[Postpartum depression: prevalence and risk factors. A prospective Study concerning 302 Tunisian parturients]. / La dépression du postpartum: prévalence et facteurs de risque Etude prospective concernant 302 parturientes tunisiens.

BACKGROUND: Depression is a common condition especially in the postpartum. It exposes mothers, newborns and couples for psychosocial complications. AIMS: They were to estimate the prevalence of the depression in postpartum in a population of 302 Tunisian parturients and to identify its associated factors. METHODS: Our study was prospective, in two stages: at the first week (T1), then between sixth and tenth week of the postpartum (T2). The study was conducted at CHU Hédi Chaker in Sfax, Tunisia. We used the Arabic version and validated the Edinburgh Postnatal Depression Scale (EPDS) for screening for postpartum depression. We used the scale MSSS. "Maternity Social Support Scale"to assess the social and family support and the Azrin scale to evaluate the satisfaction of the conjugal relationship. An epidemiologic questionnaire was used to collect the sociodemographic and clinical data. RESULTS: At T1, 302 women were examined. At T2, 139 were reexamined (46% of the initial population). In the first stage, the prevalence of the intense postpartum blues, according to EPDS, was 19,2%. In the second stage, the prevalence of the postnatal depression was 12, 9%. Factors associated with postpartum blues intense were the low socioeconomic status (p =0, 01), a lower educational level (p = 0,017), the poor marital relationship (p =0, 04), an insufficient social support (p 0,001), the difficulty to accept pregnancy (p =0,001), the presence of psychiatric the presence of psychiatric history (p =0,001), the prematurity (p =0,001) and an ill newborn birth (p =0,001). Factors associated with the post natal depression were the low socioeconomic status (p =0,01), the poor marital relationship (p =0,034), difficulty with pregnancy (p =0,001) and the presence of psychiatric history (p =0,001). CONCLUSION: Postpartum depressions are common. It seems to be the result of the interaction of several biological, psychological and social factors. This suggests the importance of screening for women having such risk factors to prevent the installation of this depression. This detection should be done early in postpartum or else in the later postnatal consultations. This allows an adequate treatment for the mothers, for the relationship mother-new born and later, for the psychological equilibrium of the child.

Quality of life in alopecia areata: a sample of tunisian patients.

Background. Alopecia areata (AA) has a significant impact on the quality of life and social interaction of those suffering from it. Our aim was to assess the impact of AA on the quality of life. Methods. Fifty patients diagnosed with AA seen in the Department of Dermatology of Hedi Chaker University Hospital, between March 2010 and July 2010, were included. Quality of life was measured by SF 36; severity of AA was measured by SALT. Results. Eighty percent had patchy alopecia with less than 50% involvement, 12% had patchy alopecia with 50-99% involvement, and 8% had alopecia totalis. Compared with the general population, AA patients presented a significantly altered quality of life, found in the global score and in five subscores of the SF-36: mental health, role emotional, social functioning, vitality, and general health. Gender, age, marital status, and severity of alopecia areata had a significant influence on patients' quality of life. Conclusions. This study indicates that patients with AA experience a poor quality of life, which impacts their overall health. We suggest screening for psychiatric distress. Studies of interventions such as counseling, psychoeducation, and psychotherapeutic interventions to reduce the impact of the disease may be warranted.

[Role of the psychosocial factors in blood pression balance; cross-sectional study including 100 ambulatory hypertensive patients]. / Rôle des facteurs psychosociaux dans l'equilibre tensionnel: etude transversale de 100 hypertendus ambulatoires.

INTRODUCTION: Hypertension is a real public health problem. His pathogenesis involves a combination of several factors including environmental and psychosocial factors. AIM: We focus on the links between the blood pressure imbalance and some psychosocial factors in a population of ambulatory patients with hypertension. METHOD: It was a cross-sectional study on 100 patients with hypertension followed up in Cardiology in Sfax (Tunisia). Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Behavioral pattern was evaluated by a clinical interview, referring to the model of Friedman and Rosenman. We also collected socio-environmental, clinical, therapeutic and prognostic data. RESULTS: The most predictive factors of an unbalanced blood pressure were independently: personality type "A" or unspecified (p = 0002), high fat diet (p = 0026), poor drug adherence (p = 0038) and depression (p = 0015). CONCLUSIONS: Several sociodemographic and lifestyle factors are interrelated and implicated in the blood pressure imbalance, suggesting the need of a hygienic behavior joining the international recommendations. We insist on the treatment of the anxious and depressive disease and the psychotherapeutic approach of some personality patterns in the management of hypertension.