Diabetes Distress and Illness Perceptions in Tunisian Type 2 Diabetes Patients.

Purpose: Diabetes distress (DD) refers to the negative emotions and burden of living with diabetes. Illness perceptions are among the factors that can influence self-management and psychological distress in diabetics. This study aimed to determine the prevalence and the associated factors of DD in Tunisian patients with type 2 diabetes mellitus. We also studied the relationship between DD and illness perceptions in diabetics. Patients and Methods: This was a cross-sectional study conducted among individuals with type 2 diabetes, followed up at the outpatient endocrinology unit at the Hedi Chaker University Hospital, Tunisia. DD was assessed using the Diabetes Distress Scale (DDS-17). The Brief Illness Perception Questionnaire (Brief-IPQ) was used to assess diabetes illness perceptions. Multivariate logistic regression was used to determine independent factors associated with the presence of DD. Results: A total of 103 patients were recruited. The mean age was 59.31 (±10.83) years; 54.4% were female. In total, 70.9% had DD. Using regression analysis, we demonstrated that the illness perceptions of personal control, HbA1C, absence of comorbidities, lower age at diabetes diagnosis, and socioeconomic status were significantly associated with DD. Conclusion: This study sheds light on the high prevalence of DD among patients with type 2 diabetes in Tunisia. Illness perception-focused psychological intervention would be efficacious in reducing diabetes distress in patients with type 2 diabetes mellitus.

[Knowledge, attitudes and practice of medical students concerning sexual matters]. / Connaissances, attitudes et pratiques des étudiants en médecine en matière de sexualité.

Sexuality is a central aspect of being human throughout life. People with sexual problems commonly turn to their doctor, because he is regarded as competent and well informed. The purpose of our study was to assess the knowledge, attitudes and practice of medical students concerning sexual matters and to identify the main determinants of the lack of basic knowledge on this subject. We conducted a descriptive and analytical study of students in the Faculty of Medicine of Sfax (Tunisia). The questionnaire, completed individually and anonymously by each student, collected sociodemographic data, knowledge about sexuality as well as sources, student's attitude towards sexuality and sexual practices. The overall average score of sexology related questions was 11,05/20. Factors correlated with a medium high score of sexology related questions were: male sex (p=0.003), married status (p=0.012), high socioeconomic status (p=0.02), books as a source of the information (p=0.041) and sexual practices (p<0.001). Sexual practices were significantly more frequent among male students (p<0.001). There are gaps in knowledge about sexuality among medical students, at least in some of its aspects. A complete and uniform educational program about human sexuality, especially in its physiological aspects, can significantly improve the ability of future physicians to provide optimal patient care.

Anxiety and Problematic Internet Use in Tunisian students.

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

Impulsivity in bipolar disorders in a Tunisian sample.

Impulsivity as a trait characteristic is increased in bipolar disorder and may be a core factor of the illness. The objectives of our work are to evaluate the level of impulsivity among patients with bipolar disorder and to study its relation with mood state, alcohol misuse, suicide attempts and other socio-demographic and clinical factors. We measured impulsivity in 60 subjects with bipolar disorder in relationship to socio-demographic and clinical variables. The subjects completed Data included socio-demographic details and clinical variables, the Barratt Impulsiveness Scale (BIS-11) in an Arabic version to assess impulsivity, The Mini International Neuropsychiatric Interview "MINI" version 05 to screen for alcohol abuse or dependence and mood graphic rate scale (MGRS) to evaluate mood state. Our results show that the mean score of BIS-11 was 71.5. Fifty-five per cent of the patients had a high level of impulsiveness. No differences were found relating to mood state. Impulsivity was related to Male gender, lower educational level, early age of onset, smoking, alcohol and drug misuse and prior suicide attempts. The treatment of patients with BD should consider to reduce impulsivity to improve morbidity.

[Athletic performance, self-esteem and temperamental profile : Which relationship?]. / Le rendement sportif, l'estime de soi et le profit temperamental: Queslles relations?

BACKGROUND: Several authors emphasize the close relationship between self-esteem and athletic performance; such a relationship may raise the following question: by saying "strong" or "without any physical condition", is it a fair presentation of the individual's abilities or he reveals the most fundamental aspects of his personality, such as emotional temperament? OBJECTIVES: To evaluate self-esteem, physical self and temperamental profile in a group of sportsmen, and to look for a relationship between these variables and athletic performance. METHODS: We performed a cross-sectional, descriptive and analytic study in 80 young handball players of the "senior" category. We assessed self-esteem using the Rosenberg Self Esteem Scale, physical self-using the Physical Self-Inventory (PSI), and temperamental profile using the Temperament Evaluation of Memphis, Paris and San Diego Auto-questionnaire (TEMPS-A). Athletic performance was evaluated by the team coach by means of a score ranging from 1 to 10. RESULTS: High self-esteem was correlated to female gender (p=0.03), to an early start of physical activity (p<0.01), and certain dimensions of the physical self: perceived physical value (p=0.02), appearance (p<0.01), and the global score (p=0.01). Athletic performance was correlated to high self-esteem (p<0.01) and to two dimensions of the physical self: the global score (p=0.01) and the perceived physical value (p<0.01). Hyperthymic temperament was associated with high self-esteem (p=0.001). Good athletic performance was associated with hyperthymic (p<0.01) and cyclothymic (p<0.01) temperament. Low athletic performance was associated with depressive (p=0.04) and irritable (p=0.01) temperament. CONCLUSION: Our study shows the close relationship between selfesteem, temperamental profile and athletic performance. We suggest that the intervention of a psychiatrist or a psychologist aimed at improving sportsmen's' self-esteem might help to achieve better athletic performance. In this intervention, the individual temperamental profile should be taken into account.

[Schizophrenia and education: about 32 Tunisian students suffering from schizophrenia]. / Schizophrénie et scolarité : etude tunisienne à propos de 32 lycéens et étudiants atteints de schizophrénie.

AIM: To study the schooling among school and university students suffering from schizophrenia. METHODS: A retrospective, descriptive and analytic study based on information from medical records of patients treated in Psychopedagogy Unit in psychiatry department «B" of the Hedi Chaker Hospital University of Sfax, during the period from 1995 to 2009. Inclusion criteria were: diagnosis of schizophrenia (DSM-IV-TR) and follow-up duration of at least one year. RESULTS: Thirty-two patients were included. The sex ratio (M/F) was 2.2. The average age was 20.7 years at the first consultation and 19.17 years at the disease onset which was insidious in 75% of cases. Undifferentiated (46.8%) and paranoid (31.2%) were the most frequent types of schizophrenia. The education level at the disease onset was secondary (62.5%) and high (37.5%). The school results were low in 62.5%. Patients who received at least one blank year were 56.3% and those who were reoriented 12.5%. They dropped out in 75% of cases. Grade repetition after the onset of schizophrenia (53.1%) was correlated with two factors: low socioeconomic status (p= 0.008) and conventional antipsychotic treatment (p= 0.021). CONCLUSION: Our results confirm the negative impact of schizophrenia on the normal course of schooling. Collaboration between psychiatrist, school doctor and teacher becomes a necessity to guarantee early schizophrenia diagnosis and adequate medical and educational care.