ABSTRACT
Clinical aspects in schizophrenia suggest a unique relationship with the proper name. Discuss the validity of the hypothesis that the non-transmission of the surname may be a vulnerability factor in schizophrenia. Descriptive cross-sectional study conducted among 60 patients with schizophrenia and their families. Data were collected using a semi-structured interview. Seven patients carried a different surname from their father [11.6% of participants]. The disparity has only concerned the child with schizophrenia. Family characteristics [birth rank, desired character of pregnancy, family history of schizophrenia] and evolutif profile of the disease were comparable between patients with a family name according to the father and those with a different surname. It appears that patients with schizophrenia maintain a special relationship with the proper name, which could be involved in the genesis of schizophrenia. Our early hypothesis, supported by the psychoanalytic, transgenerational and behavioral theories, would be a plausible starting point for studies with a broader spectrum including witnesses of the general and psychiatric populations
ABSTRACT
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?
ABSTRACT
Unlike schizophrenia, the impact of gender on the criminality of patients with bipolar disorder has received little attention. To estimate the sex ratio in relation to acts committed by forensic bipolar patients and evaluate the impact of gender on the characteristics of this crime. A comparative study by gender, conducted at the psychiatric hospital Razi has included all patients with bipolar disorder hospitalized between 1990 and 2010 after being relaxed for mental illness, owing to the Tunisian penal code. The total number of patients was 36 and the sex ratio of 3.5. A suicide history was four times more common in women. Alcohol abuse was found only in men. Relapses were more frequent in women [3.06 / year against 1.14 / year, p= 0.02]. Rapid cycling and comorbid anxiety were noted only in female patients. Filicide and prostitution were committed exclusively by women, economic crimes and sexual assaults were the preserve of men. The male offenses were more impulsive and unpremeditated [p=0.04]. Although sex ratio is in favor of men, women's representation in the violence induced by bipolar disorder is significant, resulting, particularly during depressive phases, by serious and deadly acts. Preventive measures of acting out in bipolar patients must be supported and especially adapted to the genre
ABSTRACT
Sleep disorders in the elderly are common. However, they are often under diagnosed and poorly supported. To study the characteristics of sleep in the elderly consultant at the front line. A cross-sectional survey was conducted on a random sample of fifty persons aged 65 years and over, consultant in the center of basic health of Ezzahra and in a private practice in the same delegation. The sleep efficiency index was 0.85. Nighttime awakenings were present in 44 persons [88%]. Unexplained late night awakening was reported by 19 subjects [38%]. Among the respondents, 40 [80%] were considered to have at least one sleep disorder. The subjective complaint of insomnia was present in 70% of subjects. Excessive daytime sleepiness and/or hypersomnia were present in 70% of subjects. Nocturnal snoring was reported by 22 persons [44%]. Nine subjects [18%] had respiratory pauses during sleep. Despite the high incidence of sleep disorder among the respondents, only 6 persons [15%] among them consulted their General Practitioner for this reason. Among patients with sleep disorder, 14 persons [40%] were taking hypnotics, from which 6 [43%] by self-medication. Sleep disorders in the elderly as well as self-medication with hypnotics are common and under diagnosed. They should be sought systematically in front-line consultation