Le psychotraumatisme constitue un enjeu de santé publique. La création du Centre National de Ressources et de Résilience et des Centres Régionaux de Psychotraumatisme, en 2018, constitue une avancée majeure dans le domaine du parcours de soins et de résilience des victimes. Le Centre Régional de Psychotraumatisme de Paris Centre et Sud (CRPPCS), qui couvre un territoire composé de plusieurs départements (dont Paris et le sud de l’Île-de-France), est organisé sur un modèle de fédération de plusieurs structures de soins et associatives. L’originalité du dispositif du CRPPCS réside dans la mise en place d’une plateforme téléphonique d’accueil, d’évaluation et d’orientation.

L’étude menée a pour objectif de dresser les profils des appelants, en étudiant les différents types de traumatisme, la comorbidité addictive, les parcours de soins ainsi que les données démographiques. Il s’agit d’une étude observationnelle descriptive et rétrospective de septembre 2020 à fin juin 2021.

Notre échantillon était composé de 502 personnes, dont 75 % de sexe féminin, avec un âge compris entre 25 et 60 ans dans 70 % des cas et majoritairement originaires de la région Île-de-France (98 %). Un diagnostic de psychotraumatisme a été posé pour 411 personnes. Le motif de psychotraumatisme principal était dans 32 % des cas des violences intrafamiliales. Deux cent quatre-vingt-neuf des appelants ont été réorientés vers une structure spécialisée pour la suite de leur prise en charge et parmi eux 20 % présentaient également une comorbidité addictive.

Le CRPPCS, via sa plateforme téléphonique, permet un accès direct à un personnel spécifiquement formé. Il contribue à l’amélioration de la santé psychique grâce à un repérage précoce des troubles et une orientation pour une prise en charge spécialisée adaptée du psychotraumatisme et de ses comorbidités associées.

Psychotrauma is a public health issue. Prior to 1995 in France, support for victims of psychotrauma was mainly provided by associations. Following the terrorist bombing in the Paris metro at the Saint-Michel station on 25 July 1995, a new emergency care unit, the Cellule d’Urgence Médico-Psychologique (CUMP), was created. Its main mission is to provide immediate and post-traumatic event care to victims of disasters or events involving a large number of victims and likely to result in significant psychological repercussions. Following the 2015 attacks in Paris and Saint-Denis, the creation of the National Resource and Resilience Center and the Regional Psychotrauma Centers in 2018, represented a major step forward in the field of victim care and resilience. The Regional Psychotrauma Center for Central and Southern Paris (CRPPCS), which covers an area that consists of several departments (including Paris and the south of the Île-de-France region), is organized on a model of the federation of several care and associative structures. The originality of the CRPPCS system lies in the establishment of a call center, assessment, and referral platform. Three state-certified nurses trained in psychotraumatology engage callers in a semi-structured interview, explaining the course and purpose of the interview; noting the reason for the call, then evaluating any psychotraumatic symptoms according to a grid inspired by the Posttraumatic Stress Disorder Checklist version DSM-5. They also evaluate potential comorbidities (associated depression, addictions, suicidal behaviors, somatoform disorders, etc.). The callers’ psychiatric and addictological history are explored.

The aim of this study is to establish the profiles of callers, studying the different types of trauma, addictive comorbidity, treatment approaches and demographic data.

This is a descriptive and retrospective observational study that was carried out from September 2020 to the end of June 2021. Our sample comprised 502 people, 75% of whom were women, 70% of whom were aged between 25 and 60, and the majority of whom were from the Île-de-France region (98%).

Psychotrauma was diagnosed in 411 out of the 502 individuals. The main causes of trauma, in descending order of importance, were: domestic violence (32%), rape, physical assault, psychological assault, sexual assault other than rape, traumatic bereavement, confrontation with death, traffic accidents, verbal aggression/psychological violence/harassment at work, fire/explosion, traumatic migration path, assistance provided to a loved one in danger, and serious medical problems. For 24% of the sample, a previous history of traumatic events was reported. Among, these callers, 289 were redirected to a specialized structure for further treatment, and 20% of them also had an addictive comorbidity. Of the 52 people with a substance use disorder, 20 % reported a sexual assault as a child, 31% had been the victim of a rape, 26% of a sexual assault in adulthood and 43% of a traumatic migration journey. Of the 289 calls involving psychotrauma in the network, the distribution between the different subtypes was as follows: 137 people experienced a simple psychotrauma (47%) and 152 people were suffering from a complex psychotrauma (52%).

The high prevalence of psychotrauma as well as the medical and social cost of its chronicity and associated frequent comorbidities illustrate the urgency to act in order to establish coherent public health strategies. The CRPPCS telephone platform provides direct access to specially trained staff. It contributes to an improvement in mental health by identifying disorders at an early stage and by referring patients for appropriate specialized care for psychotrauma and associated comorbidities. Our study highlights the significant addictive comorbidity associated with PTSD, which is often secondary to the onset of PTSD, as well as the risk of developing complex trauma if early treatment is not provided. These conclusions stress the need for simultaneous joint care of both the psychotrauma and the comorbidity of addiction.