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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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- 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
Self-esteem is associated with loss of autonomy and depression in the elderly
- W. Bouali, M. Kacem, W. Haouari, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S846-S847
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Introduction
Self-esteem is an important aspect of adaptive processes at all ages of life and particularly in older adults: it is linked to the quality of adaptation, well-being, life satisfaction and health.
Objectivesstudy the links between self-esteem, autonomy and depression in the elderly
MethodsThis is a descriptive and analytical study carried out over four months in the offices of three doctors. The population of the study were the consultants whose age was over 65 years the study was made using a pre-established sheet with certain socio-demographic characteristics, the pathological antecedents of subjects. We assessed self-esteem using the Rosenberg scale, autonomy using the activities of daily living scale (KATZ index), and depression using the mini GDS. The analysis of the results was carried out using SPSS 17 software.
ResultsOur sample is made up of 54 consultants. The average age was 68 years old. The sex ratio was equal to 0.875. Negative self-esteem, loss of autonomy, depression were observed respectively in 40%, 56.7%, 36.7% of cases. We found an association between negative self-esteem and loss of autonomy (p=0.01) on the one hand, and depression (p<0.0001) on the other.
ConclusionsOur work showed an association between loss of autonomy, depression and negative self-esteem. Depression and negative self-esteem could be a consequence of the loss of autonomy or contributing factors?
Disclosure of InterestNone Declared
Burnout Syndrome and its associated factors among anesthesia technicians in a Teaching Hospital in the central region of Tunisia
- Z. Athimni, A. Chouchen, H. Kalboussi, L. Nsiri, F. Ferhi, A. Aloui, A. Gaddour, M. Bouhoula, M. Maoua, A. Brahem, O. Maalel, S. Chatti, I. Kacem, N. Mrizak
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S462-S463
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Introduction
Burnout (BO) is a syndrome combining psychological and somatic symptoms caused by exposure to several years of chronic stress at work. Far from being a theoretical problem, it is a real social problem that has become globalized as societies change. Anesthesiology is among the most stressful medical disciplines which expose to BO in Tunisia and around the world.
ObjectivesIdentify associated factors to BO among anesthesia technicians.
MethodsWe conducted a cross-sectional study during two months, from October 1st, 2015 to December 31th, 2015, among anesthesia technicians affected in the different operating rooms of the Farhat Hached teaching Hospital in Sousse. Data collection was based on a self-administered questionnaire with validated tools assessing BO (Maslach Burnout Inventory) and stress (Siegrist and Karasek)..
ResultsForty-six senior anaesthesia technicians was included in the study. The mean age of our population was 43.76 ±7.74 years with a female predominance (89.1%). According to the Karasek model, 59% of the workers were in job strain, and according to the Siegrist model 23.9% of the participants had an imbalance between high effort and low reward. The BO rate among anaesthesia technicians at the Farhat Hached University Hospital was 39.1%. The results showed a statistically significant association between working at the gynaecology-obstetrics department (p=0.001), the seniority in the department superior or equal to 20 years (p=0.006), the absence of break time at work (p=0.003) and the risk of the occurrence of BO. Furthermore, the last 2 consecutive day rest dates back to more than 15 days (p=0.001), the number of free weekends during the last 3 months less than four (p=0.044) were also significant associated to BO.
ConclusionsOur study confirms that BO is a tangible reality in our country especially among anesthesia technicians, so it must be addressed by adopting effective preventive strategies.
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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- 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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- 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
Prescription of benzodiazepines and related drugs in the Psychiatry Department in the Psychiatry department of Tahar Sfar, Mahdia hospital
- S. Brahim, W. Bouali, M. E. bakhouch, M. Kacem, S. Khouadja, R. Ben Soussia, S. Younes, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S305-S306
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Introduction
Benzodiazepines are the most widely prescribed drugs worldwide for insomnia and anxiety disorders. However, few studies have been conducted on the professional practice of these drugs for patients with psychiatric disorders .
ObjectivesTo describe the prescribing practices of benzodiazepines for patients with psychiatric disorders at the Psychiatry Department of the EPS Taher Sfar Mahdia.
MethodsThis is a retrospective study of patients who were admitted for the first time to the psychiatry department of the EPS Taher Sfar in Mahdia and had a prescription of benzodiazepines during their hospitalization.
ResultsA total of 234 patients were included in our study. We found that 77.8% of patients on benzodiazepines had a prescription for benzodiazepines for a period of less than 3 months. Secondly, we determined that 66.2% of patients who had a benzodiazepine’s prescription had a taper dose of benzodiazepines before the withdrawal. No patients with contraindications to benzodiazepines had a prescription of these medications. The maximum indicated dosage was respected in 92.3% of the prescriptions. Lorazepam was the most used drug, accounting for 49.1% of prescriptions. Our study showed that 46.2% of prescriptions were for anxiolytic purposes only, 43.2% were for hypnotic purposes only. Our analysis also showed a higher proportion of males in the < 3 months group with 82.9% which is significantly higher than for females. (p=0.004).
Our analytical study concluded that gender (p=0.004), professional status (p=0.014), history of addiction (p=0.003), cannabis use (0.025) were related to the duration of benzodiazepine prescription. We noted that 89.9% (n=71) of patients with a documented history of addiction had been prescribed benzodiazepines for less than 3 months. We were also able to conclude that there were correlations between the duration of prescription and medical and/or surgical history (p=0.002), the molecule prescribed (p=0.0001) as well as the renewal of the prescription (0.0001).
However, we did not find a correlation between the associated psychiatric disorders and the duration of prescription. As well for associated psychotropic drugs and duration of prescription
ConclusionsWe can conclude that misuse of benzodiazepines exists, but to a much lesser extent than in the literature. A larger-scale study would be essential to establish a Tunisian overview of benzodiazepine prescription practices.
Disclosure of InterestNone Declared
Cannabis and cognitive deficiency: a descriptive study
- M. Kacem, W. Bouali, M. Henia, S. Brahim, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S563-S564
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Introduction
Cannabis is the most widely used illicit drug; 3.8% of the world’s population consumes cannabis on a regular basis. Cannabis use–associated alterations in the domain of cognition have been extensively studied.
ObjectivesTo research memory deficiency in the young consumers of cannabis in Tunisia.
MethodsThis is a transversal descriptive study conducted during two months (January and February 2022). The research involved about 137 participants aged between 18 and 35 years old, exhaustively recruited amid emergency patients of Mahdia Hospital regardless of the reason for their health care seeking. The patients were declared as consumers of cannabis and accepted to be part of this study. Therefore, Data were collected on a pre-determined data sheet that included various information (age, sex, lifestyle, personal and family psychiatric history, age when first used cannabis and the rate of cannabis use …).
Principally, a Functional Impact Assessment (ERF: French abbreviation for échelle d’évaluation des Répercussions Fonctionnelles ) scale was used to assess and review working memory.
ResultsIn our study population, there was a noticeable male predominance of 71%. Hence, the age structure ranged between 18 years old and 35 years old. Among the latters, 65.9% were single, and 29.7% experienced school failure. In this sample, 23.2% had a psychiatric history like depression, bipolarity, etc. The average age of the first use of cannabis was between 18 and 25 years old in 70% of cases.
Besides, a high percentage of association of other substances was found among cannabis users as follows: use of alcohol 72.5%, tobacco 74.6%, ecstasy 41.3%, and cocaine 25.4%. First and foremost, the use of cannabis was considered as a means of indulgence for 66.7% of the study population, as an anxiolytic for 26.8%, and as a sedative for 23.9%.
Additionally, the effect of cannabis use on working memory deficiency according to the functional impact assessment scale was: no deficiency in 19% of cannabis users, minimal in 34%, mild in 32%, moderate in 9%, fairly severe in 4%, very severe in 1%, and extreme in 1% of cases.
More importantly, the percentage of consumers with significant memory deficiency (moderate to extreme) was 15%.
ConclusionsThe assumption of the effect of cannabis on memory and cognitive deficiency remains controversial and leads us to suggest further in-depth study of this subject.
Disclosure of InterestNone Declared
Sociodemographic and clinical characteristics of employees on long-term sick leave
- S. Brahim, W. Bouali, S. Khouadja, M. Kacem, R. Ben Soussia, S. Younes, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S865
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Introduction
Mental health in the workplace is a rapidly developing field of research, which involves the well-being of the individual on a psychological and social level. However, this balance can be suddenly disrupted and can have such a repercussion that the individual finds himself unable to do his job. In this case, he can benefit from a work stoppage called long term sick leave, governed for the public sector, by the decree number 59-239 of August 24, 1959.
ObjectivesTo study the socio-demographic and clinical profile of public sector employees who have been on long-term sick leave and examined as part of the assessment of their ability to work.
MethodsIt is a retrospective study that focused on all public sector employees on long-term sick leave, examined as part of the evaluation of their ability to work in the psychiatric service CHU MAHDIA during the period from January 2013 to April 2014.
ResultsWe collected 73 patients. The mean age at the time of the examination was 51.1 years. There was a clear female predominance 67% and the sex ratio was 0.48. The vast majority were married (71%), of average socioeconomic status (52%) and high school level (43%). Most of the patients (67%) were from the Ministry of Public Health, followed by the Ministry of Education with 26% of the study population. The average length of service was 20.4 years with extremes between 3 and 36 years. The average length of leave was 13 months. The most frequent diagnosis of the prescribing physician was adaptation disorder (41%), major depressive disorder (27%). Somatic comorbidity was found in 38% of cases, dominated by hypertension, diabetes and cervicarthritis in 50%, 28% and 18% respectively. At the end of the leave, 82% of the patients were able to return to work. For the other patients, a professional reclassification was necessary.
ConclusionsLong-term sick leave has a heavy economic burden for society and serious socio-economic and psychological repercussions on the patient. Hence the interest in identifying vulnerable subjects and jobs at risk in order to prevent the occurrence of psychopathological disorders.
Disclosure of InterestNone Declared
Assessment of self-esteem among Tunisian cannabis users
- M. Kacem, W. Bouali, M. Henia, S. Brahim, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S669
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Introduction
Self-esteem plays a role in the adaptive functioning of the human being. It could be a protective factor regarding multiple risks particularly substance use.
ObjectivesThe aim of this study is to assess self-esteem among a group of young Tunisian users of cannabis.
MethodsThe total study sample was composed of 137 participants, who took part of a transversal descriptive study during two months (January and February 2020). These partakers were comprehensively recruited among Emergency patients of Mahdia Hospital. Thereupon, the main criteria for the selection of these patients was their consumption of cannabis, regardless of their primary health care seeking reason or purpose.
The research was carried out upon their declaration of cannabis consumption and their compliance to be part of such a study. Thus, Data were collected on a pre-determined data sheet that included various information (age, sex, lifestyle, personal and family psychiatric history, age at which they started their cannabis consumption and the rate of cannabis use …).
Accordingly, Self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). Consequently, the interview took place after the subject’s verbal and informed consent and the assurance of anonymity and confidentiality of the interview content.
ResultsIn our study population, the cannabis consumers were young adults aged between 18 and 35 years old, with a male predominance of 71%. Among those users, 65.9% were single and 29.7% dropped out of school or experienced academic failure. On a socio-economic level, we concluded to a rate of 5.8% (lower class), 60.9% (middle class) and 33.3% (upper class).
Besides, 40.8% were employed. In total, 23.2% had a psychiatric history. Furthermore, the use of other substances was also prominent and frequent as follows: alcohol 72.5%, tobacco 74.6%, ecstasy 41.3% and 25.4% cocaine. The use of cannabis was considered as a means of indulgence and pleasure for 66.7%, as an anxiolytic for 26.8% and as a sedative for 23.9%.
Self-esteem, among those cannabis users, was very low in 20% of cases, low in 38% of cases, medium in 15% of cases and high in 25% of cases. Consequently, more than half of the study population remains below the medium average according to RSES.
ConclusionsThese results lead us to question the relation between cannabis and self-esteem. The question that is evolved about the use of cannabis is the following: Is it used as a remedy or is it the cause of self-esteem deficiency?
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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- 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
Fatal pulmonary embolism related to anti-psychotics: forensic implications. About four autopsy cases with review of the literature
- M. Kacem, W. Bouali, Y. Mahjoub, S. Brahim, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S882
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Introduction
The association between the intake of antipsychotic drugs and the occurrence of thromboembolic complications is widely described in the literature. The occurrence of this complication may call into question the medical responsibility of the attending physician.
ObjectivesThe objective of this work is to describe the physiopathological mechanisms involved in the occurrence of thromboembolic complications in a patient under antipsychotic treatment, whether or not associated with physical restraint and to discuss the forensic implications.
MethodsOur study is retrospective on cases of fatal pulmonary embolism, discovered at autopsy, in connection with the taking of antipsychotics. The autopsies were carried out in the Department of Forensic Medicine of the Tahar Sfar University Hospital in Mahdia. The cases were collected over a period of 04 years. A review of the literature was carried out. We only selected articles published until February 2021 and dealing with cases of patients on antipsychotics, diagnosed with pulmonary embolism by performing a chest CT scan or during an autopsy.
Results915 autopsy cases were performed during the study period. Twenty cases of pulmonary embolism, discovered at autopsy, were collected. Four cases were related to the taking of antipsychotics (incidence 0.004%), including two men and two women, aged between 25 and 52 years. They were all on antipsychotic treatment for at least 5 years, with the exception of one case who was put on 3 antipsychotics, 7 days before his death, with indication of physical restraint.
After analysis of the memorial data, the external examination and the autopsy, the results of additional examinations, the death was attributed, in the 4 cases, to a massive fibrino-cruoric pulmonary embolism.
A selection of 45 studies regarding thromboembolic complications associated with taking antipsychotics, was included in the final review.
ConclusionsThe reported cases provided additional evidence on the involvement of antipsychotics in the occurrence of thromboembolic complications. Psychiatrists should be careful when prescribing these treatments. The establishment of therapeutic guidelines, taking into account the thromboembolic risk factors, becomes essential, in order to avoid the occurrence of a complication which could engage both the vital prognosis of patients and the responsibility of the physician.
Disclosure of InterestNone Declared
Diabetes-related distress and its associated factors among patients with type 2 diabetes mellitus in Tunisia
- R. Masmoudi, M. Bouattour, F. Hadj Kacem, R. Ben Jemaa, F. Cherif, J. Masmoudi, M. Abid
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S773-S774
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Introduction
Diabetes-related distress (DD) is one of the psychological disorders affecting patients with diabetes.
ObjectivesThe aim of this study was to assess the prevalence and level of DD and its associated factors among patients with type 2 diabetes.
MethodsThis was descriptive and analytical cross-sectional study, carried out with patients followed for type 2 diabetes at the endocrinology consultation.
The participant’s sociodemographic and clinical information was obtained through face-to-face interviews and medical records.
DD was assessed using the Arabic version of diabetes distress scale (DDS-17). The DDS contains 17 items, each rated on a 6-point Likert scale. The scale yields a total diabetes distress score, and scores for four subscales: emotional burden, regimen distress, physician distress and interpersonal distress.
ResultsThere were 103 subjects. The mean age was 59.31 ±10.83 years with a sex ratio (M/F) = 1.19.
Median duration of diabetes was 7 years (IQR 3 ; 12 years). Among our patients, 31.1% of patients had properly controlled diabetes (HbA1c < 7%) and 41% had at least one diabetes complication.
The prevalence of diabetes related distress was 70.90% in which emotional distress was the most prevalent (78.60%) domain.
Low socio-economic level (p=0.001), married status (p=0.034) having diabetes complications (p=0.008) younger age at onset of diabetes (p=0.001) were associated with diabetes related distress. Poor HbA1c control (HbA1c≥7%) was significantly correlated with DD (p≤0,001).
ConclusionsOur study suggests that diabetes related distress was highly prevalent in type 2 diabetes patients in Tunisia. Active screening for DD should be an integral part of diabetes care.
Disclosure of InterestNone Declared
Levels of anxiety, depression and stress among health care workers during the COVID19 pandemic: Study conducted at the University Hospital Farhat Hached of Sousse-Tunisia
- N. Belhadj Chabbah, S. Chatti, Z. Athimni, M. Bouhoula, A. Chouchane, A. Aloui, I. Kacem, M. Maoua, A. Brahem, H. Kalboussi, O. Elmaalel, N. Mrizek
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S815
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Introduction
During the COVID-19 pandemic, health care workers found themselves threatened by developing psychological effects.
ObjectivesThe objective of this study is to evaluate the impact of exposure to COVID-19 on the mental health of medical and paramedical staff at Farhat Hached Hospital in Sousse and to identify potential risk factors.
MethodsThis is a descriptive cross-sectional study that included 166 health care workers of Farhat Hached Hospital of Sousse throughout 3 months. The patient health questionnaire (PHQ-9), the generalized anxiety disorder (GAD-7), and the revised event impact scale (IES- R) were used to assess depression, anxiety, and stress respectively.
ResultsThe mean age of the participants was 37.06 ±11.07 years with a female predominance (80.1%). The median professional seniority was 7.5 years with extremes ranging from 1 to 39 years. Nurses were the most represented (34.3%) followed by medical residents (24.7%). PHQ-9, GAD-7, and IES- R scores revealed that 51.8%, 40.4%, and 28.3% of participants had moderate or severe levels of depression, anxiety, and stress, respectively. Personal history of psychiatric disorders was significantly associated with depression (p<10-3) and anxiety (p=0.004). On the other hand, paramedical staff had a significantly higher risk of experiencing symptoms of depression (OR = 2.40 ; 95% CI [1.28-4.48] ; p= 0.006) and stress (OR = 2.03 ; 95% CI [1.01-4.11] ; p= 0.04) than medical personnel.
ConclusionsThis study reported a high prevalence of symptoms of anxiety, depression and stress among health care workers. Improving mental well-being and providing psychological support to health care workers is recommended.
Disclosure of InterestNone Declared
Cannabis Consumption Among Musicians: About A Series Of 37 Cases
- S. Brahim, W. Bouali, I. Ghachem, M. Kacem, S. Khouadja, R. Ben Soussia, S. Younes, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S677
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Introduction
Many musicians have suffered the consequences of drug addiction. What about cannabis use?
ObjectivesTo describe the epidemiological characteristics of cannabis users among musiciens
To study the prevalence of anxiety and depression disorders among these consumers
MethodsA descriptive and retrospective study of the epidemiological characteristics and prevalence of depression and anxiety in a population of 37 musicians who consume cannabis. This sample was selected among 202 musicians having participated in an anonymous questionnaire
ResultsThe prevalence of cannabis use among musicians in our study is about 18.31%. 76% of them are professionnals with sex ratio of 6.25. The mean age of these musicians is 27 years old. They started using cannabis at a mean age of 21 years old. The history of school failure was found in 1/3 of all cases, with a younger age at the onset of cannabis use (18 years old vs 22 years old in absence of school failure). 72.4% of cannabis users are single, 27.5% are in a relationship, 66.7% of the 37 musicians are Tabaco smokers, 55.6% are alchoolics, and 19,4% are using other drugs. 16.7% of these musicians are followed for depressive disorder, anxiety or bipolar disorder. The mean duration of cannabis use is 7 years, often in group of people. The first contact with cannabis occurs after the start of learning music in 44.4% of cases (a mean of 12 years after).The average consumption is about 4 times per week, mostly outside the musical activity in 3/4 of the cases. 53.6% believe that cannabis can cause a decline in their health. 10 musicians increased cannabis use and 8 of them believe that it can improve their performance and creativity. On the other hand, only 9 musicians wish to wean the use of cannabis. 19/29 musicians (65.5%) have an anxiety (A) and/or depression (D), that is proven to be moderate to severe respectivelly in 2/3 and half of cases, The mean of the A score and D score of the HAD scale is 10 and 9, respectivelly.
ConclusionsThe reasons of cannabis addiction are various: fleeing reality, seeking the anxiolytic or sedatif effects and improving performance.
Disclosure of InterestNone Declared
Assessment of addictive behaviors in patients with schizophrenia
- M. Kacem, W. Bouali, H. Babba, F. Zaouali, 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. S669
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Introduction
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.
ObjectivesThe objectives of our study were to estimate the prevalence and identify the characteristics of addictive behaviors in patients with schizophrenia.
MethodsA 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.
ResultsThe 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.
ConclusionsSubjects 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.
Disclosure of InterestNone Declared
Addictive behaviors in schizophrenic patients: Descriptive and analytical study
- W. Bouali, H. Babba, F. Zaouali, M. Kacem, S. Brahim, 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. S1092
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Introduction
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.
Objectivesdetermine the impact of addictive behavior on patients suffering from schizophrenia.
MethodsA 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.
ResultsThe 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).
ConclusionsAccording 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.
Disclosure of InterestNone Declared
Occupational factors related to burnout among agents of a service center of a telecommunications operator in Tunisia
- Z. Athimni, A. Chouchen, H. Kalboussi, M. T. Haloul, A. Aloui, A. Gaddour, M. Bouhoula, M. O. Maoua, A. Brahem, O. Maalel, S. Chatti, I. Kacem, N. Mrizak
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S862
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Introduction
Burnout syndrome (BO), considered to be the final stage of stress, is a dynamic process resulting from the gradual loss of the employee’s ability to face psychosocial risk factors and the exhaustion of personal resources. This syndrome can affect all professional categories. It represents a major threat for the worker and has a high economic cost
ObjectivesTo identify the professional factor associated with BO among agents of a service center of a telecommunications operator in the governorate of Sousse in Tunisia
MethodsCross-sectional descriptive study, conducted from February 1st, 2020 to January 31st, 2021 among agents of a service center of a telecommunications operator in the agencies of the governorate of Sousse. The collection of data was based on an anonymous self-questionnaire. The evaluation of stress was done via validated measurement instruments, namely the questionnaires of Siegrist and Karasek and the evaluation of BO by the Maslach Burnout Inventory (MBI).
ResultsNinety four actel agents were identified in our study, and 59 participants answered the questionnaire. The average age of our population was 43.93 ± 8 years. The female gender was predominant with a sex ratio of 0.48. The Karasek Job Content Questionnaire showed that 23.7% of the participants were in job strain. Furthermore, 28.3% of our total population had an imbalance between extrinsic efforts and rewards. The assessment of burnout by the Maslach Burnout Inventory showed that 64.2% of the workers were in occupational BO, and in 11.8% of these cases, BO was considered high. Our study showed that work-related organisational and environmental factors were significantly associated with BO, such as the number of customers seen per day: exceeding 50 (p = 0.048) and being a victim of verbal aggression (p = 0.038).
ConclusionsThe results of this study showed that BO among agents of a service center of a telecommunications operator in Tunisia, was significantly associated with some professional factors. Therefor, in the future, it would be advisable to improve the working conditions of these agents by introducing collective and organisational preventive measures (primary prevention) and individual measures (secondary prevention) and by facilitating their professional reintegration (tertiary prevention) to avoid relapses.
Disclosure of InterestNone Declared
Screening for anxiety and depression in active military personnel with asthma
- H. Ziedi, I. Mejri, M. Kacem, S. Mhamdi, S. Daboussi, C. Aichaouia, Z. Moatemri
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S757
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Introduction
Asthma is the most common allergic respiratory disease and is frequently associated with symptoms of depression and anxiety. However, this association remains poorly understood, especially in active military personnel with asthma who are particularly exposed to a high mental and physical load.
ObjectivesTo investigate the presence of anxiety and depression in active military personnel with allergic asthma.
MethodsThis is a descriptive cross-sectional study conducted at the pneumology department of the Tunis military hospital that interested active military personnel followed for asthma and who consulted the department in the period from January 1, 2022 to October 31, 2022. The Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety.
ResultsDuring the study period, 36 asthma patients were included. The mean age was 35±8 years with a male predominance of 83%. The majority of the participants were non-commissioned officers (91%), whom were in field positions in 68% of cases. The median professional seniority was 9 [6; 17] years. Active smoking was noted in 47% of the participants. Half of the patients had comorbidities. A history of major depressive syndrome was reported by 8% of patients. Current antidepressant treatment was mentioned by only one patient. Asthma was well controlled in 66.7% of cases. Definite anxiety was found in 30% of the patients while it was doubtful in 26% of the population. Depression was present in 18% of the participants. Specialist psychiatric care was recommended for patients with depression and anxiety.
ConclusionsAnxiety and depression are significant comorbidities in asthma patients. Screening for these risks is necessary, especially in the military population whose work requires mental and physical integrity.
Disclosure of InterestNone Declared
Antipsychotic prescription amongst the elderly: Descriptive and analytical study
- W. Bouali, R. Omezzine Gniwa, S. Younes, M. Kacem, 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. S943
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Introduction
Antipsychotics are frequently used to treat certain delusional, psychotic and behavioral symptoms in the elderly. However, the data in the literature show a great variability in the practices of different teams as well as numerous misuses in the use of this therapeutic class.
ObjectivesThe aims of this work were to evaluate the prescription of antipsychotics in the elderly admitted in a psychiatric department and to compare them with the Information in the literature.
MethodsThis was a retrospective and descriptive study carried out in the Psychiatry Department at Mahdia Hospital. We included all patients aged 65 years and older, admitted between January 2016 and December 2021 and having received antipsychotic treatment.
ResultsOur sample consisted of 53 patients with a mean age of 69.8 years with a standard deviation of 4.2. The sex ratio (M/W) was 2.7. The most common diagnoses in our sample were schizophrenia and dementia with rates of 31.8% and 27.3% of cases respectively. Regarding antipsychotic treatment, 34.1% received first generation oral antipsychotic treatment (AP1G), 31.8% received second-generation oral antipsychotic treatment (AP2G), 27.3% received a combination of AP1G and AP2G and 6.8% received a long-acting injectable antipsychotic. More than a quarter of our patients (34.1%) reported adverse events due to antipsychotic treatment.
ConclusionsThe results of our study highlighted various indications for which an antipsychotic treatment was prescribed in an elderly person despite an often poor and multi-medicated health status, to which side effects were added.
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