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Background The worldwide coronavirus outbreak has put hospital workers under extreme stress with possible mental health problems. In this context, we decided to rapidly design and implement a psychological support system for all hospital workers in Paris during the Covid-19 outbreak. Methods We built a hotline in 3 days using the following steps: 1) official mandate, 2) request for the creation of hotline numbers, 3) formulation of psychological intervention materials and policies, 4) call for volunteer certified psychologists, 5) call for volunteer certified psychiatrists in case of psychiatric cases, 6) creation of an anonymous and protected database, and 7) communication and regular reminders about the existence of the hotline for hospital workers. Results After the first 26 days, we received 149 calls with a mean of 5.73 calls/day (SD=3.22). The average call duration was 18.5 min (min=1; max=65min; SD=14.7), and mostly women (86%) called. The mean age was 32.7 years old (SD=11.0). Calls from hospital workers were from all professions; though mostly represented by frontline healthcare workers, non-frontline departments also called (total of 44 departments). Reasons for calling were anxiety symptoms (n=73, 49%), request for hotline information (n=31, 20.8%), worries about Covid-19 (n=23, 15.44%), exhaustion (n=17, 11.41%), trauma reactivation (n=10, 6.11%), insomnia (n=9, 6.0%), anger (n=8, 5.37%), depressive (n=6, 4.02%), and psychotic symptoms (n=3, 2.01%). Regarding referrals, 105 (70.47%) of them were referred to psychosocial, Covid, and general support. Conclusions This psychological support system can be easily duplicated and seems to benefit all hospital professions that all appeared psychologically affected.

BackgroundThis study aims to identify the prevalence and at-risk situations of alcohol use disorders among patients examined in the emergency department and to compare the scales commonly used to identify alcohol use disorders.MethodsWe used the CAGE and AUDIT questionnaires and a structured interview, the MINI.FindingsOf the presenting patients, 9.5% met the DSM-IV criteria for alcohol use disorders. The CAGE questionnaire was less sensitive (75%) and more specific (92%) than the AUDIT (87 and 80%, respectively). The typical alcohol-dependent patient is a young man who is unemployed and brought to the emergency department by the police. During the past 24 h, he has consumed alcohol, nicotine, cocaine, sedatives or cannabis.ConclusionOf the patients, 9.5% examined in the emergency department present with alcohol abuse or dependence without asking spontaneously for treatment for their addiction. These results support the importance of systematically identifying alcohol use disorders with a simple and rapid questionnaire such as the CAGE questionnaire.

Abstract:Objective: The authors want to examine the prevalence of all impulse control disorders (ICD) among patients examined in a French psychiatric emergency ward and to compare patients with and without ICD.Method: 210 consecutive patients examined in a psychiatric emergency ward were included. We used the Minnesota Impulsive Disorders Interview, a semi-structured clinical interview assessing impulse control disorders (ICD): compulsive buying, trichotillomania, compulsive sexual behavior, kleptomania, pyromania and intermittent explosive disorder. We assessed the DSM-IV-TR criteria for personality disorders and we used the Zuckerman scale to study the level of sensation-seeking. All patients answered in addition the South Oaks Gambling Screen (SOGS) for pathological gambling, the Lejoyeux scale of compulsive buying, the DETA questionnaire for alcohol use disorders and the Fagerström questionnaire for nicotine consumption.Results: Fifty-four patients (25%) showed signs of at least one ICD. Fifteen patients (7%) reported current symptoms of two impulse control disorders. The most common impulse control disorders were compulsive buying (N=41, 19.5%), pathological gambling (N=13, 6.2%) and intermittent explosive disorder (N=11, 5.2%). Psychiatric comorbidity was not different between patients from the ICD+ and the ICD-groups. Alcohol, nicotine and cannabis consumption were equivalent in the ICD+ and ICD-groups.Patients with co-occurring impulse control disorders were younger. They had a higher score of pathological gambling assessed with the SOGS and a higher level of sensation seeking. Sub-scores of disinhibition, experience seeking and boredom susceptibility were also significantly higher.Conclusion: An important proportion of patients (25%) examined in a French psychiatric emergency service shows at least one diagnosis of impulse control disorder. Emergency ward may give them an opportunity for identifying ICD and offering information and treatment. Additional research could try to validate effective treatment for psychiatric patients with impulse control disorder.