Les survivants de l’épidémie récente de la maladie à virus Ebola au service de psychiatrie de l’hôpital national Donka en Guinée-Conakry : étude psychopathologique et psychothérapeutique

Abstract

ObjectivesThe aim of this study was to report the psychosocial experience of patients having recovered from Ebola virus infection and other persons affected by it psychologically in Conakry (Guinea), and to describe the psychological methods implemented for their care. MethodsThe study was prospective, cross-sectional and descriptive, and lasted for three months in the epidemic crisis period. It concerned patients who had been infected and had recovered, and patients affected psychologically by Ebola, seen in the psychiatric department of Donka national hospital for psychological support on request from the NGO Save the Children. The patients were seen between May and August 2014 and divided into different groups. The interviews were confidential, and under the responsibility of two psychiatrists and psychotherapists1. All patients gave their informed consent to take part in the study. For children, parental or legal representative consent was sought. ResultsBetween May 30th and 9th August 2014, sixty-eight (68) patents were seen in the psychiatric department of Donka national hospital for psychological support. Among them, there were 37 Ebola virus-infected subjects reported cured, 17 contact subjects, and 14 non-contact subjects but presenting psychological trauma. Three of the patients in the overall cohort, or 4.41%, presented a state of post-traumatic stress, and seven (10.9%) presented moderate depression without psychotic symptoms. In the social sphere, 37 patients (54%) experienced rejection and stigmatisation by their community and/or professional entourage. DiscussionThe fear of falling ill and dying, anxiety, insomnia, mistrust or avoidance, feelings of rejection, withdrawal, hospitalism for the orphans, and loss of interest in usual activities (anhedonia) were the main psychological problems presented by these patients as a whole. Psychological debriefing, followed by supportive psychotherapy and cognitive behavioural therapy, with use of antidepressants in some cases, were the therapeutic means deployed. Advice on individual and collective hygiene was provided for all subjects in a prevention drive. Once the patients had regained confidence, they joined a NGO to back up monitoring and awareness-raising teams in the districts of Conakry and across the country. ConclusionPatients who have had Ebola virus infection and have recovered, like those affected in other ways by the epidemic, undergo genuine psychological trauma. The provision of psychological support efficiently alleviated the psychological suffering of these individuals and contributed to their social and professional rehabilitation. A further, wider study on victims of Ebola could enable a clearer understanding of the psychological disruption occasioned, so as to improve psychotherapeutic care. The psychological accompaniment of survivors should be a healthcare priority.