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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.
Chronic exposure to damaging noise can lead to hearing loss . People suffering from hearing problems find it increasingly difficult to communicate and become withdrawn. This lack of contact can lead to the onset of anxiodepressive disorders .
Objectives
To study the epidemiological and clinical particularities of hearing loss in patients with psychoaffective disorders.
To study the impact of this association on the medical aptitude for work.
Methods
Retrospective descriptive study of depressive patients with hearing loss who consulted the Occupational Medicine Department at Charles Nicolle Hospital over a six-year period from January 2016 to November 2022.
Results
Out of 150 patients with hearing loss who consulted our service, 10 patients had an axio-dépressive disorder . Seven were men and three were women. The mean age was 43 ± 5 years and the mean job seniority was 11 years [3-20]. they belonged to the telecommunications (n=6), industry (n=2), printing(n=1), and transport sectors (n=1) . The job positions were : teleconsultant (n=6), operator machine (n=3) and driver (n=1) the symptoms presented by the patients were hearing loss (n=4), otalgia (n=1) , diziness (n=1), tinnitus(n=1) . The average time to onset of symptoms was 13±8 years [1-35] . The hearing deficits presented by the patients were: sensorineural hearing loss (n=7), mixed hearing loss (n=1) and conductive hearing loss (n=2). The mean of Hearing loss were 34±9 dB in the right ear and 34±6 dB in the left ear . A declaration of the deafness as an occupational disease was indicated in two of the cases. the univariate statistical study showed that anxiety-depressive disorders were associated with tinnitus (p=0,036,OR=4,2[0,99-17,659]) and the position of teleconsultant (p=0,009,OR=5,622[1,338-23,627] . Eviction from exposition to noise was indicated in seven cases
Conclusions
According to our study, hearing loss in patients with anxio-depressice disordes is associated with tinnitus and teleconsultant job position . Early screening early screening of people at risk is recommended.
The driver’s job is a safety job requiring a meticulous neuropsychological assessment, which can affect the decision on fitness to drive. Professional driving benefits from codified regulations concerning neuropsychological disorders.
Objectives
To describe the socio-professional characteristics of drivers with psychiatric illnesses
To specify the impact of these pathologies on decisions on fitness for work
Methods
Retrospective descriptive study of drivers with psychiatric disorders who consulted the occupational pathology and fitness for work department of the Charles Nicolle Hospital for fitness for work assessment during the period from January 2016 to January 2023.
Results
Out of 98 drivers who consulted our department for an aptitude assessment, nine (n=9) patients had a psychiatric disorder. The average age was 45±7 years. They were all men. They were bus (n=7), light car (n=1), and lorry (n=1) drivers. They belonged to the transport (n=7) and service (n=2) sectors. Length of service ranged from one year to 35 years. The pathologies presented by the patients were: anxiety-depressive disorder (n=7) , bipolar disorder (=1) and drug-addiction (n=1). They were being treated with antidepressants (n=7), anxiolytics (n=3), and thymoregulators (n=1). The medico-legal decision was to avoid professional driving (n=7) and to avoid professional driving at night (n=2).
Conclusions
psychiatric illnesses can compromise fitness to work. The role of the occupational physician in the primary and secondary prevention of people at risk is important.
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.
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
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.
The U.S. Food & Drug Administration (FDA) has cleared SNT (Stanford Neuromodulation Therapy) for treatment of major depressive disorder (MDD) in adults who have failed to achieve improvement from at least two prior trials of antidepressants. SNT protocol requires both structural and functional connectivity MRIs which is limited by high cost and lack of availability, its use without neuronavigation is still considered an off label use and need more investigation.
Objectives
1-To investigate efficacy of SNT like accelerated off-label protocol without Neuronavigation in treating patients with TRD and suicidality.
2-To investigate durabiliy ( up to one month ) of SNT like accelerated off-label protocol without Neuronavigation in treating patients with TRD and suicidality
Methods
Two cases diagnosed as treatment resistant unipolar depression with suicidal ideations received accelerated intermittent theta burst stimulation (a iTBS); with figure of eight coil administered to the left dorsolateral prefrontal cortex (DL-PFC) determined using Beam method. Stimulation was at 90% MT for 1800 pulses with an intersession interval of fifty minutes. Patients received ten sessions every day for five consecutive days for a total of fifty sessions (90,000 pulses). The following scales were applied at the baseline and at the end of each day of five treatment days:The Montgomery and Asberg Depression Rating Scale (MADRS) The Beck Depression Inventory, Columbia Suicide Severity Rating Scale (C-SSRS) and Young Mania Rating Scale (YMRS).
Results
The two cases at the end of the fifth day were completely improved regarding both suicidal ideations and depression without emerging of hypomania. Follow up was done weekly for one month with durable results.
Conclusions
SNT protocol without neuronavigation needs to be well investigated in suppressing both suicidality and depression in patients with TRD.
Sleep quality depends on several factors such as smoking, physical activity, diet, and certain pathologies such as obstructive sleep apnoea syndrome. Indeed, following a COVID-19 infection, several trainee doctors complained about a deterioration of their sleep quality.
Objectives
To evaluate the quality of sleep of medical trainees working at Charles Nicolle Hospital who were infected by SARS-COV2.
Methods
We conducted a descriptive cross-sectional study, among medical trainees at Charles Nicolle Hospital, infected by COVID-19 during the period from July 2020 to November 2020. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Trainees were contacted during the period August 2022 to September 2022.
Results
Fifty-three trainee doctors have joined our study. Forty-five of them had a significant sleep disturbance with a Pittsburgh Sleep Quality Index (PSQI) greater than five. The average age was 29.4±3.07 years old with a female majority (75%). No psychiatric history was found. The most affected category of trainees were residents (74%), particularly those working in the general surgery department (18%) and the anaesthesia and intensive care department (9%). Among those trainees, 80% had night shifts with an average of six shifts per month. Sleep latency was high in 20% of cases. A sleep duration of less than five hours per night was found in 18% of the cases. Six participants reported using sleeping pill three to four times a week.
Conclusions
Our study revealed a significant sleep disturbance among trainee doctors. This could be due to the SARS-COV2 infection but can also be explained by the night shifts burden and the great mental load at work during this pandemic period.
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.
Anxiety and depressive disorders are major public health problems associated with multiple adverse occupational outcomes, including unemployment, reduced productivity, and absenteeism.
Objectives
To study the socio-professional and medical characteristics of workers with mixed anxiety -depressive disorders and to evaluate their impact on work ability.
Methods
A 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.
Results
The 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).
Conclusions
The 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.
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.
Objectives
To assess fatigue and quality of life in patients with MS.
Methods
Descriptive 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).
Results
Twenty-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).
Conclusions
The 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.
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.
Objectives
to measure social and professional stigma and guilty feelings among HCWs in a Tunisian hospital.
Methods
A 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.
Results
A 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.
Conclusions
Based 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.
Occupational exposure to organic solvents remains a real risk for exposed employees, particularly in mental health and quality of life.
Objectives
- To evaluate the quality of life of employees exposed to organic solvents
- To research the professional and extra-professional determinants of this quality of life.
Methods
This is a descriptive cross-sectional study that compared 196 employees exposed to organic solvents with 64 non-exposed employees from the same socio-professional environment. The investigation took place in four different companies in the governorate of Tunis. An environmental study combining an evaluation of working conditions and atmospheric monitoring was carried out to identify and quantify exposure to solvents. Quality of life was assessed using the SF36 questionnaire in its Arabic version.
Results
The solvent mixtures to which the employees were exposed mainly contained hexane, toluene, ethyl acetate, methyl ethyl ketone, cyclohexane, and perchloroethylene. Exposure to these solvents is primarily from glues and paint products. The study population was relatively young (34.1 years +/-9.8), predominantly male (sex ratio=2.2), with an education level of no more than secondary school in 90% of cases, with an average work experience of 10.3 years (+/-8.2) and represented mainly by manual workers (75.4%). The pathological history of the exposed patients was dominated by chronic neuropsychological disorders (48.1%). The global score of SF36 (SFG) was significantly poorer in the solvent-exposed group (SFG= 64.1+/- 21.1 versus 70.1+/-23.3) (p=0.05). Among the eight dimensions of the SF36, a very significant alteration of the dimensions: “perceived health ”, “psychological health” and “repercussion of psychological health on daily activities ” was noted in the solvent-exposed group.
The main determinants of the quality of life of workers exposed to solvents were: level of education, frequency of exposure, length of exposure, and company.
According to the job-exposure matrix, only “perceived health” appeared to be impaired by high levels of cumulative solvent exposure (p= 0.0006).
Conclusions
According to this study, organic solvents can affect the quality of life of exposed employees by acting essentially on perceived health, psychological health, and the “impact of psychological health on daily activities”.
When we think of multiple sclerosis (MS), we usually talk about the sensory and motor symptoms of the disease and their impact on the functioning of the individual affected. However, this disability can lead to a wide range of symptoms, including psychological and cognitive manifestations that also have a significant impact on the quality of life of patients
Objectives
To estimate the incidence of psychiatric disorders in patients with MS.
Methods
A cross-sectional descriptive study that interested MS patients referred to the occupational pathology consultation of the Charles Nicolle Hospital, during the period from July 1, 2020, to September 30, 2022. The data collected concerned the characteristics of the disease. The detection of psychiatric disorders was studied through a validated self-questionnaire GHQ-12 (General Health Questionnaire).
Results
The study population consisted of 26 cases. The average age was 38 ± 9 years. A predominance of females was noted in 77% of cases. Eight patients (31%) were smokers. Nine cases (47%) had a relapsing-remitting form and six cases (32%) had a primary progressive form. All patients were on disease-modifying therapy. The average duration of the disease was 6 ± 3 years. The average duration of work during the illness was 4 years [one year-12 years]. The average duration of work stoppage in the last 12 months of activity was 63 days [2-240 days], of which 54% was long-term sick leave. The mean GHQ-12 score was 4.38 [0-10]. Twenty patients (77%) had psychological disorders.
Conclusions
This study shows the high frequency of psychiatric disorders in our MS patients. The role of the neuropsychologist is therefore often crucial in the care of these patients.
Mental health disorders are among the most burdensome health concerns in the world; it affects more than 970 million people in 2019. These disorders deteriorate all aspects of life, especially the professional field, impacting mainly physical capability, daily functioning, and productivity among the working-age population.
Objectives
To study the socio-professional and medical characteristics of workers with psychiatric disorders and to assess the repercussions of these pathologies on work ability.
Methods
A descriptive and retrospective study included all the medical files of workers with psychiatric disorders who were referred to the occupational medicine department at Charles Nicolle Hospital for a medical opinion of fitness for work during the period from January 1, 2014, to December 31, 2020.
Results
The average age of the 224 cases collected was 41.74± [25-60 years] with a sex ratio of 0.67. The average professional seniority was 13.4 years±8.27 years. The most common occupational sectors were health (38.1%) and communication (20.2%). The patients were mainly suffering from either an anxiety-depressive disorder (36.6%) or psychosis (11.6%). These included 21 cases of bipolar disorder, 21 cases of schizophrenia, two cases of chronic hallucinatory psychosis and 3 cases of delusional psychosis. Forty-three patients were fit to continue working, 133 patients were fit with restrictions and twenty-six were unfitted to work.
A professional reclassification was recommended for 37 patients in positions with a lower mental load. One employee suffering from advanced schizophrenia was offered early retirement on grounds of disability. Permanent unfitness was pronounced in 11.6% of cases.
Conclusions
The impact of mental disorders on cognitive abilities can be so significant as to result in temporary or permanent unfitness for work. However, the decision of medical fitness for work for the same psychiatric pathology may vary from one individual to another and from one workstation to another.
Work on atypical schedules could lead to alertness and sleep disorders, which makes people with psychiatric pathologies more likely to exacerbate their illness.
Objectives
To study the impact of psychoaffective diseases on the fitness for night or/and shiftwork
Methods
A descriptive cross-sectional study was conducted with patients with psychoaffective disorders working atypical hours who have consulted the Occupational Medicine Department of the Charles Nicolle Hospital for statements of medical fitness. The study period was six years from January 2016 to June 2022.
Results
Among 224 employees who had shift/night work , 32.1% (n=76) had psycho-affective disorders. The average age was 43.32±8.64 years. The sex ratio (M/F) was 0.46. The average professional seniority was 17.35±9.17 years. The most represented sectors were: health (56%), the electronics industry (5%), finance (5%) and the plastics industry (5%). The most occupied jobs were: nurses (21%), blue collar workers (20%), senior techniciens (20%) and security guards (8%). Psychiatric pathologies were represented by anxiety disorders (80%), psychoses (8%), schizophrenia (8%) and bipolar disorders (4%). The consultants were on medication in 88% of cases. Antidepressants were prescribed in 75% of cases, followed by anxiolytics (54%), antipsychotics (22%) and thymoregulators (4%). Concerning the medical fitness for work of the patients, a definitive eviction from shift/night work was indicated in 56% of cases.
Conclusions
A medical assessment of the fitness to work on atypical schedules for workers with psychiatric disorders is required, in particular, during the employment medical examination
By its nature, the activity of teleoperators seems to be a propitious environment for the development of psychosocial disorders, sometimes severe
Objectives
To study the frequency of psychiatric disorders among teleoperators and their impact on medical fitness for work
Methods
This is a retrospective descriptive epidemiological study. We examined the files of teleoperators who were referred to the occupational medicine department of Charles Nicolle between 2014 and 2022 for a medical opinion of aptitude
Results
A total of 82 cases were identified, 27 of which had psychological complaints. A clear female predominance was noted (21). The average age was 38.22+-6.536 years. All the patients were telephonists at the call-taking station with an average professional seniority of 9.3+-3.395 years. The symptoms noted were: sad mood (19), irritability (15), anxiety (10), sleep disorders (8), loss of vital impetus (8), neurovegetative signs (6), psychomotor slowing (5), concentration and memory disorders (3). Only one patient had suicidal thoughts. Symptoms had been evolving for an average of 34.32+-34.527 months. Psychiatric follow-up was noted in 16 patients. The diagnoses retained were: anxiety and depressive disorder (19), adjustment disorder (4), panic disorder (2), obsessive-compulsive disorder (1), and a satisfactory state of health (1). In some cases, the evolution was marked by complications: addiction(1), tonic stuttering with phobic disorder(1) and speech disorder(1). The prescribed treatments were: an antidepressant(2), an antidepressant-anxiety combination(8) and psychotropic drugs(2). Concerning the ability to work, 21 patients required an eviction from call taking (definitive (9) or temporary for 3 months (7) or 6 months (5) with re-evaluation of the medical ability to work at the end of this period), 1patient had an eviction from night work and an other had a reduction of the working hours.
Conclusions
Teleoperators are exposed to several risks which can affect both their mental and physical health and put their medical fitness for work at risk.