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IntroductionCollege students seem to be a population group that is increasingly recognized to be at risk of having sleep difficulties. Some studies revealed that medical students, in particular, are believed to be more stressed and sleep deprived than their non-medical peers.AimThe present work aimed at investigating the quality of sleep among medical students at the University College of Medicine in Sfax, Tunisia.MethodsThe study consisted of an anonymous, voluntary survey for a sample of 74 students. A two-part questionnaire was used, including demographic criteria and the Pittsburgh Sleep Quality Index (PSQI), a self-rated instrument that measures sleep habits for a month (a total score of 5 or greater is indicative of poor sleep quality).ResultsThe average age was 24 years (range 19–33) with a sex ratio almost equal to 1. In 47.3% of cases, students were married. These latter had at least one child in 34.2% of cases. A total of 39.4% of the students reported being smokers, while 25.6% of them admitted having regular alcohol consumption.Poor sleep quality was reported by 63.5% of students with a PSQI average score of 9.32 ± 3.64.The most correlated factors with poor sleep quality were parenthood (P = 0.031), alcohol consumption (P = 0.004) and stressful studies (P = 0.02).ConclusionPoor sleep quality was pervasive among surveyed medical students and this seemed to be in relationship with some factors. This study points to the need for further evaluation of medical students’ sleep problems in order to improve their performance and their quality of life as well.Disclosure of interestThe authors have not supplied their declaration of competing interest.

ObjectivesIn our study, we compared the prevalence of alexithymia in diabetic patients with non-diabetic controls and investigated the relationship between Alexithymia and glycaemic control in diabetes.MethodsIn this cross-sectional study, TAS-20 scores of 100 diabetic patients and 50 non-diabetic controls were compared.A structured questionnaire was used to collect socio-demographic data to describe the participants and aspects of their diabetes.ResultsPrevalence of Alexithymia was not significantly higher than in the control (45% Vs 40%;p=0.56).The diabetic study population was predominantly female (71%) and married (73%).The average age in diabetic population: 56.21 years (ET=10.58); starting age: 46.8 years; average duration of diabetes: 9.41 years.Alexithymic diabetic patients have more traumatic events (93.3% Vs 78.2%; p=0.035), especially such as the death of a parent (73.3% Vs 50.9%; p=0.022), than non-alexithymic counterparts. Factors such as comorbidities and presence of diabetic complications were not significantly associated with TAS-20.Alexithymic diabetic patients were under a worse glycaemic control compared to their non-alexithymic counterparts (84.4% Vs 65.5%; p=0.031).ConclusionThe high prevalence of alexithymia among diabetic individuals is an indicator of its importance in the approach to diabetic patients. The presence of alexithymia seems to be related to glycaemic control and might be of value in terms of risk stratification of the individual diabetic patient for developing diabetic complications.

IntroductionEvidence is accumulating that mitochondrial dysfunction is involved in the pathophysiology of some psychiatric disorders such as Bipolar Disorder and Schizophrenia. In addition, among their other symptoms, people diagnosed with mitochondrial disease have high rates of psychiatric disorders. Leigh syndrome is a heterogeneous disorder, usually due to a defect in oxidative metabolism. The symptoms begin in the childhood by neurological troubles. Few reports mention psychiatric disorders. The objective of this work is to study relations between mitochondrial dysfunction and psychiatric disorders through a case of Leigh Syndrome.Case reportIt was a 20 year-old male patient, who had taken L-Dopa to treat severe extrapyramidal symptoms caused by Leigh syndrome. He developed, four months ago, acute psychotic symptoms such us audio-visual hallucinations, persecution and mystic delirium. The cerebral MRI had shown signal abnormalities in Basal Ganglia. This aspect was similar to those observed in the MRI having been practiced five years ago. The EEG recording was normal.The CSF and blood lactate levels were normal. The hypothesis that drug (L-Dopa) caused psychiatric disorders was possible. But, the digression of medicine was impossible due to the severity of extrapyramidal symptoms. The evolution under atypical antipsychotic was only partial.Discussion and conclusionIn this case, the CSF lactate levels mean that mitochondrial dysfunction is not an overall explanation for these psychiatric disorders but may at least play a partial role. Psychiatric disorders may be induced by drugs or may just be a simple comorbidity.

The Charles Bonnet syndrome is characterized by the presence of complex visual hallucinations among elderly patients with ophthalmic disease previously free of any psychiatric disorder. It has long been considered rare because of the reluctance of patients for fear of being thought mentally ill.The objective of this work is to recognize the clinical characteristics of Charles Bonnet syndrome, allowing early detection and adequate care, through the presentation of two cases.The authors report two cases of elderly, free of any dementia, patients, with the result of an intervention on cataract complicated by a bilateral blindness. Charles Bonnet syndrome is revealed by complex visual and stereotyped hallucinations.These hallucinations exacerbated at night, disturbing the sleep of these patients.Only when the insomnia was associated with anxiety agitation, their respective families decided to make the patients consult the psychiatrist.The evolution under antipsychotic and antidepressant drugs was only partial.

The objective of our study is to estimate the prevalence of depression, anxiety and alexithymia, of patients presenting a diabetes type 2 and their echo on the disease.MethodOur study, descriptive and forward-looking, was led with diabetics type 2, consulting in the service of endocrinology of HEDI CHAKER Hospital of Sfax.The collection of the information was realized with the help of:-A data sheet containing socio-demographic data and clinical data concerning the diabetes.-Hospital-Anxiety and Depression Scale (HADS).-Toronto Alexithymia Scale of 20 items.ResultsOur sample consisted of 96 diabetics: 67 women and 29 men.The average age was of 56.23 years (ET=10, 85)The prevalence of depression was 32.3%, that of anxiety was 56. 3%.The alexithymia was estimated at 46.9%.The depression was correlated to the presence of cardiac co-morbidity (p=0,012).High prevalence of depression was found in diabetic's suffering from neurological (0.002) and renal (p=0.007) complications.The depression was the source of a less regular follow-up.The association depression-alexithymia was correlated at a less good balance of the diabetes (p=0.038).The anxiety does not seem to interfere with the clinical characteristics of the type 2 diabetes.Discussion and conclusionDiabetics suffering from depression have more co-morbidity and complications. This risk was increased by the association of alexithymia. So, a screening of the psychiatric symptoms is necessary to improve the quality of life and the evolution of the disease.

ObjectivesThe aim of this work was:•to understand and measure the emotional effects of chemotherapy-induced alopecia by exploring self-esteem, body image, anxiety and depression in cancer patients•to analyse the strategies used to cope with hair loss.MethodsThis was a cross-sectional study. It involved the use of a questionnaire with patients from the medical oncology unit of the Habib Bourguiba University Hospital. The questionnaire included Socio-demographic data, type and stage of cancer, data concerning the alopecia (partial or total) and its impact on social life, work, and sexuality.Four measurement scales were used:-Rosenberg's Self-Esteem scale,-Bruchon-Schweitzer's Body image questionnaire (QIC)-Hospital Anxiety and Depression scale (HAD)-Brief copeResultsPreliminary studyIt was a population of 24 patients. 55.2% were males. The mean age was 45.9 years. 75.9% were married.Alopecia was the most distressing side effect of chemotherapy in 30.4% of cases. 45.8% were suffering from the stigma of the alopecia which disturbed their social interaction. It led to a loss in self-confidence in half of patients and altered sexuality in third. Self-esteem was low in 34.5%.The average score of the scale body image was 61. 41.4% of patients were anxious and only 27.6% were depressed.The religion was the major strategy used to cope with alopecia.ConclusionThe findings suggest that the chemotherapy-induced alopecia has the potential to affect various aspects of patient's life, but Tunisian cancer patients seems to be less affected compared with literature.

IntroductionSocial phobia is the most prevalent anxiety disorder. It is accompanied by a deterioration of the quality of life and social adaptation. This has further impact that this disorder begins at a young age at the time where the topic has not yet acquired a stable socio-professional status.The aim of our study was to assess the sounding of the social phobia among a population of 200 students.MethodsIt was a cross-sectional study, focusing on a group of 200 students from 5 universities in Sfax city, Tunisia.We used:-The Liebowitz Social Anxiety Scale for screening the social phobia,-The Sheehan scale for the evaluation of the sounding on the social, professional and family life.ResultsThirty three per cent of this population presented a social phobia.According to Sheehan scale, the disturbance in school, social and family life was mild to moderate (schooling: 3. 29; social: 2.95; family: 2.62).Discussion and conclusion: Our study showed that the impact of the social phobia is lightweight at the family and social level but more important in the area of schooling. This suggests the necessity for screening and treatment of social phobia among students for a better socio-family insertion and especially for better academic achievement.

ObjectiveThe objective of our study is to determine the relationship between cyber addiction and temperament in a population of young students.Population and methodsOur population was composed of 60 students belonging to 2 different colleges.For data collection, we used: -A data sheet containing demographic data, reasons for Internet connection …-The test of Dr. Young to detect users suffering from an addiction to the Internet.-The TEMPS-A: to assess the affective temperaments.ResultsOur sample was formed by 60 students’ devised into 2 groups: -30 Students were cyber addicts.-30 Students witnesses.The mean age was 22.6 years, with extremes ranging from 19 to 30 years.The reasons for connection to the Internet were in: -43.3% to deepen knowledge.-28.3% as a hobby.-16.7% to expand the circle of friendship.Cyber addict's students had a cyclothymic temperament in 50% cases, 26% were hyper mood, 13% were anxious and 11% had a depressive temperament.In our sample, cyber addiction was significantly correlated with cyclothymic temperament (p = 0.024).ConclusionAccordingly, patients suffering from Internet addiction should be given a specific addiction treatment and monitoring taking into account the temperament.

There is a growing interest about comorbidity between bipolar disorders and epilepsy expressed in three perspectives: clinical, therapeutic and neuroscientist.The prevalence of bipolar disorder among epileptic patients is about 0.1 to 5%.At a clinical level, there are peri-ictal, inter-ictal bipolar troubles and those induced by the treatments (drugs, electric and surgical) of the epilepsy.It seems that bipolar disorders have clinically specific characteristics (rapid cycles, less severe symptoms with each episode), where there is an association with epilepsy.Then, therapeutic management of bipolar disorders among epileptic patients is specific.The objective of this work is developed through a literature review, the clinical, the therapeutic and the evolutive characteristics of these disorders when found simultaneously.