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Assessment of addictive behavior in patients with schizophrenia
- M. Zbidi, W. Bouali, H. Baba, M. Kacem, S. Younes, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1077
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Introduction
Schizophrenia, a chronic and complex psychiatric pathology, can be isolated. However, it may have other comorbidities and thus be accompanied by addictive behaviors complicating their management.
Objectivesto estimate the prevalence and identify the characteristics of addictive behavior among patients with schizophrenia.
MethodsA retrospective study of 151 patients with schizophrenia and hospitalized in the psychiatry department of the Taher Sfar university hospital in Mahdia from January 2017 to December 2021.
ResultsThe mean age of the patients was 39.8 ± 11.23 years with a predominance of age group 36-45 years (38.4%). All of the patients were males . Three quarters of patients (75.5%) were users of psychoactive substances (PSA): nearly three quarters (72.8%) dependent on tobacco, more than a third (39.7%) dependent on alcohol, more a quarter (29.1%) dependent on cannabis and almost a quarter (26.5%) dependent on other SPA. In more than half of the cases (54.4%), the age at which SPA consumption began was between 16 and 25. SPA use preceded the onset of schizophrenia in 62.3% of case. The relationship with the entourage was marked by hetero-aggressiveness in 77.5% of the patients, a withdrawal from the entourage for 16.6% of the patients and a conflict for 5.3% of the patients. The impact on the relationship with oneself was marked by self-aggressiveness in 18.5% of patients. Regarding professional impact, three quarters of patients (76.1%) had to stop working. The majority of patients (84.1%) continued their usual treatment, while 15.2% of patients stopped it. In only one patient increased doses were necessary.
ConclusionsSubjects suffering from schizophrenia are particularly vulnerable to addictions, mainly to tobacco and alcohol. They are therefore a group at greater risk of harmful effects of psychoactive substances and at worsening the clinical course of their psychiatric illness. Screening and treatment measures their addictive behaviors early on, even before schizophrenia sets in, should be offered.
Disclosure of InterestNone Declared
Antipsychotics in elderly people: to prescribe or to ban?
- M. Zbidi, W. Bouali, M. Kacem, W. Haouari, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S940
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Introduction
The prescription of psychotropic drugs is a major health problem , especially in the elderly. In fact, many studies highlight the misuse of psychotropic drugs and in particular the over-prescription of antipsychotics in the elderly which would be deleterious and not indicated.
ObjectivesTo evaluate the prescription of antipsychotics in hospitalized elderly people in a psychiatric environment and to compare them with data from the literature.
MethodsThis is a retrospective descriptive study of patients aged over 65, hospitalized in the psychiatry department between January 2017 and December 2021 and who received first- or second-generation antipsychotic treatment during their hospitalization.
ResultsOur sample consisted of 20 patients. More than half of our sample (55%, N=11) had at least one somatic history. More than 20% of subjects, was polymedicated; and for only one patient, the ECG showed an elongation of the space QT counter indicating the use of antipsychotics. The most common diagnosis found was schizophrenia with a rate of 35%,followed by paranoia (20%), and chronic hallucinatory psychosis (15%). More than a quarter of our sample (30%, N=6) received antipsychotic treatment of first generation (AP1G), 10 patients (50%) received antipsychotic treatment of second generation(AP2G) and three patients (15%) received a combination of AP1G and AP2G. More than a quarter of our patients (30%, N=6) reported adverse effects due to neuroleptic treatment.
ConclusionsThe results of our study highlighted different indications for which an antipsychotic treatment was prescribed for an elderly person despite a ground often flawed, polymedicated and where the undesirable effects are superimposed.
Disclosure of InterestNone Declared
Evaluation of social autonomy of schizophrenic patients
- M. Zbidi, W. Bouali, W. Haouari, M. Kacem, R. Bensoussia, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1077-S1078
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Introduction
Schizophrenia is a debilitating and mutilating mental illness, generally progressing in a Chronic way . It is at the origin of a limitation of social autonomy and source of psychological distress .
Objectivesevaluate the effective social autonomy of schizophrenic patients.
Methodsit is a cross-sectional study carried out at the EPS psychiatry consultation in Mahdia during a period of 3 months, with schizophrenic patients meeting the DSM 5 criteria, having an age varying from 19 to 65 years and whose duration of evolution was at least of one year. Have been excluded those in a state of decompensation, presenting a severe organic disease or having a major cognitive impairment. Information was collected from patients and fromtheir medical records using a pre-established questionnaire. The scale of social autonomy (EAS) of Legay with 17 items grouped into 5 dimensions was used for the evaluation.
ResultsThe general characteristics of the 360 schizophrenic patients who met the inclusion criteria, revealed an average age of 40.2 years, a sex ratio of 2.33, a majority of single (55.8%), a low level of education(66.7%), an absence of professional activity (67.3%) and a deteriorated socioeconomic level (68.6%).Clinical Characteristics noted an average onset age of the disorder of 26 years, an average duration of evolution of 14 years and a preponderance of the residual type and of the episodic evolutionary course with residual symptoms between episodes respectively in 40.6 and 76.4%. The average of EAS scores were 39.08. Three quarters of the population (75.7%) had a score below 59. 24.3% of patients had scores between 60 and 108 signifying impaired social autonomy.
ConclusionsThe evaluation of effective social autonomy is essential for any therapeutic project considering psychosocial integration and rehabilitation of schizophrenic patients.
Disclosure of InterestNone Declared
Music therapy and depression : the alternative approach
- M. Zbidi, W. Bouali, M. Hnia, M. Kacem, R. Bensoussia, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S418
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Introduction
Depression is a highly prevalent disorder associated with reduced social functioning, impaired quality of life, and increased mortality. This disease is one of the most common reasons for the use of complementary and alternative therapies. Music therapy is a therapeutic approach that uses musical interaction as a means of communication and expression.
ObjectivesTo assess, through a systematic review, the effectiveness of music therapy in patients with depression disorder, and to design a research protocol for a randomised controlled trial of group music therapy for depressed patients in a Psychiatry Department.
MethodsWe conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA).We systematically searched 3 databases (Pubmed, Google Scholar and SciElo) and reviewed randomized controlled trials. The evaluation of the trials was made using the CONsolidated Standards of Reporting Trials (CONSORT) guidelines.The review included studies of 16-to-80-year-old impatients and outpatients of both genders with clinical depression using any diagnostic criteria such as ICD 10 (WHO 1992) or DSM 5 Research Diagnostic Criteria. Change in depressive symptoms was measured with various scales. An experimental protocol was then designed to conduct a randomized controlled trial for depressed patients in the Psychiatry Department at the University Hospital of Mahdia, seeking to supplement scientific knowledge in the field of music therapy that has not yet been explored.
ResultsA total of 13 articles were included in the study: The analysis of these articles highlighted a predominance of Anglo-Saxon papers and an increasing rate of publication over time.The duration of treatment varied between 2 weeks and 10 weeks and the number of music therapy sessions varied between 4 sessions and 20 sessions.Two major music therapy approach were identified, active method where patients are the ones making music and receptive or passive methods where patients will receive the music.12 researches included in our review reached the conclusion that music therapy had a significant positive effect on patients as the score scales were significantly lower after the end of the therapy. Only one included research found no significant difference between music therapy group and treatment as usual.In addition the results of all studies came on the conclusion that music therapy improved symptoms of anxiety and scores were significantly lower.
ConclusionsThis systematic review and meta-analysis suggests that music therapy has an effect on reducing depressive symptoms to some extent. However, high-quality trials evaluating the effects of music therapy on depression are required. Thus,the aim of our study protocol is to contribute to the development of this therapy
Disclosure of InterestNone Declared
Impact of cannabis use on Schizo-affective disorder
- M. Zbidi, W. Bouali, W. Haouari, M. Kacem, S. Khouadja, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S586
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Introduction
Schizoaffective disorder (SAD) is a nosographic entity characterized by an association of schizophrenic symptoms with thymic episodes. Addictive substance abuse behaviours precede or appear concomitantly with thymic and/or schizophrenic symptoms for the majority of patients.
ObjectivesThe objective of our work was to specify the sociodemographic ,clinical and therapeutic characteristics of this population and to compare them to a group of schizophrenic patients who do not use cannabis.
MethodsThis is a retrospective descriptive study of patients with Schizoaffective Disorder (SAD) meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, 5th Version (DSM-5), hospitalized between January 2015 and December 2021 in the psychiatry department of the EPS Tahar Sfar Mahdia.
ResultsOur sample was composed of two groups: A first group formed by patients with a positive toxicological assessment to tetra-hydro-cannabinol (n=14) and a second group witha negative toxicological assessment (n=36). In SAD subjects using cannabis, the average age at first hospitalization was younger (27.5 years) than in the other groups, hospitalization was earlier (27.27 vs 33.58; p=0.04), the duration in number of days of hospitalization was greater (29.33 vs. 24.67; p=0.02) and they had required during their hospital stay a higher dosage of antipsychotics in equivalent doses of chlorpromazine (723 vs 603; p=0.04). There was a significant difference (p ≤ 0.04) in the psychometric scales (BPRS, SAPS and SANS) in favour of patients who did not use cannabis.
ConclusionsThe deleterious psychic effects of chronic cannabis use have long been suspected for a long time. Patients followed for SAD present more frequently than the reference population addictive behaviours towards cannabis which is associated with many negative events affecting clinical symptomatology, evolution, prognosis and therapeutic response.
Disclosure of InterestNone Declared
North African reference equation for peak nasal inspiratory flow
- M Denguezli Bouzgarou, H Ben Saad, A Chouchane, I Ben Cheikh, A Zbidi, J F Dessanges, Z Tabka
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- Journal:
- The Journal of Laryngology & Otology / Volume 125 / Issue 6 / June 2011
- Published online by Cambridge University Press:
- 28 February 2011, pp. 595-602
- Print publication:
- June 2011
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Aim:
To assess, in healthy North African subjects, the applicability and reliability of a previously published reference equation and normal values for peak nasal inspiratory flow, and to calculate a peak nasal inspiratory flow reference equation in this population.
Subjects and methods:Anthropometric data were recorded in 212 volunteers (100 females and 112 males) aged 13–27 years. Peak nasal inspiratory flow was measured several times. Univariate and multiple linear regression analyses were used to determine the reference equation.
Results:The previously published reference equation and normal values did not reliably predict peak nasal inspiratory flow in the study population. In our subjects, the reference equation (r2 = 30 per cent) for peak nasal inspiratory flow (l/min) was 1.4256 × height (m) + 33.0215 × gender (where 0 = female, 1 = male) + 1.4117 × age (years) − 136.6778. The lower limit of normal was calculated by subtracting from the peak nasal inspiratory flow reference value (84 l/min).
Conclusion:This is the first published study to calculate a reference equation for peak nasal inspiratory flow in North African subjects. This equation enables objective evaluation of nasal airway patency in patients of North African origin.