Search

Introduction: The mental health of residents is a growing significant concern, particularly with respect to hospital and university training conditions. Our goal was to assess the professional, academic, and psychological determinants of the mental health status of all residents of the academy of Lyon, France. Materials and methods: The Health Barometer of Lyon Subdivision Residents (BASIL) is an initiative which consists in proposing a recurrent online survey to all residents in medicine, pharmacy, and dentistry, belonging to the Lyon subdivision. The first of these surveys was conducted from May to July 2022. Participants should complete a series of validated questionnaires, including the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and the Kessler Psychological Distress Scale (K6), respectively, and ad-hoc questions assessing their global health and hospital and academic working conditions. A Directed Acyclic Graph (DAG) analysis was conducted prior to multivariable analyses, to explore the determinants associated with low wellbeing (WEMWBS <43) and high psychological distress (K6 ≥ 13). Results: A total of 904 residents (response rate: 46.7%) participated in the survey. A low level of wellbeing was observed in 23% of participants, and was significantly associated to job strain (OR = 2.18; 95%CI = [1.32-3.60]), low social support (OR = 3.13; 95%CI = [2.05-4.78]) and the experience of very poor university teaching (OR = 2.51; 95%CI = [1.29-4.91]). A high level of psychological distress was identified for 13% of participants, and associated with low social support (OR = 2.41; 95%CI = [1.48-3.93]) and the experience of very poor university teaching (OR = 2.89, 95%CI = [1.16-7.21]). Conclusion: Hospital working conditions, social support, and the perception of teaching quality, were three major determinants of wellbeing and psychological distress among health profession residents. Demographic determinants, personal life and lifestyle habits were also associated. This supports a multilevel action in prevention programs aiming to enhance wellbeing and reduce mental distress in this specific population and local organizational specificities. [ABSTRACT FROM AUTHOR]

What's the post-traumatic stress disorder? Post-traumatic stress disorder (PTSD) is a major public health problem by virtue of its frequency, chronicity and the disability it generates in daily life. PTSD has been known since Antiquity and explored by military psychiatrists and early psychoanalysts, but today more than ever it is a topical issue because of the large number of events such as terrorist attacks or meteorological disasters that occurred lately in France and outside the country. This disorder is characterized by four main dimensions: reexperiencing, avoidance, hyperarousal, and cognitive and mood disturbances. Sleep is very often disrupted and comorbidity is common. The suicidal risk is also frequent. PTSD can affect anybody even though a number of individual risk factors have been identified, such as gender, socio-economic status and psychiatric or traumatic history, with a special focus on peri-traumatic dissociation. As we know, this disorder is the result of exceptional events but is can also be the consequence of more "daily" events which general practitioners are often the first to be consulted for. Despite an apparent "popularization" of the symptoms by greater media coverage, this specific disorder is still poorly understood in its definition and in routine medical practice., Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts.

Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts

Treatment of post-traumatic stress disorder. Psychological traumas, whose cares are complex, need to be furthermore clarified since they recently became a major public health issue in the wake of the terrorists' attacks that struck France over the past three years. It is its temporality since the event which will determine the type of disorder which might appear thus its adequate processing treatment. In the short term, in the context of collective events or disasters, treatments of psychological suffering by the Medico-Psychological Units (CUMP) are very specific by combining sorting out and direct health care to the victims as well as indirect care such as crisis management. For the health practitioner, a precise knowledge of the disorders which might appear at the early stage, prior to the onset of PTSD, is mandatory. Likewise, approaching a patient with a high emotional load requires specific skills. This is about establishing a real therapeutic alliance with the patient, key factor to prevent a more embedded pathology. Medical treatments at this stage are yet sparsely codified. When pathology is confirmed, post-traumatic stress disorders together with the existence of potential comorbidity (depression, addiction, etc.) require specialized care. Targeted psychotherapies are the first-line treatments, often combined with medical treatments (SSRI antidepressants, for instance) depending on the symptom's seriousness. Sleep disorders, likely conditioning the pathology, will require heightened vigilance. In any case, medication should be adapted to the patient. Similarly, elements of relational approach, any advice, or other health lifestyle rules together with referral to more specific cares, should be individualised., Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts.