Folie à deux ou le partage de symptômes comme modalité relationnelle: à propos d’un cas

Le trouble psychotique partagé ou Folie à deux (FD) est une entité rare et controversée qui pose des problèmes d’ordre phénoménologique, nosographique et psychopathologique. Elle interroge la nature du délire et sa survenue en dehors d’une structure psychotique ainsi que la question de la contagion du symptôme en psychiatrie. Nous proposons l’analyse sémiologique d’un cas intrafamilial de Folie à deux, cas dont la particularité clinique est le partage de symptômes délirants mais aussi d’éléments psychotiques non délirant (déficitaires). A travers quoi nous revenons sur les caractéristiques épidémiologiques et les facteurs communs avec les autres cas rapportés dans la littérature dans différentes cultures. Nous dressons ensuite l’historique de l’entité et son évolution au fil des classifications depuis sa première description par Legrand jusqu’au DSM 5. Et de là, nous soulignons le caractère insuffisant d’une approche purement descriptive et mettons l’accent sur le lien possible avec d’autres situations cliniques plus fréquentes avec comme point commun la transmission entre deux ou plusieurs personnes de symptômes psychiques. Puis, nous proposons une réflexion psychopathologique qui s’axe essentiellement sur le partage du symptôme et non sa nature tout en interrogeant la fonction du délire au sein d’un couple délirant

Considérations nosographiques sur le délire d’infestation parasitaire à travers trois observations cliniques

Le syndrome d'Ekbom, ou délire d'infestation parasitaire, est une pathologie rare, caractérisée par la conviction inébranlable d'avoir une peau infestée d'insectes ou de parasites. Il s'agit d'un délire monothématique à mécanisme hallucinatoire qui touche typiquement les femmes d'âge avancé. Nous rapportons les cas de trois patients qui présentent un délire d'infestation parasitaire dans des contextes cliniques différents. Le premier patient souffre d'un délire d'infestation isolé correspondant à la forme décrite par Karl Ekbom. Le deuxième cas présente un délire d'infestation secondaire, s'inscrivant dans le cadre d'une leuco-encéphalopathie de type CADASIL. Enfin, le troisième patient se présente dans un tableau évocateur d'un épisode dépressif avec une caractéristique psychotique qui intègre le délire d'infestation. Ces trois vignettes cliniques illustrent parfaitement le caractère trans-nosographique de ce syndrome ainsi que les difficultés de prise en charge de ces patients, tant au niveau de l'alliance thérapeutique que sur le plan des choix en matière de traitement pharmacologiques.Pan African Medical Journal 2016; 2

Ramadan Fasting and Patients with Cancer: State-of-the-Art and Future Prospects

Ramadan fasting represents one of the five pillars of the Islam creed. Even though some subjects (among which patients) are exempted from observing this religious duty, they may be eager to share this particular moment of the year with their family and peers. However, there are no guidelines or standardized protocols that can help physicians to properly address the issue of patients with cancer fasting in Ramadan and correctly advising them. Moreover, in a more interconnected and globalized society, in which more and more Muslim patients live in the Western countries, this topic is of high interest also for the general practitioner. For this purpose, we carried out a systematic review on the subject. Our main findings are that (1) very few studies have been carried out, addressing this issue, (2) evidence concerning quality of life and compliance to treatment is contrasting and scarce, and (3) generally speaking, few patients ask their physicians whether they can safely fast or not. For these reasons, further research should be performed, given the relevance and importance of this topic

ramadan fasting and infectious diseases a systematic review

Ramadan represents the fourth of the five pillars of the Islamic creed. Although patients are exempted from observing this duty, they may be eager to share this moment of the year with their peers. However, there are no guidelines that can help physicians to address the concerns of patients with infectious diseases fasting during Ramadan. For this purpose, we performed a systematic review. of 51 articles. Our main findings are that: 1) patients suffering from diabetes at risk of developing infectious complications should not fast; 2) Ramadan fasting has little impact on diarrheal patients; 3) HIV represents a challenge, and ad hoc drug combinations should be recommended to patients, and the patients should be advised not to take fatty meals that could interfere with the treatment; 4) Ramadan has no effect on the effectiveness of anti-helminthic therapy; and 5) patients with active ulcers should not fast, as they have a higher probability of developing complications

Genital self-mutilation in an attempt of suicide by a patient with a borderline personality

Self‑mutilation acts are known to characterize the borderline personality disorders. However, voluntary cutting of the male genital organ remains extremely rare. The present paper reports a case of a 25‑years‑old young male with a borderline personality. The patient committed a genital self‑mutilation (GSM) targeting suicide during incarceration stage in jail. In addition, a discussion of the epidemiological and psychopathological aspects of the self‑mutilation of borderline patients was been conducted. A particular interest is attributed to the genital self‑mutilation and a review of the literature is presented

A case report of Lhermitte–Duclos disease revealed by psychiatric disturbances

Abstract Background Lhermitte–Duclos disease (LDD) is a rare cerebellar lesion characterized by a hamartomatous lesion in the posterior fossa. Mainly diagnosed by MRI, the clinical presentation is usually made of neurological symptoms. Case presentation We present here a rare case of a woman who developed depressive symptoms that inaugurated the clinical presentation of LDD. Conclusion Psychiatric symptoms may occur in all brain lesions, delaying the diagnosis and causing therapeutic escalation. More attention should be given by practitioners to psychiatric aspects of LDD

Factors associated with psychological burden of breast cancer in women in Morocco: cross‑sectional study

Abstract Background Depression and anxiety are among the psychological diagnoses impacting individuals diagnosed with breast cancer. This study aims to estimate the prevalence, as well as the predictors, of anxiety and depression in women with breast cancer. Materials and methods This was a cross-sectional, multi-center study conducted over an eight-month period among women with breast cancer in oncology centers in southern Morocco. Anxiety and depression were assessed using the validated Moroccan dialectal version of the Hospital Anxiety and Depression Scale (HADs). To identify the predictors of anxiety and depression in the study population. Multiple linear regression analyses were performed, including variables for which univariate analyses were significant with a p < 0.05 value. Statistical analyses were performed using Jamovi software version 2.2.3. Results A total of 230 participant responses were collected. The prevalence of anxiety and depression was 77.4% and 62.6%, respectively. Multiple linear regression analysis revealed the following factors increased anxiety: being younger than 50 years old, not having studied beyond elementary school, having children aged between 10 and 18 and having TNM stage III and IV. The following factors decreased anxiety in patients with breast cancer: good physical functioning (Karnofsky score), satisfaction with social support and financial support. Regarding depression, the following factors decreased depression: good physical functioning (Karnofsky score), a minimum of 2.5 h per week of physical activity, active occupational status, satisfaction with social support and financial support. In contrast, the recurrence of breast cancer was an associated factor with increased depression. Conclusion The prevalence of anxiety and depression in women with breast cancer is very high in our context. Therefore, routine screening tests for depression and anxiety as well as psychosocial management care are necessary for patients with breast cancer in Morocco

Clinical assessment of depression and type 2 diabetes in Morocco: Economical and social components

Background: The global prevalence of diabetes is increasing worldwide. In Morocco, diabetes and depression are major public health problems, requiring improvement in their care. Diabetes and depression are associated with morbidity and early mortality. This association contributes to raising the risk of the complications that occur, while causing higher suffering to patients, as also an increased cost toward healthcare. Aim: This study aims to assess the prevalence of depression in patients with type 2 diabetes (T2D), and identify the main risk factors for depression in this category of diabetic patients. Patients and Methods: Type 2 diabetic patients and older than 18 years of age were recruited. The exclusion criteria included being type 1 diabetic, pregnant woman, hospitalized patients, a history of neurological disorders, such as, stroke, infectious episidodes, and history of psychiatric disorders. The individual patient data was collected through individual and confidential interviews lasting 30 minutes, at the end of the diabetology consultation, by the same diabetologist, trained to use the psychometric scales that were needed. The Moroccan-Arabic version of the Beck diagnostic scale of depression was used. Patients assessed with depressive disorders were reviewed in a specialized psychiatric consultation. The statistical analysis was achieved by using SPSS package (version 17). We retained a threshold P value of 0.05. Settings and Design: A cross-sectional study was conducted that included adults with type 2 diabetes. The depression diagnosis was performed using the Arabic version of the Beck Depression scale. Statistical Analysis: We included 142 patients with type 2 diabetes, with an average age of 56.26 years. The prevalence of depression was 33.1%. The risk factors recognized for depression were, lack of social security, hypertension, and a history of type 2 diabetes of more than five years. Results and Conclusions: In this study, we have focused on the frequent association of ′Type 2 diabetes and depression′ and the risk of mutual aggravation of both pathologies that might require multidisciplinary healthcare, as well as, improvement in the risk factors of depression through improved access to healthcare, with the extension of social security. The stability of the healthcare personnel involved in the treatment of both chronic diseases, including diabetes and hypertension screening, should also be considered for better management of psychiatric complications