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IntroductionStigma, including beliefs about mental illness, can operate in different cultures in different ways, making Western theoretical bases considered “universal” on the stigmatization of theories not applicable to non-Western cultures; hence the need for international studies on this subject.ObjectivesThis work aimed to assess knowledge of mental illness, available treatments and recovery in a non-clinical sample of Tunisian university students.MethodsIn a cross-sectional descriptive study from October 1 to November 30, 2019, we evaluated 714 students from 3 Tunisian public universities using the Mental Health Knowledge Schedule scale (MAKS).ResultsWe found that 34.2% of students did not agree that drugs can be an effective treatment for people with mental health issues, while 76.4% agreed on the effectiveness of psychotherapy. In addition, 34.3% did not consider drug addiction as a mental illness and 21.9% did not consider depression as a mental illness. We objectified a significant correlation of the MAKS score with gender (p=0.019), living environment (p=0.001), high academic level of father (p=0.000) and mother (p=0.027) and presence of personal psychiatric history (p=0.013).ConclusionsAwareness and information campaigns aimed at developing the general public’s knowledge of the scientific, medical and psychosocial causes of mental illness and the means of management should be established.

IntroductionSexual health significantly influences individual well-being. It is thus crucial for primary care physicians to address these concerns effectively.ObjectivesTo evaluate the perspectives and approaches of primary care practitioners towards sexual health.MethodsA descriptive survey was disseminated to 350 primary care physicians via Google Forms in August 2022.ResultsOf the respondents, 53.1% were female. The majority (71.4%) were affiliated with the public health sector, and over 75% were based in urban areas. All acknowledged the importance of addressing sexuality in their patients’ health. In this context, 62% spontaneously initiated discussions on the subject with their patients. Also, 72% noted that patients anticipate a regular dialogue about sexual health with their primary care provider. Over 90% believed in the value of addressing sexual dysfunctions more proactively, with 56% comfortable in leading such discussions. Additionally, 64% were inclined to include targeted questions on sexual health in their consultations. Notably, 77.6% expressed interest in creating specialized sexual health consultations in their practice. However, 54% felt unease in discussing sexual health with opposite-gender patients, and 82% lacked referrals to sexologists.ConclusionsSexual health issues are not uncommon in general practice. Primary care providers play a vital role in counseling, screening, and educating patients on these concerns, necessitating specialized training to enhance patient management.Disclosure of InterestNone Declared

IntroductionSexual dysfunctions related to psychotropic drugs are among the most distressing adverse effects and can lead to non-adherence to treatment.ObjectivesTo elucidate the mechanisms of psychotropic-induced sexual dysfunctions and to suggest strategies for their management.MethodsLiterature review based on the keywords “psychotropics,” “sexuality,” and “sexual dysfunction”.ResultsPsychotropic medications can impact sexuality either directly or indirectly. The direct effect is primarily due to a decrease in the mesocortical dopaminergic atmosphere, either by blocking D2 receptors or by stimulating 5HT2A receptors. D2 receptor blockade in the tubero-infundibular pathway triggers an increase in prolactin secretion, which can subsequently lead to erection problems, decreased libido, and difficulties achieving orgasm. Action in the nigrostriatal pathway may result in an extrapyramidal syndrome, which can, in turn, hinder intimate physical relations. The indirect effect can also be caused by metabolic complications, which are significant risk factors for sexual dysfunction, as they can lead to male hypogonadism and a negative self-image.Therapeutic strategies suggest either reducing doses (if the patient’s condition allows), changing the drug, or adding an adjunctive medication. Aripiprazole, being a partial agonist of D2 and 5-HT1A receptors and an antagonist of D3 and 5-HT2A receptors, appears to cause fewer sexual dysfunctions and can reduce hyperprolactinemia when added to other antipsychotics.ConclusionsHealthcare professionals must proactively gather information on sexuality given its impact on quality of life and treatment adherence. Prioritizing this dimension of well-being demonstrates a respectful approach toward the patient and establishes the foundation for a strong therapeutic alliance.Disclosure of InterestNone Declared

IntroductionG6PD is essential for the production of NADPH, which is a cofactor for many enzymes involved in antioxidant defense and neurotransmitter synthesis. A deficiency in this enzyme could lead to increased oxidative stress, impaired neurotransmitter and immune function. The latter have been implicated in the pathophysiology of schizophrenia.ObjectivesThe present case is presented to underscore the infrequent and uncharacteristic manifestation of this condition, in the context of clinical symptoms and the trajectory of evolution of schizophrenia when associated with G6PD Deficiency. Moreover, it sheds light on the challenges clinicians encounter in the management of such cases.MethodsA case report of a patient who was admitted to the Psychiatry Department (“Ibn Omrane”) of Razi Hospital”.ResultsMr. M.T is a 26 year-old unmarried man. He comes from a non-consanguineous marriage and has an educational level of a bachelor’s degree plus three additional years of study. He has a significant family medical history. His maternal uncle is under treatment for a chronic psychotic disorder. He has a personal history of G6PD deficiency and no specific habits to note. At the age of 24, he insidiously developed anxiety with incoherent statements of persecution accompanied by behavioral manifestations leading to mistrust and social isolation. He discontinued his studies for a year and began verbalizing suicidal thoughts accompanied by self-harm behaviors.The family sought help from a psychiatrist who prescribed 5 mg of olanzapine, which was covertly administered to the patient.At the age of 28, after a suicide attempt, he was involuntarily admitted to Razi Hospital. The clinical presentation was dominated by disorganization, with a partial response to treatment.ConclusionsMore research is needed to confirm the association between G6PD deficiency and schizophrenia and to determine the underlying mechanisms. Larger studies with well-defined populations and methodologies are needed. It is also important to study the interaction between G6PD deficiency and other genetic and environmental factors that contribute to schizophrenia.Disclosure of InterestNone Declared

IntroductionSchizophrenia is a severe debilitating condition, with elevated level of aggressiveness reaching 33% in a large sample of patients. Unaffected biological relatives of schizophrenia patients share similar though less severe neurocognitive and behavioral abnormalities seen in their affected relatives. Recent findings demonstrates that first degree relatives of schizophrenia patients are at increased risk of violence and aggressive behavior, especially during adolescence, with poor outcome. Besides, adolescents aged from 12 to 18 years old, may experience aversive and overwhelming emotions difficult to regulate due to immaturity of neuronal networks. There are evidence of an association of emotion dysregulation and violent conduct among youth. However, to our knowledge, studies among first degree relatives of psychotic patients were not performed.ObjectivesThe aim of this study was to evaluate the aggressiveness and emotion dysregulation among unaffected adolescents with fist degree family history of schizophrenia and to investigate the association linking these two entities.MethodsIn this purpose wo conducted a cross sectional descriptive study in Razi hospital during three months: from July to September 2022. Unaffected adolescents aged 12 to 18 whom first-degree relatives were diagnosed with schizophrenia according to DSM-5 criteria were included. Adolescents with psychiatric conditions or medical affections associated with psychiatric presentation were not included. Sociodemographic data were collected on a preestablished questionnaire and the following scales were used: The Life History of Aggression LHA, an 11 items self-reported tool, in the Arabic version, The Aggression Questionnaire AQ which is a 29 items self-reported scale in Arabic version and the The Emotion Regulation Questionnaire (ERQ), a 10 items self-reported measure rated on a likert scale, in the validated Arabic version. Written informed consent was obtained from the legal tutor of each adolescent.ResultsResults of this survey are ongoing.ConclusionsResults of this survey are ongoing.Disclosure of InterestNone Declared

IntroductionViolence is a common behavioral and health concern among adolescents, aged 12 to 18 years old. In fact, aggressiveness may result in severe outcome in a critical age characterised by biological, psychological, and social changes. Schizophrenia is a severe and chronic condition, with elevated level of aggressiveness. Since unaffected biological relatives of schizophrenia patients share similar though less severe neurocognitive and behavioral abnormalities seen in their affected relatives, they are at increased risk of violence mainly during adolescence. However, studies including adolescents with schizophrenia first degree history are scarce.ObjectivesThe aim of this survey was to evaluate the aggressiveness among unaffected adolescents with fist degree family history of schizophrenia and in a control group of adolescents with no family psychiatric history.MethodsIn this purpose wo conducted a case-control cross sectional study in Razi hospital during three months: from July to September 2022. Unaffected adolescents aged 12 to 18 whom first-degree relatives were diagnosed with schizophrenia according to DSM-5 criteria were included. Adolescents with psychiatric conditions or medical affections associated with psychiatric presentation were not included. Control group was selected amongst the population. Sociodemographic data were collected on a preestablished questionnaire and the following scales were used: The Life History of Aggression LHA, an 11 items self-reported tool, in the Arabic version, The Aggression Questionnaire AQ which is a 29 items self-reported scale in Arabic version. Written informed consent was obtained from the legal tutor of each adolescent.ResultsResults of this survey are ongoing.ConclusionsResults of this survey are ongoing.Disclosure of InterestNone Declared

IntroductionDissociative identity disorder (DID) is a debilitating and controversial psychiatric disorder with a lifetime prevalence estimated around 1,5%. It remains underdiagnosed despite recognition in international classification of mental disorders. In fact, based on the DSM-5 criteria, DID is characterised by two or more distinct personality states that coincide, with fluctuating consciousness and changing access to autobiographical memory. The aetiology of DID has long been debated with recent neuroimaging evidence supporting the trauma model of this condition.ObjectivesThe aim of this presentation is to describe the case of a young female diagnosed with DID related to childhood trauma.MethodsWe also conducted a literature review in order to discuss the aetiology of the disorder. The following keywords were searched through the pubmed website: dissociative identity disorder, trauma, aetiology.ResultsWe report the case of a 20 years old female with no past medical, nor psychiatric history. However, she had a family history of an uncle and an aunt with chronic psychosis. Her father died when she was 8, thus she lived with her mother and her brother and two sisters. She was a brilliant student and started engineering studies. She has no particular personality trait. She was raised within a strict religious family with little time dedicated to leisure activities. Importantly, since the age of 10, she was exposed to her mother’s religious extremist and threatening discourses, related to death and “grave’s torture” and comprising many cultural beliefs. She seeks for psychiatric care complaining of “soliloquy” that became remarkable by her relatives. On psychiatric evaluation she presented daily fluctuating consciousness during at least one hour, in which she switches identity toward the daughter of a famous singer. This alter was having pleasant activity with her mother and was singing and hanging out most of the time. No particular triggers were identified. The trouble started by the age of 14 then worsened gradually and became an unvoluntary phenomenon with significant distress. She had no depressive nor psychotic nor anxiety or obsessive symptoms. Her sleep and appetite were not disturbed. She met DSM-5 diagnostic criteria for DID and was referred to a trained psychiatrist for adequate psychotherapy management.ConclusionsWe exposed a rare case of a young student complaining of soliloquy since the age of 14 that was diagnosed with DID subsequent to a particular childhood trauma which consisted in exposure to threatening religious and cultural beliefs about life after death told by her mother. This unique case emphasises the trauma model of DID, where the nature of the trauma influences the clinical expression of DID. Given the recent neuroimaging evidence, DID can be framed as a chronic psychiatric disorder based on neurobiological, cognitive, and interpersonal non-integration as a response to unbearable stress.Disclosure of InterestNone Declared

IntroductionAssessing the attitudes of family medicine residents toward schizophrenia is of greatest concern since family physicians potentially have a key role in identifying the signs and symptoms of schizophrenia at earlier stages and in engaging young people in treatment, especially in low- and middle-income countries.ObjectivesWe aimed to investigate attitudes towards schizophrenia in a group of Tunisian family medicine residents, and to examine the link between these attitudes and help-seeking intentions in this group.MethodsThis was a cross-sectional survey. A 18-item questionnaire concerning attitudes toward schizophrenia was used.ResultsA total of 88% participants have reported favorable help-seeking intentions. In total, 48.4% of residents would oppose if one of their relatives would like to marry someone who has schizophrenia, and 37.1% of them would not like to have a neighbor with schizophrenia. Only about a half of residents agreed that “schizophrenia has the chance of recovery”, and 68.8% thought that “schizophrenia can be treated”. Pearson correlations found a significant negative relationship between age and social distance in residents (p<.001). Year of residency was significantly associated with attitudes toward schizophrenia, with more unfavorable attitudes in third-year residents (p=.042). After controlling for potentially confounding sociodemographic variables, help-seeking intentions did not contribute to the prediction of attitudes toward schizophrenia in the residents.ConclusionsImplementing anti-stigma programs in medical schools may help improve future physicians’ attitudes and prepare them to provide primary mental health care to young help-seekers with psychosis should be given priority attention.

IntroductionCorpus callosum agenesis (CCA) is a rare congenital disorder in which there is a partial or complete absence of the corpus callosum. Within the framework of an anatomoclinical approach to schizophrenia, a few studies have focused on its association with neurological disorders, including CCA.ObjectivesIn this perspective, we report a rare case of an adolescent with intellectual disability, with whose complete CCA was revealed by a recent-onset schizophrenia.MethodsA case report and literature review.ResultsThe teenager M.A. is from a first degree consanguineous marriage. He had no family history, no special habits and no history of seizures. Since early childhood, he had had a psychomotor acquisition delay and relationship difficulties that tended to worsen later. At school, he was teased by his peers and failed 4 times in different rows. At the age of 15, he dropped out of school. Verbal and physical aggressiveness, soliloquy, unmotivated laughter and vague ideas of persecution suddenly appeared, hence his psychiatric consultation one month later. Neuropsychological tests indicated current low Intelligence Quotient (60). Brain imaging revealed complete ACC (see Figure 1). He was diagnosed with schizophrenia and put on antipsychotic treatment at adequate doses and durations, with poor therapeutic response.ConclusionsOur observation provides additional support for neurodevelopmental models of schizophrenia, and confirms literature data indicating that severe structural brain abnormalities would lead to early onset psychotic symptoms which are often refractory to pharmacological treatments

IntroductionFew people seek mental health care despite the high prevalence of mental illnesses and their serious consequences. Barriers explaining this lack or absence of help-seeking have been the subject of several studies with stigma being the most prominent barrier.ObjectivesWe aimed to assess the relationship between stigma and help-seeking intentions in a sample of Tunisian college students.MethodsThis was a cross-sectional survey. The “Mental Health Knowledge Schedule”, and the “Reported and Intended Behavior Scale” were administered to a total of 714 college students (62.2% female; mean age =20.9).ResultsMore than one-third of students (39.6%) felt that it would be “unlikely” or “very unlikely” to seek the help of a health professional for mental health problems. Pearson product moment correlations indicated that help-seeking intentions significantly and positively correlated with behavior (p<0.001, r=0,103) and knowledge (p<0.001, r=0,163). The multiple hierarchical linear regression analysis found that after controlling for demographic variables (gender, age) and other personal-related variables (marital status, family income, living environment, substance use, personal psychiatric history), help-seeking intentions were significant contributors to behaviors and knowledge.ConclusionsGiven that stigma and discrimination against people with mental illness is a real and perceived barrier to seeking help and treatment, psycho-educational campaigns should be put in place to address the negative perceptions and attitudes of the general population about mental health issues, and should be tailored to the needs of specific groups (including students in different disciplines), taking into account their attitudes, fear and concerns about mental illness.