Introduction: Tramadol* is a synthetic opioid agonist used as an analgesic. Despite its minor potential of addiction, it created recently a lot of concern. Its misuse may be motivated by a need to control the pain or by looking for her euphoric character. The aim of our study was to proceed a psychopathological reading of a case of addiction to Tramadol in a sickle cell patient with histrionic personality traits. Methods: We report the case's management of a patient with addiction to Tramadol in a sickle cell patient with histrionic personality traits. The diagnosis was based on the DSM IV criteria. The review was done in the model of semi-structured interviews. Observation: Miss DP is 23 years old, sickle cell patient (AS profile). It is addressed to us for the management of an excessive consumption of Tramadol* started 4 years ago. Because of the difficulties of care in outpatient, we conducted hospitalization. The interviews highlight the histrionic personality traits and disruption of family dynamics. Discussion: Painful chronic diseases require a long analgesic treatment. It is a factor of dependence specially when the patient has a personality disorder. Multidisciplinary treatment between psychiatrist and addiction specialist and medical doctor is a guarantee of success.

Depression is often encountered with chronic diseases such as renal failure, for which the prognosis has been improved by hemodialysis. The occurrence of depression with these chronic ailments is related to several factors. The aim of this work was to identify risk factors for depression in a population of patients undergoing hemodialysis due to renal failure. We conducted a cross-sectional descriptive study from 1 st January 2012 to 31 st May 2014 in the setting of the hemodialysis unit of the Nephrology Department of the Aristide Le Dantec Hospital in Dakar, Senegal. The study population was comprised of chronic hemodialysis patients who had freely and unequivocally provided their informed consent. The self-reporting Beck Depression Inventory (BDI) short-form for depression was used. This short-form version of the BDI was a tool designed to allow the practitioner to perform a rapid assessment of depression. It consisted of 13 items. After administering this assessment, we also collected all the epidemiological and clinical data for this patient population using a pre-established form. Eight-three patients were recruited during the course of the study. These comprised 39 males (47%) and 44 females (53%), i.e. a sex ratio of 0.88. The mean age was 44.73 years, ranging from 18 to 79. The incidence of depression, according to the shortform BDI, for this population was 57.8%. The duration of the dialysis treatment and a diabetic background constituted the principal factors that correlated significantly with depression. Depression correlated neither with age, gender, nor marital status. Professional engagement, level of education, socioeconomic status and prior incidences of depression also did not correlate with the occurrence of depression. In this study, depression affected more than half of the individuals with renal failure. The principal risk factors were the duration of the dialysis treatment and a diabetic background.