The relationship between cyber video game addiction and impulsivity is controversial. Some studies have shown a significant link, others have found no association between the two behaviours.

To study impulsivity in adolescents with problematic use of internet video games.

This was a cross-sectional, descriptive and analytical study, conducted among a sample of adolescents randomly collected in 6 schools in the region of Sfax-Tunisia, during the month of February 2022. The rate of addiction to video games was assessed by the 20-item “Internet Gaming Disorder-20” (IGD-20) scale and impulsivity by the 30-item “Barratt Impulsivity Scale” (BIS-11). Both scales are validated in Arabic.

The study involved 360 secondary school students, with a mean age of 16.62 +/- 0.822 years. The sex ratio was 1.09.

A gaming addiction was found in 4.7% of cases.

Similarly, impulse control disorder was noted in 23.6% of adolescents.

Problematic internet game use was significantly related to motor impulsivity (p=0.025).

There was no significant association between cyber video game addiction and cognitive or non-planning impulsivity.

According to the results, impulsiveness is a factor to consider for understanding the development of addiction to internet video games. Thus, impulsiveness should be taken into account to explain problematic gaming behaviour as well as to design preventive and treatment interventions.

None Declared

For several years, strong theoretical and clinical links have been established between intra-family relationships and eating disorders.

To study intra-family relationships in adolescent with food addictive behaviour.

This was a cross-sectional, descriptive and analytical study conducted among a sample of adolescents randomly collected in 6 schools in the region of Sfax-Tunisia, during the month of February 2022. The food addiction symptomatology was assessed by the “Dimensional Yale Food Addiction Scale version 2.0 For Children” (dYFAS-C 2.0) and the family attitude was studied by the “Brief Family Relationship Scale” (BFRS) which evaluates three dimensions: cohesion, expressiveness and conflict, each having a separate score. Both scales are validated in Arabic.

The study involved 360 high school students, with a mean age of 16.62 +/- 0.822 years. The sex ratio was 1.09.

The total score for food addiction symptomatology in our sample ranged from 0 to 56 with an average of 16.37 +/- 12.380.

Of the three dimensions of the quality of intra-family relationships studied, conflict had the highest mean score: 25.29+/-9.027.

A high food dependence score was significantly related to these three dimensions of the intrafamily relationship: lack of conflict (p=0.044), cohesion (p=0.011) and expressiveness (p=0.005) presence.

The present study shows that the symptomatology of food addiction is influenced by the quality of the intra-family relationship.

Enhanced perception of the family environment and involvement of the family in possible care can help to prevent the onset of eating disorders and to plan an appropriate intervention.

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The course of adolescence is marked by feelings of insecurity, vulnerability and can be accompanied by the emergence of several mental health problems.

Having a good self-esteem brings many benefits such as security, well-being and a strong sense of confidence. Low self-esteem is often accompanied by psychological distress such as stress.

To assess the level of stress and self-esteem in young high school students and to identify the risk factors associated with low self-esteem in these adolescents.

This was a cross-sectional, descriptive and analytical study conducted among a sample of adolescents randomly collected in 6 schools in the region of Sfax-Tunisia, during the month of February 2022. The level of stress was assessed using the Lovibond Depression Anxiety Stress Scale (DASS-21) and self-esteem by the Rosenberg Self-Esteem Scale, both scales are validated in Arabic.

We collected 396 adolescents. The mean age was 16.65+/-0.897 years and the sex ratio was 0.82.

Of these adolescents, 102 had stress symptoms according to the DASS-21 scale, i.e. 26% of the sample. Stress was severe to extremely severe in 37.2% of cases.

Low to very low self-esteem was found in 65.7% of cases compared to 14.7% with high self-esteem.

In addition to the association with high levels of stress in these adolescents (p=0.002), low self-esteem was associated with other psycho-social factors such as intra-family relationship problems (p=0.014), a history of repeating a year (p=0.026), low to average school performance (p=0.027) and behavioural problems in the school environment (p=0.032).

These results suggest that the association of stress with certain psycho-social factors helps the deterioration of self-esteem in adolescents and vice versa.

Having high self-esteem may protect the individual from psychological vulnerabilities such as stress and help him/her to cope with them.

None Declared

Gayet Wernicke Encephalopathy (GWE) is a diagnostic and therapeutic neuropsychiatric emergency due to thiamin deficiency (vitamin B1).

The purpose of our work is to recall some clinical situations suspecting GWE, along with radiological and evolutionary profile.

We conducted a retrospective study concerning patients who were hospitalized in the neurology department of Habib Bourguiba Hospital between 2013 and 2020 for management of GWE.

The median age of 7 patients was 39.57 years with sex ratio (H/F):1.33. The most common risk factor found is incoercible vomiting (5 patients), followed by chronic alcoholism (3 patients). Confusional state was the most frequent symptom found in 4 patients. The characteristic clinical triad of confusion, oculomotor disorders and ataxia was only found in 2 patients. Neuroimaging showed a typical aspect in 3 patients. The serum levels of thiamine were low in five patients and normal in two patients. After receiving parental than oral thiamin supplementation, three patients were independent after one month with a mRS score <3.

GWE is an acute neuropsychiatric emergency. Chronic alcoholism is recognized as its most common cause. The clinical triad is not constantly present. MRI shows typically bilateral symmetrical hyperintensities in periaqueductal area, periventricular region, thalami and mammillary bodies. Thiamin level can be normal since it does not accurately represent body thiamine status or in case of mutations in a thiamine-transporter gene. Thiamine therapy is warranted if any component of the GWE triad is present in an appropriate clinical setting to prevent irreversible neurological sequelae.

Evidence is accumulating that mitochondrial dysfunction is involved in the pathophysiology of some psychiatric disorders such as Bipolar Disorder and Schizophrenia. In addition, among their other symptoms, people diagnosed with mitochondrial disease have high rates of psychiatric disorders. Leigh syndrome is a heterogeneous disorder, usually due to a defect in oxidative metabolism. The symptoms begin in the childhood by neurological troubles. Few reports mention psychiatric disorders. The objective of this work is to study relations between mitochondrial dysfunction and psychiatric disorders through a case of Leigh Syndrome.

It was a 20 year-old male patient, who had taken L-Dopa to treat severe extrapyramidal symptoms caused by Leigh syndrome. He developed, four months ago, acute psychotic symptoms such us audio-visual hallucinations, persecution and mystic delirium. The cerebral MRI had shown signal abnormalities in Basal Ganglia. This aspect was similar to those observed in the MRI having been practiced five years ago. The EEG recording was normal.The CSF and blood lactate levels were normal. The hypothesis that drug (L-Dopa) caused psychiatric disorders was possible. But, the digression of medicine was impossible due to the severity of extrapyramidal symptoms. The evolution under atypical antipsychotic was only partial.

In this case, the CSF lactate levels mean that mitochondrial dysfunction is not an overall explanation for these psychiatric disorders but may at least play a partial role. Psychiatric disorders may be induced by drugs or may just be a simple comorbidity.

Infant Schizophrenia is a severe developmental disorder affecting most areas of children's adaptive functioning; especially the social field.

The objective of this work was to study the psychosocial implications of early onset schizophrenia.

We conducted a descriptive and retrospective survey on 58 children and adolescents who were hospitalized in the child and adolescent psychiatry department of Sfax for schizophrenia according to the DSM-IV TR criteria, during 14 years (from 1 January 2000 to 31 December 2013)

In this study, patients frequently showed disruption of family interactions. Indeed, the child's relationship with his parents was marked by the withdrawal in 26% of cases, the dominance in 19% of cases and rejection in 13.7% of cases. For their part, parents demonstrated attitudes of indifference in 29% of cases, hyper protection in 28% of cases and rejection in 24% of cases.

In addition, adjustment difficulties were noted in 63.3% of cases, a tendency of isolation in 43.6% of cases and a conflictual relationship with peers in 27.3% of cases.

Academically, patients had difficulties in school in 62% of cases. It was as type of school decline in 36% of cases, absenteeism in 36% of cases, school disinvestment in 30.5% of cases and grade repetition in 12% of cases.

This study shows that children and adolescents with schizophrenia had family, social and school adjustment difficulties; which joined the literature as to the severity of early onset schizophrenia whose prognosis is often unfavorable.

To identify correlates that might constitute risk factors for problematic video game use (PVU) among urban Tunisian secondary school students.

This multivariate cross-sectional study was carried out on 587 secondary school students, aged 14 to 20 years. They were randomly selected from seven secondary schools in the urban area of Sfax. The self-administered Fisher's nine-item questionnaire was used in this survey. To identify an associated problematic internet use video game addiction, Young's eight-item questionnaire was used. A self-administered, anonymous questionnaire covered socio-demographic, individual and family data.

The prevalence of PVU was 14.01%. In multivariate logistic regression analysis, we found that the individual risk factors for problematic video game use were anxiety symptoms (P = 0.034) and an associated problematic Internet use (P < 0.001). Playing sport was a protective factor (P = 0.011). The poor relationships within the family (P = 0.001), the lack of parental supervision of time spent on playing video game (P < 0.001) and mother profession as mid-to upper level manager (P = 0.002), predicted PVU.

The identification of risk factors can help to determine individuals at high risk, and alert mental health providers to be careful to screen these patients for PVU. Total avoidance of the Internet is unrealistic and inadvisable; but a sensibilisation outreach for youth, their families and health professionals may help to limit the onset of PVU among young people.

The authors have not supplied their declaration of competing interest.

Stuttering constitutes for children a psychological and social disability, in which the environmental context plays an important role in the installation, stabilization and aggravation or attenuation.

Our study aims to describe the socio-familial characteristics of children with stuttering.

This is a descriptive and analytical-retrospective study carried out on 80 children with stuttering and had been followed-up in the child psychiatry department of UMC Hédi Chaker Sfax (Tunisia) for more than 3 years (January 2012 to 31 December 2013).

In our study, the prevalence of stuttering in child psychiatry consultation department of Sfax is 4%. Most of the patients were either the youngest (36.25% of cases) or seniors (35% of cases).

Personal history of speech disorder had been reported in 8 children (10% of cases). Family history of speech disorder was reported in 33.75% of cases. These disorders had been kind of stuttering in 60.66% of cases, speech delay in 18.52% of cases and sound speech disorder in 7.41% of cases.

The parent–child relationship is marked by a parental rigidity in 18.6% of cases. The existence of triggering factor was noted in 37.5% of cases: traumatic situation (30% of cases), the birth of a younger sibling (22% case).

The emergence and evolution of stuttering depend on predisposing, precipitating and chronicisants factors. Identifying these factors and adopting a favorable parental attitude contribute to the fight against stuttering in children and, at least, avoid aggravation and chronicity of this disorder.

The authors have not supplied their declaration of competing interest.

However, impulsivity is more likely to be present in externalizing disorders, little focus seems to have been made on the research of impulsivity in depression.

On this study, we sought to investigate impulsivity among adolescent with Depressive disorder compared to a control sample.

Employing a matched case-control study, participants included 100 adolescents divided into two groups: 30 adolescents (12 to 17 years) with depressive disorder and a control sample of 70 adolescents. Participants were recruited during a period of 2 years (2015, 2016). Depressive disorder patient were drawn from the consultation unit or inpatient unit of the department of child psychiatry in Sfax, Tunisia. Controls were recruited from two secondary schools and they haven’t depressive symptoms according to the child depression inventory (CDI). Impulsivity was evaluated in the two groups by the Barratt Impulsiveness Scale (BIS-11), an instrument designed to measure trait impulsivity.

Adolescents with depressive disorder displayed significantly higher total BIS-11 impulsivity scores than controls (71.6 ± 16 vs 61.6 ± 9; P = 0.003). They scored significantly higher than the controls on motor (P = 0.0001) and attentional impulsivity (P = 0.006). There was no difference in non-planning Impulsivity between the two groups. Motor impulsivity was high in adolescents with history of suicide attempt.

Our findings suggest that trait impulsivity is increased among adolescents with depressive disorder. Impulsivity seems to be a risk factor for suicide attempts, so it that should be systematically evaluated in depressive disorder.

The authors have not supplied their declaration of competing interest.

The aim of our study was to investigate and compare the quality of life of parents of children with ADHD and parents of children within psychiatric troubles.

We conducted a cross sectional and comparative study, on 20 families of children with ADHD, followed in child and adolescent psychiatry department of Sfax, Tunisia, and 20 control families. We used the Short Form Health Survey (SF 36) translated and validated in Arabic to evaluate the quality of life of the parents of the two groups.

The average age of the patients of our survey was 9 years 8 months with a predominance of boys. We objectified a significant difference between the overall scores of the quality of life of parents of children with ADHD and the control sample. A highly significant difference was noted in the following areas: mental health, bodily pain and social functioning. The difference was significant in vitality score. The difference was not significant in 4 scores: general health, physical functioning, role physical, and role emotional.

Families with a child with ADHD have many challenges which impact certainly in their quality of life. As a child and adolescent's psychiatrics, we should be aware of these consequences in order to help the parents to improve their quality of life.

The authors have not supplied their declaration of competing interest.

Persistent encopresis is part of a fairly specific pathologic complex including personality, and familial factors. To a very large extent, interest in encopresis issues has revolved around the mother–child relationship.

In this study, we aimed to assess the psychological profile and the counter attitudes of encopretic children's mothers.

We led a retrospective and descriptive study carrying on 91 medical records of children with encopresis, followed in the outpatient child psychiatry department of the Hédi Chaker university hospital of Sfax over a period of seven years, going from January 1st, 2000 till December 31st, 2006.

In our study, emotional deprivation was noted in 62.2% of cases. Besides, repeated separations from mothers were noted in 26.4% of cases with 2.2% cases of prolonged separations. Our study also revealed that 19.8% of mothers have obsessive personality traits while 14% have rather anxious traits. Furthermore, 6.6% of encopretic children's mothers were found to have anxio-depressive spectrum disorders according to the DSM-IV-TR. Mothers’ intolerance towards encopresis was estimated at 53.3%. This intolerance was mainly reflected in physical punishment, depreciation, blame and humiliation. Toilet training was rigid in more than half of cases (62.2%).

Childhood encopresis can be viewed as a result of a maternal-child conflict. In fact, the mother–child relationship appears to be directly involved in the genesis of encopresis. Nevertheless, the role of the own child neurodevelopmental state in response to the family system should not be ignored.

The authors have not supplied their declaration of competing interest.