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Introduction Sleep disturbances are commonly observed in schizophrenia and are associated with worse psychotic symptoms and poorer clinical outcomes. This has generated considerable interest in characterizing the relationship between disturbed sleep and schizophrenia. Objectives The aim of this study is to assess sleep quality in patients recently diagnosed with schizophrenia that are antipsychotic-naïve and to analyze their association with sociodemographic and clinical data in the same patient group. Methods We conducted a cross-sectional, descriptive and analytical study among patients in the psychiatry department "G" at Razi Hospital, over a period of six months. Three scales were used: the Global Assessment of Functioning (GAF) Scale, the Positive and Negative Syndrome Scale (PANSS) and the Pittsburgh Sleep Quality Index (PSQI). Results The mean age of patients was 26.8 years and 65% were male. The mean age of onset of the disease in patients included in our study was 24.8 years. The majority of patients (96.3%, n=52) were considered poor sleepers (PSQI threshold value >5). We objectified a negative and statistically significant association between patient functioning (total GAF score) and sleep quality (r= -0.277, p=0.043). The PSQI total score was positively and significantly correlated with the negative scale scores (r=0.315, p=0.021), the general psychopathology scale scores (r=0.411, p=0.002) and the PANSS total score (r=0.378, p=0.005); while no significant association was objectified with scores of the positive scale. Conclusions Our study has demonstrated a high prevalence of sleep disorders during the first episode of schizophrenia, as well as their association with the severity of symptoms. Disclosure of Interest None Declared

Introduction Substance abuse is a common problem associated with significant morbidity and mortality, but is often underdiagnosed and unrecognized in geriatric patient populations. Objectives to determine the prevalence of substance use disorders geriatricic inpatient population. Methods Data from 2010 to 2020 were retrospectively reviewed from a clinical database. 148 admissions of patients older than 60 years were identified. Descriptive statistics were used to group patients with and without a diagnosis of substance use, which included intoxication, withdrawal, abuse, dependence, and substance-induced disorders. Results There were 148 hospital admissions for patients over 60 years of age, with a mean age of 72.38 ± 5.64 years and a mean length of stay of 13.91 ± 14.15 days. Of all admissions, 44% (n=64) were associated with at least one substance use diagnosis. In this group of 64 patients, the most frequently used substance was tobacco with associated disorders ( 65% N=42). The prevalence of other substance use diagnoses was as follows: sedative-hypnotic abuse/dependence 32% (N=21), cannabis abuse 10% (N=6), alcohol-related disorder 12.5% (N=8). Compared with patients without a substance abuse diagnosis, these patients were significantly younger, had shorter lengths of stay, were less likely to be readmitted, and were more likely to be single men Conclusions Given the inherent difficulties in diagnosing substance use disorders and the retrospective nature of this study, the true prevalence of substance use disorders in elderly psychiatric inpatients is likely higher than found. Cross-sectional or cohort studies are more appropriate to shed light on this condition. Disclosure of Interest None Declared

Introduction Data on the differences between young and elderly patients with bipolar disorder and between elderly patients with early and late age of onset are limited. Objectives to study the clinical differencies between bipolar patients with an onset in old age and other bipolar patients. Methods This is a retrospective study of 420 bipolar patients. In this study, patients with onset after age 60 (n=37) were compared to other patients with early-onset bipolar (EOB) (<>50 years; n=383). Results In the year before recruitment, older patients more frequently reported a rapid course of the illness, but fewer suicide attempts , more often a single psychotropic medication and had less severe manic and psychotic symptoms, atypical antipsychotics were administered less frequently. but no difference in depressive symptomatology was observed. Conclusions Elderly bipolar patients differ from younger bipolar patients in course and treatment. Medication use and the occurrence of rapid cycling in elderly bipolar patients deserve careful investigation. Disclosure of Interest None Declared

Introduction Despite the projected growth of the geriatric population, there is currently no clear treatment framework for these patients. This treatment requires specific training for psychiatrists in the field of geriatric psychiatry. Objectives to evaluate the attitudes of psychiatric residents in Tunisia with regard to gerontopsychiatry. Methods All psychiatry residents at Razi Hospital in Tunis in April 2022 were asked to complete an anonymous online survey with questions related to previous experience with the elderly, exposure to geriatric psychiatry patients during medical school, future career plans and interest in pursuing a geriatric psychiatry rotation, and factors involved in their decision. Results 55 of 72 (76%) residents responded, of whom 63 (n=34)% were in their second year of residency. 69% (n=38) of residents reported no exposure to geriatric psychiatry patients during medical school, but of those who had, 70% (n=24) had a positive experience. Only four residents (7%) reported considering a career in geriatric psychiatry. With respect to the geriatric psychiatry curriculum, all residents felt that changes were needed in geriatric psychiatry education and career path. Conclusions Residents’ interest in further training in geriatric psychiatry is low. The most common reason is the perception of a poor prognosis for this patient population. Future studies are needed to develop strategies to increase interest in this field. Disclosure of Interest None Declared

Introduction The evolution of schizophrenia with age remains poorly studied. The prevalence of negative symptoms in elderly people with schizophrenia is even less described in the literature. Objectives to evaluate the prevalence of remission of negative symptoms in the elderly and to study the sociodemographic and clinical variables associated with this remission. Methods The sample consisted of 83 subjects aged 55 years and over, followed at the psychiatry department "G" of the Razi hospital in Tunis and suffering from schizophrenia according to the DSM5 criteria. Global remission was defined as a score below 4 on the seven negative symptom items of the PANSS. A questionnaire was administered to each patient to collect epidemiological and anamnestic data. Results 59% of the sample showed remission of global negative symptoms. 84% and 60% were in remission on the emotional and cognitive subscales, respectively. The existence of remission was correlated with lower PANSS global score, more preserved cognitive functioning, later age of onset, more family and social support, and the absence of a concomitant somatic illness. Conclusions This study showed that measures to optimize treatment of positive symptoms and cognitive functioning may have an impact on negative symptoms. Similarly, quality of social network in later life impacts the level of negative symptoms. Disclosure of Interest None Declared

Introduction Patients with chronic schizophrenia experience significant disturbances in the quality and quantity of their sleep and it had been mainly attributed to severity of symptoms and antipsychotic use. Recent studies suggested that antipsychotic-naïve early course patients with schizophrenia and their non-psychotic first-degree relatives also show altered sleep quality. Objectives In this study we aimed to compare sleep parameters in antipsychotic-naive first-episode schizophrenia patients to their healthy siblings and age- and sex-matched healthy controls. Methods We conducted a cross-sectional, descriptive case-control study in the Psychiatry « G » department at Razi Hospital, for a period of six months. Our sample consisted of three groups: a group of schizophrenic patients, a group of their healthy siblings and a group of healthy controls. The three groups were matched by age and sex. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of symptoms in patients with schizophrenia. The Morningness-Eveningness Questionnaire (MEQr), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI) were used in the three groups to assess Circadian preference, daytime sleepiness and sleep quality. Results There was no significant difference between the groups regarding the chronotype. Patients had significantly higher daytime sleepiness compared to siblings (p=0.001) and controls (p

Introduction Charles Bonnet Syndrome (CBS) is an age-related disorder characterized by complex visual hallucinations in older persons with vision loss and underlying ocular pathology. The management of these symptoms is imprecise and combines psychological measures with psychotropic drugs. Objectives to discuss the non-pharmacological management of Bonnet syndrome through a case report. Methods We report a case of atypical CBS in a 76-year-old male patient presenting with visual and auditory hallucinations that were improved by reassurance. Results The past medical history was significant for diabetic retinopathy, difficulty hearing due to bilateral sensorineural hearing loss. He recognized these visions as unreal and felt distressed by them. No cognitive impairment was observed on several neuropsychological tests. He was reassured of the false nature of the visual experiences after explanations that he had no mental illness and that the problem could disappear. He was taught how to keep the images away by closing his eyes for sometimes and repeated blinking. After six weeks of psychological intervention, the visual experiences had disappeared without using any drug Conclusions In the management of CBS drug treatments remain partially satisfactory. Nonpharmacological interventions focus on the reduction of the visual pathway deprivation. This therapeutic alternative seems to provide positive benefits. Disclosure of Interest None Declared

Introduction Nowadays, the smartphone use is increasing, similar is the trend among medical students and professionals. The problematic use of mobile phone has become a major public health concern as it may lead to its addiction and other disorders such as sleep disorders, depression and decreased life satisfaction. Objectives This study aims to determine the association between mobile phone usage, Insomnia and depressive symptoms among medical students and medical professionals. Methods We conducted a descriptive and analytical study among 40 medical students and doctors. They were asked to fill out an anonymous online survey. Problematic Use of Mobile Phones (PUMP) scale was used to assess mobile phone usage. Insomnia Severity Index (ISI) was used to screen for insomnia and the Patient Health Questionnaire-9 (PHQ-9) to screen for depression. Results The mean age of participants was 27,8 years, with a sex ratio of 1/3. The mean of the duration of mobile phone use was 3.4 hours per day. We found that 77% of participants spend most of their time on social media (Facebook, Instagram, Tik Tok) when using their mobile phones. In our study, participants with higher problematic use of mobile phone (PUMP) score were significantly more likely to present symptoms of insomnia (p=0.031) and depression (p=0.023) according to ISI and PHQ-9 scales. Furthermore, a significant association was found between the duration of mobile phone use, Insomnia and depression. In fact, the Odds Ratio (OR) of Insomnia was 1.66 in participants who used mobile phone more than 2 hours per day compared to those who used mobile phone < 2 hours per day. Similarly, the OR of depressive symptoms was significantly increased with prolonged mobile phone use (>= 2 hours per day) compared to those who used it

Introduction Bipolar disorder is a frequent and particularly severe psychiatric pathology that causes significant morbidity and mortality. The rapid cycling forms are more severe in terms of their expression, evolutionary course, therapeutic responses and associated comorbidities. Objectives The aim of this study is to conduct a descriptive assessment of therapeutic characteristics in patients with rapid cycling bipolar disorder. Methods Our work involved a population of 97 patients followed for bipolar disorder diagnosed according to DSM5 criteria, including 37 patients meeting the specification “with rapid cycles”. The patients were divided into two groups: - Group of patients with bipolar disorder with rapid cycles (TBCR) - Group of patients with bipolar disorder without rapid cycling (TBNCR). We compared the therapeutic features among these two groups. Results The dominant polarity was depressive in patients with rapid cycles. They required more mood stabilizers. A greater proportion of them had received treatment with serotonin reuptake inhibitor antidepressants. They were more likely to use hypnotics such as antihistamines and zolpidem. Conclusions Rapid cycling TB is a relatively common clinical modality that should be investigated and identified.The use of antidepressants is associated with this course of the disease. Their utilization in the treatment of bipolar depression must be thoughtful and well studied Disclosure No significant relationships.

Introduction The epidemic of COVID-19 has affected the psychological health of people, especially frontline medical and paramedical staff. Several coping strategies have been used to combat the impact of this virus on their lives. Objectives Describe the impact of coronavirus on mental health and identify coping strategies Methods We carried out a cross-sectional, descriptive and analytical study, conducted over a period of two months ( september and october 2020), in 22 hospitals in Tunisia, including frontline medical and paramedical staff. To evaluate anxiety and depression, we used the Beck Inventory. To identify coping strategies, we used the Brief COPE. Results We collected 78 professionals. The mean age was 29.86+-5.4. The majority were medical residents (67.9%) working in covid units in 39.7% of cases. The rythm of work was daily in almost half of the cases, giving direct care to the patients tested positive in 76.9%. More than half had not received adequate training, and protective equipment was available in only 50% of cases. We found 35.9% of the staff who had to move for fear of infecting their families. More than half of the frontline staff were victims of stigma (57.7%). Depression and anxiety were tested minor in 40%. The most used coping strategy in the face of this distressing virus was social support (64.1%) followed by emotion-focused mechanisms (53,8%). Social support strategy was significantly correlated with prevention of anxiety (p=0.048) Conclusions Participants practiced and recommended various coping strategies to deal with stress, depression and anxiety emerging from COVID-19 pandemic. Disclosure No significant relationships.

Introduction Antisocial personality disorder (ASPD) is characterized by a long term pattern of disregard for, or violation of the rights of others that occurs in childhood or early adolescence and continues into adulthood. This disorder remains unknown in women. Objectives The aim of this study was to describe socio-demographic, clinical, psychometric and therapeutic characteristics of women with ASPD hospitalized in psychiatric ward. Methods A cross-sectional and descriptive study was conducted in G psychiatry department, in Razi hospital. It included 20 women with ASPD and hospitalized in psychiatric ward. Socio-demographic, clinical and therapeutic characteristics were assessed. A psychometric evaluation was carried out by the application of six scales: BIS 11, HCR 20, VRAG, PCL-R, ENFP and PID5-BF. Results The mean age of the patients was 34 ± 9 years. Patients with a personal history of suicide attempt accounted for 45% of the study population. Patients with a criminal history accounted for 67.5% of the study population. A substance-related disorder was found in 85% of the patients. Adjustment Disorder was retained in 42.5% of the patients and Psychotic Disorder was diagnosed in 32.5% of the population. The average score at VRAG was 6.18 ± 5.8. The mean score at PCL R was 24 ± 4.2. High impulsivity scores were found. Conclusions ASPD represents a major concern for clinicians in psychiatric wards. A better knowledge of the characteristics of this trouble in women could improve their quality of care. Disclosure No significant relationships.

Introduction Anxiety has become a topical issue since the arrival of the coronavirus pandemic, especially for frontline healthcare professionals as they deal with patients affected by the Covid-19. Objectives Objectify anxiety in frontline medical and paramedical staff and study its associated factors. Methods We conducted a national descriptive and analytical cross-sectional study via a survey over a 2-month period from September to October 2020. We used “Beck Anxiety Inventory” to screen anxiety as well as “Brief Cope Scale” to detect probable correlations between anxiety and coping mechanisms. Results We collected 78 persons. The mean age was 29.86 years. 35.9% moved out of home. 39.7% worked in Covid units. 7.7% had personal psychiatric history. 76.9% provided direct care to patients with Coronavirus. The frontline staff reported that only 29.5% of patients were stables. Only 48.4% received adequate training of protection against Covid-19. 64.1% of professionals did PCR test and only 16.7% of them tested positive. We objectified an increase of 6.4% in the anxiolytics use. Stigma affected 57.7% of professionals. We highlighted a link between anxiety and social support strategy (p=0.048). 92.3 % of the staff suffered from anxiety according to Beck Anxiety Inventory. Conclusions Screening anxiety among frontline medical and paramedical staff might enhance their productivty and thus provide patients with the best care. Disclosure No significant relationships.

Introduction Tinnitus is an auditory perception of a “phantom” nature with highly changing features. There is an established correlation between anxiety, depression, sleep disorders and tinnitus. Objectives To evaluate the prevalence of sleep disorders and emotional disorders during tinnitus and their correlation to the severity of the symptomatology Methods A descriptive cross-sectional study of 60 patients consulting for subjective tinnitus. For each patient we collected epidemiological data and performed an ENT and general examination, an audiometric and psychoacoustic evaluation and a psychometric evaluation. To evaluate the severity of the tinnitus we used the visual analog scale VAS and the subjective tinnitus severity test (STSS). Disability was assessed by the Tinnitus Handicap Inventory (THI). Anxiety and depression were assessed by: the Hamilton anxiety Rating scale and the Beck depression inventory. Results The prevalence of emotional disorders was: 21.7% for depression, 48.33% for generalized anxiety disorder, 11.67% for dysthymia, 5% for agoraphobia 16.67% for panic disorder and 1.67% for social phobia. The intensity of tinnitus was correlated with more panic disorder (p=0.008). Subjective severity of tinnitus was correlated with disability (p=0.0001), awareness of tinnitus in relation to sleep duration (p=0.006) and disturbed sleep (p=0.047). Disability was correlated with subjective tinnitus severity (p=0.0001), panic disorder (p=0.0007), generalized anxiety disorder (p=0.033), and poor sleep quality (p=0.005). Conclusions Our results emphasize the importance of emotional disorders as well as sleep disorders in chronic “tinnitus”. These disorders should be systematically investigated and eventually treated in order to optimize the management of the patients. Disclosure No significant relationships.

Introduction The current coronavirus pandemic is a unique and unusual situation. It is putting the general population under severe strain. However, frontline medical and paramedical staff remain particularly vulnerable to depression because of its close contact with patients. Objectives The aim of this work was to screen and evaluate depression in the frontline professionals during the pandemic and to study their associated factors . Methods In this study , we conducted a national descriptive and analytical cross-sectional study over a 2-month period from September to October 2020. We used “Beck Depression Inventory” to assess depression and “Brief Cope Scale” to detect a possible correlation between depression and coping mechanisms. Results We collected 78 professionals. The mean age was 29.86 years. 2/3 of workers were women. 67.9% of the staff were residents. 39.7% worked in Covid units. 7.7% had personal psychiatric history. 56.4% of the staff worked daily and 76.9% of them provided direct care to patients with Coronavirus. 52.6% of workers did not receive adequate training of protection against Covid-19.The staff reported 66.7% of death among their patients. 42.3% suffered from minor depression and only 2.3% suffered from severe depression. During this period we objectified an increase of 14.1% in the psychoactive substances use. Stigma affected 57.7% of professionals. We didn’t objectify a significant correlation between Depression and coping mechanisms . Conclusions Screening depression among healthcare professionals should be considered in order to prevent it, ensure continuity of care and avoid sick leaves. Disclosure No significant relationships.

Using a high-resolution primitive equation model of the western Mediterranean Sea, we analyzed the dispersion properties of a set of homogeneously distributed, passive particle pairs. These particles were initially separated by different distances D0 (D0 = 5.55, 11.1 and 16.65 km), and were seeded in the model at initial depths of 44 and 500 m. This realistic ocean model, which reproduces the main features of the regional circulation, puts into evidence the three well-known regimes of relative dispersion. The first regime due to the chaotic advection at small scales lasts only a few days (3 days at 44 m depth, a duration comparable with the integral timescale), and the relative dispersion is then exponential. In the second regime, extending from 3 to 20 days, the relative dispersion has a power law tα where α tends to 3 as D0 becomes small. In the third regime, a linear growth of the relative dispersion is observed starting from the twentieth day. For the relative diffusivity, the D2 growth is followed by the Richardson regime D4/3. At large scales, where particle velocities are decorrelated, the relative diffusivity is constant. At 500 m depth, the integral timescale increases (> 4 days) and the intermediate regime becomes narrower than that at 44 m depth due to the weaker effect of vortices (this effect decreases with depth). The turbulent properties become less intermittent and more homogeneous and the Richardson law takes place.

This study investigated composition and toxicity of Thyme EOs against two main stored grain insect pests. Carvacrol was distinguished as a major compound (78.34%). In laboratory tests, EOs applied by both direct contact and fumigant tests was more toxic to L. serricorne than T. castaneum . The EOs were also tested combined with two Tunisian Diatomaceous earths (DEs) against T. castaneum . The LC 50 was 6.28 µL/L air for natural preparation EO/R1, 5.90 µL/L air for EO/R2 and 121.17 for crude EOs by fumigant test, respectively. While, contact test revealed that natural DEs; dust act as an insecticide with 'LC 50 ' values of 3.22 and 0.29 µL/cm 2 f or R1 and R2, respectively. Moreover, a significant difference was noted between crude EO, EO/R1 and EO/R2. Overall, the enhancement of the Tunisian DEs' insecticidal activity by its mix with EOs may be a promising active substance as a stored grain protectant.

Introduction: Attitudes and knowledge of health professionals are critical dimensions in the management of suicidal behavior. The "Suicide Behavioral Attitude Questionnaire" (SBAQ) was designed in Brazil to measure these variables in paramedical personnel., Aim: To translate and validate the SBAQ in literary Arabic., Methods: After author-approved translation and back-translation, the Arabic version of the SBAQ was distributed to 125 Tunisian caregivers working in psychiatric departments. Factor analysis and internal consistency were calculated. The stability was measured overtime using the paired Student's T-test., Results: Cronbach's alpha value was 0.741. The adequacy index of the factorization factor Kaiser-Meyer-Olkin (KMO) of our sample was 0.74. This value was higher than 0.5 which indicates that our data was suited for factor analysis. Bartlett's sphericity test result was significant, rejecting the null hypothesis. Three factors were extracted explaining 50.7% of the overall variance. Cronbach's alpha value for the three subscales was 0.735, 0.713 and 0.798. The instrument had good stability over time., Conclusions: The Arabic version of the SBAQ showed good reliability and validity allowing its use in Arabic speaking paramedical personnel.

Chitosan films lack various important physicochemical properties and need to be supplemented with reinforcing agents to bridge the gap. Herein, we have produced chitosan composite films supplemented with copolymerized (with polyacrylonitrile monomers) cellulose nanofibers and diatomite nanocomposite at different concentrations. The incorporation of CNFs and diatomite enhanced the physicochemical properties of the films. The mechanical characteristics and hydrophobicity of the films were observed to be improved after incorporating the copolymerized CNFs/diatomite composite at different concentrations (CNFs: 1%, 2% and 5%; diatomite: 10% and 30%). The antioxidant activity gradually increased with an increasing concentration (1-5% and 10-30%) of copolymerized CNFs/diatomite composite in the chitosan matrix. Moreover, the water solubility decreased from 30% for chitosan control film (CH-0) to 21.06% for films containing 30% diatomite and 5% CNFs (CNFs-D30-5). The scanning electron micrographs showed an overall uniform distribution of copolymerized CNFs/diatomite composite in the chitosan matrix with punctual agglomerations., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Sleep disturbances in schizophrenia are common throughout its course including in the prodrome, and have been mainly attributed to severity of symptoms and antipsychotic use. We aimed to investigate whether early course patients with schizophrenia and young non-psychotic siblings of patients with schizophrenia also show sleep disturbances and whether sleep correlates with symptoms and functioning., Methods: Three study groups, that is, adults newly diagnosed with schizophrenia (n = 54), young non-psychotic siblings of schizophrenia patients (n = 56) and a sample of healthy controls matched to the patients and siblings (n = 61) were evaluated on Horne and Ostberg Morningness-Eveningness Questionnaire, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Severity of symptoms and functioning are assessed using the Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale, respectively. Age, gender, occupation and marital status were regarded as covariates, and differences between the three groups were evaluated using analysis of covariance., Results: Early course schizophrenia patients and non-psychotic siblings of schizophrenia patients showed significantly reduced sleep quality relative to healthy controls (P < .001). Schizophrenia patients had significantly higher daytime sleepiness compared to controls (P < .001). Chronotypes in schizophrenia patients and unaffected siblings did not significantly differ from those of the healthy controls., Conclusions: Like chronic medicated schizophrenia patients, early course schizophrenia patients and young non-psychotic siblings of individuals with schizophrenia have sleep disturbances. These findings indicate that sleep markers can distinguish unaffected siblings of schizophrenia from healthy controls and serve as an endophenotype for schizophrenia., (© 2020 John Wiley & Sons Australia, Ltd.)