Introduction Adolescent suicide and suicide attempts (SA) present a complex and multifactorial problem that deserves special attention. Identifying particularities of suicidal behavior in this age group is essential in order to identify suffering adolescents. Objectives To determine the characteristics of adolescent suicide attempts compared to those of adults. Methods It was a retrospective study carried out on a clinical population who consult in the psychiatry department at the Gabes regional hospital during the period from January 1st, 2020 to September 30, 2020. Sociodemographic and clinical data of the patients as well as their family dynamics, their education, their personal and family history, characteristics of the SA and psychiatric symptoms preceding the act were assessed. We compared two subgroups: patients aged 10 to 19, and those aged 20 and over. Results 278 suicide patients were included. 101 of them were adolescents (10 -19 years), of which 89 (88.11%) were female. Mean age of suicidal adolescents was 16.5 years. They were mostly living with their families (92.07%). Intentional drug ingestion was more common in adolescents (81.1%) than in adults (40%). Adolescent suicide attempts were correlated with a conflictual family environment (p=0.04), exposure to mistreatment (p=0.001), the absence of underlying mental disorders (p<10-3), the presence of academic difficulties (p<10-3) and the presence of a precipitating factor such as family conflict (p<10-3) or school failure (p= 0.004). Conclusions A good knowledge of the particularities of suicidal behavior in adolescents is preliminary to support an effective preventive measure targeting both family and school environment

Introduction Covid19 pandemic in Tunisia has disturbed the health system. Health care workers, who were in the frontline to face this disease, had experienced reactions of anxiety, depression and distress.ObjectivesTo assess the level of anxiety and depression among health care workers of regional hospital of Gabes (south of Tunisia) and its associated factors.Methods We conducted a cross-sectional study, from April 19, 2020, to May 5, 2020 on healthcare workers in Gabes regional Hospital. All hospital departments and units were included. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data. Hospital Anxiety and Depression Scale (HAD) validated in the Tunisian dialectal version was used to assess anxiety and depression.ResultsAmong the 289 responding participants, 100 (34.6%) were frontline health care workers directly engaged in managing patients with coronavirus disease. Our study revealed that 43.6% of health care workers were suffering from anxiety and 44.3 % from depression. There was a significant association between anxiety and female gender (p<0.001), being married (p=0.006), mental health conditions (p<0.001) especially anxiety disorders (p<0.001) and depressive disorders (p=0.03), personal medical history of dysthyroidism (p=0.013) and smoking (p=0.005). Nurses experienced more likely anxiety symptoms than other occupation (p=0.021). There was significant relationship between depression and female gender (p<0.001), married status (p=0.02), age under 50 (p=0.032) and mental health conditions (p<0.001) such as anxiety disorders (p=0.001) and depressive disorders (p=0.013).ConclusionsIt is crucial to provide care for health care workers with mental health problems during their struggle with covid19.

Introduction COVID19 outbreak had affected physical and mental health of individuals. Different adverse health behaviors had worsened and eating disorders had evolved. Health care workers were not spared.ObjectivesTo screen binge eating disorder among health care workers of regional hospital of Gabes (south of Tunisia) and its associated factors.Methods We conducted a cross-sectional, descriptive and analytical study, from April 19, 2020, to May 5, 2020 on 289 in Gabes regional Hospital. All healthcare workers were included (n=620). Workers who were on sick leave during the study were excluded. During this period, the total confirmed cases of COVID-19 exceeded 900 cases in Tunisia and around 20 cases in Gabes. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data. DSM-5 diagnostic criteria were used to assess Binge-Eating Disorder.ResultsOf the 289 responding participants, 85 were physicians (29%), 166 nurses (57.4%), 8 ambulance drivers (2.8%) and 30 health-related administrators (10.3%). A total of 100 participants (34.6%) were frontline health care workers directly engaged in diagnosing, treating or caring for patients with coronavirus disease. Nine percent of participants experienced binge eating disorder during the outbreak. Binge eating disorders were associated to past psychiatric history of eating disorder (p=0.001), social isolation (p=0.001), increased consumption of tea and coffee (p=0.02) and the fact of being a frontline care giver (p=0.009).Conclusions Binge eating disorders are usually associated with health problems: obesity and consequently severe form of coronavirus disease. Screening those disorders is important to alleviate its physical impact.

IntroductionImpulsivity is an important component of the phenomenology of bipolar disorder. Recent studies show that bipolar patients use various strategies to deal with life stressors and with the discomfort related to their disease.ObjectivesTo study impulsivity and coping strategies in bipolar patients in remission phase and the factors associated with them.Methods A cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder, in remission, at the psychiatric outpatient clinic at CHU Hédi Chaker in Sfax. We used a socio-demographic and clinical data sheet, the Ways Of Coping Checklist to assess coping and the Barratt Impulsivity Scale to assess impulsivity.ResultsThe average age was 43.77 years, the sex ratio was 0.5. Smoking was found in 30%. Bipolar I disorder was diagnosed in 93% of patients. The mean age of onset was 27.8 years, and the mean duration of illness was 15 years. *Impulsivity was found in 20% of cases and was correlated with the duration of the disease (p = 0.016) and smoking (p = 0.009). *Coping focused on the problem present in 70% of patients, correlated with the duration of the disease (p = 0.032) and coping (p=0.02). *Emotion-centered coping revealed in 20% of patients, correlated with gender (p = 0.037) and cognitive impulsivity (p=0.032). *Coping focused on seeking social support was present in 10% of patients.ConclusionsImpulsivity is quite frequent in remitted bipolar patients, who mainly used problem-focused coping and a cognitive management of the stressful event. Thus the hypothesis was that impulsivity is core trait of bipolar disorder.

Introduction Smoking and nicotine dependence are particularly common in patients with a psychiatric disorder compared to the general population. Objectives To study the prevalence of smoking in patients followed at the department of psychiatry and to assess their dependence on nicotine. Methods This was a cross-sectional, descriptive and analytical study. The study focused on patients followed at the department of psychiatry of the regional hospital of Gabes. Sociodemographic and clinical data were assessed. Fagerstrom questionnaire in its validated French version was used to assess the nicotine dependence. Data were analyzed using the software SPSS (20th edition). Results 100 patients were included. They were male (60%) and single (50%) and with a mean age of 45.3 years [18-71]. The three most common pathologies were anxiety disorders (31%), schizophrenia (30%) and depression (29%). Among the patients surveyed 48% were smokers. Of which, 93.7% smoked cigarettes, 20.8% snorted chewing tobacco and 12.5% smoked hookah. The average number of pack-years was 11.6, with an average of 22.8 cigarettes per day. The mean duration of regular smoking was 19.1 years. Regarding nicotine dependence, 42% of patients were dependent. Regarding the degree of dependency, 43.7% were heavily dependent, 25% were weakly dependent and 18.8% were moderately dependent. Smoking was significantly associated with the male gender (p≤10-3), alcoholism (p=0.002) and schizophrenia (p=0.006). Conclusions Results of our study show that smoking is frequent in patients followed at the psychiatry department. This aspect should be taken into account during the psychiatric evaluation, especially when therapeutic resistance occurs.

IntroductionAddictive behaviors and suicide have important risks that need to be explored for any patient followed at the department of psychiatry, possibly endangering his vital and psychosocial prognosis.ObjectivesOur study aims to identify the link between addictive behavior and suicidal behavior in patients followed at the psychiatry department at the regional hospital of Gabes.MethodsWe conducted a cross-sectional, descriptive and analytical study carried out on a clinical population who consult in the psychiatry department in the Gabes’s regional hospital during the period from January 1st, 2020 to September 30, 2020.Sociodemographic and clinical data of the patients as well as their personal and family history were assessed. The evaluation of psychopathological disorders was carried out according to the diagnostic criteria of DSM-5. Suicide Behaviors Questionnaire (SBQ) was used for suicide risk assessment. Fagerstrom questionnaire in its validated French version was used to assess the of nicotine dependence. The exploration of childhood physical and emotional trauma was carried out by the Childhood Trauma Questionnaire (CTQ) scale. Data were analysed using the software SPSS.Results100patients were included. The mean age was 45.5years. TableI: Breakdown of addictive behavior and suicide attempts by gender. TableII: Common vulnerability factors between addictive behavior and suicidalityThe analytical study showed that suicide attempts were correlated with addictive behaviors (p = 0.03) and that suicidal recurrence was correlated with addictive behaviors (p = 0.01).ConclusionsSuicidal behavior in patients followed in psychiatry is closely linked to addictive behavior, hence the importance of early management.

Introduction The COVID19 outbreak has disrupted the mental health of resident doctors who had to care for patients. Eating disorders were among these reported mental health problems. Objectives To screen binge eating disorder among young Tunisian doctors and its associated factors. Methods We conducted a cross-sectional, descriptive and analytical online-based survey, from April 19, 2020, to May 5, 2020 on 180 medical residents in training. We sent the survey via a google form link. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data of young doctors. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria were used to assess Binge-Eating Disorder. Results Among 180 young doctors who enrolled the survey, 70,2% were female, 16% were married. The mean age was 29 years. 51,1% were frontline caregivers, working directly in diagnosing, treating or caring for patients with coronavirus disease. Among our participants, 5% presented anxiety disorder, another 5 % presented depression disorder and 1,7% had eating disorder. Binge eating disorder were present among 8,9 % of participants and it was associated to personal history of eating disorder (7,7% vs 1,1%, p<10 -3 ), past history of depression disorder (7,2% vs 3,3%, p=0.008), exposure to media or news about coronavirus outbreak (0.5% vs 8,3%, p=0.04). Conclusions Our study indicated the evolving proportion of binge eating disorder among young doctors. Screening eating disorder is important in order to prevent related physical health problems.

Explorer la souffrance psychologique des parents des enfants atteints de diabète en dressant leur profil anxio-dépressif. Nous avons mené une étude transversale auprès de 40parents, accompagnant leurs enfants atteints de diabète, à leurs rendez-vous à la consultation de pédiatrie et au service pédiatrie de Gabès. Nous avons utilisé une fiche préétablie contenant les données sociodémographiques des enfants et des parents et les données concernant la maladie, l’échelle de détresse parentale et l’échelle de dépression et d’anxiété(échelle HAD). Les parents étaient des adultes jeunes(38 ans en moyenne), mariés (100 %) avec un niveau d’étude universitaire dans 37,5 % des cas. Parmi les parents enquêtés, 10 % avaient un abus d’alcool et 30 % étaient tabagiques. Dans 55 % des cas, le diabète a été découvert chez l’enfant avant l’âge de 5 ans. Parmi les enfants inclus, 70 % souffraient de difficultés psychologiques, 30 % avaient des difficultés scolaires et 20 % avaient des difficultés relationnelles. À l’analyse des scores de l’échelle(HAD), 52 % des parents avaient une symptomatologie anxieuse certaine et 37,5 % avaient une dépression. Le diabète de type1, une maladie chronique, implique que l’aide des parents sera prolongée, ce qui peut conduire à un large éventail de risques pour leur santé y compris des risques psychologiques avec des émotions dont la chronicité pourrait se révéler dangereuse. On y retrouve le stress, la culpabilité, la peur de perdre le contrôle, l’impuissance, le manque de confiance en soi, la frustration, le renoncement à la vie personnelle, l’anxiété, la peur et la dépression.

Mesurer la prévalence de l’obésité chez les patients suivis en psychiatrie et déterminer les facteurs qui lui sont associés. C’est une étude transversale, descriptive et analytique faite pendant l’année 2018. Nous avons inclus tous les malades ayant consulté durant la période de l’étude. Nous avons mené un entretien semi-directif avec le patient et un membre de sa famille. Pour le diagnostic des troubles mentaux, nous nous sommes basés sur le Manuel Diagnostique et Statistique des troubles mentaux (DSM-V). L’obésité a été estimée par l’indice de masse corporelle (IMC). Cet indice se définit par le rapport du poids (kg) sur la taille au carré (m2). Le surpoids est défini par un IMC entre [25-29,9 kg/m2] et l’obésité par un IMC ≥ 30 kg/m2. Notre échantillon était formé de 115malades. La moyenne de l’IMC était de 25. Parmi les malades, 40,9 % avaient un surpoids. L’obésité a été notée chez 49 %des cas. L’obésité était significativement plus fréquente chez les femmes (63,8 % vs 39,7 %, p = 0,009), vivant en couple (60,9 % vs 42 %). Nous n’avons pas noté de différences entre les malades obèses et non obèses concernant le niveau socioéconomique, le niveau d’instruction, l’activité professionnelle et le diagnostic. L’association entre obésité et troubles psychiatriques est controverse, certaines études ont trouvé qu’il n’y a pas de différences concernant la prévalence de l’obésité en psychiatrie entre les hommes et les femmes, alors que deux études américaines ont montré une association positive entre l’obésité et la dépression chez les femmes, non retrouvée chez les hommes.

Familial spastic paralysis is a rare degenerative progressive disorder involving mainly the pyramidal tracts in the spinal cord. It is characterized clinically by weakness and rigidity of the lower limbs. Depression is a fairly common psychiatric comorbidity.