Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They cons...Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They constitute a real “invisible” handicap. In sub-Saharan Africa, we are not aware of any studies specifically assessing executive functions. These functions are at the heart of all adaptation processes to new or complex situations. This prompted the authors to carry out this study at the Ibrahima Pierre Ndiaye Neuroscience Department of the Fann National University Hospital Centre (Senegal). Objective and Methodology: The aim of this study was to assess and characterize post-stroke alterations in executive functions in our context. We conducted a descriptive cross-sectional study. It took place over a 4-month period from April 1 to August 31, 2021. Patients were matched to controls according to age, gender and educational level. Executive functions were assessed using the Frontal Assessment Battery (FAB). Results: A total of 30 patients with stroke were enrolled. These patients were matched to controls. The mean age of the patients was 46.87 ± 17.65 years. For the control group, it was 39.27 ± 12.33 years. The prevalence of executive function disorders was 20% in post-stroke patients. The majority of executive functions assessed were impaired. Sensitivity to interference and environmental autonomy were the only ones preserved. Conclusion: Impaired executive functions are common after stroke. They should be systematically assessed in all stroke patients to ensure optimal management.展开更多
Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-...Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-sectional, descriptive, and analytical study of physicians in permanent contact with patients at the Fann and Aristide Le Dantec teaching hospitals in Dakar, Senegal. Results: A total of 159 doctors were included in the study, with a sex ratio (M/F) of 1.3 in favor of men. The prevalence of burnout was 91.8%. Burnout was significantly associated (p Conclusion: Burnout is a threat to doctors at university hospitals in Senegal. It has several determinants linked above all to work organization. It is essential to set up psychological support units in hospitals and integrate occupational medicine into various organizational processes.展开更多
Introduction: Fostering is a widespread practice in West Africa. It played an essential role in the circulation of children. The failure of its community regulation, not compensated by a legal framework, has made its ...Introduction: Fostering is a widespread practice in West Africa. It played an essential role in the circulation of children. The failure of its community regulation, not compensated by a legal framework, has made its practice precarious. Observation: A case study was conducted on Dior, who was hospitalised in a psychiatric ward for a delusional disorder of filiation. Dior was entrusted to her maternal grandmother and aunt at ages 2 and 9. During these fosterings, the place of the symbolic father was not substituted, causing a void that challenged her imagination. The outcome was an inscription in a genealogy where she had found herself with prestigious parents. Discussion: Fostering has strongly disrupted the family dynamics in Dior’s case. One of her options was to assume the paternal function, the use of which was perceived as a defiance or even a transgression. This same function would be a starting point of a psychosis whose filial character would only be an attempt at rectification where reality and imagination collide. Conclusion: Our study reveals the importance of stable parental figures at stake in fostering contexts, which constitute a risk factor for the development of a subsequent psychosis.展开更多
Introduction: Postpartum depression is the most common psychiatric disorder affecting women in the perinatal period. According to the WHO, it affects 10% - 15% of women who have just given birth. In Africa, and partic...Introduction: Postpartum depression is the most common psychiatric disorder affecting women in the perinatal period. According to the WHO, it affects 10% - 15% of women who have just given birth. In Africa, and particularly in Senegal, epidemiological studies focusing exclusively on postpartum depression are rare or non-existent. For this reason, we conducted this screening study on postpartum depression to assess the socio-demographic characteristics and associated factors. Methods: This was a prospective cross- sectional study with descriptive and analytical aims. It was carried out in the twelve Dakar referral health centres during the period August 2021 to June 2022. Results: At the end of our survey we had recruited one hundred and twenty-two (122) participants with a PPD prevalence rate of 25.41%. The most common age group was 24 - 29 years. 40% of the participants were of Fulani ethnicity, followed by Wolof. Married women made up 93% of the sample. The school enrolment rate was 89%. Most participants were not in paid employment. Domestic violence was present in 14% of couples. 28% of mothers reported experiencing a stressful life event during their pregnancy. 22% of the women had a chronic medical condition, of which 55% had high blood pressure. 1% of the women reported a personal psychiatric history and 5% a family psychiatric history. Most women had between two and four healthy living children. The pregnancy was unwanted in 17% of cases and 12% of participants had a complication. 6% were dissatisfied with the quality of their antenatal care. The caesarean section rate was 18%. In terms of associated factors, eight factors were identified in a bivariate analysis: single marital status, lack of support from partner, domestic violence, conflict with in-laws, and the occurrence of a stressful life event during pregnancy, the presence of a personal medical history, lack of satisfaction with pregnancy follow-up, and mode of delivery by caesarean section. Conclusion: Our study showed the high prevalence of PPD (25.41%) and identified associated risk factors. Among these factors, two were strongly associated with postpartum depression: lack of satisfaction with pregnancy care and experiencing a stressful life event during pregnancy. Systematic screening or identification of risk factors during pregnancy is necessary for comprehensive treatment based on a biopsychosocial approach.展开更多
<strong>Context:</strong> HIV infection is an infectious, viral, chronic disease described as a public health problem. It has an impact on bio-psycho-social well-being. Thus, the objective of our study is ...<strong>Context:</strong> HIV infection is an infectious, viral, chronic disease described as a public health problem. It has an impact on bio-psycho-social well-being. Thus, the objective of our study is to decrypt the representations of HIV infection in our patients. <strong>Methodology:</strong> 31 consecutively recruited HIV-infected patients participated in our study. The completed questionnaire included socio-demographic characteristics, association membership, psycho-social aspects of HIV infection, mode of transmission and adherence to antiretroviral treatment. Secondly, we proceeded to an assessment of the psychological state of the patient. <strong>Results: </strong>Almost 77% of HIV patients do not date peers in an association. At the time of the study, more than half of patients or 19/31 with HIV had a positive image of the disease. Before the diagnosis of the disease, more than 2/3 of patients with HIV, <em>i.e.</em> 25/31, have a negative image of the disease. The 31 PLHIV have been aware of their positive HIV status for an average of 11 years with extremes of 2 years and 21 years. Almost 21/31 of PLHIV have shared their positive serological status. The main barrier in patient communication was the risk of disclosure of HIV status. Most of the patients (45.2%) thought of death when they announced their positive HIV status, and 19.4% thought of their children. In 80.6% of cases, relationships with family, friends and neighbors were normal and remained unchanged for 74% of patients. The patients thought they had been infected through sexual intercourse in 84% of cases. Our study showed that 6 of the 31 PLHIV experienced stigma. Among these 6 patients, 3 had psychological repercussions and a voluntary interruption of treatment. <strong>Conclusion:</strong> The representations are dynamic. In Senegal, the eradication of discrimination among people living with HIV must imperatively involve a reconstruction of individual, collective and social representations.展开更多
<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questio...<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questions leading to therapeutic applications such as focal brain stimulation. The cingulate gyrus is the primary target of these brain stimulation therapies for the treatment of depression. The objective of this work is to establish anatomoclinical correlations and to deduce the therapeutic implications. <strong>Methodology:</strong> Our work is a review of the literature. The inventory of the cingulate gyrus and depression was based on the development of a critical synthesis of bibliographic knowledge. <strong>Results:</strong> We found a bipartite Brodmann subdivision which evolved into a subdivision into four regions of the cingulate gyrus. Descriptions of the cingulate gyrus boundaries are imprecise and divergent. The anterior end of the anterior cingulate cortex is a confirmed target of stimulation in the treatment of major and resistant depression, thus requiring the authors, a consensus in its delineation. Brodmann’s area 25 has been described as the main target of brain stimulation therapies. Dysfunction by local lesion or by alteration of the connectivity of Brodmann’s area has repercussions on these different structures to which it is interconnected. These disturbances when they are in the direction of collapse paint a picture similar to major depression. <strong>Conclusion: </strong>The anterior cingulate cortex is involved in depression. The functional system organization of affectivity will allow new brain stimulation techniques to act on the entire functional system or on one of its components.展开更多
文摘Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They constitute a real “invisible” handicap. In sub-Saharan Africa, we are not aware of any studies specifically assessing executive functions. These functions are at the heart of all adaptation processes to new or complex situations. This prompted the authors to carry out this study at the Ibrahima Pierre Ndiaye Neuroscience Department of the Fann National University Hospital Centre (Senegal). Objective and Methodology: The aim of this study was to assess and characterize post-stroke alterations in executive functions in our context. We conducted a descriptive cross-sectional study. It took place over a 4-month period from April 1 to August 31, 2021. Patients were matched to controls according to age, gender and educational level. Executive functions were assessed using the Frontal Assessment Battery (FAB). Results: A total of 30 patients with stroke were enrolled. These patients were matched to controls. The mean age of the patients was 46.87 ± 17.65 years. For the control group, it was 39.27 ± 12.33 years. The prevalence of executive function disorders was 20% in post-stroke patients. The majority of executive functions assessed were impaired. Sensitivity to interference and environmental autonomy were the only ones preserved. Conclusion: Impaired executive functions are common after stroke. They should be systematically assessed in all stroke patients to ensure optimal management.
文摘Objectives: To assess the socio-professional determinants of burnout among the medical staff of Dakar University Hospitals. The aim was to propose effective means of prevention. Material and Methods: This was a cross-sectional, descriptive, and analytical study of physicians in permanent contact with patients at the Fann and Aristide Le Dantec teaching hospitals in Dakar, Senegal. Results: A total of 159 doctors were included in the study, with a sex ratio (M/F) of 1.3 in favor of men. The prevalence of burnout was 91.8%. Burnout was significantly associated (p Conclusion: Burnout is a threat to doctors at university hospitals in Senegal. It has several determinants linked above all to work organization. It is essential to set up psychological support units in hospitals and integrate occupational medicine into various organizational processes.
文摘Introduction: Fostering is a widespread practice in West Africa. It played an essential role in the circulation of children. The failure of its community regulation, not compensated by a legal framework, has made its practice precarious. Observation: A case study was conducted on Dior, who was hospitalised in a psychiatric ward for a delusional disorder of filiation. Dior was entrusted to her maternal grandmother and aunt at ages 2 and 9. During these fosterings, the place of the symbolic father was not substituted, causing a void that challenged her imagination. The outcome was an inscription in a genealogy where she had found herself with prestigious parents. Discussion: Fostering has strongly disrupted the family dynamics in Dior’s case. One of her options was to assume the paternal function, the use of which was perceived as a defiance or even a transgression. This same function would be a starting point of a psychosis whose filial character would only be an attempt at rectification where reality and imagination collide. Conclusion: Our study reveals the importance of stable parental figures at stake in fostering contexts, which constitute a risk factor for the development of a subsequent psychosis.
文摘Introduction: Postpartum depression is the most common psychiatric disorder affecting women in the perinatal period. According to the WHO, it affects 10% - 15% of women who have just given birth. In Africa, and particularly in Senegal, epidemiological studies focusing exclusively on postpartum depression are rare or non-existent. For this reason, we conducted this screening study on postpartum depression to assess the socio-demographic characteristics and associated factors. Methods: This was a prospective cross- sectional study with descriptive and analytical aims. It was carried out in the twelve Dakar referral health centres during the period August 2021 to June 2022. Results: At the end of our survey we had recruited one hundred and twenty-two (122) participants with a PPD prevalence rate of 25.41%. The most common age group was 24 - 29 years. 40% of the participants were of Fulani ethnicity, followed by Wolof. Married women made up 93% of the sample. The school enrolment rate was 89%. Most participants were not in paid employment. Domestic violence was present in 14% of couples. 28% of mothers reported experiencing a stressful life event during their pregnancy. 22% of the women had a chronic medical condition, of which 55% had high blood pressure. 1% of the women reported a personal psychiatric history and 5% a family psychiatric history. Most women had between two and four healthy living children. The pregnancy was unwanted in 17% of cases and 12% of participants had a complication. 6% were dissatisfied with the quality of their antenatal care. The caesarean section rate was 18%. In terms of associated factors, eight factors were identified in a bivariate analysis: single marital status, lack of support from partner, domestic violence, conflict with in-laws, and the occurrence of a stressful life event during pregnancy, the presence of a personal medical history, lack of satisfaction with pregnancy follow-up, and mode of delivery by caesarean section. Conclusion: Our study showed the high prevalence of PPD (25.41%) and identified associated risk factors. Among these factors, two were strongly associated with postpartum depression: lack of satisfaction with pregnancy care and experiencing a stressful life event during pregnancy. Systematic screening or identification of risk factors during pregnancy is necessary for comprehensive treatment based on a biopsychosocial approach.
文摘<strong>Context:</strong> HIV infection is an infectious, viral, chronic disease described as a public health problem. It has an impact on bio-psycho-social well-being. Thus, the objective of our study is to decrypt the representations of HIV infection in our patients. <strong>Methodology:</strong> 31 consecutively recruited HIV-infected patients participated in our study. The completed questionnaire included socio-demographic characteristics, association membership, psycho-social aspects of HIV infection, mode of transmission and adherence to antiretroviral treatment. Secondly, we proceeded to an assessment of the psychological state of the patient. <strong>Results: </strong>Almost 77% of HIV patients do not date peers in an association. At the time of the study, more than half of patients or 19/31 with HIV had a positive image of the disease. Before the diagnosis of the disease, more than 2/3 of patients with HIV, <em>i.e.</em> 25/31, have a negative image of the disease. The 31 PLHIV have been aware of their positive HIV status for an average of 11 years with extremes of 2 years and 21 years. Almost 21/31 of PLHIV have shared their positive serological status. The main barrier in patient communication was the risk of disclosure of HIV status. Most of the patients (45.2%) thought of death when they announced their positive HIV status, and 19.4% thought of their children. In 80.6% of cases, relationships with family, friends and neighbors were normal and remained unchanged for 74% of patients. The patients thought they had been infected through sexual intercourse in 84% of cases. Our study showed that 6 of the 31 PLHIV experienced stigma. Among these 6 patients, 3 had psychological repercussions and a voluntary interruption of treatment. <strong>Conclusion:</strong> The representations are dynamic. In Senegal, the eradication of discrimination among people living with HIV must imperatively involve a reconstruction of individual, collective and social representations.
文摘<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questions leading to therapeutic applications such as focal brain stimulation. The cingulate gyrus is the primary target of these brain stimulation therapies for the treatment of depression. The objective of this work is to establish anatomoclinical correlations and to deduce the therapeutic implications. <strong>Methodology:</strong> Our work is a review of the literature. The inventory of the cingulate gyrus and depression was based on the development of a critical synthesis of bibliographic knowledge. <strong>Results:</strong> We found a bipartite Brodmann subdivision which evolved into a subdivision into four regions of the cingulate gyrus. Descriptions of the cingulate gyrus boundaries are imprecise and divergent. The anterior end of the anterior cingulate cortex is a confirmed target of stimulation in the treatment of major and resistant depression, thus requiring the authors, a consensus in its delineation. Brodmann’s area 25 has been described as the main target of brain stimulation therapies. Dysfunction by local lesion or by alteration of the connectivity of Brodmann’s area has repercussions on these different structures to which it is interconnected. These disturbances when they are in the direction of collapse paint a picture similar to major depression. <strong>Conclusion: </strong>The anterior cingulate cortex is involved in depression. The functional system organization of affectivity will allow new brain stimulation techniques to act on the entire functional system or on one of its components.
