[Persistent auditory hallucinations in out-patients with schizophrenia]

Objectives: to estimate the prevalence of persistent auditory hallucinations [AHs] in a group of schizophrenic patients, to evaluate their dimensions and to identify their clinical associated factors

Method: This was a cross-sectional study carried-on 144 out-patients followed for schizophrenia, according DSM-IV-TR criteria. The assessment was consisted by the collect of epidemiological, clinical and therapeutic data and the use of the Hoffman's auditory hallucinations rating scale [AHRS], and the positive and negative symptoms scale [PANSS]

Results: The prevalence of persistent AHs [AHRS score >/= 5] was 40.3%. The mean total score of the AHRS was 10.7 +/- 7.8 for all patients and 19.4 +/- 7.7 for patients with persistent AHs. The AHs dimensions with higher sub-scores were the number, the influence and the reality of the voices. The PANSS items most related to the AHRS total score were P3 "hallucinatory activity", G1 "somatic concerns", G4 "tension" and the G5 "mannerisms and posture disorders". The clinical associated factors with persistent AHs after multivariate analysis were the absence of tobacco consumption, the hallucinatory onset of disorders, the notion of previous hospitalization and the continuous course

Conclusion: Our results support the multidimensionality of AHs and confirm the existence of inter individual differences in the characteristics of these hallucinations. Persistent AHs were associated with poor prognosis, requiring more effective therapeutic strategies

[Violence against women in the marriage: cross-sectional study in the family planning clinic monastir]

Background: Violence against women in the marriage is now recognized as a violation of human rights and as a major problem of public health

Aim: The objectives of this study were to estimate the prevalence, specify the typology and to determine associated factors with violence against women in the marriage

Methods: It was a cross-sectional study carried on 197 married women recruited in family planning center of Monastir, by means of a questionnaire containing some sociodemographic characteristics of the consultant and her spouse and the Woman Abuse Screening Tool to estimate the violence in the marriage

Results: The lifetime prevalence of violence against women in the marriage was 56.9%. The most common form of violence was psychological [56.9%], followed by economic violence [41.1%], physical violence [32%] and sexual violence [10.6%]. The combination of at least two forms of violence was reported by 84% of victims. The precarious professional status of consultant and her spouse, spouse's alcoholism, the number of children upper for three were the main factors associated with violence in marriage

Conclusion: These results justify the implement of screening and support programs for women victims of violence in marriage

Psychometric properties of the Arabic version of the schizotypal personality questionnaire in Tunisian university students

The schizotypal personality disorder is considered as a marker of schizophrenia proneness. The schizotypal personality questionnaire [SPQ] is an instrument to help to the diagnosis of schizotypal personality disorder extensively studied in the literature. To assess psychometric properties [reliability and factor structure] of the Arabic version of the SPQ in a sample of Tunisian university students. The sample included 490 students [145 males and 345 females; mean age: 20.4 +/- 1.4 years], from the faculty of medicine and the health sciences school of Monastir. Thirty-three students participated in the second assessment of the SPQ three months later. Cronbach's [alpha] internal consistency reliability coefficients were 0.92 for the total SPQ and from 0.62 to 0.75 for the SPQ subscales. The test-retest reliability was good with the intraclass correlation coefficients equal to 0.83 for the total SPQ and from 0.67 to 0.87 for the SPQ subscales [P<0.0001]. Factor analysis indicated that the three-factor model [positive or cognitive-perceptual, negative or interpersonal, and disorganized] and the four-factor model [cognitive-perceptual, paranoid, interpersonal, and disorganized] have provided a good fit to the data, accounting for 70.7% and 77.3% of the total variance of the scale, respectively. The results showed that the Arabic version of the SPQ had adequate psychometric properties and confirmed the multidimensional structure of the schizotypal personality in nonclinical populations

[Influence of consanguinity on clinical characteristics and affective disorders frequency in relatives of bipolar I patients]

The genetic transmission of bipolar disorder remained undetermined up to now, partly due to clinical and genetically heterogeneity. In Tunisia, genetic study will profit from the existence of high rates of consanguinity. To determine the rate of consanguinity in bipolar I disorders sample and to compare the clinical characteristics and the frequency of affective disorders in first and second degree relatives of probands with and without consanguinity. One hundred thirty subjects met DSM-IV criteria for a bipolar I disorder were recruited. Available Information was obtained from a structured clinical interview, collateral history and medical records. The family investigation allowed completion of genealogies over three generations. The comparison was based on the clinical characteristics [age of onset, numbers of affective episodes, nature and severity of the last affective episode] and the frequency of affective disorders in first and second degree relatives of probands with and without consanguinity. The rate of consanguinity was estimated to 28, 5%It was higher in patients with family history of affective disorders: 34, 2%versus 20, 4%[p=0, 08]. Bipolar I patients with consanguinity were characterised by a high frequency of affective episodes and a more severe of the last affective episode, but theses differences were not significantly. However, the frequency of affective disorders was significantly increased in first degree relatives of probands with consanguinity: 10, 5%versus 6, 1%[p=0, 01], and in first and second degree relatives of probands with consanguinity: 4, 5%versus 2, 9%[p=0, 02]. The influence of consanguinity on the clinical characteristics and the frequency of affective disorders in first and second degree relatives of bipolar patients is en favour the recessive polygenetic transmission of bipolar disorders

[Validation of a school children addictive behaviors questionnaire]

The aim was to develop and validate an addictive behaviors screening tool in school children

Methodology: A cross sectional study including a self administrated 223 item questionnaire developed in Arabic language. The questionnaire included identification of the student and seven life domains: school, family, addiction, relationships with peers, leisure and well being. risky behaviors and personality traits. N = 854 high school children. of Monastir City

Results: the questionnaire Alpha Cronbach's Coefficient ranged between 0.3 and 0.8. Only items with a coefficient higher than 0.6 were maintained in the final version. The time reliability by using the Bland and Altman method 15 days after the first measure showed a Pearson's coefficient of 0.81. Validity evaluated by principal components analysis led to 3 independent factors consisting respectively in 20, 4 and 3 well correlated items: family, school and risky behaviors

Conclusion: validated version of the questionnaire consisted in 102 items, easy to, read and understand. This version doesn't require much time to be filled in and takes into consideration cultural particularities of the school children of Monastir. It could be considered as an interesting tool for both the assessment and the prevention of addictive behaviors in school

[Psychiatric morbidity and quality of life in vitiligo: a case control led study]

The aims of this study were to value the psychiatric morbidity and its influence on the quality of life of patients with vitiligo

Methods: It was a case-controlled study bearing on 60 outpatients with vitiligo examined in the department of Dermatology of the University Hospital of Monastir, compared to 60 controls matched according to age and sex, among outpatients with others dermatologic disorders as warts or superficial mycoses. The assessment consisted in the epidemiological and clinical evaluation, including these questionnaires: the Dermatology Life Quality Index [DLQI], the Montgomery and Asberg Depression Rating Scale [MADRS] and the Hamilton Anxiety Appreciation Scale [HAMA]

Results: Mean scores of depression in the MADRS and anxiety in the HAMA were significantly more elevated in patients with vitiligo [p=0,0005]. Quality of life was significantly more altered in patients with vitiligo: DLQI mean score = 9,4 +/- 17,1 versus 2,5 +/- 1,0 among the controls [p <0.0001]. A positive correlation has been noted between the quality of life scores and the MADRS depression scores [p<10[-10]] and the HAMA anxiety scores [p<10[-10]]

Conclusion: The quality of life decrease in patients with vitiligo is especially related to the psychiatric comorbidity underlining the multidisciplinary therapeutic necessity including the psychotherapeutic approach