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Introduction Childhood trauma encompasses instances of sexual, physical, and emotional abuse, along with neglect experienced during childhood and adolescence. Individuals with psychosis, particularly those with schizophrenia, exhibit a heightened prevalence of childhood trauma. One potential mediator in understanding this connection is insecure attachment. Objectives This study aimed to better understand how childhood trauma relates to schizophrenia by examining two aspects of attachment: attachment anxiety and attachment avoidance. Methods We conducted a descriptive and analytical cross-sectional study among stabilized female patients with schizophrenia or schizoaffective disorder, in the ‘B’ psychiatry department at Hedi Chaker University Hospital in Sfax, Tunisia, from May to June 2023. We administered the 26-item Revised Psychosis Attachment Measure (PAM_R) questionnaire, translated into Arabic, to assess attachment. Additionally, participants completed the 28-item Childhood Trauma Questionnaire (CTQ). We used both the Wilcoxon test for paired samples and the Spearman correlation test to assess the statistic differences and correlations. Results We included 41 female patients, of which 65.9% had schizophrenia and 34.2% had schizoaffective disorder. The average age of the participants was 49.19 years. Among the attachment styles, avoidant attachment was the most prevalent (60.97%), followed by anxious attachment (24.39%), and disorganized attachment (14.63%). Regarding childhood trauma, the average total score on the Childhood Trauma Questionnaire (CTQ) was 56.34. Specifically, 39% of patients reported experiencing physical abuse, 24.4% reported sexual abuse, 14.6% reported emotional abuse, and 4.9% reported physical neglect. The Spearman correlation analysis between avoidant attachment and scores on the Childhood Trauma Questionnaire (CTQ) yielded a diverse set of findings. It indicated a significant positive correlation with physical abuse (ρ = 0.004, p < 0.001), a significant negative correlation with emotional abuse (ρ = -0.045, p < 0.001), a significant positive correlation with sexual abuse (ρ = 0.036, p < 0.001), a significant negative correlation with physical neglect (ρ = -0.083, p < 0.001), a significant negative correlation with emotional neglect (ρ = -0.047, p < 0.001), and a significant positive correlation with denial (ρ = 0.080, p < 0.001). On the other hand, the Spearman correlation analysis between anxious attachment and scores on the CTQ showed varying correlations: a significant positive correlation with physical abuse (ρ = 0.094, p < 0.001) and sexual abuse (ρ < 0.0001, p = 0.05). Conclusions Our findings indicate that individuals with an insecure attachment style and a history of childhood trauma should be considered a high-risk group, necessitating early clinical intervention, continuous monitoring, and personalized therapeutic approaches designed to alleviate the psychological effects of trauma. Disclosure of Interest None Declared

Introduction The Palestine-Israel War has reverberated across borders, transcending boundaries to affect individuals far beyond the conflict zone. While much attention has been rightfully directed toward the immediate physical and psychological consequences within the war-torn regions, there is a growing need to explore the broader impact on the mental health of populations in neighboring countries including the sleep disorders among the Tunisian population during this war. Objectives To study the sleep disorders in Tunisian people related to the extensive war news broadcasting and to identify the factors associated to it. Methods It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform. We used a socio-demographic and clinical data sheet and the Insomnia Severity Index (ISI) to measures the severity of insomnia. Results A total of 1091 participants completed the questionnaire.The participants’ mean age was 32.7 ± 9.8 years, with a sex ratio (F/M) = 3.5. The study revealed that 100% of the respondents followed the war, predominantly relying on social media (98.6%) with 55% closely monitoring the war via the media during more than 3 hours per day. 74.1% of the participants were Religious practitioners According to the (ISI): a significant insomnia was found in 75.2% of participants. The breakdown of insomnia severity indicated that 47.3% experienced subthreshold insomnia, 25.7% clinical insomnia of moderate severity, and 2.2% clinical insomnia of severe intensity. The factors significantly associated with severe insomnia were: a male population (p=0.018) and an increase in religious practices (p=0.031). Conclusions The impact of the Palestine-Israel war on Tunisian individuals’ sleep patterns, predominantly mediated through increased exposure via social media with using increase in religious practices as a possible coping mechanism. The study highlights support initiatives to address the psychological repercussions of international conflicts on mental health. This suggests the importance of applying sleep hygiene rules and screening for sleep disorders. Disclosure of Interest None Declared

Introduction Domestic violence is a universal phenomenon that destroys the fabric of society and threatens the lives, health and prosperity of all. It can take different forms, including physical abuse. This is one of the most serious form of violence, as it can range from a simple shove to homicide. Objectives To determine the prevalence and describe the various forms of physical violence perpetrated by husbands against their wives. Methods We contacted women who consulted at the psychiatric emergency of ‘Hedi Chaker hospital’,Sfax examined in the context of medical expertise on the period between May 2021 until January 2022. A questionnaire regarding the violence was asked to responders. It included a section for collecting socio-demographic and clinical data on the woman, and a section for assessing the various forms of domestic violence. Results 122 women were surveyed. The average age of victims was 35.66 years with extremes of 18 and 64 years. 78.7% (n=96) of ladies were of urban origin. The majority of them (44,3%) had secondary level education. The half of the population (51.6%) had an average socio-economic level and 43.4% (n=53) lived in rented houses. All the women of our population were married: it was the first marriage in (89.3%) and the majority (86.1%) had children. Almost all women (95.1%; n=116) were victims of physical violence. Different types of physical violence were reported with decreasing prevalence: slap (65,6%), punch (58,2%), strangle (46,7%), kicking (38,1%), stabbing threat (28,7%), kidnapping (4,9%), and gun threat (3,3%). Should be noted that some women experience different forms of violence simultaneously. Conclusions Our study showed a high prevalence of physical violence with different shapes. These figures must be taken into account by the authorities given the gravity of physical and psychological consequences of this form of violence. Disclosure of Interest None Declared

Introduction Violence is a global phenomenon, destroying the fabric of society and threatening the lives, health and prosperity of all. In recent years, there has been an upsurge in domestic violence in Tunsia. Unfortunately, few studies have focused on the relationship within these couples. Objectives To describe the characteristics of marriage between Tunisian couples where domestic violence prevails. Methods Our study was descriptive and analytical cross-sectional, carried out with women victims of domestic violence examined in the context of psychiatric expertise. An anonymous survey was asked to these ladies concerning the socio-demographic characteristics of the wife and spouse and the characteristics of the marriage. Results Our population was made up of 122 couples. The average age of ladies was 35.66 years (from18 to 64 years). As for the spouses, their average age was 41.68, with extremes of 22 and 70. 92,6% of couples had at least one child. Professionally, (6.6%) of the husbands were inactive and 51.6% (n= 63) of couples had an average socio-economic level. 43.4% (n=53) lived in rented houses, 41% (n=50) owned their own homes, 14.8% (n=18) lived in a room with their in-laws and 0.8% (n=1) were homeless. The average duration of marriage in our study was 11.16 ± 9.12 years and extremes of 1 and 40 years.Judicial records were found in 28.7% of assailants (n=35).The majority of women surveyed, 92.6% (n=113), were victims of three types of violence at once (verbal, psychological and physical). Sixty-two women (50.8%) were victims of four types of violence simultaneously (verbal, psychological, physical and sexual).Various causes of violence were reported, dominated mainly by claims for money, sexual problems, drunkenness and infidelity, with prevalence rates of 38.5%, 23.8%, 22.1% and 21.3% respectively.The majority of women, 66.4% (n=81), had been assaulted by their spouses during the first year of marriage. Forty-seven ladies (38.5%) were subjected to violence on a daily basis.According to the survey, 86.9% of women have been assaulted at least once before, and 38.7% of them have reported previous assaults to the police.The first person contacted after the violence was the mother, with a percentage of 48.4% (n=59).53.3% of ladies were assaulted during pregnancy, 43% of whom suffered obstetrical complications of varying severity. Conclusions According to our results, there is no typical profile of a couple where conjugal violence can reign. Neither the length of the marriage nor pregnancy prevented the woman from being a victim of domestic violence. Disclosure of Interest None Declared

Introduction Attachment refers to the emotional bond between a child and their primary caregiver, reflecting the child’s confidence in the caregiver’s capacity to offer security. Evaluating attachment styles in individuals with schizophrenia spectrum disorders holds significance in pinpointing a potential factor affecting therapeutic relationships. This, in turn, indirectly aids in comprehending the emergence of low adherence as a significant barrier to schizophrenia Objectives The goal of this study is to assess attachment styles in women with schizophrenia spectrum disorders. Methods We conducted a descriptive and analytical cross-sectional study at the Psychiatry “B” department of Hedi Chaker University Hospital in Sfax, Tunisia, during May and June 2023. Our study involved stabilized female patients diagnosed with either schizophrenia or schizoaffective disorder. We utilized the 26-item Revised Psychosis Attachment Measure (PAM_R) questionnaire translated into Arabic and the Positive and Negative Syndrome Scale (PANSS) score to assess schizophrenic symptoms. Results We enrolled a total of 41 female patients in our study, with 65.9% diagnosed with schizophrenia and 34.2% with schizoaffective disorder. The average age of the participants was 49.19 years, ranging from 17 to 79 years old. In terms of attachment styles, avoidant attachment was the most prevalent (60.97%), followed by anxious attachment (24.39%), and disorganized attachment (14.63%). Our study revealed significant associations between avoidant attachment and several factors. Patients who began psychiatric follow-up with hospitalization had a significantly higher level of avoidant attachment compared to those starting with outpatient consultation (p < 0.001). The type of therapy also influenced avoidant attachment, with a significant difference (p < 0.001). Insight into their condition also played a significant role (p < 0.001). Moreover, the age at which psychiatric follow-up began showed a statistically significant correlation with avoidant attachment (Spearman’s ρ = 0.000, p < 0.001). Individuals with higher avoidant attachment tended to have a longer duration of untreated psychosis, supported by a statistically significant positive correlation (Spearman’s ρ = 0.082, p < 0.001). There was also a statistically significant relationship between avoidant attachment and the equivalent dose of chlorpromazine, with a positive correlation (Spearman’s ρ = 0.091, p < 0.001), indicating that individuals with higher avoidant attachment may require higher equivalent doses of chlorpromazine. Finally, higher levels of avoidant attachment were associated with a lower presence of positive symptoms in schizophrenia (Spearman’s ρ = -0.026, p < 0.001). Conclusions Insecure attachment is a valuable mechanism for understanding the evolution of schizophrenia spectrum phenomenology and may be a useful target for prophylactic interventions. Disclosure of Interest None Declared

Introduction Domestic violence is a major public health problem. The situation is alarming in Arab countries: the prevalence of domestic violence is 39.3% in Saudi Arabia, 55% in Morocco and 62.2% in Egypt. In Tunisia, a national survey carried out by the national family planning office in 2010, published in July 2011, drew attention for the first time to the frequency of this phenomenon in Tunisia and the recurrent nature of this form of violence. Unfortunately, few studies have focused on domestic violence during pregnancy and its impact on the mental health of expectant mothers. Objectives To study the prevalence of domestic violence during pregnancy among Tunisian women consulting in the context of medical expertise and its association with anxiety. Methods Our study was descriptive and analytical cross-sectional, carried out with women examined in the context of medical expertise following domestic violence at ‘Hedi Chaker hospital’,Sfax , from May 2021 until January 2022. An anonymous survey was asked to these ladies, it included a section for collecting socio-demographic data. The HADS questionnaire was used to screen for anxiety. Results 122 responses was collected. The average age of victims was 35.66 ± 9.94 years. All the women in our population study were married, and each one was a victim of at least one form of violence. The majority (86.1%) had children. Most of them had secondary (44.3%) or university (31.1%) level education. More than half of the women (63.9%) had no occupation. Sixty-five women (53.3%) were assaulted during pregnancy, 43% of whom suffered from complications of varying severity. Different consequences on pregnancy were reported with decreasing prevalence: 16.9% hospitalization in a gynecological ward, 13.8% abortion, 6.2% fetal death in utero and premature delivery in 4.6% of cases. According to the HADS, seventy-six of women surveyed (62.3%) had anxiety symptoms. Anxiety was significantly associated with exposure to violence during pregnancy (p=0.03). Conclusions Our results showed a significant incidence of domestic violence during pregnancy and a significant association with anxiety. Different actions must be taken towards these anxious women such as: Identify a “referent” in maternity wards to screen for domestic violence and directing women to structures and shelters that can help and, above all, protect them. Disclosure of Interest None Declared

Introduction The war in Gaza is a stressful life event. Due to its significant human and financial losses, it affected the mental health of people around the world including the middle east citizens. Objectives To study the coping strategies of Tunisian people toward Palestine-Israel war in its first month and the factors associated with them. Methods It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform. We used a socio-demographic and clinical data sheet and the “Brief-COPE” to assess coping strategies. Results A total of 1091 participants completed the questionnaire. Their mean age was 32,7± 9.8 years, with a sex-ratio (F/M) of 3.5. Among participants, 46,1% are married, 42,5% have children and 19,5% have a psychiatric follow history. Sport’s practitioners represent 23,3% of the participants and 10,6% increased their use of sports after the war news. In terms of coping strategies: problem focused coping was the most used strategy (mean= 2,02) followed by emotional focused coping (mean= 1,98) and avoidant coping (mean= 1,63). Tunisians rely the most on religion, accepting reality and planning as coping mechanisms (score= 2,85; 2,4 and 2,23 respectively). Substance use was the last resort option (score= 1,11). Our survey revealed significant associations between coping mechanisms and several factors: Venting, humor and behavioral disengagement were significantly correlated with sex gender (p=0,000 ; 0,000 ; 0,000 respectively); Substance use coping mechanism was significantly correlated with participants having a psychiatric follow history (p=0,001); Avoidant coping subscale was significantly correlated with having children (p=0,000); Self distraction was significantly correlated with the increase use of sport among Tunisians (p=0,000). Conclusions These findings underscore the need for healthcare and productive coping strategies for Tunisians and middle east people during the Palestine-Israel war. Disclosure of Interest None Declared

Introduction Schizophrenia spectrum disorders profoundly impacts social functioning, affecting interpersonal relationships, work interactions, and self-care. This disorder often leads to cognitive, perceptual, motor, and emotional challenges that result in social withdrawal. Objectives The aim of the study is to identify the specific challenges in social functioning faced by women diagnosed with schizophrenia spectrum disorders. Methods We conducted a descriptive cross-sectional study among stabilized female patients with schizophrenia or schizoaffective disorder, in the ‘B’ psychiatry department at Hedi Chaker University Hospital in Sfax, Tunisia, from May to June 2023. We collected both sociodemographic and clinical data from the participants. The Social Functioning Scale (SFS) and Global Functioning Scale (EGF) were used to assess social and global functioning, respectively. Results Forty-one patients were included: 65.9% had schizophrenia, and 34.2% had schizoaffective disorder. The mean age was 49.19 years, ranging from 17 to 79 years. More than a third (39%) of our patients had significant impairment in global functioning (EGF

Introduction Attachment styles is intrinsically related to the capacity for forming close social bonds, making it a vital lens through which to understand social functioning. Objectives This study investigates the link between attachment styles and social functioning among women diagnosed with schizophrenia. Methods We carried out a descriptive and analytical cross-sectional study from May to June 2023, focusing on stabilized female patients diagnosed with schizophrenia or schizoaffective disorder. The study took place in the ‘B’ psychiatry department of Hedi Chaker University Hospital in Sfax, Tunisia. Data on attachment styles and social functioning were collected using self-report questionnaires: the Revised Psychosis Attachment Measure (PAM_R) and the Social Functioning Scale (SFS). In our study, we employed both the Wilcoxon test for paired samples and the Spearman correlation test to assess the differences and correlations between attachment scores and social functioning scores, respectively. Results In the study, 41 female patients were included. The participants had a mean age of 49.19, ranging from 19 to 79 years old. Attachment styles were predominantly avoidant (60.97%), followed by anxious (24.39%) and disorganized (14.63%). A significant portion, 39%, exhibited low social functioning. The domains most affected were leisure (63.41%) and employment (60.97%). Our analysis revealed negative correlations between avoidant attachment and social functioning in leisure activities (Spearman’s ρ = -0.057, p < 0.05) as well as between avoidant attachment and independence performance (Spearman’s ρ = -0.040, p < 0.05). Also, the correlation coefficient for anxious attachment and leisure activities is 0.041, demonstrating a positive association (p < 0.005). Conclusions These initial findings may imply a potential association between attachment styles and social functioning in schizophrenia. Disclosure of Interest None Declared

Introduction Schizophrenia is a complex and multifactorial disorder believed to arise from the interplay between genetic factors and environmental influences. Among these environmental factors, childhood trauma stands out as a significant contributor to the onset of schizophrenia in adulthood. Objectives The objective of this study was to assess the occurrence rates of physical, emotional, and sexual abuse, as well as physical and emotional neglect in a group of Tunisian women diagnosed with schizophrenia spectrum disorders. Methods We conducted a descriptive cross-sectional study among stabilized female patients with schizophrenia or schizoaffective disorder, in the ‘B’ psychiatry department at Hedi Chaker University Hospital in Sfax, Tunisia, from May to June 2023. We administered the 28-item Childhood Trauma Questionnaire (CTQ). Results In this study, 41 female patients were enrolled, with 65.9% diagnosed with schizophrenia and 34.2% with schizoaffective disorder. The average age of participants was 49.19 years, ranging from 17 to 79. The mean score on the Childhood Trauma Questionnaire (CTQ) was 56.34, with scores ranging from 43 to 98. Emotional neglect was the most prevalent form of trauma, reported by 40 patients (97.6%). Following emotional neglect, physical abuse was found in 16 patients (39%), sexual abuse in 10 patients (24.4%), emotional abuse in 6 patients (14.6%), and physical neglect in 2 patients (4.9%). Conclusions Based on these findings, our recommendation is to establish government-operated facilities that offer emotional and psychological support, legal assistance, parenting guidance, and medical monitoring in collaboration with educational institutions and social and child protection services for those in need. Disclosure of Interest None Declared

Introduction The Gaza-Israel conflict has far-reaching consequences that extend beyond the immediate geographic confines of the conflict zone.This war certainly has repercussions on people who follow it via the media. Objectives To study the prevalence of acute stress disorder among Tunisian people and determinate the factors associated to it. Methods It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform. We used the the National stressful Events survey acute Stress Disorder Short scale (NSESSS) to assess the severity symptoms of acute stress disorder . The National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS) is a 7-item patient assessment measures that assesses the severity symptoms of acute stress disorder in individuals age 18 and older following an extremely stressful event or experience. Results A total of 1091 participants completed the questionnaire. The participants had a mean age of 32.7 ± 9.8 years. More females (77.7%) than males (22.3%) participated in the study with a sex ratio (F/M) = 3.5. They were divorced in 2.1% .A history of psychiatric follow-up was found in 19,5% of case. Results demonstrated that 100% of the respondents closely monitored the war, primarily relying on social media (98.6%) as their primary source of information. According to the NSESSS ,83.4% of the participants had an acute stress disorder. The breakdown of acute stress disorder severity indicated that 29.7% experienced mild symptoms, 27.5% moderate, 21.6% severe, and 4.6% extreme symptoms. The factors associated with high score of NSESSS were: female sex ( p=0.000), the divorced people (p=0.001)and previous history of psychiatric follow-up (p=0.000) Conclusions These findings indicate a substantial impact of the Palestine-Israel conflict on the mental well-being of the Tunisian population, as evidenced by high rates of acute stress disorder. Understanding the heightened prevalence of acute stress disorder among different demographic groups following such international conflicts is crucial for developing tailored interventions to support the mental health and well-being of affected individuals. Disclosure of Interest None Declared

Introduction Anxiodepressive disorders in Parkinson’s disease (PD) are quite frequent and considered as non-motor signs of the disease. Few studies have studied the link between these entities. Objectives The objective of this study is to determinate the prevalence of anxiety and depression in patients with PD, and factors associated with them Methods A descriptive and analytical cross-sectional study collected from patients followed at the neurology consultation of Habib Bourguiba’s university Hospital in Sfax, Tunisia. We used: - a sociodemographic, clinical and therapeutic data sheet - Hospital Anxiety and Depression Scale(HADS): to study anxiety and depression. A score ≥10 means a certain anxiety or depression Results We have involved 47 patients. The average age was 61.47 years with a sex ratio (M/W)=1,47. Amantadine was received by 12.77% of patients, anticholinergics by 14.9% of patients and 87.24% of patients were treated with Levodopa. HADS: the average scale of Depression was8.62 ± 4.54 and the median scaleanxiety was 7 [1-18]. Depression and anxiety were presentin 38.29% and 27.68% of cases, respectively. Depression was significantly correlated with Amantadine intake (P=0.036) and Levodopa dose (P=0.016). Anxiety was significantly associated with anticholinergic intake(P=0.011).Both depression and anxiety were notstatistically correlated to the presence ofmotor complications of dopa therapy (P= 0.44 and 0.7 respectively) Conclusions The therapeutic management of patients with PD influences the occurrence of anxiety and depression, which proves the importance of early detection of these disordersto ensure better support Disclosure of Interest None Declared

Introduction The violence against women massively committed by their spouses is a scourge that transcends countries, ethnicities, cultures, classes social and age groups. This violence is traumatic and represents a serious attack on the physical integrity and mental health of the women who are victims Objectives To study the prevalence and predictors of peritraumatic distress among women victims of domestic violence Methods We contacted 122 women who consulted at the psychiatric emergency of ‘Hedi Chaker hospital’,Sfax examined in the context of medical expertise on the period between May 2021 until January 2022 A questionnaire regarding the violence was asked to responders .It included demographic and violence exposure questions and a scale applied during violence ‘Peritraumatic distress inventory’ Results The average age of women assaulted in our study was 35.6 ± 9.94 years (min=18,max=64). 78.7% (n=96) of ladies were of urban origin. The majority of them(44,3%) had secondary level education. The half of the population (51.6%) had an average socio-economic level. (86.1%) had children. 98.7%were victim of verbal violence,94.7% of physical violence, 97.3% of psychological violence and 54.7 %of sexual violence. 72.1% of women (N=88) developed peritraumatic distress related to the assault with a risk of developing post-traumatic stress disorder. Women who were threatened by their spouses were more in distress than others (0,04). Physically abused women using a knife developed more peritraumatic distress (p=0,02). Conclusions Domestic violence is a global public health problem, that calls for urgent actions.Peritraumatic distress linked to violence may lead to psychotraumatic disordersthat are the source for traumatized victims of great suffering mental health and a possible vital risk (suicide, risky behavior). Disclosure of Interest None Declared

Introduction Instagram is the most popular social media platform which is frequently used by population today. Besides, this subject has not been well discussed among doctors. Objectives To study the prevalence of addiction to instagram among tunisian doctors and to identify its associated factors. Methods This was a cross-sectional descriptive study carried out among doctors (interns, residents and university hospital doctor) during the months of septembre and octobre 2022. A socio-demographic and clinical characteristics were collected using an online anonymous questionnaire from Google form that we distributed via facebook. Instagram Addiction Scale (IAS) was used to assess Instagram addiction levels. A score above 37 indicates addiction to instagram. Results Our sample included 106 patients. The mean age was 32.32 years (SD=5.66 years) and the sex ratio (M/F) was 0.60. More than half (56.6%) were married and lived with their husband. They were residents in 37% and they were using psychoactive substances in 42.5%. All of participants used other socialnetwork, the most used was facebook (63.2%). IAS : The mean score was 31.18 (SD=11.64). The prevalence of addiction to instagram was 42.5%. The instagram addiction was significantly correlated with : age (p=0,0001), the female gender (p=0.043), the celibacy (p=0.0001), the number of children (p=0.0001) and the number of siblings (p=0.049). Residents were more likely to develop an addiction to instagram (p=0.0001). Conclusions The study highlighted the high level of instagram addiction among tunisian doctors and identified individuals who were at higher risk. Specific interventions were necessary to deal with the problem of addiction. Disclosure of Interest None Declared

Introduction Instagram is one of the most popular social media platforms among young people and it has specific features leading to problematic and addictive use. Objectives To study instagram addiction and the particularities of its use in a population of tunisian doctors. Methods A cross-sectional, descriptive and analytical study conducted on tunisian doctors (interns, residents and university hospital doctor) during the months of septembre and octobre 2022. An anonymous self-questionnaire with different items was used via google-forms in order to collect data that co-occur the use of instagram. Instagram Addiction Scale (IAS) Was used to assess Instagram addiction levels. A score above 37 indicates addiction to instagram. Results The study included 106 doctors. The average age of the first connection to instagram was 28.17 years (SD=6.93 years). The total number of friends on instagram was 240. The average time spent on instagram was 84.5 minutes per day and the number of connections to instagram was 2.78 per day(SD=1.31). The majority(74.5%) used the cell phone as a means of connection while being alone(73.6%). The use of instagram was observed during the whole week(73.6%). The mean score for addiction to instagram was 31.18(SD=11.64). Instagram addiction has been found in 42.5% and 36.8% were mildly addicted. The instagram addiction was significantly correlated with : the age of the first connection (p=0.0001), the total number of friends on instagram (p=0.0001), time spent on that social network (p=0.0001), the number of connections to instagram per day (p= 0.0001) and the mode of connection (p=0.001). Conclusions Our results stated that addiction to instagram affects almost half of the doctors. Many factors were contributing to this addiction. Interventions targeting these factors seems to be crucial in order to deal with this type of addiction. Disclosure of Interest None Declared

Introduction Several psychiatric signs are part of non-motor signs of parkinson’s disease (PD), including alexithymia. Objectives The objective of this study is to determine the frequency of alexithymia in patients with PD and to study factors associated with it. Methods Descriptive and analytical cross-sectional study collected from patients followed at the neurology consultation of Habib Bourguiba’s University Hospital in Sfax, Tunisia. We used: - A sociodemographic, clinicaland therapeutic datasheetincludingthe Hoehn and Yahr motor scalefor the staging of the functional disability associated with PD - The Toronto Alexithymia Scale (TAS-20) with a cutoff score = 61 Results We recruited 47 patients. The average age was 61.47 years with a sex ratio (M/W) = 1.47. The average age of onset of the disease was 51.97 years. Sleep disorders were present in 51.1% of cases.41 patients (87.23%) were treated with dopa therapy. An Hoehn and Yahr stage ≥ 3 was found in 25.5% of patients. TAS: The mean score was 47.38 and alexithymia frequency was 19.1%. Alexithymia was statistically correlated with the presence of sleep disorders (P=0.023) and with an Hoehn and Yahr stage ≥ 3 (p=0.039).The occurrence of alexithymia was not significantly associated with taking dopatherapy (P= 0.31). Conclusions Alexithymia has been quite frequent in patients with PD and associated with motor gravityand sleep disorders. It is considered as a non-motor symptom of the disease that needs to be treated promptly. Disclosure of Interest None Declared

Introduction Intimate partner violence is an under recognized problem in our society that is misjudged and often overlooked. Violence in women has been linked to chronic health, emotional complications, one of which includes low self-esteem Objectives To study the prevalence and predictors of low self-esteem among women victims of domestic violence. Methods Our study was descriptive and analytical cross-sectional, carried out with women examined in the context of medical expertise, from May until January 2022. An anonymous survey was asked to these ladies. The Rosenberg questionnaire was used to assess the self esteem Results 122 responses was collected.The average age of the assaulted women in our study was 35.66 years(from18 to 64 years) 98.4%were victims of verbal violence, 95,1% of physical violence, 97,5% of psychological violence and 54.7 %of sexual violence. Self esteem was very low among 43,4% of women ,low among 18,9%,average among 15,6%,high among 15,6% and very high among 6,6%. Women with children had lower self-esteem (p=0.02). Low self-esteem were significantly correlated with: the husband cannabis consumption (p=0.01). The ladies victims of sexual violence such as an unusual type of relationship had lower self-esteem (p=0.01). Women who were threatened by their spouses had lower self-esteem (0,01). An history of aggression during pregnancy was a risk factor for low self-esteem (p=0, 01). Conclusions Results suggest domestic violence has on women, not only physically effect but mentally and emotionally, this is why an urgent reaction must be taken by the state to reduce this scourge and hs repercussions on the mental health of the victims. Disclosure of Interest None Declared

Introduction Instagram, one of the most widely used social media by population was changed the way individuals communicate around the world. It can be used to increase individual self popularity or increase self-esteem. Objectives To determine the relationship between the instagram addiction and self-esteem in a population of tunisian doctors. Methods A cross-sectional study was conducted online using the Google Forms platform, with a sample of tunisian doctors in september and october 2022. We used : - Instagram Addiction Scale (IAS) : to assess Instagram addiction levels. A score above 37 indicates addiction to instagram. - Rosenberg Self-Esteem Scale : to measure the level of self-esteem. Higher scores indicate higher levels of self-esteem. Results The sample comprised 106 doctors. - IAS : The mean score was 31.18 (SD=11.64). Less than half (42.5%) presented an addiction to instagram and 36.8% were mildly addicted. - The mean self-esteem score was 29.70 (SD=3.57). Less than half (44%) had low to very low self-esteem. - The instagram addiction score was negatively correlated with the self-esteem score (r=-0.543 ; p=0.0001). It was found that these scores were significantly lower in the addicts (p=0.0001) indicating lower self-esteem. Among addicts, 80% had low to very low self-esteem. Among non addicts, 18% had low to very low self-esteem. Conclusions It was found that the higher the intensity of using instagram the lower the self esteem. Further research is expected to be carried out with a wider population to verify the present findings and to study other factors related to instagram addiction such as loneliness and life satisfaction. Disclosure of Interest None Declared

Introduction Instagram is currently the fastest growing social networking site in the world. Its image-driven nature might encourage users to mainly share positive and idealized moments of their lives. Objectives To study the link between instagram addiction and the life satisfaction among tunisian doctors. Methods This was a cross-sectional, descriptive and analytical study conducted on 106 doctors during the months of september and october 2022. We used: - An anonymous self-questionnaire via google-forms in order to collect data that co-occur the use of instagram. - Instagram Addiction Scale (IAS) : to assess Instagram addiction levels. A score above 37 indicates addiction to instagram. - The Satisfaction With Life Scale (SWLS) : to measure an individual’s global satisfaction with life. Higher score displayed higher satisfaction with life. Results The study included 106 doctors. The mean age was 32.32 years (SD=5.66 years) and the sex ratio (M/F) was 0.60. The mean score for addiction to instagram was 31.18 (SD=11.64). The prevalence of instagram addiction was : 42.5%. The mean life satisfaction score was 20.43 (± 4.21). More than forty percent (42.5%) were slightly satisfied and 30.2% were slightly dissatisfied. The instagram addiction was correlated negatively with life satisfaction (r=-0.292; p=0.002). Instagram addiction was associated witn low satisfaction (p=0.0001). Among addicted doctors, 53.3% were slightly dissatisfied. Among non-addicted doctors, 55.7% were slightly satisfied. Conclusions Our findings suggest that the higher the intensity of using instagram the lower the life satisfaction. So, interventions targeting addiction to instagram should be integrated in order to ameliorate life satisfaction and quality of life. Disclosure of Interest None Declared

Introduction The phenomenon of domestic violence poses, long been a problem at the social and family. The magnitude of the consequences, associated with this issue justifies the importance placed on the quality of marital satisfaction among abused women. Objectives To study the quality of marital satisfaction among women victims of domestic violence and to determine predictors of bad marital satisfaction Methods Our study was descriptive and analytical cross-sectional, carried out with women examined in the context of medical expertise at ‘Hedi Chaker hospital’,Sfax , from May 2021 until January 2022. An anonymous survey was asked to these ladies. The AZRIN questionnaire was used to study the quality of marital satisfaction Results The age oscillates between 18 and 64 years. The half of the population (51.6%) had an average socio-economic level. 43.4% (n=53) lived in rented houses, 41% (n=50) owned the houses, 14.8% (n=18) lived with the husband’s family and 0.8% (n=1) was homeless. All the women of our population were married: it was the first marriage in (89.3%). The majority (86.1%) had children. The average duration of marriage in our study was 11.16 years ± 9.12 years (min=1,max=40). 66.4% (n=81) were abused by their spouses during the first year of marriage. Forty-seven women (38.5%) lived this ordeal daily. 98.7%were victim of verbal violence,94.7% of physical violence, 97.3% of psychological violence and 54.7 %of sexual violence. Marital satisfaction was poor among 71,3% of ladies , average among 9% and good among 19,7%. Bad marital satisfaction was significantly correlated with verbal violence (p=0,02),physical violence (p=0,01),psychological violence (p= 0,003)and sexual violence (p=0,04). Conclusions As our results have shown, we do not expect assaulted women to be satisfied in their couple relationships. Urgent help must be provided to these women to save them from this burden. Disclosure of Interest None Declared

Introduction Recent studies in the word found an increase of substance use among medical students. Objectives To determine the prevalence of substance use and associated factors among medical residents in Tunisia. Methods It was a descriptive and analytical cross-sectional study among medical residents from the 4 medical faculties of Tunisia. A questionnaire was created from Google Forms and was published on the social network Facebook. We asked about the current consumption of different psychoactive substances. We used the Patient Health Questionnaire (PHQ-9) to identify depressive symptoms. Results The sample included 241 residents. The female sex was predominant (83.4%, n = 201). The average age was 28.18 (± 2.13) years. Among these residents, 27.8% (n = 67) currently consume at least one psychoactive substance and 71% (n = 171) had depressive symptoms. The substances consumed by residents were: tobacco 18.7% (n = 45), alcohol 18.7% (n = 45), cannabis 6.2% (n = 15) , amphetamine 3.3% (n = 8), sleeping pills (without medical prescription) 2.9% (n = 7), hallucinogens 2.9% (n = 7), cocaine 2.1 % (n = 5) and inhaled solvents 0.4% (n = 1). The use of at least one psychoactive substance was significantly associated with male sex (p = 0.01), the presence of financial problems (p = 0.08), lack of religiosity (p

The interplay between human microbiota and various physiological systems has garnered significant attention in recent years. The gut microbiota plays a critical role in maintaining physiological homeostasis and influences various aspects of human health, particularly via the gut brain axis. Since 2017, the challenging concept of the gut-retina axis has emerged thanks to a network analysis emphasizing the potential role of the gut microbiota disruption in the development of the age-related macular degeneration and further retinal damages. Many other ocular disorders have been linked to the dysbiosis of the gut microbiota, including uveitis and glaucoma. It has been shown that age related macular degeneration can be prevented or reversed using a diet that induces changes in the gut microbiota. The potential link between the gut microbiota as well as others types of microbiota such as the ocular surface microbiota and the development/progression of age related as well as inherited retinal degenerations and other degenerative eye diseases, has recently been broadened. Therefore, the pathogenesis of several eye diseases has recently been associated with a larger perception called the gut eye axis. This mini-review examines the potential mechanisms underlying the gut eye axis and suggests implications for the management of eye diseases. By understanding the modulation of the gut microbiota and its impact on eye disease, this mini-review provides insight into potential therapeutic interventions and avenues for future research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kammoun, Rekik, Dlensi, Aloulou, Smaoui, Sellami, Trigui, Gargouri, Chaari, Sellami, Elatoui, Khemakhem, Hadrich, Neji, Abdelmoula and Bouayed Abdelmoula.)

Objectives: - Our study aimed to assess anxiety, depression, and post-traumatic stress disorder in post coronavirus disease 2019 (Covid-19) and identify associated factors., Patients and Methods: - Our study is a descriptive and analytical cross-sectional study carried out during the period from March 1 to May 15 th 2021 on patients who were hospitalized and discharged from the Covid-19 unit in the pneumology department at the Hedi Chaker hospital in Sfax (Tunisia). Patients who met all of the following criteria were included: aged 18 and over; having a diagnosis of Covid-19 by polymerase chain reaction (PCR) and/or by CT scan; monitored at the Covid-19 unit and who their clinical conditions did not require intensive care; survivors after 3 months of leaving the service; and having given their informed and informal consent to participate in the study., Results: - Our study included 154 patients. The prevalence of anxiety, depression and post-traumatic stress disorder was 24.7%, 11% and 13.6% respectively. We found an association between depression and female gender (p= 0.025), gastrointestinal involvement (p= 0.002) and stigma (p= 0.002). We found an association between anxiety and grade level (p= 0.034), and between anxiety and asthenia (p= 0.032)., Conclusions: - Anxiety, depression, and post-traumatic stress disorder were independent of the majority of disease characteristics including the severity of Covid-19., (© 2022 Elsevier Masson SAS. All rights reserved.)