Explore the vast range of titles available.

IntroductionSchizophrenia is characterised by a loss of contact with reality due to the presence in its symptomatology of a delusional and/or hallucinatory syndrome, also called positive symptoms and/or a dissociative syndrome, which reflects the negative component of the disease. Few studies suggest a probable link between testosterone and the symptomatic dimension of schizophrenia, but this subject remains poorly documented.ObjectivesThe purpose of this study was to describe Testosterone profile in male patients with schizophrenia who are naïve to antipsychotic treatment or have been off it for at least two months and to investigate the relationship between testosterone levels and disease severity.MethodsThis was a descriptive, cross-sectional study of fifty male patients hospitalized for a psychotic relapse who were naïve or discontinuing treatment for at least two months. Patients were assessed using a semi-structured questionnaire and The Positive and Negative Syndrome Scale (PANSS). A blood sample was taken to measure testosterone level.ResultsThe age of the patients included ranged from 17 to 65 years, with an average of 36.4±11.51 years. The PANSS score ranged from 50 to 195 with a mean of 116.76 +/- 31.817. Testosterone values ranged from 2.01 to 10.03 ng/ml with a mean of 4.74± 2.01 ng/ml. The majority had normal testosterone levels (94%) ; only 4% had high values and 2% had low values. A positive correlation was found between the positive component of PANSS and elevated testosterone (p=0.011). For the other subscales, no correlation with testosterone levels.ConclusionsThe present study is in favour of a testosterone aggravation of the mostly positive clinical signs of the disease in a significant way. Hormone assays could thus be a specific marker of certain patient profile with a particular evolution.Disclosure of InterestNone Declared

IntroductionCannabis was used as a medicinal plant in Asia before the Christian era. Nowadays, after 40years of a “war on drugs” with an illegal status, there is a big interest on the use of cannabis in some medical conditions. With more and more users revealing having used this substance to cope with certain psychiatric manifestations, researchers have tried to explore this substance in the psychiatric field where the actual pharmacological treatments and psychotherapy remain ineffective in some cases.ObjectivesTo Explore the medical use of cannabis in psychiatric disorders.MethodsA literature review was based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar over the last 10 years.ResultsGiving the interactions between cannabinoids and specific neurotransmitters, it has been suggested that cannabis may have medical effect on some psychiatric illnesses. In this direction, a significant overlap has been demonstrated between PTSD and cannabis use. CBD a non-psychotomimetic cannabinoid, seemed to show promising results as an enhancer of fear extinction and therapeutic consolidation of emotional memories. Military veterans are increasingly using it for reducing induced nightmares although this residual symptom remains difficult to treat. No benefit for improving depression was proved. One isolated study indicated a potential efficacy for cannabinoid combined with terpene in ADHD.ConclusionsStudies exploring the possibility of using cannabis in the treatment of psychiatric illnesses are promising but it is premature to recommend this drug for the moment especially since it requires gradual titration, regular assessment and precaution in certain diseases.DisclosureNo significant relationships.

IntroductionHypokalemia is often detected on standard biological assessments of patients hospitalized for psychiatric disorders. Many explanations are advanced by clinicians like insufficient food intake or drug effects. But what if there was a relationship between this ionic disorder and psychotic relapses?ObjectivesTo assess the frequency of hypokalemia in patients hospitalized for a psychotic relapse and to study its relationship with certain clinical characteristics.MethodsThis is a cross-sectional study conducted over a 3-month period (july-september 2021), including 37 male patients diagnosed with schizophrenia and hospitalized in a psychiatric unit for a psychotic relapse. Patients had blood collection before medication that was sent for a complete blood count and blood chemistry testing.ResultsBlood potassium level ranged from 2.92 to 4.87 mmol/L with an average of 3.74 mmol/l. Half patients ( 54.1% , N=20 ) had hypokalemia. Among them, two had electric signs on their ECG and two had physical symptoms. In patients with hypokalemia, the cause of hospitalization was the agitation in 80% of cases versus 58.8% in patients with normal potassium levels. The correlation was not significant between hypokalemia and the use of a restraint (p=0.160) or the somatic history (p=0.495).Conclusionshypokalemia is an ionic disorder that should be detected in patients with schizophrenia. It exposes the patient to the risk of a sudden death, especially with use of antipsychotics that are at a high risk for torsade de pointes.DisclosureNo significant relationships.

IntroductionMore than half patients with schizophrenia are smokers. Heavy smoking has been correlated to more severe positive symptoms, a higher number of hospitalizations and a less efficiency of antipsychotics. Unfortunately, abstinence is difficult to achieve in these patients, therefore it is importance of understanding the link between smoking and psychosis.ObjectivesAnalyzing the complex relationship between schizophrenia and nicotine’s effects on the human brain.MethodsThe study was a review of literature over the past 10 years based on the pubmed database.ResultsSmoking might be a precipitating factor in the development of schizophrenia since it preceded the onset of this illness for several years.Shared genetic background was also emphasized establishing a complex biological link between nicotine and schizophrenia.In another approach, the “self-medication hypothesis” has been proposed suggesting a beneficial effect of nicotine on both cognitive impairment and negative symptoms in schizophrenia, related to the regulation of the dopamine and nicotinic receptor systems. But this conclusion is controversial since other studies concluded to a more neurocognitive impairment in smokers compared to controlled population.ConclusionsSmoking in schizophrenia is a complex “phenomenon” that remains, so far, misunderstood. Greater differences might exist between heavy and light smokers making it more difficult to point out the exact effect of nicotine on the brain. Smoking cessation therapies taking into account the specificity of patients with schizophrenia should be more developed.DisclosureNo significant relationships.

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.

IntroductionSchizophrenia is a chronic and multifactorial mental disorder. Research suggests the presence of an abnormality in prolactin secretion during the genesis of the disease and at the same time, the involvement of genetics in its pathogenesis has long been the demand of researchers in the field of genetics since familial forms of schizophrenia have been observed.ObjectivesThe objective of this study was to describe the prolactin profile and and to study its relationship to the patients’ family history of pyshciatric illness.MethodsThis was a descriptive, cross-sectional study of thirty male patients hospitalized for a psychotic relapse who were naïve or discontinuing treatment for at least two months. Patients were assessed using a semi-structured questionnaire. A blood sample was taken to measure levels of prolactin.ResultsThe age ranged from 17 to 56 years. Most patients had a family medical history. Twenty patients (66%) had a family psychiatric history of schizophrenia (56%), mental retardation (3%), personality disorder (3%) and schizoaffective disorder (3%). Prolactin levels ranged from 0.5 to 45.67 ng/mL with a mean of 14.03 ng/mL. Seven patients (23%) had hyperprolactinaemia. All patients with hyperprolactinaemia had a family history of psychiatry with a statistically significant difference (p= 0.033).ConclusionsHyperprolactinemia could be one of the “endophenotypes” that reflect a vulnerability to schizophrenia, found in familial forms of the disease. In this context, longitudinal studies on a larger scale and family studies including siblings without schizophrenia should be undertaken.Disclosure of InterestNone Declared

IntroductionPatients in psychotic relapse may exhibit violent behavior towards objects, themselves or others. These behaviors, although usually unconscious, are a common reason for hospitalization and a source of rejection and stigmatization by family and society.ObjectivesThe objective of this study was to evaluate the presence of aggressive behavior in relapsed inpatients with schizophrenia in the F psychiatry department at the Razi Hospital in Tunisia.MethodsThis was a descriptive, cross-sectional study of fifty male patients hospitalized for a psychotic relapse who were naïve or discontinuing treatment for at least two months. Patients were assessed using a semi-structured questionnaire and the Overt Aggression Scale (OAS).ResultsThe age of the patients included ranged from 17 to 65 years, with an average of 36.4±11.51 years. More than half of the patients were without occupation (58%, N= 29). For personnal history : Seven patients (14%) had attempted suicide ; Eight patients (16%) showed evidence of self-harm ; Thirteen patients (26%) had a history of arrests of which eleven (22%) were incarcerated.The OAS score ranged from to 0 to 35 with a mean at 9.7+/- 10.3. Twenty-seven patients were aggressive (54%).ConclusionsPreventive strategies should focus more on predicting the aggressive potential of patients with schizophrenia and its socio-professional implication. Perhaps when using a less holistic approach to the disease and when approaching aggressive behavior as a symptom in its own right, we will be able to find other alternative options.Disclosure of InterestNone Declared

IntroductionRecent studies find a high level of prolactin in naive patients with consequences on their behavior. These results have shed light on new etiopathogenic avenues in schizophrenia and suggested new preventive approaches.ObjectivesThe objective of our work was to investigate the links that may involve prolactin levels to agressive behavior in patients followed for antipsychotic-naïve schizophrenia or in therapeutic discontinuation.MethodsWe conducted a one-year descriptive and cross-sectional study of thirty male patients hospitalized for a treatment-naïve psychotic relapse or who had been discontinued for more than two months. These patients were assessed using a questionnaire as well as the Overt Agression Scale (OAS). A blood sample was taken to specify the prolactin level.ResultsEleven patients were aggressive (37%). Seven patients (23%) had hyperprolactinemia. Hyperprolactinemia was also inversely associated with aggression since inversely significant correlations were objectified for prolactinemia and respectively the OAS score and the verbal aggression subscore (Rho=-0.391 ; p=0.033) and (p=0.016, Rho=-0.438). The score of aggressiveness towards others also evolved inversely to the prolactin level with a p close to significance (p =0.056).ConclusionsOur results support the hypothesis of a probable action of prolactin as a protective factor against aggression. High prolactin levels may therefore represent a diagnostic lead for a particular profile of a certain patient group with a particular course. However, this subject is still unresolved in the literature and future studies seem necessary.Disclosure of InterestNone Declared

IntroductionThe COVID-19 pandemic affected today more than 76,000,000 worldwide, and more than half of humanity has been placed in quarantine. This pandemic affects mental health problems and influences the onset of symptoms.ObjectivesThe aim of this review is to analyze the impact of the COVID-19 pandemic on psychotic disorders and its interaction with the various risk factors.MethodsWe undertook a review of the impact of COVID-19 pandemic on psychosis. We carried out a systematic review of electronic databases using the keywords “COVID-19”, “pandemics”, “psychotic disorders”, and “delusions”. Relevant literature was limited to articles conducted around the world and published between January and December 2020.ResultsWe identified ten papers addressing incident cases of psychosis relapse linked to coronavirus pandemic. In multiple cases, psychotic symptoms were characterized by delusional thoughts about being infected by the coronavirus. The limited access to regular medications and psychosocial interventions was the main factor to psychotic relapse. This review included one cross-sectional clinical study comparing the impact of this pandemic on patients suffering from severe mental illness compared with healthy controls and they found that patients with mental disorders reacted to the pandemic and the lockdown restrictions with higher anxiety levels than the general public. Our study also revealed that elderly people suffering from psychosis and other chronic illness were the most vulnerable to relapse.ConclusionsPsychotic disorders can relapse during stressful events like COVID-19 pandemic. Therefore, specific attention to these vulnerable subjects is crucial to prevent relapses in times of worldwide pandemic.DisclosureNo significant relationships.

IntroductionThe rapid spread of the SARS‐CoV‐2 pandemic among the world poses challenges to the management of both physical and mental health. This unexpected situation could predict an exacerbation of anxiety, depressions, obsessions, and even multiple cases of psychosis.ObjectivesThe aim of this literature review is to identify and analyze studies conducted in 2020 that investigate the incidence of psychotic disorders, related to COVID-19 pandemic and describe its symptoms.MethodsA systematic search in the PubMed electronic database was performed using keywords “COVID-19”, “pandemics”, “psychotic symptoms”, and “ first episode of psychosis” Relevant literature was limited to articles describing studies conducted and published in 2020.Results9 papers met the inclusion criteria. The selected studies reported 20 cases of psychosis in patients with no psychiatric history, directly triggered by stress derived from the COVID-19 pandemic and by social distancing and quarantine. All cases were characterized by sudden behavioral changes out of character, increased concern about coronavirus risk infection, anxiety, psychomotor agitation, and insomnia. In multiple cases, psychotic symptoms were characterized by thoughts of reference, persecution, and structured delusional. 5 patients were convinced that COVID-19 Pandemic was part of a conspiracy and that someone was trying to infect them by diffusing the COVID-19 or other pollutants. Half of the patients had the delusional conviction that they got infected and they were contagious.ConclusionsCOVID-19 pandemic appears to be the trigger for precipitating psychosis which has a high risk of suicidal behavior. During pandemics, mental health professionals should carry out more focused diagnostic and therapeutic strategies.DisclosureNo significant relationships.