[Sexual violence against minors in a Tunisian population: study of 53 psychiatric expert reports]. / Violence sexuelle sur mineurs dans une population tunisienne: étude de 53 expertises psychiatriques.

In Tunis, the reported cases of children who are victims of sexual abuse have increased in recent years. Child psychiatrists are asked to perform a psychiatric evaluation and treat patients. The purpose of this study was to describe the socio-familial and clinical profile of children who were victims of sexual violence and to describe data concerning the circumstances and nature of sexual abuse. We conducted a descriptive and analytic, retrospective study of children examined by child psychiatrists practising at the Hédi CHAKER hospital in Sfax following sexual violence. The study covered the period from January 2011 to October 2017. Child psychiatrists evaluated 53 child sexual abuse cases during the study period. The victims were girls in 64.2% of cases, with an average age of 10 years and primary school students in 46.2% of cases. Intra-family conflict was reported in 16.6% of cases. Intra-familial abuse was reported in 25% of cases, touching and anal penetration were the most frequent types of violence observed (63.5% of cases and 26.9% of cases respectively). More than half of children who were victims had a psychiatric disorder (post-traumatic stress in 32.7% of cases). This study shows that child sexual abuse is a complex problem with serious consequences. Measures must be taken to ensure children have adequate treatment.

Impulsivity in adolescents with major depressive disorder: A comparative tunisian study.

BACKGROUND: The association between impulsivity and depressive disorders in adolescence has been little studied at the literature and in our country, yet impulsivity is a major risk factor for suicide. Thus we aimed on this study to evaluate impulsivity in 25 adolescents with Major Depressive Disorder MDD compared to a control sample and to analyze the correlations between impulsivity and clinical features of MDD. METHODS: Employing a matched case-control design, participants included 25 adolescents with MDD and 75 controls. We have administered the Barratt Impulsivity Scale BIS-11 for the two groups to evaluate impulsivity. Semi structured interviews according DSM 5 criteria were conducted for adolescents with MDD. The Child Depressive Inventory CDI was used to measure depressive symptoms in the control sample. RESULTS: Adolescents with MDD were more impulsive compared to controls according to the BIS-11 in its three domains: motor (24.96±6.26 against 20.6±4.84; p=0.000), attentional (20.88±5.03 against 16.64±3.2; p=0.000) and non planning (28.2±7.26 against 24.44±4.32; p=0.02). Impulsivity was not correlated with clinical features of MDD (suicide attempts, psychiatric comorbidities, antidepressant medication …). CONCLUSION: Adolescents with MDD seem to be more impulsive than control subjects regardless their clinical features. Whether it is a specific characteristic or a symptom among others of MDD, impulsivity predicts health-related behaviors and associated damage that need to be detected and prevented in time.

[Attention Deficit Hyperactivity disorder at schools in Sfax-Tunisia]. / Caractéristiques épidémiologiques du trouble deficit de l'attention/hyperactivité en population scolaire dans la region de Sfax-Tunisie : Etude transversale.

BACKGROUND: Frequency, social impact, the negative effects of ADHD on personal development, make it a public health problem. Tunisian existing data confirm its frequency and severity in clinical population. The absence of data in student population has led us to develop this work.The objectives of our study were to study epidemiological profile of ADHD in school population. METHODS: The analysis involved a cross-sectional descriptive study conducted from April 2008 to October 2008 using a representative randomized multistage sample of schoolchildren between 6 and 12 years old. Measurement was performed in two stages first the parents and teachers of each children filled Conners questionnaire separately then students with the score in subscales inattention, hyperactivity with impulsivity higher than 70 were selected for psychiatric interview. Psychiatric interview was intended to confirm or refute the diagnosis of ADHD. The diagnoses were made according to DSM IV-TR. To study the possible associated factors with the disorder they were compared in children with ADHD and children without the disorder taken as controls. RESULTS: A total of 51 students out of 513 had ADHD. Prevalence was found to be 9,94%. For the study of factors associated with ADHD were found in males, neonatal hospitalization, psychiatric and family history of ADHD and the existence of a family dysfunctionment. CONCLUSION: Our prevalence is similar to the majority of those reported by studies conducted through the same methodology as ours. The etiology of ADHD is not unequivocal. The disorder appears to be multifactorial.