Avant 2001, les soins psychiatriques sur l’île de Mayotte étaient assurés par des missions venant de la Réunion. Depuis cette date, une organisation de la santé mentale a été mise en place progressivement, même si la culture mahoraise, mêlant pratiques musulmanes et traditions animistes, laisse encore une large place aux tradipraticiens. Il s’agit ici d’une étude rétrospective portant sur 1212 dossiers de psychiatrie visant à répertorier les différentes psychopathologies sur l’île de Mayotte entre 1998 et 2004 selon la CIM 10. Ont été comparés les dossiers avant et après l’ouverture du centre de santé mentale ainsi que les diagnostics psychiatriques des Comoriens et des expatriés. Les résultats montrent une évolution des pathologies rencontrées entre 1998 et 2004. Il convient de noter un nombre de tentatives de suicide beaucoup plus faible que dans les pays occidentalisés. Les particularités culturelles sont également prises en compte dans la discussion de ces résultats. Les résultats de cette étude confortent les impressions ressenties par les praticiens et montrent les effets de la politique de santé mentale sur l’île tout en pointant les axes de développement possibles dans ce domaine.

Before 2001, psychiatric care on the island of Mayotte was ensured by missionaries from the Reunion Island. A mental health system has since been gradually installed, although the culture in Mayotte, mixing practicing Muslim women and traditional animists, still leaves a broad place for traditional healers. This paper presents a retrospective study of 1212 psychiatric case reports, aimed at indexing the various psychopathologies according to the CIM 10, on the island of Mayotte between 1998 and 2004. The files, before and after the opening of the mental health centre, were compared with those of the psychiatric diagnoses of the Comorians.

The results show an evolution in the chronic pathologies treated in the Comorians: delirious disorders, and the organic, major, mental disorders in the first psychiatric files have given way to depressive episodes and somatoform disorders. Nevertheless, an underlying prevalence of depression and addiction persist. It is interesting to note the reduced number of suicide attempts, far lower than in western countries: one suicide attempt per annum for 375 inhabitants in metropolitan France, whereas, in this study, one suicide attempt in Mayotte was reported for 2504 inhabitants.

The cultural characteristics are also taken into account in the discussion of these results. Thus, if there are more demonstrations with somatic expression in the Comorians, related to a stronger implication of the body in situations of psychological faintness: 1.75% of hysterical conversion in the Comorians versus 0.99% in Mayotte, this does not mean a more histrionic personality in this population: 1.8% of Comorians, against 1.98% in Mayotte.

The results of this study consolidate the impressions felt by the experts and show the effects of the mental health policy on the island. Thus, the assumption of responsibility of chronic psychotics made it possible to improve their quality of life, and to decrease the number of medical evacuations that decreased from 17 to three, between 2001 and 2004. However, this study also underlined the possible axes of development in this field, namely the assumption of responsibility of psychiatric emergencies with a crisis centre, and the development of a specialized pedopsychiatric assumption of responsibility. Indeed, in the first six months of 2004, 35% of the patients were 0–20year-old.