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ObjectivesBreast cancer is the most frequent solid cancer among menopausal women. The main objective of this study is to evaluate the body image and the sexual function in menopausal women diagnosed with nonmetastatic and operable breast cancer.MethodsThis is a prospective cohort-type study of 200 menopausal women diagnosed then operated on for breast carcinoma between January 2017 and January 2019 in the department of Gynecology and Obstetrics of Farhat Hached Teaching Hospital Sousse, Tunisia. Patients were stratified based on whether they underwent conservative (G1) or radical (G2) breast surgery.The data collection used 2 standardized psychometric assessment scales validated in Arabic:The Body-Esteem Scale for Adolescents and Adults (BESAA) for the evaluation of the body image and The Arab Female Sexual Function Index (ArFSFI) for evaluation of sexual function.ResultsThe two groups were comparable in terms of age and of socio-economical characteristics of the patients and their spouses. The median tumor size at the time of cancer diagnosis was 3.6 cm (± 1.2) in G1 and 6.1 cm (± 2.6). The body image was lower after mastectomy with a significant difference for the item appearance( p = 0.047); without influencing any aspect of the sexual function. The results concerning the sexual function are synthesized in the following table 1.There is an inversely positive correlation between the husband’s education level and the feminine sexual dysfunction p = 0.042.Abstract 338 Table 1Comparison of the sexual function scores according to the Arab Female Sexual Function Index (ArFSFI)ConclusionAlthough the body image esteem is lower after mastectomy in menopausal women, there is no difference in their sexual function.

IntroductionPost-traumatic stress disorder affects emotional, social and professional functioning. It can also affect physical and sexual health.ObjectivesThe aim of this study is to write down the prevalence of sexual dysfunction in men with PTSD and to economize on potential predictors of sexual dysfunction.MethodsA total of 30 male patients with PTSD were included in this study. We collected socio-demographic and clinical data and we used Post-Traumatic Stress Disorder (PCLS) and International Erectile Function Index (IIEF15) scales.ResultsThe mean PTSD severity score was 65.43 ± 2.95. The mean score for revitalization, avoidance, cognitive and mood alteration, and hypervigilance were 15.80 ± 1.44, respectively; 8 ± 0; 24.07 ± 1.20 and 17.57 ± 2.95. The mean IIEF-15 score was 51.16 ± 6.82. The mean sub-scores were 3.93 ± 0.52 for sexual desire; 18.80 ± 5.68 for erectile function; 8.93 ± 8.97 for orgasmic function; 5.13 ± 1.10 for satisfaction with intercourses and 4.13 ± 1.16 for overall satisfaction. The IIEF15-EF score was negatively correlated with the presence of a personal medical history (p = 0.02) and the impairment cognitions and mood score (p = 0.023). The IIEF-OF score was significantly associated with reviviscence, hypervigilance, cognition and mood alterations (p = 0.015; 0.041; 0.045). The IIEF-15 SD score was negatively correlated with altered cognition and mood (p = 0.007).ConclusionsOur study focused on the importance of assessing sexual function in men followed for PTSD and helps to understand the association of PTSD with different types of sexual dysfunction.

IntroductionExposure to extreme traumatic events can lead to post-traumatic stress disorder (PTSD). This disorder affects emotional, social and professional functioning. Recent studies suggest that it can lead to sexual dysfunction.ObjectivesThe aim of this study is to compare the level of sexual dysfunction between men with PTSD and control subjects.MethodsA total of 30 male PTSD patients and 30 controls were included in this study. We used the Post-Traumatic Stress Disorder Check Scale (PCLS) to assess the intensity of PTSD symptoms and the International Erectile Function Index (IIEF15) to assess sexual dysfunction of both patients and controls.ResultsThe mean IIEF-15 score was 51.16 ± 6.82 in patients followed for PTSD versus 77.33 ± 2.02 in healthy controls with a non-significant difference (p = 0.26). Three patients (10%) had an alteration of desire while the control reported only dysfunction but there was no significant difference between the mean scores of IIEF-SD (p = 0.22). No patient or control had erectile dysfunction and there was no significant difference between the IIEF-EF sub-scores in the 2 groups (p = 0.20). The mean sexual intercourse satisfaction (SD) score in the patients was 5.13 ± 1.10 versus 8.86 ± 0.40 with a non-significant difference (p = 0.09). Altered satisfaction with intercourse was noted in 15% (n = 5) of subjects with PTSD versus a single control.ConclusionsIt is important that practitioners address the subject of sexuality in patients followed for PTSD and refer their patients, if necessary, to a sexology consultation.

IntroductionVarious therapeutic approaches for post-traumatic stress disorder have been the subject of numerous studies. Antidepressants are sometimes used in PTSD. They improve the symptoms of PTSD. But their effect is not clear on the sexual dysfunctions that accompany this disorder.ObjectivesThe aim of this study is to display the effect of antidepressants on sexual dysfunctions in men with PTSD.MethodsA total of 30 male patients with PTSD were included in this study. The International Erectile Function Index (IIEF15) was used to assess sexual dysfunction in participants before treatment and two months after starting antidepressant treatment.ResultsHalf of the patients (50%) used sertraline, 23% paroxetine, 20% fluoxetine and 7% escitalopram.The mean IIEF-15 score was 51.16 ± 6.82 in patients with PTSD before initiation of treatment. The average scores of the areas of sexuality studied by this scale were 3.93 ± 0.52 for sexual desire; 18.80 ± 5.68 for erectile function; 8.93 ± 8.97 for orgasmic function; 5.13 ± 1.10 for satisfaction with intercourse and 4.13 ± 1.16 for overall satisfaction. After 2 months of use of the antidepressant treatment, there was a statistically significant improvement in sexual functions: significant increase in the total score of the IIEF15 (p <0.001), and in the mean scores of the areas of sexuality.ConclusionsAntidepressant treatment could, by improving post-traumatic symptoms, improve sexual dysfunction.

Introduction : Le cancer est à l’origine de détresse psychologique alourdissant les morbidités des patients. Le cancer colorectal constitue un problème de santé publique de par son ampleur et sa gravité, en plus de son retentissement psychologique chez les patients et chez leur entourage. Notre objectif est de déterminer la prévalence de la dépression et de l’anxiété chez un groupe de patients tunisiens atteints de cancer colorectal et d’en rechercher les éventuelles relations avec les données cliniques. Patients et méthodes : Nous avons mené une étude observationnelle longitudinale prospective durant six mois (de mars à août 2017) colligeant tous les patients présentant un cancer colorectal et suivis à la consultation d’oncologie médicale au CHU Farhat-Hached à Sousse (Tunisie). En plus d’une grille à remplir par l’enquêteur se rapportant aux données épidémiologiques et cliniques du patient après l’entretien et la consultation du dossier médical, la mesure de l’anxiété et de la dépression a été faite à l’aide d’un autoquestionnaire validé en langue arabe : l’Hospital Anxiety and Depression Scale (HADS). La saisie et l’analyse des données ont été faites par le logiciel SPSS V20.0. Résultats : Cinquante-deux patients ont accepté de répondre à notre questionnaire. Ils étaient répartis en 28 femmes et 24 hommes ; l’âge moyen était de 57 ± 13 ans, la durée moyenne de la maladie était de 3,2 ± 1 ans. Les patients inclus dans l’étude étaient au stade métastatique (stade IV) de leur maladie dans 27%des cas. Nos patients ont bénéficié d’un traitement curatif dans 54 % des cas, d’une chirurgie de la tumeur primitive dans 88,6 %, d’une chimiothérapie dans 94,3 %, d’une radiothérapie dans 34,6 %, et 15,5 % ont reçu le cetuximab. La dépression détectée auprès de nos patients était douteuse dans 17,3 %et certaine dans 13,5 %. L’anxiété était douteuse chez 13,5 % et certaine dans 7,5 %. Une corrélation positive significative a été mise en évidence entre d’une part la symptomatologie dépressive et d’autre part le stade métastatique de la maladie ( r = 0,741, p = 0,042), la présence de stomie ( r = 0,811 ; p = 0,005), la fatigue ( r = 0,720 ; p = 0,005) et les effets indésirables à type de nausée et vomissement ( r = 0,653 ; p = 0,045). Conclusion : Il existe une forte prévalence de la dépression et de l’anxiété chez les patients atteints de cancer colorectal dans notre travail. Ces troubles psychiques devraient être systématiquement recherchés afin de préconiser une prise en charge adéquate de ces patients dans leur parcours de soins. Background : Cancer causes psychological distress that impairs patient’s morbidity. Colorectal cancer is a public health problem because of its severity and impact, in addition to its psychological consequences on patients and their entourage. The aim of this work is to determine the prevalence of depression and anxiety in a group of Tunisian patients with colorectal cancer, and its correlations with clinical factors. Patients and methods : We have conducted a prospective longitudinal observational study for 6 months (from March to August 2017) collecting all patients with colorectal cancer that were treated and followed up in the medical oncology consultation at CHU Farhat Hached in Sousse (Tunisia). Assessment was based on a grid to be completed by the investigator. It contains epidemiological and clinical data based on medical records and a validated self-questionnaire measuring depression and anxiety (Hospital Anxiety and Depression Scale (HADS)). Data entry and analysis were performed by SPSS V20.0 software. Results : Fifty-two patients were enrolled into the study. They were divided into 28 women and 24 men; their mean age was 57 ± 13 years, the mean disease’s duration was 3.2 ± 1 year. Metastatic stage (stage IV) was found in 27% of cases. Fiftyfour percent of our patients had curative treatment, 88.6% had surgery of their primary tumor, 94.3% had chemotherapy, 34.6% had radiotherapy, and 15.5% had received cetuximab. Doubtful depression concerned 17.3% of patients and 13.5% of them had a sure depression, 13.5% scored a doubtful anxiety and 7.5% had a sure anxiety. A significant positive correlation was noted between depression and metastatic stage ( r = 0.741, P = 0.042), presence of ostomy ( r = 0.811; P = 0.005), fatigue ( r = 0.720; P = 0.005) and adverse events like nausea and vomiting ( r = 0.653; P = 0.045). Conclusion : There is a high prevalence of depression and anxiety in patients with colorectal cancer in our study. These disorders should be systematically screened in order to provide comprehensive care for patients.

ObjectivesBreast cancer of young women is the most frequent solid cancer among women under 40. The main objective of this study is to evaluate the impact of the surgery for non-metastatic and operable breast cancer in young women on their couple’s relationship.MethodsThis is a prospective cohort-type study of 200 women under the age of 40 operated on for breast carcinoma between 2016 and 2019 in the department of Gynecology and Obstetrics of Farhat Hached Teaching Hospital Sousse, Tunisia. Patients were stratified based on whether they underwent conservative (G1) or radical (G2) breast surgery.The patient‘s couple relationships were evaluated by The Locke and Wallace Marital Adjustment Test (MAT): a standardized psychometric assessment scale validated in Arabic.ResultsThe two groups were comparable in terms of age and socio-economical characteristics of the patients and their spouses.The median tumor size at the time of cancer diagnosis was 3 cm (± 1.2) in G1 and 5.7 cm (± 1.4).The median MAT questionnaire score was 112 (± 31) in G1 and 124 (± 13) in G2 with p = 0.064.A couple dysfunction was found in 42% of G1 patients and 47% of G2 patients with a p = 0.136.ConclusionThe breast surgery technique for breast cancer (conservative treatment versus mastectomy without reconstruction) does not influence the marital agreement in young Tunisian married women diagnosed and operated in for breast cancer before the age of 40.

Sexual dysfunction is frequent in patients with schizophrenia compared to the general population. Screening for this dysfunction seems essential, and a scale such as the Arizona Sexual Experience (ASEX) Scale may help practitioners. The aim of this study was to assess the validity of the Arabic version of the ASEX scale. Arabic translation of the ASEX scale was obtained by the “forward/backward translation” method. Adaptations were made after a pre-test including ten outpatients with schizophrenia. For validation, one hundred outpatients with schizophrenia were recruited in the psychiatric department in Sousse (Tunisia) during a period of three months. Internal consistency was assessed by Cronbach alpha coefficient and test-retest was conducted by use of Pearson correlation. For factor analysis, principal components analysis and Varimax rotation were adopted. The study of internal consistency between the 5 Items was found to be good (α=0.82). The test-retest reliability was satisfactory (r=0.92, p<10−3). Regarding construct validity, factor analysis revealed one factor that was responsible for 83.7% of the variance. This study assessed the reliability and validity of the Arabic version of the ASEX scale. These findings demonstrate the highly acceptable psychometric properties of ASEX in patients with schizophrenia.

If the severity of dermatitis artefacta (DA) is accepted by most authors, few published studies have sought to clarify its etiology and impact. It is in this context that this work aimed to compare Life Events (LE) and quality of life (QoL) scores in patients with DA, in their siblings and in control patients with other chronic dermatological diseases. This is a descriptive and comparative cross-sectional study carried out in the dermatology department of Farhat Hached hospital in Sousse, Tunisia. Thirty female patients diagnosed with DA according to DSM-IV criteria were retrospectively recruited. For each patient with DA, one of her sisters, the closest in age, was enrolled in the siblings group. The control group consisted of thirty female patients with other chronic dermatological diseases, matched with DA patients for age and duration of disease progression. Assessment was based on Paykel inventory for LE and on SF-36 for QoL. Compared to both control groups, DA patients reported more LE with more objective negative impact of these events and had a lower score and more often impaired mean global score of QoL. LE would have a role in the pathogenesis of DA which seems to alter the QoL of patients. These results could help to improve the understanding of DA and incite clinicians to focus not only on the diagnosis and treatment of DA but also on the impact of this disease.

Non-adherence to treatment in patients with schizophrenia is associated with increased hospitalization, higher health care costs, and poorer long-term outcomes in terms of relapse rates. It is established that a negative drug attitude was a risk factor for non-adherence in long-term schizophrenia. The scale “Drug Attitude Inventory\" is one of the scales designed to assess this concept. It has been translated and validated in different languages. However, its psychometric properties have not yet been studied in our sociocultural context. The aims of this study were to translate into Tunisian Arabic dialect the scale “Drug Attitude Inventory\" with 30 dichotomous items (DAI-30) and validate it in Tunisian sociocultural context in patients with schizophrenia. This study was performed in 234 outpatients with schizophrenia, recruited through a random drawing. These patients are in remission and meet remission criteria proposed by “The Remission in schizophrenia Working Group\". We recruited 30 patients for pretest and 204 patients for linguistic validation. Forward and backward translation of the DAI-30 was performed according to the protocol of the “MAPI Research Institute\". This final version was submitted to 24 experts and followed by a pretest. Construct validity has been established by performing a principal component analysis factor on a sample of 204 patients. Internal consistency was assessed by Cronbach alpha coefficient and inter-rater reliability was assessed by the use of Intra-Class Correlation coefficient (ICC). For the test–retest reliability evaluation, the “r” Pearson's coefficient was used between the DAI scores obtained in the initial evaluation and those obtained at 15 days. Regarding construct validity, factor analysis revealed seven factors that were responsible for 59.9% of the variance. The study of internal consistency between the 30 items was rated good (α=0.88). The test–retest reliability was satisfactory (r=0.99, p<10−3), as well as inter-rater reliability (ICC=0.99). In the Tunisian cultural context, the DAI-30 presented seven factors with good consistency and an inter-rater reliability.

The linear and nonlinear viscoelastic behaviors of poly(ethylene oxide) (PEO) in aqueous media have been investigated as a function of concentration and molecular weight. A particular interest has been paid to study the effect of turbulent flow under stirring, inducing both shear and elongational stresses, on the rheological behavior of the polymer solutions. The comparison of intrinsic viscosity and viscoelastic properties between shaken and stirred PEO solutions is discussed at the molecular scale in terms of chain scission and aggregation. Results point out that the effect of the mechanical history on the rheological response of PEO solutions depends also on the concentration regime and molecular weight. Indeed, the influence of the dispersion procedure vanishes by decreasing both the concentration and the molecular weight.