Our results suggest an association between CT and current MDD in French-speaking sub-Saharan Africa, and that this relationship may be explained by PD symptoms. Prospective studies to confirm these results are warranted.

Few studies have examined the association between childhood maltreatment (CM) and personality disorders (PDs) in adulthood in two different cultural contexts, including sub-Saharan Africa. The aims of this study were to compare the frequency of CM between patients in treatment in France and Togo for a major depressive disorder (MDD), to explore the link between CM and PDs, and to examine the mediating effect of personality dimensions in the pathway from CM to PDs in 150 participants (75 in each country). The 28-item Childhood Trauma Questionnaire, the International Personality Item Pool, and the Personality Diagnostic Questionnaire (PDQ-4+) were used to assess CM, personality dimensions, and PDs respectively. Togolese participants reported sexual and physical abuse (PA) and emotional and physical neglect significantly more frequently than French participants. In Togo, severe PA was associated with schizoid, antisocial, narcissistic, obsessive-compulsive, depressive, and negativist PDs whereas in France, PA was only linked to paranoid PD. In Togo, emotional instability partly mediated the relationship between CM and PDs while in France, no personality dimension appeared to mediate this link. Our results support the hypothesis that CM is more common in low-income countries and suggest that the links between CM and PDs are influenced by social environment.

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Objectif : Décrire les aspects psychopathologiques des malades admis pour hématémèse dans le service d'hépa-togastroentérologie du CHU Campus de Lomé (Togo). Méthode : Il s'agit d'une étude prospective menée de juillet 2007 à août 2008. Elle avait consisté à recueillir directement par entretien semi-directif des informations sur la représen-tation et le vécu psychologique des patients admis en hospitalisation pour hématémèse. L'observation au quotidien avait constitué une source permanente de données, autant sur le vécu que sur la représentation de ces patients. Résultats : Les paramètres comme l'âge, le sexe, la situation matrimoniale et la religion ne comportaient pas de particularité vis-à-vis des états dépressifs des patients. Néanmoins, ces paramètres pouvaient influencer le vécu et la représenta-tion de la maladie. Ainsi, la majorité des patients (84 %) se représentaient l'hématémèse comme une maladie grave ou mortelle, et 53 % comme l'empoisonnement et/ou l'envoû-tement. L'hématémèse était vécue par les patients comme étant une persécution (76 %) et dans 66 % des cas comme une culpabilisation. Il ressort dans ce travail que l'angoisse de mort retrouvée chez nos patients serait liée à l'installation brutale de la maladie dans 76,3 % des cas, puis à l'attitude plaignante ou à l'exagération de la maladie par l'entourage dans 58 % des cas et enfin à l'origine supposée de la maladie qui est spirituelle dans 71 %. Conclusion : Suite à ces résultats, une collaboration étroite entre les médecins et les psychologues s'avère nécessaire pour une meilleure prise en charge de ces patients. Mots clés Hématémèse · Vécu · ReprésentationAbstract Objective: The aim of this study is to describe the psychopathological aspects of the patients admitted for haematemesis in the service of hepato-gastroenterologie of the CHU Campus of Lomé (Togo). Method: A prospective study was conducted from July 2007 to August 2008. It consisted in collecting information from semi-structured interview on the representation and the psychological experience of the patients admitted for haematemesis. The daily observation had been a constant source of data both on experience and on the representation of these patients. Results: Parameters such as age, sex, matrimonial situation and religion did not comprise a characteristic with respect to the depressive states of the patients. Nevertheless, these parameters could influence living and the representation of the disease. Thus, the majority of the patients (84%) accounted haematemesis as a serious illness or death, and 53% as poisoning. The haematemesis was experienced by the patients as persecution (76%), and by 66% of the cases as guilt. It appears in this work that the fear of death found among our patients would be related to the sudden onset of the disease in 76% of the cases, then to the plaintiff attitude or the exaggeration of the disease by the entourage in 58% of the cases, and finally to the supposed origin of the disease which is spiritual in 71%. Conclusion: All this shows that the psych...