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Caractéristiques de la population prise en charge au Service de Psychiatrie du CHU Yalgado Ouédraogo de Ouagadougou (Burkina Faso) de 1990 à 2000
Abstract
Mental disorders constitute an important portion of the world sickness ratio. In developing countries, in the absence of data on morbidity, hospital statistics are worthy of interest. Our study was carried out on a population of patients under care in the department of psychiatry of the Ouagadougou Hospital between January 1st 1990 and December 31st 2000, a period of 11 years. For each patient, we noted the sociodemographical features and the clinical diagnosis refering to the ICD-10 of the WHO. Within the scope of the study, 7 313 patients (60% men and 40 % women) were analysed. The average age of the patients was 31.06 ± 13.07 years. Among these patients, 80.60 % had been exclusively under ambulatory-care and 19.40 % had been hospitalized at least once. The main categories of the avai-lable diagnoses were listed according to recurrence : acute psychotic disorders (20.68 %), schizophrenia (17.25 %) and depression (15.13 %). In the men, the main diagnosis was acute psychotic disorders, whereas depression came top of the list for women. In the present state of socio-economic and cultural development in Burkina Faso, we note that only very serious mental disorders and/or those who cannot obtain favourable response with the traditional care system, come to medical centers. Therefore, there is a need to investigate the population as a whole, and to assess their need for medical care in this domain.
... La fréquence des hospitalisations était d´environ 10% dans notre étude. Au Burkina Faso, Ouedraogo et al. ont trouvé une fréquence de 19,4% [13]. En absence de données sur la santé mentale en population générale au Mali, ce faible taux des hospitalisations en psychiatrie (0,01 pour 100000 habitants) pourrait s´expliquer soit par l´inaccessibilité du système de soins aux personnes malades. ...
... Les hommes étaient relativement jeunes avec un âge moyen de 32,2 ± 10,7 ans comparé aux femmes chez qui l´âge moyen était de 35,3 ± 12,8 ans. Au Burkina, Ouédraogo et al. ont trouvé un âge moyen de 31,06 ± 13,07 ans avec une élévation significative de l´âge chez les femmes (32,01 ± 14,04 ans) comparées aux hommes (30,42 ± 12,33 ans) [13]. Notre population de patients hospitalisés était pour la majorité des célibataires avec plus de 50% (Tableau 1). ...
... Au Maroc, Belghazi et al. affirme que l´hospitalisation psychiatrique concerne les cas graves de schizophrénie, de dépression, et troubles bipolaires [12]. Dans le contexte africain, les demandes de soins psychiatriques sont le plus souvent formulées devant des manifestations socialement peu tolérées, comme l´agitation, l´agressivité [13,20,32]. Nos résultats confirment ce constat; nous avons trouvé l´agressivité comme premier motif d´hospitalisation en psychiatrie suivi de l´agitation (Tableau 3). ...
Introduction:
in Mali, there are no data on the prevalence of mental disorders. The purpose of this study was to describe the clinical and epidemiological features of patients hospitalised in the Department of Psychiatry.
Methods:
we conducted a cross-sectional study in the Department of Psychiatry at the University Hospital of Point G between January 2014 and December 2018. Data were collected from the medical records of 1105 patients hospitalised for psychiatric disorders.
Results:
the average age of patients was 32.6 ± 11.1 years, ranging from 13 to 82 years. Male patients accounted for 83.8% (926/1105) of enrolled subjects, 53.2% (588/1105) were single, 18.8% (208/1105) were not employed and 28.2% (310/1105) had primary education. Seventy-four percent (818/1105) had a history of psychiatric disorders, 22.7% (251/1105) were born to consanguineous parents. Drug use was reported in 42.9% (474/1105) of cases, including tobacco 32.6% (361/1105), cannabis 26.0% (287/1105) and/or alcohol 15.6% (172/1105). The demand for care came from families in 87.5% (967/1105) of cases. Aggression was the most common reason for consultation (44.5%; 492/1105). In 67.8% (749/1105) of cases, the diagnosis was schizophrenia, schizotypic disorders or delusional disorders. The first use of care was traditional in 58.7% (649/1105) of cases.
Conclusion:
people hospitalised for psychiatric disorders from 2014 to 2018 were predominantly young and male with a history of psychiatric disorders. They mainly had schizophrenia, schizotypic disorders and delusional disorders.
... Le contexte burkinabè est marqué par le peu de donné es é pidé miologiques concernant la santé mentale, ce qui fait qu'il est difficile de dé terminer avec exactitude l'ampleur des TPAT dans la morbidité psychiatrique nationale. Dans une é tude ré trospective sur 11 ans mené e entre les anné es 1990 et 2000, Oué draogo et al. [16] avaient trouvé que les TPAT venaient en tête des pathologies prises en charge dans le service de psychiatrie du centre hospitalier universitaire Yalgado Oué draogo (CHU-YO), repré sentant 20,68 % des diagnostics, devant les schizophré nies (17,25 %) et les troubles dé pressifs (15,13 %). Les facteurs qui pré disposent à la survenue de ces troubles sont multiples et intriqué s, et, pourquoi pas, é volutifs dans le temps. ...
... La pré valence de 19,53 % que nous avons trouvé e au cours de notre pé riode d'é tude confirme la relative grande fré quence des TPAT dans notre contexte [16]. Mais nous pensons que cette pré valence est sous-estimé e à l'é chelle nationale pour diverses raisons. ...
... Mais notre ré sultat est similaire à ceux d'autres é tudes qui trouvaient é galement une pré dominance masculine. C'est ainsi que Oué draogo et al. [16] au Burkina Faso (Ouagadougou) trouvaient un taux de 68,23 %. Nubukpo et al. [13] au Togo (Lomé ) rapportaient le chiffre de 60,32 %, Chakraborty et al. [4] rapportaient en Inde 61,1 %, Shaltout et al. [21] au Qatar rapportaient 69 %, Singh et al. [22] en Grande-Bretagne (Nottingham) rapportaient 65,62 %. ...
Acute and transient psychotic disorders (ATPD) are common in Africa, particularly in Burkina Faso. In order to determine their epidemiological and clinical features in the psychiatry department of the centre hospitalier universitaire Yalgado Ouédraogo, we brought up a retrospective, descriptive and transversal study over 5 years from January 2003 to December 2007. All patients admitted in the psychiatric yard for ATPD were identified through medical records and patient registers. Data analysis was performed with Epi info 2007. During this period, 1106 admissions were registered and 216 had the diagnosis of ATPD. The study included 188 inpatients with complete files, 149 men and 39 women from 13 to 60 years old. This study showed that the point prevalence of ATPD was 19.53%. It mainly affected single men, in early adulthood (28 years on average), living in towns and working in the informal sector. The main diagnosis was acute polymorphic disorder without symptoms of schizophrenia (71.28% of cases). Delusions of persecution were the most common (43% of the themes). Mechanisms were dominated by imaginative ideas (32.62% of the mechanisms), visual and auditory hallucinations. Under medical treatment, main symptoms disappeared and recovery was obtained after an average of 15 days. We discussed the psychopathology of the ATPD in Africa and particularly in Burkina Faso. Considering their heavy socioeconomic and cultural consequences, their management must be improved by a better knowledge of their determinants and evolution.
... These studies inform on the prevalence of specific conditions but provide little information on the development of pathologies and the influence of poverty and living conditions on psychological distress. As Ouédraogo and colleagues[31]have pointed out, people seeking help from psychiatric facilities are those for whom traditional medicine has not worked and who have developed a chronic or recurrent condition (transitory psychotic disorder, schizophrenia, or major depressive disorder). They are thus not representative of the overall mental health needs of the general population, who are more likely to consult traditional healers due to greater compatibility with their beliefs[32]. ...
... Various factors may explain this discrepancy, including financial barriers, geographical barriers, stigma, lack of mental health literacy, or lack of knowledge about available psychiatric services-factors that are also linked to a lack of trained human resources and to a lack of funding[51,52,[54][55][56]. Surprisingly, our respondents also did not appear to have sought the help of traditional healers, who are thought to engage in healing rituals and techniques that fit better with socially shared conceptions of mental health and mental illness[31,32]than do psychiatric facilities or medical structures. It seems that, in both cases, financial costs and stigma may act as important barriers to care. ...
Background
Poverty is known as an important determinant of health, but empirical data are still missing on the relationships between poverty, other adverse living conditions, and psychological distress, particularly in low-income countries.
This study aimed to assess mental health needs and psychological distress among the poorest in rural settings in Burkina Faso where food security and access to water, electricity, schooling, and healthcare are limited.
Methods
We randomly selected 2000 individuals previously identified as indigents by a community-targeting process. Interviewers visited participants (n = 1652) in their homes and completed a questionnaire on mental health variables that included presence and intensity of anxious, depressive, psychotic, and aggressive symptoms, as well as level of psychological distress. Descriptive statistics, Spearman correlations, and logistic regressions were performed.
Results
In all, 40.2% of the sample reported 10 or more anxious/depressive symptoms in the past 30 days, and 25.5% reported having experienced at least one psychotic symptom over their lifetime, 65.6% of whom had had those symptoms for many years. The number of anxious and depressive symptoms was significantly associated with the level of psychological distress (r = 0.423, p < .001). Predictors of distress level included: poor health condition (F(1) = 23.743, p <. 001), being a woman (F(1) = 43.926, p < .001), not having any income (F(1) = 16.185, p < .001), having begged for food in the past 30 days (F(1) = 12.387, p < .001), being illiterate, and being older (F(1) = 21.487, p < .001). Approximately one third of respondents reporting anxious/depressive or psychotic symptoms (28.2 and 30.0%, respectively) had not talked about their symptoms to anyone in their social network.
Conclusions
These results suggest alarmingly high levels of psychological distress and reported symptoms among the poorest in rural settings in Burkina Faso, which can be explained by their difficult living conditions. However, these results must be interpreted from a transcultural perspective to avoid decontextualized misinterpretations. Ethnographic works are needed to document the larger context within which these distress results can be analyzed.
... Les études réalisées en population clinique au CHU Yalgado Ouédraogo de 1990 à 2000 par Ouédraogo et al. [4] indiquaient que les troubles psychotiques aigus transitoires (20,68 %), les schizophrénies (17,25 %) et les troubles dépressifs (15,13 %) étaient les principales catégories diagnostiques les plus fréquemment retrouvées. Mais seule une faible minorité des personnes souffrant de ces troubles recevaient des soins dans les structures sanitaires, d'où l'importance des enquêtes en population générale. ...
Objectives:
To determine, with the use of the Mini-International Neuropsychiatric Interview (MINI), the prevalence of mental disorders in the general population of Burkina Faso; To identify the factors associated with the occurrence of these disorders.
Methods:
We conducted a cross-sectional descriptive and analytical survey of a representative sample of the general population aged 18 years and over (n=2587). The only non-inclusion criterion was absence from the place of residence during the investigation period for whatever reason. This approach allowed us to select at random 840 households with a total number of 2587 persons aged 18 years and over. The data collection tools we used were a written questionnaire, developed by ourselves, and the Mini International Neuropsychiatric Interview or MINI questionnaire. On the ethical level, the protocol of this research and its appendices have received the prior approval of the Ethics Committee for Health Research of Burkina Faso as well as support from local customary and administrative authorities.
Results:
The surveyed population consisted of 1 479 women (57.17 %) and 1108 men (42.83 %). Of the 2 587 people surveyed, 1 072 or 41.43 % met the criteria for at least one of the mental disorders. The prevalence rate was significantly higher among women than men (46.24 % versus 35.01 %). The depressive episode was the most frequent disorder in the surveyed population (11.60 %). Gender, place of residence and marital status were the main factors significantly associated with the occurrence of mental disorders.
Conclusion:
This first national survey revealed a high prevalence of mental disorders. Considering the importance of mental disorders in the general population, it is important to train and involve more nurses and general practitioners in the identification and management of these disorders as there are very few specialists in the field at present.
... Ce résultat va dans le sens de la proportion des sujets a ˆgés dans la population générale togolaise, qui e ´tait de 5,45 % [3]. Cela est comparable aux résultats de Ouédraogo et al. [5], qui notent 4,24 % a ` Ouagadougou (Burkina Faso) dans une e ´tude similaire. Ces deux fréquences sont différentes de celle rapportée par Lorant et al. [6], en Belgique, qui e ´tait de 10,8 % de sujets a ˆgés de 65 ans et plus pour l'ensemble des patients hospitalisés en psychiatrie. ...
The objective of this study was to describe the social, demographic, and clinical profile of inpatients and outpatients 60 years or older treated for psychiatric disorders. This descriptive and analytic retrospective study took place at the inpatient and outpatient psychiatry departments at two university hospital centers in Lomé: Campus and Sylvanus Olympio of Lomé. It included patients aged 60 years or older seen during the 10-year period 2004-2013 who met ICD-10 diagnostic criteria for psychiatric disease. This series comprised 224 patients with a mean age of 67.6 ± 7.37 years (range: 60-97). Insomnia (16%), hallucinations (8.53%), and somatic complaints (7.73%) were the most frequent motives for consultation. Family or friends accompanied 80.36% of these patients to the consultation. Among the patients, 66.96% were aware of their disorder, and 60.71% showed an adherence to treatment. The main diagnoses were depressive disorders (25.89%) and various forms of dementia (23.66%) The prevention of depression disorders in this population requires real work on mourning.
Les sorties sans avis médicale (SSAM) ont fait l’objet de peu de travaux en Afrique. L’objectif de cette étude était d’étudier les SSAM au service de psychiatrie du CHU-YO. Il s’est agi d’une étude transversale rétrospective de 10 ans. A partir du registre d’hospitalisation nous avons inclus les patients. Les données collectées ont été saisies traitées avec le logiciel SPSS 20. La prévalence moyenne des SSAM était de 12.02 %. L’âge moyen des patients était de 31.32 ans. La durée moyenne de leur hospitalisation était de 9.54 jours. Ces patients avaient des ATCD psychiatriques (70.70 %). L’agitation (69.10 %) et l’agressivité (60.90 %) étaient les motifs d’hospitalisation les plus fréquents. Près de la moitié des patients (47.30 %) consommaient des SPA. Les troubles schizophréniques étaient le diagnostic le plus fréquent (51.20 %). Près de la moitié des patients (48.80 %) quittaient l’hôpital pendant la première semaine.
Introduction : Au Burkina Faso, le manque d’études sur les itinéraires thérapeutiques en santé mentale limite la compréhension des obstacles associés au recours aux soins. Comme dans plusieurs pays d’Afrique subsaharienne, cette situation se traduit par une difficulté des systèmes de santé à adapter l’offre de soins disponible à la réalité des personnes souffrant de troubles mentaux. But de l’étude : Dans cette étude, des observations participantes ont été faites ; sept groupes de discussion et 25 entretiens individuels ont ainsi été organisés afin d’explorer les représentations sociales et l’utilisation des soins existants en santé mentale. Différents acteurs ont été interrogés : patients, soignants, accompagnants et informateurs clés. Résultats : Une analyse thématique a révélé la présence de trois systèmes de soins dans la ville de Bobo-Dioulasso : 1) les soins psychiatriques associés à une fonction diagnostique et à la prise en charge de pathologies graves ou déclenchées par des causes « naturelles », 2) les soins traditionnels perçus comme ayant une fonction de guérison pour les pathologies « surnaturelles », mais associés à un risque d’escroquerie, et 3) les soins informels prodigués par la famille identifiés comme représentant le pilier des itinéraires thérapeutiques. Conclusions : Cette étude révèle qu’à travers la diversité des ressources consultées, l’entourage direct représente le principal pourvoyeur de soins et que les contraintes financières constituent l’obstacle principal aux recours aux soins. Ce constat nous amène à formuler des recommandations relatives à l’élaboration d’éventuelles politiques publiques à l’échelle nationale ainsi qu’à l’organisation des services de santé dans la ville de Bobo-Dioulasso.
Background
In Burkina Faso, prevalence of mental health disorders and the characteristics of people living with these disorders are scarce, especially among the poorest.
Methods
This study aims at providing a descriptive portrait of the prevalence of psychiatric symptoms and their determinants among indigent individuals living in rural Burkina Faso. A cross-sectional design was chosen, using a stratified sampling procedure. A questionnaire comprising 73 questions was administered to 1314 respondents.
Results
Mental health symptoms were grouped into three types: anxiodepressive, somatic and psychotic. A total of 1234 (93.9 %) participants reported having experienced at least one anxiodepressive symptom and 1087 (82.7%) respondents reported at least one somatic symptom one month prior to the interview. Furthermore, 256 (19.5%) participants reported at least one psychotic symptom in their lifetime. Differences in the expression of distress between regions were noted as well as a feeling of exclusion among respondents to their communities were common to all symptomatic profiles, which opens up avenues of targeted intervention for future equitable mental health policies.
Conclusions
The mental health action plan 2014-2018 in Burkina Faso ⁷ identified the lack of evidence in mental health as one of the most salient issues. This study contributes to addressing this limitation and participates in the Movement for Global Mental Health (MGMH) by providing knowledge on the prevalence of symptoms of mental health disorders in a vulnerable population living in rural areas.
Objective
Dark-skinned immigrants have a higher risk for schizophrenia and other psychoses than other immigrants. The first British studies reported that first-generation immigrants (FGIs) from the Caribbean presented atypical psychoses. This study examines the characteristics of psychotic episodes in black FGIs to Canada. Method
The charts of 18 FGIs from Africa and Haiti, extracted from a series of 20 black patients consecutively admitted to Psychiatry, were retrospectively reviewed regarding clinical features, diagnoses and vitamin D levels. ResultsYoung FGIs presented acute psychotic episodes with abrupt onset, florid positive symptoms, few negative symptoms and good evolution. The onset was more insidious in older FGIs. Overall, catatonia was very frequent (28%), and mood symptoms still more frequent (44%). No cognitive decline was observed during follow-up. Serum levels of 25-hydroxy vitamin D were in the insufficiency range. Supplementation at 1000 IU/day did not restore normal levels. Conclusion
The clinical features of psychotic episodes in black FGIs are similar to those reported in dark-skinned FGIs to other countries. They are also observed in other immigrants and in non-immigrants. These atypical psychoses are possibly related to a recent vitamin D deficit. This hypothesis should be tested by clinical trials of sufficient vitamin D supplementation.
The aim of this study was to determine the epidemiological and clinical features of dissociative and somatoform disorders in the psychiatry department of the Centre Hospitalier Universitaire Yalgado Ouédraogo, in Burkina Faso.
We carried out a retrospective and descriptive study over five years, from January 2003 to December 2007, of patients admitted in the psychiatric department for dissociative and somatoform disorders. The data were extracted from the medical notes and registers of consultation. After identification of the patients, the medical notes were exploited with a structured collect form for data on sociodemographic characteristics, life events and ICD-10 diagnoses. All the data were recorded by the same person. Data analysis was performed with Epi info 2007.
During a period of 5 years, 3967 patients were registered, 179 had the diagnosis of dissociative and somatoform disorders (3.65% of the admissions) and 145 were included in our study. The majority of the patients were followed as outpatients (71%). Women were more represented with a sex ratio of four women to one man. The majority of the patients were young with an average age of 30 and mostly single (57.9%). The majority of the patients had a low academic standard, in connection with young age of the population. A striking biographic event was found in the majority of the cases; essentially family difficulties and death. Neurological symptoms were the most frequent in 63% of the cases. According to ICD-1O, dissociative disorders were most frequent (65.6%). Depression was mainly associated in15 cases.
Dissociative disorders and somatoform disorders are frequent in our hospital; we must overcome the difficulties due to the complexity of the diagnosis and the cultural resistances to modern health care to determine the real prevalence of these disorders among the population in Burkina Faso.
Depression is one of the most important causes of morbidity and disability in developing countries.1 Zimbabwe, in common with other developing nations, has absolute poverty, economic reform programmes, limited public health services, widespread private and traditional healthcare services, civil unrest, cultural diversity, and sex inequality. We have conducted research on depression in Zimbabwe over the past 15 years, covering ethnographic and epidemiological studies in a range of populations. We compared our findings with research from other developing countries and with evidence from industrialised countries. In the context of developing countries we examined the validity of World Health Organization classifications and medical concepts of depression, the public health implications of depression, and the implications for clinical practice and research.
#### Summary points
Depression is common in developing countries, especially in women, with a vicious cycle of poverty, depression, and disability
Depression typically presents with multiple physical symptoms of chronic duration, though simple questions can often elicit psychological symptoms
Anxiety often coexists with depression, and multiple diagnostic categories for common mental disorders have limited validity
Low recognition and treatment of symptoms rather than cause are the hallmarks of current practice in general health care
In Zimbabwe, multiple somatic complaints such as headaches and fatigue are the most common presentations of depression. 2 3 On inquiry, however, most patients freely admit to cognitive and emotional symptoms.4 Many somatic symptoms, especially those related to the heart and the head, are cultural metaphors for fear or grief. Most depressed individuals attribute their symptoms to “thinking too much” ( kufungisisa ), to a supernatural cause, and to social stressors. Our data confirm the view that although depression in developing countries often presents with somatic symptoms, most patients do not attribute their symptoms to a somatic illness and cannot be said to have “pure” somatisation. 2 5 6 This means …
Cette etude se situe dans le contexte de la reorganisation des services de sante et des services sociaux au Quebec et vise a decrire les caracteristiques physiques et mentales des personnes demeurant au centre hospitalier psychiatrique. Dans la premiere etude, 146 personnes presentant une deficience intellectuelle dont 74 forment le groupe en externe (dans la communaute) et 72, le groupe interne (hospitalise). Les resultats indiquent que 84 % des personnes presentant une deficience intellectuelle demeurant en institution presentent des besoins suffisamment importants aux trois variables sante, deficits et comportements pour justifier un encadrement plus intensif. La variable qui influence le plus l'integration sociale est celle des comportements prejudiciables. Comme les personnes demeurant en institution et qui devront eventuellement integrees la communaute, ont un degre d'incapacite eleve et des comportements prejudiciables plus nombreux, l'encadrement devra etre soutenu et intensif aupres des sujets et des responsables de services. Dans la deuxieme etude, 928 personnes en milieu institutionnel souffrant de troubles mentaux ont ete etudies selon les variables, âge, sexe, diagnostic et les scores agglomeres de l'Inventaire du niveau de soins et l'autonomie fonctionnelle. Les resultats demontrent que la proportion de femmes de 35 ans et plus croit progressivement par rapport aux hommes. La repartition des diagnostics est principalement la schizophrenie se situant approximativement a 70 %. L'âge devient un facteur important dans l'evaluation des soins physiques des personnes souffrant de problemes mentaux. La population interne est vieillissante et les femmes sont de plus en plus nombreuses dans ces groupes d'âge. Ces personnes presentent davantage des troubles physiques et une autonomie declinante. En vertu du soutien requis par ces personnes au moment de l'integration dans la communaute, on devra offrir des ressources plus structurees et plus specialisees pour repondre a leurs besoins.
We seek to investigate socio-economic differences in psychiatric in-patient care regarding admission, treatment and outcome.
This study is undertaken on a comprehensive and exhaustive psychiatric case register of all psychiatric in-patient care carried out in Belgium in 1997 and 1998 (n=144 754).
Lower socio-economic groups were more likely to be compulsorily admitted, to be cared for in a non-teaching or psychiatric hospital, to be admitted in a hospital with unexpectedly long average length of stay and to be admitted to a ward with a more severe case-mix. They were less likely to receive antidepressants and psychotherapies. The improvements in functioning and in symptoms were also less favourable for these groups. The lowest group had a higher risk of dying in the hospital.
Psychiatric in-patient care is associated with moderate socio-economic differences in access, treatment and outcome. Further research is needed to clarify the causes of such disparities.
Of 1,232 patients receiving psychiatric medication in outlying areas of South Africa more than half had diagnoses of schizophrenia. Significantly more men than women had substance-induced psychosis, while significantly more women had depressive and anxiety disorders.
Many studies are searching clinical and social-demographic predictive factors of the management options in psychiatric emergency. The greater part of these researches are published in US and are seeking about patients and about conditions of psychiatric practice different of the European circumstances. Such differences have motivated us to perform a comparison between the characteristics of the native Swiss and of the foreign patients in the psychiatric emergencies. The other aim of the study was to detect, if differences are proven, some predictive factors of their management strategies. This study describes the social-demographic and clinical characteristics of a sample of 1 028 unduplicated consultations and investigates possible relationships between these clinical characteristics and different management strategies, with a particular focus on the foreign patients, covering 46.5% of all consultations. Because quite half of the psychiatric emergency visits occur with foreigners, it plays a potentially important role in searching the disparities in diagnosis and management. To verify these differences, we studied two specific questions: 1) are there nationalities differences in diagnosis with respect to the Swiss native population, and 2) are there nationality differences in management of patients visiting a psychiatric emergency service?
Demographic and clinical data were obtained prospectively from the psychiatric emergency service of Geneva, located in the county general hospital, during a 13 weeks period. The study involved all patients aged between 18 and 65 years, inhabitants of county of Geneva-Switzerland, presented at the psychiatric emergency service of the general hospital. To limit the bias of screening the chronic patients, we have included only once, at the first examination, the patients with more than one emergency consultation in the considered interval.
As a general trend, the probability for the foreign patients to consult the emergency psychiatrist is greater than for the Swiss natives: OR=1.44, p=0.000. The social-demographic factors show significant differences between the foreigners and Swiss population: the immigrating population is younger, more active and clustered to a familial structure. Despite the availability and use of the same clinical criteria, foreign patients are disproportionately differently diagnosed, with less alcohol abuse (14.7% for foreigners versus 23.9% in the Swiss population), less personality disorders (8.1% versus 13%), more affective disorders (54.7% versus 43%) and more anxious disorders (18.4% versus 12.3%). Furthermore, on the sum of all diagnoses, the single statistically significant difference in management is found in respect to the recommendation for a Short-term Therapeutic Centre , done more frequently for the foreigners: 15.5% versus 11.3%. Some immigration-related predictive factors of diagnosis and management are found and detailed.
The apparent habit of the foreigners to appeal to the hospital emergencies could be, at least partially, due to a minority or cultural factor: the patients seem to be easily appealing to a great hospital rather than to a territorial policlinic by failure to find a psychiatrist into the Swiss health network. This hypothesis is to be confirmed by further studies. The inexistence of significant differences in management of the patients with the same diagnosis between the two patient groups suggests the equality of resources spent for the two patient groups. The main methodological limit of this study consists of the gathering of different immigrated nationalities in a unique patient group in order to find, if any, significant differences in comparison to the Swiss patients, whereas may be matter of heterogeneous populations.
These observations suggest that further researches are needed to clarify the decision-making process in diagnosis and patient management in psychiatric emergency department, especially for foreigners, and to distinguish different cultural groups rather than different nationalities. The reassessment of all patients with their clinical evolution and the allocated health resources could lead to the question on the relevance of health management decisions in psychiatric emergency circumstances, as well as to the question on the influence of the foreigner status on therapeutic decisions.
Rapport sur la santé dans le monde : la santé mentale : nou-velle conception, nouveaux espoirs
- Oms
OMS. Rapport sur la santé dans le monde : la santé mentale : nou-velle conception, nouveaux espoirs. Genève : OMS, 2001. L'Encéphale, 2006 ; 32 : 437-43, cahier 1 Caractéristiques de la population prise en charge au Service de Psychiatrie de Ouagadougou 443
Classification Internationale des Maladies Dixième révision (CIM-10) Chapitre V (F) : Troubles mentaux et troubles du compor-tement
- Oms
OMS. Classification Internationale des Maladies. Dixième révision (CIM-10). Chapitre V (F) : Troubles mentaux et troubles du compor-tement. Paris : Masson, 1993.
Une typo-logie des secteurs de psychiatrie générale en 1999
- Hardy-Baylé Mc
COLDEFY M, BOUSQUET F, HARDY-BAYLÉ MC et al. Une typo-logie des secteurs de psychiatrie générale en 1999. DREES, Études et Résultats 2002 ; n° 163.
Les personnes suivies régulièrement pour troubles psychiques ou mentaux
- Peretti C Chapireau
ANGUIS M, PERETTI C, CHAPIREAU F. Les personnes suivies régulièrement pour troubles psychiques ou mentaux. DREES, Étu-des et Résultats 2003 ; n° 231.
Étude compa-rative des caractéristiques sociodémographiques et des facteurs prédictifs de soins de patients suisses et étrangers consultant un service d'urgences psychiatriques
- Damsa C Schutzbach
BALEYDIER B, DAMSA C, SCHUTZBACH C et al. Étude compa-rative des caractéristiques sociodémographiques et des facteurs prédictifs de soins de patients suisses et étrangers consultant un service d'urgences psychiatriques. Encéphale 2003 ; 29 : 205-12.
La santé mentale en région Ile-de-France : des données épidémiologiques à la planification
- Chanoit Pf
KOVESS V, LABARTE S, CHANOIT PF. La santé mentale en région Ile-de-France : des données épidémiologiques à la planification. Inform Psychiatr 2002 ; 76 : 43-55.
Psychiatrie itinérante : expérience du Centre médical solidarité d'Abomey
- Tognon Tchegnonsi F
- Gandaho P
- Ahyi
TOGNON TCHEGNONSI F, GANDAHO P, AHYI RG. Psychiatrie itinérante : expérience du Centre médical solidarité d'Abomey. Benin Med 2002 ; 22 : 28-31.
Admissions and readmissions into a psychiatric hospital in Nigeria. A study of demographic and clinical correlates
- Ihezue Uh
- Nwakoby Ban
- Okonkwo
- Ko
IHEZUE UH, NWAKOBY BAN, OKONKWO KO et al. Admissions and readmissions into a psychiatric hospital in Nigeria. A study of demographic and clinical correlates. Psychopath Afric 1993 ; 25 : 105-14.
Admissions and readmissions into a psychiatric hospital in Nigeria. A study of demographic and clinical correlates
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