General Population In France Research Articles

Problématiques de la dépression

Doubt, one of the fundamental symptoms of depression. Patients frequently believe they're incurable. They are persuaded that nothing can be done for them. Most of the time, when they are told, they do not accept that they are going through a crisis, a critical period in life. The ever repeated question is: "What's the use?" Which shows to what extent the person is depressed and disillusioned. For them there is nothing that can be of any use. A frequent problem. The Yearly prevalence of phases of major depression in the general population in France is of around 10% and throughout life of more than 10% in men and 20% in women. In France the estimation is that more than one out of 7 inhabitants is depressed. The role of the general practitioner. The physician must help those who surround the depressed patient, but it is often necessary that the practitioner refer to a consulting specialist who will specify what type of depression the patient is suffering from, eventually make an assessment (using specific scales) of the intensity of the episode, and indicate which type of antidepressor is best adapted, the side effects that should be monitored, the associations to be avoided, and any control biological assays to be foreseen. The role of the specialist. In parallel, the specialist will schedule a psychotherapy, either maintenance or more structured (in such a way that the patients, if they wish, can work on the mechanisms that provoked the depression and hence protect themselves against any eventual relapse). The interest of co-therapies. It can be interesting that the general practitioners and specialists collaborate in the necessity for hospitalisation or not (with patient's consent or not), monitoring of a suicide risk, or the need to change treatment. The sharing of the tasks is always very positive for the patients. The patients, as those who surround them, are reassured by the fact that the family doctor and a specialist are collaborating in order to optimise treatment as rapidly as possible. The organisation of such co-therapies requires that the general practitioner also have good knowledge of the various types of psychotherapy available for the patient.

Prevalence and description of chronic daily headache in the general population in France

The objective of this study was to describe the epidemiology, clinical presentation and consequences of chronic daily headache (CDH) in France. A representative nation-wide sample of the general population was identified using a stratified sampling method. Ten thousand five hundred and eight-five subjects were screened in face-to-face interviews, and data collected using a standard questionnaire. An overall point prevalence of CDH in the general population of 2.98% was observed. Two-thirds of these subjects presented migraine-like features. Severity, functional impact and healthcare consumption were higher than in subjects reporting episodic migraine in the same sample. Of the subjects, 28.2% reported the most severe migraine disability assessment scores (Grades 3 and 4), compared to 12% of episodic migraineurs. A qualité de vie et migraine score of 68.4 was observed, indicating severely attenuated quality of life. Only 6.6% of subjects were taking prophylactic treatment, whilst 88% were using non-specific acute headache treatments. The frequency of physician consultations and laboratory examinations was significantly higher than in individuals with episodic headache. CDH is thus a relatively prevalent condition in the general French population, associated with an important burden of suffering and with considerable expenditure in the health service. Management of this condition is generally inappropriate.

Proposition of an aging indicator from general health examination in France.

We present an indicator of aging based on eight quantitative variables, measured during the periodical health examination offered by French social security to the general population in France. The used sample derived from the population examined each year. We selected a reference group of 24,510 adults older than 25 years (non-smokers, drinking less than 44 g alcohol per day, with body mass index less than 35, and not using medication). A multiple regression analysis by gender was used to select significant variables to predict age from all quantitative variables measured during the health examination. The resulting biological age could be calculated from the measured variables and the aging indicator was defined as the difference between the calculated age and the chronological age. By definition, this indicator is independent of age in the reference population and gives an indication of the difference between an individual's status in the process of aging and the mean status of people of the same chronological age. Associations between this indicator and life style habits such as tobacco and alcohol use, and occupational status were observed. A geographical analysis also exhibited significant variation over France. Such an indicator can be used at the individual level as a pedagogical tool to explain the observed individual health status. It is also of interest for the epidemiological studies, where it could contribute to a better understanding of the aging process and associated factors.

A population-based study on radical prostatectomy in France.

There has as yet been no descriptive study of the practice of radical prostatectomy in the general population in France. The objective of this work was to investigate the use of radical prostatectomy (RP) in France and its determinants and geographic variations. A total of 175 radical prostatectomies was identified in a random sample of 798 cases of prostate cancer recorded in 1995 by four cancer registries, in the departments of Bas-Rhin, Calvados, Isère and Tarn. Tumour characteristics, diagnostic procedures and histopathological results were analysed. Multivariate analysis by logistic regression was used to take into account age, prostate specific antigen (PSA) levels and clinical stage in order to study variations between geographical departments and sectors of activity (private or public). The mean age of the patients at the time of diagnosis was 65.3 y (range 46-76). Median PSA level was 18.2 ng/ml (range 1-184). Diagnosis was made by randomised biopsies in 73.8% of cases or by transurethral resection (6.9%). Clinical stage was classified T(1) (22.3%), T(2) (64%), T(3) (8.6%), N(+) (0.6%) and unknown (4.5%). The histopathological result was pT(2)N0 in 46.3% of cases, pT(3)N0 in 40%, pT(4)N0 in 1.7%, pT(x)N(+) in 8.6% and unknown in 3.4%. Adjuvant therapy (radiotherapy 13.7%, hormonal treatment 13.7% or both 3%) was administered in 54 patients (31%). Logistic regression showed that the probability of undergoing RP was three times higher in one department than in the other departments, and was 2.6 times as high in the private sector. This study on the practice of RP is the first performed in the general population in France. It shows that practice differs according to geographical region and sector of activity, indicating that schools of thought and medical culture vary within the same country.Prostate Cnacer and Prostatic diseases (2001) 4, 118-123

How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study.

To determine the prevalence of chronic and debilitating symptoms of the overactive bladder, defined here as the presence of chronic frequency, urgency and urge incontinence (either alone or in any combination), and presumed to be caused by involuntary detrusor contractions. Subjects and methods Data were collected using a population-based survey (conducted by telephone or direct interview) of men and women aged >/= 40 years, selected from the general population in France, Germany, Italy, Spain, Sweden and the United Kingdom, using a random stratified approach. The main outcome measures were: prevalence of urinary frequency (> 8 micturitions/24 h), urgency and urge incontinence; the proportion of participants who had sought medical advice for symptoms of an overactive bladder; and current or previous therapy received for these symptoms. In all, 16 776 interviews were conducted in the six European countries. The overall prevalence of overactive bladder symptoms in individuals aged >/= 40 years was 16.6%. Frequency (85%) was the most commonly reported symptom, followed by urgency (54%) and urge incontinence (36%). The prevalence of overactive bladder symptoms increased with advancing age. Overall, 60% of respondents with symptoms had consulted a doctor but only 27% were currently receiving treatment. Conclusion Symptoms of an overactive bladder, of which frequency and urgency are as bothersome as urge incontinence, are highly prevalent in the general population. However, only a few affected individuals currently receive treatment. Taken together, such findings indicate that there is considerable scope for improvement in terms of how physicians diagnose and treat this condition.

Analysis of the underestimation of induced abortions in a survey of the general population in France

Introduction A pilot study has been conducted in France to estimate the extent of underreporting of induced abortion and the factors linked to underreporting.Methods A representative random sample of 300 women aged between 18 and 44 years of age who had been pregnant during the previous 2 years and 100 women who had not was selected from the telephone directory. Interviews were conducted by telephone.Results The annual incidence of induced abortion for the 18–44-year-old age group was 6.9 per 1000 (95% confidence interval 2.2–11.6), while the rate derived from national statistics was 15 per 1000. Five women who reported a therapeutic abortion in their lifetime had confused induced abortion and therapeutic abortion.There was no significant difference in the proportion of women reporting induced abortion in their lifetime between those answering with another adult present and those who were alone when answering (13.1% versus 11.1%, p = 0.8). There was also no significant difference according to the sex of the interviewer (10.0% for men versus 12.2% for women, p = 0.6).Conclusion The results suggest that the context in which the questions were asked does not affect the validity of the answers and that there is a problem in the comprehension of the terminology used. Extensive rewriting and reformulation of the questions is required to minimize the underreporting of induced abortion.

High Cholesterol, Low Stress, and Long Life in Bayeux, Lower Normandy, France

The residents of Bayeux, Lower Normandy, France, who live 2 years/sex longer on the average than the general population of France and 4 years/sex longer than that of the USA, ingest foods high in cholesterol and fat, diets which published reports show advance the development of cardiovascular disease (CVD). Albeit CVD leads in causes of death in France (36%) and America (46%) and is epidemical in Bayeux, it counts for fewer deaths among these Normans (32%). Why is this? Since 1982, I have conducted fieldwork in Bayeux. Results of participant observation and reports of 171 elders derived from key-informant interviews and an 11-point questionnaire concerning the importance of their dependable, predictable, and routinized social system to the felt well-being of these elderly Bayeuxans suggest the conclusion that the cultural construction of Bayeux, reminiscent of a former era and diet notwithstanding, contributes to their perceived well-being, quality of life, and lowered mortality from CVD, by attenuating both ambivalence about role expectations and the subsequent fear that activates the stress cascade which then results in specific deleterious physiologic effects on the cardiovascular system.

Non-acquired immune deficiency syndrome-defining malignancies in a hospital-based cohort of human immunodeficiency virus-infected patients: Bordeaux, France, 1985-1991. Groupe d'Epidémiologie Clinique du SIDA en Aquitaine.

Non-acquired immune deficiency syndrome-defining malignancies in a hospital-based cohort of human immunodeficiency virus-infected patients: Bordeaux, France, 1985-1991. Groupe d'Epidémiologie Clinique du SIDA en Aquitaine.