Perception of Tunisian Medical Students with Chronic Conditions: Pilot Study.

Background: Medical studies are hard to manage especially for students with specific needs. These students warrant some adaptations in studies and trainings in order to achieve learning goals. Studies showed they face structural and cultural barriers and stigma. Current efforts aim to encourage integration of these persons in order to increase diversity. Objective: This study aimed to assess perception of Tunisian medical students with specific needs. Method: Cross-sectional study through online questionnaire including learners affiliated to the Faculty of Medicine of Tunis (students, interns, and residents) who consider they have specific needs. This questionnaire was elaborated by authors and explored barriers faced by participants, needed help, and suggested solutions. Study respected consent and confidentiality. Results: This study included 40 participants. Most of them (n = 32) were post-graduate (interns and residents). The most reported condition was mental disability (n = 14). Main challenges faced by participants were work time schedule, unhealthy lifestyle, and negative attitudes from peers and supervisors, and 19 felt victim of stigma. Reported specific needs were adapting work schedule and psychological support from peers, from supervisors, or from mental health professionals. Almost half of the participants did never disclose their difficulties (n = 21). Suggested solutions involved to have a counseling center within the faculty. Only 8 participants knew there was a new unit helping students with specific needs in FMT. Conclusions: Despite efforts of the university, medical learners with chronic conditions still face many structural and cultural barriers to inclusion. Most participants suggested to have more psychological support from faculty.

Posttraumatic Stress Disorder in First-Episode Psychosis: Prevalence and Related Factors.

INTRODUCTION: The experience of psychosis or related treatment can be conceptualized as a traumatic event, which might lead to posttraumatic stress disorder (PTSD) or PTSD syndrome (which is defined as the presence of PTSD symptoms irrespective of the DSM-IV criterion A definition of a traumatic event as an actual or threatened harm). Few studies explored the subject so far. METHODS: This cross-sectional study included 52 clinically stabilized patients who were hospitalized for a first-psychotic episode during the two years preceding the study. Sociodemographic and clinical information were collected including past trauma history and drug and alcohol use. Patients were administered the Clinician-Administered PTSD Scale (CAPS), the Major Depression Inventory (MDI), the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning scale (GAF), and the Brief COPE. RESULTS: A total of 22 patients (42.3%) met full PTSD criteria and 36 patients (69.2%) met PTSD syndrome criteria. Full PTSD as well as PTSD syndrome were both associated with physical restraint, higher scores on the MDI and its maladaptive coping scales. The most distressing symptoms were paranoid delusions, and the most distressing treatment experiences involved physical restraint and problems with other hospitalized patients. DISCUSSION/CONCLUSIONS: Our data showed high rates of psychosis-related PTSD. To prevent PTSD, conditions of hospitalization should be optimized and the use of coercive treatments should be limited. Subjects with recent-onset psychosis should be screened for PTSD symptoms. Improving coping abilities with a well-fitted therapy would be useful in these patients.

High prevalence of antineuronal antibodies in Tunisian psychiatric inpatients.

The authors aimed to determine the prevalence of antineuronal antibodies in 103 psychiatric inpatients and 41 control subjects with no history of malignancies or neurological disorders. All sera were tested by indirect immunofluorescence and positive sera by immunoblot. Using immunofluorescence, antineuronal nuclear autoantibodies were detected in 20 patients and none of the control subjects, and antibodies reacted with the cytoplasm of Purkinje cells in six patients and two control subjects. The immunoblot confirmed well-characterized antineuronal antibodies only in five patients: two had anti-Ri and three had anti-Yo antibodies. After a follow-up of 5 years, none of these patients developed neurological disorder or malignancy.