[Qualitiy of life of patient with schizophrenia treated by conventional and atypical neuroleptics]

The quality of life of patients suffering from schizophrenia was extensively studied but it seems that impact on quality of life of neuroleptics, particularly atypical antipsychotic treatment was not clearly elucidated. In this study we have compared the impact on quality of life of atypical antipsychotic versus classic neuroleptics. We have enrolled, prospectively, all patients with schizophrenia as confirmed by DSM-IV TR. These patients intakes antipsychotics for unless 6 months. We excluded patients with acute schizophrenia, mental deficiency and severe organic disease. Evaluation of clinical features is based on the PANSS scale [Positive and Negative Syndrome Scale]. The quality of life is evaluated using the MOS-SF36 scale [Medical Outcomes Study 36-item Short Form]. Extra pyramidal symptoms were evaluated by the Chouinard scale We have enrolled 65 patients; 35 under classic neuroleptics and 30 under atypical antipsychotics. Clinical features were similar in the two groups. Patients with atypical antipsychotics were less hospitalized [2,4 +/- 3,2 vs 4,5 +/- 4,2 ; p=0,02] and needing less anti cholinergic treatment [26,6%vs 88,6%; p <0,0001]. Adverse effects were more common with classic neuroleptics [Pakinsonism score: 6,1 +/- 7 vs10,8 +/- 8,6 ; P=0,01]; global clinical dyskinesia 1,22 +/- 0,8 vs 1,90 +/- 1,7; p=0,04; global clinical judgement of parkinsonism [2,4 +/- 2,1 vs 3,72 +/- 2,4; p=0,02]. Quality of life was better in patients with atypical antipsychotics on the basis of vitality [76,7 +/- 27,8 vs 62 +/- 29,6; p=0,04] and social function [53,3 +/- 33 vs 36,9 +/- 27,5; p=0,03] we found a negative correlation between adverse effects and quality of life in patients with classic neuroleptics Quality of life of patients suffering from schizophrenia with atypical antipsychotics is better than in those with classic neuroleptics and this may be due to the frequency of adverse effects particularly extra pyramidal symptoms

practice of traditional therapies in psychiatric environment: study about 100 cases

In all the communities, parallel forms of healing continue to be practised by the population in addition to the services offered by the [modern] psychiatry. The aim is to examine the current state of the traditional therapy in Tunisia and to try to deal with its scope, profile and determinants surveying the population of mentally ill patients. It is about a specific study carried out on 100 consecutive patients having consulted the service of psychiatry [C] of Hospital [RAZI] in Tunis. All the patients having an intellectual deficiency were excluded. We proceeded by a semi-open questionnaire in dialectical Arabic. 90 patients, composed of 38 women [42.2%] and 52 men [57.8%] at the age of 37.8 years in average, were kept in our study. 50% of our patients had recourse to the traditional therapy, 70% of whom before consulting a psychiatrist. This behaviour was not influenced by the age, the profession and the educational level. In 75% of the cases, it was chosen under the effect of the opinion of a member of the family. 1/3 of the patients having had consulted a traditional therapist have improved after his intervention. These are the patients who were convinced of the diagnosis identified by the traditional therapist. The therapeutic observance and the adherence to the modern psychiatry were not influenced by the recourse to the traditional therapy. At the end of this research, we conclude that in Tunisia the recourse to the traditional therapy still persists and continues to perform its function. It makes us think about the necessity to accept its place in the devices for treatment of the mentally ill patients and why not to collaborate with it