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Study of the association of work-related musculoskeletal disorders and anxiety-depressive diseases
- L. Ben Afia, D. Brahim, I. Youssef, S. Ernez, W. Ayed, M. Mersni, N. Mechergui, N. Ladhari
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S962-S963
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Introduction
Mental disorders, musculoskeletal diseases (MSDs) and their comorbidities are major threats to work and functional ability. The relationship between mental health and the common MSDs has not received enough attention
ObjectivesTo study the socio-professional characteristics of workers suffering from work related MSD
To evaluate the association of work related MSDs with anxiety and depression disorders
MethodsA descriptive cross-sectional study conducted among workers with work-related MSDs who consulted the occupational medicine department of the Charles Nicolle Hospital between January 2022 and September 2022. A remote survey was conducted among these workers to screen for anxiety and depressive disorders using the Hospital anxiety and Depressive Scale
ResultsThe study population consisted of 54 workers with MSDs with a sex ratio (M/F) of 0.74. The average age was 44.4 [27-61 years]. The average professional seniority was 14.9 years±7 years and the sectors with the highest prevalence of MSDs were the health sector (22%), the food industry (13%) and the textile industry (11%). The workers reported MSDs of the lumbar spine in 61%, gonarthrosis in 31%, followed by MSDs of the upper limb in 25%. The prevalence of anxiety and depressive disorders were respectively 46% and 38%. There was no significant association between socio-demographic factors and anxiety depressive disorders. The anxiety disorder was associated with MSDs of the lumbar spine (p: 0.05; OR: 0.32 CI95% [0.1-1.09]).
ConclusionsAnxiety and depressive disorders were common among workers with MSDs related to work. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce their musculoskeletal pain.
Disclosure of InterestNone Declared
Identification of anxiety-depressive disorders in paramedics working shift work
- D. Brahim, N. Mechergui, I. Youssef, W. Ayed, M. Mersni, S. Ernez, N. Ladhari
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S473
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Introduction
Shift work can lead to mental health problems evolving into real anxiety disorders with significant socio-professional repercussions.
ObjectivesThe purpose of our work was to screen paramedics with shift work for anxiety disorders.
MethodsCross-sectional study carried out among the paramedical staff of a Tunisian university hospital. The data was collected from a pre-established record sheet. Screening for anxiety-depressive disorders was done using the HAD scale
ResultsThe study included 158 paramedics. The average age was 36.48 years with female predominance at 70.9%. The average working time was 11.1 8.9 years and the average working time in shift work was 10.27 9.2 years. Of the 13 departments with non-standard hours of work, the main departments represented were resuscitation (n=24; 15.2%), emergencies (n=18; 11.4%) and radiology (n=17; 10.8%). Nurses accounted for 46.2%, manual workers for 23.4% and senior technicians for 19%.Certain anxiety symptomatology was found in 53.2% (n=84) and doubtful symptomatology in 29.1% (n=46) of the general population. Certain depressive symptomatology was noted in 17.1% (n=27) and doubtful symptomatology in 30.4% (n=48) of the general population. Occupational seniority and seniority in shift work were statistically significantly associated with both anxiety (p=0.04/p=0.05) and depression (p=0.05/p=0.006) symptomatology. ). Similarly, this anxiety-depressive symptomatology was associated with the position occupied (p=0.02 / p=0.04) and the assignment department (p=0.008 / p=0.01).
ConclusionsAnxiety-depressive disorders are common among paramedics working shift work in hospitals. Screening consultations in occupational medicine are necessary to detect these disorders early.
Disclosure of InterestNone Declared
Control of the medical fitness for work of health care workers on psychiatric leave
- S. Ernez, D. Brahim, M. Mersni, L. Ben Afia, W. Ayed, N. Mechergui, I. Youssef, N. Ladhari
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S300
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Introduction
Absenteeism from work is considered to be a major source of disorganization and professional marginalization. Psychiatric leave is a frequent form of absenteeism in the hospital environment requiring medical control of the ability to work in order to detect certain abusive prescriptions or certain psychological disorders that can be professionally disabling.
ObjectivesTo draw up the socio-demographic, professional and clinical profile of the health care workers examined within the framework of a medical examination of the aptitude for work following a psychiatric sick leave.
To determine the medical fitness-for-duty decisions in interaction with the prescribed psychiatric leave
MethodsRetrospective descriptive study on the files of health care personnel who had psychiatric leaves and who were examined in a framework of multidisciplinary medical commission of absenteeism carried out in the department of professional pathology and aptitude for work at the Charles Nicolle Hospital of Tunis. The study period was from January 1, 2020, to October 1, 2022
ResultsWe collected 63 records. The average age was 44.75 years +/-11.28 years. A female predominance was noticed (71%). The patients were married in 75% of cases with at least one child in charge of 77% of cases. The main professional categories were nurses (29%), workers (24%), followed by anesthesia technicians and medical secretaries (8% each). The average professional seniority was 16.07 years +/- 10.34 years. Psychiatric history was found in 34.9% of the patients, 91% of whom had anxiety-depressive disorders, 4.5% bipolar disorders and 4.5% schizophrenia.
The main psychiatric reasons for the prescribed rest were characterized depressive episodes (75%), obsessive-compulsive disorder (3.2%), bipolar disorder type 2 with psychotic features (3.2%), postpartum major depressive episodes (3.2%) and post-traumatic stress disorder (3.2%). Professional conflicts with colleagues and/or superiors were reported in 21% of cases.
Psychiatric leave was prescribed by a free practice psychiatrist in 90% of cases. The average duration of leave was 50.1 days [14-180] days.
According to the opinion of the multidisciplinary commission, the healthcare professionals were considered fit to resume their professional activities in 59% of the cases, including 9 patients with restrictions (5 cases of eviction from night work, and 1 case of eviction from contact with the public, 1 case of professional reclassification and 1 case of early retirement). The leave was considered justified in 36% of cases for temporary unfitness for work.
ConclusionsThe medical examination of fitness for work for health care workers on psychiatric leave remains a delicate decision which can run into numerous difficulties requiring a collegial opinion from the psychiatrist and the occupational physician.
Disclosure of InterestNone Declared
Daytime sleepiness among health workers affected by COVID-19 during the “OMICRON” wave
- Z. Athimni, M. Mersni, H. Ben Said, G. Bahri, D. Brahim, N. Mechergui, I. Yousssef, S. Ernez, N. Ladhari
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1105
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Introduction
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.
ObjectivesThis study was conducted to assess excessive daytime sleepiness in the SARS-COV2-affected HCWs during the “OMICRON” wave.
MethodsCross-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.
ResultsDuring 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%).
ConclusionsEarly 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.
Disclosure of InterestNone Declared
Socio-demographic, clinical and therapeutic features of patients treated for schizoaffective disorder using cannabis
- W. Bouali, W. Haouari, S. Brahim, N. Faouel, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S679
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Introduction
Psychotic disorders were formerly associated with cannabis use. It could accelerate the course of the illness and thus, constitutes a severity factor in terms of prognosis.
ObjectivesTo define the socio-demographic, clinical and therapeutic profiles of patients suffering from schizoaffective disorder (ASD) and who are consuming cannabis.
MethodsA retrospective study of 16 patients diagnosed with ASD, who were hospitalized at the psychiatric department of Tahar Sfar Mahdia’s hospital, and whose toxicology test results during the hospitalization came back positive for tetrahydrocannabinol.
Results16 patients were gathered, all male, the average age was 26 years. The average age of first hospitalization was 25 years, 41.9% were unemployed. 76.3% of our sample were single. Three quarters of patients were hospitalized without consent. The average hospital stay was 30.33 days. Our patients had required during their stay an average dosage of antipsychotic, equivalent to chlorpromazine, of 752.42 +/- 342.79 mg. The average scores of psychometric scales were: BPRS = 55.72 +/- 14.11, SAPS = 41.5 +/- 14.80 and 42.11 +/- 18.88.
ConclusionsCurrently, it is recognized that prolonged use of cannabis is an exogenous risk factor. The association between cannabis and schizoaffective disorder may amend the treatment modalities. It requires, thereby, an integrated and simultaneous treatment of schizophrenia and addictive behavior.
Disclosure of InterestNone Declared
Neuropsychological effects of occupational exposure to organic solvents: A study of 37 cases
- A. Moussa, D. Brahim, N. Mechergui, H. Ziedi, W. Ayed, S. Ernez, I. Youssef, N. Ladhari
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S962
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Introduction
Occupational exposure to organic solvents can have multiple health effects for exposed employees.Neuropsychic effects represent an important part of these effects and have a significant impact on patients’ ability to work
Objectives- To describe the socio-professional and medical characteristics of workers exposed to organic solvents
- To screen among the study population for neuropsychological effects related to an organic psychosyndrome using the Q16 questionnaire.
MethodsA retrospective descriptive study of workers exposed to organic solvents, who were referred to the occupational medicine department of Charles Nicolle Hospital in Tunis for a medical assessment of their fitness for work over the period from 2016 to 2022. The socio-professional data were collected from the medical records. The Swedish Q16 questionnaire in its French version was used to screen for neuropsychological signs of organic psycho-syndrome.
ResultsA total of 37 workers were included. The mean age was 45.38 ± 8.63 years with a clear male predominance (77%). The mean occupational seniority was 21.39 ± 11.11 years. The average duration of the occupational exposure to organic solvents was 18.25 ± 11.29 years. The most represented sectors of activity were the plastics industry (11%), the automotive industry (19%), the carpentry sector (14%) and the aeronautics sector (9%). Our population was represented by polyvalent workers in 49% of cases and by painter in 24% of cases. Psychiatric history was noted in only one case. The main functional signs reported by the workers were wheezing dyspnea with breathing difficulties (13%) and headaches (11%).
The Q16 questionnaire was found to be positive in 65% of the cases, with a higher rate of positivity for the items relating to unusual fatigue (73%), irritability for no particular reason (67%), short memory (64%) and headaches (58%). Acquired dyschromatopsia detected by a Lanthony test was found in 39% of the cases, 23% of which was associated with a positive Q16 questionnaire. Additional exploration by specific psychotechnical tests was carried out in five cases, all of which came back positive with significant attentional and cognitive impairment.
A declaration of an occupational disease according to the Table n°23 (Halogenated derivatives of aliphatic hydrocarbons) and Table n°40 (other liquid organic solvents for professional use) of the Tunisian list of occupational diseases eligible for compensation was made in three and two cases respectively. A definitive exemption from exposure to organic solvents was indicated for all workers with a positive Q16 questionnaire.
ConclusionsExposure to organic solvents is a risk encountered in various occupational sectors. Thus, education of the employees to the dangers encountered with a reinforcement of the collective and individual technical protection means are essential in order to avoid their detrimental effects on health.
Disclosure of InterestNone Declared
Psychoses and professional activity: Impact on medical fitness for work
- A. Belkahla, D. Brahim, H. Ben Said, A. Ghenim, W. Ayed, S. Ernez, I. Youssef, N. Ladhari
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S472-S473
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Introduction
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.
MethodsCross-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.
ResultsA 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).
ConclusionsThe evaluation of the social and professional impact of psychotic disorders is an area of research that requires continuous and periodic re-evaluation.
Disclosure of InterestNone Declared
Prescription of benzodiazepines and related drugs in the Psychiatry Department in the Psychiatry department of Tahar Sfar, Mahdia hospital
- S. Brahim, W. Bouali, M. E. bakhouch, M. Kacem, S. Khouadja, R. Ben Soussia, S. Younes, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S305-S306
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Introduction
Benzodiazepines are the most widely prescribed drugs worldwide for insomnia and anxiety disorders. However, few studies have been conducted on the professional practice of these drugs for patients with psychiatric disorders .
ObjectivesTo describe the prescribing practices of benzodiazepines for patients with psychiatric disorders at the Psychiatry Department of the EPS Taher Sfar Mahdia.
MethodsThis is a retrospective study of patients who were admitted for the first time to the psychiatry department of the EPS Taher Sfar in Mahdia and had a prescription of benzodiazepines during their hospitalization.
ResultsA total of 234 patients were included in our study. We found that 77.8% of patients on benzodiazepines had a prescription for benzodiazepines for a period of less than 3 months. Secondly, we determined that 66.2% of patients who had a benzodiazepine’s prescription had a taper dose of benzodiazepines before the withdrawal. No patients with contraindications to benzodiazepines had a prescription of these medications. The maximum indicated dosage was respected in 92.3% of the prescriptions. Lorazepam was the most used drug, accounting for 49.1% of prescriptions. Our study showed that 46.2% of prescriptions were for anxiolytic purposes only, 43.2% were for hypnotic purposes only. Our analysis also showed a higher proportion of males in the < 3 months group with 82.9% which is significantly higher than for females. (p=0.004).
Our analytical study concluded that gender (p=0.004), professional status (p=0.014), history of addiction (p=0.003), cannabis use (0.025) were related to the duration of benzodiazepine prescription. We noted that 89.9% (n=71) of patients with a documented history of addiction had been prescribed benzodiazepines for less than 3 months. We were also able to conclude that there were correlations between the duration of prescription and medical and/or surgical history (p=0.002), the molecule prescribed (p=0.0001) as well as the renewal of the prescription (0.0001).
However, we did not find a correlation between the associated psychiatric disorders and the duration of prescription. As well for associated psychotropic drugs and duration of prescription
ConclusionsWe can conclude that misuse of benzodiazepines exists, but to a much lesser extent than in the literature. A larger-scale study would be essential to establish a Tunisian overview of benzodiazepine prescription practices.
Disclosure of InterestNone Declared
Assessment of the quality of life of workers exposed to organic solvents: Study of 33 cases
- H. Ziedi, D. Brahim, H. Ben Said, A. Moussa, W. Ayed, S. Ernez, I. Youssef, N. Ladhari
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S963-S964
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Introduction
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
ObjectivesTo assess, using a validated questionnaire, the quality of life of workers exposed to SO.
MethodsCross-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.
ResultsWe 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).
ConclusionsIn 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.
Disclosure of InterestNone Declared
Impact of COVID-19 on the mental health of hospital staff
- S. Chemingui, I. Yousfi, N. Mechergui, M. Mersni, S. Ernez, D. Brahim, H. Ben Said, G. Bahri, I. Youssef, N. Ladhari
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S808-S809
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Introduction
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.
ObjectivesTo assess the frequency of anxiety-depressive disorders in HCWs who have contracted the SARS-Cov2 virus.
MethodsCross-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.
ResultsThe 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.
ConclusionsThe 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.
Disclosure of InterestNone Declared
Cannabis and cognitive deficiency: a descriptive study
- M. Kacem, W. Bouali, M. Henia, S. Brahim, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S563-S564
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Introduction
Cannabis is the most widely used illicit drug; 3.8% of the world’s population consumes cannabis on a regular basis. Cannabis use–associated alterations in the domain of cognition have been extensively studied.
ObjectivesTo research memory deficiency in the young consumers of cannabis in Tunisia.
MethodsThis is a transversal descriptive study conducted during two months (January and February 2022). The research involved about 137 participants aged between 18 and 35 years old, exhaustively recruited amid emergency patients of Mahdia Hospital regardless of the reason for their health care seeking. The patients were declared as consumers of cannabis and accepted to be part of this study. Therefore, Data were collected on a pre-determined data sheet that included various information (age, sex, lifestyle, personal and family psychiatric history, age when first used cannabis and the rate of cannabis use …).
Principally, a Functional Impact Assessment (ERF: French abbreviation for échelle d’évaluation des Répercussions Fonctionnelles ) scale was used to assess and review working memory.
ResultsIn our study population, there was a noticeable male predominance of 71%. Hence, the age structure ranged between 18 years old and 35 years old. Among the latters, 65.9% were single, and 29.7% experienced school failure. In this sample, 23.2% had a psychiatric history like depression, bipolarity, etc. The average age of the first use of cannabis was between 18 and 25 years old in 70% of cases.
Besides, a high percentage of association of other substances was found among cannabis users as follows: use of alcohol 72.5%, tobacco 74.6%, ecstasy 41.3%, and cocaine 25.4%. First and foremost, the use of cannabis was considered as a means of indulgence for 66.7% of the study population, as an anxiolytic for 26.8%, and as a sedative for 23.9%.
Additionally, the effect of cannabis use on working memory deficiency according to the functional impact assessment scale was: no deficiency in 19% of cannabis users, minimal in 34%, mild in 32%, moderate in 9%, fairly severe in 4%, very severe in 1%, and extreme in 1% of cases.
More importantly, the percentage of consumers with significant memory deficiency (moderate to extreme) was 15%.
ConclusionsThe assumption of the effect of cannabis on memory and cognitive deficiency remains controversial and leads us to suggest further in-depth study of this subject.
Disclosure of InterestNone Declared
Changes in smoking behaviour among healthcare workers with COVID-19
- H. Ziedi, M. Mersni, D. Brahim, G. Bahri, N. Mechergui, I. Youssef, S. Ernez, H. Ben Said, N. Ladhari
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S676
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Introduction
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.
ObjectivesTo study smoking behaviour in HCWs with COVID-19.
MethodsA 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.
ResultsDuring 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).
ConclusionsThe 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.
Disclosure of InterestNone Declared
Medical Fitness in workers suffering from mixed anxiety-depressive disorders:
- L. Ben Afia, G. Bahri, H. Ben said, H. ziedi, M. Mersni, D. Brahim, S. Ernez, N. Mechergui, I. Youssef, N. Ladhari
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S875
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Introduction
Anxiety and depressive disorders are major public health problems associated with multiple adverse occupational outcomes, including unemployment, reduced productivity, and absenteeism.
ObjectivesTo study the socio-professional and medical characteristics of workers with mixed anxiety -depressive disorders and to evaluate their impact on work ability.
MethodsA descriptive and retrospective study conducted in the occupational medicine department at Charles Nicolle Hospital, involving all the medical records of workers suffering from mixed anxiety –depressive disorders that were referred for a medical opinion of fitness for work from January 1, 2014, to December 31, 2020.
ResultsThe study included 62 females and 20 males diagnosed with mixed anxiety-depressive disorders with a mean age: 41.4± 8 years. The average professional seniority was 12.8 years±7.8 years. The most auspicious occupational sectors for these disorders were health (41%) and communication (30%). Most of these workers (62%) were fit for work with professional restrictions (10 workers to positions with a lower mental load and 20 exclusions from night shift work), though 12% were declared unfit for work temporarily. Twenty-one workers were fit to continue working and one worker was unfitted to work.
The overall prevalence of mixed anxiety –depressive disorders was found to be significantly elevated in female patients (p: <0.001).
ConclusionsThe decision of medical fitness for work among workers with psychiatric disorders considers their physical and mental capacities as well as the conditions in which the work is carried out, aiming to annihilate the risk of psychic imbalance. Thus, an adjustment of workstations can be an important determinant in the prevention of psychosocial risks.
Disclosure of InterestNone Declared
Sociodemographic and clinical characteristics of employees on long-term sick leave
- S. Brahim, W. Bouali, S. Khouadja, M. Kacem, R. Ben Soussia, S. Younes, L. Zarrouk
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S865
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Introduction
Mental health in the workplace is a rapidly developing field of research, which involves the well-being of the individual on a psychological and social level. However, this balance can be suddenly disrupted and can have such a repercussion that the individual finds himself unable to do his job. In this case, he can benefit from a work stoppage called long term sick leave, governed for the public sector, by the decree number 59-239 of August 24, 1959.
ObjectivesTo study the socio-demographic and clinical profile of public sector employees who have been on long-term sick leave and examined as part of the assessment of their ability to work.
MethodsIt is a retrospective study that focused on all public sector employees on long-term sick leave, examined as part of the evaluation of their ability to work in the psychiatric service CHU MAHDIA during the period from January 2013 to April 2014.
ResultsWe collected 73 patients. The mean age at the time of the examination was 51.1 years. There was a clear female predominance 67% and the sex ratio was 0.48. The vast majority were married (71%), of average socioeconomic status (52%) and high school level (43%). Most of the patients (67%) were from the Ministry of Public Health, followed by the Ministry of Education with 26% of the study population. The average length of service was 20.4 years with extremes between 3 and 36 years. The average length of leave was 13 months. The most frequent diagnosis of the prescribing physician was adaptation disorder (41%), major depressive disorder (27%). Somatic comorbidity was found in 38% of cases, dominated by hypertension, diabetes and cervicarthritis in 50%, 28% and 18% respectively. At the end of the leave, 82% of the patients were able to return to work. For the other patients, a professional reclassification was necessary.
ConclusionsLong-term sick leave has a heavy economic burden for society and serious socio-economic and psychological repercussions on the patient. Hence the interest in identifying vulnerable subjects and jobs at risk in order to prevent the occurrence of psychopathological disorders.
Disclosure of InterestNone Declared
Assessment of self-esteem among Tunisian cannabis users
- M. Kacem, W. Bouali, M. Henia, S. Brahim, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S669
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Introduction
Self-esteem plays a role in the adaptive functioning of the human being. It could be a protective factor regarding multiple risks particularly substance use.
ObjectivesThe aim of this study is to assess self-esteem among a group of young Tunisian users of cannabis.
MethodsThe total study sample was composed of 137 participants, who took part of a transversal descriptive study during two months (January and February 2020). These partakers were comprehensively recruited among Emergency patients of Mahdia Hospital. Thereupon, the main criteria for the selection of these patients was their consumption of cannabis, regardless of their primary health care seeking reason or purpose.
The research was carried out upon their declaration of cannabis consumption and their compliance to be part of such a study. Thus, Data were collected on a pre-determined data sheet that included various information (age, sex, lifestyle, personal and family psychiatric history, age at which they started their cannabis consumption and the rate of cannabis use …).
Accordingly, Self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). Consequently, the interview took place after the subject’s verbal and informed consent and the assurance of anonymity and confidentiality of the interview content.
ResultsIn our study population, the cannabis consumers were young adults aged between 18 and 35 years old, with a male predominance of 71%. Among those users, 65.9% were single and 29.7% dropped out of school or experienced academic failure. On a socio-economic level, we concluded to a rate of 5.8% (lower class), 60.9% (middle class) and 33.3% (upper class).
Besides, 40.8% were employed. In total, 23.2% had a psychiatric history. Furthermore, the use of other substances was also prominent and frequent as follows: alcohol 72.5%, tobacco 74.6%, ecstasy 41.3% and 25.4% cocaine. The use of cannabis was considered as a means of indulgence and pleasure for 66.7%, as an anxiolytic for 26.8% and as a sedative for 23.9%.
Self-esteem, among those cannabis users, was very low in 20% of cases, low in 38% of cases, medium in 15% of cases and high in 25% of cases. Consequently, more than half of the study population remains below the medium average according to RSES.
ConclusionsThese results lead us to question the relation between cannabis and self-esteem. The question that is evolved about the use of cannabis is the following: Is it used as a remedy or is it the cause of self-esteem deficiency?
Disclosure of InterestNone Declared
Assessment of Fatigue and Quality of Life in Multiple Sclerosis Patients: A Cross-Sectional Study
- S. Chemingui, M. Mersni, I. Youssef, I. Yousfi, S. Ernez, N. Mechergui, D. Brahim, G. Bahri, H. Ben Said, N. Ladhari
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S300-S301
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Introduction
Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system that is associated with a range of devastating symptoms including fatigue. In addition, the accumulation of disability that occurs in most MS patients can have a detrimental effect on their quality of life.
ObjectivesTo assess fatigue and quality of life in patients with MS.
MethodsDescriptive cross-sectional study that interested MS patients referred to the occupational pathology consultation of Charles Nicolle Hospital, during the period from 1 July 2020 to 30 September 2022. The data collected concerned socio-demographic and occupational characteristics. The impact of MS on quality of life was studied using the SF-12 quality of life scale. Fatigue was assessed by the Fatigue Severity Scale (FSS).
ResultsTwenty-six cases of MS were identified. The mean age was 38 ± 9 years with a sex ratio (M/F) of 0.3. The average occupational seniority was 11 ± 8 years. The health sector was the most represented (23%, n= 6) followed by the transport sector (19%, n= 5). The main occupations were manual workers (31%), drivers, and administrative agents (19% each). The occupational constraints were physical in 44% of cases and psychological in 24% of cases. Fourteen patients (87% of the cases) lost their jobs because of the disease. The decision on occupational fitness was definitive incapacity in 44% of cases. The mean FSS score was 4±1.74. Sixteen patients (62%) had moderate fatigue (FSS 36-52), eight patients (31%) had mild fatigue (FSS <36) and two patients (8%) had severe fatigue (FSS >52). In addition, the mean scores for the physical and mental components of perceived health were estimated to be 37.04±7.67 and 44.93±7.23, respectively. The mean global score (SG) of SF12 was 40.98±7.23. The majority of patients (92%, n=24) had an average quality of life (SG- SF12 between 30 and 60) and two patients (8%) had a poor quality of life (SG <30).
ConclusionsThe impact of MS on the socio-professional quality of life of patients was noted in the majority of cases. It is therefore imperative to improve the care of our patients on both the physical and psychological levels.
Disclosure of InterestNone Declared
Fatal pulmonary embolism related to anti-psychotics: forensic implications. About four autopsy cases with review of the literature
- M. Kacem, W. Bouali, Y. Mahjoub, S. Brahim, L. Zarrouk
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S882
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Introduction
The association between the intake of antipsychotic drugs and the occurrence of thromboembolic complications is widely described in the literature. The occurrence of this complication may call into question the medical responsibility of the attending physician.
ObjectivesThe objective of this work is to describe the physiopathological mechanisms involved in the occurrence of thromboembolic complications in a patient under antipsychotic treatment, whether or not associated with physical restraint and to discuss the forensic implications.
MethodsOur study is retrospective on cases of fatal pulmonary embolism, discovered at autopsy, in connection with the taking of antipsychotics. The autopsies were carried out in the Department of Forensic Medicine of the Tahar Sfar University Hospital in Mahdia. The cases were collected over a period of 04 years. A review of the literature was carried out. We only selected articles published until February 2021 and dealing with cases of patients on antipsychotics, diagnosed with pulmonary embolism by performing a chest CT scan or during an autopsy.
Results915 autopsy cases were performed during the study period. Twenty cases of pulmonary embolism, discovered at autopsy, were collected. Four cases were related to the taking of antipsychotics (incidence 0.004%), including two men and two women, aged between 25 and 52 years. They were all on antipsychotic treatment for at least 5 years, with the exception of one case who was put on 3 antipsychotics, 7 days before his death, with indication of physical restraint.
After analysis of the memorial data, the external examination and the autopsy, the results of additional examinations, the death was attributed, in the 4 cases, to a massive fibrino-cruoric pulmonary embolism.
A selection of 45 studies regarding thromboembolic complications associated with taking antipsychotics, was included in the final review.
ConclusionsThe reported cases provided additional evidence on the involvement of antipsychotics in the occurrence of thromboembolic complications. Psychiatrists should be careful when prescribing these treatments. The establishment of therapeutic guidelines, taking into account the thromboembolic risk factors, becomes essential, in order to avoid the occurrence of a complication which could engage both the vital prognosis of patients and the responsibility of the physician.
Disclosure of InterestNone Declared
Anxio-depressive disorders among healthcare workers in COVID-19 department
- M. N. Fendri, D. Brahim, I. Youssef, W. Ayed, N. Mechergui, S. Ernez, M. Mersni, N. Ladhari
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S458
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Introduction
The COVID pandemic has troubled the world and disrupted the professional and personal lives of healthcare workers, putting their mental health at risk.
ObjectivesDetermine the prevalence of anxiety-depressive disorders among health personnel assigned to the COVID-19 circuit.
MethodsCross-sectional study carried out on healthcare personnel assigned to departments dedicated to the care of patients hospitalized for a SARS-COV2 infection. The study took place between March and September 2021. Data collection was done from a pre-established sheet. Anxiety-depressive disorders were screened using the HAD scale.
ResultsThe study included 140 health personnel. The sex ratio (M/W) was 0.62 with 54 men and 86 women. The mean age was 36.4±9 years. Nurses represented the largest professional category (64.6%). Professional seniority was 10 ± 9 years. Staff had been caring for patients with COVID for an average of 9 ±5 months. They worked an average of 4 days a week. The number of patients ranged from 1 to 55 per department. Psychiatric history was found in 29 participants, depression in 7% and anxiety in 2%. The workload was rated very hard at 42.1% and hard at 37.1%. Thirty percent of the population declared having received the moral support necessary to face the wave. The prevalence of anxiety and depression were 75.7% and 72.9% respectively. With 48.6% of patients presenting with definite anxiety and 27.1% with probable anxiety. Depression was certain in 40% of cases and doubtful in 32.9% of cases.
ConclusionsAnxio-depressive disorders are common among healthcare staff assigned to the COVID circuit. Setting up listening cells with regular monitoring of these staff is very important to avoid psychologic impact
Disclosure of InterestNone Declared
Social and professional stigma during COVID-19 among healthcare workers in a Tunisian hospital
- N. Mechergui, N. Chaouech, I. Youssef, M. Mersni, D. Brahim, G. Bahri, S. Ernez, H. Ben Said, N. Ladhari
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S599
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Introduction
Healthcare workers (HCWs) are on the front line in the management of the COVID-19 pandemic. They are at higher risk of acquiring SARS-CoV2 infection and might transmit the virus to other person or their family members. All these gave rise to stigma toward society, family, and HCWs.
Objectivesto measure social and professional stigma and guilty feelings among HCWs in a Tunisian hospital.
MethodsA cross-sectional study using a questionnaire (sociodemographic and professional characteristics and three questions (yes/no) related to social and professional stigma and guilty feelings) was conducted from September 1 to December 31, 2020, at Charles Nicolle hospital of Tunis. The survey was distributed among HCWs consulting the department of occupational health after a COVID-19 infection.
ResultsA total of 259 HCWs were included in the study. The mean age was 41±10 years with a sex ratio of 0.25. The HCWs were married in 66.8% of cases. The professional categories were represented mainly by nurses in 33.5% of cases followed by technicians and physicians in 26.2% and 17.4% of cases respectively. The average professional seniority was 13 years (min=1 year; max=13 years).
The social stigma was reported by 30.5% and professional stigma by 20.1%. The stigmatized population was predominantly female (86%), and the proportion of married people was 63%. The predominant professional category was nurses (36%) followed by senior technicians and workers (25% and 16% respectively). The average length of employment was 13 years. Guilt was felt by 57.1% of the cases.
ConclusionsBased on the results of this study, the social and professional stigma during COVID-19 among HCWs was significant as well as the feeling of guilt. This may have an adverse impact on HCWs’ mental health.
Disclosure of InterestNone Declared
Recurrence and profile of reconsultants: descriptive study of 162 patients
- S. Brahim, W. BOUALI, K. Mohamed, K. Sabria, B. S. Rim, Y. Samira, Z. Lazhar
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S287
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Introduction
Emergency psychiatric consultation requests present certain specificities both in the situations encountered and in their management, due to a close relationship between the consultant and his environment. They do not only correspond to psychiatric emergencies, in the strict sense of the term, but also to psychological emergencies with their possible social dimension. They require an adapted response that can be decisive for the future
ObjectivesTo determine the epidemiological and clinical characteristics of patients reconsultants in the emergency medical department.
MethodsThis is a cross-sectional study, conducted over a period of 12 months, from 01 April 2020 to 31 March 2021, in the emergency medical department of Mahdia University Hospital.
ResultsDuring the study period, 162 reconsultations for psychiatric emergencies were recorded. the age ranged from 18 to 61 years with an average of 35 years. The level of education was primary or secondary in 78.8% of cases. The majority of reconsultants had single marital status (70%). The absence of professional activity and social security coverage was found in 72.3 and 49% of cases respectively. The presence of family and personal psychiatric history was noted in 29.8% and 91.5% of reconsultants respectively. Heteroaggressiveness followed by instability were the most frequently encountered reasons for consultations with 23.4% and 12.8% of cases respectively. The presence of a triggering factor was found in 63.8% of cases where problems with the main support group followed by those related to the social environment and those related to access to health services were the most reported with 49.23 and 13% respectively. The syndromic psychiatric diagnoses were, in decreasing order of frequency, psychomotor excitement (23.4%), delusional syndrome (17%), dissociative syndrome (12.8%) and somatic conversion (12.8). For reconsultants, relational approach and/or injectable treatment were the most used therapeutic means immediatly (49%). Neuroleptics and benzodiazepines were prescribed in 38% and 13% of cases, respectively. The decision to hospitalize in a psychiatric department concerned 45% of reconsultants.
ConclusionsReferral decisions favored the organization of ambulatory follow-up, with a decrease in the rate of hospitalization. These results make it possible to identify the evolutionary trends of the population consulting in emergency
Disclosure of InterestNone Declared