Facteurs influençant la qualité de vie chez des patients souffrant d’un état de stress post traumatique (ESPT) : impact des blessures physiques, étude rétrospective comparative portant sur 35 patients du service de psychiatrie de l’Hôpital d’Instruction des Armées Robert Picqué

Abstract : Introduction: due to the actual geopolitical situation (terrorism, international conflicts, mass murders), PTSD is more and more mediatized and studied. PCL-S is a scale that can evaluate the severity of PTSD. Its symptomatology is characterised by three main symptoms: repetition, hyper vigilance and avoidance. Those symptoms can alterate one’s psychological and daily life functioning wich can influe on quality of life. The WHOQoL BREF, is a questionnaire allowing the assessment of quality of life and is validated in French population. Our work is based on the study of a cohort of 35 patients presenting PTSD and followed in HIA Robert Picqué. The main objective is to look for a relationship between the presence of a physical wound on these patients and the alteration of their quality of life. The secondaries objectives are to look for risk and protective factors that can affect quality of life. Materials and Methods: our work is a descriptive, retrospective study of a population of 35 people followed and/ or hospitalized for PTSD at HIA Robert Picqué between 2008 and 2018. The inclusion criteria were: presenting a PTSD with a PCL-S score ≥ 34; presence of WHOQoL-BREF and PCL-S scale completed. The exclusion criteria were: incomplete WHOQoL-BREF and/or PCL-S. 33 people were included for the study of the main objective. Comparisons for qualitative data were made using a Mann Whitney Wilcoxon test and the R version 3.2.2 software. Result: we didn’t show a significative relationship between presence of physical injury and impairment of quality of life in patient with PTSD. However, we observed that wounded people had a tendancy to have a more alterated quality of life than unaffected individuals. We also observed an inversely proportional and significative relationship (p>0,05) between PCL-S score and WHOQoL BREF. We did not highlight any protective or risk factors affecting the quality of life. Discussion: our study could not reveal a significative relationship between the existence of a physical wound and impairment of quality of life in patients suffering from PTSD. A stronger study employing a larger amount of people, multicentered and done prospectively would be interesting to perform to obtain more meaningful results. However we could show an inversely proportional and significative link between PCL-S and WHOQoL-BREF scores, which, to our knowledge, has not been found in any other study. Yet, this relation should be confirmed with a statistically more powerful study. Conclusion: general physicians encounter constantly in everyday life the concepts of quality of life and PTSD. Thus, their knowledge is essential in order to improve the way we look up to our patients.
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Raoul Vezies. Facteurs influençant la qualité de vie chez des patients souffrant d’un état de stress post traumatique (ESPT) : impact des blessures physiques, étude rétrospective comparative portant sur 35 patients du service de psychiatrie de l’Hôpital d’Instruction des Armées Robert Picqué. Médecine humaine et pathologie. 2019. ⟨dumas-02109117⟩

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