Pertinence de la prise en charge des psychotraumatismes des exilés primo-arrivants par les médecins généralistes

IF 0.5 4区 医学 Q4 PSYCHIATRY
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引用次数: 0

Abstract

Exiles have often experienced multiple traumas, and when they arrive in France, they generally find themselves in precarious social situations, often with a certain level of nomadism and significant isolation. Unfortunately, the existing mental health care services available for exiles are currently inadequate, and more resources and innovative approaches to providing care would help alleviate the pressure of demand. The presentation of Post-Traumatic Stress Disorder (PTSD) in this population is often somatic, with frequent initial misdiagnoses. Through the study of three clinical vignettes, we are able to substantiate that a trained general practitioner, as the primary care physician, can readily establish a bond of trust that has often been broken, restore a sense of security, and provide support, which is at the core of trauma care for these patients who are often dehumanized and isolated, far from their supportive cultural environment. The general practitioner can screen, refer, and manage these psycho-traumas according to their competence, serving as a resource person and using a complementary approach while taking into account all the symptoms presented by the patients. Addressing PTSD in a transcultural context requires essential decentralization and comprehensive patient care to establish a therapeutic alliance necessary for quality care. This approach is increasingly being used in general medical practice. Additionally, the continuity of care over time helps prevent breaks in treatment, which can be traumatic for these patients. The treatment provided by the general practitioner will help to improve access to mental healthcare for refugees and to develop structures specialized in treating psychotrauma in migrant populations, while at the same time being innovative in patient care.

全科医生治疗新到流亡者精神创伤的相关性
流亡者往往经历过多重创伤,当他们抵达法国时,通常会发现自己的社会处境岌岌可危,往往具有一定程度的游牧性和严重的孤独感。遗憾的是,目前为流亡者提供的心理保健服务并不充分,更多的资源和创新的护理方法将有助于缓解需求压力。这类人群的创伤后应激障碍(PTSD)通常表现为躯体症状,最初经常被误诊。通过对三个临床案例的研究,我们能够证实,训练有素的全科医生作为初级保健医生,可以随时建立经常被破坏的信任纽带,恢复安全感,并提供支持,这是创伤护理的核心,因为这些患者经常被非人化和孤立,远离其支持性的文化环境。全科医生可以根据自己的能力对这些精神创伤进行筛查、转诊和管理,充当顾问,采用补充方法,同时考虑到患者出现的所有症状。在跨文化背景下解决创伤后应激障碍问题需要基本的权力下放和全面的病人护理,以建立优质护理所需的治疗联盟。这种方法正越来越多地应用于普通医疗实践中。此外,长期持续的护理有助于防止治疗中断,因为治疗中断可能会给这些患者造成创伤。全科医生提供的治疗将有助于改善难民获得心理保健的机会,并发展专门治疗移民人口精神创伤的机构,同时在病人护理方面具有创新性。
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来源期刊
Annales medico-psychologiques
Annales medico-psychologiques 医学-精神病学
CiteScore
1.30
自引率
33.30%
发文量
196
审稿时长
4-8 weeks
期刊介绍: The Annales Médico-Psychologiques is a peer-reviewed medical journal covering the field of psychiatry. Articles are published in French or in English. The journal was established in 1843 and is published by Elsevier on behalf of the Société Médico-Psychologique. The journal publishes 10 times a year original articles covering biological, genetic, psychological, forensic and cultural issues relevant to the diagnosis and treatment of mental illness, as well as peer reviewed articles that have been presented and discussed during meetings of the Société Médico-Psychologique.To report on the major currents of thought of contemporary psychiatry, and to publish clinical and biological research of international standard, these are the aims of the Annales Médico-Psychologiques.
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