Une lecture de la SahwĀ ou les mille et un visages du tribalisme irakien

RéSUMéNé à l’automne 2006 de l’alliance de tribus sunnites de la province d’Al-Anbār avec les forces de la coalition étrangère contre Al-Qaida, le phénomène de la Sòahòwā (« réveil » tribal) reflète les mutations, décompositions et recompositions du champ tribal irakien. Alors que de nombreuses incertitudes continuent de peser sur la transition issue des ruines du régime de Saddam Hòussein et que s’amorce le retrait militaire américain, l’auteure propose quelques grilles de lecture de la Sòahòwā, et ce dans une perspective anthropologique, historique et sociopolitique. Elle revient sur les continuités et discontinuités du tribalisme irakien contemporain puis inscrit ce « réveil » tribal dans le contexte du conflit qui l’a opposé à la mouvance jihadiste radicale et, plus largement, dans le contexte de la guerre d’Irak et des formes de violence qu’elle a engendrées.ABSTRACTThe Sòahòwā arose in the autumn of 2006 out of an alliance between Sunnite tribes in Al-Anbār Province and the foreign coalition forces fighting against Al-Qaeda. This tribal «awakening » reflects the reworking of tribalism in Iraq. While much uncertainty still surrounds the transition arising out of the ruins of Saddam Hòussein’s regime at a time when American forces have begun withdrawing, grids are proposed for interpreting the Sòahòwā anthropologically, historically and sociopolitically. After reviewing continuities and discontinuities in contemporary Iraki tribalism, the tribal «awakening » is placed in the context of the conflict between it and the radical jihadist movement and in the broader context of the war in Iraq and the violence generated by it

Chronic stimulation of the pituitary-adrenal axis in rats by interleukin-1ß infusion: In vivo and in vitro studies

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Frailty as a predictor of mortality in older adults within 5 years of psychiatric admission

Objectives Older adults with psychiatric disorders have a substantially lower life expectancy than age-matched controls. Knowledge of risk factors may lead to targeting treatment and interventions to reduce this gap in life expectancy. In this study, we investigated whether frailty independently predicts mortality in older patients following an acute admission to a geriatric psychiatry hospital. Methods Clinical cohort study with a 5-year follow-up of 120 older patients admitted to a psychiatric hospital between February 2009 and September 2010. On admission, we assessed frailty with a frailty index (FI). We applied Cox regression analyses with time to death as the dependent variable, to examine whether the FI was a predictor for mortality, adjusted for age, sex, level of education, multimorbidity (Cumulative Illness Rating Scale for Geriatrics, CIRS-G scores), functional status (Barthel Index), neuropsychiatric symptoms (NPS), and severity of psychiatric symptoms at admission (Clinical Global Impressions Scale of Severity). Results Of the 120 patients, 63 (53%) patients were frail (FI >= 0.25), and 59 (49%) had died within 5 years. The FI predicted mortality with a hazard ratio (HR) of 1.78 (95% CI, 1.06-2.98) per 0.1 point increase, independent of the covariates. Co-morbidity measured by the CIRS-G and functional status measured by the Barthel Index were not significantly associated. Conclusions Frailty was a strong predictor of mortality, independent of age, gender, multimorbidity, and functional status. This implies that frailty may be helpful in targeting inpatient psychiatric treatment and aftercare according to patients' life expectancy

Psychiatric characteristics of older persons with Medically Unexplained Symptoms:a comparison with older patients suffering from Medically Explained Symptoms

BACKGROUND.: Empirical studies on the clinical characteristics of older persons with medically unexplained symptoms are limited to uncontrolled pilot studies. Therefore, we aim to examine the psychiatric characteristics of older patients with medically unexplained symptoms (MUS) compared to older patients with medically explained symptoms (MES), also across healthcare settings. METHODS.: A case-control study including 118 older patients with MUS and 154 older patients with MES. To include patients with various developmental and severity stages, patients with MUS were recruited in the community (n = 12), primary care (n = 77), and specialized healthcare (n = 29). Psychopathology was assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria (Mini-International Neuropsychiatric Interview) and by dimensional measures (e.g., psychological distress, hypochondriasis, and depressive symptoms). RESULTS.: A total of 69/118 (58.5%) patients with MUS met the criteria for a somatoform disorder according to DSM-IV-TR criteria, with the highest proportion among patients recruited in specialized healthcare settings (p = 0.008). Patients with MUS had a higher level of psychological distress and hypochondriasis compared to patients with MES. Although psychiatric disorders (beyond somatoform disorders) were more frequently found among patients with MUS compared to patients with MES (42.4 vs. 24.8%, p = 0.008), this difference disappeared when adjusted for age, sex, and level of education (odds ratio = 1.7 [95% confidence interval: 1.0-3.0], p = 0.070). CONCLUSIONS.: Although psychological distress is significantly higher among older patients with MUS compared to those with MES, psychiatric comorbidity rates hardly differ between both patient groups. Therefore, treatment of MUS in later life should primarily focus on reducing psychological distress, irrespective of the healthcare setting patients are treated in