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IntroductionOne of the common symptoms of schizophrenia is sleep disturbances, which can have a significant impact on the quality of life of patients. Several studies suggest the existence of a complex link between sleep disorders and agressive behavior in patients with schizophrenia.Objectivesto determine the impact of sleep disorders on aggressive behavior in patients with schizophrenia.MethodsWe conducted a cross-sectional, descriptive, and analytical study that took place over a period of one month (from 1st to 31nd March 2023) with patients consulting the post-cure of Psychiatry Service D at Razi Hospital, Tunisia. We included patients diagnosed with schizophrenia according to DSM5, and stabilized on a psychiatric plan. We used the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality over a period of one month. The Buss & Perry Aggression Questionnaire (QABP) was used to measure aspects of aggression. We used the Adult Social Relationships Scales (ASRS), part of the National Institute of Health (NIH) toolkit, assessing six domains of social relationships: perceived rejection, perceived hostility, loneliness, friendship, instrumental support and emotional support.ResultsWe collected data from 40 male patients with a mean age of 42.5 ± 14.02. The mean global PSQI score was 9.23 ± 4.58.Ten patients were on typical antipsychotics, 25 patients were on atypical antipsychotics, and the remaining five patients were on a combination therapy (both atypical and typical antipsychotics). Regarding the use of benzodiazepines, 34 patients were taking lorazepam at a dose of 2.5 to 5 mg per day. he mean QABP global score was 45 ± 12.3 out of 72.For the subjective evaluation, all patients self-reported feeling “irritable,” “dysphoric,” “unable to communicate with others,” and “wanting to break objects” when they experienced insomnia.We found a statistically significant association between QABP and daytime dysfunction (p=0.003).The overall PSQI score was higher, and statistically significantly associated, in patients who reported low emotional support (p=0.018) and perceived social rejection (p=0.04).ConclusionsAn integrated approach that includes the evaluation of sleep disorders, as well as the prevention and management of violence, can play a key role in the overall improvement of the mental health of patients with schizophrenia.Disclosure of InterestNone Declared

IntroductionHyperthyroidism, characterized by excessive production of thyroid hormones, is a common endocrine disorder that affects various body systems. While most commonly recognized for its classic symptoms such as weight loss, tremors, and palpitations, it is important to acknowledge that hyperthyroidism can also lead to a rare but significant complication: psychosis. Psychosis in the context of hyperthyroidism refers to the presence of delusions, hallucinations, and disordered thinking, which can significantly impact an individual’s mental health and overall well-being.ObjectivesThis case report aims to describe a rare case of hyperthyroidism-related psychosis in a patient including the clinical presentation, diagnosis, and management. Additionally, we aim to increase awareness of and promote further research into this condition.MethodsWe present a comprehensive case report detailing the clinical course of a 29-year-old male patient with no previous medical or psychiatric history, who sought urgent psychiatric evaluation at the Razi Hospital La Manouba’s emergency department due to escalating symptoms of agitation and paranoia persisting for three days. The patient, identified as Mr. S.O., a Tunisian male, presented with severe agitation and paranoia necessitating the use of restraints upon admission to the psychiatric emergency department. The initial physical examination revealed no notable abnormalities, except for the presence of tachycardia, which was subsequently confirmed on an electrocardiogram, arousing suspicion of a primary psychiatric illness.ResultsWhile the standard blood workup yielded unremarkable findings, the endocrine workup revealed decreased levels of thyroid-stimulating hormone (TSH) and elevated free thyroxine (FT4). Further laboratory investigations demonstrated elevated anti-thyroid-stimulating hormone receptor antibodies, leading to the diagnosis of Graves’ disease. Collaborative consultation with an endocrinologist resulted in the initiation of a treatment regimen consisting of methimazole, propranolol, and risperidone. Notably, within three days of the initiated therapy, the patient exhibited significant improvement in terms of reduced agitation, coherent speech, and the development of self-reflection regarding the episode, ultimately leading to his discharge on the seventh day of hospitalization. This case report serves to highlight the complexity of psychiatric presentations associated with underlying endocrine disorders and underscores the importance of interdisciplinary collaboration in achieving optimal patient outcomes.ConclusionsWhile mental health factors play a significant role in the development of psychosis, it is essential to recognize that underlying medical conditions may also contribute to its onset or exacerbation.Disclosure of InterestNone Declared

IntroductionFemale sexuality is a complex and multifactorial domain that can be influenced by a variety of psychological, biological, relational, and sociocultural factors. However, sexual dysfunctions in women remain a taboo subject in many cultures and are often underestimated, underdiagnosed, and undertreated. In Tunisia, few studies have been conducted to assess the prevalence of sexual dysfunctions in women and their predictive factors.Objectivesto determine the prevalence of sexual dysfunctions in a group of Tunisian women and to identify the predictive factors of these dysfunctions.MethodsThis is a cross-sectional, descriptive, and analytical study, over a period of three months, from September to December 2022, conducted online via a pre-established questionnaire to collect various sociodemographic data, personal history, psychoactive substance consumption, weight, and height. We used the Female Sexual Function Index (FSFI) scale to evaluate sexual functioning in participants. We recruited sexually active Tunisian women over 18 years of age who agreed to anonymously respond to the questionnaire. The form was disseminated on social networks, in groups that focus on women, with a rate of three publications per week.ResultsWe collected data from 90 women with a mean age of 35 ± 12.84 years.More than half of our population (60%, n=54) had at least one sexual dysfunction.The most common sexual dysfunctions reported were arousal disorders (31.3%), followed by desire disorders (26.8%) orgasm disorders (12.4%).We found that several factors were significantly associated with sexual dysfunctions : Women over 45 years of âge (p<10-3), who are divorced (p=0,02), have a low socioeconomic status (p=0,04), and report having experienced traumatic romantic/sexual expériences (p<10-3) were found to have a higher prevalence of sexual dysfunctions.According to our results, cannabis consumption had a negative impact on lubrication (p<10-3) and orgasm (p=0.003) among our study respondents. Personal psychiatric history also had a negative influence on arousal (p=0.02) and sexual satisfaction (p=0.01).ConclusionsBy identifying sexual dysfunctions early and treating them effectively, we can improve the quality of life of those affected and avoid serious consequences on their physical and mental health. It is therefore crucial to promote a proactive approach to sexual health and encourage healthcare professionals to approach sexuality openly and comprehensively.Disclosure of InterestNone Declared

IntroductionSleep disturbances and suicidal behaviors are common among patients with type II bipolar disorder ( BDII), but the relationship between the two is unclear. Investigating this connection is important to identify interventions that can improve the quality of life and reduce the risk of suicide in this population.ObjectivesOur study’s objective is to examine the association between sleep disorders and suicidal behavior in patients with type II bipolar disorder (BDII).MethodsIn order to comprehensively investigate the association between sleep disturbances and suicidal behaviors among individuals diagnosed with type II bipolar disorder (TBII), we conducted a cross-sectional, descriptive, and analytical study over a duration of one month, specifically from the 1st to the 31st of October 2022. Our research was conducted within the follow-up unit of the mental health department at Nabeul Hospital, Tunisia, with the aim of capturing a diverse range of participants representative of the population of interest.To ensure the integrity and accuracy of our findings, we meticulously selected participants who met specific eligibility criteria. This included individuals aged between 18 and 60 years, who had a confirmed diagnosis of type II bipolar disorder according to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM V). Furthermore, we sought to include participants who were psychiatrically stable, meaning they had not required hospitalization in the six months preceding the study.The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the participants’ sleep quality over a one-month period, while the Suicidal Behavior Questionnaire-Revised (SBQ-R) was used to assess suicidal behavior.The data was gathered through a questionnaire that prioritized ethical concerns, including obtaining informed consent from participants and maintaining confidentiality and anonymity throughout the study.ResultsIn this study, we enrolled 40 male patients with a mean age of 36 ± 13.2 years and evaluated their sleep quality and suicidal behaviors. The results showed that the participants had a mean PSQI score of 7.28 ± 3.35, indicating that the overall sleep quality was not optimal. Specifically, 65% of the participants had poor sleep quality (> 5), and 45% reported poor sleep(PSQI ≥ 8) . The mean SBQ-R score was 10.3 ± 3.6, indicating a moderate level of suicidal behavior. Interestingly, we found a statistically significant correlation between PSQI and SBQ-R subscales, particularly with regard to suicidal thoughts (p=0.003) and suicide attempts (p=0.002).ConclusionsOur study found a strong link between sleep problems and suicidal behavior in people with type II bipolar disorder. This highlights the need to address sleep issues to reduce suicide risk in these patients.Disclosure of InterestNone Declared

IntroductionSleep disorders are a significant concern for patients with schizophrenia, and they can have a profound impact on their quality of life. Studies have shown that sleep disturbances are prevalent in patients with schizophrenia, and they may be linked to the clinical characteristics of the disorder. Despite this, the exact nature of the relationship between sleep disorders and schizophrenia remains unclear. Understanding this relationship is critical as it may lead to better diagnosis and treatment of both conditions, ultimately improving the overall health and wellbeing of patients.ObjectivesTo establish the link between sleep disorders and clinical characteristics in a clinical population being treated for schizophrenia.MethodsWe conducted a cross-sectional, descriptive, and analytical study that took place over a period of one month (from 1st to 31nd March 2023) among patients consulting the post-care service of Psychiatry Department D at Razi Hospital, Tunisia. We included patients aged between 18 and 65 years, diagnosed with schizophrenia according to DSM-5, and stabilized on psychiatric treatment. We used the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality over a period of one month. The evaluation of the clinical characteristics of schizophrenia was carried out using the Positive and Negative Syndrome Scale (PANSS).The interview was conducted by a single researcher, and when the questionnaire was distributed to the participants, we explained the framework and the principle of this study as well as the implications of participating in it and explained that the participant could stop participating at any time if he or she wished.ResultsWe collected data from 30 male patients with a mean age of 42.5 ± 14.02. The mean overall PSQI score was 9.23 ± 4.58. The subscales evaluating the subjective quality of sleep obtained an average score of 1.42 ± 0.72, sleep latency was 1.61 ± 1.33, sleep duration was 1.01 ± 0.98, habitual sleep efficiency was 0.67 ± 0.75, sleep disturbances were 0.91 ± 0.52, sleep medication use was 1.36 ± 1.68, and daytime dysfunction was 1.12 ± 0.96. The mean scores of PANSS were: positive scale (28.26 ± 5.93), negative scale (18 ± 6.15), and general psychopathology scale (90.03 ± 16.21). We found a statistically significant association between the positive PANSS scale and sleep latency (p=0.002) and sleep medication use (p<10-3).ConclusionsThe findings highlight the importance of evaluating and addressing sleep disturbances in the overall management of patients with schizophrenia, as they may have an impact on the severity of clinical symptoms.Disclosure of InterestNone Declared

IntroductionSleep disruptions are frequently observed in individuals with bipolar disorder and have been linked to various unfavorable consequences, such as an elevated risk of relapse and lower quality of life. Nonetheless, the impact of sociodemographic factors on the development and progression of these disruptions remains largely unexplored. Gaining insight into the relationship between sleep disruptions and sociodemographic factors is essential for designing effective interventions and enhancing clinical outcomes for individuals affected by bipolar disorderObjectivesThe objective of this study is to examine the association between sleep disorders in patients with bipolar disorder II (BDII) and sociodemographic characteristics.MethodsThis is a cross-sectional, descriptive, and analytical study that was conducted over a one-month period from October 1 to October 31, 2022, with patients attending the follow-up unit of the mental health department at Nabeul Hospital ,Tunisia.The study employed a questionnaire as a tool for data collection, and participants provided voluntary and informed consent before responding. The protection of participant confidentiality and anonymity was carefully observed during all stages of the study.ResultsIn this study, we enrolled patients who satisfied the following eligibility criteria: age range of 18 to 60 years, a confirmed diagnosis of type II bipolar disorder based on DSM V criteria, and psychiatric stability as demonstrated by no hospitalization within the preceding 6-month period.Our study included a sample of 40 male patients diagnosed with type II bipolar disorder. The participants had a mean age of 36 ± 13.2 years, and the majority were unmarried and living with their families or alone. Over two-thirds of the participants had attained a university level of education, while a large proportion of the patients, specifically 80%, reported being regular smokers.The results of the study revealed that the mean global score on the Pittsburgh Sleep Quality Index (PSQI) was 7.28 ± 3.35, indicating an overall low quality of sleep. The majority of the participants, that is 65% (26), had poor sleep quality scores (> 5), while 45% (18) reported experiencing poor sleep (PSQI ≥ 8).Our analyses further demonstrated that there was a significant association between tobacco consumption and PSQI scores (p=0.003). Additionally, we found that participants who were above 40 years old had a higher likelihood of experiencing sleep disturbances (p=0.0017).ConclusionsAccording to the findings of our study, it appears that patients diagnosed with type II bipolar disorder may experience impaired sleep quality, which can be influenced by age and tobacco consumption. These results underscore the need for a holistic approach to patient care that addresses both the biological and sociodemographic factors that can impact sleep in this population.Disclosure of InterestNone Declared

IntroductionSchizophrenia is a debilitating mental illness that can cause significant disruptions in a person’s life, leading to difficulty with thinking, emotions, and behaviors. While the symptoms of schizophrenia are well-known and extensively studied, comorbidities like eating disorders are often overlooked and undertreated, despite their prevalence in patients with schizophrenia.Objectivesdetermine the different eating attitudes among schizophrenic patients and establish the link between eating attitudes, age, weight status, and psychotropic medication.MethodsThis is a cross-sectional and descriptive study that took place from September to November 2022 among patients who consulted the post-care consultations of Psychiatry D service at Razi Hospital, Tunisia. We included patients who had been followed for at least one year for schizophrenia according to the diagnostic criteria of DSM-V and who had not relapsed for at least 2 months. The collection of sociodemographic and clinical data was done retrospectively by referring to the patients’ clinical records. Anthropometric measurements (weight, height, waist circumference, etc.) were recorded for each participant at the end of the interview. The Three-Factor Eating Questionnaire (TFEQ) was used to analyze eating attitudes.ResultsAccording to our results among 30 patients followed for schizophrenia, 74% were men with a mean age of 45 years (3.8). Sixty percent of the participants had a BMI <18.5, 35% had a BMI between 18.5 and 25, and the rest had a BMI greater than 25. on the therapeutic level, 12 patients were on olanzapine, 15 patients were on risperidone and the rest were on haloperidol. The TFEQ score shows that uncontrolled eating was the most prevalent attitude in our population. A statistically positive association was found between uncontrolled eating and the use of olanzapine (p<0.05).ConclusionsOur study contributes to draw the attention of mental health professionals to the screening of eating disorders in patients followed for long term mental disorders and insists on multidisciplinary management to ensure a better quality of life for patients.Disclosure of InterestNone Declared

IntroductionSeveral 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.ObjectivesTo determine the factors influencing the perception of fetal loss in grieving mothers.MethodsThis 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)ResultsThe 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).ConclusionsTo 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 InterestNone Declared

IntroductionGambling disorder involves repeated problematic gambling behavior that causes significant problems or distress. It is also called gambling addiction or compulsive gambling.In Tunisia, a muslum country, gambling is prohibited and casinos are non-existent or only for tourists with foreign currency. Lately, with the spread of casinos online and sites of sports betting, gambling’s become problematic in Tunisia. People accumulated huge debts with feelings of shame and guilt leading to suicidal attempts.ObjectivesStudying the link between gambling disorder and suicidal attempts and comparing the different preventive measures proposed for online gambling.Methodsa case of a patient with gambling disorder that was hospitalized in a psychiatric hospital for a suicidal attempt by stabbing himself and a review of a literature.ResultsMr R.A was a 42-year-old man with no family nor personal psychiatric history. He has no history of a particular substance use disorder. He was married and a father of two children and has a regular job.A year ago, he stated gambling on internet sites using his phone cell and, in several months, he lost a lot of money and accumulated debts.Lately he committed two attempts of suicide. The first one was by swallowing rat poison. The second one was a month later, by stabbing himself with a knife that caused evisceration and required surgery then an hospitalization in a psychiatric unit.ConclusionsThere’s evidence that GD and SB are associated, although there’s disagreement about the nature of this association. Adequate preventive measures should be considered by governmentsDisclosureNo significant relationships.

IntroductionAnxiety manifestations are one of the most described symptoms during pregnancy. Meanwhile, the effect of the coronavirus disease 2019 (COVID-19) pandemic on the mental health and anxiety distress in particular, of pregnant and postpartum women remains unclear.ObjectivesThe purpose of our study was to evaluate anxiety among prgnant women during covid19 and describe its associated factorsMethodsIt was a comparative cross-sectional case- control study in a Tunisian gynecologic department. All women were in the third term of pregnancy. Anxiety symptoms were evaluated using Beck Anxiety Inventory (BAI). The data were compared to a control group assessed in a similar study conducted before the pandemic in the same city. Eighty pregnant women was investigated during the covid pandemic and 100 pregnant women investigated before the COVID-19 outbreak in Tunisia was assigned to the control group.ResultsPregnant women during COVID-19 scored less on BAI than controls (15.49±9.223 vs 17.40±7.410). Less patients presented moderate to severe anxiety during pandemic (38.8% (n=31) than controls 51% (n=51)). The difference between groups in means and prevalence values was not significant. The negative results could be related to the low power of the test (P=0.36).ConclusionsDespite the expected psychological distress among vulnerable population , Covid-19 didn’t impact anxiety prevalence or scores among pregnant women in our current study .DisclosureNo significant relationships.