Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals

BackgroundThere is evidence that culture deeply affects beliefs about mental illnesses\u27 causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking.MethodsWe carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public.ResultsMore than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p \u3c .001), knowledge (F = 88.7, p \u3c .001), and help-seeking attitudes (F = 32.4, p \u3c .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants.ConclusionInterventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations

Depression Prevalence in Neuropathic Pain and Its Impact on the Quality of Life

Introduction. The management of neuropathic pain remains complex, generally because of the psychiatric comorbidity that is often underdiagnosed. The objectives of our work were to determine the link between depression and the characteristics of NP on the one hand and quality of life on the other hand, in a sample of subjects consulting for neuropathic pain (NP) regardless of etiology. Methods. We conducted a cross-sectional study involving 61 neuropathic pain consulting patients in whom we assessed five parameters, namely, neuropathic pain based on DN4, pain intensity using EVA, anxiety, and depression according to the HADS and quality of life. Results. The study population mean age was 52.71 ± 14.29 years while the sex ratio (m/f) was 0.52. The neuropathic pain’s most common etiologies were postherpetic pain, carpal tunnel syndrome, and diabetic neuropathy. Depression and anxiety prevailed by 65.6% and 73.7%, respectively. The quality of life was impaired with average SF-12 physical and mental scores of 33.76 ± 8.03 and 37.78 ± 11.52, respectively. The overall mean BPI score was 5.53 ± 1.76. Patients with high DN4 scores were significantly more depressed (p=0.025). A significantly positive association was found between the depression score and the pain intensity (p=0.001, r = 0.41). Depressed subjects had a poor quality of life according to SF-12 and BPI. Conclusion. Given the depressive comorbidity impact on the neuropathic pain components as well as the quality of life, screening for this comorbidity should be part of the baseline ND assessment

Schizotypal traits in a large sample of high-school and university students from Tunisia: correlates and measurement invariance of the arabic schizotypal personality questionnaire across age and sex

Abstract Background The main goal of the present study was to examine the characteristics of schizotypal traits and their correlations with genetic (i.e., family history of mental illness), demographic (i.e., age, sex), environmental (e.g., income, urbanicity, tobacco/alcohol/cannabis use), and psychological (i.e., personal history of mental illness other than psychosis) factors in Tunisian high-school and university students. Our secondary goal was to contribute the literature by examining the factor structure and factorial invariance of the Arabic Schizotypal Personality Questionnaire (SPQ) across sex and age (adolescents [12–18 years] vs. young adults [18–35 years]) groups. Method This was a cross-sectional study involving 3166 students: 1160 (36.6%) high-school students (53.0% females, aged 14.9 ± 1.8); and 2006 (63.4%) university students (63.9% females, aged 21.8 ± 2.3). All students were asked to complete a paper-and-pencil self-administered questionnaire containing sociodemographic characteristics as well as the Arabic version of the SPQ. Results The total sample yielded total SPQ scores of 24.1 ± 16.6 out of 74. The SPQ yielded good composite reliability as attested by McDonald's omega values ranging from .68 to .80 for all nine subscales. Confirmatory Factor Analysis indicated that fit of the 9-factor model of SPQ scores was acceptable. This model is invariant (at the configural, metric and structural levels) across sex and age. Except for “Odd or eccentric behavior”, all schizotypy features were significantly higher among female students compared to males. Multivariable analyses showed that female sex, being a university student, lowest family incomes, tobacco use, and having a personal history of psychiatric illness were significantly associated with higher positive, negative and disorganized schizotypy subscales scores. Conclusion Future research still needs to confirm our findings and investigate the contribution of the identified factors in the development of clinical psychosis. We can also conclude that the Arabic SPQ is appropriate for measuring and comparing schizotypy across age and sex in clinical and research settings. These findings are highly relevant and essential for ensuring the clinical utility and applicability of the SPQ in cross-cultural research

The Influence of Organs on Biochemical Properties of Tunisian <i>Thuja occidentalis</i> Essential Oils

In this study, the chemical composition and biological activities of the essential oil (EO) extracts (from leaves and cones) of the Tunisian Thuja occidentalis were evaluated. The composition of the leaf EO extract was more complex than that of the cones. The major components of the leaf EO extract were &#945;-Pinene (34.4%), cedrol (13.17%), and &#946;-Phellandrene (8.04%), while the composition of the cone EO extract was characterized by the predominance of &#945;-Pinene (58.55%) and 3-Carene (24.08%). All EO extracts showed much better antioxidant activity than Trolox against 2, 2&#8242;-diphenyl-1-picryl hydrazyl (DPPH) radical scavenging, but EOs extracted from leaves exhibited the highest total antioxidant activity. All EOs showed strong antibacterial and antifungal activities against nine tested foodborne microorganisms (Bacillus cereus American Type Culture Collection (ATCC) 1247, Listeria monocytogenes ATCC 7644, Staphylococcus aureus ATCC 29213, Aeromonas hydrophila EI, Escherichia coli ATCC 8739, Pseudomonas aeruginosa ATCC 27853, Salmonella typhimurium NCTC 6017, Aspergillus flavus (foodborne isolate), and Aspergillus niger CTM 10099. The highest antimicrobial activities by disk diffusion assay were recorded for the EOs extracted from leaves, while no difference in potency was marked between leaf and cone EO extracts by the agar dilution method. The most potent antimicrobial activity was recorded among fungi. This study confirms the strong antimicrobial and antioxidant potential of EO extracts from the Tunisian T. occidentalis (from the Sidi Bou Said site), highlighting its potential as a natural preservative against foodborne pathogens, particularly against E. coli and S. typhimurium

Phytochemical identification of volatile fraction, essential oil and screening of antioxidant, antibacterial, allelopathic and insecticidal potential from Artemisia herba-alba leaves

In the present paper, the essential oil and the volatiles emitted in vivo by leaves of A. herba alba, which grows wild in center of Tunisia, were analyzed by GC-MS and SPME, respectively. The essential oil was characterized by the predominance of oxygenated monoterpenes (93.3%) with α-thujone as the major compound (45.5%) followed by β-thujone (11.4%), trans-sabinyl acetate (10.1%) and 1,8-cineole (7.4%). The SPME analyses showed that oxygenated monoterpenes were the most representative compounds (64.9%). The major ones were α-thujone (37.9%), germacrene D (16.5%), 1,8-cineole (8.4%) followed by β-thujone (7.8%). Moreover, different activities (antioxidant, antibacterial, allelopathic and insecticidal) of the leaf essential oil were investigated. The antioxidant activity was ascertained by evaluating its inhibitory effect against DPPH and ABTS. The results showed that the essential oil had a strong activity and it was more effective against the DPPH radical (IC50 = 6μg/mL) than the ABTS radical (IC50 = 40μg/mL). In antibacterial screening, it inhibited the growth of all bacteria tested except Salmonella anatum and Salmonella salamae which were resistant to this oil type. Staphylococcus aureus and Vibrio cholera were found to be extremely sensitive with the lowest MIC value (0.007 mg/mL). In addition, allelopathic activity was evaluated against Lactuca sativa and Raphanus sativus. Data showed that, with essential oil, seed germination was completely inhibited for both of them, suggesting a potent allelopathic potential for the evaluated oil. Insecticidal activity was investigated against Culex pipiens larvae and a weak activity (LC50 241.1 ppm) for this A. herba alba essential oil

Radiation Therapy Delivery Challenges in Older Patients During Coronavirus Disease 2019 Pandemic

Purpose: The management of older patients in radiation therapy (RT) departments has been challenging in the context of the Coronavirus Disease 2019 (COVID-19) outbreak. We report our experience of RT adapted schedules or strategy changes in older patients during the COVID-19 pandemic. Methods and Materials: Patients aged ≥75 years were recruited during weekly chart rounds. All were potentially eligible for a specific intervention to reduce the frequency of patients’ visits to the hospital. The effect of deferring radiation and hypofractionation of RT schedules was assessed in terms of the number of courses initially planned and replanned during the lockdown. Results: Twenty patients were identified during the official lockdown in France (March 17 to May 11). Median age was 78 years (75-95 years). Most patients were male (n = 12, 60%) being treated in the postoperative setting (n = 17, 85%). RT was delayed in 11 cases (55%) with hormonal therapy prescribed in 10 cases (50%). Altered RT fractionation was proposed for 5 cases (25%); combinations of altered fractionation and deferral of radiation were applied in 3 cases (15%). The number of radiation courses initially planned and replanned according to the pandemic context: 563 and 197, respectively (−62%; P < .001). None presented recurrence when RT was initiated, and no patient developed symptomatic COVID-19 infection. Conclusions: In the context of the COVID-19 outbreak, individual risk-based radiation therapy seems to be safe. Systematic screening of patients for COVID-19 before starting radiation therapy is mandatory. In our department the oncogeriatrics expertise availability for daily practice was of great use during the pandemic. Other prospective studies are needed to validate such strategies in case of resurgence of similar outbreaks