[Social representation of the psychiatric diseases in Tunisia]

Nowadays, and thanks to the major transformations experienced by psychiatry, since a half century, we estimate that the perception of the persons with psychiatric disorders would have changed and that they would have acquired the statute of patient with whole share. To study social representation of psychiatric diseases in Tunisia. Prospective study, based on the socio-anthropological fold of the study "Mental health in general population: images and realities", the social representations associated with "madness", "mental illness" and "depression" in a representative sample of 920 subjects. Gradual images for these 3 archetypes were found. In fact, the depression is perceived as a soft disorder, which is reactional to the difficulties of life. The behaviour related to depression not only is seen as the least dangerous, but also the closest to the normality. Therefore, the "depressive" remains relatively accepted and integrated within the society. On the contrary the image of the "insane" is printed by a pejorative connotation and is marked by dangerousness, unpredictability, and immorality. Besides, the origins of the madness seem enigmatic. The "insane" is, therefore, stigmatized and thrown back. His exclusion extends as well to the family, social and professional domains. The image of the mental illness seems some what blurred, taking place in the interface of madness, depression and neurological diseases

[Social representations of the psychiatric care in Tunisia]

The progress in the field of the treatment of the mental illnesses is considerable. However, the clinical reality confirms the delay in access to care for numerous patients. This avoidance is due, in big part, to the pejorative representations of the psychiatrics' system care. To assess the social images in the Tunisian population, regarding 3 stereotypes: "insane", "mentally ill" and "depressive". The used instrument is the socio-anthropological questionnaire of the " Mental health in general population: images and realities" survey. The medicinal treatment occupies the first place of the planned care for an "insane" and for the "mentally ill". For the "depressive" and for our self, population would rather use relational support. Also, we notice that the family, in spite of its suffering and of the undergone daily load, is given is a central place in perception of the care for psychiatric pathologies. Finally, an "insane" is not perceived as possibly cured while it is more expected for the "mentally ill" and even more for the "depressive", even without any medical intervention. In the term of our analysis, let us underline the misunderstanding of the available therapeutic possibilities in psychiatry and the necessity of large-scale raising awareness

[Clinical and evolutionary characteristics of bipolar disorder according to the polarity of the first episode]

The polarity of the inaugural episode seems to determine the clinical and evolutionary profile of bipolar disorder. To study the clinical and evolutionary characteristics bipolar disorder according to the polarity of the first episode. We undertook a retrospective, descriptive and comparative study including all the patients reached of bipolar disorder I and II [DSM IV TR] who were hospitalized between January 1 2000 and December 31 2006. The minimal duration of follow-up was 4 years. Patients were divided into two groups according to the polarity of the first episode: maniac or hypomaniaque and depressive. The characteristics sociodemographic, clinical, evolutionary and therapeutic were raised and compared between the two groups. The sample was composed of 38 patients [23 men and 15 women]. The first episode was of polarity maniac in 57.89% of cases. This mode of beginning was related to a later polarity preferentially maniac, more often punctuated of characteristics psychotics with a sur representation of the addictives conduits and bipolar disorder of type I an episode index of depressive polarity was associated to more chronic evolution, marked by a stronger recurrence of episodes particularly depressive episodes, with a raised suicidal risk and a high representation of the bipolar disorder II. The clinical and evolutionary profile of the bipolar disorder seems strongly related to the polarity of the first episode. The strategies of prevention must take account of the inaugural polarity

[Attitude of general practitioners faced to schizophrenia]

The chronic character of schizophrenia, the suffering that it generates, its triple social and human economic cost, make of it a major stake of public health. The general practitioners are the first actors in the tracking of onset schizophrenia and the follow-up of this chronic pathology. To study knowledge, the attitudes and the practices of the general practitioners faced to schizophrenia. A descriptive cross-sectional study, using an autoquestionnaire, including 300 general practitioners registered in the table of the order of the Doctors of the area of Large Tunis, exerting in private and public sectors. The rate of answer was 22.6% [68] of general practitioners. The middle age of the participants was 48.1 years [ +/- 8.3]. The sex ratio was 1.6; including 58.8% exerting in the private sector. Meadows the fifth [19.1%] of them knew the exact prevalence of schizophrenia in the general population, whereas 77.9% did not have any idea of the rate of suicide among patients. 76.5% of the doctors estimated that prodromal signs preceded the emergence of schizophrenia. The odd behaviors, hallucinations/delirum and social withdrawal constituted the most evocative symptoms in respectively 80.8%; 79.4% and 64.7%. In case of onset- schizophrenia; 20.5% of the experts thought that it was not necessary to prescribe any treatment and 48.5% were unable to mention the exact drug to be prescribed in case of first episode psychotic. Our results highlight gaps in knowledge and the practical conduits of the general practitioners faced to schizophrenia. Measurements aiming the improvements in education and the sensitizing of the general practitioners are necessary

[Beck inventory depression assessment in chronic pain patients]

Epidemiologic studies indicate that depression is a common comorbidity associated with chronic pain states. Both conditions are so interwoven and emerging evidence suggests that they share common pathways. This study purpose was to assess the prevalence of depression in a sample of chronic pain patients. 100 chronic pain patients were investigated through the Beck Depression Inventory to evaluate depresseion degree and through the visual analogical test to evaluat chronic pain degree. All patients belonged to the unique Tunisian Pain Management Centre. The prevalence of major depression reached 59% [27,5% had a mild depression, 26,5% had a moderate depression and 5% had a severe depression]. The rate of major depression increased significantly with longer pain history. Our results are similars to those of literature. Despite this high depression prevalence, only one patient out of ten received an effective antidepressant. A treatment and a seek for depressive symptoms are needed in case of chronic pain

Appoche psychosomatique de psoriasis: Evenement de vie et psoriasis

Psoriasis today is unanimously recognized as a psychosomatic disorder. Authors have searched for the life events occuring one year before the appearance of psoriasis. The study included group of 30 patients with psoriasis and a group of 30 patients suffering from a dermatosis other than psoriasis. Events such as the loss of a loved one have been found in 76,7% of patients suffering from psoriasis