[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.

[Evaluation of depression in elderly people living in nursing homes: a study involving 35 people]. / De la dépression chez la personne âgée en maison de retraite: Etude auprès de 35 résidents.

BACKGROUND: Depression in the elderly is often inadequately diagnosed and insufficiently treated. Regardless of the nature of the depression, the influence and the impact of the biological, situational, social and psychological factors would be more important in old subjects than in young ones when the disorder occurs. The nursing home, as an institution, is another factor facilitating the appearance of depression. AIM: The aim of our survey is to determine the prevalence of depression in old people living in a nursing home and to evaluate the degree of their autonomy. METHODS: Our study is a transverse, descriptive and analytical survey carried out on 35 old people at a nursing home in Sfax. Forty residents were excluded from this survey for reasons of dementia (25 cases), debility (5 cases), disabling psychiatric pathologies (4 cases), deafness (5 cases) and one resident who refused the interview. The evaluation has been achieved using two scales specific to the geriatric practice: • The scale of depression: GDS (geriatric depression Scale) applied to 30 items. • The scale of autonomy: IADL (Instrumental Activities of Daily Living) applied to 6 items. RESULTS: • The examined population was composed of 35 people aged from 65 to 93 with a sex ratio of 1.05. • 51.4% of the residents were in a state of depression. • Depression was more frequent in: • Female subjects (58.8% of women compared to 44.4% of men) • Subjects aged less than 70 (66% of subjects aged less than 70 versus 40% of older subjects) • 17.1% of the residents were independent, 42.9% were dependent and 40% were heavily dependent. CONCLUSION: Depression in the elderly is related to several depressice factors particularly for patients living in institution. This situation needs very important adaptive capacities.