Affections somatiques chez les patients en psychiatrie : étude transversale sur 24 mois

Abstract

Somatic comorbidities in patients suffering from severe psychiatric disorders have become an important issue in the overall care of these patients. They aggravate the prognosis for both diseases, and complicate the therapeutic management and impact upon the vital prognosis. We illustrate through this work the experience of the psychiatric unit at the University Hospital Center (UHC) Hassan II of Fez (Morocco) in the detection and treatment of the somatic comorbidities among patients with serious psychiatric disorders through consultation or hospitalization from January 2010 to December 2011. ObjectivesTo provide insight into the nature of organic pathology observed in the psychiatric domain. To study the various interactions between the psychiatric diseases and the somatic comorbidities and to compare them between in- and out-patients. MethodsWe conducted a cross-sectional study of patients attending the emergency room and those hospitalized in our department of psychiatry, these patients show clinical signs in favor of an organic pathology, they were then transferred for opinion to other medical and surgical units in the UHC of Fez, on a 24-month period from January 2010 to December 2011. The information gathering was done based on a standard clinical information sheet with 23 items. ResultsOver a period of 24 months, 80 patients were included in our study. The most common reasons for requests for advice from medical and surgical services were: the suspicion of an organic cause of the psychiatric symptoms in 35% of cases, and the presence of a sign of an organic disease in 22%. Medical and surgical services most requested were: emergency department and the neurology department in 30% of cases each. The relationship between the psychiatric disorder and the somatic disease was comorbidity in 32% of cases, a side effect of psychotropic drugs in 24% of cases and a psychiatric manifestation of an organic disease in 13% of cases. Somatic comorbidities were essentially: infections in 45% of cases and trauma in 20% of cases. Side effects of psychotropic drugs were predominantly neurological in 32% of cases. ConclusionSomatic comorbidities in patients hospitalized or in consultation in psychiatric hospitals are very common, often unrecognized and their management can be difficult and complex.