[Influence of consanguinity on clinical characteristics and affective disorders frequency in relatives of bipolar I patients]. / Influence de la consanguinité sur les caractéristiques cliniques et le risque morbide dans le trouble bipolaire type I.

BACKGROUND: 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. AIM: 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. METHODS: 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. RESULTS: 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 29% (p=0,02). CONCLUSION: 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.

[Seasonal depressive disorder: a controlled study in Tunisian psychiatric sample]. / Les depressions saisonnieres: etude comparative d'une population hospitaliere Tunisienne.

Seasonal affective disorder is considered as a clinical subtype of major depression. The criteria for seasonal pattern has been recently described in the international classification of mental disorders. The aim of this study was to compare the clinical characteristics of patients with major depression and with a seasonal and a non seasonal pattern. The study was conducted at the psychiatric ward at Monastir university hospital. 16 inpatients with major depression and seasonal pattern, diagnosed with DSM-IV criteria, were matched in age, sex and diagnostic sub-type to 32 inpatients with non seasonal mood disorders. Clinical symptoms and short term course during the most recent depressive episode were obtained. The onset of the depression with seasonal pattern was frequently in winter. It was marked by significantly higher rates of anxiety. The patients with seasonal depression had significantly higher rates of dysphoria, atypical vegetative symptomatology and lower rates of psychotic characteristics and suicidal thoughts. No differences were found as to the psychiatric family histories or the age at the first depressive episode. This study could focus of the novel psychiatric entity and may lead to the development of the genetic and neurobiologic research related to seasonal affective disorder.

[Adjustment disorders: a clinical study of a psychiatric hospital population in Tunisia]. / Troubles de l'adaptation: étude clinique d'une population hospitalière tunisienne.

The objectives of this study were to determine the frequency of adjustment disorders in psychiatric hospital and to establish the clinical and evolutional profiles of these disorders. A descriptive and retrospective study with approximately 115 patients hospitalized a first time in a psychiatric setting of the university hospital of Monastir in Tunisia for adjustment disorders according to the DSM-IV. The frequency of adjustment disorders in a psychiatric hospital was estimated at 11,8 %. The majority of patients were young (65,3 % between 16 and 20), female (60,9 %), of low professional and socio-economical status, and without any psychiatric history (59,1 %). The acute appearance of adjustment disorders caused by psychosocial stress factors which were usually various (60 %), recent (61,7 %) and with a high severity (69,6 %). The suicide attempts were frequent (53 %) representing the first reason for hospitalization. An evolution was favourable in 75,7 % of cases after a short hospitalization (about 8,2 days). Finally, the authors insist on the short hospitalization in order to provide evaluation, observation and treatment setting for these disorders.

[Validation of the French version of the Raine schizotypal personality questionnaire in a population of Tunisian students]. / Validation de la version française du questionnaire de personnalite schizotypique de Raine en population estudiantine Tunisienne.

Schizotypal personality disorder is considered as a marquer of schizophrenia proneness. In opposition at other self report measures of schizotypal personality disorder, the "Schizotypal Personality Questionnaire" (SPQ) developed by Raine, assesses all nine features of this disorder. The aims of this study is to present the validation on the French version of the SPQ on Tunisian student sample. It consists on a transversal study directed from April to may 2000. The sample was compound of 198 healthy and voluntary students from the medical university of Monastir. The questionnaire has a high internal reliability (SPQ total: Cronbach's alpha = 0.91; SPQ nine subscales: Cronbach's alpha = 0.59 to 0.74). The ten percent high and low cutoffs for the top and the bottom ten percents of SPQ scores were respectively 42/74 and 10/74 for women, 42/74 and 7/74 for men and 42/74 et 9/74 for total sample. A principal component analysis revealed two main factors or dimensions of schizotypal personality disorder in our sample: positive dimension (made up of ideas of reference, magical thinking and unusual perceptual experiences) and a negative dimension (made up of no close friends, social anxiety and blunted affect). Our results were closely similar to these found by Raine and, other validation studies with SPQ. However some sociocultural aspects were found in our study.