Depression, as a psychiatric entity, has a number of emotional components. These are mainly known among patients over the age of 65: sadness, physical and mental exhaustion, irritability, feeling of emptiness and loneliness.

The main objective of this study is to detect if the effects of the Covid 19 pandemic over 65 years of age such as fear, excessive anxiety, lack of motivation, uncertainty and environmental changes, isolation (resulting in sleep disorders, appetite and attention) caused the exacerbation of depression.

This study included a total number of 126 patients, each over 65, hospitalized at the Psychiatric Hospital “Elisabeta Doamna” in Galati in the context of the COVID-19 pandemic. They were diagnosed with depression, according to ICD-10 and the Hamilton scale.

All data obtained were centralized and used to detect whether, in Galați, the lockdown impacted the number of admissions of people over 65, diagnosed with depression, with an average age of 68,62. There is an increased incidence of female patients (75%), thus reporting an odds ratio of 3:1. The incidence of cases reported during the months of presentation is as follows: January (24%), February (28.8%), March (14.4%), April (3.2%), May (5.6%), June (23.2%).

Environmental factors, unique in this situation, isolation, social distancing and changes in the daily routine, each associated with this global epidemiological crisis determinated a decrease of the number of depressive elderly admissions between March 15th and May 15th.

Antipsychotics are frequently used for managing psychiatric and behavioral symptoms of dementia. However, it’s an off-label resource which remains controversial due to significant safety concerns in the elderly population, namely increasing cardiovascular adverse effects.

To access antipsychotic safety and potential risks when used in dementia.

A non-systematic review was carefully conducted on PubMed using the following keywords: “dementia”, “antipsychotics” and “safety.” We selected clinical trials, meta-analysis, randomized controlled trials published in the last 10 years.

A total of 43 articles was obtained, of which 22 were excluded because they didn’t meet our inclusion criteria. Regarding atypical antipsychotics, one study found an incidence of severe events in 23,7% of patients and a OR=2.5 for cerebrovascular side effects. Quetiapine was suspended midway given it had a higher incidence of adverse effects compared to others. There weren’t any significant statistic differences concerning serious events between classes of antipsychotics(p<0,01). No study was found comparing typical and atypical antipsychotics safety in dementia.

Overall, we can conclude that antipsychotics pose a risk of serious adverse effects when used in elderly patients, namely cerebrovascular events. Among atypical antipsychotics, quetiapine, used frequently for controlling neuropsychiatric symptoms in these patients appears a higher risk for severe adverse events compared with other drugs. Their use should be restricted after there aren’t any other options available. New protocols could be developed to control these symptoms, for example, environmental measures before resorting to antipsychotics.

Alzheimer’s Disease (AD) is associated with neuropsychiatric symptoms such as agitation depression and apathy. It has been proposed that the pathophysiology of apathy, that is defined as quantitative reduction in goal-directed activity compared with previous functioning, in AD is associated with degeneration of prefrontal cortex and dysfunction of dopamine and norepinephrine neurons in the brain. Methylphenidate (MPH) is a dopamine and norepinephrine reuptake inhibitor and its action increase the availability of these neurotransmitters in the extracellular space of striatum and prefrontal cortex. Over the past decade there has been an effort to study the benefit of the use of MPH for treatment of apathy in patients with Alzheimer’s dementia.

Study the benefit of methylphenidate in the treatment of apathy in AD.

Basic literature review collecting data from PubMed (2010-2020) using the words “Methylphenidate”, “Apathy”, “Alzheimer”, “Dementia”.

Clinical trials using 10 to 20mg of MPH per day, for 6 weeks, demonstrated a mitigation in apathy symptoms in one third of patients, with good tolerability. Another clinical trial using the same dosage, for 12 weeks, led to improvement in cognition, functional status, depression and caregiver burden.

New clinical trials with larger groups of patients over a longer period are needed to consolidate the existing results. Although there are still many questions concerning the usefulness of methylphenidate in this population that need to be answered, methylphenidate might be an option to deal with one of the most prevalent neuropsychiatric symptoms, apathy, in some AD patients.

Patients diagnosed with vascular dementia often present with apathy, executive dysfunction or/and memory impairment. Some of these psychiatric domains are not responsive to antidepressants or acetylcholinesterase inhibitors. Since methylphenidate enhances frontal lobe function, it may be a valid therapeutic option.

To report a case where methylphenidate was used as a therapeutic approach in vascular dementia.

We present a case of a patient diagnosed with vascular dementia with substantial clinical improvement after treatment with methylphenidate.

A 67 year-old male was observed in a psychiatric consultation reporting memory loss, inability to retain information and inattention. According to her spouse, the patient has been mostly isolated at home and recently he has become unable to accomplish some daily living activities. There was no history of previous psychiatric disorder. Cognitive assessment was performed using MoCA test: 19/30 points (predominantly in executive, attention and delayed recall domains). After this evaluation, it was introduced bupropion 150mg od and donepezil 5mg od with insignificant clinical improvement. The patient underwent a routine workup which was unremarkable and a brain computed tomography scan that revealed ischemic leukoencephalopathy. Three months later no clinical benefit was reported. Attention and functional improvement were observed after introduction of methylphenidate with progressive dose adjusting till 30 mg/day.

Besides not being a consensual therapeutic approach, considering that there is a lack of efficient pharmacological strategies in vascular dementia, methylphenidate may play a significant role in this field contributing to clinical improving and ultimately to an enhanced quality of life.

The concepts of spirituality and religiousness has not been investigated so far in patients after stroke.

The aim of this study is to explore whether self-reports in two questionnaires measuring the personal experience of spirituality and religiousness can influence quality of life and estimations of rehabilitation in male older adult patients and their wives when compared with control dyads.

Fifteen male stroke patients and their wives participated one year after their hospitalization for stroke. The mean age of the patients and their wives was 75.58 years (SD = 7.50, range 61-90), level of education 15.47 years (SD = 3.82). In addition to that, fifteen married couples with similar demographics, were also measured. Depressive symptoms of the participants were assessed with the 15-item Geriatric Depression Scale. Family dyads consisting of an older adult and one family member, in all cases the wife, also responded to the Daily Spiritual Experience Scale, the Systems of Belief Inventory (SBI-15R), and the Satisfaction with Life Scale (SWLS). A 5-point Likert scale question was also administered examining the opinion of rehabilitation achieved.

indicated that there was a statistically significant difference between the two groups regarding the levels of spirituality, religiousness and quality of life in both partners, with the stroke patient dyad showing lower scores, but positive stronger correlations.

Although spirituality, religiousness and quality of life are lower in the stroke patient dyad, they show significantly statistical positive correlations in older adults suffering from stroke as well as their wives.

Spirituality and religiousness are not so far extensively investigated in patients after stroke.

The aim of this preliminary study is to explore whether self-reports in two questionnaires measuring the personal experience of spirituality and religiousness can influence cognition and more specifically performance on neuropsychological tests examining attention.

Fifteen male stroke patients participated voluntarily one year after their hospitalization. The mean age of the patients was 75.58 years (SD = 7.50, range 61-90), level of education 15.47 years (SD = 3.82). In addition to that, fifteen controls with similar demographics, free of physical and mental diseases, were also examined. Depressive symptoms of the participants were assessed with the 15-item Geriatric Depression Scale. The Daily Spiritual Experience Scale, the Systems of Belief Inventory (SBI-15R) and a number of standardized tests examining attention were administered: Trail Making Test-Part A (TMT-A) time to completion, the Digit Span (WAIS-III) greatest forward span, the Ruff 2 & 7 Selective Attention Test automatic detection speed (ADS) and controlled search speed (CSS).

indicated that there was a statistically significant difference between the control group and the stroke group in attention. No statistically significant difference was found between the two groups regarding the levels of spirituality and religiousness.

Although spirituality and religiousness may be related with quality of life, cognitive functioning such as attention does not seem to be influenced by these variables one year post-stroke. Future research should further investigate the possible influence of the abovementioned factors in post-stroke recovery and rehabilitation.

The relationship of spirituality, religiousness and stroke is a topic of interest.

The aim of this preliminary study is to explore whether self-reports in two questionnaires measuring the personal experience of spirituality and religiousness can influence cognition and more specifically performance on neuropsychological tests examining visual memory.

Fifteen male stroke patients participated voluntarily one year after their hospitalization. The mean age of the patients was 75.58 years (SD = 7.50, range 61-90), level of education 15.47 years (SD = 3.82). In addition to that, fifteen controls with similar demographics, free of physical and mental diseases, were also examined. Depressive symptoms of the participants were assessed with the 15-item Geriatric Depression Scale. The Daily Spiritual Experience Scale, the Systems of Belief Inventory (SBI-15R) and a number of standardized tests examining visual memory were administered: visual perception (copy condition) and memory (Rey-Osterrieth Complex Figure Test-number of correct components on immediate and delayed recall trials and recognition-true positive responses).

indicated a statistically significant difference between the control group and the stroke group in performance regarding visual memory. There was no statistically significant difference between the two groups regarding the levels of spirituality and religiousness.

Visual memory does not seem to be influenced by spirituality and religiousness one year post-stroke. Future research should further investigate the possible influence of the abovementioned factors in post-stroke recovery and rehabilitation.

Patients after stroke may experience different cognitive and emotional changes based on the levels of their spirituality and religiousness.

This preliminary study aims to explore whether self-reports in two questionnaires measuring the personal experience of spirituality and religiousness can influence cognition and more specifically performance on neuropsychological tests examining verbal functions.

Fifteen male stroke patients participated voluntarily one year after their hospitalization. The mean age of the patients was 75.58 years (SD = 7.50, range 61-90), level of education 15.47 years (SD = 3.82). In addition to that, fifteen controls with similar demographics, free of physical and mental diseases, were also examined. Depressive symptoms of the participants were assessed with the 15-item Geriatric Depression Scale. The Daily Spiritual Experience Scale, the Systems of Belief Inventory (SBI-15R) and a number of standardized tests examining verbal functions such as word list learning (number of words on immediate and delayed recall), story learning (number of words on immediate and delayed recall).

showed a statistically significant difference between the control group and the stroke group in performance regarding verbal functions, with the first group showing higher scores. No statistically significant difference was found between the two groups regarding the levels of spirituality and religiousness.

Although spirituality and religiousness may be related with quality of life, cognitive functions such as verbal functions are not influenced one year post-stroke.

Neuropsychiatric symptoms (NPS) are common, disabling and burdensome core-features of dementia, with important diagnostic and prognostic value. However, their measurement remains challenging. The Neuropsychiatric Inventory (NPI) is the most widely used NPS measure. Nevertheless, it is also time-consuming and impractical in most clinical settings. Therefore, the Abe’s BPSD score (ABS) has been proposed as a brief score to facilitate the NPS assessment.

To explore the concurrent validity of the Portuguese ABS by comparing the 10 ABS items with the relevant NPI-12 domains.

A cross-sectional study was conducted with outpatients attending a gerontopsychiatric consultation. Patients were included if they were ≥65 years and had a reliable caregiver. NPS frequency rates (number of patients with a symptom) were estimated with ABS and NPI-12, and an agreement analysis was undertaken by calculating kappa-coefficients (k) and the respective 95% confidence interval [95%CI] between ABS items and relevant NPI-12 domains.

Overall, 107 patients were included. Kappa-values ranged from 0.277 to 1.000. Higher agreement was recorded for the ABS items eating/toilet problems (k=1.000), day–night reversal (k=0.976[0.925-1.000]) and depressive/gloomy mood (k=0.957[0.899-1.000]), with the NPI-12 appetite/eating abnormalities, night-time behavioural disturbances and dysphoria domains, respectively. The ABS item violent force recorded the lowest agreement (k=0.277[0.104-0.45]) with the NPI-12 agitation/aggression domain.

This exploratory analysis demonstrates good levels of agreement between most ABS items and relevant NPI-12 domains. Data add to the evidence that both measures capture a comparable broad spectrum of psychopathology, supporting the ABS use in clinical routine. Support: FCT(PD/BD/114555/2016), and National Funds through FCT-within CINTESIS, R&D Unit (ref.UIDB/4255/2020).

Prescribing benzodiazepines (BZD) in patients over 65 years old requires special precautions in view of the frequency and the severity of their side effects, especially in this age group.

The objectives of our work were to evaluate the modalities of BZDs prescribing in elderly patients in psychiatry and to assess their compliance with international recommendations.

This is a descriptive cross-sectional study conducted through a Google-forms self-administered questionnaire, intended for psychiatrists and psychiatric residents, over a period of two months, from April 1 to May 31, 2019.

One hundred physicians practicing in psychiatry answered our questionnaire. The response rate was 28%. Special precautions were taken in elderly patients by 96.5% of the participants. In eldery patients, long half-life BZDs were prescribed in 15% of cases. The majority of the participants indicated that the risk of falls (98.1%) and memory impairments (75.2%) were the main risks to which they were particularly vigilant during the prescribing of BZDs in eldery patients. In the elderly, 20% of the participants said they did not take special precautions when stopping BZDs.

The frequency and severity of side effects associated with BZDs in the elderly are the cause of strict prescribing rules in this age group. According to the results of our study and to the literature data, the prescribing practices of these molecules in the elderly remain insufficiently in accordance with the guidelines.

The frail elderly with multimorbidity and polytherapy may need both residential and home services. The psychogeriatric patient can make both of these contexts very demanding and painful, so that the care burden increases.Psycho-behavioral events lead to an unexpected and particularly complex workload, requiring specific and integrated skills in the fields of health, social assistance and education.

Evaluate whether the integrated team, operating in the health district, is able to intecept multimorbidity in the presence of psychogeriatric disorders. A possible index of the ability to take charge of psychogeriatric multimorbidity is to measure admission rates to acute psychiatric services or to nursing homes.

Metodi. This is an observational study on a cohort of thirty elderly patients over-65, consecutively assessed in the health district with multimorbidity and psycho-behavioral, followed for six months.

One third of psychogeriatric patients with multimorbidity, despite being intercepted by health services of community, are admitted to acute psychiatric services for brief observation or hospitalization. Psychogeriatric patients have high clinical instability, reducing ability to make adequate choices, lower levels of consistent actions.

Organizational models, in response to the growing multimorbidity, and the allocation of resources cannot be oriented to the single pathology but to groups of patients in the perspective of long term care. The case-mix is an index of the complexity of the cases treated; when we refer to the psychogeriatric population, this index is high, due to emergence of social and medical problems in both residential and home services.

Artificial intelligence and machine learning are increasingly being researched within the field of psychiatry to find out what use it might be. With this review, therefore, we would like to assess what literature, if any, exists that answers the question of whether this technology can be useful for providing dementia care. We also wanted to consider the ethical questions of autonomy, consent and privacy when working with this vulnerable group of patients.

To identify and appriase the literature to assess the existing research landscape of the area of machine learning and AI, relating to the care of people with dementia.

A literature search was conducted, searching the PsychInfo, Medline, PubMed and Embase databases. We assessed the quality of the research and considered what overall findings there were in the existing literature.

619 papers were identified, of which 28 related to the use of AI in the care of people with dementia. The papers were divided into categories to show the utility and effectiveness these technologies may have: 1: to alert caregivers to problems 2: to facilitate activities for people with dementia 3: to help plan care for people with dementia 4: to consider the ethical implications of the use of artificial intelligence and machine learning

Despite a paucity of literature in the area, existing studies show potential, if used well, for technologies to be a useful addition to care of people with dementia. The experience of patients and their carers must be integral to their development and use.

The COVID-19 pandemic has required services to evolve quickly to continue routine care and telemedicine has been rapidly implemented to facilitate this. Older persons are at high risk of serious complications of COVID-19 and it is essential that their exposure to COVID-19 is minimized.

Our aim was to assess staff and patient satisfaction with remote psychiatric assessments using mobile tablets in long-stay facilities.

Remote clinics using Skype video on mobile tablets were conducted with patients in long-stay facilities attending psychiatry in rural North-West Ireland between April and July 2020. At each review, a satisfaction survey was administered to the patient, their keyworker and the clinician. The patient/keyworker survey instrument had four yes/no statements and the clinician survey had four statements with 5-point likert scale responses (1=very low to 5=very high). Open feedback was also obtained for thematic analysis. Descriptive analyses were completed using SPSS software.

23 patients (mean age 80.9yrs) were assessed in 10 long-stay facilities. All patients were agreeable to participating in video consultation although only 13 patients were able to respond to survey due to cognitive impairment. There was a 92.3% positive patient response (12/13) and 95.7% positive keyworker response (N=22/23) for all statements. The mean score on the assessor response ranged from 3.43 to 4.04 with the lowest rate for quality of transmission. The main themes identified were related to the quality of connection and sensory difficulties.

Video consultations using mobile tablets offer an acceptable form of remote psychiatry assessment for older persons in long-stay facilities.

Age-related vascular changes have long been documented as an etiopathogenic factor of some geriatric depressive syndromes. More recently, it has emerged the concept of “Vascular Depression” recognizing that cardiovascular disease may predispose, precipitate or perpetuate late life depression. This condition was defined by an episode of major depressive disorder within the preceding 12 months in elderly with cardiovascular/cerebrovascular disease, or major cardiovascular risk factors. Vascular Depression isn`t described in DSM-V, and that difficults clinical recognition and affects clinically informed systematic studies.

Regarding a clinical case, we enphasize the clinical impact of Vascular Depression`s hypothesis.

We present a qualitative review of this topic using the Pubmed Central database.

74 years old male patient, with major depressive disorder about ten years. Depressive and cognitive symptoms didn`t respond to antidepressive treatment and his functional state has gradually declined.

Vascular depression develops after the 60 – 65 years in the absence of personal and family history of affective disorder. The key symptoms are low energy, anhedonia, deficits in selfinitiation, psychomotor retardation, reduced processing speed and lack of insight into mood symptoms. Clinical assessment includes a review of history of vascular risk factors or/and disease, but also an imagiological evidence demonstrating subcortical white matter abnormalities. Insidious and chronic course tends to delay its recognition and management. This becomes critical because Vascular Depression is associated with poor response to antidepressant treatment and persistent depressive symptoms. It`s also associated with poor selfmanagement of comorbidities and impairment in daily function. Increased mortality from all causes is widely documented.

PTSD manifestation is determined by facing extreme life threatening experience going beyond our stress coping skills. The diagnosis of the serious illness like cancer or SARS-2 COVID 19 can be considered as one of the PTSD risk factors. In our clinical practice we have to distinguish the patients groups vulnerable to comorbid PTSD as well as define the psychological factors like good life hardiness, adaptive internal illness image or specific personality profile that can help to cope with disease stress and should be strengthen with psychosocial interventions.

After screening with PTSD Trauma Screening Questionnaire and an expert clinical interview aimed to verify the PTSD diagnosis according to ICD-10 criteria 97 breast cancer patients were enrolled in the study, 46 with comorbid PTSD, 51 well coped with stress

Semi-structured interview, Hardiness Survey questionnaire,Experiences in Close Relationships-Revised (ECR-R) Adult Attachment questionnaire,Impact of Event Scale-R – IES-R, the questionnaire of the internal disease model, Ego-structure test by G. Ammon(ISTA),.

The correlation analysis revealed negative correlation between PTSD diagnosis and hardiness, especially its Involvement, Control, Risk acceptance sub-scales and with the Traumatic event impact score. Deficient-destructive ISTA personality profile had a positive correlation with PTSD and traumatic Impact scores, the strongest correlation were with deficient aggression(r=0,698, p=0.01), destructive anxiety (r=0,674, p=0,01), and deficient internal and external demarcation (r=0,678, p=0,01). The adaptive internal illness image types had a negative correlation with PTSD

Hardiness, maladaptive illness images types and destructive-deficient personality dimension should be the main targets for psychotherapy in comorbid PTSD treatment and prevention

life hardiness ptsd breast cancer internal image of the illness construct anxiety social support

In palliative care, depression and pain are prevalent variables with a reciprocal and controversial relationship. Depression is common in people with chronical diseases. In the last decades, self-compassion has been pointed as a protective psychological process to negative affect.

The current study aimed to test the role of self-compassion in the relationship between pain and depression in palliative patients.

Sample was composed of 33 patients in palliative care, with a mean of 74.12 years of age (SD = 12.76). Participants completed self-report questionnaires and data was analyzed using SPSS.

From the descriptive analysis of the results of the Geriatric Depression Scale, 22 patients were depressed (66.6%), 9 of them in severe depression (27.7%). Self-compassion presented a negative and moderate correlation with depression. Depression was positively correlated with pain. A hierarchical regression to predict depression was conducted. Firstly, pain was entered as a predictive variable with a significant effect. Secondly, self-compassion was entered, and the model was significantly incremented, explaining 41% of depression. Only self-compassion was significant in this model.

Discussion and conclusion: The association between pain and depression in palliative care corroborate previous research. Results seemed to show that self-compassion has a significant effect in the relationship between pain and depression. Cultivating a compassion self-to-self relationship might have an important effect attenuating the link between pain and depression in palliative care.

Freudenberger was the first to define burnout as a feeling of helplessness and guilt, as well as boredom and disinterest.

Our study aimed to analyze functional complaints and the behavior of healthcare professionals in this area associated with this syndrome.

This was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health professionals were asked to answer the Maslach –Burnout Inventory Test.

The average age was 34 years ± 6.7. Burn-out was found in 15 of the participants, (21%). In our population, a high emotional exhaustion score was significantly associated with its repercussions: Sadness, Blockage, sleep disturbances, unexplained pain, Epigastralgia / fatigue, Addictive behavior ; avoidance behavior, repercussions on the relationship with those around them, desire for a transfer, regret for choosing a profession, suicidal thoughts, absenteeism and smoking. A high depersonalization score was significantly associated with several functional and behavior complaints, in particular: irritability, anger, feeling of indifference, guilt, unexplained pain, decreased performance, suicidal thoughts. A low personal achievement score was significantly associated with psychotropic drug use. Global burn-out was significantly associated with feeling of blockage, guilt, unexplained pain, epigastralgia and fatigue, addictive behaviors and avoidance behaviors as well as suicidal thoughts, absenteeism and consumption of psychotropic drugs.

Through its impact on professionals, burnout in medical oncology represents a major threat to the quality of care and the survival of institutions.

Burnout syndrome concerns 27.8% of the general working population against 37% among doctors.

This study aimed to report the prevalence of burnout among health care professionals in medical oncology in Tunisia.

This was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health profeessionals were asked to answer the Maslach –Burnout Inventory Test. Three scores allowing to locate the burn-out state of the person: the Score of emotional exhaustion (SEE), the Depersonalization score (SD) and the Score of personal achievement at work (SAP).

Le taux de participation était de 58,3%. La combinaison d’un SEE élevé, d’un SD élevé et d’un SAP bas définit le syndrome de Burn-out. Le SEE était élevé chez 44 travailleurs (63%), indiquant un épuisement émotionnel sévère. Un SD élevé a été trouvé chez 37 répondants (53%). La majorité des participants (59%) avaient un PAS faible. Le burnout est défini par l’association chez la même personne d’un épuisement émotionnel élevé, d’une dépersonnalisation élevée et d’un faible rendement personnel. Cela a été trouvé chez 15 des participants (21%). Selon l’étude analytique, le sexe féminin était significativement associé à un SEE élevé, un SAP bas et un épuisement global. Le travail de nuit était significativement associé à un degré élevé de dépersonnalisation et à un degré élevé d’épuisement général.

Burnout is linked to an increasingly ergonomic load. Health care professionnel, particularly in oncology, are frequently faced to this syndrome.

Health care professionals are particularly concerned with burnout

This study aimed to evaluate the the factors predisposing to occupational burnout

This was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health profeessionals were asked to answer the Maslach –Burnout Inventory Test.

The mean age was 34 ± 6.7 years [23 - 57]. The sex ratio was 0.22. Our study population included 37 doctors (53%) and 33 nurses (47%). The inappropriate working conditions mentioned by the participants were as follows: The requirementss of patients and their families (91.5%), the lack of resources (87%), overwork found (83%), unsatisfactory effort- salary ratio (83%) and the reduced number of staff (77%). Several Burn-out factors mentioned by the participants were significantly associated with a high emotional exhaustion syndrome: overwork, poor service organization, lack of resources, lack of time, lack of recognition, conflicts with colleagues, lack of communication, unsatisfactory salary - effort ratio, assaults by patients. Several factors were positively and significantly associated with a high depersonalization score: overwork, poor service organization, small number of staff, lack of resources, lack of respect, lack of recognition. The global burnout associating the achievement of the three dimensions was significantly associated with overwork, lack of recognition, conflicts with colleagues and assault by patients.

Burnout has become a major issue in Tunisian medicine. If left untreated, burnout epidemic may continue to worsen, to the detriment of patients and doctors

Autism spectrum disorder (ASD) and cancer are two pathologies that appear to be different, but whose multifactorial determinism involves shared genetic and environmental factors.

This study aimed to find an association between maternal cancer and ASD in children by comparing the frequencies of ASD between children of mothers followed for cancer and children of mothers free from cancer

We recruited, between March and August 2018, women divided into 2 groups: G1; women followed for cancer at the oncology consultation of Monastir and Sousse (N1 = 100) and G2; women free from cancer (N2 = 101). We screened their offspring aged 18 months to 11 years for ASD using the C-AQ and the M-CHAT. We confirmed the diagnosis of ASD using ADI-R in children who tested positive.

Nous avons examiné un total de 332 enfants. La fréquence des enfants atteints de TSA chez les mères G1 était de 5,4%, celle des enfants de mères G2 était de 1,2 avec une association significative entre cancer maternel et TSA (p = 0,035), qui est restée significative après analyse multivariée. (p = 0,001) D’autres facteurs que nous avons trouvés associés aux TSA dans notre population sont la présence d’une expérience stressante pendant la grossesse; exposition précoce avant l’âge de 2 ans à la télévision> 2 heures par jour; antécédents psychiatriques de la mère, du père et de la fratrie et dépression post-partum.

Le cancer maternel et les TSA semblent partager des mécanismes étiopathogènes communs