Introduction In an increasingly interconnected world, migration has become a defining characteristic of the 21st century. While immigration offers new beginnings and prospects, it also presents unique challenges, particularly concerning mental health. The experience of migrating can exert pressure on mental health through factors such as acculturation stress, discrimination, and economic hardships. These challenges can, in turn, contribute to the development of mental health issues. Objectives To study the socio-demographic and clinical profile of immigrants hospitalized in the “C” psychiatry department, Hedi Chaker Hospital, in Sfax, Tunisia. Methods We conducted a retrospective descriptive study of immigrants hospitalized in the psychiatry department “C”, Hedi Chaker Hospital, Sfax Tunisia from 2011 to 2023. Socioeconomic data and clinical profiles of immigrants were collected from archived files. Results The total number of immigrants hospitalized during these 12 years was 32, with an average age of 28.81 years ±7.8 years, all of them were males, as the psychiatric department “C” only hospitalizes men. All were of African origin, of whom 21.9% (n=7) had Libyan nationality, 15.6% (n=5) had Somali nationality and 12.5% (n=4) had Sudanese nationality. Communication with them was possible in 87.5% of cases, primarily through the native Arabic language in 56.3% of instances. Illegal immigration was the most prevalent form, accounting for 75% of cases. During the immigration process, 18.8% of individuals reported experiencing violence.” The majority of hospitalized immigrants were single (71.9%), had a primary school education (37.5%), a low socio-economic level (81.3%), and no profession (59.4%). 21.9% of them had received social assistance, and 59.4% lived in a refugee camp. Psychoactive substance consumption was reported by 53.1% of our study population. Regarding the clinical profile of the population, 21.9% had a history of somatic conditions, 43.8% had a psychiatric history, including 9.4% who had attempted suicide, and 34.4% who had experienced traumatic events since arriving in Tunisia. The primary reason for hospitalization was behavioral disorders in 71.9% of cases and suicide attempts in 15.6%. The most prevalent diagnoses were schizophrenia (50%), and bipolar disorder (18.8%). Upon discharge, 15.6% encountered administrative issues. Conclusions Hospitalized immigrants exhibit diverse socio-demographic and clinical profiles. These findings underscore the significance of acquiring a deeper understanding of the mental health needs and existing barriers to healthcare within various immigrant communities. This is particularly crucial as immigration continues to be a central focus in Tunisia’s public policies and discussions. Disclosure of Interest None Declared

Introduction It’s a well-known fact that violence, particularly repetitive violence or violence lasting several years, as is often the case with intimate partner violence (IPV), has a severe psycho-traumatic impact. Although not all women are affected to the same degree or in the same way, post-traumatic stress disorder (PTSD) is the most common mental health consequence of IPV. Objectives To assess the psycho-traumatic impact of IPV on female victims. To study the factors associated with PTSD among these women. Methods We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hédi Chaker, Sfax, Tunisia for medical expertise at the request of the court. We studied the PTSD in these women using the Post Traumatic Stress Disorder Checklist Scale (PCLS). Results The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women’s clinical characteristics, 19.2% were under psychiatric care, 15% had attempted suicide and 10% had a history of childhood abuse. Regarding the couple’s profile, marriage was arranged in 58.3% of cases, and the average duration of marriage was 12.34 years, exceeding 10 years in 44.2% of cases. The impact reported by our women was 100% psychological and 96.7% familial. As a result, 75.8% had sought help from family and friends, and 55.8% had decided to separate from their partners. According to the PCLS scale, 78.3% of female victims showed PTSD with a positive score > 44. It was associated with a higher number of suicide attempts (p=0.04), a marriage duration exceeding 10 years (p=0.02), help-seeking (p=0.001), and divorce (p=0.014). Conclusions PTSD is a particularly serious psychiatric condition. However, its impact remains insufficiently understood and taken into account in medical, psychological, social, and legal care. Knowing the psycho-traumatic consequences of violence is absolutely essential to better protect, support, and care for victims. Disclosure of Interest None Declared

Introduction A woman’s emotional dependence on a man refers to a marked need for care, protection, and support, even in situations where the woman is able to function autonomously. This dependence fosters a fusional bond that makes it difficult for the woman to leave the relationship, however unhealthy it may be. This puts the victim at greater risk of suffering and tolerating violence, in particular intimate partner violence (IPV). Objectives To study the emotional dependence of women who are victims of IPV, and to determine the factors associated with this dependence. Methods We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hedi Chaker, Sfax, Tunisia for medical expertise at the request of the court. Emotional dependence was assessed using the Emotional Dependence Questionnaire (EDQ) which contains 20 items. Responses are given on a seven-point Likert-type scale which is recoded so that a high score reflects a high level of emotional dependence in relationships. Results The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women’s clinical characteristics, 19.2% were under psychiatric care, 15% had attempted suicide and 10% had a history of childhood abuse. Tobacco was the only psychoactive substance consumed by 12.5% of the women. The average length of marriage was 12.34 years, exceeding 10 years in 44.2% of cases. Marital conflicts had existed since the very beginning of the relationship in 91.7% of cases. The mean total score of the EDQ was 79.38, indicating a slight emotional dependence of these women on their spouses. It was correlated with childhood violence (p=0.028), smoking (p=0.049), early conflict (p<10-3), and personal psychiatric history (p=0.02). Conclusions A link, probably bidirectional, may occur between emotional dependence and IPV, particularly a link with maintaining the relationship in an IPV context. However, the slight emotional dependence of our victims may explain why they seek help from the police and report the violence. Disclosure of Interest None Declared

Introduction The prevalence of suicidal behavior in individuals diagnosed with Bipolar Disorder Type 1 is a topic of great concern within the field of psychiatry and mental health research. Bipolar Disorder Type 1 is characterized by extreme mood fluctuations that can contribute to a heightened risk of suicidal ideation, attempts, and completions in affected individuals. Objectives - To examine the socio-demographic and clinical profiles of Bipolar Type 1 patients admitted to the “C” psychiatry department at Hedi Chaker Hospital in Sfax, Tunisia. - To identify and understand the factors associated with suicidal behavior in this population. Methods We conducted a retrospective descriptive and analytic study of hospitalized patients suffering from bipolar disorder type 1 in the psychiatry department “C”, Hedi Chaker Hospital, Sfax Tunisia from 2021 to 2023. Socioeconomic data and clinical profiles of patients were collected from archived files. Results The total number of patients was 98, with an average age of 36.74 ± 12.3 years. The majority were single (67%), living with their families (76.5%), jobless (45.9%), and receiving family support (94.9%). In terms of psychoactive substance use, 81.6% have used tobacco, 46.9% have used alcohol, and 34.7% have used cannabis. Concerning family history, 55% of patients had at least one family member being treated for a mood disorder. Among them, 7.1% had attempted suicide, and 6.1% had died by suicide. Concerning the clinical profile of the study population, 28.6% had a personal somatic history. The diagnosis of bipolar disorder was made at the age of 27.52±8.6 years. 11.2% had a comorbid personality disorder with bipolar disorder. The majority of patients were on antipsychotics (95.9%), 84.7% were using mood stabilizers, 33.7% were prescribed anxiolytics, and only 4.1% were on antidepressants. Treatment compliance was poor in 61.2% of cases and 63.3% of patients had a poor insight. Ten percent of these patients had attempted suicide, 50% during a depressive episode, 50% occurring during a depressive episode, 30% during a manic episode, and 40% of attempts were related to discontinuation of treatment. 3.1% had used hanging, and 3.1% had engaged in voluntary drug ingestion as a method of self-harm. None of the suicide attempts necessitated intensive care hospitalization, but 60% of the individuals were admitted to psychiatric care. There was a statistically significant correlation between suicide attempts and a family history of suicide (p=0.049). Conclusions Bipolar patients face a heightened risk of suicide, which is closely tied to the distinctive attributes of the disorder, including biological factors, thymic decompensation, and psychological aspects. Consequently, managing their condition necessitates a tailored approach, demanding ongoing vigilance for individuals diagnosed with bipolar disorder. Disclosure of Interest None Declared

Introduction Intimate partner violence (IPV) is a major source of perceived stress for the women who suffer from it. To cope, they tend to implement multiple coping strategies depending on a number of contextual factors including, among others, the severity and frequency of abuse, the duration of the relationship, and available resources such as social support and financial resources. Objectives To study the coping strategies used by women who are victims of IPV. To study the factors associated with coping strategies among these women. Methods We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hedi Chaker, Sfax, Tunisia for medical expertise at the request of the court. The Brief-COPE is a 28-item self-assessment questionnaire designed to measure coping with a stressful life event. It can be divided into 3 subscales: problem-focused, avoidance-focused, and emotion-focused. Results The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women’s clinical characteristics, 19.2% were under psychiatric care and 15% had attempted suicide (SA). Almost all the women surveyed (99.2%) had reported at least one previous incident of IPV. These incidents were daily in 60.5% of cases. Emotional violence was severe in 75.8% of women. The emotion-focused strategy was the most widely used, with a mean score (29.68) on the Brief cope scale. It was correlated with the absence of a personal psychiatric history (p=0.02), the absence of SA (p=0.036), and the occasional frequency of IPV (p=0.037). The scores for problem-focused coping and avoidance-focused coping are 19.3 and 17.24 respectively. Avoidance-focused coping was negatively correlated with the presence of severe emotional abuse. Conclusions The most used strategy by our population was the emotion-focused strategy, with a relatively high average score compared to the other strategies. Indeed, it may be an extremely effective strategy for recovering from a traumatic event, through actions designed to help these women manage and relieve their psychological distress and reduce its negative impact. Disclosure of Interest None Declared

, personal and political factors. Further studies seem to be necessary to explain this emigration phenomenon. Disclosure: No significant relationships.

Introduction Burnout is an occupational psychological syndrome induced by chronic stress defined by three dimensions: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Objectives Estimate burnout among residents and interns in Tunisia. Identify factors related to burnout. Methods We conducted a cross-sectional, descriptive, and analytical study between March 1 and April 15, 2021. Data collection among young physicians was done by a self-questionnaire published online. The assessment of the degree of burnout was done by the Maslach Burnout Inventory (MBI). Results The total number of participants was 56 of which 71.4% were women. The average age was 26.76 years. The pourcentage of the married was 21.4% of which 58.3% had children. 30.4% had parents in charge. Most of the participants worked in university hospitals and 75% of them in a medical department. Residents represented 64.3% of the participants. Number of working hours exceeded 40 hours per week in 60.7% of the cases with an average number of shifts per month estimated at 4.71±2.36. According to MBI, 94.6% of the participants had a score in favor of burnout, of which 19.6% was severe. The number of hours worked per week and the number of shifts per month were significantly associated with the presence of a burnout syndrome with respective correlation factors of 0.027 and 0.047. Conclusions Most residents and interns suffered from burnout with a variable degree of severity. The workload with a greater number of working hours and on-call duty favored the emergence of this burnout. Disclosure No significant relationships.

Introduction Preventing burnout and promoting resilience are important to the well-being of health care professionals and the quality of patient care. Indeed, it’s a promising way to mitigate the negative effects of stressors and allow professional growth. Objectives study the association between job satisfaction and resilience in medical interns and residents. Methods As part of a descriptive and analytical cross-sectional study, interns and medical residents completed an online self-questionnaire using ’Google Forms’. It collected socio-demographic data and assessed the level of job satisfaction using a 5-point Likert-type scale for each item. The Brief Resilience Scale (BRS) was used to assess the level of resilience. Results The total number of participants was 56, of which 64.3% were medical residents.75% of the participants worked in a medical department and most had a number of shifts per month ≥4. The average years of practice was 2.27±1.23 years. Participants expressed dissatisfaction at work with salary (69.6%), task allocation and organization (66.1%), availability of resources (66.1%), comfort (57.1%), safety (53.6%) and supervision (50%). Referring to the BRS scale, higher resilience scores were objectified in male participants (p=0.002). The level of resilience decreased with the number of years of practice (p=0.039). Good satisfaction by management and recognition at work could enhance the level of resilience (p=0.029 and p=0.043 respectively). Conclusions The results of our study suggest that dissatisfaction with work-related aspects may influence the level of resilience. These results deserve special attention to improve job satisfaction and preserve resilience. Disclosure No significant relationships.

IntroductionEmigration is the act of leaving one’s country of nationality or habitual residence to settle in another nation. In Tunisia, this phenomenon is increasing in particular for doctors.ObjectivesEvaluating the intentionality of emigration among interns and medical residents in Tunisia while studying the factors related to it.MethodsWe conducted a cross-sectional, descriptive and analytical study of interns and medical residents who participated in our study through the social network ’Facebook’ by an anonymous self-questionnaire. The level of satisfaction with the different aspects of life were assessed by a 5-point Likert scale, from “not at all satisfied” to “very satisfied”.ResultsThe total number of participants was 56 of which 64.3% were medical residents. More than 50% of the participants expressed dissatisfaction with the distribution of tasks and organization of work (66.1%), safety at work (53.6%), comfort (57.2%), time allocated to personal life (53.6%) and salary (69.6%). The political, health and educational situation in the country was considered unsatisfactory by the majority of participants (90% to 95%). Among our participants, 44.6% regretted having chosen the profession of medicine and 53.6% had plans to immigrate to work abroad. The intentionality of immigration was significantly higher among men (p=0.02), those with siblings abroad (p=0.047) and those without dependent relatives (p=0.040).ConclusionsYoung physicians are strongly looking for emigration. This decision could emanate from professional, personal and political factors. Further studies seem to be necessary to explain this emigration phenomenon.DisclosureNo significant relationships.

IntroductionResilience is the ability to bounce back or cope successfully with stress. Fostering resilience is a promising way to mitigate the negative effects of stressors and prevent burnout.ObjectivesStudy the level of resilience among Tunisian medical interns and residents.MethodsWe conducted a cross-sectional descriptive study between March 1 and April 15, 2021. Medical interns and residents were invited to complete an online self-questionnaire. We used the Brief Resilience Scale (BRS) to assess the level of resilience.ResultsThe total number of participants was 56 of which 28.6% were male. The average age was 26.76±2.52 years. Most of the students had studied at the Faculty of Medicine in Sfax, 58.9%. 64.3% of the participants were residents, 55.4% of them in a medical specialty. 75% of participants were working in a medical department. The average years of practice was 2.27±1.23. The number of working hours per week exceeding 40 hours was found in 60.7% of participants. The number of shifts per month exceeding 4 shifts was found in 67.9%. 46.4% of the participants wanted to change their profession and 44.6% regretted choosing medicine. The mean score by BRS was 2.79±0.48. The level of resilience was high in 42.9% of the participants and normal in the rest of the respondents.ConclusionsThe level of resilience was normal to high in Tunisian medical interns and residents. Assessing the presence of burnout and the coping strategies used could provide insight into the quality of work life.DisclosureNo significant relationships.

IntroductionAnxiety and depression are among the most common psychiatric comorbidities in multiple sclerosis (MS) patients. These disorders could lead to significant emotional disturbances.ObjectivesTo study the different dimensions of alexithymia in patients with MS and determine their relationship with anxiety and depression.MethodsOur study, descriptive and analytical, focused on patients followed for MS at the neurology department in Sfax (Tunisia). In addition to collecting sociodemographic data, we used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depressive symptoms and the Toronto Alexithymia Scale (TAS-20) to assess alexithymia and its three dimensions: difficulty identifying emotions (DIE), difficulty differentiating emotions (DDE), and externally oriented thinking (EOT).ResultsThis study included 93 patients followed for MS. Our results showed a prevalence of 58.1% for alexithymia, 38.7% for anxiety and 26.9% for depression. The median score of the dimension DIE was 22. The median score of the dimension DDE was 17. The mean score for the dimension EOT was 26.96 ± 4.18. Alexithymic patients were more anxious and depressed (p = 0,002 and p < 10-3, respectively). Both dimensions DIE and DDE were associated with anxiety (p = 0.001 and p = 0.022, respectively) and depression (p < 10-3 and p < 10-3, respectively). Non-depressed patients had a higher score on the EOT dimension (p = 0.003).ConclusionsOur results showed a relationship between depression, anxiety and alexithymia, hence the importance of looking for alexithymia in MS patients with anxiety or depressive symptoms.DisclosureNo significant relationships.