L’activité physique et sportive et l’estime de soi chez les adolescents handicapés : le cas de la pathologie du pied bot

People with a disability are often perceived by the “non disabled” as a disadvantaged minority and are the subjects of generalisations and stereotypes. These stigmatisations reinforce the feeling of incapacity and differences on the physical and psychological plans. Moreover the body perception plays an important role in the construction of self-esteem. Sports programs of (re)adaptation are employed in order to help physically disabled people. But beyond this work of self-awareness on the purely functional plan, sport and/or leisure activities could be a support for a better psychosocial integration of these persons, thanks to a more positive perception of their self-value and image. We have thus examined the concept of self-esteem through the practice of a physical activity in a sample of young people suffering from a congenital foot malformation: idiopathic clubfoot, knowing that self esteem is a major preoccupation during adolescence. The population consisted of two groups of disabled adolescents treated at the American Memorial Hospital (Reims, France): Group 1, non sport group, N = 9; M_age = 12.44 years old; S.D. = 1.51, sex ratio 4G/5B; and Group 2, sport group, N = 10, M_age = 12.30 years old; S.D. = 1.33, sex ratio 4G/6B. The French translation of the Rosenberg Self Esteem Scale and of the Physical Self-Perception Profile were given to each participant after an individual explanation of the protocol. The results of the study show that adolescents practicing a physical activity have higher self-esteem and better self-perception than the adolescents who do not practice any sport. Moreover, it has already been shown that a low self-esteem is associated with depressive troubles. These relationships are really important especially for people who suffer from a physical deficiency. Thus, the practice of a physical activity could be a way to enhance self-esteem and self-perception, and may have a positive effect on depressive disorders.     

Le suivi psychologique de sportifs de haut niveau : enjeux et réalité

In recent years, numerous studies have shown that the intensive practice of sport was not without psychopathological risks. Act No. 99-223 of 23 March 1999 relative to the protection of athletes’ health and to the fight against doping has, for the first time, taken into consideration the psychological dimension of sport regardless of the concept of performance. Since then, the 16 June 2006 decree amending the decree of 11 February 2004 established the nature and frequency of medical examinations under Articles L.3621-2 and R.3621-3 of the Public Health Code. The interest of this review is to allow the athlete, who is an object of so many desires on the part of his parents, of his coach, of the public and of the society of spectacle, etc., to regain his place as an individual within the time of an interview. During this interview the professional will establish a link allowing the athlete to register his sport in a “life project” (athlete, academic, professional, family, etc.) and in a sphere of which sport is only an aspect. By allowing the athlete to “be”, during and after his sport career, the professional will try to locate him/her outside the “sports play-acting”, which is a source of vulnerability to the disease of “doing” (drug addiction, alcoholism, addiction gestures, etc.). Furthermore this interview is also an opportunity to seek personal vulnerabilities and to elaborate a psychopathological epidemiology of high-level sport, which has hitherto not been undertaken. This legislative progress integrated into the longitudinal medical monitoring is an important advance in the care of athletes who have gone from hero status to that of participating in an industry of recreation and sports spectacle. However, these texts leave many issues untreated, more especially that so far this assessment has been launched in a parsimonious and disparate way (method, processes, stakeholders, professional sportsmen, etc.) according to the sports federations and institutions that often resist its implementation.     

The FAQ self-report is a valid instrument to characterize endophenotypes of the autistic spectrum in parents of children with autism

Background

We have previously developed the FAQ self-report, an adaptation of the Baron-Cohen's Autism Quotient self-report, in order to detect traits of the autistic spectrum in the parents and siblings of children with autism. We have previously shown that parents of children with autism show significant differences in their global scores and in their social functioning scores according to their answers to the FAQ self-report.

Objective

Our aim was to validate the FAQ self-report in a population of control parents, and to confirm our previous results concerning parents of children with autism.

Methodology

Hundred and twenty-seven adults (67 female, 60 male), parents of children with normal development were recruited in the general population. They were asked to fulfill the 40 questions of the FAQ self-report at two different times. Sixty-six parents of children with autism were asked to fulfill the FAQ self-report, for group comparisons. Statistical factor analysis and test-retest reliability analysis was performed with the Matlab toolbox^© software.

Results

Statistical factor analysis and test-retest reliability show that the FAQ is structured in two main factors, socialization and communication on one hand, rigidity and imagination on the other, with good test-retest reliability. Further comparison between parents of children with autism and control parents shows a significant difference between the two groups for the socialization and communication domain, and for the global score. We show for the first time that scores of the parents of children with autism remain unchanged from infancy to adulthood.

Conclusion

The FAQ is the first French validated self-report focused on the detection of traits of the autistic spectrum in parents and siblings of children with autism. It is structured in two main factors, corresponding to imagination/rigidity, which are negatively correlated, and communication and socialization, which are positively correlated. The FAQ is therefore a reliable instrument to measure endophenotypes associated with the autistic spectrum in parents of children with autism, and may be useful in genetic studies.     

Dopage, limites et transgression. Rapports à l’individuel, à l’institutionnel et au juridique

The evolution of contemporary practices allowed us to consider doping as a new object of social discourse, placing this transgressive practice within the borders of medical, sociological and juridical prospects. The development of a legislation framing sporting practices leads to the installation of new institutions like to the emergence of concepts, such as “medical monitoring of sportspeople”, contributing to the introduction of new social control devices.     

Conduites à risques et variation de l’estime de soi chez les adolescents : l’exemple du parkour

The aim of this study was to explore the relationships between general self-esteem, physical self-worth, sport competence, physical condition, an attractive body, physical strength and the involvement in a risk-taking sport: The parkour. This sport may be included in gymnastics and acrobatics but it is practised outside of the gymnasium. Indeed, serious parkouristes are tremendous athletes who practice their stunts in a controlled environment such as a gymnasium, with mats, pads and foam pits. Many of these participants have some gymnastics or martial arts training, and they are also fully aware of the risks involved in practicing this sport. It consists of finding new and potentially dangerous ways to traverse the city landscape. Parkour is said to be the art of moving fluidly from one part of the environment to another. It may also be known as: the art of movement, free running, urban-running or obstacle coursing. This activity is a way of using obstacles in one's path in order to jump and perform acrobatics. It involves the scaling of walls, roof-running and leaping from building to building. These multiple acrobatics are submitted to peers appreciation considering fluidity, aesthetics and originality. Self-perception is of great importance in the construction of self-esteem. This concept has been identified as a state which evolved depending on spatiotemporal factors of the environmental context. It can be measured with the Physical-Self Inventory (PSI). This is a six-item questionnaire especially developed for repeated measurements. It measures six dimensions hierarchically organized Global Self-Esteem (GSE), Physical Self-Worth (PSW), Physical Condition (PC), Sport Competence (SC), Attractive Body (AB), Physical Strength (PS). Seventy-six male participants were asked to take part in the study: Group 1: Parkour (n = 32, M_age = 15.07 years, E.t. = 1.98) and Group 2: acrobatics (n = 41, M_age = 14.96 years, E.t. = 2.01). The PSI-6 was taken at three different times: Time 1 (T1, pre-test before practicing parkour), Time 2 (T2, just after having stopped the parkour), Time 3 (T3, two hours after T2). As expected, and with the exception of PC and PS, the data confirmed the prediction that, compared to Group 2, Group 1 would score significantly higher on each subscale of the PSI, including GSE, PSW, SC, and AB. That is to say, skydiving could de used as a way to regulate self-esteem, this confirms our assumption. Self-esteem has recurrently been invoked as a contributing or explanatory factor for socially problematic behavioural outcomes (i.e., risk-taking behaviours such as restrictive or dysfunctional eating, substance abuse, aggression). In relation to our results, sports could bring an extra dimension to studies on risk-taking especially among adolescents. Indeed, risk-taking sports are usually perceived as an intrinsically gratifying practice that is socially adapted and accepted. However, benefits in self-esteem regulation derived from an engagement in a risk-taking sport must be put into perspective. Although the results indicated for Group 1: a lower level of self-esteem before practice and a higher level after, the retention test shows that these results do not last more than two hours. This finding suggests that, even if the emotion regulation produced by parkour is positive, one session is not enough for adolescents to experience positive rewards from their engagement in a risk-taking behavior. Thus, in order to recreate the positive emotional state they were in, they may possibly put themselves in another risk-taking situation. However, the link with addiction cannot be made directly as it implies several factors which have not been measured in this study. Future research should take this interesting point in account and use a longitudinal methodology. This will authorize authors to draw out our assumptions and emphasize the possible link between addiction and risk-taking sports.     

Sport et alliance thérapeutique en milieu carcéral

In this report, the author advances the hypothesis that sport activities could compromise a therapeutic alliance in the case of psychiatric follow-ups. The approach is a phenomenological, clinical and anthropological one based on three clinical situations. This hypothesis was verified but has not been applicable to the whole population of prisoners. If psychiatric and psychotherapic follow-ups can not be positively correlated with the notion of therapeutic alliance, there is a risk factor and therefore a predictability of relapse for bipolar disorders and for clinical decompensation whether auto- or heteroaggressive. Finally, the components of the universe of the exercise grounds and of psychopathology in the prison society of the Fleury-Mérogis prison are psychiatry, sports, stimulating and sedative substances. The hypothesis was confirmed by facts, as follow-ups are not frequent due to « too much sport », and to patients « sinking » into a psychopathological process. The following other variables were analysed: sex, age, personal health antecedents and justice antecedents. The three patients studied had a criminal past consisting of sexual assault, murders or drug dealing. Based on available data, the analysis indicates that the three prisoners decompensate along same mode: bipolar disorders followed by immediate admission in a psychiatric hospital, which in turn entails a change in the initial punishment.     

Validation study of the French schizotypal personality questionnaire in a sample of adolescents: a confirmatory factor analysis

Aims

This article aims to validate the schizotypal personality questionnaire in a sample of French speaking adolescents. Because early schizotypal manifestations are predictive of psychosis-proneness, reliable self-report measures are crucial for early detection of vulnerability to schizophrenia during adolescence. Unlike most existing self-reports, the questionnaire de personnalité schizotypique (SPQ) assesses individual differences in all nine feature of DSM-IV schizotypal personality (i.e. ideas of reference, excessive social anxiety, odd beliefs, unusual perceptual experience, odd behaviour, no close friends, odd speech, constricted affect and suspiciousness). Furthermore, it yields dimensional scores concerning the main schizotypal factors, which represent valuable information for the clinician's case formulation and can be used as a screening instrument in the general population.

Method

Our sample consisted of 174 adolescents (98 girls) between 12 and 17 years old. All completed the SPQ 74-item self-report. Participants were recruited in secondary schools in Switzerland, and through the child and adolescent community outpatient psychiatric service (office médico-pédagogique) affiliated to the University of Geneva's Psychiatry Department and to the Canton of Geneva Education Department. A confirmatory factorial analysis was conducted on our sample to test nine competing models of SPQ. The 3-factor model of Raine et al. was compared to concurrent 2, 3, and 4-factor models. Simple structure models of Raine et al. and Stefanis et al. were also tested.

Results

The following observations were highlighted in our results: (1) goodness-of-fit indices are better for structures allowing cross loadings than for simple structures; (2) amongst the simple structures, the best goodness-of-fit index was obtained for the Raine model and (3) the fit between our data and the Raine model is improved by a cross loading for suspiciousness subscale. The latter seems problematic for the global data fitting. This led us to test simple structures models of Siever and Gunderson, Raine et al., and Stefanis et al., based on eight subscales rather than nine. Without suspiciousness subscale, goodness-of-fit indices are enhanced in these three models. The 3-factor model yields the clearest and most reliable results in comparison with other competing models. In summary, the best goodness-of-fit indices were obtained for the 3-factor Raine model. Goodness-of-fit indices could be improved by the exclusion of the suspiciousness scale.

Conclusions

Consistent with earlier analyses by Raine et al. and Dumas et al., our data confirm the 3-factor model of the SPQ (cognitive-perceptive; interpersonal; disorganized) in a sample of French speaking adolescents. Our analyses confirm that two dimensions are insufficient to explain the structure of schizotypy during adolescence. These results further suggest the stability of a 3-factor structure during lifespan. We note that the inclusion of the suspiciousness subscales engenders statistical issues. Most studies to date have dealt with these issues by performing a cross-loading with this subscale, or by the inclusion of a paranoid factor which is linked with the negative and the cognitive-perceptive factors. We found that the most statistically sound strategy was reached without the inclusion of the suspiciousness subscale. Future studies with larger samples could investigate the SPQ structure at an item-level, which carries the benefit of reduced restrictions on the factorial analysis. In conclusion, the current study shows that the French version SPQ constitutes a reliable self-report questionnaire for the assessment of schizotypal trait expression during adolescence that may assist in the evaluation of psychosis proneness in youths.     

Aspects nosologiques des troubles bipolaires maniaco-dépressifs. Considérations critiques

Critical revue of the concept of bipolar disorders and spectrum and the categories in DSM-IV and ICD10.     

Données sur la représentation morale du dopage chez l’enfant et l’adolescent

Two chronometric studies are described with the goal of outlining a moral representation of doping for children and adolescents. The first study, a moral chronometric task, was proposed to a sample of participants from children to adults. The conclusions indicated that children had a superficial understanding and a lack of internalisation concerning doping. A second study, a moral Stroop task, focalised on adolescence, which is a significant period of risk for doping and drug addiction. The aim of this study was to investigate whether young adolescents displayed an attentional bias to doping words and whether this attentional bias was related to physical self-esteem. Results indicated carry-over effects in young adolescents only for doping words. In addition, a poor physical self-esteem significantly enhanced carry-over effects. Finally, the results emphasise the complexity and at the same time the singularity of the morality of doping in terms of moral judgement.     

Validation of a scale of sexuality (interests, emotions, relationships: IERS) in prime adolescence (12 to 15 years)

Background

Early adolescence, which we also call prime adolescence, is marked by the transformations of puberty and the sexualisation of the body, changes in cognition and the progressive involvement in sexuality. This study is the continuation of an earlier work dealing with the construction and validation of a questionnaire on sexuality during adolescence (Courtois et al., 1998) [8].

Methods

Population. The sample was composed of 312 middle-school students (7 to 9^th grade) from four middle-schools in Tours and its suburbs (Indre-et-Loire, France): 164 girls (52.6%) and 148 boys (47.4%); with a mean age of 13.8 (S.D. = 1.02; from 10.7 to 16.9) (without significant differences between boys and girls). Material. The material was composed of 22 items calling for true or false answers and including 13 items from the initial questionnaire by Courtois et al. (1998) [7] and [8] structured in three dimensions (“Behavioral engagement in sexuality”, “Love and fidelity” and “Taste for flirting”). Procedure. The study was carried out in 2008 in the classroom (anonymity guaranteed).

Results

The results of the factorial analysis (as the main component and by the method which maximizes variance, Varimax) made it possible to find three factors which explain 41% of total variance: “Going out with someone” (value of 4.6, explaining 21% of the total variance); “Giving priority to love” (value of 2.8 explaining 13% of the variance); “Flirting with the aim of having sexual relations” (value of 1.6 explaining 7% of variance). The Cronbach alphas are 0.79, 0.70 and 0.66 respectively. The first and third factors are correlated. In order to obtain a shorter final instrument and to favor the orthogonality between factors, we only retained the items which are strongly saturated by the factors (> 0.50). A confirmatory analysis revealed the good adequation of the model retained (Chi²: 162, 87 dof, P < 0.001; Goodness of fitness index [GFI] of Joreskog: 0.91; Root mean square error of aaproximation [RMSEA] = 0.05). Following these analyses, we are able to propose a shorter questionnaire (15 items), structured in three dimensions of sexuality significant in prime adolescence (in accordance with interests, emotions and relationships). The analyses were conducted according to gender and age. There is no significant difference for “Going out with someone” between boys and girls. On the other hand, there is a difference between “Giving priority to love”, which is more important for girls (P < 0.05) and for “Flirting with the aim of having sexual relations”, more important for boys (P < 0.001). However, as ages increase, we notice a rise in scores for “Going out with someone” for girls as well as for boys (P < 0.05); a drop in scores for “Giving priority to love” (for girls, (P < 0.05) and an increase in the scores for “Flirting with the aim of having sexual relations” (only for boys (p < 0.05).

Discussion

This study allowed us to validate a scale of sexuality in prime adolescence that presents good psychometric qualities. It was carried out on a larger and more representative sample of this period than the initial study, although essentially finding the same results as previously. Thus, the use of this scale, coupled or not with the individual analysis of the items which make it up, could allow us to understand sexuality in prime adolescence in three significant dimensions of psychosexual development, as well as regarding risky sexuality, i.e., an excessive interest in genital sexuality, behavioral involvement and precocious sexual relations or an absence of feelings.     

La notion de handicap psychique comme analyseur des mots de la psychiatrie

The evolution of manners and the legislation for about ten years has introduced a lifting of inhibition to speaking about the psychiatric affections and using technical or comparable terms. The clinical relation shows that it is often illusory to think that words, whatever they are, could to some extent neutralize the psychic violence which in particular the concept of psychosis comprises, which puts the therapist at the long course in the embarrassment with a redundant insistence. The concept of psychic handicap can represent a progress on certain plans, it does not remain about it less one “hostile” concept for most patients, as it comes to start a psychic wish of integrity always bitterly defended.     

Cannabis withdrawal syndrome in patients with cannabis dependence only, and in patients with cannabis and opioid dependence

Background

The cannabis withdrawal syndrome occurs after cannabis cessation in more than 50% of dependent smokers. But although opioid-dependent patients are more frequently cannabis users and cannabis-dependent than the general population, the frequency and phenomenology of cannabis withdrawal symptoms in this specific population is unknown. Our hypothesis was that cannabis-dependent patients with current opioid dependence would experience the same withdrawal syndrome after cannabis cessation.

Objective

To describe cannabis withdrawal symptoms in cannabis-only dependent patients and in cannabis-dependent patients with current opioid dependence.

Methods

Using retrospective interviews, we evaluated the number and duration of six cannabis withdrawal symptoms in two groups: 56 cannabis-dependent patients without and 43 cannabis dependent patients with current opioid dependence. Cannabis and opioid dependence diagnoses were defined with DSM IV criteria using the MINI structured interview.

Results

The two groups were not different in terms of age of onset of cannabis use, and number of cannabis joints smoked at the time of the cannabis cessation attempt. The frequency of a cannabis withdrawal syndrome (defined as at least two different symptoms) did not differ in the two groups (65%). Neither was the proportion of subjects with the following symptoms: appetite or weight loss (30.8%), irritability (45.1%), anxiety (56%), aggression (36.3%) and restlessness (45.1%). Patients with cannabis dependence and current opioid dependence were more likely to report sleep disturbances (79.1 vs. 53.6%, chi² = 6.91, P = 0.007). The median duration of this cannabis withdrawal syndrome was 20 days post-cessation.

Conclusion

This is, to our knowledge, the first study describing cannabis withdrawal syndrome in cannabis-dependent patients with current opioid dependence. These patients experience a cannabis withdrawal syndrome as often as cannabis-only dependent subjects, but describe more frequently sleep disturbances. This high rate of sleep disturbances may cause relapse to cannabis use.     

Un trouble psychotique aigu révélant un lupus érythémateux systémique

Introduction

Psychotic disorders are classical in systemic lupus and are listed among American College of Rheumatology (ARA) criteria. They are rarely inaugural and can compromise diagnosis, especially if they are isolated.

Clinical case

A 20-old-year woman was hospitalized for an acute psychotic disorder of two weeks duration with a degradation of the general status. Physical examination revealed intense osteo-tendon reflexes with a right Babinski sign. Brain MRI visualized a nodular low signal T1, T2 and high signal T2 flair in the left centrum semi-ovale. Blood counts showed lymphopenia. Antinuclear antibody and anti-DNA native antibody were positive. The clinical course favorable after treatment using oral corticosteroids, an neuroleptic and an antidepressant.

Conclusion

Systemic lupus is a potential diagnosis for any atypical psychiatric symptoms in young women.     

Apport du Multimorph à l’étude des processus de reconnaissance émotionnelle faciale (REF). Exemple de la personnalité borderline à l’adolescence

An increasing interest in the study of facial emotion recognition in many psychiatric disorders has emerged over the past few years. The morphing technique allowed opening new perspectives in experimentation, by using dynamic expressions of emotions, such as in the Multimorph task. Based on a literature review, we present here the interest of the Multimorph task. It includes 36 trials where a neutral (0%) face expresses increasing degrees of emotional intensity, slowly changing to a full-blend (100%) emotion. Then, the example of borderline personality disorder in adolescence is developed to examine how the observed pattern of results could account for the reported clinical characteristics. Limitations and prospects of the Multimorph are further discussed.     

Football et psychose

After 25 years of practicing soccer in psychiatric hospitals, the authors stress the interest of a sport involving physical activity while treating psychoses. Several clinical cases illustrate the personal advantages and more especially the collective ones for the institution.     

Correspondance et transcodage entre CFTMEA R 2010 et CIM-10

In spite of its conceptual differences with the International Classification of Disease 10 (ICD-10), the 2010 revision of the French Classification for Children and Adolescents Mental Disorders (FCCAMD) tries to propose a correspondence table as complete as possible, between the categories of both classifications, reaching their complete transcoding. The aim is to allow the continuation of CFTMEA use while responding to national and international constraints. After describing the national and international current constraints, the solutions found and the obstacles faced by the transcoding, this paper is led to observe that what opposes to the full correspondence between these two classifications is also what makes the interest of their coexistence: ICD-10 offers a categorical approach to psychiatric diagnostic, while FCCAMD brings dimensional psychopathological complementary informations essential in child and adolescent psychiatry.     

Étude sur la prise en charge des auteurs de violence sexuelle auprès d’une cohorte de psychiatres hospitaliers en France en 2011

The management of sexual offenders requires clinical, criminological and legal knowledges. On the basis of a self-assessment, our study highlights the shortcomings of practitioners in a complex and constantly evolving field. Expectations are many legitimate, it is urgent to train practitioners accepting these delicate tasks.     

Fonctionnement de la mémoire chez les sujets avec autisme

Introduction

Autism is an early developmental disorder with cognitive impairments that leads to learning and social integration disabilities. The characterization of memory functions in individuals with autism has been the subject of numerous investigations, with widely varying conclusions. The notable differences between these studies can be attributed to variations in the age, intelligence and level of severity of the participants with autism.

Literature findings

The purpose of our review of the recent literature is to describe the memory function of individuals with autism. Some of the different memory subtypes are intact, others are impaired. Short-term memory (digit span) is not impaired while working memory is impaired in some of its components, but the findings are inconsistent. More recent studies demonstrate reduced spatial working memory abilities in autism and extend previous findings by demonstrating that these deficits are significant when tasks impose heavier demands on working memory. Episodic long-term memory, as measured by free recall, cued recall or recognition tasks, is intact, but participants with autism perform significantly less well than controls as the complexity of the verbal or visual material to be recalled increases. Source or contextual memory involves a variety of characteristics specifying the conditions under which specific items or facts are acquired: it has been investigated in individuals with autism with different methods. Deficits in source memory for temporal information have been found, but there were no reality monitoring deficits. Recent findings indicate that the nature of source memory confusion in autism does not appear to reflect a generalized deficit in attaching context to memories, but rather is dependant on the specific to-be-remembered information that involves social aspects of context. The self-reference effect is missing, with individuals with autism recalling events performed by themselves less well than the events performed by a peer, suggesting they have difficulties in relation to processes involving the self. Studies involving assessment of subjective states of awareness during recognition show less conscious recollection and more feelings of familiarity. Recent investigations are consistent in demonstrating memory impairments related to the failure of subjects with autism to use organizing strategies or meaning to support memory, an effect which grows with the increasing complexity of the material. Memory deficits in autism may be related more to retrieval and less to encoding, as deficit in source memory in participants with autism is largely eliminated when source was supported at test.

Discussion

The neuroanatomical basis of the specificities of memory impairment in autism is still uncertain, but it is suggested that autism involves an impairment in the conversion of limbic inputs into medial prefrontal outputs. Memory deficits found in individuals with autism may explain some of the clinical symptoms. Failure to encode all the information, especially its social aspects, may therefore contribute to dysfunction in the social, communication, and reasoning domains. Abnormal memory functioning in autism is also related to more general cognitive impairments, including executive function deficits and central coherence weakness. Evidence of the normality of certain memory capacities, at least in individuals with moderate autistic symptomatology, is encouraging for adaptive improvements in cognitive functioning.     

Spouses and bipolar disorder

Objective

To assess the quality of life of a population of spouses of bipolar patients compared with a control population.

Patients and methods

We conducted a cross-sectional study which included two groups: a group of 30 spouses of patients followed for bipolar I disorder according to DSM IV criteria and a second group of 30 subjects from the general population. Both groups were matched by age, sex, marital status and socioeconomic level. This device was designed to limit the differences between the two groups solely those of the bipolar illness. Evaluating the quality of life was achieved using the quality of life scale: SF-36. This is a scale that has already been translated and validated in dialect Arabic.

Results

Regarding sociodemographic variables, the two study groups differed only for: recreation, friendly relations and the couple relationship that included more and better skills among the control group. In the categorical approach, the quality of life was impaired in 60% of spouses and 40% of controls with a statistically significant difference. The following standardized dimensions: mental health (D4), limitation due to mental health (D5), life and relationship with others (D6) and perceived health (D8) and mental component (CM) were significantly altered in patients’ spouses compared to controls. We found significant differences between the two groups for: overall average score (51.1 vs. 68.2), mental health (D4), limitation due to mental health (D5), life and relationship with others (D6), perceived health (D8) and perceived health (D8) standards.

Discussion

The impairment of quality of life of bipolar patients’ spouses is related to the extra responsibility, stress, financial problems and health problems, stigma, and loss of security of the person loved.

Conclusion

Considering the consequences that the appearance of bipolar disorder on the patient's spouse may have, certain measures must be proposed to improve their quality of life.     

Insight cognitif et schizophrénie

Schizophrenia is usually associated with severe and chronic lack of knowledge of mental illness. This lack of insight is found to be correlated to hypofrontality but not related to the disorder outcome or to the intelligence quotient. The cognitive insight was defined as the difference between self-reflectiveness and self-certainty. This ability is described as decreased in schizophrenia but increased in depression. Thus, schizophrenia with depressive comorbidity is associated with a higher level of insight. The authors discuss how greater awareness of psychotic illness can be lived as traumatic, which appears to be a risk factor for depression and suicide.