Obesity and its related disorders are growing epidemic across the world. As some forms of abnormal temperament are considered as subtype of the soft bipolar spectrum, we aimed to evaluate abnormal temperaments in morbid obese patients.

Using a short version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego, we investigated abnormal depressive, cyclothymic, hyperthymic, irritable or anxious temperament in 213 patients with morbid obesity compared to a control group of 90 patients admitted prior to transplantation. Additionally, the Beck-Depression Inventory (BDI) and the Self-Report Manic Inventory (SRMI) were applied to assess the current mood states.

The obese group showed statistically significant more psychiatric comorbidities compared to the control group. Abnormal temperaments were significantly more often observed in patients with morbid obesity rather than in controls. Cyclothymic, irritable and anxious temperaments showed specificity to obesity. Obese patients had significantly higher scores in BDI, while no difference for SRMI scores was registered among the whole groups. All temperaments were positively correlated with BDI and SRMI in the obese group.

Our results need replication but indicate an affective overlap in form of abnormal temperament and depressive symptoms in obese patients, whereas mood swings should be evaluated and early mood stabilization considered for patients with significant weight gain to prevent obesity or to reduce already existing overweight. Studies of mood stabilizers and prospective observations would shed further insight on this complex interface of a major clinical and public health issue.

This study aimed to determine prevalence and correlates of suicidal attempts in an adult primary care population in Sousse (Tunisia).

Sampling followed a stratified multistage probability cluster design from witch a representative sample of adult primary care population of Sousse was obtained. The sample was composed of 1249 subjects aged 18 years or more. Subjects were interviewed by trained clinicians using the Tunisian version of Composite International Diagnostic Interview 2.1.

General and clinical characteristics of subjects who had reported previous suicidal attempts were compared with those of the remainder using t test and Chi-2 test.

Mean age in our sample was 43.4 ± 17.62 years, with female gender (70.9%) and urban residency (67.8%) predominance. 62.3% of participants were married, 27.3% celibates and 10.4% divorced or widowed. 68.4% of them had low educational level and 70% were out of work during the last 12 months. Suicidal attempts were found in 2.9% of participants. They were correlated to less than 40 years age (p=0.036) and to the diagnosis of major depressive episodes (p< 10-3), recurrent major depressive disorder (p=0.005) and dysthymic disorder (p< 10-3). Among major depressive episodes, only severe ones were associated to higher prevalence of suicidal attempts (p< 10-3).

Prevalence of suicidal attempts in Sousse primary care population was 2.9%. It was correlated to low age and to depressive disorders.

Oxidative stress has been implicated in the pathogenesis of major psychiatric disorders, as the brain has comparatively greater vulnerability to oxidative damage

We are the first to study the relationship between oxidative stress (by measuring plasma F2-isoprostane, as a marker of lipid peroxidation, and glutathione peroxidase, as an antioxidant enzyme) and autoimmunity (as indicated by serum antineuronal antibodies).

We studied these markers in a group of 44 Egyptian autistic children and 44 healthy matched-children.

Our results showed that oxidative stress was found in 88.64% of autistic children. Oxidative stress, resulting from elevated plasma F2-isoprostane and/or reduced glutathione peroxidase, had significant risk for antineuronal positivity, which was found in 54.5% of autistic children, (odds ratio: 12.38 and 6.43, respectively, confidence interval: 1.37–112.10 and 1.21–34.19, respectively).

the strong association between oxidative stress and autoimmunity in autistic children may indicate the possible role of oxidative stress, through induction of autoimmunity, in some autistic patients. Therefore, studies considering the role of antioxidants and immunotherapy in amelioration of autistic manifestations are recommended.

Migration of mental health professionals is an important phenomenon influencing mental health services of host and donor countries. Data on medical migration in Europe is very limited, particularly in the field of young doctors and psychiatry. To research this hot topic, the European Federation of Psychiatric Trainees (EFPT) conducted the EFPT Brain Drain Survey.

To identify the impact of previous short-term mobility on international migration and to understand characteristics, patterns and reasons of migration.

In this cross-sectional European multicentre study, data were collected from 2281 psychiatric trainees across 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on migration.

Two-thirds of the trainees had not had a short-mobility experience in their lifetime, but those that went abroad were satisfied with their experiences, reporting that these influenced their attitude towards migration positively. However, the majority of the trainees had not had a migratory experience of more than 1 year. Flows showed that Switzerland and United Kingdom have the greatest number of immigrant trainees, whereas Germany and Greece have the greatest number of trainees leaving. ‘'Pull factors'’ were mostly academic and personal reasons, whereas ‘'push factors'’ were mainly: academic and financial reasons. Trainees that wanted to leave the country were significantly more dissatisfied with their income.

The majority of the trainees has considered leaving the country they currently lived in, but a lower percentage has taken steps towards migration.

The health sector has long been recognized to be a very stressful work environment for teams that can lead to “burnout”. Geriatric institutions are no exception to this observation; this state has deleterious effects on health care as on the quality of care.

Measure the burnout rate among caregivers in geriatric institutions and identify associated factors and coping strategies specific to this population in order to provide the necessary preventive measures.

Subjects and method A cross-sectional study, conducted among caregivers exercising at the shelter for aged subjects of Manouba, Tunisia. We used a pre-survey exploring the socio-demographic data associated with two validated scales: the Maslach Burnout Inventory assessing the level of burnout and the Brief COPE assessing coping strategies.

Thirty-one subjects were recruited. The prevalence of burnout was 45.16%. Respectively 32.26%, 25.80% and 45.16% of the respondents had high scores in dimensions emotional exhaustion, depersonalization and personal accomplishment at work. The analytical study revealed that seniority in work increased the risk of burnout. The coping strategies of caregivers in geriatric institution facing burnout were mainly centered on emotion. The number of years of experience has been associated with burnout in our study.

This work reaffirms that the population of caregivers in geriatric institution is at risk of burnout and allows to identify predictors. The establishment of individual and collective measures is essential for appropriate treatment references (In the body text, a publication should be referred to by a consecutive number between bracket)

The authors have not supplied their declaration of competing interest.

Intrusive traumatic reminiscences are among the most distressing and salient characteristics of post-traumatic stress disorder (PTSD). Associated with involuntary onsets, emotional disturbances and consciousness-related impairments, such symptoms suggest that memory functioning could be impaired in PTSD. While there is a growing body of research on experimental assessments of memory in patients with PTSD, inconsistent results remain.

Using an experimental methodology, this study aims to measure memory in PTSD in consideration of central features of intrusive symptoms, especially emotional, inhibitory and consciousness-related memory impairments.

34 patients diagnosed with PTSD were compared with 37 non-PTSD controls on an item-cued directed forgetting paradigm for emotional words combined with a remember/know recognition procedure.

Results confirmed prior findings of an increased and peculiarly conscious recognition of trauma-related words in PTSD. Interestingly, our results showed that, despite general memory inhibitory deficits, PTSD patients, if requested, presented a preserved ability to inhibit this improved recollection of trauma-related words.

While our findings highlight a biased memory functioning in favour of threatening stimuli in PTSD, inhibitory deficits for such information was not reported to play a role on this effect. Conversely, it seems that instead of inhibitory deficits, patients presented a preferential treatment of threat concordant with vigilant-avoidant models of information processing. Focusing on memory impairment in treatment for PTSD appears of prime importance. Our findings regarding preserved inhibitory skills for threat memories in the disorder could be an interesting clue for therapeutic interventions on intrusive symptoms.

The authors have not supplied their declaration of competing interest.

Violence against elderly persons is an intricate social, legal and ethic issue. Alzheimer's patients are the most vulnerable individuals to mistreatment and neglect. The aggressor can be even the main helper of the patient. We noticed a wide underestimation of this phenomenon, which remains taboo subject in our society.

– The aim of our study is to identify predictive factors of mistreatment of Alzheimer's patients through a prospective and descriptive study, within patients following in the department of neurology in Razi's hospital.

– we evaluate cognitive function (MMSE) and the importance of behavioural disorders.

– we explored helper's socio-demographic characteristics and the quality of aid relationship.

– anger and hostility within relationship were estimated through family attitude scale.

Our sample accounts 60 informal caregivers predominately female (91.7%) with an average age of 49.67 years, mostly are married (71.66%) and jobless (38.88%):

– in 78.3% of cases, caregivers spent about 12 to 24 hours per day with Alzheimer's patient.

– the average score of FAS was about 52.4% with an important emotional charge (score >60).

– twenty-five caregivers wished the death of the patient and 42 others admitted being sarcastic with him.

– We noticed a correlation between mistreatment and both cognitive function and behavioural disorders.

Our results support the fact that mistreatment of people with dementia is closely related with the exhausting situation of the main caregiver.

The authors have not supplied their declaration of competing interest.

Internet use has increased broadly worldwide. There are growing concerns about problematic Internet use (PIU) among youth. Among undergraduate students, excessive Internet use can adversely affect their interpersonal relations and academic achievements.

To estimate the prevalence of PIU among Zagazig university students, and to identify the possible associations between sociodemographic and Internet-related factors and PIU.

A cross-sectional study included a total of 732 undergraduate students, aged 17–34 years, from various colleges in Zagazig University. Participants were randomly selected and assessed for their internet use and abuse using the Internet Addiction Test (IAT), along with a semi-structured questionnaire for sociodemographic and Internet-related factors.

Maladaptive Internet use was found in 37.4% of respondents, and addictive Internet use was found in 4.1% of respondents. Logistic regression showed the predictors of PIU were: using the Internet throughout the day (OR 3.34, 95% CI: 1.75, 6.38), the number of hours spent daily using the Internet (OR 1.17, 95% CI: 1.10, 1.25), the number of days/week using the Internet (OR 1.28, 95% CI: 1.04, 1.58), accessing the Internet using multiple devices (OR 1.55, 95% CI: 1.21, 1.98), and accessing the Internet both indoors and outdoors (OR 1.57, 95% CI: 1.13, 2.19).

This is the first prevalence study of PIU at an Egyptian university. PIU was common among university students. Addressing this issue and its predictors could eventually help to enhance academic performance and achievement among those students.

The authors have not supplied their declaration of competing interest.

In some forms of sexual perversion, sexual satisfaction is achieved only by treating one's partner violently (sadism) or conversely, by suffering pain (masochism).

The objectives of our study were to understand the complex relationship between psychotic and perverse structures, and discuss the importance of some criminal risk factors for psychotics who have sexually perverse behaviors, through clinical observation and review literature.

Mr AB was 35-year-old, single and unemployed. He was hospitalized in our forensic psychiatric department following a dismissal for criminal responsibility for an act of emasculation on a child aged 5 years without sexual abuse. In his biography we have objectified cruelty to animals, charged judicial history (imprisonment for theft, murder and escape from prison, hetero aggressive acts) and substance use.

The patient explained with indifference that he heard voices making fun of his “sexual impotence and loss of his manhood”. The day of the forensic act, he got an uncontrollable urge to emasculate the first man he met on his way at the behest of this hearing hallucinatory activity. Psychiatric experts retained the diagnosis of psychosis with perverse arrangements. Under neuroleptic treatment, psychotic symptoms disappeared but the patient's sadistic problems remained present and active throughout his hospitalization.

The following case illustrates the issue of dangerousness and responsibility in a perverse psychotic author assault of a sexual nature. Given their clinical history, the path between perversion and psychosis shows that perverse manifestations are prior to the first psychotic symptoms and the perverse constitution is developed parallel to the psychotic illness.

The authors have not supplied their declaration of competing interest.

Incest may be defined as sexual relations between close blood relatives. Legally, incest and sexual aggression toward minors are classified as a criminal behaviour. Tunisia is among the countries from which incest cases are rarely reported.

The aim of this study is to investigate the relationship between the psychotic structure and incest, and to describe the individual, clinical, and criminal traits of the incestuous father through clinical observation.

Mr T.G is 46 years old. He is married and has six daughters. His wife appears to be passive, and largely dependent on her husband. Mr T.G has had incestuous relationships, initially, with his two eldest daughters. The acts were followed by the mother's complicit silence and the non-denunciation of the daughters. Two years later, he starts an incestuous behavior with his third daughter. Incest took place in the context of delusion. The patient was convinced that he is responsible of his daughters’ sexuality education. He develops an incoherent theory of purification with a tendency towards morbid rationalism. It is only after four years of insufferable paternal incestuous relationships that the third daughter filed a complaint to the police. A psychiatric expertise concluded that the accused is exempt from criminal responsibility.

Incest is a multi-faceted phenomenon, which makes its approach, comprehension, and treatment quite complex. For a psychotic patient incest is a means to deny alterity by crushing other. It also allows him to find, in this complete power, control over his annihilation anxiety.

The authors have not supplied their declaration of competing interest.

For a long time, antidepressants sexual side effects have been neglected. Currently, no reliable scientific data is available regarding the nature and frequency of sexual dysfunction induced by antidepressants. The aim of our study was to evaluate the prevalence and type of sexual dysfunction induced by antidepressants, and to identify factors associated with the occurrence of these disorders.

A descriptive and analytical cross-sectional study extending over a period of two week. For the purpose of this research, a socio-demographic card, the Arizona Sexual Experiences Scale (ASEX) and the Psychotropic-Related Sexual Dysfunction Questionnaire (SALSEX) were used.

Fifty-five patients were recruited. The diagnosis of major depressive episodes was dominant (49.1%). Moreover, fluoxetine and tricyclic were in top of the list of antidepressants with respective proportions of 41.8% and 38.2% and respective dose 20.86 mg/24 h and 72.38 mg/24 h. The score using the ASEX scale was 14.63 ± 5.23. Using the SALSEX scale, 47.3% of patients claimed to have had sexual disorders secondary to antidepressants with a moderate score of 9.19 ± 2.56. Furthermore, sexual disorders were more common in the elderly aged of 45 (66.66%) as well as in patients started on paroxetine (66.66%) and on sertraline (66.66%) (P ≤ 0.05).

The sexual side effects of antidepressants have a major impact on the quality of life and adherence to treatment. They also represent an important risk factor for relapse and recurrence in major depression, in this context, the prescription of an antidepressant.

The authors have not supplied their declaration of competing interest.

Overweight and obesity, despite their comorbidities and mortality, could deteriorate the quality of life of people with bipolar disorder.

The objective of this study is to evaluate the quality of life among patients with bipolar disorder and investigate a possible interaction between obesity and deterioration of the quality of life.

This study aims to highlight the importance of preventing overweight and obesity in people with bipolar disorder to obtain an adequate quality of life subsequently an acceptable control of the illness.

Fifty euthymic bipolar patients (Hamilton Depression Scale score ≤ 8, and Young Mania Rating Scale score ≤ 6) received the Medical Outcomes Study 36-Item Short-Form Health Survey in Arabic validated version in order to investigate the quality of life.

We examined 50 euthymic bipolar patients (60% men, 40% women). The average age was 46, 5 years (23–70). Most patients (69%) were over weighted (BMI ≥ 25.0 kg/m2) (body mass index), of whom 40% were obese (BMI ≥ 30.0 kg/m2). Seventy-two percent of the investigated patients had an affected quality of life (score < 66.7). The mental items were deteriorated in 80% of the cases. An affected quality of life was correlated with obesity. The BMI was significantly and negatively correlated with the scores of dimensions D4 (mental health) and D8 (perceived health) (P < 0.01).

The investigation of quality of life in people with mental disorder enables to reveal the social handicap caused by these illnesses consequently emphasizes health care in mental affections.

The authors have not supplied their declaration of competing interest.