bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impulsivity and cannabis use disorder among tunisian sample
Authors: Olfa B. , Rim S. , Reehab O. , Syrine A. , Abdelmajid Z. , Farah C. , Rim M. , Ines F. , Jawaher M. 
Published: August 2023

IntroductionIn the past few years, there has been a considerable amount of evidence that cannabis use can cause structural and functional brain abnormalities.Structural imaging studies of cannabis users have revealed reduced prefrontal cortex volumes and white matter damage that may be involved with impulsivity.
Objectives: To Determine the level of dependence on cannabis among cannabis users consulting the detoxification center of Sfax, Tunisia To assess in addition the impact of cannabis on impulsivity and motor control.MethodsThis is a cross-sectional, descriptive and analytical study that was conducted over a period of 13 months between September 15, 2020 and October 1, 2021 among cannabis users consulting the detoxification center of Sfax, Tunisia.A short form of the Barratt Impulsiveness Scale (the BIS-15) and a Cannabis Abuse Screening Test (CAST) were used to assess impulsivity and to determine cannabis abuse.
Results: Thirty Eight cannabis users agreed to participate in this study. The distribution of CAST scores showed that 36 users (94.7%) had problematic cannabis use at the time of the study. The mean BIS 15 score was 38.2. In our sample, The level of impulsivity was highest in people with a high level of cannabis dependence. A higher level of impulsivity was found in younger subjects. However, a greater level of impulsivity was found in subjects with a lower socio-economic level. Concerning employment status, unemployment was significantly correlated with a higher level of impulsivity.ConclusionsImpulsivity is often associated with a variety of problematic behaviors such as aggressive behavior, smoking, drug abuse, pathological gambling or compulsive buying.A higher frequency of cannabis use and earlier age of onset use have been shown to be associated with the highest rates of impulsivity.Therefore, cannabis addiction represents a real public health problem, both because of the serious complications and heavy repercussions that it causes.Disclosure of InterestNone Declared
Obsessive-compulsive disorder after long-term cannabis use – case report
Authors: Nistor D. E. , Corban M. , Horosan L. 
Published: August 2023

IntroductionObsessive-compulsive disorder (OCD) is characterised by intrusive thoughts and repetitive behaviours that considerably impact general functioning. Recent evidence links the endocannabinoid system to OCD neurobiology, and several case reports describe significant improvement after using dronabinol (synthetic tetrahydrocannabinol) in patients with severe OCD. Nevertheless, to what extent this new information can change our perspective on pharmacological treatment in OCD is unclear.Objectives
We present the case of a patient with obsessive-compulsive symptoms triggered after increased long-term cannabis use. Our purpose is to emphasise the necessity of continuous research and a better understanding of the correlation between OCD and cannabis derivates before formulating treatment recommendations.MethodsWe used psychiatric assessments to evaluate the patient’s symptoms and evolution over time and exclude other possible causes that could have triggered the disorder.ResultsOur patient is a 37-year-old man who has been frequently brought to the hospital by the police in the last 11 years for psycho-motor agitation after cannabis use. This year, he came to the hospital by himself, complaining about intrusive thoughts that required motor and mental repetitions to reduce anxiety. His obsessions were mainly about the need for symmetry and exactness and his checking compulsions about his mother’s health. The symptoms required more than half a day and caused functional impairment. A detailed history did not outline any obsessive-compulsive symptoms before the previous year. The patient denies using new drugs, and we did not identify other medical conditions that could better explain the symptoms. However, he admits to increasing the doses and frequency of cannabis use during the last year. After two weeks of cannabis abstinence and Sertraline treatment, his symptomatology improved significantly, with a reduction of more than 50% in the time spent daily on mental and motor compulsions, reduced anxiety, and a noticeable increase in overall functionality. In addition, the Yale-Brown Obsessive Compulsive Scale result decreased from 35 on the first day to 17 on discharge.ConclusionsRecent studies support the use of cannabis derivates for treating OCD symptoms. However, this case report outlines that prolonged cannabis use could also trigger OCD. Therefore, further studies are necessary to identify not only the potential benefits but also the potential risks of using cannabinoids as a pharmacological intervention.ReferencesNicolini H et.al.CannabisUseInPeopleWithOC.FrontPsychiatry.2021May10; 12:664228.doi:10.3389/fpsyt.2021.664228.PMID:34040556;PMCID:PMC8141625KayserR.R. et.al.TheEndocannabinoidSystem:ANewTreatmentTargetforOCD? CannabisandCannabinoidResearch.Jun2019.7787.doi10.1089/can.2018.0049GoodmanWK et.al.1989.YBOCS:Archives of General Psychiatry,1006–1011.doi10.1001/archpsyc.1989.01810110048007Disclosure of InterestNone Declared
Misuse of psychotropic medications among hospitalized patients
Authors: Azraf F. , Tounsi A. , Sabir M. , El Omari F. 
Published: August 2023

IntroductionPsychotropic drugs are sometimes taken outside of any medical context and can be diverted or even trafficked. This phenomenon affects more adolescents and young adults, more specifically those who are already struggling with other consumption problems. This vulnerable population is thus exposed to several negative health and social repercussions.ObjectivesThe objective of our work is to determine the sociodemographic characteristics of the patients, the main drugs used, the dose, the route of administration, the mode of obtaining the drug and the intentionality of the use.MethodsIt is a retrospective study spread over 1 year on a series of patients who were hospitalized in the service of addictology at the psychiatric hospital Ar-razi of Salé. The data collection was carried out from the medical files and an exploitation form.ResultsA total of 141 patients were hospitalized during this period of which 53 37.5 had a diverted use of medication. Our sample is characterized by a predominance of female patients (90%) with a median age of 33 years. The most misused drugs were benzodiazepines (85.7%), analgesics (11.7%), hypnotics (9.4%) and antihistamines (1.9%). Misuse is related to exceeding doses (up to 40 times the maximum dose of the AMM) and duration of treatment, to use or obtaining drugs without a prescription 79.2 , to the route of administration and to drug addiction. 11.3 of patients were dependent on a single drug; 88.7% of patients had a co-addiction: tobacco 86.8%, cannabis 77.3%, alcohol 58.5%, cocaine 34.5%, solvents 15 , heroin 1.8% or a history of addiction. Hospitalization was only related to drug misuse in 11.3% of cases. The effects sought: anxiolysis 58.5%, euphoria 30.2%, analgesic 5.7%, disinhibition 3.8%, increased performance 1.9%ConclusionsThe misuse of psychotropic drugs is a well-known public health problem. However, this phenomenon remains unknown and neglected in Morocco.Disclosure of InterestNone Declared
Sexual motivations for engaging in chemsex behaviours
Authors: Curto Ramos J. , Heredia Soriano M. T. , Azqueta I. , De Ema Lopez I. , Molina Prado R. 
Published: August 2023

IntroductionThe intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.Objectives: The objective of this study was to understand the sexual motivations for chemsex practice o a group participantes of a sexual health program for chemsex users in two Drug Substace Use Disorder Clinics in Madrid.MethodsQualitative research approach. We analyze an anonymous survey with chemsex users with open answer questions about the motivations for chemsex practice. Data analysis was based on thematic analysis of content.ResultsDifferent qualitative studies have examined the motivations for engaging in chemsex. The participants identified two main raisons: pleasure and losing inhibitions. We analyed the inhibitions described by participants: difficulties with arousal, ejaculation, social interaction in sexual context, difficulties in situations that require intimacy, sexual practices that make them feel guilt/shame (for example BDSM) problems with “erotic” self-esteem: rejection of non-normative bodies or towards non- normative gender expression perceived as undesirable.ConclusionsUnderstanding the sexual motivations for engaging in chemsex seems necessary to develop and multidisciplinary approach. Mental health proffesionals should consider sexual counselling and sexual therapy for chemsex users in their treatment.Disclosure of InterestNone Declared
Toxic encephalopathy after an overdose of cocaine : a case serie
Authors: Zouari R. , Nabli F. , Ben Mohamed D. , Saeid M. Z. , Ben Sassi S. 
Published: August 2023

Introductioncocaine is a widely used illegal drug, known for its fast ability to induce euphoria and arousal. However, cocaine exposure can contribute to several mental and physical effects. Cocaine induced brain damage can be divided into 3 mechanisms: direct effect leading to toxic encephalopathy, secondary to vascular damage causing vasculitis, stroke and vasospasm, and tertiary effect due to hypoxia through a cardiovascular collapse.ObjectivesHere, we report 2 young men who developed a subacute encephalopathy with different clinical and radiological presentation after a cocaine overdoseMethodsa case serieResultswe present two men aged respectively of 28 (P1) and 42 years-old (P2). Both had a history of alcohol consumption and toxicomania (mainly cocaine) during the past year. They manifested, 2 weeks following a cocaine overdose, with gait disorder and confusion. On examination, P1 was apathic and confused. He had a subcortical frontal syndrome with gait apraxia and grasping reflex, along with a quadri-pyramidal syndrome. While patient P2 developed a cognitive decline, parkinsonism with dystonic posture of the trunk and the right limbs, and a pseudobulbar syndrome. Brain MRI was performed in both patients and showed a bilateral multifocal leukoencephalopathy (P1) and the presence of bilateral hyper T2 and FLAIR weighted images affecting basal ganglia, the mesencephalon and the periventricular cerebral white matter. Cerebrospinal fluid (CSF) analysis showed no pleocytosis and normal proteinorrachia. Electroencephalogram was also normal. Infectious differential diagnosis including Human Immunodeficiency Virus (HIV) and syphilis were excluded and metabolic screening including copper analysis, serum and CSF lactate were normal. The urine toxic screening, performed 20 days following the drug overdose, was negative. Both patients were treated with benzodiazepine and fluids without significative improvement. They were discharged with major cognitive and motor impairment.Conclusionscocaine toxicity is associated with high morbidity and mortality. Usually, cocaine abuse can lead to cardio-vascular, pulmonary and nervous complication. Neuropsychiatric sequelae are uncommon with less recovery potential. To date, there is no drug to prevent or cure cocaine addiction. The key is to educate the patient when he or she presents to the emergency department. Patients should be urged to seek drug counseling.Disclosure of InterestNone Declared
Alcohol use: prevalence and associated factors in a sample of Tunisian students
Authors: Ben Soussia R. , Faouel N. , Bouali W. , Gharbi E. , Ben Fredj M. , Zarrouk L. 
Published: August 2023

IntroductionThe use of alcohol, in particular its harmful use and alcohol dependence, represent a public health problem of interest to all age groups. Indeed, alcohol is responsible for a heavy burden of disease and a considerable socio-economic burden.ObjectivesTo determine the prevalence of alcohol use and the main factors associated with it in a sample of Tunisian students.MethodsThis is an analytical cross-sectional study carried out during the 2020/2021 academic year with a sample of Tunisian students. We used an anonymous self-administered questionnaire distributed online via social networks. Our questionnaire included a section focusing on socio-demographic characteristics and the AUDIT test (Alcohol Use Disorders Identification Test) to detect alcohol addiction.ResultsOur study enrolled 772 students .The average age of the study population was 23.29 ±3.25.Two hundred ninety-nine students (38.7%) consumed alcohol. The mean age at first use was 18.44 (3.09). Fifty-two alcohol users (17.4%) presented a risk of alcohol dependence. The first consumption contexts were mostly “between friends” (57.4%) and “party time “(23.5%).The main effects sought were the effect of disinhibition (64.5%) and social integration (41.1%) were predominant responses. The determining factors of alcohol consumption were age (p<10-3), male gender (p<10-3), and the presence of grade repetition (p<10-3), wealthy socioeconomic level (p<10-3), and participation in community life (p<10-3).ConclusionsAlcohol use and especially alcohol dependence may have harmful effects on student’s life. It is relevant to screen this addiction to better its prevention.Disclosure of InterestNone Declared
Does antipsychotic therapy prevent the development of chronic psychotic disorders in people addicted to ilegal psychoactive substances
Authors: Kasper S. S. , Čustović A. 
Published: August 2023

IntroductionAcute psychotic disorders are increasingly being diagnosed in people addicted to PASA part of these patients develops chronic psychotic disorders for reasons that still insufficently known.ObjectivesThe aim of the study was to determine preventive potential of antipsychotics in the development of chronic psychotic disorders as well as possible side effects of theur use.MethodsThe prospective retrospective qualitative study conducted in the period Septmeber 2017-September 2022.Data from medical records and electronic databases were used in the study.A structured questionnare for conductin research,a clinnical psychatic inteview,MMPI 202,tests to determine of ilegal PAS in body flluids.ResultsAccording to the results of the study adequate treatment of the underlying desease,fewer or complete abscence of relapses,social and psychoteraapeutic support had the greater effects.In the group of opiate addicts an adequate dose of supstitution therapy it often played a crucial role.ConclusionsIn experimental conditions the hypotesis about the preventive effect of antipsychotics on the development of psychotic disorders in peoplle addicted to PAS.On the contrary a whole series of new questions has beenopened.Disclosure of InterestNone Declared
The general practitioner in charge of addictive behavior
Authors: Bouali W. , Omezzine Gniwa R. , Faouel N. , Ben Soussia R. , Zarrouk L. 
Published: August 2023

IntroductionRecent reports confirmed that more than 22% of adult world population are suffering from addiction. Tobacco and alcohol use remain the most prevalent addictive behaviors reported in Tunisia. The management of addiction is a multidisciplinary team concept. This entity may be underdiagnosed due to perception default at the first line of management.The aim of this study was to identify the limiting factors for addictive behavior approach in general practitioner (GP) clinic.Recent reports confirmed that more than 22% of adult world population are suffering from addiction. Tobacco and alcohol use remain the most prevalent addictive behaviors reported in Tunisia. The management of addiction is a multidisciplinary team concept. This entity may be underdiagnosed due to perception default at the first line of management.ObjectivesThe aim of this study was to identify the limiting factors for addictive behavior approach in general practitioner (GP) clinic.MethodsA cross-sectional study involved 84 GPs in the city of Monastir, Tunisia. Self‐reported questionnaire was designed to survey the prevalence of patients with detectable addictive behavior among the outpatient GP clinic visitors.ResultsThe participation rate was 93.3% (84/90). The prevalence of addictive behaviors was variable (38-59.5%). Tobacco use was the most common addiction (91.7%). More than seventy percent of questioned GPs were regularly consulting patients with known addictive behavior. The diagnosis was incidental in 7% of cases. Sixty percent of patients had predisposing factors for addiction. Diagnostic with screening difficulties for addictive behavior were independently related to doctor’s age >40 (OR = 6.51; p = 0.005), exercise in private clinic (OR= 6.46; p=0.004). Thirty-three percent of GPs were more involved in addiction monitoring. The use of assessment scales was noted in 15%. Young physician age (OR=5.20; p=0.002) and the absence postgraduate diploma in addictology (OR=9.66; p=0.01) were significantly associated addiction management avoidance.ConclusionsThis study aimed to assess of the attitude of GP in Monastir city regarding the addictive behaviors of their patients. The diagnosis and the management of addiction is not standardized for these health practitioners and this will not contribute to the battle against this social entity.Disclosure of InterestNone Declared
Prevalence and associated factors to Post-Traumatic Stress Disorder (PTSD) and Social Anxiety Disorder (SAD) among health workers in the emergency room
Authors: Amamou B. , Betbout I. , Ben Haouala A. , Ben Mbarek M. , Merchaoui I. , Jebali R. , Zaafrane F. , Gaha L. 
Published: August 2023

Introductionpost-traumatic stress disorder (PTSD) is a mental health illness that can develop after being exposed to one or more traumatic events. This is a serious, long-term emotional response to extreme psychological trauma. As for public health emergencies, it demands large-scale coordination among many staff, and participants, especially medical workers, are exposed to high levels of stress, which can easily lead to psychiatric illnesses such as social anxiety disorder (SAD). Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity, yet little is known regarding the nature of this relationship.ObjectivesThe aim of this study is to investigate the prevalence of PTSD and SAD among health workers in the emergency ward and study the relationship between PTSD and SAD and the associated factors to both disorders among health workers in the emergency ward to suggest some solutions to reduce their effects.MethodsThis is a quantitative descriptive cross-sectional study conducted among medical and paramedical health professionals in the emergency rooms of the university hospital of Sahloul and Hached and the regional hospital of Msaken in Tunisia. The data was collected by a questionnaire that included demographic questions and Yes/No questions, as well as several scales to assess the degree of social nxiety (Liebowitz Social Anxiety Scale) and posttraumatic stress disorder (Post-traumatic stress disorder checklist for DSM-5 (PCL-5)).ResultsIn our study, 81 healthcare workers completed the survey. Of the total responding participants 67.9% were females. We noticed that the example was young (58%), also 59.3% had <1 year of experience. The population was slightly predominated by paramedical staff (56.8%), it also had a low married percentage of 38.3. Among the participants 17.3% smoke tobacco, 12.3% drink alcohol, and 3.7% are under cannabis use. We found that 7.4% of the participants had a psychiatric illness.
In our study, 38% scored positive for PTSD and for SAD 13.58% had marked social anxiety, 12.35% had severe social anxiety and 3.7% had very severe social anxiety, this is associated rather with the female gender, the younger (age range 20-30 years) and the paramedical staff.PTSD and SAD are more pronounced among those with the fewest years of experience.We obtained a positive Pearson Correlation between PTSD and SAD (r=0.513).ConclusionsPosttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity, especially in the healthcare field. Overall, researchers reveal that the link between PTSD and SAD is complicated, owing to a variety of factors such as a person’s genes, trauma history, and psychological vulnerabilities so large-scale epidemiological investigations are required.Disclosure of InterestNone Declared
Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report
Authors: Pozuelo Moyano B. , Tzartzas K. , Kokkinakis I. 
Published: August 2023

Introduction
The disease burden due to non-specific, functional, and somatoform disorders is high. An unknown part of these medically unexplained symptoms belongs to factitious disorders. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder.ObjectivesThe aim is to highlight, on the one hand, the differences between somatoform disorder and factitious disorder and, on the other hand, the potential impact of misdiagnosis in medical expertise regarding eligibility for a disability income.MethodsA case report of Ms A. a 42-year-old Caucasian woman. She worked as a 100% fiduciary accountant until the age of 32 when she was placed on medical leave due to persistent trigeminal neuralgia. Subsequently, she developed total blindness, accompanied by distress in a crucial emotional context. A diagnosis of factitious disorder was retained by an expert psychiatrist, with severe consequences for her, such as disability income suspension and family conflict. We evaluated Ms. A. in our multidisciplinary medical expertise service for a disability income review.ResultsThe patient reported a total absence of light perception in both eyes (subjective), not confirmed by objective ocular examination and spécific neuro-ophthalmological examination.Psychiatric examination revealed that Ms. A. had been sexually assaulted at age of 7 and sexually abused for a year by her teacher at age of 14. Regarding the identity of the first abuser, she describes that she “can’t see his face” and that the multiple sexual assaults during her teenage years took place in the classroom after school, with the teacher “pulling down the window shades so it was totally dark.” She explains that, defensively, to avoid thoughts related to the traumatic experience, she was heavily invested in her studies. But, at the age of 30, after separation with her first boyfriend, diffuse pain and progressively total blindness appeared.We concluded the diagnoses of pain disorders related to psychological factors and a dissociative neurological symptom disorder with visual disturbance.Conclusions
Blindness not explained by a physiologic process may accompany trauma and psychological distress, with the search for the link between the onset of symptoms and significant unconscious psychic conflicts being crucial in the psychiatric investigation. A new diagnosis of dissociative neurological symptom disorder with visual disturbance (6B60.0) is included in the ICD-11. It is characterized by visual symptoms such as blindness, tunnel vision, diplopia, visual distortions, or hallucinations that are not consistent with a recognized disease of the nervous system, other mental, behavioral, or neurodevelopmental disorders. Differentiating this pathology from factitious disorder or simulation is essential from an insurance medicine point of view, but also for its treatment.Disclosure of InterestNone Declared