ICD10) were clustered and analyzed based on retrospective data from the syndromic surveillance system of the Children's university hospital of Nice (Southern France). The studied period ranges from 2013 to 2019, i.e., 3 years before and after the terrorist attack of 14th July 2016. Results Among 416,191 PED visits, the number of visits for stress in 4-17 years old appeared to increase in the 3 years after the attack compared to the 3 years before, particularly in September 2016 (acute effect) with 11 visits compared to an average of 2.3 visits per month from September 2013 to 2016 (p = 0.001827). In September 2017, we noticed 21 visits compared to an average of 4.8 visits per month during the following period (2013-2019). In 2017, PED visits for stress among 4-17 year olds were higher in comparison to the other years of the study: 107 visits compared to an annual average of 57. Conclusion To our knowledge, this is the first study of the use of the pediatric care system before and after a terrorist attack involving syndromic surveillance. This suggests acute and long-term effects of the terrorist attack on PED use by youth for mental health issues. Further studies of the pediatric care system involving syndromic surveillance are needed in the context of mass violent events, such as terrorist attacks.
Collapse
Affiliation(s)
- Arnaud Fernandez
- University Department of Child and Adolescent Psychiatry, Children’s Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Laure Meurice
- Santé publique France, French National Public Health Agency, Nouvelle-Aquitaine Regional Office, Bordeaux, France
| | - Florian Franke
- Santé Publique France, French National Public Health Agency, Regional Unit (CIRE, Provence-Alpes-Côte d'Azur and Corsica), Marseille, France
| | - Cecile Vuillermoz
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Social Epidemiology Research Team, Paris, France
| | - Morgane Gindt
- University Department of Child and Adolescent Psychiatry, Children’s Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Florence Askenazy
- University Department of Child and Adolescent Psychiatry, Children’s Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Stéphanie Vandentorren
- Université Bordeaux, Inserm, UMR1219, Vintage Team, Bordeaux, France
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| |
Collapse
|
3
|
Richez A, Gindt M, Battista M, Nachon O, Menard ML, Askenazy F, Fernandez A, Thümmler S. Storm Alex: acute stress responses in the pediatric population. Eur J Psychotraumatol 2022; 13:2067297. [PMID: 35599977 PMCID: PMC9116238 DOI: 10.1080/20008198.2022.2067297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION On 2 October 2020, a violent storm (Alex) reached the French Riviera and caused significant damage in three inhabited valleys in the hinterland of the city of Nice. Entire populations were exposed to prolonged stress (no means of communication, electricity nor water) and were particularly at risk of suffering from psychological consequences. We first hypothesized that a majority of children would experience an acute stress reaction. However, we also hypothesized that their clinical expression would differ depending on their developmental age. Thus, we aimed to evaluate, according to the child's level of development, the presence of acute stress symptoms. METHODS Consecutive interviews with the child/adolescent and his/her parents were conducted by child and adolescent psychologists and psychiatrists to assess symptomatology following storm Alex (from day 1 to day 3). Each interview assessed nine classes of symptoms that have been compared according to age-groups. RESULTS 116 children have been evaluated (0.2-17.6 years, mean 9.1). The 0-5-years-old showed more agitation as well as developmental regression than children aged 6-11 (p = .011, p = .045) and 12-18 years (p < .001, p < .001). Anxiety was reported more frequently among the 6-11 years old than the 0-5 years children (p = .018). Overall, the interviewed children presented at least one manifestation of acute stress after the storm (94% for the 0-5 years; 83% for the 6-11 years and 74% for the 12-18 years). DISCUSSION The results highlight the high rate of acute stress symptoms in a natural disaster context, their specificity depending on children's age. Therefore; it emphasizes the need to develop, improve and validate specific assessment tools. Scheduled follow-up evaluations will help to understand, after a natural disaster, the long-term stress response in children, paving the way for targeting early, intensive, specific and multidisciplinary symptomatic treatment approaches.Trial registration: ClinicalTrials.gov identifier: NCT04850924. HIGHLIGHTS Acute stress symptoms in children and adolescents are very frequent in the context of exposure to a natural disaster with specifications depending on the developmental age.
Collapse
Affiliation(s)
- Aurélien Richez
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.,CoBTek, FRIS, Université Côte d'Azur, Nice, France.,Centre Régional de Psychotraumatologie PACA, Nice, France
| | - Morgane Gindt
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.,CoBTek, FRIS, Université Côte d'Azur, Nice, France.,Centre Régional de Psychotraumatologie PACA, Nice, France
| | - Michèle Battista
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.,CoBTek, FRIS, Université Côte d'Azur, Nice, France.,Centre Régional de Psychotraumatologie PACA, Nice, France
| | - Ophélie Nachon
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.,CoBTek, FRIS, Université Côte d'Azur, Nice, France.,Centre Régional de Psychotraumatologie PACA, Nice, France
| | - Marie-Line Menard
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.,CoBTek, FRIS, Université Côte d'Azur, Nice, France.,Centre Régional de Psychotraumatologie PACA, Nice, France
| | - Florence Askenazy
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.,CoBTek, FRIS, Université Côte d'Azur, Nice, France.,Centre Régional de Psychotraumatologie PACA, Nice, France
| | - Arnaud Fernandez
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.,CoBTek, FRIS, Université Côte d'Azur, Nice, France.,Centre Régional de Psychotraumatologie PACA, Nice, France
| | - Susanne Thümmler
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.,CoBTek, FRIS, Université Côte d'Azur, Nice, France
| |
Collapse
|
4
|
Coulon N, Grenon M, Consigny M, Simson JP. PTSD in French Adolescent Victims Following the London Attack in March 2017: Data From the First Step of the AVAL Study. Front Psychiatry 2022; 13:728133. [PMID: 35280156 PMCID: PMC8907535 DOI: 10.3389/fpsyt.2022.728133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The terrorist attack at Westminster Bridge on March 22nd, 2017 impacted on French high school students on a school trip in London. This terrorist attack was claimed by the Islamic State. The aim of the study was to assess the mental health consequences of the attack on the French adolescents who were directly exposed (criteria A for Post-Traumatic Stress Disorder, PTSD). This involved three dimensions, namely: (1) clinical; (2) epidemiological; and (3) prevention and therapeutic. MATERIAL AND METHOD The investigation was the first observational step of AVAL (Adolescents Victimes de l'Attentat de Londres) study, a cohort monitoring project and it was then a monocentric, cross sectional, non interventional survey, at only one-year post-trauma. The study was carried out utilizing self- and clinician-administered questionnaires. Volunteers from the medico-psychological emergency unit provided support for these victims during the study protocol. RESULTS From the target population (n = 53), 39 adolescents (73.6%) agreed to participate, with a median age 16.9 years. 12 months after the attack, 25.6% of teenagers suffered from current PTSD (p < 0.0001). Those with, vs. without, PTSD showed several significant differences: (1) heightened levels of major depressive episodes (p = 0.0266) and suicidality (p = 0.0164); (2) increased substance use, including tobacco (p = 0.0284) and cannabis (p = 0.0449); and (3) impaired functioning in school (p = 0.0203), social (p < 0.0001) and family (p < 0.0001) settings. Sixty four percentage of directly exposed teenagers also had a current psychiatric disorder other than PTSD. DISCUSSION The heightened levels of PTSD, psychiatric disorders, and substance use at 12 months highlight the importance of early intervention in adolescents exposed to terrorist-linked potentially traumatic events.
Collapse
Affiliation(s)
- Nathalie Coulon
- Department of Psychiatry, Brest University Hospital, Brest, France.,Assistance Publique des Hôpitaux de Paris APHP, DHU Pe-PSY, Medical University Department of Psychiatry and Addictology Henri Mondor, Schizophrenia Expert Center, Paris Est Créteil University, Créteil, France
| | - Marion Grenon
- Department of Psychiatry, Brest University Hospital, Brest, France.,Military Hospital, HIA Clermont-Tonnerre, Departement of Psychiatry, Brest, France
| | - Maëlys Consigny
- Brest University Hospital, Delegation for Clinical Research and Innovation, Clinical Investigation Center, INSERM 14 12, Brest, France
| | - J-P Simson
- Military Hospital, HIA Clermont-Tonnerre, Departement of Psychiatry, Brest, France
| |
Collapse
|
5
|
Askenazy F, Fernandez A, Altan L, Battista M, Dückers M, Gindt M, Nachon O, Ivankovic A, Porcar-Becker I, Prieto N, Robert P, Stene LE, Thummler S, Manera V. Remote training as a common tool for the different professionals involved in the acute phase after terror attacks across Europe: Perspectives from an expert panel. Front Psychiatry 2022; 13:915929. [PMID: 36081462 PMCID: PMC9445156 DOI: 10.3389/fpsyt.2022.915929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
The acute response after a terror attack may have a crucial impact on the physical and psychological wellbeing of the victims. Preparedness of the professionals involved in the acute response is a key element to ensure effective interventions, and can be improved through trainings. Today in Europe there is a recognized lack of inter-professional and international trainings, which are important, among others, to respond to the needs and the rights of victims affected by a terrorist attack in another country than their home country. In this paper we report the perspectives of an expert panel composed by different categories of professionals on the possible role of interprofessional trainings provided remotely. The experts discussed the pertinence of remote trainings for professionals involved in the acute response of a terror attack, and highlighted their Strengths, Weaknesses, Opportunities and Threats (SWOT analysis). We concluded that, while remote trainings cannot replace in-person trainings, they may be useful to share knowledge about the role and the organization of the different categories of professionals, thus potentially improving response coordination, and to easily share good practices across professionals and countries.
Collapse
Affiliation(s)
- Florence Askenazy
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | - Arnaud Fernandez
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | | | - Michèle Battista
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | - Michel Dückers
- ARQ Centre of Expertise for the Impact of Disasters and Crises, Diemen, Netherlands.,Nivel-Netherlands Institute for Health Services Research, Utrecht, Netherlands.,Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Morgane Gindt
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | - Ophélie Nachon
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | | | - Ingeborg Porcar-Becker
- Unit for Trauma, Crisis and Conflicts at the Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Nathalie Prieto
- Cellule d'Urgence Médico-Psychologique, Centre Régional du Psychotraumatisme, Hôpital Edouard Herriot, Lyon, France
| | - Philippe Robert
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Susanne Thummler
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | - Valeria Manera
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France
| |
Collapse
|
6
|
Gindt M, Fernandez A, Zeghari R, Ménard ML, Nachon O, Richez A, Auby P, Battista M, Askenazy F. A 3-year retrospective study of 866 children and adolescent outpatients followed in the Nice Pediatric Psychotrauma Center created after the 2016 mass terror attack. Front Psychiatry 2022; 13:1010957. [PMID: 36569628 PMCID: PMC9772007 DOI: 10.3389/fpsyt.2022.1010957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The mass terrorist attack in Nice, France, in July 2016 caused deaths and injuries in a local population, including children and adolescents. The Nice Pediatric Psychotrauma Center (NPPC) was opened to provide mental health care to the pediatric population (0-18 years) who experienced traumatic events. OBJECTIVES This study describes the specificity of the care pathway for young trauma victims, with an explanation of how the NPPC works during the first three years. METHODS In this retrospective study, we conducted quantitative and qualitative data collection about new and follow-up consultations, primary and comorbid diagnoses, and the kind of trauma (terrorist attack versus other kinds of trauma). Ethics approval was obtained from the local Ethics committee. RESULTS 866 children and adolescents were followed in the NPPC. We found a high rate of Post-Traumatic Stress Disorder (PTSD; 71%) in this population with a high rate of comorbidities (67%), mainly sleep disorders (34.7%) and mood and anxiety disorders (16.2%). A high number of children and adolescents impacted by the terrorist attack required follow-up consultations after exposure to the mass terrorist attack, the first care-seeking requests continued to occur three years later, although at a slower rate than in the first and second years. New consultations for other kinds of trauma were observed over time. DISCUSSION This study supports previous findings on the significant impact of mass trauma in the pediatric population showing even a higher level of PTSD and a high rate of comorbidities. This may be explained by the brutality of the traumatic event, particularly for this age group. The findings of this study have implications for early interventions and long-term care for children and adolescents to prevent the development of chronic PTSD into adulthood.
Collapse
Affiliation(s)
- Morgane Gindt
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Arnaud Fernandez
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Radia Zeghari
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Marie-Line Ménard
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Ophelie Nachon
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Aurélien Richez
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Philippe Auby
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France
| | - Michele Battista
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Florence Askenazy
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| |
Collapse
|
7
|
Bouillon-Minois JB, Roux V, Pereira B, Flannery M, Pelissier C, Occelli C, Schmidt J, Navel V, Dutheil F. Stress among Emergency Health Care Workers on Nuclear or Radiation Disaster: A Preliminary State Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168384. [PMID: 34444134 PMCID: PMC8393601 DOI: 10.3390/ijerph18168384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The nuclear or radiation disaster risk within the French Auvergne-Rhone-Alpes state is low (but not absent) due to its proximity to four Nuclear Power Generation Centers and two regional cancer control centers. This study aims to compare subjective stress ratings for emergency health care workers regarding nuclear and radiation disasters between two locations: at work versus at home. MATERIALS AND METHODS We distributed an anonymous online questionnaire via RedCap® to all emergency health care workers who could be involved in patient care after a nuclear or radiation disaster. It comprised 18 questions divided into three parts-theoretical knowledge and practical assessment, stress assessment, and sociodemographic criteria. RESULTS We analyzed 107 responses. There was a significant 11-point increase in stress levels between work and home regarding nuclear or radiation disaster risks (p = 0.01). Less than 25% of emergency health care workers surveyed benefited from annual training. CONCLUSION The stress levels of emergency health care workers regarding nuclear or radiation disaster were higher at work than at home and increased without annual training. It is important to increase knowledge about these protocols and to mandate yearly training for all workers potentially involved in these disasters.
Collapse
Affiliation(s)
- Jean-Baptiste Bouillon-Minois
- Emergency Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
- Correspondence: ; Tel.: +33-6-74-36-04-23; Fax: +33-4-73-27-46-49
| | - Vincent Roux
- CNRS, LaPSCo, Université Clermont Auvergne, Physiological and Psychosocial Stress, 63000 Clermont-Ferrand, France; (V.R.); (F.D.)
| | - Bruno Pereira
- Clinical Research and Innovation Direction, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Mara Flannery
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York University Langone Health, New York, NY 10016, USA;
| | - Carole Pelissier
- Service de Santé au Travail, CHU de Saint-Étienne, Saint-Étienne, France. Univ Lyon 1, Univ St Etienne, 42005 Saint-Étienne, France;
| | - Céline Occelli
- CHU Nice, Emergency Department, Université Côte d’Azur, 06000 Nice, France;
| | - Jeannot Schmidt
- Emergency Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Valentin Navel
- Translational Approach to Epithelial Injury and Repair, Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, INSERM, GReD., 63000 Clermont-Ferrand, France;
- Ophthalmology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Frédéric Dutheil
- CNRS, LaPSCo, Université Clermont Auvergne, Physiological and Psychosocial Stress, 63000 Clermont-Ferrand, France; (V.R.); (F.D.)
- Occupational and Environmental Medicine, CHU Clermont-Ferrand, WittyFit, 63000 Clermont-Ferrand, France
| |
Collapse
|
8
|
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).
Collapse
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
| |
Collapse
|
9
|
Abstract
PURPOSE OF REVIEW This paper reviews recent research on the depression in young people following exposure to catastrophic stresses such as disasters, terrorism and political violence. RECENT FINDINGS Depression is one of the commonest outcomes following mass trauma, for all ages including children and adolescents. Recent articles continue to report high prevalence of depression which often continues for years. It is often comorbid with other psychiatric disorders, especially PTSD. Post-traumatic depression in children and adolescence affects purpose of life, impairs scholastic achievements, increases suicidality and has extensive comorbidity. Besides the trauma, individual constructs, personality factors, social support, exposure to other traumatic events are some of the predicting factors. Biological and genetic basis of post-traumatic depression has been reported. Studies suggest some benefit to psychotherapeutic interventions such as trauma-focussed cognitive behavioural therapy and web-based therapy. A considerable proportion of youths develop depression following mass traumatic events. More research is required regarding the effectiveness of interventions in this population.
Collapse
Affiliation(s)
- Nilamadhab Kar
- Black Country Partnership NHS Foundation Trust, Steps to Health, Showell Circus, Low Hill, Wolverhampton, WV10 9TH, UK.
| |
Collapse
|
10
|
Askenazy F, Gindt M, Chauvelin L, Battista M, Guenolé F, Thümmler S. Early Phase Psychiatric Response for Children and Adolescents After Mass Trauma: Lessons Learned From the Truck-Ramming Attack in Nice on July 14th, 2016. Front Psychiatry 2019; 10:65. [PMID: 30873048 PMCID: PMC6401610 DOI: 10.3389/fpsyt.2019.00065] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 01/28/2019] [Indexed: 12/03/2022] Open
Abstract
Recent years have seen a multiplication of terrorist attacks in public places across European and North American countries, thus heightening the need for public mental health planning and response strategies focused on the special needs of children and their families. The present article retrospectively analyzes the early phase psychiatric response for children and adolescents after the truck attack in Nice on July 14th, 2016. In addition, lessons which can be drawn from it will be discussed, with a focus on organizational challenges in the early phase. During the first 2 weeks after the attack, 668 individuals have been registered at the medico-psychological emergency unit of the Children's Hospitals of Nice, including 365 (54.6%) children and adolescents of all ages. Overall, 146 child and adolescent mental health care professionals participated in this specific facility, including 75 psychiatrists and psychologists. The implementation of the medico-psychological emergency unit dedicated to the pediatric population has been an indispensable and unprecedented public health challenge in our country. Future studies are needed in order to evaluate and to improve the efficiency of the individual as well as collective impact of early phase psychiatric interventions dedicated for children and adolescents after mass trauma.
Collapse
Affiliation(s)
- Florence Askenazy
- University Department of Child and Adolescent Psychiatry, Children's Hospital of Nice CHU-Lenval, Nice, France.,University Côte d'Azur, CoBTek, Nice, France
| | - Morgane Gindt
- University Department of Child and Adolescent Psychiatry, Children's Hospital of Nice CHU-Lenval, Nice, France.,University Côte d'Azur, CoBTek, Nice, France
| | - Lucie Chauvelin
- University Department of Child and Adolescent Psychiatry, Children's Hospital of Nice CHU-Lenval, Nice, France.,University Côte d'Azur, CoBTek, Nice, France
| | - Michèle Battista
- University Department of Child and Adolescent Psychiatry, Children's Hospital of Nice CHU-Lenval, Nice, France
| | - Fabian Guenolé
- University Department of Child and Adolescent Psychiatry, University Hospital of Caen, Caen, France.,INSERM UMR-S 1077, Caen, France
| | - Susanne Thümmler
- University Department of Child and Adolescent Psychiatry, Children's Hospital of Nice CHU-Lenval, Nice, France.,University Côte d'Azur, CoBTek, Nice, France
| |
Collapse
|