[ psychiatrist faced to the ordinance on request]

The psychiatrist often receives ordinances on request to inspect the medical files of the patient. Does the response to this request constitutes a violation of the medical secrecy? The texts of law governing the ordinance on request do not oblige the doctor to give an answer and do not expose him to sanctions in case of justifiable refusal. Moreover, the code of ethics, the penal code and the law relating to the personal data protection prohibit the response to an ordinance on, request. Thus, the communication of the medical files, in response to an ordinance on request is a violation of the medical secrecy and exposes the psychiatrist to serious sanctions

[Psychotic parricide: clinical and analytic study: about 16 cases]

The parricide is defined as "murder of the father or the mother or any other legitimate ascendant.'>It represents I to 5%of all homicides and 20 to 30%of psychotic homicides. In Tunisia, few studies have focused on this issue. We propose its this work to describe the profile of psychotic parricide. We tried to identify risk factors in order to prevent this acting out. Our study is retrospective we observed 16 male patients diagnosed with schizophrenia hospitalized between June 1979 and March 2008 in the forensic psychiatry department at the psychiatric hospital-in Tunis, discharged for no ground for prosecution following parricide. They accounted for 20.8%of psychotic homicides hospitalized during the same period [16/77] and approximately 30%of homicides committed by schizophrenic patients. We found as many as patricide as matricide. The main factors that have emerged through our study are an early age [28 years], being single [70%], the socio-cultural. Poverty, unemployment, .paranoid delusions hallucinations and recent treatment interruption. All these factors have been cited by many authors including Millaud et al, they also cited history o violence and violent behavior and alcohol or drug, abuse. One important point is that some signs of this imminent gesture are often present but misunderstood, such a sense of situational impasse, a request fur help, or reluctance during interview. It is essential to identify risk factors, even to actively seek some warning signs, which often are not spontaneously reported by the psychotic patient. Hospitalization under constraint in psychiatry should be the appropriate response if these dangrousness signals are noticed by the psychiatrist

[New mask of hysteria: three case reports]

Hysteria is a polymorphous manifestation pathology in which unconscious psychic conflicts convert symbolically into somatic and psychic symptoms. When patients used to express their symptoms mostly in motor register, we are assisting progressively to the emergence of a new expressive mode of this disease. In fact, passional attitudes of the "Great hysteria" of Charcot and Richer have become exceptional, replaced by rich and sometimes confusing psychic symptoms. We report three cases of patients with hysteria hospitalized in the department of psychiatry E at the Razi hospital of Tunis. All three patients had presented a rich psychological symptoms and confusing, looking psychotic. Some semiological characteristics and the projective personality tests have allowed us to bring the diagnosis of hysteria. Hysteria expression seems to change constantly with epochs, cultures, society evolutions and medical knowledge progress