IntroductionSleep is a basic physiological need for the health and well being. Aging brings many changes in sleep holding the advance in age, multiple comorbidities and changes in lifestyle.ObjectivesDescribe the quantity and quality of sleep in the elderly.MethodologyProspective and descriptive study involving 40 people aged over 65. The sleep evaluation was done over a period of four weeks with a sleep diary (daily self-assessment tool of sleep and wakefulness).ResultsIn our study, we found an average of hours of sleep in elderly subjects 8 to 9 hours per day. The sleep time was in 60% of cases before 10 pm and the wake-up time was in 52% cases at or before 6 am. The sleep latency did not exceed 30 min in 68% of cases. Sixty pourcent subjects have had nocturnal awakening for more than an hour. Sleep quality was considered poor by 55% of sujets and disturbance was attributed significantly to somatic diseases.ConclusionSleep disorders in the elderly are common. The effective treatment must take account of psychological, psychosocial and somatic factors specific to age.
IntroductionThe year 2020 was marked by the COVID-19 pandemic that killed more than one million people. Scientists around the world are looking for prophylactic treatment against this virus.ObjectivesThe objective of our study was to assess the acceptability of prophylactic treatment against COVID-19 by paramedics.MethodsDescriptive and cross-sectional study including paramedics (nurses, orderlies) from the military hospital of Tunis. Data collection was carried out by a clinical psychologist. We studied the acceptability of prophylactic treatment by paramedics, reasons for refusal and factors that may affect this choice.ResultsA total of 161 paramedics agreed to answer our questionnaire. The average age was 37.73 years. The average number of years worked was 14.95 years. There were 85 women (52.8%) and 76 men (47.2%). Only 59 (36.6%) agreed to take prophylactic treatment for COVID-19. The main reason for refusal was fear of side effects 57 (34.7%). Sufficient hindsight was the main factor that could make them change their decisions. This refusal was definitive for 55 (34.2%) paramedics.ConclusionsFear of drug side effects exceeds the fear of COVID.19. An information and communication strategy on the value of prophylactic treatments during a pandemic must be developed.
IntroductionPsychotraumatism can constitute for some people a real existential fracture, a real upheaval of the psychic organization.Immediate psychological reactions can vary from one-off and temporary reactions to far more severe and sometimes enduring reactions.Material and methodsWe collected the case of a patient who was hospitalised in April 2015 for manic symptoms in the immediate aftermath of a terrorist attack, with a review of the literature.Clinical caseThis is Mr. A. F., aged 38, with a personal history of AVP and a shooting wound following a terrorist attack. He had presented a psychomotor instability and an exaltation of the mood in the immediate aftermath of an ambush.Behavioural problems were identified by the psychiatric team during the group debriefing conducted at the HMPIT emergency room. During his hospitalisation, a chemotherapy based on thymoregulators, neuroleptics and anxiolytics was introduced.The evolution was marked by a significant regression of the manic syndrome after ten days, and the installation of a post-traumatic stress condition (PTSD). At the end of eight months, the patient was able to resume his work with long-term thymoregulatory treatment, a ban on weapons and safety posts.ConclusionManic episodes are rarely observed as an immediate post-traumatic reaction. Their occurrence does not prevent the subsequent installation of PTSD. Has psychic trauma revealed a latent psychosis? Is it a trauma-induced mood disorder?Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionPain is a frequent reason for psychiatric consultation. It is a symptom that is often associated with other mental disorders. It can have a significant impact on the quality of life of the patient. Yet pain is a complaint often underestimated by the clinician. It is considered inherent to mental illness and so poorly supported.ObjectiveStudying the relationship between mental illness and pain and include means to support this co morbidity.MethodologyThis is a cross-sectional and descriptive study on a population of 50 consultants who suffer from chronic pain. The evaluation consists of a questionnary on the characteristics of the pain, psychiatric illness and modality of care.ResultsAmong the patients studied, 80% were female. The mean age was 47.33 years. Predominant type of pain was headache in 78 % of cases, followed by stomach pains and diffuse arthralgia. The impact on daily life was average for most patients. Radiological exploration was performed in 35% (without abnormalities in 100% of cases). Depressive disorders were present in 60 % of cases. The most prescribed analgesics was Tier 1 (paracetamol) with a positive trend in 65 % of cases.ConclusionThe pain, especially headaches are a common complaint in psychiatry. Their association with depression is classic. But it can also accompany other mental illnesses and worsen their prognosis. A better understanding of causality of pain and its management is essential to improve the quality of life of patients.
IntroductionThe psychological changes caused by trauma reflect the difficulty of overcoming the traumatic event. This study is a trial to approach the clinical and evolutionary aspects of post traumatic pathology through an observation of a recently hospitalized patient in our military psychiatric department.Clinical observationMr M., 28 years old, was surprised by the sound of distant gunshots. Going on site, he found six of his friends killed and his best friend dying. Developing severe symptoms of acute stress disorder, he was hospitalized and treatment by an antidepressant and anxiolytics has been established. Two weeks after, anxiety and nightmares decreased but repetition and avoidance syndromes did not improve.Meanwhile, the patient was obliged to face major confrontations consisting of interrogations and legal proceedings concerning his conduct after the accident. He was suspended from his job and all his professional papers were confiscated. The patient developed consequently a major depressive episode; however, an important event occurred: the repetition syndrome disappeared. Thereafter, the mood disorder has improved and we have seen a more combative attitude from the patient.ConclusionIn this case, how can we explain the relatively early disappearance of the repetition syndrome? Is it the confrontation with facts of reality even more traumatic than the trauma itself? The long-term evolution towards recovery or towards a new relapse will clarify us on this issue.
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