Clinical trial NCT06065553: Prevalence of Psychiatric and Substance Abuse Disorders Among People in Precarious Situations in Cayenne
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.
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Psychiatric Disorder
Substance Use Disorders
Keywords: Psychiatric disorders
Substance abuse
Precarity
French Guiana
Lead sponsor: Centre Hospitalier de Cayenne
Sponsor class: OTHER
First posted: 2023-10-04
Enrollment: 150
Sex: ALL
Minimum age (years): 18
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: People in precarious situations, extreme exclusion and/or wandering on Cayenne and its surroundings

Brief 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

Detailed 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.

Eligibility criteria: 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

Primary outcomes:
measure: Prevalence of psychiatric disorders and substance abuse disorders
timeFrame: Baseline
Secondary outcomes:
measure: Description of socio-demographic profiles
timeFrame: Baseline
measure: Description of perceived health status
timeFrame: Baseline
measure: Description of use and access to health care
timeFrame: Baseline
Other outcomes:
Locations:
city: Cayenne
country: French Guiana
facility: Centre Hospitalier de Cayenne
Study officials:
affiliation: Centre Hospitalier de Cayenne
name: Caroline JANVIER, MD
role: PRINCIPAL_INVESTIGATOR
References:
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.
citation: 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.
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.
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.
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.