Introduction

Spousal abuse(SA) against women, by its frequency and its consequences on the health of the victims, is a public health issue.For this reason, the role of the physician is essential not only in the care of victims but also in the screening of psychological repercussions.

Objectives

To study the risk factors associated with the development of post-traumatic stress disorder(PTSD) in women victims of spousal abuse(SA).

Methods

Descriptive and analytical cross-sectional study conducted at the National Health Fund of Sfax(CNSS)on 110 women who consulted during the months of October and November2019.The sociodemographic and clinical characteristics of the consultants were collected using a pre established form.We used a 10-item scale,the"Women's Experience with Battering Scale"(WEBS),to screen women for SA.PTSD was assessed using a PCLS scale(17 items).

Results

(SA)was estimated at 57.3% in our population.The average WEBS score among abused women was 30.92.The prevalence of PTSD in abused women was 63.5% and the average PCLS score was 48.8.The somatic(p=0.049)and psychiatric(p=0.005)histories in the women who had experienced(SA) were related to the development of PTSD.The PCLS score was significantly associated with the WEBS score(p<.0001 and r=.76).The type of violence experienced (physical, psychological, sexual and material) was correlated with the development of PTSD;(p were respectively: <.0001; <.001; 0.02; <.0001).Similarly, repeated violence was strongly related to it(p<0.001).

Conclusions

It seems clear that the(SA)experienced by the women had a psychological impact through the development of PTSD.In addition,several other risk factors inherent to women can be incriminated in this disorder for which systematic screening remains a necessity in order to allow an apdate care.

Introduction

Matricide is the murder of the mother and it is one the rarest reported homicides with rates varying between 1% and 4% of all murders. In our country, few studies have focused on this issue.

Objectives

To precise circumstances of matricide in psychotic patients and the offender and victim’s profiles.

Methods

We report three clinical cases who were hospitalized in the department of Psychiatry “A” at the Hedi Chaker university hospital in Sfax, Tunisia, because of non-judicial proceedings for dementia during the year of 2019.

Results

Among 3 cases, two patients were male and they were aged respectively 26 and 48 years old. The third was female. All of them had very low educational and income levels and they lived with the victim. In 2 cases, the victim-offender relationship was conflictive and there was already exhibited violent behavior towards victim.Two patients had a psychiatric follow-up and many hospitalizations. The diagnoses were schizophrenia and schizoaffective disorder. However, it was a poor compliance and an interruption of treatment. In the third case, the medicolegal procedure was inaugural. His diagnosis was schizophrenia.All the victims were illiterate and unemployed. Their middle age was 64 years.In all cases, the crime was not premeditated, motivated by persecution delusions including the mother. It was committed in the family house while using a blunt object. The post homicide reaction was marked by coldness.

Conclusions

Matricide has always been considered one of the most abhorrent crimes. Regular evaluation of psychotic patients' dangerousness signals is needed to reduce the acting out.

Introduction

Burn-out is quite common in hospitals especially among young doctors. It results from a mismatch between expectation and professional reality.

Objectives

To determine the prevalence of sever burnout and to identify its associated socio-demographic and psychological factors among young residents.

Methods

Analytical and descriptive cross-sectional study conducted among residents and interns working at the Hedi Chaker and Hbib Bourguiba University hospital in Sfax, Tunisia, during the month of July 2019. The characteristics of the participants were collected using a questionnaire. Burnout was evaluated using the Maslach Burnout Inventory(MBI) differentiating 3 components: emotional exhaustion, depersonalization and luck of personal achievement.

Results

Out of 85 questionnaires disturbed,60 were selected corresponding to a response rate of 72.94%. The sex ratio (M/F) was 0.87. The middle age was 28.22. Forty three percent of the participants were married. More than half consumed tobacco and 45% of them consumed alcohol. The majority of doctors were residents(81.7%). The average working time was 55 hours per week. Burn-out was severe in 30% of our population. Furthermore, doctors who suffered from physical aggression(p=0.001) were more likely to develop severe burn-out. The dissatisfaction with the internship (p=0.01) and the feeling of do not satisfy seniors(p=0.02) were statistically associated with severe burnout. Severe burn-out was associated with anxiety (p=0.0073), conflictual partnership (p=0.0001),conflicts with colleagues(p=0.001) and the paramedical framework (p=0.0001)

Conclusions

The risk of burn-out is quite high among young doctors. Some factors seem to be associated with this phenomenon. This could affect not only the quality of life, but also the quality of care provided.

Introduction

Spousal abuse (SA)against women, by its frequency and its consequences on the health of the victims, is a public health issue. For this reason, the role of the physician is essential not only in the care of victims but also in the study of the determinants of(SA).

Objectives

To study the profile of women who have experienced(SA), their spouses and to evaluate the factors associated with spousal violence.

Methods

Analytical and descriptive cross-sectional study conducted among married patients who consulted the National Health Fund of Sfax(CNSS) during the months of October and November 2019.The sociodemographic and clinical characteristics of the victims and their spouses were collected using a pre-established form.

Results

57.3% of the population was affected by(SA). The mean age of female victims was 48.35 years(SD=9.82). 66.7% of women had a primary school level and 69% had a median socioeconomic level. The majority (60.3%) were housewives.78.18% had a somatic history. The average age of spouses was 53.82(SD=10.87).73% had an elementary school education and 49% were workers.The spouse's somatic history was found in 63.5% and psychiatric history in 11.11%. 39.68% of spouses had addictive behaviours.

Factors correlated with (SA) were: low education levels of the wife (p=0.016) and husband (p=0.0057), history of childhood abuse of the victim (p<0.0001), addictive behaviours of the husband (p=0.008).

Conclusions

It seems that the evaluation of the characteristics of women victims of (SA) and their spouses, as well as the identification of factors associated with (SA), are essential in order to cope with this scourge and avoid its repercussions.

Introduction

Violence and crime committed by individuals with mental disorders has been the focus of growing interest among mental health professionals.Added to psychopathological disorders, individual, socio familial and therapeutic factors can be involved in the criminogenic risk.

Objectives

To assess the characteristics of homicide in Tunisian patients with psychosis and to establish their sociodemographic, clinical and therapeutic characteristics.

Methods

We reported7cases of patients who attended Psychiatric department“A”at the Hedi Chaker university hospital in Sfax,Tunisia,between January2014 and September2019.They were hospitalized for committing homicide and penal irresponsibility was recognized.

Results

The homicide acts were matricide in 3cases, parricide in one case and conjugal homicide in one case.The homicide was not premeditated, committed by using knife weapon in 3cases and a blunt object in 4cases.The crime was done in the family home in the majority of cases(71.42%). The average age of patients was 34years. They were in almost cases(85.71%) male. Six patients (85.71%) had very low educational and income levels. They were mostly unmarried(71.42%)and unemployed(71.42%).Alcohol consumption was observed in3patients.However, we did not found any substance use. According to DSM-5,six patients were diagnosed with schizophrenia and one case with schizoaffective disorder.The majority(85.71%) had previous psychiatric folow-up. Furthermore, interruption of treatment was the rule.Five patients had a previous record of violent behavior towards the victim.Judicial history was notified among one patient.The persecution and influence delusion were found among 6cases.

Conclusions

Homicidal behavior is extremely rare.Evaluation of different variables of homicide’s act and offender is a fundamental issue for developing preventive and therapeutic strategies to deal with such criminal behavior.