Les corrélats des traits de personnalité psychopathiques dans un échantillon d’étudiants universitaires en Tunisie

BackgroundAlthough psychopathy and its predictive factors are well documented in clinical samples, studies in non-clinical populations are relatively rare. We proposed to assess psychopathy traits in a population of Tunisian university students and to analyze their predictive factors.MethodThis was a cross-sectional study of 516 university students enrolled at three major Tunisian universities (Faculty of Humanities and Social Sciences of Tunis, National Engineering School of Tunis, Faculty of Medicine of Tunis). Participants responded to a survey sheet containing sociodemographic data and the Levenson Self-Report Psychopathy Scale.ResultsThe students were female in 63.2 % of the cases, with a mean age of 22.7 years. The socio-economic level was middle class in 62.4% of the cases. More than one-quarter of students (26.7%) consumed tobacco. The majority of students (81.4%) spent their free time on the Internet, while 11.8% participated in associative work. Psychopathy scores were relatively high (mean LSRPS scores = 64.8) with no noticeable gender differences. Psychopathic traits were significantly associated with university (P = 0.017), maternal occupational status (P = 0.038), and tobacco use (P = 0.029). In addition, the total psychopathy score was significantly lower among students sharing activities with their families (P = 0.044) and among students participating in associational work (P = 0.025). The multivariate multiple regression has retained as predictive factors of psychopathic traits the fact of being the eldest of his siblings and the associative work.ConclusionPrevention strategies should be put in place to prevent psychopathy and its individual and social impacts in young adults in general, and in university students in particular, especially promoting associative activity in the university environment which is currently lacking in our context.     

Recherche d’association entre abus de cannabis et bipolarité : étude sur un échantillon de patients hospitalisés pour un trouble bipolaire

Introduction

Cannabis use is very frequent in bipolar disorder and has been found to increase the duration and frequency of manic symptoms while decreasing those of depression. Bipolar patients who use cannabis were shown to have poorer compliance to treatment, more symptoms that are psychotic and a worse prognosis than patients who do not. In this study, we have evaluated the importance of cannabis use among bipolar patients admitted to the Psychiatric Hospital of the Cross, Lebanon (Hôpital Psychiatrique de la Croix [HPC]) as well as the clinical differences between cannabis users and non-users.

Évaluation des états mentaux à risque de transition psychotique dans un échantillon de jeunes détenus de sexe masculin en Tunisie

BackgroundPrevalence of psychotic disorders in a prison population is higher than in the general population. Recent research has shown that early intervention is feasible in prison settings, and that approximately 5% of screened prisoners have met ultra-high-risk (UHR) for psychosis criteria. We aimed to identify the prevalence of the UHR states for developing psychosis in a group of newly incarcerated men in the Jendouba Civil Prison and to analyze the association between UHR states and socio-demographic data and substance use.MethodWe carried-out a cross-sectional study among 120 prisoners. Every prisoner was interviewed using the Comprehensive Assessment of At-Risk Mental States (CAARMS). The Social and Occupational Functioning Assessment Scale (SOFAS) was used to assess the participant's level of functioning.ResultsWe found a prevalence of subjects meeting the UHR criteria of 21.3%. UHR subjects had significantly more psychiatric family history (P = 0.035), personal history of suicide attempt(s) (0.035) and self-injury (P = 0.013) compared to non-UHR subjects. Clinical self-evaluation found significantly more depression and anxiety in the UHR group (P = 0.020 and P = 0.035, respectively). In addition, social and occupational functioning was significantly more impaired in the UHR group (P = 0.007). UHR subjects used significantly more cannabis in lifetime (P = 0.015) as well as in the past year (P = 0.022) and had a significantly higher frequency of cannabis use (P = 0.01) compared to non-UHRs.ConclusionPrison mental health teams face the challenge of identifying prisoners who need mental health services and providing early care to this vulnerable group; this challenge may offer a unique opportunity for intervention among a population that might not otherwise have had access to it.     

Observation de la spasticité d’adolescents atteints de paralysie cérébrale lors d’une activité tennistique intensive

IntroductionThis study investigated whether a physical activity considered intensive was free of deleterious effects on spasticity.Material and methodEight young people with cerebral palsy level II to IV, according to the Gross Motor Function Classification System, participated in a five-day tennis course. Spasticity of the elbow, wrist and knee flexors was measured with the modified Tardieu scale on the first, third and fifth day.ResultsThe spasticity of young people with cerebral palsy showed no difference in intra- and inter-day comparisons (P > 0.05).DiscussionThe clinical specificity of each participant resulted in large standard deviations that may account for the lack of statistical differences between the comparisons. Do individual variations in spasticity pose a risk to the reproducibility of measurements? Individual follow-up shows that the diversity of neurological impairment does not alter our findings. Future research could observe the behaviour of spasticity during long-term tennis practice. But it is essential to ensure individual follow-up.     

Apport de la transdisciplinarité sans perdre sa spécificité de kinésithérapeute dans la rééducation d’un enfant polyhandicapé : étude de cas

This paper presents the case study of Julie, a 5-year-old child presenting a cerebral palsy. Her motor function level is rated V on the Gross Motor Function Classification System for cerebral palsy (GMFCS) and her manual ability is rated V on the Manual Ability Classification Scale (MACS). Her communication level is rated IV on the Système de classification des fonction de communication (SCFC). Our work focuses on the major hypertonia observed with this child and which massively alter her voluntary motor skills. The analysis was led through an interdisciplinary re-education team and enabled us to consider the different roots for these contractions. Not only is the neuromotor function altered by the brain injury leading to an inflated basal state of contraction, but the sensory, psychological and emotional dimensions were also taken into account to understand Julie's behavior in relation to her exaggerated contractions. Based on this multidimensional diagnosis, a collective process led to a physiological and educative therapy in order to allow this young girl with multiple disabilities to achieve a certain level of control over her contractions. The installations, the organization of her environment and an adapted educational framework were the three areas chosen to answer the three identified dimensions of pathological contraction. Regulating her state of contraction appears as a necessary step towards optimizing her expression and accessing an improved state of relaxation and comfort – a key element to support her general development.     

Rôle de l’impulsivité dans la relation entre surpoids et TDAH chez l’enfant : étude exploratoire des caractéristiques cliniques,neuropsychologiques et neurobiochimiques

ObjectivesRelationship between Attention Deficit Hyperactivity Disorder (ADHD) and obesity in adults and children had previously been established in research studies. Brain imaging studies pointed out the important role of the prefrontal region in both ADHD and obesity. However, the underlying link between ADHD and obesity is not well understood. The hypothesis that impulsivity could play a role has been explored in clinical studies of ADHD and Binge Eating Disorders or Loss of Control Eating, with contradictory results. Our study aims to compare children with ADHD and obesity to children with ADHD and normal weight. We propose to compare these two populations with clinical, neuropsychological and brain spectroscopy investigation, focusing specifically on impulsivity items.MethodTen children presenting overweight or obesity were selected from a larger population of children with ADHD (5–12y) and paired with regard to gender and age with ten children with ADHD and normal weight from the same population. Conners Rating scales version parents (CPRS) and teachers (CTRS), Conners’ Continuous Performance Test II (CPT-II), and Magnetic Resonance Spectroscopy (MRS) metabolites in five regions of interest (left and right prefrontal, left and right striatal and left cerebellum regions) were measured for all the children. For MRS, ratio to creatinine levels of following metabolites were measured: glycerophosphocholine + phosphocholine/creatinine (GPC + PCh/Cr), glutamate + glutamine (Glu + Gln/Cr), myoinositol (mI/Cr) et N-acétylaspartate + N-acétylaspartylglutamate (NAA + NAAG/Cr).ResultsHyperactivity/Impusivity and Conners Global Index (CGI) subscales of Conners rating scales showed a higher rate of impulsivity in children with ADHD and obesity as compared to children with ADHD and normal weight. Neuropsychological results were comparable in the two groups. Finally, MRS showed a higher GPC + PCh/Cr ratio in right prefrontal cortex in children with ADHD and obesity as compared to children with ADHD and normal weight.ConclusionsOur results are concordant with the hypothesis that impulsivity could be the link between obesity and ADHD in a population of children with ADHD. The right prefrontal regions seem to be areas of interests that need more research in the study of the link between obesity and ADHD.     

Projet de création d’un groupe de parole pour les anciens patients et les familles de proches ayant été hospitalisés dans le service de réanimation

With medical progress, we notice that the mortality rate in intensive care units has considerably decreased. However, the psychic quality of life and the future of “survivors” and caregivers is particularly precarious after their path in the unit. The setting up of the group for the relatives during the hospitalization could allow them to break a feeling of loneliness and share with others families their experience, while trying to overcome the trauma of the hospitalization of their relatives in intensive care. For the patients who were hospitalized in intensive care, most of them could not integrate this experience due to amnesia and neurological disturbances when they woke up. This work of symbolization can begin in the same way but at a distance from the hospitalization. This attempt at representations and symbolization is thus part of a psychic integration of experience into individual subjectivity for each person in view of the lack of symbolization that the universe of intensive care unit.     

Intégration d’un médiateur de santé-pair dans une équipe de soins,son rôle et ses fonctions

In January 2012, the Psychosocial Care Unit, Pole 16 of Sainte-Anne Hospital, Paris, France integrated a peer support worker in the framework of the experimental program of peer support worker in mental health piloted by the Collaborator Center of the World Health Organization in Lille, France. The concept of peer support worker stems from its origin in the empowerment movement, alongside patient's rights to patient education, re-entry into society/community, awareness of citizenship role within the community, and rights for the handicapped/disabled. The peer support worker is a former psychiatric patient who has had a successful recovery path, with the ability to provide help to patients based on their experiential knowledge and on the acquisition of a theoretical and practical training. Originally from Canada, United States, and Great Britain, this concept has been developed for Addiction healthcare settings. It has subsequently been extended to include other areas such as health services for social exclusion patients. In France, integration into psychiatric services was a major innovation in 2012. We will discuss how this integration has been achieved in a care unit by paralleling the preliminary preparation and continuous work and application within the healthcare team as well as the peer support worker's point of view. We will underline the evolution of the functions of the peer support worker over the years. This new professional role puts into question the representations of the caregivers in their own role through clarification and their new collaboration with the peer support worker. The lesson we learn from this integration is positive in many ways, particularly among patients, for whom the peer support worker embodies the source of recovery and who presents a beacon of hope.