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Salome G, Vignaud P, Galia P, Prieto N, Chauliac N. Determinants of Care Pathways for C-PTSD Patients in French Psychotrauma Centers: A Qualitative Study. Int J Environ Res Public Health 2023; 20:6278. [PMID: 37444125 PMCID: PMC10341220 DOI: 10.3390/ijerph20136278] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/05/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
In 2018, the International Classification of Diseases (ICD-11) established a novel nosographic category within the stress-specific disorders known as complex post-traumatic stress disorder (C-PTSD). Characterized by distinctive clinical attributes and a limited response to conventional PTSD treatments, C-PTSD has prompted the reconsideration of care methods. Our study's purpose was to explore the intricate factors shaping the care pathways for individuals suffering from C-PTSD. We used a grounded theorization technique involving professionals across a range of specialized French psychotraumatology institutions. The resulting comprehensive theoretical model offers valuable insights into the constitution mechanisms of these pathways, helping elucidate the varying care options. Interestingly, we found that differences in clinical perspectives were determined by the care provider's viewpoint on clinical guidelines, screening tools, and treatment options, but also by structural and organizational factors. The distinctive dynamics and interrelationships identified in our research reveal potential areas of focus for incorporating C-PTSD care more effectively into specialized French trauma centers. This investigation offers a path toward improved understanding and management of C-PTSD, ultimately advancing patient outcomes.
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Affiliation(s)
- Germain Salome
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Philippe Vignaud
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
- Faculté de Médecine Lyon-Est, Université Claude Bernard Lyon 1, F-69008 Lyon, France
| | - Perrine Galia
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Nathalie Prieto
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Nicolas Chauliac
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290 & Université Claude Bernard Lyon 1, Domaine Rockefeller, F-69008 Lyon, France
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Vignaud P, Chauliac N, Contamin E, Richer S, Vuillermoz C, Brunelin J, Prieto N. Relevance and Feasibility of Group Traumatic Episode Protocol Delivered to Migrants: A Pilot Field Study. Int J Environ Res Public Health 2023; 20:5419. [PMID: 37048033 PMCID: PMC10093804 DOI: 10.3390/ijerph20075419] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are commonly observed in migrants. Although Eye Movement Desensitization and Reprocessing (EMDR) can be helpful to treat these diseases, it remains difficult to propose EMDR as an individual intervention in help-seeking migrants. Group EMDR, like Group Traumatic Episode Protocol (G-TEP), which was built around the 8 phases of the original EMDR protocol, could offer an effective treatment to a large number of people. It may also be more resource-efficient to provide psychiatric care to migrants. METHODS In this open-label trial, the feasibility and the effectiveness of a 6-session G-TEP intervention was investigated in a group of 10 migrants. RESULTS The intervention was well tolerated by participants. The final attrition rate was 10%. After the intervention, there was a 28.2% significant decrease in PTSD and complex PTSD symptoms, as measured by the International Trauma Questionnaires (total_ITQ) scores (p = 0.013) and a trend towards a significant decrease in MDD symptoms, as measured with the Patient Health Questionnaire (PHQ-9) (p = 0.057). CONCLUSIONS G-TEP may be effective in decreasing PTSD symptoms in migrants. The accessibility, low-cost, and very structured features of G-TEP may make its implementation sustainable in the field of psychiatric care for migrants.
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Affiliation(s)
- Philippe Vignaud
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Centre Régional du Psychotraumatisme Auvergne Rhône Alpes, F-69437 Lyon, France
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Cellule D’urgences Medico-Psychologiques, F-69437 Lyon, France
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, F-69500 Bron, France
| | - Nicolas Chauliac
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Centre Régional du Psychotraumatisme Auvergne Rhône Alpes, F-69437 Lyon, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, F-69008 Lyon, France
| | - Emmanuel Contamin
- Independent Researcher, 4 Rue du Viel Renversé, F-69005 Lyon, France
| | - Sébastien Richer
- Independent Researcher, 19 Rue de la République, F-69600 Oullins, France
| | - Cécile Vuillermoz
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), INSERM, Department of Social Epidemiology, Sorbonne Université, F-75012 Paris, France
| | - Jérôme Brunelin
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, F-69500 Bron, France
- Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, F-69500 Bron, France
| | - Nathalie Prieto
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Centre Régional du Psychotraumatisme Auvergne Rhône Alpes, F-69437 Lyon, France
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Cellule D’urgences Medico-Psychologiques, F-69437 Lyon, France
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Chauliac N, Salome G, Cheucle J, Cochennec De Biase L, Galia P, Thomas A, Grimaud O, Philippe JM, Vignaud P, Prieto N. Experiences of Inter-Hospital Transfers (IHT) by Patients and Relatives during the COVID-19 Pandemic in France: A Qualitative Study. Int J Environ Res Public Health 2023; 20:4660. [PMID: 36901672 PMCID: PMC10001538 DOI: 10.3390/ijerph20054660] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The first wave of the COVID-19 epidemic led to a rapid and unexpected saturation of the French ICU, forcing the health care system to adapt. Among other emergency measures, inter-hospital transfers were carried out. OBJECTIVE To assess the psychological experience of patients and their relatives regarding inter-hospital transfers. METHODS Semi-structured interviews were conducted with transferred patients and their relatives. A phenomenological study design was used to examine subjective experiences and their meanings for the participants. RESULTS The analysis found nine axes pertaining to the experiences of IHT (inter-hospital transfers), grouped in three super-ordinate themes: Information about inter-hospital transfers, differences in patients' and relatives' experiences, and host hospital experience. It appears that patients felt little impacted by the transfers, unlike relatives who experienced intense anxiety when the transfer was announced. Good communications between patients and their relatives resulted in a good level of satisfaction regarding their host hospitals. COVID-19 and its somatic consequences seem to have had more psychological impact on the participants than the transfers by themselves. CONCLUSION Our results suggest that there are limited current psychological consequences of the IHT implemented during the first wave of COVID-19, although the involvement of patients and their relatives in the organization of the IHT at the time of transfer could further limit them.
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Affiliation(s)
- Nicolas Chauliac
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290 & Université Claude Bernard Lyon 1, Domaine Rockefeller, F-69008 Lyon, France
| | - Germain Salome
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Juliette Cheucle
- Faculté de Médecine Lyon-Est, Université Claude Bernard Lyon 1, F-69008 Lyon, France
| | | | - Perrine Galia
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Audrey Thomas
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Olivier Grimaud
- Univ Rennes, EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS-U 1309, F-35000 Rennes, France
| | - Jean-Marc Philippe
- Direction Générale de la Santé, Ministère de la Santé et de la Prévention, F-75007 Paris, France
| | - Philippe Vignaud
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Nathalie Prieto
- Centre Régional du Psychotraumatisme Auvergne-Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
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Faucher J, Khanafer N, Chauliac N, Essadek A, Galia P, Mamimoue E, Leroux ML, Pollet MP, Imler-Weber F, Gillet Y, Fourneret P, Espi P. Factors Associated with Increased or Decreased Stress Level in French Children during the First COVID-19 Lockdown. Int J Environ Res Public Health 2023; 20:4667. [PMID: 36901677 PMCID: PMC10001992 DOI: 10.3390/ijerph20054667] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
In spring 2020, governments of many countries implemented lockdown measures to prevent the spread of the COVID-19 pandemic. Worldwide, the pandemic forced about 1.5 billion children to stay at home for several weeks and to experience homeschooling. The objective of this study was to assess the variation in stress levels and associated factors in school-aged children in France during the first COVID-19 lockdown. A cross-sectional study using an online questionnaire was designed by an interdisciplinary team involving hospital child psychiatrists and school doctors. Between 15 June and 15 July 2020, Educational Academy of Lyon (France) invited the parents of school-aged children to participate in this survey. The first part of the questionnaire concerned the children with data on lockdown conditions, socio-demographic data, daily rhythms (eating and sleeping), perceived stress variations, and feelings. The second part assessed parental perspectives on their child's psychological state and use of the mental health care system. Multivariate logistic regression was performed to identify factors associated with stress variation (increased or decreased). A total of 7218 questionnaires were fully completed by children from elementary school to high school with a balanced sex ratio. In summary, 29% of children reported a higher stress level during the lockdown, 34% reported a lower stress level, and 37% reported no stress variation in the usual situation prior to COVID-19. Parents were most often able to identify signs of increased stress levels in their children. The most influential factors in the variation of stress for children were academic pressure, family relationships, and fear of being infected or infecting a family member with SARS-CoV-2. Our study underlines the high impact of school attendance stressors on children in usual conditions and encourages vigilance for children whose stress levels have decreased during the lockdown but who may have increased difficulty re-exposing themselves upon deconfinement.
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Affiliation(s)
- Juliette Faucher
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Nagham Khanafer
- Service d’Hygiène, Épidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
| | - Nicolas Chauliac
- Regional Center for Psychotraumatism, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
| | - Aziz Essadek
- Interpsy EA4432, University of Lorraine, 54000 Nancy, France
| | - Perrine Galia
- Regional Center for Psychotraumatism, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
| | - Elise Mamimoue
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | | | | | | | - Yves Gillet
- Department of Pediatric Emergency, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Pierre Fourneret
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
| | - Pauline Espi
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500 Bron, France
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Fahmi M, Georges T, Leaune E, Chalancon B, Chasles V, Blain J, Chauliac N. Patients' and relatives' views on unmet mental health care needs through a qualitative study: Symptoms are a major barrier. Int J Ment Health Nurs 2022; 31:1249-1259. [PMID: 35794730 DOI: 10.1111/inm.13036] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
Unmet needs in mental health care are a prominent issue and concern almost half of people with such disorders. Psymobile is a mobile outreach psychiatric team whose objective is to facilitate access to psychiatric services. Its intervention is at the request of relatives or social workers, making it possible to encounter situations of long-standing unmet needs. Our objective was to understand the barriers to accessing mental health care as perceived by patients and their relatives. We conducted a qualitative study with patients and their relatives using face-to-face semi-structured interviews and a hierarchical thematic analysis. Four major themes were identified: psychological and behavioural barriers, socio-economic barriers, structural barriers and physical barriers. Anosognosia or lack of insight is cited as a primary barrier, as are fear of stigma, and former negative experiences. The complexity of the French care system and the lack of literacy about mental illnesses were also emphasized by the participants. Physical determinants, such as the distance to healthcare facilities, were rarely mentioned. As a conclusion, outreach teams appear to be an appropriate way to address the issue of unmet mental health care needs when they provide psychiatric care.
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Affiliation(s)
- Morgan Fahmi
- Permanence d'accès aux soins de santé (PASS), Centre Hospitalier le Vinatier, Bron, France
| | | | - Edouard Leaune
- Pôle de psychiatrie des urgences, Centre Hospitalier le Vinatier, Bron, France.,Institut de Recherches Philosophiques de Lyon, Université Jean Moulin Lyon 3, Lyon, France
| | - Benoit Chalancon
- Pôle de psychiatrie des urgences, Centre Hospitalier le Vinatier, Bron, France
| | - Virginie Chasles
- Département de géographie-aménagement, Université Jean Moulin Lyon 3, Lyon, France.,UMR 5600 - Environnement, Ville, Société, CNRS, Lyon, France
| | - Jeffrey Blain
- Ecole Supérieure des Professions Immobilières Réflexions et Recherches (ESPI2R), Lyon, France
| | - Nicolas Chauliac
- Regional Centre for Psychotrauma, Hospices Civils de Lyon (Lyon University Hospitals), Lyon, France.,Psymobile, Centre hospitalier le Vinatier, Bron, France.,Research on Healthcare Performance (RESHAPE), INSERM U1290 and Claude Bernard Lyon 1 University, Lyon, France
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Leaune E, Durif-Bruckert C, Noelle H, Joubert F, Ravella N, Haesebaert J, Poulet E, Chauliac N, Cuvillier B. Impact of exposure to severe suicidal behaviours in patients during psychiatric training: An online French survey. Early Interv Psychiatry 2021; 15:149-157. [PMID: 31876396 DOI: 10.1111/eip.12923] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 11/17/2019] [Accepted: 12/14/2019] [Indexed: 01/11/2023]
Abstract
AIM Patient suicide (PS) has been identified as a frequent and stressful "occupational hazard" for mental health professionals. Studies are needed to assess the impact on psychiatric trainees of the exposure to severe patient suicidal behaviours. METHODS Our cross-sectional study aimed to measure the prevalence of exposure to PS and severe patient suicide attempts (SPSA) in French psychiatric trainees. We also assessed the emotional, traumatic and professional impacts and perceived support in the aftermath through a 62-item online questionnaire that included the French version of the IES-R, a composite emotional score and questions about professional practice and perceived support. All French psychiatric trainees were contacted regarding participation in the study through email and social networks between November 2017 and March 2018. RESULTS A total of 409 trainees participated in the survey (response rate = 16.4%). 253 trainees fully completed the questionnaire. Of the 253 trainees, 43.2% were exposed to PS and 13.8% to SPSA. The exposure mostly occurred in the early stage of the training period. Ten to 15% of exposed trainees showed a high level of traumatic and emotional impact and 8.1% exhibited clinically relevant symptoms of post-traumatic stress disorder (PTSD). We found that 21.6% received no support in the aftermath, especially after PS. CONCLUSION A large proportion of psychiatric trainees encounter severe suicidal behaviours of patients, and a substantial part of them is highly impacted. Our results thus stress the need for programmes dedicated to the prevention of the deleterious effects of the exposure to PS or SPSA in psychiatric trainees.
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Affiliation(s)
- Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.,INSERM U1028, CNRS UMR5292, Claude Bernard Lyon 1 University, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France.,Philosophical Research Institute of Lyon, Jean Moulin Lyon 3 University, Lyon, France
| | | | - Hugo Noelle
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.,Lyon-EstSchool of Medicine, Claude Bernard Lyon 1 University, Villeurbanne, France
| | - Fabien Joubert
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France
| | - Noémie Ravella
- Pôle 69G35, Hôpital Saint Cyr au Mont d'Or, Saint Cyr au Mont d'Or, France
| | - Julie Haesebaert
- Université Claude Bernard Lyon 1, EA 7425 HESPER Health Services and Performance Research-Claude Bernard Lyon 1 University, Université de Lyon, Lyon, France
| | - Emmanuel Poulet
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.,INSERM U1028, CNRS UMR5292, Claude Bernard Lyon 1 University, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France
| | - Nicolas Chauliac
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.,Université Claude Bernard Lyon 1, EA 7425 HESPER Health Services and Performance Research-Claude Bernard Lyon 1 University, Université de Lyon, Lyon, France
| | - Bruno Cuvillier
- Groupe d'Etude en Psychologie Sociale (GRePS), Lumière Lyon 2 University, Lyon, France
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Chauliac N, Leaune E, Gardette V, Poulet E, Duclos A. Suicide Prevention Interventions for Older People in Nursing Homes and Long-Term Care Facilities: A Systematic Review. J Geriatr Psychiatry Neurol 2020; 33:307-315. [PMID: 31840568 DOI: 10.1177/0891988719892343] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The death rate due to suicide among older people is high, especially among men. Because many older people live in nursing homes or long-term care facilities in high-income countries, reviewing the impact of prevention strategies on the suicidal behavior of residents in these settings is of interest. METHODS Following PRISMA guidelines, we performed a systematic review of the existing literature found in Pubmed, Scopus, Web of Science, PsycINFO, and Sociological Abstracts, focusing on interventions to prevent suicidal behavior or ideation in nursing home residents. The studies' quality was evaluated according to TIDieR and MMAT. RESULTS Only 6 studies met the inclusion criteria. Four of them described various "gatekeeper" trainings for nursing home staff and 2 described interventions focused on residents. Only 1 study was randomized. Gatekeeper training studies were mostly before/after comparisons. No intervention demonstrated a direct effect on suicidal ideation or behaviors. One study showed that "life review" had a long-lasting effect on depression scores and another that gatekeeper training led to changes in the care of suicidal residents. CONCLUSIONS Interventions to prevent suicidal ideation or behaviors in nursing homes are not rigorously evaluated, and no conclusion can be drawn on their effectiveness in preventing suicidal behaviors. We propose to better evaluate gatekeeper training for staff as well as peer support. Individual interventions targeting residents could be modified for broader implementation.
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Affiliation(s)
- Nicolas Chauliac
- Suicide Prevention Centre, le Vinatier hospital, Bron, France.,EA 7425 HESPER Health Services and Performance Research, Claude Bernard Lyon 1 University, Lyon, France
| | - Edouard Leaune
- Suicide Prevention Centre, le Vinatier hospital, Bron, France.,Institut de Recherches Philosophiques de Lyon, Jean Moulin Lyon 3 University, Lyon, France
| | - Virginie Gardette
- 165271UMR INSERM 1027, Toulouse University, Toulouse, France.,University Hospital, Toulouse, France
| | - Emmanuel Poulet
- Suicide Prevention Centre, le Vinatier hospital, Bron, France.,Psychiatrie des Urgences, Edouard Herriot university hospital, Lyon, France.,PsyR2 team, Centre de Recherche en Neurosciences de Lyon, INSERM U1028 / CNRS UMR 5292 / Claude Bernard Lyon 1 University, le Vinatier hospital, Bron, France
| | - Antoine Duclos
- EA 7425 HESPER Health Services and Performance Research, Claude Bernard Lyon 1 University, Lyon, France.,Pôle Information Médicale Evaluation Recherche, Edouard Herriot university hospital, Lyon, France
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Leaune E, Cuvillier B, Vieux M, Pacaut-Troncin M, Chalancon B, Perez AF, Haesebaert J, Chauliac N, Poulet E, Durif-Bruckert C. The SUPPORT-S Protocol Study: A Postvention Program for Professionals After Patient or User Suicide. Front Psychol 2020; 11:805. [PMID: 32431643 PMCID: PMC7217323 DOI: 10.3389/fpsyg.2020.00805] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 01/30/2020] [Accepted: 03/31/2020] [Indexed: 01/26/2023] Open
Abstract
Background Exposure to patient or user suicide (PUS) is identified as a challenging occupational hazard for mental health and social work professionals. Professionals exposed to PUS may encounter several ranges of emotional, traumatic or professional impacts in the aftermath. A high proportion of exposed professionals reports a lack of support in the aftermath of PUS. SUPPORT is a postvention program designed to provide a comprehensive, adaptative and effective support to professionals impacted by PUS. The aims of the SUPPORT-S study are to (1) improve the design of the SUPPORT program, (2) evaluate the effectiveness of the program to buffer the emotional, traumatic and professional impacts and to improve the perceived social support for professionals exposed to PUS, and (3) provide more insights into the consequences of PUS on both professionals and organizations. Method The SUPPORT-S study is a mixed method collaborative and participatory action research. The simultaneous and complementary collection and analysis of qualitative and quantitative data will offer an in-depth evaluation of the implementation and the effectiveness of the program. The qualitative evaluation includes: (a) an ethnographic observation; (b) 25 semi-directed interviews with randomized participants; (c) an activity analysis with providers of the program; and (d) collaborative sharing of the results with providers and participants. The quantitative evaluation includes pre- and post-measures in participants of: (a) emotional impact (Differential Emotions Scale IV); (b) traumatic impact (Impact of Event Scale-Revised); (c) professional impact (non-validated questionnaire); and (d) perceived social support (Perceived Social Support Scale for Professionals). The action research design will rely on: (a) the cycling process of implementation/evaluation/data sharing/adjustment and (b) the participatory approach through data sharing with providers and participants. Triangulation, saturation, randomization, and participatory design will also reduce the risk of biases and will improve the generalizability of conclusions. Expected Results We expect the SUPPORT-S study to evaluate and improve the design of the SUPPORT program to effectively help professionals to cope with PUS. Conclusion The results of the study will allow us to disseminate an effective and adaptive postvention program for professionals and institutions encountering PUS.
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Affiliation(s)
- Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR 5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon, France
| | - Bruno Cuvillier
- Groupe de Recherche en Psychologie Sociale, Lumière Lyon 2 University, Lyon, France
| | - Maxime Vieux
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
| | | | - Benoît Chalancon
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,CNRS, UMR 5191, Interactions, Corpus, Apprentissages, Représentations, Ecole Normale Supérieure de Lyon, Lumière Lyon University, Lyon, France
| | - Anne-Fleur Perez
- Institut Régional Jean Bergeret, Centre Hospitalier Saint-Jean de Dieu, Lyon, France
| | - Julie Haesebaert
- EA 7425 HESPER Health Services and Performance Research - Claude Bernard Lyon 1 University, Lyon, France
| | - Nicolas Chauliac
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,EA 7425 HESPER Health Services and Performance Research - Claude Bernard Lyon 1 University, Lyon, France
| | - Emmanuel Poulet
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR 5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon, France
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Chauliac N, Brochard N, Payet C, Margue Y, Bordin P, Depraz P, Dumont A, Kroupa E, Pacaut-Troncin M, Polo P, Straub S, Boissin J, Burtin C, Montoya G, Rivière A, Didier C, Fournel C, Durand C, Barrellon M, Amigues O, Brosson A, Mahé E, Haxaire O, Bonnot C, Defaux M, Rougier D, Gaultier A, Gutierrez A, Pozo M, Lefèvre V, Nier A, Bolzan S, Liautaud M, Barbosa S, Garcia S, Anfreville A, Mazille S, Durantet C, Morlon M, Gaboriau C, Halbert C, Cholvy M, Milinkovich P, Martin L, Maury-Abello L, Toulier B, Kerleguer V, Gabriel S, Duclos A, Terra JL. How does gatekeeper training improve suicide prevention for elderly people in nursing homes? A controlled study in 24 centres. Eur Psychiatry 2020; 37:56-62. [DOI: 10.1016/j.eurpsy.2016.05.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/02/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022] Open
Abstract
AbstractBackgroundThe death rate due to suicide in elderly people is particularly high. As part of suicide selective prevention measures for at-risk populations, the WHO recommends training “gatekeepers”.MethodsIn order to assess the impact of gatekeeper training for members of staff, we carried out a controlled quasi-experimental study over the course of one year, comparing 12 nursing homes where at least 30% of the staff had undergone gatekeeper training with 12 nursing homes without trained staff. We collected data about the residents considered to be suicidal, their management further to being identified, as well as measures taken at nursing home level to prevent suicide.ResultsThe two nursing home groups did not present significantly different characteristics. In the nursing homes with trained staff, the staff were deemed to be better prepared to approach suicidal individuals. The detection of suicidal residents relied more on the whole staff and less on the psychologist alone when compared to nursing homes without trained staff. A significantly larger number of measures were taken to manage suicidal residents in the trained nursing homes. Suicidal residents were more frequently referred to the psychologist. Trained nursing homes put in place significantly more suicide prevention measures at an institutional level.ConclusionsHaving trained gatekeepers has an impact not only for the trained individuals but also for the whole institution where they work, both in terms of managing suicidal residents and routine suicide prevention measures.
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Jonckheere J, Deloulme JC, Dall’Igna G, Chauliac N, Pelluet A, Nguon AS, Lentini C, Brocard J, Denarier E, Brugière S, Couté Y, Heinrich C, Porcher C, Holtzmann J, Andrieux A, Suaud-Chagny MF, Gory-Fauré S. Short- and long-term efficacy of electroconvulsive stimulation in animal models of depression: The essential role of neuronal survival. Brain Stimul 2018; 11:1336-1347. [DOI: 10.1016/j.brs.2018.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/12/2018] [Accepted: 08/03/2018] [Indexed: 12/28/2022] Open
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Abstract
Abstract. Background: The suicide rate in older people is high. Gatekeeper training is recommended for at-risk populations in the detection and management of suicidal residents in nursing homes. Aims: This study focuses on how caregivers in nursing homes consider suicide in older people from a social perspective, and to what extent these social representations are an obstacle to the prevention of suicide. Method: This study is both observational and qualitative, and is based on semi-directed one-to-one interviews with caregivers. Results: We met with 18 caregivers from three nursing homes in 2015. We show that the social representations of caregivers working in nursing homes are essentially identical to those of the general population and those found in other studies on paramedics. Suicide is seen as an expression of autonomy, a response to the suffering associated with aging and the living conditions imposed on older people in our society, particularly in nursing homes. Limitations: Our study highlights the problems inherent to the position of caregiver, in which we can observe a conflict between professional missions and personal ideology. Conclusion: This study confirms the need to continue training on suicide prevention in nursing homes.
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Affiliation(s)
- Audrey Couillet
- Suicide Prevention Center (Centre de révention du Suicide), Centre hospitalier le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Jean-Louis Terra
- Suicide Prevention Center (Centre de révention du Suicide), Centre hospitalier le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, Equipe d'Accueil 4129 Laboratoire P2S Parcours Santé Systémique, Lyon, France
| | - Nassima Brochard
- Suicide Prevention Center (Centre de révention du Suicide), Centre hospitalier le Vinatier, Bron, France
| | - Nicolas Chauliac
- Suicide Prevention Center (Centre de révention du Suicide), Centre hospitalier le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, Health Services and Performance Research Lab (HESPER) EA 7425, Lyon, France
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Abstract
BACKGROUND Poor social interactions have been recognized as a symptom since the beginnings of psychiatry. As far as socially withdrawn youth (SWY) are concerned, studies were mostly conducted on patients seeking care. Our psychiatric outreach team called Psymobile was able to reach SWY patients who were not seeking mental health care. AIMS To identify the clinical and socio-demographic characteristics of SWY patients referred to our Psymobile unit. METHOD We carried out a retrospective study on the records of patients aged 18-34 years, who were referred to Psymobile for 'withdrawal', between April 2012 and December 2015. RESULTS In total, 66 patients were included in the study. SWY are predominantly male (80%) from large families or single-parent ones. About 42% had no prior contact with a mental health professional before being referred to Psymobile. The mean duration of withdrawal is 29 months. In all, 42% of SWY use cannabis and 73% present disorders of the sleep-wake schedule. About 71% maintain relations with their families and 73% go out occasionally. They are mostly diagnosed with schizophrenia (37%) or mood disorders (23%). CONCLUSION Over one-third of Psymobile patients aged 18-34 years were referred on grounds of social withdrawal. Our data may illustrate more accurately the situation of youth social withdrawal amid the general population than data from help-seeking patients or online questionnaires.
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Affiliation(s)
- Nicolas Chauliac
- 1 Psymobile, Service Hospitalo-Universitaire du pôle Ouest, Centre Hospitalier Le Vinatier, Bron Cedex, France.,2 Health Services and Performance Research Lab (EA 7425 HESPER), Université Claude Bernard Lyon 1, Lyon, France
| | - Audrey Couillet
- 1 Psymobile, Service Hospitalo-Universitaire du pôle Ouest, Centre Hospitalier Le Vinatier, Bron Cedex, France.,3 Université Claude Bernard Lyon 1, Lyon, France
| | - Sophie Faivre
- 1 Psymobile, Service Hospitalo-Universitaire du pôle Ouest, Centre Hospitalier Le Vinatier, Bron Cedex, France
| | - Nassima Brochard
- 1 Psymobile, Service Hospitalo-Universitaire du pôle Ouest, Centre Hospitalier Le Vinatier, Bron Cedex, France
| | - Jean-Louis Terra
- 1 Psymobile, Service Hospitalo-Universitaire du pôle Ouest, Centre Hospitalier Le Vinatier, Bron Cedex, France.,4 Equipe d'Accueil 4129 Laboratoire P2S Parcours Santé Systémique, Université Claude Bernard Lyon 1, Lyon, France
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Abstract
By its very nature, the Psymobile team is often called on to visit young adults who remain confined at home but who have no diagnosed psychiatric conditions. The team has consequently become interested in the Japanese concept of hikikomori, a notion which appeared in the 1990s and which has since spread across the world. This concept still arouses some amount of discussion regarding its aetiology, its precise definition and its relevance outside Japan.
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Dumont A, Chauliac N, Pacaut-Troncin M, Leaune E. [Psymobile, for the prevention of crisis situations]. Soins Psychiatr 2014:18-22. [PMID: 24979916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The mobile psychiatric team Psymobile is a new method of response to the mental health problems encountered within the general population, notably for patients who have stopped receiving care or who have never had access to care. Intervening before a potential emergency, its mission is primarily one of prevention. Its purpose is to improve access to care and avoid the rehospitalisation of patients suffering from psychiatric pathologies.
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