Introduction: Diabetes and depression remain among the major problems of public health in the world. These diseases complicate each other. Several factors contribute to the occurrence of depression in diabetic. Thus, it would be necessary to determine them in order to prevent its occurrence. Aims:To assess the prevalence of depression in a population of diabetics and to identify factors contributing to the occurrence of depression in diabetics. Methods: A cross case-control study among 100 hospitalized diabetics in the department of endocrinology, Hedi Chaker hospital in Sfax Tunisia. We compared them to 100 witnesses. Then, we compared the two subgroups of depressed and non-depressed diabetics. We used the Hospital Anxiety and Depression Scale to screen for depression, the Beck Depression Inventory scale to determine the degree of its severity and the MINI to identify patients with a current major depressive episode (MDE) among depressed subjects. Results: The prevalence of depression was higher in diabetics (35% versus 14%). The prevalence of MDE was 71.43%. Depression was severe in 40% of cases. Comparing to the non-depressed diabetics, depressed diabetics were predominantly female and older. The duration of diabetes, mostly type 2, was longer. These subjects had more acute and chronic complications. Correlation factors of depression in diabetics were: advanced age, low socio economic level, low physical activity, stressful life event, lower limb arteritis, gastroparesis, android obesity, disturbance of lipid profile and anxiety. Conclusion: Factors involved in the onset of depression in diabetic subjects should be taken into account to improve management of diabetes
IntroductionBipolar disorders (BP) with late onset are underestimated by their frequency, their misleading presentations and therapeutic difficulties due to the high prevalence of somatic comorbidities.AimTo identify sociodemographic, clinical and therapeutic characteristics in subjects with a late-onset BP.Patients and methodsRetrospective and comparative study of 101 patients followed for a BP (12 patients with BP started after 50 years and 89 patients with BP started earlier) from 2009 to 2015, in the department of psychiatry of the University Hospital Farhat Hached, Sousse, Tunisia.ResultsThe mean age of subjects with late-onset TBP was 46.11 ± 12.85 years. Women were in the majority (65.3%). Ten patients had a novo mania, four patients had a late-onset mania and one patient had a secondary mania. Regarding the socio-demographic data, only the regular professional activity was more reported in the elderly (P = 0.017). Regarding clinical data, BP type 1 and secondary mania were more reported in elderly with (P = 0.050 and P = 0.000 respectively). Elderly had significantly fewer depressive episodes (P = 0.026), fewer hypomanic episodes (P = 0.000). The durations of the latest episodes and the last intervals were shorter in elderly (P = 0.045 and P = 0.000). Concerning therapeutic data, elderly had fewer hospitalizations (P = 0.045), required lower mean doses of lithium (P = 0.04) and greater mean doses of tricyclic antidepressants (P = 0.047).ConclusionIt is always necessary to look for an organic cause in manic syndrome in late-onset BP. Doses of lithium should be lower. However, doses of TAD should be higher.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionTeaching, as a profession, is recognized as demanding and stressful.Objectives(1) Evaluate the professional teacher stress, (2) Identify possible factors associated with it.MethodsThis is a cross-sectional study, descriptive and analytical, conducted among teachers of high school Mahmoud Magdich in Sfax. (Tunisia). Participants were asked to complete the anonymous form detailing the socio-demographic, professional characteristics and any work stressors.The evaluation of occupational stress was evaluated by the scale of “Karasek”.ResultsThirty-six teachers replied to the questionnaires. The sex ratio (M/F) was 0.38. The mean age was 48.77 years. The average number of years of exercise was 23.20 years and the average number of hours worked per week was 16.25 hours. The participants stress profile according to the scale of “Karasek” was: 55.6% stressed, 27.8%, assets, 11.1% liabilities, and 5.6% relaxed. The main stress factors mentioned were respectively: the inadequate salary (58.3%), difficult working conditions (52.8%), problems with students and parents (25%) and lack of organization at work (22.2%). Factors correlated with the profile “stressed” were: female gender (P = 0.026), lack of pastime practice (P = 0.034), teaching high school degree (P = 0.04), feeling that they work “too hard” in their work (P = 0.005), they are “the end” at the end of the working day (P = 0.015) and low social support (P = 0.005).ConclusionThe occupational stress among teachers was quite important. Knowing how to identify factors and taking action would be interesting for the guarantee development for teachers. Students would be the ultimate beneficiaries.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Aims.To measure the insight of a clinical population of schizophrenics.To specify factors correlated with a great insight.Methods.A cross-sectional study on 30 schizophrenic male followed in the Department of Psychiatry B, Hedi Cheker hospital in Sfax, Tunisia.For each patient:We collected the demographic and clinical data and we used the following scales:The Insight Scale (IS) for the measurement of ‘insight.Positive and negative syndrome scale (PANSS) to assess the severity of symptoms.The Drug Attitude Inventory (DAI-10) to assess the assumption relating to drugs.The Calgary Depression Scale for Schizophrenia (CDSS) to assess depression.The Satisfaction With Life Scale (SWLS) to determine the degree of life satisfaction.ResultsThe average age of the group was 40,08 years. Fifteen patients had a primary school and 68% were unemployed. Socioeconomic level was low in 80% of cases. Paranoid schizophrenia was the predominant type (56%). The average duration of hospitalization was 7.28 weeks. Twenty patients consulted regularly after their first hospitalization. The insight was poor in half of cases. Twenty-six patients had a positive subjective response to treatment. The majority of subjects had no depression (84%). Eleven subjects were satisfied with their life.The great insight was correlated with positive subjective response to treatment (p = 0.023).ConclusionThe great insight was associated with better drug compliance, with a limited number of relapses and a favorable disease progression. However, it was also associated with poor life satisfaction.
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