[Attention deficit hyperactivity disorder at schools in Sfax-Tunisia]

Background: Frequency, social impact, the negative effects of ADHD on personal development, make it a public health problem. Tunisian existing data confirm its frequency and severity in clinical population. The absence of data in student population has led us to develop this work. The objectives of our study were to study epidemiological profile of ADHD in school population

Methods: The analysis involved a cross-sectional descriptive study conducted from April 2008 to October 2008 using a representative randomized multistage sample of schoolchildren between 6 and 12 years old. Measurement was performed in two stages first the parents and teachers of each children filled Conners questionnaire separately then students with the score in subscales inattention, hyperactivity with impulsivity higher than 70 were selected for psychiatric interview. Psychiatric interview was intended to confirm or refute the diagnosis of ADHD. The diagnoses were made according to DSM IV-TR. To study the possible associated factors with the disorder they were compared in children with ADHD and children without the disorder taken as controls

Results: A total of 51 students out of 513 had ADHD. Prevalence was found to be 9,94%. For the study of factors associated with ADHD were found in males, neonatal hospitalization, psychiatric and family history of ADHD and the existence of a family dysfunctionment

Conclusion: Our prevalence is similar to the majority of those reported by studies conducted through the same methodology as ours. The etiology of ADHD is not unequivocal. The disorder appears to be multifactorial

[Evolution of bipolar disorders in adolescents: About 30 cases]

Bipolar disorders in adolescence are of a great importance, partly because of the relapsing character of this disorder and its impact in terms of psychosocial adjustment. To study the evolution of bipolar disorders in adolescents. We conducted a descriptive and retrospective survey on 30 adolescents followed in the child and adolescent psychiatry department of Sfax for bipolar disorders diagnosed according to the DSM-IV TR criteria. The average number of the thymic episodes /year was 1.36 +/- 0.75. The average duration of the maniac episodes was 39. 75 day +/- 24.79 and that of the depressive episodes was 78.75 days +/- 43.73. The average duration of the inter critical intervals was 13.78 months +/- 11. 29. The complete remission was noted in 42.8% of the cases whereas the passage to chronicity was noticed in 3.6% of the cases. The family adaptation was satisfactory in 63.3% of the cases whereas the repercussion of the disorder on the school level was obvious. The social adaptation was non satisfactory in 53.3% of the cases. The suicide attempts were found in 10% of the cases. The findings of the present study justify an early identification of bipolar disorders in adolescents as well as the initiation of appropriate therapy. The early intervention will permit to reduce the duration and the severity of the episodes. It will also limit the deleterious impact on the life of the subject and decrease the risk of suicide, which seems to be raised when the subject is not or is badly treated

[Comorbidity of depression with other psychiatric disorders in adolescents: about 77 cases]

In adolescents diagnosed with depressive disorders, psychiatric comorbidity is rather the rule than the exception. To find the prevalence of the association between depression in adolescents and other psychiatric disorders and second and to study the different mental disorders comorbid to depression. We conducted a descriptive, retrospective and analytic survey carried on 77 subjects having been followed in the child psychiatry department of Sfax for depressive disorders diagnosed according to the DSM-IV TR criteria during a period of 9 years [from January 1[st] 1998 till 31[st] December 2006] 49.3% of the youths with depression had comorbid conditions: anxiety disorders in 23.37% of cases, disruptive disorders in 13% of cases [conduct disorders in 11.7 % of cases and oppositional defiant disorders in 1.3 % of cases], personality disorders in 13% of cases, substance abuse in 3.9% of cases and alimentary behavior disturbances in 2.6% of cases. A superimposed major depressive disorder in adolescents with dysthymia [" Double depression "] was present in 10.4 of cases. Throughout our study, we underline the frequency of the association between depression in teenagers and other mental disorders. The detection of this comorbidity has a great importance as it permits to understand the pathogenesis of depression in adolescents, to examine the implications of comorbidity for course and outcomes of this disorder and to elaborate the appropriate treatment