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S M Consoli

Publications and source records attributed to S M Consoli.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Psychological and behavior characteristics predicting blood pressure reactivity to mental stress].

This study was conducted with 58 subjects (31 males and 27 females): a sample of 37 normotensives (NT) (mean age 36 +/- 11) and a sample of 21 hypertensives (HT) without any antihypertensive medication (mean age 46 +/- 9). Cardiovascular reactivity was measured during a sequence of 3 computer assisted mental stress tasks (visual-motor tasks, maze test). Before and following the stress tasks the subjects were asked to respond on the same computer to psychological test and questionnaires measuring anxiety, depression (H.A.D. inventory) type A behavior (impatience, competition and drive for success; Bortner's scale), locus of control (attribution of success or failure to internal or external factors; Levenson's scale), and coping mechanisms used in response to everyday life stresses (Rosenzweig Picture Frustration Test, adapted by S. Consoli and E. Albert). Measurements of systolic (SBP) and diastolic blood pressure and heart rate were obtained automatically every minute during the entire computer session with a Colin Press-Mate BP 8800 sphygmomanometer. Pressure reactivity (PR) was defined as the relative difference between BP measured during mental stress and BP measured during non-stress condition (the reference period). Our hypotheses were that PR would be greater in HT than in NT, and that PR would be correlated with various psychological and behavioral characteristics. During the stress session, SBP in NT increased from 119.8 to 123.7 mmHg (p < 0.001) and in HT from 147.4 to 152 mmHg (p < 0.05): there was no significant difference between the two samples but in HT, SBP elevation persisted after the stress session, contrary to the NT, whose SBP quickly decreased to the reference values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1993

[Stress and the cardiovascular system].

A variety of evidence shows that stress contributes to a more or less sustained elevation of blood pressure, as well as to the triggering and aggravation of cardiovascular pathology, especially coronary heart disease. Experimentally induced changes, that may be pathogenic due to their duration or repetition, can be produced in hemodynamics, lipid metabolism, or hemostasis. High blood pressure, vascular heredity, but also a trend to inhibition of action, seem to be responsible for hyperreactivity to stress. Hypertensives are particularly reactive to active stresses related to controlable situations, experienced as challenges. Several prospective studies in healthy subjects have confirmed the increased risk for coronary heart disease of certain psychological characteristics: the most known of them is Rosenman's and Friedman's type A behavior (hyperactivity, speed and impatience, hard driving, job involvement). It is known that individuals presenting such characteristics exhibit increased neuroendocrine responses to all types of stress. Pattern A predicts the incidence of myocardial infarction, independently of other coronary risk factors, such as hypertension, hypercholesterolemia, or smoking habits. It as been proved that type A individuals deal on average with more stressing conditions than type B individuals and that they set higher goals than general population. On a cognitive level, they tend to have an internal "locus of control" (they are inclined to attribute their personal successes or failures to their own responsibility). Nevertheless, the most reactive to stress among type A individuals are those whose locus of control is external. The predictive validity of pattern A in coronary mortality is more debated.(ABSTRACT TRUNCATED AT 250 WORDS)

Arousal↗
PubMed1993

[Validation of a personality questionnaire designed for defining sub-groups at risk for ischemic cardiopathy or cancer in the Gazel cohort].

Within the context of a prospective survey project among 20,000 volunteers working for "Electricité de France--Gaz de France" Company (GAZEL cohort), we performed a feasibility study using four self-assessment questionnaires: the Jenkins Activity Survey (measuring type A behaviour pattern), the Buss and Durkee Hostility Inventory, the Center for Epidemiologic Studies--Depression Scale and a personality questionnaire developed by Grossarth-Maticek and Eysenck (GME). Questionnaires were sent twice by mail, at an interval of three months, to a random sample of 408 males: 71% returned the filled forms the first time, 66% the second time, and 80% at least once. The test-retest correlation coefficients ranged from 0.62 to 0.87. The validity of the six personality type scores, calculated from GME, was tested by correlations with the scores of the three other instruments. These correlations appeared consistent with the proposed typology, especially for the "Healthy" type, the "Cancer prone" type and the "Coronary Heart Disease prone" type. The labelling of these types was justified by their association with different disease events, suggested from previous studies.

Adult↗
PubMed1992

[Immunology and psychiatry].

This review of scientific literature comes within the interest arisen from ten years by psychoneuroimmunology, a field connecting several disciplines and illustrating in a new way the psychosomatic relationships. A first category of works has been dedicated to the study of psychiatric disorders associated with various diseases concerning immunity (systemic diseases, endocrine diseases, cancers, infectious diseases), but also to the possible effect of distressing life events on the upset activation of immune functions, or even to the discovery of predisposing personality profiles (type C profile, depressive vulnerability). A second category of works concerns the analysis of the immune disturbances associated with certain psychiatric diseases, such as depression or schizophrenia, but also with some distressing life conditions, like bereavement. Animal experimentation and human experimentation provide various informations on the factors conditioning the immunomodulating effects of stress, sometimes in the direction of an inhibition, sometimes in the direction of an activation of immune functions. Finally, several papers shed light on the immunomodulating effects of psychotropic drugs. All these works open new horizons to the scientific knowledge and let us glimpse an extension to the use of psychologic therapeutics, as well of pharmacological ones as of non pharmacological.

Autoimmune Diseases↗
PubMed1992

[Psychological aspects of short-term follow-up in myocardial infarction].

The author analyses the outcome and emotional repercussions of myocardial infarction in the patient, his or her partner, and of the medical team who manages the infarct (coronary care and cardiac rehabilitation). The adaptive value of certain psychological attitudes is emphasised, for example the denial of illness, and the poor prognosis associated not so much with "type A" behaviour reputed to cause coronary disease but more with post-infarction depression or even with a more stable tendency to hostility in the emotional control. Some of these psychological characteristics may explain the difficulties encountered in designing educative programmes or in poor therapeutic observance by patients despite being aware of the risks they run. These considerations led to therapeutic implication ranging from the strategy of communication with the coronary patient to specific relaxation techniques or with help, to the gestion of stress, to the judicious prescription of psychotropic agents.

Coronary Care Units↗
PubMed1990

[Idiopathic and secondary Raynaud's phenomenon. A comparative psychosomatic approach].

Thirty subjects with Raynaud's phenomenon admitted for determination of its cause underwent psychological examination. Raynaud's phenomenon was regarded as primary in 14 cases, secondary (usually to scleroderma) in 13 cases and eluding classification in 3 cases. The mean age of patients with primary Raynaud's phenomenon was higher than in the other groups. Interviews and psychological tests were carried out with all but 2 patients and all investigators being totally unaware of the aetiological category. Patients with secondary Raynaud's phenomenon significantly differed from those with primary Raynaud's phenomenon in their personality patterns, attitudes towards interlocutors and way of coping with conflicts. Patients with primary Raynaud's phenomenon were characterized by a relatively frequent hysterical personality and by their dodging behaviour when faced with their own aggressiveness. Patients with secondary Raynaud's phenomenon were found to be more distant, more conformist, more able to control their emotions and seemed to be less inclined to seek help when in trouble. Such findings suggest that Raynaud's phenomenon has a "psychosomatic" component: a psychic vulnerability which might contribute to the progress of the disease, and more clearly so in patients with secondary Raynaud's phenomenon than in patients with primary Raynaud's phenomenon, as confirmed by the so-called psychic fragility" score used to quantify the efficiency of mental functioning. These psychological features were unrelated to age. The profile of patients with secondary Raynaud's phenomenon is close to pattern C described as possibly having a prognostic value in proliferative or autoimmune diseases.

Adult↗
PubMed1990

[Psychiatric disorders in patient with chronic kidney failure].

The psychiatric complications and adaptation disorders observed in patients with chronic renal failure under maintenance haemodialysis are reviewed. The main psychiatric complications are depressive manifestations, while the main adaptation disorders are lack of compliance with food and water restrictions and temperamental relations with the husband or wife or the dialysis team. The mechanisms of some disorders are analyzed, and emphasis is placed on the usefulness of psychiatric and/or psychological assistance not only to the patient but also to his wife and to the medical staff.

Adaptation, Psychological↗
PubMed1989

[Stress as a risk factor].

A variety of evidence shows that stress contributes to the triggering and aggravation of cardiovascular pathology, notably ischemic cardiopathy. Experimentally induced changes that may be pathogenic due to their duration or repetition can be produced in hemodynamics, hemostasis or lipid metabolism. Prospective studies in healthy subjects have confirmed the predictive value of certain behavioral patterns (A, for instance), and it is known that individuals presenting such characteristics exhibit increased neuroendocrine responses to all types of stress. Changes in blood pressure in response to stress in hypertensives and normotensives also depend on personality and preferred adaptative strategies (coping). These considerations lead to therapeutic approaches intended to ensure long-term prevention of cardiovascular morbidity.

Coronary Disease↗
PubMed1988

[Predictive value of patient psychological profile and type of physician-patient relationship in compliance of antihypertensive treatment].

The files of 4614 hypertensive patients monitored by general practitioners (GP) were methodically analyzed. 49 p. 100 of these subjects had received no previous treatment. The protocol consisted of obligatory consultations 2, 6 and 12 months after inclusion, and questionnaires requiring specific answers, designed to describe the patient-practitioner relationship. The GP provided a psychological evaluation upon inclusion. Four main compliance classes were defined according to the data collected over 12 months: patients present at all times of the study and scrupulously respecting the medical prescription (class A: 36 p. 100 of the studied population) or neglecting the prescription (B: 33 p. 100), patients omitting one or several appointments but reestablishing contact (C: 2 p. 100) and patients lost to follow-up (D: 18 p. 100). Blood pressure parameters were better in class A as of the consultation at 2 months (ANOVA). Paradoxically, a self-assured, outgoing, serene character is a prediction factor for less satisfactory compliance than a passive, hesitant, reserved, worried character. GP behaviors were classified into homogeneous groups by principal component factorial analysis: positive prognosis factors as regards compliance are an attitude of "building up confidence" (reassuring the patient, announcing that treatment will allow him to relax, evoking possible side-effects in advance) or "medicalization of hypertension" (presented as a pathology rather than merely as a risk factor, with life-long treatment as a corollary). On the other hand, a poor prognosis factor is an attitude of "dramatization" (frightening the patient). "Building up confidence" is linked to better compliance, whatever the associated risk factors. This study statistically confirms the role of the patient-practitioner relationship in compliance.

Humans↗
PubMedDate not supplied

[Health locus of control and cholesterol representations. Results of the FRACTION survey].

UNLABELLED: The concept of the health locus of control (HLC) proved fruitful in predicting individual health behavior, in particular a person's ability to actively comply with a preventive approach. It is interesting to apply such a concept to the field of cardiovascular risk, where too many people still disregard to various degrees measures designed to control hypercholesterolemia. Now, hypercholesterolemia is recognized as a major modifiable risk factor for cardiovascular disease. OBJECTIVES: From a survey designed to explore the health beliefs concerning cholesterol and hypercholesterolemia in 1,398 subjects followed up for hypercholesterolemia by a general practitioner, we tried to determine whether the socio-demographic, clinical and cognitive characteristics of the population were related to the type of HLC of each subject (internal, chance or medical power). METHOD: All the subjects filled out a 27-item questionnaire that included one question aimed to determine their HLC type. These data were completed by a short identification sheet, encompassing various clinical data, given by the GP. A global level of dietary knowledge was computed from a question on nutritional properties of 11 foods according to the direct or indirect contribution of each food to the blood cholesterol level. RESULTS: Population consisted of 59.7% males and 40.3% females. Mean age was 57.9 +/- 11.5 years. Educational level was low (< 9 years of education) for 38% of the subjects and medium/high (10 years or more of education) for 62% of them. Hypertension was associated to hypercholesterolemia for 46.4% of the subjects, diabetes mellitus for 13.3% and coronary heart disease for 11.4% of them; 18.2% were current smokers and 34.6% past-smokers; 86.1% were already treated by lipid lowering drugs. Based on the answers to the HLC question, 42.3% of the study population can be considered as characterized by an internal HLC, 30.5% by a medical power HLC, and 27.1% by a chance HLC. An internal HLC was associated with a younger age (p < 0.008), a higher educational level (p < 0.001), less hypertension (p = 0.002), and a lower body mass index (p = 0.02). An internal HLC was also associated with several representations testifying an appropriate level of knowledge, for example: cholesterol is a basic component of the body (p = 0.001), or the presence of cholesterol in blood is normal (p = 0.04), or the desirable cholesterol level in the blood is < 2 g/l (p = 0.01) and with fewer mis-conceptions about cholesterol and hypercholesterolemia, for example: overweight individuals are more prone to have cholesterol problems (p = 0.001), or too much cholesterol may lead to cancer (p = 0.03). It was also associated with a closer identification between cholesterol and modem lifestyle (p = 0.005), with the belief that the best way of lowering cholesterol is to diet (p = 0.001) and with a lesser degree of demotivation when being aware of the role of heredity in a health problem (p = 0.001) as well as with fewer mentions of paradoxical or disappointing counter-examples of close people treated for hypercholesterolemia (p = 0.04). Finally, internal HLC subjects put forward less excuses for not to comply with dietary constraints, for example: being on diet is only possible with the spouse/family (p = 0.007), or dieting is impossible if one has an active lifestyle including eating out (p < 0.001). CONCLUSION: In spite of the very simple way used for assessing HLC in our study, without turning to a standardized multi-item inventory, these results should encourage physicians to take into account the HLC of their hypercholesterolemic patients to pass personally tailored educational messages and to motivate them to take responsibility for their own health.

Attitude to Health↗
PubMedDate not supplied

[Factors associated with suicidal risk among consulting young people in a preventive health center].

UNLABELLED: The association between suicidal risk and various psychological or biographical factors in teenagers or young adults is already well documented. Yet, the role of stressful life events or contexts during childhood or of the recent past, as well as the respective weight of such determinants, has to be specified. METHODS: One thousand one hundred and thirty-nine individuals, aged 16 to 25, who consecutively consulted in a preventive health center supported by the National Health Insurance System, located in Seine-Saint-Denis (a French department characterized by an unfavourable socio-economic context) on the occasion of a free work up were invited to fill out several self-administered questionnaires, aimed at assessing especially the level of psychosocial distress (Golberg's GHQ-28) and the level of hopelessness (Beck's hopelessness scale). They were also invited to meet a psychologist for a semi-structured interview, when the day of their consultation coincided with one of the three days a week the psychologist was present in the center; the interview was aimed at collecting information upon the biographical context and ancient or recent life events and to determine the level of suicidal risk, on the basis of a scale of suicidal ideation [Ducher's Suicidal Risk Scale (ERSD)]. The concurrent validity of the later has already been previously tested and positive correlation coefficients were found with Beck Depression Inventory, Hamilton's Depression Rating Scale and Beck's Hopelessness Scale. RESULTS: One thousand and four records could be analysed, as regards self-administered questionnaires, and among those, 576 as regards the interview with the psychologist and data related to suicidal risk. The studied population included 61.3% of females and 59.3% of individuals aged 20 to 25: mean age was comparable in males and females. GHQ-28 global score and sub-scores (somatisation, anxiety, social dysfunction and depressive mood) were all higher in women (all the p<0.001). A high suicidal risk (ERSD score 4) was found in 24.1% of the studied population. Subjects presenting with a high suicidal risk were characterized by higher levels of GHQ-28 psychosocial distress and GHQ-28 sub-scores as well as hopelessness (all the p<0.001). Several biographical antecedents during childhood were significantly associated with suicidal risk: unknown father (p<0.001), death of parents (p<0.001), separation from parents (p<0.001), severe quarrel between parents (p<0.001), money problems within the family (p<0.007), disorders related with alcohol consumption in parents (p<0.016), drug addiction within the family (p<0.001). Other predictors were several recent stressful events or contexts: violence within the family (p<0.001), social isolation (p<0.001), lack of self-esteem of (p<0.002), school difficulties (p<0.001), educational failure (p<0.001); as well as the notion of a consumption of drugs (p=0,001) or medications: neuroleptics (p<0.015), antidepressants (p=0.001) and tranquilizers (p<0.001). A series of univariate regression analyses allowed to compute the Odds Ratios (OR) and the 95% Confidence Intervals (95% CI) of the sub-group characterized by a high suicidal risk for each socio-demographic, psychological and biographical independent variable, linked to suicidal risk at a threshold of p<0.10. A multiple regression analysis was then performed in 2 steps: in a first step, independent variables were pooled by blocks, according to their nature (psychological characteristics, relational deficiencies among biographical antecedents, other stressful conditions among antecedents, stressful conditions among recent biographical context, recent consumption of drugs or medications); in a second step, all the independent variables which still remained associated with suicidal risk within each block were included in a final multiple regression analysis. Five variables continued to independently predict a high suicidal risk: hopelessness at Beck's scale (OR=4.09), depressive mood at GHQ-28 (OR=3.75), the notion of an unknown father (OR=2.95), the notion of a recent destabilizing event other than a school problem or an aggression (OR=1.90) and the notion of an educational failure (OR=1.78). CONCLUSION: These results confirm previous scientific data on this topic and underline that childhood context, educational course, psychological vulnerability and the occurrence of recent stressful life events combine their effects, enhancing the risk of a suicidal attempt. They can be useful for better sensitising educational as well as social and health care circles, for settling more efficient screening and preventive programs.

Adolescent↗
PubMedDate not supplied

[Primary Human Immunodeficiency Virus infection revealed by psychiatric symptoms].

INTRODUCTION: Any atypical psychiatric disorder, especially if associated with somatic manifestations and when any psychiatric antecedents are missing, should lead to search for an organic pathology, and notably a Human Immunodeficiency Virus (HIV) infection. In the case of Primary Human Immunodeficiency Virus Infection (PHI), which is often symptomatic, the diagnosis is seldom made, probably because of atypical or non specific manifestations. Therefore, it is essential to consider such a diagnosis, because it may have important clinical and public health consequences (stopping the contamination chain). CASE-REPORT: We present the case of a 38 year-old homosexual man from West Indies, in whom the diagnosis of PHI had been made on the basis of psychiatric symptoms evoking a Major Depressive Episode with a doubt on the presence of psychotic symptoms. To our knowledge, this is the first report of psychiatric PHI found in scientific literature. Clinical presentation was atypical: the patient had no psychiatric history (except probably a schizotypical personality, according to his family), symptoms were atypical (sudden onset and fast improvement) associated with somatic symptoms (fever, headache, sound intolerance), the latter possibly due to a meningo-encephalitis, which had been underestimated and attributed to dehydration in a period when France was faced with an important and unexpected heatwave. Blood samples were performed on admission and revealed a thrombopenia and presence of HIV P24 antigen, testifying a contamination by HIV 2 to 4 weeks earlier, this possibility having been confirmed by the patient. Further analyses found a Western-Blot partially positive test and an HIV viral load of 315 711 Eq copies/mL. DISCUSSION: The main question about this report is the primary or secondary nature of psychiatric symptoms towards HIV infection, given that in this patient mood alteration could have possibly occurred, before HIV contamination, due to particularities of his personal and professional life. We can also question whether the neurological manifestations of PHI might be changed by a schizotypical personality. Further reports are required to answer these questions.

Adult↗
PubMedDate not supplied

[French version of the video structured interview designed for type A behavior pattern assessment].

The current controversy on the predictive value of the Type A Behavior Pattern (TABP) as a coronary risk factor brought into a reconsideration of the assessment methods of this pattern. The Video Structured Interview (VSI) is a scoring method of TABP by a trained investigator, consisting of a rating scale based both on the content of the answers and on the psychomotor signs, with regard to the two main components of the TABP: sense of time urgency and hostility. The VSI appears a more objective instrument than self-assessment questionnaires, avoiding the bias of denial, a coping mechanism widely used by type A subjects. The VSI proved more sensitive and more specific than the self-assessment methods or the structured interview (SI), the initial instrument aimed to assess TABP among coronary risk patients in american populations. We here present the french version of the VSI, the technical modes of the interview and the principles of this scoring method, in order to introduce in France its use in further studies related with coronary risk factors.

Coronary Disease↗
PubMedDate not supplied

[The quality of life of hypertensive patients treated with prazosin (sustained-release) or enalapril: a randomized controlled trial over 24 weeks].

The importance of the criterion of Quality of Life (QOL) for compliance with antihypertensive drugs led us to study the QOL of 51 hypertensives receiving 2.5 mg of the new formulation of prazosin (sustained release), compared with 49 subjects treated by a converting enzyme inhibitor (enalapril 10 mg), in a double-blind randomized trial. QOL, assessed by means of a 22 item self-administered questionnaire, improved significantly with prazosin, during the 24 weeks of the trial. In the intention to treat analysis, the global score of QOL increased from 46.3 +/- 8.4 to 51.6 +/- 8.9 (p < 0.0001); the covariance analysis showed that the improvement was obtained as early as the 8th week. A similar favourable evolution was observed for anxiety, retardation and anhedonia components, computed from the same questionnaire. No significant difference in QOL evolution was found between prazosin and enalapril. Both treatments proved equivalent in respect of efficacy on blood-pressure values, and tolerance, estimated through the number of dropouts or side-effects. These results confirm the benefit to QOL of hypertensive patients of the new formulation of prazosin.

Aged↗
PubMedDate not supplied

[Psychological factors associated in smoking cessation in patients with arterial occlusive disease of the legs].

Few studies have focused on psychological factors involved in the course of peripheral atherosclerosis, particularly in smoking cessation, which is a major point in the outcome of the disease. In this view, we assessed in 19 men hospitalised for intermittent claudication, some personality and emotional characteristics associated with the patients' recent smoking behaviour. Patients included tend to have high scores of state-anxiety and alexithymia (with difficulty to identify and express their emotions), and to benefit from an efficient social support made of few persons. Concerning the smoking behaviour from the past six months, only 8 subjects stopped smoking and 13 subjects made an effort in this way, despite relatively low nicotine dependence scores, severe peripheral atherosclerosis with frequent erection disorders, and awareness of the importance to stop smoking to improve the outcome. Presence of erection disorders, and eventually higher alexithymia scores, may facilitate the smoking cessation. The main reasons explaining the difficulty to stop smoking don't seem to be pharmacologically induced, neither a denegation of the bad effects of smoking on outcome, but more surely a psychological and complex dependence. It would be essential to assess more precisely the psychological characteristics of the patient to propose more efficient treatment.

Adult↗
PubMedDate not supplied

[Prospective study of post-traumatic stress in victims of terrorist attacks].

In 1995-96 several terrorist attacks struck Paris. After that, the French government decided to optimize the service claimed to treat psychological repercussions of attacks victims. For this reason we need to better understand the psychopathology developing after these traumatic events in order to adjust the various steps of the treatment. In December 1996, a terrorist attack occurred in a Paris subway. Medical and medico-psychological teams intervened immediately on the site to help victims. Among 115 victims, 4 persons died and 35 were seriously injured. The aim of our study was to evaluate the psychological impact among a population of terrorist attacks victims by a prospective study and to identify predictive factors of posttraumatic stress disorder (PTSD). We evaluated PTSD rates at 6 and 18 months, the relationship between coping style and PTSD, and whether PTSD increased health care utilization. Two follow up evaluations were performed in the 6th and 7th month respectively, by means of self-questionnaires sent by mail. Among 115 victims of the bombing attack occurred in December 1996, the 111 survivors were asked to participate to the study. The subjects who accepted and could use French questionnaires were considered eligible for the inclusion: the main criteria of the Watson's PTSD Inventory for the specific post-traumatic symptoms were used; the Goldberg's General Health Questionnaire was used to measure the general psychopathology; to identify coping styles we used the questionnaire "Ways of Coping Check List" of Vitaliano at 6 months and the "Coping Inventory for Stressful Situations (CISS)" by Endler at 18 months; a small questionnaire was proposed to evaluate injuries, hospitalization and specific treatment immediately or after the event. Among 70 subjects who accepted to participate, 56 (33 females) could be evaluated at 6 months and 32 (14 females) subjects at 18th months. The mean age at 6 months was 38.4 years: 41% of participants met PTSD criteria at 6 months, 34.4% still had PTSD at 18 months; at 18th months, 50% subjects presented GHQ scores higher than 3, corresponding to the cut-off revealing mental suffering; people hospitalized more than two days immediately after the event presented significantly lower PTSD scores at 6 months. General characteristics of risks factors for PTSD were: at 6 and 18 months, women and younger people presented significantly higher PTSD scores; for the CISS at 18 months Emotion-oriented coping correlated significantly with PTSD (r = 0.49, p = 0.007), while task-oriented coping and PTSD correlated negatively (r = -0.39; p = 0.04). Avoidance coping's styles were not correlated with PTSD. About predictive factors: the GHQ-12 and PTSD-I scores at 6 months were significantly correlated with PTSD-I scores at 18 months (respectively r = 0.73, p = 0.018 and r = 0.75, p = 0.0029); by a multiple regression we observed that PTSD-I score at 6 months predicted the PTSD-I score at 18 months, adjusted on sex and age. The others characteristics at 18 months were: medication use increased significantly at 18 months; people who lived another traumatic event since December 1996 presented a 18 month PTSD score higher than the other victims. In spite of the small size of this sample, the principal interest of this study is the prospective data in a population exposed by the same traumatic event. We note the high score of PTSD at 18 months. Terrorism exposure resulted in persisting PTSD in a significant proportion of victims; this was related to coping style. Moreover PTSD increased health care utilization. We discuss these results comparing with other similar populations in France, Israel and USA. We discuss overall the role of coping styles during the time after an attack; we insist on considering this aspect in the therapeutic strategies. These data contribute to inform that people with a high PTSD score at 6 months presented a high risk to suffer PTSD at 18 months. These results underline the importance of early diagnosis to propose early medical and psychological help to the victims.

Adaptation, Psychological↗