Chapitre 4. Conclusion Générale
4.5 Conclusion finale
Cette thèse avait pour objectif de mieux comprendre les effets de l’EPT sur les difficultés de comportement à l’âge scolaire chez les enfants inuit du Nunavik, en plus d’explorer les effets combinés de l’EPT et des gènes des monoamines, de l’acétylcholine et du métabolisme sur ces difficultés. Les résultats obtenus suggèrent que l’EPT constitue un facteur de risque des difficultés de comportement externalisé. Les résultats indiquent également un effet d’interaction entre l’EPT et le gène métabolique CYP1A1 sur les difficultés de comportement externalisé. L’interaction trouvée ne peut s’expliquer par le modèle diathèse-stress et ne s’appuie que partiellement sur le modèle de l’hypothèse de la susceptibilité différentielle. Cette thèse indique que les génotypes CC et TC du gène CYP1A1 combinés à l’absence de l’EPT offriraient une protection relativement au développement des difficultés de comportement externalisé. Les enfants présentant ces génotypes présenteraient moins de difficultés de comportement en l’absence de l’EPT que les enfants non exposés au tabac et ayant un autre génotype pour CYP1A1 et que les enfants avec les génotypes CC ou TC, mais exposés au tabac. Cette thèse suggère ainsi l’importance d’intégrer l’hypothèse de la susceptibilité différentielle aux travaux futurs pour mieux comprendre les mécanismes derrière les GxE, en plus d’envisager les génotypes de CYP1A1 comme de possibles facteurs de protection ou de plasticité.
Les résultats de cette thèse s’ajoutent à la littérature existante qui témoigne de l’importance de mettre en place des interventions afin de réduire la consommation de tabac pendant la grossesse. La population inuit du Nunavik présente une prévalence très élevée du tabagisme pendant la grossesse et requiert un plan d’intervention adapté à sa situation sociodémographique. Des études passées indiquent que des interventions pour la cessation tabagique ciblant spécifiquement les populations autochtones peuvent s’avérer efficaces. Toutefois, un travail important en recherche est encore nécessaire pour mettre en place des interventions qui respecteront les différences culturelles afin d’améliorer leur efficacité (Carson et al., 2012). La participation de la communauté inuit dans le développement de ces interventions est primordiale dans le but de mieux comprendre ces différences, d’intégrer leurs recommandations et de promouvoir l’engagement de la communauté
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