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Master Thesis

Regards de patients souffrant de pathologies psychiatriques sévères sur la place du médecin généraliste dans leur prise en charge somatique

Abstract : Context. The life expectancy for patients with severe mental illness (SMI = schizophrenia, bipolar disorder and major depression) is twenty years lower than that of the overall population. Cardiovascular diseases are the leading cause of death. Several studies demonstrate the necessity of an ongoing collaboration between the psychiatrist and the general practitioner in screening, following up and treating these pathologies. Recommendations aimed at improving somatic care access also exist. Objective. The understanding of the way patients with SMI apprehend their somatic care and especially their relation to the general practitioner in order to have a better idea of its determining factors. Method. Qualitative study by personal semi-structured interviews with patients treated in CMP (Centre Médico-Psychologique). The interviews were transcribed and manually double coded. Results. Most of the patients consider themselves in good health. Two groups might be distinguished: the patients who are regularly followed-up by their general practitioner for somatic comorbidities and those who do not benefit from a regular monitoring and do not see the point in it. They mention a trusting relationship with their general practitioner who is seen as a partner of the attending psychiatrist in spite of the few exchanges between those two. Their care seems disorganised. Conclusion. These patients need a closer follow-up because of comorbidities associated with difficulties to health care access. The patient care is unequal and not centred enough on screening and prevention, however the general practitioner is seen as an understanding physician and a privileged actor in treatments. A specific consultation might improve the management of comorbidities. It might be organised in the CMP in order to lessen communication difficulties and prioritise the multiple therapeutic objectives of these patients.
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Master Thesis
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Submitted on : Wednesday, June 6, 2018 - 12:04:47 PM
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Anna Fablet. Regards de patients souffrant de pathologies psychiatriques sévères sur la place du médecin généraliste dans leur prise en charge somatique. Sciences du Vivant [q-bio]. 2016. ⟨dumas-01754079⟩



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