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International audience; Fibromyalgia can be considered to be a model of chronic pain resulting from dysregulation of pain processing. From a psychological point of view, it is possible to consider transdiagnostic processes that would participate in both the dysregulation of pain and associated emotions.ObjectiveThe aim of this study was to test the links that exist between the tendency to Repetitive Negative Thinking (RNT) and the anxious-depressive manifestations in fibromyalgia. More specifically, we wanted to test a double mediation model where RNT would mediate the link between pain and depression/anxiety via catastrophizing.MethodEighty-two patients with fibromyalgia completed a series of questionnaires evaluating their level of depression, anxiety, disability related to pain, catastrophizing as well as various measures of Repetitive Thoughts.ResultsThe results showed strong correlations between RNT levels, pain, and anxious-depressive manifestations in this population. Moreover, the links between pain and depression/anxiety were mediated by catastrophizing and RNT in serial.ConclusionResults support the interest of studying RNT as a transdiagnostic process in fibromyalgia pain. Considering RNT in fibromyalgia allows a better understanding of tthe links that exist between pain and emotional disorders in this population and thus to better understand the psychopathological comorbidity of fibromyalgia.; La fibromyalgie peut être considérée comme un modèle de douleur chronique résultant d’une dérégulation du traitement de la douleur. D’un point de vue psychologique, il est possible d’envisager des processus transdiagnostiques qui participeraient à la fois au dérèglement de la douleur et des émotions associées.ObjectifLe but de cette étude était de tester les liens qui existent entre la tendance aux pensées répétitives négatives (PRN) et les manifestations anxio-dépressives dans la fibromyalgie. Plus précisément, nous avons voulu tester un modèle de double médiation où les PRN médiatisent le lien entre douleur et dépression/anxiété via le catastrophisme.MéthodeQuatre ving deux patients atteints de fibromyalgie ont rempli une série de questionnaires évaluant leur niveau de dépression, d’anxiété, d’incapacité liée à la douleur, de catastrophisme ainsi que diverses mesures de pensées répétitives.RésultatsLes résultats montrent de fortes corrélations entre les niveaux de PRN, la douleur et les manifestations anxio-dépressives dans cette population. De plus, les liens entre douleur et dépression/anxiété sont médiatisés par le catastrophisme et les PRN en série.ConclusionLes résultats soutiennent l’intérêt d’étudier les PRN comme processus transdiagnostique dans la douleur fibromyalgique. Considérer les pensées répétitives dans la fibromyalgie permet de mieux comprendre les liens qui existent entre douleur et troubles émotionnels dans cette population et ainsi de mieux comprendre la comorbidité psychopathologique de la fibromyalgie.

Background Symptoms of anxiety and depression are common in adolescents with a loved one in an intensive care unit (ICU) and are known precursors of posttraumatic stress disorder (PTSD). Objectives To assess the prevalence of PTSD and associated factors in adolescent (age 12–17 years) relatives of patients in an ICU with an open visitation policy. Methods One year after the patient was discharged from the ICU, eligible adolescent relatives completed a satisfaction survey, anxiety history questionnaire, and psychometric evaluations (Hospital Anxiety and Depression Scale and 8-item Children’s Revised Impact of Event Scale). Results Thirty-two patients intubated for >2 days and with a Simplified Acute Physiology Score II >30 were included. Forty-six adolescents with first- to third-degree relationships to the patient, and in regular contact (≥monthly) with the patient before hospitalization, were enrolled. The prevalence of PTSD among the adolescents was 33%. Adolescents who visited the ICU were less likely to report feelings of regret than those who did not visit the ICU (2% vs 9%, P = .01). A past sense of threat (odds ratio [95% CI], 19.4 [1.9-201.2]; P = .01) and anxiety and depression symptoms (odds ratio [95% CI], 9.6 [1.4-63.7]; P = .02) were independent factors associated with probable PTSD. Conclusions A cautiously prepared open visiting policy should be maintained for adolescents with a relative in the ICU, because it could prevent feelings of regret and subsequent PTSD. Adolescents with risk factors should be screened and followed up.

Summary Introduction Crack cocaine use disorder (CCUD) is a major public health with a strong heritability component. Objectives This study was aimed to investigate the putative association between the dopamine transporter gene (DAT1/SLC6A3) and crack-cocaine use disorders (CCUD) as well as the possible involvement of attention-deficit hyperactivity disorder (ADHD), impulsivity and sensation-seeking. Methods Seventy-seven male subjects with CCUD were compared with 60 male control subjects of Afro-Caribbean origin. The Barratt Impulsivity Scale, the Wender Utah scale Scale-25 item and the Zuckerman Sensation-Seeking Scale were used. The subjects’ DNAs were genotyped by quantitative PCR (TaqMan method). Results We found an association with two SNPs (rs6347 and rs27048) of the DAT gene in crack-cocaine use disorder, and a significantly lower frequency of one of the three haplotype blocks of the DAT gene (AT haplotype, defined by the two previous SNPs) and CCUD. Conclusion DAT1 rs6347 and rs27048 polymorphisms seem to be associated with CCUD. The risk-effect of these polymorphisms appeared to be specific to individuals who are crack users rather than being driven by impulsivity or ADHD.

Objective To analyse the epidemiological data on suicide in French Polynesia (FP). Methods Data on suicides were collected from the Public Health Direction, Judicial Police Investigations Court of Justice records, the Centre d’Opérations et de Renseignements de la Gendarmerie, patient records for those hospitalized in psychiatry and from psychological autopsies. Results The dataset consisted of 316 suicide cases in FP over 25 years (1992–2016). In FP, suicide was more frequent in men (sex ratio 3.2:1), young people (mean age, 34.4 years) and individuals with previously diagnosed psychiatric disorders (100 of 316; 31.6%) The most common method of suicide was hanging (276 of 316; 87.3%). A history of previous suicide attempts was found in 25 of 56 (44.6%) of suicide cases, when documented. The most common potential triggering factors for suicide were emotional problems. The suicide rates have remained stable during 1992–2016 (mean 10.6/100 000 inhabitants per year), with periods of economic crises increasing suicide rates. Conclusions These results provide valuable information to enable the effective targeting of suicide prevention strategies toward those at high risk. Economic crises had larger impacts in the French overseas territories than mainland France. Given the unprecedented economic impact of the Covid-19 pandemic in FP, there is an urgent need to implement suicide epidemiological surveillance and prevention programmes.

Objectives : Cocaine dependence has a strong heritability component. The aim of this study was to investigate the putative association between the serotonin 2B receptor gene (HTR2B), crack use disorders and impulsivity. Methods : A French Caribbean male population of patients with crack use disorders (n=80) w as compared to healthy male controls (n=60). Comorbid ADHD and impulsivity were assessed. Five Single Nucleotide Polymorphisms (SNPs) in the HTR2B gene on chromosome 2 were selected: rs643700, rs 6736017, rs1549339, rs17586428 and rs3806545 Thes e five SNPs were chosen to cover most of the linkage disequilibrium (LD) blocks in HTR2B. The French translation of the Baratt Impulsivity Scale BIS -11 was used to evaluate impulsivity. Comorbid ADHD was diagnosed using the Wender Utah Rating Scale-25 item for the Attention Deficit-Hyperactivity Disorder. Results : We have found a positive association between the rs6736017 polymorphism and crack use disorders in a French Afro-caribbean male population. Conclusion : The risk effect of HTR2B rs6736017 appeare d to be specific to individuals who are crack users rather than being driven by impulsivity alone or ADHD alone

Purpose: Better know social representations and socio-cultural aspects of mental illness (FP) is critical to reduce stigma and improve care and prevention of psychiatric illness. Methods: The Mental Health in General Population Survey (MHGP) was carried out in French Polynesia (FP) in 2015 and 2017, with questionnaires on social representations of the "insane", the "mentally ill", the "depressive" and the various types of help and care. The representative sample of 968 people was built using the quota method. The data were collected in public spaces, anonymously. Results: The origin of mental health problems is considered mainly as physical, organic or hereditary. Addictive behaviours are the cause of mental illness for 1/4 of respondents. According to the Polynesian population, the “insane” or the “mentally ill” are perceived as excluded, irresponsible, unaware of their conditions and difficult to cure. Depressed people are seen as responsible for their actions, aware of their conditions and who can be treated. Conclusion: The results of this survey show stigmatizing representations of the “insane” and the mentally ill” and significant use of traditional care. They have been incorporated into the mental health plan for FP to improve the care and promotion of mental health.

Objectives To assess understudied, alternative suicide prevention modalities in a mental health care setting. Methods This was a prospective study of patients (n = 140, 68 cases and 72 controls) who were admitted to hospital or who contacted an SOS suicide crisis line for suicidal ideation or attempts. Psychiatric diagnoses (Mini-International Neuropsychiatric Interview) and intensity of anxiety/depression/suicidality (Hamilton Anxiety Rating Scale, Montgomery–Åsberg Depression Rating Scale, and Beck Scale for Suicidal Ideation) were assessed. All intervention group subjects received a crisis card with a crisis line number, interviews with psychologists or volunteers and a telephone call on days 10 to 21, then 6 months later. These subjects also had a choice between two further 4-month interventions: body contact care or mobile intervention team visits. Results The interventions significantly reduced the number of suicide attempts and suicide (3%) at 6 months compared with the control condition (12%). There were fewer losses to follow-up in the intervention group (7.35%) than in the control group (9.72%). Conclusions The results favour the implementation of integrated care and maintaining contact in suicide prevention.

International audience; BACKGROUND:In September 2017, the Hurricane Irma devastated the islands of Saint-Martin and Saint-Barthelemy (French West Indies). This was a particularly distressing time for the local healthcare staff in charge of rescuing the population. The aim of this study was to identify the explanatory factors of post-traumatic distress and burnout in hospital staff.METHODS:An anonymous questionnaire was sent to all 509 hospital workers of Saint-Martin and Saint-Barthelemy. Post-traumatic distress and burnout was assessed using the Post-Traumatic Stress Disorder Checklist (PCL-S) and Copenhagen Burnout Inventory (CBI) scales. Bivariate and multivariate analyses were used to determine the explanatory variables for these two psychological disorders.RESULTS:Two hundred and sixty-two questionnaires were completed (response rate of 51.7%). The explanatory factors of post-traumatic distress were female gender (OR = 12.93, 95% CI: 2.70-232.10), electricity shortages (OR = 2.92, 95% CI: 1.13-8.19) and home damage (OR = 1.16, 95% CI [1.02-1.33]). In parallel, the explanatory factors of burnout were post-traumatic distress (OR: 10.42, 95% CI: 4.72-25.58), female gender (OR = 2,41, 95% CI: 1.24-5.02) and paramedical staff (OR = 2,53, 95% CI: 1.15-6.21). In the multivariate analysis, only burnout was significantly associated with post-traumatic distress (OR = 9.26, 95% CI: 4.11-23.14).CONCLUSIONS:Six months after Irma, post-traumatic distress among hospital staff was strongly linked to burnout. This study revealed the lack of electricity as a new factor related to post-traumatic distress. It also suggested that psychological intervention should be strengthened.

Studies of adolescent suicide screening tools have increased with the development of questionnaires that can be used in paediatric emergency departments. This article proposes a literature review of the acceptability of such interventions. Although these tools are well accepted when they are systematized, their usefulness is determined by the availability of child psychiatric care with the right balance between the adolescent's confidentiality and parental involvement.

International audience; France has a rich history of exposure to large-scale traumas such as wars, disasters and terrorist attacks, and psychiatric teams specialized in emergency interventions for mass trauma have been created across the territory. However, no public resources are dedicated for long-term interventions or for individual trauma cases. This letter describes how a government supported model of care has been created and implemented in 2019. A national centre for resources and resilience (CN2R) and 10 regional ambulatory services specializing in psychotraumatology were created with the aim of improving public mental health-care delivery while providing a comprehensive suite of services for trauma victims from the most immediate to longer-term considerations. ARTICLE HISTORY

Cocaine dependence has a strong heritability component. The aim of this study was to investigate the putative association between the serotonin 2B receptor gene (A French Afro-Caribbean male population of patients with crack use disorders (We have observed a positive association between the rs6736017 polymorphism and crack use disorders in a French Afro-Caribbean male population.In our population, the risk effect of

RESUME Introduction Les facteurs de risques occupationnels sont des entites sociologiques qui caracterisent certaines professions et sous-groupes sociaux et qui sont susceptibles de varier selon l’evolution chronologique de la societe qu’ils decrivent. Materiel et Methodes Notre travail s’attache a etudier les specificites de la population medicale contemporaine en s’appuyant sur une recherche bibliographique exhaustive. L’offre informative dans ce sujet est peu fournie et les publications a ce sujet sont eparses. Resultats Plusieurs institutions s’attachent a l’etude et promotion de la sante des medecins. La population medicale peut beneficier de l’offre de soins cliniques et psychiatriques habituellement disponibles en population generale mais aussi des modalites de prise en charge qui lui sont specifiques : des organisations nationales comme « L’academie nationale de medecine », « L’Ordre national des medecins », l’ « Institut national de veille sanitaire », desormais section de l’Agence Sante Publique France, lui fournissent un encadrement par des recommandations ethiques ou basees sur des donnees epidemiologiques. Conclusions A la difference des autres sous-groupes populationnels dont la pathologie est intrinsequement nuisible, dans le cadre de la population medicale, des retombees societales complexifient le raisonnement quant a l’importance des maladies. Il a ete prouve (1) que la qualite des soins prodigues par les medecins en bonne sante sont superieures a ceux fournis par des confreres atteints. Ces observations ouvrent la voie a des considerations liees a la securite des patients, des eventualites de mauvaises pratiques et aux modalites adaptees a proposer de l’aide a nos confreres.

International audience; INTRODUCTION:The early postattempt period is considered to be one of the most at-risk time windows for suicide reattempt or completion. Among the postcrisis prevention programmes developed to compensate for this risk, brief contact interventions (BCIs) have been proven to be efficient but not equally for each subpopulation of attempters. VigilanS is a region-wide programme that relies on an algorithmic system to tailor surveillance and BCI provisions to individuals discharged from the hospital after a suicide attempt.AIM:VigilanS' main objective is to reduce suicide and suicide reattempt rates both at the individual level (patients included in VigilanS) and at the populational level (inhabitants of the Nord-Pas-de-Calais region).METHODS AND ANALYSIS:At discharge, every attempter coming from a participating centre is given a crisis card with an emergency number to contact in case of distress. Patients are then systematically recontacted 6 months later. An additional 10-day call is also given if the index suicide attempt is not the first one. Depending on the clinical evaluation during the phone call, the call team may carry out proportionated crisis interventions. Personalised postcards are sent whenever patients are unreachable by phone or in distress. On the populational level, mean suicide and suicide attempt rates in Nord-Pas-de-Calais will be compared before and after the implementation of the programme. Here/there cross-sectional comparisons with a control region will test the spatial specificity of the observed fluctuations, while time-series analyses will be performed to corroborate the temporal plausibility of imputing these fluctuations to the implementation of the programme. On the individual level, patients entered in VigilanS will be prospectively compared with a matched control cohort by means of survival analyses (survival curve comparisons and Cox models).DISCUSSION:VigilanS interventional components fall under the ordinary law care regime, and the individuals' general rights as patients apply with no addendums or restrictions for their participation in the programme. The research section received authorisation from the Ethical Committee of Lille Nord-Ouest under the caption 'Study aimed at evaluating routine care' and is registered in 'Clinical Trials'. The French Ministry of Health plans to extend the experimentation to other regions and probe the relevance of this type of 'bottom-up' territorial prevention policy at the national level.TRIAL REGISTRATION NUMBER:NCT03134885.

Studies of adolescent suicide screening tools have increased with the development of questionnaires that can be used in paediatric emergency departments. This article proposes a literature review of the acceptability of such interventions. Although these tools are well accepted when they are systematized, their usefulness is determined by the availability of child psychiatric care with the right balance between the adolescent's confidentiality and parental involvement.

Background French Guiana has the highest incarceration rate among French territories, it is higher than that of Brazil, Colombia or Venezuela. It is well known that mental health problems are over-represented in correctional facilities. Our objectives were to describe the prevalence of various psychiatric conditions and to study factors associated with violence and repeated offenses among arriving detainees at the sole correctional facility of French Guiana. Methods The study was cross-sectional. All consenting new adult prisoners incarcerated between 18/09/2013 and 31/12/2014 at the penitentiary centre of French Guiana were included. The Mini International Neuropsychiatric Interview (MINI) was used to screen for psychiatric diagnoses. In addition sociodemographic data was collected. Results Overall 647 men and 60 women were included. The participation rate was 90%.Overall 72% of patients had at least one psychiatric diagnosis (Fig. 2). Twenty percent had three or more diagnoses. Violent index offences were not more frequent among those with a psychiatric diagnosis (crude odds ratio 1.3 (95%CI = 0.9–2), P = 0.11. Multivariate analysis showed that after adjusting for sex and age, psychosis, suicidality and post-traumatic stress disorder were independently associated with violent offences. Generalized anxiety disorder was less likely to be associated with incarceration for violent offences. Having a history of a previous incarceration was significantly associated with a psychiatric condition in general (any diagnosis) OR = 3 (95%CI = 2–4.3), P

Objective ICU experience is linked to anxiety and depression symptomatology in family members of patients. Minors may be forbidden from visiting. To bring practices in line with evidence, we determined the prevalence of anxiety and depression symptomatology in adolescents visiting a relative in the ICU. Design One-year prospective observational monocenter study. Setting Medical-surgical ICU, University Hospital of Martinique. Patients Forty-one patients intubated for more than 2 days; 53 adolescents (12-17 yr) first- to third-degree relatives in regular contact (minimum once a month) with patient before hospitalization. Interventions Adolescents with unrestricted ICU access completed a satisfaction survey, anxiety history questionnaire, and psychometric evaluation (Hospital Anxiety and Depression Scale) before the patient's 15th day of hospitalization and extubation. Measurements and main results Forty adolescents (75.5%) visited their relative. Possible and probable anxiety and depression symptomatology prevalence was 35.9% and 18.9%, respectively, with no significant difference according to ICU visiting status. Most (80%) reported a lack of information, 40% insufficient consideration, and 27.5% misunderstood the reason for hospitalization. Two (5%) regretted visiting. Probable anxiety and depression symptomatology was associated with first-degree relationship (odds ratio, 9.1 [95% CI, 1.1-78.9]; p = 0.045), past exposure to a traumatic event (odds ratio, 8.7 [1.1-69.0]; p = 0.040) and past sense of threat (odds ratio, 10.4 [1.1-94.5]; p = 0.038). Conclusions Anxiety and depression symptomatology is common in adolescent family members of ICU patients. An open visiting policy for adolescents is recommended, with visit planning, information meetings, and individual support from ICU staff.

Resume La prevalence du trouble de l’etat de stress post-traumatique (ESPT) parmi les populations refugiees victimes de torture et de traumatismes de guerre est une des plus elevees en psychotraumatologie. Cependant, parmi les etudes ayant permis de recommander la therapie comportementale et cognitive centree sur le trauma (TCC-CT) comme premiere ligne de traitement de l’ESPT, peu ont concerne cette population. Face a ce constat, l’objectif de cet article est de rechercher dans la litterature scientifique internationale l’existence de protocoles TCC-CT specifiquement adaptes a cette population et de determiner si leurs etudes d’evaluation soutiennent une efficacite therapeutique. Trois adaptations de la TCC-CT emergent depuis une dizaine d’annee : la Somatic Focused Cognitive Behavioral Therapy, la Narrative Exposure Therapy et l’Interapy. Malgre le faible nombre d’etudes controlees et randomisees realisees pour evaluer ces approches et la presence de biais methodologiques dans celles existantes (faible taille d’echantillon, manque d’evaluation en double-insu, focalisation sur certaines communautes, etc.), les etudes montrent des resultats positifs et encourageants. D’autres etudes sont tout de meme necessaires pour confirmer ces resultats preliminaires et comparer l’efficacite therapeutique des differentes approches entre-elles.

Few data exist about post-stroke symptoms of post-traumatic stress disorder (sPTSD) and none on DSM-IV formally diagnosed PTSD (fdPTSD). We investigated the frequency and predictors of sPTSD and fdPTSD 1-6 months after a nondisabling ischemic stroke (IS) or transient ischemic attack (TIA).Consecutive patients were assessed for sPTSD (Impact of Events Scale-Revised, IES-R, significant if30) and fdPTSD (PTSD-Interview). We recorded sociodemographic factors, stroke features (including severity of the initial deficit, persistent disability, localization), associated mood changes, peritraumatic reactions during the stroke (Peritraumatic Distress Inventory (PDI) for fear and distress, Peritraumatic Dissociative Experience Questionnaire for cognitive appraisal), and psychiatric history. Patients with sPTSD and fdPTSD were compared to patients with IES-R30.Among the 40 patients (65% male, mean age 52 years) studied post-IS (n=30; mean initial NIHSS 4) or TIA, 25% had sPTSD, including 10% with fdPTSD. sPTSD was more frequent in women (p=0.02), patients with intense peritraumatic reactions especially on PDI (p=0.001) or identified prior depression and anxiety (p=0.007). No other demographic factors or stroke characteristics were associated with sPTSD. Forty percent of sPTSD patients were depressed versus none of the controls (p0.002). All fdPTSD patients had ≥ 3 prior psychiatric co-morbidities.After nondisabling IS or TIA, sPTSD is frequent, with fdPTSD for 10%. Patients with intense peritraumatic reactions, women, and those with prior psychiatric morbidity, require particular attention to detect sPTSD.

International audience; AbstractBackgroundSuicide rates in prison are high and their risk factors are incompletely understood. The objective of the present study is to measure the risk of suicide and its predictors in the only prison of multicultural French Guiana.MethodsAll new prisoners arriving between September 2013 and December 2014 were included. The Mini International Neuropsychiatric Interview (MINI) was used and socio-demographic data was collected. In order to identify the predictors of suicide risk multivariate logistic regression was used.ResultsOf the 707 prisoners included 13.2% had a suicidal risk, 14.0% of whom had a high risk, 15.1% a moderate risk and 41.9% a low risk. Predictive factors were depression (OR 7.44, 95% CI: 3.50–15.87), dysthymia (OR 4.22, 95% CI: 1.34–13.36), panic disorder (OR 3.47, 95% CI: 1.33–8.99), general anxiety disorder (GAD) (OR 2.19, 95% CI: 1.13–4.22), men having been abused during childhood (OR 21.01, 95%, CI: 3.26–135.48), having been sentenced for sexual assault (OR 7.12, 95% CI: 1.98–25.99) and smoking (OR 2.93, 95%, CI 1.30–6.63).ConclusionThe suicide risk was lower than in mainland France, possibly reflecting the differences in the social stigma attached to incarceration because of migrant populations and the importance and trivialization of drug trafficking among detainees. However, there were no differences between nationalities. The results reemphasize the importance of promptly identifying and treating psychiatric disorders, which were the main suicide risk factors.

Despite the recent interest in psychiatric illness in prison, the psychopathology of the Remire-Montjoly prison population remains largely unknown. Subject to significant population movements, French Guiana and its prison houses a very mixed population in which recent history has left a strong mark (earthquake in Haïti, civil war in Suriname, violence related to gold mining population and drug trafficking). These negative life events appear as potential vectors of psychological trauma. Additionally, strong links have been established in the literature between post-traumatic stress disorder (PTSD) and many other psychiatric disorders, including suicidal behavior and addictions. Under these conditions, we felt it essential to focus on the identification of PTSD in this sensitive population.Through adapted reception interviews, we tried to identify the PTSD, to describe by means of socio-demographic factors the studied population and to detect psychiatric comorbidities. The screening tool was the M.I.N.I. 5.0, which identifies 17 psychiatric disorders including the PTSD, based on the DSM IV definition. The target population was the prison incomers, agreeing to participate in the study, aged more than 18 years old and imprisoned between 18 January 2013 and 31 December 2013. To this date, 549 inmates were included in the study.The main result of this study was a prevalence of PTSD of 17% for incomers in detention. We found that the PTSD+ population is more likely to be female (15% against 7% p = 0.0246), which is consistent with the literature data. The M.I.N.I. 5.0 showed a higher prevalence of psychiatric disorders in the PTSD+ group. This association was confirmed in several types of pathology like mood disorders including: major depressive episode and manic or hypomanic episode, suicidal risk, some anxiety disorders including: panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. Strong association was found for current major depressive episode, current manic or hypomanic episode and suicidal risk (p 0.005).The prevalence of PTSD is very high in this study, about 24 times higher than in a general population survey using the same screening tool.A large number of comorbidities have been identified, which corresponds to those described in the literature. The specific issues of psychiatry in prison lead us to examine more specifically the significance of the results about suicide risk. A comprehensive suicide risk (sum of medium and high risk screened by the M.I.N.I.) was found in significantly more PTSD+ inmates (17% versus 7%, p = 0.005). This study supports the need for routine screening of PTSD among incomers in detention. This disease is both worrying and common in this population but the real issues are the comorbidities. Suicidal potential is among the most important issues in detention. Its evaluation should be completed by an early recognition of a PTSD.

Suicide is a growing problem around the world. A suicidal crisis is a situation where a person attempts to kill himself/herself or contemplating to do so. The digital age has played a role in increasing suicidal crisis not only because of cyberbullying but also because of the loss of interpersonal connection that can happen as a result of a digitalized society. This situation requires various methods of prevention and intervention to protect people from harming themselves. There is a great need to identify warning signs as early as possible. Prevention factors such as community support or medical or psychiatric intervention can help patients who are heading toward a crisis. We suggest that novel detection methods that leverage everyday technology and are widely accessible should be developed.

Soumis à des mouvements de population importants, la Guyane française et son centre pénitentiaire abritent une population métissée chez qui l’histoire récente a laissé une empreinte forte (tremblement de terre en Haïti, guerre civile au Suriname, violence liée à l’orpaillage et au trafic de stupéfiants). Ces événements de vie négatifs apparaissent comme autant de vecteurs potentiels de psychotraumatismes. Dans ces conditions, il nous a paru essentiel de mettre l’accent sur le repérage du trouble de stress post-traumatique (TSPT) dans cette population sensible. À l’aide d’entretiens d’accueil dédiés, nous nous sommes proposé de repérer les TSPT, de décrire sur un plan sociodémographique la population étudiée et de rechercher les comorbidités psychiatriques. Le résultat principal de cette étude était une prévalence du TSPT de 17 % chez les arrivants en détention. Le MINI 5.0 a montré une prévalence plus élevée des pathologies psychiatriques dans le groupe présentant un TSPT avec un lien très fort (p, Despite the recent interest in psychiatric illness in prison, the psychopathology of the Remire-Montjoly prison population remains largely unknown. Subject to significant population movements, French Guiana and its prison houses a very mixed population in which recent history has left a strong mark (earthquake in Haïti, civil war in Suriname, violence related to gold mining population and drug trafficking). These negative life events appear as potential vectors of psychological trauma. Additionally, strong links have been established in the literature between post-traumatic stress disorder (PTSD) and many other psychiatric disorders, including suicidal behavior and addictions. Under these conditions, we felt it essential to focus on the identification of PTSD in this sensitive population.Through adapted reception interviews, we tried to identify the PTSD, to describe by means of socio-demographic factors the studied population and to detect psychiatric comorbidities. The screening tool was the M.I.N.I. 5.0, which identifies 17 psychiatric disorders including the PTSD, based on the DSM IV definition. The target population was the prison incomers, agreeing to participate in the study, aged more than 18 years old and imprisoned between 18 January 2013 and 31 December 2013. To this date, 549 inmates were included in the study.The main result of this study was a prevalence of PTSD of 17% for incomers in detention. We found that the PTSD+ population is more likely to be female (15% against 7% p = 0.0246), which is consistent with the literature data. The M.I.N.I. 5.0 showed a higher prevalence of psychiatric disorders in the PTSD+ group. This association was confirmed in several types of pathology like mood disorders including: major depressive episode and manic or hypomanic episode, suicidal risk, some anxiety disorders including: panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. Strong association was found for current major depressive episode, current manic or hypomanic episode and suicidal risk (p

Due to many available forms (powder, pasta base, freebase and crack…) and because of multiple routes of administration (intranasal, intravenous, or smoked), cocaine has become in 30 years one of the most consumed illegal drugs worldwide, after cannabis. While the frequency of consumption decreases in North America, it continues to rise in Europe, and in some countries in South America, including Brazil, despite a growing knowledge of its specific effects, physical complications and psychiatric consequences. Elsewhere (notably in Asia and Indian Ocean), amphetamine and other stimulants (including methamphetamine), whose properties and patterns of use are very similar to those of cocaine, tend to replace it. Another amphetamine derivative, MDMA or ecstasy, is also consumed by many young people of less than 25 years, in Europe and North America, in a festive setting, with specific consequences and special procedures of care. Although there is currently no consensus for a specific medication, the most appropriate therapeutic approach seems to involve a psychosocial treatment associated with an anticraving medication, which will reduce compulsive desire to consume, in order to facilitate the psychotherapeutic and social care. However, pharmacological research remains very active, and many options are explored (GABAergic or dopaminergic agonists, amphetamine derivatives with long half-life, vaccine…), whether to treat addiction to cocaine or to methamphetamine.

Body piercing, which is prevalent in young adults, has been suggested to be associated with features usually related to posttraumatic stress disorder (PTSD) such as high-risk behaviours and psychopathological symptoms and might be motivated by a wish to deal with prior traumatic experiences. However, to date, no research has investigated the relationship between this practice and PTSD symptoms. The present research aims to investigate the possible relationship between body piercing and PTSD symptoms in French-speaking young adults. According to our results, having two or more body piercings was associated with a twofold increased risk for scoring above the cut-off score for PTSD on the PTSD checklist. Our findings suggest that two or more body piercings might serve as an identifiable marker for PTSD symptoms and may have important implications for clinical screening.