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Radhouane Achour,1 Marianne Koch,2 Yosra Zgueb,3 Uta Ouali,3 Rim Ben Hmid1 1Emergency Department of Gynecology and Obstetrics, Maternity and Neonatology Center of Tunis, Faculty of Medicine of Tunis, El Manar University of Tunis, Tunis, Tunisia; 2Department of Obstetrics and Gynecology, Medical University of Vienna Austria; 3Psychiatry Department, Razi Hospital, Faculty of Medicine of Tunis, El Manar University of Tunis, Tunis, Tunisia Background: Vaginismus affects up to 1% of the female population and often represents a physical manifestation of an underlying psychological problem. Our objective was to investigate the psychosomatic impact of vaginismus in pregnant women and evaluate the quality of their therapeutic care in Tunisia.Methods: We included pregnant patients with vaginismus who presented at our obstetric emergency department between October 2016 and March 2017. All patients were interviewed by one expert psychiatrist and gynecologist using a standardized questionnaire. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety and depression levels. Patients were prospectively followed until their postpartum period and were interviewed by the same experts after delivery. Sixteen weeks after hospital discharge, we contacted all patients via phone. All the information was simultaneously recorded in written form.Results: Twenty pregnant patients with vaginismus were included (85% primary, 15% secondary). Most women described a conservative family background (70%) in which they received little or no sexual education (60%). All women described a feeling of anxiety and anger immediately before sexual intercourse and 40% have never sought medical consultation regarding their vaginismus before. Only 50% reported regular follow-up visits during their pregnancy (without vaginal examination), whereas 25% reported irregular follow-up visits with subjectively bad experiences during attempts of vaginal examinations.Conclusion: Pregnant women with vaginismus are at risk of non-follow-up during their pregnancy due to underlying feelings of shame and experienced lack of understanding by medical staff. Obstetricians should carefully and attentively approach pregnant women with vaginismus in order to ensure adequate medical care during pregnancy. Keywords: vaginismus, pregnancy, profile, impact

Introduction: Several factors can influence the journey of perinatal grief in mothers, including the quality of care during this experience. The objective of our study was to investigate the factors influencing the perception of grieving women during the perinatal period and identify the role of medical and paramedical healthcare professionals in psychological support. Objectives: To determine the factors influencing the perception of fetal loss in grieving mothers. Methods: This was a descriptive, longitudinal, retrospective study conducted between july 2021 and march 2022 at the Fetal Pathology Department of the Center for Maternity and Neonatology in Tunis, Tunisia. The study included women who experienced perinatal loss and underwent fetal pathology examination. The study was conducted in two stages: Initial consultation at the Fetal Pathology Department, five weeks after the date of expulsion, for perinatal grief counseling. Follow-up interview one year after the date of expulsion: The participants were contacted via telephone for an average duration of twenty minutes.The assessment of perinatal grief during both interviews was conducted using the shortened version of the Perinatal Grief Scale (PGS) Results: The mean age of the patients was 31.41 years (± 5.15). The average gravidity was 2.47 (± 1.43). More than half of the patients had no living children (n=41). The majority of patients had no notable pathological history. Six patients had been followed in psychiatry, and five had a history of subfertility. The majority of patients (n=61) reported having good marital relationships. Among the participants, 20% (n=14) had a high Perinatal Grief Scale (PGS) score (PGS >= 91) at five weeks post-loss and were subsequently referred for psychiatric consultation. At one year, all participants had a PGS score > 91, demonstrating the effectiveness of psychiatric management. Multivariate analysis identified four independent factors associated with a high PGS score at five weeks: absence of living children (OR=0.59; 95% CI [0.36-0.98]; p=0.04), quality of marital relationship (OR=1.2; 95% CI [1.1-3.9]; p=0.02), family support (OR=2.52; 95% CI [1.55-4.12]; p<0.001), and quality of loss disclosure (OR=2.52; 95% CI [1.32-3.77]; p=0.003). Conclusions: To identify patients at high risk of developing complicated grief and improve the quality of psychological care, it is necessary to implement appropriate protocols, provide training to healthcare personnel, and establish well-equipped healthcare facilities. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Among all mental pathologies, bipolar disorder (BD) is the one in which addictive comorbidity is most frequent. Recent studies suggest that this comorbidity has harmful consequences, threatening patients' quality of life. Objectives: Describe addictive comorbidity and determine its prevalence in a population of patients with BD I. Study the impact of addictive comorbidity on the evolution of BD I. Methods: A cross-sectional, comparative study was conducted over a six-month period in the after-care unit of psychiatric wards at Razi Hospital, including patients treated for BD I according to DSM 5 criteria and stable on treatment. The study included two phases: first, sociodemographic, clinical and therapeutic characteristics were collected using a pre-established form. The CAGE, DUDIT and MARS scales, validated in Arabic, were then administered. Results: We included 100 patients (60 men and 40 women) with a mean age of 43.55 years. Substance use disorder (SUD) was reported in 31% of our population; 22 alcohol users with a mean CAGE score of 1.23 (0-3), while psychoactive substance use was reported in 19 patients with a mean DUDIT score of 13.37 (0-28). Forensic history was higher in the group of patients with comorbid SUD (p<0.001). Poor compliance with treatment and irregular follow-up were also significantly more associated with addictive behavior, respectively p=0.008 and p=0.048. We found no association between SUD and suicidal behavior or evolutionary symptoms of the disorder. Conclusions: SUD are generally factors in the poor prognosis of BD. It is important to identify the determinants of this comorbidity, so that these risk factors can be appropriately targeted through appropriate therapeutic interventions and thus limit these negative consequences. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Given the recurrence of mood episodes, with their negative repercussions such as high suicidal risk, significant cognitive decline and the persistence of residual signs with a negative impact on the patient's family, social and professional functioning, Bipolar Disorder is a mental disorder with a significant social stigma. Objectives: Identify the socio-demographic and clinical factors that may influence the experience of stigma in bipolar disorder type I Methods: We conducted a cross-sectional, comparative study over a six-month period at the aftercare unit of Razi Hospital's psychiatric ward "A", including patients treated for TB I according to DSM 5 criteria and stable on treatment. The study was conducted in two stages: first, sociodemographic and clinical characteristics were collected using a pre-established form. The DISCUS scale, validated in Arabic, was then administered. Results: We included 100 patients (60 men and 40 women) with a mean age of 43.55 years. The median DISCUS stigma score was 6 (0-19). The mean value of the DISCUS scale was high for patients of urban origin (p=0.042), with a low socioeconomic level (p=0.001), and poor family dynamics (p<0.001). The presence of a comorbid personality disorder was significantly associated with stigma (p=0.006). The DISCUS scale was positively associated with the number of years of follow-up, the number of hospitalizations, the number of manic episodes, the number of depressive episodes and the number of episodes with psychotic or melancholic features. Conclusions: This stigma can have a negative impact on patients' quality of life in a whole range of ways, including limiting their opportunities for education, employment and housing. Intensive therapeutic interventions should be considered for vulnerable patients to limit the consequences. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: There has been growing evidence to support the hypothesis that inflammation is involved in the pathogenesis of schizophrenia. Objectives: The aim of the present literature review was to assess the efficacy of acetylsalicylic acid (ASA) as an adjuvant agent in the treatment of an acute exacerbation of schizophrenia. Methods: We searched randomized clinical trials based on regular searches of MEDLINE, Embase, PubMed. Results: We included four studies. The results were in favor of the efficacy of ASA in the study where authors targeted early psychosis. Illness duration seems to predict response to anti-inflammatory agents. Conclusions: Further studies of early stages of schizophrenia are helpful. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]