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Introduction trauma affects not the child but the whole family. how would the parents’ reaction to trauma influence the child’s resilience capacities? Objectives study the mental health status of parents of children consulting the trauma and resilience unit. Methods Descriptive and retrospective study of 20 consultants in the trauma and resilience unit at Mongi Slim hospital between January and April 2022. The evaluation of depressive symptoms in children was made by Children's Depression Inventory (CDI). The Hamilton Depression and Anxiety Scales were used to assess anxiety and depressive symptomatology in the parents of the consultants. Results The mean age of the children was 10.46±3.24. The traumatic event was related to an assault in 75% of cases, 45% of which were intrafamilial, road accident and death of a relative in 10% respectively, 5% domestic violence. Five consultants had a CDI score ≥8 and 15 had a score >10. Only parents of children with a CDI score>19 had moderate to severe symptoms according to hamilton scales. The diagnosis of adjustment disorder was made in 45% of cases, post-traumatic stress disorder 20%, acute stress disorder 10% other 15% Conclusions The parents’ reaction to the tragedy would play a modulating role on the children’s resilience capacities. less anxious and depressed parents would help their child build his/her coping mecanisms. Disclosure of Interest None Declared

Introduction Interactions between infertility and sexuality are numerous and complex. Recently more attention is being paid to the impact of infertility on the marital sexuality. Objectives The aim of this study was to determine the effects of infertility on sexual functions. Methods A cross-sectional descriptive study, the obstetric gynecology department Basic demographic information was collected. Respondents were surveyed regarding sexual impact and perception of their infertility etiology. Results Our patients had an average age of 33.2. The average number of years of infertility was 3.9 years.. The most common cause of female infertility was an ovulat disorder (36%), that of male infertility was sperm production defect. The confrontation with a diagnosis of infertility marks a difference in the way couples organize their sexual life. In our study, sexual problems after this diagnosis were experienced by 38% of women. Sexual dysfunction was detected as a pain problem (24%), a desire problem (10%), an arousal problem (4%), and an orgasm problem in 6% and. Faced with this situation, women felt guilty (46%), angry (72%) and anxious (82%). Infertility was perceived as the worst experience of life by 78% of our patients. Conclusions Infertility can interfere negatively in women sexuality. The investigation of sexual difficulties in infertility consultations must be systematic.

Introduction The impact of intimate partner violence (IPV) can be devastating on women’s psychology. Moreover, IPV may destroy women’s self-esteem and self-identity. Objectives To identify sociodemographic characteristics associated with IPV and to assess self-esteem among women victims of IPV. Methods It was a descriptive and analytical study over a period of 03 months from June 1st to August 31st, 2018 including all cases IPV female victims in forensic department at Habib BOURGUIBA University Hospital, Sfax. In addition to epidemiological data, Rosenberg scale were used to assess the victim’s self-esteem. Results Among 142 female IPV victims, only 60 (22.3%) agreed to answer our questionnaire. Their median age was 33.5 years (27-41 years). Victims did not pass high school in 61.7% of cases and they were unemployed in 53.3% of cases. Most women got married at 23 years-old (20-26). The average length of marriage was 7 years (3-14 years). Bruises and abrasions were the most frequent lesions (58.3% and 56.7% of cases). Rosenberg Scale score’s mean was 28.3 ± 4.3. Self-esteem was low or very low among 70% of victims. Conclusions Female victims of IPV do not have a specific profile and low self-esteem is quite common among them. Additional research is needed to better understand the extent of the problem and to develop more effective reporting methods. Disclosure No significant relationships.

Introduction Family caregivers of psychotic patients are exposed to violence and stress. However, associated psychological outcomes are poorly characterized in this population. Objectives The aim of this study was to clarify the relationship between violence directed towards caregivers of patients with psychosis and developing post-traumatic stress disorder (PTSD). Methods Participants were family caregivers of psychotic patients (n=95). They completed a questionnaire assessing sociodemographic characteristics. Sociodemographic and clinical data of patients were collected from medical records. We used the perceptions of prevalence of aggression scale (POPAS) to measure the frequency and severity of aggression directed at the respondent in the past and the Impact of Event Scale-Revised (IES-R) to evaluate PTSD. Results A rate of 75.8% of caregivers reported experiencing moderate to severe levels of aggression. Decreased contact with patient (p=0.00), male gender (p=0.00), older age (p=0.00) and parent relationship (p=0.01) of caregivers, diagnosis of schizophrenia or schizoaffective disorder (p=0,00) and poor adherence to treatment (p=0,00) in affected relatives were associated with experiences of moderate–severe aggression. More than a half of caregivers (54.7%) reported potentially significant levels of PTSD which correlated with the level of aggression (p=0.00). Conclusions Our findings suggest that a large proportion of family caregivers of patient-initiated violence in psychosis reported experiencing a great distress and a high level of PTSD symptomatology. So, more attention should be paid to the support needs of caregivers who are faced with potentially life threatening aggressive behaviour by psychotic family members.

Introduction Internet addiction (IA) is a significant public health issue among adolescents. There is considerable evidence that IA is associated with various psychosocial harms. Objectives The aim of this study was to measure the prevalence of internet addiction among secondary school. Methods This cross-sectional study was conducted among 152 students enrolled in secondary school. The participants had filled the Internet Addiction Test of Young and a data file regarding the socio-demographic information, physical and information about the internet access and use. Results The sample consisted of 90 males and 62 females with a mean age of 13.14 ± 1.2 years. The majority of participants had their own smartphone (83.6%). The average duration of connection among participants was 5.3 hours per day. The prevalence of IA was 14,5%. Results showed that 46,8% feel their internet use significantly hinders their family relationships. Twenty participants (13,2%) reported that they connected to the internet while they were in classroom. The prevalence of IA was higher among boys than girls (p= 0.018). There was, also, a significant relation between IA and having academic difficulties (p=0.037). Conclusions The prevalence of IA is elevated in Tunisia. Many negative consequences are identified. Urgent measures should be taken to counter the problem.

Introduction Poorer metacognitive abilities are recognized as strong predictors of social functioning deficits in individuals with schizophrenia. Objectives The aim of the current study is to examine metacognitive functioning in people with schizophrenia and to explore correlations between metacognition, symptoms and general functioning. Methods It was a cross-sectional study involving outpatients diagnosed with schizophrenia and followed in the psychiatry “C” department at Hedi Chaker university Hospital, in Sfax -Tunisia, between may and december 2018. Sociodemographic, clinical and therapeutic data were measured using self-reported questionnaires, and metacognition was assessed with the Metacognition Assessment Scale – Abbreviated version (MAS-A). The general functioning was measured with The Global Assessment of Functioning (GAF). Results A total of 74 participants participated in the study. The average age was 34.1 ± 11.8 years and the sex-ratio was 1.6. The average score of global assessment of functioning was 49.39±10. Means and standard deviations on MAS scores were as follows: self-reflectivity 4.18 (1.46), understanding of others’ minds 3.20 (1.06), decentration 2.5 (1.8), mastery 2.54 (1.85), and the MAS total scores 12.42 (6.17). The results indicate that poor social functioning is associated with metacognitive difficulties (r=0.27, p

Introduction Schizophrenia, with its high prevalence, chronic progression and social impact, is a major challenge for health professionals. For this reason it is important to assess the impact of this disease on these patients, mainly on their quality of life. Objectives To study the quality of life in patients with schizophrenia and determine the factors correlated with it. Methods A cross-sectional, descriptive and analytical study of 28 patients with schizophrenia followed up at the psychiatric consultation in Hédi Chaker University Hospital of Sfax. Data collection was performed using a sheet exploring socio-demographic and clinical data. We used the Quality of Life Scale (Q-LES-Q-SF). Results The average age of our patients was 40.61±6.27 years. The sex ratio (M/F) was1.15. The socioeconomic level was low in 71.4%. The average number of relapses was 3.04±1.4. Follow-up and compliance were good in 28.6% of cases. The average number of hospitalizations was 3.04±1.4. The average of quality of life in patients with schizophrenia was 21±5.74. The quality of life was affected with age (p=0.023), with the high number of relapses and with a higher number of hospitalizations in psychiatric hospital (p=0.008). Quality of life was improved with regular follow-up and good adherence to the treatment (p=0.000). Conclusions The quality of life in mental disorders was impaired mainly in schizophrenics, hence the need to evaluate in a codified way the quality of life of our patients in order to raise awareness among general practitioners as well as psychiatrists to improve the therapeutic and social care of patients.

Introduction The recurrence of bipolar disorder due to poor treatment adherence can be explained by different factors.The poor awareness of the disorder seems to be the major cause. Objectives To evaluate insight in patients followed for euthymic bipolar disorders and determine the factors correlated with it,mainly the self-esteem. Methods A cross-sectional descriptive and analytical study of 33 euthymic subjects with bipolar I and II disorders (DSM 5) and followed up at the psychiatric consultation in Hédi Chaker university Hospital of Sfax.Data collection was performed using a sheet exploring socio-demographic and clinical data. We used Birchwood insight scale to assess the quality of insight and Rosenberg’s Self-Esteem scale. Results The average age of our patients was 44,52±12,99 years old.The sex ratio =0.32.Patients were followed for bipolar I disorder(60.6%).The first episode of the disease was depressive in(51.5%) of cases.The average number of depressive episodes was1.97±1.87.The last episode was depressive in(57.6%) or manic in(42.4%).There were no psychotic characteristics in(42.4%) of cases.The patients had good insight in(54.5%).The average of self-esteem score was27±7.85and it was low in 51.5% of cases.Factors correlated with good insight were bipolar II disorder(p=0.001), high number of depressive episodes(p=0.013) and absence of psychotic characteristics(p=0.003) during the last episode.In addition,good insight was significantly associated with low self-esteem(p=0.023). Conclusions Our study shows that a poor insight depends mainly on the clinical characteristics of bipolar disorders. Moreover,low self-esteem seems to be linked to it. For this reason, our attention should be focused on psychoeducation to improve insight, especially during episodes, in order to facilitate integration and increase patients’ self-esteem.

Introduction An association can be found between patient with psychosis and perpetrating acts of violence. So, the caregiving role can impact negatively on psychosis carer psychological health and wellbeing. Objectives The aim of this study was to identify the factors associated with post-traumatic stress disorder (PTSD) in family caregivers of psychotic patients following exposure to aggression. Methods This cross-sectional study was carried out involving 95 family caregivers of psychotic patients followed in psychiatry. Data were gathered from caregivers about their experiences in providing care. Sociodemographic and clinical data of patients were collected from medical records.We used the perceptions of prevalence of aggression scale (POPAS) to measure the frequency and severity of aggression directed at the respondent in the past and the Impact of Event Scale-Revised (IES-R) to evaluate PTSD. Results The caregivers were male in 51.6% and with low educational level in 46.3% of cases. A rate of 75.8% of caregivers reported experiencing moderate to severe levels of aggression. More than a half of caregivers (54.7%) reported potentially significant levels of PTSD. Decreased contact with patient (p=0.01), male gender (p=0.00), older age (p=0.00), living far from patient (p=0.00), parent relationship of caregivers (p=0.00), diagnosis of schizophrenia or schizoaffective disorder (p=0.00) and poor adherence to treatment (p=0.00) in affected relatives were associated with the presence of PTSD following exposure to moderate to severe aggression. Conclusions These findings highlight the need for interventions to promote family psychoeducation and to provide psychosocial support for caregivers of patients in order to prevent the traumatic impact of violence on them.

Introduction Gaming is a source of addiction for adolescents. It is recognized as a behavioral and mental health condition, both by the American Psychiatric Association and by the World Health Organization. Objectives To determine the prevalence of gaming addiction among secondary school students. Methods This cross-sectional study was conducted between September and October of 2020 among students enrolled in secondary school. The participants had filled the Game addiction scale and a data file regarding the socio-demographic information, physical and information about the internet access and use. Results The initial sample was composed of 180 secondary school students. Among them 28 were excluded because they did not play video games. Final sample consisted of 152 students (90 males, 62 females) with a mean age of 13.14 ± 1.2 years. The average duration of connection among participants was 5.3 hours per day. Nearly one quarter of the participants (24,3%) played videogames more than 20 h per week. The prevalence of gaming addiction was 21,7%. The participants with gaming addiction were, on average, younger than those who were not addicted to gaming Game-addicted individuals were more likely to be male than female (13,8% vs 7,9%; p=0,036). There was, also, a significant relation between IA and having academic difficulties (p=0.042). Conclusions Based on our study findings, that gaming addiction is a challenging problem among Tunisian adolescents. We recommend authorities consider gaming addiction a serious problem for the young population and make this growing phenomenon an adolescent health priority. Disclosure No significant relationships.

Introduction Pseudoneurological symptoms are frequent among children consulting in neuropediatrics. Psychogenic origin is often unrecognized, which may cause a major disruption and an increase of medical care expenses. Objectives The purpose of this study was to identify clinical features of pseudoneurological symptoms through patients admitted in neuropediatrics. Methods A descriptive retrospective study of a population of 19 children and adolescents hospitalized in the neuropediatrics department at the National Institute of Neurology in Tunis, between January 2015 and April 2019, having recieved the diagnosis of psychogenic symptoms. Results Twelve girls and seven boys were included in this study.The averge age were 11.5 years. All patients had normal cogntive and motor development. In most cases (84%), patients had a history of somatic illness. Only three patients had a history of psychiatric disorders. Family history of somatic disorders was found in 42 % of the sample and psychiatric disorders in three patients. Negative pseudoneurological symptoms such as loss of function, were detected in 60 % of patients, paraparesis and paraplegia were the most recurrent. Only one patient had pseudo-epileptic symptoms. Further investigations were performed in all patients, averaging 4 tests per patient. The average term between the beginning of the symptoms and the established diagnosis of psychogenic symptoms was 72 days with an average stay at hospital of 4 to 7 days. All patients had conversion disorder according to DSM V. Conclusions It is recognized that somatization could be a warning sign of psychological distress mainly among children. Conversion disorder, rarely seen in children, presents frequently as pseudo neurological symptoms.