Prévalence des lésions cérébrales dans une population de patients hospitalisés en unité pour malades difficiles : réflexions autour de la prévention et des adaptations thérapeutiques à apporter

Psychiatric high security care units are French psychiatric institutions caring for patients “presenting such a danger to others that they require adapted intensive therapeutic protocols and special safety measures”. In these units the prevalence of neuropsychiatric complications appears high. To evaluate or even validate this impression, a systematic review of the 34 patients of the unit of Plouguernével was carried out on March 1, 2024. It is shown: that half of the patients suffer from severe psychosis, that a third of these patients have an intellectual deficit. Ten patients have acquired neurological symptoms in their history, more or less serious. In addition, 75 % of them are polydrug addicts. The causes of the neurological damages in these patients are multiple: congenital, perinatal, traumatic, toxic, due to serious abuse, etc. These causes are analyzed here. This analysis allows us to consider preventive actions to be implemented, as well as a possible reorganization of the care of these patients with such heterogeneous profiles.