IntroductionUniversity life is stressful for the student, which is characterized by disturbed emotional regulation or alexithymia. To face these stressful events he must use certain coping strategies.ObjectivesStudying the prevalence of alexithymia and exploring coping strategies among medical students, and establish the relationship between these parameters.MethodsIt was a cross-sectional study of 97 students in Sfax university medicine (Tunisia). We used:– a questionnaire containing demographic and clinical data;– Toronto alexithymia Scale (TAS-20): a score ≥61 indicates alexithymia;– WCC (Ways of Coping Checklist-r Folkman) with 3 factors: problem-focused, emotion-focused and social support coping.ResultsThe average age of participants was 24.07 years (±2.71); the sex ratio (M/W) was 0.4. They were smoking in 36.1% and sedentary in 43.3% of case. They had a nibbling activity in 57.7%. The average score of TAS-20 was 50. 92 10.46 and alexithymia was found in 16.5% of students. Alexithymia was significantly correlated with smoking (P = 0.003) and physical inactivity (P = 0.025). Most students (72.2%) opted for problem-focused ways of coping with a highest score at WCC = 29.21. A significant correlation was found between alexithymia and coping strategy with emotion-focused (P = 0.02). The TAS score was significantly higher among students who resort to this ways of coping = 26.11. (P = 0.002).ConclusionThis study explored the role of alexithymia in stress management ubiquitous in university life. A high level of alexithymia could be a detrimental factor in stress management. Psychological support aimed specifically alexithymic dimension is indispensable.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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IntroductionWernicke’s encephalopathy is a potentially fatal neurological emergency caused by thiamine deficiency. Although it is often associated with chronic alcoholism, it can also occur in all situations that lead to a thiamine deficiency such as undernutrition and exclusive artificial feeding.ObjectivesIn this work, we propose to study the clinical and treatment concerns of Wernicke’s encephalopathy complicating catatonic schizophrenia.MethodsWe retrospectively report the case of a patient who developed a Wernicke’s encephalopathy in the aftermath of catatonic schizophrenia.ResultsMr H.L, a 47-year-old-male has been followed in psychiatric hospital since the age of 27 for catatonic schizophrenia. He has been hospitalized in July 2020 because of oral intake refusal, social isolation and lack of self-care with a poor compliance to treatment. Examination of the patient revealed catalepsy, mutism and negativism. He was treated with antipsychotics drugs, benzodiazepines and parenteral nutrition. About six weeks after his hospitalization, the patient developed horizontal nystagmus and ataxic gait. Magnetic resonance imaging was consistent with Wernicke encephalopathy. Vitamin B1 dosage was 32nmol/l. Parenteral thiamine replacement therapy was initiated with clinical improvementConclusionsCatatonic schizophrenia can be associated with severe malnutrition and thus with thiamine deficiency and Wernicke’s encephalopathy. An early intervention by supplying prophylactic thiamine given parenterally in high-risk patients is crucial to avoid Korsakoff syndrome, as well as cardiovascular and neuropsychiatric complications associated with thiamine deficiency.

Introduction this is the first study assessing the psychological impact on Tunisian general population during the first peak of the COVID-19 pandemic. We aimed to assess the prevalence of anxiety, depressive symptoms and insomnia, as well as associated factors. Methods a cross-sectional study was conducted through an online survey of 1615 people during March 23 rd to May 5 th , 2020. We used the hospital anxiety and depression scale for anxiety and depression screening, and the insomnia severity index to assess sleep disturbances. Results our study revealed a high prevalence of anxiety and depressive symptoms, and insomnia (70.9%, 71.1% and 60.6% respectively). Multivariable statistics showed that anxiety symptoms were correlated to female gender (adjusted odds ratio [aOR] 1.784, 95% confidence interval (CI 1.252-2.542; p=10 -3 ), history of mental illness (aOR: 1.680, 95% CI: 1.329-2.125; p<10 -3 ), frequently social media exposure (aOR: 1.578, 95%CI: 1.250-1.992; p<10 -3 ), times to focus on COVID-19 ≥ 3hours (aOR: 1.840, 95% CI: 1.433-2.362; p<10 -3 ), consultation with doctor in the clinic in the past 14 days (aOR: 1.821, 95%CI : 1.220-2.718; p=0.003) and recent traumatic event in the past 14 days (aOR: 1.641,95% CI: 1.331-2.024; p<10 -3 ). Principal factors associated with depressive symptoms included female gender (aOR: 1.637, 95% CI: 1.150-2.331; p=0.006), history of mental illness (aOR: 1.498, 95% CI: 1.189-1.888; p=10 -3 ), times to focus on COVID-19 ≥ 3hours (aOR: 1.956, 95% CI: 1.555-2.461; p<10 -3 ), and recent traumatic event in the past 14 days (aOR: 1.558, 95% CI: 1.265-1.919; p<10 -3 ). The main factors correlated to insomnia were younger (age <35years) (aOR: 1.592, 95% CI: 1.17 -2.152; p=0.003), female gender (aOR: 1.864, 95% CI: 1.252-2.775; p=0.002), having organic diseases (aOR: 1.527, 95% CI: 1.131-2.061; p=0.006), history of mental illness (aOR: 1.777, 95% CI: 1.396-2.263; p<10 -3 ), students (aOR: 1.931, 95% CI: 1.495-2.495; p<10 -3 ), times to focus on COVID-19 ≥3hours (aOR: 1.877, 95% CI: 1.467-2.400; p<10 -3 ) and recent traumatic event (aOR: 1.431, 95% CI: 1.144-1.789; p=0.002). Conclusion our study revealed a major mental health burden in Tunisia during COVID-19 pandemic. Many factors were correlated to anxiety, depressive symptoms and insomnia, suggesting the need for greater psychological support in general and in certain vulnerable groups.

IntroductionSystemic sclerosis (SSc) is a chronic connective tissue reaching the skin and blood vessels, responsible for disability and impaired quality of life.ObjectiveThe objective of this study was to evaluate the quality of life and mood in a group of patients with SSc.MethodsOur study was descriptive, conducted between October 2011 and June 2012; Among the 15 women hospitalized with SSc, 10 agreed to participate in the study. Quality of life was assessed by the WHOQOL BREF scale (World Health Quality of Life-Brief Version). Emotional disorders have been evaluated by the “Hospital Anxiety and Depression Scale” (HAD).ResultsThe average age was 52.4 ± 8.2 years (38-65 years). Our patients were estimated to have a quality of life overall average with a total score scale WHOQOL BREF close to 60 of 120. The values of the four domains were: physical health 46± 8.8 [31-56], psychological health 50.7± 11.2 [31-69], social relations 57.5 ±15.5 [25-75], environment 52 ± 11 [31-63]. Eight women had a score HAD A >10 defining an anxious states certain. Seven patients had a score HAD D > 10 defining a depression certain. 7 out of 10 women said they needed psychological help and were supported jointly in psychiatry.ConclusionOur results underline a high frequency of emotional disorders in patients with SSc. Similarly, the quality of life has been altered. These results suggest a widespread screening for anxiety and depression.