Introduction In Tunisia, the 2019 corona virus pandemic was a challenging health situation, with more than 28 000 confirmed deaths in May 2022. The pandemic was responsible for people losing their beloved ones in a sudden and brutal ways. Even though the numbers of bereaved people had been escalating, little attention was paid toward their mental health. Grief is a normal response to losing someone close. However, recent studies have shown that the covid-19 grief is more severe than other causes of grief. It not only causes a negative impact on the bereaved life aspects but also creates severe consequences in the society. Screening a possible dysfunctional grief is a major need to prevent serious outcomes. Objectives To identify the prevalence of covid-19 dysfunctional grief and find out the possible associated risk factors to it. Methods A cross sectional online survey designed using Google Forms and distributed on social media platforms (Facebook, Instagram, WhatsApp) was conducted from 16 February 2022 to 05 May 2022. The participants provided information related to socio-demographic data. Covid-19 grief scale was assessed using the pandemic grief scale, which was translated into Arabic but not validated. Results A sample of 106 participants were recruited to this study .The sample was composed of Approximately 72% female and 28 % males, most of them were aged between 26 and 35 years old (37.7% ) . Overall, individuals who lost a loved one more than 06 months period were more frequent (81%). 91.7 % of the sample scored above the cut score of 7 on the PGS. Covid-19 grief was higher among those who sought psychological help (p = 0.02). In this sample, there was no associated risk factors between different socio-demographic characteristics and dysfunctional grief, as well as no correlation were found between period of time since the loss and dysfunctional grief ( rho = 0.186, p = 0.56) . Conclusions Although our study did not find a significant high prevalence of dysfunctional grief giving the small number of participants. More studies and screening must be conducted to identify those at risk of developing dysfunctional grief to prevent the serious individual and general outcomes. Disclosure of Interest None Declared

IntroductionSeasonal changes, climatic factors such as temperature, sunlight intensity and precipitations as well as temporal factors seem to have an influence on suicidal behavior.ObjectivesOur study aimed to analyse the association between seasonal changes, climatic variations, temporal factors and suicide attempts.MethodsA retrospective descriptive and analytical study was undertaken including all patients consulting for the first time at Gabes psychiatry department from the 4th March 2009 to the 25th September 2020 for suicidal attempt. Sociodemographic and clinical data as well as suicidal attempts’ characteristics were assessed. Meteorologic data, related to the years 2009 through 2020, were obtained from the official weather website of Tunisia.Results278 patients were collected, including 217 female. Mean age was 26. Suicidal patients were unmarried (75.9%), childless (79.1%) and unemployed (47.5%). Results showed that suicidal attempts occurred most frequently in summer (32.5%) specifically in June and July (10.9% for each). Regarding the distribution of suicide attempts over the days of the week, the highest rate was observed on Monday (22.5%) and the lower one on Friday. There were a correlation between high temperature and suicide attempt by hanging (p=0.006), between days of sunlight and manifestations preceding the suicidal attempt (p=0.04) and between rainfall and anxiety disorder leading to suicidal attempt (p=0.03).We finded also an association between the summer and risk behavior such as runaways (p=0.024).ConclusionsA better identification of seasonality, climatic and temporal factors in suicidal behavior could allow a better prevention in suicidal attempts and a reduction in death by suicide

IntroductionDetecting warning signs of suicide attempts is a particular difficult task. However, people who plan to commit suicide almost always announce it to someone in some way.ObjectivesAims of this study were to describe signs preceding the suicide attempt in a group of suicidal persons and its links with suicidal recurrence.MethodsIt was a retrospective study that included all the patients who attempted suicide during the period from May 1st, 2009 to September 25th, 2020 and who were referred to the psychiatry department of the regional hospital of Gabes. Sociodemographic and clinical data as well as suicidal attempts characteristics were assessed.Results278 patients were included (female=78.1%), with mean age of 26. The common suicidal attempt method was intentional drug intoxication (67.8%). At least, one clinical manifestation was reported by 75.2% of suicide patients. The most common signs were the tendency to isolation (47.1%), a change in character or behavior (46.6%), thoughts of death (29.6%), anxiety or agitation (24.8%) and recent worsening of the pre-existing psychiatric symptoms (24.3%). Suicidal recurrence affected 24.8% of patients. It was correlated to the presence of a mental disorder (p<10-3), the presence of reflections on death (p=0.02), the onset of a state of anxiety or agitation (p<10-3), recent worsening of pre-existing psychiatric symptoms (p = 0.001) and verbal expression of suicidal thoughts (p<10-3).ConclusionsThe pre-suicidal syndrome is frequently heralded by changes in the patient’s character or behavior. Some suicidal warning signs are associated with the risk of suicidal recurrence.Conflict of interestNo significant relationships.

IntroductionCOVID-19 pandemic affected not only physical health of individuals, and communities but also their mental health worldwide. Young physicians, who were providing care for patients during the outbreak in a global atmosphere of stress, anxiety and depression, were not spared.ObjectivesTo assess anxiety and depression among young medical resident exposed to COVID-19 in Tunisia and its associated factorsMethods It was a cross-sectional, descriptive and analytical online-based survey, from April 19, 2020, to May 5, 2020 on 180 medical residents in training, via a Google-Form link. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data. Hospital Anxiety and Depression Scale (HAD) validated in the Tunisian dialectal version was used to assess anxiety and depression.Results Among 180 young doctors included, 70.2% were female, 16% were married, 81.8% worked in a university Hospital and 51.1% were frontline caregivers involved in primary screening. Our study revealed that 66.1% of young medical residents were suffering from anxiety (severe anxiety: 28.9 %) and 61.7% of them from depression (severe depression: 29.1%). Anxiety disorder was correlated to female gender (p=0.008), being married (0.001), worse quality of sleep (p<10-3) and increased consumption of tea and coffee (p=0.012). Depression was associated to worse quality of sleep (p<10-3), lack of physical activity (p<10-3), shortage of personal protective equipment (p=0,027) and anxiety disorder (p<10-3).ConclusionsOur study indicated a high proportion of anxiety and depression among young doctors in training, needing systematic screening in order to prevent them.

Introduction Lockdown imposed by the Tunisian government had a psychological impact such as depression, stress and anxiety, which triggered the development of eating disorders especially binge eating disorder. Objectives To screen the binge eating disorder among general population in Gabes (south of Tunisia) and to identify factors associated with it. Methods We conducted a cross-sectional, descriptive and analytical web-based survey, from April 19, 2020, to May 5, 2020 on Facebook on citizens living in south of Tunisia. During this period, the total confirmed cases of COVID-19 exceeded 900 in Tunisia. We used a self-administered anonymous questionnaire containing citizen’s sociodemographic and clinical data. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria were used to assess Binge-Eating Disorder. Results A total of 331 persons were included. They were females (65%) and singles (43,2%). 71% of our population were aged between 20 and 40 years old. Among citizens of southern Tunisia, 6,9% suffered from binge eating disorder during this period of the lockdown. Binge eating disorders were associated to past psychiatric history (2,1% vs 4,53%, p<10-3), history of eating disorder (4,5% vs 2,4%, p<10-3), social isolation (5,1% vs 1,8%, p=0,015) and lack of physical activity (3,3% vs 3,9%, p=0,025). Conclusions Our study showed that lockdown during the COVID-19 pandemic has changed the eating behavior of citizens of southern Tunisia. It is therefore important to screen them in order to manage them before complications emerge.

Introduction Covid19 pandemic in Tunisia has disturbed the health system. Health care workers, who were in the frontline to face this disease, had experienced reactions of anxiety, depression and distress.ObjectivesTo assess the level of anxiety and depression among health care workers of regional hospital of Gabes (south of Tunisia) and its associated factors.Methods We conducted a cross-sectional study, from April 19, 2020, to May 5, 2020 on healthcare workers in Gabes regional Hospital. All hospital departments and units were included. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data. Hospital Anxiety and Depression Scale (HAD) validated in the Tunisian dialectal version was used to assess anxiety and depression.ResultsAmong the 289 responding participants, 100 (34.6%) were frontline health care workers directly engaged in managing patients with coronavirus disease. Our study revealed that 43.6% of health care workers were suffering from anxiety and 44.3 % from depression. There was a significant association between anxiety and female gender (p<0.001), being married (p=0.006), mental health conditions (p<0.001) especially anxiety disorders (p<0.001) and depressive disorders (p=0.03), personal medical history of dysthyroidism (p=0.013) and smoking (p=0.005). Nurses experienced more likely anxiety symptoms than other occupation (p=0.021). There was significant relationship between depression and female gender (p<0.001), married status (p=0.02), age under 50 (p=0.032) and mental health conditions (p<0.001) such as anxiety disorders (p=0.001) and depressive disorders (p=0.013).ConclusionsIt is crucial to provide care for health care workers with mental health problems during their struggle with covid19.

Introduction COVID19 outbreak had affected physical and mental health of individuals. Different adverse health behaviors had worsened and eating disorders had evolved. Health care workers were not spared.ObjectivesTo screen binge eating disorder among health care workers of regional hospital of Gabes (south of Tunisia) and its associated factors.Methods We conducted a cross-sectional, descriptive and analytical study, from April 19, 2020, to May 5, 2020 on 289 in Gabes regional Hospital. All healthcare workers were included (n=620). Workers who were on sick leave during the study were excluded. During this period, the total confirmed cases of COVID-19 exceeded 900 cases in Tunisia and around 20 cases in Gabes. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data. DSM-5 diagnostic criteria were used to assess Binge-Eating Disorder.ResultsOf the 289 responding participants, 85 were physicians (29%), 166 nurses (57.4%), 8 ambulance drivers (2.8%) and 30 health-related administrators (10.3%). A total of 100 participants (34.6%) were frontline health care workers directly engaged in diagnosing, treating or caring for patients with coronavirus disease. Nine percent of participants experienced binge eating disorder during the outbreak. Binge eating disorders were associated to past psychiatric history of eating disorder (p=0.001), social isolation (p=0.001), increased consumption of tea and coffee (p=0.02) and the fact of being a frontline care giver (p=0.009).Conclusions Binge eating disorders are usually associated with health problems: obesity and consequently severe form of coronavirus disease. Screening those disorders is important to alleviate its physical impact.

Introduction On March, Tunisian government imposed lockdown measures on cities to contain the COVID19 outbreak. Media coverage, social distancing, quarantine and isolation led to a global atmosphere of anxiety and depression. Objectives To assess the level of anxiety and depression among citizens of southern Tunisia and theirs associated factors. Methods We conducted a cross-sectional, descriptive and analytical online-based survey, from April 19, 2020, to May 5, 2020 on 331 citizens living in south of Tunisia. During this period, the total confirmed cases of COVID-19 exceeded 900 in Tunisia. We used a self-administered anonymous questionnaire containing citizen’s sociodemographic and clinical data. Hospital Anxiety and Depression Scale (HAD) validated in the Tunisian dialectal version was used to assess anxiety and depression. Data were analysed using SPSS version 21. Results The 331 Participants were males (35%), singles (43,2%),aged between 20 and 40 years old(71%). From them, 37.5 % were suffering from anxiety and 42% of them from depression. Anxiety was correlated to the personal history of anxiety (p<10-3), the depression (p<10-3), the fear of contamination (p<10-3), the increased consumption of coffee and tea (p=0.005) and sleep disorders (p<10-3). Meanwhile, depression was associated to a past psychiatric history (p=0.001), a personal experience of psychological violence (p=0.011), increased cannabis use (p=0.011) and a broken sleep (p=0.007). Conclusions Our study identified a high prevalence of adverse psychological symptoms experienced by Tunisian citizens during this first wave of virus spread. Mitigating coronavirus effect on mental health is becoming an international public health priority.

Introduction The COVID19 outbreak has disrupted the mental health of resident doctors who had to care for patients. Eating disorders were among these reported mental health problems. Objectives To screen binge eating disorder among young Tunisian doctors and its associated factors. Methods We conducted a cross-sectional, descriptive and analytical online-based survey, from April 19, 2020, to May 5, 2020 on 180 medical residents in training. We sent the survey via a google form link. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data of young doctors. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria were used to assess Binge-Eating Disorder. Results Among 180 young doctors who enrolled the survey, 70,2% were female, 16% were married. The mean age was 29 years. 51,1% were frontline caregivers, working directly in diagnosing, treating or caring for patients with coronavirus disease. Among our participants, 5% presented anxiety disorder, another 5 % presented depression disorder and 1,7% had eating disorder. Binge eating disorder were present among 8,9 % of participants and it was associated to personal history of eating disorder (7,7% vs 1,1%, p<10 -3 ), past history of depression disorder (7,2% vs 3,3%, p=0.008), exposure to media or news about coronavirus outbreak (0.5% vs 8,3%, p=0.04). Conclusions Our study indicated the evolving proportion of binge eating disorder among young doctors. Screening eating disorder is important in order to prevent related physical health problems.