[ descriptive study of the procedures of psychiatric admissions at Razi hospital]

The law 92-83, has established the rights of the mentally ill to respect for individual freedom and to appropriate care. However some gaps in its implementation led to the revision by Act 2004-40. To study the evolution of the number of admissions with and without consent [hospitalizations at the request of a third party and compulsory hospitalizations], between 2000 and 2009. Retrospective study of the archives of the mental health unit of Razi hospital. The study population included inpatients under the mode of voluntary and involuntary admission either compulsory hospitalizations or at the request of a third party. An increase in the number of hospitalizations without the consent from 2000 to 2009 was noted. The number of compulsory hospitalizations and the one of hospitalizations at the request of a third party rose respectively from 1,048 to 1,443 and from 22 to 1,323. So the number of free hospitalizations has decreased while the number of involuntary hospitalizations has increased, leading to a constant number of total hospitalizations. The sex ratio for compulsory hospitalizations has increased from 2.04 to 5.83 while it markedly decreased for hospitalizations at the request of a third party [from 10 to 1.7].Men, unlike women, were more likely to be hospitalized compulsorily than at the request of a third party. There is a larger use of hospital admissions under constraints than free ones; is it due to a concern for the respect of law or an abuse in the deprivation of freedom for some patients?

[Violence in Schizophrenia: a study of 60 cases]

Epidemiological studies suggest a positive but controversial correlation between the major mental disorders, particularly schizophrenia and delinquent or criminal acting out. To study the occurrence of violence in patients with schizophrenia according to demographic, clinical and disease progression features. This retrospective study included all out-patients, consulting during a period of one month, suffering from schizophrenia for at least five years. The clinical and forensic history was obtained owing to a semi-structured interview with patients and their families, medical records and the passing of different scales. Sixty patients were included. 46.7% [n=28] of patients had a violent behavior in the pre morbid period. Aggressiveness was noted as the first prodrome in 13.3% [n=8] of cases. 28 major acts of violence were committed by 30% [n=18] of patients regardless of the active period of disease. In 13.3% [n=8] of cases, these acts announced the disease. The majority of acts have been committed against a non-foreign person. Recurrence was noted in 44.4% [n=8] of patients. Several risk factors of violent behavior were found. Only prodromal aggression was associated with a poor prognosis. Violences committed by patients with schizophrenia are attributed to a particular group of patients and do not have necessarily a pejorative prognostic value