Pain in Psychiatry : Impact on Length of Hospital Stays

Pain in all the populations remains a major public health issue. Patients with mental illness consult less their general practitioners while they have an increased risk of physical disease. In addition, they have a net reduction in life expectancy due to their mental illness, living conditions and drug treatments.

In this particular population, doctors faces especially difficulties assessment and treatment of pain. Indeed, there is for example in some of these patients difficulties to express that pain.

These painful events make more complex the care of hospitalized patients (eg interrelationship between pain complaints and psychiatric symptoms) and seem to lengthen their hospital stay. This is not without consequences as long as hospitalizations represent an obstacle to the patients psychosocial rehabilitation (installation of daytime activities, project work rehabilitation, development of social network ...) and impair their quality of life.

And for the patients with psychiatric disorders some points can be noticed :

• An increased risk of physical disease
• Warning signs like pain poorly known and poorly evaluated ... and poorly supported
• The presence of the pain seems to lengthen the hospital stay
• An extension of the hospital stay, which represent an obstacle to the psychosocial rehabilitation This research project is to test if the presence of a painful complaint among psychiatric inpatients is associated lengthening of the hospitalization duration.

The secondary objectives of this study are:

• To measure the prevalence of painful complaint in this specific population,
• To examine the evolution of pain during hospitalization.
• Identify factors influencing the relationship between pain and length of stay
• To identify if the intensity of the psychiatric illness is associated with pain intensity measured

Confirmation of these objectives would lead to a better understanding of the factors influencing psychiatric hospital stays and thus more efficient management of health resources.

In addition, the present study will well identify and implement standardized assessments of pain for these patients.

For these patients the interest is important because they can be in great difficulty to express a painful complaint. These people have often difficulties to communicate, and live in a sometimes precarious environment and severity of disorders reduce their access to care.

This approach is part of a comprehensive approach taking account of the psychiatric and somatic disorders in a very vulnerable population.

Inclusion criteria

• Patient eighteen years old
• Patient hospitalized in psychiatric service at Toulouse University Hospital
• Informed consent signed

Exclusion criteria

• Patient treated with maintenance sismotherapy