IntroductionStroke is an important cause of morbidity and is responsible for 9% of all deaths worldwide. The most frequent neuropsychiatric consequence of stroke is post-stroke depression (PSD). It has been shown to be associated with both impaired recovery and increased mortality. The aim of our study is to determine the benefits of antidepressant prescription after a stroke.MethodThe databases from Medline and PubMed were reviewed for articles related to post-stroke depression (PSD), antidepressant treatment and stroke, post-stroke depression and functional recovery, stroke related impairment.ResultsAntidepressant drugs have been shown to be effective in treating PSD in six double blind randomized studies. Patients treated with antidepressants had better recovery from disability than patients who did not receive antidepressant therapy: it was proved that antidepressant drugs cause an improvement in cognitive skills and functional recovery in PSD patients. In patients with ischemic stroke and moderate to severe motor deficit, the early prescription of fluoxetine with physiotherapy enhanced motor recovery after 3 months. Some studies showed that PSD can be effectively prevented: nortriptyline, fluoxetine, milnacipran and sertraline appeared to be efficacious in preventing depression after stroke and are to use without significant adverse effects in stroke patients.ConclusionAntidepressant treatment plays an increasing role in the management of patients with acute stroke. Therefore, early initiation of antidepressant therapy, in non-depressed stroke patients, may reduce the odds for development of PSD, and improve cognitive and functional recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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IntroductionThe narcissistic perversion is a psychoanalytical term resulting from the association of 2 Freudian notions: perversion and narcissism. The concept of narcissistic pervert has no clinical validity. The companions of the narcissistic perverts undergo moral suffering, often unknown by their entourage.ObjectivesWe suggest studying the trajectory of life of two wives of narcissistic perverts.AimsEmphasize the peculiarities of the narcissistic perverse personality.MethodsWe are going to postpone 2 clinical cases of spouses of narcissistic perverts.ResultsCase 1: Mrs. A., 60-year-old, divorced once. Mother of a girl. She met her current husband during the marriage of her daughter. At the beginning of their common life, Mr. M. was loving and in the small care with his wife. After three months of the marriage, Mrs. A. reported the change of character of her husband who became aggressive, decreasing her and taking her away from her family. He seized all her goods. She is actually getting a divorce.Case 2: Mrs. R., 27-year-old, married Mr. C. after 9 months of knowledge. At the beginning of their marriage, they had a good agreement. Forced to stay at home to take care only of domestic spots, she reported a real-life experience of neglect and emotional carelessness, she felt belittled and isolated. At present engaged in a divorce procedure after been physically assaulted threatened with death.Both women consulted for depression.ConclusionThe narcissistic perversion is a personality problem which affects as well the person involved but especially his entourage. When you are in connection with a narcissistic pervert, even after leaving him, you never recover from it.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe course of medical studies is a long route asking for a lot of breath. It is enclosed by the national examination for specialisation, which allows to access professional training. This examination requires a diligent preparation over several months in difficult conditions for the most part of the candidates who are in practical training.Objectivesand aims We suggest estimating the degree of anxiety and depression at the candidates in the week following the national examination for specialization of 2016.MethodsWe have put online on the pages of the various Tunisian Faculties of Medicine an anonymous questionnaire intended for the candidates who took the national examination for specialization of 2016. We used the scale HAD (Hospital Anxiety and depression scale).ResultsWe recruited 220 participants. More or less half of the participants declare to be rather often in a good mood, that they take little only of the pleasure in the same things as before, that they laugh and see the highly-rated voucher of things really less than before, that they are made of the concern very often and that they sometimes experience sensations of fear. A third of the participants feel tense or irritated most of the time feel sudden sensations of panic rather often and have the impression to work in slow motion rather often.ConclusionTaking the national examination of specialization rhymes with stress and anxiety. It leads us to question: is it necessary to assure a psychological coverage during the preparation and upstream of the competition?Disclosure of interestThe authors have not supplied their declaration of competing interest.