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Introduction: The study of affective temperaments is a dimensional approach to personality that would provide a better understanding of the emergence of psychopathological disorders including addictive behaviors. However, in the literature, there is a lack of studies focusing on the links between this type of disorder and affective temperaments. Our objectives were to study the distribution of the five known affective temperaments in a group of drug addicts compared to a control group, and to identify sociodemographic and clinical factors associated with emotional traits., Methods: This was a case-control study carried out in the drug abuse prevention center "ATUPRET" of Sfax in Tunisia. It included 50 drug addicts, all male, and 50 healthy control subjects matched for age (P=0.22), marital status (P=0.28), socioeconomic level (P=0.36) and educational level (P=0.95). Sociodemographic data were collected through an interview for drug addicts hospitalized in this center while clinical data were collected from medical records. The TEMPS-A questionnaire, 110 questions validated Tunisian version, has been used to evaluate five affective temperaments., Results: The average age of drug addicts was 32.98 years (19-59 years) and the average age at onset of drug use was 20.36 years (12-52 years). Among drug users, the highest mean scores were observed for hyperthymic temperament (13.68±4.20), followed by cyclothymic (13.14±4.89), anxious (11.32±6.00) and depressive (11.02±3.65) ones. The lowest mean score was for irritable temperament (10.14±3.95). All of these scores, except that of cyclothymic temperament, were significantly higher than in the control group (P<0.01). The age of drug addicts was negatively correlated with cyclothymic (P=0.023) and irritable (P=0.035) temperament scores. These two temperaments were more dominant in the group of drug addicts with post-secondary education (P respectively 0.035 and 0.002). The age of onset of psychoactive substance use was negatively correlated with irritable temperament (r=-0.355, P=0.012). Cyclothymic temperament was correlated with alcohol dependence (P=0.03) and psychiatric comorbidity (P=0.01) among drug addicts., Conclusion: The present study provides support for the existence of temperamental dysregulation in drug-addicted patients. This result leads us to suggest that affective temperaments are implicated as a potential endophenotype and may represent a marker for the identification of persons vulnerable to drug use. These affective temperaments also appear to influence clinical features of drug addiction., (Copyright © 2018 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Background: The FAST-MI Tunisia registry was set up by the Tunisian Society of Cardiology and Cardiovascular Surgery to assess the demographic and clinical characteristics, management and hospital outcome of patients with ST-elevation myocardial infarction (STEMI)., Methods: Data for 459 consecutive patients (mean age 60.8 years; 88.5% male) with STEMI, treated in 16 public hospitals (representing 72.2% of public hospitals in Tunisia treating STEMI patients), were collected prospectively.The most common risk factors were smoking (63.6%), hypertension (39.7%), diabetes (32%) and dyslipidaemia (18.2%)., Results: Among the 459 patients, 61.8% received reperfusion therapy: 30% with primary percutaneous coronary intervention (PPCI) and 31.8% with intravenous fibrinolysis (IF) (28.6% with pre-hospital thrombolysis). The median time from symptom onset to thrombolysis was 185 min and to PPCI was 358 min. In-hospital mortality was 5.3%. Compared with those managed at regional hospitals, patients managed at interventional university hospitals (n = 357) were more likely to receive reperfusion therapy (52.9% vs. 34.1%; p<0.001), with less IF (28.6% vs. 43.1%; p = 0.002) but more PPCI (37.8% vs. 3.9%; p<0.0001). However, in-hospital mortality in the two types of hospitals was similar (5.3% vs. 5.1%; p = 0.866)., Conclusions: Data from the FAST-MI Tunisia registry show that a pharmaco-invasive strategy of management for STEMI should be promoted in non-interventional regional hospitals., Competing Interests: The authors have declared that no competing interests exist.

Aims: To investigate the impact of pregnancy and the post partum period on the female sexuality and the coupledom, and to evaluate the quality of information and dialogue about this subject., Methods: A prospective descriptive and analytical study included patients from the department of obstetrics and gynecology in the university hospital Hédi Chaker during July and August 2010. We choose randomly 80 Tunisian women, whatever the reasons for consultation. Data were obtained via questionnaires containing 45 questions about sexual behavior during the last pregnancy and the postpartum period, the influence on coupledom, and the quality of information and dialogue about this subject. Statistical analysis was conducted using SPSS for Windows version 17. Statistical significance was defined as a p value 5% using the X2 test., Results: The average age was 31.64 (± 6) years. Before pregnancy,sexuality was qualified as "satisfactory" by nearly the half of the sample (48, 5%) against 78.8% by their partners. 18% of women thought it was not possible to have intercourse during pregnancy. This idea doesn't correlate with the education (p=0.151) neither the geographic origin (p=0.064). 54.5% of women mentioned a decrease on their sexual interest and activity during pregnancy. The three main causes of this decline were: the physical symptoms (83%), the fear to harm the fetus (66.7%) and the women hypoactive sexual desire (33.4%). After delivery, sexual interest and activity tends to be reduced in 64% of women. The resumption of normal sexual activity was about 4 months around the delivery (with variations between 1 month and 2 years). Sexuality was considered as taboo by 81, 8% of women. The information on sexuality by health professionals was deemed insufficient by 78.8% of women., Conclusion: Sexuality remains a taboo for the most of woman. Their belief in the impossibility of intercourse during pregnancy doesn't correlate with education neither with origin. The period of pregnancy and the postpartum changes the sexual behavior, interferes with the quality of life and disturbs the coupledom. However information and the support of women in this period are still insufficient.

Background: Depression in the elderly is often inadequately diagnosed and insufficiently treated. Regardless of the nature of the depression, the influence and the impact of the biological, situational, social and psychological factors would be more important in old subjects than in young ones when the disorder occurs. The nursing home, as an institution, is another factor facilitating the appearance of depression., Aim: The aim of our survey is to determine the prevalence of depression in old people living in a nursing home and to evaluate the degree of their autonomy., Methods: Our study is a transverse, descriptive and analytical survey carried out on 35 old people at a nursing home in Sfax. Forty residents were excluded from this survey for reasons of dementia (25 cases), debility (5 cases), disabling psychiatric pathologies (4 cases), deafness (5 cases) and one resident who refused the interview. The evaluation has been achieved using two scales specific to the geriatric practice: • The scale of depression: GDS (geriatric depression Scale) applied to 30 items. • The scale of autonomy: IADL (Instrumental Activities of Daily Living) applied to 6 items., Results: • The examined population was composed of 35 people aged from 65 to 93 with a sex ratio of 1.05. • 51.4% of the residents were in a state of depression. • Depression was more frequent in: • Female subjects (58.8% of women compared to 44.4% of men) • Subjects aged less than 70 (66% of subjects aged less than 70 versus 40% of older subjects) • 17.1% of the residents were independent, 42.9% were dependent and 40% were heavily dependent., Conclusion: Depression in the elderly is related to several depressice factors particularly for patients living in institution. This situation needs very important adaptive capacities.

Objectives: To evaluate the prevalence of binge eating disorder (BED) in a population of obese patients, to appreciate the impact of obesity on BED through a comparison between the obese group and a control group, and to assess anxiety, depression and quality of life in obese patients with BED., Patients and Methods: A cross-sectional study including 60 obese patients and 60 controls. BED was diagnosed using the Binge Eating Scale. Quality of life was assessed by the Quality Of Life, Obesity and Dietetics Scale, and depression and anxiety symptoms by the Hospital Anxiety and Depression Scale., Results: The obese group had a higher prevalence of BED than the control group (40% versus 8.3%; p < 0.001; OR = 3.5). The average score of BES was also higher (p < 0.001). Obese patients with BED were younger (p = 0.034). BED was correlated with an early onset of obesity (p = 0.01; OR = 1.12), depression (p = 0.002), anxiety (p = 0.008) and a poorer quality of life., Conclusion: This study confirms the relationship between obesity and BED, which is correlated with a high prevalence of anxiety and depression and with a poorer quality of life.