In addition to psychological distress, neurological and neurocognitive manifestations, the COVID19 pandemic and its medium- and long-term consequences combine other risk factors to alter sleep.

To screen for COVID19 sleep disorders and to identify epidemiological and clinical factors correlated with this disorder in post COVID19 patients.

This is a descriptive and analytical cross-sectional study that took place during the period from the 1rst of March to the 15th of May 2021 with 154 patients who were hospitalized at the COVID unit19 at the Hedi Chaker Hospital in Sfax Tunisia.

The sleep evaluation, made by telephone, was performed using the “Insomnia Severity Index” scale.

The mean age was 66.62 ± 13.34 years. Male patients represented 60.4% of the study population.

In our study, the prevalence of anxiety, depression and post-traumatic stress disorder was 24.7%, 11% and 13.6% respectively.

The mean score of the sleep disorder severity index was 3.94 with extremes of score ranging from zero to 24. Thirty-six patients (23.4%) had insomnia, which was severe in 2.6% of patients.

We found a significant association between gender and sleep disorders. Thus, women were more likely to have insomnia.

A significant association was found between insomnia, anxiety-depressive disorders and post-traumatic stress disorder.

No significant association was found between disease characteristics and sleep disorders.

In post COVID, patients suffer from an important sleep disorder. Indeed, the management of these sleep disorders in post Covid-19 is essential to improve the quality of life of these people.

None Declared

Cleft lip and palate are birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy. Individuals with a cleft of the lip and/or palate (CL/P) differ from their peers due to their facial appearance, hearing and speech problems, in addition, it causes psychosocial impacts among affected children. However, among untreated adults, it seems that psychological sequelae can be major and life limiting.

The purpose of this study is to assess Algerian untreated young CL/P patients psychological and lifestyle issues.

This is a survey-based cross-sectional study conducted during August- October 2022 in Algeria through an online survey which is a self-administered questionnaire ( SAQ). The study target population were young individuals ( age between 17 and 30) with untreated or partially treated clef lip and palate confitions. The questionnaire consisted of 10 multiple questions including a demographic section, evaluating patients satisfaction, lifestyle, psychological problems related to their conditions and limitations due to it. All participants provided their informed consent prior to their participation. The Statistical Package for the Social Sciences (SPSS) version 22.0 was used to analyse the collected data.

Final sample size consisted in 207 responses. The mean age of the participants was 24.3± 3 years. Findings showed that slightly more that three fourths (75,9%) of participants reported that they are unsatisfied of their life because of their CL/P condition. Among 120 uneducated participants, (67%) of them reported thay they abandoned school because of their appearance. For P <0.001, suicide thoughts were higher among female participants (38%) than male participants (9%). Almost half of respondents (49.4%) presented strong immigration desires due to their education, relationships and psychosocial health issues.

The psychological impact of cleft lip and palate in adults appears to be disturbing, chronic and life-limiting. Urgent approaches to ensure the early management of cleft lip and palate in Algeria remain mandatory. Increasing the number of specialized maxillofacial services seems to be a good first step.

None Declared

Coronavirus 2019 (COVID19) is a contagious disease. Infected patients are not only the vectors of the disease but also often the victim of the social stigma attached to it.

To assess the social stigma perceived by post-COVID19 patients.

This is a descriptive and analytical cross-sectional study that took place during the period from 1st March to 15th May 2021 with 154 patients who were hospitalized at the COVID19 unit at Hedi Chaker Hospital in Sfax.

The anxiodepressive disorders were screened using the “Hospital Anxiety and Depression Scale”. Post-traumatic stress disorder was assessed using the Impact of Event Scale-Revised.

Perceived stigma due to COVID19 was assessed by items from the psychometric tool: self-reported instrument measuring COVID19-related stigma.

The mean age was 66.62 ± 13.34 years. Male patients represented 60.4% of the study population.

In our study, the prevalence of anxiety, depression and post-traumatic stress disorder was 24.7%, 11% and 13.6% respectively.

In our study, 21.4% of the participants felt discrimination and social stigma, especially from neighbors (18.2%).

Anxiety was statistically correlated with the presence of stigma related to COVID19.

We have a highly significant relationship between depression and stigma. (p=0.002)

No correlation was found between stigma and post-traumatic stress disorder.

In addition to social stigma, people with COVID 19 may perceive themselves as different from normal in terms of physical or mental abilities, leading to a high likelihood of self-stigma and social isolation.

None Declared

Patients hospitalized in the case of COVID19 have had to face a complex and potentially very stressful situation. In this context a screening program for psychological distress in patients with COVID19 is necessary.

To screen for post-traumatic stress disorder post COVID19 and to identify the epidemiological and clinical factors correlated with this disorder in post COVID19 patients.

A descriptive and analytical cross-sectional study that took place during the period from 1st March to 15th May 2021 with 154 patients who were hospitalized at the COVID19 unit at Hedi Chaker Hospital Sfax.

We used a pre-established form to record sociodemographic, clinical and therapeutic data. The post-traumatic stress disorder was assessed by the “Impact of Event Scale-Revised”.

The mean age was 66.62 ± 13.34 years with a male predominance of 60.4%. In our sample, 77.9% of the patients had a somatic history, of which hypertension was the most frequent pathology (46.1%). The average length of hospitalization was 9.5 days ± 6.3. The form was considered severe in 27.9 cases.

According to the IES-R scale, twenty-one patients (13.6%) had post-traumatic stress disorder, with a predominance of women (57.1%).

A significant association was found between marital status and post-traumatic stress disorder. Thus, married or widowed patients are more likely to develop PTSD.

In the present study, we did not find statistically significant associations between the clinical characteristics of the disease (severity of the disease, length of hospitalization, functional signs) and post-traumatic stress disorder.

Psychological support interventions in surviving patients of COVID 19 is necessary aiming to increase resilience, manage coping strategies and decrease the deleterious impact of the pandemic on mental health.

None Declared

Many studies have attempted to delineate the positive relationship between anxiety and depressive symptomatology in outpatients with bronchial asthma. However, do not exist reports on the relation between the depression, anxiety and vital exhaustion in these patients.

Aim of the study is to investigate the levels and the associations between anxiety, depression and vital exhaustion in outpatients with bronchial asthma.

The study was performed in one of the largest hospitals of chest diseases in Greece. Forty (14 men και 26 women) outpatients with bronchial asthma participated in the study. Using the BDI (Beck Depression Inventory), the STAI (Spielberger Anxiety Trait Inventory) and the Maastricht Questionnaire (MQ) we assessed depression, anxiety and vital exhaustion, respectively. Age and duration of the disease were also recorded.

Means of age and of duration of the disease were 43.22±13.05 and 9.24±6.01 years, respectively. The mean STAI score was 42.47±9.9, mean BDI score was 14,16±7,54, and the mean MQ score was 21.02±11.05. Percentages of 29% and 60% of the sample were presented with significant anxiety and depressive symptoms, respectively. No correlation was observed between the demographics (age and duration of disease) and the STAI's and MQ's scores. In contrary, a positive correlation was observed between the levels of depression, anxiety and vital exhaustion (pearson correlation p< 0.001).

The study confirms the coexistence of the depressive symptomatology with anxiety and vital exhaustion in outpatients with bronchial asthma. Therefore, this comorbidity should be taken into account in order to develop specific supportive psychological interventions.

An operation is undoubtedly a stressful event, which can induce emotional, cognitive and physiological reactions in preoperative patients. Aim of our study is to investigate the associations between the levels of state - trait anxiety and the demographics (gender and age) in patients prior a thoracic surgery.

Seventy-six (57 males and 19 females) patients, with ASA I-III and with mean age 45.65±15.17 years were included in the study. All subjects fulfilled the Spielberger State-Trait Anxiety Inventory (SSTAI), 12 - 15 hours before the thoracic surgery.

Mean state and trait anxiety scores were 42.35±11.50 and 38.55±9.03, respectively and presented a strong positive correlation (Pearson Correlation, p< 0.001, r=0.585). Percentages of 30.3% and 13.2% of the sample were presented with clinically significant anxiety levels (t-test, p=0.001). Females appeared with higher state (t-test, p=0.001) and trait (t-test, p=0.076) anxiety scores compared to males. As to age, we observed a negative correlation with the levels of state and trait anxiety. (Pearson Correlation, p=0.05, r=-0,226 and p=0.006, r=-0.313, respectively).

Our findings suggest that females and younger patients are more vulnerable to anxiety symptoms prior a thoracic surgery. Thus, gender and age should be taken into account for the preoperative assessment in order to develop supportive psychological interventions.

Neuropsychiatric literature demonstrates the high impact of cognitive deficits in patients with Multiple Sclerosis (MS), as well as the increased prevalence of anxiety and depression in patients with chronic illnesses, especially in the subgroup of MS patients. The aim of our study is to investigate the existence of an association between depression, anxiety and cognitive deficits in patients with MS.

Demographic data, MS subtypes, and years since diagnosis were documented for 60 patients with MS, who participated in our study. Patients were evaluated for depression and anxiety by the Beck's Depression Inventory (BDI) and the Spielberger's questionnaire (State-Trait Anxiety Inventory) respectively. The Symbol Digital Modalities Test (SDMT) was used to evaluate cognitive deficits.

According to our preliminary data, 60% of MS-patients scored higher than normal in the BDI. There was a significant negative correlation between years since diagnosis and SDMT (Pearson's correlation <0.01), as well as between BDI and SDMT (Pearson's correlation <0.01). No correlation was established between anxiety and both depression and SDMT.

Depression and cognitive deficits have a high prevalence in patients with MS. This is due to the severity and chronicity of MS. In our study, depression is strongly associated with cognitive deficits and years since diagnosis of MS, although it is still in progress for further data evaluation. More studies are required to elucidate the cause of this established association.

Chronic prostatitis has been long considered a psychosomatic illness, however the psychological profile of patients suffering from it, has not been fully elucidated yet.

Patients diagnosed with chronic prostatitis at a tertiary care ID clinic are evaluated for the presence of alexithymia, with the use of the Toronto Alexithymia Scale, as part of a prospective cohort. Patients were categorized according to the NIH Consensus Classification System for Prostatitis Category. Association of psychiatric symptoms with prostatitis category was performed.

Preliminary results are reported for 30 patients (median age 43 years old; IQR= 36-52). According to the NIH Prostatitis Classification System patients were categorized as type II : 48.2%, type IIIa: 6.9 %, type IIIb: 38%, type IV: 6.9%. Median CPSI score was 16 (IQR: 11-25). Abnormal TAS score was noted in 72% of the population. Specifically, 90% had high scores in external orientation of emotions, 25% in identification of emotions and 38% showed reduced expression of emotions. It is of notice, that mean TAS scores were significantly higher in type IIIa prostatitis cases (p=0.002, ANOVA).

High rates of alexithymia were noted in prostatitis subjects especially in type IIIa cases. These findings need further prospective evaluation.

It is known that patients with chronic and life - threatening diseases often presents anxiety and depressive symptoms.

The comparison of the levels of anxiety and depression in patients with chronic obstructive pulmonary disease (COPD) and in patients with lung cancer.

The completion of the HADS scale was requested in 42 randomly selected patients (21 with lung cancer and 21 with COPD).

Higher rates appeared in the subscales of anxiety and depression of the HADS (12.88 SD 5.03 and 13.45 SD 5.60, respectively) compared to the general hospitalized patients. Pathological rates of anxiety appeared at the 59.5% of the sample, while pathological rates of depression were found at 45.2%. Patients with lung cancer presented higher total score at HADS against patients with COPD (29.48 SD 9.3 vs 23.19 SD 8.26, t test p < 0. 05). In the subscale of anxiety appeared statistically higher average rate in patients with cancer against patients with COPD (14.43 SD 4.97 vs 11.33 SD 4.33, t test p < 0.05). Among the demographic factors, only age seemed to participate to the anxiety variation.

Patients with COPD such as patients with lung cancer are presented with high rates of anxiety and depressive symptoms. Patient's age seems to be a significant factor at the variation of the anxiety symptoms.

To detect phenomenological gender differences in elderly patients with depression for better understanding. In addition to illustrate neuro- psychological gender differences in elderly patients with depression for better management.

A case/control, comparative study with consecutive sample. 80 elderly Egyptian subjects of both sexes aged 60 years or above recruited from psychiatry outpatient clinic in Kasr Al Aini and Beni Suef hospitals with no obvious cognitive impairment or substance related psychiatric disorders. The subjects were classified into 2 groups (depressed patients and control groups) 40 subjects each.

Diagnostic criteria of the DSM-IV TR, Symptom checklist, MMSE, GDS,WAIS and STAI were used.

Comparison between the depressed patients and the control group revealed that the depressed group has affected cognitively than the control group as assessed by MMSE and also showed deterioration of intellectual abilities (deterioration index). Comparison between the depressed males and females subgroups revealed that the characteristics of the patients and correlates of depression are similar in both sexes except for some significant findings e.g, depression in elderly women is more associated with widowhood, more suffering of sense of worthlessness, more affection of attention and more disturbance in reasoning and costructional abilities.

Depression in older patients is related to widowhood, presence of family conflicts an positive past history of depression. There were no gender differences in elderly depressed patients except for that depression in elderly women is more associated with widowhood, sense of worthlessness, more affection of attention and more disturbance in reasoning.

The high prevalence of psychiatric comorbidity in drug dependent individuals is well known. However, there is limited literature available regarding the comorbidity of psychiatric disorders in drug addicts on methadone maintenance treatment (MMT).

To determine the comorbidity of mental disorders in patients on MMT.

The Symptom Checklist 90-Revised (SCL-90R) [1] was completed by 85 drug addicts (65 male and 20 female) on MMT. We recorded demographic data, duration of addiction, and duration of MMT.

The mean age of the sample was 42.0 ± 8.8 years old, the mean duration of substance use was 24.3 ± 8.2 years and the mean duration of MMT was 6.8 ± 4.1. The majority of participants (78.8%) were unemployed and 58.3% of them had no children. Participants scored higher on the depression, paranoid ideation, anxiety, hostility, somatization, interpersonal sensitivity and psychoticism SCL-90R sub-scales, with average scores >1 [2]. On the contrary, lower scores were recorded in the obsessive-compulsive and phobic anxiety sub-scales. The percentage of participants that reported abnormal scores for each sub-scale was as follows: 89.3% for depression, 83.3% for paranoid ideation, 74.7% for anxiety, 66.7% for hostility, 64.7% for somatization, 51.2% for psychoticism and 35.7% for phobic anxiety. No abnormal scores were recorded regarding obsessive-compulsive symptoms. Only 8.4% of participants did not score abnormally on any sub-scale.

Drug-addicted patients on MMT show a high comorbidity of psychiatric disorders. In particular, the likely presence of depressive and paranoid symptoms should be taken into serious account when deciding on a therapeutic strategy.

Electroconvulsive therapy (ECT) has a long history in treating depression and its benefits are well known. Repetitive transcranial magnetic stimulation (rTMS) has been introduced more recently to the treatment spectrum.

To test the equivalence of rTMS with ECT, and compare the neurocognitive side effects of both treatment modalities.

This is a randomized comparative study, forty patients with major depressive disorder referred for ECT were randomly assigned to either a 20 session course of r TMS to the left dorsolateral prefrontal cortex or a standard course of ECT. The primary outcome measure was the score on the Hamilton Depression Rating Scale HAM-D. Secondary outcome measures were cognitive battery that assessed different aspects of cognitive functions and a subjective mood visual analogue scale. The cognitive battery comprised the Rey-Osterrieth complex figure test, the Trail making test A and B, the Digit span subtest from the Wechsler Adult Intelligence Scale.

ECT was more effective than rTMS in the short-term treatment of major depressive disorder as evident by HAM-D scores. rTMS was well tolerated with less impact on the cognitive functions compared to ECT. Level of improvement by ECT was correlated with older age, and severe baseline HAM-D symptoms, while the level of improvement by rTMS was correlated with more memory affection at the end of treatment.

ECT was more effective than rTMS in the short-term treatment of major depressive disorder regarding the overall mood symptoms. rTMS was well tolerated with less impact on the cognitive functions.

Quality of life (QoL) is a complex concept that depends on many factors such as life style, past experiences, expectations, future plans and ambitions. It may be altered in patients suffering from chronic disease.

Assess QoL in patients with asthma as well as associated factors.

We conducted a cross-sectional, descriptive and analytic study, including 30 patients followed for asthma at pulmonary outpatient department, Hedi Chaker Hospital, Sfax, Tunisia. Asthma control level was evaluated by the Asthma Control Test (ACT). QoL was assessed using the 36-item Short Form Health Survey (SF-36), that contains 36 questions grouped into 8 domains (D1: Physical Functioning, D2: Role limitations due to physical problems, D3: Bodily Pain, D4: General Health, D5: Vitality, D6: Social Functioning, D7: Role limitations due to emotional problems and D8: Mental Health).

The mean age was 51 ans. The mean duration of disease was 11 years. The average ACT score was 16.8 points. Asthma was uncontrolled in 1/3 of patients. The mean of average overall scores SF-36 was 46.22. QoL was altered in 83.3% of patients. The most altered domains were D8 followed by D7then D4 and D2. The average overall score SF-36 was correlated to ACT score (P < 0.001), early age of onset of the disease (P = 0.049) and poor asthma control (P < 0.001). Altered QoL was associated to advanced age (P = 0.016), long duration of disease (P < 0.001) and low ACT score (P = 0.034).

Optimum asthma and associated comorbidities support would improve control and therefore the patient's quality of life.

The authors have not supplied their declaration of competing interest.

Alexithymia refers to difficulties in verbal expression of emotions, commonly observed in patients with psychosomatic symptoms. In this context, asthma is described as one of psychosomatic diseases.

Identify clinical profile of asthmatic patients and assess the alexithymia level as well as associated factors.

We conducted a cross-sectional, descriptive and analytic study, including 30 patients followed for asthma at pulmonary outpatient department, Hedi Chaker Hospital, Sfax, Tunisia, during September and October 2015. We collected socio-demographic and clinical characteristics. Asthma control level was assessed by the Asthma Control Test (ACT). Alexithymia was measured using Toronto Alexithymia Scale (TAS 20).

The mean age was 51 ans. Sex-ratio F/M was 14. The mean duration of disease was 11 years. Long-term control medicines were: inhaled corticosteroids, long-acting beta agonists and theophylline respectively in 86.7%, 33.3% and 26.7%. Two thirds of our patients had a bad therapeutic adherence. The average ACT score was 16.8 points. Asthma was uncontrolled in 1/3 and well controlled in 1/3 of cases. The average TAS 20 score was 64.8 points. Twenty percent of patients were non-alexithymic, 13.3% had a probable alexithymia and 66.7% were alexithymic. This score was positively correlated to bad asthma control (P < 0.001), long term evolution (P = 0.002) and use of inhaled corticoids (P < 0.001). It was inversely correlated to ACT score (P < 0.001).

Our study shows the high prevalence of alexithymia in patients with asthma and its negative impact in asthma control. Psychological support aiming specifically alexithymic dimension in these patients is indispensable.

The authors have not supplied their declaration of competing interest.

Despite the magnitude and protracted nature of the Rohingya refugee situation, there is limited information on the culture, mental health and psychosocial wellbeing of this group. This paper, drawing on a report commissioned by the United Nations High Commissioner for Refugees (UNHCR), aims to provide a comprehensive synthesis of the literature on mental health and psychosocial wellbeing of Rohingya refugees, including an examination of associated cultural factors. The ultimate objective is to assist humanitarian actors and agencies in providing culturally relevant Mental Health and Psychosocial Support (MHPSS) for Rohingya refugees displaced to Bangladesh and other neighbouring countries.

We conducted a systematic search across multiple sources of information with reference to the contextual, social, economic, cultural, mental health and health-related factors amongst Rohingya refugees living in the Asia-Pacific and other regions. The search covered online databases of diverse disciplines (e.g. medicine, psychology, anthropology), grey literature, as well as unpublished reports from non-profit organisations and United Nations agencies published until 2018.

The legacy of prolonged exposure to conflict and persecution compounded by protracted conditions of deprivations and displacement is likely to increase the refugees' vulnerability to wide array of mental health problems including posttraumatic stress disorder, anxiety, depression and suicidal ideation. High rates of sexual and gender-based violence, lack of privacy and safe spaces and limited access to integrated psychosocial and mental health support remain issues of concern within the emergency operation in Bangladesh. Another challenge is the limited understanding amongst the MHPSS personnel in Bangladesh and elsewhere of the language, culture and help-seeking behaviour of Rohingya refugees. While the Rohingya language has a considerable vocabulary for emotional and behavioural problems, there is limited correspondence between these Rohingya terms and western concepts of mental disorders. This hampers the provision of culturally sensitive and contextually relevant MHPSS services to these refugees.

The knowledge about the culture, context, migration history, idioms of distress, help-seeking behaviour and traditional healing methods, obtained from diverse sources can be applied in the design and delivery of culturally appropriate interventions. Attention to past exposure to traumatic events and losses need to be paired with attention for ongoing stressors and issues related to worries about the future. It is important to design MHPSS interventions in ways that mobilise the individual and collective strengths of Rohingya refugees and build on their resilience.

ENT is highly under-represented in the saturated UK medical school curriculum, comprising less than 1 per cent of the curriculum. A 1-day course was implemented in order to raise awareness of ENT among medical students, educate them in the specialty and teach a basic skill.

The skills day comprised lectures by consultants followed by a consultant-led workshop teaching tracheostomy. Pre- and post-course questionnaires assessed perceptions of ENT, confidence performing tracheostomy and interest in ENT as a career.

Perceptions of ENT as a specialty were improved by up to 80 per cent (p < 0.01). There was improved understanding of and confidence in performing tracheostomies. Interest in a career in ENT was increased by 77 per cent (p < 0.01).

A 1-day course run by a student body can be a powerful adjunct to the medical school curriculum, in terms of educating undergraduates in ENT and inspiring the pursuit of ENT as a career.