Depression and Functioning during the COVID-19 Pandemic among Adults across Tunisia.

We aimed to understand how risk (trauma history, health problems, financial problems, family problems) and protective (friend support, family support) factors influenced daily functioning (e.g., self-care, mobility, social participation) among Tunisian adults during the COVID-19 pandemic, directly and through their impact on depression, with a focus on gender differences.

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Introduction: Sleep quality is a complex phenomenon with quantitative and subjective aspects that vary during adolescence. The prevalence of sleep disorders is not known in Tunisia due to the lack of validated tools.

Aim: To translate and validate the questionnaire Pittsburgh Sleep Quality Index (PSQI) into Tunisian Arabic in middle school students.

Miliary tuberculosis mimicking COVID-19 multisystemic inflammatory syndrome in children.

Miliary tuberculosis (TB) is a severe form of disseminated TB. In pediatrics, many cases are missed because the symptomatology of TB mimics common childhood diseases. We present the case of a 6-year-old girl with no remarkable history who had recurrent fever for 3 months.

Prevalence of Mood Disorders and Associated Factors at the Time of the COVID-19 Pandemic: Potocol for a Community Survey in La Manouba Governorate, Tunisia.

Aims: The present survey aims to assess the overall mood disorder prevalence and identify associated socio-demographic and clinical factors in a Tunisian community sample, with special attention to the COVID-19 pandemic.

Background: Mood disorders are one of the leading causes of all non-fatal burdens of disease, with depression being at the top of the list. The COVID-19 pandemic may have increased the prevalence of mood disorders, especially in Low and Middle-income countries (LMICs) and in vulnerable populations.

Turner syndrome: results of the first Tunisian study group on Turner syndrome (TuSGOT).

Objectives: Early diagnosis in Turner syndrome is desirable to optimize growth and puberty and yet, it is often made late. Here, we aim to identify age at diagnosis, clinical features at presentation and potential strategies to improve the care of TS girls.

Methods: Retrospective study, including patients from 14 care centers across Tunisia including neonatal and pediatric care units, adult endocrinology and genetics departments.

Highlighting successes and challenges of the mental health system in Tunisia: an overview of services, facilities, and human resources.

Background: Tunisia is a lower-middle-income country located in North Africa with strengths and challenges to its mental health system.

Aims: We present an overview of available services, facilities, and human resources to offer mental health care in Tunisia.

Methods: We conducted a cross-sectional study, where data for the year 2017 was collected between May 2018 and May 2019 by consulting stakeholders involved in the health field in Tunisia.

Covid-19 and mental disorders in children and adolescents: Experience of the child and adolescent psychiatry department of the Mongi Slim Hospital of Tunis.

The Covid-19 pandemic had a major psychosocial impact on the mental health of children and adolescents, especially when the childhas mental health problems. During containment, the healthcare structures were subject to a significant restriction of their activities. The child and adolescent psychiatry department of the Mongi Slim Hospital in Tunis has set up telephone follow-up for patients deemed to be at risk.

The influence of primary care physicians' mental health knowledge, attitudes and self-efficacy on referrals to specialised services: findings from a longitudinal pilot trial.

Background: Training based on the Mental Health Gap Action Programme (mhGAP) is being increasingly adopted by countries to enhance non-specialists' mental health capacities. However, the influence of these enhanced capacities on referral rates to specialised mental health services remains unknown.

Aims: We rely on findings from a longitudinal pilot trial to assess the influence of mental health knowledge, attitudes and self-efficacy on self-reported referrals from primary to specialised mental health services before, immediately after and 18 months after primary care physicians (PCPs) participated in an mhGAP-based training in the Greater Tunis area of Tunisia.

Reflecting on knowledge translation strategies from global health research projects in Tunisia and the Republic of Côte d'Ivoire.

Objectives: We describe the knowledge translation strategies in two projects and share lessons learned about knowledge sharing and uptake.

Methods: To generate findings for dissemination: (1) the Republic of Côte d'Ivoire (RCI) project relied on a multiple case study design to document barriers and facilitators to implementing a community-led prevention strategy targeting Ebola virus disease; and (2) the Tunisia project used several designs to assess a mental health training's effectiveness, and a case study design to explore contextual factors that may influence anticipated outcomes.

Results: To share findings with participants, the RCI project relied on workshops and a pamphlet, and the Tunisia project relied on a structured half-day dissemination workshop and research summary.

Building capacity in mental health care in low- and middle-income countries by training primary care physicians using the mhGAP: a randomized controlled trial.

To address the rise in mental health conditions in Tunisia, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to primary care physicians (PCPs) working in the Greater Tunis area. Non-specialists (such as PCPs)' training is an internationally supported way to target untreated mental health symptoms. We aimed to evaluate the programme's impact on PCPs' mental health knowledge, attitudes, self-efficacy and self-reported practice, immediately following and 18 months after training.

"We find what we look for, and we look for what we know": factors interacting with a mental health training program to influence its expected outcomes in Tunisia.

Background: Primary care physicians (PCPs) working in mental health care in Tunisia often lack knowledge and skills needed to adequately address mental health-related issues. To address these lacunas, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to PCPs working in the Greater Tunis area between February and April 2016. While the mhGAP-IG has been used extensively in low- and middle-income countries (LMICs) to help build non-specialists' mental health capacity, little research has focused on how contextual factors interact with the implemented training program to influence its expected outcomes.

[Tunisia: nursing practice of cognitive remediation in child psychiatry].

Cognitive remediation is today afforded a significant place in the treatment of neurodevelopmental disorders. A hospital team, comprising in particular a nurse offering consultations in a child psychiatry unit in a public hospital in Tunis, shares its experience with regard to this technique which aims to restore impaired cognitive functions in order to improve the efficiency and quality of life of young patients.

Atopic dermatitis and mother-child interaction: a comparative study of 48 dyads.

Background: Psychological factors and family environment may play a role in the pathogenesis and the persistence of atopic dermatitis (AD).

Aim: To evaluate the interactions between mothers and their children suffering from AD and to look for the presence of maternal depression and anxiety.

Methods: A sample of 24 children with AD and their mothers and 24 matched control dyads participated in the study.

Epigenetics and ADHD: Toward an Integrative Approach of the Disorder Pathogenesis.

Objective: Epigenetic hypothesis is one of the research pathways used to explain the complex etiology of neurodevelopmental disorders. This review highlights the findings of recent studies in the field of epigenetics in ADHD.

Methods: An electronic literature search using Medline.

Building system capacity for the integration of mental health at the level of primary care in Tunisia: a study protocol in global mental health.

Background: In low- and middle-income countries (LMICs), addressing the high prevalence of mental disorders is a challenge given the limited number and unequal distribution of specialists, as well as scarce resources allocated to mental health. The Mental Health Gap Action Programme (mhGAP) and its accompanying Intervention Guide (IG), developed by the World Health Organization (WHO), aim to address this challenge by training non-specialists such as general practitioners (GPs) in mental health care. This trial aims to implement and evaluate an adapted version of the mhGAP-IG (version 1.

Catatonia in adolescents: series of 12 inpatients.

Background: Catatonia is one of the most severe psychiatric syndromes that might be caused by many medical as well as psychiatric conditions. Catatonia in adolescents is rare and largely understudied.

Aims: This papers aims to examine cases of catatonia among adolescent psychiatric inpatients, and to scrutinize both the etiologies and the management options.

Tardive dystonia induced by atypical neuroleptics: a case report with olanzapine.

We report the case of a 17-year-old-boy with schizophrenia who developed tardive dystonia after 9 months of treatment with olanzapine. This case and the relevant literature show that when neuroleptic treatment is indicated, switching to another atypical neuroleptic might be helpful for both tardive dystonia and schizophrenia. In such a case, clozapine appears to be the first-line therapeutic option.