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Structured clinical interviews are the gold standard for assessing mental health. However limited resources may allow the use of only self-report questionnaires. In the context of emergency, such as terrorist attacks, the performance and thresholds of such tools still unclear.
We investigated the performance of the Posttraumatic stress disorder CheckList Scale (PCL-S) and of the Hospital Anxiety and Depression scale (HADS), both compared to the MINI Interview, among civilians and first responders involved in terrorist attacks.
The data came from the IMPACTS survey which was conducted from 6-10 months among civilians (N=190) and first responders (N=232) after the January 2015 terrorist attacks in the Paris Region, France. Sensitivity and specificity of the PCL-S and HADS were estimated by the ROC curve, and the optimal threshold was defined using the Youden index.
Regarding the PCL-S: for civilians and first responders respectively, the overall AUC was 0.947 and 0.899, and the optimal threshold were 38.5 and 39.5. Regarding the HADS-D: for civilians and first responders respectively, the overall AUC was 0.908 and 0.617 and the optimal thresholds were 7.5 and 1.5. For the HADS-A for civilians and first responders respectively, the overall AUC was 0.823 and 0.717, the optimal threshold were 9.5 and 6.5.
In the context of a terrorist attack, compared to the MINI, our study underlined satisfactory performance of the PCL-S and the HADS-D in screening for PTSD and depression respectively, while the screening of anxiety using the HADS-A was unsatisfactory.
We conducted a national longitudinal survey among healthcare workers in the context of the Covid-19 pandemic, (1) to assess mental health and (2) to describe the results of an intervention to improve capacity of resilience. Non-participation is rarely studied despite being an important methodological matter when performing studies on mental health.
The study aims to describe and identify the factors associated with non-participation of healthcare workers to the intervention part of a national longitudinal study on the psychological impact of the COVID-19 pandemic.
Participants were recruited from April to October 2021 via an Internet link widely disseminated. Data collected include participant’ socio-demographic, occupational and working conditions, general health, professional burnout and mental health. The intervention proposed the use of tools for self-management of stress and resilience (PsySTART-Responder® and Anticipate.Plan.Deter™ program). A robust Poisson regression was used to identify factors associated with non-participation.
Among 724 participants, 41% participated to the intervention part. Factors associated to non-participation to the intervention were to work with few or no COVID-19 patients, and low scores in the anxiety scale. Social determinants, occupational characteristics or general health were not associated with non-participation.
Our study provides a better understanding of the participation of healthcare workers that was not frequently studied. The results logically suggest lower participation among those with better mental health and not directly concerned with management of COVID-19 patients. Non-participation to the intervention was not associated with social factors, which is an argument in favour of using such a design/intervention in a socially heterogeneous population.
Some projects have described post-disaster psychosocial services and planning across Europe. However, little is known about the real psychosocial disaster responses such as low-intensity initiatives after a terrorist attack
This study aims (1) to describe psychological support (PS) in the immediate (<48 hours), post-immediate (48 hours – 1 week) periods and more than one week after a terrorist attack among terror-exposed people, and (2) to identify factors associated with a lack of short-term PS among those who suffered from mental health disorders.
This study used data from a longitudinal survey of 189 civilians exposed to the January 2015 terrorist attacks conducted 6 months after the attacks. Factors associated with lack of PS after the attacks was identified using a Robust Poisson regression in three separate models (for the 3 periods).
Among participants who suffered from PTSD (n=34), depression (n=74), or anxiety (n=59) 6-9 months after the terrorist attacks, respectively, 9%, 18% and 12% did not received psychological support. The lack of immediate PS was associated with geographical distance, type of exposure, and support in daily life. The lack of post-immediate PS was associated with geographical distance, peri-traumatic reactions and past psychological follow-up. The lack of PS after one week was associated with geographical distance and social isolation.
Characteristics of exposition and social support seem to play an important role in lack of PS after a terrorist attack and highlights the need to use strategies to reach out to people regardless of the type of exposure.
Previous studies have revealed developmental problems in children of homeless families. The number of homeless families has increased by 5 in 10 years.
To estimate the adaptative behavior of homeless children aged 0-5 years old in Paris region and to analyze the impact of homelessness on children's development.
In 2013, a random survey was conducted among homeless families housed in emergency centres for asylum-seekers, emergency housing centres, social reinsertion centres and social hotels in the Paris region. A bilingual interviewer and a psychologist conducted the survey in 17 languages. A nurse took the anthropometric measures and collected health data from child health and immunization cards. For children aged 0-5 years old, mothers (or fathers when mothers were absent) were asked about the children's adaptative behavior using the Vineland Adaptative Behavior Scales, Second Edition (Vineland-II).
The built random sample consisted in 801 families including 557 in which the selected child was 0-5 years old, which represents 11448 children (95% CI = 10354 – 12541). The estimated mean of the composite score of Vineland-II is 76.98 (95% CI = 74.07 – 76.70) (SD = 12.03) which mean that 9259 children aged 0-5 years old (95% CI = 7684 – 10833) have a developmental delay. The most associated factor with the decrease of the Vineland-II score is the age (p<10-16) in the linear multivariate model.
ENFAMS survey reveals large developmental problems among homeless children in Paris region.More children are exposed to homelessness more the disorders are important.
Children growing up in homeless families are disproportionately more likely to experience health and psychological problems. Our objective was to describe social, environmental, individual and family characteristics associated with emotional and behavioral difficulties among homeless children living in the Paris region.
Face-to-face interviews with a representative sample of homeless families were conducted by bilingual psychologists and interviewers between January and May 2013 (n = 343 children ages 4-13 years). Mothers reported children’s emotional and behavioral difficulties (Strength and Difficulties Questionnaire [SDQ]), family socio-demographic characteristics, residential mobility, and parents’ and children’s physical and mental health. Children were interviewed regarding their perception of their living arrangements, friendships and school experiences. We studied children’s SDQ total score in a linear regression framework.
Homeless children had higher SDQ total scores than children in the general population of France, (mean total score = 11.3 vs 8.9, P < 0,001). In multivariate analyses, children’s difficulties were associated with parents’ region of birth (beta = 1.74 for Sub-Saharan Africa, beta = 0.60 for Eastern Europe, beta = 3.22 for other countries, P = 0.020), residential mobility (beta = 0.22, P = 0.012), children’s health (beta = 3.49, P < 0.001) and overweight (beta = 2.14, P = 0.007), the child’s sleeping habits (beta = 2.82, P = 0.002), the mother’s suicide risk (beta = 4.13, P < 0.001), the child’s dislike of the family’s accommodation (beta = 3.59, P < 0.001) and the child’s experience of bullying (beta = 3.21, P = 0.002).
Children growing up homeless experience high levels of psychological difficulties which can put them at risk for poor mental health and educational outcomes long-term. Access to appropriate screening and medical care for this vulnerable yet underserved group are greatly needed.
An unprecedented outbreak of Ebola virus diseases (EVD) occurred in West Africa from March 2014 to January 2016. The French Institute for Public Health implemented strengthened surveillance to early identify any imported case and avoid secondary cases.
Febrile travellers returning from an affected country had to report to the national emergency healthcare hotline. Patients reporting at-risk exposures and fever during the 21st following day from the last at-risk exposure were defined as possible cases, hospitalised in isolation and tested by real-time polymerase chain reaction. Asymptomatic travellers reporting at-risk exposures were considered as contact and included in a follow-up protocol until the 21st day after the last at-risk exposure.
From March 2014 to January 2016, 1087 patients were notified: 1053 were immediately excluded because they did not match the notification criteria or did not have at-risk exposures; 34 possible cases were tested and excluded following a reliable negative result. Two confirmed cases diagnosed in West Africa were evacuated to France under stringent isolation conditions. Patients returning from Guinea (n = 531; 49%) and Mali (n = 113; 10%) accounted for the highest number of notifications.
No imported case of EVD was detected in France. We are confident that our surveillance system was able to classify patients properly during the outbreak period.
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