Explore the vast range of titles available.

IntroductionOlanzapine is a second generation antipsychotic. Sedation and weight gain are common treatment side effects. However, other rare side effects such as peripheral edema are yet to be documented.ObjectivesOur study aimed to describe the clinical presentation of edema in a patient taking Olanzapine.MethodsCase reportResultsWe present the case of a 42 male patient hospitalized for a manic episode. He was put on Olanzapine at 10 mg a day. During the hospitalization, the patient exhibited profuse pitting edema on his lower limbs and a rapid weight gain. He presented no other physical sign such as a fever, cutaneous lesions or trouble walking. Thrombophlebitis and erysipelas were eliminated after an extensive physical exam, complete blood work and doppler ultrasound exam of both legs.Olanzapine was discontinued and the patient was prescribed a 4-day course of loop diuretics. Complete resolution of symptoms was noted 5 days later.ConclusionsFurther research regarding the mechanism behind edema in patients taking second generation antipsychotics are needed. We recommend monitoring for edema with initiation and titration of Olanzapine treatment.Disclosure of InterestNone Declared

IntroductionTreatment adherence in patients living with Bipolar Disorders can influence prognosis and quality of life. It is associated with an increased morbidity and healthcare costs.ObjectivesThe aim of our study was to evaluate treatment adherence in a sample of patients living with Bipolar disorders and to determine factors associated with poor adherence.MethodsWe conducted a cross sectional study where we included bipolar patients being treated in psychiatry department A. We developed a survey containing sociodemographic and clinical features. We used the medical adherence rating scale to evaluate treatment adherence.ResultsOur sample consisted of 100 patients with a mean age of 47,5 years old. Sixty seven patients were being treated for bipolar disorder type 1. Medication adherence rate was 64%.Factors associated with poor medication adherence were being single, an early age of onset, comorbid substance abuse disorder, severe treatment side effects and poor insight.ConclusionsPoor medication adherence is a major issue for people living with Bipolar Disorders. Clinicians should pay more attention to sociodemographic and clinical factors to predict and enhance treatment adherence.Disclosure of InterestNone Declared

IntroductionThe announcement of bad news to patients is a challenging task for physicians.ObjectivesThe aim of our study is to evaluate the impact of a simulation experience of telling bad news to patients on Tunisian medical trainees.MethodsA prospective and multicenter study was conducted in two different hospitals in Tunisia. The duration of the study was two weeks. Pre-prepared questionnaires evaluating the impact of a simulation experience of the announcement of a critical illness diagnosis were handed to trainees enrolled in the faculty of Medecine in Tunis.ResultsForty trainees were included in the study. Average age was 28,1 years old with a feminine predominance (75%). Thirteen trainees role-played the clinician announcing the bad news. The median duration of the simulated interview was eight minutes. During the moment of the diagnosis announcement, twelve trainees reported feeling stressed, 6 of them felt uncomfortable and 7 felt empathic. Five trainees were in difficulty, two felt at ease and two felt neutral. During the whole interview, all the trainees reported they felt stressed and uncomfortable. Regarding their feelings at the end of the interview, only two reported they felt relieved at the end of the interview. Three trainees felt angry with themselves. Two felt angry with the patient or his family members. Eight felt upset and four were in tears. Four reported having no feelings.ConclusionsTelling bad news is a difficult moment in daily practice. Special trainings need to be implemented in the medical education program in order to prepare future doctors to this task.Disclosure of InterestNone Declared

IntroductionGiven the recurrence of mood episodes, with their negative repercussions such as high suicidal risk, significant cognitive decline and the persistence of residual signs with a negative impact on the patient’s family, social and professional functioning, Bipolar Disorder is a mental disorder with a significant social stigma.ObjectivesIdentify the socio-demographic and clinical factors that may influence the experience of stigma in bipolar disorder type IMethodsWe conducted a cross-sectional, comparative study over a six-month period at the aftercare unit of Razi Hospital’s psychiatric ward “A”, including patients treated for TB I according to DSM 5 criteria and stable on treatment.The study was conducted in two stages: first, sociodemographic and clinical characteristics were collected using a pre-established form. The DISCUS scale, validated in Arabic, was then administered.ResultsWe included 100 patients (60 men and 40 women) with a mean age of 43.55 years.The median DISCUS stigma score was 6 (0-19).The mean value of the DISCUS scale was high for patients of urban origin (p=0.042), with a low socioeconomic level (p=0.001), and poor family dynamics (p<0.001).The presence of a comorbid personality disorder was significantly associated with stigma (p=0.006). The DISCUS scale was positively associated with the number of years of follow-up, the number of hospitalizations, the number of manic episodes, the number of depressive episodes and the number of episodes with psychotic or melancholic features.ConclusionsThis stigma can have a negative impact on patients’ quality of life in a whole range of ways, including limiting their opportunities for education, employment and housing.Intensive therapeutic interventions should be considered for vulnerable patients to limit the consequences.Disclosure of InterestNone Declared

IntroductionAmong all mental pathologies, bipolar disorder (BD) is the one in which addictive comorbidity is most frequent.Recent studies suggest that this comorbidity has harmful consequences, threatening patients’ quality of life.ObjectivesDescribe addictive comorbidity and determine its prevalence in a population of patients with BD I.Study the impact of addictive comorbidity on the evolution of BD I.MethodsA cross-sectional, comparative study was conducted over a six-month period in the after-care unit of psychiatric wards at Razi Hospital, including patients treated for BD I according to DSM 5 criteria and stable on treatment.The study included two phases: first, sociodemographic, clinical and therapeutic characteristics were collected using a pre-established form. The CAGE, DUDIT and MARS scales, validated in Arabic, were then administered.ResultsWe included 100 patients (60 men and 40 women) with a mean age of 43.55 years.Substance use disorder (SUD) was reported in 31% of our population; 22 alcohol users with a mean CAGE score of 1.23 (0-3), while psychoactive substance use was reported in 19 patients with a mean DUDIT score of 13.37 (0-28).Forensic history was higher in the group of patients with comorbid SUD (p<0.001). Poor compliance with treatment and irregular follow-up were also significantly more associated with addictive behavior, respectively p=0.008 and p=0.048.We found no association between SUD and suicidal behavior or evolutionary symptoms of the disorder.ConclusionsSUD are generally factors in the poor prognosis of BD. It is important to identify the determinants of this comorbidity, so that these risk factors can be appropriately targeted through appropriate therapeutic interventions and thus limit these negative consequences.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

IntroductionMental Health Knowledge specific to symptom recognition, treatment efficacy, help-seeking, and employment can facilitate understanding when communicating with clinicians and reduce personal stigma. Better knowledge of mental illness has also been shown to decrease fear and embarrassment when interacting with people with mental illnesses. Thus, knowledge can play a key role in influencing behaviors and attitudes associated with stigma.ObjectivesThe objective of this study was to evaluate mental health knowledge among Tunisian studentsMethodsThis cross-sectional study was conducted on 2501 Tunisian students from different academic institutions. They anonymously filled in a questionnaire circulated online through social networks in pages and groups of each university. The validated Arabic version of the “Mental Health Knowledge Schedule” (MAKS) was used to assess the knowledge about mental illnesses.ResultsThe median MAKS score was equal to 45 out of 60, ranging from 30 to 56. In our study, 60.2% of the participants answered “don’t know” or “neither agree nor disagree” to item 1 indicating that “Most people with mental health problems want to have paid employment.”. Exactly 83.7% of the participants thought they knew what advice to give a friend to get professional help and 90% thought that psychotherapy could be effective in treating a person with a mental illness. In addition, 57.1% of participants thought that medication could be effective and 68.8% thought that people with severe mental health problems could make a full recovery. People with mental health problems do not seek professional help according to 39% of participants. About 90% were considering depression, schizophrenia, and bipolar disorder as mental illnesses. Stress and drug addiction were considered mental illnesses according to 71% and 63% of participants respectively. Finally, 52.9% answered that grief was a mental illness.ConclusionsIn Tunisia, anti-stigma programs are almost nonexistent. Our results would allow us to take a baseline assessment of mental health knowledge and could be the starting point for anti-stigma interventions. We should combine these findings with a behavioral and attitudinal assessment to better address stigma.Disclosure of InterestNone Declared

IntroductionA mature and fulfilling sexuality is based on appropriate sexual education. The message must be adapted to the level of knowledge and practices of young people. Old studies dating back more than 15 years have been published.ObjectivesThe objective of this study is to assess adolescents’ knowledge and attitudes about sexuality.MethodsThis is a descriptive cross-sectional study conducted among 80 adolescents using an anonymous online questionnaire.ResultsThe average age of the participants was 18 years old 45% had had at least one sexual intercourse, they are mostly male. Only 9% had used a method of contraception. Most of them had heard of contraceptive techniques. Young age, male gender, lack of dialogue with parents, low socio-economic status and lack of sex education were significantly associated with a low level of knowledge about sexuality.ConclusionsThe results show that adolescents had risky practices with a lack of information. More studies are needed to approve these results and improve sexual health of these teenagers thanks to targeted sensitization.Disclosure of InterestNone Declared

IntroductionMental illnesses affect one in eight people in the world according to the WHO in 2019. They are a leading cause of morbidity and a major public health problem. Stigma harms the quality of life of people with mental illness.ObjectivesOur study aimed to evaluate the association of mental illness stigma with socio-demographic characteristics in Tunisian students.MethodsThis is a cross-sectional study conducted on Tunisian students who anonymously completed a form circulated online through the groups and social network pages related to each academic institution. The form was containing an Arabic validated version of the “Mental Health Knowledge Schedule” (MAKS) and the “Reported and Intended Behaviour Scale” (RIBS) along with a sociodemographic questionnaire.ResultsWe have included 2501 Tunisian students with a sex-ratio Male/Female of 0.37. The mean age was 21.57 (±2.55) ranging from 17 to 42 years. Participants’ fields of study were: Science and Technology (58.7%), Literature (17,4%), Economics and management (15.8%), and Arts (4.8%). Among them, 17.1% had a history of family psychiatric disorders and 17.6% had a psychiatric disorder. Besides, 20.9% of the students were using tobacco and 75.6% of them were religious. We also found that 26.7% of participants had previously attended an awareness session. Several determinants had a statistically significant association with the stigma of mental illness in our study population. We noted that females had higher mental health knowledge scores (p=0.001), while males had higher behavior scores (p=0.002). Moreover, students in the scientific and literary fields had higher scores on both MAKS (p<10-3) and RIBS (p<10-3). In addition, we found greater knowledge of mental illness and less discrimination among participants with a psychiatric history (p=0.013 and p<10-3 respectively) and among those who had previously attended a stigma awareness session (p=0.020 and p=0.002 respectively). We also noted higher behaviour scores among people with substance use (p<10-3) and lower scores among people with religious beliefs (p=0.009).ConclusionsOur results show a multiplicity of factors related to mental illness stigma that we can target in anti-stigma strategies. Addressing stigma is a long-term effort; small and large-scale interventions should be considered and evaluated on an ongoing basis to strive for a better future.Disclosure of InterestNone Declared

IntroductionProphylactic treatment during bipolar disorder aims to prevent recurrences and to improve the functional level.ObjectivesOur aim was to compare the clinical effectiveness of lithium versus sodium valproate in the prophylactic treatment of bipolar disorder type 1MethodsRetrospective, longitudinal, comparative study conducted among 162 patients followed for bipolar disorder type 1 hospitalized at the Psychiatry A department of Razi Hospital. The Alda scale and time to recurrence were used to compare the clinical effectiveness of the mood stabilizers.ResultsA difference between the two groups of patients was noted for some variables. Lithium prescription was associated with educational level, number of depressive episodes, suicide attempts, previous prescription of other thymoregulators, depressive polarity of the index episode and use of atypical antipsychotics.The prescription of Valproate was associated with educational level, unipolar mania, manic predominant polarity, manic polarity of the index episode, presence of psychotic features, prescription of long acting antipsychotics and higher doses of antipsychotics.The study of response by Alda scale showed no significant difference in the mean score of the scale nor in the rate of responders. We noted a higher rate of recurrence in patients on Valproate considering the whole duration of the study. The recurrence rate after one year was higher in patients on Lithium, the recurrence rate after two years was comparable in both groups. Survival curves showed earlier recurrences in patients on Lithium.ConclusionsThe efficacy of the two mood stabilizers was comparable. The recurrences occured earlier under Lithium.Disclosure of InterestNone Declared