Évolution du traumatisme psychique des rescapés du naufrage du Concordia

Abstract

The first objective of this work is to study post-traumatic stress disorders possibly presented by victims of the Concordia shipwreck that occurs on January 13, 2012, in Italy. The second objective is to relate the evolution of symptoms with various characteristics of the individual, the context and the support the victims received. PatientsIn the boat, 462 French men and women were on this cruise. After the disaster, 211 French survivors founded an association of victims, and 198 of them agree to participate in our study (M=49.6 years, SD=14.7, range=19–85), mostly female (56%). Materials and methodsWith the collaboration of the association and its lawyer, for each survivor who agreed to participate in the study, we had access to the complaint files, certificates of psychologists, medical certificates, and a “diary newspaper” written by the victims. We administered the PTSD Checklist Scale (PCLS) two times, first six months after the shipwreck and secondly one year after the whipwreck. According to the authors of the French version (Yao et al., 2003), this scale measures the three sub-syndromes of PTSD described in the DSM IV (reexperience, avoidance, increased arousal). The scale assesses the intensity of 17 PTSD symptoms, rated by the subject on a scale of 1 to 5 (1=not at all, 2=somewhat, 3=sometimes, 4=often, 5=very often), thereby determining a score. This scale was sent by email to each of the victims with instructions. Finally, for each of the 198 survivors, we collected the following data: age, gender, events that motivated people to go cruising, period before discharge, estimated subjective severity scale (1 to 10), injury, days of Temporary Interruption of Work (ITT), psychotropic drugs absorption, meeting with a medical and psychological emergency unit just after the shipwreck, consulting psychologist or physician when survivors came back home. ResultsThe number of survivors with PTSD is higher than in other studies, both six months (79.3%) and one year after the shipwreck (61.6%). Two elements seem likely to explain why. First, the sample is very homogeneous, all survivors were directly exposed to the same traumatic event. The second is related to a prolonged and intense stress period during the ship sinking, and then a long period of evacuation and wandering on the island before rescues had been organized. We also found that physical injuries are related to PTSD intensity and its duration. As in other studies that measured symptoms of PTSD after a traumatic event, six months after the shipwreck, women have a higher average score than men. This difference disappears on the second assessment, one year after the event. Psychotraumatic symptoms experienced by women progressing well faster than men's. Survivors who benefited from the intervention of a medical end psychological emergency unit just after the shipwreck have higher scores on the PCLS and we also found that they look more often to health care facilities after the event. Monitoring by Primary Care Physicians indicate that most of them have not diagnosed PTSD and prescribed psychotropic drugs to 40.9% of the survivors without significantly positive effect on the improvement of symptoms. ConclusionsThe results mainly highlight the links between gender and severity of post-traumatic symptoms, presence of physical injury and the intensity and duration of the disorder and, at last, influence of the support for survivors.