S. Omri

Factors Affecting the Management of Somatic Comorbidity in Tunisian Patients with Schizophrenia

Schizophrenia is often accompanied by somatic comorbidities, which make the management challenge of such patients more difficult. In this study, we proposed to identify the sociodemographic and clinical factors correlating with somatic comorbidities in patients with schizophrenia to facilitate screening and prevention. It was a retrospective descriptive study of 78 schizophrenia patients in clinical remission and followed in outpatient psychiatry. In addition to the acquired records, other data were provided by the clinical and biological examinations performed for each patient. The evaluation of the therapeutic adherence was carried out using the Drug Attitude Inventory (DAI).Seventy-six patients (97.4%) had somatic comorbidities with a mean of 3.83 (± 1.81). This number increased significantly in males, older patients, couples, urban patients, and those receiving a combination therapy. According to a multivariate study, the four predictors of an increased risk of comorbidities were age, use of psychoactive substances, waist size and therapeutic adherence.Our findings focus on somatic comorbidities risk in schizophrenia patients, requiring particular vigilance in their follow-up, and suggest some modifiable clinical factors that might be a preferred target for reducing or preventing the occurrence of such disorders.

Alcohol Use and Associated Environmental Factors Among Middle and High School Students in Sfax (Tunisia)

Our objective was to investigate the prevalence and the environmental determinants of alcohol use among students in the region of Sfax in Tunisia. We carried out a cross-sectional study among 315 middle and high school students. We used the Alcohol Use Disorders Identification Test (AUDIT) to identify risky alcohol consumption, and we used the Parenting Styles and Dimensions Questionnaire (PSDQ) to assess the students’ perceptions of their parents’ parenting styles. The results show that 19.7% reported drinking alcohol at least once in their lifetime. Among them, 21% scored as dependent alcohol users, according to the AUDIT. Those who drank alcohol at least once were more likely to have parents with a permissive parenting style ( p  < 0.001; Cramer’s V  = 0.287), and a father ( p  < 0.001; Cramer’s V  = 0.258), a mother ( p  = 0.025; Cramer’s V  = 0.158), or a friend ( p  < 0.001; Cramer’s V  = 0.341) who drinks. Students perceiving their parents’ parenting style as permissive had the highest AUDIT score ( p  = 0.005; partial η 2  = 0.132). The authoritarian style score was significantly higher for students who were current alcohol users ( p  = 0.028; Cohen’s d  = 0.57). Our study highlights the influence of peers, family drinking, and parenting styles on alcohol use among middle and high school students. Therefore, particular attention should be given to students that are at risk of having the abovementioned environmental determinants of alcohol use. And, prevention strategies should involve parents, as well as enhanced guidance and counseling for these students.

The Management of Depressed Patients by the Tunisian General Practitioners: A Critical Trans-sectional Study

Under-diagnosed and under-treated, depression has a pejorative prognosis. The general practitioners (GP) represent the most often consulted healthcare professionals by depressed patients. The aim was to describe how the Tunisian GPs manage the depressed patients and to note the difficulties they encounter in order to suggest corrective measures. A survey was conducted among 140 GPs in Sfax Governorate. The percentage of the GPs whose responses conformed to the scientific data in at least 67% of the items was 31.4%. Four factors were correlated to a good management of depression: age (p = 0.028), masculine gender (p = 0.016), long career (p = 0.034) and participation to continuous medical education sessions on depression (p = 0.01). Our study revealed inadequacies in the management of depression by the GPs. GPs were invited to sensitizing meetings. A training on depression was assured for the future internship supervisors by the commission of medicine of family in the Faculty of Medicine of Sfax.

Correlates of Insight in Patients with Schizophrenia

Introduction Increasing evidence supports the important role of illness state and individual characteristics in insight among patients with schizophrenia (SCZ). Aim of the study To determine factors predicting the lack of insight among patients with SCZ. Methods It was a cross-sectional, descriptive and analytical study, involving 40 patients with DSM-IV diagnosis of SCZ followed in the outpatient psychiatry department at the Hedi Chaker University Hospital of Sfax inTunisia . The SAIQ (Self Appraisal of Illness Questionnaire) was used to measure 3 domains of insight (need for Treatment, Worry, and Presence/Outcome of Illness) and the PANSS (Positive and Negative Syndrome Scale) was used to measure the intensity of psychotic symptoms. Results The average age of our patients was 41 years (21-64 years). The mean duration of disease was 14 years and the number of hospitalization was 2.5. The scores of insight were independent from sociodemographic factors. The lack of insight in SAIQ was significantly correlated with a greater number of hospitalizations (p = 0.03). The worry subscale was associated with a longer duration of disease (p = 0.04) while the presence/outcome of illness subscale was associated with the intensity of negative symptoms (p = 0.03). There was no correlation between insight and positive syndrome. Conclusion Our results show that the lack of insight is closely related to negative symptoms and the duration of the illness in patients with SCZ. Therefore, interventions to better the insight should focus on early diagnosis and psychosocial therapy to improve negative symptoms.