the physical deformity of microtia has a significant emotional impact for the patients.

To evaluate life satisfaction and health related quality of life in adolescents with grade III microtia before and one year after ear reconstructive surgery.

In a prospective cohort study, 20 adolescents (aged 13–18 years) with grade III microtia (group I) presenting for ear reconstructive surgery were compared with 20 matched, healthy, adolescents (group II) with regards to life satisfaction, health related quality of life and body image disturbance. Assessment was done using Students’ Life Satisfaction Scale (SLSS), pediatric quality of life inventoryTM version 4.0 (self and parent report) and Body Image Disturbance Questionnaire (BIDQ) respectively. These measures were repeated again to the patients 1 year after the surgery.

There were a significantly higher BIDQ, lower SLSS, total, psychosocial health summary, emotional functioning and social functioning (self and parent) mean scores (P<0.001) in group I compared with group II before the surgery. There was a significant improvement in life satisfaction, psychosocial health and body image disturbance in group I one year after the surgery (P<0.001). The improvement in body image disturbance was the only significant predictor for the improvement in life satisfaction (R2 = 0.52, B = −0.79 and P = 0.002) and psychosocial health (R2 = 0.56, B = −0.81 and P = 0.001).

Ear reconstructive surgery was found to be an effective operation that leads to improvement in body image disturbance with subsequent improvement in life satisfaction and psychosocial health.

Depression commonly co-occurs with rheumatoid arthritis (RA).

To assess the prevalence of depression, associated risk factors with depression and the impact of family support on depression in a sample of female patients with RA.

In a cross-sectional study, 100 female patients with RA were recruited in the study (mean age 39.98±7.4). Depression was diagnosed in those patients using the structured clinical interview for DSM-IV axis I disorders, clinical version (SCID-I-CV) and the Center for Epidemiologic Studies–Depression Scale (CES-D), family support was assessed using the Family Cohesion Subscale of the Family Environment Scale, physical disability was measured using the Health Assessment Questionnaire Disability Index (HAQ-DI) and the disease activity was measured using The’Disease Activity Score’ for 28 joints (DAS 28).

The prevalence of depression among female patients with RA was 24% (24/100), there was a significant association between increased severity of physical disability and increased risk and severity of depression (B = 0.87, P = 0.02, odds ratio = 2.39, CI, 1.1– 4.2 and B = 0.15, P = 0.03 respectively) and there was a non significant association between disease severity and risk for depression (B = 0.42, P = 0.4, odds ratio = 0.6, CI, 0.2–1.8). Higher level of family support was significantly associated with decreased severity of depressive symptoms (B = −0.29, P = 0.001).

Increased physical disability was associated with greater risk of depression in female patients with RA. Higher level of family support may have an important role in improving the depressive symptoms.

– évaluer et apprécier le type de demandes en soins psychiatriques émanant des services médico-chirurgicaux de l’hôpital central de l’armée Alger ;

– identifier les services les plus demandeurs et les motivations réelles des appels ;

– organiser et développer la psychiatrie de liaison à l’hôpital central de l’armée.

Étude prospective portant sur les appels inter-services réceptionnés par le médecin de garde du service de psychiatrie et provenant des divers services médico-chirurgicaux de l’HCA durée : 01 année (juillet 2013–juillet 2014). Fiche-questionnaire de 20 items.

Majority of the available studies have shown that children with sickle cell disease (SCD) have a higher risk of depressive symptoms

To assess the prevalence of depression in a sample of children with SCD and evaluate the association between various types of social support and depression, quality of life in those children.

120 children were included in the study, 60 of them (group I) with SCD and 60 were matched healthy control children (group II). Depression was assessed in both groups using ThesChildren's Depression Inventory (CDI), The Children's Depression InNntory-Parent (CDI-P) and the Diagnostic Interview Schedule for Children version IV (DISC-IV). The Pediatric Quality of Life Inventory version 4.0 generic core scales (Peds-QL 4.0) was used to assess the health-related quality of life (HRQOL) and social support was measured with the Child and Adolescent Social Support Scale (CASSS).

Eight children (13%) of the 60 children with SCD scored >12 on CDI (mean score 14.50±1.19), CDI-P (mean score 14.13±1.12) and diagnosed as having clinical depression using the diagnostic interview DISC-IV. HRQOL was poor in group I compared with group II, reflected by significantly lower mean scores in all domains of Peds-QL both in self and parent report (P>0.001). Increased levels of parent support was a significant predictor associated with decreased depressive symptoms and better quality of life in children with SCD (B= −1.79, P=0.01 and B=1.89, P=0.02 respectively).

Increased parent support was significantly associated with decreased depressive symptoms and better quality of life in children with SCD, so support intervention focusing on increasing parent support may be important as a part of treatment of depression in those children.

The concept of psychosomatic family, introduced by Minuchin, refers to some family organizations that maintain and reinforce psychosomatic symptoms in their members. The literature indicates that some family factors may lead to the emergence of somatic symptoms in a child or adolescent.

The main objective of this study is the case report of an adolescent with recurrent abdominal pain and its integration in the existing literature.

A 14 year old girl presented to the emergency department (ED) with recurrent abdominal pain. She had already been hospitalized and undergone exploratory laparoscopy surgery that excluded organic causes. During observation the pain relieved with the injection of saline solution, and the adolescent was discharged from the ED and referred for psychiatric consultation at the outpatient clinic of the Child and Adolescent Psychiatry Department. Regarding the adolescent family history, her parents divorced when she was 11 years old and her father was living in another country for 7 years, maintaining an increasingly scarce contact with the patient. The girl had feelings of abandon regarding her father.

There is evidence that, as in this case, the families of children with recurrent abdominal pain are usually matrifocal, and virtual paternal deprivation may play a role in predisposing the onset of somatoform disorders. We also found a disturbed mother-father-child relationship with the establishment of an alliance between the mother and the adolescent, which was one of the interactions identified by Minuchin as being associated with somatization in children or adolescents.

L’anhédonie, perte d’intérêt et de plaisir, est l’un des symptômes principaux de l’épisode dépressif majeur.

Analyser les caractéristiques et l’évolution de l’anhédonie chez les patients déprimés traités par agomélatine.

Mille cinq cent treize patients traités par agomélatine ont été inclus dans une étude non interventionnelle, pendant une période de 10 à 12 semaines avec des évaluations à l’inclusion, 6 et 10–12 semaines à l’aide des échelles QIDS-SR, MADRS, SHAPS, CGI et SDS.

À l’inclusion, les scores moyens QIDS-SR et MADRS étaient respectivement de 17,5 ± 4,2 et 32,7 ± 7,1. Le score SHAPS moyen était de 9,8 ± 3,6, et 86,8 % des patients avaient un score SHAPS > 5, considéré comme une anhédonie sévère. Le score total SDS était de 22,2 ± 4,6. À la dernière visite, les scores QIDS et MADRS avaient diminué respectivement de–11,1 ± 5,6 et de–21,3 ± 9,3, p < 0,0001. Les taux de réponse (amélioration de 50 % du score) étaient respectivement de 74,4 % et de 77,5 % à la QIDS et à la MADRS. Un pour centage de 48,2 % des patients étaient en rémission (QIDS-SR < 6) et 51,9 % avaient un score MADRS ≤ 10. Tous les sous-scores QIDS étaient significativement améliorés, principalement les items « humeur » et « implication dans les activités ». Le score à l’échelle SHAPS était diminué significativement :–7,0 ± 4,6 (p < 0,0001). L’amélioration du score SDS était significative (p < 0,0001) pour les trois dimensions. La corrélation entre l’amélioration de l’anhédonie et l’amélioration du fonctionnement était forte (r = 0,642 ; p < 0,0001).

La prévalence de l’anhédonie est élevée chez les patients déprimés. L’anhédonie est associée à la sévérité de la dépression et aux troubles fonctionnels. L’agomélatine améliore efficacement l’humeur, l’anhédonie et le fonctionnement.

Identifying the first presenting symptoms and determining the differences of the prodromal features of affective and non-affective psychosis were also important in discovering the psychotic break process [1].

43 adolescent patients (11 females, 32 males) who had been hospitalized within the first episode of psychosis were analyzed during a period of one year were analyzed for the first presenting symptoms. Prodromal symptoms were investigated retrospectively at the begining of the hospitalization. Mood disorders with psychotic features were included in affective psychosis (AP) group and the other psychotic disorders with unkown etiology were included in non-affective psychosis (NAP) group.

The most common first symptoms in descending order were dysphoric mood, sleep disturbance, ideas of reference for the AP group. In the NAP group, most common first symptoms were social withdrawal, dysphoric mood, ideas of reference. For the AP group; mean Duration of Untreated Psychosis (DUP) was 1,9 ± 1,2 weeks, mean Duration of Untreated Illness (DUI) was 24,6 ± 37,3 weeks. For the NAP group; mean DUP was 9,8 ± 15,5 weeks, mean DUI was 47,3 ± 55,9 weeks.

Affective and non-affective psychotic disorders have differences for prodromal presentations which may be clues for definitive diagnosis.

Our recent publication demonstrated that antipsychotic drugs (APDs) can modulate expression of RhoGDI in C6 glial cell line. RhoGDI is a key regulator of Rho proteins initiated signaling pathway. Activated Rho proteins can regulate gene transcription, cell cycle progression, vesicular trafficking, stress intracellular filament production and cell morphology. The studies of which glial cells involve in schizophrenia are important to understand the pathogenesis of this disease and the therapeutic mechanisms of antipsychotic drugs.

We examine the expression of RhoA mediated proteins in RhoGDI pathway in APD (haloperidol, risperidone and clozapine) treated C6 cells. The same works were also performed in APD-treated B35 neuronal cell line.

We tried to investigate and compare the APD induced the protein expression in APD-treated glial and neuronal cells.

Whole cell protein extracts from APD-treated cells were analyzed by Western Blot.

In C6 cells, RhoA expression could be increased by all three APDs. Both c-jun and p-JNK expressions were regulated by haloperidol and clozapine. Haloperidol and clozapine also decreased ROCK1 and MLC2 expressions. ARP2/3 expression was dramatically inhibited by all tree APDs. Only haloperidol inhibited PAK1 expression. N-WASP expression was not affected by any of the three APDs. In B35 cells, regulation of cjun and JNK expression were observed in risperidone- and clozapine-treated B35. Haloperidol increased ROCK and MLC2 expressions. Clozapine dramatically inhibit ARP2/3 expression. N-WASP expression was regulated by haloperidol and clozapine.

APDs induced protein expression regulations are similar but somewhat different in glial and neuronal cells.

La révision de la classification internationale des maladies (CIM) est une responsabilité constitutionnelle de l’Organisation mondiale de la santé (OMS). La CIM est une norme diagnostique internationale utilisée par les 194 États Membres de l’OMS pour recueillir des statistiques de santé. Le département de santé mentale et abus de substance est responsable de la révision du chapitre des troubles mentaux et du comportement qui répond à une large série d’applications cliniques, de santé publique, de politique et de statistiques. Cette révision s’inscrit dans un processus global, multidisciplinaire, multilingue, transparent et indépendant de l’industrie pharmaceutique. Avec environ 220 millions de locuteurs de français dans le monde, la participation des francophones à la révision est essentielle. Ainsi le centre collaborateur de l’OMS (CCOMS) pour la santé mentale de Lille s’est associé aux CCOMS de Casablanca, Genève, Montréal, l’hôpital Razi de Tunis et l’université américaine de Beyrouth pour créer un consortium francophone d’appui à la révision.

– promouvoir la participation de la communauté francophone à la révision ;

– maximiser l’utilité clinique de la classification ;

– garantir la participation des usagers et des aidants.

Il s’agit d’un projet international, participatif, multicentrique, impliquant professionnels de santé mentale et de soins primaires, usagers et aidants, mené de 2013 à 2015 et se déclinant en quatre missions :

– promotion de la participation des professionnels de santé mentale francophones au Réseau Mondial de Pratique Clinique ;

– traduction du matériel CIM de l’anglais vers le français ;

– mise en place d’études cliniques en francophonie pour tester la validité et l’utilité clinique de la classification ;

– création d’un réseau mondial d’usagers et d’aidants en vue de leur implication dans la révision ;

Ce projet permettra de valoriser dans la prochaine version de la CIM les spécificités francophones en associant toutes les parties prenantes.

We investigated clinical and sociodemografic features of mentally ill homicidal offenders without criminal responsibility to find out the predictors of homicidal criminal acts(1).

160 of the 197 cases, we could be able to contact and who were released from the forensic psychiatry clinic of the Bakirkoy Training and Research Hospital for Psychiatric and Neurological Diseases after mandatory inpatient treatment in 2006 were investigated with the treatment history for five years after release. 48 of the 160 cases, who were qualified for insanity defense had committed a homicidal crime. Sociodemgraphic variables and variables associated with disease are documented.

All of the homicidal offenders were male, they were more likely to be single or divorced, unemployed, were living in metropolitan areas and 83,3 % had a diagnosis of psychotic disorder, 14.6 % had a diagnosis of mood disorder. They usually had a legal guardian and had social insurance. Almost none of them had a history of regular psychiatric treatment before the criminal act.

At the homicidal offenders group, schizophrenia and other psychotic disorders were more prevelant, comorbidity was rare.

To define treatment adherence and criminal history before and after the mandatory treatment of homicidal patients and_correlation of these variables with the severity of the criminal act.

160 of the 197 cases, we could be able to contact and who were released from the forensic psychiatry clinic of the Bakirkoy Training and Research Hospital for Psychiatric and Neurological Diseases after mandatory inpatient treatment in 2006 were investigated for treatment adherence and criminal history for five years after release. Criminal Violence Rating Scale is used.

30% of the 48 patients who committed homicidal acts, had criminal history prior to the mandatory treatment and these were usually severe violent criminal offenses targeting directly at the victim's life and 14,5 % of them committed more than a criminal act before the homicidal act. After the mandatory inpatient treatment, the homicidal offenders were more likely to be kept in the mandatory outpatient treatment programme in comparison to the non-homicidal patients (87,6 % and 64,3 % respectively). 41,7 % of the homicidal offenders had been rehospitalized. Mean duration of mandatory treatment was 510 days and 148 days for the homicidal and non-homicidal patients respectively.

The number of criminal offences and number of re-hospitalizations were not significantly different between the homicidal and nonhomicidal patient groups. As a consequence of risk reduction strategies the homicidal patients were internalized longer in terms of mandatory treatment and after the release, their control assessments were done at shorter intervals.

Dans le cadre du développement de la classification internationale des maladies (CIM-11), les groupes de travail ont développé des propositions avec pour objectif d’améliorer l’utilité clinique de la classification. Ces propositions sont testées via la plateforme internet « Réseau Mondial de Pratique Clinique (RMPC) » permettant de conduire à des études cliniques électroniques dans les langues officielles de l’OMS, dont le français. Cette étude s’intéresse aux catégories diagnostiques des troubles de l’alimentation et des conduites alimentaires (TCA). Des nouveaux diagnostics ont été proposés tels que le trouble d’hyperphagie et le trouble d’évitement et de restriction de l’apport alimentaire.

– évaluer l’impact des changements spécifiques des TCA entre la CIM-10 et la CIM-11 auprès des membres francophones du RMPC ;

– évaluer la validité, l’utilité clinique des nouvelles propositions et l’accord inter-juges des participants.

Étude mixte, internationale, conduite par internet auprès des membres francophones du RMPC.

Membres du RMPC maîtrisant le français (environ 1000 professionnels) et exerçant une activité clinique.

La population cible recevra un email d’invitation. Les participants seront amenés à lire deux vignettes puis à poser des diagnostics et à répondre à des questions complémentaires, en se basant sur la CIM-10 ou la CIM-11 qu’ils auront reçu de façon aléatoire.

Les vignettes représenteront des cas cliniques réels et reflèteront les changements spécifiques entre la CIM-10 et la CIM-11. Elles seront ainsi présentées par pair (8 pairs possibles).

Comparaisons :

– interparticipants portant sur l’utilisation du système diagnostique (10 ou 11) et l’attribution du diagnostic en fonction des changements spécifiques ;

– intra-participant sur l’évaluation des pairs de vignettes.

Cette étude doit permettre d’évaluer les nouvelles propositions CIM en français, en tenant compte des spécificités culturelles et linguistiques de la francophonie.

Patients with criminal history and without criminal responsibility under compulsory treatment at the forensic psychiatry unit of Bakirköy Research and Training Hospital for Psychiatric and Neurological Diseases are included in the study and the relationship of various parameters like sociodemographic and clinic features and forensic histories are compared with the duration of the hospitalization (1,2).

One-hundred five schizophrenic patients are included to the study. Patients were divided into three different groups according to the duration of hospitalization. Each group included 35 patients: 1. Group: 2–6 months, 2. Group: 1–3 years, 3. Group: more than 3 years of time. An Interview Form of the Unit Identifying Sociodemographic Properties, Disease and Criminal Characteristics of the Patients, Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Three Components of Insight, Calgary Depression Scale for Schizophrenia and the Perceived Social Support Scale of the Family were applied.

Our data indicated that to be convicted before, to be under compulsory treatment before, severity of the criminal act and the level of insight seem to associate with duration of hospitalization of schizophrenic subjects under compulsory treatment. Besides parameters like the age of onset of schizophrenia, being under guardianship and the frequency of visitors were statistically different among the groups.

Our data underlines the importance of the level of insight, which plays a crucial role at the length of hospitalization for patients with schizophrenia in forensic units.

La prévalence du syndrome métabolique est nettement plus élevée chez les patients schizophrènes que dans la population générale, pouvant atteindre 41 % [1]. Par ailleurs, il est responsable d’un risque cardiovasculaire accru [2] ainsi que d’une augmentation du risque de diabète de type 2. Ainsi, la mortalité totale est deux à trois fois plus élevée chez les personnes souffrant de schizophrénie [3].

Obtenir une prévalence du syndrome métabolique dans une population de schizophrènes suivis en ambulatoires et évaluer la qualité de l’identification de ce syndrome ainsi que de sa prise en charge.

Des patients schizophrènes, sous antipsychotiques depuis au moins 3 mois, ont été inclus lors d’une première consultation par leur psychiatre traitant dans le cadre de leur suivi habituel. Des mesures comprenant un bilan biologique (HDLc, glycémie, triglycérides…), la passation d’un entretien diagnostique structuré (le MINI), des mesures cliniques (tension artérielle, tour de taille, etc) ont été réalisées. Les patients ont été revus lors d’une seconde consultation par leur psychiatre traitant avec les résultats du bilan biologique. Enfin, nous avons effectué une hétéro-évaluation des pratiques professionnelles.

Vingt et un patients ont été inclus dans l’étude, 3 ont été perdus de vue. La prévalence du syndrome métabolique s’élève à 38,9 %. Par ailleurs, 22,2 % des sujets répondent à 2 critères de la définition du syndrome métabolique. Seulement 42,9 % des syndromes métaboliques étaient bien identifiés par les psychiatres. L’action la plus fréquemment mise en place était les règles hygiéno-diététiques (71,4 % chez les patients avec syndrome métabolique). Enfin, aucun patient ne bénéficiait d’un suivi tensionnel et très peu d’un suivi du bilan biologique (28,6 % chez les sujets avec syndrome métabolique et 54,5 % chez les sujets sans syndrome métabolique).