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Objectives. A survey was conducted to produce reliable epidemiological data concerning the role played by alcohol and drugs in fatal road accidents in France. The aims are to describe the conduct of the survey, evaluate the overall quality of the findings, and analyze the substances consumed by the involved drivers. A comparison between drivers involved under the influence of alcohol only, cannabis only, or both substances is emphasized. Methods. By a June 1999 law, all drivers in France involved in an immediate fatality accident between October 2001 and 2003 had to undergo a urine test and, if that was not possible or the test proved positive, had a blood sample taken in order to test for drugs (cannabis, cocaine, heroin, amphetamines). The results were combined with the usual procedures of the police force, which include the results of tests for illegal alcohol levels. A unique and reliable set of accident data on the role of drugs was thus compiled for epidemiological purposes: 10,000 accident reports involving over 17,000 drivers were analyzed. The responsibility level of each driver involved in an accident was determined. Results were generated for a representative sample of about 11,000 drivers. Results. Alcohol levels above the legal limit (0.5 g/L of blood) were found in 21% of all drivers involved in accidents (killed, injured, or unharmed). Cannabis headed the list of illicit drugs detected, with a prevalence of 6.8% (THC ≥ 1 ng/mL); it was present in the under-35s and especially the under-25s. About 40% of drivers under the influence of cannabis also had an illegal alcohol level. The other drugs, whether alone or in association with cannabis, are relatively rare. Accident characteristics of drivers detected positive for cannabis only are markedly different from drivers under the influence of alcohol. The overrepresentation of drivers responsible, from 1.7 over the whole population, rises to 2.3 for cannabis alone (THC ≥ 1 ng/mL), to 9.4 for alcohol alone (≥0.5 mg/L), and to 14.1 for the alcohol-cannabis combination. Conclusions. The high incidence (26%) of alcohol or drugs among the population of drivers involved in fatal accidents highlights the importance for road safety of the consumption of these substances. Alcohol remains the major risk at any age. Young drivers consuming alcohol and cannabis represent a priority target for prevention. [ABSTRACT FROM AUTHOR]

BACKGROUND: General medical practitioners are essential for the prevention, diagnosis, and management of alcohol use disorders. Studies to examine medical practice in this field, however, are very rare. METHOD: A cross-sectional study involving 2010 patients seen by a sample of 145 general practitioners in the Auvergne region of central France was conducted on a given day in May 1998. The purpose of the study was to evaluate the prevalence of alcohol use disorders (using the DSM-IV diagnostic criteria for alcohol abuse or dependence and the CAGE questionnaire) and so to estimate the proportion of nonsomatic alcohol-related care dispensed. RESULTS: Sixteen percent of patients consulting their general practitioner had an alcohol problem, 27% of men and 5% of women. On average, a quarter of these patients had not been previously identified by the physician. Diagnosis seemed particularly difficult in women: 11% of women aged between 36 and 45 had an alcohol-related problem that went unidentified in 60% of cases. Care for alcohol-related health problems was therefore seriously inadequate. In one third of cases, patients with a diagnosed alcohol-related problem were not followed up by the physician for that problem. Two thirds received no medication, and in more than 80% of cases the physician did not refer to a specialist or prescribe admission to a specialized hospital ward. CONCLUSIONS: These results underline the diagnostic and therapeutic difficulties experienced by general practitioners. This study has led to the establishment of a pilot health care network for patients suffering from alcohol use disorders. This network involves voluntary doctors who have been trained and are better paid for their services. Care protocols have been established to which these practitioners have to adhere. [ABSTRACT FROM AUTHOR]

415 Parisian pre‐school children were followed up during 3 years (1974‐1977). Four epidemiological questionnaires provided information on the familial, social situation and also on the physical and psychological development of the child of 3, 9, 18 and 36 months old. A cluster analysis was applied on the behaviour variables of the 3 year old child and three different groups were identified. Most children (69%) belong to the first group, characterized by the absence of difficulties or the presence of a few minor symptoms, 10% of the children belong to the third group a “high risk group” because of their symptom frequency. Half‐way between the 2 described groups, a “low risk group” (21%) was identified. The reliability of this analysis was born out by the study of the family (especially their social economic situation and the parents’ mental health). This research also revealed the precocity of the symptoms in high risk children. 415 enfants parisiens (XlVè Arr.) ont été suivis de 3 mois à 3 ans à l'aide de quatre questionnaires successifs portant à la fois sur leur développement et leur environnement familial et social. Grâce à l'application d'une méthode d'analyse typologique aux variables concernant la santé et le comportement de l'enfant de trois ans, trois groupes homogènes ont été identifiés. Si la majorité des enfants (69%) se retrouvent dans le groupe I dont l'état est satisfaisant, à l'opposé, 10% constituent le groupe III et présentent avec une fréquence élevée des troubles qui incitent à les considérer comme des sujets à “haut‐risque”. Un groupe intermédiaire (groupe II, 21%) peut être défini comme à “faible‐risque”. L'étude des caractéristiques parentales renforce les différences entre les groupes et valide la classification. Le caractère prospectif de l'étude permet en outre de mettre en évidence l'apparition précoce des troubles dans le groupe à haut risque. †The permission granted by ‘Archives Françalcaises de Pédiatrie’ to publish an English translation of this paper is gratefully acknowledged. The paper first appeared in ‘Archives’ 1982, No. 3 in its original French as “Mise en évidence de groupes a risque dans une cohorte d'enfants d'âge pré‐scolaire par une méthode d'analyse typologique.” The English translation was arranged by the Editor at the request of the authors. [ABSTRACT FROM PUBLISHER]

Abstract Background To efficiently plan appropriate public health interventions during possible epidemics, governments must take into consideration the following factors about the general population: their knowledge of epidemics, their fears of and psychological responses to them, their level of compliance with government measures and their communities' trusted sources of information. However, such surveys among the French general population are rare. Methods A cross-sectional study was conducted in 2006 in a representative sample of 600 subjects living in the Rhône-Alpes region (south-east France) to investigate self-reported knowledge about infectious diseases and anxiety generated by epidemic risk with particular reference to avian influenza. Data on reactions to potentially new epidemics and the confidence level in various sources of information were also collected. Results Respondents were most knowledgeable about AIDS, followed by avian influenza. Overall, 75% of respondents had adequate knowledge of avian influenza. The percentage was even higher (88%) among inhabitants of the Ain district, where an avian influenza epidemic had previously been reported. However, 39% expressed anxiety about this disease. In total, 20% of respondents with knowledge about avian influenza stated that they had changed their behaviours during the epizooty. Epidemics were perceived as a real threat by 27% of respondents. In the event of a highly contagious outbreak, the majority of respondents said they would follow the advice given by authorities. The study population expressed a high level of confidence in physicians and scientists, but had strong reservations about politicians, deputies and the media. Conclusions Although the survey was conducted only four months after the avian influenza outbreak, epidemics were not perceived as a major threat by the study population. The results showed that in the event of a highly infectious disease, the population would comply with advice given by public authorities.

The main objective of the present study is to determine the prevalence of lifetime use and use in the past 30days of narcotics in French seamen and to assess factors correlated with positive urine test in seamen as a whole. A stratified survey conducted in 19 French ports collected 1,928 self-administered questionnaires on cigarette, alcohol and narcotics consumption. Seafarers were randomly selected and interviewed during their annual seafaring aptitude consultation. Only the 1847 male respondents were included in analysis. Nearly half of the seamen had tried cannabis at some point in their life, and 16% were users in the past 30days. Lifetime use of certain other illegal drugs (cocaine, heroin, hallucinogenic mushrooms, poppers and ecstasy) was non-negligible, but cocaine and heroin were the only ones showing exceptional prevalence of consumption over the previous 30days. Lifetime use of drugs was non-negligible among seamen. Prevalence of recent cannabis use was elevated. Recent consumption as indicated by positive urine test correlated with age group, family situation, occupational category, geographical area, young age of first alcohol consumption and experimentation with other drugs. [ABSTRACT FROM AUTHOR]

The fall in the number of suicides in France in no way diminishes the urgent need to act and reinforce the efforts, initiatives and resources to fight against this human tragedy. Public policies are starting to show results. The action of the French national suicide watch, associations, health professionals as well as the perspectives of the French national mental health council should amplify this movement., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Charitable associations have a role to play in the prevention of suicide in the elderly. They are involved in drawing up public policies and national programmes and also put in place strategies to fight against social isolation, for example through remote assistance. Their maxim is listening, sociability and support for people in situations of suffering and their families. However, their voice is not always heard when it comes to needs and adequate responses for suicide prevention., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Background: The Auvergne region of central France has the third highest mortality rate in the country for alcohol-related disorders and the highest level of alcohol consumption among young people., Methods: An exhaustive cross-sectional study of regional hospital morbidity related to alcohol was undertaken on a single day in May 1998, including 9,552 hospital beds. All inpatients age 16 and older in the Departments of Medicine, Surgery, Obstetrics and Gynecology, Psychiatry, and Medium-Stay Services were studied. The aim was to define alcohol-related behavior patterns (by using the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] criteria of abuse and dependence and the CAGE questionnaire) and to measure the proportion of nonsomatic alcohol-related care dispensed in hospital., Results and Conclusions: The prevalence of alcohol use disorders in all wards was 20%. Half of these patients were alcohol dependent, a quarter were diagnosed as alcohol abusers, and a quarter had an alcohol-related problem that was not identified during the stay. Alcohol use disorders were more common in male inpatients (34% vs. 8% in female inpatients) and in certain age groups. One male subject in two and one female subject in five between 34 and 45 years had an alcohol-related problem. Almost 25% of male inpatients studied between the ages of 16 and 20 years had an alcohol-related problem, but only half had been diagnosed previously. Hospital care for alcohol-related health problems was seriously inadequate. On average, 38% of patients diagnosed with an alcohol use disorder received relevant nonsomatic alcohol care, of which 13% were alcohol abusers and 50% were alcohol-dependent patients., Significance: This exhaustive study demonstrates the degree of alcohol-related morbidity among hospitalized patients, which is particularly high in men, in the Auvergne region of France. The study emphasizes the lack of diagnosis, particularly for the young, and the apparent deficiencies in the hospital management of these patients.

Among the more noticeable health and social indicators used for adolescents, the epidemiologic data on suicide point out one of the most serious risks in the present context of violence. In France, during the year 1995, 5,324 adolescent deaths from 14 to 24 of age were reported. The corresponding mortality rate is 66 for 100,000. The cause-of-death distribution shows the importance of violent deaths among adolescents. Actually, these deaths represent 70% of the 5,324 adolescent deaths. The proportion is higher for males (74%) than for females (60%). The most part of these violent deaths is due to accidents, especially transport accidents (38%). Deaths due to suicides are lower, however they constitute a significant part of the deaths concerning adolescents: 11% of the deaths that occurred from 15 to 19 of age, 17% of the deaths that occurred from 20 to 24 of age. At this time of life, the percentage of suicides is higher than for the whole population, where suicides are only responsible for 2% of the total deaths.

As regards drug addicts morbidity, no register of patients exists; several studies are conducted with complementary aims. The annual survey of the Health Ministry since 1987 registers over one month the consultants of the whole services: specialized, psychiatric, medical or non specialized social service. The Inserm network involving clinicians and epidemiologists has been running from 1987 focusing on the topic "Drug addiction and public health". In order to know better drug addicted individuals on a socio-demographic and medical level, surveys are carried out in different counselling and treatment centres, where very different degrees of infections (HIV and hepatitis) can be observed. Inserm (Unit 302) has been entrusted with the evaluation of the program of methadone's prescription. A limited sample has led to some descriptions. 92% of the sample have carried out the HIV test and 26% are HIV-positive, 54% have had a B or C hepatitis. These are heroin addicted subjects whose endeavour to wean off failed several times and whose environmental factors represent a support to the treatment. Their state of health is severe enough to be protected within the framework of secondary prevention actions.

The foundation of INSERM and its development over the past 30 years have led to the formation of a public body known in France as EPST. With scientific and technological interests, the general aim is to promote the advancement of science and to improve the diffusion of information among scientists, teachers or decision-makers and also the general public. Epidemiology counts among the medical disciplines which are methodologically well developed and widely used by many health sectors from clinical research to public health. In the face of more stringent social demands, there is a great need for appropriate use and exploitation of knowledge and resources. In this context, epidemiological research is acquiring a great importance in the production of medical information and also in the evaluation of health practices. A good example is provided by the epidemiological studies on drug abuse which, in spite of the restrictions, furnish new information regarding this problem. 1. Epidemiological studies are limited by legislation (Public Health Code). The Mortality Bureau (INSERM) is charged with the establishment of a register of the medical causes of death. 2. Research proposals are provided by the scientific community. 3. Evaluation studies are most often requested by the Ministry of Health, but, more and more frequently, may originate in other ministerial offices and local governing bodies. The role of the researcher in relation to external collaborations (politicians, administrators and consumers) should be precisely defined.

Among the various approaches used to study behaviours of use and abuse of drugs, epidemiology is now being called upon to direct its attention to two other approaches. Firstly, it should provide a more global view of subject groups than the specific descriptions of a few specialized centres. Secondly, it should take part in studies assessing public health policies for drug addiction. In relation to procedures used by epidemiologists in other fields of health sciences, the distinctive features of drug addiction need limitations and adaptation of methods. In France, anonymity and free health care are guaranteed to all drug addicts who request them. The direct consequences of this legislation is the absence of a drug addict register, unlike in other countries, such as Great Britain. There are no either registers nor survey data base from which representative samples can be constructed. Moreover, since those definitions used are multicriteria definitions, the assessment of a case on a drug addiction scale is in practice usually highly subjective and associated with the particular orientations of a clinical team or of a school of thought, because the notion of dependence is not used in the same way. Since drug addiction develops beyond adolescence and has social and/or medical consequences, specialized or non-specialized public health services or prisons are the main areas of observation for epidemiologists. Surveys are conducted through teams specialized in the treatment of drug addicted volunteers. The anonymity of centres is guaranteed by the INSERM and the centres themselves guarantee the anonymity of subjects studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Although the phenomenon of drug abuse in France is well delimited, it constitutes a public health problem. The way it spreads is sometimes 'epidemic' in sub-groups especially exposed. The somtic or relational consequences are short-term and it concerns more and more adolescents or young adults. Two main research axes have been developed: studies in the general population, adolescents or adults, in order to know the general context of licit and illicit psychotropic use in France, and specific studies in detoxification centers in order to describe the characteristics of drug addicts and to evaluate their requirements. Results of some recent surveys can illustrate these axes. Total abstinence is exceptional. Psychotropic drug abuse is deeply established in traditional French social customs. Most subjects had a narrow relation with psychoactive drugs. The variety as well as quantity of products allow everyone to adopt a style of consumption. Globally, alcohol consumption has decreased. Moderate consumers seem to be those who especially confine their drinking to daily wine consumption. On the other hand, the consumption of aperitifs and other drinks in on the increase. The dissociation of alcohol consumption from meals enhances drunkness. Nicotine-poisoning in men had a parallel evolution and has increased in women. Psychotropic drugs (tranquillizers and hypnotics) are specially used by aged women on medical prescription. For the study of drug abuse, data is collected in specialised centers and prisons regarding socio-demographic variables, intoxication profile and medical and social consequences. For both the general and addict population, epidemiological research, especially typological analysis, allows to identify some sub-groups at risk of drug addiction.

Research on suicide risk factors among psychiatric patients has developed considerably over the last 10 years. The methodological problems are numerous. Tentatives of global prediction have been unsuccessful in describing one complete and specific picture of the mentally ill suicide, whereas lawsuits against psychiatrists are frequent after patients' suicides. Through the analysis of 37 publications from 1978 to 1988 the authors review the main suicide risk factors identified among treated psychiatric patients.