Evaluation of Religious Coping in Tunisian Muslim Women with Newly Diagnosed Breast Cancer.

Studies evaluating religious coping in Arab-Muslim populations are few. We aimed to evaluate religiosity and religious coping in a sample of breast cancer women, and to analyze the association between religiosity, religious coping, depression, anxiety, cancer clinical data, and sociodemographic data in our patients. A cross-sectional and descriptive study was conducted over a 4-month period in 61 newly diagnosed breast cancer women. We used the following scales: The Depression Anxiety Stress Scales (DASS-21), the Arabic-Brief Religious Coping Scale (A-BRCS) and the Arabic Religiosity Scale. The majority of participants (98.4%) had a moderate to high level of religiosity. A weak correlation was found between religious coping scores and stress, depression, and anxiety scores. Our patients had high scores of positive religious coping, with a mean score of 26.13 out of 28 and used more positive coping than negative coping to cope with the cancerous disease. High levels of affective religiosity were the main predictive factor of positive religious coping. Therapies should reinforce the positive religious coping patterns of breast cancer patients, and detect a possible resort to negative religious coping that may negatively affect the patients' quality of life.

Sexual dysfunction in the elderly: Prevalence and impact on quality of life.

BACKGROUND: Sexual functioning is a major component of the overall human wellbeing. However, data on the sexual disorders among the elderly remain few. AIM: Determine the prevalence of sexual dysfunction among 100 elderly Tunisian subjects and evaluate the impact on quality of life and depression. RESULTS: The rate of sexual dysfunction was 88% without significant gender differences. Erectile dysfunction was the most common disorder in men (84.2%). Disorders of sexual arousal and pain were the most frequent disorders in women. The presence of sexual dysfunction was correlated with worse quality of life scores (p <0.001). A statistically significant correlation was not found with the depression score. CONCLUSION: The improvement of the quality of life among the elderly should include systematic sexual dysfunction assessment and management. Sexual education programs should be carried out.

[Factors predicting functioning in type 1 bipolar patients during remission period]. / Facteurs prédictifs du fonctionnement chez les patients bipolaires de type 1 en période de rémission.

INTRODUCTION: Recent studies indicate that bipolar disorder is associated with a profound impairment in almost all areas of functioning. This study aims to evaluate functional recovery in type 1 bipolar patients during remission period. METHOD: We conducted a cross-sectional study of euthymic type 1 bipolar patients followed up on an ambulatory basis. In the analysis to be reported here we used Hamilton Depression Scale, Young Mania Rating Scale (YMRS), Rosenberg Self-Esteem Scale, and Functioning Assessment Short Test (FAST). RESULTS: More than half of the study population (53.3%) had overall functional impairment. The overall functioning was associated with age, education level, professional activity, the number of manic and depressive episodes, the number of hospitalizations, a higher HDRS score as well as with the two self-esteem subscores: "self-confidence" and "self-deprecation". CONCLUSION: Our results suggest that a paradigm shift in the treatment of bipolar disorders should happen and that the goals of therapy should be modified from symptomatic remission to functional remission.

[Quality of life of patient with schizophrenia treated by conventional and atypical neuroleptics]. / Qualité de vie chez les patients atteints de schizophrènie traités par neuroleptiques classiques et atypiques.

BACKGROUND: the quality of life of patients suffering from schizophrenia was extensively studied but it seems that impact on quality of life of neuroleptics, particularly atypical antipsychotic treatment was not clearly elucidated. AIMS: In this study we have compared the impact on quality of life of atypical antipsychotic versus classic neuroleptics. METHODS: We have enrolled, prospectively, all patients with schizophrenia as confirmed by DSM-IV TR. These patients intakes antipsychotics for unless 6 months. We excluded patients with acute schizophrenia, mental deficiency and severe organic disease. Evaluation of clinical features is based on the PANSS scale (Positive And Negative Syndrome Scale). The quality of life is evaluated using the MOS-SF36 scale (Medical Outcomes Study 36-item Short Form). Extra pyramidal symptoms were evaluated by the Chouinard scale. RESULTS: We have enrolled 65 patients; 35 under classic neuroleptics and 30 under atypical antipsychotics. Clinical features were similar in the two groups. Patients with atypical antipsychotics were less hospitalized (2.4 +/- 3.2 vs. 4.5 +/- 4.2; p = 0.02) and needing less anti cholinergic treatment (26.6% vs. 88.6%; p < 0.0001). Adverse effects were more common with classic neuroleptics (Pakinsonism score: 6.1 +/- 7 vs. 10.8 +/- 8.6; P = 0.01); global clinical dyskinesia 1.22 +/- 0.8 vs. 1.90 +/- 1.7; p = 0.04; global clinical judgement of parkinsonism (2.41 +/- 2.1 vs. 3.72 +/- 2.4; p = 0.02). Quality of life was better in patients with atypical antipsychotics on the basis of vitality (76.7 +/- 27.8 vs. 62 +/- 29.6; p = 0.04) and social function (53.3 +/- 33 vs. 36.9 +/- 27.5; p = 0.03) we found a negative correlation between adverse effects and quality of life in patients with classic neuroleptics. CONCLUSION: Quality of life of patients suffering from schizophrenia with atypical antipsychotics is better than in those with classic neuroleptics and this may be due to the frequency of adverse effects particularly extra pyramidal symptoms.

[The practice of traditional therapies in psychiatric environment: about 100 cases]. / La pratique de la tradithérapie en milieu psychiatrique: etude à propos de 100 cas.

BACKGROUND: In all the communities, parallel forms of healing continue to be practised by the population in addition to the services offered by the "modern" psychiatry. AIM: The aim is to examine the current state of the traditional therapy in Tunisia and to try to deal with its scope, profile and determinants surveying the population of mentally ill patients. METHODS: It is about a specific study carried out on 100 consecutive patients having consulted the service of psychiatry "C" of Hospital "RAZI" in Tunis. All the patients having an intellectual deficiency were excluded. We proceeded by a semi-open questionnaire in dialectical Arabic. RESULTS: 90 patients, composed of 38 women (42.2%) and 52 men (57.8%) at the age of 37.8 years in average, were kept in our study. 50% of our patients had recourse to the traditional therapy, 70% of whom before consulting a psychiatrist. This behaviour was not influenced by the age, the profession and the educational level. In 75% of the cases, it was chosen under the effect of the opinion of a member of the family. 1/3 of the patients having had consulted a traditional therapist have improved after his intervention. These are the patients who were convinced of the diagnosis identified by the traditional therapist. The therapeutic observance and the adherence to the modern psychiatry were not influenced by the recourse to the traditional therapy. CONCLUSION: At the end of this research, we conclude that in Tunisia the recourse to the traditional therapy still persists and continues to perform its function. It makes us think about the necessity to accept its place in the devices for treatment of the mentally ill patients and why not to collaborate with it.

Summer birth and deficit schizophrenia in Tunisia.

Summer birth has been associated with the deficit Schizophrenia syndrome, while DSM-IV schizophrenia is associated with winter birth. We confirm these monthly differences in a Tunisian sample of patients with schizophrenia, with a summer birth peak (n=34 deficit patients) and an expected winter birth peak (n=46 non-deficit patients).

[Quality of life in dermatology: Tunisian version of the Skindex-29]. / Etude de la qualité de vie en dermatologie: élaboration d'une version Tunisienne du Skindex-29.

The skin situated in the interface between the body and the outside world, is a zone privileged by the interactions between the individual and the society. The objective of our work was to study the quality of life in dermatology, while elaborating a Tunisian version of the Skindex-29 scale. For that we questioned 60 patients, among them 20 are affected by psoriasis, 20 are affected by vitiligo and 20 are affected by onychomycosis. The evaluation of the psychometric properties of the questionnaire was satisfactory. The chronic dermatosis altered the quality of life of the patients. This deterioration touches by order descending the patients affected by psoriasis, vitiligo, and onychomycosis. The patients were particularly sensitive when uncovered zones were reached, particularly the face. These results are in conformity with the data of the literature relating to the subject. The validation of this version is necessary.

[Potomania associated with schizophrenia: a case report]. / La potomanie associee a la schizophrénie: à propos d'un cas.

The potomania or primary polydipsia is associated to schizophrenia in 20% of cases. Authors reports a case of a patient 27 old years, that suffering from hebephrenia who presented potomania. It was necessary to eliminate secondary polydipsia. The main complication resulting from potomania is water intoxication. Neurobiological or psychological hypothesis were suggested related to the etiopathogeny of this association. Some biological or comportemental therapy were effective in this context.