Search

Rim Masmoudi,1 Faten Hadj Kacem,2 Maroua Bouattour,3 Fatma Guermazi,1 Rim Sellami,1 Ines Feki,1 Mouna Mnif,2 Jawaher Masmoudi,1 Imen Baati,1 Mohamed Abid2 1Psychiatry “A” Department, Hedi Chaker University Hospital, Sfax, Tunisia; 2Department of Endocrinology, Hedi Chaker University Hospital, Sfax, Tunisia; 3Department of Family Medicine, Faculty of Medicine of Sfax, University of Sfax, Sfax, TunisiaCorrespondence: Rim Masmoudi, Psychiatry “A” Department, Hedi Chaker University Hospital, Sfax, 3029, Tunisia, Tel +216 74 244 511, Email rim19masmoudi@gmail.comPurpose: Diabetes distress (DD) refers to the negative emotions and burden of living with diabetes. Illness perceptions are among the factors that can influence self-management and psychological distress in diabetics. This study aimed to determine the prevalence and the associated factors of DD in Tunisian patients with type 2 diabetes mellitus. We also studied the relationship between DD and illness perceptions in diabetics.Patients and Methods: This was a cross-sectional study conducted among individuals with type 2 diabetes, followed up at the outpatient endocrinology unit at the Hedi Chaker University Hospital, Tunisia. DD was assessed using the Diabetes Distress Scale (DDS-17). The Brief Illness Perception Questionnaire (Brief-IPQ) was used to assess diabetes illness perceptions. Multivariate logistic regression was used to determine independent factors associated with the presence of DD.Results: A total of 103 patients were recruited. The mean age was 59.31 (± 10.83) years; 54.4% were female. In total, 70.9% had DD. Using regression analysis, we demonstrated that the illness perceptions of personal control, HbA1C, absence of comorbidities, lower age at diabetes diagnosis, and socioeconomic status were significantly associated with DD.Conclusion: This study sheds light on the high prevalence of DD among patients with type 2 diabetes in Tunisia. Illness perception-focused psychological intervention would be efficacious in reducing diabetes distress in patients with type 2 diabetes mellitus.Keywords: diabetes mellitus, type 2, distress, illness perception, Tunisian patients

Introduction: The internalized stigma associated with mental illness is considered as an additional burden faced by people with mental disease. Among mental illnesses, schizophrenia is considered as the most stigmatizing. Objectives: To Assess the level of stigma in a sample of people with schizophrenia Methods: This is a cross-sectional and descriptive study carried out on 72 stabilized patients followed at the post-cure psychiatry consultation 'A' at the CHU Hedi Chaker in Sfax diagnosed with schizophrenia according to the DSM 5 criteria. Socio-demographic and clinical data were collected using a pre-established sheet We used The Internalized Stigma of Mental Illness (ISMI) scale to assess internalized stigma Results: The mean age of the patients in our study was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2. They were single in 48.5%, unemployed in 69.4%. Their level of education did not exceed primary school in 44.4% and their socio-economic level was low in 63.9%. 2% of the patients had no somatic history and 36.1% had a history of attempted suicide. The median for the total ISMI score was 2.45, which corresponded to the absence of strong stigma. The median of the subscales was distributed as follows: 2 for the level of alienation, 2.28 for stereotype endorsement, 2.4 discrimination experience, 2.36 for social withdrawal and 2.60 for stigma resistance. In our study, 45.8% of patients reported experiencing high levels of self-stigma (total score>2,5). Conclusions: Our study found levels of self-stigma in individuals with schizophrenia that align with previous research, suggesting that schizophrenia-related stigma is a global phenomenon unaffected by factors such as origin or ethnicity. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: It's a well-known fact that violence, particularly repetitive violence or violence lasting several years, as is often the case with intimate partner violence (IPV), has a severe psycho-traumatic impact. Although not all women are affected to the same degree or in the same way, post-traumatic stress disorder (PTSD) is the most common mental health consequence of IPV. Objectives: To assess the psycho-traumatic impact of IPV on female victims. To study the factors associated with PTSD among these women. Methods: We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hédi Chaker, Sfax, Tunisia for medical expertise at the request of the court. We studied the PTSD in these women using the Post Traumatic Stress Disorder Checklist Scale (PCLS). Results: The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women's clinical characteristics, 19.2% were under psychiatric care, 15% had attempted suicide and 10% had a history of childhood abuse. Regarding the couple's profile, marriage was arranged in 58.3% of cases, and the average duration of marriage was 12.34 years, exceeding 10 years in 44.2% of cases. The impact reported by our women was 100% psychological and 96.7% familial. As a result, 75.8% had sought help from family and friends, and 55.8% had decided to separate from their partners. According to the PCLS scale, 78.3% of female victims showed PTSD with a positive score > 44. It was associated with a higher number of suicide attempts (p=0.04), a marriage duration exceeding 10 years (p=0.02), help-seeking (p=0.001), and divorce (p=0.014). Conclusions: PTSD is a particularly serious psychiatric condition. However, its impact remains insufficiently understood and taken into account in medical, psychological, social, and legal care. Knowing the psycho-traumatic consequences of violence is absolutely essential to better protect, support, and care for victims. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Family caregivers of patients suffering from severe psychiatric disorders may present with health problems, lower quality of life, and painful emotions, which can seriously compromise their well-being when they do not receive appropriate professional support. Objectives: The aims of this study were to assess the level of burden and resilience in family caregivers of patients with severe mental disorders and to determine associated factors. Methods: We conducted a descriptive and analytical cross-sectional study among family caregivers of patients followed at the psychiatry outpatient clinic of the Hedi Chaker University Hospital in Sfax, during the period from February 2022 to July 2022. We used the Connor–Davidson Resilience Scale (CD-RISC) to assess resilience and the Zarit Burden Inventory to assess the level of burden. Higher scores indicate higher resilience and greater burden. Results: The sample included 90 family caregivers of patients with severe mental disorders. The average age was 50.68. They were the parents of patients in 40% of cases. Professionally active caregivers accounted for 57.8% of cases. Thirty family caregivers had a somatic disorder history (33.3%). The median age of patients was 42 years. Ten patients (11.1%) were financially independent. The diagnosis was schizophrenia in 68.9% of cases. The mean duration of illness was 16.23 years. Irregular follow-up was noted in 10 patients (11.1%). The mean scores of the Zarit Burden scale and the CD-RISC were 41.86± 10.33 and 58.46± 9.18 respectively. Unemployed caregivers and parents experienced a higher burden (p=0.001, p=0.03 respectively). The level of burden was higher in caregivers taking care of financially dependent patients (p=0.03), with a duration of the disease greater than 15 years (p=0.04), and with irregular follow-up (p=0.008). A low level of resilience in caregivers was correlated with spousal relationship (p=0.001), cohabitation with the patient (p=0.05), widowhood (p=0.01), low level of education (p=0.02), the presence of a somatic disorder history in the caregivers (p=0.04). A negative correlation was observed between CD-RISC and Zarit scores (p=0.04; r=-0.21). Conclusions: Family caregivers of mentally ill patients experienced a significant level of caregiver burden, and it was lower in caregivers with higher levels of resilience. Psycho-educational programs directed toward family caregivers are highly recommended. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Psychiatric pathologies are more common in people with epilepsy than in the general population and have a negative impact on the quality of life of these patients. Objectives: The objective of this work is to illustrate, through a series of cases, the complex relationship between epilepsy and psychiatric pathologies. Methods: We report the cases of four patients with different psychiatric pathologies associated with epilepsy admitted to the psychiatry department of Hedi Chaker Sfax. We collected the clinical characteristics of these patients based on their medical files. Results: The patients were aged 64, 45, 38 and 26 respectively. The first patient had a late-onset vascular epilepsy following the psychiatric pathology onset by 20 years. In the remaining cases epilepsy onset preceded the psychiatric pathology by 6, 3 and 1 year respectively. The aetiology of epilepsy was juvenile myoclonic epilepsy, and idiopathic in 2 cases. The psychiatric pathologies were schizophrenia, obsessive compulsive disorder with schizoid personality, schizoaffective disorder in the bipolar type and mild intellectual disability with histrionic personality, respectively. Familial history of psychiatric disorders was found 2 patients and of epilepsy in one. Conclusions: Epilepsy and psychosis have a complex and bidirectional relation. Not only are patients with epilepsy at a greater risk of developing a psychotic disorder, but patients with a primary psychotic disorder are also at greater risk of developing epilepsy. The fact that the association between these pathologies is more frequent than expected should prompt more in-depth studies concerning the underlying etiopathogenic mechanisms to improve their management. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Since that the online commerce provides an important shopping environment, it has been argued that traditional buying-shopping disorder may migrate into the online market. Objectives: The aims of the current study were to investigate the prevalence of online buying-shopping disorder, and to determine sociodemographic and psychological factors related to this addictive behavior. Methods: A cross-sectional, descriptive and analytical study was conducted among subjects who had already made at least one online shopping. Data was collected using a self-questionnaire published by GOOGLE FORMS. Assessment included the short version of the Internet Addiction Test modified for online shopping sites (s-IATshop). The Hospital Anxiety and Depression Scale (HADS) has been used to assess anxiety and depression. Results: A total of 137 participants aged 34.62 ± 9.82 years completed the online questionnaire. Only 4 (2.9%) participants had a probable compulsive buying shopping on line. The HADS-A score ranged from 0 to 14, with a mean of 6.85 +/- 3.49 and almost half of the participants (44.5%; N=61) had anxiety symptoms. A high s-IAT shopping score was correlated with secondary or university education (p=0.046). We also found that women, who were younger and had higher incomes, had the highest scores on the s-IAT-shopping scale, without however confirming statistical significance. Conclusions: Our study has shown the potential vulnerability factors for compulsive online shopping disorder. Thus, this behaviour deserves to be taken into account in behavioural addictions. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Intimate partner violence (IPV) is a major source of perceived stress for the women who suffer from it. To cope, they tend to implement multiple coping strategies depending on a number of contextual factors including, among others, the severity and frequency of abuse, the duration of the relationship, and available resources such as social support and financial resources. Objectives: To study the coping strategies used by women who are victims of IPV. To study the factors associated with coping strategies among these women. Methods: We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hedi Chaker, Sfax, Tunisia for medical expertise at the request of the court. The Brief-COPE is a 28-item self-assessment questionnaire designed to measure coping with a stressful life event. It can be divided into 3 subscales: problem-focused, avoidance-focused, and emotion-focused. Results: The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women's clinical characteristics, 19.2% were under psychiatric care and 15% had attempted suicide (SA). Almost all the women surveyed (99.2%) had reported at least one previous incident of IPV. These incidents were daily in 60.5% of cases. Emotional violence was severe in 75.8% of women. The emotion-focused strategy was the most widely used, with a mean score (29.68) on the Brief cope scale. It was correlated with the absence of a personal psychiatric history (p=0.02), the absence of SA (p=0.036), and the occasional frequency of IPV (p=0.037). The scores for problem-focused coping and avoidance-focused coping are 19.3 and 17.24 respectively. Avoidance-focused coping was negatively correlated with the presence of severe emotional abuse. Conclusions: The most used strategy by our population was the emotion-focused strategy, with a relatively high average score compared to the other strategies. Indeed, it may be an extremely effective strategy for recovering from a traumatic event, through actions designed to help these women manage and relieve their psychological distress and reduce its negative impact. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Schizophrenia is a chronic condition that leads to major socio-professional disintegration and personal suffering. In addition to the classic clinical symptoms, these patients also suffer from poor insight. Objectives: To assess insight in a population followed up for schizophrenia Methods: We conducted a cross-sectional and descriptive which concerned the patients followed in the unit of outpatient post-cure consultations of psychiatry 'A' at the CHU Hedi Chaker of Sfax. We included 72 stabilized patients diagnosed with schizophrenia according to the DSM criteria 5. For the collection of sociodemographic and clinical data, we used a pre-established sheet. We used the schedule for the Assessment of Insight–Expanded Version(SAI-E) scale to assess clinical insight Results: The mean age of the patients in our study was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2. They were single in 48.5%, and unemployed in 69.4%. Their level of education did not exceed primary school at 44.4% and their socio-economic level was low at 63.9%. In our study, 72.2% of patients had no somatic history and 36.1% had a history of attempted suicide. Using the SAI-E scale, the mean score was 20.1 with a minimum of 5 and a maximum of 28. Conclusions: At the end of this evaluation, it is important to emphasize that insight seems to be an important prognostic factor. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Schizophrenia is often considered as pathology of consciousness. Some authors have considered that patients' self-perception of their cognitive difficulties expressed in the form of subjective complaints could represent a source of stress. These cognitive difficulties may then interfere with the interpretation of symptoms, leading to poor insight. Insight and cognitive complaints in stabilized outpatients with schizophrenia. Objectives: Study the relationship between subjective cognitive complaints and clinical insight in a Tunisian population with schizophrenia. Methods: This is a cross-sectional, descriptive and analytical study carried out on 72 stabilized patients followed at the post-cure psychiatry consultation 'A' at the CHU Hédi Chaker in Sfax diagnosed with schizophrenia according to the DSM 5 criteria. We used the schedule for the Assessment of Insight–Expanded Version(SAI-E) scale to assess Clinical Insight and the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) to determine subjective cognitive complaints Results: The mean age of the patients was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2. In our study, 48.5% were single and 69.4% were unemployed. The median total SSTICS score was 25. Using the SAI-E scale, an average score of 20.1 was objectified in our study. In our study, the better the insight, the greater the subjective cognitive complaints were in all cognitive domains (p=0.00). Awareness of illness was statistically associated with working memory (p=0.001), explicit memory (p=0.004), attention (p=0.001), language (p=0.01) and executive functions (p=0.001). Conclusions: Our study highlights the relationship between awareness of illness and cognitive complaints. The clinician, faced with repetitive cognitive complaints, should assess the insight before incriminating another cause (effects of a drug, cognitive deficit, etc.). Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: In addition to the classic clinical symptoms, patients with schizophrenia suffer from cognitive difficulties, self-stigma and poor insight. Objectives: This study aims to evaluate the impact of stigma, symptom severity, and insight on subjective cognitive complaints in patients with schizophrenia. Methods: This is a cross-sectional, descriptive and analytical study carried out on 72 stabilized patients followed at the post-cure psychiatry consultation 'A' at the CHU Hédi Chaker in Sfax diagnosed with schizophrenia according to the DSM 5 criteria. We used the schedule for the Assessment of Insight–Expanded Version(SAI-E) to assess clinical insight, The Internalized Stigma of Mental Illness (ISMI) scale for the assessment of internalized stigma, the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) scale to determine subjective cognitive complaints and the Positive and Negtive Syndroms Scale (PANSS) to assess positive and negatives symptoms. Results: The average age of the patients was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2. In our study, 48.5% of the patients were single, 52.8years,% were smokers and 23 6% consumed alcohol. The level of education did not exceed the primary level for 44.4% of the patients. The average age of disease onset was 24.56 ± 5, 82. Our participants had an average score of 25 on the SSTICS total score and 20.1 on the SAI-E. The median ISMI total score and PANSS total score were 2.45 and 46respectively The predominant negative symptoms(p=0.003), stigma(p=0.009), and insight (p<10-3)were significant factors associated with increased cognitive complaints. Conclusions: In schizophrenia, the combination of cognitive difficulties, self-stigma with a low insight makes the management of these patients more difficult. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Giving care to someone who is experiencing mental distress is a difficult and challenging task that could be detrimental to the caregiver's overall quality of life. Stigma associated with mental illness is one of the most important mental health issues faced by these caregivers. Objectives: Our aims were to assess perceived stigma among family caregivers of patients with severe mental disorders and to identify its associated factors. Methods: We conducted a descriptive and analytical cross-sectional study among family caregivers of patients followed at the psychiatry outpatient clinic of the Hedi Chaker University Hospital in Sfax, during the period from February 2022 to July 2022. A structured interview questionnaire was designed to collect socio-demographic data of both patients and their caregivers. We used the Stigma Devaluation Scale (SDS) to assess stigma. Results: A total of 90 family caregivers of severely mentally ill patients were included: 26 men and 64 women, with an average age of 50.68 ±11.67 years. Patients' parents accounted for 40% of family caregivers. The majority of family caregivers (83.3%) had no more than secondary education. Married people represented 70% of cases. The median age of patients was 42 years. Schizophrenia was the diagnosis in 68.9% of cases. The mean duration of illness was 16.23 years. Daily assistance lasted from 4 to 8 hours in 30% of cases and more than 8 hours in 66.7% of cases. The mean score (SDS12) for family-focused stigma was 13.12 ± 2.34 with ranges from 8 to 18. Perceived stigma scores were significantly higher among caregivers caring for non-married patients (p=0.04), with an age <50 years (p=0.04), and with a higher level of education (p=0.02). Long duration of providing care (> 8 hours per day) (p=0.05) and insufficient information about the illness (p=0.02) were significantly associated with perceived stigma. Conclusions: The clinicians managing patients with severe mental disorders must focus on stigma and psychological distress among the caregivers and plan intervention strategies to reduce stigma. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]