3 results
Association between depression and insulintherapy
- F. Zaouali, A. El Khemiri, F. Boubaker, S. Arfa, B. Zantour, W. Alaya, M. H. Sfar
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S218-S219
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Introduction
Insulin is the basic medical therapy to manage type 1 diabetes and is also a cornerstone of treatment of type 2 diabetes as insulinopenia belongs to its natural history. However, insulintherapy is associated with many challenges especially psychological difficulties such as patient’s acceptance and compliance, which may lead to metabolic and psychological disorders.
ObjectivesThe aim of our study was to determine the association between insulintherapy and depression.
MethodsA cross sectional analytic study was conducted from October 2019 to October 2020 among a group of diabetic patients followed in the Endocrinology Department of Taher Sfar University Hospital in Mahdia, Tunisia. “DSM-V diagnosis criteria for depression screening” and “Hamilton score scale” were used to evaluate the severity of depression.
ResultsA total of 260 patients were recruited in our study. The mean age was of 57.36±15.4 years with extremities ranging from 20 to 91 years. The sex ratio M/F was situated at 0.59. The mean diabetes duration was of 10.92 years. The majority of patients had type 2 diabetes (92.3%). The micro vascular long-term complications of diabetes were the most frequent (67.7%): neuropathy (39%), retinopathy (37%) and nephropathy (24%). According to the “DSM-V diagnosis criteria”, 15% of the study population suffered from a Major Depressive disorder (MDD). Hamilton score scale showed that thirty-eight patients had severe depression symptoms (14.6%). Insulintherapy was associated with MDD and depression severity (19.1% vs 10.1% ; p=0,041 and 20% vs 8.4% ; p<10–3).
ConclusionsDiabetic patients treated with insulin seem to be exposed to severe depressive syndromes. Once insulin initiated, doctors should be careful at the psychological aspects and the burden of this decision and use in consequence appropriate tools to screen depressive symptoms and anxiety. The role of family doctor is crucial providing early psychological support and preventing complications associated with depression especially poor glycemic control.
Disclosure of InterestNone Declared
Arthralgia is the main associated symptom to anxio-depressive disorders during the “Long COVID” among Tunisian patients
- F. Zaouali, A. Chaouch, F. Boubaker, S. Bouchareb, H. E. Mrabet, A. Ben Mabrouk, I. Touil, L. Boussoffara, J. Knani, N. Boudawara, W. Alaya, M. H. Sfar
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S215
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Introduction
Various psychiatric disorders were reported during the long COVID. The most frequently cited by physicians included the insomnia, the anxio-depressive disorders and the post-traumatic stress disorder. These symptoms would have a negative impact on the quality of life as well as on the socio-professional and economic efficiency.
ObjectivesThe aim of this study was to determine the associated factors to anxio-depressive disorders during long COVID.
MethodsA cross sectional analytic study was conducted at Taher Sfar university hospital of Mahdia over a period of one year (from March 2020 to March 2021). It included patients consulting within at least 1 month after a COVID-19 documented infection. We used the Hospital Anxiety and Depression scale (HAD) to screen for anxio-depressive disorders.
ResultsWe recruited 137 patients in the study. The median age was situated at 60 years, ranging from 17 to 82 years. The sex ratio M/F was 0.073. The median HAD score was 19 [8, 33]. Anxio-depressive disorders were present in 61% of cases. There was no statistically significant association between anxio-depressive disorders and post COVID symptoms except arthralgia and myalgia (38.6% vs 13.5; p=0,006 and 26.8% vs 5.4%; p=0.007, respectively). After the multivariate analysis, only arthralgia during long COVID was associated with the anxio-depressive disorders (95% CI 1.489 to 30.25, p=0.01).
ConclusionsArthralgia is a frequent symptom sometimes underestimated and in others overtreated. As it seems to be significantly associated with anxio-depressive disorders in the post covid period, physicians should pay attention to the history of a viral documented or probable infection and to psychiatric symptoms’ screening. Our results should however be confirmed by multicenter studies with larger sample size.
Disclosure of InterestNone Declared
Organic and psychiatric symptoms of “Long COVID” among Tunisian patients: a cross sectional study
- F. Zaouali, A. Chaouch, F. Boubaker, S. Bouchareb, H. E. Mrabet, A. Ben Mabouk, I. Touil, L. Boussofara, J. Knani, N. Boudawara, W. Alaya, M. H. Sfar
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S215-S216
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- You have access Access
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Introduction
Long COVID is a condition characterized by long-term health problems persisting or appearing after the typical recovery period of COVID-19. Physical symptoms such as respiratory, neurological and musculoskeletal complaints were initially described in the foreground. A little after, psychological disorders have been widely reported.
ObjectivesThe aim of this study was to screen for somatic and anxio-depressive disorders of Long COVID.
MethodsA cross sectional descriptive study included the patients consulting within a minimum of 1 month after a COVID-19 infection. It was conducted at Taher Sfar university hospital of Mahdia over a period of one year from March 2020 to March 2021. A questionnaire and physical examination were used to look for physical symptoms and the Hospital Anxiety and Depression scale (HAD) was used to screen for anxio-depressive disorders.
ResultsWe recruited 137 patients. The median age was of 60 years with a sex ratio M/F at 0.073. Obesity was the most frequent comorbidity (36%) followed by diabetes (35%) and hypertension (32%). More than a quarter of patients was hospitalized (30%) during the acute phase, while the others (70%) were confined at home. The median stay duration at home or hospital was of 10 days with extremes ranging from 0 to 21 days. The most frequent post-COVID symptoms were dyspnea, mood disorders, myalgia, arthralgia, dry cough, sleep disorders and anorexia in 45%, 30%, 30%, 20%, 16%, 15% and 14% of cases, respectively. Pulmonary auscultation was normal in 86% of our patients, for the others we noted crackles, ronchi and wheezing among 9%, 1% and 1% of patients. The median oxygen saturation was 97% with a range from 93 to 99%. The majority of our patients (120) had saturation more than 95% in ambient air. The median HAD score was situated at 19 [8, 33]. Anxio-depressive disorders were present 61% of cases. A severe depression was noted among 24% of patients. and a severe anxiety among 28% of them.
ConclusionsOur study highlighted a high prevalence of anxio-depressive disorders (62%) which exeeds the prevalence described in the literature. The systematic use of the HAD scale among consultants could be the explanation. Thus, psychological screening and support should be considered when managing patients having a history of COVID-19 infection. Citizens should comply with the relevant legal provisions making vaccination compulsory as it was found that COVID-19 vaccination reduced long COVID risk.
Disclosure of InterestNone Declared