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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 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 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 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]

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]

Background: Epidemiological studies suggest a positive but controversial correlation between the major mental disorders, particularly schizophrenia and delinquent or criminal acting out. aim : To study the occurrence of violence in patients with schizophrenia according to demographic, clinical and disease progression features., Methods: This retrospective study included all out-patients, consulting during a period of one month, suffering from schizophrenia for at least five years. The clinical and forensic history was obtained owing to a semi-structured interview with patients and their families, medical records and the passing of different scales., Results: Sixty patients were included. 46.7% (n=28) of patients had a violent behavior in the pre morbid period. Aggressiveness was noted as the first prodrome in 13.3% (n=8) of cases. 28 major acts of violence were committed by 30% (n=18) of patients regardless of the active period of disease. In 13.3% (n=8) of cases, these acts announced the disease. The majority of acts have been committed against a non-foreign person. Recurrence was noted in 44.4% (n=8) of patients. Several risk factors of violent behavior were found. Only prodromal aggression was associated with a poor prognosis., Conclusion: Violences committed by patients with schizophrenia are attributed to a particular group of patients and do not have necessarily a pejorative prognostic value.

Background: The law 92-83, has established the rights of the mentally ill to respect for individual freedom and to appropriate care. However some gaps in its implementation led to the revision by Act 2004-40., Aim: To study the evolution of the number of admissions with and without consent (hospitalizations at the request of a third party and compulsory hospitalizations), between 2000 and 2009., Methods: Retrospective study of the archives of the mental health unit of Razi hospital. The study population included inpatients under the mode of voluntary and involuntary admission either compulsory hospitalizations or at the request of a third party., Results: An increase in the number of hospitalizations without the consent from 2000 to 2009 was noted. The number of compulsory hospitalizations and the one of hospitalizations at the request of a third party rose respectively from 1,048 to 1,443 and from 22 to 1,323. So the number of free hospitalizations has decreased while the number of involuntary hospitalizations has increased, leading to a constant number of total hospitalizations. The sex ratio for compulsory hospitalizations has increased from 2.04 to 5.83 while it markedly decreased for hospitalizations at the request of a third party (from 10 to 1.7).Men, unlike women, were more likely to be hospitalized compulsorily than at the request of a third party., Conclusion: There is a larger use of hospital admissions under constraints than free ones; is it due to a concern for the respect of law or an abuse in the deprivation of freedom for some patients?