This study aimed to determine prevalence and correlates of suicidal attempts in an adult primary care population in Sousse (Tunisia).

Sampling followed a stratified multistage probability cluster design from witch a representative sample of adult primary care population of Sousse was obtained. The sample was composed of 1249 subjects aged 18 years or more. Subjects were interviewed by trained clinicians using the Tunisian version of Composite International Diagnostic Interview 2.1.

General and clinical characteristics of subjects who had reported previous suicidal attempts were compared with those of the remainder using t test and Chi-2 test.

Mean age in our sample was 43.4 ± 17.62 years, with female gender (70.9%) and urban residency (67.8%) predominance. 62.3% of participants were married, 27.3% celibates and 10.4% divorced or widowed. 68.4% of them had low educational level and 70% were out of work during the last 12 months. Suicidal attempts were found in 2.9% of participants. They were correlated to less than 40 years age (p=0.036) and to the diagnosis of major depressive episodes (p< 10-3), recurrent major depressive disorder (p=0.005) and dysthymic disorder (p< 10-3). Among major depressive episodes, only severe ones were associated to higher prevalence of suicidal attempts (p< 10-3).

Prevalence of suicidal attempts in Sousse primary care population was 2.9%. It was correlated to low age and to depressive disorders.

In this study, we focused on the correlations between life events, affective temperaments and suicidal attempts among patients with bipolar disorder.

Patients with DSM IV diagnosis of bipolar I or bipolar II disorders were recruited from psychiatric consultation of the Farhat Hached Hospital in Sousse. All bipolar patients were in remission for at least four weeks. Suicidal attempts were checked by interrogating patients and consulting medical observations. Affective temperament dimensions were determined by using the Arabic version of TEMPS-A. The assessment of life events was based on the Paykel scale.

A total of 57 patients (47 with bipolar I disorder and 10 with bipolar II disorder) have participated in the study, with a mean age of 41,8 ± 11,3 years and a gender ratio of 2,29. Suicidal attempt number was positively correlated with depressive (p=0,021) and anxious (p=0,015) temperament, early orphanage (p=0,008) and the total number of life events (p=0,011). It was also correlated with the global negative impact of these events (p=0,036).

According to our findings, life events and their negative impact, early parental loss and anxious and depressive temperaments predispose to suicidal attempts among patients with bipolar disorder. Further prospective studies are required to confirm these results.

Although a relationship between experience of problematic life events and suicidal behaviour has been recognized during last decades, few studies of life events have been realized among depressive adults.

The aim of this study was to determine the correlations between life events and suicidal attempts among depressive adult patients.

Eighty adult outpatients were recruited from the psychiatric department of Farhat Hached hospital of sousse (in Tunisia). All patients were followed up for a Major Depressive Disorder (MDD) according to the DSM IV criteria. They also were in remission for at least four weeks. For life events we used the EVE scale of Ferreri which permitted to assess event nature, event number and patient strategies in front of stressful life events.

The gender ratio of the sample was 1.35 and the mean age was 44.4 ± 12.9 years.

Twenty five percent of the sample have committed at least one suicidal attempt.

Suicidal attempts were positively correlated with the total number of life events (p = 0.001), the number of early life events (p = 0.024) and the number of stressful life events (p < 0.001). Patients with a history of suicidal attempts were more likely to cope negatively with life events (p < 0.001).

To prevent suicide, psychotherapies focusing on stress coping could be a good therapeutic alternative among patients with MDD.

In Tunisia and in most Muslim countries, alcohol consumption has remained taboo. The aim of our study was to determine the prevalence of alcohol abuse and alcohol dependence in an adult primary care population and to compare gender prevalences and characteristics.

This is a cross-sectional prevalence survey conducted in the district of Sousse from June to November 2006. Thirty primary care centers have been randomly selected. The sample was composed of 2576 subjects aged 18 years and more. Participants were interviewed by psychiatrists and medical trainers using the Composite International Diagnostic Interview, which was translated into the Tunisian dialect and validated.

Females represented 78% of the whole sample. The lifetime prevalence rates of alcohol abuse and alcohol dependence were respectively 2,9% and 0,7%. The lifetime prevalences in the male subgroup were 12,9% for alcohol abuse and 3% for alcohol dependence. Only one case of alcohol abuse was found in the female subgroup.

The related alcohol disorders among the men of our study are as frequent as among occidental ones. The related alcohol disorders among women were unexpectedly very low. However, a similar result was reported in an other study conducted in the United Arabic Emirates. This gender alcohol use discrepancy, found in our study, led to two main interrogations. The first one concerning the usefulness of the alcohol disorder structured interviews among Arabic women and the second concerning the Arabic women beliefs about alcohol consumption (Is it a result of religious thoughts or a deny?).