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Introduction: Functional disability in bipolar disorder, despite optimal treatment, has been associated with residual symptoms. Nevertheless, the impact and relevance of each of them remain unclear in clinical practice. Objectives: The aims of the present study were to evaluate the impact of residual symptoms on overall functioning in euthymic patients with bipolar disorder and to explore the relationship between residual symptoms and specific areas of functional impairment. Methods: This was a cross-sectional, non-interventional study of adult bipolar outpatients. All patients were euthymic at the time of assessment (YMRS score <8 and BDRS =8). The Functioning Assessment Short Test was used to assess overall and specific domains of functioning (autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time). Various residual symptoms were assessed (residual mood symptoms, sleep and sexual disorders). Logistic correlation was used to determine the best model of association between functional domains and residual symptoms. Results: Almost quarter of 40 patients included (22,5%) had poor overall functioning. Residual depressive symptoms were associated with poor overall functioning and occupational functioning outcome (r=0,405, p=0,009; r=0,343, p=0,003 respectively). In addition, sleep quality appeared to have an impact on global functioning and autonomy (r=0,402, p=0,01; r=0,46, p=0,003 respectively). Residual manic symptoms and sexual function weren't correlated with functioning impairment. Conclusions: ln this study, residual depressive symptoms and sleep quality impairments were the most prominent factors associated with the level of functioning. Thereby, these residual symptoms need to be targeted in order to optimize bipolar patients functioning and quality of life. [ABSTRACT FROM AUTHOR]

Introduction Participating in the political life is a key goal of democratic institutions. The main achievement of the Tunisian revolution has been the democratization of political life and the re-conquest of liberties that remain to consecrate and consolidate. Several studies have focused on evaluating the participation of some specific groups in political life (youth, women…) but none have shed a light on the mentally ill. Objective and method Our study aims to assess the participation of patients followed in different psychiatric units of the Razi hospital in activities such as voting, attendance at political meetings, adhesion and contributions to political parties as members, political debates with their neighbors… The investigation focused on 40 patients and relied on a preestablished questionnaire. Results The study group was 40 patients followed at Razi hospital with 25 men and 15 women. The average age of patients was 40 years (24–56). The turnout was very low at 10% (4 male patients) versus an average of 60% of the general population. One patient was an active member of a political party and political meetings. Women seemed to be less interested in political issues. Conclusion The participation of the mentally ill in politics, as in the different aspects of social life, remains very limited in a particularly vulnerable group in society that has suffered considerable discrimination. [ABSTRACT FROM AUTHOR]

Introduction Substance abuse is a widespread phenomenon in Tunisia. However, although the principles of prevention and addiction treatment are accepted in Tunisia, the laws of our country remains sketchy and marked by the traditional punitive approach to drug users. Aims Assess knowledge of methadone, opioid substitution therapy, among Tunisian psychiatrists. Methods This is a descriptive cross-sectional study that included psychiatrists in the public sector, liberal sector or in training courses. These doctors completed a self-administered questionnaire posted on the website of the Tunisian Society of Psychiatry and the Association of Tunisian residents and young psychiatrists. The survey includes 18 items. The questions were grouped under three main headings: – sociodemographic data; – general knowledge of methadone; – methadone and its place in their daily practice. Results The participation rate was 15% ( n = 35). The average participant age was 32.13 years. Psychiatry residents were the most represented grade 94%. Twenty-eight percent of participants had training in addiction ( n = 10) Eighty-five percent have heard about methadone. Conclusion Given the importance of the scourge of drug abuse including opioids, political circles have expressed the desire to improve the Tunisian legislation on substitution treatment. Nevertheless, others projects more directly related to “Arab Spring” are government priorities. [ABSTRACT FROM AUTHOR]

Introduction Tunisia is knowing a significant increase of the elderly population, this phenomenon comes along with an increase of the incidence of degenerative pathologies “dependent on the age” as the Alzheimer's disease. The physical and psychic consequences of the disease and also the behavior of family members are an important determinant of quality of life and economic activities of both patients and informal caregivers. Objectives and methods Our aims are to establish characteristicsof60 informal cargivers of Alzheimer's patients followed in the department of neurology in Razi's Hospital and to estimate their socioeconomic burden through a descriptive study. Results Our sample of caregivers was predominantly female with a moderate socio-economic conditions in 36,66%. The support was provided in 2/3 of cases exclusively by the informal caregivers. 22,66% ( n = 13) of them lost their profession since the beginning of assistance's relationship. Among caregivers, 8% were forced to leave their homes to be closer to their ailing sibling. Conclusion Our results reflect the distress of informal caregivers of Alzheimer's patients, the importance of their involvement and the adverse consequences on their quality of life and professional activities. [ABSTRACT FROM AUTHOR]

Introduction Impulsivity, as defined by Barratt in 1983, is the inability to associate a behavior to context or consequences. It refers to a variety of risky behaviors, inappropriate to the situation and can lead to undesirable consequences. It is well-established that impulsivity is strongly related to bipolar disorder. Currently, we speak of impulsivity trait present even in bipolar patients in euthymia given the hereditary nature of bipolar disorder. In this study, we are interested in assessing impulsiveness in healthy relatives of bipolar patients. Methodology Impulsivity was measured using BARRAT scale [the Barratt impulsiveness Scale-11 (BIS-11)] in 30 healthy subjects who are first degree relatives of bipolar patients treated in Razi hospital; and comparing the results to 30 subjects, witnesses matched for age and sex with no personal or family history of psychiatric disorders. Results The impulsivity score among parents of bipolar patients was significantly higher compared to controls especially for motor impulsivity with average scores 19.15 versus 16.94, respectively. The general impulsivity score among parents of bipolar patients was 61.53 ± 13.83 versus an average score in controls of 47.20 ± 18.26. Limits The small sample size did not allow conclusive results. The difficulties in determining the mental history of the control group (to check the absence of a family history of bipolar disorder). [ABSTRACT FROM AUTHOR]

Introduction Violence against elderly persons is an intricate social, legal and ethic issue. Alzheimer's patients are the most vulnerable individuals to mistreatment and neglect. The aggressor can be even the main helper of the patient. We noticed a wide underestimation of this phenomenon, which remains taboo subject in our society. Objectives and methods The aim of our study is to identify predictive factors of mistreatment of Alzheimer's patients through a prospective and descriptive study, within patients following in the department of neurology in Razi's hospital. – We evaluate cognitive function (MMSE) and the importance of behavioural disorders. – We explored helpers’ sociodemographic characteristics and the quality of aid relationship. – Anger and hostility within relationship were estimated through family attitude scale. Results -Our sample accounts 60 informal caregivers predominately female (91,7%) with an average age of 49,67 years, mostly are married (71,66%) and jobless (38,88%). – In 78,3% of cases, caregivers spent about 12 to 24 hours per day with Alzheimer's patient. – The average score of FAS was about52,4%with an important emotional charge (score > 60). – Twenty-five caregivers wished the death of the patient and 42 others admitted being sarcastic with him. – We noticed a correlation between mistreatment and both cognitive function and behavioural disorders. Conclusion Our results support the fact that mistreatment of people with dementia is closely related with the exhausting situation of the main caregiver. [ABSTRACT FROM AUTHOR]

Introduction The important role of family caregivers, particularly among Alzheimer's patients is increasingly recognized. The Alzheimer's patient assistance relationship is a morally painful experience, most frequently discussed in terms of “burden” in the literature. We 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. Methodology This is a retrospective descriptive study. Patients were recruited from neurology department of Razi hospital. The burden was measured using the Zarit inventory. Results and discussion Thirty patients were included, the majority female. Most caregivers are descendants (60%), then, daughters-in-law (33.33%), and finally the spouses (23.33%). Eighty percent of caregivers lived in the same home as patients. The average burden in our sample is 59.9 + 16. We observed that 3.33% 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. Caregivers who support more severe patients have a higher burden. Thus, behavioral disorders are more frequent or severe and the numbers of incapacity to perform activities of daily life are more important. However, there the gravity of burden is not affected by age of the assisted person. Conclusion The study of factors correlated with high levels of burden aims at finding ways of intervention. However, the research needs to be broadened to further analyze the causal links between these factors. [ABSTRACT FROM AUTHOR]