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Introduction: 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. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: 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. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: 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. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: 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. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: 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. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: 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 Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: 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. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: 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. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Aim: To determine the influencing factors of health-related quality-of-life (HRQoL) perceived by North-African children/adolescents with type-1 diabetes-mellitus (T1DM) and their parents., Methods: It was a cross sectional study conducted in Tunisia. A total of 116 patients ( ie ; 43 children and 73 adolescents) and their parents were included. The Arabic validated version of the Pediatric Generic Core Quality-of-Life Inventory 4.0-Scale (PedsQL4.0) was used to evaluate the HRQoL of children/adolescents as perceived by patients and parents. The dependent data were the patients' self-report and the parents' proxy-report of the PedsQL4.0 total scores, and the independent data were the patients and parents characteristics., Results: Patients' PedsQL4.0 total score was influenced significantly by siblings in the family > 2; lipodystrophy, and glycosylated hemoglobin (HbA1C). The combination of these factors explained 34.84% of the PedsQL4.0 total score variability. Parents' PedsQL4.0 total score was influenced significantly by lipodystrophy, siblings; body mass index (BMI), hypoglycemia episodes, and HbA1C. The combination of these factors explained 56.92% of the PedsQL4.0 total score variability., Conclusion: T1DM patients self-reported HRQoL was influenced by siblings in the family > 2; lipodystrophy, and HbA1C. The parents' proxy-report HRQoL was influenced by lipodystrophy, siblings, BMI, hypoglycemia episodes, and HbA1C., Competing Interests: No competing interests were disclosed., (Copyright: © 2025 Ben Abdesselem I et al.)

Aim: To assess the effect of diabetes self-management education (DSME) on health related quality of life (HRQoL) of Tunisian children/adolescents with type 1 diabetes mellitus and their parents., Methods: This monocentral study used a randomized controlled trial design, during five-month intervention and five-month follow-up and including 110 patients (54 in the DSME intervention group and 56 in the Individual Education by Pediatrician (IEP) control group) and their parents. Pediatric Generic Core Quality-of-Life Inventory 4.0-Scale (PedsQL4.0) evaluated HRQoL., Results: At baseline, both groups had similar clinical features and PedsQL4.0 scores (p>0.05). In DSME, clinical outcomes were significantly improved from baseline to follow-up (p<0.001), while in the IEP group, which received no intervention, these outcomes remained unchanged. During follow-up, DSME showed higher PedsQL4.0 scores in parents' proxy-report and children/adolescents self-report (p<0.001). According to parents' proxy-report, PedsQL4.0 scores were significantly higher during follow-up compared to baseline in DSME (p<0.001) while they remained the same in IEP (p>0.05). DSME had higher percentage of change in the PedsQL4.0 scores than IEP (p<0.01). The median change varied from -5.01% to 0% vs 5.41% to 36.36% in IEP and DSME, respectively., Conclusion: Encouraging healthcare professionals to incorporate these interventions could enhance the HRQoL of diabetic children and bolster their self-esteem.

Introduction: Spondyloarthritis (SpA) is a common rheumatic inflammatory disease and can impact patients' work productivity. We aimed to evaluate the impact of pain catastrophizing and central sensitization on work outcomes in young SpA patients and determine the predictive factors of work productivity loss., Material and Methods: We performed a cross-sectional study over 6 months. We included patients aged between 18 and 50 years old, diagnosed with axial or peripheral SpA. Pain catastrophizing and central sensitization were assessed using the Pain Catastrophizing Scale (PCS) and Central Sensitization Inventory (CSI) questionnaire, respectively. Impact of SpA on work productivity and activity impairment during and outside of work was measured with the Work Productivity and Activity Impairment Questionnaire (WPAI: Spondyloarthritis)., Results: A total of 72 patients were enrolled, with a median age of 39 years (28.3-46), 65.3% men, and 54.4% working patients. Median scores of activity impairment outside of work, and work productivity loss were 50% (40-70), and 50% (40-60), respectively. Median absenteeism and presenteeism scores were 0% (IQR 0-7), and 100% (IQR 86.5-100), respectively. Regarding work-related outcomes: activity impairment was positively correlated with CSI and PCS; presenteeism was significantly associated with male sex ( p = 0.009); and work productivity loss was positively associated with anxiety, depression, and poor quality of life. Multivariate regression analysis identified predictive factors of work productivity loss: male sex, poor quality of life, and prolonged morning stiffness., Conclusions: Assessment of the impact of pain catastrophizing and central sensitization on work-related outcomes in patients with SpA is important to understand the burden of illness and to identify early those in need of interventions in clinical practice., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie.)

Background: Carpal tunnel syndrome (CTS) is frequently present among workers. This syndrome's professional and economic impact makes it a priority in occupational health. We aimed to describe the professional future of workers suffering from occupational CTS after surgery and the factors that could influence their retention at the job. -Methods: A retrospective descriptive study of workers operated on occupational CTS was conducted from 2014 to 2019. The data was collected using pre-established and phone questionnaires to determine their professional future after surgery., Results: We included 99 workers with operated CTS. They had a mean age of 45±6.5 years, were predominantly female (97%), and had two dependent children in 72.7% of cases. They worked as a seamstress in 44.4% of patients with a mean professional seniority of 18±7.2 years. The professional future was a return to work with a job transfer at 44.4% and job maintenance with ergonomic adjustments at 39.4%. A job loss was noticed in 12.2% of cases. Early retirement was noticed in 8.2%, dismissal in 3%, and resignation in 1% of cases. The factors influencing the professional future were age 50 to 59 years (p=0.01) and dependent children (p=0.02)., Conclusions: In our survey, most operated-CTS workers benefited from a job transfer and kept their job with ergonomic adjustments to their work conditions. Therefore, interventions aiming to improve the professional future of workers operated on CTS by ensuring sufficient staff and adjusting workplaces are needed.

Background: Atypical working hours have raised serious concerns about health effects, such as sleep disorders and psychological repercussions. These schedules are frequent among health professionals having the obligation to ensure the permanence of health services., Objective: To assess the impact of atypical working hours on sleep, sleepiness, and mood among health personnel (HP)., Methods: Comparative descriptive cross-sectional study was carried out among HP of a regional hospital in Southern Tunisia from December 2019 to May 2020. Two groups were defined according to their work schedule: group A had a fixed-day work and group B had atypical working hours. The assessment of sleep, sleepiness, and mood was based respectively on the Spiegel questionnaire, the Epworth Sleepiness Scale, and the Hospital Anxiety and Disorder scale., Results: A total of 101 HP in group A and 135 in group B were included. We found signs of pathological sleep in group B: greater delay in falling asleep (78.1% Vs 53.5%; p = 0.002), altered sleep quality (88.1% Vs 56.4%; p = 0.039), and more frequent occurrence of dreams (37% Vs 31.7%; p = 0.033). The quality of sleep was associated with the professional seniority (p = 0.01), the workplace (p = 0.02), and having dependent children (p = 0.04). The mean score of depression was higher in group B (p = 0.02). Depression was associated with the workplace (p = 0.04) and the quality of sleep (p = 0.01)., Conclusion: The results of this study indicate that atypical working hours generate both sleep and mood disorders in HP. It is vital to encourage the occupational physicians to estimate sleep and mood disorders in HP.