IntroductionThe Alzheimer's patient assistance relationship is a morally painful experience, most frequently discussed in terms of “burden” in the literature, especially as professionals and institutional intermediaries are underdeveloped in Tunisia.GoalIt is intended to assess the level of burden among caregivers of patients with Alzheimer's disease and to search factors associated with a high level of burden.MethodologyThis is a retrospective descriptive study. Patients were recruited from neurology department of Razi hospital, which were hospitalised between the months of December 2012 and March 2013. The burden was measured using the Zarit inventory.Results and discussionThirty patients were included. The majority female, most caregivers are descendants (60%), then, daughters in law (33%), and finally the spouses (23%). 80% of caregivers lived in the same home as patients. Caregivers were asked about all the items of the grid Zarit. The average burden in our sample is 59.9 + 16 3. We observed that 33% have absent to light burden (score <21), 10% have a light to moderate burden (between 21 and 40), 36, 66% have moderate to severe burden (between 41 and 60) and 50% have a severe burden (>60), according to the classification proposed by Zarit. Sex, kinship and cohabitation with the patient were not associated with a higher burden.ConclusionThe study of factors correlated with high levels of burden aims at finding ways of intervention and support to fight against the isolation of caregivers and the occurrence of anxiodepressive complications.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionIncest may be defined as sexual relations between close blood relatives. Legally, incest and sexual aggression toward minors are classified as a criminal behaviour. Tunisia is among the countries from which incest cases are rarely reported.Objectives and methodThe aim of this study is to investigate the relationship between the psychotic structure and incest, and to describe the individual, clinical, and criminal traits of the incestuous father through clinical observation.Case reportMr T.G is 46 years old. He is married and has six daughters. His wife appears to be passive, and largely dependent on her husband. Mr T.G has had incestuous relationships, initially, with his two eldest daughters. The acts were followed by the mother's complicit silence and the non-denunciation of the daughters. Two years later, he starts an incestuous behavior with his third daughter. Incest took place in the context of delusion. The patient was convinced that he is responsible of his daughters’ sexuality education. He develops an incoherent theory of purification with a tendency towards morbid rationalism. It is only after four years of insufferable paternal incestuous relationships that the third daughter filed a complaint to the police. A psychiatric expertise concluded that the accused is exempt from criminal responsibility.ConclusionIncest is a multi-faceted phenomenon, which makes its approach, comprehension, and treatment quite complex. For a psychotic patient incest is a means to deny alterity by crushing other. It also allows him to find, in this complete power, control over his annihilation anxiety.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionThe digital boom and the media coverage of the sexuality urge the youngest to expose itself more and more via the social networks and other digital applications.Aims/objectiveTo explore the virtual sexuality of the Tunisian teenagers.MethodsIt's a cross-sectional study made in August 2015, including 104 Tunisian teenagers from different social backgrounds and living in Tunis, chosen aimlessly. An auto-railing drafted in Arabic, anonymous and carrying on various items was distributed.ResultsWe included 52 boys and 52 girls. Seven of them (6.1%) was not schooled and 68.3% (n = 71) were at high school. Ninety-one of the teenagers (87.5%) reported not have sexual education at school and 74% (n = 77) have already turned to web sites to inquire about sexuality. A regular practice of cybersex at the rate of at least once a week, was founded at 36.5% (n = 36) and 41 teenagers (39.4%) have reported to have already undressed in front of their webcam. The candidates have already consulted a pornographic site at least once in their life in 76.9% (n = 80) of the cases. The allocated time for these virtual activities is made to the detriment of the sleep in 75% of the cases (n = 27). The connection was accompanied with a masturbatory activity in 38.9% (n = 14).ConclusionContrary to preconceived ideas, the computer screen does not protect from sexual risk behaviors. Therefore, a sexual education for the youngest is more than ever necessary to avoid such drift.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionSeveral studies have explored the vulnerability to mood disorders that constitute some personality traits.AimsTo study the potential relationship between mood disorders and personality disorders.ObjectiveWe hypothesized that personality disorders can be related to severe mood disorders.MethodsThis was a retrospective study including the period from January 2000 till September 2015 and related to patients in whom the diagnosis of mood disorder and personality one were retained according to the criteria of the DSM-IV TR while the sociodemographic and clinical were collected by a pre-established railing.ResultsWe included 28 patients (15 ♂, 13 ♀). The average age was 38 years. Eighteen (64.3%) patients (7 ♂, 11 ♀) are unemployed. Fifteen patients (10 ♂, 5 ♀) were schooled until secondary level. Seventeen patients (60.7%) were married. The bipolar I disorder (BD I) was most frequently founded (50%), followed by the major depressive disorder in 25% (n = 7) then by the bipolar II disorder in 21.4% (n = 6). A case of dysthymia was also noted. Half of the personality disorders were the borderline type, followed by the histrionic type in 28.6% (n = 8) then by the antisocial in 17.9% (n = 5) and finally one patient presented a paranoiac personality. The antisocial personality was significantly associated with the BD I (P = 0.011) and half of the patients with a pathological personality, presented a depressive symptomatology.ConclusionThe personality disruption is a factor of severity of the thymic disorders. Consequences on the management of patients and their response to treatments remain available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
There is a widespread use of substances abuse which might cause violence, suicide, interpersonal conflicts, lawsuits, psychiatric commitment, and even crimes. Psychiatrists are under increasing pressure to develop strategies to address the problem of coexisting criminal behaviour, addiction, and mental illness. The aim of this study was to examine the association between demographic profile, psychiatric symptomatology and substance use in forensic psychiatric inpatients, and to consider the treatment needs and opportunities for intervention among the same sample.MethodologyA retrospective study was done on patients admitted to the department for Forensic Psychiatry at the Razi Hospital from 1996 to 2016, initially jailed for detention and drug consumption and judged irresponsible by reason of insanity. Data were collected by record review.ResultsThirty-two patients were included in the study. Mean age was 27.81 years. Thirty-six percent of the participants were illiterate and 45% were single. More than half of the subjects (54%) had personal psychiatric history and 27, 27% had family history of psychiatric problems. About one third (31.81%) of participants had judicial background: 33% were arrested for public drunkenness, 44% were arrested for violence, and 22% were arrested for theft. Concerning the diagnosis, 45% were suffering from schizophrenia, 22.77% were diagnosed with personality disorder and 27.27% of them would not have any mental trouble. About 50% of the patients did not follow up with treatment.ConclusionAddictive disorders are authentic psychopathological disorders. Effective treatment is hindered by the paucity of research on clinical application of treatment models for addictive disorders in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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