Perceptions of Tunisians on COVID-19 Vaccines: a qualitative study

Introduction: In Tunisia, the Ministry of Health launched an awareness campaign in television spots and different social media platforms and started the vaccination campaign on the 13 March 2021 aiming to have vaccinated half of the Tunisian population by the end of 2021. However, to date, on July 31, 2021, only 1,104,286 people are completely vaccinated Objectives: The aim of the study was to identify Tunisians' mental perceptions and attitudes towards COVID-19 vaccines to examine the predictors of the COVID-19 vaccine hesitancy in the Tunisian population. Method(s): A group of citizens, randomly selected were invited to participate in the study. Data were collected through a focus group using a piloted topic guide. The entire discussion was recorded in audio-visual mode with a total duration of 1 hour. We also collected data on participant gender, age, education, and profession. Result(s): Seven women and four men participated in the study All participants reported having doubts about the efficacy of the vaccines. Two participants reported that their acquaintances died after being vaccinated. They suspected that expired vaccines have caused the reported deaths. "I think these vaccines can be extremely dangerous. They could contain chemicals that are carcinogens or that have a castrating effect", an interlocutor stated, supported by the rest of the group. We found unanimously in our study, attesting to the relevance of religion in the lives of the Tunisian people, which is in agreement with literature Conclusion(s): Construction of multi-component and systematic interventions are required by public health authorities.

A reason why : Suicide attempt after Coronavirus infection

Introduction: COVID19 pandemic had an important emotional and psychological impact due to the higher rates of boredom, fear, stress, anxiety, depression, etc. (Brooks et al., 2020). Cases of suicide during the COVID-19 pandemic are increasingly reported. According to an Indian study, the main cause of suicide was fear or anticipation of COVID-19 infection. Objective(s): To illustrate a case of suicide attempt after COVID-19 infection. Method(s): We report the case of a Tunisian man who did a suicide attempt after his infection with the coronavirus. Result(s): A 35-year-old Tunisian man, married, an official, with no medical or psychiatric history who was admitted in the Oto-rhinolaryngology department, after a suicide attempt by strangulation, five days after the diagnosis of COVID-19 infection. In fact, the patient was very stressed about his infection and feared transmitting the virus to his family. During his quarantine, he became anxious, had insomnia and suicidal thoughts. He was isolated in his room, and prohibit his family to approach his room. He told us that he could not support this anxiety and he decided to suicide to end this situation and save his family. Conclusion(s): The COVID-19 pandemic may increase suicide rates. Psychological consequences of this pandemic including suicide may continue to incur later than this actual worldwide crisis. Mental health promotion is the key to prevent and mitigate such mental health consequences.

The double penalty of the coronavirus: Decidedly this virus has not yet revealed all its secrets!

Introduction: The direct and indirect effects of the COVID-19 pandemic on the mental health of the population have become a concern in the field of research in psychiatry. First psychotic episodes following infection with SARS cov2 have been reported. Objective(s): Through a clinical case, we will illustrate the association of psychiatric symptoms with SARS cov2 infection. Method(s): We discussed , through a clinical case, the association of psychiatric symptoms with infection by the coronavirus 19. Result(s): L.R, Tunisian 52-year-old, diabetic (type 2) women, with no personal or family psychiatric history and no toxic habits. she did not receive receive covid 19 vaccination. Twenty days before her admission to the psychiatry departement , she had fever, cough, myalgia, and anosmia .The diagnosis of a SARS COv2 infection was retained by her general practitioner. Two weeks later she suddenly presented a persecutory delirium, distressing auditory hallucinations, and attempted rat poison suicide. On admission, The patient had a delirium of persecution towards her entourage and an auditory hallucinatory syndrome with distressing content. She was put on 1 mg of Risperidone with restitution ad integrum after 7 days. COVID-19 serology test detected IgM antibodies which allowed us to conclude that the symptomatology was related to the infection by this virus. For the etiological research, we performed a serology that confirmed the recent exposure to SARS COV2 and. The diagnosis retained is a brief psychotic disorder post-Sars Cov2. Conclusion(s): The advanced hypothesis that infection with SARS CoV-2 could be the cause of the psychiatric manifestations remains unclear to this day.

"I have brain fog." About cognitive impairment after COVID-19

Introduction: Much has been learned about SARS-CoV-2. However, the mechanism of short or long-term neuropsychiatric symptoms remains unclear. several hypotheses, including lack of oxygen caused by lung damage, inflammation affecting brain cells, or Lack of blood flow caused by swelling of the small blood vessels in the brain, have been advanced to explain these symptoms. Objective(s): Herein, we presented a case of cognitive impairment diagnosed after infection with COVID 19. Method(s): We discussed, through a clinical case, the possible mechanisms and risk factors of cognitive impairment following COVID 19 infection. Result(s): This case concerned a 28 -year-old patient. He had no personal or family psychiatric. In August 2021, he presented a SARS-CoV-2 infection without hypoxemia or respiratory failure. On day 10 the patient recovered. Two days after, he consulted our psychiatric department as he experienced impairment in memory. He had impairment in attention and executive function, and in particular verbal fluency. He said that his thinking was sluggish, fuzzy, and not sharp. He denied any alcohol or drug abuse. He was euthymic and he had no depressive symptoms. Arterial blood gas, laboratory, and clinical findings were normal. A brain CT scan with contrast was performed and did not show any abnormality. Conclusion(s): This case highlighted the possible cognitive consequences of COVID-19 during the recovery phase. Further work is required to identify risk factors of psychiatric symptoms following COVID-19 infection and their management.

Impact of the COVID19 pandemic on patients followed in psychiatry

Introduction: In the literature, some studies consider psychiatric patients to be vulnerable to COVID-19, in contrast to other studies that find them rather protected. Objective(s): To determine the impact of the COVID 19 pandemic on patients undergoing psychiatric care. Method(s): This is a descriptive and cross-sectional study that took place in the psychiatry department A at Razi hospital in Tunisia. We conducted a comparison of patient follow-up between the period of March 2018-2019 and March 2020-2021. For this we used a form including socio demographic data, data concerning the COVID-19 situation, clinical data while comparing the follow-up of patients (hospitalizations, mode of relapses, consultations in the emergency room.) Results: 100 patients were included, 60% were men, mean age 44 years (+/- 11 years) [19-65 years]. Ninety-seven percent of patients had no personal history of COVID-19 infection. Comparing the pre-pandemic year (2018-2019) and the pandemic year (2020-2021), we note an increase in the rate of emergency room visits of (17.5%) as well as a relapse rate requiring hospitalization in our department in 48%, this figure was 30% in 2019. A statistically significant increase was noted for depressive and anxiety relapses (p=0.04;r=0.7). Fear of catching the virus while attending hospital facilities (17.6%), geographical isolation (17.6%), unavailability of treatment (17%) and poor insight (41.2%) were the primary causes of poor adherence. Conclusion(s): The patients followed in our department have presented during this COVID-19 pandemic several relapses of their psychiatric pathologies compared to the previous year.

Medical residents and COVID-19

Introduction: The covid-19 pandemic is a difficult global phenomenon that causes a lot of anxiety and uncertainty. This situation has involved reactions of fear. Healthcare professionals are necessarily in contact with patients, but may find themselves torn between the duty to care and the duty to protect themselves and their relatives. Objective(s): To assess perceived stress among medical residents in Tunisia Methods: We conducted a descriptive study among a representative sample of residents working at a teaching hospital in Tunis during the first half of 2021 in different departments.Weprepared a questionnaire for the study divided in two parts: sociodemographic data;professional data (function, practice setting);data related to contact with covid-19 patients ;questions on fear of covid-19 contamination and the Perceived stress scale (10items) Results: Our sample consists of 100 residents in 10 different specialties, including 70 in services with direct contact with Covid-19 patients. Stressmanagement is rated good for 30 residents, average for 40 residents and poor for 30 residents. This management depends on the number of guards, the number of patients examined, the technical platform available and especially the period of the pandemic. Conclusion(s): Medical residents are in the front line in university hospitals in tunisia. The stress to which they are subjected depends on the working conditions and coping skills of each of them.

Psychiatrytele consultation/teleconsulting: Experience of general confinement in Tunisia

Introduction: The outbreak of the Covid-19 epidemic in Tunisia has led a total confinement starting from March 23rd, 2020. Remote interventions of psychiatrists and psychologists have been set up to help Tunisian citizens. The requests concerned panic attacks, acute stress disorder, sleep disorders and relapse of some patients followed for mood disorders, obsessive compulsive disorder or anxiety disorders. Objective(s): We propose to present 3 types of interventions by apsychiatrist in response to the request of 3 Tunisian citizens in this first experience. Method(s): We will summarize three interventions with the history of each patient and his or her request as well as the short term evolution of the presented disorder. Result(s): As a first experience, were sponded to numerous requests from people of all ages and living all over Tunisia. The first intervention concerned a lady who was voluntarily vomiting in order to maintain her current weight.She was afraid of having the covid infection related to a sore throat. The second situation is a gentleman who did not tolerate home confinement because for 20 year she has been going out for a daily walk at exactly 4 pm. The third request came from a father living in a rural area who chose to self isolate in his room and refused to go out and see his children despite their pressing demand. We offered active listening, reassurance and behavioural psychotherapy techniques. Conclusion(s): During this first experience in Tunisia, we found that citizens have adhered to new communication techniques. Anxiety, stress and relapse of priormedical conditions were the most frequent diagnoses. Several interventions have proven to be effective despite obstacles related to teleconsultation.

The behavior of tunisians during the lockdown of COVID-19

IntroductionThe general confinement in Tunisia in the covid-19 pandemic is a new event for the Tunisian society with economic, social and psychological repercussions.ObjectivesTo evaluate the behavior of Tunisians during the general confinement of 2020.Methodsdescriptive and analytical study through a questionnaire sent online under the model of “google forms”.ResultsOur sample is composed of 500 people, mostly women, with an average age of about 40 years, an average to good economic level, and a secondary and higher education level. In the Tunisian family, the most discussed topic during the lockdown is the covid-19 and its evolution in the world and the country. The most avoided subject is the behavior of neighbors. The Tunisian’s main sources of information on covid-19 are television and social networks. The behavior most adopted to avoid contamination is hand washing. Only 2/3 of the group applied the measures announced by the government. A quarter of our sample spent more than 5 hours in front of the computer screen or smartphone. During confinement the most important behaviors are smoking, eating, doing nothing and playing cards. Only 10% of our sample have plans for next year.ConclusionsFor our sample, covid-19 has greatly transformed the behavior in daily life which has become dominated by anxiety and fear of contamination.