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Pirard P, Motreff Y, Stene LE, Rabet G, Vuillermoz C, Vandentorren S, Baubet T, Messiah A. Initiation of multiple-session psychological care in civilians exposed to the November 2015 Paris terrorist attacks. Arch Public Health 2023; 81:207. [PMID: 38031202 PMCID: PMC10685664 DOI: 10.1186/s13690-023-01206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Terrorist attacks can induce post-traumatic stress disorder (PTSD) and depression, which require multiple-session psychological care (MSPC). This study aims at investigating MSPC initiation and associated factors. METHODS Data were collected from a web-based survey of civilians 8-12 months after their exposure to the November 2015 Paris terrorist attacks. Depression and partial and full PTSD were assessed using the Hospital Anxiety and Depression Scale and the PCL-5 checklist, respectively. Questionnaires collected data on socio-demographic variables, exposure to the attacks, psychological treatment history, social isolation, somatic problems, having received an outreach psychological support (OPS), consultations with a general practitioner, contact with an association for victims, MSPC initiation and, if not, reasons for not having initiated it. Logistic regressions were used to examine factors associated with MSPC initiation. RESULTS Among the 450 respondents, 154 reported having initiated a MSPC after the attacks. Of the 134 who provided the MSPC initiation date, 50% did so during the first month. Among the respondents with at least one of the considered psychological disorders, 53% declared not having initiated yet a MSPC. The primary three reasons for not having initiated a MSPC among people with PTSD were "did not feel the need", "it was not the right time to talk about it", and "not offered". For people with at least one psychological disorder, MSPC initiation was associated with the number of somatic problems, type of exposure (witness, threatened, indirectly exposed), prior psychological treatment, being a woman, being in a relationship, having consulted a psychiatrist or a psychologist, having received an OPS, and being in contact with association for victims. CONCLUSION The organization of adequate psychological care after a terror attack must take into account the need for healthcare that may emerge several months after the attack, and that witnesses seem less likely to receive MSPC than persons directly threatened despite their psychological disorder. Associations for victims and OPS seem to facilitate access to MSPC. Furthermore, our findings highlight the need to train physicians to screen for psychological disorders in persons exposed to terrorist attacks who present with somatic disorders.
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Affiliation(s)
- Philippe Pirard
- Santé Publique France, French National Public Health Agency, Saint-Maurice, F-94415, France.
- Team MOODS, Inserm-CESP, Université Paris-Saclay, UVSQ, 94807, Villejuif, France.
| | - Yvon Motreff
- Santé Publique France, French National Public Health Agency, Saint-Maurice, F-94415, France
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, F75012, France
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Gabrielle Rabet
- Santé Publique France, French National Public Health Agency, Saint-Maurice, F-94415, France
| | - Cécile Vuillermoz
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, F75012, France
| | - Stéphanie Vandentorren
- Santé Publique France, French National Public Health Agency, Saint-Maurice, F-94415, France
- UMR 1219, Bordeaux Population Health Research Center, PHARes Team, University of Bordeaux, Bordeaux, France
| | - Thierry Baubet
- Université Sorbonne Paris Nord, UTRPP EA 4403, Villetaneuse, France
- AP-HP, Hôpital Avicenne, Bobigny, France
- Resources and Resilience National Centre (CN2R), LilleParis, France
| | - Antoine Messiah
- Team MOODS, Inserm-CESP, Université Paris-Saclay, UVSQ, 94807, Villejuif, France
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Fossi LD, Debien C, Demarty AL, Vaiva G, Messiah A. Loss to follow-up in a population-wide brief contact intervention to prevent suicide attempts - The VigilanS program, France. PLoS One 2022; 17:e0263379. [PMID: 35231052 PMCID: PMC8887722 DOI: 10.1371/journal.pone.0263379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 01/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and sending postcards, according to a predefined algorithm. However, a major obstacle to such real-life intervention is the loss of contact during follow-up. Here, we analyze the occurrence of loss of follow-up (LFU) and compare characteristics of patients LFU with follow-up completers. Methods The study concerned patients included in VigilanS over the period from 1st January 2015 to 31 December 2018, with an end of follow-up on 1st July 2019. We performed a series of descriptive analysis and logistic regressions. The outcome was the loss to follow-up, relative to the 6th month call marking the end of the follow-up; the predictive variables were the characteristics of the patient at entry and during follow-up. Age and sex were considered as adjustment variables. Results 11879 inclusions occurred during the study period, corresponding to 10666 different patients. The mean age was 40.6 ± 15 years. More than a third were non-first suicide attempters (46.6%) and the most frequent means of suicide was by voluntary drug intoxication (83.2%). 8335 patients were LFU. After simple and multiple regression, a significant relationship with loss to follow-up was identified among non-first suicide attempters, alcohol consumers, patients having no companion on arrival at the emergency room, patients who didn’t make or receive any calls. An increased stay in hospital after a SA was a protective factor against loss of follow-up. Conclusion A majority of patients were lost to follow-up by the expected surveillance time of 6 months. Characteristics of lost patients will help focusing efforts to improve retention in the VigilanS program and might give insights for BCI implemented elsewhere.
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Affiliation(s)
- Larissa Djembi Fossi
- INSERM, MOODS Research unit “Depression, Anxiety, Psychotraumatism and Suicide”, Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
- INSERM, Sorbonne University, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Social Epidemiology Team, Paris, France
- * E-mail:
| | - Christophe Debien
- Department of Psychiatry, University Hospital of Lille, Lille, France
- Univ. Lille, Inserm, CHU Lille, U1172—LilNCog (JPARC)—Lille Neurosciences & Cognition, Lille, France
- Centre National de Ressources et Résilience Pour Les Psychotraumas (Cn2r Lille Paris), Department of Psychiatry, University Hospital of Lille, Lille, France
| | | | - Guillaume Vaiva
- Department of Psychiatry, University Hospital of Lille, Lille, France
- Univ. Lille, Inserm, CHU Lille, U1172—LilNCog (JPARC)—Lille Neurosciences & Cognition, Lille, France
- Centre National de Ressources et Résilience Pour Les Psychotraumas (Cn2r Lille Paris), Department of Psychiatry, University Hospital of Lille, Lille, France
| | - Antoine Messiah
- INSERM, MOODS Research unit “Depression, Anxiety, Psychotraumatism and Suicide”, Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
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Djembi Fossi L, Debien C, Demarty AL, Vaiva G, Messiah A. SUICIDE REATTEMPT IN A POPULATION-WIDE BRIEF CONTACT INTERVENTION TO PREVENT SUICIDE ATTEMPTS - THE VIGILANS PROGRAM, FRANCE. Eur Psychiatry 2021; 64:e57. [PMID: 34266505 PMCID: PMC8516749 DOI: 10.1192/j.eurpsy.2021.2221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Among the postcrisis suicide prevention programmes, brief contact interventions (BCIs) have been proven to be efficient. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls, and sending postcards, according to a predefined algorithm. However, a major problem in suicide prevention is the suicide reattempt, which can lead to final suicide. Here, we analyze the suicide reattempt in VigilanS. Methods The study concerned patients included in VigilanS over the period from January 1, 2015 to December 31, 2018, with an end of follow-up on July 1, 2019. We performed a series of descriptive analyses, survival curves, and regressions. The outcome was the suicide reattempt, and the predictive variables were the characteristics of the patient at entry and during follow-up in VigilanS. Age and sex were considered as adjustment variables. Results A total of 11,879 inclusions occurred during the study period, corresponding to 10,666 different patients, among which 905 reattempted suicide. More than half were primary suicide attempters (53.4%). A significant relationship with suicide reattempt was identified for the following characteristics: being a non-primary suicide attempter, having attempted suicide by voluntary drug intoxication and phlebotomy, alcohol consumption among primary suicide attempters, and having no companion at the emergency room visit among non-primary suicide attempters. Hanging (as suicide method), having made no call to VigilanS were protective factors. Conclusion This study provides us with a valuable insight into the profiles of patients repeating a suicide attempts, which is important for suicide prevention in general.
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Affiliation(s)
- Larissa Djembi Fossi
- INSERM, MOODS Research unit "Depression, Anxiety, Psychotraumatism and Suicide", Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France.,INSERM, Sorbonne University, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Team, Paris, France
| | - Christophe Debien
- Department of Psychiatry, University Hospital of Lille.,Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences & Cognition, F-59000Lille, France.,Centre National de Ressources et Résilience pour les psychotraumas (Cn2r Lille Paris), Lille, France Department of Psychiatry, University Hospital of Lille
| | | | - Guillaume Vaiva
- Department of Psychiatry, University Hospital of Lille.,Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences & Cognition, F-59000Lille, France.,Centre National de Ressources et Résilience pour les psychotraumas (Cn2r Lille Paris), Lille, France Department of Psychiatry, University Hospital of Lille
| | - Antoine Messiah
- INSERM, MOODS Research unit "Depression, Anxiety, Psychotraumatism and Suicide", Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
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Pirard P, Baubet T, Motreff Y, Rabet G, Marillier M, Vandentorren S, Vuillermoz C, Stene LE, Messiah A. Use of mental health supports by civilians exposed to the November 2015 terrorist attacks in Paris. BMC Health Serv Res 2020; 20:959. [PMID: 33076901 PMCID: PMC7574168 DOI: 10.1186/s12913-020-05785-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
Background The use of mental health supports by populations exposed to terrorist attacks is rarely studied despite their need for psychotrauma care. This article focuses on civilians exposed to the November 2015 terrorist attacks in Paris and describes the different combinations of mental health supports (MHSu) used in the following year according to type of exposure and type of mental health disorder (MHD). Methods Santé publique France conducted a web-based survey of civilians 8–11 months after their exposure to the November 2015 terrorist attacks in Paris. All 454 respondents met criterion A of the DSM-5 definition of post-traumatic stress disorder (PTSD). MHD (anxiety, depression, PTSD) were assessed using the PCL-5 checklist and the Hospital Anxiety and Depression Scale. MHSu provided were grouped under outreach psychological support, visits for psychological difficulties to a victims’ or victim support association, consultation with a general practitioner (GP), consultation with a psychiatrist or psychologist (specialist), and initiation of regular mental health treatment (RMHT). Chi-squared tests highlighted differences in MHSu use according to type of exposure (directly threatened, witnessed, indirectly exposed) and MHD. Phi coefficients and joint tabulations were employed to analyse combinations of MHSu use. Results Two-thirds of respondents used MHSu in the months following the attacks. Visits to a specialist and RMHT were more frequent than visits to a GP (respectively, 39, 33, 17%). These were the three MHSu most frequently used among people with PTSD (46,46,23%), with depression (52,39,20%), or with both (56,58, 33%). Witnesses with PTSD were more likely not to have RMHT than those directly threatened (respectively, 65,35%). Outreach support (35%) and visiting an association (16%) were both associated with RMHT (Phi = 0.20 and 0.38, respectively). Very few (1%) respondents initiated RMHT directly. Those who indirectly initiated it (32%) had taken one or more intermediate steps. Visiting a specialist, not a GP, was the most frequent of these steps. Conclusion Our results highlight possibilities for greater coordination of mental health care after exposure to terrorist attacks including involving GP for screening and referral, and associations to promote targeted RMHT. They also indicate that greater efforts should be made to follow witnesses.
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Affiliation(s)
- Philippe Pirard
- Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France. .,Team MOODS, CESP, Inserm, Université Paris-Saclay, UVSQ, 94807, Villejuif, France.
| | - Thierry Baubet
- CESP, Inserm, Université Sorbonne Paris Nord, Villetaneuse, France.,APHP, Hôpital Avicenne, Bobigny, France.,Centre National de Ressources et de Résilience (CN2R), Lille/Paris, France
| | - Yvon Motreff
- Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France.,Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012, Paris, France
| | - Gabrielle Rabet
- Support, Data Treatment and Analysis Division, Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Maude Marillier
- Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France
| | - Stéphanie Vandentorren
- Scientific and International Division, Santé Publique France (The French Public Health Agency), Saint-Maurice, France.,INSERM, Bordeaux Population Health Research Center, UMR 1219, Univ Bordeaux, F-33000, Bordeaux, France
| | - Cécile Vuillermoz
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012, Paris, France
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Antoine Messiah
- Team MOODS, CESP, Inserm, Université Paris-Saclay, UVSQ, 94807, Villejuif, France
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Fossi Djembi L, Vaiva G, Debien C, Duhem S, Demarty AL, Koudou YA, Messiah A. Changes in the number of suicide re-attempts in a French region since the inception of VigilanS, a regionwide program combining brief contact interventions (BCI). BMC Psychiatry 2020; 20:26. [PMID: 31992251 PMCID: PMC6986096 DOI: 10.1186/s12888-020-2443-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/13/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. They are easier to generalize to an entire population than other forms of intervention. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and mailings, according to a predefined algorithm. It was implemented gradually in the Nord-Pas-de-Calais (NPC), France, between 2015 and 2018. Here, we evaluate the effectiveness of VigilanS, in terms of SA reduction, using annual data collected by participating centers. Hypothesis tested: the higher the VigilanS implementation in a center (measured by penetrance), the greater the decrease in the number of SA observed in this center. METHODS The study period was from 2014 to 2018, across all of NPC centers. We performed a series of linear regressions, each center representing a statistical unit. The outcome was the change in the number of SA, relative to the initial number, and the predictive variable was VigilanS' penetrance: number of patients included in VigilanS over the total number of SA. Search for influential points (points beyond threshold values of 3 influence criteria) and weighted least squares estimations were performed. RESULTS Twenty-one centers were running VigilanS in 2018, with an average penetrance of 32%. A significant relationship was identified, showing a sharp decrease in SA as a function of penetrance (slope = - 1.13; p = 3*10- 5). The model suggested that a 25% of penetrance would yield a SA decrease of 41%. CONCLUSION VigilanS has the potential to reduce SA. Subgroup analyzes are needed to further evaluate its effectiveness. Subgroup analyses remain to be done, in order to evaluate the specific variations of SA by group.
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Affiliation(s)
- Larissa Fossi Djembi
- INSERM Research unit U-1178 "Mental Health and Public Health", Centre de recherche en Epidémiologie et santé des populations (CESP), INSERM, Université Paris-Sud, Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France.
| | - Guillaume Vaiva
- 0000 0001 0206 8146grid.413133.7INSERM Research unit U-1178 “Mental Health and Public Health”, Centre de recherche en Epidémiologie et santé des populations (CESP), INSERM, Université Paris-Sud, Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France ,0000 0001 2242 6780grid.503422.2SCALab Laboratory, CNRS, UMR 9193, Université de Lille, Lille, France ,0000 0004 0471 8845grid.410463.4Department of Adult Psychiatry, Hôpital Fontan, CHRU de Lille, Lille, France
| | - Christophe Debien
- 0000 0001 2242 6780grid.503422.2SCALab Laboratory, CNRS, UMR 9193, Université de Lille, Lille, France ,0000 0004 0471 8845grid.410463.4Department of Adult Psychiatry, Hôpital Fontan, CHRU de Lille, Lille, France
| | - Stéphane Duhem
- 0000 0004 0471 8845grid.410463.4Department of Adult Psychiatry, Hôpital Fontan, CHRU de Lille, Lille, France ,0000 0001 2242 6780grid.503422.2INSERM, Clinical Investigation Center (CIC) 1403, CHRU de Lille, Université de Lille, Lille, France
| | - Anne-Laure Demarty
- 0000 0004 0471 8845grid.410463.4Department of Adult Psychiatry, Hôpital Fontan, CHRU de Lille, Lille, France ,0000 0001 2242 6780grid.503422.2INSERM, Clinical Investigation Center (CIC) 1403, CHRU de Lille, Université de Lille, Lille, France
| | - Yves-Akoli Koudou
- 0000 0001 0206 8146grid.413133.7UMRS 1018 Centre de recherche en Epidémiologie et santé des populations (CESP) “Epidemiology of Cancer, Genes and Environment”, Hôpital Paul-Brousse, Villejuif, France
| | - Antoine Messiah
- 0000 0001 0206 8146grid.413133.7INSERM Research unit U-1178 “Mental Health and Public Health”, Centre de recherche en Epidémiologie et santé des populations (CESP), INSERM, Université Paris-Sud, Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
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Messiah A, Notredame CE, Demarty AL, Duhem S, Vaiva G. Combining green cards, telephone calls and postcards into an intervention algorithm to reduce suicide reattempt (AlgoS): P-hoc analyses of an inconclusive randomized controlled trial. PLoS One 2019; 14:e0210778. [PMID: 30707710 PMCID: PMC6358079 DOI: 10.1371/journal.pone.0210778] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 01/01/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Brief contact interventions (BCIs) might be reliable suicide prevention strategies. BCI efficacy trials, however, gave equivocal results. AlgoS trial is a composite BCI that yielded inconclusive results when analyzed with Intention-To-Treat strategy. In order to elicit intervention strengths and weaknesses, post-hoc analyses of AlgoS data were performed. METHODS AlgoS was a randomized controlled trial conducted in 23 French hospitals. Suicide attempters were randomly assigned to either the intervention group (AlgoS) or the control group (Treatment as usual TAU). In the AlgoS arm, first-time suicide attempters received crisis cards; non first-time suicide attempters received a phone call, and post-cards if the call could not be completed, or if the participant was in crisis and/or non-compliant with the post-discharge treatment. An As Treated strategy, accounting for the actual intervention received, was combined with subgroup analyses. RESULTS 1,040 patients were recruited and randomized into two groups of N = 520, from which 53 withdrew participation; 15 were excluded after inclusion/exclusion criteria reassessment. AlgoS first attempters were less likely to reiterate suicide attempt (SA) than their TAU counterparts at 6 and 13-14 months (RR [95% CI]: 0.46 [0.25-0.85] and 0.50 [0.31-0.81] respectively). AlgoS non-first attempters had similar SA rates as their TAU counterparts at 6 and 13-14 months (RR [95% CI]: 0.84 [0.57-1.25] and 1.00 [0.73-1.37] respectively). SA rates were dissimilar within the AlgoS non-first attempter group. CONCLUSIONS This new set of analysis suggests that crisis cards could be efficacious to prevent new SA attempts among first-time attempters, while phone calls were probably not significantly efficacious among multi-attempters. Importantly, phone calls were informative of new SA risk, thus a key component of future interventions.
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Affiliation(s)
- Antoine Messiah
- INSERM Research unit U-1178 “Mental Health and Public Health”, Centre de recherche en Épidémiologie et Santé des Populations (CESP), INSERM, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
| | - Charles-Edouard Notredame
- SCALab Laboratory, CNRS, UMR 9193, Universités de Lille, Lille, France
- Department of Child and Adolescent Psychiatry, Hôpital Fontan, CHRU Lille, Lille, France
| | - Anne-Laure Demarty
- Inserm Clinical Investigation Center (CIC) 1403, CHRU and Universités de Lille, Lille, France
- Department of Adult Psychiatry, Hôpital Fontan, CHRU Lille, Lille, France
| | - Stéphane Duhem
- Inserm Clinical Investigation Center (CIC) 1403, CHRU and Universités de Lille, Lille, France
- Department of Adult Psychiatry, Hôpital Fontan, CHRU Lille, Lille, France
| | - Guillaume Vaiva
- INSERM Research unit U-1178 “Mental Health and Public Health”, Centre de recherche en Épidémiologie et Santé des Populations (CESP), INSERM, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
- SCALab Laboratory, CNRS, UMR 9193, Universités de Lille, Lille, France
- Department of Adult Psychiatry, Hôpital Fontan, CHRU Lille, Lille, France
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Vaiva G, Plancke L, Amariei A, Demarty AL, Lardinois M, Creton A, Debien C, Duhem S, Messiah A. [Changes in the number of suicide attempts in the NPC region since the start of VigilanS: First estimates]. Encephale 2018; 45 Suppl 1:S22-S26. [PMID: 30470501 DOI: 10.1016/j.encep.2018.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/03/2018] [Accepted: 09/08/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND The implementation of a surveillance program after a suicide attempt (SA) is a very innovative step in the evolution of our system of care. It was interesting to know if we observe a decline in suicide attempts in the region, in particular of recurrences of SA. METHOD We measured the evolution of the number of suicide attempts before and after implantation of VigilanS, using two types of analysis: a first from the national medical information systems in Medicine-Surgery-Obstetrics (PMSI-MCO) and a second from the collection of the ER stays for SA in the hospitals involved in the VigilanS program. RESULTS In 2014 (year before start of VigilanS), a total of 10 119 ER stays for SA was observed (5626 women and4463 men); in 2017, the total was 9.230 stays for SA (5047 women and 3 839 men), representing a decrease of 13.5%. The reduction was balanced between men (-14%) and women (-10%). Based on the figures of PMSI, we see an acceleration of the reduction of stay for SA in the Nord-Pas-de-Calais after 2014 (-16% instead of -6%), instead of the two Picardy departments the most comparable which show a degradation of the phenomenon (+13%), and opposed to the Department of the Oise which shows a stable maintenance of the current decline (-12%). CONCLUSION These two indicators are imperfect, but evolution over three years since the implementation of VigilanS goes in the same direction. We find a uncoupling of a hospital stay in connection with a SA. The intensity of this decline seems correlated to the penetrance of the program.
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Affiliation(s)
- G Vaiva
- SCA-Lab UMR 9193 CNRS, pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, université de Lille, rue André-Verhaeghe, 59037 Lille, France.
| | - L Plancke
- Centre lillois d'études sociologiques et économiques, fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France, 59037 Lille, France
| | - A Amariei
- Centre lillois d'études sociologiques et économiques, fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France, 59037 Lille, France
| | - A L Demarty
- Inserm, Fédération de recherche clinique, CHU de Lille, 59037 Lille, France
| | - M Lardinois
- Service universitaire de psychiatrie, CHU de Versailles, 78000 Versailles, France
| | - A Creton
- Service de psychiatrie, centre hospitalier de Valenciennes, France
| | - C Debien
- SCA-Lab UMR 9193 CNRS, pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, université de Lille, rue André-Verhaeghe, 59037 Lille, France
| | - S Duhem
- Inserm, Fédération de recherche clinique, CHU de Lille, 59037 Lille, France
| | - A Messiah
- Inserm U-1178, mental health and public health, hôpital Paul-Brousse, 94800 Villejuif, France
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Duhem S, Berrouiguet S, Debien C, Ducrocq F, Demarty AL, Messiah A, Courtet P, Jehel L, Thomas P, Deplanque D, Danel T, Walter M, Notredame CE, Vaiva G. Combining brief contact interventions (BCI) into a decision-making algorithm to reduce suicide reattempt: the VigilanS study protocol. BMJ Open 2018; 8:e022762. [PMID: 30355792 PMCID: PMC6224763 DOI: 10.1136/bmjopen-2018-022762] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/07/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The early postattempt period is considered to be one of the most at-risk time windows for suicide reattempt or completion. Among the postcrisis prevention programmes developed to compensate for this risk, brief contact interventions (BCIs) have been proven to be efficient but not equally for each subpopulation of attempters. VigilanS is a region-wide programme that relies on an algorithmic system to tailor surveillance and BCI provisions to individuals discharged from the hospital after a suicide attempt. AIM VigilanS' main objective is to reduce suicide and suicide reattempt rates both at the individual level (patients included in VigilanS) and at the populational level (inhabitants of the Nord-Pas-de-Calais region). METHODS AND ANALYSIS At discharge, every attempter coming from a participating centre is given a crisis card with an emergency number to contact in case of distress. Patients are then systematically recontacted 6 months later. An additional 10-day call is also given if the index suicide attempt is not the first one. Depending on the clinical evaluation during the phone call, the call team may carry out proportionated crisis interventions. Personalised postcards are sent whenever patients are unreachable by phone or in distress. On the populational level, mean suicide and suicide attempt rates in Nord-Pas-de-Calais will be compared before and after the implementation of the programme. Here/there cross-sectional comparisons with a control region will test the spatial specificity of the observed fluctuations, while time-series analyses will be performed to corroborate the temporal plausibility of imputing these fluctuations to the implementation of the programme. On the individual level, patients entered in VigilanS will be prospectively compared with a matched control cohort by means of survival analyses (survival curve comparisons and Cox models). DISCUSSION VigilanS interventional components fall under the ordinary law care regime, and the individuals' general rights as patients apply with no addendums or restrictions for their participation in the programme. The research section received authorisation from the Ethical Committee of Lille Nord-Ouest under the caption 'Study aimed at evaluating routine care' and is registered in 'Clinical Trials'. The French Ministry of Health plans to extend the experimentation to other regions and probe the relevance of this type of 'bottom-up' territorial prevention policy at the national level. TRIAL REGISTRATION NUMBER NCT03134885.
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Affiliation(s)
- Stéphane Duhem
- Univ. Lille, Inserm, CHU Lille, CIC1403 –Clinical Investigation Center, Lille, France
- Department of Psychiatry and Forensic Medicine, CHU Lille, Lille, France
- F2RSM, Regional Federation for Research on Mental Health and Psychiatry, Lille, France
| | - Sofian Berrouiguet
- CHU Brest, Department of Psychiatry, University of Bretagne Occidentale, BP 814, Cedex, France
| | - Christophe Debien
- Department of Psychiatry and Forensic Medicine, CHU Lille, Lille, France
| | - François Ducrocq
- Department of Psychiatry and Forensic Medicine, CHU Lille, Lille, France
| | - Anne Laure Demarty
- Univ. Lille, Inserm, CHU Lille, CIC1403 –Clinical Investigation Center, Lille, France
| | - Antoine Messiah
- Inserm Research Unit U-1178 “Mental Health and Public Health”, Villejuif, France
| | - Philippe Courtet
- Department of Psychiatry and Medical Psychology, CHU Montpellier, Montpellier, France
| | - Louis Jehel
- Department of Psychiatry, CHU Martinique, Fort de France, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, CIC1403 –Clinical Investigation Center, Lille, France
- F2RSM, Regional Federation for Research on Mental Health and Psychiatry, Lille, France
| | - Dominique Deplanque
- Univ. Lille, Inserm, CHU Lille, CIC1403 –Clinical Investigation Center, Lille, France
| | - Thierry Danel
- Department of Psychiatry and Forensic Medicine, CHU Lille, Lille, France
- F2RSM, Regional Federation for Research on Mental Health and Psychiatry, Lille, France
- SCALab Laboratory, CNRS-UMR 9193, Lille, France
| | - Michel Walter
- CHU Brest, Department of Psychiatry, University of Bretagne Occidentale, BP 814, Cedex, France
| | - Charles-Edouard Notredame
- Department of Psychiatry and Forensic Medicine, CHU Lille, Lille, France
- SCALab Laboratory, CNRS-UMR 9193, Lille, France
| | - Guillaume Vaiva
- Department of Psychiatry and Forensic Medicine, CHU Lille, Lille, France
- F2RSM, Regional Federation for Research on Mental Health and Psychiatry, Lille, France
- SCALab Laboratory, CNRS-UMR 9193, Lille, France
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Messiah A, Lacoste J, Gokalsing E, Shultz JM, Rodríguez de la Vega P, Castro G, Acuna JM. Mental Health Impact of Hosting Disaster Refugees: Analyses from a Random Sample Survey Among Haitians Living in Miami. South Med J 2017; 109:458-64. [PMID: 27490654 DOI: 10.14423/smj.0000000000000502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Studies on the mental health of families hosting disaster refugees are lacking. This study compares participants in households that hosted 2010 Haitian earthquake disaster refugees with their nonhost counterparts. METHODS A random sample survey was conducted from October 2011 through December 2012 in Miami-Dade County, Florida. Haitian participants were assessed regarding their 2010 earthquake exposure and impact on family and friends and whether they hosted earthquake refugees. Using standardized scores and thresholds, they were evaluated for symptoms of three common mental disorders (CMDs): posttraumatic stress disorder, generalized anxiety disorder, and major depressive disorder (MDD). RESULTS Participants who hosted refugees (n = 51) had significantly higher percentages of scores beyond thresholds for MDD than those who did not host refugees (n = 365) and for at least one CMD, after adjusting for participants' earthquake exposures and effects on family and friends. CONCLUSIONS Hosting refugees from a natural disaster appears to elevate the risk for MDD and possibly other CMDs, independent of risks posed by exposure to the disaster itself. Families hosting refugees deserve special attention.
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Affiliation(s)
- Antoine Messiah
- From the INSERM U-1178, Hôpital Paul Brousse, Villejuif, France, the Center for Disaster & Extreme Event Preparedness, University of Miami Miller School of Medicine, Miami, Florida, and the Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami
| | - Jérôme Lacoste
- From the INSERM U-1178, Hôpital Paul Brousse, Villejuif, France, the Center for Disaster & Extreme Event Preparedness, University of Miami Miller School of Medicine, Miami, Florida, and the Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami
| | - Erick Gokalsing
- From the INSERM U-1178, Hôpital Paul Brousse, Villejuif, France, the Center for Disaster & Extreme Event Preparedness, University of Miami Miller School of Medicine, Miami, Florida, and the Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami
| | - James M Shultz
- From the INSERM U-1178, Hôpital Paul Brousse, Villejuif, France, the Center for Disaster & Extreme Event Preparedness, University of Miami Miller School of Medicine, Miami, Florida, and the Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami
| | - Pura Rodríguez de la Vega
- From the INSERM U-1178, Hôpital Paul Brousse, Villejuif, France, the Center for Disaster & Extreme Event Preparedness, University of Miami Miller School of Medicine, Miami, Florida, and the Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami
| | - Grettel Castro
- From the INSERM U-1178, Hôpital Paul Brousse, Villejuif, France, the Center for Disaster & Extreme Event Preparedness, University of Miami Miller School of Medicine, Miami, Florida, and the Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami
| | - Juan M Acuna
- From the INSERM U-1178, Hôpital Paul Brousse, Villejuif, France, the Center for Disaster & Extreme Event Preparedness, University of Miami Miller School of Medicine, Miami, Florida, and the Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami
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Baux-Cazal L, Gokalsing E, Amadeo S, Messiah A. [Suicidal behavior prevention for children under age 13: A systematic review]. Encephale 2016; 43:273-280. [PMID: 27637872 DOI: 10.1016/j.encep.2016.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/10/2016] [Accepted: 05/10/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Our objective was to review international literature on suicidal behavior prevention for children under age 13. METHODS We gathered all relevant articles on suicide prevention for children under 13. We researched all publications in the French and English languages in PubMed (MEDLINE), PsychINFO and SUDOC databases published until February 2014, with the keywords "child", "child preschool", "prevention and control", "suicide", and "suicide attempted". Publications were included if they described suicidal behavior prevention programs (suicide prevention programs, attempted-suicide prevention programs, suicidal ideation screening programs), and if the studies concerned children under age 13. We also included references cited in the articles if they were not already present in our searches but met inclusion criteria. Studies were excluded if they analyzed populations of children and adolescents without sub-analysis for children under age 13. RESULTS A total of 350 potentially relevant articles were identified, 33 of which met the inclusion criteria, including 4 retrieved from articles' bibliography. Preventive measures against suicidal behavior for children under 13 exist and include: social programs, maltreatment prevention, curriculum-based suicide prevention programs, suicide screening in schools, gatekeepers, reduction of access of lethal means of suicide, suicide screening by primary care, and post-suicide intervention programs. Overall, the evidence was limited by methodological concerns, particularly a lack of RCTs. However, positive effects were found: school-based suicide prevention programs and gatekeepers increased knowledge about suicide and how to seek help, post-suicide programs helped to reduce psychological distress in the short term. One study showed a decreased risk of attempted-suicide after entry into the child welfare system. CONCLUSION There are promising interventions but there is not enough scientific evidence to support any efficient preventive measure against suicidal behavior for children under 13, whether primary, secondary, tertiary or post-intervention. More research is needed.
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Affiliation(s)
- L Baux-Cazal
- Centre hospitalier universitaire de La Réunion, 97410 Saint-Pierre, Réunion.
| | - E Gokalsing
- Inserm unité 1178 santé mentale et santé publique, équipe impact du psychotraumatisme et du suicide outre-mer (IPSOM), établissement public de santé mentale de la Réunion, 97460 Saint-Paul, France
| | - S Amadeo
- Inserm unité 1178 santé mentale et santé publique, équipe impact du psychotraumatisme et du suicide outre-Mer (IPSOM), centre hospitalier de Polynésie française, Papete, BP 1640, 98713 Tahiti, Polynésie française
| | - A Messiah
- Inserm unité 1178 santé mentale et santé publique, équipe impact du psychotraumatisme et du suicide outre-mer (IPSOM), hôpital Paul-Brousse, 94807 Villejuif, France
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Messiah A, Dietz NA, Byrne MM, Hooper MW, Fernandez CA, Baker EA, Stevens M, Ocasio M, Sherman RL, Parker DF, Lee DJ. Combining Community-Based Participatory Research (CBPR) with a Random-Sample Survey to Assess Smoking Prevalence in an Under-Served Community. J Natl Med Assoc 2015; 107:97-101. [PMID: 27269496 DOI: 10.1016/s0027-9684(15)30030-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
ACKNOWLEDGMENTS The authors would like to thank Laura McClure for her help with the manuscript submission, the Liberty City Community Health Advisory Board for its collaboration on this study, as well as the survey interviewers, and the survey participants. INTRODUCTION Underserved communities might lag behind Healthy People 2010 objectives of smoking reduction because of smoking behavior disparities. This possibility was investigated through a random-sample survey conducted in a disenfranchised community in Miami-Dade County, Florida, using a Community-Based Participatory Research (CBPR) framework. The survey was triggered by our finding that this community had higher than expected incidence of tobacco-associated cancers. METHODS Survey methods, resulting from a dialog between the Community Advisory Board and academic researchers, included: (a) surveying adult residents of a public housing complex located within the community; (b) probability sampling; (c) face-to-face interviews administered by trained community residents. 250 households were sampled from 750 addresses provided by the county Public Housing Agency. The completed surveys were reviewed by the academic team, yielding 204 questionnaires for the current analysis. RESULTS Of the 204 respondents, 38% were current smokers. They estimated the percentages of smokers in their household and among their five best friends at 33% and 42%, respectively, and among adults and youth in the community at 72% and 53%, respectively. CONCLUSIONS A mix of state-of-art methodology with CBPR principles is seldom encountered in the current literature. It allowed the research team to find a high smoking prevalence in an underserved community, twice the statewide and nationwide estimates. Similar or higher levels of smoking were perceived in respondent's entourage. Such disparity in smoking behavior, unlikely to result from self-selection bias because of our rigorous methodology, calls for community-specific tobacco control efforts commensurate to the magnitude of the problem.
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Affiliation(s)
- Antoine Messiah
- INSERM research unit U-1178 "Mental Health and Public Health", Research team IPSOM "Psycho trauma and Suicide in Overseas Territories" Villejuif, France.
| | - Noella A Dietz
- Department of Epidemiology & Public Health, Miller School of Medicine, University of Miami
| | - Margaret M Byrne
- Department of Epidemiology & Public Health, Miller School of Medicine, University of Miami
| | | | - Cristina A Fernandez
- Department of Epidemiology & Public Health, Miller School of Medicine, University of Miami
| | | | - Marsha Stevens
- Disparities and Community Outreach Core, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami
| | - Manuel Ocasio
- Department of Epidemiology & Public Health, Miller School of Medicine, University of Miami
| | - Recinda L Sherman
- Florida Cancer Data Systems, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami
| | - Dorothy F Parker
- Disparities and Community Outreach Core, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami
| | - David J Lee
- Department of Epidemiology & Public Health, Miller School of Medicine, University of Miami
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Kunjur J, Messiah A, Manisali M. Obstructive sleep apneoa after orthognathic surgery. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Abstract
OBJECTIVES Conducting health surveys with community-based random samples are essential to capture an otherwise unreachable population, but these surveys can be biased if the effort to reach participants is insufficient. This study determines the desirable amount of effort to minimise such bias. DESIGN A household-based health survey with random sampling and face-to-face interviews. Up to 11 visits, organised by canvassing rounds, were made to obtain an interview. SETTING Single-family homes in an underserved and understudied population in North Miami-Dade County, Florida, USA. PARTICIPANTS Of a probabilistic sample of 2200 household addresses, 30 corresponded to empty lots, 74 were abandoned houses, 625 households declined to participate and 265 could not be reached and interviewed within 11 attempts. Analyses were performed on the 1206 remaining households. PRIMARY OUTCOME Each household was asked if any of their members had been told by a doctor that they had high blood pressure, heart disease including heart attack, cancer, diabetes, anxiety/ depression, obesity or asthma. Responses to these questions were analysed by the number of visit attempts needed to obtain the interview. RESULTS Return per visit fell below 10% after four attempts, below 5% after six attempts and below 2% after eight attempts. As the effort increased, household size decreased, while household income and the percentage of interviewees active and employed increased; proportion of the seven health conditions decreased, four of which did so significantly: heart disease 20.4-9.2%, high blood pressure 63.5-58.1%, anxiety/depression 24.4-9.2% and obesity 21.8-12.6%. Beyond the fifth attempt, however, cumulative percentages varied by less than 1% and precision varied by less than 0.1%. CONCLUSIONS In spite of the early and steep drop, sustaining at least five attempts to reach participants is necessary to reduce selection bias.
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Affiliation(s)
- Antoine Messiah
- INSERM Research Unit U-1178, “Mental Health and Public Health”, Hôpital Paul Brousse, Villejuif, France
| | - Grettel Castro
- Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Pura Rodríguez de la Vega
- Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Juan M Acuna
- Department of Medical and Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
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Parker DF, Dietz NA, Hooper MW, Byrne MM, Fernandez CA, Baker EA, Stevens MS, Messiah A, Lee DJ, Kobetz EN. Developing an urban community-campus partnership: lessons learned in infrastructure development and communication. Prog Community Health Partnersh 2013; 6:435-41. [PMID: 23221288 DOI: 10.1353/cpr.2012.0058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND A low-income, African American neighborhood in Miami, Florida, experiences health disparities including an excess burden of cancer. Many residents are disenfranchised from the healthcare system, and may not participate in cancer prevention and screening services. OBJECTIVE We sought to describe the development of a partnership between a university and this community and lessons learned in using a community-based participatory research (CBPR) model. METHODS To better understand the community's health behaviors and status, a randomized door-to-door survey was conducted in collaboration with a community partner. LESSONS LEARNED This collaboration helped foster a mutual understanding of the benefits of CBPR. We also describe challenges of adhering to study protocols, quality control, and sharing fiscal responsibility with organizations that do not have an established infrastructure. CONCLUSIONS Understanding the organizational dynamics of a community is necessary for developing a CBPR model that will be effective in that community. Once established, it can help to inform future collaborations.
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Félonneau ML, Causse E, Constant A, Contrand B, Messiah A, Lagarde E. Gender stereotypes and superior conformity of the self in a sample of cyclists. Accid Anal Prev 2013; 50:336-340. [PMID: 22673603 DOI: 10.1016/j.aap.2012.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 04/25/2012] [Accepted: 05/02/2012] [Indexed: 06/01/2023]
Abstract
In the field of driving, people tend to think they are more competent and more cautious than others. This is the superior conformity of the self (SCS). Our main hypothesis was that, among cyclists, women would show a higher SCS on cautiousness, though men would show a higher SCS concerning competence. 1799 cyclists provided a self-assessment of their own cautiousness and of other people's cautiousness. The same procedure was used for competence. Consistent with the hypothesis, the SCS was gender-specific: it was more prominent for women concerning cautiousness and more prominent for men concerning competence. These results could explain why people tend to ignore the safety campaigns. They also indicate the importance of adapting messages concerning safety measures to gender.
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Affiliation(s)
- Marie-Line Félonneau
- Laboratoire Psychologie, Santé & Qualité de Vie, Université de Bordeaux, F-33076, France.
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Lagarde E, Salmi LR, Messiah A, Felonneau ML, Constant A. BICYCLISTS HELMET USE IN A FRENCH CITY. RESULTS FROM A FOLLOW-UP STUDY USING A SEMI-AUTOMATED VIDEO DETECTION SYSTEM. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580c.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Encrenaz G, Kovess-Masféty V, Gilbert F, Galéra C, Lagarde E, Mishara B, Messiah A. Lifetime Risk of Suicidal Behaviors and Communication to a Health Professional About Suicidal Ideation. Crisis 2012; 33:127-36. [DOI: 10.1027/0227-5910/a000113] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: There is presently a lack of information on the role of healthcare in suicidal ideation in adults. Aims: To assess the frequencies, patterns, and factors associated with the communication of suicidal ideation toward a health professional. Methods: Participants stem from a French cross-sectional survey of 22,133 randomly selected adults. Lifetime suicidal behaviors and 12-month mental disorder patterns were assessed using the short form of the Composite International Diagnostic Interview. Participants with suicidal ideation were asked whether they had talked about it and, if they had, to whom. Results: Around 20% of people with suicidal ideation had talked about this distress to a health professional. It was more frequent for people with more severe suicidal behaviors (plan or a prior attempt), among women, those aged 30 or more, those suffering from major depressive episode, panic disorder, or drug use disorder. Above all, it was more frequent among those who had also talked to friends or relatives. Conclusions: Prevention strategies that encourage suicidal persons to seek help for their distress, whoever that is, may be the more important strategies to develop.
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Affiliation(s)
- Gaëlle Encrenaz
- Center for Research and Intervention on Suicide and Euthanasia, Université du Québec à Montréal, Montréal, Canada
- Equipe prévention et prise en charge des traumatismes, Centre de recherche INSERM U897 “Epidémiologie et Biostatistiques,” Université Victor Segalen Bordeaux 2, France
| | - Viviane Kovess-Masféty
- EA 4069 Paris Descartes University, dpt Epidemiology EHESP School of High Studies in Public Health, Paris, France
| | | | - Cédric Galéra
- Equipe prévention et prise en charge des traumatismes, Centre de recherche INSERM U897 “Epidémiologie et Biostatistiques,” Université Victor Segalen Bordeaux 2, France
- Child Psychiatry Department, University Victor Segalen Bordeaux 2, Bordeaux, France
| | - Emmanuel Lagarde
- Equipe prévention et prise en charge des traumatismes, Centre de recherche INSERM U897 “Epidémiologie et Biostatistiques,” Université Victor Segalen Bordeaux 2, France
| | - Brian Mishara
- Center for Research and Intervention on Suicide and Euthanasia, Université du Québec à Montréal, Montréal, Canada
| | - Antoine Messiah
- Equipe prévention et prise en charge des traumatismes, Centre de recherche INSERM U897 “Epidémiologie et Biostatistiques,” Université Victor Segalen Bordeaux 2, France
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Messiah A, Constant A, Contrand B, Felonneau ML, Lagarde E. Risk compensation: a male phenomenon? Results from a controlled intervention trial promoting helmet use among cyclists. Am J Public Health 2012; 102 Suppl 2:S204-6. [PMID: 22497201 PMCID: PMC3477913 DOI: 10.2105/ajph.2012.300711] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2012] [Indexed: 11/04/2022]
Abstract
Prevention tools are challenged by risky behaviors that follow their adoption. Speed increase following helmet use adoption was analyzed among bicyclists enrolled in a controlled intervention trial. Speed and helmet use were assessed by video (2621 recordings, 587 participants). Speeds were similar among helmeted and nonhelmeted female cyclists (16.5 km/h and 16.1 km/h, respectively) but not among male cyclists (helmeted: 19.2 km/h, nonhelmeted: 16.8 km/h). Risk compensation, observed only among male cyclists, was moderate, thus unlikely to offset helmet preventive efficacy.
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Affiliation(s)
- Antoine Messiah
- INSERM, Research Center U-897, Centre de Recherche Épidémiologie et Biostatistique, Injury Prevention and Control research team (Prévention et Prise en Charge des Traumatistmes), Bordeaux, France.
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Constant A, Encrenaz G, Zins M, Lafont S, Chiron M, Lagarde E, Messiah A. Why Drivers Start Drinking and Driving—A Prospective Study Over a 6-Year Period in the GAZEL Cohort. Alcohol Alcohol 2011; 46:729-33. [DOI: 10.1093/alcalc/agr126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Davila EP, Zhao W, Byrne M, Hooper MW, Messiah A, Caban-Martinez A, Dietz N, Huang Y, Lee DJ. Health-related quality of life and nicotine dependence, Florida 2007. Am J Health Behav 2011; 35:280-9. [PMID: 21683018 DOI: 10.5993/ajhb.35.3.3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore the relationship between health-related quality of life (HRQOL) and nicotine dependence in a representative sample of 3560 Florida smokers. METHODS Data from the 2007 Behavioral Risk Factor Surveillance System-Florida Tobacco Callback Survey were used. Logistic regression models were conducted to identify factors independently associated with HRQOL measures. RESULTS Greater nicotine dependence was associated with poor/fair self-rated health, 1-29 days of poor physical health, and poor mental health, and inactivity in the past 30 days. CONCLUSIONS The consequences of long-term smoking, and thus nicotine dependence, may not be confined to traditional morbidity measures but may include poor perceived health and overall well-being.
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Affiliation(s)
- Evelyn P. Davila
- Department of Epidemiology and Public Health, Univeristy of Miami, Miami, FL, USA
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Messiah A, Grondin O, Encrenaz G. Factors associated with missing data in an experience sampling investigation of substance use determinants. Drug Alcohol Depend 2011; 114:153-8. [PMID: 21075563 DOI: 10.1016/j.drugalcdep.2010.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 09/13/2010] [Accepted: 09/14/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Experience Sampling Method (ESM) collects data repeatedly over time, and is therefore prone to missing observations. Little is known about the characteristics of the subjects and of the ESM procedure associated with unanswered records. Through an ESM investigation of substance use determinants, these characteristics were able to be analyzed. METHODS Participants (n=224) were undergraduate university students enrolled for a study of substance use factors, providing data through the use of classic questionnaires and through the Experience Sampling Method (ESM) using palmtop computers. For the ESM, they were signaled five times per day for 7 days (7840 records). Characteristics of the ESM procedure and of the participants were analyzed jointly. The probability of an unanswered ESM record was analyzed using a random-intercept logistic regression, fitting a multivariate mixed-effect model for repeated measurements. RESULTS Factors significantly associated with an unanswered record were: male gender, being a Sport Science student, having higher scores of novelty seeking and of persistence, and being a poly-substance user. Unanswered records were also more frequent in the middle of the week and at the beginning of the day. CONCLUSION Findings are discussed in term of the possible impact of missing observations. In particular, the lower compliance of poly-substance users with the ESM protocol may curtail the validity of the method, since ESM records are less representative of all moments in these persons daily life. Thus, results from ESM studies of substance use should be regarded cautiously and complemented with other data gathering procedures.
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Affiliation(s)
- Antoine Messiah
- INSERM, Research Center U-897 Epidemiology and Biostatistics, Équipe Avenir INSERM Prévention et Prise en Charge des Traumatismes (PPCT)/Injury Prevention and Control, Université Bordeaux 2 case 11, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France.
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Hooper MW, Zhao W, Byrne MM, Davila E, Caban-Martinez A, Dietz NA, Parker DF, Huang Y, Messiah A, Lee DJ. Menthol cigarette smoking and health, Florida 2007 BRFSS. Am J Health Behav 2011; 35:3-14. [PMID: 20950154 DOI: 10.5993/ajhb.35.1.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examine associations between menthol cigarette smoking and nicotine dependence, quit attempts, and physical and mental health. METHODS Data were drawn from the 2007 Florida Behavioral Risk Factor Surveillance System (BRFSS) and a follow-up survey among current smokers (N = 3396). Univariate and multivariate logistic regression analyses were conducted. RESULTS In multivariate analyses, menthol cigarette smoking was associated with women, African American and Hispanic race/ethnicity, and greater mental distress. CONCLUSIONS Women, racial/ethnic minorities, and individuals reporting a greater frequency of mental distress are more likely to smoke menthol versus nonmenthol cigarettes. Implications for public health policy and cessation interventions are discussed.
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Affiliation(s)
- Monica Webb Hooper
- University of Miami, Sylvester Comprehensive Cancer Center, Coral Gables, FL 33146, USA.
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Constant A, Felonneau ML, Lagarde E, Messiah A. Investigating risk compensation theory in cyclists: results from intelligent video analysis system. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Constant A, Encrenaz G, Lafont S, Chiron M, Lagarde E, Messiah A. Factors associated with the adoption of drinking and driving during a zero tolerance period: results from a 6-years study in the GAZEL cohort. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Caban-Martinez AJ, Davila EP, Zhao W, Arheart K, Hooper MW, Byrne M, Messiah A, Dietz N, Huang Y, Fleming LE, Lee DJ. Disparities in hypertension control advice according to smoking status. Prev Med 2010; 51:302-6. [PMID: 20600258 PMCID: PMC2939289 DOI: 10.1016/j.ypmed.2010.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 05/25/2010] [Accepted: 06/11/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Hypertension is the most common modifiable cardiovascular risk factor. Blood pressure (BP) reduction, particularly among smokers, is highly effective at preventing cardiovascular diseases. We examined the association between patient smoking status and hypertension management advice. METHODS Adults who participated in the 2007 Behavioral Risk Factor Surveillance System with self-reported hypertension were examined (n=51,063). Multivariable logistic regression analysis controlling for age, gender, race/ethnicity, education, marital status, insurance status, body mass index, alcohol use, self-reported general health and survey design were conducted to examine the association between smoking status (never, former, or current) and receipt of hypertension control advice. RESULTS After controlling for potential confounders, being a current smoker was significantly associated with lower odds of receiving advice to lower salt intake (Adjusted Odds Ratio, AOR, 0.91 [95% confidence interval=0.84-0.99]), exercise (AOR 0.89 [0.80-0.98]), and to take hypertensive medication (AOR 0.80 [0.66-0.98]) compared to never smokers. However, hypertensive smokers had greater odds of receiving advice to reduce alcohol consumption (AOR 1.23 [1.10-1.45]). CONCLUSIONS Although healthcare providers are in an optimal position to provide patient education to improve BP control, hypertensive smokers may be less likely to receive important BP control lifestyle modification messages from their healthcare provider than non-smokers.
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Affiliation(s)
- Alberto J Caban-Martinez
- Department of Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA.
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Byrne MM, Davila EP, Zhao W, Parker D, Hooper MW, Caban-Martinez A, Dietz N, Huang Y, Messiah A, Lee DJ. Cancer screening behaviors among smokers and non-smokers. Cancer Epidemiol 2010; 34:611-7. [PMID: 20655820 DOI: 10.1016/j.canep.2010.06.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 06/22/2010] [Accepted: 06/23/2010] [Indexed: 01/09/2023]
Abstract
OBJECTIVE We explored whether smoking is associated with cancer screening behaviors. METHODS We used data from the 2007 Florida Behavioral Risk Factor Surveillance System and the Florida Tobacco Callback Survey to examine screening behaviors related to four cancer types (breast, cervical, prostate, and colorectal). Using multiple logistic regression analyses, we examined the association between smoking status and health screening behaviors. RESULTS For 10 of the 11 cancer screening variables, being a current smoker was significantly associated with being less likely to ever have been screened and also less likely to be compliant with screening guidelines. For breast and cervical cancer, level of nicotine dependence was also significantly related to compliance with screening recommendations; women with higher levels of dependence were less likely to be compliant. CONCLUSIONS Our results support the notion that individuals' actions related to their health are consistent across different types of behaviors. We found that smokers were less likely to engage in cancer screening behaviors. In addition, among smokers, individuals with greater nicotine dependence had lower compliance with some screening tests. Physicians should ensure that their patients who smoke are receiving appropriate and adequate screening for cancer.
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Affiliation(s)
- Margaret M Byrne
- Department of Epidemiology and Public Health, University of Miami, Miami, FL 33136, USA.
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Galéra C, Messiah A, Melchior M, Chastang JF, Encrenaz G, Lagarde E, Michel G, Bouvard MP, Fombonne E. Disruptive behaviors and early sexual intercourse: The GAZEL Youth Study. Psychiatry Res 2010; 177:361-3. [PMID: 20381166 DOI: 10.1016/j.psychres.2010.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 02/22/2010] [Accepted: 03/09/2010] [Indexed: 11/25/2022]
Abstract
Sexual health-risk behaviors in disruptive children are poorly understood. In a longitudinal population-based sample, event-time analyses showed that subjects with high levels of conduct disorder symptoms, particularly in combination with simultaneously high levels of hyperactivity-inattention symptoms, exhibited the highest risk for earlier sexual activity compared to controls, suggesting the need for prevention.
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Affiliation(s)
- Cédric Galéra
- University Victor Segalen Bordeaux 2, Charles-Perrens Hospital, Child Psychiatry Department, Bordeaux, France.
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Lee DJ, Messiah A. Population biomarker estimates and tobacco exposure: comment on the article by Roethig et al. Nicotine Tob Res 2010; 12:540; author reply 541-2. [PMID: 20231240 DOI: 10.1093/ntr/ntq046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
AIM An unprecedented decline in alcohol consumption and road mortality has been observed recently in France, but it is still unclear whether or not these changes affected driving while alcohol-intoxicated (DWI). The objective of the study was to estimate prospectively trends of excessive speed on the roads, alcohol consumption and DWI between 2001 and 2007 in a large cohort of experienced drivers. METHODS Participants were current employees or recent retirees of the French national electricity and gas company, who volunteered to participate in a research cohort established in 1989 under strict conditions of anonymity. An annual cohort questionnaire is sent to participants that includes two questions about overall alcohol consumption. In 2001 and 2007, 10,684 participants reported their driving behaviours using the same self-administered questionnaire. RESULTS Between 2001 and 2007, the proportion of participants (n = 10,684) who reported having driven at speeds at least 20 km/hour above the limit decreased from 23.7% to 4.1% in built-up areas (P < 0.001), from 34.3% to 9.3% on rural roads (P < 0.001) and from 24.3% to 2.7% on highways (P < 0.001). Regular and non-regular excessive alcohol consumption decreased from 22.7% to 19.7% and from 18.0% to 14.9%, respectively, whereas DWI increased from 22.9% to 25.3% over the same period (P < 0.001). CONCLUSIONS A recent crackdown on road violations by the French government has failed to deter DWI. Given that DWI seems to be a sporadic and rarely punished behaviour, its prevention requires more coercive measures, such as using a breath alcohol ignition interlock device.
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Affiliation(s)
- Aymery Constant
- INSERM U897-IFR99, Equipe Avenir Prévention et Prise en Charge des Traumatismes, ISPED, Bordeaux, France.
| | - Sylviane Lafont
- UMRESTTE, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement
INRETSINVSUniversité Claude Bernard - Lyon I25, Avenue François Mitterrand, F-69675 BRON Cédex,FR
| | - Mireille Chiron
- UMRESTTE, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement
INRETSINVSUniversité Claude Bernard - Lyon I25, Avenue François Mitterrand, F-69675 BRON Cédex,FR
| | - Marie Zins
- Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé
INSERM : U687IFR69Université Paris Sud - Paris XIUniversité de Versailles-Saint Quentin en YvelinesHôpital Paul Brousse 16, av Paul Vaillant Couturier 94807 VILLEJUIF,FR
| | - Emmanuel Lagarde
- Centre épidémiologie et biostatistique
INSERM : U897Université Victor Segalen - Bordeaux IIFR
| | - Antoine Messiah
- Centre épidémiologie et biostatistique
INSERM : U897Université Victor Segalen - Bordeaux IIFR
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Encrenaz G, Kovess-Masféty V, Jutand MA, Carmona E, Sapinho D, Messiah A. Use of psychoactive substances and health care in response to anxiety and depressive disorders. Psychiatr Serv 2009; 60:351-7. [PMID: 19252048 DOI: 10.1176/ps.2009.60.3.351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The use of psychoactive substances in response to psychological distress is not well documented in the general population and has never been studied in combination with health care use. This study estimated the frequency of health care and substance use in response to anxiety or depressive disorders and determined factors associated with these behaviors. METHODS From a large survey of adults from four French regions, the authors selected those with a 12-month probable anxiety or depressive disorder without a substance use disorder (N=4,071). These disorders were determined with the Composite International Diagnostic Interview Short Form, and participants were asked whether they used substances or health care in response to each disorder. RESULTS The use of substances in response to anxiety or depressive disorders was 12.9% among men and 5.2% among women. Compared with those who used health care only, those who used substances (with or without health care) were more likely to be men, single, and young. Those who used both substances and health care were also less likely to have a depressive disorder. CONCLUSIONS This study shows that a sizeable portion of the general population uses substances in response to anxiety or depressive disorders. It also shows that these substance users have distinctive sociodemographic characteristics and can thus be targeted by prevention programs. Strategies to reach substance users with depressive or anxiety disorders who do not use health care remain to be elaborated.
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Affiliation(s)
- Gaëlle Encrenaz
- Institut National de la Santé et de la Recherche Médicale, Bordeaux, France.
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Galéra C, Bouvard MP, Encrenaz G, Messiah A, Fombonne E. Hyperactivity-inattention symptoms in childhood and suicidal behaviors in adolescence: the Youth Gazel Cohort. Acta Psychiatr Scand 2008; 118:480-9. [PMID: 18778384 DOI: 10.1111/j.1600-0447.2008.01262.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although a link has been suggested between attention deficit/hyperactivity disorder (ADHD) and completed suicide, little is known about the association with suicidal behaviors in community settings. This study addresses the relationship between childhood hyperactivity-inattention symptoms (HI-s) and subsequent suicidal behaviors. METHOD Nine hundred sixteen subjects aged 7-18 were recruited from the general population and surveyed in 1991 and 1999. Parent and adolescent self-reports provided psychopathology and suicidal behavior pattern measures. Multivariate modeling was used to evaluate the effects of childhood HI-s and other risk factors on adolescent suicidal behaviors. RESULTS In males, HI-s independently accounted for the risk of lifetime suicide plans/attempts (OR=3.25, P = 0.02) and adolescent 12-month prevalence rates of suicide plans/attempts (OR=5.46, P = 0.03). In females, HI-s did not independently heighten the likelihood of suicidal behaviors. CONCLUSION This survey suggests a possible specific link between HI-s and suicide plans/attempts in males.
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Affiliation(s)
- C Galéra
- Child Psychiatry Department, University Victor Segalen Bordeaux 2, Bordeaux, France.
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Galéra C, Bouvard MP, Messiah A, Fombonne E. Hyperactivity-inattention symptoms in childhood and substance use in adolescence: the youth gazel cohort. Drug Alcohol Depend 2008; 94:30-7. [PMID: 18065164 DOI: 10.1016/j.drugalcdep.2007.09.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2007] [Revised: 09/24/2007] [Accepted: 09/26/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study addresses in both genders the relationship between childhood Hyperactivity-inattention symptoms and subsequent adolescent substance use, while controlling for psychiatric comorbidity, temperament and environmental risk factors. METHODS 916 subjects (421 males, 495 females) aged 7-18 were recruited from the general population and surveyed in 1991 and 1999. Child psychopathology and substance use patterns were evaluated through parent and adolescent self-reports. Multivariate modeling was performed to assess the effects of childhood Hyperactivity-inattention symptoms and other risk factors on adolescent substance use. RESULTS In males, Hyperactivity-inattention symptoms alone accounted for the risk of subsequent regular cannabis smoking (OR=3.14, p=0.03) and subsequent lifetime use of other drugs including stimulants, opiates, inhalants and sedatives (OR=2.72, p=0.02). In females, Hyperactivity-inattention symptoms did not independently increase the liability to later substance use. In males, the temperament trait activity was a significant predictor of subsequent regular cannabis smoking (OR=2.32, p=0.04). CONCLUSIONS This survey points to a possible specific link between Hyperactivity-inattention symptoms and subsequent cannabis use and experimentation of harder drugs in males.
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Affiliation(s)
- Cédric Galéra
- Child Psychiatry Department, Université Victor Segalen Bordeaux 2, Bordeaux, France.
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Messiah A, Encrenaz G, Sapinho D, Gilbert F, Carmona E, Kovess-Masféty V. Paradoxical increase of positive answers to the Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire during a period of decreasing alcohol consumption: results from two population-based surveys in Ile-de-France, 1991 and 2005. Addiction 2008; 103:598-603. [PMID: 18261191 DOI: 10.1111/j.1360-0443.2007.02120.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To describe trends of responses to the Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire during a period of declining alcohol consumption, in a country with no temperance history. DESIGN Two random-sample surveys, conducted in 1991 and 2005, respectively. SETTING The adult population of Ile-de-France. PARTICIPANTS A total of 1183 subjects in 1991 and 5382 subjects in 2005. MEASUREMENTS Responses to CAGE questions, obtained by face-to-face interviews in 1991 and by telephone in 2005. RESULTS were standardized on the 2005 population structure. FINDINGS The proportion of subjects giving at least two positive answers has increased by 4.2 times; the biggest increase was observed for the Guilt question (4.8 times) and the smallest for the Eye-opener question (2.6 times). Several increases were higher for women than for men: 12.9 times versus 3.3 times for two or more positive answers, 9.8 times versus 3.8 times for the Guilt question. Increases did not vary consistently by age. CONCLUSION These paradoxical trends do not support the use of CAGE in general population surveys. They confirm previous reports suggesting that CAGE was sensitive to community temperance level. They might reflect the emergence of a temperance movement in France, with stronger impact among women. This movement might be responsible for the fall in alcohol consumption.
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Affiliation(s)
- Antoine Messiah
- INSERM, Research Center U-897, Equipe Avenir, Prévention et prise en charge des Traumatismes/Injury Prevention and Control, Bordeaux, France.
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Encrenaz G, Kovess-Masfty V, Sapinho D, Chee CC, Messiah A. Utilization of Mental Health Services and Risk of 12-month Problematic Alcohol Use. Am J Health Behav 2007. [DOI: 10.5993/ajhb.31.4.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Encrenaz G, Kovess-Masféty V, Sapinho D, Chee CC, Messiah A. Utilization of mental health services and risk of 12-month problematic alcohol use. Am J Health Behav 2007; 31:392-401. [PMID: 17511574 DOI: 10.5555/ajhb.2007.31.4.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
OBJECTIVE To examine whether mental health service utilization modifies the association between lifetime anxiety or depressive disorders (ADD) and risk of 12-month problematic alcohol use. METHODS Randomly selected members (n=6518) of a mutual health-insurance company were evaluated for lifetime ADD (DSM-IV), mental health service utilization for ADD, and risk of 12-month problematic alcohol use (DSM-IV and CAGE). RESULTS Risk of 12-month problematic alcohol use was reduced when mental health services had been used for several ADD (OR=3.3 vs 5.8), but not for one ADD. CONCLUSIONS These results show the importance of taking mental health service use into account as a potential effect-modifier of psychiatric comorbidity.
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Affiliation(s)
- Gaëlle Encrenaz
- Institut National de la Santé et de la Recherche Médicale, Institut Fédératif de Recherche en Santé Publique (IFR INSERM 99), Victor Segalen Bordeaux 2 University, France.
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Encrenaz G, Messiah A. Lifetime psychiatric comorbidity with substance use disorders: does healthcare use modify the strength of associations ? Soc Psychiatry Psychiatr Epidemiol 2006; 41:378-85. [PMID: 16479324 DOI: 10.1007/s00127-006-0039-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND The frequent psychiatric comorbidity among subjects with a substance use disorder (SUD) can be explained by an increased vulnerability to problematic drug use among subjects with a non-substance-related psychiatric disorder (NSRPD). The care of this disorder should then reduce the likelihood of a secondary SUD. OBJECTIVE To examine how healthcare use for psychological symptoms modifies the lifetime association between SUD and NSRPD. METHODS Two hundred and twenty four students were evaluated for mental disorders and healthcare use. Mental disorders were assessed with the Mini-International Neuropsychiatric Interview (MINI). Healthcare use included consultations with a general practitioner (GP), a psychiatrist or a psychologist. The lifetime occurrence of a SUD was analysed by lifetime number of NSRPD and healthcare use for psychological symptoms. Analyses were adjusted on gender, university affiliation, living environment and temperament and character dimensions. RESULTS Compared to subjects without NSRPD, those with at least two NSRPD who did not use healthcare were more likely to have had a lifetime SUD (OR = 3.9). By contrast, those who had only one NSRPD seemed to be as likely as those with no NSRPD to have had a SUD. DISCUSSION These results suggest a decreased probability of SUD among subjects with several NSRPD who used healthcare. Due to the cross-sectional design of this study, causal inferences cannot be drawn. This analysis shows the importance, however, of taking healthcare use into account in comorbidity studies.
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Affiliation(s)
- Gaelle Encrenaz
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 593 Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université Victor Segalen Bordeaux 2, Bordeaux, France.
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Encrenaz G, Rondeau V, Messiah A, Auriacombe M. Examining the influence of drop-outs in a follow-up of maintained opiate users. Drug Alcohol Depend 2005; 79:303-10. [PMID: 16102374 DOI: 10.1016/j.drugalcdep.2005.01.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2004] [Revised: 01/21/2005] [Accepted: 01/25/2005] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In most longitudinal studies of problem opiate users, drop-outs are frequent, but not taken into account. However, missing data can induce important bias in parameters estimates. OBJECTIVE The aim of this study was to examine the influence of drop-outs in the statistical analysis of a follow-up of opiate users in maintenance treatment. METHODS Participants were 519 patients who had sought maintenance treatment between 1994 and 2001. Drug use was studied using the drug composite score of the Addiction Severity Index. A classical data analysis (linear mixed effects model for repeated measurements) was compared with a selection model, which consists, in this case, of a joint modelling of the score and of the drop-out probability in order to reduce bias induced by drop-outs. RESULTS At 18 months, 38% of the patients were available for evaluation. Drop-outs were associated with low drug use and were informative. Each model showed that the score decreased over time and that it was associated with psychiatric problems. Unlike the classical method, the joint model showed no significant association between the score and age or treatment setting. CONCLUSIONS These results show the importance of accounting for informative drop-outs in data analysis before drawing conclusions from such studies.
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Affiliation(s)
- G Encrenaz
- Laboratoire de Psychiatrie and Jeune Equipe 2358, Bordeaux, France.
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Lavie E, Fatseas M, Messiah A, Franques P, Tignol J, Auriacombe M. P8-8 Facteurs associés à la consommation de benzodiazépines chez des patients traités par buprénorphine pour une dépendance aux opiacés (Aquitaine, France, 2001-2004). Rev Epidemiol Sante Publique 2004. [DOI: 10.1016/s0398-7620(04)99304-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Messiah A, Navaline H, Davis-Vogel A, Tobin-Fiore D, Metzger D. Sociodemographic and behavioral characteristics associated with timeliness and retention in a 6-month follow-up study of high-risk injection drug users. Am J Epidemiol 2003; 157:930-9. [PMID: 12746246 DOI: 10.1093/aje/kwg065] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Timeliness and retention in a 6-month follow-up study were analyzed by subjects' baseline characteristics in a seroincidence study of 263 injection drug users at high risk of human immunodeficiency virus infection. Subjects were recruited from September 1997 to June 1998 in community settings in Philadelphia, Pennsylvania. Of these subjects, 93% were completers: 11% before the targeted date, 38% at the targeted date, 32% within 1 month of delay, and 12% beyond 1 month. Late completers were more likely than other completers to be younger and to live farther away from the study center, less likely to have stayed in a shelter or a welfare residence during the past year, more likely to have a lower income, and more likely to have shared rinse water, cotton, or cooker. By contrast, loss to follow-up was not associated with these variables. Subjects lost to follow-up were more likely than those retained to have a high school diploma and to have moved during the past year; their source of needles was less likely to be a needle exchange program and more likely to be a shooting gallery. None of the drug-related behaviors that increase the risk of human immunodeficiency virus infection was associated with timeliness or retention, suggesting that the study might be minimally biased.
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Affiliation(s)
- Antoine Messiah
- Center for the Studies of Addiction, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Messiah A, Escaffre N, Sannino N, Rotily M, Galinier-Pujol A. La sexualite aux temps du sida en population vulnerable: elements d'une enquete aupres de detenus. Population (French Edition) 2001. [DOI: 10.2307/1534751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Messiah A, Loundou AD, Maslin V, Lacarelle B, Moatti JP. Physician recognition of active drug use in HIV-infected patients is lower than validity of patient's self-reported drug use. J Pain Symptom Manage 2001; 21:103-12. [PMID: 11302118 DOI: 10.1016/s0885-3924(00)00248-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A French survey of 325 HIV-infected subjects with a history of injecting drugs allowed us to study the recognition of patients' injection drug use (IDU) by physicians providing HIV-infection care, and to analyze the correlation between patient demographics and incorrect IDU identification. Kappa for concordance of physician's reports of their patient's IDU with patient's declaration was 0.37; concordance was lower among socially vulnerable patients. This contrasted with a nested study of validity of patient's self-report of opioid use: Kappa for patient's declaration of opioid use within the past two days against a biological assay was 0.61, and concordance was higher among socially vulnerable patients. Concordance of physicians' ratings and patients' reports of IDU was not more than fair, even though physicians were knowledgeable about their patient's IDU history. This concordance varied with social status in a way that did not correspond with variations in self-reported opioid use validity, suggesting that identification of active IDU might be partly based on incorrect interpretation of subjective cues.
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Affiliation(s)
- A Messiah
- INSERM Unité Victor Segalen, Bordeaux, France
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Pradier C, Messiah A, Carrieri P, Rey D, Obadia Y, Moatti JP. [Trends in HIV prenatal screening from 1992 to 1994 in South Eastern France]. Rev Epidemiol Sante Publique 1998; 46:176-82. [PMID: 9690284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To study trends in HIV testing among pregnant women before and after the introduction of mandatory screening in January 1993. METHODS The study was based on data from the Prevagest surveys which were carried out in the Provence-Alpes-Côte d'Azur region in samples of pregnant women who just delivered in 1992 (n = 2,775) and 1994 (n = 2,701). RESULTS The proportion of women declaring that they had been tested during pregnancy increased from 63% in 1992 to 73% in 1994 (p < 0.001). The percentage of women who believe they were tested without consent decreased from 14% in 1992 to 6% in 1994 (p < 0.001). In 1994, 86% nevertheless declared that they received no information on AIDS and its prevention during their pregnancy. After adjustment by a logistic model, type of prenatal care and educational level longer appeared in 1994 to be associated with a lower probability of declaring having been tested. On the contrary, women originating from North Africa, those younger than 25 years and married women had a lower probability of declaring that they have been tested in 1994 as well as 1992. CONCLUSIONS This study stresses the need for improved communication between public health professionals and practitioners and the establishment of effective training programs in HIV preventive counselling for health professionals in charge of prenatal care.
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Affiliation(s)
- C Pradier
- INSERM U379, Institut Paoli-Calmettes, Marseille
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Messiah A, Bloch J, Blin P. Alcohol or drug use and compliance with safer sex guidelines for STD/HIV infection. Results from the French National Survey on Sexual Behavior (ACSF) among heterosexuals. Analyse des Comportements Sexuels en France. Sex Transm Dis 1998; 25:119-24. [PMID: 9524986 DOI: 10.1097/00007435-199803000-00001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Available literature shows that association of alcohol and/or drug use with unsafe sexual practices is not established, in contradistinction to the well-established association between such substance use and the sexual milieu itself. GOAL To analyze these two kinds of associations in a population-based sample of heterosexuals in France. STUDY DESIGN Cross-sectional telephone survey of the French adult heterosexual population in the early 1990s (n = 4213). RESULTS Subjects at risk were more likely than those not at risk to have consumed alcohol before sex; this was not the case for drug use. However, at-risk subjects who engaged in unsafe practice(s) were not more likely to have consumed alcohol or drugs. CONCLUSION Alcohol consumption appears to be a marker for being in an at-risk situation in France and may be used as such by public health providers. In contrast, the association between alcohol/drug use and unsafe sexual practices is not supported by our study and thus conflicts with prevention strategies to increase compliance with safer sex through alcohol/drug abstinence.
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Affiliation(s)
- A Messiah
- INSERM U-292, Hôpital de Bicêtre, Le Kremlin-Bicêtre, Paris, France
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Messiah A, Rey D, Obadia Y, Rotily M, Moatti JP. HIV testing, knowledge, attitudes, beliefs, and practices among minorities: pregnant women of North-African origin in southeastern France. J Natl Med Assoc 1998; 90:87-92. [PMID: 9510622 PMCID: PMC2608321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Since 1991, the French public health ministry has recommended that human immunodeficiency virus (HIV) testing be offered to all pregnant women. This study was undertaken to determine whether this recommendation is followed independently of a woman's ethnicity. It is based on a 1992 survey regarding knowledge, attitudes, beliefs, and practices on HIV infection and testing among pregnant women in southeastern France. Survey results revealed that North-African women (n = 207) were more likely to have a low socioeconomic and educational level, receive their health care at public health institutions, and be less knowledgeable about HIV transmission than French women (n = 2234). They were also more likely to have been tested for HIV without their knowing it and less likely to perceive themselves as being at risk. Consent to undergo HIV testing during pregnancy was dependent on their North-African origin after controlling for significant covariates. These results indicate that routine prenatal screening appears insufficient to ensure adequate HIV testing and counseling of women of ethnic minorities. The development of HIV prevention programs that are cultural-specific and that aim at increasing physicians' compliance with the official recommendation is needed.
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Affiliation(s)
- A Messiah
- South-Eastern French Center for Disease Control, Marseille, France
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Abstract
BACKGROUND Serious complications related to regional anesthesia have previously been described primarily in case reports and retrospective surveys. The authors prospectively evaluated a multicenter series of regional anesthetics, using preplanned criteria to measure the incidence and characteristics of associated serious complications. METHODS Requests were sent to 4,927 French anesthesiologists in advance of a subsequent 5-month study period. Participating anesthesiologists were asked for detailed reports of serious complications occurring during or after regional anesthetics performed by them during the study interval. Details regarding each complication then were obtained via a second questionnaire. RESULTS The number of responding anesthesiolgists was 736. The number of regional anesthetics performed was 103,730, corresponding to 40,640 spinal anesthetics, 30,413 epidural anesthetics, 21,278 peripheral nerve blocks, and 11,229 intravenous regional anesthetics. Reports of 98 severe complications were received, with follow-up information being obtained for 97. In 89 cases, complications were attributed fully or partially to regional anesthesia. Thirty-two cardiac arrests, seven of which were fatal, occurred during the study. Of these, 26 occurred during spinal anesthesia, with 6 being fatal, 3 occurred during epidural anesthesia, and 3 more occurred during peripheral blocks. The higher incidence of cardiac arrest during spinal anesthesia (6.4 +/- 1.2 per 10,000 patients) compared with all other regional anesthesia (1.0 +/- 0.4 per 10,000 patients) was statistically significant (P < 0.05). Of 34 neurologic complications (radiculopathy, cauda equina syndrome, paraplegia), 21 were associated either with paresthesia during puncture (n = 19) or with pain during injection (n = 2), suggesting nerve trauma or intraneural injection. Twelve patients who had neurologic complications after spinal anesthetics had no paresthesia during needle placement and no pain on injection. Of these 12 patients (7 with radiculopathy and 5 with cauda equina syndrome), 9 received intrathecal hyperbaric lidocaine, 5%. The incidence of neurologic injury was significantly greater after spinal anesthesia (6 +/- 1 per 10,000 cases; P < 0.05) than after each of the other types of regional procedures (1.6 +/- 0.5 per 10,000 cases for the weighted average). Seizures attributed to elevated serum levels of local anesthetics occurred in 23 patients, but none suffered a cardiac arrest. CONCLUSIONS (1) The incidence of cardiac arrest and neurologic injury related to regional anesthesia were very low, but both were more than three SDs greater after spinal anesthesia than after other regional procedures. (2) Two thirds of the patients with neurologic deficits had either a paresthesia during needle placement or pain on injection. (3) Seventy-five percent of the neurologic deficits after nontraumatic spinal anesthesia occurred in patients who had received hyperbaric lidocaine, 5%.
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Affiliation(s)
- Y Auroy
- Department of Anesthesiology, Bicêtre Hospital, Le Kremlin-Bicêtre, France
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Messiah A, Dart T, Spencer BE, Warszawski J. Condom breakage and slippage during heterosexual intercourse: a French national survey. French National Survey on Sexual Behavior Group (ACSF). Am J Public Health 1997; 87:421-4. [PMID: 9096545 PMCID: PMC1381016 DOI: 10.2105/ajph.87.3.421] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study examined condom failure rates in a representative sample of French men and women. METHODS Condom users who experienced breakage or slippage were compared with those who reported no difficulties. RESULTS The rate of breakage at last heterosexual intercourse was 3.4%, and the slippage rate was 1.1%. Significantly associated with breakage and slippage were being age 25 through 34, being sexually active for more than 5 years, condom use for less than 5 years, condom not used for contraception, and sexual intercourse 12 or more times per month. CONCLUSIONS People who became sexually active before the era of acquired immunodeficiency syndrome, who began condom use in recent years, and who have frequent sex are at increased risk. The low risk observed among experienced condom users below age 25 supports condom promotion to youth.
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Affiliation(s)
- A Messiah
- Service de Santé Publique et Epidémiologic, Hôpital de Bicetre, France
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Warszawski J, Messiah A, Lellouch J, Meyer L, Deville JC. Estimating means and percentages in a complex sampling survey: application to a French national survey on sexual behaviour (ACSF). Analyse des Comportements Sexuels en France. Stat Med 1997; 16:397-423. [PMID: 9044529 DOI: 10.1002/(sici)1097-0258(19970228)16:4<397::aid-sim391>3.0.co;2-t] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Two-phase stratification sampling with unequal selection probabilities is a relatively cost-efficient strategy to address problems on a nationwide basis and to perform comparative analyses of specific subgroups. This was the case with the ACSF survey. Specific procedures to estimate the variances of unbiased estimators in complex sampling designs are not included in standard statistical packages and no specialized software is available for two-phase sampling. A detailed synthesis of general basic rules for inference about a target population from a probability sample is first presented. We follow with a standard procedure to estimate means and percentages with their confidence intervals according to the design. Finally, numerical results are discussed.
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Affiliation(s)
- J Warszawski
- INSERM U292, Hôpital, de Bicêtre, Le Kremlin-Bicêtre, France
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