IntroductionAttention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental condition that affects millions of children and adolescents worldwide. Knowledge of risk factors associated with ADHD may reduce its prevalence and its severe impact on patient’s quality of life. The aim of this study was to identify risk factors associated with ADHD and to discuss their involvement in the genesis of the disorder.MethodsThis is a case-control study involving a first group of 74 children (mean age = 9 years) diagnosed with ADHD. The second group included 80 healthy control children. They were randomly selected and matched for age and gender. A literature-based questionnaire assessing the socio-demographic data, biological and environmental factors associated with ADHD was administered to the parents. The diagnosis of ADHD group was made by a trained child psychiatrist according to the DSM-5 criteria supplemented by the Conners scales of parents and teachers. For the control group, we added to the questionnaire the MINI-kid section of ADHD to screen for possible presence of ADHD symptoms. Univariate then multivariate analyses were conducted to identify factors associated with ADHD.ResultsSeveral factors were more prevalent in children with ADHD than in controls: disturbed family dynamics, low socio-economic status, family history of psychiatric and organic pathologies, and particularly several early environmental factors, including passive smoking during pregnancy, prematurity, fetal distress, caesarean delivery and low birth weight. In the early childhood period, early exposure to television was also strongly associated with ADHD. However, the multivariate model conducted to determine the variables independently associated with ADD/ADHD revealed only three determining factors: passive smoking during pregnancy (OR = 4.60 [2.14, 9.94]; p < 0.001), acute fetal distress (OR = 5.08 [1.47, 17.52]; p = 0.01), and familial psychiatric history (OR = 9.37 [2.46, 35.59]; p = 0.001).DiscussionThe recognition of factors involved in the genesis of ADHD within different ethnic populations may help understanding and broaden our knowledge of this disorder to develop targeted strategies for prevention and early intervention. Further participants with more robust statistical output are required to confirm our findings to a more generalized population.

Introduction Le pédopsychiatre est de plus en plus sollicité dans notre contexte tunisien par les instances judiciaires pour l’examen des enfants et des adolescents. Cette augmentation de demandes serait en partie en rapport avec les progrès dans la législation de protection de la femme et l’enfant. Toutefois, plusieurs difficultés semblent toujours entraver le bon déroulement et suivi de ces examens. Objectifs Ceci nous a motivé à mener ce travail dont l’objectif était de déterminer les caractéristiques épidémiologiques et cliniques des enfants examinés dans le cadre d’un examen médico-légal et de discuter les obstacles à l’origine de difficultés de gestion de ces demandes. Patients et méthodes Il s’agit d’une étude transversale descriptive et analytique qui a porté sur les dossiers de tous les consultants adressés à la consultation de pédopsychiatrie de Monastir dans le cadre d’un examen médico-légal, durant les années 2021–2022. Nous avons ainsi procédé au remplissage d’une fiche explorant les données sociodémographiques de l’enfant, ses antécédents ainsi que les caractéristiques de l’examen médico-légal. Résultats Notre étude a inclus 454 enfants et adolescents dont le sex-ratio M/F était égal à 1,03 et l’âge moyen de 11 ans. Il s’agit d’une population appartenant majoritairement à un milieu socioéconomique défavorisé et vivant dans une dynamique perturbée. La maltraitance (60,1 %) notamment sexuelle (53,5 %) était le motif le plus fréquent à l’origine de la demande d’examen médico-légal et les diagnostics retenus étaient dominés par les états de stress aigu et post-traumatique et les troubles de l’adaptation. Nous avons aussi noté un taux important de perte de vue pour ceux nécessitant un suivi ainsi que de peu d’informations disponibles sur les suites judiciaires pour les enfants ayant nécessité une prise en charge. Conclusion Le présent travail a étudié un sujet crucial, dans lequel nous avons rapporté les caractéristiques sociodémographiques et cliniques des enfants examinés en pédopsychiatrie dans un cadre médico-légal. Une coopération entre tous les intervenants est ainsi nécessaire pour garantir une meilleure prise en charge et surtout une continuité dans les soins accordés à cette population particulière.

Given that resilience is the ability to cope with adversities, and impulsivity is characterized with rapid reactions without foresight, we aimed to explore the pathways between intra-familial childhood adversities, resilience, impulsivity and suicidal behaviors among adolescents in Mahdia and Gafsa cities (Tunisia). We conducted a cross-sectional study in secondary schools from January to February 2020. Exposure to intra-familial early life experiences was evaluated by the Adverse Childhood Experiences (ACEs)-International Questionnaire. Resilience and impulsivity were assessed via the Adolescent Psychological Resilience and the Barratt Impulsivity Scale. A total of 3170 students were recruited with a response rate of 74%. About 81.1% of them reported being emotionally abused. The resilience mean score was 86.10 ± 9.85. Impulsivity was screened among 42.2% of them. About 38% of students presented suicidal thoughts, 16.4% had a suicide plan, and 10.8% have made a suicide attempt. We found that exposure to intra-familial ACEs predicts suicidal behaviors through impulsiveness (% mediated = 18% for emotional violence) and interpersonal resilience (% mediated = 24% for emotional violence; % mediated = 20.4% for physical violence). Our results emphasize the need to prevent ACEs, and to seek out a way to promote ACE protective factors among adolescents such as resilience.

Radiotherapy-induced muscle injury (RIMI) is a major complication of radiotherapy for nasopharyngeal carcinoma. Transcription factor (TF) expression and alternative splicing are crucial events in transcriptional and posttranscriptional regulation, respectively, and are known to be involved in key signaling pathways contributing to a variety of human disorders, including radiation injury. To investigate the TFs and alternative splicing events involved in RIMI, we constructed a tree shrew model as described previously in which the RIMI group received 20 Gy of irradiation on the tensor veli palatini (TVP) muscles. The irradiated muscles were evaluated by RNA sequencing (RNA-seq) 6 months later, and the results compared with those for normal TVP muscles. The alt5p and alt3p events were the two main types of differentially regulated alternative splicing events (RASEs) identified via the Splice sites Usage Variation Analysis (SUVA) software, and these RASEs were highly conserved in RIMI. According to functional enrichment analysis, the differentially RASEs were primarily enriched in pathways related to transcriptional regulation. Furthermore, we identified 16 alternative splicing TFs (ASTFs) in ASTF–differentially expressed gene (DEG) networks based on co-expression analysis, and the regulatory networks were chiefly enriched in pathways linked to cell proliferation and differentiation. This study revealed that RASEs and ASTF–DEG networks may both play important regulatory roles in gene expression network alteration in RIMI. Future studies on the targeting mechanisms and early interventions directed at RASEs and ASTF–DEG networks may aid in the treatment of RIMI.

Background The rapidly emerging Coronavirus infectious disease 2019 (COVID-19) has spread around the world yielding in significant changes in almost every aspect of daily life. While primary research of the epidemic COVID-19 has focused on the psychological impact on the general population and health professionals, no survey of the pandemic-resulting containment on parents and their children has been yet addressed in the Tunisian-North African population. This study aimed to assess the psychological profile of parents and youth in Tunisia during a period of COVID 19 lockdown, and to identify associated factors to parental anxiety symptoms. Methods This is an analytical cross-sectional study composed of a total of 538 adults including 464 mothers and 74 fathers. Parents of children aged less than 18 years completed an online survey (Google Forms) on the Psychological Impact of Confinement which includes the Generalized Anxiety Scale (GAD-7), the Parental Burnout Assessment (PBA), and the infantile trait-anxiety scale. The survey was initiated in May 2020 on a population of the Tunisian-North African citizens and lasted for more than 6 weeks. Results The median GAD-7 score was 11 corresponding to a moderate anxiety with 27.8% reporting severe anxiety. The median PBA score was 31 corresponding to a moderate risk of burnout, with 19.5% being affected. The children's anxiety scores were associated with their parents' anxiety ratings with 24% of the children reported signs of moderate anxiety. Conclusions The COVID-19 pandemic affected parental and their children’ psychological behavior due to a direct social isolation and distancing. Pediatricians need to be alerted on this issue and future measures are essential to avoid parental emotional burnout and anxiety disorder in similar situations.

Abstract Background Williams Beuren Syndrome is a multisystemic disorder manifested by congenital heart defects associated with dysmorphic features, intellectual delay, and a particular behavioural profile due to a microdeletion in 7q11.2. Methods To establish a genotype-phenotype correlation; we carried out a molecular cytogenetic analysis on 31 Tunisian WBS patients using the CGH-array and FISH techniques. Results 6 patients were investigated by CGH-array. All of them had a typical WBS deletion ranging from 1.4Mb to 1.7Mb. Curiously in 2 patients autistic spectrum disorders were noted in contrast to the behavioural profile generally observed in the other patients which are characterized by good contact. If we analyse the distal region of the generally deleted region, we found that the HIP1 gene is included. HIP1 encodes a central nervous system expressed protein and is considered the candidate gene for autism in this region. Conclusion Considering the presence of autism, a CGH analysis is essential to determine the exact etiology of this disorder, which seems strange for this syndrome, but is becoming progressively frequent. We suggest that alteration of the HIP1 gene could be indirectly responsible for autism, but specific environmental factors might act as risk factors triggering the development of this trait...

The SDB (Sleep-Disordered Breathing) group consisted of 16 previously untreated children with SDB (age: M = 8.56 years, SD = 2.31)The control group consisted of 16 healthy subjects were matched by age (age: M = 8.75 years, SD = 1.44, t(30) = 0.28, p = .78)

Objective: The aims of the study were to determine the prevalence of ADHD in a population of high school students and to explore the factors associated with this disorder. Method: This was a cross-sectional study that had included 447 high school students. The diagnosis of ADHD was made by the Adult ADHD Self-Report Scale translated in Arabic language. The sociodemographic and clinical characteristics were evaluated by a preestablished questionnaire. The self-esteem was assessed by the Rosenberg Self-Esteem Scale. Results: The prevalence of ADHD was 18.1%. The logistic regression analysis showed an association between the diagnosis of ADHD and the bad relationships with parents (odds ratio [OR] = 16.43; p < 10-3), the presence of personal psychiatric antecedents (OR = 12.16; p < 10-3), internet misuse (OR = 2.39; p = .014), and maltreatment antecedents (OR = 3.16; p = .009). Conclusion: The prevalence of ADHD in this study was one of the highest prevalence reported. The factors associated with ADHD may have diagnostic and therapeutic implications.