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

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.

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

Study Overview

• Status: Recruiting
• Conditions: Substance Use Disorders; Psychiatric Disorder

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.

• Study Type: Observational
• Enrollment (Estimated): 150

Contacts and Locations

• Study Contact: Name: Caroline JANVIER, MD; Phone Number: +594 594 39 50 47; Email: caroline.janvier@ch-cayenne.fr
• Study Contact Backup: Name: Edith PELLERIN; Phone Number: +594 594 39 50 47; Email: edith.pellerin@ch-cayenne.fr

Study Locations

• French Guiana
  • Cayenne, French Guiana, 97300
    • Recruiting
    • Centre Hospitalier de Cayenne
    • Contact: Caroline JANVIER, MD; Phone Number: +594 594 30 50 47; Email: caroline.janvier@ch-cayenne.fr
    • Contact: Edith PELLERIN; Phone Number: +594 594 30 50 47; Email: edith.pellerin@ch-cayenne.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

People in precarious situations, extreme exclusion and/or wandering on Cayenne and its surroundings

Description

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

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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 Outcome Measures

Outcome Measure	Measure Description	Time Frame
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
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
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

Collaborators and Investigators

• Sponsor: Centre Hospitalier de Cayenne
• Investigators: Principal Investigator: Caroline JANVIER, MD, Centre Hospitalier de Cayenne

Publications and helpful links

General Publications

• 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.
• 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.
• 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.
• 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.
• 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.

Helpful Links

• Mental health status of homeless people in Paris, 1997
• Mental health status and abuse disorders of homeless people in Paris region, 2010
• When homelessness puts at risk children mental health
• Mental health in the general population: images and reality in French Guiana
• 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
• Health survey in French Overseas department
• PTSD screen for DSM-5

Study record dates

Study Major Dates

• Study Start (Actual): June 9, 2023
• Primary Completion (Estimated): October 31, 2024
• Study Completion (Estimated): September 30, 2025

Study Registration Dates

• First Submitted: June 7, 2023
• First Submitted That Met QC Criteria: September 29, 2023
• First Posted (Actual): October 4, 2023

Study Record Updates

• Last Update Posted (Actual): July 26, 2024
• Last Update Submitted That Met QC Criteria: July 25, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Psychiatric disorders; Substance abuse; French Guiana; Precarity
• Additional Relevant MeSH Terms: Behavioral Symptoms; Chemically-Induced Disorders; Substance-Related Disorders; Problem Behavior; Mental Disorders
• Other Study ID Numbers: EPICEA

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No