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Sexual dysfunction among pregnant Tunisian women
- A. Zouari, F. Guermazi, B. Amamou, R. Masmoudi, I. Feki, I. Baati, J. Masmoudi, L. Gaha
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S643
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Introduction
Sexual life is affected by physiological, psychological and social changes during pregnancy. Therefore, pregnancy is considered as a stressor affecting sexual lives of women and as a period when sexual dysfunctions can easly appear.
ObjectivesThe aim of our study was to explore the prevalence of sexual dysfunctions among pregnant womens.
Methodswe conducted a cross-sectional and descriptive study among Tunisian pregnant women. The questionnaire used was performed with Google Forms and posted on social media. It contained questions concerning personal and sociodemographic aspects and questions concerning obstetrical data such as parity, gestational age and complications during the current pregnancy. We used the Female Sexual Function Index to examine Sexual dysfunction. Total scores of 26.55 or less characterize deficiency of female sexual function.
ResultsFifteen women (44.1%) were primiparous and 19 (55.9%) were multiparous with 29% being in the first trimester, 27% in the second, and 44% in the third. Half had at least one child. Most of participants reported better satisfaction with their sexuality before pregnancy than during pregnancy (76.5% vs. 26.5%). This difference in satisfaction was statistically significant (p=0.004). A sexual dysfunction was found in 70.6% of cases and we did not identify any correlations between the presence of sexual dysfunction and sociodemographic or clinical data of the current pregnancy.
ConclusionsThe prevalence of sexual dysfunction among Tunisian pregnant women was high and not related tosocio-demographic characteristics.
Disclosure of InterestNone Declared
Thrombotic complications of treatment with antipsychotic drugs : risk factors
- W. Abid, F. Chérif, N. Bouattour, R. Masmoudi, F. Guermazi, I. Feki, R. Sallemi, J. Masmoudi
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S590
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Introduction
Antipsychotic agents (AP) are widely used drugs to treat psychotic symptoms. For decades, some studies suggested that there is a relationship between using (AP) and the risk of venous thromboembolism (VTE) and pulmonary embolism (PE). The causality of this association, its risk factors, and its implications for clinical practice have not been fully elucidated.
ObjectivesWe undertook a systematic literature review to evaluate the evidence for an association between antipsychotic medication and venous thromboembolic events (VTE) and to identify risk factors for these adverse effects.
MethodsTo identify relevant studies, we searched the PubMed, Science Direct databases up using the following keywords « pulmonary embolism », « venous thromboembolism » « antipsychotics agents ». We also searched the reference lists relevant articles for related studies.
ResultsTwelve articles are included in this analysis and indicate an elevated risk of VTE in antipsychotic drug users. The results showed that compared with non-users, current AP users have significantly increased risks of VTE. The risk of venous thrombosis in obese people was higher than that in overweight people, patients not less than 65 years old had an increased risk compared with younger patients . In addition, women taking antipsychotics had a higher risk of pulmonary embolism than men. The other factors that increased risk were use of second-generation antipsychotics and antipsychotic polytherapy. The highest risk was noted in the first 3 months of treatment. Data also suggested a dose-dependent increase in the risk of thrombotic complications. For individual drugs, increased risk of VTE and PE was observed in taking clozapine , haloperidol, risperidone and olanzapine. Clozapine was associated with the highest risk. However, careful interpretation is needed because of high heterogeneity among studies and scarce data.
ConclusionsThe use of antipsychotics will increase the risk of venous thromboembolism and pulmonary embolism, which will be affected by AP and patient characteristics.
Disclosure of InterestNone Declared
Socio-demographic characteristics and clinical profile among suicide attempters
- R. Ouali, R. Masmoudi, F. Guermazi, F. cherif, I. Feki, O. Chakroun, E. Derbel, R. sellami, J. Masmoudi, N. Rekik
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S874
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Introduction
Suicide is a real public health problem. Like many other countries, Tunisia seems to be experiencing an amplification of the phenomenon. Suicide attempts are much more frequent and are estimated to be around 20 times the number of suicides
ObjectivesThe objective was to describe the sociodemographic characteristics and clinical profile of suicide attempters in patients hospitalized in the emergency room.
MethodsThis study was carried out with patients admitted to vital emergencies for attempted suicide over a period of 6 months.
A pre-made questionnaire was used to collect sociodemographic and clinical data. We used the SIS “suicide intention scale” to assess the intent of the suicide attempt and the PHQ9 “PATIENT HEALTH QUESTIONNAIRE” to assess the presence and severity of depressive symptoms.
We excluded Patients with major cognitive impairment, which prevents understanding of the questionnaire.
ResultsOur sample consisted of 101 patients. Of the participants, 69.3% were female. Their age varied between 18 and 65 years with an average age of 30.93 years. The socioeconomic level was low in 23.8% of cases. The level of education did not exceed secondary school for 91% of suicides. Almost half of suicide attempters (45%) have been professionally inactive. Participants included in our study were single in 51.5% of cases. Participants had a family history of attempted suicide in 15% of cases. Prior psychiatric follow-up was found in 34% of suicides attempts. More than a third (36.6%) of participants had moderate to severe depression according to the results of the PHQ-9. Recurrences concerned 44% of suicides attempt in our survey and the average number of previous suicides attempts was 3.9. Suicidal intent was rated strong in 47% of suicides attempts .
ConclusionsSuicidal behavior is one of the leading causes of death and disability worldwide. In our study, more than 1 in 3 suicide attempters had depression. Further research is needed to identify suicide risk factors and to examine the relationship between the presence of mental illness and suicidal attempt
Disclosure of InterestNone Declared
Depressive disorders in patients with sleep apnea syndrome
- N. Rmadi, N. Kammoun, N. Kotti, R. Masmoudi, S. Rekik, M. L. Masmoudi, K. Jmal Hammami, J. Masmoudi, S. Kammoun, S. Msaed, M. Hajjaji
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S604
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Introduction
A growing body of literature has documented that obstructive sleep apnea syndrome (OSAS) is associated with an increased risk of depressive disorders.
ObjectivesThis study aimed to determine whether depression is associated with OSAS.
MethodsThis was a descriptive prospective comparative study conducted over two years among patients with OSAS. Excessive daytime sleepiness was assessed by the Epworth Sleepiness Score (SES). The presence and intensity of depressive symptoms were screened using the Patient Health Questionnaire PHQ9. Data were analysed using SPSS software.
ResultsA total of 139 patients participated in the survey with an average age of 48.98 ± 9.80 years. According to the SES, the study population was divided into two groups: a group including 70 subjects with normal SES (< 11); and a group including 69 subjects with pathological SES (≥11). The PHQ9 depression score was higher in sleepy subjects with SES ≥ 11 compared to non-sleepless subjects; the difference being very highly significant (PHQ9=11.97 ± 4.99 and 6.54 ± 5.27 respectively; p=0.0000). The frequency of mild to moderate depressive disorders was found to be greater in non-sleepy subjects (94.3% and 78.3% respectively; p=0.007). For moderately severe to severe depression, their frequency was more marked in sleepy subjects (21.7% and 5.7% respectively; p=0.007).
ConclusionsDepressive disorders constitute a major comorbidity in OSAS. Therefore, it is necessary to improve the quality of these patients’ health by the early detection of the symptoms of overlapping OSAS and depression.
Disclosure of InterestNone Declared
Role of Body Mass Index on Perceived Stress in Medical Students
- R. Jbir, R. Masmoudi, M. Abdelkefi, S. Hentati, I. Feki, R. Sellami, J. Masmoudi
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S907
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Introduction
The study period to become a medical professional is notoriously stressful This label can be attributed to various factors like long tedious training, social expectations, long work hours, high liability, sleep deprivation, and a constant lack of time to relaxin this vulnerable area, physical appearance, either weight loss or obesity, can affect the mental health of these young people.
ObjectivesTo determine the role of body mass index (BMI) on the levels of perceived stress in medical students.
MethodsOur study was descriptive and analytical cross-sectional, carried out with medical students in the faculty of medicine of sfax (Tunisia) during October 2022.
An anonymous survey was asked to the students.
Data collection was done by a self-administered questionnaire via Google Forms administered in the students’ Facebook groups. The questionnaire was composed of a part for the collection of socio-demographic data and a psychometric scale:
- Cohen’s Perceived Stress Scale (PSS) to determine the level of stress
ResultsA total of 95 responses was collected.The average age of our sample was 25.8±3.4 with female predominance (78,9%).
The half of the population (53,7%) were residents in medicine.
The majority of them (88,4%) had an average socio-economic level and singles (83,2%) .
81,1% had a stressor related to studies in 50,5%,to family in 40 % and financial in 9,5%.
Tobacco consumption were reported by 14,7 % .
A psychiatric history was reported by 17.9% of the students, 76.5% of whom are anxiety disorders.
27.4% tried to control their weight. Several methods of weight control were used, the most frequent (65.4%) was diet, none resorted to laxatives and 8.4% consulted a nutritionist.
Almost half of the population (57,9%) slept between 5 and 7 hours.
The average body mass index was 23.64 kg/m2 (SD=3.53).
According to PSS scores, 21.1% of students had severe level of stress, 69.5% had moderate stress level while 9.5% had low level of stress.
Those followed in psychiatry had a higher level of stress (p<10-3), especially those with anxiety disorder (p=0,02).
The students pressed for weight control were more stressed than their peers.
The levels of stress were higher among underweight students (BMI < 18.5) and overweight students (BMI >25) without significantly correlations.
ConclusionsThe current study revealed that medical students, especially underweight or overweight students, are more susceptible to develop stress symptoms,that is why psychic support must be available on their university.
Disclosure of InterestNone Declared
Characteristics of suicide attempts seen in emergency service
- R. Ouali, R. Masmoudi, F. Guermazi, A. Mellouli, O. Chakroun, R. Sellami, E. Derbel, I. Feki, J. Masmoudi, N. Rekik
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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
The suicidal phenomenon constitutes a real public health problem not only by the human losses it causes, but also by the psychological and social problems to which it testifies.
ObjectivesThe objective was to describe suicide attempts in patients hospitalized in the emergency room.
MethodsA descriptive cross-sectional study was carried out with patients admitted to vital emergencies for attempted suicide over a period of 6 months.
We excluded Patients with major cognitive impairment, which prevents understanding of the questionnaire
A data collection sheet was used for the evaluation of the suicide attempts.
ResultsOur sample consisted of 101 suicide attempts. Using non-physical methods (drugs, caustics, pesticides, gases) was reported in 91.9% of cases and while physical methods (hanging, phlebotomy, drowning) in 8.9% of cases. Self-poisoning by medications was the most frequent (51%) method used in suicide attempt. The majority of suicide attempts were reactive (77.2%). Family or marital conflicts were the precipitating factor most mentioned (74%). The suicidal act was unpremeditated in 66% of cases. Communication of suicidal intent either verbally or in writing was reported in 34.7% of cases. The passage to the suicidal act was preceded by taking alcohol in 7% of cases and cannabis in 3% of cases. In 44.6% of cases, regret was the attitude most adopted by suicide attempters towards the act. The somatic state on admission was unstable on the cardiac level in 23% of the cases, on the respiratory level in 27% of the cases and on the neurological level in 38% of the cases
ConclusionsThe data from our study suggest that suicidal attempts were mostly unpremeditated. Clinicians should not minimize the significance of impulsive attempts, as they are associated with a similar level of lethality as premeditated attempts
Disclosure of InterestNone Declared
Relationship between orthorexia nervosa and self-esteem in Tunisian medical students
- M. Abdelkefi, R. Masmoudi, R. Jbir, F. Cherif, I. Feki, R. Sellami, J. Masmoudi
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S851-S852
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Introduction
The effect of self-esteem in eating disorders has been investigated in several studies, but it’s still not extensively investigated in orthorexia nervosa.
ObjectivesTo study the prevalence and factors associated with orthorexic eating behaviors in medical students and it’s relation with self-esteem.
MethodsA cross-sectional study was conducted through an online survey among medical students of the faculty of medicine of Sfax (Tunisia). Participants completed an anonymous self-administered questionnaire. We collected their sociodemographic and clinical data. Orthorexia nervosa (ON) was assessed using the self-reported scale, ORTO-15. We used the Rosenberg’s self-esteem scale to assess self-esteem.
ResultsNinety five medical students completed the survey. The mean age was 25.8±3.4 years and the sex ratio (F/M) was 3.75. The average body mass index was 23.64±3.53 kg /m2.
Fifty-eight percent of the students (58%) reported that they were dissatisfied with their eating habits, and 27.4% tried to control their weight. Several methods of weight control were used, the most frequent (65.4%) were diet and physical exercise, none resorted to laxatives and 8.4% consulted a nutritionist.
Self-esteem was very low in 27.1% and low in 34.7% of the students.
Overall, the prevalence of orthorexia among our participants was 52.6%. The mean score of the ORTO-15 was 39.19±4.48.
Orthorexia was significantly correlated with the use of weight control measures (p=0.035) and physical activity (p=0.042).
Students with low self-esteem had higher tendency for orthorexia but with no significant correlation.
ConclusionsOur study supports a non-negligible frequency of orthorexic behaviors in medical students but future studies are needed to assess the direct effect of self-esteem on orthorexia.
Disclosure of InterestNone Declared
Psychiatric Adverse Effects of treatement with Corticosteroids: A Tunisian case report
- N. Boussaid, F. Guermazi, W. Abid, R. Masmoudi, I. Feki, I. Baati, J. Masmoudi
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S958
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Introduction
Corticosteroids are certainly an efficacious treatment for several inflammatory and immunologic disorders. However, their abuse can lead to dangerous consequences such as psychiatric complications. Physicians and Psychiatrists should cooperate to treat and prevent, if possible, the deleterious adverse psychiatric effects of corticosteroids.
Objectivesto describe a patient whose psychotic symptoms occured within 2 weeks of starting corticosteroid abuse, to review the literature and to suggest treatment.
MethodsTo present a case of a female young patient suffering from corticosteroid-induced psychosis due to corticosteroid abuse and review case report data published during the past quarter-century on adverse corticosteroid-induced psychiatric effects.
ResultsThe patient was investigated to exclude other causes of her psychosis and she was treated with chlorpromazine and Risperidone. Numerous cases investigating these psychiatric corticosteroid-induced symptoms were identified. Data on incidence, drug dose, onset of symptoms, course of illness and treatment were arranged.
ConclusionsCorticosteroid abuse should be put in the spotlight especially for young Tunisian females desiring to look plump. This misjudged abuse may have sever psychiatric complications. Thus we should establish strategies of prevention and cure to these psychiatric complications
Disclosure of InterestNone Declared
Associations between psychosocial factors and work ability in a Tunisian electricity and gas company
- N. Rmadi, N. Kammoun, A. Hrairi, N. Kotti, R. Masmoudi, K. Jmal Hammami, M. L. Masmoudi, J. Masmoudi, M. Hajjaji
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S298-S299
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Introduction
Work ability can be influenced by numerous factors, particularly psychosocial ones. These latter can be individual psychosocial factors but also psychosocial factors at the workplace.
ObjectivesThis study aimed to explore psychosocial determinants of work ability among workers in a Tunisian electricity and gas company.
MethodsWe conducted a cross-sectional survey among 83 male workers in a Tunisian electricity and gas company. We used a self-administered questionnaire that included socio-demographic profile, psychosocial factors assessment through the Job content questionnaire (JCQ) and General Health Questionnaire (GHQ-12), and Work Ability Index (WAI) questionnaire. Data were analysed using SPSS software. We used the student’s test to compare means between two groups.
ResultsThe mean WAI score among workers in the studied electricity and gas company was 8.96 (SD=1.37). At the time of the survey, one person out of 3 among the participants suffered from a psychological distress (37.3% with a GHQ-12 score ≥ 3). These Workers had a weaker work ability compared to those with not (p=0.033). We found also that having low social support and passive jobs were associated with low work ability (p=0.003 and p=0.005 respectively).
ConclusionsMost personal and occupational psychosocial factors had significant associations with WAI in the studied company. Thus, enhancing the psychosocial environment in the workplace can promote work ability in such occupations.
Disclosure of InterestNone Declared
Anxiety and depression among patients with spondyloarthritis
- A. Feki, Y. Mejdoub, I. Mnif, I. Sellami, Z. Gassara, S. Bendejemaa, M. Ezzeddine, M. H. Kallel, H. Fourati, R. Akrout, M. L. Masmoudi, S. Yaiich, S. Baklouti
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S834
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Introduction
Ankylosing spondylitis (AS) is an inflammatory rheumatic disease characterized by spinal and/or peripheral involvement, enthesitis, dactylitis, and several extra-articular manifestations. Chronic inflammation often leads to reduced spinal mobility and functional disability. The frequency of psychological problems has increased in AS patients.
ObjectivesThe objective of this study was to determine the prevalence of symptoms of anxiety and depression among AS patients and explore the underlying associated factors.
MethodsThe Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and other clinical measures were collected during the clinical trial. We evaluated also the hospital anxiety and depression scale (HADs). P values < 0.05 were considered statistically significant.
ResultsSixty-two patients with AS were included in the study. The average age was 41 years [18-65]. The diagnostic delay varied from one year to 26 years with an average of 4 years. Twenty-nine years is the average age of onset of symptoms with a standard deviation of 10 years. The mean duration of the disease was 10 ± 8 years. At baseline, the mean BASFI score was 53.9 ± 2 and BASDAI was 4.5± 2.
Clinically significant symptoms of anxiety and depression were present in 48.4% and 54.8% of patients, respectively. Depression was noted with a mean HADS depression of 10,5 ± 5,2. Anxiety was noted with a mean HADS anxiety of 11,3 ± 4,6.
In univariate analysis, anxiety was associated with the low educational level of patients (p = 0.038) and with CRP level (p= 0.041). There was a significant association between depression and anxiety (p=0.000). There was no relationship between these psychiatric disorders and disease activity, treatment modalities or functional status (p>0.05)
ConclusionsIn patients with Ankylosing spondylitis, the prevalence of risk of mental disorders is high.
Anxiety and depression are common in AS and even alter the quality of life.
Patients should be regularly screened for these disorders.
Disclosure of InterestNone Declared
Coherence Abnormalities in Tunisian Schizophrenic patients: case-control study.
- M. Mnif, L. Triki, N. Smaoui, D. Jardak, R. Feki, G. Imen, S. Omri, N. Charfi, J. Ben Thabeut, L. Zouari, M. Maalej, K. Masmoudi, M. Maalej
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1074-S1075
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Introduction
Resting state electroencephalogram (EEG) abnormalities in schizophrenia (SCZ) suggest alterations in neural oscillatory activity. However, few studies have examined EEG coherence in this population.
ObjectivesTherefore, this study investigated whether these electrophysiological characteristics differentiate schizophrenic patients from healthy controls.
MethodsThis was a cross-sectional, descriptive, and analytical case-control study. The selected patients were followed for SCZ at the psychiatry "C" department at the Hedi Chaker hospital of Sfax. Patients were assessed by the Positive and Negative Schizophrenia scale (PANSS) and the Treatment Adherence Scale (MARS). They all benefited from an EEG at the service of functional explorations in Sfax. Student’s test was performed to compare the coherence values between groups.
ResultsThirty men including 15 schizophrenic patients and 15 age- and sex-matched controls were included. The average age was 40 years ±12.72 years for schizophrenics and 47.93 ± 15.61 years for healthy controls. Schizophrenics had an average PANSS of 64.6±22.7, and an average MARS score of 5.8 ± 3.09.
In terms of intra-hemispheric coherence, Schizophrenic patients generally exhibited higher coherence at the Delta band compared to healthy controls. In contrast, schizophrenic patients appeared to have decreased intra-hemispheric connectivity for other frequency bands, particularly between the frontal and other brain lobes bilaterally.
ConclusionsIn this study, we found that the schizophrenic patients had significantly higher coherence in the delta frequency band compared to the normal controls. These findings suggest that EEG can be a sensitive measure for diagnosing SCZ.
Disclosure of InterestNone Declared
Aggression and its association with childhood trauma in euthymic bipolar disorder patients
- A. Mellouli, R. Masmoudi, R. Ouali, F. Guermazi, I. Feki, R. Sellami, J. Masmoudi
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S694
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Introduction
Aggression and negative behaviours are used to be present in individuals with bipolar disorder, who are sensitive to life events. Thus, many studies investigated the emergence of impulsivity and aggression in the developmental process and revealed its relationship with childhood adversities.
ObjectivesThe aim of this study was to determine the relationship between childhood trauma and aggressive behaviour in euthymic patients with bipolar disorder.
MethodsIt was a cross-sectional descriptive and analytical study involving patients diagnosed with bipolar disorder and followed in the psychiatric department at the University Hospital ofSfax (Tunisia).
All subjects completed the Childhood trauma questionnaire (CTQ) and the Buss–Perry Aggression Scale (BPAS). Euthymiawas defined as a score on the Montgomery-Åsberg Depression Rating Scale (MADRS) not higher than 14 and by a score on theYoung Mania Rating Scale (YMRS)not higher than seven.
ResultsWe included 35 patients. Their mean age was 46.69 ± 12.01 years with a sex ratio (M/F) =0.45. Most of them lived in urban areas (91.42%) and had a moderate socioeconomic level(88.57%).
The most frequent trauma type was physical neglect with 74.28%, followed by emotional abuse (42.85%), emotional neglect (42.85%), physical abuse (37.14%) and sexual abuse (31.42%).
The mean score of CTQ was 58.57 ±9.51. Theaverage total score of BPAS was 82.26 ±14.57.
The mean scores of subscales of BPAS were 25.49±4.59 for physical aggression, 13.74±3.51for verbal aggression, 19.14±6.22 for anger and 23.89±5.57 for hostility.
A statistically significant and positive correlation was determined between CTQ and BPAS (p=0.011). The score of BPAS was significantly correlated with physical abuse (p=0.003) and physical neglect (p=0.014).
ConclusionsThe relationship between CTQ and BGHA scores suggests the possibility that childhood trauma may be one determinant of aggression in patients with bipolar disorder. Considering the childhood trauma history in the evaluation of these patients may prevent their aggression and thus their psychosocial functioning.
Disclosure of InterestNone Declared
Exploring the prevalence and factors associated with fatigue and quality of life in patients with Ankylosing Spondylitis
- A. Feki, Y. Mejdoub, I. Sellami, I. Mnif, Z. Gassara, S. Bendjmaa, M. Ezzeddine, M. H. Kallel, H. Fourati, R. Akrout, M. L. Masmoudi, S. Yaiich, S. Baklouti
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S953
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Introduction
Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton and may alter the quality of life of patients. Fatigue, one of the major clinical features of rheumatic diseases is a major clinical feature of AS, yet it has often been ignored in clinical practice.
ObjectivesThis study aims to evaluate the quality of life in AS and to address the prevalence of fatigue in this disease and its associated factors.
MethodsWe conducted a cross-sectional study among AS patients. The Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), The Ankylosing Spondylitis Disease Activity Score (ASDAS) and other clinical measures were collected during the study.
We evaluated the psychometric characteristics of the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue subscale) and the AS Quality of Life questionnaire (ASQoL). P values < 0.05 were considered statistically significant.
ResultsSixty-two patients with AS were included in the study. The average age was 41 years [18-65]. The diagnostic delay was between 1 year and 26 years with an average of 4 years. The mean duration of the disease was 10 ± 8 years. The erythrocyte sedimentation rate (ESR) was between 2 and 50 mm/hour and the C reactive protein (CRP) level was between 1 and 45 mg/l. At baseline, the mean BASFI score was 53.9 ± 2, the mean BASDAI score was 4.5± 2 and the mean ASDAS score was 3.9 ± 2.
The mean FACIT-Fatigue score observed in these patients with AS was 20± 10,8 and the mean ASQoL score was 12,8 ± 4,8. Severe fatigue was observed in 43.5 % of patients and poor quality of life was detected in 62.9% of patients.
In univariate analysis, fatigue was associated with the low educational level of patients (p = 0.011), with sacroiliitis stage (p= 0.018) and with ASQoL score (p=0.000). ASQol was also associated with a high level of ESR (p=0.01). There was no relationship between FACIT or ASQoL and disease activity or functional status (p>0.05)
ConclusionsThis study confirms that poor QoL and fatigue were frequent in patients with AS which can expose them to the risk of psychiatric disorders like anxiety and depression. Therefore, patients suffering from AS should be regularly evaluated for these disorders.
Disclosure of InterestNone Declared
Assessment of psychosocial risks in Electricity and Gaz Company
- A. Hrairi, N. Kammoun, N. Rmadi, R. Masmoudi, K. Jmal Hammami, M. L. Masmoudi, J. Masmoudi, M. Hajjaji
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S960
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Introduction
Risk evaluation is a global process covering different aspects of employee’s workandfamily life. Nowadays, psychosocial risks are as important as physical and chemical risks, and their identification isdeterminant in each workplace.
ObjectivesOur study aimed to assess psychosocial risks among Electricity and Gas Company’s employees and to identify factors related to these risks.
MethodsA cross sectional study was conducted among male workers in a Tunisian electricity and gas Company. The KRASEK scale was used to assess psychosocial risks. The Statistical analysis was performed with SPSS version 23.
ResultsAmong male workers in the company, 83 employees participated in this study. The mean age of our population was 41.28 years± 12.12 years. Manuel labour was identified in 67.5% of cases. High psychological demands were reported by 63.9% of the employees. The assessment of decision latitude dimension identified low autonomy at work in 54.2% of cases. The mean social support scale was 23.73± 4.18. Job strain was identified among 32.5% of participants. Among employees in job strain, twenty-one subjects (77.8%) were affected in the technical division and 21.7% were in “iso strain”. Job strain and iso strain were associated with sedentary workers aged less than 45 years, p values were 0.006 (OR= 5.474; IC 95% [1.477-20.290]) and 0.010 (OR= 4.917; IC 95% [1.353-17.872]) respectively. However, Iso strain was negatively associated with being married (p=0.038) (0.0327 IC 95% [0.111-0.964]).
ConclusionsThis study highlighted the importance of psychosocial risks in this company. The identification of these risks in the workplace may further help preventers to recommend proper interventions to offer employees a supportive work environment and to enhance their personal and professional well-being.
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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- Journal:
- 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
Course of bipolar disorder in patients with Childhood maltreatment
- A. Mellouli, R. Masmoudi, F. Guermazi, F. Cherif, I. Feki, R. Sellami, J. Masmoudi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S693
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Introduction
Patients with mood disorders have the greater frequency of childhood trauma compared with the general population, and adverse childhood experiences can exert a negative impact on their clinical course. Therefore, many studies confirmed the relationship between childhood traumas and the disadvantageous features of the illness course.
ObjectivesThe aim of this study was to determine the impact of negative childhood experiences on the clinical course of bipolar disorder.
MethodsIt was a cross-sectional descriptive and analytical study involving patients diagnosed with bipolar disorder and followed in the psychiatric department at the University Hospital of Sfax (Tunisia).Personal information form and Childhood trauma questionnaire (CTQ) were used for data acquisition. Euthymia was defined as a score on the Montgomery-Åsberg Depression Rating Scale (MADRS) not higher than 14 and by a score on the Young Mania Rating Scale (YMRS) not higher than seven.
ResultsWe included 35 patients. Their mean age was 46.69 ± 12.01 years with a sex ratio (M/F)=0.45.
The average onset of bipolar disorder was 28.37±10.26 years and the average disease duration was 18.26 ± 11.55 years.
Almost the third of our population had a suicidal attempt (31.42%) and a violence history (28.57%). A family history of bipolar disorder was found in 57.14% of the patients.
The patients have been hospitalized at least once in 42.85% of cases.
Our patients have presented psychotic symptoms in 51.42% of cases and mixed characteristics in 57.14% of cases.
Emotional, physical and sexual abuse were reported by 42.85%, 37.14% , 31,42% of patients, respectively, while 74,28% and 42.85% of patients reported physical neglect and emotional neglect.
Early age at illness onset was significantly associated with total CTQ score (p=0.014) and the subtype sexual abuse (p=0.009). The presence of psychotic symptomswas significantly associated with total CTQ score (p=0.003) and emotional neglect (p=0.025). Physical neglect was associated with mixed characteristics (p=0.015). Emotional abuse was associated with a greater number of hospitalisations (p=0.023).
ConclusionsOur results suggest that childhood trauma is associated with a more severe course of bipolar illness. Clinical assessment of patients with bipolar disorder should include investigation of exposure to childhood trauma in order to determine appropriate therapeutic strategies.
Disclosure of InterestNone Declared
Does risperidone seem safe in patients with antipsychotic-induced leukoneutropenia? Case report
- W. Abid, F. Chérif, H. Trigui, S. Hentati, I. Feki, R. Sallemi, J. Masmoudi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S591
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Introduction
Antipsychotic-related hematological abnormalities have been reported in the literature, but remain a rare complication of some second-generation antipsychotic drugs. It has been suggested that risperidone is the preferred alternative when adverse hematological effects have been induced by conventional antipsychotic drugs. Blood dyscrasia adverse reactions have been reported rarely with risperidone.
ObjectivesWe aims to call attention to leukopenia as a potential side effect of during treatment with risperidone.
MethodsWe report a case in which a patient developed leukoneutropenia during treatment with risperidone
ResultsA 46-year-old man was admitted to psychiatric department for aggressive behavior. The patient had a history of right bundle branch block and has been diagnosed with schizophrenia at age of 36 years. This patient had only one psychiatric hospitalization in 2021 where he developed persistent leuko-neutropenia. A viral cause was retained. The patient was discharged on risperidone 4 mg and had been poorly compliant with his antipsychotic medication for the last year.
Currently, the patient was excited, very talkative and refused medication. He received an intramuscular injection of haloperidol 10 mg and chlorpromazine 50 mg. Under these doses, the patient became sedated and his balance sheet showed a leukoneuropenia amounting to 1960 cells/mm3. Then, it was decided to stop chlorpromazine and Haloperidol and put the patient on Diazepam. A complete blood count was done the next day showing that his white Blood Cells (WBC) count went up to 4360 cells /mm3 (neutrophils rate = 62,4 %). The reintroduction of haloperidol with diazepam caused the WBC to fall back to 2000. Haloperidol stopped as a possible cause of the leucopenia. The patient started taking risperidone orally 1 mg daily, which was gradually up titrated to 4 mg daily. Two weeks later the WBC went up to 4680 cells/mm3 (neutrophil rate = 60,4%) three week after stopping haloperidol. However, three days after increasing the dose of risperidone to 5 mg the leukoneutropenia recurred, (WBC = 2960 cells/mm3, neutrophil rate = 41%). When risperidone was reduced to 4 mg, his WBC count remained stable for two weeks (WBC = 2970, neutrophil rate = 48,9%). Clinically , the patient is no longer excited.
ConclusionsRisperidone-induced leuko-neutropenia (RILN) is very unusual and its incidence rate is unknown. Currently, there are no evidence-based alternative antipsychotic recommandations for RILN. For the case presented here, we achieved stabilisation of RILN by dose reduction.
Routine monitoring of the WBC level of patients on risperidone treatment, regardless of their hematological baseline, might be good practice for all psychiatrists. We recommend extending this practice to inpatient and outpatient services.
Disclosure of InterestNone Declared
Electroencephalographic frequency activity of patients with bipolar disorder
- M. Mnif, L. Triki, N. Smaoui, D. Jardak, S. Omri, I. Gassara, R. Feki, M. Maalej, J. Ben Thabeut, L. Zouari, N. Charfi, K. Masmoudi, M. Maalej
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S705
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Introduction
Bipolar disorder (BD) is a common psychiatric condition. However, it is underdiagnosed. Electroencephalography (EEG) has been proposed as a neurophysiological biomarker to delineate psychotic disorders.
ObjectivesTo compare the EEG tracings of patients with BD with those of normal subjects to aid in diagnosis.
MethodsThis was a cross-sectional, descriptive, and analytical case-control study conducted with patients followed for BD in the psychiatry "C" department at the Hedi Chaker hospital in Sfax. Patients were assessed by the Young Mania Scale (YMRS), the Hamilton HDRS-17 Scale, and the Medication Adherence Report Scale (MARS). Healthy controls were included. All participants benefited from an EEG. It was undertaken in resting eyes closed testing conditions at the service of the functional exploration at the Habib Bourguiba hospital in Sfax. The powers of each band were measured using the power spectral density method called absolute power (AP). Statistical analyses were carried out.
ResultsFifteen bipolar patients and 15 healthy controls, all male, were included. The average age of bipolar was 36.07 ± 10.50 years. The one of health control was 47.93 ± 15.61 years. There were no significant differences in age between bipolar patients and healthy controls. The mean scores on the HDRS-17 and YMRS and MARS scales were 2.73±2.08, 1.67±3.53 and 5.8±2.83 respectively.
At the quantitative EEG, differences appeared to be insignificant. There was an overall decrease in AP for alpha band particularly in the parietal and occipital lobes in bipolar patients (158,84 ± 447,71 μV2 and 188,21 ± 415,55 μV2 respectively) compared to controls (335,15 ± 994,73 μV2 and 400,24 ± 1109,95 μV2 respectively). An overall increase in AP for delta and beta was found for bipolar patients compared to controls.
ConclusionsOur main finding was a higher delta and beta frequency activity, and lower alpha frequency activity in bipolar patients compared to controls, which may aid in the diagnosis of this disorder.
Disclosure of InterestNone Declared
Study of self-esteem and perceived stress in medical students in Tunisia
- M. Abdelkefi, R. Masmoudi, R. Jbir, S. Hentati, I. Feki, R. Sellami, J. Masmoudi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S303-S304
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Introduction
Self-esteem affects people’s reaction to stressful events and the way individuals cope with stress. At the same time, stressful events negatively affect self-esteem, which is a psychological resource against psychological disorders.
ObjectivesTo study the link between self-esteem and perceived stress in medical students.
MethodsA cross-sectional study was conducted through an online survey among medical students of the faculty of medicine of Sfax (Tunisia). Participants completed an anonymous self-administered questionnaire and two psychometric scales: Rosenberg’s self-esteem scale for the evaluation of self-esteem and Cohen’s Perceived Stress Scale (PSS) for the evaluation of the level of perceived stress.
ResultsOur sample consisted of 95 students. Their mean age was 25.8±3.4, with a sex ratio (M/F) = 0.25.The majority were single (83.2%) and live with their parents (64.2%). Only 14.7% of the participants were smokers, and 13.6% consumed alcohol.
History of psychiatric disorders was reported by 17.9% of students, 76.5% of which were anxiety disorders.
On the Rosenberg scale, self-esteem was very low in 27.1% and low in 34.7% of the students. According to the PSS scale, 21.1% had a severe stress level and 69.5% had a moderate stress level.
Female students had lower self-esteem with no significant correlation.
Students with a history of anxiety disorders had a significantly lower self-esteem (p<10-3).
Low self-esteem was significantly correlated with severe stress (p=0.01).
ConclusionsOur study showed significant frequencies of low self-esteem and considerable stress among medical students. Low self-esteem was associated with severe stress. Further studies should be conducted to better investigate this relationship in order to promote student’s mental health and the use of stress management techniques, which can not only reduce stress, but also improve self-esteem.
Disclosure of InterestNone Declared
Frequency and characteristics of delusions and hallucinations in first admitted patients.
- M. Abdelkefi, I. Baati, M. Mnif, F. Guermazi, I. Feki, R. Sellami, J. Masmoudi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S871
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Introduction
Delusions and hallucinations are common in schizophrenia and related psychotic disorders and they are frequently reported at the first admission to psychiatry departments.
ObjectivesThe study aims to examine the themes and frequency of delusions and hallucinations in first admitted patients.
MethodsInformation was collected retrospectively from selected medical files of patients who were admitted for the first time to the department of psychiatry "A" of the university hospital Hedi Chaker, in Sfax, during the years 2020 and 2021.
ResultsNinety patients were included in our study. Their mean age was 34.79 ± 11.4 years, with a sex ratio (M/F) = 1.3. They reached high school in 51.1% of the cases. Half of the patients were smokers, 30% used alcohol and 16.7% used cannabis.
The average age of onset of the disorders was 30.36 years, and the duration of evolution of the illness before hospitalization was 56.54 days. The most common reason for hospitalization was environmental violence (62.5%). The diagnosis of schizophrenia was retained in 32.2% of the cases, and that of bipolar disorder in 23.3% of the cases.
At initial presentation to the ward, 72.2% of patients were found to have delusional beliefs. The most commonly held delusions were delusions of persecution (62.2%), reference (28.9%) bewitchment (27.8%) and grandiosity (26.7%) with changes of behavior in 34.4 % of the patients in response to their delusional beliefs.
Hallucinations reported by 43.3% of the patients were mainly auditory (30%), visual (20%) and 15.6% reported hearing internal voices. Olfactory hallucinations were only reported by 3.3% of the patients.
ConclusionsDelusions of persecution and reference appear to be the main delusional themes in this patient group. Auditory hallucinations were also commonly reported.
A better awareness of clinical presentations of the first admitted patients may aid early identification of the illness and engagement of the patients in the treatment process.
Disclosure of InterestNone Declared