Breast cancer is the leading cancer in women in developed and developing countries. Treatment strategies can affect sexuality in the short or long term.

The aim of our study was to assess sexuality and martial satisfaction in patients followed for breast cancer.

Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We passed the Female Sexual Function Index (FSFI) and the martial adjustment test (MAT).

Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. Radiotherapy and targeted therapy were prescribed in 12 and 2 case, respectively. Amenorrhea, hot flushes and vaginal dryness were noted in 98.7%, 26.7% and 7.6% of patients, respectively. Sexual disorders were found in 53.3% of cases, which settled in a chronic mode in 75% of cases and progressed in a continuous mode in half of cases. The assessment of physical and erotic life was revealed to be neat in 73.3% of the patients. The mean score of the FSFI questionnaire was 17.25 [2.6-31.9]. Eleven patients (73.3%) had sexual dysfunction. A low marital satisfaction was found in 34% of cases.

The medical consultation to identify sexuality disorders in correlation with the martial dissatisfaction in women followed for new breast cancer is crucial allowing a better management of this pathology.

None Declared

Breast cancer is the most frequently encountered malignant tumor among women in Tunisia and in the world. The quality of sexual life of patients with breast cancer is impaired by multifactorial mechanisms.

The aim of our study was to determine the factors associated with sexual disorders in patients followed for breast cancer.

Cross-sectional analytic study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We collected sociodemographic and clinical data with an assessment of sexuality (FSFI), marital satisfaction (MAT), psychological profile (HAD) and quality of life (SF36).

Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. The mean score of the FSFI questionnaire in our study was 17.25. Eleven patients (73.3%) had an FSFI score below 26.55. We found negative correlations between age and FSFI score (r=-0.622; p=0.013). We noted statistically significant negative correlations between FSFI and HAD-D (r=-0.606; p=0.017) and FSFI and HAD-a (r=-0.707; p=0.01) as well as significant correlations between FSFI and the following items: RE (r=0.84p=0.000), SF (r=0.684 p=0.005), GH (r=0.671 p=0.006) and MCS (r=0.788 p=0.000).

Focusing on a small sample of patients followed for breast cancer, our study provides an assessment of the sexual function in its various areas and shows how sexuality is deeply intertwined with other sections of medical management.

None Declared

Schizoaffective Disorder is frequently associated with somatic and addictive comorbidities. This association can change the expression of the disease as well as its prognosis. In addition, this association can affect many functional and psychosocial aspects that can lead to impaired quality of life (QOL) and overall functioning of patients.

the aims of this work were to study the impact of somatic and addictive comorbidities on QOL and global functioning of patients followed for schizoaffective disorder.

This is a cross-sectional study carried out at the psychiatric consultation of the University Hospital of Mahdia for a period of 6 months. The evaluation of the QOL was made using a generic instrument for measuring quality of life: the SF-36 in its version in literary Arabic using the Global Evaluation of Functioning scale .

fifty-two patients with schizoaffective disorder were included in the study. The age of the patients varied from 29 to 62 years with an average of 38 years. The sex ratio (M/F) was 1.6. Singles accounted for 46.2%. Somatic comorbidities were found in 30.8% of patients. Diabetes ranked first (13.5%) followed by arterial hypertension (9.6%) then epilepsy (3.8%). Addictive comorbidities were noted in 63.5% of patients. Tobacco, alcohol and Cannabis were the most consumed substances with respective rates of 57.7; 28.8 and 13.5%. The evaluation of the QoL of the patients revealed that 80.8% of the patients had scores attesting to an altered QoL. Regarding the evaluation of global functioning by EGF, (65.4%) of patients had a score of less than 70 attesting to an impairment of global functioning. The analytical study of correlation between the dimensions of the SF-36 and somatic comorbidities found that dimension D1 (physical activity) is significantly influenced by somatic comorbidities (10-4). The deterioration in the global functioning of the patients was not correlated with the presence of somatic comorbidities (p=0.28). The change in QoL was not correlated with the consumption of psychoactive substances (0.32 for alcohol and p=0.23 for drug addiction).

It is accepted that the objectives of the management of patients suffering from schizoaffective disorder go beyond the remission of clinical symptoms to the improvement of QoL and socio-professional functioning. Larger-scale work is needed to study the influence of comorbidities associated with schizoaffective disorder on these dimensions.

None Declared

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.

The aim of our study was to determine the association between insulintherapy and depression.

A 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.

A 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).

Diabetic 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.

None Declared

The assessment of quality of life is an essential complement to medical care. Some studies have shown that young women are more vulnerable to the disease impact and have a greater worsening of their quality of life.

The aim of our study was to assess the quality of life of patients with breast cancer.

Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We applied the 36-Item Short Form Survey SF-36.

Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. There was unequal impairment of different areas of the SF-36 questionnaire. The physical component was the most affected with a mean physical score (PCS) of 62.64; the RP score (limitations due to physical condition) was the lowest with a mean of 45 and the score of the item “Life and relations with others” was the best with a mean of 77.5.

The quality of life in relation to breast cancer in our population was at the medium rating, with moderately high scores. Sustainable improvement of the quality of life of women with breast cancer is a priority issue among the treatment objectives. Further studies are needed to assess the impact on the spouse, which is inseparable from the couple.

None Declared

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.

The aim of this study was to determine the associated factors to anxio-depressive disorders during long COVID.

A 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.

We 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).

Arthralgia 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.

None Declared

Menopause is a special period for women which can have both physical and psychological consequences.

The aim of our study was to assess the impact of menopause on women’s quality of life.

A cross-sectional descriptive study conducted on menopausal women consulting at the basic health center in réjiche over a period from 12 september to 12 october 2022. The impact of menopause on the mental health of women was assessed by the menopause rating scale (MRS).

A total of 83 women were incluted in our study. The mean age was 61.89±11.03 years. The median age of menopause was 45 years (50-43). The majority of women (90.4%) were married and five women (6%) lived alone. Twenty-six women were professionally active and more than half were sedentary (54.2%). The comorbidities were dominated by arterial hypertension (50.6%). The mean BMI was 30.6±4.75 Kg/m². All the women had a variable psychological impact (from minor to very strong). The median score of the psychological scale was 10 (13-7): median scores for depressed mood, anxiety and physical and intellectual fatigue equal to 3 (4-1), each and median score for irritability equal to 2 (4-1). Physical and mental fatigue was the most common psychological symptom in 88% of cases followed by irritability in 86.7% of patients. Depressive and anxious symptoms were noted in 85.5% and 84.3% of cases, respectively. Psychological impact was severe in 33.7% of patients (strong or very strong symptoms).

Focusing on a small sample of menopausal patients, our study revealed a high prevalence of psychological distress during menopause which requires early adequate assessment and treatment.

None Declared

Schizophrenia, a chronic and complex psychiatric pathology, can be isolated. However, it can be associated with other comorbidities and thus be accompanied by addictive behaviors that complicate their management.

The objectives of our study were to estimate the prevalence and identify the characteristics of addictive behaviors in patients with schizophrenia.

A retrospective study of 151 patients with schizophrenia hospitalized in the psychiatry department of Taher Sfar University Hospital in Mahdia from January 2017 to December 2021.

The mean age of the patients was 39.8 ± 11.23 years, with a predominance of the 36-45 age group (38.4%). All patients were male. Three quarters of the patients (75.5%) were users of psychoactive substances (PAS): nearly three quarters (72.8%) were addicted to tobacco, more than one third (39.7%) were addicted to alcohol, more than one quarter (29.1%) were addicted to cannabis and nearly one quarter (26.5%) were addicted to other PAS. In more than half of the cases (54.4%), the age of onset of substance use was between 16 and 25 years. The use of PAS preceded the onset of schizophrenia in 62.3% of cases. The relationship with the entourage was marked by hetero-aggressiveness in 77.5% of patients, withdrawal from the entourage in 16.6% of patients and conflict in 5.3% of patients. The impact on the relationship with oneself was marked by self-aggressiveness in 18.5% of patients. Concerning the professional impact, three quarters of the patients (76.1%) had to stop working. The majority of patients (84.1%) continued their usual treatment, while 15.2% of patients stopped it. Only one patient required an increase in dose.

Subjects suffering from schizophrenia are particularly vulnerable to addictions, mainly to tobacco and alcohol. They are thus a group more at risk of the deleterious effects of psychoactive substances and of the aggravation of the clinical and psychosocial evolution of their psychiatric disorders. Measures for early detection and treatment of their addictive behaviors even before the onset of schizophrenia should be proposed.

None Declared

The association of an addictive disorder (harmful use, abuse or dependence) with a schizophrenic disorder is the rule. Genetic vulnerability and social and economic factors are common to both disorders.

determine the impact of addictive behavior on patients suffering from schizophrenia.

A descriptive and analytical retrospective study of 150 patients with schizophrenia hospitalized in the psychiatry department of Taher Sfar University Hospital in Mahdia from January 2017 to December 2021.

The average age of the patients was 39.8 ± 11.23 years with a predominance of the age group 36-45 years (38.4%). All of the patients were male. Three quarters of the patients (75.5%) were consumers of psychoactive substances (PSA): nearly three quarters (72.8%) were dependent on tobacco, more than a third (39.7%) were dependent on alcohol, more than a quarter (29.1%) dependent on cannabis and almost a quarter (26.5%) dependent on other SPAs. Criminal history, suicide attempts and hospitalization in psychiatry were significantly more frequent in patients who consumed SPA than those who did not consume (39.5% vs 8.1%; p=0.008, 17.5% vs 2.7%; p=0.02, 89.5 % vs 75.7%; p=0.03, respectively). Patients who consumed SPA had significantly more positive signs of schizophrenia (51.8% vs 10.8%; p=0.001) and were significantly less observant to treatment (55.3% vs 16.3%; p=0.001) than those who did not consume. Hetero-aggressiveness, self-aggressiveness and job change were significantly more frequent in patients with addictive behaviors than those without addiction (86.8% vs 48.7%; p=0.001, 23.7% vs 2.7%; p= 0.004, 14.9% vs 0%; p=0.015, respectively). Multivariate analysis revealed that criminal history, hetero-aggressiveness, predominant positive symptomatology and work stoppage were the factors independently associated with SPA consumption in patients with schizophrenia in our study (β=14.7 95% CI 3.23–67.01, p=0.001, β=0.099, 95% CI 0.03–0.31, p=0.001, β=7.18, 95% CI 2.09–24.67, p=0.002, β=5.24 95% CI 1.27–21.7; p=0.02, respectively).

According to our study, addictive comorbidities concern three quarters of our patients. They expose them to a higher risk of legal problems, hetero-aggressiveness, predominance of positive signs and instability at work. These results encourage the development of methods for early diagnostic identification of addictive behavior comorbid with schizophrenia as well as integrated care combining psychiatric and addictological care.

None Declared

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.

The aim of this study was to screen for somatic and anxio-depressive disorders of Long COVID.

A 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.

We 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.

Our 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.

None Declared

Neoplastic disease affects all aspects of life. People with cancer may experience a variety of emotions and reactions to their new reality that may be mild or intense, transitory or permanent.

The aim of our study was to assess the psychological distress of patients with breast cancer.

Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We used the “Hospital Anxiety and Depression Scale (HAD-S)” for the assessment of anxiety and depression.

Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. The mean anxiety and depression scores according to the HAD-S were 9.53 and 4.93, respectively. The majority of our patients had no depressive symptoms (80%) against only 2 patients (13.33%) with depressive symptoms. On the other hand, most of our patients were anxious: 6 patients (40%) showed probably clinically relevant levels of anxiety (score of 11 or higher) and 5 patients showed possibly clinically relevant levels of anxiety (scores of 8 or higher) (33,33%).

Our study revealed a high prevalence of psychological distress. The presence of clinical psychologists in the medical oncology department and the training of nursing staff in psycho-oncology are essential for the overall care of patients with cancer.

None Declared

Glycemic control for elderly diabetics is a challenge. Treatment satisfaction reflects this control.

To determine the factors associated with insulin treatment satisfaction among type 2 diabetic elderly.

A cross-sectional study on 86 type 2 diabetic insulin dependent elderly recruited from the outpatient endocrinology consultation during June and July 2021. We applied the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and geriatric assessment scores.

Three quarters of the patients were satisfied with the insulin therapy. Satisfied patients had significantly less history of hospitalization and more regular follow-up. Diabetic neuropathy medications were significantly less taken by satisfied patients. The number of daily insulin injections was significantly higher in the unsatisfied patients. Diabetic foot was significantly more frequent in unsatisfied patients. Satisfied patients were significantly less depressed, more independent in both basic and instrumental activities of daily living, without memory impairment, in better nutritional status and not falling. Higher DTSQ scores were associated with regular follow up (β 7.92, 95% CI 1.83 to 34.3). Lower DTSQ scores were associated with the history of hospitalization (β 0.12, 95% CI 0.02 to 0.58), the taking of medications for diabetic neuropathy (β 0.07, 95% CI 0.09 to 0.51), the high number of insulin injections (β 0.43, 95% CI 0.19 to 0.97) and the presence of diabetic foot (β 0.17, 95% CI 0.01 to 0.38).

Risk factors for patients’ insulin dissatisfaction should be detected early and managed appropriately to improve patients’satisfaction and consequently their well-being.

No significant relationships.

Although depression is one of the most common diseases among older people, it is still underdiagnosed due to frequent misleading symptoms.

The aims of our study were to assess depression in type 2 diabetic insulin-dependent older adults and to identify factors associated with depression among this population.

A cross-sectional study on 100 type 2 diabetic insulin-dependent elderly recruited from the outpatient endocrinology consultation during June and July 2021. We applied the geriatric assessment scores: the Geriatric Depression Scale 15-item, the KATS score, the Lawton scale. the five-word test, the Mini Nutritional Assessment and the Timed Up and Go test.

The mean age of the population was 70.8±5.8 years with sex ratio of 0.85. Depression was noted among 57% of the patients who were distributed as follow: around one fifth (21%) had mild depression while 36% had moderate to severe depression. Around one quarter of the patients (24%) were dependent in the basic activities of daily living. Depression was significantly associated with dependency (β = 5.27; 95% CI, 1.01 to 27.35), ophthalmologic diseases (β = 8.81; 95% CI, 2.18 to 35.63), high frequency of nocturia (β = 3.71; 95% CI, 1.24 to 11.05) and high frequency of bleeding at insulin injection site (β = 4.21; 95% CI, 1.49 to 11.84).

Our findings suggest that the prevalence of depression is high among type 2 diabetic insulin-dependent older adults. Early assessment of depression’s risk factors is a major pillar of the comprehensive care of our seniors.

No significant relationships.

The term “Sexual and Gender Minorities” includes lesbian, gay, bisexual, transgender, queer, intersex and/or asexual populations. It was introduced in the MeSH Database in 2018. Mental health research on sexual and gender minority populations is gaining momentum.

To describe mental disorders among sexual and gender minorities.

This is a review of the literature via Medline. The database was searched using the keyword combination “sexual gender minorities” OR “homosexuality” OR “bisexuality” OR “transgender persons” OR “intersex persons” AND “mental disorders”. The filters applied were Full text, Meta-Analysis, Systematic Review and in the last 5 years.

A total of 59 articles were included. The lowest rates of depression and anxiety were reported among heterosexual people. Depressive symptoms, suicidality, interpersonal trauma exposure, substance use disorders, anxiety, and general distress have been consistently elevated among transgender and gender non-conforming people. Among transgender people, the prevalence of binge drinking ranged from 7%-61%. Depression was the most frequent mental disorder among sexual minority men (43.2%) followed by anxiety (32.2%), suicidal ideation (21.2%), suicide plans (6.2%) and suicide attempts (7.3%). Eating disorders were more frequent among sexual minority women compared with heterosexual peers. Compared with heterosexual youth, sexual minority youth had 123% to 623% higher odds of lifetime substance use, 82% to 317% higher odds of depressive symptoms and suicidality and 20% to 280% higher odds of violence victimization.

The prevalence of mental disorders is high among sexual and gender minorities for whom mental health prevention and treatment programs are needed.

No significant relationships.