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Cross-cultural comparison of attitudes toward seeking professional psychological help : A Multinational Population-Based Study from 16 Arab Countries and 10,036 Individuals
- M. Stambouli, F. Fekih Romdhane, A. Jaoua, F. Ghrissi, W. Cherif, M. Cheour
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S343
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Introduction
There has been an increasing interest in people’s attitudes toward seeking psychological help. Although recent research has shown a rise in the number of people seeking help from psychological services, there is still a significant number who choose not to see a mental health specialist.
ObjectivesThe aim of the current study was to examine the attitudes toward help-seeking psychological help among Arab population and to investigate factors related to these attitudes in the whole sample.
MethodsWe carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries.The Community Attitudes toward the Mentally Ill scale,the Mental Health Knowledge Schedule scale and the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form were administered to participants from the general public.
ResultsThe study sample was predominantly female (77%), married (41%), educated (89% with tertiary education), living in urban areas (85%), with a mean age of 29.6 ± 10.8 years.
Participants tended to have a higher preference to seek help from a psychologist or a psychiatrist (85.7%) and primary care physicians (80.7%).We also found that family members represented a preferred source of help in 80.4% of the cases.
In bivariate analyses, help-seeking attitudes positively correlated with attitudes (r=.265) and knowledge (r=.121). Besides, multivariate regression analyses revealed that being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes.
ConclusionsAttitudes toward seeking professional psychological help are intricate. Determining factors associated with help-seeking attitudes may guide interventions in order to avoid delays in help-seeking.
Disclosure of InterestNone Declared
A case-control study of aggressiveness in adolescents with schizophrenia family history
- F. Ghrissi, F. Fekih-romdhane, M. Stambouli, B. Abassi, M. Cheour
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1068
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Introduction
Violence is a common behavioral and health concern among adolescents, aged 12 to 18 years old. In fact, aggressiveness may result in severe outcome in a critical age characterised by biological, psychological, and social changes. Schizophrenia is a severe and chronic condition, with elevated level of aggressiveness. Since unaffected biological relatives of schizophrenia patients share similar though less severe neurocognitive and behavioral abnormalities seen in their affected relatives, they are at increased risk of violence mainly during adolescence. However, studies including adolescents with schizophrenia first degree history are scarce.
ObjectivesThe aim of this survey was to evaluate the aggressiveness among unaffected adolescents with fist degree family history of schizophrenia and in a control group of adolescents with no family psychiatric history.
MethodsIn this purpose wo conducted a case-control cross sectional study in Razi hospital during three months: from July to September 2022. Unaffected adolescents aged 12 to 18 whom first-degree relatives were diagnosed with schizophrenia according to DSM-5 criteria were included. Adolescents with psychiatric conditions or medical affections associated with psychiatric presentation were not included. Control group was selected amongst the population. Sociodemographic data were collected on a preestablished questionnaire and the following scales were used: The Life History of Aggression LHA, an 11 items self-reported tool, in the Arabic version, The Aggression Questionnaire AQ which is a 29 items self-reported scale in Arabic version. Written informed consent was obtained from the legal tutor of each adolescent.
ResultsResults of this survey are ongoing.
ConclusionsResults of this survey are ongoing.
Disclosure of InterestNone Declared
Aggressiveness and emotion dysregulation among adolescents first degree relatives of schizophrenia patients
- F. Ghrissi, F. Fekih-romdhane, M. Stambouli, B. Abassi, M. Cheour
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1068
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Introduction
Schizophrenia is a severe debilitating condition, with elevated level of aggressiveness reaching 33% in a large sample of patients. Unaffected biological relatives of schizophrenia patients share similar though less severe neurocognitive and behavioral abnormalities seen in their affected relatives. Recent findings demonstrates that first degree relatives of schizophrenia patients are at increased risk of violence and aggressive behavior, especially during adolescence, with poor outcome. Besides, adolescents aged from 12 to 18 years old, may experience aversive and overwhelming emotions difficult to regulate due to immaturity of neuronal networks. There are evidence of an association of emotion dysregulation and violent conduct among youth. However, to our knowledge, studies among first degree relatives of psychotic patients were not performed.
ObjectivesThe aim of this study was to evaluate the aggressiveness and emotion dysregulation among unaffected adolescents with fist degree family history of schizophrenia and to investigate the association linking these two entities.
MethodsIn this purpose wo conducted a cross sectional descriptive study in Razi hospital during three months: from July to September 2022. Unaffected adolescents aged 12 to 18 whom first-degree relatives were diagnosed with schizophrenia according to DSM-5 criteria were included. Adolescents with psychiatric conditions or medical affections associated with psychiatric presentation were not included. Sociodemographic data were collected on a preestablished questionnaire and the following scales were used: The Life History of Aggression LHA, an 11 items self-reported tool, in the Arabic version, The Aggression Questionnaire AQ which is a 29 items self-reported scale in Arabic version and the The Emotion Regulation Questionnaire (ERQ), a 10 items self-reported measure rated on a likert scale, in the validated Arabic version. Written informed consent was obtained from the legal tutor of each adolescent.
ResultsResults of this survey are ongoing.
ConclusionsResults of this survey are ongoing.
Disclosure of InterestNone Declared
A rare case of trauma related dissociative identity disorder
- F. Ghrissi, F. Fekih-Romdhane, M. Stambouli, B. Abassi, M. Cheour
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S957
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Introduction
Dissociative identity disorder (DID) is a debilitating and controversial psychiatric disorder with a lifetime prevalence estimated around 1,5%. It remains underdiagnosed despite recognition in international classification of mental disorders. In fact, based on the DSM-5 criteria, DID is characterised by two or more distinct personality states that coincide, with fluctuating consciousness and changing access to autobiographical memory. The aetiology of DID has long been debated with recent neuroimaging evidence supporting the trauma model of this condition.
ObjectivesThe aim of this presentation is to describe the case of a young female diagnosed with DID related to childhood trauma.
MethodsWe also conducted a literature review in order to discuss the aetiology of the disorder. The following keywords were searched through the pubmed website: dissociative identity disorder, trauma, aetiology.
ResultsWe report the case of a 20 years old female with no past medical, nor psychiatric history. However, she had a family history of an uncle and an aunt with chronic psychosis. Her father died when she was 8, thus she lived with her mother and her brother and two sisters. She was a brilliant student and started engineering studies. She has no particular personality trait. She was raised within a strict religious family with little time dedicated to leisure activities. Importantly, since the age of 10, she was exposed to her mother’s religious extremist and threatening discourses, related to death and “grave’s torture” and comprising many cultural beliefs. She seeks for psychiatric care complaining of “soliloquy” that became remarkable by her relatives. On psychiatric evaluation she presented daily fluctuating consciousness during at least one hour, in which she switches identity toward the daughter of a famous singer. This alter was having pleasant activity with her mother and was singing and hanging out most of the time. No particular triggers were identified. The trouble started by the age of 14 then worsened gradually and became an unvoluntary phenomenon with significant distress. She had no depressive nor psychotic nor anxiety or obsessive symptoms. Her sleep and appetite were not disturbed. She met DSM-5 diagnostic criteria for DID and was referred to a trained psychiatrist for adequate psychotherapy management.
ConclusionsWe exposed a rare case of a young student complaining of soliloquy since the age of 14 that was diagnosed with DID subsequent to a particular childhood trauma which consisted in exposure to threatening religious and cultural beliefs about life after death told by her mother. This unique case emphasises the trauma model of DID, where the nature of the trauma influences the clinical expression of DID. Given the recent neuroimaging evidence, DID can be framed as a chronic psychiatric disorder based on neurobiological, cognitive, and interpersonal non-integration as a response to unbearable stress.
Disclosure of InterestNone Declared
Internet addiction and psychological distress in highly schizotypal students
- Y. Boukadida, F. fekih_romdhane, R. Away, R. Damak, F. ghrissi, M. Cheour
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S272
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Introduction
There is some limited evidence of an association between technology addictions and the emergence of pre-psychotic symptoms, high psychoticism , psychotic like experiences, and high schizotypy among young non-clinical adults. These addictions and their subsequent distress are likely to contribute to transition to psychosis in individuals at risk .
Objectiveswe aimed to explore the association between Internet addiction and distress in the high schizotypy group , expecting that the two would be associated .
MethodsFrom a pool of 700 students, the final sample consisted of 74 low schizotypal and 70 high schizotypal students. Data were collected using a self-administered questionnaire which contained five research scales: The Schizotypal Personality Questionnaire (SPQ) , the Depression, Anxiety and Stress Scales (DASS-21) , the Internet Addiction Test (IAT).
ResultsBivariate analyses revealed significant positive correlations between Internet addiction and depression (r=.344, p<.0001), anxiety (r=.320, p<.0001) and stress (r=.336, p<.0001) in the high schizotypy group. In this same group, positive symptoms of schizotypy correlated positively with internet addiction (r=.294 ;p=.014).
After controlling for demographics, psychosocial factors and schizotypy symptoms, Internet addiction predicted psychological distress in the high schizotypy group (R2= 0.380, F (13, 55) = 2.597, p<0.001) and explained an additional 19.7% of variation in DASS total scores in the final model (R2 Δ= 0.197)
ConclusionsThis study’s results portrayed a statistically significant relationship between addiction to Internet and psychological distress in this at risk group.Although preliminary, our findings shed light on relatively new avenues for prevention and early intervention in psychosis. Given the widespread use of Internet among individuals with schizotypy, clinicians and researchers should find ways to utilize it as a potential resource to help these vulnerable individuals in their care pathways, by turning it into a protective rather than stressor factor.Finally, our findings highlight the need for further studies to better understand Internet use patterns and effects on young individuals in order to help mitigate its risks and increase its benefits.
Disclosure of InterestNone Declared
Primary caregiver Reports of Patient-Initiated and Suffered Violence in Schizophrenia: A cross-sectional study in Tunisia
- M. Stambouli, F. Fekih Romdhane, F. Ghrissi, W. Cherif, M. Cheour
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S448-S449
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Introduction
Aggressive behavior in psychosis is not uncommon. Studies found that among the patients with schizophrenia engaged in violence, more than half committed violence directly against family members. However, few studies have explored violence victimization and perpetration among caregivers of patients with schizophrenia.
ObjectivesOur study investigated caregiver reports of aggressive acts committed or suffered by their relative with schizophrenia
MethodsThis is a cross-sectional study among caregivers of patients with schizophrenia during the period from June to August 2022.Patients who attended our department of psychiatry at the Razi.The questionnaire was divided into three sections.
The first section: contained items regarding patient and caregiver-related information.
The second section: caregivers were asked questions about their experience of violence perpetration and victimization involving their relative with schizophrenia in the past 12 months.Beyond frequency, caregivers were also asked to specify, the causes of the violence perpetrated and suffered.
The third section contained two measures: The Depression Anxiety and Stress Scales (DASS-21) and the abridged version of the Zarit Burden Interview (ZBI), assessing psychological distress and caregiving burden, respectively.
ResultsFinally 110 caregivers were included ,the majority of caregivers were females (63.6%) and consisted of patients’ parents (50.9%). Verbal violence was the most reported type of violence victimization (35.5%). In addition, 54.5% of caregivers disclosed having perpetrated verbal violence at least once against their ill relative.
Bivariate analysis showed that lower caregivers’ educational level (p=.017), unemployment (p<.001), other person in charge (p=.027), burden levels (p<.001), depression (p<.001), anxiety (p<.001) and stress (p<.001) symptoms are positively associated with violence victimization occurrence. while being male caregiver (p=.007), having other person in charge (p<.001) and higher levels of depression (p<.001), anxiety (p<.001), and stress (p<.001) were associated with more violence perpetration.
ConclusionsOur findings suggested that violence victimization and perpetration in schizophrenia are not uncommon.Appropriate procedures for minimizing it should be considered.
Disclosure of InterestNone Declared
Cross-cultural comparison of mental illness stigma : A Multinational Population-Based Study from 16 Arab Countries and 10,036 Individuals
- M. Stambouli, F. Fekih Romdhane, F. Ghrissi, A. Jaoua, S. Ellini, M. Cheour
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S342
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Introduction
Attitudes toward people with mental disorders in Arab countries have undergone huge transformations throughout history. Stigmatization of the mentally ill has been a long tradition in our communities. The public’s views have evolved since then, however, little is known about the current situation regarding mental illness stigma in our context.
ObjectivesExplore attitudes towards mental illness and mental health knowledge in Arab countries.
MethodsWe carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries.The Community Attitudes toward the Mentally Ill scale,the Mental Health Knowledge Schedule scale and the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form were administered to participants from the general public.
ResultsThe study sample was predominantly female (77%), married (41%), educated (89% with tertiary education), living in urban areas (85%), with a mean age of 29.6 ± 10.8 years.
Based on the CAMI, MAKS, and ATSPPH-SF total scores, 75th, 50th, and 25th percentile were considered as cut-off points for the high, medium, and low scores. We found that 26.5% exhibited stigmatizing attitudes towards people with mental illnesses, 31.7% had poor knowledge, and 28.0% hold negative attitudes toward help-seeking. Regarding attitudes toward mental illness, the highest mean score was on the social restrictiveness subscale (35.1 ± 5.6), reflecting the lowest amounts of stigma in this dimension; while the lowest mean score was on the Authoritarianism subscale (32.0 ± 4.6).
We found a significant difference between countries regarding attitudes (F=194.8, p<.001) and knowledge (F=88.7, p<.001).
ConclusionsAlthough much scientific progress has been made in the fields of diagnosing and treating mental illness, at a societal level the stigmatization of mental illness is still an important societal problem. The general population is largely ignorant about mental disorders, and fear of the mentally ill remains prevalent.
Disclosure of InterestNone Declared
Factors attributed to violent behaviour by primary caregivers toward their relative with schizophrenia
- M. Stambouli, F. Fekih Romdhane, F. Ghrissi, W. Cherif, M. Cheour
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1069
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Introduction
There is a modest but consistent association between violent behavior and schizophrenia. Persons with schizophrenia are at a modestly increased risk of committing violence ,with approximately half of victims being relatives
ObjectivesOur study examined the factors attributed to violent behaviour within the relationship patient-caregiver in schizophrenia according to caregivers.
MethodsThis is a cross-sectional study among caregivers of patients with schizophrenia during the period from June to August 2022.Patients who attended our department of psychiatry at the Razi.
The questionnaire was divided into three sections. The first section contained items regarding patient- and caregiver-related information.
In the second section, caregivers were asked questions about their experience of violence perpetration and victimization involving their relative with schizophrenia in the past 12 months.
Beyond frequency, caregivers were also asked to specify, the causes of the violence perpetrated and suffered
The third section contained two measures, i.e. the Depression Anxiety and Stress Scales (DASS-21) and the abridged version of the Zarit Burden Interview (ZBI), assessing psychological distress and caregiving burden, respectively. The protocol of the study was approved by the ethics committee of the Razi Psychiatric Hospital.
ResultsThe majority of caregivers were females (63.6%), and consisted of patients’ parents (50.9%).
The most endorsed causes of violence victimization were symptoms of illness (57.3%), followed by refusal to adhere to treatment (49.1%), drug reaction (23.6%), and negative events; while the most reported causes of violence perpetration were refusal to adhere to treatment (42.7%), Symptoms of illness (37.3%), and limitation of patients’ activities and/or liberty (32.7%).
Bivariate analysis showed that lower patients’ economic status (p=.042), tobacco (p=.015) and alcohol use (p=.014) as well as taking Trihexyphenidyl (p=.001) were significantly and positively associated with violence perpetration by caregivers against their relatives with schizophrenia.
Multivariable analysis (Logistic regression) revealed that caregivers’ levels of burden remained significantly associated with violence victimization occurrence (p=.026; OR=1.48), while only having other person in charge of caring represented a significant factor associated with perpetration of any form of violence against patients (p=.007; OR=.17).
ConclusionsIt is important for medical staffs to provide caregivers with professional knowledge about patients’ real motivation for violence in order to improve their skills of problem-solving.
Disclosure of InterestNone Declared
Assessment of attitudes toward schizophrenia in tunisian family medicine residents
- B. Abassi, F. Fekih-Romdhane, H. Fayhaa, F. Ghrissi
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S403
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Introduction
Assessing the attitudes of family medicine residents toward schizophrenia is of greatest concern since family physicians potentially have a key role in identifying the signs and symptoms of schizophrenia at earlier stages and in engaging young people in treatment, especially in low- and middle-income countries.
ObjectivesWe aimed to investigate attitudes towards schizophrenia in a group of Tunisian family medicine residents, and to examine the link between these attitudes and help-seeking intentions in this group.
MethodsThis was a cross-sectional survey. A 18-item questionnaire concerning attitudes toward schizophrenia was used.
ResultsA total of 88% participants have reported favorable help-seeking intentions. In total, 48.4% of residents would oppose if one of their relatives would like to marry someone who has schizophrenia, and 37.1% of them would not like to have a neighbor with schizophrenia. Only about a half of residents agreed that “schizophrenia has the chance of recovery”, and 68.8% thought that “schizophrenia can be treated”. Pearson correlations found a significant negative relationship between age and social distance in residents (p<.001). Year of residency was significantly associated with attitudes toward schizophrenia, with more unfavorable attitudes in third-year residents (p=.042). After controlling for potentially confounding sociodemographic variables, help-seeking intentions did not contribute to the prediction of attitudes toward schizophrenia in the residents.
ConclusionsImplementing anti-stigma programs in medical schools may help improve future physicians’ attitudes and prepare them to provide primary mental health care to young help-seekers with psychosis should be given priority attention.
Acute family marital psychosis
- D. Falfel, W. Homri, F. Ghrissi, M. Stambouli, M. Ben Bechir, L. Mouelhi, N. Bram, I. Ben Romdhane, R. Labbane
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S322
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Introduction
Acute marital psychosis is an acute psychotic episode occurring in a particular context which is marriage. In fact, marriage represents an event with a very important emotional load especially in the Arab-Muslim culture. This event can, in some people, induce a relapse of certain psychiatric disorders, particularly psychotic ones. We propose in this work to report two clinical observations concerning two brothers who both presented, a few years apart, an acute nuptial psychosis with two different evolutions.
ObjectivesStuding the characteristics of nuptial psychotic episode in a one family and the different evolution of each one.
MethodsReporting two clinical cases of two brothers who represented both acute psychotic episode in a nuptial context with different evolution.
ResultsThe two patients are brothers with common psychiatric background which is their mother treated for chronic psychotic disorder. They were hospitalized in our psychiatric service for acute psychotic episode occuring in a nuptial context with chronic evolution for the first one and a partial recovery for the second one.
ConclusionsMarriage represents an event with a very important emotional load especially in the Arab-Muslim culture. In thiscontext, acute psychotic episode can occur with different evolution for patients predisposed. Studing socio-cultral circumstances related to psychotic episode can help mental health professional to improve the quality of health care service.
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