Assessing parents' and children's psychological well-being and its associated factors during the COVID-19 lockdown in a Tunisian-North African population.

BACKGROUND: The rapidly emerging Coronavirus infectious disease 2019 (COVID-19) has spread around the world yielding in significant changes in almost every aspect of daily life. While primary research of the epidemic COVID-19 has focused on the psychological impact on the general population and health professionals, no survey of the pandemic-resulting containment on parents and their children has been yet addressed in the Tunisian-North African population. This study aimed to assess the psychological profile of parents and youth in Tunisia during a period of COVID 19 lockdown, and to identify associated factors to parental anxiety symptoms. METHODS: This is an analytical cross-sectional study composed of a total of 538 adults including 464 mothers and 74 fathers. Parents of children aged less than 18 years completed an online survey (Google Forms) on the Psychological Impact of Confinement which includes the Generalized Anxiety Scale (GAD-7), the Parental Burnout Assessment (PBA), and the infantile trait-anxiety scale. The survey was initiated in May 2020 on a population of the Tunisian-North African citizens and lasted for more than 6 weeks. RESULTS: The median GAD-7 score was 11 corresponding to a moderate anxiety with 27.8% reporting severe anxiety. The median PBA score was 31 corresponding to a moderate risk of burnout, with 19.5% being affected. The children's anxiety scores were associated with their parents' anxiety ratings with 24% of the children reported signs of moderate anxiety. CONCLUSIONS: The COVID-19 pandemic affected parental and their children' psychological behavior due to a direct social isolation and distancing. Pediatricians need to be alerted on this issue and future measures are essential to avoid parental emotional burnout and anxiety disorder in similar situations.

ADHD in Tunisian Adolescents: Prevalence and Associated Factors.

OBJECTIVE: The aims of the study were to determine the prevalence of ADHD in a population of high school students and to explore the factors associated with this disorder. METHOD: This was a cross-sectional study that had included 447 high school students. The diagnosis of ADHD was made by the Adult ADHD Self-Report Scale translated in Arabic language. The sociodemographic and clinical characteristics were evaluated by a preestablished questionnaire. The self-esteem was assessed by the Rosenberg Self-Esteem Scale. RESULTS: The prevalence of ADHD was 18.1%. The logistic regression analysis showed an association between the diagnosis of ADHD and the bad relationships with parents (odds ratio [OR] = 16.43; p < 10-3), the presence of personal psychiatric antecedents (OR = 12.16; p < 10-3), internet misuse (OR = 2.39; p = .014), and maltreatment antecedents (OR = 3.16; p = .009). CONCLUSION: The prevalence of ADHD in this study was one of the highest prevalence reported. The factors associated with ADHD may have diagnostic and therapeutic implications.

Autism in Phenylketonuria Patients: From Clinical Presentation to Molecular Defects.

Autism has been reported in untreated patients with phenylketonuria. The authors aimed to explore autism in 15 Tunisian and 4 Algerian phenylketonuria patients, and report their clinical, biochemical and molecular peculiarities. The Childhood Autism Rating Scale and the Autism Diagnostic Interview-Revised were used for the diagnosis of autism. Five exons of phenylalanine hydroxylase gene (7, 6, 10, 11, and 5) were amplified by polymerase chain reaction and directly sequenced. Among these patients, 15 were suffering from autism at the time of evaluation. Six mutations were identified: p.E280K, p.G352Vfs, IVS10nt11, p.I224T, p.R261Q, and p.R252W. There was no correlation between autism and mutations affecting the phenylalanine hydroxylase gene, but the age of diet onset was the determining factor in autistic symptoms' evolution.