Conséquences psychopathologiques du confinement

Abstract

Les effets psychologiques de l'isolement ont déjà été décrits dans la littérature (expéditions polaires, sous-marins, prison). Néanmoins l'échelle du confinement mis en oeuvre à l'occasion de la pandémie à COVID-19 est inédite. Il nous faut non seulement relire les études publiées, mais aussi anticiper les problèmes psychologiques qui pourraient survenir pendant ou à distance du confinement. Nous avons fait le choix d'aller au-delà de la littérature COVID-19 pour examiner les implications des conséquences connues du confinement : l'ennui, l'isolement social, le stress, le manque de sommeil. L'anxiété, le trouble de stress post-traumatique, la dépression et les conduites suicidaires, les conduites addictives, les violences domestiques sont des effets décrits du confinement, mais les mécanismes d'émergence de ces troubles et leurs interrelations restent à étudier. Par exemple, quels sont les mécanismes d'émergence du trouble de post-traumatique dans le cadre du confinement ? Nous rappelons aussi les points de vigilance à garder sur des conséquences telles que les troubles des conduites alimentaires, les hallucinations, curieusement ignorées dans la littérature sur le confinement, alors qu'une vaste littérature fait le lien entre isolement social et hallucinations. Du fait de conséquences psychopathologiques larges, il nous faut partir à la recherche des différents symptômes pour permettre leur prise en charge. Nous résumons rapidement les approches diagnostiques et thérapeutiques déjà mises en place, comme la télémédecine, qui connaît un développement rapide à l'occasion de la crise du COVID-19. AbstractThe psychological effects of isolation have already been described in the literature (polar expeditions, submarines, prison). Nevertheless, the scale of confinement implemented during the COVID-19 pandemic is unprecedented. In addition to reviewing the published studies, we need to anticipate the psychological problems that could arise during or at a distance from confinement. We have gone beyond the COVID-19 literature in order to examine the implications of the known consequences of confinement, like boredom, social isolation, stress, or sleep deprivation. Anxiety, post-traumatic stress disorder, depression, suicidal or addictive behaviours, domestic violence are described effects of confinement, but the mechanisms of emergence of these disorders and their interrelationships remain to be studied. For example, what are the mechanisms of emergence of post-traumatic stress disorders in the context of confinement? We also remind the reader of points of vigilance to be kept in mind with regard to eating disorders and hallucinations. Hallucinations are curiously ignored in the literature on confinement, whereas a vast literature links social isolation and hallucinations. As with domestic violence, we need to look for these symptoms in order to enable management. Due to the broad psychopathological consequences, we have to look for these various symptoms to manage them. We quickly summarize the diagnostic and therapeutic...

Impact of the Covid-19 lockdown period on adult musculoskeletal injuries and surgical management: a retrospective monocentric study

“…The proportion of high severity trauma with an ISS > 16 requiring surgery increased drastically between the pre-lockdown (2 (1.1%)) and the early lockdown period (7 (7.8%), (p = .010)), with most of these being due to road tra c injuries, suicide attempts, and domestic accidents. This result was consistent with the late lockdown period (10 (8.3%)) (18,19). This phenomenon could be explained by behavioral changes due to con nement.…”

“…We also hypothesize that suicide attempts were more frequent in the late con nement period due to prolonged stress, isolation, and lack of psychiatric support (17,18). Lastly, people spending time at home engaged in home improvements or do-it-yourself tasks that resulted in falls from ladders or roofs, as described by Park et al (9).…”

COVID-19 Pandemic: Home Confinement Problems and Mental Health

“…To our knowledge, there is no previous empirical research about global home con nement in the literature. Therefore, based on the similarity between home con nement and imprisonment situation (Gurney, 2020;Mengin, 2020), we adapted the long-term imprisonment scale (Richards, 1978) to measure the problems experimented by people during home con nement.…”

“…A rst limitation was the use of the long-term imprisonment scale to measure the problems of home con nement. Although we are aware that they are not the same situation, the authors decided to use a previously validated scale of the problems of imprisonment to identify the problems of home con nement during the COVID-19 lockdown because of their similarities (Gurney, 2020;Mengin, 2020).…”

“…The COVID-19 pandemic is the rst time in history in which the general population has been con ned to their homes, and, as far as we know, no previous empirical research has studied the speci c stressors of this situation. However, previous research showed that there is some similarity between the experience of home con nement and the feelings of social isolation and loss of freedom of movement experienced in incarceration and house arrest (Gurney, 2020;Mengin, 2020).…”