Combination of morphological and molecular markers for the characterization of ancient native olive accessions in Central-Eastern Tunisia.

Increasing olive germplasm erosion in the coastline of Tunisia has required an imperious conservation of the traditional genotypes before an ultimate disappearance. This region has been relatively neglected in the literature sources of olive identification. In this context, a prospection effort and a preliminary selection of olive accessions belonging to Central-Eastern Tunisia was carried out. Twenty-seven ancient olive accessions were studied by combining molecular and morphological data in order to fingerprint them, and to evaluate their relationships with classical cultivars. Compared to known classic Tunisian olive cultivars, the new prospected olive accessions were well distinguished, presenting a potential use as promising genotypes. The morphological and molecular data showed a high diversity between genotypes. 92 and 63 polymorphic bands were scored using 10 RAPD and 9 SSR markers, respectively. Significant correlation coefficients were obtained among fruit and stone sizes (r=0.90) and among their shapes (r=0.73). The genetic distances obtained with the two DNA marker systems were significantly correlated (r=0.45) according to Mantel's test. No significant correlation was observed between distances based on molecular and morphological markers. UPGMA analysis based on molecular data showed no clear clustering trends according to morphological traits or fruit use. Despite the high genetic variation among accessions in each prospected area, geographical origin seemed to have significant impact on the observed variability. The relationship between morphological and molecular data has confirmed that each marker expressed different aspects of variability. Integration between all markers will be useful for distinguishing new accessions and genotyping local varieties.

Increased Interleukin-17 and decreased BAFF serum levels in drug-free acute schizophrenia.

Hypotheses regarding an immune-cytokine basis of schizophrenia have been postulated with controversial findings and a lack of data related to many cytokines. The aim of this study was to assess serum levels of Interferon-γ (IFN-γ), Interleukin-4 (IL-4), Transforming Growth Factor-ß (TGF-ß), Interleukin-17 (IL-17) and B-cell Activating Factor (BAFF) in schizophrenic patients and to determine correlations between cytokine levels and clinical parameters. Serum cytokine levels were measured with ELISA techniques in 60 neuroleptic-free patients on acute phase of the disease (BPRS≥40) and 28 healthy controls matched for age and sex. Current symptoms were assessed with Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). No significant difference was found between patients and controls regarding IFN-γ serum levels. IL-4 was not detected in both groups. Patients exhibited significantly higher IL-17 and lower BAFF serum levels. IL-17 and BAFF levels were negatively correlated in schizophrenic patients. SANS global score was negatively correlated with IL-17 and positively correlated with IFN-γ serum levels. These results argue against the involvement of Th1 or Th2 population cells in schizophrenia. IL-17 and BAFF could be valuable markers for schizophrenia.

[The physicians' perception of the general practitioner management of mental disorders: importance, difficulties and perspectives]. / Perception par les médecins du rôle du généraliste dans la prise en charge des troubles mentaux: importance, difficultés et perspectives.

BACKGROUND: Mental disorders are common in general medicine consultation. According to international studies, their prevalence in primary care varies from 34 to 54%. In Tunisia, the general practitioner role, as well as the difficulties that encountered them in the management of these disorders, are little known. AIM: The objective of this work was to pull opinions of the general doctors and the psychiatrists concerning the current role of the general doctors, the difficulties that encountered them, as well as the possible solutions in promoting mental disorder management. METHODS: It was a descriptive investigation carried out in Mars 2008, near 200 doctors (100 general practitioners and 100 psychiatrists). A questionnaire was drawn up with two parts: the first for collecting the doctors' opinions concerning general practitioner mental disorder management and the strategies of improving it. The second was devoted to the assessment of the collaboration between general practitioners and psychiatrists. RESULTS: The answer's rate was 45.5%. The majority of the general doctors qualified as secondary their role in the mental disorder management and limited to the tracking of patients with mental disorders. This modest implication of the general practitioners in the treatment and the follow-up of patients with mental disorders could be explained by the lack of competence and training recognized by them and also reported by the majority of psychiatrists. Doctors in this investigation have proposed to set up training programs for managing mental diseases and to organize regularly common scientific conferences between general practitioners and psychiatrists in order to improve their collaboration. CONCLUSION: This investigation has permitted to identify reciprocal expectations of general practitioners and psychiatrists. They both agreed upon the need of a more important implication of the general practitioners in the mental disorder management and the necessity of psychiatrists' involvement in the general practitioners training and information.

[Comorbid personality disorders in major depressive disorder: a comparative study in 160 Tunisian female inpatients]. / Comorbidite trouble depressif majeur et troubles de la personnalite: etude comparative dans un groupe de 160 patientes hospitalisees.

BACKGROUND: Major Depressive Disorder (MDD) is often comorbid with personality disorders which are known to change its clinical aspects and worsen its outcome. AIM: This study aimed to compare clinical and outcome aspects of a female depressed inpatients group according to the existence or not of a comorbid personality disorder. METHODS: The study was carried in the psychiatry female inpatient unit of Farhat Hached hospital of Sousse. All entrances to the unit from January 1999 to August 2002 were retrospectively reviewed. 160, corresponding to MDD, were selected. Assessment was based on demographic characteristics, medical history, axis I comorbid disorders, clinical aspects of the index episode and outcome characteristics. RESULTS: 77 patients (48.1%) had personality disorder. Compared to those without comorbid personality disorder, these patients were younger (p < 10-4), with higher educational level (p = 0.005) and better vocational functioning (p = 0.018). They also had an earlier age at onset of their depression (p < 10-4), more previous suicide attempts (p = 0.012) and more axis I comorbid disorders (p < 10-4). Comorbid personality disorders were correlated to an impaired outcome, with higher rate of relapses (p = 0.021), more recurrences (p = 0.026), more persistent symptoms (p < 10-4) and more suicide attempts (p = 0.031).

Diagnosis and treatment difficulties of psychiatric symptoms in Klinefelter syndrome: a case report.

Klinefelter syndrome (KS) can involve various psychiatric symptoms that are often heterogeneous and atypical. To illustrate the diagnosis and treatment difficulties of psychiatric non-specific symptoms occurring in KS, we report a 17-year-old man presenting with gynaecomastia and marfanoid features. Investigations showed high concentrations of gonadotrophins and a 47,XXY karyotype. Although his serum testosterone was normal, the patient had clinical hypogonadism and suffered from recent headache. Magnetic resonance imaging revealed pituitary non-invasive macroadenoma. Treatment with Cabergolin resulted in a normalisation of prolactin levels and a decrease in tumour size. During follow-up, the patient presented a permanent state of passivity and disinterest in imaginative experiences, without any obvious specific diagnoses, according to psychiatric examination. Further investigations showed major depression, schizotypical personality and patterns of psychotic functioning. Initial treatment with selective serotonin re-uptake inhibitors was not effective and he was switched to an atypical antipsychotic drug that was not tolerated and rapidly stopped by the patient.

Personality disorders in a group of psychiatric outpatients: general aspects and cluster B characteristics.

BACKGROUND: Personality disorders are common among patients seeking psychiatric care and often coexist with axis I disorders. Cluster B types are reported as being the most common in those patients. They are often correlated with specific demographic features, higher rates of axis I comorbidity and impaired outcome. AIM: This study aimed to describe general and clinical features of personality disorders types in a Tunisian outpatient psychiatric unit and to determine characteristics of cluster B personality types, compared to those of cluster A and C. METHODS: This study was held in Sousse psychiatric outpatient unit, from January 2000 to December 2004. 148 cases were retrospectively recruited and assessed according to axis I and axis II DSM-IV criteria. RESULTS: Personality disorders prevalence was 6%. 85.1% of patients had at least one current axis I disorder, which mainly consisted of depressive disorder (42.3%). Cluster B types were the most frequent (54.7%). Comorbid addictive and somatoform disorders were more frequent in cluster B. Anxiety disorders were more frequent in cluster C and psychotic disorders were more frequent in cluster A. CONCLUSION: Our results show prevalence and clinical profile of personality disorders in a Tunisian clinical population. Cluster B types were the most frequent and seem to have specific comorbid disorders. This support the idea that patients with cluster B personality types need adapted psychiatric care.