N. Gaddour | University of Monastir (original) (raw)

Papers by N. Gaddour

le tabagisme chez les adolescents prend de plus en plus d'ampleur et ses complications a cet ... more le tabagisme chez les adolescents prend de plus en plus d'ampleur et ses complications a cet âge ne sont pas que physiques. Les objectif de notre travail etaient de determiner la prevalence des conduites tabagiques chez les adolescents de Monastir et de rechercher des facteurs associes. Pour ce faire nous avons realise une etude transversale descriptive portant sur un echantillon representatif des eleves des colleges et lycees de la ville de Monastir (N=854, âge moyen 16 ± 2 ans). L'evaluation a consiste en un questionnaire valide auto-administre de 102 items. Nous avons note que 30,4% des eleves ont experimente le tabac et que 11,3% parmi eux etaient des fumeurs reguliers. Parmi les fumeurs, la cigarette constituait le principal mode de consommation et la dependance a la nicotine etait faible a tres faible. Le tabagisme de la mere et des amis ont ete les facteurs les plus significativement associes a celui de l'adolescent. 23% des eleves ont affirme douter de l'effe...

European Psychiatry, 2021

IntroductionBecause emotional symptoms are common in attention-deficit/hyperactivity disorder (AD... more IntroductionBecause emotional symptoms are common in attention-deficit/hyperactivity disorder (ADHD) patients and associate with much morbidity, some consider it to be a core feature rather than an associated trait.Objectives Assess the possibility that symptoms of emotional dysregulation should be considered as core diagnostic feature of ADHD.Methods It’s a cross sectional study, including 60 children with ADHD and 60 children without ADHD ranging from 6 to 19 years of age (mean age 10.43 years). We defined moderate emotional dysregulation if a child had an aggregate cut-off score of ˃180 on the Anxiety/Depression, Aggression, and Attention scales of the CBCL and severe emotionaldysregulation if a child had an aggregate cut-off score of ˃ 210. This profile was selected because of its conceptual congruence with the clinical concept of emotionaldysregulation.Results Sixty-three percent of children with ADHD had a severe emotional dysregulation versus 12% of controls (P˂0.001). Emotio...

European Psychiatry, 2021

IntroductionBullying is a serious problem for school youth. It is prevalent across the elementary... more IntroductionBullying is a serious problem for school youth. It is prevalent across the elementary and secondary school years and it has serious consequences for both bullies and victims.ObjectivesThe aim of this study was to investigate the relationship between self-esteem and bullying behavior.MethodsWe conducted a cross-sectional study including children enrolled in two high schools in Sousse, Tunisia. The students were asked to complete two questionnaires: the Adolescent Peer Relations Instrument witch is a multidimensional scale designed to assess bullying involvement both as target and perpetrator and the Rosenberg self-esteem scale.ResultsWe recruited 600 adolescent. The mean age of our population was 13.76 ±1.37 and the sex ratio was 1. More than 95% of adolescent who reported that they had been victims of bullying had a very low self-esteem comparing to those who stated that they had never been bullied (4.4%). Our results have also shown that bullies had a lower self-esteem ...

L'objectif du travail etait de decrire le profil epidemiologique et criminologique des affair... more L'objectif du travail etait de decrire le profil epidemiologique et criminologique des affaires d'agressions sexuelles traitees en justice penale dans une region du centre-est tunisien. Il s'agit d'une etude retrospective, realisee a partir des registres juridiques des affaires d'agressions sexuelles jugees de 1993 a 1998. 629 affaires ont ete recensees, correspondant a une incidence de 14,7 victimes pour 100000 habitants par an. Quatre-vingt-un pour cent des victimes etaient mineures et 58 % de sexe feminin. Les agresseurs etaient quasi exclusivement de sexe masculin et 38 % d'entre eux etaient mineurs. Les agresseurs mineurs ont surtout des victimes de sexe masculin alors que les agresseurs adultes jeunes ont surtout des victimes de sexe feminin. Le viol etait l'agression la plus frequente (53 %), surtout quand la victime etait mineure et du sexe masculin. Ces resultats etaient compares a ceux d'autres etudes et des commentaires en sont deduits pour...

African journal of psychiatry, 2010

The issue of sub-specialization within a developing world setting has been raised as an issue for... more The issue of sub-specialization within a developing world setting has been raised as an issue for developing world psychiatrists. The current editorial poses the question as to whether sub specialists in child and adolescent psychiatry are a luxury or a necessity. In a continent where over 50% of the population are children and adolescents and one in five will have a mental health problem, how appropriate is this question? Yet the question needs to be answered if effective Child and Adolescent Psychiatry (CAP) services are to be developed and extended in Africa.

European Psychiatry, 2021

Introduction Marriages’ dissolution phenomenon had increased in recent years in Tunisia. The impa... more Introduction Marriages’ dissolution phenomenon had increased in recent years in Tunisia. The impact of divorce on children depends on the interweaving of several factors and is not inevitably pathological. We have noticed in our daily practice a concomitant increase in the number of request for expert opinions concerning children. Objectives Determine the clinical children’s profile of separated parents carried out within the framework of legal expertise. Methods We carried out a retrospective study in the outpatient child psychiatry ward at Fattouma Bourguiba general hospital in Monastir, Tunisia. Including all the expert reports of children affected by parental separations during a period of two years (2017 to 2019). Results 56 children were included in our study. The average age were (6.7 years) with a majority of males (58.2%). School failure concerned (24%). In most cases, the request for expertise was made in the context of mistreatment’s suspicion (60.7%), than following the ...

African Journal of Psychiatry, 2008

2008 Meeting of the African Association of Psychiatrists and Allied Professions (AAPAP), Accra, G... more 2008 Meeting of the African Association of Psychiatrists and Allied Professions (AAPAP), Accra, Ghana, 25 - 27 June News from Tunisia and North-Africa Report on the World Federation for Mental Health (WFMH) forum Obituary : Olabisi Adebayo Odejide

African Journal of Psychiatry, 2010

The issue of sub-specialization within a developing world setting has been raised as an issue for... more The issue of sub-specialization within a developing world setting has been raised as an issue for developing world psychiatrists. The current editorial poses the question as to whether sub specialists in child and adolescent psychiatry are a luxury or a necessity. In a continent where over 50% of the population are children and adolescents and one in five will have a mental health problem, how appropriate is this question? Yet the question needs to be answered if effective Child and Adolescent Psychiatry (CAP) services are to be developed and extended in Africa.

le tabagisme chez les adolescents prend de plus en plus d'ampleur et ses complications a cet ... more le tabagisme chez les adolescents prend de plus en plus d'ampleur et ses complications a cet âge ne sont pas que physiques. Les objectif de notre travail etaient de determiner la prevalence des conduites tabagiques chez les adolescents de Monastir et de rechercher des facteurs associes. Pour ce faire nous avons realise une etude transversale descriptive portant sur un echantillon representatif des eleves des colleges et lycees de la ville de Monastir (N=854, âge moyen 16 ± 2 ans). L'evaluation a consiste en un questionnaire valide auto-administre de 102 items. Nous avons note que 30,4% des eleves ont experimente le tabac et que 11,3% parmi eux etaient des fumeurs reguliers. Parmi les fumeurs, la cigarette constituait le principal mode de consommation et la dependance a la nicotine etait faible a tres faible. Le tabagisme de la mere et des amis ont ete les facteurs les plus significativement associes a celui de l'adolescent. 23% des eleves ont affirme douter de l'effe...

Introduction Autism spectrum disorder (ASD) and cancer are two pathologies that appear to be diff... more Introduction Autism spectrum disorder (ASD) and cancer are two pathologies that appear to be different, but whose multifactorial determinism involves shared genetic and environmental factors. Objectives This study aimed to find an association between maternal cancer and ASD in children by comparing the frequencies of ASD between children of mothers followed for cancer and children of mothers free from cancer Methods We recruited, between March and August 2018, women divided into 2 groups: G1; women followed for cancer at the oncology consultation of Monastir and Sousse (N1 = 100) and G2; women free from cancer (N2 = 101). We screened their offspring aged 18 months to 11 years for ASD using the C-AQ and the M-CHAT. We confirmed the diagnosis of ASD using ADI-R in children who tested positive. Results Nous avons examiné un total de 332 enfants. La fréquence des enfants atteints de TSA chez les mères G1 était de 5,4%, celle des enfants de mères G2 était de 1,2 avec une association sign...

Introduction Trichotillomania is a disorder characterized by the compulsive pulling out of one’s ... more Introduction Trichotillomania is a disorder characterized by the compulsive pulling out of one’s own hair. It usually starts just before or after puberty, and about 1 to 2% of people have this disorder. But its incidence is variable over the years and socio-demographic data. Objectives Describe the profile of children and adolescents consulting for trichotillomania. Methods An incidence survey was carried out among children and adolescents followed for trichotillomania at the out-patient unit of child psychiatry (Monastir - Tunisia) from January 2003 to September 2020. Results Among the 11000 patients who were followed during the study period, 47 patients presented trichotillomania, corresponding to a rate of 0.42%. Three of them presented with associated trichophagia and two were operated on in pediatric surgery for trichobezoar. A female predominance was noted with a sex-ratio of 0.37. The average age was 9.3 years with extremes ranging from 2 to 15 years. Almost all of the patien...

Dear colleagues Child and adolescent mental health: change has come to the African continent! My ... more Dear colleagues Child and adolescent mental health: change has come to the African continent! My journey in the field of child and adolescent mental health, including subspecialty training in child and adolescent psychiatry. My journey so far Training in child and adolescent psychiatry at the University of Pittsburgh The revolution in Tunisia - impact on children Short CAMH news from Africa Africa in IACAPAP Bulletin African participation to ESCAP Congress in Helsinki Don't forget the next IACAPAP congress in Paris www.iacapap2012.org Sanofi-aventis Registrar Development Award

Language Learning

We have documented the significant presence of spontaneous and productive use of Modern Standard ... more We have documented the significant presence of spontaneous and productive use of Modern Standard Arabic (MSA) in the speech of five Tunisian boys with autism, an unusual phenomenon. In typical development, MSA is not fully acquired before the late school years. The Arabic language in Tunisia is in a state of diglossia, and (unlike the colloquial Tunisian Arabic variety) MSA is virtually never used in everyday conversation. Television programs broadcast across the Arabic-speaking world constitute the most important source of MSA for preschool children. Typically developing children require active social interaction to develop language, but some children with autism may use television and cartoons as noninteractional input to acquire language. This study highlighted the existence of a noninteractional language-learning strategy that may partly compensate for the sociopragmatic deficits that characterize autism.

French Journal of Psychiatry

Neuropsychiatrie de l'Enfance et de l'Adolescence, 2012

African journal of psychiatry, 2010

L'Encéphale, 2014

The multidimensional aspect of the concept of impulsivity is proven by the composite structure of... more The multidimensional aspect of the concept of impulsivity is proven by the composite structure of the rating scales of impulsivity. Several studies have already found correlations between trait-impulsivity and externalizing disorders. However, the studies interested in the relationship between trait-impulsivity and internalizing problems are rare. We have tried to explore correlations between impulsivity and externalization and internalization problems, in a population of adolescent outpatients. We recruited 31 adolescent out-patients in the child and adolescent psychiatry department in the University Hospital of Monastir, Tunisia. The Barratt Impulsivity Scale (BIS) was used to evaluate a multidimensional concept of trait-impulsivity, including the dimensions of "Motor", "Non-planning" and "Attentional" impulsivities. The Strength and Difficulties Scales (SDQ) was used to assess different domains of externalizing and internalizing problems, including "Emotional symptoms", "Conduct problems", "Hyperactivity" and "Peer problems". The sex-ratio was 1.21. The mean age was 15.19±1.27 years. All patients but one were attending school. The diagnosis was "Major Depressive Episode" in 32 % and "Behavior Disorder" in 38 %. The means of the scores of externalizing and internalizing problems were 9.35±4.41 and 9.65±3.26, respectively. The total score of the BIS was significantly related to both scores of externalizing and internalizing problems. The "Motor" impulsivity was specially correlated with the externalizing dimension of the SDQ. The non-planning impulsivity was correlated with both scores of externalizing and internalizing problems, but it was mainly related to internalizing problems. The attentional impulsivity was also correlated with both dimensions of externalizing and internalizing problems. The dimensions of trait-impulsivity were correlated with various dimensions of the SDQ concerning externalizing and internalizing problems. That confirms the hypothesis that the impulsiveness is associated with wide domains of the psychopathology of the teenager which are not limited to behavior disorders. We can process these problems by influencing the "Motor impulsivity" and "Non-planning impulsivity". The cognitive and behavioral therapy and the selective serotonin reuptake inhibitor may be efficient.

le tabagisme chez les adolescents prend de plus en plus d'ampleur et ses complications a cet ... more le tabagisme chez les adolescents prend de plus en plus d'ampleur et ses complications a cet âge ne sont pas que physiques. Les objectif de notre travail etaient de determiner la prevalence des conduites tabagiques chez les adolescents de Monastir et de rechercher des facteurs associes. Pour ce faire nous avons realise une etude transversale descriptive portant sur un echantillon representatif des eleves des colleges et lycees de la ville de Monastir (N=854, âge moyen 16 ± 2 ans). L'evaluation a consiste en un questionnaire valide auto-administre de 102 items. Nous avons note que 30,4% des eleves ont experimente le tabac et que 11,3% parmi eux etaient des fumeurs reguliers. Parmi les fumeurs, la cigarette constituait le principal mode de consommation et la dependance a la nicotine etait faible a tres faible. Le tabagisme de la mere et des amis ont ete les facteurs les plus significativement associes a celui de l'adolescent. 23% des eleves ont affirme douter de l'effe...

European Psychiatry, 2021

IntroductionBecause emotional symptoms are common in attention-deficit/hyperactivity disorder (AD... more IntroductionBecause emotional symptoms are common in attention-deficit/hyperactivity disorder (ADHD) patients and associate with much morbidity, some consider it to be a core feature rather than an associated trait.Objectives Assess the possibility that symptoms of emotional dysregulation should be considered as core diagnostic feature of ADHD.Methods It’s a cross sectional study, including 60 children with ADHD and 60 children without ADHD ranging from 6 to 19 years of age (mean age 10.43 years). We defined moderate emotional dysregulation if a child had an aggregate cut-off score of ˃180 on the Anxiety/Depression, Aggression, and Attention scales of the CBCL and severe emotionaldysregulation if a child had an aggregate cut-off score of ˃ 210. This profile was selected because of its conceptual congruence with the clinical concept of emotionaldysregulation.Results Sixty-three percent of children with ADHD had a severe emotional dysregulation versus 12% of controls (P˂0.001). Emotio...

European Psychiatry, 2021

IntroductionBullying is a serious problem for school youth. It is prevalent across the elementary... more IntroductionBullying is a serious problem for school youth. It is prevalent across the elementary and secondary school years and it has serious consequences for both bullies and victims.ObjectivesThe aim of this study was to investigate the relationship between self-esteem and bullying behavior.MethodsWe conducted a cross-sectional study including children enrolled in two high schools in Sousse, Tunisia. The students were asked to complete two questionnaires: the Adolescent Peer Relations Instrument witch is a multidimensional scale designed to assess bullying involvement both as target and perpetrator and the Rosenberg self-esteem scale.ResultsWe recruited 600 adolescent. The mean age of our population was 13.76 ±1.37 and the sex ratio was 1. More than 95% of adolescent who reported that they had been victims of bullying had a very low self-esteem comparing to those who stated that they had never been bullied (4.4%). Our results have also shown that bullies had a lower self-esteem ...

L'objectif du travail etait de decrire le profil epidemiologique et criminologique des affair... more L'objectif du travail etait de decrire le profil epidemiologique et criminologique des affaires d'agressions sexuelles traitees en justice penale dans une region du centre-est tunisien. Il s'agit d'une etude retrospective, realisee a partir des registres juridiques des affaires d'agressions sexuelles jugees de 1993 a 1998. 629 affaires ont ete recensees, correspondant a une incidence de 14,7 victimes pour 100000 habitants par an. Quatre-vingt-un pour cent des victimes etaient mineures et 58 % de sexe feminin. Les agresseurs etaient quasi exclusivement de sexe masculin et 38 % d'entre eux etaient mineurs. Les agresseurs mineurs ont surtout des victimes de sexe masculin alors que les agresseurs adultes jeunes ont surtout des victimes de sexe feminin. Le viol etait l'agression la plus frequente (53 %), surtout quand la victime etait mineure et du sexe masculin. Ces resultats etaient compares a ceux d'autres etudes et des commentaires en sont deduits pour...

African journal of psychiatry, 2010

The issue of sub-specialization within a developing world setting has been raised as an issue for... more The issue of sub-specialization within a developing world setting has been raised as an issue for developing world psychiatrists. The current editorial poses the question as to whether sub specialists in child and adolescent psychiatry are a luxury or a necessity. In a continent where over 50% of the population are children and adolescents and one in five will have a mental health problem, how appropriate is this question? Yet the question needs to be answered if effective Child and Adolescent Psychiatry (CAP) services are to be developed and extended in Africa.

European Psychiatry, 2021

Introduction Marriages’ dissolution phenomenon had increased in recent years in Tunisia. The impa... more Introduction Marriages’ dissolution phenomenon had increased in recent years in Tunisia. The impact of divorce on children depends on the interweaving of several factors and is not inevitably pathological. We have noticed in our daily practice a concomitant increase in the number of request for expert opinions concerning children. Objectives Determine the clinical children’s profile of separated parents carried out within the framework of legal expertise. Methods We carried out a retrospective study in the outpatient child psychiatry ward at Fattouma Bourguiba general hospital in Monastir, Tunisia. Including all the expert reports of children affected by parental separations during a period of two years (2017 to 2019). Results 56 children were included in our study. The average age were (6.7 years) with a majority of males (58.2%). School failure concerned (24%). In most cases, the request for expertise was made in the context of mistreatment’s suspicion (60.7%), than following the ...

African Journal of Psychiatry, 2008

2008 Meeting of the African Association of Psychiatrists and Allied Professions (AAPAP), Accra, G... more 2008 Meeting of the African Association of Psychiatrists and Allied Professions (AAPAP), Accra, Ghana, 25 - 27 June News from Tunisia and North-Africa Report on the World Federation for Mental Health (WFMH) forum Obituary : Olabisi Adebayo Odejide

African Journal of Psychiatry, 2010

The issue of sub-specialization within a developing world setting has been raised as an issue for... more The issue of sub-specialization within a developing world setting has been raised as an issue for developing world psychiatrists. The current editorial poses the question as to whether sub specialists in child and adolescent psychiatry are a luxury or a necessity. In a continent where over 50% of the population are children and adolescents and one in five will have a mental health problem, how appropriate is this question? Yet the question needs to be answered if effective Child and Adolescent Psychiatry (CAP) services are to be developed and extended in Africa.

le tabagisme chez les adolescents prend de plus en plus d'ampleur et ses complications a cet ... more le tabagisme chez les adolescents prend de plus en plus d'ampleur et ses complications a cet âge ne sont pas que physiques. Les objectif de notre travail etaient de determiner la prevalence des conduites tabagiques chez les adolescents de Monastir et de rechercher des facteurs associes. Pour ce faire nous avons realise une etude transversale descriptive portant sur un echantillon representatif des eleves des colleges et lycees de la ville de Monastir (N=854, âge moyen 16 ± 2 ans). L'evaluation a consiste en un questionnaire valide auto-administre de 102 items. Nous avons note que 30,4% des eleves ont experimente le tabac et que 11,3% parmi eux etaient des fumeurs reguliers. Parmi les fumeurs, la cigarette constituait le principal mode de consommation et la dependance a la nicotine etait faible a tres faible. Le tabagisme de la mere et des amis ont ete les facteurs les plus significativement associes a celui de l'adolescent. 23% des eleves ont affirme douter de l'effe...

Introduction Autism spectrum disorder (ASD) and cancer are two pathologies that appear to be diff... more Introduction Autism spectrum disorder (ASD) and cancer are two pathologies that appear to be different, but whose multifactorial determinism involves shared genetic and environmental factors. Objectives This study aimed to find an association between maternal cancer and ASD in children by comparing the frequencies of ASD between children of mothers followed for cancer and children of mothers free from cancer Methods We recruited, between March and August 2018, women divided into 2 groups: G1; women followed for cancer at the oncology consultation of Monastir and Sousse (N1 = 100) and G2; women free from cancer (N2 = 101). We screened their offspring aged 18 months to 11 years for ASD using the C-AQ and the M-CHAT. We confirmed the diagnosis of ASD using ADI-R in children who tested positive. Results Nous avons examiné un total de 332 enfants. La fréquence des enfants atteints de TSA chez les mères G1 était de 5,4%, celle des enfants de mères G2 était de 1,2 avec une association sign...

Introduction Trichotillomania is a disorder characterized by the compulsive pulling out of one’s ... more Introduction Trichotillomania is a disorder characterized by the compulsive pulling out of one’s own hair. It usually starts just before or after puberty, and about 1 to 2% of people have this disorder. But its incidence is variable over the years and socio-demographic data. Objectives Describe the profile of children and adolescents consulting for trichotillomania. Methods An incidence survey was carried out among children and adolescents followed for trichotillomania at the out-patient unit of child psychiatry (Monastir - Tunisia) from January 2003 to September 2020. Results Among the 11000 patients who were followed during the study period, 47 patients presented trichotillomania, corresponding to a rate of 0.42%. Three of them presented with associated trichophagia and two were operated on in pediatric surgery for trichobezoar. A female predominance was noted with a sex-ratio of 0.37. The average age was 9.3 years with extremes ranging from 2 to 15 years. Almost all of the patien...

Dear colleagues Child and adolescent mental health: change has come to the African continent! My ... more Dear colleagues Child and adolescent mental health: change has come to the African continent! My journey in the field of child and adolescent mental health, including subspecialty training in child and adolescent psychiatry. My journey so far Training in child and adolescent psychiatry at the University of Pittsburgh The revolution in Tunisia - impact on children Short CAMH news from Africa Africa in IACAPAP Bulletin African participation to ESCAP Congress in Helsinki Don't forget the next IACAPAP congress in Paris www.iacapap2012.org Sanofi-aventis Registrar Development Award

Language Learning

We have documented the significant presence of spontaneous and productive use of Modern Standard ... more We have documented the significant presence of spontaneous and productive use of Modern Standard Arabic (MSA) in the speech of five Tunisian boys with autism, an unusual phenomenon. In typical development, MSA is not fully acquired before the late school years. The Arabic language in Tunisia is in a state of diglossia, and (unlike the colloquial Tunisian Arabic variety) MSA is virtually never used in everyday conversation. Television programs broadcast across the Arabic-speaking world constitute the most important source of MSA for preschool children. Typically developing children require active social interaction to develop language, but some children with autism may use television and cartoons as noninteractional input to acquire language. This study highlighted the existence of a noninteractional language-learning strategy that may partly compensate for the sociopragmatic deficits that characterize autism.

French Journal of Psychiatry

Neuropsychiatrie de l'Enfance et de l'Adolescence, 2012

African journal of psychiatry, 2010

L'Encéphale, 2014

The multidimensional aspect of the concept of impulsivity is proven by the composite structure of... more The multidimensional aspect of the concept of impulsivity is proven by the composite structure of the rating scales of impulsivity. Several studies have already found correlations between trait-impulsivity and externalizing disorders. However, the studies interested in the relationship between trait-impulsivity and internalizing problems are rare. We have tried to explore correlations between impulsivity and externalization and internalization problems, in a population of adolescent outpatients. We recruited 31 adolescent out-patients in the child and adolescent psychiatry department in the University Hospital of Monastir, Tunisia. The Barratt Impulsivity Scale (BIS) was used to evaluate a multidimensional concept of trait-impulsivity, including the dimensions of "Motor", "Non-planning" and "Attentional" impulsivities. The Strength and Difficulties Scales (SDQ) was used to assess different domains of externalizing and internalizing problems, including "Emotional symptoms", "Conduct problems", "Hyperactivity" and "Peer problems". The sex-ratio was 1.21. The mean age was 15.19±1.27 years. All patients but one were attending school. The diagnosis was "Major Depressive Episode" in 32 % and "Behavior Disorder" in 38 %. The means of the scores of externalizing and internalizing problems were 9.35±4.41 and 9.65±3.26, respectively. The total score of the BIS was significantly related to both scores of externalizing and internalizing problems. The "Motor" impulsivity was specially correlated with the externalizing dimension of the SDQ. The non-planning impulsivity was correlated with both scores of externalizing and internalizing problems, but it was mainly related to internalizing problems. The attentional impulsivity was also correlated with both dimensions of externalizing and internalizing problems. The dimensions of trait-impulsivity were correlated with various dimensions of the SDQ concerning externalizing and internalizing problems. That confirms the hypothesis that the impulsiveness is associated with wide domains of the psychopathology of the teenager which are not limited to behavior disorders. We can process these problems by influencing the "Motor impulsivity" and "Non-planning impulsivity". The cognitive and behavioral therapy and the selective serotonin reuptake inhibitor may be efficient.