Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique最新文献

Background: The co-occurrence of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) is common in military personnel, leading to complex clinical challenges and poor prognosis. To enhance the care of PTSD patients, a TBI screening protocol was developed at a French Military Training Hospital (MTH). The Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID), a self-administered questionnaire, was translated into French (OSU TBI-ID Fr) to help standardize screening. This study aims to evaluate the feasibility and tolerance of the TBI screening protocol, to explore its potential to improve clinical outcomes for military personnel suffering from PTSD, and to assess TBI prevalence in our population.

Design: This observational, retrospective, monocentric study was conducted at the MTH psychiatric unit. PTSD military personnel and veterans were screened for TBI using three questionnaires: OSU TBI-ID Fr, the PTSD Checklist for DSM-5 (PCL5), and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Data on patient characteristics and screening results were extracted from medical records to determine TBI prevalence. Feasibility was assessed based on the proportion of eligible patients who underwent screening, with reasons for non-participation documented. Tolerance was evaluated by recording side effects. Exploratory analyses included subgroup comparisons based on TBI or Repeated subconcussive Head Impacts (RHI) and correlations between PCL5 and RPQ scores.

Results: Of the 233 PTSD patients treated in the psychiatry unit, 14.1% (n=33) completed the TBI screening between September 2022 and March 2023. Among the screened patients, 39.4% (n=13) had a history of TBI, and 48.5% (n=16) had been exposed to RHI. Three participants reported anxiety while completing OSU TBI-ID Fr. The average PCL5 score was 45.8, and the average RPQ score was 25.7. The main barriers to screening in the rest of the eligible population were lack of time, oversight, and interview setting (e.g., teleconsultation).

Discussion and conclusion: This study introduces the French version of the OSU TBI-ID as a standardized TBI screening tool for military personnel with PTSD. The high prevalence of undiagnosed TBI, often discovered through screening, highlights the importance of early detection. This study demonstrates the acceptability and tolerance of the OSU TBI-ID Fr in this population and suggests its potential to improve care by enabling earlier TBI identification. Future research should focus on refining the protocol, enhancing its applicability across settings, and optimizing integrated care pathways to improve clinical outcomes.

To permit swift care of psychiatric and suicidal crisis, a post-emergency department unit (named UPSAM) opened on 25th March 2024 at the Angers University hospital. This unit permits a brief stay in a secure environment during which psychiatric care allows a decrease in suicidal ideation and etiological diagnosis followed by a multimodal suicide prevention strategy and ambulatory care organization. For 6 months 348 patients were hospitalized from all 3 corresponding departments. The mean length of stay was 5.6 days resulting in mean bed occupancy of 87.4% discharge; only 37.9% of patients needed public psychiatric care. UPSAM permitted a decrease in waiting time before hospitalization, with a mean delay before hospitalization of 59.4hours in April and 27.4hours in September. Other models of short-stay unit have been tested and showed efficacy in decreasing emergency department waiting time. Further work is needed to better understand appropriate care regimens according to clinical and topographical situations.

Context: Sexual sensation seeking and sexual compulsivity are two characteristics associated with sexual risk taking and can be studied in different contexts, one of these being that of forensics. Among the different tools used to assess these characteristics, the Sexual Sensation Seeking Scale (SSSS) and the Sexual Compulsivity Scale (SCS) are particularly concise and specific.

Method: This study proposes a French translation of those scales, the fSSSS and the fSCS, validated among a sample of 536 participants from France. Assessments of factor structure, internal consistency and reliability showed good psychometric properties. Convergent and divergent validities were assessed using various forensic-related measures and demonstrated the relevance of both scales in this context.

Introduction: Social functioning is an individual's ability to interact effectively and appropriately with his or her social environment. In psychiatry, acting on social functioning is necessary to reduce the intensity of symptoms and promote patient life in the community. This study proposes a cross-cultural validation of the Social Functioning Questionnaire (SFQ) in Moroccan dialectal Arabic.

Methods: This work consists of creating a translated version according to a rigorous methodology, including direct and reverse translation, as well as evaluation by linguistic experts. A sample of 160 participants was then selected to evaluate the psychometric properties of the SFQ in a statistical study.

Results: The validation study showed high acceptability and reliability, with a Cronbach's alpha coefficient of 0.803. The results also showed good reproducibility, with perfect inter-observer stability between the test and the retests.

Conclusion: This version of the SFQ is reliable and valid for measuring social functioning in our Moroccan population.

Objectives: Psychiatric patients are frequently exposed to factors that increase their risk of developing chronic liver diseases. These factors include the presence of metabolic syndrome, high rates of current or past alcohol and illicit substance use, and the direct liver toxicity of certain psychiatric medications. Despite this, systematic screening for chronic liver diseases in this population is not routine. Transient elastography (FibroScan®), a non-invasive method to assess liver stiffness, could facilitate early detection of advanced hepatic fibrosis. This study aimed to assess the acceptability of non-invasive liver fibrosis evaluation using FibroScan® among psychiatric inpatients and to evaluate the prevalence of alcohol and illicit drug use, viral hepatitis, significant liver fibrosis, and linkage to somatic care.

Methods: This prospective, interventional cohort study was conducted in a tertiary psychiatric hospital from March 2023 to January 2024. Liver stiffness measurement (LSM) by transient elastography (FibroScan®) screening for the detection of significant liver fibrosis was proposed to all hospitalized patients after providing informed consent. Patients responded to a structured interview that included the AUDIT-C questionnaire to assess alcohol use disorders, along with items on illicit drug use and other liver disease risk factors like metabolic syndrome or viral hepatitis. Significant fibrosis was defined as liver stiffness measurement (LSM) ≥10kPa. Demographic, clinical, biological and virological data was collected from patients' medical files.

Results: A total of 180 patients were included in the study, with 122 (67.8%) consenting to FibroScan® screening. The cohort's mean age was 44.4±15.5 years, with 61% male. The seroprevalence of HCV antibodies was 2.5%, with a higher prevalence among men (6.5%). Chronic HBV infection prevalence was 0.81%. Metabolic syndrome was present in 28.7% of patients. Alcohol use disorders were identified in 45.9% of patients, with men showing higher AUDIT-C scores than women (P=0.04). Drug use was reported by 37.7% of patients, with recent use in 20%. Significant fibrosis was detected in 0.8% of patients and linkage to care was provided in this case.

Conclusions: Transient elastography is an acceptable method for screening hepatic fibrosis in psychiatric settings. It represents an excellent option to assess other associated comorbidities in this underserved population and improve linkage to somatic care.

Objectives: This project aimed to explore the impact of psychological distress (anxiety, depression and post-traumatic stress) and resilience on quality of life and psychological health at work (well-being or distress at work) of nursing home and healthcare staff members in the Moselle department in Northeastern France.

Methods: In the spring of 2021 230 professionals replied to an online questionnaire. The theoretical model was tested through path analyses.

Results: Results showed that higher resilience scores were associated with lower post-traumatic stress, anxiety, and depression scores. Anxiety and depression were negatively correlated with quality of life, while higher quality of life scores were linked to greater well-being at work. Resilience was found to have a significant impact on the psychological state of professionals, with differences observed between well-being and distress at work.

Discussion: In conclusion, our study revealed that resilience plays a significant role in influencing the psychological state of professionals, ultimately impacting their psychological health at work. Therefore, interventions aimed at addressing anxiety, depression, and traumatic symptoms could potentially enhance resilience and mitigate work-related psychological disorders among frontline healthcare professionals.