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IntroductionThere has been growing evidence to support the hypothesis that inflammation is involved in the pathogenesis of schizophrenia.ObjectivesThe aim of the present literature review was to assess the efficacy of acetylsalicylic acid (ASA) as an adjuvant agent in the treatment of an acute exacerbation of schizophrenia.MethodsWe searched randomized clinical trials based on regular searches of MEDLINE, Embase, PubMed.ResultsWe included four studies. The results were in favor of the efficacy of ASA in the study where authors targeted early psychosis. Illness duration seems to predict response to anti-inflammatory agents.ConclusionsFurther studies of early stages of schizophrenia are helpful.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.

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.

IntroductionPhysical restraint is a therapeutic procedure allowing to immobilize an agitated patient.Although it is an effective method especially in the states of psychomotor instability, its practice is not devoid of risks which imposes a codified technique with particular monitoring.ObjectivesThe aim of this work was to evaluate the knowledge of nurses and nursing assistants in the practice and monitoring of physical restraint and to establish a suitble protocol codifing it.MethodsOur study was a descriptive cross-sectional study based on a questionnaire grouping together a set of questions on general and professional characteristics, the decision of physical restraint, its prescription, its means, its monitoring, informing the patient and his relatives, physical restraint’s risks, the patient’s experience, the caregiver’s experience as well as the relationship between caregiver and patient. Our target population was composed of nurses and orderlies of the psychiatry department <> of the Razi hospital in Manouba.ResultsWe collected 30 professinals.90% of them were women. 30% of our sample had less than five years of experience. Only 23.30% of caregivers had mental health training at the beginning of their professional career. 50% of them received training focused on physical restraint.83.30% reported using physical restraint for psychomotor agitation.56.6% ignored the psychological effects of the physical straint on patients. 73.3% of caregivers informed patients before straint.ConclusionsA physical restraint protocol, codifying the technique of implementation and monitoring parameters is needed in order to improve the relation patient-cargiver and ensure an optimal care .DisclosureNo significant relationships.

IntroductionMental disorders of pregnancy or postpartum correspond to all the psychopathological states linked to the period of the pregnancy-puerperium. They are the subject of prevention and screening and are currently a public health priorityObjectivesDescribe the socio-demographic characteristics of the patients who presented mental disorders during pregnancy and/or postpartum. Identify the various risk factors predisposing to these disordersMethodsWe carried out a retrospective descriptive analytical study including patients who presented mental disorders during their pregnancy or postpartum and who were hospitalized during the period from January to October 2020.We collected 20 patients.ResultsThe average age was 39.84 years. Mental disorders were present in 73.7% during the postpartum period. The patients had a personality disorder in 47.7%. They were smokers in 57% of cases. Pregnancy was desired in 73.7% with regular follow-up in 84.2%. Pregnancy was complicated by toxemia in 22% of cases and gestational diabetes in 27% of cases. Delivery was by caesarean section in 68.4% with primiparity in 50%. According to the DSM5, the psychic disorder most often found during pregnancy was the characterized depressive disorder 43%, and during the postpartum we found the brief psychotic episode 42.1%. The treatment was in half of the cases association between antidepressants and antipsychotics. Mental disorders were significantly correlated with the presence of stressful life events during pregnancy (p =0.02)ConclusionsMental disorders during pregnancy and postpartum are frequent and important to detect. Early diagnosis and adequate care are the two essential elements that should allow these women to fully experience their motherhood

IntroductionThe COVID-19 pandemic is associated with several psychiatric manifestations leaving undoubtedly psychological consequences. However by escaping death ,do COVID-19 survivors present a higher risk for suicide ?ObjectivesIn this study, we aimed to explore suicidal risk among recovering COVID 19 patients .MethodsOur literature review was based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar using the following combination ( suicide [MeSH terms]) AND (COVID-19 survivors[MeSH terms]).ResultsRecovering COVID 19 patients are at risk for developping posttraumatic stress disorder , anxiety , depression and sleep abnormalities , especially in severe forms. Added to that ,cognitive impairment was largely described in COVID 19 causing judgment and reasoning decline. These manifestations would partially explain the suicidiality among survivors regardless to their medical hisotry. Nonetheless,many COVID-19 survivors experience persistent physical symptoms and psychiatric disorders leading to post-COVID syndrome which is associated with increased suicidal ideation and behavior In addition , social factors are considered as a suicide risk factor such as isolation ,loss of loved ones ,loss of job and economic instability .ConclusionsOver the course of illness , COVID 19 survivors may suffer from psychiatric and medical conditions leading to serieous suicide risk. Therefore ,suicide prevention interventions and appropriate medical management need to be provided to keep survivors alive .DisclosureNo significant relationships.

IntroductionCoronavirus disease 2019 (COVID-19) is the current world issue, with huge impact on mental health. More specifically,we expect that it will have a naocif effect on the pregnant women’s mental health and their well being, since they are more likely to be hospitalized and require more intensive care units admission than non-pregnant women.ObjectivesThe aim of this work was to evaluate the evolution of depression symptoms in the time of pandemic and their associated factors.MethodsIn the current work, we conducted a comparative in field cross-sectional study. We compared depressive scores and prevalences before and after the COVID-19 outbreak in Tunisia in pregnant women.The sampling period was outside the lockdown period to avoid quarantine bias. The sampling period was from September to October 2020.Resultsshowed a significantly higher prevalence of depressive symptoms in expecting mothers during the pandemic. Multivariate analysis showed that the pandemic multiplied by 3 the risk of severe depression symptoms. The impact of the COVID-19 period on depression was independent of sociodemographic and obstetric changes related to the pandemic.ConclusionsThese results highlighted the emergency of preparing strategies to avoid post-partum psychiatric disorders and to enable a healthy development of born. Screening the post-partum depression and assessing the mother-children early interactions should be considered in the up-coming births.DisclosureNo 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.

IntroductionOver the course of COVID 19 illness, olfactory dysfunction was largely described as hyposmia and anosmia. What about phantosmia?ObjectivesIn this study, we aimed to explore olfactory hallucinations among COVID 19 patients.MethodsOur literature review was based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar using the following combination ( phantosmia [MeSH terms]) OR (olfactory hallucinations[MeSH terms]) AND (COVID-19 [MeSH terms]).ResultsSmell dysfonction is one of the most revealing sign of COVID 19 infection. However, other symptoms particularlty phantosmia tend to emerge later in the course of the disease. Female predominance was noted among patients sufferning from olfactory hallucinations regardless to their medical history. An unpleasant olfactory sensation was the most described sign. The occurene of phantosmia was also described in one case of women suffering from schizophrenia whom tested positive for COVID 19 infection.ConclusionsOlfactory hallucinations are more and more associated with COVID-19 disease regardless to psychiatric disorders. The pathological mechanism remains unclear and further studies are needed for a better comprehension and management.DisclosureNo significant relationships.

IntroductionSince the beginning of Coronavirus pandemic, the world is facing huge challenges for the prevention of mass infection. Studies shows that wearing facemasks and hand washing seems to be the best protection from disease transmission. Indeed, the spread of SARS-CoV-2 was efficaciously controlled in countries where mask wearing is respected. However, such recommendations may not be easily established with inpatients with mental disorders due to limited ability to embrace instructions.ObjectivesThe purpose of this study was to evaluate the use of facemasks and hand’s wash among inpatients with mental disorders during coronavirus pandemic in a psychiatric hospital in Tunisia.MethodsThis hospital-based cross-sectional study was conducted from September to October 2021 among thirty hospitalized inpatients in a psychiatric department suffering from schizophrenia. All patients responded to an anonymous questionnaire about mask wearing and washing hands status. Knowledge about COVID-19 was assessed by a 6-item questionnaire inspired from a Corean study.ResultsPreliminary findings showed that most patients are aware of covid-19 pandemic and about barrier gestures but only a very few (less than 20%) wear masks. Inpatients with schizophrenia were in most cases not afraid from covid-19 contamination within the hospital and less that 50% were vaccinated.ConclusionsDuring a pandemic, psychiatric departments needs an extra attention because of the high-risk of spreading infections in inpatients with mental diseases. Communication has to be clearer, and repeated assistance by correctly reminding measures has to be implanted above all for patients with schizophrenia.DisclosureNo significant relationships.