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Diagnosing a non-epileptic seizure is difficult in the absence of a video electroencephalogram. The expert commission of the international league against epilepsy proposes a diagnostic approach allowing the diagnosis to be made according to a degree of certainty with or in the absence of a video electroencephalogram. Our objective was to determine the hospital frequency of psychogenic non-epileptic seizures in the absence of video-electroencephalogram. Using the outpatient registry, we identified patients followed for epilepsy with two normal interictal electroencephalographies, between January 2020 and October 2021. A review of the patients' medical records and an assessment of the validity of the diagnosis were carried out. Out of 64 patients evaluated with normal interictal electroencephalogram, 19 were included as suffering from psychogenic non-epileptic seizures, i.e. 26.68%. The average age was 23.94 +/- 9.4 years. Women represented 68.4%. Patients followed in neurology represented 84%. A history of childhood trauma was found in (47.4%). The first crisis was preceded by stressful events in 47.36%. Post-traumatic stress disorder was the most represented with 73.7% of cases. The average age was 20.95 +/- 9.8 years for the first crisis and the average duration of evolution of the crises was 3 years +/- 2 years. This study illustrates the possibility of making a presumptive diagnosis of psychogenic non-epileptic seizure in the absence of video-electroencephalogram., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Gaoussou Keita et al.)

Suicide and self-harm are major public health concerns for adolescents globally, but there is a dearth of related research in West Africa. This study aims to examine the prevalence and associated factors for self-harm, suicidal ideation and suicide attempts among adolescents in the West African country of Mali. A questionnaire survey was conducted among adolescents attending school or university in August 2019 in Bamako, the capital of Mali. Logistical constraints necessitated convenience sampling. Outcome measures were self-harm and suicide ideation and attempts. Predictor variables included sociodemographic characteristics, bullying and mental health problems. There were 606 respondents who completed questionnaires; their mean age was 16.1 (SD = 2.4); 318 (52.5%) were identified as male; and 44.4% reported self-harm at some point in their life, with 21% reporting suicide ideation and 9.7% actual suicide attempts. For all three outcomes, older age, knowing somebody personally who had experienced self-harm or taken their own life, moderate to severe depression or anxiety, and being a victim of bullying were highly significant risk factors for self-harm, suicidal ideation and suicide attempts in these adolescents, while high self-esteem decreased the risk. The study suggests that self-harm and suicidal behaviour are relatively common in Malian adolescents who are still in education. However, much more research is needed to better understand this phenomenon.

Introduction: in Mali, there are no data on the prevalence of mental disorders. The purpose of this study was to describe the clinical and epidemiological features of patients hospitalised in the Department of Psychiatry., Methods: we conducted a cross-sectional study in the Department of Psychiatry at the University Hospital of Point G between January 2014 and December 2018. Data were collected from the medical records of 1105 patients hospitalised for psychiatric disorders., Results: the average age of patients was 32.6 ± 11.1 years, ranging from 13 to 82 years. Male patients accounted for 83.8% (926/1105) of enrolled subjects, 53.2% (588/1105) were single, 18.8% (208/1105) were not employed and 28.2% (310/1105) had primary education. Seventy-four percent (818/1105) had a history of psychiatric disorders, 22.7% (251/1105) were born to consanguineous parents. Drug use was reported in 42.9% (474/1105) of cases, including tobacco 32.6% (361/1105), cannabis 26.0% (287/1105) and/or alcohol 15.6% (172/1105). The demand for care came from families in 87.5% (967/1105) of cases. Aggression was the most common reason for consultation (44.5%; 492/1105). In 67.8% (749/1105) of cases, the diagnosis was schizophrenia, schizotypic disorders or delusional disorders. The first use of care was traditional in 58.7% (649/1105) of cases., Conclusion: people hospitalised for psychiatric disorders from 2014 to 2018 were predominantly young and male with a history of psychiatric disorders. They mainly had schizophrenia, schizotypic disorders and delusional disorders., Competing Interests: Les auteurs ne declarent aucun conflits d'intérêts., (Copyright: Souleymane Papa Coulibaly et al.)

Introduction: Mental health is a state of equilibrium and well-being, any alteration of which leads to the appearance of a state of distress and/or mental disorder., Objective: The objective of this work was to study familial and environmental factors associated with mental disorders., Materials and Methods: A cross-sectional study was conducted in the Psychiatry Department of the Point G University Hospital Center from April 1, 2016 to March 31, 2017 among outpatients with a psychiatric disorder in whom factors associated with psychiatric disorders were studied., Results: We included 288 patients. The median age was 33.0 years. The sex ratio was 1.88 in favor of males. Married patients accounted for 45.5%. First born uterine siblings accounted for 26.7%. Patients born of an inbreeding alliance accounted for 25.7%. Cases with a family history of a psychiatric disorder represented 59.0% and those who spent their childhood with their parents accounted for 64.2%. Cases of psychoactive substance use prior to the onset of the mental disorder accounted for 42.7%. The main psychosocial stress factors that preceded the onset of the mental disorder were grief (46.2%) and family conflict (22.6%). Psychotic disorders accounted for 77.8%., Conclusion: Our results show an association of mental disorders with family history of psychiatric disorder among patients followed in psychiatry. Further studies, such as genetic association may prove useful., Competing Interests: Conflit d’intérêt : Les auteurs ne déclarent aucun conflit d’intérêt.

Introduction: The objective of this work was to determine the frequency of mental disorders among female inmates of the C.S.D.R.F "Bollé"., Method: This was a descriptive, cross-cutting, prospective study that took place from August to September 2016 at (C.S.D.R.F) "Bollé" in Bamako. It concerned all female inmates present during the study period. The data were collected from pre-established fact sheets, the administration of the Mental Health Screening Questionnaire (MSQ) and clinical variables according to ICD10 criteria., Results: In total, 85 of inmates, or 74% (N-115) agreed to participate in the study. The 14-24 age group accounted for 61.0%. Singles accounted for 56.5% and 95.3% of female inmates had no previous prison history. Seventy-four percent were in pre-trial detention 12.6% had psychotic disorders. Personality disorders were observed in 11.8%. An inmate was on the committee. Thyme disorders were present in 4.7% of female inmates. Drug abuse was observed in 2.4% of female inmates., Conclusion: Detention can trigger, promote or aggravate a mental disorder., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: Diabetic polyneuropathy (DPN) with or without neuropathic pain is a frequent complication of diabetes. This work aimed to determine the prevalence of diabetic polyneuropathy, to describe its epidemiological aspects, and to analyze the therapeutic itinerary of patients with DPN., Methods: This was a cross-sectional, descriptive study performed synchronously over six months at two major follow-up sites for patients with diabetes in Mali. DPN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). The neuropathic nature of the pain and the quality of life of patients were evaluated by the DN4 and the ED-5D scale, respectively. We used three (3) different questionnaires to collect data from patients (one at inclusion and another during the follow-up consultation) and from the caregivers of patients with DPN., Results: We included 252 patients with diabetes, and DPN was found to have a healthcare facility-based prevalence of 69.8% (176/252). The sex ratio was approximately three females for every male patient. The patients were mostly 31 to 60 years of age, 83% had type 2 diabetes, and 86.9% had neuropathic pain Approximately half of the patients (48.3%) had autonomic neuropathy and they reported moderate to intense pain, which was mainly described as a burning sensation. The patients exhibited impaired exteroceptive and proprioceptive sensations in 51.7% of cases. The patients smoked tobacco in 3.4% of cases, while 36.6% of the patients were obese and had dyslipidemia. The caregivers clearly indicated that appropriate medications were not readily accessible or available for their patients with DPN., Conclusion: The healthcare facility-based prevalence of DPN with or without neuropathic pain was high in our cohort. These inexpensive and easy-to-use tools (MNSI, DN4) can be used to adequately diagnose DPN in the African context. In Mali, screening and early treatment of patients at risk of DPN should allow for a reduction of the burden of the disease, while caregivers need to be adequately trained to manage DPN., Competing Interests: The authors have declared that no competing interests exist.

Background and Purpose: The indication and benefit of plasma level of antiepileptic (AEDs) has been debating in the monitoring of people living with epilepsy and the epilepsy treatment gap has largely been documented in developed countries. This study was aimed to highlight the epilepsy treatment gap between rural and urban Mali., Methods: We conducted a pilot study on AEDs treatment from September 2016 to May 2019. For 6 months, 120 children and young adults living with epilepsy (rural site, 90; urban site, 30) received phenobarbital, valproic acid and/or carbamazepine. At our rural study site, we determined the AED plasma levels, monitored the frequency, severity and the duration of seizure, and administered monthly the McGill quality of life questionnaire. At our urban study site, each patient underwent an electroencephalogram and brain computed tomography scan without close monitoring., Results: At the rural study site, patients were mostly on monotherapy; AED levels at 1 month (M1) (n=90) and at 3 months (M3) (n=27) after inclusion were normal in 50% at M1 versus 55.6% at M3, low in 42.2% at M1 versus 33.3% at M3 and high in 7.8% at M1 versus 11.1% at M3. AED levels at M1 and at M3 were significantly different p <0.0001. By M3, seizures (n=90) were <1/month in 26.7%, and lasted less than 1 minute in 16.7%. After a yearlong follow up, all 90 patients reported a good or excellent quality of life. At our urban study site, patients (n=30) were on carbamazepine and valproid acid in 66.67% and monotherapy (carbamazepine) in 33.33%. By November 2018, only six out 30 patients (on bi-therapy) were still taking their medications., Conclusions: Epilepsy diagnostic and treatment are a real concern in Mali. Our data showed appropriate AED treatment with close follow up resulted in a better quality of life of patients in rural Mali. We will promote the approach of personalized medicine in AED treatment in Mali., Competing Interests: Conflict of Interest The authors declare that they have no conflicts of interest., (Copyright © 2020 Korean Epilepsy Society.)

Introduction: Spino-cerebellar ataxia or SCA are dominant neurological diseases caused by mutations in several genes. According to social and cultural contexts, especially in populations with low education level, the advent of such diseases might generate other kinds of suffering beside those caused by the physical impairment and disability. The aim of this work was to determine the impact of this disease in patients and their relatives., Methods: It was a qualitative approach carried out through semi-directive clinical interviews, neuropsychiatric observations and the administration of the Hamilton depression scale., Results: The study included a polygamous family in which mothers had 10 and 12 maternities. Neurological manifestations concerned four children of the same siblings and the father in a subtle form. The mother of these children was designated as responsible for the transmission of the disease and presented a reaction depression. Irritability, anxiety and depression reactions were observed in two patients and an unaffected brother. The advent of the disease was associated to the hatching of a latent familial conflict related to the father's status that has been established only after four years., Conclusion: In a social and cultural setting of polygamy, the advent of dominant ataxia with anticipation might revive latent familial conflicts and have psychological and social repercussions on the affected individuals and their relatives., Competing Interests: Lien d’intérêts: Les auteurs déclarent ne pas avoir de liens d’intérêts.

Aims: Autism is a global and early developmental disorder that appears before the age 3 years old. It is characterized by a triad of symptoms affecting the following domains: social interaction, verbal and non-verbal communication, imagination and behaviors. This work aimed to determine the frequency of autism and to identify its risk factors in Malians aged 0-17 years old., Method: In a cross sectional and prospective study, we reviewed clinical data in 2068 medical charts dating from 1992 to 2012 from all the mental health care centers in Bamako., Results: We found a frequency of 7.8% (162/2068). The age range 0-5 years old was the most represented. The sex ratio was 1.7. The autistic child was issued from a consanguineous marriage in 25.4% (41/162) of the cases. To have parents in divorce, being the first child, and male gender were associated with autism with statistical significance. Our data suggest an elevated number of autism cases in Mali. We plan to carry out a larger prospective study to determine other autism risk factors and importantly to identify autistic families for a molecular genetic study., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Objective: Determine prevalence of the depression in a population of patients chronic hemodialysis. Look for the associated sociodemographic, clinical and biological factors., Method: It was a transverse study. She concerned the at least 18-years-old patients, followed in the center of Hemodialysis of the CHU at the rate of 2 - 3 sessions a week. The patients having agreed, were in dialysis at least for 3 months and benefited from an individual interview through an index card of investigation based of Hamilton's scale French version in 17 items., Results: On a sample of 107 patients, the average age was 43, 24 ± 14 years old with extremes between 20 and 75 years. The average duration in dialysis was of ±40, 37 36, 5 months with extremes between 4 and 144 months. Prevalence of the depression was 88 %. The depression was light in 78, 5 %, moderated in 6,5% and severe in 3 %. The anemia was present at 94 patient's among whom 76 had a light depression., Conclusion: We observed that prevalence of the depression remains high to the chronic hemodialysis., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Objective: To determine the prevalence of psychiatric disorders in a prison population in Abidjan (Côte d'Ivoire)., Patients and Methods: This was a descriptive cross-sectional study, conducted from June to August 2008 at the Medical Department of the Prison and Correctional Center of Abidjan (PCC). 200 inmates were interviewed following the completion of a MINI supplementing a questionnaire on sociodemographic and penitentiary data., Results: The prison population of this study was predominantly male (90%) with a mean age of 33 years. Nearly half of the prisoner were single and without children (52.5%) and serving their first incarceration (54%); 76.5% of the inmates had completed at least 12 months in detention. The study found that 76% of prisoners had a DSM IV Axis I psychiatric disorder. The prevalence of major depressive episodes was 50.5% with an estimated 38.5% suicide risk. 23% had antisocial personality and 11% of respondents displayed a psychotic syndrome. Illicit drugs were found in 14% of prisoners and abuse of these drugs was reported by 17% of them. 8% had a state of post-traumatic stress and 3.5% obsessive compulsive disorder., Conclusion: The high prevalence of psychiatric morbidity in the prison settings argues in favor of a better organization of medical and psychological assistance to inmates., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)