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Recent advances in information technology (IT) provided us with novel teaching solutions, with the potential of a new enhanced learning experience, that is, more adapted to the needs and preferences of the younger generations of psychiatric trainees. These tools include the use of online/virtual whiteboards, live surveys/polls, live quizzes, virtual classrooms, and virtual reality. In the present paper, we describe the implementation of modern technology in psychiatric training in Tunisia, a North‐African middle‐income country. We discuss the potential benefits arising from this implementation, and we report the challenges and difficulties. Overall, the implementation of these modern technology‐based tools in psychiatric training has been successful, with a very few obstacles. It seems that the integration of these novel approaches is possible even in middle and low‐income countries without much hassle. These tools can enhance trainees' participation, motivation, and engagement, thereby potentially improving learning outcomes. Most disadvantages are related to potential technical glitches, and are likely to improve as technology progresses. Teaching is the art of tailoring the educational tools to the learning objectives and to the learners' characteristics and preferences. To achieve optimal learning outcomes, it is often needed to use a mixture of different "modern" and "less modern" techniques. [ABSTRACT FROM AUTHOR]

Background: This study aims to verify the accuracy of item 10 on the energy level of the Short-Form Health Survey (SF-12) in an item screening according to Mood Disorder Questionnaire (MDQ) results, providing a measure of hyper-energy. Methods: Regression techniques were employed in a dataset comprising 4093 records of respondents to test both linear and nonlinear relationships between predictor and outcome variables (energy level and symptoms considered in the MDQ). We examined the relationship of energy level with cases identified using MDQ with a cut-off of 7. Results: Levels of energy, as rated on item 10 of the SF-12, were related to the MDQ score with sensitivity = 0.72 and specificity = 0.70. In linear regression, the associations were stronger with MDQ items on excessive energy or activity, showing a medium effect size and an explained variance of 10% or higher. A greater association was observed for items on excessive energy and activity, as expected, as well as for items concerning self-confidence, sociability, and talkativeness. Conclusions: This result may have implications for the research on risk factors and the pathogenesis of the dysregulation of mood, energy, and social rhythms syndrome (DYMERS), a syndrome that is hypothesized to occur in stressful conditions like those shown under the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

L'électroconvulsivothérapie (ECT) est la plus ancienne technique encore utilisée en psychiatrie. Néanmoins, ses effets indésirables cognitifs sont fréquents, notamment les plaintes mnésiques. L'objectif principal de cette revue est de décrire la nature des troubles mnésiques liés à L'ECT, l'évolution à court et à long terme et les facteurs de risques associés puis de proposer des recommandations d'évaluation et de suivi appropriées. Une revue systématique de la littérature a été réalisée au mois d'avril 2022, suivant la méthodologie PRISMA. Les équations de recherche ont été entrées dans PubMed et Cochrane en utilisant les termes suivants : « cognition » et « electroconvulsivetherapy » ou « amnesia » et « electroconvulsive therapy » ou « adverse effects » et « electroconvulsivetherapy ». La recherche a été réalisée de l'année 2000 à 2022. Notre revue a permis d'inclure vingt articles dont quatre sur la nature et l'évolution des troubles mnésiques, trois sur les mécanismes, six sur les facteurs de risque, trois sur l'évaluation et les tests cognitifs et quatre sur la prise en charge. Les données ont montré une atteinte de la mémoire antérograde et rétrograde. Dans les jours qui suivent la séance, les capacités de se souvenir des événements survenus après l'ECT ainsi que des connaissances générales et autobiographiques sont altérées. Mais la plupart des fonctions cognitives s'améliorent au bout de quatre semaines. Certains patients néanmoins peuvent présenter des déficits de la mémoire autobiographique trois à six mois après l'ECT. La durée de la période confusionnelle est un facteur prédictif de la persistance des troubles de la mémoire. Les plaintes subjectives ne sont pas corrélées aux troubles mnésiques objectifs mais plutôt à la sévérité de la dépression. Ils durent plus longtemps que les troubles objectifs. L'atteinte est d'autant plus marquée que les événements sont proches de l'ECT. Nous avons trouvé, à la lumière des études incluses, l'absence d'origine lésionnelle, une altération du fonctionnement de l'hippocampe et un ralentissement cérébral. En effet, la présence d'ondes thêta à l'EEG dans les régions frontotemporales était associée à la durée de la confusion post-ictale et à une amnésie rétrograde. Il existe plusieurs facteurs associés à l'apparition des troubles mnésiques. Ces facteurs sont la nature et la charge du courant, le placement des électrodes, la fréquence des séances, le produit anesthésique, ainsi que des facteurs individuels tels que l'âge et le sexe. L'utilisation d'un courant ultrabref avec placement des électrodes en unilatéral droit réduit considérablement les effets cognitifs indésirables et préserve également l'efficacité. Différents tests cognitifs ont été utilisés en fonction du domaine cognitif à évaluer. Le test Mini-Mental State Examination (MMSE) était le test le plus utilisé pour une évaluation globale. Certaines études ont mis en place une batterie cognitive avec des délais d'évaluation allant d'un à six mois. Différentes molécules ont été essayées au cours de l'ECT, notamment les anticholinesthérasiques et le piracetam sans trouver de résultats concluants. Toutefois, les résultats des essais par la kétamine et la mémantine étaient encourageants. L'électroconvulsivothérapie a montré son efficacité dans le traitement de plusieurs troubles psychiatriques. Il est primordial de faire un suivi cognitif en pré- et post-ECT pour détecter d'éventuels troubles mnésiques et assurer une meilleure prise en charge. Electroconvulsive therapy (ECT) is the oldest technique still in use in psychiatry. Nevertheless, its adverse cognitive side effects are frequent, particularly complaints about memory. The main objective of this review is to describe the nature of ECT-related memory disorders, their short- and long-term evolution and associated risk factors, and to propose recommendations for appropriate evaluation and follow-up. À systematic review of the literature was conducted in April 2022, using the PRISMA methodology. The English search equations gleaned from the literature published were entered into PubMed and Cochrane using the search queries: 'cognition' and 'electroconvulsive therapy' or 'amnesia' and 'electroconvulsive therapy' or 'adverse effects' and electroconvulsive therapy'. The search was carried out on literature published between 2000 to 2022. Our review included 20 articles, including 4 articles on types of memory disorders, 3 articles on mechanisms, 6 articles on risk factors, 3 articles on cognitive testing and 4 articles on treatment. The data indicated impairment of both anterograde and retrograde memory. In the days following the session of ECT, the ability to recall events that occurred post-treatment, as well as general and autobiographical knowledge, was impaired. However, most cognitive functions improve within 4 weeks. Nevertheless, some patients, may show autobiographical memory deficits for from 3 to 6 months after ECT. The duration of the confusion is a predictive factor for the persistence of memory disorders. Subjective complaints are not correlated with objective memory disorders, but rather with the severity of depression. They last longer than objective disorders. The greater the proximity of the events to the ECT, the greater the impairment. In light of the studies included, we found altered hippocampal function and cerebral slowing. Indeed, the presence of EEG theta waves in frontotemporal regions was associated with the duration of post-ictal confusion and retrograde amnesia. There are several factors associated with the onset of memory disorders. These include the nature and charge of the electrical current, electrode placement, frequency of sessions, anaesthetic product administered, as well as individual factors such as age and gender. The use of ultra-short current with right unilateral electrode placement considerably reduces undesirable cognitive effects and preserves efficacy. Different cognitive tests were used, depending on the cognitive domain to be assessed. The Mini-Mental State Examination (MMSE) was the most widely used test for global assessment. Some studies used a cognitive array of tests with evaluation ranging from 1 to 6 months after treatment. Various molecules have been tried during ECT, notably anticholinesterase drugs and piracetam, with no conclusive results. However, the results of trials with ketamine and memantine were encouraging. Electroconvulsive therapy has been shown to be effective in the treatment of several psychiatric disorders. It is essential, however, to carry out cognitive testing before and after ECT to detect possible memory disorders and to ensure better management. [ABSTRACT FROM AUTHOR]

The article focuses on the stigma associated with mental health in movies and urges the film industry to take action. It discusses how, despite its popularity and influence, cinema can unintentionally perpetuate stigmatizing portrayals of mental health issues through inaccurate and discriminatory representations, and it highlights factors that contribute to this problem, such as misinformation, stereotypes, fear of change, and sensationalism.

Grief is the physical or mental suffering experienced after a major loss, usually the death of a loved one. It is a universal experience, but sociocultural factors, such as cultural or ethnic identity and religious beliefs predict and shape the expression of grief. The circumstances under which people are experiencing grief during the coronavirus outbreak have adversely affected the grieving process. Unexpected deaths, social distancing rules and visitor restrictions in healthcare facilities have posed a heavier burden on the loss and have heightened the risk of grievers experiencing complicated or persistent grief. This concern led us, as early career psychiatrists (ECPs) from 14 different countries connected by the Early Career Psychiatrists Section of the World Psychiatric Association (WPA), to share our country-specific experiences on the mourning, grief tradition, and burial rites during the COVID-19 pandemic. In this paper, we discuss our experiences, similarities and differences with relation to the: 'Effect of the pandemic on mourning', 'Restrictions and Guideline on burial rites due to the pandemic', 'Effect of the pandemic on social support' and 'Role of media and telecommunication on mourning practices and burial rites'. We conclude that while telecommunication means have attempted to bridge the gap and provide some form of social connectedness, the total and global effect of the pandemic is yet to be fully seen and understood. [ABSTRACT FROM AUTHOR]

Background: Early identification and prevention research has provided huge advances in our understanding of early screening and identification of young people at clinical high‐risk (CHR). Most of these procedures were developed in high‐income countries, yet middle‐income countries in North Africa such as Tunisia can benefit from these empirically‐based assessment approaches. Methods: Using established procedures, nine Tunisian psychiatric raters were trained on structured assessments: the CAARMS, BPRS, and SCID to high standards of interrater reliability. These raters developed a clinical high‐risk program (CHiRP) in Tunisia and recruited 10 patients who were exhibiting possible signs of CHR. These patients were evaluated to determine if they met criteria for a CHR group, such as Attenuated Psychosis. Results: Trained raters met the following interrater reliability criteria for the CAARMS and BPRS (ICC =.80 or greater) and the SCID (Kappa =.75 or greater). Of 10 pilot patients, six were classified as CHR and belonging to the Attenuated Psychosis Group. One of the six patients converted to psychosis 3 months after study entry for a conversion rate of 17% which is comparable with currently published rates globally. Discussion: The first CHR program has been established in Tunisia, a middle‐income country using methods developed in high income countries. Efforts aimed at assembling a group of prevention‐oriented psychiatrists, obtaining administrative support, and training raters to high levels of interrater reliability were successful. The feasibility was demonstrated for screening, assessing, treating, and following‐up of 10 CHR patients suggesting that conversion rates are comparable to those of Western and European countries. [ABSTRACT FROM AUTHOR]

Objectives: The global crisis of COVID-19 and its consequential strict public health measures placed around the world have impacted mental health. New scales and tools have been developed to measure these mental health effects. This narrative review assesses the psychometric properties of these scales and tools and methodological aspects of their development.Methods: PubMed, PubMed Central, and Google Scholar were searched for articles published from 15 May 2020 to 15 August 2020. This search used three groups of terms ("tool" OR "scale" AND "mental" OR "psychological"; AND "COVID-19" OR "coronavirus"). The identified scales were further evaluated for their psychometric properties and methodological aspects of their development.Results: Though the studies developing these scales (n = 12) have demonstrated their robust psychometric properties, some methodological concerns are noteworthy. Most of the scales were validated using internet-based surveys, and detailed descriptions of the mode of administration, sampling process, response rates, and augmentation strategies were missing.Conclusions: The heterogeneous and inadequate reporting of methods adopted to evaluate the psychometric properties of the identified scales can limit their utility in clinical and research settings. We suggest developing guidelines and checklists to improve the design and testing, and result in reporting of online-administered scales to assess the mental health effects of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Clozapine is recommended as first-line treatment for treatment-resistant schizophrenia (TRS). Despite its established position in all international guidelines, prescribing and utilization rates of clozapine have consistently been low among psychiatrists. The primary aim of the current study was to survey psychiatrists in the Middle East and North Africa (MENA) region on clozapine prescription patterns and practices, attitudes towards the medication, and perceived barriers and facilitators for prescribing. Data were collected from 17 of the 21 countries belonging to the MENA region via an online questionnaire. The majority of participants stated that the most common indication for clozapine was TRS. While most reported high levels of expertise with clozapine and rated it as an effective treatment, only 53.1% used it as their first-line treatment. The main stated barriers were concerns over patients’ poor compliance, the burden of regular blood testing, and the associated side effects. Years of practice and the setting of practice did not influence prescribing attitude and behavior. This study confirms that psychiatrists in the MENA do not diverge from the norm of clozapine under prescription. Structural reforms are required to establish services that have the capacity and experience to address clozapine prescribing. [ABSTRACT FROM AUTHOR]

Research on how stigma had hindered the control of the above-mentioned infectious disease outbreaks might also shed some light on the potential impact of stigma in the battle against the COVID-19 pandemic. Conclusions Preventing the dissemination of stigma-related attitudes and behaviors may help decrease the spread of the COVID-19 pandemic, as stigma may lead to underreporting of symptoms and decrease the use of health facilities. [Extracted from the article]

aimi,7 Lynda Bensid,8 Mohamad Ali Cheaito,9 Alkhansa Mahdi Emberish,10 Amine Larnaout,11 Ahmed Radwan,12 Mohammad Slaih,13 Firas Kobeissy,14 Maya Bizri11Department of Psychiatry, American University of Beirut, Beirut, Lebanon; 2Helwan Mental Health Hospital, Cairo, Egypt; 3The Sudan Medical Specialization Board, Khartoum, Sudan; 4Department of Psychiatry, Damascus University, Damascus, Syria; 5Department of Psychiatry, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia; 6Oman Medical Specialty Board, Psychiatry Program, Muscat, Sultanet of Oman; 7Psychiatric Department, Al Ain Hospital, Abu Dhabi, United Arab Emirates; 8Department a, University of Algiers, Drid Hocine Hospital Specialized in Psychiatry, Algiers, Algeria; 9Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon; 10Alrazi Hospital for Mental Health, Tripoli, Libya; 11Psychiatry Department D, Razi Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia; 12Mental Health Service, Hamad Medical Corporation, Doha, Qatar; 13National Center for Mental Health, Ministry of Health, Amman, Jordan; 14Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, LebanonCorrespondence: Samer El HayekDepartment of Psychiatry, American University of Beirut, Bliss Street, PO Box: 11-0236, Riad El Solh, Beirut 1107 2020, LebanonTel +961 70941362Email samer.elhayek@gmail.com Purpose: Telepsychiatry, a subset of telemedicine, has been increasingly studied to meet the growing demands for psychiatric care. The utility of telepsychiatry is relevant now more than ever as the world endures the COVID-19 global pandemic. This paper describes the prior state and the changes that the COVID-19 outbreak brought to telepsychiatry in a selected group of Arab countries of the Middle East and North Africa (MENA) region. Patients and Methods: We invited twelve early-career psychiatrists from different Arab nations to share information related to telepsychiatry in their respective countries before and during the COVID-19 pandemic. The information was collected using a semi-structured guide. This was complemented by a search for relevant articles in five search engines using terms such as "COVID-19," "telepsychiatry," and "Arab world". Results: Before the pandemic, digital mental health services were provided in several Arab countries, mainly through hotlines and messaging services. The COVID-19 pandemic has marked a major shift in digital psychiatric services in the Arab MENA world, through the transformation of many clinics and some hospitals into digital mental health systems. Many non-governmental organizations also started remote initiatives for psychological support and psychiatric counseling. Three main barriers of patient-related, healthcare-related, and system-related hurdles of using telepsychiatry emanated from the analysis. Conclusion: The use of digital mental health services varies between different Arab countries. Even though some nations have laws that regulate the provision of such services, most struggle with multifactorial barriers. As affordable and attainable solutions cannot only rely on training and recruiting more psychiatrists, telepsychiatry would help meet the exceeding demands in the Arab world, particularly after the COVID-19 outbreak. [ABSTRACT FROM AUTHOR]