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Background: The timing of this study coincides with the growing rate of penetration of Internet service across the country.  However, it is predictable that any new technology may be associated with a variety of human responses, sometimes harmfull. The young students seem to be especially vulnerable., Objective: The purposes of this study were to evaluate Problematic Internet Use among medical undergraduate students and to investigate for associated anxious symptoms., Methods: We conducted a cross-sectional study on 120 students enrolled in undergraduate medical studies at the University of Medicine of Sfax- Tunisia. The self-administered Young's 8-item questionnaire was used in this survey. The state and trait anxiety inventory was administered to screen for anxiety symptoms., Results: The results showed that 21.7% of the students have Problematic Internet Use (PIU).The rate of the PIU is greater in male students than infemale students (p=0.035). Anxiety trait was significantly associated in students with PIU compared to those without PIU (p=0.002). Anxiety state was significantly associated in students with PIU compared to those without PIU ( p = 0.003)., Conclusion: Problematic Internet Use is frequent in our students population. Asking students about the characteristics of their Internet usage will help to determine the threats to which they might be exposed. Such association with other psychopathologic problems, especially anxiety, should be sought.

Background: Alopecia areata (AA) is a skin disease characterized by the sudden appearance of areas of hair loss on the scalp and other hair-bearing areas, but its aesthetic repercussions can lead to profound changes in patient's psychological status and relationships. Aim: The goal was to investigate a possible relationship between AA and alexithymia as well as two other emotional dimensions, anxiety and depression. Materials and Methods: Fifty patients with AA seen in the Department of Dermatology of Hedi Chaker University Hospital, Sfax were included in this study. Anxiety and depression were evaluated by Hospital Anxiety and Depression scale questionnaire, alexithymia was assessed by Toronto Alexithymia scale 20, and severity of AA was measured by Severity of Alopecia Tool. Results: Patient's mean age was 32.92 years. 52% of patients were females. Depression and anxiety were detected respectively in 38% and 62% of patients. There was statistically significant difference between patients and control group in terms of depression (P = 0.047) and anxiety (P = 0.005). Forty-two percent of patients scored positive for alexithymia. No significant difference was found between patient and control groups (P = 0.683) in terms of alexithymia. Anxiety was responsible for 14.7% of variation in alexithymia (P = 0.047). Conclusions: Our study shows a high prevalence of anxiety and depressive symptoms in AA patients. Dermatologists should be aware of the psychological impact of AA, especially as current treatments have limited effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: Lockdown due to the management of infectious diseases such as corona virus disease affect mental health. We would think that with the end of the lockdown due to the corona virus pandemic, the feeling of regaining freedom and movement would be good for our morale. Objectives: Through this servery, we examine the prevalence of anxiety symptoms in the Tunisian population face to the end of lockdown. Methods: The survey was conducted using the online anonymous questionnaires and distributed through social networks from 24 April to 23 May 2020(which was considered the end of the lockdown in Tunisia). It included socio-demographic questions and participants' experience of SARS-CoV-2related stressful events (A member of your family was suspected of having Corona virus/someone you know had Corona virus's symptoms/You were quarantined). Anxiety symptoms were evaluated with the Hospital anxiety and depression scaleanxiety (HADS-A). Results: Our study included 80 participants: 71.3% female and 42.5% married. The mean age of the participants was 29.30 years (SD = 8.72). The mean HADS-A score was 8.03 (SD=2.938) (maximum=16 minimum=1). Two-thirds of the participants exhibited anxiety symptoms (66.3%) with 1.3 % reported moderate severe anxiety symptoms. Anxiety was correlated with age and gender (p=0.013, p=0.027). Conclusions: Our results suggest that in this early phase of the COVID-19 lockdown resolution we can already observe its fundamental impact on anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a chronic inflammatory skin disease that affects approximately 2% of the population. It seems to have a multifactorial aetiology and it can be considered as a psychosomatic disorder. Objectives: To determine risk factors for anxiety and depression in psoriasis Methods: Case-control study including 44 subjects with psoriasis and 50 controls without psoriasis. All participants answered the Hospital Anxiety and Depression Scale (HADS) to measure the severity of anxiety and depression Results: Descriptive study: We solicited 44 patients and the average age was 45.8 years. The majority of patients were married (70.5%), unemployed (40.5%), without medical heredity (84,6%). Psoriasis was in plaque (65.9%), guttate (20.5%), pustular (13.6.5%). Its severity, assessed by BSA, was mild to moderate in 72.7% of cases and associated arthropathy was noted in 29.5% of patients.the prevalences of anxiety and depression estimated at 29.54% and 18.18% respectively. Analytical study: Subjects with psoriasis, as opposed to controls, showed higher levels of anxiety (29,54% vs 15,9%) and depression (18,18% vs 4,54%) but there was no significant difference (p=0,335, p=0,573) Depression was significantly more important for single (p=0.043), for patients with associated arthropathy (=0.005) and for guttate form (p=0.015) According to the severity of the disease: patients with mild disease are more anxious and patients with severe disease are more depressed Conclusions: Higher scores in anxiety and depression is common in psoriasis. Dermatologists should give special attention to this subgroup of persons with psoriasis in order to prevent future psychopathology. [ABSTRACT FROM AUTHOR]

Introduction: The 2019 Coronavirus disease epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Objectives: To study the psychological repercussions in terms of anxiety and depression of the Coronavirus pandemic on the Tunisian population. Methods: This was a cross-sectional, descriptive and analytical study. We used an online questionnaire on Facebook, on June 2020. The heteroquestionnaire included epidemiological data and two scales: the State-Trait Anxiety Inventory (STAI Form Y-1) to evaluate the anxiety level at the time of the study, and the Patient Health Questionnaire (PHQ 9) to detect a characterized depressive episode. Results: We included 121 participants. They had an average age of 36.52 years with a sex ratio (M/F) of 0.41. The mean STAI score was 43.12 while the PHQ score was 7.46, indicating that 30.8% of the participants suffered from depression. Both scores were correlated to female sex (p=0.01 for STAI and p=0.02 for PHQ), a history of anxiety (p<0.001) and depressive disorders (p<0.001) and to poor sleep quality (p<0.001). The STAI score was also associated with a family history of high blood pressure (p=0.004), while the PHQ score was correlated to a family history of diabetes (p=0.02), a widowed or divorced marital status (p<0.001) and to a single lifestyle (p=0.03). Furthermore, the two scores (STAI-Y and PHQ 9) were also associated (p<0.001; r=0.67). Conclusions: The psychological impact of Coronavirus epidemic seems not negligible requiring psychological interventions to improve the mental health of vulnerable groups. [ABSTRACT FROM AUTHOR]

INTRODUCTION: women's sexuality may be particularly affected after breast cancer. The Objectives of this study were to evaluate the changes in sexual life after treatment of breast cancer in Tunisian women and to identify the influence of demographic and clinical factors on sexuality. METHODS: we recruited 50 patients who were in remission for at least 3 months after initial treatment of breast cancer. Sexuality and body image were evaluated using the Arabic version of the specific scale of breast cancer QLQ-BR23. Screening for emotional disorders has been done with the Arabic version of HAD scale (Hospital anxiety and depression scale). RESULTS: patients had poor sexual functioning and sexual satisfaction and the mean scores were respectively 45.3% and 43.9%. Only menopausal status and sexual difficulties in the partner was significantly related to poorer sexual satisfaction (p respectively 0.018 and 0.014). According to the HAD scale, 42 % of patients had anxiety and 44 % had depression. The sexual satisfaction was statistically associated with the presence of anxiety symptoms (p=0.0003). CONCLUSION: results suggest that the psychological side and the sexual difficulties in partner are the most important factors that appear to be involved in sexual satisfaction of Tunisian women after breast cancer. So, those factors need to be taken into account in therapeutic process and psychological counseling to maintain and enhance patient's psychological well-being.

Introduction: Alopecia areata is a frequently encountered hair disorder characterized by the rapid hair loss, usually from the scalp. It has few physically harmful effects, but may lead to psychological consequences, including high levels of anxiety and depression. Aim: This case-control study was undertaken to determine the psychiatric morbidity among patients with alopecia areata. Methods: The study included 50 patients diagnosed with alopecia areata and 50 age-sex matched individuals selected from a general population without any hair loss (control group). For evaluating psychological distress, we used Hospital Anxiety and Depression Scale (HADS). Severity of the disease was evaluated by Severity of Alopecia Tool (SALT). Results: Patient''s mean age was 32.92 years. Fifty-two percent of patients were females. Patients were single in 52% of cases, divorced in 2% of cases and married in 46% of cases. Depression and anxiety were detected respectively in 38% and 62% of patients. There was statistically significant difference between the patients and control group in terms of depression (p=0.047) and anxiety (p=0.005). Depression was statistically higher in women with alopecia areata (p=0.016). Disease severity was higher in psychiatric morbidity cases. Conclusion: The results of this study indicate that alopecia areata is associated with psychiatric morbidity. Dermatologists should be aware of the psychological impact of alopecia areata, especially as current treatments have limited effectiveness. [Copyright &y& Elsevier]

Objective: The objective of this work was to study the prevalence of anxiety and depression in a population of elderly diabetics and their impact on the glycemic control and the disease evolution. Methods: It was a prospective, descriptive and analytical study on 62 elderly patients with type 2 diabetes. A structured questionnaire was used to collect socio-demographic data to describe the participants and aspects of their diabetes. Anxiety and depression symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS). Results: The patients’ mean age was 66.82 years with a standard deviation of 4.8. The diabetes study population was predominantly female (74.2%). Average duration of diabetes was 12 years with a standard deviation of 8.11. Prevalence of anxiety and depression in diabetic elderly patients was respectively 40.3% and 22.6% with a female dominance. 67.7% of elderly diabetes had poor glycemic control. Comparing anxiety mean scores, patients with worse glycemic control had significantly higher scores (9 06±3. 14 vs 6.55; p=0. 017). We didn’t found a relationship between depression and glycemic control. In our population, the presence of complications were significantly associated with anxiety and depression. Conclusion: Several studies have shown that the prevalence of anxiety and depression symptoms in elderly patients with diabetes is considerably higher than in general population samples. Depression represent a risk factor for morbidity specially in elderly subjects, which justify a detection of psychiatric symptoms in order to improve the quality of life and the evolution of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Le diabète est une pathologie en constante augmentation surtout chez la population âgée. Plusieurs études ont montré une prévalence élevée des troubles de l’humeur chez les diabétiques âgés pouvant avoir un retentissement sur l’évolution de la maladie. L’objectif de notre travail a été de rechercher une éventuelle relation entre l’anxiété la dépression et la survenue de complications diabétiques. Patients et méthodes: Il s’agit d’une étude transversale portant sur 62 diabétiques de type 2 âgés en moyenne de 66,82 ans, consultant au service d’explorations fonctionnelles, endocrinologie et maladies métaboliques. Nous avons recueilli les informations relatives aux données sociodémographiques, les antécédents et les caractéristiques cliniques et thérapeutiques du diabète. L’anxiété et la dépression ont été évaluées grâce au Hospital Anxiety and Depression Scale (HADS). Résultats: L’ancienneté moyenne de diabète a été de 12,4 ans (ET=8,11). La prévalence de l’anxiété et de la dépression a été respectivement de 40,3 % et de 22,6 % avec une prédominance féminine significative pour l’anxiété (p=0,008). 64,5 % des diabétiques âgés présentaient un diabète compliqué. Les sujets diabétiques anxieux présentaient plus de complications à type de néphropathie et de rétinopathie que ceux non anxieux (p=0, 024 et p=0,04). De même, les sujets déprimés présentaient plus de complication à type de neuropathie périphérique et de rétinopathie que ceux indemnes de ce trouble (p=0,006 et p=0,05). D’autre part, les patients déprimés avaient significativement un régime alimentaire moins équilibré (p=0,038). Conclusion: Il existe une association significative entre la dépression, l’anxiété et plusieurs complications du diabète du sujet âgé. Cette comorbidité alourdit le pronostic global, altère la qualité de vie, accroit les dépenses de soins et augmente la mortalité. De ce fait, le dépistage de la pathologie anxiodépressive chez la population diabétique âgé est primordial. [Copyright &y& Elsevier]

Introduction: Social phobia is the most prevalent anxiety disorder. It is accompanied by a deterioration of the quality of life and social adaptation. This has further impact that this disorder begins at a young age at the time where the topic has not yet acquired a stable socio-professional status. The aim of our study was to assess the sounding of the social phobia among a population of 200 students. Methods: It was a cross-sectional study, focusing on a group of 200 students from 5 universities in Sfax city, Tunisia. We used: [-] The Liebowitz Social Anxiety Scale for screening the social phobia, [-] The Sheehan scale for the evaluation of the sounding on the social, professional and family life. Results: Thirty three per cent of this population presented a social phobia. According to Sheehan scale, the disturbance in school, social and family life was mild to moderate (schooling: 3. 29; social: 2.95; family: 2.62). Discussion and conclusion: Our study showed that the impact of the social phobia is lightweight at the family and social level but more important in the area of schooling. This suggests the necessity for screening and treatment of social phobia among students for a better socio-family insertion and especially for better academic achievement. [Copyright &y& Elsevier]

To determine the factors of vulnerability to the addiction to smoking to the medical and paramedical staff and to prevent them. Patients and methods: Our study concerned 100 medical and paramedical staffs practicing in the HEDI CHAKER HOSPITAL, Sfax A structured questionnaire was used to collect socio-demographic, somatic, psychiatric and the tobacco consumption data. We also used Hospital-Anxiety and Depression Scale (HADS) and Rosenberg''s self-esteem scale. Results: The population was consisted of 100 staffs of the health, distributed in two groups Group 1 (n = 50), regular or occasional smokers Group 2 (n = 50), no-smoking witnesses The mean age was 30 years. Sex-ratio (H/F) was 1. The smokers were single in 60%. They began to smoke in an average age of 16 years. Their motivations to smoke were mainly: curiosity (44%), decreasing stress (28%), searching pleasure (16%) and doing as the others (12%). The smokers, compared with witnesses, consumed more alcohol and reported more stress factors (divorce of the parents, the frequent quarrels in the family, financial difficulties). In our study, low self-esteem and anxiety were statistically correlated to the tobacco consumption (p=0.00). Conclusion: It emerges from this work that the addiction to smoking in the medical and paramedical staff is frequently associated with traumatic events, anxious disorder and low self-esteem. [Copyright &y& Elsevier]

Introduction Excessive tobacco consumption among students has negative repercussions on their health and education. Medical students are no exception. Numerous studies have demonstrated the relationship existing between smoking and depressive disorders. Objective To study the relationship between depression, anxiety and students smoking. Method We conducted a cross-sectional, descriptive and analytical study which included 80 students of the Faculty of Medicine of Sfax in Tunisia: 40 smokers and 40 no-smokers. We used the Hospital Anxiety and Depression Scale (HADS) for screening depressive and anxious symptoms. The evaluation of tobacco dependence was performed by Fagerstrom test. Results The average age of the participants was 23 years with a male predominance (SR=1,66). The smokers were in 80% of cases males and in 55% of cases dependents. Thirty-one percent (31%) of our population were depressed and 28.7% were anxious. A statistically significant correlation was found between smoking and the presence of depression (p = 0.025) on one hand, and anxiety (p = 0.022) on the other hand. Tobacco dependence was related to male sex (p = 0.04) and depression (p = 0.03). There was no link between the same variable and anxiety. Conclusion It appears from our study a statistically significant relationship between smoking and anxio-depressive disorders. The degree of dependence is particularly related with depression. This dimension has to be considered in the therapeutic withdrawal project. [ABSTRACT FROM AUTHOR]

The objective of our study is to estimate the prevalence of depression, anxiety and alexithymia, of patients presenting a diabetes type 2 and their echo on the disease. Method: Our study, descriptive and forward-looking, was led with diabetics type 2, consulting in the service of endocrinology of HEDI CHAKER Hospital of Sfax. The collection of the information was realized with the help of: [-] A data sheet containing socio-demographic data and clinical data concerning the diabetes. [-] Hospital-Anxiety and Depression Scale (HADS). [-] Toronto Alexithymia Scale of 20 items. Results: Our sample consisted of 96 diabetics: 67 women and 29 men. The average age was of 56.23 years (ET=10, 85) The prevalence of depression was 32.3%, that of anxiety was 56. 3%. The alexithymia was estimated at 46.9%. The depression was correlated to the presence of cardiac co-morbidity (p=0,012). High prevalence of depression was found in diabetic''s suffering from neurological (0.002) and renal (p=0.007) complications. The depression was the source of a less regular follow-up. The association depression-alexithymia was correlated at a less good balance of the diabetes (p=0.038). The anxiety does not seem to interfere with the clinical characteristics of the type 2 diabetes. Discussion and conclusion: Diabetics suffering from depression have more co-morbidity and complications. This risk was increased by the association of alexithymia. So, a screening of the psychiatric symptoms is necessary to improve the quality of life and the evolution of the disease. [Copyright &y& Elsevier]

Objectives: The aim of this work was: [•] to understand and measure the emotional effects of chemotherapy-induced alopecia by exploring self-esteem, body image, anxiety and depression in cancer patients [•] to analyse the strategies used to cope with hair loss. Methods: This was a cross-sectional study. It involved the use of a questionnaire with patients from the medical oncology unit of the Habib Bourguiba University Hospital. The questionnaire included Socio-demographic data, type and stage of cancer, data concerning the alopecia (partial or total) and its impact on social life, work, and sexuality. Four measurement scales were used: [-] Rosenberg''s Self-Esteem scale, [-] Bruchon-Schweitzer''s Body image questionnaire (QIC) [-] Hospital Anxiety and Depression scale (HAD) [-] Brief cope Results: Preliminary study It was a population of 24 patients. 55.2% were males. The mean age was 45.9 years. 75.9% were married. Alopecia was the most distressing side effect of chemotherapy in 30.4% of cases. 45.8% were suffering from the stigma of the alopecia which disturbed their social interaction. It led to a loss in self-confidence in half of patients and altered sexuality in third. Self-esteem was low in 34.5%. The average score of the scale body image was 61. 41.4% of patients were anxious and only 27.6% were depressed. The religion was the major strategy used to cope with alopecia. Conclusion: The findings suggest that the chemotherapy-induced alopecia has the potential to affect various aspects of patient''s life, but Tunisian cancer patients seems to be less affected compared with literature. [Copyright &y& Elsevier]

Introduction Road Traffic Accidents (RTA) are most probably the leading cause of post-traumatic stress disorder (PTSD) in developed countries but it remains under-estimated. Objective – To determine the prevalence of PTSD in our population. – To determine the relationship between PTSD, anxiety and depression. Method This is a cross-sectional study which involved 120 road traffic accidents victims, followed in the outpatient orthopedic department of Sfax in Tunisia. We assessed the severity of the injuries by the AIS scale, post-traumatic stress by the PCL-S and anxiety and depression by the HADS scale. Results Our population was relatively young (average age ≈ 37 ans). In our population, AIS score (assessment of the severity of injuries) was higher than 3 in 62.5%. According to the HADS score, 36.7% suffer from depression and 27.5% from anxiety. In our series, the prevalence of PTSD in road accident victims was important: 54.17%. The risk factors identified were: female gender ( P = 0.043); rural origin ( P = 0.015); and the handicap caused by the accident ( P = 0.013). Concerning comorbidities, anxiety and depressive disorders were significantly associated with PTSD ( P = 0.000). Conclusion Psychological consequences of RTA such as PTSD, depression and anxiety are not easily apparent. These people who have suffered from the most severe emotional shock are often neglected and/or forgotten. [ABSTRACT FROM AUTHOR]