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Biomedical subjects

S Douki

Publications and source records attributed to S Douki.

16 recordsLinked to original sources
PubMed2006

A double-blind randomised comparative trial of amisulpride versus olanzapine for 2 months in the treatment of subjects with schizophrenia and comorbid depression.

PURPOSE: To compare the efficacy and safety of amisulpride and olanzapine in subjects with schizophrenia and comorbid depression in a randomised double-blind trial. PATIENTS: Eighty-five adult patients fulfilling DSM-IV criteria for schizophrenia and presenting a depressive episode were randomised to amisulpride (200-600 mg/day) or olanzapine (5-15 mg/day) for 8 weeks. Primary efficacy variables were change in Calgary Depression Scale (CDS) score and Clinical Global Impression (CGI) of Change. Safety was monitored by adverse event reporting and determination of extrapyramidal function and metabolic variables. RESULTS: The mean change from baseline of CDS score was -6.84 in the amisulpride group and -7.36 in the olanzapine group. 65.9% and 61.5% of subjects, respectively, were considered "much" or "very much" improved. No significant inter-group difference in effect size was observed. The frequency of adverse events was low and emergence of extrapyramidal symptoms was not seen. Four patients in the olanzapine group developed abnormal triglyceride levels. Mean weight gain was 1.45 and 0.5 kg, respectively, in the olanzapine and amisulpride groups. CONCLUSION: Amisulpride and olanzapine are effective in patients with schizophrenia and comorbid depression. Tolerance of both drugs was acceptable, although use of olanzapine was associated with a trend toward greater metabolic side-effects .

Adult↗
PubMed2003

Violence against women in Arab and Islamic countries.

In Arab and Islamic countries, domestic violence is not yet considered a major concern despite its increasing frequency and serious consequences. Surveys in Egypt, Palestine, Israel and Tunisia show that at least one out of three women is beaten by her husband. The indifference to this type of violence stems from attitudes that domestic violence is a private matter and, usually, a justifiable response to misbehaviour on the part of the wife. Selective excerpts from the Koran are used to prove that men who beat their wives are following God's commandments. These religious justifications, plus the importance of preserving the honour of the family, lead abusers, victims, police and health care professionals to join in a conspiracy of silence rather than disclosing these offences. However, a fair reading of the Koran shows that wife abuse, like genital mutilation and "honour killings" are a result of culture rather than religion.

Arabs↗
PubMed1999

[Therapeutic strategies in the first psychotic episode].

A first psychotic episode includes a wide range of disorders with different outcomes: schizophrenia, bipolar disorder, schizophreniform disorder, schizoaffective disorder, drug-induced psychosis, brief reactive psychosis, organic psychoses and delusional disorder. The course and outcome of a first psychotic episode is greatly dependent on its initial management. Major clinical, etiopathogenic and therapeutic advances have been achieved in this field and have allowed specific management strategies to be adopted. The primary task of therapists involved in the management of patients who have experienced a first episode of psychosis is promotion of recovery and prevention of secondary morbidity, relapse and persistent disability. The main guidelines of an early psychosis management are:--to keep in mind that early psychosis is not early schizophrenia. Thus, clinicians and therapists should avoid an early diagnosis of schizophrenia. Diagnosis in early psychosis can be highly unstable. A diagnosis of schizophrenia, with its implications of pessimism, relapse and disability, does not contribute anything positive in terms of guiding treatment. On the contrary, such a diagnosis may damage the patient and family by stigmatizing them and affecting the way they are viewed and managed by healthcare professionals.--To integrate biological, psychological and social interventions: effective medications is useful in reducing the risk of relapse, but is not a guarantee against it. Psychological and social interventions can greatly help promote recovery.--To tailor the various strategies to met the needs of an individual: as an example, it is important to formulate appropriate strategies for the different stages of the illness (prodromal phase, acute phase, early recovery phase and late recovery phase) because patients have different therapeutic needs at each stage.--In the acute treatment, not to concentrate on short-term goals in indicating antipsychotic treatment: prescribing principles for first-episode psychosis are to maximise benefit and minimise side effects because the first experience of medication may influence a patient's future attitudes of therapy of all types. Effective strategies which may reduce long-term morbidity and improve recovery are currently available but their implementation is too often delayed. The time lag between the onset of symptoms and the start of treatment can be many months or years and this delay can have serious consequences. The critical period of the first 2-5 years after the first psychotic episode is a time of maximum vulnerability and of maximum opportunity. Consequently, actions should be undertaken to promote early recognition and assistance in psychotic disorders: understanding of the factors that may cause delay in treatment can help minimise this problem and lead to the initiation of appropriate treatment at the earliest opportunity. Training the general practitioners who have an important part to play in the early recognition is also of crucial importance.

Acute Disease↗
PubMed1999

[Psychopathological and psychotherapeutic approach to the first psychotic episode].

The studies and research on the psychopathology of delusions are extremely numerous and varied and have resulted in the construction of psychoanalytic, systemic, cognitive and other explanatory models. All the theories stress the interaction between the subject and his/her environment, in particular when an initial psychotic episode emerges. In addition to their etiopathogenic interest, these models have the advantage of constituting specific therapeutic approaches, which indubitably increase the impact of treatment when associated with chemotherapy.

Family↗
PubMed1995

[Depression and cancer. Results of an initial study of 707 patients].

Within a multifactorial etiology of cancers and a bio-psycho-social approach of patients, considering, among the risk factors, those related to personality in a preventive view, the authors investigate, by an epidemiologic methodology, for a correlation between break-down phenomena and the development of a cancer. The study was carried out at the Salah Azaïez Institute in 1992 and included 707 patients aged from 15 to 82 years, 44% presenting a malignant tumour. For a retrospective evaluation of break-down semiology, the study is based on DSM-III criteria of break-down diagnostic. Search for a clinic/psychic diagnostic relation reveals the difficulty of coexistence between break-down signs and the development of a cancer. That difficulty increases in case of an organised break-down.

Adolescent↗
PubMed1993

[Problems posed by medico-psychiatric emergencies in Tunisia].

The writers are interested in the consequences resulting from dividing emergencies into medico-surgical and psychiatric emergencies which would concern the efficiency of first aid to the cases where ther's an interference between medical and psychiatric disorders. Three situations will be envisaged and commented upon according to examination medico-surgical emergencies with a psychiatric expression, medico-surgical emergencies of the mentally-ill patient and psychiatric emergencies with a medico-surgical expression. The authors conclude by showing the interest of simultaneously taking into account both the somatic and the psychiatric fields. This would implicate a larger collaboration between somatic physician and psychiatric physician.

Adult↗
PubMed1988

[Epidemiology of tardive dyskinesias in the Maghreb].

The most prescribed type of psychotropic medication in maghrebian psychiatry is neuroleptics. It is therefore legitimate to study the epidemiology of the most frequent side-effect of long-term treatment with neuroleptics: Tardive Dyskinesia (TD). At the moment, a collaborative study is under way on epidemiology of TD within the framework of the Maghrebian Association of Biological Psychiatry; several studies have also been conducted on this topic in the University Psychiatric Centre Ibn Rochd, Casablanca, Morocco in 1984, 1986 and 1987. For the maghrebian study, only preliminary results from Tunis will be presented. These studies have been interested in two epidemiological aspects: prevalence of TD in hospitalized and out-patients treated with neuroleptics; prevalence of TD-like movements among never treated schizophrenics. The assessment tool used for all the studies was the Abnormal Involuntary Movement Scale (AIMS). Main results of these studies are: 1) General prevalence of TD and risk factors in neuroleptized patients: In Tunis, Douki and Benamor in their on-going study, found a general prevalence of 20.50% (N = 200 in patients). A multi-factor analysis showed that risk factors are (in decreasing order): female gender, age above 60, associated depression, total duration of neuroleptic treatment above 20 years, a frequently discontinued treatment, shock therapies in antecedents or associated, a diagnosis of non schizophrenic psychosis, haloperidol intake below 25 mg and fluphenazine depot above 100 mg daily. In Casablanca, in 1984, Chorfi found a general prevalence of 10% (N = 50 out-patients). In 1986, Bentounsi found a 14.50% prevalence in Casablanca (N = 400 out-patients) and 63.97% in the oldest psychiatric hospital in Morocco in Berreshid (N = 605 in-patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Influence of personality disorder on the course of manic-depressive illness].

In these past years, comorbidity of manic-depressive illness with personality disorders were the subject of many studies. In order to study the influence of personality disorder on the course of the disease, the authors have compared a group of manic depressive patients with personality disorders to an other group of manic depressive patients without personality disorders. The comparison between the outcome and prognosis of each group has leaded to the conclusion that manic depressive patients with personality disorders evaluate worse than those without personality disorders: they are more often hospitalized and have more suicide attempts, they are more vulnerable to stress factors and finally they have low scores on the Global Assessment of Functioning scale (GAF).

Adolescent↗
PubMedDate not supplied

[Plea for benzodiazepines or is there a future for benzodiazepines in psychiatry?].

Thirty years ago chlordiazepoxide was used in psychiatry for the first time. Benzodiazepines, a therapeutic class with a large spectrum of activities, are now used regularly by 5 to 15% of adults. In France 15% of prescriptions include at least 1 benzodiazepine and 5 compounds of this class appear among the 30 most frequently prescribed of state reimbursed medications. In a developing country like Tunisia sales of psychotropic drugs increased by 84% between 1984 and 1987, benzodiazepines representing half of the prescriptions. Criticisms were voiced as early as in the years 1970. Ralph Nader himself led a campaign against those drugs used in suicidal attempts, provoking car accidents and industrial injuries, memory deficits and dependence. Later, several side effects were pin-pointed: amnesia, which has been used with criminal intent in a few dramatic cases; in fact it should be differentiated from the cognitive troubles resulting from anxiety itself; tolerance: for instance in drug addicts using high doses; it concerns only some effects of the drug; dependence: which remains rare when contrasted with the large consumption of benzodiazepines; withdrawal reaction should be differentiated from teh relapse of anxiety once the drug has been discontinued. In the public opinion one is supposed to bear any pain--and never complain--when it is psychic and not somatic. Benzodiazepines that alleviate psychic pain were considered with spite and then grudge, to use the terminology of erotomania. Actually, benzodiazepine treatment should be a part of a larger therapeutic program taking into account the characteristics of each individual patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Benzodiazepines↗
PubMedDate not supplied

[Seasons of birth of schizophrenic patients. Retrospective study of a hospitalized population in Tunisia].

Epidemiological research concerning the seasons of births of schizophrenics show for the greatest part that there's an excess of births in winter and in the beginning of spring. Research about the environmental theories of schizophrenia suggest that there would exist one or many seasonal environmental factors affecting the foetus and the neonate, and which would be likely to increase the risk of a subsequent development of schizophrenia. As no research concerning this subject have been published so far in Africa, the writers propose to study the distribution of births of a population of schizophrenics born in Tunisia in comparison to the general population and to compare it to a group of patients hospitalized because of major affective disorders. The results achieved show a significant decrease in the number of schizophrenics births during the third trimester and an excess of births during the month of october, the risk being greater in the case of disorganized schizophrenia. The greater risk for people born in october to develop subsequently schizophrenia is not found in the case of major affective disorders but it is found rather in the case of schizo-affective disorders. More over, we notice a decrease in the number of births during the month of July for the patients presenting major affective disorders and for those presenting schizo-affective disorders. Results seem to demonstrate that there would exist seasonal environmental factors specific to North Africa which are likely to affect the subsequent appearance of schizophrenic disorders. A particular interest should be given to viral infectious to enteroviruses which are responsible for summer diarrhea in Tunisia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗