Bipolar disorder is presumed to involve difficulties in emotion regulation. However, little is known about the specific emotion regulation profile associated with this disorder.

To study emotion regulation in bipolar patients in remission phase and to determine the factors correlated with it.

A cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder in remission, at the psychiatric outpatient clinic at the Hédi Chaker University Hospital in Sfax. We used a socio-demographic and clinical data sheet and the Cognitive Emotion Regulation Questionnaire (CERQ) which assesses cognitive strategies (maladaptive and adaptive) for regulating emotion.

The mean age of the patients was 43.77 years, the sex ratio was 0.5. Bipolar I disorder was diagnosed in 93% of patients. A good adherence to treatment was found in 86.7% of cases and a good social integration in 40%. The mean total score of the adaptive CERQ was 66.73 and the most used adaptive strategy was acceptation (mean score =13.87), while the mean total score of the maladaptive CERQ was 36.7 and the most used maladaptive strategy was self blame (mean score =9.47). Adaptive cognitive emotion regulation was predominant in 93.3% of patients. It was significantly correlated with good adherence to treatment (p = 0.047) and good social integration (p = 0.026).

Our patients with euthymic bipolar disorder showed a satisfying level of adaptive emotion regulation strategies. A cognitive remediation seems important to embetter this capacity and improve the income of the disease.

No significant relationships.

Since COVID19 pandemic emergence, containment measure have been taken by the Tunisian government imposing a new lifestyle resulting in psychological repercussions and a change in behavior.

Highlighting changes of behavior and lifestyle of the general public secondary to the COVID19 pandemic and to confinement and to assess their levels of psychological.

This is a qualitative, descriptive and analytical cross-sectional study realized between April and May 2020 with the general public using an anonymous online questionnaire covering: socio-demographic data; behavior during confinement; epidemic psychological impact; Mental health status was measured using Depression, Anxiety and Stress Scale(DASS-21). Anger level was assessed by STAXI-10 items.

132 responses were received: 68.2% were women; the average age 32.01(±11.10); half were single; 77.3% were at higher education level; 41.7% were healthcare professionnels. Consumption increased by 26.5% in coffee, 8.3% tobacco and 1.5% alcohol. 33.3% of participants increased their religious practice. 56.1% experienced sleep disorder mostly women(p<0.05). 91.7% followed COVID19 evolution through media essentially Facebook. Partners relationship was deteriorated in1.7% and improved in 25%. Child abuse increased by 13.7%. During confinement: 15.9%depression (0.8%severe depression), 12.9%anxiety (0.8%severe anxiety), 5.3% stress and 27.3%feelings of anger. Depression, anxiety and anger were related to younger age(p<0.05). Stress wasn’t age related. Depression was observed in participants without children (p<0.05). No association founded between psychological impact and gender, profession and civil status.

The COVID19 pandemic and the containment had consequences on individuals behavior and mental health. A psychological listening unit was launched during the period of confinement to overcome psychological impact.

The postpartum depressions (PPD), rank first postpartum complications and therefore pose a public health problem by their frequencies and their adverse consequences.

To detect the depression among a Tunisian parturient, to evaluate their perceived stress and to study the link between these entities

A cross-sectional, analytical study of 40 first week postpartum women hospitalized in the gynecology department in Hedi Cheker hospital in Sfax-Tunisia, during the month of September 2019. We used the Arab version of Edinburgh Postnatal Depression Scale (EPDS) and the Cohen perceived stress scale (PSS).

The average age of the participants was 31.07 years old. The Parturient have a rural origin in 62.5% of cases, they have a secondary school level in 52.5% of cases. There were exaggerated sympathetic signs in 52.5% of the cases. An organic pathologies were present during pregnancy in 47.5%. The postpartum period was simple in 77.5% of cases. For the post-natal period, 90% of parturient were going to receive help of a family member. EPDS: the average score was5.35 and the risk of developing a PPD was 20%. PSS we found that life represents a perpetual threat in 27% of cases. The factors correlated with the PPD were: a high level of perceived stress (p < 0.00) and organic pathology during pregnancy (p=0.02).

Our study shows that the risk of postpartum depression is high among Tunisian parturient and it is associated with high level of stress, because of this a precocious screening is necessary.

No significant relationships.

In March 2020, the World Health Organization characterized the COVID-19 outbreak as a pandemic. This new health situation has created an anxiety-provoking climate, in particular among health professionals

To study the prevalence and predictors of anxiety and depression among health workers

Our study was descriptive and analytical cross-sectional, carried out with healthcare on the period between May until June 2020. An anonymous online survey was sent to caregivers. The HADS questionnaire was used to screen for anxiety and depression

125 responses was collected The average age of the sample was 32 years. The participants were predominantly female (72.8%), married (48%), and had at least one child (39.2%). 21.6% of the participants worked in the resuscitation anesthesia service and urgent medical aid, 14.4% in the medical services at high risk of contamination, 1.6% in the COVID-19 unit Many changes in habits were reported by the participants: 28.7% had increased their consumption of coffee/tea, especially with anxious people (p = 0.001). This increase was also noted for tobacco (30.8%) and alcohol consumption (12.5%). According to the HADS scale, anxiety was retained in 44% and depression in 47.2%. Anxiety was significantly related to sex with (p = 0.039) and affects more women than men The consumers of coffee/tea developed more anxiety (p = 0.034) and depression (p = 0.026).

This tragic health crisis had a major impact on the mental health of our heroes This is why we should better understand their vulnerability to psychological suffering to provide them with the necessary support

Munchausen syndrome by proxy, is a very rare form of abuse, lying on the border between pediatric, psychiatric and legal fields.

To describe a case of Munchausen syndrome by proxy in a mother after the discovery of severe hypoglycemia in her 14-month-old child, hospitalized in the CHU Hédi Chaker Sfax pediatric ward.

This is a presentation of a clinical case and review of the literature via pubmed using the following keywords : “children, abuse, maltreatment, Munchhausen syndrome”.

This is a 23-year-old woman, mother of two daughters, with a psychiatric history, married to a 43-year-old men known to have diabetes on insulin for several years. The patient was admitted to our ward under constraint for aggressiveness towards her one-and-a-half-year-old daughter. Indeed, one month before her hospitalization, her youngest daughter was hospitalized (accompanied by her mother) in the pediatric department at the Hédi Chaker Sfax University Hospital for severe hypoglycemia (0.3g / l). During hospitalization, the girl presented a more severe hypoglycaemia relapses (0.1g / l) and neurological complications. As the mother was indifferent to her daughter’s troubles and was neglectful of her while caring for the other hospitalized children, a mother-child separation was decided and then the blood sugar levels was stabilized. Besides, several other incidents have been happening repeatedly for the two children. In view of the total history, Münchhausen syndrome by proxy has been mentioned.

Munchausen syndrome by proxy is a complex form of child abuse by the mother, representing a major diagnostic and therapeutic challenge for both somaticians and psychiatrists.

The influence of personality on how people deal with stressful situations has long been discussed. In bipolar disorder, these two entities seem to have a role in the outcome of the disease.

To study the relationships between coping strategies in stressful situations and personality dimensions in euthymic bipolar patients.

This is a cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder in remission, at the psychiatric outpatient clinic at the Hédi Chaker Uuniversity Hospital in Sfax. We used a socio-demographic and clinical data sheet and the Ten Items Personality Inventory (TIPI) to evaluate personality dimensions and the Ways Of Coping Checklist (WWC) for the assessment of coping.

The mean age of the patients was 43.77 years, the sex ratio was 0.5. Bipolar I disorder was diagnosed in 93% of patients. WCC : -Coping focused on the problem : 70% of the patients. -Emotion-centered coping : 20% of patients -Coping focused on seeking social support : 10% of patients. TIPI : Conciousness was the most represented trait of personality (36.7%), agreableness (30%) and extraversion (20%). Extraversion was associated with coping focused on the problem: (p=0.015). Agreableness was associated with coping focused on seeking social support:(p=0.033).

Our study showed that conciousness is the most common trait of personality in bipolar disorder patients. The coping focused on the problem is the most frequent strategy which correlated with extraversion, so, personality dimensions appear as a target for cognitive interventions.

No significant relationships.

In Tunisia, traditions of marriage are still preserved by certain regions of the country : the taboo of sexuality and the requirement of the preservation of virginity until marriage mark the Tunisian mentality till this day.

To discuss the impact of the Tunisian culture related to marriage on the precipitation of psychotic disorders in the bride.

A case report and a review of litterature via PubMed using the terms : « nuptial, psychosis, bride».

A 31-year-old woman With no personal desease, developped a mutism, refusal of food and heteroagressiveness since the day after the wedding. The wedding party went well and it was consumed on the first night without any real incidents, yet, Ms. H was very anxious about the loss of her virginity and especially because of the low bleeding she had. The day after the wedding day, the bride was especially worried because of the presence of her family waiting in front of the bedroom to see the the blood-stained sheet : proof of the virginity of their daughter and the virility of the husband. In fact, incertain of the reaction of the family, the patient left her house early without informing her husband and was found by the police. Later, she developped an incoherent speech, audio-visual hallucinations and delusions against those around her.

In Tunisia, despite the progress made in terms of equality betwen men and women, women’s sexuality still suffer from certain taboos. Sexual education needs to be improved among young people to avoid subsequent sexual problems.

No significant relationships.

In March 2020,World Health Organization characterized the COVID-19 outbreak as pandemic. This new health situation has created an anxiety-provoking climate among health professionals

To provide risks associated with the exposure of caregivers to COVID-19 for their mental health by studying the prevalence and predictors of post-traumatic stress disorder, anxiety and depression.

Our study was descriptive and analytical cross-sectional, carried out with healthcare in different hospitals in Tunisia, between 13 May until 20 June 2020. An online survey was sent to caregivers. mental health was assessed using 3 scales: PCL-5:measure the symptoms of post-traumatic stress disorder HADS :screen for anxiety and depression. PSQI:see the existence of a disturbance in sleep quality

125 caregivers participated in the survey. The average age was 32 years. The participants were predominantly female (72.8%), married (48%), and had at least one child (39.2%). 28.7% of participants had increased their consumption of coffee, especially anxious people (p = 0.001). Anxiety was retained in 44% and depression in 47.2%. Anxiety was significantly related to sex with (p = 0.039) and affects more women. The consumers of coffee developed more anxiety (p = 0.034) and depression (p = 0.026). 42.4% of participants had presented post-traumatic stress disorder. Three parameters were correlated with post-traumatic stress disorder: young age, having children and fewer years of professional experience. 62.4% of caregivers had a bad quality of sleep

This health crisis had a major impact on the mental health of our heroes. So, we should provide for them with the necessary support.

Medical studies have always been considered as very stressful. Although these students are generally among the most academically successful students, they are not spared from developing both substance and behavioral addictions, particularly pornography cyberaddiction.

To evaluate the pornography cyberaddiction in a group of tunisian students, to study their impulsivity and determinate the link between these two entities.

A descriptive and analytical cross-sectional study including 155 medical students. We used the S-IAT sex : to evaluate pornography cyberaddiction and Barrat bis 10 : to evaluate impulsivity.

The average age of students was 25.8 ±3.5 years old. The sex ratio (M/W) was 0,72. This medical students were single in 76.8%, had a high socio-economic status in 99.4% of case. They had a personal psychiatric history in 15.0%. They are smokers in 20%, consume alcohol in 30.3% and cannabis in 9% of case. The mean score of : the BIS 10 was 63.3 and the S-IAT was 15.6. The viewing of pornographic movies started around the age of 15 years old. Pornographic sites are the most frequently used tool (58.2%). The factors correlated with this addiction are: male sex (p=0.014), tobacco consumption (p=0.012), alcohol consumption (p=0.02) and impulsivity (p=0.03).

It resort from our study that medical students may suffer from pornography cyberaddiction. This increased use may be associated with impulsivity and substance use. Psychological support aimed specifically should be used to protect medical students.

Impulsivity is an important component of the phenomenology of bipolar disorder. Recent studies show that bipolar patients use various strategies to deal with life stressors and with the discomfort related to their disease.

To study impulsivity and coping strategies in bipolar patients in remission phase and the factors associated with them.

A cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder, in remission, at the psychiatric outpatient clinic at CHU Hédi Chaker in Sfax. We used a socio-demographic and clinical data sheet, the Ways Of Coping Checklist to assess coping and the Barratt Impulsivity Scale to assess impulsivity.

The average age was 43.77 years, the sex ratio was 0.5. Smoking was found in 30%. Bipolar I disorder was diagnosed in 93% of patients. The mean age of onset was 27.8 years, and the mean duration of illness was 15 years. *Impulsivity was found in 20% of cases and was correlated with the duration of the disease (p = 0.016) and smoking (p = 0.009). *Coping focused on the problem present in 70% of patients, correlated with the duration of the disease (p = 0.032) and coping (p=0.02). *Emotion-centered coping revealed in 20% of patients, correlated with gender (p = 0.037) and cognitive impulsivity (p=0.032). *Coping focused on seeking social support was present in 10% of patients.

Impulsivity is quite frequent in remitted bipolar patients, who mainly used problem-focused coping and a cognitive management of the stressful event. Thus the hypothesis was that impulsivity is core trait of bipolar disorder.

The new coronavirus has spread rapidly across the planet confining entire populations, filling hospitals overwhelmed by massive arrivals of patients This new health situation was traumatic especially for health-professionals

To study the prevalence and predictors of post-traumatic stress disorder, among health-workers.

Our study was descriptive and analytical cross-sectional, between May until June 2020. An anonymous online-survey was sent to collect those parameters Sociodemographic-information Physical symptoms The existence of contact with a suspected case The need for quarantine The stressful event The state of mental health, using: PCL-5: 20 items which measures the 20 symptoms of post-traumatic stress-disorder according to DSM-5. PSQI: 9 questions to see the existence or not of a disturbance in sleep

125 participants: 28 university-hospital doctors, 55 residents, 5 interns, 4 specialist-doctors, 2 general-practitioners, 14 nurses, 14 senior-technicians, 2 midwives and a pharmacist. The average seniority at the job was 6 years. Two factors were the most stressful: The characteristics of this pandemic 37.6% The fear of caching the virus and transmit it to their families: 37.6%. 42.4% of participants presented a post-traumatic stress disorder. 3 parameters were correlated with post-traumatic stress disorder: young age, having children (p = 0.007) and fewer years of professional-experience. This pandemic altered the quality of sleep of caregivers, 62.4% of them had a bad quality of sleep. The bad sleepers developed more post-traumatic stress disorder

This health crisis had a major impact on the mental health of our heroes that is why we should provide them with the necessary psychological support.

Sixty five patients diagnosed panic disorder and generalized anxiety disorder, having a follow up in the psychiatric department of University hospital of Sfax in Tunisia, were included in the study.

Patients were evaluated by a questionnaire assessing socio-demographic, clinical and therapeutic parameters, and the Beck Depression Inventory

Depression was associated with panic disorder in 68.6% of cases and in 56.7% with generalized anxiety disorder. In the sample of patients having a panic disorder, depression was correlated with unemployment (p = 0.048), a low educational level (p = 0.021), an addictive behavior (p = 0.015) and an impaired quality of life (p = 0.012) For patients having a generalized anxiety disorder, depression was correlated with alcoholism (p = 0.04) and an impaired quality of life (p = 0.017)

These data confirm the existence of a relationship between depression, panic disorder and generalized anxiety disorder.

These clinical findings lead to the unitary concept of anxiety and depression.

The circadian disturbance associated with night-shift work is a source of occupational hazard that has a negative impact on the physical and mental health of workers.

Explore the sleep disorders and the psychological impact among night workers.

A cross-sectional study carried on 35 employees in an industrial company . It uses a questionnaire exploring the socio-professional data, psychological effects (fatigue, sleep, anxiety and depression) and family impact of the night work.

The following scales were used:

1. – SPIEGEL questionnaire to screen for sleep disorders.

2. – EPWORTH Sleepiness Scale to evaluate daytime sleepiness.

3. – PICHOT‘s fatigue scale to assess the intensity of fatigue.

4. – HAD scale: Hospital Anxiety and Depression scale.

The overage of the workers was 32.3 ± 6.7 years. Most of them (85%) were male.

The level education was superior in 74% of cases. Two thirds of employees work at night.

Among night workers, frequent nocturnal awakenings and sleep onset difficulties were noted in respectively 65% and 35% of cases.

Nearly three-quarters of subjects had anxiety symptoms and nearly a third had depressive symptoms.

Night workers complained mainly of impaired concentration (74%) and memory impairment (52%). Excessive fatigue was identified in 17, 4% of cases.

At the family level, 65% of subjects reported that night work cause disruption of their family life and of their quality of life.

Sleep disorders, anxiety and depression disorders are frequently found in night work. Besides, working the shift night can affect family life and the quality of life as well.

Impulsivity is recognized as a predisposing factor for addictive, suicidal and aggressive behavior.

The aims of our study were to evaluate the level of impulsivity in inpatients and identify risk factors associated.

Our study was conducted among 32 inpatients in the psychiatry ward ‘B’ in Sfax, Tunisia.

We collected socio-demographic and clinical data and we measured impulsivity using the Barratt Impulsiveness Scale (BIS-11), insight using insight Q8 scale and medication adherence rating scale (MARS).

The mean age of the sample was 36.72 years.

Patients had a low socioeconomic status in 50% of cases.

They had a criminal record in 25% of cases, a history of suicide in 34.4% of cases and addictive behaviors in 59.4% of cases.

Ninety-four percent of patients had a violent behavior.

Patients were diagnosed with schizophrenia in 59.4% of cases, suffering from mood disorders in 28.1% of cases, and had manifested personality disorder in 18.8% cases.

The percentage of patients with a high degree of impulsivity was 59.4.

Patients had poor insight in 75 % of cases and were not adherents to treatment in 65.6 % of cases.

Impulsive patients were smokers (p=0.046), had a familial history of violent behavior (p=0.01), had poor insight (p=0.02) and were not adherent to treatment (0.04).

Impulsive behavior is associated with several factors, including addictive behavior, poor insight and lack of adherence to treatment. It is imperative to detect and treat them in time to avoid serious consequences.

Marital abuse is a serious social problem that has damaging impact on women's wellbeing. Therefore, prevention and intervention efforts require determining the risk factors involved.

Study the prevalence and risk factors of marital violence against women.

A descriptive cross-sectional and analytical study carried on 50 married women without psychiatric history.

Data collection was conducted via a questionnaire exploring socio-demographics characteristics and the marital relationship.

- The Conflict Tactics Scales (CTS): to assess verbal domestic violence (six items) and physical domestic violence (nine items).

- Maternity social support scale (MSSS): to evaluate the social and family support.

- Marital satisfaction scale of Azrin: assessing the satisfaction experienced of the wife at the partner's behavior.

The average age was 41 ± 11.5 years.

Education level did not exceed the primary level in 64% cases. The socioeconomic level was judged to be average in 72% of cases.

The prevalence of marital violence in its verbal and physical forms was 72%. More than one third of women (44%) reported that they were victims of physical violence.

Low socioeconomic level (p=0,003), low partner’s educational level (p=0,049), parental history of childhood abuse (0,002), poor marital satisfaction (0,001) and poor social and family support (0,01) were significantly associated with physical violence.

Marital abuse in its various forms remains a worldwide phenomenon. Several risk factors inherent to the woman, the husband and their marital relationship seem to be associated with marital violence in its physical form.

Diabetes and depression remain among the major problems of public health in the world. These diseases complicate each other. Several factors contribute to the occurrence of depression in diabetic. Thus, it would be necessary to determine them in order to prevent its occurrence.

To assess the prevalence of depression in a population of diabetics and to identify factors contributing to the occurrence of depression in diabetics.

A cross case-control study among 100 hospitalized diabetics in the department of endocrinology, Hedi Chaker hospital in Sfax Tunisia. We compared them to 100 witnesses. Then, we compared the two subgroups of depressed and non-depressed diabetics. We used the Hospital Anxiety and Depression Scale to screen for depression, the Beck Depression Inventory scale to determine the degree of its severity and the MINI to identify patients with a current major depressive episode (MDE) among depressed subjects.

The prevalence of depression was higher in diabetics (35% versus 14%). The prevalence of MDE was 71.43%. Depression was severe in 40% of cases. Comparing to the non-depressed diabetics, depressed diabetics were predominantly female and older. The duration of diabetes, mostly type 2, was longer. These subjects had more acute and chronic complications. Correlation factors of depression in diabetics were: advanced age, low socio economic level, low physical activity, stressful life event, lower limb arteritis, gastroparesis, android obesity, disturbance of lipid profile and anxiety.

Factors involved in the onset of depression in diabetic subjects should be taken into account to improve management of diabetes

Thirty two women diagnosed PCOS, were included in the study. The questionnaire contains a general part concerning socio-demographic conditions, medical history, health problems, PCOS symptoms Sexual satisfaction was evaluated by “the Female Sexual Function Index” (FSFI).

The mean age of PCOS women was 28.9 ± 5.6 years, Sixty per cent of PCOS women had miscarriages and half of of the sample was treated for infertility.

Eighty five percent of patients with PCOS had a morbid obesity (BMI > 30 kg/m2). Ninety five per cent of PCOS women had an hirsutism Marital sexual dysfunctions were found in 50% of the sample (global score of FSFI < 26). Marital sexual disorders were significantly increased with presence of hirsutism (p < 0.01). BMI had no impact on the sexual satisfaction. Both obese and non obese women with PCOS reported being significantly less satisfied with their sex life in the past month (p < 0.001), finding themselves significantly less sexually attractive (p = 0.03), perceived their husbands as less satisfied with their sex life (p = 0.001), and reporting that excessive body hair affected their sexuality (p = 0.003). BMI also had no significant effect on the frequency of sexual intercourse or sexual thoughts and fantasies.

This study shows many sexual problems affecting patients with PCOS. A medical treatment which aimed to improving PCOS-related symptoms can reduce psychological distress and improve sexual self-worth.

Women with bipolar disorder warrant special consideration with regard to sexual health. The impairment in sexual function would be frequent but underestimated and contributes to non-compliance with treatments.

(1) Evaluate sexuality among a population of women affected by bipolar disorder.

(2) Determine the factors associated with impaired sexual function.

This is a cross-sectional and descriptive study during the period ranging from 1st September to 15 October 2015.

It was conducted in 40 women suffering from bipolar disorder.

The exclusion criteria were: relapse period in sick, age over 60 years or severe somatic comorbidity.

The evaluation of sexual function was made using the “Sexual Behavior Questionnaire” (SBQ).

The mean age was 30 years. Bipolar disorder type I accounted for 72.5%.

According to the SBQ, 37.5% of patients had a desire disorder, 57.5% had a frequency less than 3 times per week sexual intercourse, 45% had a drop in excitation and 42.5% were not satisfied with their sex life.

Sexual problems are positively correlated at an early age of onset of bipolar disorder (P = 0.001).

The lack of desire, the sexual excitation disorder and the decrease in the frequency of sexual intercourse are positively correlated with the depressive phase of bipolar disorder.

A better understanding of sexual behavior in women with bipolar disorder and the early screening of the sexual disorders must be integrated into the management of the disease. It can improve their quality of life and adherence to therapy.

The authors have not supplied their declaration of competing interest.