{"id":1800,"date":"2005-10-01T01:00:00","date_gmt":"2005-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/propositions-pour-laccompagnement-psychologique-des-patients-traites-par-interferon-pour-hepatite-cpartage-dune-experience-au-sein-dun-service-hospitalier-a-laide\/"},"modified":"2018-10-20T18:39:37","modified_gmt":"2018-10-20T16:39:37","slug":"propositions-pour-laccompagnement-psychologique-des-patients-traites-par-interferon-pour-hepatite-cpartage-dune-experience-au-sein-dun-service-hospitalier-a-laide","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/propositions-pour-laccompagnement-psychologique-des-patients-traites-par-interferon-pour-hepatite-cpartage-dune-experience-au-sein-dun-service-hospitalier-a-laide\/","title":{"rendered":"PROPOSITIONS POUR L\u2019ACCOMPAGNEMENT PSYCHOLOGIQUE DES PATIENTS TRAITES PAR INTERFERON POUR HEPATITE C\nPARTAGE D\u2019UNE EXPERIENCE AU SEIN D\u2019UN SERVICE HOSPITALIER, A L\u2019AIDE D\u2019UN OUTIL D\u2019EVALUATION SIMPLE."},"content":{"rendered":"

2005<\/strong><\/p>\n

N.RAIFF\u00c9 \u2013 C.RIOU – B. NALET
\nService de Gastro-ent\u00e9rologie – Centre Hospitalier- 26200 Mont\u00e9limar.<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a02005-08-24 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Le traitement de l\u2019h\u00e9patite C par interf\u00e9ron provoque des effets secondaires importants parmi lesquels un syndrome d\u00e9pressif.
\nLa manifestation de ces troubles (anxio-d\u00e9pressifs \/ maniaques) peut parfois requ\u00e9rir l\u2019interruption du traitement, suite \u00e0 une plainte spontan\u00e9e du patient ou au rep\u00e9rage d\u2019un risque important pour l\u2019\u00e9conomie psychique du sujet (souffrance morale, cons\u00e9quences sur les relations familiales, risque suicidaire).<\/p>\n

Objectif :\tLe but de ce travail est de proposer un exemple de prise en charge psychologique pour une meilleure appr\u00e9hension des effets secondaires sur l’humeur li\u00e9s \u00e0 l\u2019interf\u00e9ron. <\/p>\n

Mat\u00e9riel : \tLes outils utilis\u00e9s pour ce travail sont d\u2019une part l\u2019entretien semi directif, d\u2019autre part l\u2019\u00e9chelle d\u2019\u00e9valuation de la d\u00e9pression de Montgomery & Asberg. C\u2019est un outil rapide qui \u00e9voque en 10 items les \u00e9l\u00e9ments principaux de l\u2019\u00e9tat d\u00e9pressif, permettant d\u2019obtenir un score indicateur du niveau de s\u00e9v\u00e9rit\u00e9 (d\u00e9pression > 18).
\nSur 25 patients \u00e9valu\u00e9s : 18 sont actuellement trait\u00e9 (5 sur 24 semaines, 11 sur 48 semaines, 2 en traitement suspensif), 3 sont en attente et 4 ne seront pas trait\u00e9s.<\/p>\n

M\u00e9thodes : Il s\u2019agit d\u2019\u00e9valuer tr\u00e8s r\u00e9guli\u00e8rement les patients trait\u00e9s, afin de pr\u00e9venir les modifications de l\u2019humeur puis de proposer des r\u00e9ponses pr\u00e9coces.
\nUn calendrier des consultations (h\u00e9patologue, infirmi\u00e8re r\u00e9f\u00e9rente, psychologue) est mis en place, en fonction de la dur\u00e9e du traitement. Les entretiens d\u2019\u00e9valuation de l\u2019humeur d\u00e9butent avant le traitement et se poursuivent toutes les 8 semaines pendant la dur\u00e9e du traitement ainsi que les 6 mois qui suivent.
\nL\u2019ensemble des donn\u00e9es recueillies au cours de l\u2019entretien clinique, ainsi que les scores obtenus \u00e0 l\u2019\u00e9valuation, vont permettre d\u2019objectiver les variations de l’humeur chez un patient et de r\u00e9ajuster ou v\u00e9rifier l’effet du traitement en fonction de l’\u00e9volution de ces scores :
\nLorsque le score est faible (inf\u00e9rieur \u00e0 14), le calendrier pr\u00e9alable est respect\u00e9. Un contact t\u00e9l\u00e9phonique est maintenu pour une plus grande vigilance.
\nLorsque le score est interm\u00e9diaire (entre 14 et 18- d\u00e9pression sub-syndromique), le patient est invit\u00e9 \u00e0 se manifester entre deux rendez-vous programm\u00e9s, si lui ou un membre de son entourage per\u00e7oit une alt\u00e9ration de l\u2019humeur dans l\u2019intervalle.
\nLe m\u00e9decin est inform\u00e9 de cet \u00e9tat et \u00e9value la pertinence d\u2019un traitement antid\u00e9presseur \/ anxiolytique.
\nLorsque le score est \u00e9lev\u00e9 (sup\u00e9rieur \u00e0 18 il convient selon les auteurs d\u2019\u00e9voquer un \u00e9tat de d\u00e9pression), le m\u00e9decin est interpell\u00e9 afin d\u2019\u00e9valuer la pertinence d\u2019un traitement antid\u00e9presseur \/ anxiolytique.
\nPar ailleurs, des entretiens de soutien psychologique sont programm\u00e9s tous les 8 jours (avec \u00e9valuations syst\u00e9matiques) jusqu\u2019\u00e0 r\u00e9cup\u00e9ration d\u2019un score inf\u00e9rieur \u00e0 18. <\/p>\n

R\u00e9sultats pr\u00e9liminaires : Parmi les 18 patients trait\u00e9s, 9 ont n\u00e9cessit\u00e9 une modification importante du calendrier pr\u00e9alable, ainsi que des prescriptions :
\nAnxiolytique : 4 \t– Antid\u00e9presseur : 5 – Antid\u00e9presseur et anxiolytique: 3
\nA ce jour, le score moyen de l\u2019ensemble des \u00e9valuations a progressivement diminu\u00e9 au cours des 5 premi\u00e8res consultations.
\nConclusion :
\nUn accompagnement psychologique du patient trait\u00e9 par interf\u00e9ron ainsi que le rep\u00e9rage et la r\u00e9ponse pr\u00e9coce aux troubles de l\u2019humeur, permettent de :
\n– Minimiser l\u2019inconfort psychologique provoqu\u00e9
\n– R\u00e9duire les interruptions de traitement li\u00e9es \u00e0 des \u00e9pisodes d\u00e9pressifs majeurs.<\/p>\n

L. Cast\u00e9ra, F. Zigante, A. Bastie, C. Buffet, D. Dhumeaux, P. Hardy \u2013Incidence of Interferon Alfa-Induced Depression in Patients With Chronic Hepatitis C ; Hepatology, 2002; .35: 978-979.<\/p>\n","protected":false},"excerpt":{"rendered":"

2005 N.RAIFF\u00c9 \u2013 C.RIOU – B. NALET Service de Gastro-ent\u00e9rologie – Centre Hospitalier- 26200 Mont\u00e9limar. H\u00e9patologie – \u00a02005-08-24 –\u00a0CO – ________________________________ Le traitement de l\u2019h\u00e9patite C par interf\u00e9ron provoque des effets secondaires importants parmi lesquels un syndrome d\u00e9pressif. La manifestation de ces troubles (anxio-d\u00e9pressifs \/ maniaques) peut parfois requ\u00e9rir l\u2019interruption du traitement, suite \u00e0 une […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[16],"class_list":["post-1800","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-16"],"yoast_head":"\nPROPOSITIONS POUR L\u2019ACCOMPAGNEMENT PSYCHOLOGIQUE DES PATIENTS TRAITES PAR INTERFERON POUR HEPATITE C PARTAGE D\u2019UNE EXPERIENCE AU SEIN D\u2019UN SERVICE HOSPITALIER, A L\u2019AIDE D\u2019UN OUTIL D\u2019EVALUATION SIMPLE. - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/propositions-pour-laccompagnement-psychologique-des-patients-traites-par-interferon-pour-hepatite-cpartage-dune-experience-au-sein-dun-service-hospitalier-a-laide\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"PROPOSITIONS POUR L\u2019ACCOMPAGNEMENT PSYCHOLOGIQUE DES PATIENTS TRAITES PAR INTERFERON POUR HEPATITE C PARTAGE D\u2019UNE EXPERIENCE AU SEIN D\u2019UN SERVICE HOSPITALIER, A L\u2019AIDE D\u2019UN OUTIL D\u2019EVALUATION SIMPLE. - 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