Prevalence of Psychiatric and Substance Abuse Disorders Among People in Precarious Situations in Cayenne

Substance Use Disorders Clinical Trial

— EPICEA  

Official title:

Study on the Prevalence of Psychiatric and Substance Abuse Disorders Among People in Precarious Situations, Extreme Exclusion and/or Wandering on Cayenne and Its Surroundings.

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06065553
• Other study ID #: EPICEA
• Status: Recruiting
• Start date: June 9, 2023
• Est. completion date: December 31, 2023

Study information

• Verified date: September 2023
• Source: Centre Hospitalier de Cayenne
• Contact: Caroline JANVIER, MD
• Phone: +594 594 39 50 47
• Email: caroline.janvier[@]ch-cayenne.fr
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This is an observational, descriptive, cross-sectional, single-center study. The main objective of the study is to estimate the prevalence of the main psychiatric disorders and substance abuse disorders among people living in precarious, excluded and/or wandering on Cayenne and its surroundings

Description:

In French Guiana, the mental health care and support system (health, medical-social, social, associative and institutional structures) is structurally lagging behind.

The density of specialist professionals is low; the psychiatric private sector is absent.

In order to adapt care provision, it is necessary to gain a better understanding of certain target populations, in particular those with multiple vulnerabilities, who have specific needs and expectations.

As highlighted by the results of a number of studies already carried out in France and elsewhere in the world, psychaitric disorders and substance-related addictive disorders have a greater impact on people living in situations of extreme exclusion, precariousness and homelessness.

In 2017, in French Guiana, one person out of two lives below the poverty line, compared to 14.9% in France.

A recent study estimated the prevalence rate of psychiatric disorders in the general population of the CACL (Communauté d'Agglomération du Centre Littoral) in French Guiana (SMPG

• Santé Mentale en Population générale - study in 2021). Nowadays, there is no recent study measuring the prevalence of psychiatric disorders specifically among populations in precarious situations, wandering and/or extreme exclusion on Cayenne Island.

The main hypothesis of the research would therefore be to observe a prevalence of psychiatric disorders and addictive disorders in the precarious population that is at least as high, if not higher, than in the general population of the CACL.

Another hypothesis of the research would be to find that the distribution of the prevalence of each psychiatric disorder is not identical to that found in the general population of the CACL (more addictive disorders and more psychotic disorders in the precarious population, more disorders linked to post-traumatic stress disorder in migrant populations).

Another research hypothesis would be to observe that the use of healthcare and the perception of health are different from those of the general population of the CACL, and that it is therefore necessary to develop appropriate human and structural resources.

However, it seems essential to know this prevalence in order to adjust the offer of care and adapt it as much as possible to the specific needs of this population.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 150
• Est. completion date: December 31, 2023
• Est. primary completion date: October 31, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 99 Years

Eligibility

Inclusion Criteria:

• Adults over 18 years old

• person who uses support services intended for people in situations of precariousness, extreme exclusion and/or wandering on Cayenne and its surroundings - person agreeing to participate in the study.

Exclusion Criteria:

• Person refusing to participate in the study

• Person presenting an acute state of decompensation of a psychiatric pathology and/or a state of crisis (agitation crisis, suicidal crisis) and/or confusion or presenting an acute intoxication to a substance preventing him/her from understanding and answering questions.

• Impossibility of having an interpreter for a person with no (or little) French

Related Conditions & MeSH terms

• Mental Disorders
• Problem Behavior
• Psychiatric Disorder
• Substance Use Disorders
• Substance-Related Disorders

Locations

Country	Name	City	State
French Guiana	Centre Hospitalier de Cayenne	Cayenne

Sponsors (1)

Lead Sponsor	Collaborator
Centre Hospitalier de Cayenne

Country where clinical trial is conducted

French Guiana, 

References & Publications (5)

Ayano G, Shumet S, Tesfaw G, Tsegay L. A systematic review and meta-analysis of the prevalence of bipolar disorder among homeless people. BMC Public Health. 2020 Jun 9;20(1):731. doi: 10.1186/s12889-020-08819-x. — View Citation

Ayano G, Solomon M, Tsegay L, Yohannes K, Abraha M. A Systematic Review and Meta-Analysis of the Prevalence of Post-Traumatic Stress Disorder among Homeless People. Psychiatr Q. 2020 Dec;91(4):949-963. doi: 10.1007/s11126-020-09746-1. — View Citation

Ayano G, Tesfaw G, Shumet S. The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis. BMC Psychiatry. 2019 Nov 27;19(1):370. doi: 10.1186/s12888-019-2361-7. — View Citation

Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet. 2014 Oct 25;384(9953):1529-40. doi: 10.1016/S0140-6736(14)61132-6. — View Citation

Hossain MM, Sultana A, Tasnim S, Fan Q, Ma P, McKyer ELJ, Purohit N. Prevalence of mental disorders among people who are homeless: An umbrella review. Int J Soc Psychiatry. 2020 Sep;66(6):528-541. doi: 10.1177/0020764020924689. Epub 2020 May 28. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Prevalence of psychiatric disorders and substance abuse disorders	To estimate the prevalence of the main psychiatric disorders, as well as the prevalence of addictive disorders to psychoactive substances among people in a precarious situation, excluded and/or wandering on Cayenne Island and who use primary care services	Baseline
Secondary	Description of socio-demographic profiles	Describe the different socio-demographic profiles of people in a precarious situation, excluded and/or wandering on Cayenne Island and who use primary care services.	Baseline
Secondary	Description of perceived health status	To describe the perceived health status of people in a precarious situation, excluded and/or wandering on Cayenne Island and who use primary care services	Baseline
Secondary	Description of use and access to health care	To describe the use of and access to care for people in a precarious situation, excluded and/or wandering on Cayenne Island and who use primary care services	Baseline

External Links

•   Health survey in French Overseas department
•   Mental health in the general population: images and reality in French Guiana
•   Mental health status and abuse disorders of homeless people in Paris region, 2010
•   Mental health status of homeless people in Paris, 1997
•   PTSD screen for DSM-5
•   Public Health Aspects of Mental Health Among Migrants and Refugees: A Review of the Evidence on Mental Health Care for Refugees, Asylum Seekers and Irregular Migrants in the WHO European Region
•   When homelessness puts at risk children mental health