French University Psychiatry and Research

Abstract

France has one of Europe's largest psychiatrist per inhabitants ratios (around 12,500 for 63 million of inhabitants) as well as one of the richest medical care systems, devoting nearly 1 percent of its gross domestic product to mental health expenditure through its national Social Security. Most psychiatric care is organized in psychiatric hospitals (two beds out of three), with 15,000 beds in public general hospitals, including university hospitals. There are 31 university psychiatric departments in France, with 1.5 percent of French psychiatrists working in these university hospitals. Psychiatrists working in university departments, therefore, represent a very small proportion of psychiatrists. Although the numbers of psychiatrists and beds are high, France has a low level of research activity, as testified to by the Institute of Scientific Information for citations of authors and manuscripts (France is -20 compared to the world average). This lack of research is also reflected in the modest role of French psychiatric journals in the world (the only one quoted in PubMed has an impact factor of 0.48) and the proportion of manuscripts for various psychiatric disorders for which the first author is located in France. This French paradox may be tempered by the fact that the relatively low level of activity of research can be considered acceptable if the number and amount of available grants are taken into account (i.e., much smaller in France than other European countries) and if specific topics are specifically analyzed, such as addictive and bipolar disorders.