Health outcomes research in cognitive, mental and motor disabilities
The team «Health outcomes research in cognitive, mental and motor disabilities» is a research unit which focuses on health questions concerning disability in several clinical domains: severe mental disorders (schizophrenia, bipolar disorders, autism spectrum disorders), traumatic brain injuries, cerebrovascular accidents, neuromuscular disorders and spinal cord injuries.
The team gathers researchers specialised in psychiatry, physical and rehabilitation medicine and public health that share a medical model of disability conceived as a chronic condition that result from the interaction, along a longitudinal trajectory, between physiopathological, social, and environmental determinants. Notwithstanding the growing awareness of the role played by these multiple determinants, data concerning the best therapeutic strategies to apply in real life situations to people affected by cognitive, mental or motor disabilities are lacking.
The aim of the unit is to promote multidisciplinary studies to increase the knowledge of the determinants of disabilities and provide scientific evidence to orient health decisions towards the reduction of impairments, activity limitations, and participation restrictions generated by illnesses.
The project of the unit is articulated along four main axes:
- Diagnostic innovation (i.e., development of measures of cognitive or mental disability, of tools for measuring the functional consequences of the disorders, of instruments for predicting outcome or helping in the decision-making process of compensation),
- Therapeutic innovation (especially in the domain of rehabilitation and cognitive remediation and in the domain of novel therapeutic approaches),
- Identification of health/illness trajectories of our populations of interest to explore the determinants of disabilities and to determine when, where, and how to intervene (via the constitution of clinical cohorts and the analysis of existing databases),
- Evaluation of interventions and health services developed for our populations of interest (i.e., identification of measures of impact, indicators of efficacy).
The common model of disability shared by the members of the unit allows a mutualisation of the methods that have been developed, in the domains of assessment and rehabilitation/remediation, for specific clinical populations (i.e., measures of social cognition deficits of schizophrenic patients, measures of neuro-cognitive deficits for brain injured patients).
Health outcomes research on disabilities needs a direct access to the populations of interest in real life situations. The members of the research team are all affiliated to specialised clinical centres (i.e.: Réseau des Centres Experts de FondaMental, Réseau National des Centres Ressources Autisme, Pôle de psychiatrie du Centre Hospitalier de Versailles, Service de réadaptation neurologique de l’hôpital Raymond Poincaré de Garches) and have developed long lasting collaborations and networks between health and social organisations (for mental disabilities: the GCS-Réseau de Promotion de la Santé Mentale dans les Yvelines Sud, with more than 350 institutions receiveing persons affected by a mental disability; for cognitive disabilities: several institutions for brain injured patients, UEROS-UGECAM, SAMSAH 92, ADEP-CICL, COS, CRFTC). These collaborations allow the deployment of the research projects of the unit.
The expertise of the unit in the domains of epidemiology and public health allows the study of the trajectories of disabled persons via the exploitation of existing or developing databases (Assurance Maladie, Enquête Handicap-Santé, PMSI, MDPH-CNSA, Observatory for spinal cord injuries).
The research team is affiliated with the Graduate School of Public Health 420 ED (Paris Saclay) but also works with other doctoral schools (Brain Cognition and Behavior, University of Paris 6 or Cognition, Language, interaction, University of Paris 8).