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
Early diagnosis of schizophrenia can improve its outcome. Hence, screening policies should be held and suitable tools must be available for general practitioners. To translate the section G [about schizophrenia] of the Composite International Diagnostic Interview to the Tunisian dialect and to check its validity and reliability. The Arabic version of section G of the Composite International Diagnostic Interview has been translated to the Tunisian dialect by psychiatrists speaking fluently both languages. Metric features of the instrument [sensitivity, specificity and predictive values] were assessed by checking its results against those of the gold standard i.e. the expert's opinion owing to the criteria of the Diagnostical and Statistical Manual of mental disorders 3rd revised edition. Reliability has been measured by the index of observer agreement. The instrument showed a low sensitivity of 45% [32% - 58%] and a high specificity of 96% [93% - 99%]. It looked as a diagnostical test that can avoid wrong diagnoses of such a serious and stigmatizing illness. These values are similar or even better than those of literature. The observer agreement index was 0.83 showing a very good reliability. The interviews mean duration was 20 minutes. The instrument showed no variability towards the sex, the age or the educational level of interviewees. Even though section G of the Composite International Diagnostic Interview failed to detect most cases with schizophrenia and showed a poor sensitivity, this instrument can be useful for screening strategies carried out by lay interviewers in the general population
ABSTRACT
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
ABSTRACT
Acupuncture is one of the most popular types of complementary/alternative medicine in the world. It is sometimes used as a treatment for schizophrenia mainly in China. To assess the contribution of acupuncture in the treatment of patients treated for schizophrenia in Tunisian population. Our study is a clinical randomized trial about 31 hospitalized patients with schizophrenia or schizo-affectif disorder [DSM IV]. They were evaluated by the Positive and Negative Syndrome Scale [PANSS], the Scale for the Assessment of Negative Symptoms [SANS] and the Scale for the Assessment of Positive Symptoms [SAPS] the first and 23rd day of the study. Manual acupuncture was used for 10 sessions at the rate of three sessions per week. All patients were under drug therapy. Among them, 15 were treated by acupuncture and 16 by sham acupuncture. Scores of the PANSS, SAPS and SANS were similar in the two groups at the end of the study. Our study did not provide any evidence for the effectiveness of acupuncture in treating schizophrenic symptoms
ABSTRACT
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