Les Troubles Psychiatriques chez les Émigrés au Service de Psychiatrie du CHU Point G (Bamako)

RESUME Introduction. L’emigration, surtout clandestine, est un facteur hautement stressant et generateur de troubles psychiatriques selon plusieurs etudes en Afrique et dans le monde. Mais au Mali, tres peu d’etudes y ont ete dediees. Objectif. Exposer les troubles psychiatriques chez les emigres de retour au pays. Materiels et methodes. Il s’agissait d’une etude transversale descriptive retrospective effectuee de janvier a Decembre 2008, ayant exploite les donnees concernant 3105 patients hospitalises dans le service de psychiatrie du CHU du « Point G » de Janvier 1998 a Decembre 2007. Dans notre etude, nous nous sommes limites aux cas dont le retour etait du a l’eclosion des troubles dans le pays d’accueil. Resultats. 359 migrants ont ete colliges (11,5% des patients hospitalises). Il s’agissait generalement de patients de sexe masculin (90.2%), âges de 27 a 35 ans, celibataires, non scolarises et d’ethnie Soninke. Les facteurs ayant favorise la decompensation etaient les difficultes d’insertion, les expulsions et les incarcerations. Les psychoses aigues (bouffee delirante’ aigue, confusion mentale, psychoses reactionnelles et psychoses puerperales) avec 42% et la schizophrenie (28%) ont domine les pathologies psychiatriques. La recherche d’une prise en charge traditionnelle a ete le motif de retour chez environ 59% des patients. Conclusion. Des etudes plus approfondies permettraient de mieux preciser le lien entre sante mentale et emigration. ABSTRACT Introduction. Emigration, especially when clandestine, is a highly stressful factor generating psychiatric disorders according to several studies in Africa and in the world. But in Mali, very few studies have been dedicated to it. Goal. To report psychiatric disorders among returning Malian emigrants at the University Teaching Hospital Point G. Patients and Methods. This was a cross sectional descriptive retrospective study from January to December 2008, which collected data of 3105 patients hospitalized in the psychiatric ward from January 1998 to December 2007. The main inclusion criterion was the outbreak of unrest in the host country. Results. 359 returning migrants (11.5% of inpatients) were studied. They were generally male (90.2%), aged between 26 and 35, single, out of school and of Soninke ethnic group. Factors favoring decompensation were insertion difficulties, expulsions and incarcerations. The main psychiatric pathologies were acute psychoses (acute psychosis, mental confusion, reactive psychoses and puerperal psychoses)(42%) and schizophrenia (28%). Desire of traditional care was the reason for returning home for 59% of patients. Conclusion. More in-depth studies are necessary to clarify the link between migration and mental pathologies.