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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ann+Med+Psychol+(Paris)
2020 ; 178
(7
): 699-710
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Le confinement généralisé pendant l?épidémie de Coronavirus : conséquences
médico-psychologiques en populations générales, soignantes, et de sujets
souffrant antérieurement de troubles psychiques (Rétrospective concernant les
répercussions des risques létaux de masse, modèles scientifiques du confinement
collectif, premières observations cliniques, mise en place de contre-mesures et
de stratégies thérapeutiques innovantes)
#MMPMID32836303
Auxéméry Y
; Tarquinio C
Ann Med Psychol (Paris)
2020[Sep]; 178
(7
): 699-710
PMID32836303
show ga
BACKGROUND: The situation we are currently experiencing is unprecedented.
Declaring a state of health emergency in order to curb a frightening epidemic,
the authorities have decreed the home confinement of the majority of the
population of our country for several weeks. In a few days, innumerable questions
arise for very diverse spaces: epidemiological, immunological, sociological,
information scientists, medical, administrative, political, etc. OBJECTIVE: We
propose a reflection intended to describe the psychological risks, to clarify the
disorders found, and to discuss the means to take care of them in the duration.
MATERIAL AND METHODS: We base our thinking on a review of the literature
confronted with our current clinical experience, including concerning the
possibilities of dematerialised medico-psychological monitoring. RESULTS: We
recall the collective repercussions of emerging lethal mass risks, and in
particular viral infectious agents, before approaching the existing scientific
models of collective confinement according to military operations in war zones,
polar wintering missions and aerospace conquest. It appears that for the study of
a global containment, somewhat studied during previous pandemics, the conceptions
of stress reaction and psychodynamic adaptation prove to be relevant. We detail
the psychological consequences of confinement on individual mental health and
their countermeasures according to three population typologies: general
population, population of caregivers on the front line against the epidemic, and
population of subjects already suffering from mental illness or seeing their
disorders reappear. We also refer to works in social cognitive psychology
explaining how, in an anxiety-provoking situation, reasoning can be biased and
lead to choices that ultimately prove to be not very rational, in the opinion of
those who made them. The current situation in the health sector is favourable in
this, as evidenced by the "debate on chloroquine" widely reported in the media
and on social networks, opposing conclusions most often decided on the basis of
beliefs on contrary to evidence based medicine. DISCUSSION: The psychological
repercussions of confinement appear conditioned by the multiple forms that it can
take: voluntary or suffered, more or less prolonged, spent at home or in another
place, lived in individual isolation or in a small community, associated other
stressors and/or traumatic factors, etc. The home confinement of a population
across a country has never been assessed. This experience seems to us to confront
our society as a whole with the taboo of death, which is imposed, death more and
more evaded as the "Western man" tries to move away from his terrestrial origins.
In this sense, psychotraumatic type repercussions are to be prevented. In order
to face multiple challenges, the healthcare system has adapted with, in
particular, the development of the use of the Internet for the provision of
information intended to better experience confinement, or even the generalisation
of e-psychotherapy asking as many questions as it provides answers. These
intricacies of computer techniques in the area of psychotherapy, techniques with
which we had some questioning, became established as quickly as the virus: the
task of clinicians and researchers to measure the issues and the consequences.
CONCLUSION: Public health programs could emerge on the model of those already
existing in order to manage well-known chronic endemic disorders: protection
against the effects of an unbalanced diet associated with a sedentary lifestyle,
fight against smoking and alcoholism, prevention of self-aggressive behaviour,
etc. We will also need to support the caregivers who have been on the front line
and who will emerge tested from this pandemic: depending on the sustainability of
the action capacities of our healthcare system to return to its nominal state and
also perhaps, so that it can face consequences resulting from other crises,
especially social ones.