Patricide, Matricide: A Comparative Study Among Tunisian Patients With Psychotic Disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S459-S459 ◽  
Author(s):  
B. Ghajati ◽  
S. Ghezaiel ◽  
R. Chebbi ◽  
I. Berrahal ◽  
R. Ridha
Keyword(s):  
Comparative Study ◽  
Psychotic Disorders ◽  
Criminal Code ◽  
Professional Status ◽  
Significant Difference ◽  
Instructional Level ◽  
Tunisian Patients ◽  
Dsm Iv ◽  
Competing Interest ◽  
Conflictual Relationship

Parricide is defined as the homicide of a father or mother by a biological or adopted child. In adults, it is generally associated to a psychotic condition. Scientific research on the subject, have been mainly interested in matricide, patricide or double parricide. Studies comparing authors of patricide to those of matricide are rare.ObjectivesTo compare socio-demographic and clinical profiles of patricide and matricide patients.To compare modus operandi in matricide and patricide patients.MethodsA retrospective, descriptive and comparative study was conducted, based on medical charts’ consult. Were included patients suffering from psychotic disorders (DSM-IV), hospitalized in the forensic psychiatry department of Razi hospital between 1995 and 2015, after not being held for insanity according to article 38 of Tunisian Criminal Code. Only patients who committed patricide or matricide were included.ResultsOur sample included 26 patients (13 patricides; 13 matricides). There was non-significant differences between two groups concerning: instructional level (P = 0.277), professional status (P = 0.387) and marital status (P = 0.790). Committers of patricide and matricide did not differ in terms of psychiatric diagnosis (P = 0.242) and substance abuse (P = 0.550). A significant difference was found between the two groups in terms of schizophrenia subtypes, patricide patients suffered from a disorganized schizophrenia whereas matricide patients suffered from paranoid subtype (P = 0.05). Patricide was more frequently associated to a conflictual relationship between son and father (P = 0.05). We did not record a significant difference in the crime weapon or its motivations.ConclusionOur results helps draw a profile for parricide patients in order to help identify the ones at risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prescription profile of antipsychotics in inpatients with psychotic disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S612-S612
Author(s):  
M.D.C. García Mahía ◽  
Á. Fernández Quintana ◽  
M. Vidal Millares
Keyword(s):  
Psychotic Disorders ◽  
Treatment Resistance ◽  
Psychiatric Inpatients ◽  
Total Sample ◽  
Response To Treatment ◽  
Typical Antipsychotic ◽  
Concurrent Use ◽  
Significant Difference ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionPrevious studies of prescribing in psychiatric services have identified the relatively frequent use of combined antipsychotics in schizophrenia.Aims– To analyze the proportion of patients treated with more than one antipsychotic;– to study clinical as sociodemographic variables associated with types of prescription.MethodsRetrospective descriptive study of treatment prescribed to psychiatric inpatients treated in an acute care unit of Psychiatry Service in a large teaching hospital during a period of 3 years. Consecutively admitted inpatients receiving concurrent antipsychotics were compared with those treated with a single antipsychotic. Prescription drug records at discharging were revised, n = 263.ResultsFrom the total sample, 61% received more than one antipsychotic. The most common types of combinations were atypical plus a typical antipsychotic followed by two atypical antipsychotics, being less frequent combination of three or more antipsychotics. There were 19 different drug combinations. Concurrent antipsychotics were most frequently prescribed in schizophrenia and schizoaffective disorder. Patients with more previous episodes of illness received more frequently concurrent antipsychotics than patients with low number of previous episodes of illness (P < 0.03). Patients with longer time of hospitalization, and age between 30 and 50 years were treated more frequently with several antipsychotics. Analysis with other variables is presented in the study.ConclusionsThere is a significant difference in the strategies of treatment with antipsychotics depending on diagnosis and number of previous episodes of illness. The concurrent use of multiple antipsychotics in psychiatric inpatients appears to be a response to treatment resistance and is frequent in schizophrenic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Schizophrenia is not disappearing in south-west Scotland

2000 ◽  
Vol 177 (1) ◽  
pp. 38-41 ◽  
Author(s):  
J. Allardyce ◽  
G. Morrison ◽  
J. Van Os ◽  
J. Kelly ◽  
R. M. Murray ◽  
...  
Keyword(s):  
Rate Ratio ◽  
Psychotic Disorders ◽  
Linear Trend ◽  
Incidence Rates ◽  
South West ◽  
Significant Difference ◽  
Icd 10 ◽  
Dsm Iv ◽  
Over Time ◽  
Methodological Difficulties

BackgroundRecent work has reported a decline in the incidence of schizophrenia, but it is unclear if these findings reflect a true decrease in its incidence or are an artefact arising from methodological difficulties.AimsTo take account of these methodological difficulties and report service-based incidence rates for schizophrenia in Dumfries and Galloway in south-west Scotland for 1979–98.MethodUsing both clinical diagnoses and diagnoses generated from the Operational Checklist for Psychotic Disorders (OPCRIT) computer algorithm for ICD–10 and DSM–IV schizophrenia, we measured change in the incidence rates over time. We used indirect standardisation techniques and Poisson models to measure the rate ratio linear trend.ResultsThere was a monotonic and statistically significant decline in clinically diagnosed schizophrenia. The summary rate ratio linear trend was 0.77. However, using OPCRIT-generated ICD–10 and DSM–IV diagnoses, there was no significant difference over time.ConclusionsOPCRIT-generated consistent diagnoses revealed no significant fall in the incidence of schizophrenia. Changes in diagnostic practice have caused the declining rates of clinically diagnosed schizophrenia in Dumfries and Galloway.

Body dysmorphic disorder: Classification challenges and variants

2017 ◽  
Vol 41 (S1) ◽  
pp. S459-S459
Author(s):  
N. De Uribe-Viloria ◽  
A. Alonso-Sanchez ◽  
S. Cepedello Perez ◽  
M. Gomez Garcia ◽  
M. De Lorenzo Calzon ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Body Dysmorphic Disorder ◽  
Treatment Options ◽  
Obsessive Compulsive ◽  
Dsm 5 ◽  
Bibliographic Search ◽  
Dsm Iv ◽  
Competing Interest ◽  
Core Symptoms

IntroductionThe main feature of body dysmorphic disorder (BDD) is impairing preoccupation with a physical defect that appears slight to others. Previously, its delusional and nondelusional variants were sorted in two separate categories, but owing to new data suggesting that there are more similitudes than differences between them, DSM-5 now classifies both as levels of insight of the same disorder.ObjectivesTo enunciate the similarities and differences between the two variants of BDD.AimsTo better understand the features and comorbidity of BDD, so as to improve its management and treatment.MethodsTaking DSM-5 and DSM-IV-TR as a reference, we have made a bibliographic search in MEDLINE (PubMed), reviewing articles no older than 5 years that fit into the following keywords: body dysmorphic disorder, delusions, comorbidity, DSM-IV, DSM-5.ResultsBoth the delusional and nondelusional form presented many similarities in different validators, which include family and personal history, pathophysiology, core symptoms, comorbidity, course and response to pharmacotherapy.ConclusionsThe new classification of delusional and nondelusional forms of BDD as levels of insight of the same disorder, which places them closer to the obsessive-compulsive spectrum than to the psychotic one, not only improves treatment options, but also reinforces the theory that delusions are not exclusive of psychotic disorders, setting a precedent for the understanding and classification of other disorders with delusional/nondelusional symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A comparative study between the attachment styles of adults who were raised by mothers with schizophrenic disorders, depression, and those raised by mentally healthy mothers

2016 ◽  
Vol 33 (S1) ◽  
pp. S632-S633
Author(s):  
S. Hatam ◽  
D. Lea Baranovich
Keyword(s):  
Mental Disorders ◽  
Comparative Study ◽  
Attachment Style ◽  
Clinical Diagnosis ◽  
Attachment Styles ◽  
Secure Attachment ◽  
Maternal Psychopathology ◽  
Significant Difference ◽  
Spectrum Disorders ◽  
Competing Interest

IntroductionMaternal psychopathology can have a server effect on the ability of mothers to attach to their children.AimTo ascertain the level of attachment of adults between the ages of 18–25 years of age who were raised by mothers who suffer from schizophrenic disorders and depressive spectrum disorders, then compared to adults who were raised by mothers with no formal clinical diagnosis.MethodThis study used the Adult Attachment Questioner (AAQ), by Simpson Rholes Philips (1996) to ascertain the level of attachment of adults between the ages of 18–25 years of age who were raised by mothers who suffer from schizophrenic disorders (n = 30) and depressive spectrum disorders (n = 30). The findings of these two groups were then compared to adults who were raised by mothers with no formal clinical diagnosis (n = 30).ResultThe findings indicated that there is a significant difference between adults who were raised by mothers with the aforementioned mental disorders (schizophrenic and depression), as compared to those who were raised by mentally healthy mothers.ConclusionThe style of attachment in adults who were raised by mothers with the aforementioned clinical diagnosis (schizophrenic and depression) have insecure attachments, while the children who were raised by mentally healthy mothers have almost secure attachment style.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Paranoia: When criminology predicts vocational prognosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S586-S586
Author(s):  
B. Ghajati ◽  
G. Sahar ◽  
B. Imen ◽  
R. Rim
Keyword(s):  
Mental Health Professionals ◽  
Health Professionals ◽  
Forensic Psychiatry ◽  
Criminal Code ◽  
Delusional Disorder ◽  
Acting Out ◽  
Attempted Murder ◽  
Dsm Iv ◽  
Competing Interest ◽  
Disorder Type

Patients with paranoia have always been a group of exiting but daunting patients for mental health professionals. Indeed, the risk of a violent acting out with important aggressive discharges confers to these patients an elevated dangerosity potential. If various criminological aspects of violence in paranoia have been described, their link to functional prognosis of patients have been seldom addressed.AimTo determine if criminological details of violence acts in paranoia patients predict their functional prognosis.MethodsA retrospective, descriptive and analytic study have been conducted, based on a chart consult. Twenty-three patients with paranoia (i.e. Chronic delusional disorder type jealousy or erotomania in DSM IV) patients have been included. These patients have been hospitalized in the forensic psychiatry department of Razi hospital of Tunis (Tunisia), between 1995 and 2015, after not being held by reason of insanity, according to article 38 of the Tunisian Criminal Code.ResultsDelusional disorder types were: jealousy (17), persecution (4), erotomania (1) and claim (1). The majority were married (18), undereducated (17), with irregular work (13). Forensic acts were uxoricide (15), attempted murder (5), violence against people (2) and destruction of public properties (1). Patients used bladed weapon in most of the cases (13), in the victim's residence (19), with premeditation in (17) of the crimes. Only 5 patients worked regularly after discharge.ConclusionIf our results expose further data concerning potential dangerosity of patients with delusional disorders, they also highlight the marginalized situation of these patients when released back into society.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Association of cannabis use-related predictor variables and self-reported psychotic disorders: US adults, 2001-2002 and 2012-2013

2020 ◽  
Author(s):  
Ofir Livne ◽  
Dvora Shmulewitz ◽  
Aaron Sarvet ◽  
Deborah Hasin
Keyword(s):  
Psychotic Disorders ◽  
Cannabis Use ◽  
Therapeutic Interventions ◽  
Medical Cannabis ◽  
Cannabis Dependence ◽  
Epidemiologic Survey ◽  
Significant Difference ◽  
Dsm Iv ◽  
Cannabis Use Disorders ◽  
Over Time

Objective: To determine the association of cannabis use-related variables and self-reported psychotic disorders during two time periods (2001-2002; 2012-2013). Methods: Logistic regression was used to analyze data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2002; N=43,093) and NESARC-III (2012-2013; N=36,309). Among those with and without cannabis predictors (any and frequent [≥3 times a week] non-medical use, DSM-IV cannabis use disorders [CUD], cannabis dependence [CD]), standardized prevalence of past-year self-reported psychotic disorders were estimated. Association was indicated by within-survey differences in psychotic disorders by cannabis-related predictor status. Whether associations changed over time was indicated by difference-in-difference tests (contrasts between the surveys). Results: In both surveys, self-reported psychotic disorders were significantly more prevalent in those with than those without any non-medical cannabis use (2001-2002: 1.65% vs 0.27%; 2012-2013: 1.89% vs. 0.68%), with similar associations in both periods. Self-reported psychotic disorders were unrelated to frequent non-medical use in 2001-2002 but were significantly more prevalent in those with than without frequent non-medical use in 2012-2013 (2.68% vs. 0.71%), with no significant difference over time. In both surveys, self-reported psychotic disorders were significantly more prevalent in those with than without CUD (2001-2002: 2.43% vs. 0.30%; 2012-2013: 3.26% vs. 0.72%), with no significant differences in the associations over time. Self-reported psychotic disorders were unrelated to CD in 2001-2002 but were significantly more prevalent in those with than without CD in 2012-2013 (8.54% vs. 0.73%), showing a significantly stronger relationship in 2012-2013; similarly, among past-year non-medical cannabis users, the association was significantly stronger in 2012-2013. Conclusions: Cannabis-related variables, especially cannabis dependence, remain related to self-reported psychotic disorders. Therefore, clinicians should closely monitor cannabis-dependent users and assess the need for preventive and therapeutic interventions for these individuals.

Sexual dysfunctions and treatment compliance in individuals with psychotic disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S342-S342
Author(s):  
G. Unsal ◽  
S. Karaca ◽  
N. Onan ◽  
Y. Can Oz ◽  
S. Aydın ◽  
...  
Keyword(s):  
Sampling Method ◽  
Psychotic Disorders ◽  
Compliance Rate ◽  
Treatment Compliance ◽  
Sexual Problems ◽  
Sexual Dysfunctions ◽  
Significant Difference ◽  
Weak Negative Correlation ◽  
Competing Interest

IntroductionSexual dysfunctions are more common in individuals with psychotic disorders and has a major impact on both quality of life and compliance.ObjectivesThe purpose of this study is to investigate whether a relationship between sexual dysfunction and level of treatment compliance in individuals with psychotic disorders.MethodsThe sample group of the study consisted of 173 in-patients who agreed to participate were selected by random sampling method. The permission was obtained from the hospital's ethics committee. In this study, to assess the sexual functionality Golombok-Rust inventory of sexual satisfaction male and female form and to assess the treatment compliance; medical treatment compliance rate scale is used.ResultsWhen sexual problems and treatment compliance compared to gender, subscales of satisfaction (t = 4,423, P = 0.000), avoidance (t = 3.348, P = 0.001), touch (t = 2.165, P = 0.032) and overall total (t = 4.015, P = 0.000), although a statistically significant difference was found, there were no differences in treatment compliance. Aditionally, there is no relation between sexual problems and treatment compliance in men. It is also found that there is a weak negative statistical relation amongst treatment compliance and communication (r = −0.244, P = 0.027), avoidance (r = −0.270, P = 0.014), anorgasmia (r = −0.253, P = 0.022) and overall total (r = −0.249, P = 0.024) in women. According to these findings while sexual problems increase, treatment compliance decreases.ConclusionsThe level of compliance to the treatment and subscales of sexual problems; satisfaction, avoidance, and touch mean scores differ from each other. There was a weak negative correlation in between Women's compliance and sexual problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comparative Study between Endoscopic Aided Septoplasty with Two Handed Technique using Endoholder and Conventional Septoplasty

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Apar Pokharel ◽  
Naganawalachullu Jaya Prakash Mayya ◽  
Nabin Gautam
Keyword(s):  
Comparative Study ◽  
Nasal Septum ◽  
Deviated Nasal Septum ◽  
Endoscopic Septoplasty ◽  
Septal Surgery ◽  
Significant Difference ◽  
Common Causes ◽  
Prospective Comparative Study ◽  
Evolutionary Step ◽  
One Year

Introduction: Deviated nasal septum is one of the most common causes for the nasal obstruction. The objective of this study is to compare the surgical outcomes in patients undergoing conventional septoplasty and endoscopic septoplasty in the management of deviated nasal septum. Methods:  Prospective comparative study was conducted on 60 patients who presented to the Department of ENT, College of Medical sciences, during a period of one year. The severity of the symptoms was subjectively assessed using NOSE score and objectively assessed using modified Gertner plate. Results: There was significant improvement in functional outcome like NOSE Score and area over the Gertner plate among patients who underwent endoscopic septoplasty. Significant difference in incidence of post-operative nasal synechae and haemorrhage was seen in conventional group compared to endoscopic group. Conclusions: Endoscopic surgery is an evolutionary step towards solving the problems related to deviated nasal septum. It is safe, effective and conservative, alternative to conventional septal surgery.

scholarly journals Scanning Electron Microscopy Analysis of the Anterior Capsulotomy Edge: A Comparative Study between Femtosecond Laser-Assisted Capsulotomy and Manual Capsulorhexis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Daniele Tognetto ◽  
Chiara De Giacinto ◽  
Alberto Armando Perrotta ◽  
Tommaso Candian ◽  
Alessandro Bova ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Femtosecond Laser ◽  
Comparative Study ◽  
Surface Irregularity ◽  
Significant Difference ◽  
Group 2 ◽  
Cut Surface ◽  
Scanning Electron ◽  
Group 1

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.

Ultra-resistant schizophrenia and potentiation strategies

2017 ◽  
Vol 41 (S1) ◽  
pp. s834-s834 ◽  
Author(s):  
S. Khouadja ◽  
R. Ben Soussia ◽  
S. Younes ◽  
A. Bouallagui ◽  
I. Marrag ◽  
...  
Keyword(s):  
Treatment Resistance ◽  
Cost Benefit ◽  
Clinical Excellence ◽  
University Hospital ◽  
Dsm Iv ◽  
Competing Interest ◽  
A Prospective Study ◽  
Psychiatric Department ◽  
The Cost ◽  
The University

IntroductionTreatment resistance to clozapine is estimated at 40–70% of the treated population. Several clozapine potentiation strategies have come into clinical practice although often without evidence-based support.ObjectiveThe aim of our work was to identify the potentiation strategies in ultra-resistant schizophrenia depending on the subtype of schizophrenia.MethodologyThis is a prospective study conducted on patients with the diagnosis of schizophrenia, based on DSM-IV-TR criteria, and hospitalized in the psychiatric department of the university hospital in Mahdia, Tunisia. The study sample consisted of patients meeting the resistant schizophrenia criteria as defined by national institute for clinical excellence (NICE), and the prescription of clozapine for 6 to 8 weeks was shown without significant improvement.Resultswe have collected 10 patients. The mean serum level of clozapine was 462.25 mg/L. The potentiation strategies were different depending on the subtype of schizophrenia. For the undifferentiated schizophrenia, we have chosen ECT sessions. For the disorganized schizophrenia, we opted for amisulpiride and aripiprazole. For the paranoid forms, we have chosen the association of risperidone and ECT. A psychometric improvement was noted in BPRS ranging from 34 to 40%.ConclusionEvery potentiation strategy entails a cost, whether it is an additional monetary cost, adverse effects or greater stress to caregivers. The cost/benefit equation should be thoroughly evaluated and discussed before commencing a strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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