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Master Thesis

Repérage des prodromes de passage à l’acte par les équipes paramédicales en psychiatrie

Abstract : Aims: In general psychiatry, two main categories of events show the dangerousness of adult inpatients: suicide and aggression. Psychiatric health care staffs describe prodromal symptoms, which can precede these acting out events but are difficult to assess. The aim of this study was to describe these prodromal symptoms, and give solutions to improve their communication. Methods: A descriptive epidemiological prospective study was conducted for 6 months. Acting outs were included when they were reported during the study time, and enacted by adults inpatients hospitalized in general psychiatric units. To analyse the prodromal symptoms, an ALARM scale and a semi-structured interview were organized during the three weeks after the event. Results: 30 acting outs took place during the study time, 25 could be analysed. Health care staff considered that 32 % of these events could have been avoided. Health care staff described conflicted therapeutic relationships with these patients, and a clinical worsening prior to the acting outs in 80 % of the cases. A logistic regression showed that a long stay in hospital and a reduction of the frequency of medical appointments were, according to healthcare staff, predictive variables of a possible avoidance of an acting out. Conclusion: The possible avoidance of an acting out, as felt by the healthcare staff, seems to be associated with the methods of patient care. Hospital care organisations should consider improving communication between psychiatrists and health care staff, concerning inpatients with the highest risk of acting out.
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Master Thesis
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Submitted on : Monday, October 17, 2016 - 4:26:46 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:22 AM


  • HAL Id : dumas-01382838, version 1
  • PPN : 19564493X


Camille Rabourdin. Repérage des prodromes de passage à l’acte par les équipes paramédicales en psychiatrie. Médecine humaine et pathologie. 2016. ⟨dumas-01382838⟩



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