vendredi 3 janvier 2020

ETUDE RECHERCHE l'impact des conduites suicidaires graves de patients sur les internes en psychiatrie

Impact of exposure to severe suicidal behaviours in patients during psychiatric training: An online French survey.
Leaune E 1,2,3, Durif-Bruckert C 4, Noelle H 1,5, Joubert F 1, Ravella N 6, Haesebaert J 7, Poulet E 1,2, Chauliac N 1,7, Cuvillier B 4.
1 Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.
2 INSERM U1028, CNRS UMR5292, Claude Bernard Lyon 1 University, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France.
3 Philosophical Research Institute of Lyon, Jean Moulin Lyon 3 University, Lyon, France.
4 Groupe d'Etude en Psychologie Sociale (GRePS), Lumière Lyon 2 University, Lyon, France.
5 Lyon-EstSchool of Medicine, Claude Bernard Lyon 1 University, Villeurbanne, France.
6 Pôle 69G35, Hôpital Saint Cyr au Mont d'Or, Saint Cyr au Mont d'Or, France.
7 Université Claude Bernard Lyon 1, EA 7425 HESPER Health Services and Performance Research-Claude Bernard Lyon 1 University, Université de Lyon, Lyon, France.

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.
https://onlinelibrary.wiley.com/doi/abs/10.1111/eip.12923
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COMPLEMENT : 
Info signalée & source  Leaune Edouard @EdouardLeaune ·26 déc. 2019
" 2/3 Près de deux-tiers de notre échantillon (253 internes en psychiatrie français) ont été exposés au suicide ou à la TS grave d'un(e) patient(e). 17% présentent des réactions post-traumatiques et 8% des signes cliniques de PTSD. 11% rapportent un état de détresse émotionnelle"
" 3/3 50% décrivent un impact professionel négatif sur leur pratique. Deux phénomènes très inquiétants: un interne sur cinq déclare n'avoir reçu aucun soutien après l'évènement et plus d'un quart des internes de l'échantillon ont eu des idées suicidaires au cours de leur internat