Gerstmann syndrome is a rare neurological disorder that consist primarily of 4 neuropsychological signs that include acalculia (impairment in performing calcultaions), digital agnosia (dificulty discriminating their own fingers), agraphia (impairment or dificulty to write by hand); and left-right disorientation (impairment of distinguishing left from right.

Presentation of a case report of a patient with Gertsmann syndrome secondary to breast cancer metastasis.

We analyze the case of a 79 years-old female with a history of breast cancer in remission, with a severe depressive episode of 8 months of evolution, dysphoria, apathy, decrease in the ability to carry out basic activities of daily life, acute personality changes and sleep disruption. 15 days previous to the first examination the patient suffers gait disturbances, falling from her own height, memory impairment, suicide ideation and nomination aphasia.

At the examination we encounter digital agnosia, acalculia, agraphia, right-left disorientation, right hemiparesis. MRI are taken founding 3 tumor lesions in the left and right frontal lobe, 2 solid lesions with a necrotic appearance in the right parietal lobe, one of them in the angular gyrus of the parietal cortex. CT scan found a solid tumor-like lesion in the left pulmonary apex. CA-125 antigen 429.5 U/mL. She was sent to continue her treatment with oncology, receiving radiotherapy.

The psychiatric abnormalities secondary to Gerstmann syndrome make the relatives of this patient seek psychiatric care, requiring multidisciplinary work to reach an accurate diagnosis. Gerstmann syndrome is a rare neurological condition that can mimic lots of other clinical pictures.

No significant relationships.

Bariatric surgery is considered an effective treatment against obesity. Psychiatric illness is relatively common in patients who have undergone bariatric surgery. Over one-third of these patients are prescribed psychotropic drugs, particularly antidepressants. Unlike medications for diabetes, hypertension or hyperlipidemia, which are generally reduced and at times discontinued, postsurgery psychotropic use is only slightly reduced. The surgical intervention and the subsequent weight loss can affect several pharmacokinetic parameters, leading to a possible need of dosing adjustment.

To review the influence of bariatric surgery on the use and pharmacokinetics of psychotropic drugs.

Non-systematic review of literature through search on PubMed/MEDLINE for publications from 2011 to 2021, following the terms psychotropic and bariatric surgery. Textbooks were consulted.

It is difficult to predict how psychotropics will be affected by bariatric surgery because of interindividual differences and limited data. Malabsorptive surgical procedures have a relatively greater potential to alter drug exposure. Medication disintegration, dissolution, absorption, metabolism and excretion have been found to be altered in postbariatric patients. Antidepressants are the best studied psychotropics in the bariatric population and their absorption is reduced. The risk of gastric bleeds with bariatric surgery will probably be increased by serotoninergic antidepressants. Antipsychotics and mood stabilisers are not well studied in these patients. Depot antipsychotics avoid the risk of reduced absorption after surgery. Lithium use requires particular close monitoring.

Close treatment monitoring and the ongoing monitoring of symptoms are needed after bariatric surgery. Many patients may not require significant changes to drug treatment after surgery.

No significant relationships.

Many different causes of catatonia are well-documented in medicine. Modern understanding of catatonia has evolved in the last 100 years with the suggestion that there is a root cause in neuroinflammation. This is a case report of a young woman who presented to the emergency department with altered mental status, found to have catatonia responsive to lorazepam, with the underlying etiology being a diagnosis of multiple sclerosis.

A case-based approach is used to support the following learning objectives: - Review the diagnostic criteria for catatonia - Distinguish between simple and malignant catatonia - Review the Bush-Francis Scale - Review available treatment

Mother brings 24-year-old woman into the hospital for altered mental status and changes in behavior including staring spells, periods of withdrawal, refusal to eat, lack of purposeful movement, apraxia, and mutism that worsened 24 hours prior to presentation.

The patient was afebile with negative covid-19 test. Recent diagnosis of Bell’s palsy treated with antivirals and oral steroird, which terminated just prior to presentation. Additionally, patient had outpatient treatment for vertigo. Lumbar puncture was negative for an infectious process. MRI revealed multiple stable white matter lesions in the periventricular, pontine, and subcortical regions, some oriented perpendicular to the corpus callosum.

This case of a 24-year-old woman with catatonia brought an opportunity to retrospectively review a case in detail in order to feature learning objectives that review very important considerations in the evaluation, differential diagnosis, symptom tracking, and treatment of catatonia. The future of research in catatonia is bright and diverse.

No significant relationships.

The HIV is a retrovirus, which is immunosuppressive, predisposing the individual to opportunistic infections and certain neoplasm. In addition to impairment in immune functions, evidence has suggested that HIV is neurotropic. It should therefore be anticipated that neuropsychiatric complication might be common in HIV positive individuals during all phases of HIV related illness. The neuropsychiatric aspect of the AIDS remains a challenge for psychiatrists involved in patients care.The relationship between HIV and psychiatric symptoms and conditions is complex and the direction of effects between severe mental illness and HIV infection is unclear. In general, people with severe mental illness are at increased risk of contracting and transmitting HIV, and the prevalence of HIV infection among them is higher than in the general population.

To determine how frequently psychiatric symptoms in an HIV positive adult population occur, as well as to determine social, demographic and clinical factors that are associated with the presence of these symptoms.

Literature review on Pubmed

Depression has a high prevalence in HIV-positive individuals, ranging between 5.8 and 36.0%. Typical features of depression are similar to those in HIVnegative people, although fatigue, loss of appetite and weight, impaired concentration, hopelessness and guilt are more common.Depressed HIV-positive individuals are at high suicide risk.Apathy has also been more commonly reported among HIV patients than in the general population.The prevalence of anxiety among HIV-positive individuals ranges from 4.3 to 44.4%

The rate of psychiatric symptoms in HIV positive patients in this population is high. Most of them go unnoticed and therefore untreated.

No significant relationships.

Bipolar disorder (BD) is considered a risk factor for developing Parkinson’s Disease (PD) because of an altered dopamine activity in both entities. Comorbidity may delay diagnosis and difficult therapeutic management.

To describe the case of a patient with both BD and PD and to determine the appropriate diagnostic and therapeutic approach for patients presenting both entities.

We present the case of a 58-year-old woman attended in our neurology unit due to the initial presence of visual hallucinations as a core symptom.

Psychotic symptoms as hallucinations and off-times, frequently observed in PD, may be misdiagnosed with a worsening of depressive polarity of BD. Thus, overlap between symptoms may lead to a challenging differential diagnosis. Moreover, there is no consensus about the therapeutic management of the comorbidity, due to the bidirectional worsening of symptoms when treatment is adjusted. In our case, a diagnosis of dopaminergic psychosis was made so antipsychotic treatment with quetiapine 50 mg/d was initiated. A worsening of symptoms was observed, presenting the patient a stuporous status, mutism and generalized rigidity. Neuroimaging and lumbar puncture were performed showing no alterations; electroencephalogram showed diffuse slowing. Final diagnosis was an off-episode of PD and a multifactorial encephalopathy resulting in visual hallucinations.

Coexistence of PD and BD may lead to a diagnostic and therapeutic delay and therefore a worse prognosis. Although these diseases are well-known, it is still challenging to manage patients presenting both entities. Further research is needed to clarify the proper diagnostic and therapeutic approach for these patients.

No significant relationships.

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder, affecting about 20% of people worldwide. This complex and multifaceted disorder has been proposed as a system disease involving not only individual systems including the nervous, endocrine, imune, digestive, microbiota and the environment but also the interactions of these systems. The aetiology of IBS is complex and incompletely understood and this disease are frequently associated with a comorbid psychiatric disease. Current treatment is symptom-directed, rather than based on underlying pathophysiological mechanisms.

The authors elaborate a narrative literature review to identify the pathophysiology and therapeutic approach of IBS.

Pubmed databased searched using the therms “psychiatry”, “irritable bowel syndrome” and “treatment”.

The IBS is the most common and best described of the functional bowel disorders, which represents a considerable therapeutic challenge. Studies looked at the efficacy of fibre, antispasmodics and peppermint oil in the treatment of IBS found moderately effectiveness in the treatment of global symptoms. Elimination diets are helpful in improving IBS. There is evidence that a low-FODMAP diet can have a favorable impact on IBS symptoms, especially abdominal pain, bloating and diarrhea with improved irritable bowel syndrome symptoms and quality of life. Among the currently available classes of drugs for the treatment of IBS, antidepressants such as selective serotonin releasing inhibitors and tricyclic antidepressants are useful because of their analgesic properties, independent of their mood-improving effects.

Evidence suggest that antidepressants might be useful for treatment symptom of IBS however further investigation is required.

No significant relationships.

The WHO would increase diagnosis and treatment of viral hepatitis in the world by 2030, based on the high efficacy of direct-acting-antivirals against HCV, extended vaccination programs in HBC, and epidemiological data. Diagnostic of HCV/HBV infection has been simplified by point-of-care (POC) devices (cheap/easy-to-use/interprete/qick-results), detecting anti-HCV-antibodies or HBV-antigen in capillary blood at the patients´site. The current seroprevalence of viral hepatitis B/C in general population in Spain is 0.5%/1% and would be higher (3-17%) in people with severe-mental-disorder due to risk factors and traditionally less access to health care.

To design a screening protocol for HCV eradication and HBV-detection, and risk factors among severe-mental-disorder patients in a CommunityMentalHealthCenter. To guarantee equal access to viral hepatitis screening and therapy among this population.

Outpatients visited along one-year who accepts participate. Using POC-device for qualitative detection of anti-HCV-antibodies (Quickview-of-Lumiquick-Diagnostics®)/HBsAG (Abbott-Rapid-Diagnostics®). Socio-demographic data; mental disorder(ICD-10); HCV/HBV risk-factors; Neurotoxicity-scale (mood/cognition/sleep/gastrointestinal/sickness/motor); SF-12; Patient-satisfaction. Subjects with positive HCV/HBV POC-test will have a on-site venopuncture to assess hemograme/liver tests, and HCV-RNA (Cobas-TaqMan-RocheDiagnostics)/HBsAg-ELISA (Atellica-Siemens). In positive HCV-RNA (active infection) the psychiatric-team will inform the hepatology-team for non-invasive liver fibrosis assessment and DAA prescription. The patient will receive 8-12-weeks on-site treatment, and assessed (Neurotoxicity/SF-12).HCV cure will be confirmed by HCV-RNA in blood. Chronic-cases will be managed at Hepatology-Unit.

We will present the results of the implementation of the programme and their ability to detect viral-hepatitis-positive cases among patients with severe-mental-disorders and to treat them effectively.

Our results may support the generalisation of the programme in among CMHC’s.

No significant relationships.

Dissociative seizures (DS) are classified as dissociative convulsions within the group of dissociative disorders. Although they share many features with epileptic seizures (ES), they are not a consequence of abnormal brain discharges and may be related to psychogenic causes. DS represent a common diagnostic and are often confounded with ES.

The aim of this study is to review the current evidence about the differential diagnosis between DS and ES.

We conducted a non-sytematic review on the topic, using Pubmed/Medline database.

Studies emphasize a correct diagnosis before treatment of seizures. DS and ES respond differently to anticonvulsant medication and early or incorrect prescription of can even exacerbate DS. Clinical features and a neuropsychiatric history can also help. The presence of a dissociative “stigmata”, such as unexplained sensory loss, may support a non-epileptic diagnosis. EEG videorecording method is the gold standard diagnosis for DS, however often displays rhythmic movement artifacts that may resemble seizure activity and confound the interpretation. The absence of ictal EEG discharges characteristic of epilepsy is a sign of DS. However, this may not be true for some partial ES, particularly those from temporal lobes, whom also tend to report shorter duration of seizures, whereas patients with DPD often describe experiences lasting for hours or longer.

Distinguish DS from ES can be challenging. However, there are features that can help in the differential diagnosis. A correct diagnosis is essential for an adequate therapeutic approach, better prognosis, reduction of medical costs and also a referral to the right medical specialty.

No significant relationships.

Delirium of parasitosis was first described by Karl Ekbom in Sweden in 1938. It is a hallucinatory monothematic delirium characterized by the unwavering conviction of having the skin infested with insects or parasites. Multiple etiologist has been described such as psychiatric and neurological disorders, substance intoxication or other medical conditions. We present a case of debut of Ekbom’s syndrome in an individual recently diagnosed with acute urethritis on antibiotic treatment.

To report a case of a patient with a debut of Ekbom’s syndrome and acute urethritis.

A 40-year-old man with no previous psychiatric history is admitted psychiatric emergency room accompanied by his wife for intense anxiety and isolation at home. During the examination, the patient explains a lot of fear of a series of bugs such as bees and small parasites that invade him. The onset of symptomatology coincides with a diagnosis of chlamydia urethritis and the initiation of treatment with ceftriaxone 500mg IM + Azithromycin 1g VO. Complete physical examination is performed without alterations. Toxicological, biochemistry, hormonal and vitamin study did not show any alterations.

Antipsychotic treatment was started with Olanzapine up to 10mg/day and supportive treatment with benzodiazepines. The patient showed rapid improvement. At discharge, he is asymptomatic from the urological and psychopathological point of view.

Ekbom’s syndrome is a multifactorial disorder. The patient was diagnosed of an acute psychotic disorder due to another medical condition and/or treatment with antibiotics.

No significant relationships.

The transition into parenthood is associated with an increased psychopathological vulnerability. Most studies have focused on mothers, although recently, the role of fathers has grown more importance. Paternal perinatal depression (PPD) is an episode of major depressive disorder occurring in new or expectant fathers during the perinatal period. PPD is not widely acknowledged and research are rare.

The authors intend to review the literature about PPD, focusing on its prevalence, risk factors, clinical features, treatment and consequences.

Non-systematic review of the literature through PubMed.

A meta-analysis of PPD estimated a prevalence of 10.4%. Risk factors of PPD are multiple and complex. There are sociodemographic factors, such as marital status, monthly income and social support. Psychological factors, for instance history of depression, maternal prenatal anxiety and maternal depression. Some literature also suggests hormonal changes on men like increase estrogen and lower testosterone levels. PPD can present with symptoms of mood alterations, like irritability and restricted emotions, anxiety, fatigue, insomnia, loss of appetite. Also common are behavioural disturbances such as interpersonal conflicts, impulsivity, violence, avoidance behaviour, and substance abuse. There are no studies to specific treatments to PPD, so the treatment is the same for women, such as antidepressants and psychotherapy. If untreated, PPD can have an adverse influence on the health and wellbeing of the mother and child.

PPD is still underscreened, underdiagnosed and undertreated. It is fundamental identifying risk factors and the development of specific interventions. Further research on PPD is needed.

No significant relationships.

The COVID-19 has affected both physical and mental health of the elderly.

The purpose of the present study was to estimate the impact of the second lockdown in Greece, on both quality of life and mental health in older people.

A cross sectional study was conducted among older adults who visited a primary care physician, from 1st of March to April 30th. An anonymous questionnaire was administered to collect basic sociodemographic data and implementation of hygiene precaution measures. The 5-item World Health Organization Well-Being Index (WHO-5) to measure well-being, the Generalized Anxiety Disorder Assessment (GAD-7) instrument was used to assess the anxiety levels and Geriatric Depression Scale (GDS-15) depressive symptoms of the responders, respectively. Statistical analysis was performed with SPSS v.24.0

222 elderly took part in the study. 62.6% were female. According to the WHO-5, 37.4% present poor quality of life. GDS-15 reveals that 70.7% of the participants screened positive for moderate depression and 1.8% with severe symptoms. GAD-7 results estimated 32.9% of the participants to suffer from serious anxiety disorder and 37.4% from moderate. GAD-7 and GDS-15 were strongly associated (p <0.05) with female gender, low educational level and with comorbidities (coronary disease, diabetes mellitus and skeletomuscular diseases). Health precaution measures were negative correlated with mental health of the elderly. However, in participants with frequent contact with family and friends, lower anxiety levels were detected.

Our results highlight that older adult has experienced negative impact on both quality of life and mental health during 2nd Covid-19 lockdown in Greece.

No significant relationships.

Whether exist a potential association between schizophrenia spectrum disorders following past exposure to ionizing radiation and SARS CoV-2 infection is unknown.

To assess a possible role of double radiation-viral exposure in pre- and postnatal periods in schizophrenia spectrum disorders genesis.

Integration and analysis of information available with the results of own clinical and epidemiological studies.

The renaissance of interest to the viral hypothesis of schizophrenia is observing during the current COVID-19 pandemic. There is an increasing number of cases and case series reports on psychotic schizophreniform disorders following SARS CoV-2 infection diagnosed as COVID-19-asssociated brief psychotic disorder, first episode psychosis, acute and transient psychotic disorder. The prevalence rate of schizophrenia in A-bomb survivors in Nagasaki was very high – 6 % (Nakane and Ohta, 1986), and increased in those prenatally exposed to A-bombing (Imamura et al., 1995) and medical X-irradiation (Gross et al., 2018). We found a significant increase in the schizophrenia incidence in the Chornobyl exclusion zone personnel, as well as schizophreniform syndromes in Chornobyl clean-up workers (liquidators) irradiated by moderate to high doses (more than 0.30 Sv). The neural diathesis-stressor hypothesis of schizophrenia spectrum disorders was proposed (Loganovsky and Loganovskaja, 2000; Loganovsky et al., 2005). Recently we observed the clinical case of organic schizophrenia-like disorder in the liquidator who was ill with COVID-19.

The linkage between schizophrenia spectrum disorders following past exposure to ionizing radiation and SARS CoV-2 infection can exist that should be studied on the irradiated cohorts with following COVID-19.

No significant relationships.

Coronavirus Disease 19 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020. Since the outbreak, neuropsychiatric presentations such as delirium have been developing.

Our aim is to describe sociodemographic and clinical differences between inpatients cursing with Acute Confusional Syndrome (ACS) with and without COVID-19 pneumonia.

This is an observational-descriptive study. All patients attended by the liaison psychiatry service of Hospital del Mar, between February and April 2020, with ACS diagnosis were included. The sample was divided in 2 groups (with and without COVID-19 pneumonia). Sociodemographic and clinical variables including sex, age, previous somatic or psychiatric history, ACS risk factors, ACS subtype and pharmacological treatment were compared. Chi-square and U Mann Whitney tests were used.

The total sample was 62 patients. 43.5% were women with a mean age of 71,7 (SD 11,3). Covid pneumonia group included 26 patients. There was a higher percentage of Hypoxemia in Covid pneumonia patients (p<0,001). There were significant differences between Covid pneumonia group and ACS in relation to: a previous diagnosis of Ischemic Heart Disease (p=0,007), Heart Failure (p=0,029) and Nephropathy (p=0,022). Dexmedetomidine (p=0,001) was highly used for ACS treatment in Covid pneumonia patients.

In this sample, patients with ACS and Covid pneumonia had a bigger rate of hypoxemia and previous history of Ischemic Heart Disease, Heart Failure and Nephropathy compared to the rest of ACS patients. Dexmedetomidine was more commonly used for the treatment of ACS in Covid pneumonia group. More studies would be necessary to assess the significance.

No significant relationships.

The COVID-19 pandemic resulted in national lockdowns in several countries. Previous global epidemics led to an increase in the number of psychiatric patients presenting symptoms of anxiety or depression. Knowledge about the impact of early lockdown initiatives during the COVID-19 pandemic on the number of healthcare interactions is sparse.

To investigate both the impact of the Danish lockdown event on psychiatric patients’ contact with the healthcare system, stratified by type of contact (face-to-face (FTF) or virtual) and ICD-10 diagnosis, and how acute contacts were impacted in the five regions in Denmark.

Contacts in this study include all recorded FTF and virtual treatment interactions between patients and healthcare systems. An interrupted time series analysis was applied to determine the effect of the COVID-19 lockdown event on the number of contacts with psychiatric hospitals in Denmark, from February 25, 2019 to May 3, 2020. The analyses took a Box-Jenkins approach to fit an autoregressive integrated moving average (ARIMA) model.

Virtual contacts replaced most FTF contacts during the lockdown. For most patient groups, the total number of contacts did not decrease significantly. However, for child and adolescent patients diagnosed with F 10–19, 70–79, and 80–89, the number of contacts decreased during lockdown. The number of acute contacts with the psychiatric system decreased significantly during lockdown.

The Danish healthcare system was forced to introduce innovative tele-psychiatry to mental health care during the lockdown. Disruption to service delivery was minimized because the resources were in place to sustain the transition from FTF to virtual contacts.

No significant relationships.

International experience convincingly shows the prevalence of mental disorders secondary to COVID-19, the pathogenesis of which includes biological and psychosocial factors, which characterizes this area of research as relevant and timely.

Analysis of the structure of the most common forms of psychopathology within consequences in COVID-19.

The study involved 45 patients with depressive episodes of varying severity (F 32.0, 32.1, 32.2) and 37 ones with anxiety disorders (F 40, 41). The average age of the examined groups was 39.42 ± 5.68 and 31.54 ± 4.36 years respectively. Clinico-psychopathological, psychodiagnostic, statistical methods were used.

Significantly more patients with depressive disorders before the first clinical manifestations of the disease experienced COVID-19 in mild and moderate form (31.82% and 68.18% of individuals, respectively) (p <0.05), while patients with anxiety disorders were more affected to some stressors of the SARS-COV-2 pandemic (including threatening information background (83.78% of people), quarantine measures in the form of self-isolation (75.66% of people), uncertainty of the impact of coronavirus infection on the socio-economic situation) (62.16% of people)) (p < 0.05). It was found that the examined patients with a history of coronavirus COVID-19 are more likely to have depressive and asthenic syndromes in the clinical picture (p < 0.05), while patients with psychogenic effects of the pandemic - anxiety-phobic and somato-autonomic syndromes (p < 0,05).

Data on the influence of coronavirus disease COVID-19 and stressors of the SARS-CoV-2 pandemic on the formation of mental disorders of various genesis will allow to develop prevention algorithms and personalize therapeutic programs.

No significant relationships.

COVID-19-related stigma has been raised as a crisis since the beginning of the pandemic. We intended to develop a valid and reliable questionnaire to measure COVID-19-related stigma, attributed by the non-infected general population, and applied it in Tehran from September to October 2020.

This study measures the COVID-19-related stigma attributed by the non-infected general population using a valid and reliable questionnaire specific to COVID-19-related stigma.

A preliminary questionnaire with 18 items was developed. The score ranged from 18 to 54 while the higher score indicating a higher level of COVID-19-related stigma. Out of 1064 randomly recruited Tehran citizens without a history of COVID-19 infection, 630 participants, who completely responded to the questions on a phone call, entered the study.

The content validity was established with a scale content validity index of 0.90. Item CVI and Item content validity ratio were higher than 0.78 for all items. Internal consistency was confirmed with Cronbach’s alpha of 0.625. Exploratory factor analysis revealed seven latent variables, including “blaming and penalty-seeking behavior”, “social discrimination”, “dishonor label”, “interpersonal contact”, “spreading rumors and myths”, “overvalued idea”, and “apathy toward the patients”. The mean (SD) of the score was 25.1(4.71) in our study. 86.8% of participants reported a low level of stigma with a score below 31. 13.2% of them demonstrated a moderate level of stigma, and none of the participants showed a high level of stigma.

we found a low level of stigmatizing thoughts and behavior in Tehran, which may be due to social desirability bias.

No significant relationships.

COVID-19 affects nervous system and the mental health of patients.

The aim of the study was to determine the prevalence of depression, anxiety, and insomnia among patients hospitalized with COVID-19 in order to understand mediating factors and inform tailored intervention.

To the study patients with mild and moderate COVID -19 were included. It was no included patients with diagnosed psychiatric disorders. It was conducted an interview, including using telemedicine technologies, assessed HADS, MFI-20, Pittsburgh Sleep Quality Index (PSQI) questionnaire.

It was analyzed the data of 119 patients, 34% patients was female, mean age 58,7±11,1 range 47 to 69 years. Anxiety-depressive symptoms were observed in 33/119 (28%) patients by HADS scale. Clinically significant anxiety and depression were seen in 11% and 4% of the patients, respectively. In 13% patients was observed as anxiety as depression. An increase in the MFI-20 scale (more than 20 points) was found in 87 (73.0%) patients, sleep disorders in accordance with the PSQI questionnaire was recorded in 32 (27.0%) patients. Sleep disorders were manifested by dissatisfaction with sleep quantity or quality that is associated with difficulty falling asleep. All patients have asthenic symptom.

It was noted that in most patients with COVID-19, along with a depressive and anxiety disorders, an asthenic symptom complex, sleep disturbances are recorded. The choice of the medical intervention should be based on the severity of the violations identified taking into account the side effects of the prescribed drugs, drug interactions and somatic status of patients

No significant relationships.

In Romania, the first case of COVID-19 was detected on 26 February 2020 and the number of cases has been rising afterward.

The goal of this study was to assess anxiety and resilience regarding the COVID-19 pandemic and to analyse possible protective measures and risk factors.

This is a cross-sectional study and data were collected March and April 2021. Participants filled in the Zung Self-Rating Anxiety Scale and the Connor-Davidson Resilience Scale.

The sample consisted of 440 participants who presented to the general practitioner (female-65.7%) and the most representative age group was 35-64 years old; 18.4% of the participants stated that they were infected; 56.6% reported that they do not know anyone in their entourage who was infected/ has died of COVID-19 (group A), 32.9% knowing people with an infection in their close social environment (group B) and 10.5% had close people who died (group C). Almost half of the respondents (49,3%) scored above the cut-off point of the anxiety index (mild 38.6%, moderate 9.9%, severe 0.8%). As we expected, there is a strong negative correlation between anxiety levels and resilience (Pearson Correlation=-.551, p<0.01). If groups A and B had similarities regarding anxiety levels (44.97 and 44.23), those knowing someone who died of COVID-19 (group C) had a higher anxiety level (47.81%) (p<0.05).

The recent COVID-19 pandemic has caused an understandable surge in anxiety among the general population. Low level of resilience is predictive of the phenomenon of having high anxiety in the face of the death of others.

No significant relationships.

The constraints linked to COVID-19 may reduce resilience and intensify depressive feelings especially in vulnerable populations such as teachers.

To understand the psychological distress in terms of depression of the COVID-19 pandemic among secondary school teachers in Sfax, Tunisia and to determine the correlated factors.

This was a descriptive and analytical cross-sectional study of 97 medium and high school teachers from Sfax, Tunisia. The study was conducted on google drive in May 2021, including an information sheet and the Patient Health Questionnaire (PHQ)-9 to assess depression.

In our study, the sex-ratio (M/F) was 0.32 and the average age was 44.23 years old. The median professional seniority was 16 years (minimum=1, maximum=37). Suicidal thoughts were described by 10.4% of teachers while 54.2% reported the presence of sleep disturbances since the onset of the pandemic. The median PHQ-9 score was 8 (Q1=4, Q3=15). The distribution of scores indicated that 59.7% of participants had no to mild symptoms of depression while 40.3% had moderate to severe depression. Furthermore, the presence of depression was associated with an age ≤ 40 years old (p=0.037), a professional seniority ≤ 20 years (p=0.035), the female gender (p=0.005), the presence of sleep disturbances (p<0.001) as well as with suicidal thoughts (p=0.006).

It seems that COVID-19 health situation in education have led to the emergence of a teacher overexertion and a depth adaptation to the new environment demands. Thus, clinical attention to the depression level of the teachers is certainly warranted.

No significant relationships.

Stress among physician parents is still poorly studied, especially during the SARS-COV-2 pandemic.

To describe the stress of being both a doctor and a parent during COVID-19 epidemic.

It was a cross-sectional, descriptive and analytical study, carried out on google drive in March 2021, and relating to 93 Tunisian medical parents. We used a questionnaire containing the parents’ personal and professional data as well as the perceived stress scale (PSS10).

The majority of parents (94.7%) were women. The average age was 34.43 years old. The average age of marriage was 29.6 years for men and 25.4 years for women. The majority of parents (89.4%) had one or two children and 70.2% were satisfied with their relationship with their children. On another side, 71.3% of doctors had to provide on duty services in the hospital, with 44.1% providing 3-4 on-calls per month, while 69% were providing on duty services in the COVID units. The average PSS score was 22.6. The distribution of scores indicated medium and high stress level in respectively 84.9% and 14% of parents. Furthermore, the PSS score was negatively correlated with the marriage age (p = 0.046, r = -0.2). On the other hand, no association was observed with the children number nor with the satisfaction of the relationship with his child.

It follows from our study that stress among physician parents is at a fairly high level. Managing this stress during a pandemic is not easy and requires the activation of several defense mechanisms.

No significant relationships.