Epidemiological Profile of Women with Mental Disorders in Hospital in Dakar

Introduction: Women are currently more likely than men to suffer from mental health problems. The prevalence of mental health problems among women is also increasing. However, few studies conducted in Africa provide epidemiological data on women. The aim of this study was to describe the epidemiological profile of women with mental health problems in Dakar. Methodology: This was a cross-sectional, retrospective, descriptive study over a five-year period, from 1 January 2017 to 31 December 2021. It concerned all women hospitalised for psychiatric reasons at the Psychiatry Department of Fann Hospital, Dakar, Senegal. The data collection form provided information on the sociodemographic profile, i.e., age, current address, marital status, ethnicity, religion, level of education, professional activity, and use of psychoactive substances. Results: The prevalence of mental disorders was 34.9% and concerned the following ICD-10 pathology groups [F00 - 09], [F10 - F19], [F20 - F29], [F30 - F39], [F40 - 48], [F50 - F59] and [F60 - F69]. The mean age of the patients was 37 years, with a standard deviation of 13 and extremes from 16 to 74 years. Most patients were unmarried (56%). Among the married patients, the monogamous regime was in the majority in our study: 56% compared with 44% for the polygamous regime. Women had to attend French school in 74% of cases. In our study, 32% of patients had reached university level. The majority were unemployed (67%). The notion of mourning was found in 214 patients (30.2%). The birth of one or more children marked the lives of 184 patients (26%). Divorce was noted in 103 patients (14.5%). Marital conflicts were experienced by 94 patients (13.3%). Twenty percent of the patients had used psychoactive substances. Conclusion: The epidemiological profile of a woman with a mental disorder in Dakar is that of a single woman in her forties who had attended university and was a housewife. She does not use psychoactive substances and has experienced at least one mourning in her life.

Clinical Profile of Women with Mental Disorders in Dakar Hospitals

Introduction: In Senegal, knowledge of the clinical profile of mental disorders in women has not been the subject of many studies, even though it is of vital importance to those involved in mental health. Thus, the aim of our study was to describe the clinical aspects of psychiatric disorders in women hospitalized at Fann. Methodology: This was a cross-sectional, retrospective, and descriptive study over a five-year period. We identified 402 cases that met the selection criteria. The data collection form provided information on aspects of the clinical profile of mental disorders, such as medical, surgical, gynecological, obstetrical and psychiatric history, instigator of the request for care, diagnosis, duration and number of hospitalizations. ICD-10 was used for the various pathologies identified. Results: Asthma was noted in 7% of patients, as was hypertension. Gynecological surgery was found in 43 patients (11%). Eight patients were menopausal (2%). The mean number of gestations was 2.09, with a standard deviation of 2.257 and extremes between 0 and 10 gestations. Patients with a history of abortion numbered 58 (14%). The decision to hospitalize the patients was made by 96% (384 patients) of those around them. Hetero aggression was the most recurrent reason for hospitalization (19%). Pathology group F20-29 (schizophrenia, schizotypal disorder, and delusional disorders) was the majority group. Conclusion: The clinical profile of the mentally ill woman in Dakar is a woman in her mid-forties who most often presents with a personal psychiatric history, and her hospitalization is prompted by hetero-aggression and/or logorrhea. She usually suffers from schizophrenia and related disorders. Hospitalization usually lasts between 11 and 20 days.

Study of Descriptive Determinants of Moral Harassment at Work in a Factory in Senegal

Introduction: Globalization and the attendant contemporary system of work organization, industrial competitiveness and workplace hostility could be a source of stress. Behaviors considered to be hostile tend to constitute the foundation on which moral harassment at work rests and contributes significantly to work place mental health. Methodology: We conducted a quantitative, cross sectional descriptive study between April 1 and June 30, 2018 at the Grands Moulins de Dakar “GMD”. We used a questionnaire containing the socio-demographic data to which we added the Masson Meret and Steiner questionnaire called, “Ambiance in professional environment”. We used the Epi info software for data entry and analysis. Results: Sample population was 100 subjects with average age of 42.18 years ± 7.6, a male predominance of 91% and average length of service in the company was 15.27 years ± 10.1. Hostile behavior was more frequently reported than stress, with 49% and 28% respectively. Among the hostile behavior we found criticism in the professional field in 35% of the cases and rumors mongering was observed in 25% of the cases. The most reported stress symptom was general fatigue (45%), hostile behavior was more common in males (40 - 49 years of age and those with more than 10 dependents). Of the officers who felt generally unwell, 78.9% were victims of hostile behavior. Conclusion: Hostile behavior forms the basis of moral harassment at work and their devious nature makes them difficult to detect, this contrasts with its harmful consequences on the health of the staff. Potentially harmful workplace stress has become more frequently encountered in the contemporary workplace and has constituted an occupational hazard. The most common symptoms reported are feeling unwell and general fatigue.

The Use of Atypical Neuroleptics in Drugs Management in Fann’s Psychiatry Department

Background and Objectives: Neuroleptics have revolutionized pharmacological management in psychiatry. The advent of atypical neuroleptics constitutes a major turning point in this therapeutic challenge. The objective of our study was to determine the prescription of these atypical neuroleptics in Fann’s psychiatry department. Methodology: It was a descriptive retrospective cross-sectional study that involved 223 patients hospitalized in the psychiatry department of Fann Hospital during the period from January 2015 to December 2017. Results: Our study shows a majority prescription of classic neuroleptics in combination Haloperidol-Chlorpromazine 53% and 14% in monotherapy and a prescription of atypical neuroleptics at 4%. They are prescribed in combination with the classics at 4%. Conclusion: These results show a still low prescription of atypical neuroleptics which raises questions about the availability and affordability of such drugs, but also about prescription habits in the context of developing country.

Quantitative Study on Individual Representations in Senegalese Patients Living with HIV (PLHIV)

Context: 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. Methodology: 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. Results: 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, i.e. 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. Conclusion: 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.

Contribution of the Neuroanatomy of the Cingulate Gyrus to the Neuroscientific Approach to Depression

Introduction: 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. Methodology: 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. Results: 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. Conclusion: 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.