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1.
Sante Publique ; 29(2): 255-262, 2017 Apr 27.
Artigo em Francês | MEDLINE | ID: mdl-28737344

RESUMO

Aim: This study was designed to assess the prevalence of alcohol consumption and factors associated with alcohol consumption among students of the Sousse region of Tunisia. Methods: This was a cross-sectional study conducted among 556 students of Sousse universities during the 2012-2013 academic year, using an anonymous self-report questionnaire. Data capture and statistical analysis were performed with SPSS software 18.0. Results: Our study population was composed of 268 males (48.2%) with a mean age of 21.8 ± 2.1 years. Eighty-four students (15.1%) had consumed alcohol at least once. On multivariate analysis, male gender (OR = 6.94; 95%CI = [2.32-20.72]), smoking (OR = 13.21; 95%CI = [6.20-27.78]), drug use (OR = 32.22; 95%CI = [6.73-154.26]) and parental alcohol consumption (OR = 4.31; 95%CI = [1.70-10.91]) were the factors significantly associated with alcohol consumption among students. Conclusion: This study was designed to determine the characteristics of alcohol consumption among Tunisian students. Alcohol consumption levels were comparable to those reported in the general population and were significantly related to smoking and drug use. The next step of this study will consist of developing strategies to prevent risk behaviours in the student population.


Assuntos
Consumo de Álcool na Faculdade , Consumo de Bebidas Alcoólicas/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Tunísia/epidemiologia , Adulto Jovem
2.
Tunis Med ; 94(1): 60-5, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27525607

RESUMO

BACKGROUND: Medication non-adherence is a major problem in patients with bipolar disorder as it is associated to poor clinical outcomes with frequent relapses and consequently poor quality of life. The reasons that patients are non adherent with medication are not well understood by clinicians who often consider it as related to the illness itself.    AIMS: To assess sociodemographic, clinical and therapeutic factors related to medication compliance in bipolar disorder. METHODS: A cross-sectional study was conducted at the department of psychiatry of FarhatHached Hospital of Sousse. We included 50 outpatients with bipolar disorder type I or II according to the criteria of the DSM-IV TR. The sociodemographic, clinical and therapeutic data were collected and adherence was evaluated with the Medication Adherence Report Scale (MARS) of Thompson. RESULTS: The mean age of our patients was of 31.9 years. The most frequent diagnosis was the bipolar disorder type I (60 %). Most of the participants were single (n=30; 60%), unemployed and living with their families. Factors associated to medication non-adherence were: young age, addiction, complexity and adverse effects of medications, lack of information about the disease and utility of treatments, low income and type I of bipolar disorder. CONCLUSION: Improving medication compliance strategies in bipolar patients must take into account psycho education of patients about their disease and simplification of prescriptions that must be also well tolerated mainly in young subjects, having addictive behaviors and low income.


Assuntos
Transtorno Bipolar/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Antipsicóticos/uso terapêutico , Transtorno Bipolar/classificação , Estudos Transversais , Feminino , Letramento em Saúde , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto Jovem
3.
Tunis Med ; 93(5): 297-301, 2015 May.
Artigo em Francês | MEDLINE | ID: mdl-26578046

RESUMO

BACKGROUND: The prevalence related to alcohol use disorders in adults is 1.7%. It varies around the world. In Tunisia, as in most Arab and Muslim countries, alcohol consumption is still a taboo and little studied. AIMS: To estimate the prevalence of alcohol abuse and dependence Band to assess associated socio-demographic factors in primary care patients in Sousse governorate. METHOD: It's a descriptive study carried out between June and November 2006. The sample included 30 primary care units in Sousse governorate, chosen by a stratified random method. We used the Composite International Diagnostic Interview (CIDI 2.1) translated and validated in Tunisian dialect. RESULTS: Our sample included 2577 participants. The lifetime prevalence of alcohol abuse and during the last 12 months were 2.8% and 1%. Those of alcohol dependence were respectively 0.7% and 0.3%. Only one case of alcohol abuse was found among women and no cases of dependence have been noticed. For men's, the prevalence of alcohol abuse at the lifetime and during the last 12 months were 12.8 % and 4.5 %. For men's alcohol dependence, prevalence rates were 3% and 1.6 %. Associated factors with abuse or alcohol dependence were studied in men's sample (n=560). Alcohol abuse was more common after multivariate logistic regression in the age group betwen18 and 34 years and in those with a diploma. Alcohol dependence was associated with only high level of education. CONCLUSION: Our study provides further evidence that alcohol abuse and dependence in primary care remain low compared to other international studies and highlights the role of primary care physicians in the screening of these health problems especially among men.


Assuntos
Alcoolismo/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Tunísia/epidemiologia , Adulto Jovem
4.
Int J Clin Pharm ; 37(6): 992-5, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26373547

RESUMO

CASE PRESENTATION: Mr. S is a 32-year-old male with schizophrenia. Due to poor responses to various antipsychotic medications, he was started on clozapine with the dose titrated to 300 mg/day during a 4-week period. The weekly checks of the complete blood cell count showed gradual increases in the eosinophil count from normal values to 4320 per mm(3). Mr. S did not have any symptoms except some increased salivation. Clozapine was suspended, and eosinophils gradually began to decline to the normal range. Clozapine was subsequently re-started and there were no changes in eosinophil counts. Mr. S exhibited improvement of symptoms but complained of acute auricular pain and increased salivation, 8 weeks after clozapine rechallenge. He also developed a swelling of his both parotid glands. The diagnosis of clozapine-induced parotitis was suggested. Symptomatic medication was prescribed with a favorable outcome. CONCLUSION: We report a case of a patient who developed eosinophilia shortly after clozapine use, and then developed parotitis. There is debate in the literature over how to manage these complications of clozapine treatment. Generally they do not warrant clozapine discontinuation.


Assuntos
Antipsicóticos/efeitos adversos , Clozapina/efeitos adversos , Eosinofilia/induzido quimicamente , Parotidite/induzido quimicamente , Adulto , Antipsicóticos/uso terapêutico , Clorpromazina/uso terapêutico , Clozapina/uso terapêutico , Humanos , Contagem de Leucócitos , Masculino , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico
5.
Compr Psychiatry ; 56: 69-74, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25270281

RESUMO

BACKGROUND: Non-adherence to treatment in patients with schizophrenia is associated with increased hospitalization, higher health care costs, and poorer long-term outcomes in terms of relapse rates. It is established that a negative drug attitude was a risk factor for non-adherence in long-term schizophrenia. The scale "Drug Attitude Inventory" is one of the scales designed to assess this concept. It has been translated and validated in different languages. However, its psychometric properties have not yet been studied in our sociocultural context. OBJECTIVES: The aims of this study were to translate into Tunisian Arabic dialect the scale "Drug Attitude Inventory" with 30 dichotomous items (DAI-30) and validate it in Tunisian sociocultural context in patients with schizophrenia. MATERIALS AND METHODS: This study was performed in 234 outpatients with schizophrenia, recruited through a random drawing. These patients are in remission and meet remission criteria proposed by "The Remission in schizophrenia Working Group". We recruited 30 patients for pretest and 204 patients for linguistic validation. Forward and backward translation of the DAI-30 was performed according to the protocol of the "MAPI Research Institute". This final version was submitted to 24 experts and followed by a pretest. Construct validity has been established by performing a principal component analysis factor on a sample of 204 patients. Internal consistency was assessed by Cronbach alpha coefficient and inter-rater reliability was assessed by the use of Intra-Class Correlation coefficient (ICC). For the test-retest reliability evaluation, the "r" Pearson's coefficient was used between the DAI scores obtained in the initial evaluation and those obtained at 15 days. RESULTS: Regarding construct validity, factor analysis revealed seven factors that were responsible for 59.9% of the variance. The study of internal consistency between the 30 items was rated good (α=0.88). The test-retest reliability was satisfactory (r=0.99, p<10(-3)), as well as inter-rater reliability (ICC=0.99). CONCLUSION: In the Tunisian cultural context, the DAI-30 presented seven factors with good consistency and an inter-rater reliability.


Assuntos
Atitude , Cultura , Psicologia do Esquizofrênico , Adulto , Antipsicóticos/uso terapêutico , Comparação Transcultural , Feminino , Humanos , Idioma , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Variações Dependentes do Observador , Pacientes Ambulatoriais , Análise de Componente Principal , Reprodutibilidade dos Testes , Tunísia
7.
Saudi J Kidney Dis Transpl ; 25(3): 605-9, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24821159

RESUMO

We report a case of a 41-year-old man suffering from paranoid schizophrenia. The patient has been consulting in our psychiatric hospital since he was 29 years old. Eight years later, he developed kidney failure and required peritoneal dialysis. After more than two years, the nephrology team indicated a renal transplantation and his brother suggested giving his kidney. There were no obstacles for transplantation in the immune and histological compatibilities; the psychiatric staff decided to check the patient's compliance with medication. The patient was compliant to all his medications and to the salt-free diet after the transplant operation. Few weeks later, he developed steroid-induced diabetes. Through the last two years, he had psychotic exacerbations with major anxiety and fear of losing the transplant. These relapses were managed by increasing doses of antipsychotics without need for hospitalization. At the present time, three years after transplantation, the nephrologists are decreasing the immunosuppressive agents and the steroids. The renal function is optimum and the diabetes is stabilized. This case exemplifies the potential for schizophrenic patients to undergo renal transplantation and to comply with follow-up medical care through a close cooperation between the patient's family, the psychiatric staff and the nephrology team.


Assuntos
Transplante de Rim , Insuficiência Renal/cirurgia , Esquizofrenia Paranoide/complicações , Adulto , Antipsicóticos/uso terapêutico , Comportamento Cooperativo , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Imunossupressores/uso terapêutico , Comunicação Interdisciplinar , Transplante de Rim/psicologia , Doadores Vivos , Masculino , Adesão à Medicação , Equipe de Assistência ao Paciente , Diálise Peritoneal , Relações Profissional-Família , Insuficiência Renal/complicações , Insuficiência Renal/diagnóstico , Esquizofrenia Paranoide/diagnóstico , Esquizofrenia Paranoide/tratamento farmacológico , Esquizofrenia Paranoide/psicologia , Psicologia do Esquizofrênico , Fatores de Tempo , Resultado do Tratamento
8.
Compr Psychiatry ; 55(6): 1473-7, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24850067

RESUMO

BACKGROUND: Sexual dysfunction is frequent in patients with schizophrenia compared to the general population. Screening for this dysfunction seems essential, and a scale such as the Arizona Sexual Experience (ASEX) Scale may help practitioners. The aim of this study was to assess the validity of the Arabic version of the ASEX scale. METHOD: Arabic translation of the ASEX scale was obtained by the "forward/backward translation" method. Adaptations were made after a pre-test including ten outpatients with schizophrenia. For validation, one hundred outpatients with schizophrenia were recruited in the psychiatric department in Sousse (Tunisia) during a period of three months. Internal consistency was assessed by Cronbach alpha coefficient and test-retest was conducted by use of Pearson correlation. For factor analysis, principal components analysis and Varimax rotation were adopted. RESULTS: The study of internal consistency between the 5 Items was found to be good (α=0.82). The test-retest reliability was satisfactory (r=0.92, p<10(-3)). Regarding construct validity, factor analysis revealed one factor that was responsible for 83.7% of the variance. CONCLUSION: This study assessed the reliability and validity of the Arabic version of the ASEX scale. These findings demonstrate the highly acceptable psychometric properties of ASEX in patients with schizophrenia.


Assuntos
Árabes , Psicologia do Esquizofrênico , Comportamento Sexual , Inquéritos e Questionários/normas , Traduções , Adulto , Arizona , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/psicologia , Pacientes Ambulatoriais/estatística & dados numéricos , Psicometria , Reprodutibilidade dos Testes , Autorrelato/normas , Tunísia
9.
Compr Psychiatry ; 55(4): 1050-4, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24636191

RESUMO

BACKGROUND: The Schedule for the Assessment of Insight-Expanded Version (SAI-E) consists of 11 items that encompass: awareness of having a mental illness, ability to rename psychotic phenomena as abnormal, and compliance with treatment. AIMS: To translate into Arabic and validate the Tunisian version of this instrument. METHOD: The Arabic translation of the SAI-E was obtained by the "forward/backward translation" method. Adaptations were made after a pilot study involving 20 outpatients with schizophrenia and after taking account the opinions of 15 experts in psychiatry. For validation, 150 outpatients suffering from schizophrenia were recruited by a random drawing in the psychiatric department in Sousse (Tunisia). For factor analysis, principal components analysis and Varimax rotation were adopted. Convergent validity was assessed by correlating the translated scale with the G12 item (lack of judgment and awareness of the disease) of the positive and Negative Syndrome Scale (PANSS). Internal consistency was assessed by Cronbach alpha coefficient and inter-rater reliability was assessed by the use of intra-class correlation coefficient (ICC). RESULTS: Regarding construct validity, factor analysis revealed three factors that were responsible for 70.2% of the variance. As for concurrent validity, we found a negative correlation between the score of the SAI-E and that of the G12 item of the PANSS (r=- 0.82 and p<10(-3)). The study of internal consistency between the 11 items was found to be good (α=0.82). The test-retest reliability was satisfactory (r=0.8, p<10(-3)), and so was inter-rater reliability (ICC=0.84). CONCLUSION: In the Tunisian cultural context, the SAI-E presented three factors with good consistency and an inter-rater reliability compatible with the insight dimensions that are intended to be evaluated.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Escalas de Graduação Psiquiátrica , Psicologia do Esquizofrênico , Traduções , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Projetos Piloto , Psicometria , Reprodutibilidade dos Testes , Tunísia , Adulto Jovem
10.
Tunis Med ; 90(4): 311-5, 2012 Apr.
Artigo em Francês | MEDLINE | ID: mdl-22535346

RESUMO

BACKGROUND: The prevalence of cigarette smoking is significantly higher among patients with schizophrenia than in the general population. Several authors explained this excess of smoking by the self-medication hypothesis. It suggests that patients with schizophrenia smoke to reduce psychotic symptoms or antipsychotic side effects. AIM: In this study, we aimed to evaluate the prevalence of tobacco consumption in patients with schizophrenia and to test if smoking reduces psychotic and extra-pyramidal symptoms. METHODS: We included 115 patients with schizophrenia (DSM IV) treated with conventional antipsychotics. We assessed psychotic symptoms with the Positive and Negative Syndrome Scale (PANSS) and extrapyramidal symptoms with the Simpson-Angus scale. RESULTS: Prevalence of smoking was 60% (80% in men and 22.5% in women). The majority of them started their consumption before their illness. Smokers and non-smokers had similar rates of psychotic and extrapyramidal symptoms with comparable doses of antipsychotics and anticholinergic agents which were prescribed for similar durations. CONCLUSION: In this study, patients with schizophrenia smoke a lot for reasons other than reducing psychotic or extrapyramidal symptoms.


Assuntos
Psicologia do Esquizofrênico , Fumar/psicologia , Adulto , Antipsicóticos/uso terapêutico , Estudos Transversais , Feminino , Humanos , Masculino , Esquizofrenia/tratamento farmacológico
11.
Tunis Med ; 89(10): 774-8, 2011 Oct.
Artigo em Francês | MEDLINE | ID: mdl-22076901

RESUMO

BACKGROUND: Acupuncture is one of the most popular types of complementary/alternative medicine in the world. It is sometimes used as a treatment for schizophrenia mainly in China. AIM: To assess the contribution of acupuncture in the treatment of patients treated for schizophrenia in Tunisian population. METHODS: Our study is a clinical randomized trial about 31 hospitalized patients with schizophrenia or schizo-affectif disorder (DSM IV). They were evaluated by the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS) the first and 23nd day of the study. Manual acupuncture was used for 10 sessions at the rate of three sessions per week. All patients were under drug therapy. Among them, 15 were treated by acupuncture and 16 by sham acupuncture. RESULTS: Scores of the PANSS, SAPS and SANS were similar in the two groups at the end of the study. CONCLUSION: Our study did not provide any evidence for the effectiveness of acupuncture in treating schizophrenic symptoms.


Assuntos
Terapia por Acupuntura , Esquizofrenia/terapia , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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