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The delicate balance between the need to ensure quality patient care and the reality of physicians dealing with psychiatric diseases poses a major challenge within the medical field. This issue raises fundamental ethical, legal, and medical questions, highlighting the complexity of decision-making regarding professional aptitude for practitioners affected by mental disorders.
Objectives
To examine the impact of psychiatric diseases on the medical aptitude of physicians.
Methods
This was a retrospective descriptive study that focused on physicians with psychiatric diseases referred to the occupational pathology clinic at Charles Nicolle Hospital in Tunis for medical evaluations of their work aptitude between January 1, 2021, and September 15, 2023.
Results
During the study period, we collected data from 20 patients. The mean age was 38 ± 11 years, with a sex-ratio (F/M)of 4.5. Five examined physicians had family histories of psychiatric disorders. Medical specialties were the most represented (N=17), including three general practitioners, two family medicine practitioners, and two anesthesiologists. The study population included 10 residents, eight hospital assistants, and two medical interns. The most common psychiatric diagnosis was depression (N=7), followed by bipolar disorder (N=5). The medical treatment prescribed was combinations of antidepressants and anxiolytics in seven cases, antipsychotics in five cases, and antidepressants in two cases. Medication adherence was noted in 10 physicians. Fourteen physicians had taken long-term sick leave, with an average duration of 203 days. Five physicians were declared fit to continue their regular professional activities, seven physicians were declared fit with restrictions on night work, and one physician was declared fit with workplace accommodations.
Conclusions
This study highlights the challenges surrounding the medical aptitude of physicians with psychiatric diseases. However, it is imperative to promote mental health awareness and to implementsupport measures to ensure both compassion for physicians and patient safety.
Internet use can become uncontrollable, leading to physical and psychological suffering and what is known as cyberaddiction.
Objectives
To assess the frequency of cyberaddiction in a population of young doctors.
Methods
We conducted a cross-sectional, descriptive study of a population of young doctors. We collected socio-professional and medical data using a Google Forms self-questionnaire. The Young scale was recommended for screening for cyberaddiction. A score ≥5 indicates Internet addiction. The Hospital Anxiety and Depression Scale (HAD) was adopted to reveal anxiety-depressive disorders.
Results
A total of 45 physicians responded to our survey. The mean age was 29.93±4.8 years. The sex ratio (M/F) was 0.3. Participants were single in 69% of cases. Residents represented 64% of the population. Physicians were family medicine residents in 11% of cases. The mean Young’s score was 3.13±1.97/8. Cyberaddiction was noted in 24% of cases. A definite anxiety-depressive disorder was found in 6.7% and 13.3% of cases respectively. Internet addiction was significantly associated with female gender (p<0.05) and a positive HAD (A) score (p=0.03).
Conclusions
According to the results of our study, cyberaddiction is common among medical staff. A preventive strategy is needed to counter the harmful effects of this addiction.
Excessive use of tobacco, alcohol and other illicit drugs has a negative impact on the physical and mental health and work capacity of users. Physicians are no exception to these dreadful practices.
Objectives
To assess tobacco and alcohol use among medical staff and the factors associated with these uses.
Methods
Descriptive cross-sectional study of physicians practicing in different Tunisian hospitals. The levels of tobacco and alcohol dependence were assessed by the Fangeström and AUDIT tests. Anxiety and depression disorders were screened by the hospital anxiety and depression scale (HAD)
Results
A total of 45 physicians participated in our study. The average professional seniority was 3.36 ± 3.5 years. The mean age was 32.11 ± 6.08 years with a sex ratio (M/F) of 0.32. The participants were medical residents in 64% of the cases. The frequency of smoking was estimated at 24%. The level of smoking dependence was high in 9% of cases. Men were more addicted to nicotine than women (p=0.014). Alcohol consumption was 18%, made up of 62% of women; with a strong dependence rate in 25% of users. Definite anxiety disorders were found in 7% of cases and definite depressive disorders were present in 13% of cases. No correlation between medical specialty, grade, anxiety disorders and level of dependence was observed.
Conclusions
Doctors seem to be particularly affected by addictive behaviours and psycho-emotional disorders which could sustain these practices. Awareness-raising sessions and special monitoring must be introduced to combat these scourges.
Clozapine is the standard treatment for managing treatment-resistant schizophrenia (TRS). However, concerns arise due to potential hematologic side effects, such as agranulocytosis, especially during the COVID-19 pandemic.
Objectives
This study aims to investigate the association between clozapine treatment and an increased risk of severe COVID-19 infection in patients with TRS.
Methods
A retrospective study reviewed clinical records of forensic patients with TRS from 2020 to 2022 at Razi Hospital’s forensic psychiatry department in Tunisia. Twenty-five patients, including 18 on clozapine treatment, were included.
Results
All patients were male, with an average age of 39.7 years. Twenty-three patients received at least one vaccine dose. Twenty-two patients contracted COVID-19. Among those treated with clozapine, two required intensive care unit admission and oxygen therapy without intubation. Clozapine treatment remained uninterrupted, with no dose escalation during infection episodes. Lymphopenia was the most commonly reported hematologic abnormality.
Conclusions
While there may be an association between clozapine use and an increased risk of COVID-19 infection, no clear correlation with infection severity and antipsychotic treatment was established in this study. Further research is needed to explore this potential association comprehensively.
Being a doctor is a profession with special medical requirements. Therefore, the assessment of medical fitness for work among physicians remains a complex decision, particularly for those with psychiatric disorders.
Objectives
To assess the fitness for work decisions among physicians with psychiatric disorders.
Methods
Descriptive and retrospective study including physicians with psychiatric disorders referred to the occupational department of the Charles Nicolle Hospital in Tunis for a medical fitness for work from January 1, 2018 to August 30, 2023.
Results
The study included 28 patients with a female predominance (sex ratio M/F at 0.3) and a mean age of 44.1 ± 12 years. Participants were general practitioners (N=12), junior doctors (N=10), specialists (N=5) and one dentist. They worked in the public health sector in 93% of cases, and had a mean professional seniority of 12.4 ± 9.3 years. A psychiatric history was found in 20 patients. Current psychiatric disorders recorded were: depression (N=15), bipolar disorder (N=7), anxiety-depressive disorder (N=4), personality disorders (N=1) and addiction (N=1). Concerning the fitness for work, six patients were fit for work and 11 were temporarily unfit. Job adjustments were proposed for 11 physicians, mainly night shift exemption.
Conclusions
Physicians are exposed to several occupational hazards and require strict medical qualifications. The impact of psychiatric disorders on medical fitness for work is considerable, and could be avoided by appropriate prevention by occupational health practionnairers, starting from professional orientation.
Patients with mental illness, particularly those with treatment-resistant schizophrenia, are at increased risk of severe COVID-19. The protective effect of vaccination against severe disease has been demonstrated, and vaccination of vulnerable individuals was a priority during the vaccination campaign. However, the effect of vaccination on the psychiatric symptoms of the disease is not well understood.
Objectives
To investigate the impact of COVID-19 vaccination on psychiatric symptoms and somatic symptoms in patients hospitalized for treatment-resistant schizophrenia.
Methods
Thirty patients hospitalized for treatment-resistant schizophrenia with a history of medico-legal acts were admitted to the forensic psychiatry department at Razi Hospital in Manouba, Tunisia. The consent of patients and/or their relatives was obtained before vaccination, and potential side effects were explained to patients and their families. A neuropsychiatric assessment and clinical examination of patients were performed by their referring psychiatrist before vaccination and one month after.
Results
The patients were all male, with a mean age of 42.3 years.No patient had an allergic reaction to the vaccine. No patient was infected with the virus one month after vaccination. On the clinical level, 30% of patients had general symptoms such as fatigue and myalgia, which improved spontaneously within a few days. On the psychiatric level, exacerbation of positive symptoms such as hallucinations and delusions was found in 26% of patients. No increase in the frequency of agitation episodes or risk of hetero-aggressive behavior was reported. Sleep disturbances such as difficulty falling asleep and fragmented sleep were reported. The most common functional complaints reported by patients were palpitations, which were a source of somatic concern.
Conclusions
Several side effects of the vaccine have been documented and are taken into account in the daily practice of practitioners, but psychiatric effects are poorly reported and are sometimes attributed to the underlying disease. A complete examination, objective assessment, and regular follow-up are necessary to identify symptoms early and prevent relapses.Because of the small size of the sample;results could not be generelized.Further studies on a larger scale should be conducted.
Clozapine is an atypical antipsychotic that is primarily prescribed for treatment-resistant schizophrenia. Despite its proven efficacy, the prescription of clozapine is sometimes limited by its hematologic side effects, including agranulocytosis. During the SARS-CoV-2 pandemic, schizophrenia is recognized as a risk factor for developing severe forms of the infection. Early and complete vaccination of patients has been recommended. However, there is limited data on the effect of the vaccine on the risk of hematologic abnormalities in patients treated with clozapine.
Objectives
To study the hematologic effect of the mRNA vaccine against COVID-19 in a population of patients with treatment-resistant schizophrenia treated with clozapine.
Methods
Twenty-five patients hospitalized for schizophrenia at the forensic psychiatry department of Razi Hospital in Manouba, Tunisia, were included. Eighteen patients were treated with clozapine, and seven patients were treated with other antipsychotics. Consent from patients and/or their relatives was obtained before vaccination. The results of complete blood counts performed as part of the therapeutic protocol were compared between the two groups before and after administration of the vaccine.
Results
No patient experienced agranulocytosis induced by clozapine after vaccination against COVID-19.Blood cells counts,red blood cells counts,and platelets were within the normal ranges.However,a decrease in the number of WBCs,neutrophils,and lymphocytes was observed in patients treated with clozapine without significant difference compared to the patients treated with other neuroleptics, but there was no severe neutropenia or need to stop treatment.
Conclusions
The prescription of clozapine, the introduction protocol, and treatment administration have been greatly influenced by the COVID-19 pandemic due to the hepatotoxic risk of the drug. Vaccination is essential to prevent severe forms of the infection, especially in at-risk populations such as patients treated for schizophrenia.The potentiation of hematologic side effects induced by clozapine by the vaccine is not documented.The COVID-19 mRNA vaccine is safe even with clozapine
Assessing the medical fitness of workers with mood disorders remains a topical issue, because of its organizational, socioeconomic and professional impact.
Objectives
To assess the medical and occupational characteristics of workers with mood disorders.
To evaluate the impact of these psychiatric disorders on the medical decision of fitness for work.
Methods
Descriptive and retrospective study, over six years (January 1, 2018 to August 30, 2023) including all medical records of workers with mood disorders (bipolar disorder, anxiety disorder, and depression), referred to the occupational department of the Charles-Nicolle Hospital in Tunis for a medical fitness for work.
Results
The study included 101 patients, mostly female (sex ratio = 0.4), with a mean age of 43.3 ± 9.2 years. The most represented sector of activity was health care. The participants were mainly nurses (25%), followed by technicians (22%) and workers (21%). The mean job seniority was 16.5 ± 9.3 years. A pathological history was found in 74.3% of cases, of which 47.5% were psychiatric disorders. Mood disorders identified in our population were: bipolar disorder (53.5%), anxiety disorder (43.5%), and depression (3%). After medical examination and the decision of treating physician, 39% of the patients (N=39) were declared fit for work, and 31.4% (N=32) were fit with ergonomic adjustments. These accomodations consisted mainly of night shift exemptions in 75% of cases. Temporary unfitness was declared in 24 patients (23.6%). Job mutation was recommended for four patients. Early retirement due to invalidity was proposed for two patients.
Conclusions
The decision on the medical fitness of workers with psychiatric disorders remains a delicate issue that requires the attention of both legislators and occupational health practitioners.
Adult and child psychiatry residents encounter unique stressors in their training distinct from those in other medical specialties. Patient suicide has been identified as one of the most distressing experiences during psychiatric training.
Objectives
This study represents the first Tunisian investigation aiming to assess (1) the impact of patient suicide on psychiatry residents and (2) the limitations of the institutional support system in dealing with such cases.
Methods
A Google Forms questionnaire was distributed via email to all residents, gathering socio-demographic data, assessing traumatic impact using the PTSD Checklist for DSM-5 (PCL-5), and soliciting open-ended responses regarding personal experiences and expectations of the institutional support system.
Results
Fifty-three residents participated in the study. Among them, 29 residents had encountered patient suicide, with 12 directly involved. Symptoms of PTSD were detected in three residents. The physician directly involved in treating the suicidal patient reported the highest PCL-5 score. The majority of residents (27 out of 29) expressed the need for a structured support and training program tailored to healthcare professionals dealing with suicide.
Conclusions
The findings suggest that psychiatric residents may require additional training and support to effectively address the complex issue of patient suicide. Implementing specific training programs could significantly enhance their ability to manage such situations.
Euthanasia is the active deliberate ending of life by another person at the explicit request of a patient who is suffering from an incurable condition deemed unbearable by him or her.young doctors in tunisia might be exposed in their daily practice to a request of (E). In some countries the procedure is regulated by law while in others the issue has not been discussed. Before assessing the public opinion the medical core has to be implicated in the debate about the subject.Within the limits of our knowledge this is the first study on the subject in the countries of North Africa
Objectives
To describe the attitudes of tunisian medicine resident toward euthanasia
Methods
The validated questionnaire of physicians’ Attitudes and opinions on assisted suicide and euthanasia was distributed via mails addresses to 50 tunisian resident. The participation was entirely voluntary and anonymity was guaranteed.
Results
Thirty seven medicine resident participate to the study the response rate was 74%. The average age of participants was 28.2years old.The majority;23 were female and 29 had religious beliefs.The most represented speciality was family medicine with 6 participants.Only 2 of doctors were practicing in Europe.About 8 of young doctors were requested for (E).Tunisian medicine residents are generally supportive of the legalization of euthanasia (29), but many have concerns about their own participation in the procedure.
Conclusions
Ethical and legal complexities surround the topic of euthanasia.It is imperative to deepen our understanding of this practice within the context of the North Africa region,in order to formulate a comprehensive and well-informed policy.
Long-term leave for psychiatric illness is the most frequently prescribed reason for leave, and appears to be on the increase in recent years.
Objectives
To draw up a sociodemographic, occupational and clinical profile of workers who have taken long-term sick leave for psychiatric illness
Methods
Retrospective descriptive study involving the medical files of workers from both the public and private sectors, having benefited from long-term sick leave over a period going from August 17, 2022 to September 12, 2023, referred to the occupational medicine and pathology department of Charles Nicolle Hospital in Tunis for medical fitness-for-work assessment. Data collection was based on a pre-established synoptic form.
Results
During the study period, we identified 639 long-term sick leave prescribed for psychiatric illnesses. Our study population was predominantly female, with a sex ratio of 0.29 and a mean age of 46.82 ± 25.06 years. Sixty percent of employees were married. The most represented occupational category was nurses (33%). Average job seniority was 17.21±10.41 years. Depressive syndrome was the most common psychiatric pathology in our population (80.3%), followed by bipolar disorder (6.4%) and anxiety disorder (5%). Long-term sick leave was prescribed by a psychiatrist working in the private sector in 90.3% of cases. The average duration of leave was 63.70±31.58 days. The triggering factor was work-related and social in 33.6% and 30.1% of cases respectively. The agents returned to work after the long-term sick leave in 92% of cases.
Conclusions
Long-term sick leave for psychiatric reasons is a handicap to productivity in society. Non-occupational factors are thought to be responsible for these mental health disorders. Setting up and improving social structures in the workplace would reduce the number of cases of long-term sick leave
Acute dystonia, an adverse effect of neuroleptics, is linked to D2 neuronal receptor hypersensitivity or neurotoxicity due to oxidative stress mechanisms. Pisa syndrome (PS) or Pleurothotonus, a relatively uncommon condition, manifests as dystonia of the trunk and is potentially reversible with early intervention.
Objectives
To describe PS following haloperidol decanoate injection in a treatment-resistant schizophrenia (TRS) patient, identify associated risk factors, and present therapeutic options.
Methods
We provide a comprehensive case description and perform a PubMed database search using the following keywords: “Pisa syndrome,” “dystonia,” “schizophrenia,” and “antipsychotic”.
Results
A 54-year-old man with TRS, previously treated with 100 mg of haloperidol decanoate and 10 mg of olanzapine due to clozapine-induced myocarditis, exhibited hallucinatory delusional syndrome and behavioral disturbances. Neurological examination, lab tests, and brain imaging confirmed a psychotic relapse. Haloperidol decanoate dosage was increased to 150 mg. Four days later, the patient developed a trunk tilt that resolved after receiving anticholinergic treatment.Despite PS being more common in females and associated with brain conditions, this patient presented multiple risk factors, including prolonged typical antipsychotic treatment, advanced age, and an increase in antipsychotic doses. Discontinuing the causative antipsychotic or adding synthetic anticholinergics led to symptom reversibility.
Conclusions
PS is a rare occurrence. Understanding associated risk factors and frequently implicated medications is crucial for elucidating the phenomenon and managing the disorder
Sleep quality depends on several factors such as smoking, physical activity, diet, and certain pathologies, namely obstructive sleep apnoea syndrome. Indeed, following their vaccination against COVID19, several medical trainees complained about a deterioration of their sleep quality.
Objectives
To evaluate the quality of sleep of medical trainees who work at Charles Nicolle Hospital and who were vaccinated against SARS-COV2.
Methods
We conducted a descriptive cross-sectional study among medical trainees at Charles Nicolle Hospital who were vaccinated against COVID-19 during the period from March 2020 to August 2022. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Trainees were contacted during the period August 2022 to September 2022.
Results
Sixty-nine medical trainees, vaccinated against Covid19 joined our study. Forty-nine of them had a significant sleep disturbance: Pittsburgh Sleep Quality Index (PSQI) greater than five. The average age was 29.39±3.04 years with a female majority (73.5%). No psychiatric history was found. The most affected category of trainees were residents (71.4%). Forty-three of them were inoculated with the messenger RNA vaccine and 4 with inactivated vaccine. Twenty-one patients vaccinated with the messenger RNA vaccine received two doses, seventeen received three doses and only one received a single dose. Sleep latency was high in 20,4% of cases. A sleep duration of less than five hours per night was found in 18,4% of the cases. Six participants reported using a sleep aid three to four times a week.
Conclusions
Our study revealed a significant sleep disturbance in medical trainees at Charles Nicolle Hospital. This could be due to the SARS-COV2 vaccination but can also be explained by the night shifts and the stress to which they are exposed, especially during this pandemic period.
Adult and child psychiatry residents encounter unique stressors in their training distinct from those in other medical specialties. Patient suicide has been identified as one of the most distressing experiences during psychiatric training.
Objectives
This study represents the first Tunisian investigation aiming to assess (1) the impact of patient suicide on psychiatry residents and (2) the limitations of the institutional support system in dealing with such cases.
Methods
A Google Forms questionnaire was distributed via email to all residents, gathering socio-demographic data, assessing traumatic impact using the PTSD Checklist for DSM-5 (PCL-5), and soliciting open-ended responses regarding personal experiences and expectations of the institutional support system.
Results
Fifty-three residents participated in the study. Among them, 29 residents had encountered patient suicide, with 12 directly involved. Symptoms of PTSD were detected in three residents. The physician directly involved in treating the suicidal patient reported the highest PCL-5 score. The majority of residents (27 out of 29) expressed the need for a structured support and training program tailored to healthcare professionals dealing with suicide.
Conclusions
The findings suggest that psychiatric residents may require additional training and support to effectively address the complex issue of patient suicide. Implementing specific training programs could significantly enhance their ability to manage such situations.
Bipolar disorder (BD) is a severe and chronic mental illness characterized by recurrent major depressive episodes and mania (BD-I) or hypomania (BD-II). In addition to the burden of the disease and its consequences, people living with BD, like many other people suffering from mental illness, must deal with their difficulty of integration which can influence their personal and professional life and consequently their quality of life (QOL).
Objectives
The aim of our study is to assess the QOL among working patients with BD.
Methods
A cross-sectional study was carried out in the occupational medicine department of the Charles-Nicolle hospital in Tunisia. Sociodemographic and occupational data were collected from the medical records of patients with bipolar disorder who consulted our department during the period 2022 to 2023. and a telephonic survey was carried out to complete the SF 12 international scale, which is a general health questionnaire that consists of 12 questions which investigates the patient’s state of health via 8 different dimensions: General health perception, Physical health, Limited physical role function, Physical pain, Vitality, Mental health, Limited emotional role function and social functioning.
Results
We enrolled a total of 46 cases where 76% with BD type 1 with an average age of 43±9 years. Most participants were female (76%) and the most frequent sectors of activity were healthcare and administration (80% and 12% respectively). BD was well balanced in 39% of cases with an average bipolar history of 7 years. The median annual absence due to psychiatric problems was 92±61 days per year. The average score was 44±18 for the General Health, 57±35 for physical health and 67±18 for mental health.
Conclusions
This study revealed that people living with BD’s QOL seems to be altered. Clinicians need to be attentive to the QOL of their patients, its assessment, and its empowerment in their daily clinical practice. Future work is required to establish valid strategies to fight low QOL among patients suffering from BD.
Excessive daytime sleepiness is a frequent symptom in the general population. It may be fleeting, due to transient circumstances, or it may be related to certain pathologies. Indeed, following their infection with SARS-COV2, several healthcare workers (HCWs) have complained of excessive daytime sleepiness.
Objectives
This study was conducted to assess excessive daytime sleepiness in the SARS-COV2-affected HCWs during the “OMICRON” wave.
Methods
Cross-sectional descriptive study, conducted among the HCWs of Charles Nicolle Hospital with COVID-19 during the period from 22 December 2021 to 31 January 2022. Sleepiness was assessed using the Epworth Sleepiness Scale administered during the return to work medical visit.
Results
During the “OMICRON” wave, 58 HCWs joined our study. The average age was 39 +/- 10 years. The sex ratio (M/F) was 0.2. The participants had no previous history of sleep disorders. Excessive daytime sleepiness was found in 21 participants (36% of cases). Excessive daytime sleepiness was mild in 81% of cases, moderate in 14%, and severe in 5%. The category most affected was senior technicians in 57% of cases. Most of the HCWs suffering from daytime sleepiness were working in the gynecology department (19%) and the neurology department (19%).
Conclusions
Early and systematic screening for sleep disorders after any SARS-COV2 infection is necessary to ensure the good health of the HCWs and to reduce accidents and errors in professional procedures.
Psychoses constitute an extremely heterogeneous clinical entity, with variable medical and socio-professional prognosis depending on several associated factors.
Objectives
- To describe the socio-professional and medical characteristics of patients with psychotic disorders.
- To study the repercussions of these psychotic disorders on the patients’ medical fitness for work.
Methods
Cross-sectional descriptive study of workers with psychotic disorders referred to the consultation of occupational pathology of Charles Nicolle Hospital in Tunis for a medical opinion of fitness during the period from January 2013 to July 2022.
Results
A total of 34 patients were included. The average age was 41.67 ± 10 years. A male predominance was noted with a sex ratio (M/F) of 1.12. Patients with bipolar disorders represented 77% (n=26) of the psychotics versus 23% with schizophrenia (n=8). Two cases had a family history of psychosis. The most represented sector was the health sector in 41% of cases, followed by the tertiary sector in 11.8% of cases. The most prevalent job position was administrative assistant (14.7%). The average professional seniority was 17.07 ± 11.18 years. At the end of the medical aptitude consultation, 17% of the patients (n=6) were considered fit to continue their usual professional activity and 70% of the patients (n=24) had certain restrictions, mainly an exemption from night work in 46% of the cases (n=11) and from security and responsibility functions in 17% of cases (n=4). Temporary unfitness for work was indicated for 18% of patients (n=6) with a median duration of 8 ± 3.46 months. Twenty-three percent (23%) of the patients were judged permanently unfit for their jobs. Early retirement was proposed for five patients. The main diagnosis for permanent unfitness was bipolar disorder (7/8 patients).
Conclusions
The evaluation of the social and professional impact of psychotic disorders is an area of research that requires continuous and periodic re-evaluation.
Exposure to organic solvents (SO) is a significant occupational hazard in industrial settings. This can lead to neurobehavioural and physical effects that can affect the quality of life of workers
Objectives
To assess, using a validated questionnaire, the quality of life of workers exposed to SO.
Methods
Cross-sectional descriptive study conducted at the occupational medicine department of the Charles Nicolle Hospital in Tunis, which interested patients exposed to SO who had consulted for a medical opinion on fitness for duty during the period from January 1, 2017 to August 31, 2022. The data collection was carried out by a telephone call using the SF12 questionnaire. Socio-demographic and medical data were completed from medical records.
Results
We identified 51 workers exposed to OS. Thirty-three employees agreed to answer the SF12 questionnaire, for a response rate of 65%. The average age was 44 8 years with a clear male predominance of 75%. The most represented sectors of activity were the automobile industry (34%), followed by the leather and footwear industry (15%) and the plastics industry (12%). The jobs most exposed to SO were manual workers (54%) and painters (9%). The median occupational seniority was 15[10; 23] years. Comorbidities were observed in 72% of employees. The average physical composite score was 48%. The average mental composite score was 49%. The average overall score was 49%. Average quality of life (overall SF12 score above 50) was noted in 60% of the population. Moderate disability (overall SF12 score between 30 and 39) was found in 18% of respondents. Twenty-one percent of workers had a severe disability (overall SF12 score below 30).
Conclusions
In addition to socio-professional conditions, exposure to SO may be implicated in altering the quality of life of exposed workers. This implies the need to strengthen preventive measures in order to preserve the mental and physical health of these workers.
The COVID-19 pandemic had a significant psychological and physical impact throughout the world. Indeed, the rapid increase in the number of cases of infection created stressful situations and an anxiety-inducing climate that significantly affected the mental health of the world’s population, particularly that of healthcare workers (HCWs) who were massively mobilized to deal with the crisis.
Objectives
To assess the frequency of anxiety-depressive disorders in HCWs who have contracted the SARS-Cov2 virus.
Methods
Cross-sectional descriptive study interested the HCWs of the Charles Nicolle Hospital of Tunis having had COVID-19 during the period from September 1, 2020, to December 31, 2020. The psychological impact was studied through the HAD questionnaire (anxiety and depression assessment scale), administered to hospital workers at the time of the medical visit to return to work.
Results
The study population consisted of 531 Hcws. The mean age was 40 years with extremes ranging from 24 to 63 years. A female predominance of 76.6% was noted. The average professional seniority was 10 years [one year-37 years]. Nurses were the main professional category (32.4%). The study population belonged mainly to the departments of gynecology (8.3%), general surgery (7.2%), internal medicine (6.4%), and emergency (5.5%). A pathological history was found in 89.6% of cases, 7.2% of which were psychiatric. Anxiety (total score >10) was noted in 36.5% of patients. On the other hand, a certain depression (total score “depression” >10) was found in 33.3% of HCWs.
Conclusions
The COVID-19 pandemic induced a significant psychological impact on the HCWs placed in the first line in the management of this health crisis. As a result, long-term psychological follow-up of healthcare workers is essential in order to preserve health at work in care settings.
The COVID-19 pandemic had a considerable psychosocial impact on healthcare workers (HCWs) who were constantly requested during this era with an increased risk of infection. This implies behavioural changes, especially in smoking behaviour.
Objectives
To study smoking behaviour in HCWs with COVID-19.
Methods
A cross-sectional descriptive study conducted in the department of occupational pathology of Charles Nicolle Hospital in Tunis involving the smoking HCWs affected by COVID-19 during the period from September 1, 2020, to February 28, 2021. The data collection was carried out by a telephone call using a standardized questionnaire.
Results
During the study period, 61 smoking HCWs were identified. Thirty-two patients agreed to answer the questionnaire, with a response rate of 52%. The mean age was 41±10 years. The sex ratio (M/F) was 1.46. Half of the participants had comorbidities. The most represented occupational categories were blue-collar workers (n=11) followed by nurses (n=10) and physicians (n=7). The median professional seniority was 13 [3.5; 20] years. The mean age of smoking initiation was 20±5 years. The most common mode of smoking was cigarettes (93%) with an average consumption of 19 cigarettes per day. Water pipe smoking was noted in 3 patients. All patients started smoking before the COVID-19 infection. Strong tobacco dependence was noted in 25% of patients. Twenty-one per cent of the population had moderate dependence. Half of the participants maintained the same level of smoking as before the COVID-19 infection. An increase in smoking was noted in 34% of patients. A decrease in the level of smoking was reported by 15% of respondents. Four participants stopped smoking after COVID-19 infection. The reasons for smoking cessation were COVID-19 damage (n=3) and confinement with family (n=1).
Conclusions
The change in smoking behaviour during the COVID-19 pandemic is notable, particularly in HCWs who are exposed to a high physical and mental load. The presumed association of smoking with severe forms of COVID-19 infection makes tobacco control in HCWs an obligation in order to preserve the continuity of care.