Comparer les profils sociodémographique et clinique des conduites addictives chez les adolescents en population clinique, entre deux périodes avant et après la révolution tunisienne.

Il s’agit d’une étude rétrospective et comparative portant sur 69 adolescents ayant été hospitalisés au service de pédopsychiatrie du CHU Hédi Chaker de Sfax, Tunisie, et ayant une ou plusieurs conduites addictives. Ces adolescents ont été recrutés sur deux périodes différentes : de 1995 à 2004 pour le premier groupe (n=25) et de 2011 à 2019 pour le deuxième groupe (n=44).

L’âge moyen d’initiation à la consommation était plus précoce dans le groupe 2. Le sex-ratio était de 1,5 pour le deuxième groupe alors que tous les adolescents du premier groupe étaient de sexe masculin. La consommation de tabac a augmenté de façon significative dans le deuxième groupe (48 % G1 vs 86,4 % G2), contrairement à la consommation des solvants organiques dont la fréquence a diminué de façon significative (68 % G1 vs 38,6 % G2). La consommation de Subutex, de même que l’addiction à l’Internet ont été exclusivement notées dans le deuxième groupe. Le diagnostic de troubles des conduites a augmenté de fréquence dans le groupe 2 (31,8 % dans le G2 vs 16 % G1).

La présente étude a relevé un changement des caractéristiques démographiques et cliniques chez les adolescents ayant des conduites addictives. Ce qui suscite l’intérêt de mener des études épidémiologiques de prévalence et de réévaluer les facteurs de risque et de protection chez ces adolescents prenant en compte les remaniements socio-familiaux actuels.

Addiction in adolescence is becoming a serious problem. Findings postulate that social changes in societies are accompanied by changes in the socio-demographic profile and in frequencies of addiction among adolescents. The growing rate in the prevalence of addiction around the world coincides with the social and familial changes that our country is going through.

To identify changes in the demographic and clinical profile of adolescents with addictive behaviors.

We conducted a retrospective and comparative study on 69 adolescents who were hospitalized in the clinical department of child psychiatry of the Hospital University of Hedi Chaker of Sfax, Tunisia, and who had one or more addictive behaviors that correspond to the criteria of dependency according to the DSM IV-TR. The adolescents were recruited in two different periods and divided into two groups: the 1st group was recruited from 1995 to 2004and the 2nd group from 2011 to 2019.

We are taking care of increasingly younger adolescents (the mean age was 16 years for the group 1 against 14.9 years in the group 2). We noted that adolescents from the 2nd group consume psychoactive substances at an earliest age (the average age of initiation of the consumption decreased from 13.5 years to 12 years). The sex ratio was 1.5 while adolescents from the group 1 were all boys. We noted a significant increase in smoking (48 % in the group 1 against 86.4% in group 2). The frequency of organic solvent consumption have decreased in adolescents of nowadays. Cannabis and Subutex are recently consumed by adolescents (in respectively 34% and 6.8% of cases). Internet addiction emerged also as a new addictive behavior in our context. Furthermore, we noted change in the families’ composition, which becomes mononuclear in 68 % of cases in the group 2 against 20% in the group 1. On the other hand, we noted an increase in the frequency of conduct disorder on the recent years when diagnoses were previously dominated by psychotic disorders.

Our study noticed a change in the demographic and clinical profile of adolescents with addictive behaviors in the recent years. This raises the interest of conducting epidemiological prevalence studies and reassessing the risk and protective factors in these adolescents taking into account the current socio-familial reorganizations in our society.