Introduction
Natural caregivers of patients with schizophrenia constitute a main source of care as they have to shoulder a multitude of caregiving responsibilities and are then confronted with ...considerable difficulties while providing care. As a result, natural caregivers, often described as “the hidden patients” usually suffer from psychological consequences such as anxiety and depression.
Objectives
This study aimed to asses anxiety and depression among natural caregivers of patients with schizophrenia and to identify risk factors for developing such disorders.
Methods
We conducted a cross-sectional, descriptive and analytical study, including 80 natural caregivers of patients with schizophrenia. We used the Hospital Anxiety and Depression Scale (HADS) to evaluate anxiety and depression.
Results
The typical caregiver profile was consistent with a 55-year old married illiterate first degree relative (mostly parents or spouses) with a low socio-economic level.
The mean anxiety score was 10.6± 5,1 and the mean depression score was 11.6± 6.2. Depression and anxiety were diagnosed in 66% of caregivers.
Anxiety and depression scores were significantly higher among female illiterate unemployed caregivers, those with organic history and among parents and correlated with the caregiving duration.
Anxiety scores were higher when patients in charge had poor therapeutic adherence and aggressive behavior and correlated with the age of caregivers and the number of other sick persons in charge.
Caregivers reported higher levels of depression when patients in charge were not married, unemployed and had a history of suicide attempts.
Anxiety score were significantly correlated with depression scores.
Conclusions
Caregivers of patients with schizophrenia, although thought to be a privileged source of emotional and social support, are hardly taken into account following the deinstitutionalization movement.
Disclosure of Interest
None Declared
Introduction
Exposure to severe childhood trauma has been associated with the onset and the severity of bipolar disorder in adults.
Objectives
The aim of this study was to examine the relationship ...between childhood trauma and functioning of patients suffering from bipolar disorder.
Methods
We conducted a cross-sectional, descriptive, and analytical study, including sixty-one remitted patients with BD. We used the Childhood Trauma Questionnaire (CTQ-SF) to measure history of traumatic childhood experiences and the Functioning Assessment Short Test (FAST) to assess functioning.
Results
The mean age of patients was 43.4. The sex ratio was 2.4. Almost two-thirds of patients (64%) had experienced at least one type of childhood trauma. An overall functional impairment was found in 70.5% of participants. The CTQ total score was significantly associated with low educational level (p=0.001), low socio-economic status (P=0.034), a family history of psychosis (P=0.022), the number of mood episodes (P=0.001), the number of hospitalizations (P=0.04), the number of relapses with psychotic features (p=0.002) and that of depressive relapses (P<0.001), rapid cycling (P=0.012), higher rates of suicide attempts (P=0.04) and poor functioning (P<0.001).The logistic regression analyses showed a significant association of childhood trauma with low educational level (p=0.001), high number of depressive episodes (p=0.013) and poor functioning (p<0.001).
Conclusions
Our findings demonstrate that childhood abuse and neglect are risk factors associated with worsening clinical course of bipolar disorder and higher functional impairment. These findings press the urgency for preventive practices and early intervention strategies to diminish the prevalence of childhood trauma and minimize their impact.
Disclosure
No significant relationships.
Introduction
A history of childhood trauma and Comorbid anxiety disorders have each been identified as potential predictors of unfavorable outcomes in patients with bipolar disorder. Nevertheless, ...the relationship between these two prognostic features has been little studied.
Objectives
In the present study, we aim to explore the relationship between childhood trauma and comorbid anxiety disorders in bipolar patients.
Methods
We conducted a cross-sectional, descriptive, and analytical study. Sixty-one euthymic patients with bipolar disorder were recruited in the department of psychiatry B of Razi Hospital, during their follow-up. We assessed history of childhood traumatic experiences with the Childhood Trauma Questionnaire (CTQ) and current diagnosis of anxiety disorders with the M.I.N.I. International Neuropsychiatric Interview.
Results
The mean age of patients was 43.4. The sex ratio was 2.4. Almost two-thirds of patients (64%) had experienced at least one type of childhood trauma. Twenty-one percent of participants had one anxiety disorder and 12% participants had two or more current anxiety disorders. Of the anxiety disorders, social anxiety disorder was significantly associated with emotional abuse subscale (p=0.002). Generalized anxiety disorder was significantly associated with the physical abuse subscale (p=0.025) and the number of severe childhood trauma per patient (p=). A statistically significant association was found between the number of current anxiety disorders and the emotional abuse sub score (p=0.021).
Conclusions
Exposure to childhood traumatic experiences is associated with more common comorbid anxiety disorders among bipolar patients. These prognostic features should systematically be a part of clinical assessment and taken into account in the management of these patients.
Disclosure
No significant relationships.
Introduction
Childhood trauma has been demonstrated to be associated with several indicators of worse course in bipolar disorder (BD). Links between early adversity and the complexity of the disorder ...might be mediated by various dimensions of psychopathology, such as impulsivity.
Objectives
The aim of this study was to investigate the impact of traumatic childhood experiences on impulsivity in individuals with bipolar disorder.
Methods
We conducted a cross-sectional, descriptive, and analytical study. Sixty-one euthymic patients with bipolar disorder were recruited in the department of psychiatry B of Razi Hospital, during their follow-up. The Childhood Trauma Questionnaire (CTQ) and the Barratt Impulsiveness Scale-11 (BIS-11) were used to assess childhood traumatic experiences and impulsivity.
Results
The mean age of patients was 43.4. The sex ratio was 2.4. The mean score obtained on the Bis-11 scale was 74.8. More than half of patients (53%) had high levels of impulsivity. Almost two-thirds of patients (64%) had experienced at least one type of childhood trauma. Higher scores on the various dimensions of childhood trauma apart from physical neglect, were significantly associated with higher total BIS-11 score as well as with all its subscales. Linear regression with the CTQ total score as the independent variable showed a statistically significant effect of childhood trauma score on attentional impulsivity.
Conclusions
Our findings suggest that interventions that target impulsive behavior in individuals with bipolar disorder should pay particular attention to traumatic childhood experiences. Furthermore, early identification and management of childhood trauma may reduce levels of impulsivity and thus improve the outcome and prognosis of bipolar disorder.
Disclosure
No significant relationships.
Introduction
Depression is one of the most common chronic illnesses. It requires long-term multidisciplinary care, combining pharmacological and non-pharmacological treatments. Hence the need for an ...educational approach to improve the quality of life of these patients.
Objectives
Our objective is to create a personalized educational program for patients followed for depression allowing them to acquire the necessary skills to become autonomous in the management of their pathologies on a daily basis.
Methods
The therapeutic education program is aimed at patients followed for depression and their families. Our team is multidisciplinary made up of a psychiatrist, a nurse and a dietitian. The educational tools are rich and varied, including computerized resources, written information, brochures and educational games.
Results
The first step is the educational diagnosis which allows to identify the personalized needs of the patient. The caregiver-educator sets with the patient the objectives to be achieved throughout the course, thus defining the educational contract. Then the patient and his entourage can follow a personalized therapeutic patient education program. We offer a program consisting of 7 sessions at the rate of one session per one to two months (2 individual sessions and 5 group workshops). At the end of the program, evaluation and self-evaluation grids are completed.
Conclusions
Therapeutic patient education provides knowledge through which patients with depression develop personal and interpersonal coping skills. This program will allow them to give an acceptable place to their disease so that they can evolve well with it.
Disclosure of Interest
None Declared
Introduction
Patients with bipolar disorder may adjust their behaviors and choose a coping strategy to face self-stigma and avoid unpleasant social and professional adversities. These coping ...orientations are either defensive, or active behavioral strategies.
Objectives
The aim of this study was to assess self-stigma in remitted patients with bipolar disorder and to investigate coping strategies to struggle the internalized stigma.
Methods
We conducted a cross-sectional, descriptive, and analytical study of 61 patients with bipolar disorder. Euthymia was verified using the Hamilton scale for depression and the Young scale for mania. We used the Internalized Stigma of Mental Illness (ISMI) to evaluate self-stigma, the Stigma coping orientation Scale (SCOS) to assess coping strategies.
Results
The mean age of patients was 43.4 years. The sex ratio was 2.4. The mean score on the ISMI was 2.36. More than half of our patients (59%) were self-stigmatized. Secrecy (57%) and withdrawal (56%) were the most adopted coping strategies. The mean self-stigma score was significantly associated with higher scores on defensive coping strategies such as secrecy (p<10
-3
) and withdrawal (p<10
-3
). However, scores on challenging (p<10
-3
), education (p<10
-3
) and distancing (p=0.014) strategies were inversely correlated with self-stigma scores. The logistic regression analyses revealed a significant association between defensive coping strategies (secrecy and withdrawal) and internalized stigma.
Conclusions
The relationship between defensive coping strategies and self-stigma appears to be bidirectional. Enhancing coping strategies oriented to education, challenging and engaging patients in social interaction and reducing the use of deleterious coping strategies focusing on secrecy and withdrawal may lead to restrict self-stigma.
Disclosure
No significant relationships.
Introduction
The prevalence of depressive disorders in patients with schizophrenia is estimated at 25%. Nevertheless, depressive symptoms occurring during the acute decompensation of schizophrenia ...have rarely been studied.
Objectives
The aim of our study was to assess depressive symptoms in hospitalized patients suffering from schizophrenia.
Methods
We conducted a cross-sectional, descriptive and analytical study, including 30 schizophrenic patients, hospitalized in the psychiatry B “department of the Hedi Chaker university hospital in Sfax. The assessment of clinical severity of schizophrenia was performed by the Positive and Negative Syndrome Scale (PANSS), that of depressive symptoms by the “Calgary Depression Scale for Schizophrenia” (CDSS).
Results
The mean age of patients was 41.2. Most of patients were male (86.7%) and unemployed (83.3%). Only 13.3% of them were married. Patients were hospitalized 8.83 times in average. A personal history of suicide attempts was found in 16.70% of cases. The mean score in the CDSS scale was 5.12. According to the CDSS score, a depressive state was diagnosed in 36.7% % of patients. Depression was associated with significantly more frequent history of suicide attempts (p=0.028), as well as significantly higher scores in the positive dimension of the PANSS (p=0.03).
Conclusions
Our results show that depressive symptoms are common during the acute decompensation phase of schizophrenia. They are associated with impaired functioning of patients, as well as a higher risk of suicide. Screening for depressive symptoms in patients hospitalized for schizophrenia is therefore essential in order to ensure better management.
Disclosure
No significant relationships.
Introduction
Obsessive-Compulsive Symptoms (OCS) are common in patients with schizophrenia, with a prevalence of 3.5% to 25%.
Objectives
The aim of our study was to assess the frequency of OCS in ...patients with schizophrenia, and to study the clinical and evolutionary characteristics of schizophrenia and OCS comorbidity.
Methods
We conducted a cross-sectional, descriptive, and analytical study. Thirty schizophrenic patients were recruited in the department of psychiatry B of Hedi Chaker university hospital of Sfax. We used the Yale-Brown Obsession-Compulsion Scale (Y-BOCS) to assess obsessive and compulsive symptoms, at the end of hospitalization, after clinical remission of schizophrenic symptoms.
Results
The mean age of patients was 41.2, that of disease onset was 27.3. Most of patients were male (86.7%) and unemployed (81.3%). A personal history of suicide attempts was found in 16.6% of patients. The average number of hospitalizations was 8.83. OCS were noted in 36% of patients with a Y-BOCS mean score of 5.5. Patients with OCS had significantly more frequent alcohol use (p = 0,008), a higher number (p = 0.03) and longer duration of hospitalizations (P = 0,034) and are more frequently treated with atypical antipsychotics (p = 0.001).
Conclusions
Our results show that patients with schizophrenia frequently present OCS. This comorbidity has a negative impact on the evolution and the prognosis of the disease, as well as the functioning of patients. Therefore, it should be investigated in order to ensure better care and promote the socio-professional reintegration of these patients.
Disclosure
No significant relationships.
Introduction
Self-stigmatization in patients with bipolar disorder could lead to shame, self-judgement, impaired quality of life, and could negatively affect self-esteem imeding recovery.
Objectives
...The aim of this study was to assess self-stigma in remitted patients with bipolar disorder and to evaluate its impact on self-esteem.
Methods
We conducted a cross-sectional, descriptive, and analytical study of 61 patients with bipolar disorder. Euthymia was verified using the Hamilton scale for depression and the Young scale for mania. We used the Internalized Stigma of Mental Illness (ISMI) to evaluate self-stigma, and the Rosenberg scale to assess self-esteem.
Results
The mean age of patients was 43.4 years. The sex ratio was 2.4. The mean score on the ISMI was 2.36. More than half of our patients (59%) were self-stigmatized. With regard to self-esteem, the mean score obtained on the Rosenberg scale was 27.72. Low or very low self-esteem was found in 54% of patients. The most self-stigmatized patients had significantly lower self-esteem (p<10
-3
).
Conclusions
Internalized stigmatization negatively affects self-esteem of patients with bipolar disorder. Psychoeducation and cognitive behavioral therapy would improve self-esteem and enhance psychosocial treatment adherence and move people with bipolar disorder toward a culture of recovery based on hope and self-determination.
Disclosure
No significant relationships.
Introduction
Self-stigma is widespread in patients with bipolar disorder, with many consequences for family, social and occupational functioning, as well as treatment adherence.
Objectives
The aim of ...this study was to evaluate self-stigma in remitted patients with bipolar disorder and to investigate its impact upon functioning.
Methods
We conducted a cross-sectional, descriptive, and analytical study of 61 patients with bipolar disorder. Euthymia was verified using the Hamilton scale for depression and the Young scale for mania. We used the Internalized Stigma of Mental Illness (ISMI) to evaluate self-stigma, the Functioning Assessment Short Test (FAST) to assess functioning.
Results
The mean age of patients was 43.4 years. The sex ratio was 2.4. The mean score on the ISMI was 2.36. More than half of our patients (59%) were self-stigmatized. Regarding functioning, a global impairment was noted in more than two thirds of the patients (71%). Occupational functioning was the most affected area (82%). Patients with higher self-stigma scores had significantly more impaired functioning (p<10
-3
). To decompose the relationship between stigma and functioning into more specific spheres, we found that all scores on the different domains of functioning were associated with a significantly higher mean self-stigma score.
Conclusions
The relationship between self-stigma and functioning seems to be bidirectional. Therefore, improved social functioning could reduce self-stigma and improve self-esteem.
Disclosure
No significant relationships.
